Federal Courts Rules

I, (full name and occupation of deponent), of the (City, Town, etc.) of (name) in the (County, Regional Municipality, etc.) of (name), SWEAR (or AFFIRM) THAT:

(for personal service on an individual, corporation, etc.)

• 1 On (date), at (time), I served (identify person served) with (identify the document served) leaving a copy with that person at (address where service was made).

  (Where the Federal Courts Rules provide for personal service on a corporation, etc.,

  by leaving a copy of the document with another person, substitute:)

  by leaving a copy with (identify and give the position or function of the person served) at (address where service was made).

• 2 I was able to identify the person by means of (state the means by which the person’s identity was ascertained).

(for personal service by leaving a copy with an adult person in the same household)

• 1 I served (identify person served) with (identify the document served) leaving a copy on (date), at (time) with a person (insert name if known) who appeared to be an adult member of the same household in which (identify person served) is residing at (address where service was made), and by sending a copy by regular mail (or registered mail) on (date) to (identify person served) at the same address.

• 2 I ascertained that the person was an adult member of the household by means of (State how it was ascertained that the person was an adult member of the household.).

(for personal service by mail)

• 1 On (date), at (time), I sent to (identify person served) by registered/ordinary mail a copy of (identify the document served).

• 2 On (date), I received the attached acknowledgement of receipt card/post office receipt bearing a signature that purports to be the signature of (identify person).

(for service by mail on solicitor)

I served (identify party served) with (identify document served) by sending a copy by registered/ordinary mail on (date) to (name of solicitor), solicitor for the (identify party).

(for non-personal service by fax on a solicitor)

I served (identify party served) with (identify document served) by sending a copy by fax on (date) to (name of solicitor), solicitor for the (identify party), at (fax number).

(for non-personal service by courier)

• 1 I served (identify party served) with (identify document served) by sending a copy by (name of courier), a courier to (name of solicitor), solicitor for the (identify party), at (full address of place for delivery).

• 2 The copy was given to the courier on (date).

(for non-personal service on party acting in person)

• 1 I served (identify party served) with (identify document served) by sending a copy by registered/ordinary mail/fax/courier on (date) to (full mailing address/fax number), the last address for service provided by (identify party)(or, where no such address has been provided:) the last known address of (identify party).

• 2 The copy was given to the courier on (date).

Sworn (or Affirmed) before me at the (City, Town, etc.) of (name) in the (County, Regional Municipality, etc.) of (name) on (date).
Commissioner for Taking Affidavits (or as the case may be)	(Signature of Deponent)