Skip to main content

Search Google Appliance

Search Google Appliance

FORM FOR AFFIDAVIT OF SERVICE BY MAIL BY LOCAL EDUCATIONAL AGENCY LIAISON FOR HOMELESS CHILDREN AND YOUTH

 

STATE OF NEW YORK

COUNTY OF _____________________ss.:

______________________________________, being duly sworn, deposes and says that he/she is over the age of eighteen years and is the local educational agency liaison for homeless children and youth for the _______________________________ school district; that on the ____day of _______________________, 20 ____, deponent served the within ___________upon _______________________________________ in this action, at _____________________________________________________________________, the address designated by ________________________________________________ for that purpose, by depositing a true copy of the same by mail, enclosed in a post paid wrapper addressed to the named school district employee or officer or a person in the office of the superintendent who has been designated by the board of education to accept service on behalf of the school district, in (check one) _______ a post office ________ official depository (mailbox) under the exclusive care and custody of the United States Post Office Department.

____________________
(Signature)

 

Subscribed and sworn to before me this ____ day of ________ 20 ______

 

______________________________
(Signature of notary public)