(1) Person Filing: Mailing Address: City, State, Zip: Phone Number: Representing Self SUPERIOR COURT OF ARIZONA, COUNTY OF COCONINO (2) Petitioner: Case Number: DO ACCEPTANCE OF SERVICE Respondent: (3) To : Please sign this form in front of a notary public and return it to me in the enclosed self-addressed, stamped envelope to save the cost of hiring someone to serve you with the court papers. Signing does not mean you agree with what I’m asking for. Court Papers: I acknowledge I have voluntarily accepted the Summons and a copy of the following legal papers in this case. (4) [ ] Divorce with Children Petition Preliminary Injunction Parenting Plan Joint Custody Agreement, if applicable Parent’s Worksheet for Child Support Amount Child Support Order Order of Assignment Notice Regarding Community Debts Notice of Right to Convert Health Insurance [ ] Legal Separation with Children Petition Preliminary Injunction Parenting Plan Joint Custody Agreement, if applicable Parent’s Worksheet for Child Support Amount Child Support Order Order of Assignment Notice Regarding Community Debts [ ] Divorce without Children Petition Preliminary Injunction Notice Regarding Community Debts Notice of Right to Convert Health Insurance [ ] Legal Separation without Children Petition Preliminary Injunction Notice Regarding Community Debts Page 1 of 2 Revised April 2009 Coconino County Law Library and Self-Help Center Forms American LegalNet, Inc. www.FormsWorkflow.com [ ] Child Custody, Parenting Time, and Child Support Petition Child Support Order Parenting Plan Joint Custody Agreement, if applicable Order of Assignment Parent’s Worksheet for Child Support Amount Accept and Waive Formal Service: I waive formal service of process (service by a process server or sheriff) and understand that by accepting these papers it is the same as if I were personally served under Arizona Law (Rules 40, 41, and 42, Arizona Rules of Family Law Procedure). Response Deadline: I am aware that my right or obligation to file a written Response to this action is not affected by accepting service of these court papers and signing this paper. I understand that if I do not agree with any request in the Petition, I must respond within 20 days from the day I signed the original Acceptance of Service if I accepted service in Arizona or 30 days from that date if I received the papers outside of Arizona. Default Judgment, Order, or Decree: I understand that if I do not appear and defend in this action in Court within the time allowed by law I may lose my right to be heard in this case. I understand that failure to respond could result in the Court giving the other party any and all things requested in his or her legal papers through a default judgment, order, or decree. Divorce Cases Only: Restore Name: (Complete this part only if you want to restore your name to what it was before the marriage.) I took the name of my spouse at the time of marriage, and I want to restore my name to the name I used before the marriage. That name is: Signature of Person Accepting Service (5) Address of Person Accepting Service: Phone #: State of Arizona County of Subscribed and sworn before me this date: Seal: Page 2 of 2 Revised April 2009 ) ) ) by: Notary Public: Notary Expiration Date: Coconino County Law Library and Self-Help Center Forms American LegalNet, Inc. www.FormsWorkflow.com