AFFIDAVIT AND PETITION FOR ORDER OF PUBLICATION Commonwealth of Virginia VA. CODE §§ 8.01-296(3), -316; -317; 16.1-264 RETURN DATE FILE NO. .............................................................................................................................. . [ ] General District Court [ ] Juvenile and Domestic Relations District Court AFFIDAVIT AND PETITION FOR ORDER OF PUBLICATION Party to be served: . . I, the undersigned applicant, state under oath that the object of this suit is to and that: [ ] Diligence has been used without effect to ascertain the location of the above-named person(s) to be served; .............................................................................................................................................................................................................................. , [ ] Commonwealth of Virginia, in re ........................................................................................, a Juvenile [ ] The last known residence of the person(s) to be served was in the county or city in which service is sought and that a return has been filed by the Sheriff that the process has been in his or her hands for 21 days and that he or she has been unable to make service; or [] ........................................................................................................ PLAINTIFF [ ] The party to be served is: [ ] a foreign corporation, [ ] a foreign unincorporated association, order or foreign unincorporated common carrier, or [ ] a non resident individual other than a nonresident individual fiduciary who has appointed a statutory agent under § 26-59. The last known post office address of the party against whom Publication is ordered is: ................................................................................................................. ................................................................................................................. v. ................................................................................................................. DEFENDANT ................................................................................................................. ................................................................................................................. [ ] ................................................................................................................................................................................................................................... [ ] The post office address of the party against whom publication is asked is unknown. Wheretofore, I ask for service of process by ORDER OF PUBLICATION: [ ] and that the Court dispense with publication in a newspaper. ....................................................................... DATE ___________________________________________________________________________ APPLICANT'S SIGNATURE [ ] PLAINTIFF [ ] ATTORNEY Attorney for .................................................................................... ................................................................................................................. NAME ................................................................................................................. ADDRESS ................................................................................................................. Subscribed and sworn to before me this day: ....................................................................... DATE FOR NOTARY PUBLIC'S USE ONLY: State of ............................................................................................ [ ] City [ ] County of ................................................................................................. Acknowledged, subscribed and sworn to before me this .............................. day of .............................................................................. , 20 ...................... .......................................................................................... NOTARY REGISTRATION NUMBER ___________________________________________________________________________ CLERK ................................................................................................................. TELEPHONE NOTARY PUBLIC (My commission expires: ________________________________________________________ ..............................................) FORM DC-435 MASTER 11/10 American LegalNet, Inc. www.FormsWorkFlow.com