Fill and Sign the Plaintiffpetitioner Affiant Being Duly Sworn Upon Herhis Oath and Being of Legal 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 Ac tion 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. Th e Defe ndant /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 o r 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 acce ptable 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 cause showing the making of such service. 4. That I am re questing 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 N umber : Subscribed and sworn to before me on this ____ day of ________________, 20___. WITNESS my hand and official seal. _________________________________ Notarial Officer My commission expires: ____________________