Summons and Complaint - Michigan

SUMMONS AND COMPLAINT
Case No.PROOF OF SERVICE
TO PROCESS SERVER: You are to serve the summons and complaint not later than 91 days from the date of filing or the date
of expiration on the order for second summons. You must make and file your return with the court clerk. If you are unable to complete
service you must return this original and all copies to the court clerk.
OFFICER CERTIFICATE AFFIDAVIT OF PROCESS SERVER
CERTIFICATE / AFFIDAVIT OF SERVICE / NONSERVICE
I certify that I am a sheriff, deputy sheriff, bailiff, appointed
court officer, or attorney for a party (MCR 2.104[A][2]), and
that: (notarization not required)
Being first duly sworn, I state that I am a legally competent
adult who is not a party or an officer of a corporate party, and
that: (notarization required)
I served personally a copy of the summons and complaint,
I served by registered or certified mail (copy of return receipt attached) a copy of the summons and complaint,
together with
on the defendant(s):
OR
List all documents served with the Summons and Complaint
Title
Signature
Service fee Miles traveled Mileage fee Total fee
$ $ $
I acknowledge that I have received service of the summons and complaint, together with
on
on behalf of .
Subscribed and sworn to before me on , County, Michigan.
My commission expires: Signature:
Notary public, State of Michigan, County of
Date
Date Deputy court clerk/Notary public
Day, date, time
Signature
ACKNOWLEDGMENT OF SERVICE
Attachments
I have personally attempted to serve the summons and complaint, together with any attachments, on the following defendant(s)
and have been unable to complete service.
Complete address(es) of service Day, date, time
Defendant's name
Complete address(es) of service Day, date, time
Defendant's name
Name (type or print)
I declare that the statements above are true to the best of my information, knowledge, and belief.
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