Form 241 Rev 06/13 The Family Court of the State of Delaware In and For New Castle Kent Sussex County AFFIDAVIT THAT A PARTY'S ADDRESS IS UNKNOWN Petitioner Name: Respondent Name: File Number State of Delaware County ) ) ) day of , Petition Number BE IT REMEMBERED, that on this , personally appeared before me, a Notary Public for the State and County aforesaid, ("Affiant"), who, being by me duly sworn according to law did depose and say: 1. 2. My name is I do not know the current address and/or telephone number, nor do I know anyone who could provide me with the current address and/or telephone number of . I have contacted his/her: (Please check as appropriate) 3. Parent Spouse Employer Other: His/Her last known address and telephone number were: Street Address (including Apt) P.O. Box Number City/State/Zip Code Phone Number Information as of: (date) 4. 5. I have had no contact with him/her since . I have been informed of my responsibility to accomplish publication, unless the Court has approved my application to proceed In Forma Pauperis, and my failure to do so will result in the petition being dismissed after 30 days. The information contained herein is true and correct to the best of my knowledge and belief. 6. Affiant Sworn to subscribed before me this day of , Clerk of Court/ Notary Public Date American LegalNet, Inc. www.FormsWorkFlow.com