[Firm Name]

[Firm Address]

[Firm Phone Number]

[Firm Fax]

[Firm Email]

[Attorney Name and Bar Number]

Attorney for Plaintiff(s)


[State Trial Court System], [Location] County


[Plaintiff Name(s)],










Case No.




Assigned to the Hon. [Judge]




[Affiant], being duly sworn, upon oath, deposes and says as follows:

  1. I am the attorney for plaintiff [Plaintiff] in this action. I submit this Affidavit to demonstrate the circumstances warranting the utilization of service of process under [local civil rule] and to establish the completion of such service.
  2. Defendant [Defendant] is an individual who is known to reside within the State of [name of state] at [address of defendant].
  3. As is evidenced by the Affidavit of Service of Process by Private Person annexed hereto, however, repeated and diligent attempts to secure service of process upon defendant [name of defendant] at that address have been unsuccessful. [Detailed description of efforts made to locate and serve defendant].
  4. Based on repeated, diligent, but unsuccessful efforts to find and serve defendant, it appears that defendant [Defendant] is attempting to avoid service of process, thereby rendering service by means of publication appropriate under the provisions of [local civil rule].
  5. In accordance with the provisions of [local civil rule], on [date of mailing], I caused a Summons and a copy of the Complaint in this action to be deposited in the United States mails, first class postage prepaid, properly addressed to the defendant [name of defendant] at the address specified above.
  6. Thereafter, I caused a Summons and a statement as to the method by which a copy of the Complaint could be obtained, to be published in [name of publication]. This newspaper is regularly published and circulated in the County where this action is pending.
  7. I caused the information described herein to be first published on [date of first publication] and published thereafter on the following dates [dates of additional publication], which is at least once a week for four successive weeks.
  8. Service was complete on [date of competed service], which is [number of days outlined by local civil rule] days after the first publication.
  9. A true copy of the Summons, and of the statement as to the manner in which a copy of the Complaint could be obtained, as printed and published, is attached to this Affidavit as Exhibit 1.


Dated this [Day] of [Month], [Year].



[Name of Plaintiff’s Attorney]

[Firm Name]

[Firm Address]

Attorney for Plaintiff