Certificate of Service Form (Last Revised 12/2015)
UNITED STATES COURT OF APPEALS FOR THE SECOND CIRCUIT
CAPTION:
CERTIFICATE OF SERVICE*
Docket Number:
v.
I, , hereby certify under penalty of perjury that
(print name)
on , I served a copy of
(date)
(list all documents)
by (select all applicable)**
___ Personal Delivery
___ United States Mail ___ Federal Express or other
Overnight Courier
___ Commercial Carrier
___ E-Mail (on consent)
on the following parties:
Name Address City State Zip Code
Name Address City State Zip Code
Name Address City State Zip Code
Name Address City State Zip Code
*A party must serve a copy of each paper on the other parties, or their counsel, to the appeal or
proceeding. The Court will reject papers for filing if a certificate of service is not simultaneously
filed.
**If different methods of service have been used on different parties, please complete a separate
certificate of service for each party.
Today’s Date Signature
