STATE OF SOUTH CAROLINA	)

)	BEFORE THE ARBITRATION PANEL OF COUNTY
In the matter of Arbitration between	)
)

)

)

)

Case number -CP- -
Claimant(s)	)

)

vs.	)

)	AFFIDAVIT OF SERVICE

(Claim Served Herewith)
)

)

)
Defendant(s)	)

The undersigned, , being duly sworn, states that he served the Summons for Arbitration and the Claim for Property Damage in this action on the Defendant(s), , by delivering a copy (or copies) of the same to , the Defendant(s) personally, or to , the day of , , that affiant knows the person(s) so served to be the Defendant(s) or persons mentioned and described above, and that affiant is not a party to, nor interested in, the action.

Sworn to before me this

day of , .

Affiant

NOTARY PUBLIC FOR SOUTH CAROLINA
My Commission expires:

SCCA/203(3/2005)

STATE OF SOUTH CAROLINA

DSmith

2005-03-24

SCJD

South Carolina Judicial Dept.