Affidavit For Service By Publication-Order Of Publication-Adoption {CCR-A-10}

V I R G I N I A IN THE CIRCUIT COURT OF FAIRFAX COUNTY IN RE: ADOPTION OF MINOR CHILD : ADOPTION NO. AFFIDAVIT FOR SERVICE BY PUBLICATION Comesnow , Petitioner herein, seeking service on , the natural parent by ORDER OF PUBLICATION, and who under oath deposes and states under oath that th e Natural Parent in this cause, Is a non-resident individual, other than a non-resident individual fiduc iary who has appointed a statutory agent; OR Cannot be found, and that diligence has been used without effect to ascertain the location of the party to be served; OR Cannot be served with court process, and that a return has been filed by the Sheriff which shows that the process has been in his or her hands for twenty-one (21) days and the Sheriff has been unable to make service; OR OTHER: and the last known mailing address of Natural Father/Mother is as follow s: Name Address OTHER INFORMATION: Signature of Petitioner Counsel for Petitioner TO BE COMPLETED BY A NOTARY PUBLIC/ OR DEPUTY CLERK In the Commonwealth/State of: In the County of : Subscribed and sworn to before me thisday of , . My Commission Expires: Notary Public/Deputy Clerk CCR-A-10 (October, 2001) American LegalNet, Inc. www.USCourtForms.com<<<<<<<<<********>>>>>>>>>>>>> 2V I R G I N I A: IN THE CIRCUIT COURT OF FAIRFAX COUNTY IN RE: ADOPTION OF MINOR CHILD : ADOPTION NO. ____________________________________ ORDER OF PUBLICATION The reason for this cause is to obtain an adoption . An affidavit having been made and filed showing that the Natural Parent in the above- entitled cause is Is a non-resident individual, other than a non-resident individual fiduc iary who has appointed a statutory agent; OR Cannot be found, and that diligence has been used without effect to asce rtain the location of the party to be served; OR Cannot be served with court process, and that a return has been filed by the Sheriff which shows that the process has been in his or her hands for twenty-one (21) days and the Sheriff has been unable to make service; OR OTHER: and last known mailing address of Natural Father/Mother is as follows: Name Address TO BE COMPLETED BY CLERKS OFFICE Upon consideration, this Order of Publication is granted, and it is ORDE RED that the above named Natural Parent shall appear here on or before day of , after proper publication of this Order, to protect his/her interest in this cause. Entered: TESTE: JOHN T. FREY, CLERK BY: DEPUTY CLERKSignature of Petitioner or Counsel for Petitioner Address: Phone Number: CCR-A-10 (October,2001) American LegalNet, Inc. www.USCourtForms.com