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NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA. District Court (City of Oakland)

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NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA.
© TexasLawHelp.org, Waiver of Service Only- SET B, September 2015 Page 1 of 2
AND IN THE INTEREST OF: (List all children you and your spouse have together who are under 18 or still in high school.)
1. _________________________ 2. _________________________ 3. _________________________
4. _________________________ 5. _________________________ 6. _________________________
Waiver of Service Only (Specific Waiver)
WARNING to Respondent: Without the advice and help of an attorney, you may be putting yourself, your
property and your money at risk. For a referral to an attorney, or if you are poor to the nearest Legal Aid Office,
call the State Bar of Texas Lawyer Referral Information Service at 1-800-252-9690.
If you are a victim of domestic violence, or if at any time you feel unsafe, you can get confidential help from the
National Domestic Violence Hotline at 1-800-799-7233 or legal help from the Texas Advocacy Project Family
Violence Legal Line at 1-800-374-4673.
INSTRUCTIONS to Respondent: If you decide to use this form:
● Do not sign it until at least one day after the Original Petition for Divorce has been filed (turned in to the
court). If you sign this form before then, you will have to redo it. Your spouse should have given you a copy
of the Original Petition for Divorce. The official court stamp on your copy will tell you when it was filed.
● Fill out this form completely. You MUST include your mailing address.
● Sign this form in front of a notary. Do not sign until you are standing in front of the notary.
● File (turn in) the original signed form to the court where your spouse filed the Original Petition for Divorce.
Keep a copy for your records. Give a copy to your spouse.
● Get additional information about divorce at www.TexasLawHelp.org.
The person who signed this affidavit appeared, in person, before me, the undersigned notary,
and stated under oath:
“I am the Respondent in this case.
“My name is: ________________________________________________________________________.
First Middle Last
“My mailing address is: ________________________________________________________________.
Mailing Address City State Zip
“My phone number is: (_________) __________-___________________.
“My email address is: _________________________________________________________________.
“My fax number (if available) is: _________________________________________________________.
“The last three numbers of my driver’s license number are: ___ ___ ___. My driver’s license was
issued in (State): ________________________.
Or “ I do not have a driver’s license number.
Cause Number:
Print court information exactly as it appears on the Original Petition for Divorce.
IN THE MATTER OF THE MARRIAGE OF
In the ______________
(Court Number)
District Court
County Court at Law
County, Texas
Print first, middle and last name of the spouse filing for divorce.
And
Respondent:
Print first, middle and last name of other spouse.
© TexasLawHelp.org, Waiver of Service Only - SET B, September 2015 Page 2 of 2
“The last three numbers of my social security number are: ___ ___ ___.
Or “ I do not have a social security number.
“I have been given a copy of the Original Petition for Divorce filed in this case. I have read the Original
Petition for Divorce and understand what it says. I do not give up my right to review a different Petition for
Divorce if it gets changed (amended).
“I understand that I have the right to be given a copy of the Original Petition for Divorce by a constable,
sheriff or other official process server (legal notice). I do not want to be given legal notice. I give up my
right to legal notice.
“I ask that the Court not
enter any orders in this case unless the order is signed by me or unless I have
received prior written notice of the date, time, and place of hearing.
“If I reach an agreement and sign a Final Decree of Divorce, the court can enter the Decree without me
being present and without giving me notice. If I sign an agreed Final Decree of Divorce, I do not want a
court reporter to make a record of the testimony.
“I understand that by signing this form I am entering an appearance in this case. I agree that a Judge or
Associate Judge in the county and state where this case is filed may make decisions about my divorce,
even if the divorce should have been filed in another county.
“I understand that I must let the Court and my spouse’s attorney (or my spouse if s/he is not
represented by an attorney) know in writing if my mailing address or email address changes
during this case. If I don’t, then I understand that any notices about this case will be sent to me at the
mailing address or email address on this form.
Military Status
(Check one box.)
“ I am not in the military.
“ I am in the military. I agree to the provisions stated above and I waive only the rights, privileges, and
exemptions I have under the Servicemember’s Civil Relief Act that are contrary to those provisions.
Name Change (Check one box.)
“ I am NOT asking the court to change my name.
“ I ask the Court to change my name back to a name I used before my marriage. I am not asking the
court to change my name to avoid criminal prosecution or creditors.”
_________________________________________________________________________________________
First Middle Last
Signature of Respondent (Do NOT sign until you are in front of a notary.)
Date
Notary fills out below.
State of
(Print name of state where this Affidavit is notarized)
County of
(Print the name of the county where this Affidavit is notarized)
Sworn to and subscribed before me, the undersigned notary, on this date:
/
/
at
a.m./p.m.
Month day year
time
circle one
by
(Print name of person who is signing this Affidavit. NOT the notary’s name.)
[Notary Stamps Here ]
Notary’s Signature
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NOTICE: THIS DOCUMENT CONTAINS SENSITIVE DATA. District Court (City of Oakland)

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Completed 5 November 2020

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