IN THE COURT OF COMMON PLEAS OF PHILADELPHIA COUNTY : : : : : : : : :
_____________________________, PLAINTIFF vs. _____________________________, DEFENDANT
FAMILY COURT DIVISION CIVIL ACTION
D.R. NO.
CERTIFICATE OF SERVICE I certify that a true and correct copy of the Rule to Show Cause, Order, and Petition scheduling a hearing for the _________ day of ____________, 20 ____ in Courtroom ______ at 34 South 11th Street, Philadelphia was served upon Respondent in the above case by: Check all that apply: ___ First class mail, postage prepaid, and certified mail, return receipt requested at the following address:
AND/OR ___ In person by an adult other than Petitioner at the following address:
The person who made the service was: Name: Address: Signature of person who made service:
I certify that this service was made on the ________ day of _____________, 20 _____.
Petitioner