DIV904 State ENG Rev 10/17www.mncourts.gov/formsPage 1 of 1State of Minnesota District Court County of: Select County Judicial District: Court File Number: Case Type: Dissolution with ChildrenIn Re the Marriage of: Petitioner (first, middle, last)and Respondent (first, middle, last)Affidavit of Service by MailI, , state that I am at least 18 years of age having been born on and that on, I served the following papers: (List all papers mailed to the other party)by placing in an envelope a true and correct copy of each document addressed to at in the City of , State of Zip Codeand depositing the envelope, with sufficient postage, in the United States at the Post Office located in the City of in the State of.I declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116. Dated: Signature County and State where signed Name: Address: City/State/Zip: Telephone: E-mail address: American LegalNet, Inc. www.FormsWorkFlow.com