Affidavit of Service on Corporation

Court/Case Name: Case Number:

I, being duly sworn, depose and say:

I served the following documents:

On (Corporation Name):

By delivering to (Name/Title):

Relationship to Corporation:

On (Date): At (Time):

Place of Service (address):

Method of Service:

Additional Details (if any):

Signature of Server

Date

Sworn and subscribed before me on (date):

Notary Public / Authorized Officer

My commission expires