AO 441 (Rev. 07/10) Summons on Third-Party Complaint
UNITED STATES DISTRICT COURT
for the
__________ District of __________
)
)
)
)
)
)
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Plaintiff
v.
Civil Action No.
Defendant, Third-party plaintiff
v.
Third-party defendant
SUMMONS ON A THIRD-PARTY COMPLAINT
To:
(Third-party defendant’s name and address)
A lawsuit has been filed against defendant
, who as third-party plaintiff is making
this claim against you to pay part or all of what the defendant may owe to the plaintiff .
Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you
are the United States or a United States agency
, or an officer or employee of the United States described in Fed. R. Civ.
P. 12 (a)(2) or (3) — you must serve on the plaintiff and on the defendant an answer to the attached complaint or a
motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the defendant or
defendant’s attorney, whose name and address are:
It must also be served on the plaintiff or plaintiff’s attorney, whose name and address are:
If you fail to respond, judgment by default will be entered against you for the relief demanded in the third-party
complaint. You also must file the answer or motion with the court and serve it on any other parties.
A copy of the plaintiff’s complaint is also attached. You may – but are not required to – respond to it.
Date:
CLERK OF COURT
Signature of Clerk or Deputy Clerk
AO 441 (Rev. 07/10) Summons on Third-Party Complaint (Page 2)
Civil Action No.
PROOF OF SERVICE
(This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l))
This summons for
(name of individual and title, if any)
was received by me on (date) .
I personally served the summons on the individual at
(place)
on (date) ; or
I left the summons at the individual’s residence or usual place of abode with
(name)
, a person of suitable age and discretion who resides there,
on
(date) , and mailed a copy to the individual’s last known address; or
I served the summons on
(name of individual) , who is
designated by law to accept service of process on behalf of
(name of organization)
on (date) ; or
I returned the summons unexecuted because ; or
Other
(specify):
.
My fees are $ for travel and $ for services, for a total of $ .
I declare under penalty of perjury that this information is true.
Date:
Server’s signature
Printed name and title
Server’s address
Additional information regarding attempted service, etc:
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