Proof Of Service And Affidavit Of Mailing Additional Service List (Appeal) {PSA-AS 1604.1}

This form is approved by the Illinois ADDITIONAL SERVICE LIST In 1, fill in the full name and address of the party or lawyer to 1. To: whom you are sending Name: the document and First Middle Last check the box to show how you are sending it. Address: Street , Apt # City State ZIP By: Personal hand delivery Regular, First - Class Mail, deposited into the U.S. Mail with postage paid at : CAUTION: You may send the document by email or fax only if the other party has agreed to receive documents in the lawsuit by email or fax. If you are serving additional parties or lawyers, fill out and attach additional copies of this form to the Proof of Service & Affidavit of Mailing (Appeal). Address of Post Office or Mailbox Third - party commercial carrier , delivered to : Name (for example , FedEx or UPS ) and office address 000F Email Sender's address: @002 Recipient's address:002 @ 000F Fax Sender's number: Recipient's number: 000F Mail from a correctional institution, deposited into : Place of deposit into institutional mail PSA - AS 1604.1 Page 1 of 1 ( 0 6 / 16 )