Summons In An Adversary Proceeding Page 2

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B 250 A Summons in an Adversary Proceeding
EASTERN DISTRICT OF TEXAS
CERTIFICATE OF SERVICE
I,_________________________________ , certify that I am, and at all times during the
(Name)
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. I further certify that the service of this
summons and a copy of the complaint was made ________________ by:
(Date)
Mail service: Certified or Regular, first class U.S. mail, postage fully pre-paid,
addressed to:
Personal Service: By leaving the process with defendant or with an officer or agent
of defendant at:
Residence Service: By leaving the process with the following adult 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]
(Name of State)
Under penalty of perjury, I declare that the foregoing is true and correct.
_______________
_____________________________________
Date
Signature
Print Name
Business Address
City
State
Zip
2

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