Affidavit Of Service Of Restraining Notice
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1CIVIL COURT OF THE CITY OF NEW YORK
County of ___________________
Index Number _______________
________________________________________
Affidavit of Service
of
Claimant/Plaintiff,
Restraining Notice
-against-
____________________________
Judgment Debtor’s Name
____________________________
Address
Defendant.
____________________________
City , State, Zip
________________________________________
State of New York, County of _______________ ss.:
.
_____________________________________, being duly sworn, deposes and says:
Name of Deponent
I am over the age of 18 and not a party to this action. At ________________, on
________________________,
Time
Date
I served the following papers:
check the box next to the title(s) papers served
~ ~ ~ ~ A. Restraining Notice;
~ ~ ~ ~ B. Restraining Notice and Notice to Judgment Debtor, or
~ ~ ~ ~ C. Restraining Notice, Exemption Notice and two Exemption Claim forms with
sections titled “Address A” and “Address B” filled out,
on
______________________________________________________________________________
G G G G by mailing the papers in an envelope addressed to
_________________________________________________________________________
by Certified Mail Return Receipt Requested.
OR
G G G G by delivering papers to ______________________________________________________
at the following address: _____________________________________________________.
_____________________________
Signature of Server
Sworn to before me
this ______ day of ______________, 20 ___
____________________________________
Signature of Notary
FREE CIVIL COURT
No fee may be charged to fill in this form.
CIV-SC-58 (Revised 1/09)
Form can be found at:
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