INSTRUCTIONS: THIS AFFIDAVIT MUST BE USED FOR SERVICE OF INITIATING PAPERS (A SUMMONS ANDCOMPLAINT, SUMMONS WITH NOTICE, NOTICE OF PETITION AND PETITION, OR ORDER TO SHOW CAUSEAND PETITION). SERVER MUST SIGN HIS/HER NAME IN THE PRESENCE OF A NOTARY PUBLIC. PRINTAND USE BLACK INK ONLY. FILL IN THE NAMES OF THE PARTIES AND COMPLETE THE BLANK SPACESPRINTED IN BOLD TYPE.SUPREME COURT OF THE STATE OF NEW YORKCOUNTY OF QUEENS-------------------------------------------------------------------xIndex Number[FILL IN NAME(S)] /[INSERT INDEX NUMBER]Plaintiff(s)/Petitioner(s)AFFIDAVIT OF SERVICE-against-OF INITIATING PAPERS [FILL IN NAME(S)] Defendant(s)/Respondent(s)-------------------------------------------------------------------xSTATE OF NEW YORK COUNTY OF ss.: [FILL IN COUNTY WHERE AFFIDAVIT WAS SIGNED]I, [NAME OF PERSON WHOSERVED PAPERS], being duly sworn, depose and say: I am over 18 years of age and am not aparty to this case. I reside at [SERVER'S ADDRESS]. On , 200 [DATE OF SERVICE], at A.M./P.M. [TIME OF DAY],I served the attached papers, namely the [IDENTIFYTHE PAPERS SERVED] on [INSERT NAME OF PARTYSERVED], a Defendant/Respondent [CIRCLE ONE] in this case. The address of the place where the papers were served is [STATELOCATION WHERE PAPERS WERE SERVED]. American LegalNet, Inc. www.FormsWorkFlow.com I served the papers in the manner indicated below [CHECK OFF THE APPROPRIATE BOX]:1)GINDIVIDUAL by delivering a true copy of each to the defendant personally; I knewthe person served to be the person named in those papers. [FILL OUT DESCRIPTIONBELOW.]2)GCORPORATION , a domesticcorporation, by delivering a true copy of each to [IDENTIFY PERSON SERVED], who is [IDENTIFY THE INDIVIDUAL TOWHOM THE PAPERS WERE DELIVERED AND HIS/HER JOB TITLE]; I knew the corporationto be that listed in the papers served and I knew the title of the person named aboveand that he/she was authorized to accept service. 3)GSUBSTITUTED SERVICE by delivering a true copy of each to [INSERT NAME OF PERSON], a person of suitable age anddiscretion, at the actual place of business, dwelling house, or usual place of abode in the state, and mailing, as indicated below. GSUBSTITUTED SERVICE by affixing a true copy to the door at Which is the defendants .I made prior attempts to serve at this location on the following dates and times:2 American LegalNet, Inc. www.FormsWorkFlow.com .MAILINGI also enclosed a copy of the above papers in a postpaid (already had the stamps(USEon it), sealed envelope properly addressed to defendant at defendant's last WITH 3)known residence or actual place of business, located at [ADDRESS], and I deposited theenvelope in a post office depository under the exclusive care and custody of theUnited States Postal Service within New York State.DESCRIP-The individual I served had the following characteristics:TION Male Female Hair color Skin Color (USE WITH 21-34 yrs. 35-50 yrs. 51-61 yrs. Over 611,2 OR 3) 120-150 lbs. 151-181 lbs. Over 182 lbs. GMILITARY SERVICEI asked the person to whom I spoke whether the defendant was in active service in the military of the United States or New YorkState in any capacity and I was told that he/she was not. Defendant did not weara military uniform. I state upon information and belief that the defendant is not inthe military service of the United States or New York State. The bases for mybelief are the conversations and observations described above.[SERVER'S NAME SIGNED]Sworn to before me onthis day of , 20.[SERVER'S NAME PRINTED] Notary Public3 American LegalNet, Inc. www.FormsWorkFlow.com