IN THE DISTRICT/SUPERIOR COURT FOR THE STATE OF ALASKA AT ) ) Case No. F) ) ) ) ) CI PETITIONER (protected person), Birthdate: M Petitioner is a child. Who is signing for the child? Name: Birthdate: Relationship to child: PETITIONER (protected person), Birthdate: M ) ) Case No. F) ) ) ) ) CI Petitioner is a child. Who is signing for the child? Name: Birthdate: Relationship to child: PETITIONER (protected person), Birthdate: M ) ) Case No. F) ) ) ) ) CI Petitioner is a child. Who is signing for the child? Name: Birthdate: Relationship to child: PETITIONER (protected person), Birthdate: M ) ) Case No. F) ) ) ) ) CI Petitioner is a child. Who is signing for the child? Name: Birthdate: Relationship to child: PETITIONER (protected person), Birthdate: M ) ) Case No. F) ) ) ) ) CI Petitioner is a child. Who is signing for the child? Name: Birthdate: Relationship to child: v. RESPONDENT (restrained person), Birthdate: M Respondent is a child. Who is signing for the child? Name: Birthdate: Relationship to child: ) ) ) ) F) ) ) ) ) ) REQUEST FOR SERVICE AND PEACE OFFICER'S RETURN OF SERVICE (MULTIPLE PETITIONERS) Court Date: Court Fax: Page 1 of 2 DV-125-M (4/12)(cs) REQUEST FOR SERVICE AND RETURN OF SERVICE (MULTIPLE PETITIONERS) American LegalNet, Inc. www.FormsWorkFlow.com Please immediately serve the following documents on respondent The next court hearing is scheduled for Petition for Protective Order(s) Emergency Protective Order (72 hours) 20-Day Ex Parte Protective Order Long-Term Domestic Violence Protective Order Stalking or SA Order (20 days) and Reassignment Order Order Extending Ex Parte Protective Order Order on Petition for Protective Order Notice of Hearing Stalking or SA Order (6 months) A return of service must be filed with or faxed to the court (at the number on page 1) before the hearing. RETURN OF SERVICE I certify that I: Served the document(s) listed above on respondent and by handing to, and leaving a true and correct copy with him (address) in , Alaska on (date) Turned custody of the minor child(ren) her them, personally at at .m. over to Removed respondent from petitioners' residence located at Explained direct / indirect contact and communication to the person(s) served. Explained effective dates of the protective order (section B) to the person(s) served. Entered into DV Registry by DSN Did not serve the above-listed documents on the respondent named above because Return Date Time Spent Distribution: Signature Print Name and Title 1. Original to law enforcement agency with jurisdiction where respondent is located. 2. Copy to court file. Page 2 of 2 DV-125-M (4/12)(cs) REQUEST FOR SERVICE AND RETURN OF SERVICE (MULTIPLE PETITIONERS) American LegalNet, Inc. www.FormsWorkFlow.com