CO 249 Rev. 7/07 UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLUMBIA ____________________________________ Plaintiff(s) Civil Action No. _______________ vs. ____________________________________ Defendant(s) AFFIDAVIT OF MAILING I, _________________________________________, hereby state that: On the __________ day of ________________________, _______, I caused to be deposited in the United States Mail a copy of the summons and complaint in the above captioned case, postage prepaid, return receipt requested, restricted delivery, addressed to the following defendant: I have received the receipt for the certified mail, No. ______________________________ (attached hereto), indicating that delivery of the summons and complaint was made upon said defendant on the __________ day of ________________________, _______. I declare under penalty of perjury that the foregoing is true and correct. ________________________ (Date) _________________________________ (Signature) American LegalNet, Inc. www.FormsWorkflow.com
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