Form Cc-Dr 56 - Affidavit Of Service - Maryland Judiciary
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1Circuit Court for
Case No.
City or County
vs.
Name
Name
Street Address
Apt #
Street Address
Apt #
(
)
(
)
City
State
Area
Telephone
City
State
Zip Code
Area
Telephone
Zip Code
Code
Code
Plaintiff
Defendant
AFFIDAVIT OF SERVICE
(Certified Mail)
(DOM REL 56)
All Blanks Must Be Completed
I certify that I served the following documents (Check all that apply):
Writ of summons
Date the summons for the Complaint/Petition/Motion listed below was issued
Complaint/Petition/Motion:
List name of complaint/petition/motion
Domestic Case Information Report (DCIR Form)
Financial Statement
Show Cause Order and Petition:
List type of petition
Other:
List all other documents served
which were previously filed with this Court upon
Name of person served
on
,
, at
Date
Street Address
City
State
Zip Code
by certified mail, restricted delivery, return receipt requested. The original return receipt signed by
is attached and who is (1) a resident of the above-listed address: or
Name of person served
(2) a person of suitable age and discretion in a relationship to the defendant of
and that: (3) the above-listed address is the defendant's residence or usual
place of abode. Also attached is a copy of any summons ("process") issued by the Court, the original of
which I included in the certified mail service upon the person served. I certify that I am over eighteen
(18) years of age and I am not the Plaintiff or the Defendant.
I SOLEMNLY AFFIRM under penalties of perjury that the contents of the foregoing paper are true to the
best of my knowledge, information, and belief.
Date
Name of person certifying service (signature)
Name of person certifying service (printed or typed)
City
State
Zip Code
Street Address of
person certifying service
(
)
-
Area Code
Telephone Number of person certifying service
CC-DR 56 (Rev. 6/2010)
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