SUPERIOR COURT OF WASHINGTON COUNTY OF SPOKANE In re the Petition for Change of Name of: CASE NO. ____________________________ _________________________________ MOTION AND DECLARATION FOR a Minor Child SERVICE OF SUMMONS BY PUBLICATION (DCLR) I. MOTION The petitioner moves the court, pursuant to RCW 4.28.100 for an order allowing service of the summons and petition by publication. Dated: __________________________ Signature of Lawyer or Petitioner __________________________________________ Print or Type Name II. DECLARATION 2.1 Service of summons by publication is justified because: the non-petitioning party is not a resident of this state. the non-petitioning party cannot be found in this state because: the non-petitioning party has departed from Washington to avoid service of summons. the non-petitioning party has concealed himself/herself to avoid service of summons. other: NAME CHANGE-MOTION & DECLARATION FOR PAGE 1 OF 2 SERVICE OF SUMMONS BY PUBLICATION RCW 4.28.100, CR4 (3/2004) >>>> 22.2 The facts supporting the above allegations are: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 2.3 The following efforts were made to locate the non-petitioning party for personal service: __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 2.4 A copy of the summons (substantially in the form prescribed in RCW 4.28.110) and the petition have been deposited in the post office, directed to the non-petitioning party at the non-petitioning partys place of residence. I do not know the non-petitioning partys address. I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. Signed at ________________________________ on ___________________________ [Place] [Date] _______________________________________ Signature _______________________________________ Print or Type Name NAME CHANGE-MOTION & DECLARATION FOR PAGE 2 OF 2 SERVICE OF SUMMONS BY PUBLICATION RCW 4.28.100, CR4 (3/2004)