Motion To Dismiss Petition
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1IN THE SUPERIOR COURT FOR THE STATE OF ALASKA
AT __________________
In the Matter of the Necessity
)
for the Hospitalization of:
)
)
,
)
Case No.
Respondent.
)
)
AFFIDAVIT IN SUPPORT OF
MOTION TO DISMISS PETITION
I, being duly sworn, state as follows:
1.
I am the
in this matter.
2.
Because of the following facts, I believe that the petition of
should be dismissed:
Date
Signature
Print Name and Title
Subscribed and sworn to or affirmed before me at
, Alaska,
on __________________________, 20_______.
(SEAL)
Clerk of Court, Notary Public or other person
authorized to administer oaths.
My commission expires:
I certify that on ___________________
a copy of this affidavit was sent to:
court (original)
respondent's attorney
attorney general
respondent
treatment facility
Other:
By: ______________________
Petitioner
MC-506 (3/01)(cs)
AFFIDAVIT IN SUPPORT OF MOTION TO DISMISS PETITION
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