       IDesILaytags  f  l 
13420814941                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  X   [                                                                                                  a                                                                                                                                                            ^  J                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         b         4   j   f                  _      `   `   a   c   b                                                                                                              &    ,    2    8    >    D    J    P    V    \    b    h    n    t    z                            6     Z         Submit             0 S        6       v+ y	Q  QQ !        6         k  
Q    "           6    $    	   
M}    "f         H  4  *   .     40917100670009307   40917100670009307           j  B   "               @        \          X       	    
         ^ ^ n n       n   n         
 n n ,  	Helvetica    
 .     +X        @@                         @@                      @@      \        @@      *                 @    @@         	F%f   ':gFfgFgFgFF̽XgF   & eP  e& f4%&Pf}gFgFf     gF̾gF       eXe  
&Pf}@&P&Pf   '8gF   gL\    (   gF       e   &}Lex&f}       k       &gL\   gL\  U  V       k     f ex' f}δ&g9f   '8gL\f       @@   gL\                   @@ @                                            
                                0                  X       	    
         ^SLPI   
	    "       N    6  8                                                                                                       0                                      1&@   XX    
.i      XX    
.   d        '               #_ W       
  o  d        P        
    <         d      o    $     q v    + e     w    2 x    9 y    @ z    G {    N |    U }    \ ~    c f         j g         x                                              h     i       Cell1Cell2Cell3Cell4Cell5Cell6Cell12Cell19Cell20Cell21Cell22Cell23Cell24Cell25Cell26Cell27Cell39Cell18Cell40Cell41Cell42Cell43Cell44Cell45Cell46Cell47Cell48Cell49	    "u C !	W #    %% SendPSLPI  "     60 SLPI         V    ~   3     Submit               ta Versp            J          Graphics
     0Header PgL  6	FieldListp      <          ^                          @@                  X           
                 @@                        @@                     @@              @@                       @    @@            R* 8  ) h    *  ) h    *   Z R* ;8D    Z  Rx6hI D ;8       R      T X Z P RiI         D       \I          RR   J     RxI iI  ZxI RwI    F nR{I    D  dD    n J    ɫD ֫D      ( nn                   bD    D -OR    D Q       @@ @                                       
                                @@                  X           
                   @@ @                                          
                                  @@                 X           
                       @@ @                                        
                                 @@                 X           
                   @@             R bD    8 -OR                 @@                 X       
               D-  
               L     0           ^         ` `            ` `         d        '  @L          Eu $        
  o  d              {                  [         L       B    H   N  	    "     60 SLPI          X  H   "               1#AFd   %% SendPSLPI   
pR    "      60 SLPI        (A|Other     )\
(specify):  
	    8   %% SendPSLPI  "     60 SLPI  1, ON q   %% SendPSLPI   
  Z^    "      60 SLPI           (I Paper Final  
	    8   %% SendPSLPI  "     60 SLPI   %% SendPSLPI   
(Rq    "      60 SLPI )(           ) Copies   %% SendPSLPI   
	    "     60 SLPI   %% SendPSLPI  #     60 SLPI   %% SendPSLPI  #     60 SLPI "  ! 5 # !   %% SendPSLPI   
 6    "      60 SLPI   (DATE TO LIST   
[;    "M  "9A   "M  "9   "M   
	 " C !Z5 #    %% SendPSLPI  "     60 SLPI   %% SendPSLPI  #     60 SLPI "5  !  # !   %% SendPSLPI   
 6    "      60 SLPI (BPROJECTED DUE DATE   
1[    "Ms         D    N  @X      
            <    SUPERIOR COURT OF WASHINGTON FOR COUNTY OFJUVENILE DIVISION           
           %  U         %     U        
                        
 %  U ,  Arial         
 ( 9 +SUPERIOR COURT OF WASHINGTON FOR COUNTY OF                  ( GJUVENILE DIVISION             @	             #    VOLUNTARY FOSTERCARE PLACEMENT OF:           
           U            U              
 %  U                 
 U    ,  Arial         
 ( i $VOLUNTARY FOSTER           ( w $CARE PLACEMENT OF:              `                 NO.           
           U w@        U  @   w        
 U                    
 U w@ ,  Arial         
 ( iNO.             	@!             P    DECLARATION OF NOTIFICATION - VOLUNTARYFOSTER CARE PLACEMENT VALIDATION HEARING          
           n %        n  %           
 U w@                 
 n % ,  Arial        
 ( (DECLARATION OF NOTIFICATION - VOLUNTARY         ( (FOSTER CARE PLACEMENT VALIDATION HEARING              P0	              PP	 @D                                 P       
                    d                          Title          
              	0	   D   	0	         	@
                 An Indian Child           
              v            v           
                 
    v ,  Arial         
 (  $An Indian Child             0                 I,           
              8            8           
    v                 
    8 ,  Arial         
 (  #I,              P              P  @D                                        
                    e                          Title          
                 D            `!                 hereby declare:           
            )          )           
    8                 
  ) ,  Arial         
 ( hereby declare:             0p             ,    I am over the age of eighteen years; on the            
                                     
                 
     ,  Arial         
 (  #,I am over the age of eighteen years; on the               @@O @                                 P       
                    f                          Title          
               >`BP       @`@P       ppp                 day of           
            Q          Q           
                     
  Q ,  Arial         
 ( 'day of              `A@              p@ @D                                 `       
                    g                          Title          
              >`B@   D   @`@@         Pp                 , 19           
                                 
                 
   ,  Arial         
 ( , 19              "               @!p @D                                 `       
                    h                          Title          
              "    D           >B!   D   @@!      !"   D               ,          
            ,          ,           
                   
  , ,  Times New Roman        
 ( ,                 @                 at           
            	 ;            ;  	        
  ,                 
  	 ; ,  Arial         
 (  $at              P                PP  @D                                        
                    i                          Title          
                   D               p              -    a.m./p.m. I notified the above-named child's:           
            
             
        
  	 ;                 
  
 ,  Arial         
 (  -a.m./p.m. I notified the above-named child's:             !              !   D   !      ! @D                                        
                    o                          Title          
                 `0@`             g    of the foster care placement validation hearing regarding the child.  Notification was accomplished by:           
          L n        L    n        
                 
L n ,  Arial         
 (` #gof the foster care placement validation hearing regarding the child.  Notification was accomplished by:             `"P              "P   D   "P      `	 "O @D                                        
                    v                          Title          
                 p0P!             t    I declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.           
         $         $          
L n                 
 $ ,  Arial         
 ( #tI declare under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct.              0             	    SIGNED at           
            c           c          
 $                 
  c ,  Arial         
 ( #	SIGNED at                              , Washington, this           
          _     _              
                 
_ ,  Arial         
 (i, Washington, this              0              0 @D                                 0       
                    x                          Title          
              ~`   D   `         !                 day of           
          $         $          
_                 
$ ,  Arial         
 (day of               P`!               P!` @D                                  P       
                    y                          Title          
              !`!   D   !`!         !!                 , 19           
           )            )        
$                 
 ) ,  Arial         
 ( , 19               p"                p! @D                                  p       
                    z                          Title          
              ! "    D           !!   D   !!      ! "   D               .          
          /*K     /    K  *        
                 
/*K ,  Times New Roman        
 (9.                                ~   D           @D                                         
                    w                          Title          
                 "$!`              "$ !` @D                                 #P       
                    {                          Title          
              #$!`   D   $ $ !`         $&A!`              $&@!` @D                                 #P       
                    |                          Title          
              &>&B!`   D   &@&@!`         ' (!`              ' (!` @D                                 #P       
                    }                          Title          
              (~(!`   D   ((!`         )@*!`              )@*!` @D                                 #P       
                    ~                          Title          
              **!`   D   **!`         #$             	    DECLARANT                     4 V5        4  5  V        
                 
4 V5 ,  Arial          (J 	DECLARANT             & '              P    ADDRESS                                                                   STREET                     X z        X    z        
4 V5                 
X z ,  Arial          (n PADDRESS                                                                   STREET              (`)@!P             |    CITY                                                                                                STATE           ZIP CODE                   

|     
   |            
X z                 
|  ,  Arial          ( |CITY                                                                                                STATE           ZIP CODE              *+                 TELEPHONE NUMBER                      T          T          
|                  
 T ,  Arial          ( TELEPHONE NUMBER              +,             (    DISTRIBUTION;  Court file;  Service file      	                                    
                 
  ,  Arial          ( (DISTRIBUTION;  Court file;  Service file              - @.              P    Declaration of Notification - Voluntary Foster Care Placement Validation Hearing           	           u          u          
                  
 u ,  Arial         	 ( $PDeclaration of Notification - Voluntary Foster Care Placement Validation Hearing              -@.                 DSHS 09-767(08/1991)                      r           r          
 u                 
  r ,  Arial         ( $DSHS 09-767(08/1991)              P!  @                                        
                                              Title          
               @  @                                    
                            P                   mother           
            ? w      ?      w          
  r                 
  ? w ,  Arial         
 ( Jmother               0 @     	                               
                            @                  father           
          
 ?+ w      ?  
   w  +        
                 

 ?+ w ,  Arial         
 ( Jfather                 0 @     
                               
                            0                    Indian custodianfather           
           ?:       ?       :        

 ?+ w                 
 ?:  ,  Arial         
 (- JIndian custodianfather                  @                                    
                            0                   tribe           
          ) ?J s      ?  )   s  J        
 ?:                  
) ?J s ,  Arial         
 (= Jtribe              	 @                                    
                             	                   Other (specify)           
          8 ?Y       ?  8     Y        
) ?J s                 
8 ?Y  ,  Arial         
 (L JOther (specify)              `@@ @                                    
                            p@0              2    personal service of written notice (copy attached)           
          ] ?~-      ?  ]  -  ~        
8 ?Y                  
] ?~- ,  Arial         
 (q J2personal service of written notice (copy attached)               P0@ @                                    
                            `00              %    mailed written notice (copy attached)           
          l ?-      ?  l  -          
                 
l ?- ,  Arial         
 ( J%mailed written notice (copy attached)              0 @                                    
                            @              	    telephone           
          z ?       ?  z             
l ?-                 
z ?  ,  Arial         
 ( J	telephone               @                                    
                                           	    telegraph           
           ?       ?               
z ?                  
 ?  ,  Arial         
 ( J	telegraph                @                                    
                                              telex           
           ?       ?               
 ?                  
 ?  ,  Arial         
 ( Jtelex               @                                    
                                              Other (specify)           
           ?       ?               
 ?                  
 ?  ,  Arial         
 ( JOther (specify)                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       N    T   3     Submit                              _  `    
1342081494e' f   gFg1fg8tg8|f) eg8xg8tf p         '@e0 @f&'(gFfg8tgL\g |   'H@        'f                          `  f       ,,    b	yg(   ,,    (    d       '              h                                                           6  `  l                                        a          @         @     @              }۰}۰}۰}۰}۰}}                                 propalis  T   propalis  Z   propalis  f   propalis  l   ropalis  T   propalis  Z   propalis  f   propalis  l                  6  a  x   this                                      b         
	Signature    Version0p  	Data Versp      $	Blue Keys        *Graphics
     0Header PgL  6	FieldListp      <	Form Info        `LayoutPropsg   rDesPathInfog@  x       +  b  r     @      ,   @     @         "                 ,߮~߮~߮߮߮߮3kǻ߮                                    propalis  T   propalis  Z   propalis  f   propalis  l   Data      < E            porpsila  ~   porpsila                            Arialtica                                                       Arial                                                           Times New Roman    W         `   `          &                               c  0    F                @@                  X           
                 @@                        @@                     @@              @@                       @    @@            R* 8  ) h    *  ) h    *   Z R* ;8D    Z  Rx6hI D ;8       R      T X Z P RiI         D       \I          RR   J     RxI iI  ZxI RwI    F nR{I    D  dD    n J    ɫD ֫D      ( nn                   bD    D -OR    D Q       @@ @                                       
                                @@                  X           
                   @@ @                                          
                                  @@                 X           
                       @@ @                                        
                                 @@                 X           
                   @@             R bD    8 -OR                 @@                 X       
               D-  
               L       B    H   N                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      