IN THE SUPERIOR COURT OF THE STATE OF WASHINGTON

IN AND FOR THE COUNTY OF

In the Guardianship of: . An Alleged Incapacitated Person.	) ) ) ) ) )	Case No.: DECLARATION OF SERVICE (AFSR)

The undersigned declares as follows:

1.	I am over the age of 18 years, and I am not a party to this action.

2.	I served , (Name of AIP) in person, copies of the Petition for Guardianship, Order Appointing Guardian ad Litem and Notice to Alleged Incapacitated Person.

3.	The date, time and place of service were:

Date: Time: am/pm

Address: __

I DECLARE UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT.

Signed at , Washington, , 20

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