Affidavit Of Service printable pdf download

SUPREME COURT OF THE STATE OF NEW YORK

COUNTY OF

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Plaintiff,

Index No.:

-against-

AFFIDAVIT OF SERVICE

Defendant.

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STATE OF

}

ss:

COUNTY OF

}

______________________________ being duly sworn, says:

I am not a party to the action, am over 18 years of age and reside at:

________________________________________________________________________

On__________________, at ____a.m./p.m. at ________________________________

_________________________________________ I served the

summons with

notice OR

summons and verified complaint, and the notice of automatic orders,

on ____________________________, the Defendant named by delivering a true

copy to the Defendant personally.

In addition I served a copy of the Child Support Standards Chart.

In addition I served a copy of the Notice of Continuation of Health Care Coverage

The notice required by the Domestic Relations Law, Section 232 -- “ACTION FOR A

DIVORCE” -- was legibly printed on the face of the summons served on the Defendant.

I knew the person so served to be the person described in the summons as the Defendant.

My knowledge of the Defendant and how I acquired it is as follows: (select one)

I have known the defendant for _______ years and____________________

__________________________________________________________________

I identified the Defendant by a photograph annexed to this affidavit and which was

given to me by the Plaintiff.

Plaintiff accompanied me and pointed out the Defendant.

I asked the person served if he/she was the person named in the summons and

Defendant admitted being the person so named.

(Form UD-3 - Rev. 9/11)

Affidavit Of Service