Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: Lawyer's Bar Number: Representing Self, without a Lawyer or Attorney for Petitioner OR Respondent For Clerk's Use Only SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case Number: Name of Applicant AFFIDAVIT OF SERVICE BY CERTIFIED MAIL 1. I am familiar with the facts stated in this Affidavit, and I make this Affidavit to show that I have served copies of the "Application for Change of Name" and the "Notice of Hearing Regarding Application for Change of Name" on the person named below by certified mail/restricted delivery, return receipt requested. Person served (name of other party): Address where other party was served: Date of receipt by the other party: 2. The Application and Notice listed above were received by the other party as shown by the receipt, the original of which is attached to this Affidavit on a separate piece of paper. UNDER OATH OR BY AFFIRMATION I swear or affirm under penalty of perjury that the contents of this document are true and correct to the best of my knowledge and belief. Date Petitioner's Signature STATE OF COUNTY OF Subscribed and sworn to or affirmed before me this: (date) . (notary seal) Deputy Clerk or Notary Public by © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED AFM Page 1 of 1 CVNC24f - 050115 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com