For Clerk’s Use Only Name of Person Filing: Mailing Address: City, State, and Zip Code: Daytime Phone Number: Evening Phone Number: _________________________________ ATLAS Number (if applicable): State Bar Number (if applicable): Representing: Self Petitioner Respondent SUPERIOR COURT OF ARIZONA MOHAVE COUNTY Case Number: (Name of Petitioner) ACCEPTANCE OF SERVICE AND IN STATE OUT OF STATE (Name of Respondent) THE PERSON WHO SIGNED BELOW MAKES THESE STATEMENTS UNDER OATH: 1. COURT PAPERS: I acknowledge that I have voluntarily accepted copies of the following legal papers (Check the boxes that apply under your type of case. Do not check the box unless you received a copy of the document.) CASES: (Choose One) DIVORCE ANNULMENT LEGAL SEPARATION: with children without children Petition Petition Summons Summons Preliminary Injunction Preliminary Injunction Health Insurance Notice Health Insurance Notice Parent Education Program Notice Notice to Creditors Order to Parent Education Program Notice to Creditors Parent=s Worksheet for Child Support Amount PATERNITY Complaint Summons Parent Education Program Notice Order to Parent Education Program ____________________________ ____________________________ 6/1/2006 CIVIL CASE Complaint Certificate of Compulsory Arbitration Summons __________________________ __________________________ __________________________ Page 1 of 2 American LegalNet, Inc. www.FormsWorkflow.com Case No:_________________ 2. ACCEPT AND WAIVE FORMAL SERVICE. I waive formal service of process (service by a 3. RESPONSE DEADLINE. I am aware that by accepting service of these court papers and signing 4. DEFAULT JUDGMENT, ORDER OR DECREE. I understand that if I do not appear and defend 5. MILITARY SERVICE. I am not in the military forces of the United States of America in any process server or sheriff), and understand by accepting these papers, it is the same as if I were personally served under Arizona Law [Rules 40-43, Arizona Rules of Family Law Procedure]. this paper, my right or obligation to file a written Response or Answer to this action is not affected. I understand that if I do not agree with any relief asked for in the Petition, I must Respond or Answer within 20 days from the day I signed the original of this Acceptance of Service, if I accepted service in Arizona, or 30 days from the day I signed the original of this Acceptance of Service, if I received the papers somewhere other than Arizona. in this action in Court, within the time allowed by law, that I may lose my right to be heard in this case. I understand that failure to Respond or Answer 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. capacity or, if I am in the military forces of the United States of America, I waive the protection of the Soldiers and Sailors Relief Act of 1940. OATH AND VERIFICATION STATE OF ARIZONA County of ) ) ss. ) I, the Respondent, being duly sworn and under oath, state that I have received the above listed documents and read this Acceptance of Service. __________________________ Date Signature SUBSCRIBED AND SWORN to before me this day of by , . __________________________________________ My Commission Expires 6/1/2006 , 20 ______________________________________ Notary Public / Deputy Clerk Page 2 of 2 American LegalNet, Inc. www.FormsWorkflow.com