Mc 040 Form – Fill Out and Use This PDF

Under ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address), enter the name, State Bar number and address, with the TELEPHONE NO., the FAX NO. (Optional) and the E-MAIL ADDRESS (Optional), and under ATTORNEY FOR (Name) enter the name.

Enter the SUPERIOR COURT OF CALIFORNIA, COUNTY OF, with the STREET ADDRESS, the MAILING ADDRESS, the CITY AND ZIP CODE and the BRANCH NAME.

Enter the CASE NUMBER, the PLAINTIFF/PETITIONER, the DEFENDANT/RESPONDENT, the JUDICIAL OFFICER and the DEPT.

In box 1, enter the date after "Please take notice that, as of (date):".

Mark the self-represented party or the attorney for, then name the party after the one that applies: a. plaintiff (name), b. defendant (name), c. petitioner (name), d. respondent (name) or e. other (describe), who has changed his or her address for service of notices and documents or other contact information in the action.

Mark the box when a list of additional parties represented is provided in Attachment 1.

In box 2, enter the (name) in "The new address or other contact information for (name): is as follows:".

Enter the Street and the City, and the Mailing address if different from the Street and City.

Enter the State and zip code and the Telephone number.

Enter the Fax number (if available) and the E-mail address (if available).

In box 3, all notices and documents regarding the action should be sent to the above address.

Enter the Date, the (TYPE OR PRINT NAME) and the (SIGNATURE OF PARTY OR ATTORNEY).

You cannot serve the Notice of Change of Address or Other Contact Information if you are a party in the action.

The person who served the notice must complete this proof of service.

Please use a different proof of service, such as Proof of Service-Civil (form POS-040), if you serve this notice by a method other than first class-mail, such as by fax or electronic service.

1. At the time of service, I was at least 18 years old and not a party to this action.

2. I am a resident of or employed in the county where the mailing took place. My residence or business address is (specify):

3. I served a copy of the Notice of Change of Address or Other Contact Information by enclosing it in a sealed envelope addressed to the persons at the addresses listed in item 5 and (check one): a. deposited the sealed envelope with the United States Postal Service with postage fully prepaid, or b. placed the sealed envelope for collection and for mailing, following the server's ordinary business practices.

Enter 4. The Notice of Change of Address or Other Contact Information was placed in the mail: a. on (date) and b. at (city and state).

Enter 5. The envelope was addressed and mailed as follows: a. Name of person served, Street address, City and State and zip code.

Mark the box when names and addresses of additional persons served are attached. (You may use form POS-030(P).)

The declarant enters the Date and the (TYPE OR PRINT NAME OF DECLARANT), and signs the (SIGNATURE OF DECLARANT), to declare under penalty of perjury under the laws of the State of California that it is true and correct.

Form MC-040, approved for optional use by the Judicial Council of California, is the Notice of Change of Address or Other Contact Information. Page 2 of 2 may be used for proof of service by first-class mail of the Notice of Change of Address or Other Contact Information.

File the original Notice that you and the server signed with the court.⁠^[2]