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)

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)
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)
Process Servers for New York City:
Queens, Brooklyn, Manhattan and Bronx.
Tel.: 718-277-2968             Fax: 347-295-0244
Tel.: 718-345-0244
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