Affidavit Or Affirmation Of Service Page 2

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AFFIRMATION OF SERVICE
Revised 05/01 WDNY
(If you are not having your signature notarized, use this form)
UNITED STATES DISTRICT COURT
WESTERN DISTRICT OF NEW YORK
,
Plaintiff(s),
AFFIRMATION OF SERVICE
v.
________-CV-__________
,
Defendant(s).
I, (print your name)
, served a copy of the attached papers
(state the name of your papers)
upon all other parties in this case
by mailing
by hand-delivering
(check the method you
used)
these documents to the following persons (list the names and addresses of the people you
served)
on (date service was made)
I declare under penalty of perjury that the foregoing is true and correct, to the best of my
knowledge, information and belief.
Executed on
(date)
(your signature)

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