Petition For Personal Protection Order Nondomestic (Page 4 of 4) in pdf

Petition For Personal Protection Order Nondomestic Page 4

Petition for Personal Protection

Order (Nondomestic)

PROOF OF SERVICE

Case No.

TO PROCESS SERVER: You must serve the copies of the petition for personal protection order and file proof of service with the

court clerk. If you are unable to complete service, you must return this original and all copies to the court clerk.

CERTIFICATE / AFFIDAVIT OF SERVICE / NONSERVICE

OFFICER CERTIFICATE

AFFIDAVIT OF PROCESS SERVER

I certify that I am a sheriff, deputy sheriff, bailiff, appointed

Being first duly sworn, I state that I am a legally competent

court officer, or attorney for a party [MCR 2.104(A)(2)], and

adult who is not a party or an officer of a corporate party, and

that:

(notarization not required)

(notarization required)

I served a copy of the petition for personal protection order by:

personal service

registered mail, delivery restricted to the respondent (return receipt attached)

on:

Respondent name

Complete address of service

Day, date, time

I have personally attempted to serve a copy of the petition for personal protection order on the following respondent and have

been unable to complete service.

Respondent name

Complete address of service

I declare that the statements above are true to the best of my information, knowledge, and belief.

Signature

Service fee

Miles traveled Fee

Name (type or print)

Incorrect address fee Miles traveled Fee

TOTAL FEE

Title

Subscribed and sworn to before me on

County, Michigan.

Date

My commission expires:

Signature:

Date

Deputy court clerk/Notary public

Notary public, State of Michigan, County of

ACKNOWLEDGMENT OF SERVICE

I acknowledge that I have received a copy of the petition for personal protection order on

Day, date, time

Signature of respondent

MCR 2.105(A)

Petition For Personal Protection Order Nondomestic Page 4

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