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This page links to an example of a completed form. This is the actual form with sample text added in each section.
You should make sure that your form relates to your circumstances. If you need more help to prepare your form, get
legal advice. Do not try to file this sample form.
This sample form is provided in Word
Sample Affidavit of Service (Form 41)
For more information on completing this form, see
Instructions for filling out the Affidavit of Service.