Adversary Case:
CERTIFICATE OF SERVICE
Plaintiff: vs.
Defendant:
I, ___________________________________________, certify that I am, and at all times during the
(name)
service of process was, not less than 18 years of age and not a party to the matter concerning which service of process was made. I further certify that the service of this summons and a copy of the complaint was made _________________________ by:
(date)
Mail Service: Regular, first class United States mail, postage fully pre-paid, addressed to:
Personal Service: By leaving the process with defendant or with an officer or agent of defendant at:
Residence Service: By leaving the process with the following adult at:
Certified Mail Service on an Insured Depository Institution: By sending the process by certified mail addressed to the following officer of the defendant at:
Publication: The defendant was served as follows: [Describe briefly]
State Law: The defendant was served pursuant to the laws of the State of ________________________, as follows: [Describe briefly] (name of state)
Under penalty of perjury, I declare that the foregoing is true and correct.
_______________________________________ Date
__________________________________________________________________ Signature
Print Name Business Address City State Zip