IMPOUNDED CONFIDENTIAL AFFIDAVIT OF MINOR (Pursuant to G.L. c. 112, 247 12S) DOCKET NUMBERCASE NAME: Trial Court of MassachusettsThe Superior Court COURT NAME & ADDRESS IN THE MATTER OF MARY MOE AOSC 6/2019 CountyClerk of CourtsSignatureDated 1. I am the woman who has filed the petition in this case using the name "Mary Moe." 2. I am less than eighteen years of age. 3. My legal name is: 4. If it is necessary, I can be reached - through my attorney of record at: (please provide attorney's name and telephone number) by the following means: (please provide any special instructions you wish observed should it be necessary for the Court to reach you) Special Instructions: American LegalNet, Inc. www.FormsWorkFlow.com