If the defendant is an individual, plaintiff states and declares that:

Defendant is not on active military service. Plaintiff's statement that Defendant is not on active military service is based upon the following facts: *if you know they are not in the military

OR

Plaintiff is unable to determine whether or not Defendant is not on active military service military service. *if yes, or unsure if they are in the military

I swear or affirm under the penalties of perjury that the foregoing representations are true.

Dated: Date
Signature of Affiant: Your Signature