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Affidavit (Certificate) of Service Form

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Affidavit (Certificate) of Service Form

Updated June 17, 2024

An affidavit (certificate) of service provides proof after documents have been delivered to a recipient. This is common when delivering court papers to parties of a case. It’s common to pay a process server or the local sheriff for delivery.

Also Known as 

  • Affidavit for Return of Service
  • Certificate of Service
  • Service of Process
  • Proof of Service
  • Proof of Delivery
  • Return of Process

Table of Contents

By State

State Form Laws
 Alabama PDF, MS Word, OpenDocument Rules of Civil Procedure (Rule 5)
 Alaska Form TF-700 State Definition
 Arizona Form COA1 Rule 5(c)(2)
 Arkansas PDF Ark. R. Civ. P. 4
 California Form POS-040 CIV [1010-1020]
 Colorado Form JDF 1313 Colo. R. Civ. P. 5
 Connecticut Form JD-CV-123 Sec. 52-57
 Delaware PDF Del. R. Civ. P. Super. Ct. 5
 Florida Family Law Form 12.914 § 48.031
 Georgia PDF Ga. Ct. App. R. 6
 Hawaii Form #2DC04 Rules of Civil Procedure
 Idaho Form CAO FL 4-4 Idaho R. Civ. P. 5
 Illinois PDF 735 ILCS 5/
 Indiana Form No. 6 Ind. R. Trial. P. 5
 Iowa Form 104 Iowa R. Civ. P. 1.442
 Kansas Form 251 § 38-2238, § 60-303
 Kentucky Form AOC-105 Ky. R. Civ. P. 5.03
 Louisiana PDF CCP 1313
 Maine MS Word Rule 4(c)
 Maryland Form CC-DR-055 RULE 1-323
 Massachusetts PDF Mass. R. Civ. P. 5
 Michigan Form PC 564 Section 600.1910
 Minnesota PDF, MS Word Rule 5, Rule 355
 Mississippi Form 2 Rule 2.06
 Missouri PDF Rule 43
 Montana MS Word Rule 4
 Nebraska Form CC 3:22, Form DC 6:4.5 Rule 2-5
 Nevada Certificate of Service, Affidavit of Service Rule 4(c)
 New Hampshire PDF N.H. Supp. R. Sup. Ct. Elec. Fil. 12
 New Jersey Family Court, Superior Court Rule 1:5
 New Mexico PDF N.M. R. Civ. P. Dist. Ct. 1-005
 New York PDF R306 – Proof of Service
 North Carolina AOC-CV-105 Rule 5
 North Dakota Certificate of Service, Affidavit of Service (by mail) Rule 5
 Ohio PDF Ohio Civ.R. 4.2
 Oklahoma PDF Okla. Stat. tit. 12 § 2
 Oregon PDF Or. Uni. Trial. Ct. R. 2.020
 Pennsylvania PDF 52 Pa. Code § 1.58
 Rhode Island PDF R.I. Sup. Ct. R. 6
 South Carolina Form SCCA203 Rule 4
 South Dakota PDF Section 15-6-4(g)
 Tennessee PDF Rule 5.02
 Texas PDF Tex. R. Civ. P. 501.4
 Utah Form 1021GE Utah R. Civ. P. 5
 Vermont District Court, Superior Court § 691
 Virginia Form DC-413 § 8.01-296
 Washington Form CR 4(g) CR 4(d) – Service
 Washington D.C. Form OAH-414 Rule 4
 West Virginia Form SCA-FC-314 Rule 4.1
 Wisconsin Form FA-4120V § 801.10
 Wyoming PDF § 801.11

Ways to Serve an Affidavit of Service (6)

  1. Deliver in person (and obtain a signature)
  2. Deliver to someone who lives at the residence
  3. Deliver to someone who works at the workplace
  4. Post or slide under the door
  5. Send by certified mail (with return receipt)
  6. Send by standard mail

When to Use an Affidavit of Service

An affidavit of service is used to verify that documents have been received by an individual. Common for notices and to notify of a court hearing.

It is commonly used for:

  • Answers
  • Complaints
  • Court Hearing Dates
  • Motions
  • Notices (eviction)
  • Orders
  • Subpoenas
  • Summons



County of [COUNTY]
State of [STATE]

Date: [DATE]

1. SERVER I, [SERVER NAME], declare under penalty of perjury that the following documents were delivered and served in the following manner:

2. DOCUMENTS. The documents served are described as: [DESCRIBE].

3. RECIPIENT. The above-mentioned documents were delivered to:

  • Defendant/Respondent: [RECEIPIENT NAME]
  • Address/Location: [ADDRESS]
  • Date: [DATE], 20[YEAR] Time: [HOUR]:[MINUTE] AM PM

4. DELIVERY. The Recipient received the documents by: (check one)

Mail. The Server sent the documents in the mail by: (check all that apply)

– Standard Mail
– Electronic Mail (E-Mail)
– Certified Mail (with return receipt)
– FedEx
– Other

Direct Service. The Server handed the documents to a person identified as the Recipient.

Someone at the Residence. The Server handed the documents to someone who identified as living at the residence and stated their name is: [NAME].

Someone at the Workplace. The Server handed the documents to someone who identified to be the Recipient’s co-worker and stated their name is: [NAME].

Leaving at the Residence. The Server left the documents in the following area: [AREA].

Recipient Rejected Delivery. The Server delivered the documents to the Recipient in-person and did not accept delivery.

Other. [DESCRIBE].

5. VERIFICATION. I declare under penalty of perjury under the laws located in this State that the foregoing is true and correct.

Server’s Signature: ________________________ Date: ______________

Print Name: ________________________