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New Jersey Affidavit of Service

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The New Jersey Affidavit of Service provided by New Jersey Courts is for use by private service.

New Jersey Affidavit of Service
New Jersey Affidavit of Service
Affidavit of Service (9/30/02)
Plaintiff
vs.
Defendant
Superior Court of New Jersey
Venue
Docket Number
Person to be served (Name & Address):
AFFIDAVIT OF SERVICE
(For Use by Private Service)
Attorney:
Cost of Service pursuant to R. 4:4-3(c)
$
Papers Served:
Service Data:
Served Successfully _____ Not Served Date: Time:
______________
Attempts: ___________
Delivered a copy to him / her personally
Left a copy with a competent household
member over 14 years of age residing
therein (indicate name & relationship at right)
Left a copy with a person authorized to
accept service, e.g., managing agent,
registered agent, etc.
(Indicate name & official title at right)
Name of Person Served and relationship / title:
Description of Person Accepting Service:
Sex: ____ Age: ____ Height: Weight: ____ Skin Color: Hair Color:
Unserved:
( ) Defendant is unknown at the address furnished by the attorney
( ) All reasonable inquiries suggest defendant moved to an undetermined address
( ) No such street in municipality
( ) No response on: Date Time
Date Time
( ) Other:____________________________ Comments or Remarks_______________________
Server Data:
Subscribed and Sworn to me this
____ day of __________________
Notary Signature
Name of Notary / commission expiration
I, <Name of Server>, was at the time of service a
competent adult not having a direct interest in the
litigation. I declare under penalty of perjury that
the foregoing is true and correct.
Signature of Process Server Date
<Insert Private Server’s name, address and telephone number.>
Revised 9/30/2002, CN 10516-English
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New Jersey Affidavit of Service