RF-112 Rev. 03/18
Arizona Department of Real Estate (ADRE)
Real Estate Recovery Fund
www.azre.gov
Proof of ServicePublication (RF-112)
DOUGLAS A. DUCEY
GOVERNOR
JUDY LOWE
COMMISSIONER
100 N. 15th Ave., Suite 201 Phoenix, AZ 85007
For Department Use Only
RF File No.
The undersigned Applicant states the following:
1.
A
pplicant is a citizen of the United States over the age of 18 years, and is competent to testify to the facts stated
herein, which describe the circumstances warranting service by publication on the following Judgment
Debtor:
____
_____________________________________________________________________________________
2. Judgment Debtor currently holds or did hold a license issued by the Department of Real Estate.
3.
J
udgment Debtor was last known to reside in: City_______________, County ______________, State.
4
. P
ursuant to A.R.S. §32-2188.01(B), Applicant attempted to serve the Notice to Judgment Debtor (Form RF- 109)
and Application for Payment from the Real Estate Recovery Fund (Form RF-107) on the Judgment Debtor by
personal service utilizing a licensed private process server. The process server performed a search to locat
e
J
udgment Debtor, and attempted personal service on the date(s) and at the address(es) listed in the process server’s
affidavit(s), the original(s) of which are attached.
5.
A
fter exercising reasonable diligence, Applicant has been unable to ascertain the current whereabouts of th
e
J
udgment Debtor, and therefore has affected service by publishing the Notice to Judgment Debtor (Form RF-109)
once a week for (2) two consecutive weeks in the newspaper identified in the attached Publisher’s Certificate. Th
e
n
ewspaper identified in the certificate is one of general circulation in the county in which the judgment debtor was
last known to reside.
CERTIFICATION BY APPLICANT
I declare that I have prepared and read the foregoing Proof of Service and know of my own knowledge that the facts,
circumstances and statements made therein are true and correct.
EXECUTED on __________________, 20____, Signature:
a
t ____________________________, Arizona. X ______________________________________
Applicant’s Name: ___________________________________________
A
ddress: _______________________________________________
C
ity, State, ZIP: _________________________________________
Phone Number(s): _______________________________________ Email: _______________________________
N
OTICE TO APPLICANT:
·
Y
our Application is not substantially complete without proof of service on each Judgment Debtor against whom
you are making a claim.
· Only use this method of service if both of the following conditions apply:
(1) The Judgment Debtor does not currently hold a license issued by the Department.
(2)
A
fter reasonable diligence, you cannot affect personal service on the Judgment Debtor.
·
W
hen you receive the Publisher’s Certificate, complete this form and attach the original certificate and process
server’s Affidavit(s) referenced in No. 4 above. Mail or submit via Message Center
completed form and all
attachments to:
Arizona Department of Real Estate
Recov
ery Fund Administrator
100 N. 15th Ave., Suite 201
Phoenix, AZ 85007