CIVIL COURT OF THE CITY OF NEW YORK COUNTY OF Part
Index No. AFFIDAVIT OF SERVICE OF SUMMONS WITH ENDORSED COMPLAINT (Other than Personal Delivery)
Plaintiff(s), against Defendant(s). State of New York, County of
Name of Server
ss: , being duly sworn, deposes and says:
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 attached by:
Name of Defendant as shown above
SUMMONS WITH ENDORSED COMPLAINT in this matter on a) delivering the said SUMMONS to: who was substituted for the defendant.
I
Name of person served
Description of Individual Substituted: Sex: Color of Skin: Approximate Age: Approximate Weight: b) affixing the summons to a conspicuous part of the door of
Color of Hair: Approximate Height:
Address
Previous attempts were made on A copy of the summons and complaint was mailed to the defendant in an envelope marked personal and confidential on
Signature of Deponent
Sworn to before me this
day of
20
Notary Public
CIV-GP-18A-i(5/04) FREE CIVIL COURT FORM No fee may be charged to fill in this form. Form can be found at: http://www.nycourts.gov/courts/nyc/civil/forms.shtml.