SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________________________________ Plaintiff vs. _________________________________ Defendant(s) _____ LIT _____ (linked to __________) (Estate of: __________________) AFFIDAVIT OF SERVICE BY PROCESS SERVER I, _________________________, having been duly authorized to make service in the above captioned case, hereby depose and say: 1. My age and date of birth are: ___________________________________________________ 2. My residential or business address is: _____________________________________________ _________________________________________________________________________________. 3. I am not a party and am without an interest in this case. 4. On ___________________, 20__, at __________ a.m./p.m. I served a summons, a copy of the complaint and the initial order setting the case for an Initial Scheduling Conference as follows (check one of the following): On the defendant____________________________, personally, at _________________________________________________________________________________ _________________________________________________________________________________. By leaving said copy with ___________________________, a person of suitable age and discretion, who resides with defendant at ________________________________________________ _________________________________________________________________________________. For a corporation, partnership, or association only: I served _________________________________, who is: an officer a managing or general agent an agent authorized by appointment or law to receive service of process 5. Set forth specific facts from which the Court can determine that process was served as indicated above and in compliance with Superior Court, Civil Division Rule 4, including a physical description (approximate age, height, weight) of any person on whom service was made: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _____________________________________ Signature of Process Server Subscribed and sworn to before me this ______day of ______________________, 20____. ____________________________________ Notary Public/Deputy Clerk _______________________________ My commission expires **A separate Affidavit is required for service on each named Defendant** Jan. 2010 American LegalNet, Inc. www.FormsWorkFlow.com