Form B 250e - Summons To Debtor In Involuntary Case Page 2
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1
2CERTIFICATE OF SERVICE
I,
(name), certify that on
(date), I served this summons and a copy of the involuntary petition on
(name), the debtor in this case, by [describe the mode of service and the address at which the
debtor was served]:
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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