Name of Person Filing Document: Your Address: Your City, State, and Zip Code: Your Telephone Number: Attorney Bar Number (if applicable): Representing Self (Without an Attorney) OR Attorney for Petitioner OR Respondent FOR CLERK’S USE ONLY SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY Case Number: Name of Petitioner/Plaintiff AFFIDAVIT SUPPORTING DEFERRAL OR WAIVER OF SERVICE COSTS Name of Respondent/Defendant STATE OF ARIZONA ) COUNTY OF MARICOPA ) ss 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): An enforceable injunction against harassment or order of protection has been granted to me against the person to be served. © Superior Court of Arizona in Maricopa County June 25, 2007 ALL RIGHTS RESERVED ASA Page 1 of 2 GNF21f Use current form American LegalNet, Inc. www.FormsWorkFlow.com Case No. . 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 SIGNATURE UNDER PENALTY OF PERJURY Today’s Date: Signature: Print Your Name: INFORMATION FOR SERVICE You must provide the following information: To the best of my knowledge, as of (date) , the last known address of the person to be served was: . (Street Address, City and State) © Superior Court of Arizona in Maricopa County June 25, 2007 ALL RIGHTS RESERVED ASA Page 2 of 2 GNF21f Use current form American LegalNet, Inc. www.FormsWorkFlow.com