SUPERIOR COURT OF WASHINGTON
COUNTY OF _______________________
JUVENILE COURT
Dependency of: No:
Motion and Declaration to Publish
Notice and Summons
D.O.B.: (MTAF)
I. Motion
Based upon the following declaration, I move for an order allowing notice by publication of the
[ ] dependency [ ] termination [ ] guardianship petition filed in this matter to: [ ] the mother
[ ] the father [ ] anyone else claiming a parental interest in the child.
Date:
Signature
Type or Print Name/Title/WSBA No.
II. Declaration
I, declare as follows:
Notice and summons directed to ________________________________ [name] should be
published because:
[ ] the parent or guardian is a nonresident of this state;
[ ] the [ ] parent [ ] guardian of the child is believed to be a resident of another county other
than the county in which the petition has been filed, namely _________________________
____________________________________ [County and State];
[ ] the name or place of residence or whereabouts of the child's parent or guardian is unknown;
[ ] after due diligence, the person attempting service has been unable to serve the summons or
notice and a copy has been deposited in the post office, postage prepaid, directed to the
Mt/Decl to Publish (MTAF) - Page 1 of 2
WPF JU 03.0210 (11/2009) - RCW 13.34.080
American LegalNet, Inc.
www.FormsWorkFlow.com
child's parent or guardian at the last known place of residence:
______________________________
___________________________________________________. The following sources were
investigated or used in my attempt to serve the notice and summons:
[Check applicable boxes and explain in the space below how you used that source or location.
If more space is needed use an attached continuation sheet.]
[ ] All known addresses:
.
[ ] School: _______ .
[ ] Telephone Book/Directory Assistance:
.
[ ] Relatives:
.
[ ] Friends/Neighbors:
.
[ ] Landlords/Roommates:
.
[ ] Law Enforcement:
.
[ ] Workplace/Business:
.
[ ] DSHS/ /DOC:
.
[ ] Other:
I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and
correct.
Signed at ____________________________[city], Washington on _________________________ [date].
Signature
Type or Print Name/Title/Agency
Mt/Decl to Publish (MTAF) - Page 2 of 2
WPF JU 03.0210 (11/2009) - RCW 13.34.080
American LegalNet, Inc.
www.FormsWorkFlow.com