Free Microsoft Word - CCT103 - Minnesota

Form 508.1 State of Minnesota
County

Conciliation Court Affidavit of Service District Court
Judicial District: Court File Number: Case Type:

Select County

Plaintiff vs. Defendant

Affidavit of Service

STATE OF MINNESOTA

) ) ss. COUNTY OF _____________)
, being sworn/affirmed under oath, states: Check and complete one of the following: 1. [Service by Mail] I am over eighteen years of age or I am over eighteen years of age and not a party to the action. [Note: A party may generally not serve process, but is allowed to serve a Conciliation Court Summons by Certified Mail and a Demand for Removal/Limited Removal by First Class Mail.] On the day of , 20___, I served the Summons Demand For Limited Removal Other Document _______________________________________(specify) 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, first-class postage or (specify one or both) Certified Mail, postage prepaid, in the United States mail. 2. [Personal Service] I am over eighteen years of age and not a party in the above-entitled action. I served a copy of the Summons Demand For Limited Removal Other Document _______________________________________(specify)

CCT103

State

ENG

Rev 8/08-R

www.mncourts.gov/forms

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upon , (title) by delivering a copy personally to him/her at at am/pm, on 3.

, , 20 .

[Service not completed; party not found.] I am over eighteen years of age. 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.

Dated:
Signature of Server (Sign only in front of notary public or court administrator.)

Subscribed and sworn to before me this day of , 20_____. Telephone:

Notary Public \ Deputy Court Administrator

CCT103

State

ENG

Rev 8/08-R

www.mncourts.gov/forms

Page 2 of 2