FAMILY COURT FIRST CIRCUIT STATE OF HAWAI221I ORDER FOR SERVICE BY PUBLICATION [ ]and Mailing of Notice CASE NUMBER FC-A NO. In the Matter of Adoption of A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: A [ ]MALE [ ]FEMALE CHILD, Born on: by [ ]the legal spouse of [ ]and [ ]the child(ren)'s legal parent [ ]husband and wife [ ]an unmarried person Petitioner(s). [ ]ATTORNEY FOR PETITIONER(S) [ ]PETITIONER(S) PRO SE Name Address City, State, Zip Code Telephone Number It appearing from the petition/motion and affidavit that service by publication of the annexed notice is appropriate and reasonable, IT IS HEREBY ORDERED as follows: 1. Hearing of the petition for adoption shall be had at the time and place set forth in such notice. 2. Notice of the pendency of the petition shall be given to the nonconsenting parent by publication in a newspaper once, each week, for four successive weeks, the last publication to be not less than twenty-one (21) days prior to the time of hearing. 3. Publication shall be in the , a newspaper suitable for the advertisement of legal notices in judicial proceedings. 4. There shall be filed in this proceeding, prior to the time of hearing of the petition, an affidavit of publication, pursuant to this order, which shall constitute proof of service under the provisions of this order. [ ]5. It is further ordered that a certified copy of the petition and notice be mailed to the nonconsenting parent by regular mail at his or her last known address. Date Signature of Judge 08/07/01 ORDER FOR SERVICE BY PUBLICATION [ ]AND MAILING OF NOTICE American LegalNet, Inc. www.FormsWorkFlow.com