AFFIDAVIT OF SERVICE
(Commonwealth of Massachusetts)
[// GUIDANCE: This template is drafted for use in the Massachusetts Trial Court system (e.g., Superior Court, District Court, Housing Court, Probate & Family Court). Adapt the caption and references to fit the specific Department and Division in which the action is pending.]
DOCUMENT HEADER
Court Caption
Commonwealth of Massachusetts
Trial Court – [COURT DEPARTMENT]
[Court Division, if any]
Docket No.: [DOCKET NO.]
Case Title
[PLAINTIFF NAME]
v.
[DEFENDANT NAME]
Document Title
Affidavit of Service
Effective Date
[DATE OF EXECUTION]
TABLE OF CONTENTS
- Defined Terms
- Affiant Identification and Competency
- Service Details
- Manner of Service
- Compliance Statement
- Certification Under Oath
- Notary Acknowledgment
1. DEFINED TERMS
For purposes of this Affidavit of Service (the “Affidavit”), the following capitalized terms have the meanings set forth below:
1.1 “Action” means the civil action identified in the above caption.
1.2 “Documents” means the pleadings, summons, subpoenas, notices, motions, or other legal papers delivered as part of the service effectuated herein, specifically:
a. [DOCUMENT #1 (e.g., Complaint)]
b. [DOCUMENT #2 (e.g., Summons)]
c. [ADDITIONAL DOCUMENTS, if any]
1.3 “Service Date” means the calendar date on which the Documents were delivered or otherwise deemed served pursuant to Mass. R. Civ. P. 4.
1.4 “Subject Individual/Entity” means the person or entity upon whom service was made, identified in Section 3 below.
[// GUIDANCE: Add, remove, or revise defined terms to match the actual papers served.]
2. AFFIANT IDENTIFICATION AND COMPETENCY
I, [FULL LEGAL NAME OF PROCESS SERVER] (the “Affiant”), being duly sworn, depose and state as follows:
2.1 I am over the age of 18 and competent to testify to the matters set forth herein.
2.2 I am (check one)
□ a Massachusetts constable duly authorized to serve process within [COUNTY], Massachusetts.
□ a deputy sheriff for the County of [COUNTY], Massachusetts.
□ a disinterested individual who is not a party to the Action and is otherwise qualified under Mass. R. Civ. P. 4(d) to serve process.
2.3 My business address is: [AFFIANT ADDRESS, CITY/TOWN, STATE, ZIP].
2.4 My commission/badge number (if applicable) is: [NUMBER].
3. SERVICE DETAILS
3.1 Subject Individual/Entity Served: [NAME AND TITLE OR CAPACITY OF RECIPIENT; IF CORPORATION, INCLUDE “Registered Agent” OR OTHER CAPACITY].
3.2 Physical Address of Service:
Street: [ADDRESS]
City/Town: [CITY/TOWN]
State: Massachusetts
ZIP: [ZIP]
3.3 Date of Service: [MM/DD/YYYY]
3.4 Time of Service: [HH:MM A.M./P.M.]
4. MANNER OF SERVICE
Pursuant to Mass. R. Civ. P. 4(d)–(f), I effected service by the following method(s): (check all that apply)
□ Personal in-hand delivery to Subject Individual.
□ Substitute service by leaving a copy of the Documents at the Subject Individual’s last and usual place of abode with a person of suitable age and discretion, namely:
Name: [RESIDENT NAME]
Relationship: [RELATIONSHIP TO SUBJECT INDIVIDUAL]
□ Service upon corporation/partnership/association by delivering copies to:
Name: [REGISTERED AGENT/OFFICER]
Title: [TITLE]
□ Service by certified mail, return receipt requested, as authorized by [SPECIFY RULE/ORDER].
□ Other method authorized by the Court’s order dated [DATE] (attach copy of order).
[// GUIDANCE: Strike methods that do not apply. If multiple service attempts occurred, attach an addendum with each attempt’s date, time, and outcome.]
5. COMPLIANCE STATEMENT
5.1 The foregoing service was completed within the time limits prescribed by Mass. R. Civ. P. 4(j) (90-day service period) or as otherwise ordered by the Court.
5.2 I received no objection or refusal from the Subject Individual/Entity at the time of service.
5.3 The Documents served were exact duplicates of the originals filed or issued by the Court.
6. CERTIFICATION UNDER OATH
I declare under the pains and penalties of perjury, pursuant to Mass. R. Civ. P. 4(f) and G.L. c. 268, § 1A, that the foregoing facts are true and correct to the best of my knowledge, information, and belief.
Date: [DATE]
[AFFIANT NAME]
Process Server
7. NOTARY ACKNOWLEDGMENT
Commonwealth of Massachusetts
County of [COUNTY], ss.
On this ___ day of ____, 20__, before me, the undersigned notary public, personally appeared [AFFIANT NAME], proved to me through satisfactory evidence of identification, which was ☐ photographic identification with signature issued by a federal or state governmental agency ☐ [OTHER ID], to be the person whose name is signed on the preceding or attached document, and acknowledged to me that (he) (she) signed it voluntarily for its stated purpose.
Notary Public
My Commission Expires: ____
[// GUIDANCE:
1. Attach any required proof of mailing (e.g., USPS Form 3811) or additional service attempt logs.
2. After filing, retain a conformed copy for the Affiant’s records to establish compliance.
3. If service occurred outside Massachusetts or under special Court order, confirm any additional affidavit elements mandated by the governing rule or order.]