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Affidavit Of Service - Arizona

Affidavit Of Service Form. This is a Arizona form and can be used in Civil Superior Court Mohave Local County .
 Fillable pdf Last Modified 7/14/2011
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For Clerk's Use Only Name of Person Filing: _______________________________________ Mailing Address: _______________________________________ City, State, and Zip Code: _______________________________________ Daytime / Evening Phone: _______________________________________ ATLAS Number (if applicable):_______________________________________ State Bar Number (if applicable):_____________________________________ Self (Without a Lawyer) OR Representing Attorney for Plaintiff / Petitioner or Defendant / Respondent (If Attorney, include State Bar Number) SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case Number:________________________ (Name of Plaintiff / Petitioner) AFFIDAVIT OF SERVICE (Name of Defendant / Respondent) I received the Summons / Subpoena addressed to _____________________________________________ and dated at this time Name: Date: Place: Manner: ______________________________ on this date _______________________________ ______________________________ and I personally served it as follows: _________________________________________________________________________ _________________________________ Time: ________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ I declare under penalty of perjury that the foregoing is true and correct. Date: ___________________________________ Printed Name: Street Address: City, State, Zip: Phone: FEES MILEAGE OTHER TOTAL $_____________________ $_____________________ $_____________________ $_____________________ ______________________________________ Signature ______________________________________ ______________________________________ ______________________________________ ______________________________________ Revised: 8/18/2010 . 00 0 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com
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