4 ATTORNEY OR PARTY WITHOUT AN ATTORNEY (Name and address) TELEPHONE NO.: FOR COURT USE ONLY FAX NO.: ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CRUZ FAMILY DIVISION 1 Second Street, Room 300 Watsonville, CA (5076 PETITIONER: RESPONDENT: VERIFICATION OF SERVICE BY POSTING OF SUMMONS CASE NUMBER 1. I am over the age of 18 and not a party to this case. My name is _________________________________. My address is __________________________________________________________________________________. (Write in street address, city and state where you live) 2. On _____________________ (date) from _____________________________ (city and state), I mailed a filed copy of the Summons and Petition to Respondent’s last known address. I mailed the Petition and Summons to Respondent’s last known address at: ___________________________________________________________________________________________. 3. On _____________________ (date) at ____________________ (time) I posted a filed copy of the Summons and Petition on the designated bulletin board at: ______________________________________________________________________________________________ (name of location posted and address). I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: ______________________ ________________________________ Print Your Name Here _______________________________ Sign Your Name Here Notice to Petitioner: This verification must be attached to Proof of Service of Summons, Form FL-115, before filing. VERIFICATION OF SERVICE BY POSTING (FAMILY/UNIFORM PARENTAGE/PETITION FOR CUSTODY AND SUPPORT OF MINOR CHILDREN) Santa Cruz Superior Court Adopted for Optional Use New January 1, 2009 Page 1 of 1 SUP CV 1067 American LegalNet, Inc. www.FormsWorkflow.com 4 VERIFICATION OF SERVICE BY POSTING (FAMILY/UNIFORM PARENTAGE/PETITION FOR CUSTODY AND SUPPORT OF MINOR CHILDREN) Santa Cruz Superior Court Adopted for Optional Use New January 1, 2009 Page 1 of 1 SUP CV 1067 American LegalNet, Inc. www.FormsWorkflow.com