Ull name) I live in (Municipality & province) and I swear/affirm that the following is true: 1. I served , on , 20 , (Date) (Full name of person/corporation/etc. who was served) at (Street or mailing address (street and number, unit, municipality, province) or email address) the address of the person s home which is the address of the place of business of the corporation/partnership/sole proprietorship the address of the person's or corporation's representative on record with the co.

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