Form 9-221A. Party's certificate of service.

[For use by parties in the Magistrate and Municipal Courts] CERTIFICATE OF SERVICE I hereby certify that on this __________ day of ______________, __________ this notice was [mailed by United States first class mail and addressed to] Name: ________________________________________________________________ Address: ___________________________________________________________ City, State and zip code: __________________________________________________________ [faxed by ______________________________________ (name of person who faxed document) to ________________________ (name of recipient). The transmission was reported as complete and without error. The time and date of the transmission was ____________ [a.m.] [p.m.] on ______________ (date).] [e-mailed to ________________________ (name of party or attorney) who has agreed to receive e-mail at ________________________ (electronic mail address of recipient) which is on file with the clerk of the Supreme Court for service by electronic mail. The transmission was successful. The time and date of the transmission was ____________ [a.m.] [p.m.] on ______________ (date).] [delivered to ________________________. (Specify how service by delivery was made. See Use Note for the methods service may be made using this alternative.) __________________________________] _______________________________ Signature of attorney _______________________________ Date of signature If this notice was served by a person other than an attorney, the following must also be completed and filed with the court: AFFIDAVIT OF SERVICE I declare under penalty of perjury that a copy of this paper was served by [mail] [fax] [electronic transmission] as described above on this __________ day of ______________, __________. ________________________________ Signature of person who made service Subscribed and sworn to before me this __________ day of ______________, __________. ______________________________ Judge, notary or other officer authorized to administer oaths ______________________________ Official title