600-00028 Acceptance of Service (09/2017) Page 1 of 1
STATE OF VERMONT
SUPERIOR COURT
Unit
Docket No.
ACCEPTANCE OF SERVICE
I, ______________________________, hereby Accept Service of the ______________________________
filed on _________________________ in the above entitled case and hereby waive any further form of
service.
Dated
_____________________________ ___________________________________
Signature
Case Name