Superior Court of Washington, County of In re parentage: Petitioner (person who started this case): No. And Respondents: (parent / presumed parent / alleged parents) Chain of Custody Declaration (DCLR) Children over age 2: Chain of Custody Declaration I declare: 1. 2. My name is: in (city): . I work for (employer): as (job title): I confirmed the . On (date): , at (location): identity of, and witnessed the collecting of (type): samples from the following people: Name: Name: 3. Immediately after the samples were collected, I placed them in a sealed container that was addressed to: , and identified by this shipping number: . I then gave that container to an employee of (shipping company): Other (specify): . 4. 5. I declare under penalty of perjury under the laws of the state of Washington that the facts I have provided on this form are true. Signed at (city and state): Sign here RCW 26.26.415 Optional Form (05/2016) FL Parentage 308 Date: Print name (if lawyer, also list WSBA No.) Chain of Custody Declaration p. 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com