On August 30, 2022 a
Proof of Service
was filed
involving a dispute between
Saratoga Hospital,
and
Roxane Kipp,
for Other Matters - Contract - Other
in the District Court of Washington County.
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FILED: WASHINGTON COUNTY CLERK 11/10/2022 02:51 PM INDEX NO. EC2022-34320
STATE
NYSCEF OF NEW
DOC. NO. YORK,
2 RECEIVED NYSCEF: 11/10/2022
SUPREME COURT COUNTY OF WASHINGTON
SARATOGA HOSPITAL
PO BOX 5178
SARATOGA SPRINGS, NY 12866
Plaintiff, AFFIDAVIT OF PERSONAL SERVICE
-against-
ROXANE KIPP, Index #: EF2022-34320
Defendant.
STATE OF NEW YORK, COUNTY OF WASHINGTON | ss.:
Robert B. Bond, being duly swom, deposes and says that: 1am over the age of 18 years, and not a party to this action.
That on 11-5, 2022, at 11:30 a.m. at 3943 State Route 67, Eagle Bridge, New York 12057 deponent served a true and complete copy
of the within:
O Summons Notice of Electronic Filing
O Summons With Notice O Summons and Petition
O Summons and Complaint O Subpoena / Judicial Subpoena Duces Tecum
Summons and Verified Complaint O Other -
on Roxane Kipp
INDMDUAL
by delivering a true and complete copy of each to said recipient personally; deponent knew the person so served to be the person
described as said recipient therein.
CORPORATION
O a corporation, by delivering thereat a true and complete copy of each to personally, deponent knew said corporation so
served to be the corporation described in said Summons as said recipient and knew said individual to be the thereof.
SUITABLE AGE PERSON
O by delivering thereat a true and complete copy of each to , a person of suitable age and discretion; said person being an agent
for service on the person in this proceeding as designated under CPLR §318. Said premises is recipients actual place of business
O dwelling house (usual place of abode) within the state.
AFFlXING TO DOOR, ETC.
O by affixing a true and complete copy of each to the door of said premises, which is recipients O actual place of business O dwelling
house (usual place of abode) within the state. Deponent was unable, with due diligence, to find recipient or a person of suitable age
and discretion thereat, having called there:
(1) at or about a.m./p.m.
(2) at or about a.m./p.m.
(3) at or about a.m./p.m.
Deponent talked to at said premises who stated that recipient O lived there O worked there.
FOLLOW-UP MAILING
O Deponent also enclosed a copy of same in a post-paid sealed wrapper property addressed to recipient at recipients last known
residence, at , , New York and deposited said wrapper in an Official Depository maintained and exclusively
controlled by the U.S. Postal Service within New York State.
O The mailing was made by certified mail (Receipt No. ) within one day after such delivering to such suitable person or such
affixing O and with retum receipt requested.
DESCRIPTION SEX COLOR HAIR AGE HEIGHT WEIGHT
5'
OF RECIPIENT O Male White Skin O Black Hair O White Hair O 14-20 yrs. O Under O < 100 Ibs.
5'O"-5'3"
Female O Black Skin O Brown Hair O Balding O 21-35 yrs. O
5'4"-5'8"
O 100-130 lbs.
O Yellow Skin Blond Hair O Mustache @ 36-50 yrs. 131-160 Ibs.
5'9"-6'0"
O Brown Skin O Gray Hair O Beard O 51-65 yrs. O 6'
O 161-200 lbs.
O Red Skin O Red Hair O Glasses O > 65 yrs. O Over O > 200 lbs.
WITNESS FEES
O $ , the authorized traveling expenses and one day's witness fee was O paid (tendered) to recipient
O
with subpoena mailed to witness
MILITARY SERVICE
I asked the person spoken to whether recipient was in active military service of the United States or of the State of New York in any
capacity whatever and received a negative reply. Recipient wore ordinary civilian clothes and no military unifonn. The source of my
information and the grounds of my belief are the conversations and observations a narrated U rmation and belief I aver
that the recipient is not in the military service of New York State or of the United as th i either the State or in
the Federal Statutes.
Swom to before me, this Robert B. Bond
95
day of November, 2022. ___.......---...
Keny A. Rubscha
NCTmY PUBUC, STATE OF NEW YORK
Registration No. 4960342
Qualified in Fulton County
Commission Ex s Dec©mber 26, 0_
1 of 1
Document Filed Date
November 10, 2022
Case Filing Date
August 30, 2022
Category
Other Matters - Contract - Other
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FILED: WASHINGTON COUNTY CLERK 11/10/2022 02:51 PM INDEX NO. EC2022-34320 STATE NYSCEF OF NEW DOC. NO. YORK, 2 RECEIVED NYSCEF: 11/10/2022 SUPREME COURT COUNTY OF WASHINGTON SARATOGA HOSPITAL PO BOX 5178 SARATOGA SPRINGS, NY 12866 Plaintiff, AFFIDAVIT OF PERSONAL SERVICE -against- ROXANE KIPP, Index #: EF2022-34320 Defendant. STATE OF NEW YORK, COUNTY OF WASHINGTON | ss.: Robert B. Bond, being duly swom, deposes and says that: 1am over the age of 18 years, and not a party to this action. That on 11-5, 2022, at 11:30 a.m. at 3943 State Route 67, Eagle Bridge, New York 12057 deponent served a true and complete copy of the within: O Summons Notice of Electronic Filing O Summons With Notice O Summons and Petition O Summons and Complaint O Subpoena / Judicial Subpoena Duces Tecum Summons and Verified Complaint O Other - on Roxane Kipp INDMDUAL by delivering a true and complete copy of each to said recipient personally; deponent knew the person so served to be the person described as said recipient therein. CORPORATION O a corporation, by delivering thereat a true and complete copy of each to personally, deponent knew said corporation so served to be the corporation described in said Summons as said recipient and knew said individual to be the thereof. SUITABLE AGE PERSON O by delivering thereat a true and complete copy of each to , a person of suitable age and discretion; said person being an agent for service on the person in this proceeding as designated under CPLR §318. Said premises is recipients actual place of business O dwelling house (usual place of abode) within the state. AFFlXING TO DOOR, ETC. O by affixing a true and complete copy of each to the door of said premises, which is recipients O actual place of business O dwelling house (usual place of abode) within the state. Deponent was unable, with due diligence, to find recipient or a person of suitable age and discretion thereat, having called there: (1) at or about a.m./p.m. (2) at or about a.m./p.m. (3) at or about a.m./p.m. Deponent talked to at said premises who stated that recipient O lived there O worked there. FOLLOW-UP MAILING O Deponent also enclosed a copy of same in a post-paid sealed wrapper property addressed to recipient at recipients last known residence, at , , New York and deposited said wrapper in an Official Depository maintained and exclusively controlled by the U.S. Postal Service within New York State. O The mailing was made by certified mail (Receipt No. ) within one day after such delivering to such suitable person or such affixing O and with retum receipt requested. DESCRIPTION SEX COLOR HAIR AGE HEIGHT WEIGHT 5' OF RECIPIENT O Male White Skin O Black Hair O White Hair O 14-20 yrs. O Under O < 100 Ibs. 5'O"-5'3" Female O Black Skin O Brown Hair O Balding O 21-35 yrs. O 5'4"-5'8" O 100-130 lbs. O Yellow Skin Blond Hair O Mustache @ 36-50 yrs. 131-160 Ibs. 5'9"-6'0" O Brown Skin O Gray Hair O Beard O 51-65 yrs. O 6' O 161-200 lbs. O Red Skin O Red Hair O Glasses O > 65 yrs. O Over O > 200 lbs. WITNESS FEES O $ , the authorized traveling expenses and one day's witness fee was O paid (tendered) to recipient O with subpoena mailed to witness MILITARY SERVICE I asked the person spoken to whether recipient was in active military service of the United States or of the State of New York in any capacity whatever and received a negative reply. Recipient wore ordinary civilian clothes and no military unifonn. The source of my information and the grounds of my belief are the conversations and observations a narrated U rmation and belief I aver that the recipient is not in the military service of New York State or of the United as th i either the State or in the Federal Statutes. Swom to before me, this Robert B. Bond 95 day of November, 2022. ___.......---... Keny A. Rubscha NCTmY PUBUC, STATE OF NEW YORK Registration No. 4960342 Qualified in Fulton County Commission Ex s Dec©mber 26, 0_ 1 of 1