Affidavit Of Service
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Affidavit Of Service Form. This is a New Jersey form and can be use in Civil Division Statewide.
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Tags: Affidavit Of Service, 10516, New Jersey Statewide, Civil Division
Plaintiff
Superior Court of New Jersey
Venue _____________________
Docket Number ______________
vs.
Defendant
Person to be served (Name & Address) :
AFFIDAVIT OF SERVICE
(For Use by Private Service)
Cost of Service pursuant to R. 4:4-3(c)
Attorney:
$
Papers Served:
Service Data:
Served Successfully
_____
Not Served
Date:
Time: ______________
Attempts: ___________
Delivered a copy to him / her personally
Name of Person Served and relationship / title:
Left a copy with a competent household
member over 14 years of age residing
therein (indicate name & relationship at right)
Left a copy with a person authorized to
accept service, e.g., managing agent ,
registered agent, etc.
(Indicate name & official title at right)
Description of Person Accepting Service:
Sex: ____
Age: ____
Height:
Weight: ____ Skin Color:
Hair Color:
Unserved:
(
(
(
(
) Defendant is unknown at the address furnished by the attorney
) All reasonable inquiries suggest defendant moved to an undetermined address
) No such street in municipality
) No response on:
Date
Time
Date
Time
( ) Other:____________________________ Comments or Remarks_______________________
Server Data:
Subscribed and Sworn to me this
____ day of __________________
I, _____________________, was at the time of service
a competent adult not having a direct interest in the
litigation. I declare under penalty of perjury that the
foregoing is true and correct.
Notary Signature
Signature of Process Server
Date
Name of Notary / commission expiration
Affidavit of Service (9/30/02)
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