100-00261 Sheriff’s Return of Service (04/2015) Page 1 of 1
STATE OF VERMONT SUPERIOR COURT CIVIL DIVISION
Unit Docket No.:__________________________ Plaintiff(s)
Defendant(s) vs.
SHERIFF’S RETURN OF SERVICE
Give this form to the sheriff or constable if the defendant does not send an answer
in response to the mailed Summons and Complaint.
☐ Summons ☐ Default Judgment Order
☐ Complaint ☐ Motion for Trustee Process
☐ Answer form ☐ List of Exemptions
☐ Information and Instructions for the Defendant ☐ Trustee’s Disclosure Form
☐ Attachment(s) ☐ Other _________________________
__________________________________________________________________________________________________ STATEMENT OF SERVICE FEES
SERVICE $ ________ MILEAGE ( _______ miles @ _______ per mile ) $ ________ TOTAL $ ________ Less Deposit $ ________ REFUND OR BALANCE DUE $ ________ __________________________________________________________________________________________________
RETURN OF SERVICE On ___________________ (Date), I served the documents checked above by delivering a copy to:
☐ The defendant named at the following address: _______________________________________________________.
☐ A person of suitable age and discretion residing at the named defendant’s address: Person’s Name: __________________________________________________________________________________
Age: ________ Relation to Defendant: ______________________________________________________________
Address: _______________________________________________________________________________________
☐ Other (give name and address)
______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________
___________________________________
Signature of Serving Officer
IMPORTANT: The plaintiff must send the Original Copy of the Return of Service to the Court immediately after service has been completed.
Keep a copy for your records.
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