Affidavit of Service

Court Name:
Case Number:
Plaintiff:
Defendant:

Service Details

Name of Person Served:
Date of Service:
Time of Service:
Place of Service:
Documents Served:
Method of Service:

I, , declare under penalty of perjury that the foregoing is true and correct.
Date Signed:
City/County:
___________________________
Signature of Server
Printed Name of Server:
Address:
Phone: