GENSUMN(12/96)
SHERIFF'S FEES
Service and return........................................ $____________
Miles______................................................ ____________
Total............................................................ $____________
____________________________________
Sheriff of ______________________County
I certify that I served this summons on defendants as follows:
(Check appropriate box, and complete information below)
(a)--Individual defendants--personal):
By leaving a copy and a copy of the complaint with each individual defendant personally.
(b)--(Individual defendants--abode):
By leaving a copy and a copy of the complaint at the usual place of abode of each individual
defendant with a person of his family, of the age 13 years or upwards, informing that person
of the contents and also by sending a copy of the summons in a sealed envelope with postage
fully prepaid, addresses to each individual defendant at his usual place of abode.
(c)--(Corporation defendants):
By leaving a copy and a copy of the complaint with the registered agent, officer or agent of
each defendant corporation.
(d)--(Other service):
Name of Defendant_____________________________
Name of Defendant ____________________________
Name of Person
Name of Person
Summons Given to_____________________________
Summons Given to ____________________________
Sex_______ Race_________ Approx. Age_________
Sex_______ Race_________ Approx. Age________
Place of Service________________________________
Place of Service_______________________________
_____________________________________________
____________________________________________
_____________________________________________
____________________________________________
Date of Service_________________ Time__________
Date of Service_________________ Time__________
Date of Mailing________________________________
Date of Mailing_______________________________