CERTIFICATE OF SERVICE

Caption Example

STATE OF VERMONT
SUPERIOR COURT
[DIVISION] DIVISION
[COUNTY] UNIT

[PLAINTIFF NAME],
Plaintiff,

v. Docket No. [DOCKET NUMBER]

[DEFENDANT NAME],
Defendant.

Service Statement

Pursuant to V.R.C.P. 5, I certify that on [DATE OF SERVICE] I served the [TITLE OF DOCUMENT SERVED] on the following:

• Recipient: [NAME]
• Capacity: [E.G., "Attorney for Defendant"]
• Service Address/Email: [CONTACT INFORMATION]
• Method(s):
• [ ] Electronic service via Odyssey File & Serve (registered user)
• [ ] Electronic mail (consent per V.R.C.P. 5(b)(2))
• [ ] Hand delivery / courier
• [ ] First-Class Mail, postage prepaid
• [ ] Certified Mail / Commercial carrier
• Time of Service: [TIME]

[Repeat bullet list for additional recipients.]

Additional Notes

• Mailing deposited at: [CITY, STATE].
• Odyssey filing transaction/reference number: [ID].
• If alternative service authorized under V.R.C.P. 4(d), 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]
[VERMONT BAR NUMBER]
[FIRM NAME]
[ADDRESS]
[PHONE]
[EMAIL]
Attorney for [PARTY] / Self-Represented [PARTY]

Practitioner Notes

• Retain proof of service for inclusion in any motion or appellate record.
• Ensure compliance with V.R.P.A. 7 regarding redaction of personal identifiers.
• Some divisions require courtesy copies to judges or hearing officers; document such deliveries if made.