AFFIDAVIT DELIVERED BY PRIVATE SERVICE
I am over the age of ________________ (eighteen) years, and, on ______________, I transmitted the ________________ (describe the paper or document mailed). One copy of this paper or document, which is attached to this affidavit, was sent to the addressee set forth below. The paper or document was sent by depositing a copy enclosed in the prescribed wrapping of _____________ (name of private delivery service), at the office of __________ (name of private delivery service), located at ______________________________________________________. The address on the package is as follows: ____________________________________ (name and address of addressee).
A true and correct copy of the receipt for delivery charges of ____________________ (name of private delivery service) for the delivery of above-described ______________ (describe paper or document) is attached to this instrument.