Form Ps-31152 - Summons - Indiana Page 2
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1
2SHERIFF’S RETURN OF SERVICE OF SUMMONS
I hereby certify that I have served this summons on the _____ day of _________________, 20____:
1.
By delivering a copy of the Summons and a copy of the complaint to the Respondent
identified on the first page of Summons.
2.
By leaving a copy of the Summons and a copy of the complaint at
_______________________________________, which is the dwelling place or usual place of abode of
and by mailing a copy of the Summons to the Respondent at the above address.
3.
Other Service or Remarks:
_________________________________________
_________________________
_____________________________________
Sheriff’s Costs
Sheriff
By:
_______________________________
Deputy
CLERK’S CERTIFICATE OF MAILING
I hereby certify that on the ______ day of ________________, 20___, I mailed a copy of this
Summons and a copy of the Complaint to the Respondent identified on the first page of the Summons by
__________ mail, requesting a return receipt, at the address provided by the Petitioner.
_____________________________
Clerk, __________________ County
Dated: ______________, 20____
By:
_________________________
Deputy
RETURN ON SERVICE OF SUMMONS BY MAIL
I hereby certify that the attached receipt was received by me showing that the Summons and a
st
copy of the Complaint mailed to the Respondent identified on the 1
page of this Summons was
accepted by the Respondent on the _______ day of __________________, 20____.
I hereby certify that the attached return receipt was received by me showing that the Summons
and a copy of the Complaint was returned not accepted on the ______ day of __________________,
20____.
I hereby certify that the attached return receipt was received by me showing that the Summons
st
and a copy of the Complaint mailed to the Respondent identified on the 1
page of this Summons was
accepted by ____________________ on behalf of the Respondent on the _____ day of
______________, 20____.
_____________________________
Clerk, __________________ County
By:
_________________________
Deputy
Form #PS-31152
Approved by State Court Administration 02/10
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