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FORM 3


AFFIDAVIT OF PERSONAL SERVICE

STATE OF NEW YORK:
:ss.
COUNTY OF _______:

 

__________________ being duly sworn, deposes and says that he/she is over the age of eighteen years and is not a party in this proceeding; that on the _____________ day of ________ 20___, at No. ______ Street, in the town of ______________, county of _____________, State of New York, he/she served the annexed _____________ on ______________________ by delivering to and leaving with said ______________________ at said time and place a true copy thereof.

Deponent further says he/she knew the person so served to be the said __________________ who is _______________ in said district and who is duly authorized to accept service.

 

_________________________
Signature

Subscribed and sworn to

before me this ____ day of

_________________ 20 ____

 

______________________________
(Signature of notary public)

 

NOTE: Where appropriate, include the following above the signature line:

Unsuccessful Attempts to Serve Respondent

Date                  Time                   Place