Form 16.4

Form of certificate of service, or intimation on a warrant, by post

CERTIFICATE OF SERVICE [OR INTIMATION] BY POST

I, (name and designation), certify that I served [or intimated] this summons (or other document (specify)) on [or to] (name of defender or other person on whom served) [where applicable, by first class recorded delivery] by posting a copy of it with a citation [or notice] attached, to that person between (time) and (time) on (date) at (name of post office) post office in a registered envelope [or recorded delivery envelope] addressed as follows:- (address).  

(Signed)

Solicitor [or Agent] for pursuer [or other Party]
[or Messenger-at-Arms]

(Address)