JDF 1102(b) 9 - 18 RETURN OF SERVICE District Court County, Colorado Court Address: In re the Marriage of: c Petitioner: and Respondent: COURT USE ONLY Case Number: Division Courtroom RETURN OF SERVICE I declare under oath that I am 18 years or older and not a party to the action and that I served this Summons, a copy of the Petition, and if applicable , the Case Management Order, Notice of Initial Status Conference, and Other (Please identify): in this case on the Respondent in (County) (State) on (date) (time) at the f ollowing location: By (Check one): By handing it to a person identified to me as the Respondent: (print name of person served) . By leaving it with (Type or write name legibly), who is designated to receive service for the Respondent because of the following relationship with the Respondent: as provided for in C.R.C.P. 4(e). I attempted to serve the Respondent on occasions but have not been able to locate the Respondent. Return to the Petitioner is made on (date). I attempted to leave it with Respondent who re fused service. I have charged the following fees in this matter: Private process server Sheriff, County Fee $ Mileage $ By checking this box, I am acknowledging I am filling in the blanks and not changing anything else on the form. By checking this box, I am acknowledging that I have made a change to the original content of this form. VERIFICATION AND ACKNOWLEDGMENT I (name) swear/affirm under oath, that I have read the foregoing RETURN OF SERVICE and that the statements set forth therein are true and correct to the best of my knowledge. Printed name Signature Date Subscribed and affirmed, or sworn to before me in the County of , State of , this day of , 20 . My Commission Expires: Notary Public/Clerk American LegalNet, Inc. www.FormsWorkFlow.com