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Declaration Of Service L-0984d - California

Declaration Of Service Form. This is a California form and can be used in Probate Orange Local County .
 Fillable pdf Last Modified 7/8/2014
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ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): FOR COURT USE ONLY Telephone No.: E-Mail Address (Optional): ATTORNEY FOR (Name): Fax No. (Optional): Bar No: SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE Central Justice Center 700 Civic Center Dr. West Santa Ana, CA 92701-4045 IN THE MATTER OF: CASE NUMBER: DECLARATION OF SERVICE I, the undersigned, hereby declare that I mailed or hand delivered a copy of the Petition for Reappointment of Conservator and Notice of Hearing as follows: 1. Date: __________ Mailed Hand Delivered to: Orange County Health Care Agency Mental Health Director th 405 West 5 Street, Suite 458 Santa Ana, CA 92701 Orange County Public Guardian P.O. Box 11526 Santa Ana, CA 92711 Office of the Public Defender Mental Health Unit 901 West Civic Center Dr., Suite 200 Santa Ana, CA 92703 Conservatee: ____________________________ Address: ________________________________ ________________________________________ Facility: _________________________________ Address: ________________________________ ________________________________________ Other: __________________________________ Address: ________________________________ ________________________________________ 2. Date: __________ Mailed Hand Delivered to: 3. Date: __________ Mailed Hand Delivered to: 4. Date: __________ Mailed Hand Delivered to: 5. Date: __________ Mailed Hand Delivered to: 6. Date: __________ Mailed Hand Delivered to: I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct Date: ________________________ ____________________________________ (TYPE OR PRINT NAME) _____________________________________ (SIGNATURE OF CONSERVATOR) L-0984d (Rev. March, 2014) DECLARATION OF SERVICE Welfare and Institutions Code, ยงยง 5350-5372 American LegalNet, Inc. www.FormsWorkFlow.com
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