Fill and Sign the Form 11certificate of Service Pennsylvania Courts

Divorce Form 11 Instructions Certificate of Service Form 11 Divorce Form 11 Instructions Form 11 – Certificate of Service The numbers on these instructions correspond with the numbers in the boxes on the form. Use the form with the boxes to guide you through filling out the blank form. Box 1: Print the name of the county in which you filed exactly as you wrote it on Form 1. Box 2: Print the name of the Plaintiff exactly as it appears on Form 1 . Box 3 : Print the docket number that the Prothonotary's Office wrote on Form 1 at the time of filing. Box 4 : Print the name of the Defendant exactly as it appears on Form 1. Mark the box or boxes naming the document(s) you are mailing to your spouse. If you are mailing a form not listed, write the name of the form in the “othe r” space provided. Box 5: Print your spouse's name and address. Box 6: Write the date . Box 7: Sign and Print your name . File the completed form with the Prothonotary / Clerk. Divorce For m 11 AOPC 5 .1 .14 IN THE COURT OF COMMON PLEAS OF ___________ COUNTY, PENNSYLVANIA CIVIL ACTION _______________________________, : PLAINTIFF : : : Case No. ______________ vs. : : _______________________________, : DEFENDANT CERTIFICATE OF SERVICE The undersigned hereby certifies that on this date, a true and correct copy of the following have been served: (check any of the following that apply)  Affidavit Under Section 3301(d) of the Divorce Code  Notice of Intention to Request Entry of Section 3301(d) Divorce Decree, and Counter -Affidavit Under 3301(d)  Affidavit of Non -Military Service  Notice of Intention to Request Entry of Section 3301(c) Divorce Decree, and Counter -Affidavit Under 3301(c)  (Other)___________________________________________________ The undersigned hereby certifies that the above documents were served by first class mail to the following : ____________________________ (spouse’s name) ____________________________ (spouse’s address) ____________________________ ____________________________ Date:____________________ __________________________________ (Signature) __________________________________ Print Name 1 2 4 3 5 6 7 Divorce For m 11 AOPC 5 .1 .14. IN THE COURT OF COMMON PLEAS OF ___________ COUNTY, PENNSYLVANIA CIVIL ACTION _______________________________, : PLAINTIFF : : : Case No. ______________ vs. : : _______________________________, : DEFENDANT CERTIFICATE OF SERVICE The undersigned hereby certifies that on this date, a true and correct copy of the following have been served: (check any of the following that apply)  Affidavit Under Section 3301(d) of the Divorce Code  Notice of Intention to Request Entry of Section 3301(d) Divorce Decree, and Counter -Affidavit Under 3301(d)  Affidavit of Non -Military Service  Notice of Intention to Request Entry of Section 3301(c) Divorce Decree, and Counter -Affidavit Under 3301(c)  (Other)___________________________________________________ The undersigned hereby certifies that the above documents were served by first class mail to the following : ____________________________ (spouse’s name) ____________________________ (spouse’s address) ___________________________ _ ____________________________ Date:____________________ __________________________________ (Signature) __________________________________ Print Name