@ Civil Law Self-Help Center (Rev. 2/5/18)
JUSTICE COURT, LAS VEGAS TOWNSHIP
Clark County, Nevada
Case No: _____________
Department No: _______
Name of Plaintiff(s) / Counterdefendant:
MOTION FOR SERVICE
OF SMALL CLAIMS
COMPLAINT OR
COUNTERCLAIM BY
CERTIFIED MAIL
Filed by :
[ ] Plaintiff
[ ] Counterplaintiff
VERSUS
Name of Defendant(s) / Counterplaintiff:
The undersigned
Plaintiff or Counterplaintiff (“Movant”) requests that the Court
allow service of process to be made upon
(Name of Defendant(s) or Counterdefendant(s))
_______________________________ by certified mail, return receipt requested. This Motion
is made pursuant to JCRCP 91 and is based on the following facts:
The last known address of party on whom service was attempted was (insert address where service was
last attempted)
:_________________________________________________________________________.
The Movant is informed and believes that this is the last known address of the
Defendant/Counterdefendant because
(state why you believe that to be the last known address):
______________________________________________________________________________________
_____________________________________________________________________________________.
The Movant provided file-stamped copy(ies) to a person over the age of 18 who is neither a party
to nor interested in these proceedings, and that person made efforts to personally serve the
Defendant(s)/Counterdefendant(s) with process but has been unable to complete service. A Declaration
of Due Diligence is attached.
The Movant therefore requests that the Court enter an Order allowing the undersigned to
effectuate service by sending a file-stamped copy of the
(check one box) Complaint Amended
Complaint
Counterclaim Amended Counterclaim by certified mail, return receipt requested to the
Defendant(s)’/Counterdefendant(s)’ last known address.
Per NRS 53.045, I declare under penalty of perjury that the foregoing is true and correct.
(Signature):
(Type or print name):
(Date):
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@ Civil Law Self-Help Center (Rev. 2/5/18)
JUSTICE COURT, LAS VEGAS TOWNSHIP
Clark County, Nevada
Case No: _____________
Department No: _______
Name of Plaintiff(s) / Counterdefendant:
CERTIFICATE OF
MAILING:
SMALL CLAIMS
COMPLAINT OR
COUNTERCLAIM BY
CERTIFIED MAIL
Filed by :
[ ] Plaintiff
[ ] Counterplaintiff
VERSUS
Name of Defendant(s) / Counterplaintiff:
I certify that I mailed a true and correct copy of the (check one box) Small Claims Complaint
Amended Small Claims Complaint Counterclaim Amended Counterclaim to Plaintiff
Defendant Counterplaintiff or Counterdefendant by certified mail, return receipt requested on
(date mailed) __________________. The Certified Mailing Receipt is attached hereto with the United States
Postal Service’s legible tracking number.
Affix Return Receipt Card or Post Office Receipt with Tracking Number
Per NRS 53.045, I declare under penalty of perjury that the foregoing is true and correct.
Executed on __________________________ ___________________________________
(Date) (Signature)
___________________________________
(Printed Name)
For Court Use Only: Date of Service / Delivery verified per USPS website tracking by Deputy Clerk: _____________
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signature
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