1 Code: 3720 2 Name: ______________________________ Address:_____________________________ ______________________________ Telephone No.________________________ Appearing in Proper Person 3 4 5 6 IN THE FAMILY DIVISION 7 OF THE SECOND JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA 8 IN AND FOR THE COUNTY OF WASHOE 9 10 11 In the Matter of the Guardianship of the Person, the Estate, or the Person and Estate of: 12 ________________________________________ 13 ________________________________________ An Adult. _____________________________________________/ 14 15 16 Case No. ________________________ Dept. No. ________________________ AFFIDAVIT OF SERVICE OF CITATION TO APPEAR AND SHOW CAUSE AND ORDER EXTENDING TEMPORARY GUARDIANSHIP AND AFFIRMING PERMANENT GUARDIANSHIP HEARING DATE (Form #7) 17 18 STATE OF NEVADA 19 COUNTY OF WASHOE 20 __________________________________, being first duly sworn under penalties of perjury, (Name of person making service) states as follows: 21 22 1. ) ) ss. ) That I am: (check the appropriate blank) 23 _____ a party in this action and am appearing in proper person. 24 _____ a person not involved in this action and have no interest in this action and am over the age of 18 years. 25 26 2. That on the _______ day of ____________________, 20______, I served a true and (date) (month) (year) 27 28 correct copy of the document(s) entitled: Citation to Appear and Show Cause and Order Extending Revised 2005 1 American LegalNet, Inc. www.FormsWorkflow.com 1 Temporary Guardianship and Affirming Permanent Guardianship Hearing Date in the following 2 way: 3 IF THE DOCUMENTS WERE SERVED BY MAIL FILL IN THE FOLLOWING: 4 _____ by placing a copy enclosed in a sealed envelope and mailing it certified, return receipt requested 5 6 The envelope was addressed to: 7 Name: _______________________________ Name: ___________________________________ 8 Address: _____________________________ Address: _________________________________ 9 City, State, Zip ________________________ City, State, Zip ____________________________ 10 that there is regular communication by mail between the place of mailing and the place addressed. 11 12 13 IF THE DOCUMENTS WERE PERSONALLY SERVED FILL IN THE FOLLOWING: _____ by personally serving: 14 Name: _______________________________ Name: ___________________________________ 15 Address: _____________________________ Address: _________________________________ 16 City, State, Zip ________________________ City, State, Zip ____________________________ 17 (Additional names and addresses may be attached to this document, if needed) 18 19 DATED this _______ day of ________________________, 20______. 20 21 ____________________________________________ (Your Signature) 22 ____________________________________________ (Print Your Name) 23 24 SUBSCRIBED and SWORN to before me 25 this _______ day of ________________________, 20______. 26 27 __________________________________________________ NOTARY PUBLIC 28 Revised 2005 2 American LegalNet, Inc. www.FormsWorkflow.com 1 SECOND JUDICIAL DISTRICT COURT COUNTY OF WASHOE, STATE OF NEVADA 2 3 AFFIRMATION Pursuant to NRS 239B.030 4 The undersigned does hereby affirm that the preceding document, 5 6 7 (Title of Document) 8 9 filed in case number: 10 Document does not contain the social security number of any person 11 -OR- 12 Document contains the social security number of a person as required by: 13 A specific state or federal law, to wit: 14 ______________________________________________________ (State specific state or federal law) 15 16 -or- 17 For the administration of a public program 18 -or- 19 For an application for a federal or state grant 20 -or- 21 Confidential Family Court Information Sheet (NRS 125.130, NRS 125.230 and NRS 125B.055) 22 23 24 Date: (Signature) 25 26 (Print Name) 27 28 (Attorney for) Affirmation Revised December 15, 2006 American LegalNet, Inc. www.FormsWorkflow.com