SC-5100V, 05/18 Affidavit of Service of SC-500, Summons and Complaint Eviction (Small Claims) 247247799.12 and 799.24(3), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional materials Page 1 of 2 Enter the name of the county in which this case was filed. STATE OF WISCONSIN, CIRCUIT COURT, COUNTY Enter the name as it is listed on the Summons and Complaint . Plaintiff(s): - vs - Defendant(s): Enter the name as it is listed on the Summons and Complaint. Enter the case number. Amended Affidavit of Service of SC - 500 , Summons and Complaint E viction (Small Claims) Case No. U NDER OATH, I STATE : For 1, check the box to ind icate the state where you live. 1. I am an adult resident of the State of Wisconsin. Illinois. Iowa. Michigan. Minnesota . Note: A party in this case cannot personally serve the summons and complaint on the defendant. 2. I am am not a plaintiff in this case. For 3, make sure that the served copy was signed at the time of service. Include the time, date, place, manner of service, and upon whom service was made. 3. I served an authenticated copy of the Small Claims Summ ons and Complaint. At the time of service, I signed my name on the copy that was served [F or example, on the back o r in any blank space ] and indicated the time, date, place, manner of service, and upon whom service was made . For 4, check 4A, or 4B, or 4C. If 4A, fill in the address, date and time. 4. The manner of s ervice was A. I gave a copy to the defendant personally at [Address] on [Date] at [Time] a.m. p.m. If 4B, fill in the name, address, date, and time. If 4B, also explain what other efforts you made to find and serve the defendant personally before you left a copy with someone else. B. I could not give a copy to the defendant personally even after reasonable effort(s). I left a copy with a competent adult or a member of the family at least 14 years of of the papers. I left a copy with [Name] at [Address] on [Date] at [Time] in the a.m. p.m Before leaving a copy, I made the following efforts to serve the defendant personally: . If 4C, fill in the dates. If 4C, also explain what other efforts you made to find and serve the defendant personally before you attached and mailed a copy. C. I could not give a copy to the defendant personally or leave a copy with a competent adult or a member of the family at least 14 years of age currently living I attached a copy on to some part of the premises where it could be conveniently read on [Date] , which was at least 7 business days before the court date, and ast known address on [Date] , which was at least 5 business days before the court date. See Pre - Judgment: Basic Steps to Small Claims Service (SC - 6050V). Before leaving and mailing a copy, I made the following efforts to serve the defendant personally or leave a copy with a competent adult or a member of the family at least 14 years : American LegalNet, Inc. www.FormsWorkFlow.com SC-5100V, 05/18 Affidavit of Service of SC-500, Summons and Complaint Eviction (Small Claims) 247247799.12 and 799.24(3), Wisconsin Statutes This form shall not be modified. It may be supplemented with additional materials Page 2 of 2 STOP! Take this document to a Notary Public BEFORE you sign it. A fter you, the server, have been sworn by a Notary Public, sign and print your name and date the document in front of the Notary Public . Signature Print or Type Name Date Have the Notary Public sign, date, and seal the document. State of County of Subscribed and sworn to before me on Notary Public/Court Official Name Printed or Typed My commission/term expires: American LegalNet, Inc. www.FormsWorkFlow.com