Editable Word doc:  Form 55D: Affidavit of Service on a Relevant Person

Form 55D

AN CHÚIRT CHUARDA
THE CIRCUIT COURT

     CIRCUIT                                                                                                    COUNTY OF 

Record number:

In the matter of the Assisted Decision-Making (Capacity) Act 2015 and in the matter of …………………..of …………………………………., *(relevant person)*(ward)

*CAPACITY APPLICATION
PART 5 OF THE ASSISTED DECISION-MAKING (CAPACITY) ACT 2015 

*DISCHARGE APPLICATION
PART 6 OF THE ASSISTED DECISION-MAKING (CAPACITY) ACT 2015 

Application of……………………….of …………………………………., Applicant(s)

AFFIDAVIT OF SERVICE ON A RELEVANT PERSON OR A WARD

I, [name] of [address] aged 18 years and upwards, make oath and say as follows:—

1. On the ………day of …………..20…., between the hours of ……. and …….. I personally served the *(Relevant Person) *(Ward) with notice of the application herein.

2. I effected such service at [set out the address at which service was effected] by showing him/her personally copies of the

*(Capacity Application) *(Discharge Application), Statement of Particulars and grounding affidavit(s) (and any exhibits), and form for reply,

*(Originating) notice of motion, and grounding affidavit(s) (and any exhibits), and form for reply,

and at the same time delivering to him/her in person and leaving with him/her true copies of the same.

3. I explained the nature and implications of the application to the *(Relevant Person) *(Ward).

[or explain what action was taken in this regard]

4. The response of the *(Relevant Person) *(Ward) was ………. [or state that the respondent made no response].

5. At the time of such service I was acquainted with the appearance of the *(Relevant Person) *(Ward) or the *(Relevant Person) *(Ward) was identified to me by ………….

Sworn etc.