FORM 3
SUPERIOR COURT OF THE DISTRICT OF COLUMBIA
CIVIL DIVISION, LANDLORD AND TENANT BRANCH
th
BLDG. B, 510 4
Street N.W., Room 110
Washington, D.C. 20001
Telephone (202) 879-1152
L&T _______________________
Date of Initial Hearing__________
___________________________________
___________________________________
Plaintiff/Landlord
Defendant/Tenant
___________________________________
vs.
___________________________________
Address
Address
__________________________________
___________________________________
AFFIDAVIT OF SERVICE
I, ______________________, age ____, residing at ______________________________________and not a party to this case, depose
and say that on _________, 200__, at ______AM/PM, I served a copy of the complaint and summons as follows:
On the Defendant/Tenant____________________________ personally.
By leaving said copy with ___________________________, a person of suitable discretion above the age of sixteen (16) years,
residing who resides on or at Defendant/Tenant’s address given above, the Defendant/Tenant having left the District of Columbia or
not to be found.
Having at least twice attempted with due diligence and failed to effect service upon the Defendant/Tenant personally or upon a
person of suitable discretion above the age of sixteen (16) years residing on or at the Defendant/Tenant’s address given above by
posting said copy on the door of the premises where it could be conveniently read. The date and time of all attempts at personal service
were as follows:
First attempt: Date/Time __________, 201__, at __________AM/PM
Second attempt: Date/Time _________, 201__, at _________AM/PM
Other attempts (if applicable) ______________________________________________________________________________
In addition to the service noted above, I mailed a coy of the Complaint and Summons to the Defendant/Tenant at the following address:
____________________________________________ by first class U.S. mail, postage prepaid on _______, 200___.
(For a corporation or limited liability company) I served _________________________, an officer, managing agent or general agent,
or ____________________, a registered agent.
You must set forth specific facts from which the Court can determine that process was served as indicated above and in compliance
with D.C. Code Section 16-1502 and SCR L&T 4, including a physical description of any person on whom service was made and, if
service was by posting at the Defendant/Tenant’s address, a description of the door, including its location, color and any distinguishing
marks: ______________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
_____________________________________
Special Process Server
Subscribe and sworn to before me this ______day of ____________, 200__.
_____________________________________
____________________________________
My commission expires
Notary Public
NOTE: A separate Affidavit is required for service on each named Defendant/Tenant.
Form CV-2070/Sept.03