Instructions for:
Form 3-B
Affidavit of Service by
Mail
Form 3-B - Affidavit of Service by Mail
The numbers on these instructions correspond with the numbers in the arrowboxes on the
form. Use the form with the arrowboxes to guide you through filling out the blank form.
1. Write the name of the county you are filing in by arrowbox 1. Write exactly what
you wrote on Form 1, by arrowbox 1.
2. Write your name by arrowbox 2. Write your name exactly as you wrote it on
Form 1, by arrowbox 2.
3. Write your spouse's name by arrowbox 3. Write your spouse's name exactly as
you wrote it on Form 1, by arrowbox 3.
4. Write the docket number by arrowbox 4. The docket number is the number that
the office where legal pleadings are filed wrote on Form 1, by arrowbox 4 at the
time of filing.
5. Write your name by arrowbox 5.
6. Write the date you mailed Form 1 by arrowbox 6.
7. Write the date your spouse signed the green card by arrowbox 7.
8. Write today’s date by arrowbox 8.
9. Sign your name by arrowbox 9.
10. File this form with the office where legal pleadings are filed.
The returned green card must be filed with this form. It is recommended that you
tape the green card, with the date and signature side up, to a second sheet of paper
and staple it to this form when you file it with the office where legal pleadings are
filed.
Note: Because this is original service (see Introduction section), you must also provide
a copy of the complete service document to the other party.
Form 3-B
Page 1 of 1
IN THE COURT OF COMMON PLEAS OF
_______________________ COUNTY, PENNSYLVANIA
_______________________________, : CIVIL ACTION LAW
PLAINTIFF (your full name) :
:
: Case No. ______________
vs. :
:
_______________________________, :
DEFENDANT (spouse’s full name) : IN DIVORCE
AFFIDAVIT OF SERVICE BY MAIL
I, ______________________, Plaintiff in the above-captioned action depose and
say the following:
1. On _______________(date mailed documents), a copy of the Complaint in
Divorce and Notice to Defend and Claim Rights with Notice of Availability of
Counseling in the above-captioned matter was mailed to the Defendant by
Certified Mail, Return Receipt Requested, Deliver to Addressee Only, and
regular mail at Defendant’s last known address, as indicated on the attached
mailing receipt.
2. On _______________(date of spouse’s signature on green return card),
Defendant received the aforesaid Divorce Complaint and the mailing receipt
and return receipt card evidencing the same are attached hereto and made a
part hereof.
I verify that the statements in this document are true and correct to the best of my
knowledge, information, and belief. I understand that false statements herein are made
subject to the penalties of 18 Pa.C.S. § 4904, relating to unsworn falsification to
authorities.
Respectfully Submitted,
Date:____________________ __________________________________
Plaintiff’s Signature
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IN THE COURT OF COMMON PLEAS OF
_______________________ COUNTY, PENNSYLVANIA
_______________________________, : CIVIL ACTION LAW
PLAINTIFF (your full name) :
:
: Case No. ______________
vs. :
:
_______________________________, :
DEFENDANT (spouse’s full name) : IN DIVORCE
AFFIDAVIT OF SERVICE BY MAIL
I, ______________________, Plaintiff in the above-captioned action depose and say the following:
1. On _______________(date mailed documents), a copy of the Complaint in Divorce and Notice
to Defend and Claim Rights with Notice of Availability of Counseling in the above-captioned
matter was mailed to the Defendant by Certified Mail, Return Receipt Requested, Deliver to
Addressee Only and regular mail, at Defendant’s last known address, as indicated on the
attached mailing receipt.
2. On _______________(date of spouse’s signature on green return card), Defendant received
the aforesaid Divorce Complaint and the mailing receipt and return receipt card evidencing the
same are attached hereto and made a part hereof.
I verify that the statements in this document are true and correct to the best of my knowledge,
information, and belief. I understand that false statements herein are made subject to the penalties of 18
Pa.C.S. § 4904, relating to unsworn falsification to authorities.
Respectfully Submitted,
Date:____________________ __________________________________
Plaintiff’s Signature