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COURT OF WASHINGTON FOR Petitioner vs. DOB . Respondent DOB NO. PROOF OF MAILING (AFML) I certify under the penalty of perjury under the laws of the state of Washington that I am 18 y ears of age or older and I am not the Petitioner or the Respondent, and that on (date) I deposited two copies of the following documents: Petition for Order for Protection Tem porary Order for Protection and Notice of Hearing Order Transferring Dom estic Violence Case and Setting Hearing Order for Protection Reissuance of Tem porary Order for Protection Order Realigning Parties and Notice of Hearing Notice of Hearing Motion to Modify /Term inate Order for Protection Order Modify ing/Term inating Order for Protection Other: in the U.S. m ail, postage prepaid, one first class a nd one certified (return receipt requested), addressed to the Respondent Petitioner at the last known m ailing address of: . Signed on at , Washington. (Date) (Place) Signature Address Print Nam e SER VER: 1) Co mplete and return this form to this court: and 2) deliver a copy to the law enforcement agency where petitioner lives. PROOF OF MAILING (AFML) – Page 1 of 1 WPF DV-9.040 (6/2002) - RCW 26.50.050, .123

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