Affidavits of Service of a Petition filed pursuant to these Rules upon an alleged incapacitated person shall be substantially in the following form:
(Caption)
AFFIDAVIT OF SERVICE
I, ____________, an adult individual residing at ______________, hereby verify and state as follows:
1. I am a person trained and experienced in evaluating persons with incapacities of the type alleged in the petition filed to the above term and number.2. On _______, 20___, at ______________m. I personally served a true and correct copy of the said petition and required citation and notice pursuant to O.C. 1.8(a) and 14.5, upon the alleged incapacitated person at ________________ (State place of service).3. At the time of service of the petition, I left a true and correct copy of the petition and required citation and notice pursuant to O.C. 1.8(a) and 14.5, with the alleged incapacitated person. In addition, I explained the contents and terms of the petition to the maximum extent possible in language and terms the alleged incapacitated person is most likely to understand.4. I verify that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18Pa.C.S§ 4904 relating to unsworn falsifications to authorities._________________________________
(Signature)