| Property Address: | |
|---|---|
| Tenant Name(s): | |
| Unit/Apartment #: |
| Type of Notice Served: | |
|---|---|
| Date Notice Served: | |
| Method of Service: | |
| Served By (Name): |
I declare, under penalty of perjury, that I personally served the above-described eviction notice to the tenant(s) specified above at the address listed, on the date and by the method indicated.
| Date: | |
|---|---|
| Process Server's Signature: | |
| Printed Name: |