Affidavit Of Service By Certified Mail Name Change No Minor Children

Name of Person Filing: Street Address: City, State, Zip Code: Telephone Number: Email Address: ATLAS Number (if applicable) Representing Self (No Attorney) If Attorney, Bar Number: or Represented by Attorney SUPERIOR COURT OF ARIZONA PINAL COUNTY In the Matter of: CASE NUMBER: CV2 AFFIDAVIT OF SERVICE BY CERTIFIED MAIL Name of Applicant HONORABLE: STATE OF ARIZONA COUNTY OF PINAL ) ) ss. 1. I am familiar with the facts stated in this Affidavit, and I make this Affidavit to show that I have served copies of the "Application for Change of Name" and the "Notice of Hearing Regarding Application for Change of Name" on the person named below by certified mail/restricted delivery, return receipt requested. Person served (name of other party): Address where other party was served: Date of receipt by the other party: 2. The Application and Notice listed above were received by the other party as shown by the receipt, the original of which is attached to this Affidavit on a separate piece of paper. (Signature) SUBSCRIBED AND SWORN TO before me this day of 20 By My Commission Expires: (Deputy Clerk/Notary Public) Page 1 of 1 CV_ASCM_COSCPinal_04.09.12 Use only most current version American LegalNet, Inc. www.FormsWorkFlow.com