Request For Appointment Of Process Server Form
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1
2In the
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CIRCUIT COURT
For File Stamp Only
Of St. Louis County, Missouri
_________________________
__________________________________________
Date
Plaintiff/Petitioner
_________________________
Case Number
vs.
_________________________
Division
__________________________________________
└
┘
Defendant/Respondent
REQUEST FOR APPOINTMENT OF PROCESS SERVER
Comes now _______________________________________________________, pursuant
Requesting Party
to Local Rule 28, and at his/her/its own risk requests the appointment of the Circuit Clerk of
___________________________________________________________________________
Name of Process Server
Address
Tel e phone
___________________________________________________________________________
Name of Process Server
Address or in the Alternative
Tel e phone
___________________________________________________________________________
Name of Process Server
Address or in the Alternative
Tel e phone
Natural person(s) of lawful age to serve the summons and petition in this cause on the below
named parties. This appointment as special process server does not include the authorization
to carry a concealed weapon in the performance thereof.
SERVE:
SERVE:
____________________________________________
____________________________________________
Name
Name
____________________________________________
____________________________________________
Address
Address
____________________________________________
____________________________________________
City/State/Zip
City/State/Zip
SERVE:
SERVE:
____________________________________________
____________________________________________
Name
Name
____________________________________________
____________________________________________
Address
Address
____________________________________________
____________________________________________
City/State/Zip
City/State/Zip
Appointed as requested:
JOAN M. GILMER, Circuit Clerk
___________________________________________
Signature of Attorney/Plaintiff/Petitioner
___________________________________________
Bar No.
By
________________________________________
___________________________________________
Deputy Clerk
Address
___________________________________________
___________________________________________
Phone No.
Fax No.
Date
CCADM62-WS
Rev. 08/16
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