Name of Person Filing Document: Your Address: Your City, State, Zip Code: Your Telephone Number: Attorney Bar Number (if applicable): Self (Without a Lawyer) OR Representing Attorney for: FOR CLERK'S USE ONLY SUPERIOR COURT OF ARIZONA IN MARICOPA COUNTY IN THE MATTER OF: Case Number: DECLARATION OF SERVICE BY CERTIFIED MAIL 1. I am familiar with the facts stated in this Declaration and know of my own knowledge that the facts stated herein are true and correct. I make this Declaration to show that I have served the court papers on the other party by certified mail, postage prepaid, return receipt requested, pursuant to Rule 48 of the Rules of Procedure for the Juvenile Court and A.R.S. �8-841(E). A copy of the verified Petition and Notice of Hearing were sent to: Person served (Name of Other Party): Relationship of Other Party to Me: Address where Other Party was served: Date of receipt by the Other Party: Date of return of green receipt to me: 2. 3. These court papers were received by the other party as shown by the green receipt, the original of which is attached to this Declaration. Service by certified mail instead of personal service was used because: (Be specific) DECLARATION I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge and belief. Signature Date � Superior Court of Arizona in Maricopa County December 15, 2009 JV24f Page 1 of 1 Use current form ALL RIGHTS RESERVED American LegalNet, Inc. www.FormsWorkFlow.com