Proof of Service / Certificate of Delivery Affidavit
Category: Notices & Demands
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Execution & Signatures
PROOF OF SERVICE / CERTIFICATE OF DELIVERY AFFIDAVIT
1. Signatory
This document is made on October 9, 2026 (New York) by:
John Doe (Individual)
2. EXECUTION & SIGNATURES
By: John Doe (Person Who Served the Documents)
Date: ____________
What you'll need
Have these details ready before you start:
- Person Who Served the Documents: full name or company name, address, and ID or registration number
- Details for this document:
- Document(s) Served
- Person Served
- Date & Time of Service
- Place of Service
- Method of Service
- The effective date and the place of signing
- Everyone who will sign, to sign and date the final copy
How to fill it in
Enter the parties
Enter the Person Who Served the Documents: choose a person or a company, then enter the name, address and ID number.
Fill in the document details
Complete the fields for this agreement: Document(s) Served, Person Served, Date & Time of Service, Place of Service, and Method of Service.
Check the preview
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Download, print and sign
Download a PDF, Word or text file or print the document, then have the Person Who Served the Documents sign and date it.
Proof of Service / Certificate of Delivery Affidavit: a practical guide
A Proof of Service or Certificate of Delivery Affidavit records how, when, and where a document was delivered or an attempt was made, and who handled it. It is a written record of those events, not the notice, demand, or other document that was sent.
What it's for
People use this document to make a dated record after delivering or attempting to deliver a notice, demand, or other important paper. It can help the sender keep track of what was sent, how it was sent, and what happened during delivery.
The person who handled delivery usually completes the record while the details are fresh. Identify the document clearly, including its title and date, and state whether delivery was completed, refused, or could not be completed. If you need to tell someone what action to take or by when, prepare the notice or demand itself; this certificate only records delivery.
An affidavit may involve a sworn or affirmed statement, while a certificate may be an unsworn confirmation. The names, wording, witness, and signing steps needed for either can depend on where it will be used. Check local requirements or ask a qualified lawyer if the record may matter in a dispute.
Who uses it
- A person or business that sends an important notice and wants a written record of delivery.
- A person asked to deliver a document on someone else's behalf.
- A landlord, tenant, property manager, or service provider recording delivery of a written notice.
- A creditor or customer recording delivery of a payment demand or other business document.
- A recipient and sender who want to document a delivery attempt, refusal, or other unusual outcome.
Terms to decide on
- Document delivered
- Identify the document by its exact title and date, and note any attached pages or enclosures. This helps distinguish it from other papers sent around the same time.
- Sender and recipient
- Use the names of the person or company that sent the document and the intended recipient. If several people or a company are involved, make clear who sent it and who was meant to receive it.
- Person who delivered it
- State who handled delivery and, where useful, their relationship to the sender. The person signing should describe what they personally did or observed.
- Date, time, and place
- Record when and where delivery occurred or was attempted, as precisely as the person can recall. If there were multiple attempts, list each separately with its outcome.
- Delivery method and outcome
- Describe the method used and what happened, such as delivery to the named recipient, delivery to another person, refusal, or no answer. Do not call an attempt completed delivery unless the document was delivered in the way you describe.
- Recipient identification
- Explain how the person receiving the document was identified, if known, and note any uncertainty. Avoid guessing a name or relationship that the deliverer could not verify.
- Statement and signature
- Use a clear statement limited to facts the signer knows, then sign and date it. Add witnesses, an oath or affirmation, or notarization only when needed for the place and intended use.
Common mistakes
- Naming only a general type of paper, such as “notice,” without giving its title or date. The reader may not be able to tell which document the record describes.
- Recording the date the paper was prepared instead of the date it was delivered or attempted. Keep those dates distinct.
- Writing that delivery was completed when the person only left a message, made an unsuccessful attempt, or heard that someone else delivered it.
- Leaving out the method, location, recipient, or outcome. These details help explain what actually happened.
- Including assumptions as facts, such as stating that a recipient refused the document without describing what the deliverer observed.
- Signing long after delivery from memory, or asking someone to sign for an event they did not handle or witness.
- Treating a certificate as a replacement for the notice or demand itself. The record describes delivery; it does not set out the recipient's requested action or response.
Before you sign
- Compare the document title and date with the copy that was delivered.
- Check that the sender, intended recipient, and person who handled delivery are identified clearly.
- Confirm that each date, time, place, method, and outcome reflects what the signer knows firsthand.
- Separate completed delivery from an attempt, refusal, or uncertain result.
- Read the statement for assumptions, unclear wording, and missing details before signing.
- Check whether local rules call for a witness, oath or affirmation, notarization, or particular wording.
- Ask a qualified lawyer about local signing or delivery requirements if the record may be important in a dispute.
Frequently asked questions
Does this document prove that the recipient read the notice?
It records the delivery details the signer states, but delivery does not by itself show that the recipient read or understood the document. Record only what the deliverer observed or can accurately confirm.
Can I use it if delivery was refused or unsuccessful?
You can record an attempt and its outcome, including a refusal or inability to deliver. Describe what happened and when, without saying that delivery was completed if it was not.
Does the person who sent the document have to sign?
The person who handled delivery is generally best placed to describe the event from personal knowledge. Who must sign, and whether another person must witness the signature, can depend on local rules and the document's intended use.
Is a signed certificate enough for my situation?
That depends on local rules, the circumstances, and how the document is completed and signed. AnAgreement.com cannot confirm that it is valid or enough for a particular purpose; check local requirements or ask a qualified lawyer.
Can I use this for a document sent by email or post?
You can record what was sent, when, to whom, and by what method, including an electronic or postal method. Whether that method meets the requirements for your purpose depends on the rules where the document will be used.
This guide is general information, not legal advice. Rules differ between countries and regions, so for important matters ask a qualified lawyer where the document will be used.