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Work Address - Signator of Proof of Service form should identify his/her campus address (include city, state, and zip code).
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Date of Delivery - The date the document is handed to the employee.
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Date of Mailing - The date the document is placed in the USPS Mail box.
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Subject of Document - Identify document (Example: Intent to Dismiss).
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Name of Recipient - The name of the individual to whom the document is being personally delivered via Proof of Service.
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Location of Recipient - Identify the work location of the recipient if delivered at work (Example: Physics, 366 LeConte Hall, University of California at Berkeley).
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Name, street address, city, state, and zip code - Identify the name of the individual to whom the document is being mailed and the individual's mailing address.
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Name/Signature - The name of the individual who will be handling the Proof of Service.