Free Affidavit of Service of Order to Show Cause and Affidavit in Support - New York

CIVIL COURT OF THE CITY OF NEW YORK County of Part

Index No.: AFFIDAVIT OF SERVICE OF ORDER TO SHOW CAUSE AND AFFIDAVIT IN SUPPORT

Claimant(s)/Plaintiff(s), -againstDefendant(s) State of New York, County of
SS:

, being duly sworn, deposes and says:
(Name of Deponent)

I am over 18 years of age and not a party to this action. At
(Time)

AM/PM, on
(Date)

at
(Address)

in the County of , City of New York, I served the annexed ORDER TO SHOW CAUSE and AFFIDAVIT IN SUPPORT of the Order in this matter on: 1.
(Name of Person Served)

known to me to be the
(Claimant/Plaintiff/Defendant)

by:

(a) Delivering a true copy to him/her at the above address.
Description of Individual Served in Person: Sex: Approximate Age: Color of Skin: Approximate Weight: Color of Hair: Approximate Height:

(b) Mailing a true copy, properly sealed and enclosed in a post-paid wrapper, by Certified Mail, Return Receipt Requested, in a Post Office of the United States Postal Service within the State of New York addressed to the
(Claimant/Plaintiff/Defendant)

AND ALSO SERVED THEM ON

2. Marshal (a) Delivering a true copy to a person in the Marshal's office.

by:
(Name of Person Served)

Description of Individual Served in Person: Sex: Approximate Age: Color of Skin: Approximate Weight: Color of Hair: Approximate Height:

(b) Mailing a true copy, properly sealed and enclosed in a post-paid wrapper, by Certified Mail, Return Receipt Requested, in a Post Office of the United States Postal Service within the State of New York addressed to the above-named Marshal at:

Sworn to before me this

day of

20

(Notary Public or Court Employee and Title)

(Signature of Deponent)

FREE CIVIL COURT FORM CIV-GP-19(Revised, January, 2004)-i No fee may be charged to fill in this form. Form can be found at: http://www.nycourts.gov/courts/nyc/smallclaims/forms.shtml.