Person Filing: Address (if not protected): City, State, Zip Code: Telephone: Email Address: Lawyer's Bar Number: Licensed Fiduciary Number: ___________________________________ Representing Self, without a Lawyer or Attorney for Petitioner OR FOR CLERK'S USE ONLY Respondent SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY In the matter of: Case Number PB AFFIDAVIT SUPPORTING DEFERRAL OR WAIVER OF SERVICE COSTS Name of protected (or deceased) person NOTE: FILL OUT THIS FORM ONLY IF YOU REQUESTED DEFERRAL OR WAIVER OF SERVICE COSTS IN THE APPLICATION. YOU MUST HAVE ATTEMPTED PERSONAL SERVICE OR HAVE A VALID REASON FOR NOT DOING SO. SERVICE BY PUBLICATION IS USED AS A LAST RESORT. STATEMENTS MADE TO THE COURT UNDER OATH OR AFFIRMATION. I swear or affirm that the information in this application is true and correct. I make this statement under the penalty of prosecution for perjury if it is determined that I did not tell the truth. I have requested a deferral or waiver of the following fees in my case: Fees for service of process by a sheriff, marshal, constable, or law enforcement agency: In support of my request, I state that (check and complete any that apply): I have attempted to obtain voluntary acceptance of service of process without success on the person to be served. It would be useless or dangerous for me to try to obtain voluntary acceptance of service by the person to be served because (explain): © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED ASA PBW21f- 090114 American LegalNet, Inc. www.FormsWorkFlow.com Case No. An enforceable injunction against harassment or order of protection has been granted to me against the person to be served. Fees for publication: In support of my request, I state that I have attempted to locate the person to be served but I have been unable to locate that person (check and complete any that apply): This is what I did to try to find the other party (explain): I have contacted the person(s) listed below to try to find the location of the other party. NAME ADDRESS INFORMATION FOR SERVICE You must provide the following information: To the best of my knowledge, as of (date) person to be served was: (Street Address, City and State) , the last known address of the . SIGNATURE UNDER PENALTY OF PERJURY Today's Date: Signature: Print Your Name: © Superior Court of Arizona in Maricopa County ALL RIGHTS RESERVED ASA Page 2 of 2 PBW21f- 090114 American LegalNet, Inc. www.FormsWorkFlow.com