HI · rules
Haw. R. Civ. P. Form 29-D
Certificate of Service to Accompany the Notice of Appeal to the Circuit Court. (Mail a copy of all the documents submitted to the Court to each of the Appellees listed)
IN THE CIRCUIT COURT OF THE (insert the judicial circuit no.) CIRCUIT
STATE OF HAWAIʻI
(Your Name), ) Civil No.
)
Appellant, ) Agency Docket/Case No.
)
v. )
) CERTIFICATE OF SERVICE
(Name of governmental official or agency, )
whose order or decision is being appealed); )
(Name(s) of any other party to the proceeding )
before the official or agency), )
)
Appellee(s). )
)
CERTIFICATE OF SERVICE
I hereby certify that on this date, a copy of the document within was served by depositing a copy of the same in the U.S. mail, postage prepaid to the following:
Insert name of agency that made the decision being appealed)
(Address of agency)
(Insert name(s) and address(es) of each Appellee, or if the Appellee has an attorney, the name and address of the Appellee's attorney)
DATED: (Name of City you are in), (Name of State you are in), (Date of mailing).
(Your signature)
(Print or Type your name here)
Provenance
- Source
- www.courts.state.hi.us
- Retrieved
- 2026-10-02
- Edition
- supplied-hi-03-2026-07-01
- Content hash
698e9865ab9ea4fe93b79f7858ce84256abbb3974164526ffdde14fd42a6fca7
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