CERTIFICATE OF SERVICE

Caption Example

STATE OF RHODE ISLAND
[COURT NAME]
[COUNTY] COUNTY

[PLAINTIFF NAME],
Plaintiff,

v. C.A. No. [CASE NUMBER]

[DEFENDANT NAME],
Defendant.

Service Statement

Pursuant to Super. R. Civ. P. 5, I certify that on [DATE OF SERVICE] I served the [TITLE OF DOCUMENT SERVED] upon the following person(s):

• Recipient: [NAME]
• Capacity: [E.G., "Attorney for Defendant"]
• Service Address/Email: [CONTACT INFORMATION]
• Method(s):
• [ ] Electronic service via Rhode Island Judiciary File & Serve (registered user)
• [ ] Electronic mail (written consent)
• [ ] Hand delivery
• [ ] First-Class Mail, postage prepaid
• [ ] Certified Mail / Commercial courier
• Time of Service: [TIME]

[Repeat bullet list for each additional recipient.]

Additional Notes

• Mailing deposited at: [CITY, STATE].
• File & Serve transaction/reference number: [ID].
• If court ordered alternative service (Rule 4), describe compliance: [DETAILS OR "N/A"].

Declaration

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

Date: [DATE]

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

Practitioner Notes

• Retain File & Serve confirmation emails for the case record.
• Verify compliance with Article X of the Supreme Court Rules regarding confidentiality of personal data.
• Some dockets require additional service on clerks or special masters—consult local administrative orders.