For Clerk’s Use Only Name of Person Filing: ______________________________________ Mailing Address: ______________________________________ City, State, and Zip Code: ______________________________________ Daytime / Evening Phone: ______________________________________ ATLAS Number (if applicable):______________________________________ State Bar Number (if applicable):____________________________________ Self or Attorney for Petitioner Respondent Representing: (If Attorney, include State Bar Number) SUPERIOR COURT OF ARIZONA MOHAVE COUNTY _______________________________________ Name of Petitioner/Plaintiff Case Number: ___________________________ AFFIDAVIT OF SERVICE WITH SIGNATURE CONFIRMATION _______________________________________ name of Respondent/Defendant For Family Court Cases Arizona Rules of Family Law Procedure 41 & 42 YOU MUST ATTACH A COPY OF A SIGNED RETURN RECEIPT FOR DELIVERED MAIL and A COPY OF THE RECEIPT THAT SHOWS TO WHOM AND WHERE THE DOCUMENTS WERE SENT. I sent the Family Court legal documents checked or listed below to the other party in the manner indicated. The documents were signed for BY THE OTHER PARTY ONLY AND NO ONE ELSE. A copy of the OTHER PARTY’S SIGNATURE acknowledging receipt of delivery is attached to page 3. Mailed to (Name): ___________________________________________________________________________ Address: ___________________________________________________________________________ City, State, Zip: ___________________________________________________________________________ Date documents sent: (Month/Day/Year) _______________________________________________ Date documents delivered: (Month/Day/Year) _______________________________________________ Mark the box beside each document you sent to the other party. You must send each and every document listed under your type of court case unless indicated otherwise. DIVORCE (OR ANNULMENT) DIVORCE (OR ANNULMENT) WITH CHILDREN WITHOUT CHILDREN Petition Petition Summons Summons Preliminary Injunction Preliminary Injunction Health Insurance Notice Health Insurance Notice Parent Info. Program Notice Notice to Creditors Notice to Creditors Affidavit Regarding Minor Children PATERNITY (to establish) LEGAL SEPARATION LEGAL SEPARATION WITH CHILDREN WITHOUT CHILDREN Petition Petition Summons Summons Preliminary Injunction Preliminary Injunction Notice to Creditors Notice to Creditors Health Insurance Notice Parent Info. Program Notice Affidavit Regarding Minor Children TEMPORARY ORDERS Motion for Temporary Order Order to Appear Family Court Dept. Notices About: Returns/Conferences Temporary Orders Affidavit of Financial Info. (if for spousal maintenance) Parents Worksheet for Child Support (if for child support) Parenting Plan (if for custody/parenting time) 1/21/2010 Petition Summons Parent Info. Program Notice Page 1 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case No.________________________________ CHILD CUSTODY, PARENTING TIME, SUPPORT (to establish when paternity already legally established) Petition Summons Parent info. Program Notice CHILD SUPPORT (to establish when paternity already legally established) Petition Order to Appear Parents Worksheet for Child Support MODIFY CHILD SUPPORT 15% OR MORE (“Simplified Mod”) Petition to Modify Parents Worksheet for Child Support Blank Request for Hearing MODIFY SPOUSAL MAINTENANCE OR SPOUSAL AND CHILD SUPPORT (“Standard Mod”) Petition to Modify Support Order Affidavit of Financial Information Order to Appear MODIFY CHILD SUPPORT MODIFY CUSTODY and/or PARENTING TIME AND (“Standard Mod”) SUPPORT Petition to Modify Child Support – Std. Process Petition to Modify Affidavit of Financial Information Notice of Filing for Modification of Custody Order to Appear Parents Worksheet for Child Support Affidavit Regarding Minor Children (only if children have not lived in Mohave County whole time since last custody order) STOP ORDER OF ASSIGNMENT Petition to Stop Order of Assignment Blank Request for Hearing MODIFY (Change) ORDER OF ASSIGNMENT Petition to Modify Order of Assignment Blank Request for Hearing OTHER TYPE CASE (List Type): (Example: “Annulment”) _______________________________________________ (Below list name of each document you received: Example: “Petition for Annulment,” “Summons,” etc.) _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ How I sent the documents: U.S. Mail (Express or Priority Mail with Signature Confirmation, Certified or Registered Mail. Copy of OTHER PARTY’S SIGNATURE of Receipt is attached. Commercial Delivery Service (FEDEX, UPS, etc.) Copy of OTHER PARTY’S SIGNATURE of Receipt is attached. OATH AND VERIFICATION STATE OF ARIZONA County of Mohave ) ) ss. By signing below, I swear or affirm under penalty of perjury that I have read and understand the contents of this document are true and correct to the best of my knowledge and belief. _____________________________________________ Signature SUBSCRIBED AND SWORN to before me this _____________________________ Date day of , 20 , by ______________________________________ Notary Public / Deputy Clerk My Commission Expires _____________________ 1/21/2010 Page 2 of 3 American LegalNet, Inc. www.FormsWorkFlow.com Case No.__________________________________ Attach a copy/printout of the other party’s signature acknowledging receipt of the court papers here. If using Certified Mail, tape the green signed return receipt card to this page with the signature side visible. • Note that the only acceptable signature is that of the OTHER PARTY • You may specify “restricted delivery” so that no other person is permitted to sign • Some delivery services do not offer restricted delivery Attach a copy of the cash register receipt/mailing invoice from the Postal Service or company paid to make delivery or a copy of the package label that shows to whom and where the documents were sent. 1/21/2010 Page 3 of 3 American LegalNet, Inc. www.FormsWorkFlow.com