Form H2500b - Summons And Notice Of A Scheduling Conference In An Adversary Proceeding Page 2
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1
2In re
Bankruptcy Case No.
Debtor(s)
Adversary Proceeding No.
Plaintiff(s)
vs.
Defendant(s)
CERTIFICATE OF SERVICE
I, ___________________________________ (name), certify that service of this summons and a
copy of the complaint was made ________________________ (date) by:
Mail service: Regular, first class United States mail, postage fully pre-paid, addressed to:
Personal Service: By leaving the process with the defendant or with an officer or agent of
defendant at:
Residence Service: By leaving the process with the following adult at:
Certified Mail Service on an Insured Depository Institution: By sending the process by
certified mail addressed to the following officer of the defendant at:
Publication: The defendant was served as follows: [Describe briefly]
State Law: The defendant was served pursuant to the laws of the State of
__________________, as follows: [Describe briefly]
If service was made by personal service, by residence service, or pursuant to state law, I further
certify that I am, and at all times during the service of process was, not less than 18 years of age and not a
party to the matter concerning which service of process was made.
Under penalty of perjury, I declare that the foregoing is true and correct.
Date __________________
Signature _____________________________
Print Name :
_____________________________
Business Address:
_____________________________
_____________________________
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