In the District Court of ______________________ County State of Oklahoma Re: Application of ______________________ ) for License as a Statewide Private ) Process Server ) No. _______________ Application Name of Applicant ____________________________________________________________________ All Other Names Presently or Previously Used Residence Address _________________________________________________ ____________________________________________________________________ City ________________________ State ___________ Zip ____________ Residence Phone ____________________________________________________________________ Business Address ____________________________________________________________________ City ________________________ Business Phone State ___________ Zip ____________ ____________________________________________________________________ Social Security Number ____________________________________________________________________ Driver’s License No. ____________________________________________________________________ Applicant hereby applies for a license as a private process server to serve process issued by this court in civil cases for service within the State of Oklahoma, in accordance with the provisions of 12 O.S. § 158.1. Applicant avers that (s)he is eighteen (18) years of age or older, possesses good moral character, and should be deemed ethically and mentally fit to obtain this license. Once found qualified for the license sought hereby, applicant will execute the required statutory bond for faithful performance of his duties and will abide by all the provisions of the applicable law. Supplied herewith are: (check applicable paragraph) ____ Original application fee of One-Hundred-Fifty Dollars ($150.00) and the court costs as provided by law. ____ Renewal of original application fee of Fifteen Dollars ($15.00). ____ Photograph (if required). Dated ___________________________ By ______________________________________________ Verification State of Oklahoma County of ____________________ ) ) ) SS I, ________________________________________, of lawful age and being duly sworn, states that (s)he has read the foregoing Application, that (s)he is familiar with the contents thereof, and that the statements set forth therein are true and correct. Subscribed and sworn to before me on _________________________________________. AOC Form 10c; Revised 10/05 ___________________________________ Court Clerk American LegalNet, Inc. www.USCourtForms.com