_____________________________________________ COURT __________________________________ COUNTY OF .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. :: Index No. :: :: Plaintiff(s) : : : : : Defendant(s) : ...................................................... STATE OF NEW YORK COUNTY OF ) ) ) AFFIDAVIT OF SERVICE (for Service of Papers Commencing Action upon Infant, Incompetent or Conservatee CPLR § 309) -against ss.: The undersigned, being duly sworn, deposes and says; 1. I am not a party to the within action; 2. I am over eighteen (18) years of age; 3. I reside at 4. That on (insert date and time of service) I served the within (summons and complaint/third-party summons and complaint/summons with notice/petition/notice of petition/order to show cause *) (hereinafter referred to as the "papers") on the defendant (insert name of defendant infant, incompetent or conservatee) who I knew to be (an infant/a person judicially declared to be incompetent to manage his affairs and for whom a committee has been appointed/a person for whom a conservator has been appointed) (hereinafter referred to as the "infant", "incompetent" or "conservatee", as the case may be) at (insert address where served or if no address, place of service) by: (NOTE: YOU MUST COMPLETE SECTION DESCRIBING PHYSICAL CHARACTERISTICS OF PERSON SERVED (BELOW)) (a) delivering a true copy of the papers within the state at the said address to a (parent/guardian/legal custodian of the infant /(if the infant is married) adult spouse with whom the infant resides) ___________________________________________________________________ I knew the infant to be under 14 years of age at the time of service of the said papers; (if infant is 14 years of age or older) personally delivering a true copy of the papers within the state at the said address to a (parent/guardian/legal custodian of the infant /(if the infant is married) adult spouse with whom the infant resides) and upon the infant personally who I (if infant is under 14 years of age) personally (b) American LegalNet, Inc. www.FormsWorkflow.com knew to be the defendant described in the papers and an infant not younger than 14 years of age at the time of service of the said papers; (c) (if service could not be made by (a) or (b) above within the state) personally delivering a true copy of the papers at the said address to a person (with whom the infant resides/by whom the infant is employed) as service on a parent, guardian or legal custodian of the infant, or adult spouse with whom the infant resided, could not be made within the state. I knew the infant to be under 14 years of age at the time of service of the said papers; (d) (if defendant is person judicially declared to be incompetent to manage his affairs and for whom a committee has been appointed) personally delivering a true copy of the papers within the state at the said address to the committee appointed for the incompetent, and (unless otherwise directed by the court) to the incompetent personally who I knew to be the defendant described in the said papers; (e) personally delivering a true copy of the papers within the state at the said address to the conservator appointed for the conservatee, and (unless otherwise directed by the court) to the conservatee personally who I knew to be the defendant described in the said papers. (if defendant is person for whom a conservator has been appointed) Physical Description of Person Served: Gender: Male/Female Skin color: Hair color/Bald/Balding: Facial Hair, if any: Approximate age: Approximate height: Approximate weight: Other identifying features, if any (ex. eyeglasses, scars, etc.): ___________________________________________ _________________________________________________________________________ (Sign above and type or print name below) License No. Sworn to before me on this of , 20 day Notary * All words in italics contained in this document indicate options. Choose option that applies. American LegalNet, Inc. www.FormsWorkflow.com