City or Town Where Court Is Located




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IN THE SUPERIOR COURT FOR THE STATE OF ALASKA

AT


City or Town Where Court Is Located



)

Plaintiff, )

)

vs. )


)

)

Defendant. )



) Your Case No.

RETURN OF SERVICE AFFIDAVIT

I certify that on , I served the following documents: (Date)

 Summons  Standing Order

 Complaint  Child Custody Jurisdiction Affidavit

 Child Support Affidavit  Property & Debt Worksheet

 Other:


upon ___ (Name of Person served)
at this location

(Address)
by handing or leaving a true and correct copy with ,

(Name of Person who received papers)
a person of suitable age and discretion living at the defendant’s usual place of residence.


______________________________________

Notarized Signature of Process Server or Police Print Name of Process Server or Police

Officer or Prison Shift Captain Officer or Prison Shift Captain
_________________________________________ ______________________________________

Print Name of Process Server Business or Police Print Address of Process Server Business or

Station or Prison Facility Police Station or Prison Facility

Subscribed and sworn to or affirmed before me at , on . Name of City, Town or Village

Date

­­­­­­ Notary Public or other person authorized to administer oaths.

My commission expires on



Return of Service Affidavit SHC-193 (02/10)

Page 1 of 1






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