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`Case 6:21-cv-00816-ADA Document 12 Filed 08/10/21 Page 2 of 2
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`AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2)
`Civil Action No. 6:21−CV−00816−ADA
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`PROOF OF SERVICE
`(This section should not be filed with the court unless required by Fed. R. Civ. P. 4(1))
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` This summons for(name of individual and title, if any)_____________________________________
`was received by me on(date)________________.
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` I personally served the summons on the individual at (place)_______________________________
` _______________________________________________on (date)___________________; or
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` I left the summons at the individual's resident or usual place of abode with(name)______________
` ________________________________, a person of suitable age and discretion who resides there,
` on (date)_______________________, and mailed a copy to the individual's last known address; or
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` I served the summons on(name of individual)___________________________________, who is
` designated by law to accept service of process on behalf of(name of organization)_____________
` __________________________________________________ on(date)________________; or
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` I returned the summons unexecuted because _______________________________________; or
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` Other (specify):________________________________________________________________
` ___________________________________________________________________________
` ___________________________________________________________________________
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`My fees are $_____________ for travel and $_____________ for services, for a total of $____________.
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`I declare under penalty that this information is true.
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`Date: ________________
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`_______________________________________
`Server's signature
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`_______________________________________
`Printed name and title
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`_______________________________________
`Server's Address
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`Additional information regarding attempted sevice, etc:
`_________________________________________________________________________________
`_________________________________________________________________________________
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`08/26/2021
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`x
`
`Trudy Desbiens at CSC
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`YouTube, Inc.
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`08/26/21 @ 2:08pm
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`08/27/2021
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`ANGELICA LEZAMA
`Registration #2015-50
`Sacramento County
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`4110 Truxel Rd Ste 150
`Sacramento, CA 95834
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`Petitioners' Exhibit 1065
`Page 0001
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