Superior Court of Washington County of In re: No. Motion and Declaration for Service of Summons by Publication (DCLR) Petitioner, and Respondent. I. Motion _______________________________________ [moving party] moves (asks) the court, pursuant to RCW 4.28.100, for an order allowing service of the summons and petition by publication. Dated: Signature of Moving Party or Lawyer/WSBA No. Print or Type Name II. Declaration 2.1 Service of summons by publication is justified because: [] [] _________________________ [nonmoving party] is not a resident of this state. _________________________ [nonmoving party] cannot be found in this state because: [] [] [] the nonmoving party has departed from Washington to avoid service of summons. the nonmoving party has concealed himself/herself to avoid service of summons. other: Mt and Decl for Serv by Publication (DCLR) - Page 1 of 2 WPF DRPSCU 01.0260 (6/2006) - RCW 4.28.100, CR 4 American LegalNet, Inc. www.USCourtForms.com 2.2 The facts supporting the above allegations are: 2.3 [] Nonparental Custody Petition (You must also complete this part if you are filing a Nonparental Custody Petition): The child [ ] is [ ] is not in the physical custody of (living with) the petitioner(s). 2.4 The following efforts were made to locate the nonmoving party for personal service or service by mail: 2.5 [] [] 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 nonmoving party at the nonmoving party’s place of residence. I do not know the nonmoving party’s address. I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Signed at ________________________, [City] ______________ [State] on _________________ [Date]. Signature of Moving Party Print or Type Name Mt and Decl for Serv by Publication (DCLR) - Page 2 of 2 WPF DRPSCU 01.0260 (6/2006) - RCW 4.28.100, CR 4 American LegalNet, Inc. www.USCourtForms.com