NOTICE OF ACTION AND REQUEST FOR WAIVER OF SERVICE OF SUMMONS
The above referenced action has been commenced against you. Enclosed are copies of the Summons and
Complaint, the Interim Domestic Order, a Scheduling Order and other important court documents. These
documents have been sent to you because you are the Defendant in this case.
☐ The Plaintiff
☐ The Court
requests that you sign and return the enclosed waiver of service to save the cost of serving you by law
enforcement personnel or certified mail.
IF YOU WANT TO WAIVE SERVICE: The waiver of service must be received by the Court no later than 21 days
from the mailing date indicated below. This means that the Court must receive the documents by,
________________________, 20_______. An envelope addressed to the Court is enclosed along with an
extra copy of the Waiver for your records.
If you sign and return the enclosed WAIVER OF SERVICE on time, the case will go forward as if you had been
served on the date the Waiver was received by the Court. Your Answer to the Complaint will be due 21 days
from the mailing date indicated below. This means that the court must receive your Answer by
________________________, 20_______.
IF YOU DO NOT RETURN THE SIGNED WAIVER BY THE DUE DATE:
If you do not return the Waiver of Service by the due date, you will be personally served by a law enforcement
officer, certified mail, or some other method authorized by law. You may be required to PAY the expenses
incurred in serving you with the documents.
☐ The Plaintiff
☐ The Court
declares that this NOTICE AND REQUEST were mailed to the Defendant by first class mail on the date
shown below.
Please note this form can only be used by a Plaintiff if there are no minor children involved in the case.
Dated
_____________________________ ___________________________________
Signature of Plaintiff/Court Clerk
___________________________________
Printed Name of Plaintiff/Court Clerk