North Carolina Affidavit of Service

Introduction

I, [YOUR NAME], being duly sworn, depose and state as follows:

Statement of Facts

1. I am over the age of eighteen (18) years and not a party to the action entitled [CASE NAME], do hereby certify under penalty of perjury that on [SERVICE DATE], I served the following documents:

   • Summons

   • Complaint

2. The manner of service was as follows:

   • On the aforementioned date, I personally served the documents to the defendant, [DEFENDANT'S NAME], at [PRONOUN] residence located at [DEFENDANT'S ADDRESS]. I approached the address and confirmed the identity of the individual as [DEFENDANT'S NAME] based on [PRONOUN] driver's license, which was provided upon request.

3. The identity of the individual served, if applicable, is as follows:

   • Name: [DEFENDANT'S NAME]

   • Date of Birth: [DEFENDANT'S BIRTH DATE]

4. The time and date of service were as follows:

   • Date: [SERVICE DATE]

   • Time: [SERVICE TIME]

Oath or Affirmation

I, [YOUR NAME], hereby affirm and attest under oath that all statements made herein are true and accurate to the best of my knowledge and belief. I understand that any false statements may be punished by fine, imprisonment, or both under North Carolina law.

Signatures

[YOUR NAME]

Sworn to and subscribed before me on this [DATE].

[NOTARY PUBLIC'S NAME]

Notary Public, State of North Carolina

[NOTARY COMMISSION EXPIRY DATE]

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