ATTACH THE GREEN SIGNATURE RECEIPT CARD TO THIS FORM
© 2017 Family Law Self-Help Center Certificate of Mailing – (Registration)
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CERT
Name:
Address:
Telephone:
Email Address:
Self-Represented
DISTRICT COURT
CLARK COUNTY, NEVADA
____________________________
Petitioner,
vs.
____________________________
Respondent.
CASE NO.: ____________________
DEPT: ____________________
CERTIFICATE OF MAILING
I, (name of person who mailed document)_____________________________________,
declare under penalty of perjury under the law of the State of Nevada that the following is true
and correct. That I served the Notice of Petition for Registration of Out of State Child Custody
Determination with a copy of the Petition for Registration attached by ( check one)
Certified mail, return receipt requested
Registered mail, return receipt requested
I sent the documents on (month) ___________________________ (day) _____, 20____,
addressed to: (Print the name and address of the person you mailed the documents to)
________________________________
________________________________
________________________________
DATED (month) ___________________ (day) _________, 20___.
Submitted By: (your signature) _______________________________
(print your name) _______________________________
