400-00231 Affidavit as to Military Service on Default of Appearance by Defendant (03/2007) Page 1 of 1
STATE
OF
VERMONT
SUPERIOR COURT
FAMILY DIVISION
Unit
Docket No.
Plaintiff Defendant
V.
Affidavit as to Military Service on Default of Appearance by Defendant
www.vermontjudiciary.org
Date: ____________________
I/We, _________________________ of ________________________ in the County of ________________
and State of _____________________ on oath depose and that I/we am /are Plaintiff(s) in the above entitle
action and set forth the following fact showing:
1. that the defendant(s) ___________________________________ is/are not in the military or other
service of the United States included in the provision of Servicemembers’ Civil Relief Act.
2. on oath depose and say that the defendant(s) ___________________________________ is/are in the
military or other service of the United States included in the provision of Solders’ and Sailors’ Civil
Relief Act of 1940, as amended to wit:
3. on oath depose and say that I/we am/are unable to determine whether or not
_____________________________________ defendant(s) is/are in the military or other service of the
United State included in the provisions or Servicemembers’ Civil Relief Act.
I swear or affirm that the facts set forth in this petition are true and correct to the best of my knowledge and
belief.
Date: ___________________________ Signature: ____________________________________________
Printed Signature: ______________________________________
Signed and sworn to before me:
Date: ___________________________
Expiration Date: ___________________ Signature of Notary: ____________________________________
N.B. Required by Title 50 App. USCA 520. As to who are persons in the military service within the meaning
of the above Act. See Tide 50 App. USCA 464, 511 and annotations thereunder.