For Clerk's Use Only Name of Person Filing: ________________________________________ Mailing Address: ________________________________________ City, State, and Zip Code: ________________________________________ Daytime Phone Number: ________________________________________ State Bar Number (if applicable):______________________________________ Representing: x Self (no Attorney) or x Attorney SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Regarding the Matter of Case Number: ________________________ AFFIDAVIT OF PUBLICATION _______________________________________ (NAME) 1. Attached to this page is the original Affidavit of Publication from the Newspaper. DATED _____________________ _____________________________________ Signature of Person Filing Document Revised: 4/14/2011 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com