Supporting Affidavit (For Service by Mail or Personal Service Without the State)

This affidavit can be executed by the affiant who is responsible for the prayer of the petition that a proper notice to a part is given.

Extracted Text for Proper Search

FAMILY COURT 
 FIRST CIRCUIT 
  STATE OF HAWAI‘I  	 SUPPORTING AFFIDAVIT  
  (For Service by Mail or Personal 
  Service Without the State)  	CASE NUMBER 
FC-A NO.	
 	
 
In the Matter of Adoption of 
A [ ]MALE [ ]FEMALE CHILD, 
Born on:                                                                   
A [ ]MALE [ ]FEMALE CHILD, 
Born on:                                                                   
A [ ]MALE [ ]FEMALE CHILD, 
Born on:                                                                   
A [ ]MALE [ ]FEMALE CHILD, 
Born on:                                                                   
 
by 
 
                                                                                
[ ]the legal spouse of  [ ]and 
                                                                                
[ ]the child(ren)'s legal parent 
[ ]husband and wife 
[ ]an unmarried person 
 
Petitioner(s).	
  
 	
 
 
The undersigned being first duly sworn on oath, deposes and says that: 
This affidavit is made in support of the prayer of the petition that notice to the non-consenting  
[  ] mother   [  ] father  [  ] legal guardian  [  ] legal custodian  of the subject child be given by [  ] mail  
[  ] personal service without the state. 
The name of  the non-consenting person/agency is:                                                           	
. 
The present address or the last known address of the non-consenting person/agency is as 
follows: 
                                                                                                                                                               	
. 
 	
 
Signature of Petitioner 
 
 
State of Hawai‘i, County 
of Honolulu: 
 
                                         
 
 Date  
Signature: 
 
 
                                                                  
Notary Public, State of Hawai‘i  
Printed Name of Notary Public: 
 
 
                                                   
  
  
Commission 
Expires: 
 
                          
  
08/07/01 SUPPORT AFFIDAVIT (For Service

by Mail or Personal Service Without the State)