JDF 1262 (b) 8 - 14 RETURN OF SERVICE District Court County, Colorado Court Address: In re the Civil Union of: Petitioner: and Respondent: COURT USE ONLY Case Number: Division Courtroom RETURN OF SERVICE I declare under oath that I am 18 years of age 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. Private process server Sheriff, County Signature of Process Server Fee $ Mileage $ Name (Print or type) 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