AFFIDAVIT OF SERVICE

[// GUIDANCE: This template is drafted for use in civil proceedings before Nebraska state courts. Adjust the caption to match the exact court, case number, and party names as they appear on the pleadings.]

IN THE _ COURT OF _ COUNTY, NEBRASKA
__________,
  Plaintiff,

v.                            Case No. ____

__________,
  Defendant.

I. DOCUMENT HEADER

1. Title. Affidavit of Service (“Affidavit”).
2. Affiant. [NAME OF SERVER] (“Affiant”), whose business address is [ADDRESS], and whose telephone number is [PHONE].
3. Effective Date. This Affidavit is executed on the ___ day of ____, 20__ (“Execution Date”).
4. Governing Law & Venue. All matters arising under or relating to this Affidavit shall be governed by the procedural laws of the State of Nebraska, with exclusive venue in the Nebraska state court identified in the caption.

II. DEFINITIONS

For purposes of this Affidavit, the following capitalized terms have the meanings set forth below:

“Affected Party” means any individual or entity to whom legal documents were delivered as described herein.
“Documents Served” means the pleadings, motions, notices, or other papers identified in Section III(1).
“Method of Service” means the manner in which service was effected (e.g., personal, residence, certified mail, designated delivery service, or substitute service).
“Service Address” means the physical location or mailing address at which service occurred.
“Service Date” means the calendar date on which the Affected Party was served with the Documents Served.
“Substitute Service” means leaving the Documents Served with a person of suitable age and discretion residing at the Affected Party’s usual place of residence or as otherwise permitted by Nebraska law.

III. OPERATIVE PROVISIONS

1. Description of Documents Served. Affiant states that on the Service Date identified below, Affiant served the following papers (“Documents Served”):
     a. [Summons];
     b. [Complaint/Petition];
     c. [Other: _____]
    [// GUIDANCE: List every document exactly as titled in the court file.]

2. Service Details. 
    a. Service Date: ___ / ___ / 20__ (MM/DD/YYYY)
    b. Service Time: _____ ☐ a.m.  ☐ p.m.
    c. Method of Service (check all that apply):
     ☐ Personal service on Affected Party.
     ☐ Residence service at Affected Party’s usual place of abode.
     ☐ Substitute Service on [NAME & RELATIONSHIP], a person of suitable age and discretion residing with the Affected Party.
     ☐ Certified mail, return-receipt requested, postage prepaid.
     ☐ Designated delivery service with signature confirmation.
    d. Service Address: [STREET], [CITY], NE [ZIP].
    e. Authorized Capacity. Affiant is:
     ☐ A county sheriff/deputy sheriff.
     ☐ A person specially appointed by the court to make service.
     ☐ A private process server duly certified/registered where required.

3. Timing Compliance. Service was completed within the time limits prescribed by Nebraska law and any court orders in this matter.

4. Additional Acts. (If applicable) Affiant performed the following additional acts to complete service: [e.g., multiple attempts; diligent inquiry; posting; etc.].

IV. REPRESENTATIONS & WARRANTIES

1. Capacity. Affiant is at least 21 years of age, competent to testify, and authorized to effect service of process under Nebraska law.
2. Truthfulness. All statements contained in this Affidavit are true and correct to the best of Affiant’s personal knowledge.
3. Compliance. Affiant effected service strictly in accordance with Nebraska statutes, court rules, and any specific orders of the above-captioned court.
4. Document Preservation. Affiant retains original proof of delivery (e.g., signed return card, delivery service tracking record) and will produce it upon request.

V. COVENANTS & RESTRICTIONS

1. Future Cooperation. Affiant shall, upon reasonable notice, appear in court or provide supplementary affidavits or testimony to validate the service described herein.
2. No Unauthorized Disclosure. Affiant shall not disclose non-public personal information obtained during service except as required by law or court order.

VI. DEFAULT & REMEDIES

1. Perjury Acknowledgment. Affiant acknowledges that any willful false statement contained in this Affidavit is subject to the penalties of perjury under Nebraska law.
2. Court-Ordered Remedies. If service is deemed defective due to Affiant’s failure to comply with applicable rules, the court may order re-service at Affiant’s expense and may impose any other sanction it deems just.

VII. RISK ALLOCATION

[Reserved – Not applicable to an Affidavit of Service.]

VIII. DISPUTE RESOLUTION

Any challenge regarding the sufficiency of service described in this Affidavit shall be heard exclusively by the Nebraska state court identified in the caption, applying Nebraska procedural law.

IX. GENERAL PROVISIONS

1. Severability. If any provision of this Affidavit is held invalid or unenforceable, the remaining provisions shall remain in full force and effect.
2. Counterparts & Electronic Signatures. This Affidavit may be executed in counterparts, each of which is deemed an original. Signatures transmitted electronically (e.g., PDF, facsimile) are deemed valid and binding.

X. EXECUTION BLOCK

I, [AFFIANT NAME], solemnly swear or affirm under penalty of perjury that the foregoing statements are true and correct.

NOTARY ACKNOWLEDGMENT

State of Nebraska )
: ss.
County of ____ )

On this ___ day of ____, 20__, before me, the undersigned Notary Public, personally appeared [AFFIANT NAME], known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing Affidavit of Service, and acknowledged that he/she executed the same for the purposes therein contained.

IN WITNESS WHEREOF, I hereunto set my hand and official seal.

Notary Public

My commission expires: ________

[// GUIDANCE: Nebraska law requires a jurat (the affiant swears to the truth of the contents) and a standard notary acknowledgment. Attach any physical proof of service (e.g., signed return receipt) as an exhibit and reference it in Section III(1). If using substitute service, ensure the substituted individual’s name, age, and relationship are recorded, and confirm that no reasonable effort could locate the defendant for personal service.]