1 2 3 4 Code: 3715 Name________________________________ Address______________________________ ______________________________ Telephone No.________________________ Acting in Proper Person 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 12 13 14 _______________________________, Plaintiff/Petitioner VS Case No. _____________________ Dept. No. _____________________ _______________________________, Defendant/Respondent. 15 PROOF OF PUBLICATION 16 17 Attached is the proof of publication of the Notice. 18 This document does not contain the Social Security number of any person. 19 I declare, under penalty of perjury under the law of the State of Nevada, that the 20 foregoing is true. 21 DATED this _______ day of ________________________, 20______. 22 23 ________________________________________ (Your Signature) 24 25 26 27 28 1 American LegalNet, Inc. www.FormsWorkFlow.com