Fill and Sign the Declaration Re Service Form

Decl re Service Member’s Civil Relief Act (AFSCR) - Page 1 of 2WPF All Cases 01.0200 (06/2018) RCW 38.42.050Superior Court of WashingtonCounty ofIn r e : Petitioner, and Respondent. No. Declaration re: Service Members Civil Relief Act(Active Duty Military)(Optional Use)(AFSCR)(The federal Servicemembers Civil Relief Act covers: Army, Navy, Air Force, Marine Corps, and Coast Guard members on active duty;  National Guard or Reserve members under a call to active service for more than 30 days in a row; and commissioned corps of the Public Health Service and NOAA.The state Service Members’ Civil Relief Act covers those service members listed above who are either stationed in or residents of Washington state and their dependents, except for the commissioned corps of the Public Health Service and NOAA.) I (name) ______________________________ , Declare that: (Name): is not a service member or a dependent covered by the state or federal Service Members’ Civil Relief Acts. (Name): is a service member covered by the state or federal Service Members’ Civil Relief Acts. (Check all that apply): Branch of Service Washington State Connection Duty Status U .S . A rm ed F orc e s (A rm y, N avy, A ir Fo rc e , M arin e C orp s, Co a st G uard ) N atio nal G uard o r Re se rv e s c o m m is sio ned c o rp s of P ublic H ealt h Serv ic e o r N atio nal S ta tio ned in or r e sid ent o f Wa sh in gto n N one I n m ilit a ry s e rv ic e ( m eanin g a ctiv e d uty or a c a ll t o a ctiv e s e rv ic e f o r m ore t h an 30 d ays in a r o w ) I s w it h in 9 0 d ays a fte r t e rm in atio n o f o r re le a se f r o m m ilit a ry s e rv ic e ( 5 0 U SC 522 (a )(1 )) I s w it h in 1 80 d ays a fte r t e rm in atio n o f or r e le ase f r o m m ilit a ry s e rv ic e ( R CW 38.4 2.0 60(1 )(a )) Decl re Service Member’s Civil Relief Act (AFSCR) - Page 2 of 2WPF All Cases 01.0200 (06/2018) RCW 38.42.050O ce anic a nd Atm osp heric Ad m in is tr a tio n N ot o n a ctiv e d uty o r a c a ll t o a ctiv e se rv ic e f o r m ore t h an 3 0 d ays in a r o w (Name): is a dependent of (name): , who is a service member covered by the state Service Members’ Civil Relief Act and who is under a call to active service for more than 30 days in a row. (Dependent means a spouse, child under 18, or other person who got at least 50% of his/her financial support from a covered service member.)I know this because (check all that apply): The attached report from the Defense Manpower Data Center (DMDC) shows his/her status. (To get the report, visit https://scra.dmdc.osd.mil/scra/. You will need his/her birth date or social security number to search this website.)I sent him/her a Notice re Military Dependent (form All Cases 01.0230) to inform him/her of dependents’ rights. S/he did not respond within 20 days claiming to be a protected military dependent. Therefore, the other party should not be considered a protected military dependent. The Notice was (check one): personally served on (date): mailed by first class mail on (date): I have personal knowledge of his/her military or dependent status (explain): Other (explain): S/he is a service member or a dependent covered by the state and/or federal Service Members’ Civil Relief Act, and in this case:has his/her own lawyer.has a lawyer appointed by the court. The court: h as s u sp ended o r d ela ye d t h is c a se . h as n ot s u sp ended o r d e la ye d t h is c a se . I d on’t k n ow w heth er ( name): is a s e rv ic e m em ber o r a d ependent c o ve re d b y t h e s ta te a nd/o r f e dera l S erv ic e M em bers ’ C iv il R elie f A ct. I d id th e f o llo w in g t h in gs t o t r y t o f in d o ut: I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Decl re Service Member’s Civil Relief Act (AFSCR) - Page 3 of 2WPF All Cases 01.0200 (06/2018) RCW 38.42.050Signed at (city) ______________________, (state) __________ on (date) ________________.Signature of Petitioner or Lawyer/WSBA No.Print Name