AFFIDAVIT OF SERVICE

(SUPERIOR COURT OF WASHINGTON – [COUNTY] COUNTY)

COURT CAPTION

TABLE OF CONTENTS

1. Document Header ……………………………………………………………….. 1
2. Definitions ………………………………………………………………………….. 2
3. Operative Provisions (Statement of Service) ……………………………….. 3
4. Representations & Warranties ………………………………………………… 4
5. Covenants & Restrictions (Reserved) ………………………………………… 5
6. Default & Remedies (Reserved) ……………………………………………… 5
7. Risk Allocation (Reserved) …………………………………………………… 5
8. Dispute Resolution ……………………………………………………………… 5
9. General Provisions ……………………………………………………………… 6
10. Execution Block ………………………………………………………………… 7

I. DOCUMENT HEADER

1.1 Declarant. I, [NAME OF SERVER] (“Declarant”), declare under penalty of perjury that the following is true and correct.
1.2 Effective Date. This Affidavit of Service (“Affidavit”) is made effective as of [DATE] in the State of Washington.
1.3 Jurisdiction. This Affidavit is made pursuant to and in compliance with Washington Superior Court Civil Rules (“CR”) 4 and 5, and Revised Code of Washington (“RCW”) 4.28.080 & 9A.72.085.

II. DEFINITIONS

For purposes of this Affidavit, the following terms have the meanings set forth below. Capitalized terms not defined herein shall have the meanings assigned by applicable Washington law.

“Action” – The above-captioned civil proceeding pending in the Superior Court of Washington for [COUNTY] County, Case No. [CASE NUMBER].

“Documents” – Collectively, the papers served by Declarant in this Action, specifically identified in Section 3.2.1.

“Recipient” – The individual or entity upon whom service was effected, identified in Section 3.2.5.

“Service Address” – The physical address at which service occurred, identified in Section 3.2.3.

“Service Date” – The calendar date on which the Documents were delivered to the Recipient, identified in Section 3.2.2.

“Service Method” – The legally authorized means by which the Documents were delivered (e.g., personal delivery, substitute/abode service, certified mail), identified in Section 3.2.4 and compliant with CR 4(d) or CR 5(b).

“Substitute Service” – A form of service authorized under RCW 4.28.080 and CR 4(d)(2) that allows delivery to a person of suitable age and discretion at the Recipient’s usual abode when personal service is not reasonably practicable.

III. OPERATIVE PROVISIONS (STATEMENT OF SERVICE)

3.1 Personal Knowledge
Declarant is over the age of eighteen (18), competent to testify, and not a party to the Action. Declarant makes this Affidavit based on personal knowledge acquired while effecting service of process.

3.2 Service Details
3.2.1 Documents Served
• [Describe each document served, e.g., “Summons,” “Complaint,” “Notice of Hearing,” etc.]

3.2.2 Service Date & Time
• Date: [MM/DD/YYYY]
• Time: [HH:MM A.M./P.M.]

3.2.3 Service Address
• [STREET ADDRESS, CITY, STATE, ZIP]

3.2.4 Service Method
☐ Personal delivery to the Recipient pursuant to CR 4(d)(2).
☐ Substitute service at Recipient’s usual abode pursuant to CR 4(d)(2) & RCW 4.28.080(16).
☐ Certified mail, return-receipt requested, pursuant to CR 5(b)(2)(B).
☐ First-class mail pursuant to CR 5(b)(2)(A).
☐ Other: [DESCRIBE] (must comply with WA law).

3.2.5 Recipient Information
• Full Name: [RECIPIENT NAME]
• Relationship to Party (if substitute service): [e.g., Spouse/Sibling/Co-resident of suitable age & discretion]

3.3 Compliance Statement
Service was effected in strict accordance with Washington CR 4 or CR 5, as applicable, and the timing requirements therein. No service occurred on a legal holiday, weekend, or outside the hours permitted by RCW and local court rules.

3.4 Attempts at Personal Service (if applicable)
Declarant made [NUMBER] diligent attempts at personal service on the following dates and times before effectuating substitute service or service by mail:
• Attempt 1 – [DATE @ TIME]
• Attempt 2 – [DATE @ TIME]
• Attempt 3 – [DATE @ TIME]

3.5 Fees & Mileage (Optional)
Declarant’s statutory or agreed-upon service fee is $[AMOUNT], plus mileage of [NUMBER] miles at the rate authorized under RCW 36.18.040.

3.6 Attachments
• Signed return-receipt (if service by certified mail).
• Photographic evidence or GPS log (if maintained).
• Additional affidavit pages (if multiple Recipients).

IV. REPRESENTATIONS & WARRANTIES

4.1 Accuracy. Declarant represents and warrants that all statements herein are true, correct, and complete to the best of Declarant’s knowledge, information, and belief.
4.2 Non-Party Status. Declarant is not a party to the Action, not an officer, director, or employee of a party, and has no interest in its outcome.
4.3 Survival. The representations and warranties herein shall survive filing of this Affidavit and may be used in any proceeding related to proof of service.

V. COVENANTS & RESTRICTIONS (RESERVED)

VI. DEFAULT & REMEDIES (RESERVED)

VII. RISK ALLOCATION (RESERVED)

VIII. DISPUTE RESOLUTION

8.1 Governing Law. This Affidavit shall be governed by and construed in accordance with the procedural and substantive laws of the State of Washington.
8.2 Forum Selection. Any dispute concerning the validity, sufficiency, or admissibility of this Affidavit shall be determined exclusively by the Superior Court of Washington for [COUNTY] County.
8.3 Arbitration; Jury Waiver; Injunctive Relief. Not applicable to this Affidavit.

IX. GENERAL PROVISIONS

9.1 Amendments. Any amendment to this Affidavit must be set forth in a supplemental sworn statement referencing this Affidavit and filed with the Court.
9.2 Severability. If any provision of this Affidavit is held invalid, the remaining provisions shall continue in full force and effect to the maximum extent permitted by law.
9.3 Integration. This Affidavit constitutes the entire statement of service for the Documents and supersedes any prior oral or written statements relating thereto.
9.4 Counterparts & Electronic Signatures. This Affidavit may be executed in counterparts, each of which is deemed an original. Signatures transmitted by electronic means (e.g., PDF, facsimile) are deemed original signatures for all purposes.

X. EXECUTION BLOCK

10.1 UNSWORN STATEMENT UNDER RCW 9A.72.085

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

Executed on [DATE], at [CITY], Washington.

_____________________________________
[NAME OF SERVER], Declarant

10.2 NOTARIZED AFFIDAVIT (ALTERNATIVE)

State of Washington )
) ss.
County of [COUNTY] )

On this [DATE], before me, the undersigned Notary Public, personally appeared [NAME OF SERVER], known to me or proven on the basis of satisfactory evidence to be the individual whose name is subscribed to the within Affidavit, and acknowledged to me that s/he executed the same for the purposes therein stated.

_____________________________________
Notary Public in and for the State of Washington
My commission expires: ____________