I-K Superior Court of the District of Columbia PROBATE DIVISION In re: Intervention Proceeding _________________________________ An Adult No. ____________________________ AFFIDAVIT OF PERSONAL SERVICE I, _________________________ being first duly sworn, say: That I am over the age of eighteen years and am not a party to the above entitled action and that my address is __________________________________________________________ _____________________________________________________________________. That on the________ day of ___________________________________,20__ I served personally the attached Notice of Hearing on Petition on the person or persons named below by delivery to and leaving with the person or persons at the time and place set forth below a copy of the said notice. Names of Persons Served Address Place of Service Date of Service __________________________ _______________ ________________ ____________ __________________________ ________________ ________________ ____________ __________________________ ________________ ________________ ____________ __________________________ ________________ ________________ ____________ _______________________________ Affiant’s Signature Subscribed and sworn before me _____________________, 20_____. _______________________________ Notary Public/Clerk American LegalNet, Inc. www.USCourtForms.com