SUPERIOR COURT OF CALIFORNIA, COUNTY OF IMPERIAL 939 W. MAIN STREET EL CENTRO, CA 92243 PETITIONER: FOR COURT USE ONLY RESPONDENT: CASE NUMBER: CERTIFICATE OF EXECUTION The undersigned authority has the honor to certify that the documents described below: 1. Were served on the Respondent (name) _______________________________________________________________, on (date) __________________ at (time) ___________a.m./p.m., at (address) _____________________________________ _______________________________ by one of the following methods authorized by the Letter Rogatory: (Please mark the appropriate box) By personal service on the identified address to Respondent; In the following method in accordance with the law of the State of Destination: Substitute service Posting 2. Publication Other (describe)____________________________________________ Were not served, by reason of the following facts(state reasons): ___________________________________________ ____________________________________________________________________________________________________ ANNEXES Documents returned: __________________________________________________________________________________ Executed at ___________________________________, this _______ day of ______________, 20______. (City, State, and Country) _________________________________________________ Name, signature and/or stamp of the Receiving Authority of the State of Destination Mark box next to documents served on the Respondent: Summons Petition for Dissolution of Marriage Petition for Legal Separation Petition for Nullity Petition to Establish Parental Relationship Property Declaration Declaration of Disclosure (Preliminary) Income and Expense Declaration Schedule of Assets and Debts Copy of this Letter Rogatory Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Declaration of Diligence Regarding Attempts to Locate Respondent Notice of Family Law Case Management Conference Blank Response to Petition for Dissolution of Marriage, Legal Separation or Nullity Blank Response to Petition to Establish Parental Relationship Blank Declaration Under Uniform Child Custody Jurisdiction and Enforcement Act (UCCJEA) Blank Property Declaration Blank Declaration of Disclosure Blank Income and Expense Declaration Blank Schedule of Assets and Debts Blank Case Management Questionnaire Other: __________________________________ ________________________________________ . Form Approved for Optional Use FL-18C (Adopted 01/01/11, Revised 01/01/12-01/01/15) imperial.courts.ca.gov CERTIFICATE OF EXECUTION American LegalNet, Inc. www.FormsWorkFlow.com