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In the United States Bankruptcy Court District of Arkansas Western In Re: Debtor(s) Plaintiff(s) vs. Adversary Proceeding No: Defendant(s) Bankruptcy Case No:
Certificate of Service I, , certify that I am, and at all times during the service of process was, not less than 18 years of age and not a party to the matter concerning which service of process was made. I further certify that service of the summons and a copy of the complaint, in the above-styled case, was made by: Mail service: Regular, first class United States mail, postage fully pre-paid, addressed to:
Personal Service: By leaving the process with defendant or with an officer or agent of defendant at:
Residence Service: By leaving the process with the following person of suitable age and discretion (then residing therein) at:
Publication: The defendant was served as follows: [Describe briefly]
State Law: The defendant was served pursuant to the laws of the State of as follows: [Describe briefly]
,
Under penalty of perjury, I declare that the foregoing is true and correct.
Dated:
Signature: /s/