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SUPERIOR COURT OF THE DISTRICT OF COLUMBIA Civil Division - Small Claims and Conciliation Branch 510 4th Street, N.W., Court Building B, Room 120, Washington, D.C. 20001 Telephone Number: (202) 879-1120 Website: www.dccourts.gov , Plaintiff(s) vs. Case No.: , Defendant(s) APPLICATION FOR APPROVAL OF SPECIAL PROCESS SERVER(S) This application is made by , (Name of Plaintiff or Defendant/Counter-Plaintiff) who represents that (Name of Special Process Server(s)) is/are competent person(s), at least 18 years of age, and not a party to or otherwise interested in the claim. Plaintiff222s or Defendant/Counter-Plaintiff222s (or agent222s) Signature Date CV-3123/Jul. 2018 D.C. Code 247 16-3902 (a) American LegalNet, Inc. www.FormsWorkFlow.com