CHC604 State ENG Rev 2/19 www.mncourts.gov/forms Page 1 of 2 State of Minnesota District Court County Judicial District: Court File Number: Case Type: , Name of Petitioner (first, middle, last) WAIVER OF SERVICE OF SUMMONS and PETITION FOR THIRD PARTY CUSTODY , Name of Co - Petitioner, if any (first, middle, last) and , Name of Respondent Parent A (first, middle, last) , Name of Respondent Parent B (first, middle, last) . Name of Respondent Guardian or Custodian (first, middle, last) TO: . (Name of -represented petitioner) I received your request that I waive service of the Summons and Petition for Third party Custody. I have also received a copy of the Summons and Petition for Third Party Custody, two copies of this document (CHC604), and a means for returning the signed waiver to you without cost to me. I agree to save the cost of service of the Summons and Petition in this proceeding. I understand the following: 1. Signing this document starts the third party custody process; 2. Signing this document does not mean that I agree with everything in the Petition. It only means that I have received a copy of the Summons and Petition, and I understand that I will retain all defenses or objections to this proceeding or to the jurisdiction or venue of the court except for objections based on a defenct in the Summons or in the service of the Summons; 3. I have sixty (60) days from (the date the request for waiver was sent), or ninety (90) days if the request was sent outside of the United States, to serve on the Petitioner an Answer to the Petition; American LegalNet, Inc. www.FormsWorkFlow.com CHC604 State ENG Rev 2/19 www.mncourts.gov/forms Page 2 of 2 4. If I do not serve an Answer within sixty (60) days, I may be found in default and Petitioner may ask the Court for everything Petitioner has asked for in the Petition for Third Party Custody; 5. I do not have to sign this Admission. But if I do not sign, Petitioner can start the action by having the Summons and Petition personally served upon me and I may have to pay the cost of Petitioner doing this. Dated: Signature Name: Note: Court Form CHC604 is substantially similar to Minn. R. Civ. P. Form 22B and meets the rule requirements. American LegalNet, Inc. www.FormsWorkFlow.com