Service Assistance Form

Instructions to law enforcement: Do not serve this form with the other papers. You may keep this form for your records or destroy it. Service Assistance Form This is a Private Record (CJA 4-202.02) Case Number Court Name & Address Name of Person Requesting Service Document to be Served Information About the Person to be Served (Print clearly.) Plaintiff/Petitioner Name Alias/Nickname SSN Race Weight Hair color Defendant/Respondent DOB Sex Height Eye color Special characteristics (tattoos, scars, etc.) Home: street address, city, state, zip Cell phone Home phone Best times to reach Work: name, street address, city, state, zip Work phone Best times to reach Driver's license number Car license number Car Make Year Is this person on probation or parole? Yes No Don't know If known, print the name of the supervising agency and officer and the officer's telephone number. Has this person used weapons or been violent in the past? Yes No Don't know Model Color Service Assistance Form Approved Board of District Court Judges May 21, 2008 Amended December 14, 2012 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com