IN THE FAMIL Y COURT OF COUNTY, WEST VIRGIN IA In re: The Marriage / Children of: ___________________, Petitioner, and ___________________, Respondent. Civil Action No. _____. Request for Indirect Servi ce on Person Permitted to Withhold Identifying Information I, ___________________________, the ___ Petitioner ___ Respondent, have been informed by court personnel that ________________________________, has been permitted to withhold identifying information from pleadings and other papers filed in this case. Without access to such information I am unable to serve pleadings and other papers directly on this person. Therefore, I request that the Family Court serve the following papers on ____________________________ in the manner indicated below. I have attached copies of these papers to this request. Papers to be served are: ____________________________________________________ _____________________________________________________________________________. Type of service requested is: _______________________________________________. ___ I have paid to the Circuit Clerks Office the necessary fees for the type of service I have requested, and I have attached a copy of my receipt for the payment of those fees. ___ I have qualified for a waiver of fees and costs, and I have enclosed the proof of my waiver. Without proof of payment of the fees for service, or proof of waiver of the fees, your papers will not be served. _____________________ _______________________ ________________ (Print your name.) Signature Date SCA-FC-142 (12/01 ) Request for Indirect Serv ice Page 1 of 1