Form APP-109E Proof of Electronic Service (Appellate Division) - California

Form APP-109E or the "Proof Of Electronic Service (appellate Division)" is a form issued by the California Superior Court.

Download a PDF version of the Form APP-109E down below or find it on the California Superior Court Forms website.

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Proof of Electronic Service
Clerk stamps date here when form is filed.
APP-109E
(Appellate Division)
Instructions
This form is only for providing proof that a document has been
electronically served (delivered) in a proceeding in the superior court
appellate division.
The person who serves (delivers) a document in this case and who fills out
this form must be at least 18 years old.
You fill in the name and street address of the court
that issued the decision that is being challenged in
Before you fill out this form, read What Is Proof of Service? (form
this case:
APP-109-INFO) to understand your responsibilities.
Superior Court of California, County of
1
At the time I served the documents listed in
, I was at least 18 years
3
old.
You fill in the number and name of the trial court
2
a.
My
home
business address is:
case in which the decision being challenged was
issued:
Trial Court Case Number:
Street
City
State Zip
b.
My electronic service address is:
Trial Court Case Name:
3
I electronically served the following document, as indicated below
(check or fill in the name of the document you are serving).
You fill in the appellate division case number (if
you know it):
Appellate Division Case Number:
Notice of Appeal/Cross Appeal (Limited Civil Case)
Notice Designating Record on Appeal (Limited Civil Case)
Proposed Statement on Appeal (
Limited Civil Case
Misdemeanor
Infraction)
Appellant’s Opening Brief
Respondent’s Brief
Appellant’s Reply Brief
Abandonment of Appeal (Limited Civil Case)
Petition for Writ (Misdemeanor, Infraction, or Limited Civil Case)
Other (write in the name of the document):
APP-109E,
Judicial Council of California, www.courts.ca.gov
Proof of Electronic Service
Page 1 of 2
New January 1, 2017, Optional Form
(Appellate Division)
Proof of Electronic Service
Clerk stamps date here when form is filed.
APP-109E
(Appellate Division)
Instructions
This form is only for providing proof that a document has been
electronically served (delivered) in a proceeding in the superior court
appellate division.
The person who serves (delivers) a document in this case and who fills out
this form must be at least 18 years old.
You fill in the name and street address of the court
that issued the decision that is being challenged in
Before you fill out this form, read What Is Proof of Service? (form
this case:
APP-109-INFO) to understand your responsibilities.
Superior Court of California, County of
1
At the time I served the documents listed in
, I was at least 18 years
3
old.
You fill in the number and name of the trial court
2
a.
My
home
business address is:
case in which the decision being challenged was
issued:
Trial Court Case Number:
Street
City
State Zip
b.
My electronic service address is:
Trial Court Case Name:
3
I electronically served the following document, as indicated below
(check or fill in the name of the document you are serving).
You fill in the appellate division case number (if
you know it):
Appellate Division Case Number:
Notice of Appeal/Cross Appeal (Limited Civil Case)
Notice Designating Record on Appeal (Limited Civil Case)
Proposed Statement on Appeal (
Limited Civil Case
Misdemeanor
Infraction)
Appellant’s Opening Brief
Respondent’s Brief
Appellant’s Reply Brief
Abandonment of Appeal (Limited Civil Case)
Petition for Writ (Misdemeanor, Infraction, or Limited Civil Case)
Other (write in the name of the document):
APP-109E,
Judicial Council of California, www.courts.ca.gov
Proof of Electronic Service
Page 1 of 2
New January 1, 2017, Optional Form
(Appellate Division)
Appellate Division
Appellate Division Case Number:
Case Name:
4
I electronically served the document checked in
3
as follows
(1)
Name of person served:
a.
On behalf of (name or names of parties represented, if person served is an attorney):
(2)
Electronic service address of person served:
(3)
On (date):
b.
(1)
Name of person served:
On behalf of (name or names of parties represented, if person served is an attorney):
(2)
Electronic service address of person served:
(3)
On (date):
Check here if you gave copies of the document listed in
3
to more people. Attach a separate page listing the
names of these people, the names of parties represented if the person served is an attorney, the electronic
service address used for each person served, and the date you electronically served the document. Write
“APP-109E, Item 4” on top of the page.
5
I declare under penalty of perjury under California state law that the information above is true and correct.
Date:
Type or print server’s name
Server signs here after serving
Proof of Electronic Service
APP-109E,
New January 1, 2017
Page 2 of 2
(Appellate Division)
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