AFFIDAVIT OF SERVICE
Index No.:___________________Date Filed:_____________________
STATE OF NEW YORK, COUNTY OF KINGS ss.:
(PROCESS SERVER'S NAME) , being duly sworn deposes and says:
I am not a party to this action; I am over (18) eighteen years of age;I reside in New York State.
On ________________at ________, I served the within SUMMONS AND VERIFIED COMPLAINT on JOHN DOE at
_______________________________________________in the manner indicated below:
[__] SUITABLE AGE. By delivering a true copy of each to _________________________________, a person of suitable age and discretion.
Said premises are the recipient's [_] actual place of business [_] dwelling house (usual place of abode) within the state.
[__] MAIL COPY. Pursuant to CPRL-Section 3215(g)(3)(i), on __________________, deponent completed service by depositing a true copy
of each document to the above address in a 1st Class postpaid properly addressed envelope not indicating that mailing was from an
attorney or concerned legal action and marked " Personal and Confidential" in an official depository under the exclusive care and custody of
the United States Post Office in the State of New York.
A description of the Defendant, or the person served on behalf of the Defendant is as follows:
Other features: ________________________________________________________
[__] MIL SRVC. Your deponent asked the person spoken to whether defendant was in the active military service of the United States or New
York State ; and received a negative reply. Upon information and belief I have ;being based on the conversations & observations above
narrated, defendant is not in the military service.
[__] OTHER. Private house. No apartment number.
Sworn to before me on _________ ___________________________________
PROCESS SERVER'S NAME
___________________________ LIC ____________
Notary Public, Qualified in ________
Commission Expires _____________
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Queens, Brooklyn, and Bronx.
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Licensed and bonded process servers for all the counties of The City of New York.
Process Server NYC License # 1223225 Expiration Date: 02/28/2014.