Enter the name of the county in which you are STATE OF , CIRCUIT COURT, filing, or have already filed, this case. COUNTY Plaintiff(s): Enter the Plaintiff’s name. ____________________________________________________ -vs- Enter the Defendant’s Defendant(s): name. Affidavit of Mailing Enter the case number. Case No. UNDER OATH, I STATE: After you have mailed the I placed in an envelope a copy of the following documents: summons and complaint, or other document, you Authenticated Copy of the Summons and Complaint must complete the information to the right. Motion: Other: I mailed that envelope with proper postage affixed on to: [Date] Name the date [month, day, Address year] on which you placed Address the documents in a City State Zip mailbox, and the name(s) and address(es) of the Name person to whom you Address mailed them. Address City State Zip STOP! Take this document to a Notary Public BEFORE you sign it. ► After you have been sworn by a Notary Public, Signature sign and print your name and date the document in Print or Type Name front of the Notary Public. Date State of County of Subscribed and sworn to before me on Have the Notary Public sign, date, and seal the Notary Public/Court Official document. (Seal) Name Printed or Typed My commission/term expires:
Enter the name of the county in which you are filing, or have already filed, this case. STATE OF , CIRCUIT COURT, COUNTY Enter the Plaintiff’s name. Plaintiff(s): ____________________________________________________ -vs- Defendant(s): Enter the Defendant’s name. Enter the case number. Affidavit of Mailing Case No. After you have mailed the summons and complaint, or other document, you must complete the information to the right. UNDER OATH, I STATE: I placed in an envelope a copy of the following documents: Authenticated Copy of the Summons and Complaint Motion: Other: the date [month, day, year] on which you placed the documents in a mailbox, and the name(s) and address(es) of the person to whom you mailed them. I mailed that envelope with proper postage affixed on [Date] to: Name Address Address City State Zip Name Address Address City State Zip STOP! Take this document to a Notary Public BEFORE you sign it. After you have been sworn by a Notary Public, sign and print your name and date the document in front of the Notary Public. ► Signature Print or Type Name Date Have the Notary Public sign, date, and seal the document. State of County of Subscribed and sworn to before me on Notary Public/Court Official Name Printed or Typed My commission/term expires: (Seal)
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