Fill and Sign the Instructions for Completing Affidavit of Form

INSTRUCTIONS FOR COMPLETING AFFIDAVIT OF MAILING PUBLISHED NOTICE HEADING • Enter the name of the county where you are filing the Complaint or Petition. Check the box next to what kind of case this is NOTE: These checkboxes and names will NOT print on your completed form. • In cases for Divorce: • Enter your first, middle, and last names. You are the plaintiff. • Enter your spouse’s first, middle and last names. Your spouse is the defendant. • In Cases for Name Change for a Minor: • Enter the current names of the child(ren) that you are requesting name changes for in this case. • Enter your name as “Parent or Guardian” • In Cases for Name Change for an Adult: • Enter your first, middle and last names. You are the Petitioner. • In cases for Emancipation: • Enter your first, middle and last names. You are the Petitioner. • The clerk of the district court will give you a case number when you file the Complaint or Petition. You must include the case number on any papers you file. • BODY OF THE AFFIDAVIT In the blank following “County of” enter the name of the county where you are signing this Affidavit. Enter your full name in the next blank. This paragraph does not have a number. The numbers below give instructions for completing the paragraphs with the same numbers in the Affidavit. Paragraph 1. Enter the date you filed your petition Paragraph 2. Enter the name of the newspaper and the date the notice was published for the first time. Paragraph 3. Enter the date you mailed a copy of the published notice (the newspaper should give you copies) and the names and addresses of the interested persons(s) you mailed copies to. • If there are more names and addresses, check the box and report those on a separate sheet. Page 1 of 2 DC 6:6.8a Rev. 06/19 FINAL SIGNATURE • • • • • ONLY WHEN YOU ARE BEFORE A NOTARY PUBLIC, on the first line sign your first, middle, and last names and enter the date. On the second line enter your first, middle, and last names. On the third line enter your full street address. On the fourth line enter your city, state, and ZIP code. On the fifth line enter your telephone number, including the area code, and your e-mail address, if any. The notary public will fill out the date at the end of the Affidavit and will sign his or her name in the last blank. Page 2 of 2 DC 6:6.8a Rev. 06/19