Form Cv-506 - Publication Affidavit Of Mailing Or Facsimile
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1STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
Publication Affidavit of
Petitioner:
Protected Person
Mailing or Facsimile
(If different than
Domestic Abuse
:
Petitioner)
Harassment
-VS-
Respondent:
Case No.
1. The undersigned being first duly sworn, says that he/she placed a true copy of the following documents:
Petition for Injunction
Notice of Extension of Time for Hearing
in an envelope postpaid for first-class handling which bore the sender’s name and return address and deposited
the envelope and the contents in the United States Mail in
]
, on
[City, State
.
[Date]
The envelope was addressed to:
Name of Respondent
Address of Respondent
- OR -
2. The undersigned being first duly sworn, says that he/she sent a true copy of the following documents:
Petition for Injunction
Notice of Extension of Time for Hearing
via facsimile to the respondent on
.
[Date]
The facsimile was addressed to:
Name of Respondent
Facsimile Number of Respondent
3. I do not know the respondent’s address or facsimile number. I have exercised due diligence in attempting to
obtain this information.
State of
Signature
County of
Subscribed and sworn to before me on
Print or Type Name
Notary Public/Court Official
Address
Name Printed or Typed
Address
My commission/term expires:
Date
CV-506, 08/10 Affidavit of Mailing or Facsimile (Domestic Abuse/Harassment)
§813.12(2)(a), Wisconsin Statutes
This form shall not be modified. It may be supplemented with additional material.
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