OFP502 State ENG Rev 7/15www.mncourts.gov/formsPage 1 of 1State of Minnesota District Court County of: Select County Judicial District: Court File Number: Case Type: Domestic AbuseIn the Matter of: Petitionervs. RespondentAffidavit of Personal Service by Peace Officer/Corrections Officer (Domestic Abuse) (Minn. Stat. 247518B.01, subd. 8)I, state that I am a: Peace officer licensed by the state of Minnesota, or Corrections officer, including but not limited to probation officer, court services officer, parole officer or a jail or correctional facility employee. OnI personally served true and correct copies of the following:(Place an X in the box next to the documents that you served.) Affidavit of (Name of person who signed Affidavit) Petition for Order for Protection Notice of Hearing Ex parte Order for Protection Other (Title of any other documents served) uponin the above entitled matter Address (Include name of facility if appropriate) Apartment Number .City State Zip CodeI declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116. Dated: Signature County and State where signed Name: Address: City/State/Zip: Telephone: E-mail address: American LegalNet, Inc. www.FormsWorkFlow.com