1 2 3 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF --------------------------------------------------------------------X Plaintiff, -againstAFFIDAVIT OF SERVICE Index No.: 4 5 Defendant. -------------------------------------------------------------------X STATE OF COUNTY OF } ss: } 6 7 1. ______________________________ being duly sworn, says: I am not a party to the action, am over 18 years of age and reside at: ________________________________________________________________________ On__________________, at ____a.m./p.m. at ________________________________ _________________________________________ I served the summons with notice OR summons and verified complaint, and the notice of automatic orders, and, if the divorce was commenced on or after January 25, 2016, the notice of guideline maintenance on ____________________________, the Defendant named by delivering a true copy to the Defendant personally. In addition I served a copy of the Child Support Standards Chart. In addition I served a copy of the Notice of Continuation of Health Care Coverage The notice required by the Domestic Relations Law, Section 232 -- "ACTION FOR A DIVORCE" -- was legibly printed on the face of the summons served on the Defendant. I knew the person so served to be the person described in the summons as the Defendant. My knowledge of the Defendant and how I acquired it is as follows: (select one) I have known the defendant for _______ years and____________________ __________________________________________________________________ __________________________________________________________________ OR I identified the Defendant by a photograph annexed to this affidavit and which was given to me by the Plaintiff. OR Plaintiff accompanied me and pointed out the Defendant. OR I asked the person served if he/she was the person named in the summons and Defendant admitted being the person so named. 8 2. 3. 9 4. (Form UD-3 Rev. 1/25/16) American LegalNet, Inc. www.FormsWorkFlow.com Deponent describes the individual served as follows: Sex Height Weight Age Color of Skin Under 5' Under 100 Lbs. 14-17 Yrs. Describe color: Male Female 5'0"-5'3" 100-130 Lbs. 18-20 Yrs. ____________ 5'4"-5'8" 131-160 Lbs. 21-35 Yrs. ____________ 5'9"-6'0" 161-200 Lbs. 36-50 Yrs. ____________ Over 6' Over 200 Lbs. 51-65 Yrs. ____________ Over 65 Yrs. 5. Color of Hair Black Brown Blond Gray Red White Balding Bald Other identifying features, if any:___________________________________________________. 10 6a. At the time I served the Defendant, I asked him/her if he/she was in the military service of this state, any other state, or this nation, and the Defendant responded in the negative. The Defendant stated that he/she is in the following military service The Defendant refused to answer. . 6b. 6c. 11 ______________________________ Server's Signature Subscribed and Sworn to before me on NOTARY PUBLIC (Form UD-3 Rev. 1/25/16) American LegalNet, Inc. www.FormsWorkFlow.com