(Copy Receipt) (Clerk’s Date Stamp) SUPERIOR COURT OF WASHINGTON COUNTY OF ___________________ In the Guardianship of: CASE NO. __________________________ ___________________________________ DECLARATION OF SERVICE (AFSR) I declare: 1. I am a competent person over the age of eighteen (18) years, a citizen of the United States, a resident of the State of Washington and am not a party to this action. 2. I caused to be served true and correct copies of the: Petition for Appointment of Guardian Notice of Guardianship Petition Order Appointing Guardian ad Litem and Notice of Hearing Other: ____________________________________________________ on (date) __________________________ (time) ________________ to the following individuals at the following address by the method indicated: (If additional space is needed, attach a separate sheet of paper.) Name: __________________________ Address: ________________________ ________________________________ #11-DECLARATION OF SERVICE Hand Delivered (Personal Service) Regular 1st Class US Mail Certified Mail, Return Receipt Requested Other: ________________________ PAGE 1 OF 2 REVISED 7/05 American LegalNet, Inc. www.USCourtForms.com Name: _________________________ Address: _______________________ _______________________________ Hand Delivered (Personal Service) Regular 1st Class US Mail Certified Mail, Return Receipt Requested Other: ________________________ Name: _________________________ Address: _______________________ _______________________________ Hand Delivered (Personal Service) Regular 1st Class US Mail Certified Mail, Return Receipt Requested Other: ________________________ Name: _________________________ Address: _______________________ _______________________________ Hand Delivered (Personal Service) Regular 1st Class US Mail Certified Mail, Return Receipt Requested Other: _______________________ (Attach Return Receipt if service by certified mail.) I declare under penalty of perjury under the laws of the State of Washington that to the best of my knowledge the statements above are true and correct. Dated this _________ day of___________________, 20_______, at (city)_________________________, (state)_________________. Signature Printed Name Address Telephone/Fax Number City, State, Zip Code Email Address #11-DECLARATION OF SERVICE PAGE 2 OF 2 REVISED 7/05 American LegalNet, Inc. www.USCourtForms.com