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                                                                                   NEW YORK AFFIDAVIT OF SERVICE

                                                                                                                                                                Index No.:_________________________
                                                                                                                                                                Date Filed:________________________

Defendant/Respondent: ___________________________________


__________________________________________________ , 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__________________________________________________________________________ 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:
Sex__________ Color of skin_________________Color of Hair__________________Age______________________________________
Height:__________________________Weight__________________Other features: __________________________________________

[__]  MILITARY SERVICE. 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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