Affidavit Service LT

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FORM 3

SUPERIOR COURT OF THE DISTRICT OF COLUMBIA


CIVIL DIVISION, LANDLORD AND TENANT BRANCH
BLDG. B, 510 4th Street N.W., Room 110
Washington, D.C. 20001 Telephone (202) 879-4879

_______ LTB_______________________
Date of Initial Hearing__________

___________________________________ ___________________________________
Plaintiff/Landlord Defendant/Tenant
___________________________________ vs. ___________________________________
Address Address
__________________________________ ___________________________________

AFFIDAVIT OF SERVICE

I, ______________________, age ____, residing at ______________________________________and not a party to this case, depose
and say that on _________, 20___, at ______AM/PM, I served a copy of the complaint and summons as follows:

‰ On the Defendant/Tenant____________________________ personally.

‰ By leaving said copy with ___________________________, a person of suitable discretion above the age of sixteen (16) years,
residing who resides on or at Defendant/Tenant’s address given above, the Defendant/Tenant having left the District of Columbia or
not to be found.

‰ Having at least twice attempted with due diligence and failed to effect service upon the Defendant/Tenant personally or upon a
person of suitable discretion above the age of sixteen (16) years residing on or at the Defendant/Tenant’s address given above by
posting said copy on the door of the premises where it could be conveniently read. The date and time of all attempts at personal service
were as follows:

First attempt: Date/Time __________, 20___, at _________ AM/PM


Second attempt: Date/Time ________, 20___, at______AM/PM
Other attempts (if applicable) ______________________________________________________________________________

In addition to the service noted above, I mailed a copy of the Complaint and Summons to the Defendant/Tenant at the following
address: ____________________________________________ by first class U.S. mail, postage prepaid on _______, 20___.

‰ (For a corporation or limited liability company) I served _________________________, an officer, managing agent or general agent,
or ____________________, a registered agent.

‰ You must set forth specific facts from which the Court can determine that process was served as indicated above and in compliance
with D.C. Code Section 16-1502 and SCR L&T 4, including a physical description of any person on whom service was made and, if
service was by posting at the Defendant/Tenant’s address, a description of the door, including its location, color and any distinguishing
marks: ______________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________

_____________________________________
Special Process Server

Subscribe and sworn to before me this ______day of ____________, 20_____.

_____________________________________ ____________________________________
Notary Public My commission expires

NOTE: A separate Affidavit is required for service on each named Defendant/Tenant.


Form CV-2070/Dec. 2016

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