On [date] at [place], I served [name of person served] with the following documents [describe documents served. If the document served is a filed document include the date the document was filed in the description eg statement of claim filed (date). Do not attach a copy of any document already filed.]
I served the documents by [method of service].
#At the time of service [name of person served] stated [record what, if anything, the person served said].