CERTIFICATE OF SERVICE

______________

vs.

_________________

Type of Violation:  _______________

Property:  _______________

Date Complaint was Filed:  ____________

Bureau Case #:  ____________

Government Representative:  _______________

I certify that on the _______ day of _________ 2021, I served a true and accurate copy of the Complaint, Statement of Rights, and Notice of Hearing from the above-captioned case, as well as Zoom participation instructions (if any), on the following persons or entities via United States Post Office first-class mail:

_______________________________

Government Representative Name

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