Name: Mailing Address: Daytime Telephone Representing Self, Without a Lawyer IN THE SUPERIOR COURT OF ARIZONA, YAVAPAI COUNTY Regarding the matter of DO ACCEPTANCE OF SERVICE Petitioner/Plaintiff and [200] IN STATE [237] OUT OF STATE Respondent/Defendant 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.) DIVORCE OR ANNULMENT: PATERNITY: 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 [ ] LEGAL SEPARATION: ] ] ] ] ] ] Complaint Summons Parent Education Program Notice Order to Parent Education Program CIVIL CASE: with children without children [ ] Petition [ ] Petition [ ] Summons [ ] Summons [ ] Preliminary Injunction [ ] Preliminary Injunction [ ] Parent Education Program Notice [ ] Notice to Creditors [ ] Order to Parent Education Program [ ] Parent=s Worksheet for Child Support Amount [ ] Notice to Creditors Superior Court of Arizona in Yavapai County January 2006 [ [ [ [ [ [ [ [ [ [ [ [ ] Complaint ] Certificate of Compulsory Arbitration ] Summons ] ] ] Page 1 of 2 Use only most current version American LegalNet, Inc. www.FormsWorkflow.com 2. ACCEPT AND WAIVE FORMAL SERVICE. I waive formal service of process (service by a 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]. 3. RESPONSE DEADLINE. I am aware that by accepting service of these court papers and signing 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. 4. 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, 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. 5. MILITARY SERVICE. I am not in the military forces of the United States of America in any 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. Signature SUBSCRIBED AND SWORN to before me this day of by , . My Commission Expires: , 20 NOTARY PUBLIC Superior Court of Arizona in Yavapai County January 2006 Page 2 of 2 Use only most current version American LegalNet, Inc. www.FormsWorkflow.com