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Supreme Court of the State of New York Appellate Division: Second Judicial Department AFFIDAVIT OF SERVICE Appellate Division Docket No.: ________________________ State of New York ) County of ______________________________) ss.: _________________________________________________________, deposes and says that: being duly sworn, 1. The deponent is not a party to the action, is 18 years of age or older, and resides at: 2. On the _______ day of _______________________, 200___, the deponent served the following described paper upon the person or persons listed in paragraph 5 hereof: 3. The number of copies served on each of said persons was ____________. 4. The method of service on each of said persons was: By delivering the paper to the person personally pursuant to CPLR 2103(b)(1). By mailing the paper to the person at the address designated by him or her for that purpose by depositing the same in a first class, postpaid, properly addressed wrapper, in a post office or official depository under the exclusive care and custody of the United States Postal Service within the State of New York pursuant to CPLR2103(b)(2). Where the person served is an attorney, by leaving the paper with the person in charge of the office of that attorney, pursuant to CPLR 2103(b)(3). Where the person served is an attorney whose office was not open for business at the time of service, by depositing the paper, enclosed in a sealed wrapper directed to the attorney, in the attorney's office letter drop or box pursuant to CPLR 2103(b)(3). By leaving the paper at the person's residence within the State of New York with a person of suitable age and discretion, pursuant to CPLR 2103(b)(4) where service at the person's office could not be made pursuant to CPLR 2103(b)(3). By transmitting the paper by facsimile transmission to the telephone number or other station designated by the person for that purpose, pursuant to CPLR 2103(b)(5). A signal was obtained from equipment of the person served indicating that the transmission was received and a copy of the paper was mailed to the person 2002 © American LegalNet, Inc. By dispatching the paper to the person by overnight delivery service at the address designated by the person for that purpose, pursuant to CPLR 2103(b)(6). 5. The name of the person or names of the persons served and the address or addresses at which service was made are as follows: Dated: ___________________, New York ________________ ___, 200___ ___________________________________ Sworn to before me this ________ day of _____________________, 200___ _________________________________ Notary Public 2002 © American LegalNet, Inc.