Reply And Request For Hearing Form Page 4
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4Certificate of Service
I certify that I served a copy of this document on the following people.
Served at this
Served on
Person’s Name
Method of Service
Address
this Date
[ ] Mail
[ ] Hand Delivery
[ ] Fax
(Person agreed to service by fax.)
[ ] Email
(Person agreed to service by email.)
[ ] Left at business
(With person in charge or
in receptacle for deliveries.)
[ ] Left at home
(With person of suitable age
(Other Party or Attorney)
and discretion residing there.)
[ ] Mail
[ ] Hand Delivery
(Clerk of Court)
[ ] Electronic File
[ ] Mail
[ ] Hand Delivery
[ ] Fax
(Person agreed to service by fax.)
[ ] Email
(Person agreed to service by email.)
[ ] Left at business
(With person in charge or
in receptacle for deliveries.)
[ ] Left at home
(With person of suitable age
and discretion residing there.)
[ ] Mail
[ ] Hand Delivery
[ ] Fax
(Person agreed to service by fax.)
[ ] Email
(Person agreed to service by email.)
[ ] Left at business
(With person in charge or
in receptacle for deliveries.)
[ ] Left at home
(With person of suitable age
and discretion residing there.)
Sign here ►
Date
Typed or Printed Name
Reply and Request for Hearing
Approved Board of District Court Judges October 17, 2008
Page 4 of 4
Revised April 7, 2015
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