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