Pennsylvania Affidavit of Service Template
State of Pennsylvania
County of ____________________
Before me, the undersigned authority, personally appeared ____________________, who being duly sworn, deposes and says:
1. I am over the age of 18 and am not a party to this action.
2. I reside at ____________________, in the County of ____________________, State of Pennsylvania.
3. On ____________________, I served the following documents:
- ____________________
- ____________________
- ____________________
4. The documents were served to:
- Name: ____________________
- Address: ____________________
5. The method of service was as follows:
- Personal Delivery
- Certified Mail
- Other: ____________________
6. I declare under penalty of perjury that the foregoing is true and correct.
Executed on ____________________, at ____________________.
___________________________
Signature of Affiant
___________________________
Printed Name of Affiant
Sworn to and subscribed before me this ____ day of ____________________, 20____.
___________________________
Notary Public
My commission expires: ____________________