TO FILE RETURN OF SERVICE-SERVED

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                          SC-20-0684

COURT CLERK'S oO;
County of McCurtain, State of Ontchoma

IN THE DISTRICT COURT OF MCCURTAIN COUNTY FILED
STATE OF OKLAHOMA
JAN 13 2021

McCurtain Memorial Hospital )

Plaintiff, ) by. KATHY GRAY, Court Clerk
vs. ) CASE NO.: SC-20-0684 Deputy
FREDERICK H JARNIGAN )

Defendant )

AFFIDAVIT OF RETURN SERVICE

AFFIDAVIT OFRERA See

Koester ORNL cent that L attempted service of, and / or served, the attached

for Case No.: SC-20-0684 (FREDERICK H JARNIGAN) as follows:

Personal Service To:
Located At:
Usual Place of Residence: To: Jorn LoQez owen
tocated at: AY Padre Way Gn ORT
Unable to Serve: To the following addresses:
Total
[Fees for Service:§ gy SS | Additional Fee: $ [Tota $ OW |

The undersigned, certifiesa true copy of the above mentioned document was sereedipon the above
named Defendant on the day of 5 ‘C WW > 20g at at AM (rm. )

The undersigned, certifies he / she was unable to obtain service at the address of the last know
residence.

Signature of person serving su…