STATE OF MINNESOTA - DOC 6 by h6xKdfjN

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									                                                                          Mail to Plaintiff by ______________________
                                      Return the completed and notarized affidavit by 3:00 pm______________________

STATE OF MINNESOTA                                                             FOURTH JUDICIAL DISTRICT

COUNTY OF HENNEPIN                                                                                DISTRICT COURT

__________________________________                                   AFFIDAVIT OF SERVICE BY MAIL

__________________________________
                                          Plaintiff                      Case No.: 27-CV-HC-_________________
Vs
                                                                         Hearing Date: ________________________
__________________________________
                                                                         Time: 1:30pm
__________________________________
                                          Defendant



_______________________________________, being first duly sworn, upon oath states that on
(Name of person who mailed documents)

___________________________, 20__, she/he served a Motion for Expungement and Order
(Date documents mailed)

Setting Motion for Expungement in an Eviction

Action upon ___________________________________________ by placing a true and correct
                     (Name of person(s) to whom documents were mailed)


copy of the documents in an envelope addressed to the person(s) at his/her last known address of

_________________________________________ in the City of ________________________,
(Street address of person to whom documents were mailed)

State of Minnesota, and whose Zip Code is ________________, and depositing the envelope

with sufficient postage in the U. S. Mail at the Post Office located in the City of

____________________________________, State of Minnesota.

                                                      Signature: ___________________________________
                                                      Street Address: _______________________________
                                                      City/State/Zip: _______________________________
                                                      Daytime Phone: ______________________________

Subscribed and sworn to before me on

this ___ day of ___________________, 20__.

_____________________________________
Notary Public/Court Clerk


HOU503        District4       ENG         Rev 7/06                 www.courts.state.mn.us/forms          Page 1 of 1

								
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