Fill and Sign the Arizona Certified Mail Form

Person Filing:       Mailing Address:       City, State, Zip:       Day/Evening Phone:       /       Person Filing is: SELF (No Attorney) OR Attorney If Attorney, Bar No.:       Atty. Phone:       SUPERIOR COURT OF ARIZONA ____________ COUNTY       Case Number: Name of Applicant AFFIDAVIT OF SERVICE BY CERTIFIED MAIL 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. The contents of this document are true and correct to the best of my knowledge and belief.       Signature of Sender Date Sworn to or affirmed before me this date: My Commission expires Notary Public or Deputy Clerk Affidavit of Service by Page 1 of 1 Certified Mail For Clerk’s Use Only