Form 277 (Rev. 02/11) The Family Court of the State of Delaware In and For New Castle Kent Sussex County AFFIDAVIT OF SERVICE PURSUANT TO 10 Del. C. §3104(d) Petitioner Name Street Address P.O. Box Number City/State/Zip Code Attorney Name v. Respondent Name Street Address P.O. Box Number City/State/Zip Code Attorney Name File Number Petition Number 1. I am to act for the petitioner in this case. 2. The respondent Delaware who, on information and belief, resides at the Petitioner or person duly authorized is a non-resident of the State of 3. On I mailed to defendant by return receipt mail a copy of the summons and petition. I also included any additional materials originally filed with the Court. The form of mail service I used was USPS Certified USPS Registered Other (Please Specify): 4. On I received the return receipt and that receipt was returned: Received Refused Unclaimed If returned "received" or "refused", the return receipt is attached to this affidavit. If returned "unclaimed", the envelope is attached to this affidavit. I swear that the foregoing statements are true and correct to the best of my knowledge and belief. Affiant Date Sworn to subscribed before me this ______ day of ______________________, _________ Clerk of Court/Notary Public American LegalNet, Inc. www.FormsWorkFlow.com