______________ County Sheriff's Department, State of ____________ Return of Service - Order of Protection Case # Expires: Respondent: Leads #: Address: Geo. Code: Work Address: Attempts to Serve # Date Time Documents to be Served Notes Summons - Order of Protection Petition for Order of Protection Emergency Order of Protection Order of Protection Affidavit of Visitation Supervisor Uniform Order of Support Order-Extension, Modification, Hearing for Petition for Order of Protection Order with Statutory Findings regarding Petition for Order of Protection 1 2 3 4 5 6 Service Information: I certify that I served this summons on Respondent as follows: Date Served Time Served Substitute Service: A copy of Summons and Complaint was left at the usual place of abode of the Respondent with some person of the family of the age of 13 years or upwards. The Officer or other authorized person making service sent a copy of this Summons with attachments on _________________ (mmddyyyy) in a sealed envelope with postage fully prepaid, addressed to the Respondent at his usual place of abode. Name __________________________________________________ Relation: ____________________ Address served (If different than above): Street _______________________________________________ City - State-Zip: ________________________________________________________________________ Personal Information: Sex _____ Race ________ Age _________ Deputy _______________________ Body # ______ / Deputy _______________________Body # ______ Service Information: I certify that I served this summons on Respondent as follows: Date Served Time Served Personal Service: A copy of Summons and attached documents was left with the Respondent. Address served (If different than above): Street: ______________________________________________ City-State-Zip: ________________________________________________________________________ Personal Information: Sex _____ Race ________ Age _________ Deputy _______________________ Body # ________ / Deputy ____________________ Body # _______ American LegalNet, Inc. www.USCourtForms.com