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Juvenile

In the Matter of the Welfare of the Child(en)of: Parent Parent STATE OF MINNESOTA COUNTY OF
(County where Affidavit signed)

Legal Custodian Legal Custodian ) ) SS )

Affidavit of Diligent Efforts to Locate Parent and Order for Service By Publication

________________________, being duly sworn upon oath, deposes and states: 1. 2. Your affiant is employed by _________________County Social Services and has attempted to locate the parent in the above-captioned matter. The name and birth date of the parent who is the subject of this affidavit is as follows: Name _________________________ DOB __________________________ 3. The last known address on record for this parent, for purposes of meeting the requirements for publication, is as follows:

___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________

4.

Through the following process, your affiant has confirmed that this address is not the current address for this parent: Attempts to contact parent by phone and mail at this address have failed. Attempts to have parent personally served at this address have failed. Diligent efforts have been made by your affiant, or staff under your affiant's direction, to locate this parent by checking the following resources:
Resource SSIS / CSIS [Social Service Records] MAXIS [Economic Assistance Records, GA, MFIP] County Parental Fee Unit Child Support & Collections Telephone Directory Date Checked Last Address on Record Explanation of Last Address on Record

5.

CHP602

State

ENG

Rev 5/08-D

www.mncourts.gov/forms

Page 1 of 2

Resource Directory Assistance Reverse Directory Criminal Check / SIP County Corrections Department [probation / parole records] Tribe Other Parent Relatives: [list relationship] Internet Search Other:

Date Checked

Last Address on Record

Explanation of Last Address on Record

6.

Your affiant's efforts to locate the above-named parent have been unsuccessful and your affiant respectfully requests that service upon this parent be made by publication and that a copy be mailed to the last known address. FURTHER YOUR AFFIANT SAYETH NOT. _____________________________________________
For Social Services

Subscribed and sworn to before me on this ____ day of___________, 20___. ________________________________ Notary Public ORDER Based upon the foregoing Affidavit of Diligent Efforts, this Court hereby orders publication on the above-referenced matter and that a copy be mailed to any last known address. DATED: BY THE COURT:

Judge of District Court

CHP602

State

ENG

Rev 5/08-D

www.mncourts.gov/forms

Page 2 of 2