Affidavit (Certificate) of Service Form

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Updated September 15, 2022

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 of Service;
  • Affidavit for Return of Service;
  • Certificate of Service;
  • Service of Process;
  • Proof of Service;
  • Proof of Delivery; and
  • Return of Process.

Table of Contents

By State

State Form Laws
 Alabama Adobe PDF, MS Word, OpenDocument Rules of Civil Procedure (Rule 5)
 Alaska Form TF-700 State Definition
 Arizona Form COA1 Rule 5(c)(2)
 Arkansas Adobe 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 Adobe PDF Del. R. Civ. P. Super. Ct. 5
 Florida Family Law Form 12.914 § 48.031
 Georgia Adobe 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 Adobe 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 Adobe PDF CCP 1313
 Maine MS Word Rule 4(c)
 Maryland Form CC-DR-055 RULE 1-323
 Massachusetts Adobe PDF Mass. R. Civ. P. 5
 Michigan Form PC 564 Section 600.1910
 Minnesota Adobe PDF, MS Word Rule 5, Rule 355
 Mississippi Form 2 Rule 2.06
 Missouri Adobe 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 Adobe PDF N.H. Supp. R. Sup. Ct. Elec. Fil. 12
 New Jersey Family Court, Superior Court Rule 1:5
 New Mexico Adobe PDF N.M. R. Civ. P. Dist. Ct. 1-005
 New York Adobe 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 Adobe PDF Ohio Civ.R. 4.2
 Oklahoma Adobe PDF Okla. Stat. tit. 12 § 2
 Oregon Adobe PDF Or. Uni. Trial. Ct. R. 2.020
 Pennsylvania Adobe PDF 52 Pa. Code § 1.58
 Rhode Island Adobe PDF R.I. Sup. Ct. R. 6
 South Carolina Form SCCA203 Rule 4
 South Dakota Adobe PDF Section 15-6-4(g)
 Tennessee Adobe PDF Rule 5.02
 Texas Adobe PDF Tex. R. Civ. P. 501.4
 Utah Form 1021GEJ 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) – Process
 Washington D.C. Form OAH-414 Rule 4
 West Virginia Form SCA-FC-314 Rule 4.1
 Wisconsin Form FA-4120V § 801.10
 Wyoming Adobe PDF § 801.11

Ways to Serve (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); or
  6. Send by standard mail.

When to Use

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; and
  • Summons.

Sample

AFFIDAVIT OF SERVICE

County of [COUNTY]
State of [STATE]

Date: [DATE], 20[YEAR]

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
– UPS
– 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: ________________________