State of
County of
I, , residing at , being of legal age and duly sworn, do hereby declare and state as follows:
On , I, on behalf of , delivered and served the original of the following documents: to (the "Recipient"), located at .
Method of service. The specified documents were delivered using the following means:
Acknowledgment of truthfulness. I swear under penalty of perjury that the information provided in this Affidavit of Service is true and correct to the best of my knowledge and belief.
______________________
(Place for signature)
State of
Acting in the county of
Sworn to and subscribed before me on ___________________________.
___________________________________
Place for signature
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Notary public's name and seal