A filled out affidavit of service by mail form

Here is a sample filled-out Affidavit of Service by Mail form:

Affidavit of Service by Mail

State of [STATE] County of [COUNTY]

I, [YOUR NAME], being first duly sworn, do hereby depose and say:

  1. That I am the [YOUR RELATIONSHIP TO THE PARTY, e.g. attorney for, agent for, etc.] of [PARTY'S NAME], the [PARTY'S TITLE, e.g. plaintiff, defendant, etc.] in the above-entitled action.
  2. That on [DATE OF MAILING], I mailed a true and correct copy of the [DOCUMENT TYPE, e.g. summons and complaint, notice of motion, etc.] to [NAME OF DEFENDANT/RESPONDENT], at [DEFENDANT'S/RESPONDENT'S ADDRESS].
  3. That the mailing was made by first-class mail, postage prepaid, and was properly addressed to the defendant/respondent at the address listed above.
  4. That I have not received any return receipt or other indication that the mailing was refused or undeliverable.
  5. That I have no knowledge of any other means by which the defendant/respondent could have received actual notice of the [DOCUMENT TYPE].

Sworn to and subscribed before me this [DATE] day of [MONTH], [YEAR].

Signature of Affiant: ___

Printed Name of Affiant: ___

Address of Affiant: ___

Notary Public's Seal: ___

Notary Public's Signature: ___

Notary Public's Name: ___

Notary Public's Commission Number: ___

Notary Public's Address: ___

Note: This is a sample and may need to be modified to comply with the specific requirements of your jurisdiction. Additionally, the notary public's seal and signature are typically required to be notarized.