NYC Courts | Housing Forms – CIV-RC-95

CIV-RC-95 – Affirmation of Service (Other than Personal Delivery) – New York

The “CIV-RC-95 – Affirmation of Service (Other than Personal Delivery)” form is a legal document used in the state of New York to affirm that a specific legal document has been served to a party by means other than personal delivery. This affirmation is made under the penalties of perjury, meaning that the person affirming the service is swearing that the information provided is true to the best of their knowledge. The form is typically filed in a court of law as part of the legal process.

Instructions for Completing the Form

• Date of Affirmation

1. • Fill in the day (____) and month (__________________) of the affirmation.
   • Fill in the year (20____).

• Affirmation Statement

1. • The person affirming must state that the information provided is true under the penalties of perjury.

• Personal Information

1. • Print your full name on the line labeled “Printed Name: _________________________”.
   • Sign your name on the line labeled “Signature: _______________________________”.

• Affirmation Text

1. • The person affirming will state their name and affirm, depose, and say the details of the service.

• Penalties of Perjury

1. • Understand that by signing this document, you are declaring under the penalties of perjury that the information provided is true. The penalties for perjury under New York law can include fines or imprisonment.

Additional Notes

• Ensure all information is accurate and truthful before signing.
• This form is typically used in legal proceedings, so it is important to retain a copy for your records.
• If you have any doubts or require assistance in completing this form, it is advisable to seek legal counsel.

This guide provides an overview of how to complete the Affirmation of Service form correctly. Please refer to specific court instructions or legal advice if needed.