VERIFICATION OF DEFENDANT'S ADDRESS BY PLAINTIFF IN TRADE OR COMMERCE OR PURSUING ASSIGNED DEBT PLAINTIFF(S) DOCKET NO.: Trial Court of Massachusetts District Court Department COURT DIVISION DEFENDANT(S) This form must be filed along with the Complaint for any claim incurred in the course of plaintiff's trade or commerce, or for assigned debt. Use separate forms for multiple defendants if they have different residential addresses. RESIDENTIAL ADDRESS OF DEFENDANT(S) Pursuant to Joint Standing Order 2-15, upon personal knowledge, the defendant's residential address shown above has been verified in the following manner: Verified with the following municipal record within the past 12 months: Municipal Record (e.g. street list or tax records): Date verified: Verified with Registry of Motor Vehicles records within the past 12 months. Check at least one of these methods: Date verified: Verified by receipt of correspondence from the defendant with that return address within the past 12 months. Date correspondence received: Other verification from the defendant within the past 12 months that address is current: Describe: OR A letter was mailed to the defendant at the above address by first class mail on: Date within 6 months, and at least 4 weeks before filing this civil action: and has not been returned to sender by the postal service. Check at least two of these methods: Verified using the following online database (other than white pages or other unpaid general telephone directory) within the past 6 months: Name and source of database: Verified with an additional source, specifically: DATE SIGNED PLAINTIFF OR PLAINTIFF'S ATTORNEY (SIGNED UNDER THE PENALTIES OF PURJURY) x Rev. 10/2015 American LegalNet, Inc. www.FormsWorkFlow.com