Independent Process Service
PO Box 506
Princeton, Minnesota 55371
Office 763-360-1585    Fax: 763-634-9192
E-mail: Chuck@IndependentProcessService.com
Web Site: http://IndependentProcessService.com
PROCESS SERVICE REQUEST FORM

Client _________________________________________ Date: _________________________________________

Address _________________________________________, _________________________________________

Phone:_______________________________________Fax:__________________________

Special Instructions             Please Make First Attempt at:
[  ] Rush [  ]  Residence
[  ] Regular Service[  ]  Business

Case Title_______________________vs ____________________________________________

Document:_________________________________Last Date to Serve:______________________

__________________________________________________________________________________________________________
Serve (as it should appear on the Affidavit of service )


__________________________________________________________________________________________________________
Description

DOB:     Height:Weight:Race:Sex:Hair:       Other:
__________________________________________________________________________________________________________
Home Address:Work Address:



Best time to serve:Hours Worked:
__________________________________________________________________________________________________________

Hearing Date:___________@ _______am pm  Court____________________________ 

________________________________________________________________________________________________________

Clients comments:  ______________________________________________________________________________________

___________________________________________________________________________________________________________________________________________________
Reports

_____Personal Service _____Substitute Service ____Not Served

Date Served:_______________________am pm


Independent Process Service
FAX to: 763-634-9192
Independent Process Service 
Website: www.independentprocessservice.com.
Email: chuck@independentprocessservice.com.

FROM:______________________________

_____________________________________

Message:_____________________________

_____________________________________


Confidentiality Notice:
The documents(s) that accompany this cover sheet may contain confidential information that is legally privileged and is only for the use of the intended recipient named above.  if you are not the intended recipient you are hereby notified that any disclosure, copying, distributing or taking any action in reliance on this telecopy information except in its direct delivery to the intended recipient above, is strictly prohibited.  If you have received this fax in error, please notify us immediately by telephone so we can arrange for the return of the original fax document to us.  Thank you.