I hereby certify that I have served the within summons:
(1) By delivering on the ______ day of ____________, 20__ the summons and a copy of the petition to each of the within-named defendants
(2) By leaving on the ______ day of ____________, 20__ for each of the within-named defendants
a copy of the summons and a copy of the petition at the respective dwelling place or usual place of abode of such defendants with some person of suitable age and discretion residing therein.
(3) By delivering on the ______ day of ____________, 20__, a copy of the summons and a copy of the petition to each of the following agents authorized by appointment or by law to receive service of process __________.
(4) By leaving a copy of the summons and a copy of the petition at the dwelling house or usual place of abode and mailing by first-class mail to each of the following defendants a notice that such copy has been so left _________ on the ______ day of ____________, 20__.
______________________________
Special Process Server
Subscribed and sworn to before me this ___ day of ______________, 20__.
My appointment expires ______________________