CCT103 State ENG Rev 7/15www.mncourts.gov/formsPage 1 of 2State of Minnesota Conciliation Court County of: Select County Court File Number: Judicial District: Case Type: Conciliation 1.[Service by Mail]I am over eighteen years of age and not a party to the action. [Note: A party may generally not serve process, but is allowed to serve a Conciliation Court Summons by Certified Mail and a Demand for Removal/Limited Removal by First Class Mail.] I am over eighteen years of age or , I served the On Summons Demand For Limited Removal Other Document (specify) by placing a true and correct copy of it in an envelope addressed as follows: uponwhich is the last known address of said party or attorney and depositing it, Street Address: City/State/Zip: first-class postage or} specify one or both Certified Mail, postage prepaid}, in the United States mail. 2.[Personal Service] I am over eighteen years of age and not a party in the above-entitledaction. I served a copy of the Name : Summons Plaintiff or attorney for Defendant Plaintiff (first, middle, last)Conciliation Court Affidavit of Service vs. Defendant (first, middle, last) , states the following: Check and complete one of the following: American LegalNet, Inc. www.FormsWorkFlow.com CCT103 State ENG Rev 7/15www.mncourts.gov/formsPage 2 of 2 Demand For Limited Removal Other Document (specify) upon , (title) , by delivering a copy personally to him/her at at on..m.,I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. 247 358.116. 3.[Service not completed; party not found.]I am over eighteen years of age.After diligent search and inquiry, I was unable to locate (name of party to be served) , or any residenceor business address for him/her at which service could be attempted. Dated: Signature County and State where signed Name: Address: City/State/Zip: Telephone: E-mail address: American LegalNet, Inc. www.FormsWorkFlow.com