SERVICE BY PUBLICATION M.R. Civ. P. 4(g)(ii) Date (Name and Address of Party) (Name and Address of Newspaper) RE: v. To Whom it May Concern: I am forwarding to you a copy of the Order for publication in the above entitled matter to be published in your newspaper for three successive weeks, first publication to begin within 20 days of the date of the Court's Order. When this has been completed, would you please complete the enclosed verification, have it notarized and return it to me, along with a tear sheet showing the actual publication. Sincerely, Party's signature CV-172, Rev. 06/14 Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com