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THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name: Case Name: Case Number:
(if known)
AFFIDAVIT OF RECEIPT OF SERVICE
For: Petition for Divorce Petition for Legal Separation Petition for Civil Union Dissolution Parenting Petition Other:
I, received the petition specified above and the: Notice to Spouse Notice to Respondent Notice of Post-Decree Action Notice
(Fill in type of notice)
, do hereby state under oath that I
Date
Signature
State of This instrument was acknowledged before me on My Commission Expires Affix Seal, if any
, County of by
Signature of Notarial Officer / Title
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NHJB-2067-FS (12/27/2007) Page 1 of 1