Certificate Of Registration As A Process Server Template

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(File Stamp)
State of California
County of Yolo
Term of Registration: 2 years
(see reverse for more information)
CERTIFICATE of REGISTRATION as a PROCESS SERVER
Corporation or Partnership
(Business & Professions Code Section 22350, 22351(a))
(check one)
New Registration
Renewal Registration
The undersigned declare that________________________________________________________________________________
(Name of Corporation or Partnership)
is a
____________________________ corporation
partnership
(State of incorporation)
Registration in the County of Yolo is proper because the principal place of business is located in this county at:
Physical Address
City
St
Zip
Have any general partners or officers been convicted of a felony.
(A felony conviction will cause this application to be denied.)
YES
NO
The corporation or partnership has been organized and existing continuously for a period of
one year immediately preceding the filing of the certificate or a responsible managing
employee, partner or officer has been previously registered.
YES
NO
The corporation or partnership will perform its duties as a process server in compliance
with the provisions of law governing the service of process in this state.
YES
NO
Each of the undersigned declare(s) under penalty of perjury that the foregoing is true and correct except for the personal information contained
herein; and, as to that personal information, each declares under penalty of perjury that personal information is true and correct
only to the extent that it applies to him / her. (Attach page(s) for additional partners or corporate officers, if necessary.)
Name / Title __________________________________________________________
Age _______
Phone _____________________
Address ______________________________________________________________
Signature _______________________________
Name / Title __________________________________________________________
Age _______
Phone _____________________
Address ______________________________________________________________
Signature _______________________________
Name / Title __________________________________________________________
Age _______
Phone _____________________
Address ______________________________________________________________
Signature _______________________________
Name / Title __________________________________________________________
Age _______
Phone _____________________
Address ______________________________________________________________
Signature _______________________________
Office Use Only:
Registration # _________________________
Bond Expiration Date ________________________
Temp ID Card Issued on ____________________
Document # (Bond) ____________________________
Permanent ID Card Expires ___________________
Recorded Date ______________________
Initials ______________

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