Fill and Sign the Age Hereby States and Alleges as Follows Form

Affidavit to Allow Service by Registered or Certified Mail July 2014 Page 1 of 2 STATE OF WYOMING ) IN THE DISTRICT COURT ) ss COUNTY OF ________________ ) _______________ JUDICIAL DISTRICT Plaintiff/Petitioner: , ) Civil Action Case No. ___________ (Print name of person filing) ) ) vs. ) ) Defendant/Respondent:______________________. ) (Print name of other party ) AFFIDAVIT TO ALLOW SERVICE BY REGISTERED OR CERTIFIED MAIL STATE OF WYOMING ) ) ss. COUNTY OF ___________ ) The Plaintiff/Petitioner-Affiant, being duly sworn upon her/his oath and being of legal age, hereby states and alleges as follows: 1. I am the Plaintiff/Petitioner in the above referenced matter. Service of Summons cannot be made within the state. 2. The Defendant/Respondent ’s address is: . 3. In accordance with Wyoming Rules of Civil Procedure 4(l)(2), upon the request of any party the clerk shall send by registered or certified mail a copy of the complaint and summons addressed to the party to be served at the address given in this affidavit. The mail shall be sent marked "Restricted Delivery," requesting a return receipt signed by the addressee or the addressee's agent who has been specifically authorized in writing by a form acceptable to, and deposited with, the postal authorities. When such return receipt is received signed by the Affidavit to Allow Service by Registered or Certified Mail July 2014 Page 2 of 2 addressee or the addressee's agent the clerk shall file the same and enter a certificate in the c ause showing the making of such service. 4. That I am requesting service by certified mail because the Defendant/Respondent ca nnot be served within the state. FURTHER, I swear under penalty of perjury that the information provided in this form is true and correct. DATED this ____ day of ______________, 20___. Signature Printed name: Address: Phone Number : Subscribed and sworn to before me on this ____ day of ________________, 20___. WITNESS my hand and official seal. _________________________________ Notarial Officer My commission expires: ____________________