For Clerk's Use Only Name of Person Filing: ______________________________________ Mailing Address: ______________________________________ City, State, and Zip Code: ______________________________________ Daytime Phone Number: ______________________________________ Evening Phone Number: ______________________________________ ATLAS Number (if applicable):______________________________________ State Bar Number (if applicable):____________________________________ Self Representing: Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case Number: _______________________ (Name of Petitioner/Plaintiff) AND (Name of Respondent/Defendant) AFFIDAVIT SUPPORTING OUT-OF-STATE SERVICE A.R.C.P. 4.2(b)); A.R.F.L.P. 42(B) (Required to be filed prior to any default) As required by Arizona rules of civil Procedure, Rule 4.2(b), or Arizona Rules of Family Law Procedures, Rule 4.2(B), I am filing this Affidavit to inform the court why service was made by a person authorized to serve process under the law of the state where such service was made. 1. Reason for service by process outside the State of Arizona: x x The other party resides or works outside the State of Arizona. Other Reason: ____________________________________________________________________ 2. I have attached the Affidavit of the person who served the papers upon the other party, including a statement of the date, time, and circumstances of delivery. The Affidavit indicates the person who served the papers is: x x x 3. A licensed or registered process server in the state where the papers were served. Sheriff, Deputy Sheriff, or other law enforcement Other person authorized to serve process under the laws of the state where service is made, namely: ____________________________________________________________ OATH OR AFFIRMATION State of Arizona Mohave County ) ) ss. By signing this document, I state to the court under penalty of perjury that its contents are true and correct to the best of my knowledge and belief. ___________________________________________________ _____________________________ Signature Date Sworn to or Affirmed before me this ______________ day of ______________________, 20_________ by _________________________________________ My Commission Expires: _______________________ ____________________________________ Deputy Clerk or Notary Public 10/12/2010 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com