Form Sfn 499 - Affidavit Of Mailing

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AFFIDAVIT OF MAILING
Clear Fields
NORTH DAKOTA DEPARTMENT OF HUMAN SERVICES/CFS
SFN 499 (6-2007)
STATE OF NORTH DAKOTA
DEPARTMENT OF HUMAN SERVICES
NOTIFICATION OF CHILD ABUSE
)
AFFIDAVIT OF MAILING
OR NEGLECT CASE DECISION
)
)
)
The undersigned certifies that a true and correct copy of the NOTIFICATION OF CASE DECISION was mailed,
1st
day of
, 20
to:
regular mail, on the
January
16
Signature
DISTRIBUTION: Original sent with notification of case decision, copy for case file.

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