Who fills out this form?

The person who served the documents fills out this form. It is a voluntary form.

Does this form need a notary?

No, you do not have to take this document to a Notary Public if you provide an unsworn declaration. You sign it under the criminal penalty of false swearing instead.

SC-5100V

Declaration of Service of SC-500, Summons and Complaint Eviction (Small Claims)

Wisconsin · Wisconsin Court System · Effective September 12, 2024

This form is used to tell the court that someone has officially given copies of the Summons and Complaint for an eviction case to another person. It asks the person filling it out to explain exactly how and when the documents were given out.

The court describes it as: To provide a document by which a person who has served documents on another person can provide the necessary information concerning that service. Voluntary form.

Open the official PDFfrom Wisconsin Court System

Where this fits in a case

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This form is used after a person has served the initial court papers in a small claims eviction case. It is a voluntary form that provides details about the service of those documents.

Either party may file.

Official instructions

How-to guides published by the court for this form.

Plain-language summary

Common questions

Who fills out this form?: The person who served the documents fills out this form. It is a voluntary form.
Does this form need a notary?: No, you do not have to take this document to a Notary Public if you provide an unsworn declaration. You sign it under the criminal penalty of false swearing instead.

Revision history

No changes recorded since we started tracking this form on October 10, 2026. The current version took effect September 12, 2024.

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