Fill and Sign the Maryland Dom Rel 55 Affidavit of Service Private Process Form

Area Code Telephone Nu\ mber of Server AFFIDAVIT OF SERVICE (Private Process) (DOM REL 55) I certify that I served \ at a.m./ \ p.m. on , , at \ , , \ , , a copy of the following documents (Check all that apply): Writ of summons: Complaint/Petition/Motion: Domestic Case Information Report (DCIR Form) Financial Statement Show Cause Order and Petition: Other: which were previously filed with this Court. Attached is a copy of any summons ("process") issued by the Court, the original of which I served upon the person served. Service was made in the following manner: The person I left the papers with acknowledged being: (1) a resident o\ f the above-listed address; or (2) of suitable age and discretion in that the relationship to the defendant is\ and that; (3) the above-listed address is the defendant's residence or\ usual place of abode. Description of Defendant/Person Served: Race Sex Height Weight Age Name of person served TimeCheck one Date Street AddressCityState Zip Code List name of complaint/petition/motion List type of petition List all other documents served Name of Server (signature) Name of Server (printed or typed) Street Address, City, State, Zip Code of Server Date CC-DR 55 (Rev. 6/2010) All Blanks Must Be Completed Date the summons for the Complaint/Petition/Motion listed below was issued I certify that I am over eighteen (18) years of age and I am not the P\ laintiff or the Defendant. I SOLEMNLY AFFIRM under the penalties of perjury that the contents of th\ e foregoing paper are true to the best of my knowledge, information, and belief. Circuit Court for Case No. City or County Plaintiff Defendant ( ) ( ) City StateArea CodeTelephone City State Zip CodeArea CodeTelephone vs. Name Street Address Zip Code Name Street Address Apt # Apt # ( ) -