State of Minnesota Judicial District: Court File Number: Case Type: In the Matter of the Welfare of the Child(en)of: Parent Parent Juvenile District Court Affidavit of Diligent Efforts to Locate Parent and Legal Custodian Order for Service By Publication Legal Custodian ) ) SS ) STATE OF MINNESOTA COUNTY OF , state the following: 1. Your affiant is employed by County Social Services and has attempted to locate the parent in the above-captioned matter. The name and birth date of the parent who is the subject of this affidavit is as follows: Name DOB 2. 3. The last known address on record for this parent, for purposes of meeting the requirements for publication, is as follows: 4. Through the following process, your affiant has confirmed that this address is not the current address for this parent: Attempts to contact parent by phone and mail at this address have failed. Attempts to have parent personally served at this address have failed. Diligent efforts have been made by your affiant, or staff under your affiant's direction, to locate this parent by checking the following resources: Resource SSIS / CSIS [Social Service Records] MAXIS [Economic Assistance Records, GA, MFIP] County Parental Fee Unit Date Checked Last Address on Record Explanation of Last Address on Record 5. CHP602 State ENG Rev 7/15 www.mncourts.gov/forms American LegalNet, Inc. www.FormsWorkFlow.com Page 1 of 2 Resource Child Support & Collections Telephone Directory Directory Assistance Reverse Directory Criminal Check / SIP County Corrections Department [probation / parole records] Tribe Other Parent Relatives: [list relationship] Internet Search Other: Date Checked Last Address on Record Explanation of Last Address on Record 6. Your affiant's efforts to locate the above-named parent have been unsuccessful and your affiant respectfully requests that service upon this parent be made by publication and that a copy be mailed to the last known address. FURTHER YOUR AFFIANT SAYETH NOT. I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. § 358.116. ________________________________________ For Social Services ORDER Based upon the foregoing Affidavit of Diligent Efforts, this Court hereby orders publication on the above-referenced matter and that a copy be mailed to any last known address. DATED: BY THE COURT: Judge of District Court CHP602 State ENG Rev 7/15 www.mncourts.gov/forms American LegalNet, Inc. www.FormsWorkFlow.com Page 2 of 2