Form for Notice and Acknowledgment for Service by Mail under Ark. R. Civ. P. 4()()(B) This form is to be used only for service by mail under Rule 4(g)(1)(B) of the Arkansas Rules of Civil Procedure. It cannot be used for se rvice by mail under Rule 4(g)(1)(A) or for service by a commercial delivery company under Rule 4(g)(2). NOTICE To: [ ] A lawsuit captioned [insert caption of case from complaint] has been filed against you in the Circuit Court of County, Arkansas. The enclosed summons and complaint are served on you in accordance with Rule 4(g)(1) of the Arkansas Rules of Civil Procedure. You must complete the acknowledgment part of this form and return one copy of the completed form to the sender within 20 days. If you do not do so, you (or the party on whose behalf you are being served) may be required to pay any expenses incurred in serving a summons and complaint in any other manner permit ted by law. If you do complete and return this form, you (or the party on whose behalf you are being served) must answer the complaint within the time specified in the summons. If you fail to do so, judgment by default will be entered against you for the relief demanded in the complaint. You must sign and date the acknowledgment. If you are served on behalf of a corporation, partnership, limited liability company, unincorporated association, or other entity, you must indicate under your signature your r elationship to that entity. If you are served on behalf of another person and are authorized to receive service, you must indicate under your signature your authority. As the sender of this Notice and Acknowledgment of Receipt of Summons and Complaint, I declare under penalty of perjury that it is being mailed on [date]. American LegalNet, Inc. www.FormsWorkFlow.com [Signature] [Printed Na me] [Date of Signature] ACKNOWLEDGMENT OF RECEIPT OF SUMMONS AND COMPLAINT I declare, under penalty of perjury, that I received a copy of the summons and of the complaint in the lawsuit referenced above at [address] on [date]. [Signature] [Printed Name] [Relationship to Entity / Authori ty to Receive Service] [Date of Signature] American LegalNet, Inc. www.FormsWorkFlow.com