Sworn Statement For Alternative Service By Delivery To The Premises (Eviction Case), Declaration Of Officer, Declaration Form

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Instructions: The sheriff or constable may file a sworn statement for the court to authorize service by delivery to the premises in an Eviction Case if efforts to serve
the citation on at least two occasions at all addresses of the defendant in the Harris County were unsuccessful. The petition must list all home and work addresses of the
defendant that are known to the plaintiff. The Court may authorize delivery to the premises at least 6 days before the trial date by placing a copy of the citation and
petition through the door mail chute or under the front door, or affixing it to the front or main entry door of the premises, and mailing a copy to the defendant at the
address of the premises. The date of delivery of the citation and the date it was deposited in the mail must be noted on the Return.
Rule 510.4
NO. ______________
______________________________
§
IN THE JUSTICE COURT OF
______________________________
§
HARRIS COUNTY, TEXAS
PLAINTIFF(S)
§
PRECINCT ___ PLACE ___
VS.
§
_________________________
______________________________
§
_________________________
______________________________
§
_________________________
DEFENDANT(S)
§
SWORN STATEMENT FOR ALTERNATIVE SERVICE BY DELIVERY TO THE PREMISES (EVICTION CASE)
TO THE COURT:
The undersigned process server requests authorization for alternative service by delivery to the premises and in
support would show:
That attempts to serve the defendant in this case by personal delivery or by leaving a copy with a person over the
age of 16 years at the defendant’s usual place of residence have been unsuccessful;
That diligent efforts to serve the citation on at least two occasions at all addresses of the defendant in Harris County
were made, as follows:
Defendant: ___________________________________________________________________________________
Date of Attempt
Address of Defendant
Result
________________________
_________________________________
____________________________
________________________
_________________________________
____________________________
That the plaintiff has stated in the Petition that the plaintiff knows of no other home or work addresses of the
defendant in Harris County other than the addresses listed in the petition.
That this Court should authorize delivery of the citation and a copy of the petition to the defendant at the Premises
and by mail.
_________________________________________________________
Signature
Printed Name: _____________________________________________
Title: ____________________________________________________
Address: _________________________________________________
_________________________________________________________
Telephone: __________________
Fax: ________________
E-Mail Address: ___________________________________________
DECLARATION OF OFFICER
Name: _______________________________________________________________________________________
I am an employee of the the following governmental agency: ___________________________________________.
I am making this declaration as part of my assigned duties and responsibilities. I declare under penalty of perjury
that the information provided in the foregoing Request is true and correct.
Executed on _______________, in ______________ County, Texas, on _______________________________.
_____________________________________________, Declarant
DECLARATION
Name: _______________________________________________________________________________________
Address: _____________________________________________________________________________________
City: ___________________ State: __________ Zip Code: __________ Date of Birth: _____________________
Identification Number: ________________ Date: _________________ Expiration: ________________________
I declare under penalty of perjury that the information provided in the foregoing Request is true and correct.
Executed on _______________, in ______________ County, Texas, on _______________________________.
_____________________________________________, Declarant

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