New York Affidavit of Service Form
The Affidavit of Service is a form that has to be used by the person who is responsible for serving copies of the divorce papers to the defendant. The mentioned form is used for verifying that the defendant has received all of the required papers.
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SUPREME COURT OF THE STATE OF NEW YORK 1COUNTY OF --------------------------------------------------------------------X 2 3Plaintiff,Index No.:-against-AFFIDAVIT OF SERVICE 4Defendant.-------------------------------------------------------------------X 5STATE OF }ss:COUNTY OF } 6______________________________ being duly sworn, says: 71.I am not a party to the action, am over 18 years of age and reside at:________________________________________________________________________ 82.On__________________, at ____a.m./p.m. at _________________________________________________________________________ I served the ‘ summons withnotice OR ‘ summons and verified complaint, and the notice of automatic orders, on ____________________________, the Defendant named by delivering a truecopy to the Defendant personally. ‘ In addition I served a copy of the Child Support Standards Chart. ‘ In addition I served a copy of the Notice of Continuation of Health Care Coverage 3.The notice required by the Domestic Relations Law, Section 232 -- “ACTION FOR ADIVORCE” -- was legibly printed on the face of the summons served on the Defendant. 94.I knew the person so served to be the person described in the summons as the Defendant.My knowledge of the Defendant and how I acquired it is as follows: (select one)‘I have known the defendant for _______ years and________________________________________________________________________________________________________________________________________________________OR‘I identified the Defendant by a photograph annexed to this affidavit and which wasgiven to me by the Plaintiff. OR‘Plaintiff accompanied me and pointed out the Defendant. OR‘I asked the person served if he/she was the person named in the summons andDefendant admitted being the person so named.(Form UD-3 - Rev. 9/11) 5.Deponent describes the individual served as follows: SexHeightWeight Age Color of SkinColor of Hair‘ Male‘ Female‘ Under 5’‘ 5’0”-5’3”‘ 5’4”-5’8”‘ 5’9”-6’0”‘ Over 6'‘ Under 100 Lbs.‘ 100-130 Lbs.‘ 131-160 Lbs.‘ 161-200 Lbs.‘ Over 200 Lbs.‘ 14-17 Yrs.‘ 18-20 Yrs.‘ 21-35 Yrs.‘ 36-50 Yrs.‘ 51-65 Yrs.‘ Over 65 Yrs.Describe color:________________________________________________‘ Black‘ Brown‘ Blond‘ Gray‘ Red‘ White‘ Balding ‘ Bald Other identifying features, if any:___________________________________________________.10 ‘ 6a.At the time I served the Defendant, I asked him/her if he/she was in the military service of thisstate, any other state, or this nation, and the Defendant responded in the negative. ‘6b.The Defendant stated that he/she is in the following military service . ‘6c.The Defendant refused to answer.11 ______________________________Server’s Signature Subscribed and Sworn to before me on NOTARY PUBLIC (Form UD-3 - Rev. 9/11)
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