Transcript
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AFFT
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(Your Name) ______________________
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(Address)_________________________
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_________________________________ (Telephone) _______________________ (Email Address)____________________
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Self-Represented
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DISTRICT COURT
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CLARK COUNTY, NEVADA
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_______________________
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CASE NO.: ____________________
Plaintiff,
DEPT NO.: ____________________ vs. _______________________ Defendant.
AFFIDAVIT OF SERVICE
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(Name of person who served the documents, the “Affiant”)_________________________
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__________________________, states that at all times herein Affiant was and is over 18 years of age, not a party to nor interested in the proceeding in which this affidavit is made. That Affiant has a business or home address of (street,city,state,zip) _________________ ______________________________________________________________________________.
23 That Affiant’s telephone number is (
) ________________.
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That Affiant is not required to be a licensed process server because Affiant is not engaged
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in business as a process server as defined in NRS 648.014 or Affiant is a licensed process server
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whose license number is stated below.
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© Family Law Self-Help Center Rev. 9_13
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Affidavit Of Personal Service 9-13 ALL RIGHTS RESERVED
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That Affiant received a copy of the (list the documents) __________________________ ____________________________________ on the
day of
, 20____.
That Affiant personally served the (5 check one)
Plaintiff
Defendant with a copy of the above stated documents on the ___________ day __________________, 20___ at about
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(time) ______ a.m./p.m. by: (check and complete option A or B)
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A.
Delivering and leaving the documents with said party at (street address) ________
_____________________ (city) ________, (state)_____________, (zip code)________.
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OR B.
Delivering and leaving a copy with (first and last name of person that the
documents were given to) ____________________________________, who is a person of suitable age and discretion that lives with the above state party at (street address) _______ ______________________ (city) ________, (state)_____________, (zip code)________.
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I declare under penalty of perjury under the law of the State of Nevada that the foregoing is true and correct.
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Dated: __________________________
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__________________________________________ Signature of Affiant
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________________________________________ Printed Name of Affiant
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__________________________________________ Process Server License Number (If you are not a licensed process server write N/A)
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© Family Law Self-Help Center Rev. 9_13
2
Affidavit Of Personal Service 9-13 ALL RIGHTS RESERVED
