Free Affidavit of Service - New Jersey


File Size: 395.8 kB
Pages: 1
File Format: PDF
State: New Jersey
Category: Court Forms - State
Author: New Jersey Judiciary - Civil Division
Word Count: 231 Words, 1,643 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.judiciary.state.nj.us/civil/forms/10516.pdf

Download Affidavit of Service ( 395.8 kB)


Preview Affidavit of Service
PrintForm

Clear form

vs.

Plaintiff Defendant

Superior Court of New Jersey Venue Docket Number

Person to be served (Name & Address) :

AFFIDAVIT OF SERVICE
(For Use by Private Service)

Attorney:

Cost of Service pursuant to R. 4:4-3(c)

$
Papers Served: Service Data: Served Successfully ______________

_____

Not Served

Date:

Time: Attempts: ___________

Delivered a copy to him / her personally Left a copy with a competent household member over 14 years of age residing therein (indicate name & relationship at right) Left a copy with a person authorized to accept service, e.g., managing agent , registered agent, etc.
(Indicate name & official title at right)

Name of Person Served and relationship / title:

Description of Person Accepting Service: Sex: ____ Unserved: ( ( ( ( ) Defendant is unknown at the address furnished by the attorney ) All reasonable inquiries suggest defendant moved to an undetermined address ) No such street in municipality ) No response on: Date Time Date Time ( ) Other:____________________________ Comments or Remarks_______________________ Server Data: Subscribed and Sworn to me this ____ day of __________________ I, , was at the time of service a competent adult not having a direct interest in the litigation. I declare under penalty of perjury that the foregoing is true and correct. Signature of Process Server Date Age: ____ Height: Weight: ____ Skin Color: Hair Color:

Notary Signature

Name of Notary / commission expiration


Affidavit of Service (9/30/02)

Revised 9/30/2002, CN 10516-English

page 1 of 1