AFFIDAVIT OF (PERSONAL SERVICE) (MAIL SERVICE)
STATE OF NEW YORK
COUNTY OF_________________ RETURN DATE:___________________________
PART______________________
DOCKET NO.________________
I.____________________________________________________being duly sworn, depose and say;
(Name of Person Making Service)
1. That I am at least 18 years of age and not a party to the above action, and reside at:
_______________________________________________________________________________
(Street) (City) (County)
2. On the ___day of_____________ 200__, at _______________________
(specific time)
at ________________________________in the City of ___________________, County of
___________, State of New York, I personally served a copy of
O Order O Petition O Summons O Order to Show Cause
O Objections to Support Magistrate Final Order O Notice of Motion/Affidavit in Support
O Rebuttal to Objections to Support Magistrate Final Order
_____________________________________________________________________________________________
3. I personally served_______________________________________copies of the said papers by
(Name of Person Served)
delivering and leaving with _____________________________________ at said time and place.
(Name / to whom papers given)
4. I knew the person so served to be _______________________________________________
(Name / to whom papers given)
a. O the person name in said papers as the (respondent/petitioner in this action
b. O I believe this person would give the papers to the Respondent/Petitioner. (You must also
mail a copy and complete # 6)
5. DESCRIPTION OF PERSON SERVED:
sex:_____ color of skin:________hair:_______ approx. age:________ approx. ht:_____
approx. wt: ________ other identifying features:_________________________
_____________________________________________________________________________________________
6. Depositing a true copy of said papers upon___________________________________________
(Name of Person Served)
enclosed in a post-paid wrapper in the
O Post Office O a Branch Post Office O a Post Office Box
regularly maintained by the United States government at _________________________________
County of _______________, State of New York,
directed to_______________________________________________________________
(Address papers mailed to)
O the residence of said__________________________________________________
(Person papers mailed to)
OR
O the address within the State designated by (him) (her) to receive communication by mail.
_____________________________________________________________________________________________
Sworn to before me this
________day of_________________, 200________ _________________________________
(Signature/Person Serving)
__________________________________________
(Notary Public)