§ Form 5.10 Return of Service
Form 5.10 Return of Service [FN1]
(CAPTION) [FN2] RETURN OF SERVICE
On the _______ day of (month), 19__, I made service of the (document served) upon the [Plaintiff]/[Defendant]/[Witness]/(other, describe), (name), at (address of place of service).
_________ By delivering a copy in hand.
_________ By leaving copies at the individual's dwelling house or usual place of abode with a person of
suitable age or discretion who resided therein; and whose name is
__________________________________________________________.
_________ By delivering a copy to an agent authorized to receive service of process, and whose name is
__________________________________________________________, at
__________________________________________________________.
_________ By (describe other manner of service):
____________________________________________________________________________________________________________________.
Service $________________
Travel,
miles one-way: $________________
Postage: $________________ ____________________________
(signature)
Other,
______________ $________________ ____________________________
(title)
TOTAL $________________
[FN1] Previously Form 2B.
[FN2] The Return of Service may be filed as a separate document, or included on the original summons or other pleading served. In the latter case a caption is unnecessary.