Affidavit Of Proof Of Service At Jail Facility
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1IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA
AT ____________________
)
)
)
Plaintiff,
)
)
v.
)
)
)
) CASE NO.
Defendant.
)
)
AFFIDAVIT OF PROOF OF
SERVICE AT JAIL FACILITY
TO: Shift Supervisor at
(Name of Jail or Correctional Facility)
Pursuant to AS 09.05.050, please do the following:
a.
Serve
the above-named defendant
with the attached documents:
Summons
Complaint
Subpoena
Other Documents (List):
b.
Complete the "Affidavit of Proof of Service" below.
c.
Mail this completed form to:
AFFIDAVIT OF PROOF OF SERVICE
1.
I am the shift supervisor at
, located at
(Jail or Correctional Facility)
, Alaska.
(City)
2.
On
, 20____, I personally delivered the documents listed above
to
the above-named defendant
.
Signature of Shift Supervisor
Print Name
Subscribed and sworn to or affirmed before me at
, Alaska,
on
, 20
.
Notary Public in and for the State of Alaska
My Commission Expires:
CIV-140 (6/01)(st.2)
AS 09.05.050
AFFIDAVIT OF PROOF OF SERVICE AT JAIL FACILITY
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