CERTIFICATE OF SERVICE

Caption Example

IN THE DISTRICT COURT OF [COUNTY] COUNTY, KANSAS
[CIVIL/PROBATE/DIVISION]

[PLAINTIFF NAME],
Plaintiff,

v. Case No. [CASE NUMBER]

[DEFENDANT NAME],
Defendant.

Statement of Service

Pursuant to K.S.A. 60-205 and Kansas Supreme Court Rule 122, I certify that on [DATE OF SERVICE] the [TITLE OF DOCUMENT SERVED] was served upon the following:

• Recipient: [NAME]
• Capacity: [E.G., "Attorney for Defendant"]
• Service Address/Email: [CONTACT INFORMATION]
• Method(s) of Service:
• [ ] Electronic service via Kansas eFlex (registered user)
• [ ] Electronic mail (consent under Supreme Court Rule 111)
• [ ] Hand delivery
• [ ] U.S. Mail, postage prepaid
• [ ] Certified Mail / Commercial carrier
• Time of Service: [TIME]

[Repeat for each additional recipient.]

Additional Notes

• Mailing deposited at: [CITY, STATE].
• eFlex submission ID/transaction number: [ID].
• If a party is exempt from e-filing, describe alternative service authorized by administrative order: [DETAILS OR "N/A"].

Declaration

I declare under penalty of perjury that the foregoing is true and correct.

Executed on [DATE] at [CITY], Kansas.

[NAME OF SERVING ATTORNEY OR PARTY]
[KANSAS SUPREME COURT NO.]
[FIRM NAME]
[ADDRESS]
[PHONE]
[EMAIL]
Attorney for [PARTY] / Pro Se [PARTY]

Practitioner Notes

• Confirm compliance with privacy rules (Kansas Supreme Court Rule 123) for personal identifiers.
• Retain service confirmations for at least the duration of the case.
• Some divisions require additional distribution lists (e.g., case managers); include as necessary.