Affidavit Of Service Of Notice To Intervene As A Party {ADO-403}

State of Minnesota County District Court Judicial District: Court File Number: Case Type: Adoption In Re the Petition of: , Petitioner and , Petitioner To Adopt: . (child's current name) Affidavit of Service of Notice to Intervene as a Party State Of Minnesota ) ) SS County Of ) (County where Affidavit Signed) I, (Name of person who mailed or hand delivered documents) , state that on , I served the attached Notice of Intervention (Date Service Made) as a Party as a Matter of Right by (check one): hand delivering the document to the following persons at the following addresses: OR mailing the document to the following person(s) at the following addresses: 1. First Name Street Address City County Last Name Apt. No. State 2. First Name Street Address City County Last Name Apt. No. State American LegalNet, Inc. www.FormsWorkFlow.com ADO403 State ENG 7/15 www.mncourts.gov/forms Page 1 of 2 3. First Name Street Address City 4. First Name Street Address City 5. First Name Street Address City 6. First Name Street Address City County Last Name Apt. No. State County Last Name Apt. No. State County Last Name Apt. No. State County Last Name Apt. No. State I declare under penalty of perjury that everything I stated in this document is true and correct. Minn. Stat. § 358.116. Dated: Signature Name: Street Address: City/State/Zip: E-mail address: American LegalNet, Inc. www.FormsWorkFlow.com ADO403 State ENG 7/15 www.mncourts.gov/forms Page 2 of 2