SUPERIOR COURT OF THE DISTRICT OF COLUMBIA PROBATE DIVISION _________ INT _________ _________ IDD _________ In re: ________________________________ An Adult 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 _________________________________________________ ___________________________________________________________________. 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 ________________________________ Telephone number ________________________________ Email address Subscribed and sworn to before me this _____ day of___________________, 20______. ____________________________ Notary Public/Clerk April 2014 ­ 901.10.v2 American LegalNet, Inc. www.FormsWorkFlow.com