AFFIDAVIT OF SERVICE

(Indiana – Trial Rules 4 & 4.16–Compliant)

TABLE OF CONTENTS

1. Document Header
2. Definitions
3. Operative Provisions
4. Representations & Warranties
5. Covenants & Restrictions
6. Default & Remedies
7. General Provisions
8. Execution Block

1. DOCUMENT HEADER

STATE OF INDIANA )
) SS:
COUNTY OF [COUNTY] )

IN THE [COURT LEVEL] COURT OF [COUNTY] COUNTY
Cause No.: [CAUSE NUMBER]

[PLAINTIFF], Plaintiff,
v.
[DEFENDANT], Defendant.

1.1 Title

AFFIDAVIT OF SERVICE

1.2 Recitals

A. This Affidavit of Service (“Affidavit”) is executed on [EFFECTIVE DATE] pursuant to the Indiana Rules of Trial Procedure, including but not limited to Ind. R. Trial P. 4.1 and 4.16.
B. Affiant has personal knowledge of all facts stated herein and is competent to testify thereto.
C. This Affidavit is tendered as proof of lawful service of the below-described documents in the above-captioned matter.

2. DEFINITIONS

For purposes of this Affidavit:

“Affiant” – The individual executing this Affidavit of Service.
“Service Documents” – The pleadings, summons, notices, or other legal papers served, identified in § 3.2.
“Recipient” – The person(s) or entity(ies) upon whom the Service Documents were served.
“Service Method” – The manner of service utilized, as authorized by Ind. R. Trial P. 4.1 (e.g., Personal, Certified Mail, Sheriff, or Substitute Service).
“Service Date” – The calendar date on which service was effected.
“Substitute Service” – Service accomplished by leaving a copy of the Service Documents at the Recipient’s dwelling or usual place of abode with a person of suitable age and discretion, or upon an authorized agent, as permitted under Ind. R. Trial P. 4.1(A)(3)-(4).

3. OPERATIVE PROVISIONS

3.1 Affiant Identity & Competency

1. My name is [AFFIANT NAME]; I am over 18 years of age and not a party to this action.
2. My business/residential address is [AFFIANT ADDRESS]; my telephone number is [PHONE].

3.2 Service Documents

I served the following document(s) (collectively, the “Service Documents”):
• [DOCUMENT TITLE 1]
• [DOCUMENT TITLE 2]
• [ADD ADDITIONAL AS NEEDED]

3.3 Recipient Information

Service was made upon:
Recipient Name: [RECIPIENT FULL NAME]
Capacity/Title (if any): [CAPACITY]
Residence/Business Address: [ADDRESS]

3.4 Service Method & Details

Service Method (check one):
☐ Personal service (Ind. R. Trial P. 4.1(A)(2))
☐ Certified mail, return receipt requested (Ind. R. Trial P. 4.1(A)(1))
☐ Sheriff or deputy (Ind. R. Trial P. 4.1(A)(2))
☐ Substitute service at dwelling with person of suitable age (Ind. R. Trial P. 4.1(A)(3))
☐ Service on authorized agent (Ind. R. Trial P. 4.1(A)(4))
☐ Other: [DESCRIBE]

Service Date: [SERVICE DATE]
Service Time: [HH:MM A.M./P.M.]

[// GUIDANCE: Delete all methods not used; retain the citation for the method actually employed.]

3.5 Timing Compliance

Service was effected within the time period prescribed by:
☐ Court order dated [DATE]
☐ Indiana Trial Rule 4(C) (90-day service requirement)
☐ Other applicable rule or statute: [DESCRIBE]

3.6 Substitute Service Due Diligence (complete only if substitute service box checked)

1. I made the following diligent efforts to accomplish personal service prior to substitute service:
   • Attempt 1 – Date/Time: [DATE/TIME]; Result: [RESULT]
   • Attempt 2 – Date/Time: [DATE/TIME]; Result: [RESULT]
2. Based on the foregoing, I believe further personal attempts would have been futile or unduly burdensome.

4. REPRESENTATIONS & WARRANTIES

1. Affiant conducted service in strict compliance with the Indiana Rules of Trial Procedure and any applicable court orders.
2. All statements herein are true, correct, and complete to the best of my knowledge, information, and belief.
3. Affiant is not a party to, nor interested in, the outcome of the above-captioned proceeding.
4. Return receipts, signed delivery logs, or other contemporaneous proofs of service (if applicable) are attached hereto as Exhibit A.

5. COVENANTS & RESTRICTIONS

1. Affiant will immediately notify the Court and all parties if any information contained herein is discovered to be inaccurate or incomplete.
2. Affiant agrees to appear for deposition or hearing testimony concerning this Affidavit upon reasonable notice.

6. DEFAULT & REMEDIES

1. Knowingly filing a false affidavit constitutes perjury under Indiana law and may subject Affiant to criminal penalties, contempt sanctions, and civil liability.
2. Should any material statement herein be proven false, the served party may move to quash service, and the Court may impose any other remedy available at law or in equity.

7. GENERAL PROVISIONS

1. Integration. This Affidavit constitutes the entire proof of service statement relating to the Service Documents and supersedes any prior oral or written statements by Affiant concerning service.
2. Severability. If any provision of this Affidavit is held invalid, the remaining provisions shall remain in full force and effect to the maximum extent permitted by law.
3. Governing Law. This Affidavit is governed by the procedural laws of the State of Indiana.

8. EXECUTION BLOCK

I affirm, under the penalties of perjury, that the foregoing representations are true.

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Date: ____ \
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Signature: ____
Printed Name: _____

NOTARY ACKNOWLEDGMENT

State of Indiana )
) SS:
County of __ )

Subscribed and sworn to before me, a Notary Public in and for said County and State, this ___ day of _, 20.

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Notary Public Signature: _____
Printed Name: ____
My commission expires: ___
County of residence: _________

[// GUIDANCE: Attach delivery receipts, postal records, or sheriff’s return as Exhibit A. If multiple Recipients were served, duplicate Sections 3.3–3.6 for each. Retain this executed Affidavit for filing with the Clerk and provide copies to all counsel of record.]