CERTIFICATE OF SERVICE

Caption Example

COMMONWEALTH OF MASSACHUSETTS
[COURT DEPARTMENT AND DIVISION]

[PLAINTIFF NAME],
Plaintiff,

v. Civil Action No. [CASE NUMBER]

[DEFENDANT NAME],
Defendant.

Statement of Service

Pursuant to Mass. R. Civ. P. 5, I certify that on [DATE OF SERVICE] the [TITLE OF DOCUMENT SERVED] was served upon the following:

• Recipient: [NAME]
• Capacity: [E.G., "Counsel for Defendant"]
• Service Address/Email: [CONTACT INFORMATION]
• Method(s) of Service:
• [ ] Electronic service via eFileMA (registered user)
• [ ] Electronic mail (consent obtained under Rule 5(b))
• [ ] Hand delivery / courier
• [ ] First-Class Mail, postage prepaid
• [ ] Certified Mail / Commercial carrier
• Time of Service: [TIME]

[Add additional entries as necessary.]

Additional Notes

• Mailing deposited at: [CITY, STATE].
• eFileMA transaction ID: [ID].
• If service required by Standing Order (e.g., Business Litigation Session) differs, describe compliance: [DETAILS OR "N/A"].

Declaration

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

Date: [DATE]

[NAME OF SERVING ATTORNEY OR PARTY]
[BBO NUMBER]
[FIRM NAME]
[ADDRESS]
[PHONE]
[EMAIL]
Attorney for [PARTY] / Pro Se [PARTY]

Practitioner Notes

• Confirm compliance with Trial Court Administrative Directive 17-2 (if applicable).
• Maintain proof of electronic service and mailings for appellate record assembly.
• If filing in Probate & Family Court, ensure additional service to interested nonparties is documented separately.