IN THE SUPERIOR COURT FOR THE STATE OF ALASKA AT __________________ In the Matter of the Necessity for the Hospitalization of: Respondent. , ) ) ) ) ) ) Case No. AFFIDAVIT OF SERVICE OF DOCUMENTS I state on oath or affirm that on of on respondent and by , 20 (title of document) , at .m., I served a copy (institution) (manner in which service was accomplished) . Date Signature Print Name Title Subscribed and sworn to or affirmed before me at , 20____. Alaska, on (SEAL) _______________________________________ Notary Public for Alaska My commission expires: MC-500 (3/01)(cs) AFFIDAVIT OF SERVICE OF DOCUMENTS American LegalNet, Inc. www.FormsWorkFlow.com