Free Statement of Mailing: Exhibit "1" and Exhibit "2" - Hawaii

STATE OF HAWAI`I
FAMILY COURT THIRD CIRCUIT

CASE NUMBER

STATEMENT OF MAILING EXHIBITS "1" AND "2" u u

FC-D NO.

This document is prepared by
Plaintiff Atty. for Plaintiff

PLAINTIFF (Full Name) VS.

_________________________________________________
Name

_________________________________________________ _________________________________________________
Address

_________________________________________________ DEFENDANT (Full Name)
City, State, Zip

_________________________________________________
Phone

STATEMENT OF MAILING
I REPRESENT THAT I caused one certified copy each of the Complaint For Divorce; Summons to Answer Complaint; and Motion for Service by Mail and Affidavit; Order for Service by Mail; and _________________________________, to be mailed by certified or registered mail, return receipt requested, restricted delivery to: _________________________________________________________________________________
Defendant's Name

_________________________________________________________________________________
Defendant's Address

_________________________________________________________________________________
City/State/Zip

Defendant At the time of mailing, the receipt attached hereto as Exhibit "1" was postmarked and dated. Thereafter, the return receipt attached as Exhibit "2" was received.

DATE

PLAINTIFF'S SIGNATURE

REPROGRAPHICS (6/08)

STATEMENT OF MAILING/EXHIBITS "1" AND "2"

Reset Form

3F-P-261

EXHIBIT "1"

EXHIBIT "2"

REPROGRAPHICS (6/08)

3F-P-261