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THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH http://www.courts.state.nh.us
Court Name: Case Name: Case Number: (if known)
AFFIDAVIT OF RECEIPT OF SERVICE For:
Petition for Divorce Petition for Legal Separation Petition for Civil Union Dissolution Parenting Petition Other:
I,
, do hereby state under oath that I
received the petition specified above and the: Notice to Spouse Notice to Parties Notice of Post-Decree Action Notice (Fill in type of notice)
Date
Signature
Phone Number:
Address:
State of
, County of
This instrument was acknowledged before me on My Commission Expires Affix Seal, if any
NHJB-2067-FS (12/14/2011)
by Signature of Notarial Officer / Title
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