For Clerk’s Use Only Name of Person Filing: _________________________________________ Mailing Address: _________________________________________ City, State, and Zip Code: _________________________________________ Daytime / Evening Phone: _________________________________________ ATLAS Number (if applicable):_________________________________________ State Bar Number (if applicable):_______________________________________ Self (Without Attorney) OR Representing: Attorney for Petitioner Respondent (If Attorney, include State Bar Number) SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Regarding the matter of Case Number: _______________________ ACCEPTANCE OF SERVICE _______________________________________ (Name) 1. I acknowledge that I have voluntarily accepted a copy of the following legal papers: (List) _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ I waive formal service of process (personal service), and understand by accepting these papers, it is the same as if I were personally served under Arizona Law. 2. I am aware that my accepting service of these court papers and signing this document does not in any way reduce my rights or obligation to file a written objection or come to court to object. 3. I am not in the military forces of the United States of America in any capacity or I waive the protection of the Soldiers and Sailors Relief Act. OATH AND VERIFICATION STATE OF ARIZONA County of Mohave ) ) ss. ) I, swear or affirm under penalty of perjury that I have read and understand the contents of this document and that the information I have provided is true and correct to the best of my knowledge and belief. __________________________ Date Signature SUBSCRIBED AND SWORN to before me this day of by . __________________________________________ My Commission Expires 2/11/2010 , 20 , ______________________________________ Notary Public / Deputy Clerk Page 1 of 1 American LegalNet, Inc. www.FormsWorkFlow.com