STATE OF HAWAI`I
FAMILY COURT FIRST 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
4/98
STATEMENT OF MAILING/EXHIBITS "1" AND "2"
Reset Form
1F-P-739
EXHIBIT "1"
EXHIBIT "2"
1F-P-739