This form contains 89 fields organized into 20 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Acknowledging Person Details
Acknowledged Status Text
Please specify the acknowledged status of the person with whom the papers were left, such as their relationship to the defendant. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Facts for Age and Discretion Text
Please provide the factual observations that led to the conclusion that the individual served is of suitable age and discretion. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Case Information
Court Jurisdiction (City/County) Combobox
Enter the name of the city or county where the district court has jurisdiction.
Cecil County Baltimore County Talbot County Allegany County Howard County Charles County St. Mary's County Garrett County Worcester County Anne Arundel County Queen Anne County Dorchester County Frederick County Calvert County Baltimore City Prince George's County Washington County Montgomery County Wicomico County Carroll County Somerset County Kent County Caroline County Harford County
Case Parties
Plaintiff/Judgment Creditor Name Text
Please enter the full name of the plaintiff or judgment creditor.
Defendant/Judgment Debtor Name Text
Please enter the full name of the defendant or judgment debtor.
Court And Case Information
Court Address Text
Please provide the complete address of the court, including the city and county.
Case Number Text
Please enter the unique identifying number for this case.
Defendant Information
Defendant Name Text
Please provide the full name of the defendant.
Defendant Address Text
Please provide the street address of the defendant.
Delivery Specifics
Delivery Location Text
Enter the specific address or location where the delivery was made. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Delivery Date Date
Enter the date on which the delivery occurred. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Delivery Time Time
Enter the time of the delivery. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Time Period Text
Indicate whether the delivery time is in the morning (AM) or afternoon/evening (PM). Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
General
Primary Facts Supporting Suitable Age and Discretion Text
Additional Facts Supporting Suitable Age and Discretion Text
Reset Button
Inability to Serve Details
I was unable to Checkbox
Check this box if you were unable to complete a required action, and then indicate the specific action(s) that could not be performed from the options provided.
serve Checkbox
Check this box if you were unable to serve the documents or process.
replevy the goods Checkbox
Check this box if you were unable to replevy (recover possession of) the specified goods.
levy the goods Checkbox
Check this box if you were unable to levy (seize property to satisfy a debt) the specified goods.
Reason for Inability Text
Explain the primary reason for the inability to serve, replevy, or levy the goods. Fill only if 'I was unable to' is 'Yes'.
Depends on: I was unable to
Further Explanation Text
Provide any additional details or further explanation regarding the inability to serve, replevy, or levy the goods. Fill only if 'I was unable to' is 'Yes'.
Depends on: I was unable to
Method of Summons Service
Service by Delivery Checkbox
Check this box if the summons was served by delivering the complaint and all supporting papers, or a Motion for Order Declaring Judgment Satisfied, in accordance with Md. Rule 3-626.
Restricted Mail Checkbox
Check this box if the summons was served by restricted mail with a return card attached.
Alternative Service by Court Order Checkbox
Check this box if the summons was served using an alternative method pursuant to a court order and Md. Rule 3-121(c).
Alternative Service Description Text
Provide a description of the alternative service method used, as authorized by court order and Md. Rule 3-121(c). Fill only if 'Alternative Service by Court Order' is 'Yes'.
Depends on: Alternative Service by Court Order
First Class Mail Service Checkbox
Check this box if the summons was served by first class mail as authorized by court order and in accordance with Md. Rule 3-626.
Delivery To Checkbox
Check this box if the summons was delivered to a specific individual or location that needs to be identified.
Delivery Recipient Text
Enter the name of the person to whom the summons was delivered. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Order For Service
Expiration Date of Process Date
Please provide the expiration date of the process.
Clerk's Name Text
Please provide the name of the clerk.
Plaintiff/Attorney Information
Plaintiff/Attorney Name Text
Enter the full name of the Plaintiff or the Attorney.
Attorney Bar Number Text
Enter the attorney's bar or license number.
Plaintiff/Attorney Address Line 1 Text
Enter the first line of the Plaintiff's or Attorney's street address.
Plaintiff/Attorney Address Line 2 Text
Enter the second line of the Plaintiff's or Attorney's street address, if applicable.
Private Process Server Affirmation
Private Process Server Signature Text
Enter the signature of the private process server.
Private Process Server Printed Name Date
Enter the printed full name of the private process server.
Private Process Server Firm Name or Title Text
Enter the firm name or the professional title of the private process server.
Private Process Server Address and Telephone Text
Enter the full mailing address and telephone number of the private process server.
Private Process Service Fee
Private Process Service Fee Checkbox
Check this box if a fee for private process service is being charged.
Private Process Service Fee Number
Enter the fee charged for private process service.
Property-related Service Actions
Posted the premises Checkbox
Check this box if service was performed by posting legal documents on the premises.
Premises Post Location Text
Enter the specific location where the premises were posted. Fill only if 'Posted the premises' is 'Yes'.
Depends on: Posted the premises
Levied goods or property Checkbox
Check this box if the service involved levying (seizing) attached goods or property.
Removed goods or property Checkbox
Check this box if the service involved removing attached goods or property.
Furnished writ to person in possession Checkbox
Check this box if a copy of the writ and schedule was furnished to any person found in possession of the goods or property.
Replevied goods Checkbox
Check this box if the service involved replevying (recovering) specific goods.
Replevied Goods Description Line 1 Text
Provide a detailed description of the first line of goods that were replevied. Fill only if 'Replevied goods' is 'Yes'.
Depends on: Replevied goods
Replevied Goods Description Line 2 Text
Provide a detailed description of the second line of goods that were replevied. Fill only if 'Replevied goods' is 'Yes'.
Depends on: Replevied goods
Refund Information
Refund Recipient Name Text
Provide the name of the person or entity to whom the refund should be sent. Fill only if 'I was unable to' is 'Yes'.
Depends on: I was unable to
Refund Address Text
Provide the address where the refund should be mailed. Fill only if 'I was unable to' is 'Yes'.
Depends on: I was unable to
Request for Service Details
Trial Date Date
Enter the date of the trial.
Issue Date Date
Enter the date the process was issued.
Expiration Date Date
Enter the date the process expires.
Received From Text
Provide the name of the entity or person from whom the process was received.
Special Instructions Line 1 Text
Enter the first line of any special instructions for serving the process.
Special Instructions Line 2 Text
Enter the second line of any special instructions for serving the process.
Special Instructions Line 3 Text
Enter the third line of any special instructions for serving the process.
Served Document Details
I Served The Checkbox
Check this box if you served a document or order as specified by the following options.
Writ of Garnishment on Wages/Property on the Garnishee Checkbox
Check this box if a Writ of Garnishment on Wages/Property was served to the Garnishee.
Show Cause Order Checkbox
Check this box if a Show Cause Order was served.
Order to Appear for Oral Examination in Aid of Enforcement Checkbox
Check this box if an Order to Appear for Oral Examination in Aid of Enforcement was served.
Other Document Served Checkbox
Check this box if a type of document other than those explicitly listed was served.
Other Service Type Text
Please specify the type of service if it is not one of the listed options for serving a document. Fill only if 'Other Document Served' is 'Yes'.
Depends on: Other Document Served
By Restricted Delivery Mail, Return Card Attached Checkbox
Check this box if the service of the document was performed by restricted delivery mail with a return card attached.
By Delivery To Checkbox
Check this box if the service of the document was performed by direct delivery to an individual or specific location.
Recipient of Delivery Text
Please provide the name or description of the person or entity to whom the document was delivered. Fill only if 'By Delivery To' is 'Yes'.
Depends on: By Delivery To
Service Attempts
First Service Attempt Date Date
Enter the date of the first service attempt.
Second Service Attempt Date Date
Enter the date of the second service attempt.
Third Service Attempt Date Date
Enter the date of the third service attempt.
Fourth Service Attempt Date Date
Enter the date of the fourth service attempt.
Service Cost and Person Served Description
Service Cost Number
Enter the total cost of the service.
Person Served Race Text
Provide the race of the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Person Served Sex Text
Provide the sex of the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Person Served Height Text
Provide the height of the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Person Served Weight Number
Provide the weight of the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Person Served Hair Color Text
Provide the hair color of the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Person Served Eye Color Text
Provide the eye color of the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Person Served Age Text
Provide the age of the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Person Served Other Description Text
Provide any other descriptive details about the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Other Checkbox
Check this box if an 'Other' description of the person served is provided, and a copy of the complaint and all supporting papers were left with the person served. Fill only if 'Delivery To' is 'Yes'.
Depends on: Delivery To
Service Target Information
Type of Paper Text
Enter the type of legal paper to be served.
Defendant Checkbox
Check this box if the process is to be served on the defendant.
Garnishee/Agent Checkbox
Check this box if the process is to be served on a garnishee or agent.
Garnishee/Agent Name Text
Enter the full name of the garnishee or agent to whom the service is directed. Fill only if 'Garnishee/Agent' is 'Yes'.
Depends on: Garnishee/Agent
Garnishee/Agent Address Text
Enter the street address for the garnishee or agent.
Garnishee/Agent City, State, Zip Text
Enter the city, state, and zip code for the garnishee or agent.
Other Checkbox
Check this box if the process is to be served on a party other than the defendant or garnishee/agent.
Other Service Details Text
Provide any additional details or instructions for service not covered by the standard options. Fill only if 'Other' is 'Yes'.
Depends on: Other