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James W. Muller Sheriff

David Allison

Chief Deputy

SHERIFF'S OFFICE OF ADAMS COUNTY

Bernard A. Yannetti Solicitor

Kevin E. Miller Lieutenant

Plaintiff _____

Plaintiff

Docket Number

Defendant _____ Docket Date _____

Defendant

Docket Date

Type of Writ ___

Type of Writ

Note: We require the plaintiff or designee to complete a copy of this form for each defendant. One copy of the documentation per defendant to be served is sufficient. We do not need separate copies for each address.

TO THE SHERIFF OF ADAMS COUNTY, PENNSYLVANIA, YOU ARE HEREBY

REQUEST SERVICE OF DOCUMENTS UPON THE FOLLOWING:

Name: ___

Name:

Mobile: _____

Mobile:

Primary Address: ___

Primary Address:

Phone: ___

Phone:

Alternate Address: ___

Alternate Address:

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Phone: ___ Service will be attempted according to Pa Title 231: Rule 402. Manner of Service. Acceptance of Service.

Phone:

Service will be attempted according to Pa Title 231: Rule 402. Manner of Service. Acceptance of Service.

Original process may be served

by handing a copy to the defendant; or

by handing a copy

at the residence of the defendant to an adult member of the family with whom he resides; but if no adult member of the family is found, then an adult person in charge of such residence; or

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at the residence of the defendant the clerk or manager of the hotel, inn, apartment house, boarding house or other place of lodging at which he resides; or

at any office or usual place of business of the defendant to his agent or to the person for the time being in charge thereof.

In lieu of service under this rule, the defendant or his authorized agent may accept service...

(b) In lieu of service under this rule, the defendant or his authorized agent may accept service...

Special Instructions/Additional Information:

_____

Attorney/Originator:

Address: ___

Address:

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Phone: _____

Phone:

<table><tr><td>Sheriff's Office Use Only:</td></tr></table>

Sheriff's Office Use Only:

Now, this day of 20

Now, this

day of

I, James W. Muller, Sheriff of Adams County Pennsylvania do hereby deputize the Sheriff of County

deputize the Sheriff of

to execute service of the document herewith and make return thereof according to law.

Law Firm ___

Law Firm

Sign

Sheriff's Office Use Only:

James W. Muller, Sheriff

Please provide a self-addressed, stamped envelope for return of service

NOTE: ONLY APPLICABLE ON WRIT OF EXECUTION: N.B WAIVER OF WATCHMAN - Any deputy sheriff levying upon or attaching any property under within writ may leave same without a watchman, in custody of whomever is found in possession, after notifying person of levy or attachment, without liability on the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction, or removal of any property before sheriff's sale thereof.

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Instructions for completing the Request for Service Form

Note: A separate form will be required for each defendant, even if they reside at the same address.

Plaintiff: Fill in the block with the name exactly as it appears on the document.

Defendant: Fill in the block with the name exactly as it appears on the document.

Docket Number: Type the number exactly as it appears on the document.

Type of Writ or complaint: Use the drop down box to select the appropriate document category or type in the information, as you would like it to appear.

Service information: Complete each entry to help the deputy fulfill the request.

Name: Defendant's known name

Address: Primary location of the defendant, include apt., floor, etc.

Cell #: The defendant's cellular telephone number.

Home #: The defendant's home telephone.

Alternate Address: Use this area to relate another location of the defendant,i.e. work, friend, etc.

Other #: Any other contact telephone numbers for the defendant.

Service:

Service will be attempted according to Pa Title 231:

Rule 402. Manner of Service. Acceptance of Service.

Original process may be served

by handing a copy to the defendant; or

by handing a copy

at the residence of the defendant to an adult member of the family with who he resides; but if no adult member of the family is found, then to an adult person in charge of such residence; or

at the residence of the defendant to the clerk or manager of hotel, inn, apartment house, boarding house or other place of lodging at which he resides; or

at any office or usual place of business of the defendant to his agent or to the person for the time being in charge thereof.

In lieu of service under this rule, the defendant or his authorized agent may accept service...

Special Instructions: Use this block to type any specific service requests, i.e. personal, posted, etc. or any added comments to help the deputy fulfill the request.

Attorney/Originator information:

Name: Type in the name of the attorney or originator.

Address: Insert the address of the attorney or originator.

Phone #: Add contact telephone number.

Law Firm: Type in the name of the law firm if applicable

Sign: The signature of the attorney or originator.

Save (optional), print and sign the document.