Free STATE OF MINNESOTA - Minnesota

M.S. § 524.5-113

State of Minnesota
Select County County of ________________

District Court Probate Division Judicial District: _____________ Court File No. ______________ Case Type: 14, Conservatorship

Guardianship In Re: Conservatorship of ________________________

Affidavit of Personal Service

_______________________________________________________ being first sworn, says that on (date) _____________________, 20_____ the undersigned personally served the ________________________ ____________________________________________________________________________________ ____________________________________________________________________________________ (document served) on the ward or protected person and that the present address and telephone number of the ward or protected person is:___________________________________________________________ ____________________________________________________________________________________ ____________________________________________________________________________________.

Sworn/affirmed before me on _______________________________.

________________________________________________ Signature of Affiant (Guardian/Conservator or other person who serves the notice on the ward/protected person.)

__________________________________
Notary Public \ Deputy Court Administrator

(Notary Seal)

THIS PAGE MUST BE COMPLETED AND RETURNED TO THE COURT WITH A COPY OF THE DOCUMENT GIVEN TO THE WARD / PROTECTED PERSON

GAC 2-U

State

ENG

Rev 12/03

www.courts.state.mn.us/forms

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