CIVIL COURT OF THE CITY OF NEW YORK County of Part
Index No.: AFFIDAVIT OF SERVICE OF ORDER TO SHOW CAUSE AND AFFIDAVIT IN SUPPORT
Claimant(s)/Plaintiff(s), -againstDefendant(s) State of New York, County of
SS:
, being duly sworn, deposes and says:
(Name of Deponent)
I am over 18 years of age and not a party to this action. At
(Time)
AM/PM, on
(Date)
at
(Address)
in the County of , City of New York, I served the annexed ORDER TO SHOW CAUSE and AFFIDAVIT IN SUPPORT of the Order in this matter on: 1.
(Name of Person Served)
known to me to be the
(Claimant/Plaintiff/Defendant)
by:
(a) Delivering a true copy to him/her at the above address.
Description of Individual Served in Person: Sex: Approximate Age: Color of Skin: Approximate Weight: Color of Hair: Approximate Height:
(b) Mailing a true copy, properly sealed and enclosed in a post-paid wrapper, by Certified Mail, Return Receipt Requested, in a Post Office of the United States Postal Service within the State of New York addressed to the
(Claimant/Plaintiff/Defendant)
AND ALSO SERVED THEM ON
2. Marshal (a) Delivering a true copy to a person in the Marshal's office.
by:
(Name of Person Served)
Description of Individual Served in Person: Sex: Approximate Age: Color of Skin: Approximate Weight: Color of Hair: Approximate Height:
(b) Mailing a true copy, properly sealed and enclosed in a post-paid wrapper, by Certified Mail, Return Receipt Requested, in a Post Office of the United States Postal Service within the State of New York addressed to the above-named Marshal at:
Sworn to before me this
day of
20
(Notary Public or Court Employee and Title)
(Signature of Deponent)
FREE CIVIL COURT FORM CIV-GP-19(Revised, January, 2004)-i No fee may be charged to fill in this form. Form can be found at: http://www.nycourts.gov/courts/nyc/civil/forms.shtml.