ࡱ> MOL@ -bjbj.. >$DD^8*F4E=%%%%?>&D 1D <$1>R@<"""<<%%%"d%%"%%%%z Oci[#p%%|=0E=%A#A%A%pb% !<<  $d Superior Court of Washington County of In re: Petitioner(s), and Respondent(s). No. Declaration of _________________________ [Name] (Optional Use) (DCLR) This declaration is made by: Name: ___________________________________________ Age: ___________________________________________ Relationship to the parties in this action: __________________________________________________ I Declare: (Attach Additional Pages if Necessary and Number Them.) I declare under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct. Signed at _______________________, [City] ____________ [State] on ____________________ [Date]. Signature of Declarant Print or Type Name Do not attach financial records, personal health care records or confidential reports to this declaration. Such records should be served on the other party and filed with the court using one of these cover sheets: 1) Sealed Financial Source Documents (WPF DRPSCU 09.0220) for financial records 2) Sealed Personal Health Care Records (WPF DRPSCU 09.0260) for health records 3) Sealed Confidential Report (WPF DRPSCU 09.270) for confidential reports If filed separately using a cover sheet, the records will be sealed to protect your privacy (although they will be available to all parties in the case, their attorneys, court personnel and certain state agencies and boards.) See GR 22(C)(2).  Declaration (DCLR) - Page page \* arabic2 of ____ WPF DRPSCU 01.0100 (6/2006)   ')12;`cdjw rkkkkkkkkkk h1>*CJh~o56CJOJQJ^Jh<56CJOJQJ^JhOJ5CJOJQJ^JaJh<5CJOJQJ^JaJ#h<h15CJOJQJ^JaJh1@CJ h<h1CJOJQJ^JaJh<5CJOJQJ^JaJ#h<h15CJOJQJ^JaJ h1CJ*   (23:;< p@ P$*$If$ p@ P$*$Ifa$$ p@ P`'*$a$ p@ P`'*$ ,<KOPQ`abhix$ p@ P$*$Ifa$ p@ P$*$If$  p@ P`'$*$Ifa$  4 n_$ $dh*$a$ p@ P`'dh*$$ p@ P`'dh*$a$$ p@ P`'*$a$Ekd$$Ifh0n$n"4 hah $ $dh*$a$    7 > ? @ A C 8 9 [ ^ Ҝҋҋ hS$?56CJOJQJ^JaJ h|jq56CJOJQJ^JaJ&h ph56CJOJQJ^JaJ h56CJOJQJ^JaJ h56CJOJQJ^JaJ h* CJh$h1>*CJ h1>*CJ h1CJ6    ?  `'<gdS$? `'gd `'<gdS$? `'x(gd$ $*$a$$ `'*$a$$ p@ P`'*$a$ "#'()*+,-ǽviehh<hOJQJ^J h~l6OJQJ^JmHnHu$jh<h6OJQJU^Jh6OJQJ^Jh<h6OJQJ^J h@@CJh@@jh@@CJU h1CJ h~l56CJOJQJ^JaJ h56CJOJQJ^JaJ hS$?56CJOJQJ^JaJ *+,- p@ P`'*$d$ `'*$a$gd< 0000&PPBP/ =!"#$%$$Ifh!vh5n5"#vn#v":V h5n5"/  /  / / / 44 hah H@H Normal5$7$8$9DH$_HmH sH tH DA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k@(No List P@P TOC 1, (#$0*$]^`0L@L TOC 2( (#$0*$]^`0L@L TOC 3( (#$p0*$]^p`0L@L TOC 4( (#$@ 0*$]^@ `0L@L TOC 5( (#$0*$]^`0D@D TOC 6  (#$0*$^`0:@: TOC 70*$^`0D@D TOC 8  (#$0*$^`0D@D TOC 9  (#$0*$^`0P @P Index 1( (#$`*$]^``P @P Index 2( (#$0*$]^`0@.@@  TOA Heading (#$*$."@. CaptionCJ:O: _Equation Caption4@4 Header  !4 @4 Footer  !@@@ Balloon Text CJOJQJ-$ (23:;<KOPQ`abhix4 ?*+.000000000000000P0P0P0P0P0P0P0P 0P0P00P0000P 0T 000000000000000000000000000000000000000000000000000000@0@0@0@0@0@0@0P0  (23:;<KOPQ`abhix4 ?*+.0000000000000000000000 00000000 0 0000000000000000000000000000000000000000000000000 0N^~00<^~00<^~00<^~00<@0@0^~00 0 ]]]` -< - , %46`!#n3dBn3 n3$?!n3>"n3T)#n3ӽ$n3$%n3&n3>'n3l(n3)n3,*n3+n3,n3-n3D.n34\/n3[0n3[1n3t[2n34[3n3Z4n3ԇ5n36n3T7n38n3|B9n3l#:n3,M;n3\#*urn:schemas-microsoft-com:office:smarttags PersonName #"! ####"! ###################### +.+.3389"#'(+.+.* !]4be$<S$?6|W~l~o|jq$@@1OJEhuku =y(23`+.!(y0@\\WSSCSRV1\WSSC-CanonCopNe02:winspoolCanon iR5000-6000 PCL6\\WSSCSRV1\WSSC-CanonCop<h  odXCanonY Canon iR5000-6000 PCL6ddd      d d d d dd@@d  d  d dd d"edd     ddd     d!!d      !"#$ddA     A d     @8o ((G o ((G AXXd2\SRGBCO~1.ICM\SRGBCO~1.ICM\SRGBCO~1.ICM CONFIDENTIALCONFIDENTIALHArialDefault Settings@\\WSSCSRV1\WSSC-CanonCop<h  odXCanonY Canon iR5000-6000 PCL6ddd      d d d d dd@@d  d  d dd d"edd     ddd     d!!d      !"#$ddA     A d     @8o ((G o ((G AXXd2\SRGBCO~1.ICM\SRGBCO~1.ICM\SRGBCO~1.ICM CONFIDENTIALCONFIDENTIALHArialDefault Settings@K-@UnknownGz Times New Roman5Symbol3& z Arial5& zaTahoma"9)7F&åfOwf  !)xx4d2Q)H?=yDeclaration (Optional Use)Amargins 3 pt top, 1 pt left, 1 pt right, 1 pt bottom, footer 1 pt Merrie GoughLaVonne NadeauOh+'0@T lx    Declaration (Optional Use)ecl Merrie GoughOpterrBmargins 3 pt top, 1 pt left, 1 pt right, 1 pt bottom, footer 1 pth Normal.dottLaVonne Nadeaup7VoMicrosoft Word 10.0@ @gK@?~@i՜.+,0 hp  Supreme Court  O Declaration (Optional Use) Title  !"#$%&'()*+,-./0123456789:;=>?@ABCEFGHIJKNRoot Entry F{jiPData 1TableAWordDocument>$SummaryInformation(<DocumentSummaryInformation8DCompObjj  FMicrosoft Word Document MSWordDocWord.Document.89q