Free Microsoft Word - CCT503 - Minnesota

State of Minnesota
County
Select County

District Court
Judicial District: Court File Number: Case Type:

Plaintiff

vs.

Affidavit of Service on Limited Removal from Conciliation Court

Defendant

STATE OF MINNESOTA

) ) ss. COUNTY OF ____________ ) , being sworn/affirmed under oath, states: 1. I am over eighteen years of age and not a party in the above-entitled action.

Check and complete one of the following: 2. day of , , I served the On the Demand For Limited Removal upon , (plaintiff/defendant or attorney for ), by placing a true and correct copy of it in an envelope addressed as follows:

which is the last known address of said party or attorney and depositing it, postage prepaid, in the United States mail. 3. I served a copy of the Demand for Limited Removal on , (title) by delivering a copy personally to him/her at at am/pm, on

, .

4.

After diligent search and inquiry, I was unable to locate (name of party to be served), or any residence or business address for him/her at which service could be attempted.
Signature of Server (Sign only in front of notary public or court administrator.)

Dated:

Subscribed and sworn to before me this day of , .
Telephone

Notary Public \ Deputy Court Administrator

CCT503

State

ENG

Rev 8/08

www.mncourts.gov/forms

Page 1 of 1