Full Name of Party Filing Document Mailing Address (Street or Post Office Box) City, State and Zip Code Telephone Email Address (if any) IN THE DISTRICT COURT FOR THE JUDICIAL DISTRICT FOR THE STATE OF IDAHO, IN AND FOR THE COUNTY OF , Petitioner, vs. , Respondent. Case No. ACKNOWLEDGMENT OF SERVICE BY RESPONDENT I, , the Respondent in the above-entitled action, admit and acknowledge that service of a copy of the Petition together with a Summons Order to Attend parent education program Joint Temporary Restraining Order (Children) Joint Temporary Restraining Order (Property) other was made on me because I received them on the day of , 20 . I certify that: I am over the age of eighteen, I am mentally competent, I read and write the English language; and: ACKNOWLEDGEMENT OF SERVICE BY RESPONDENT CAO FL 2-1 7/01/2016 PAGE 1 American LegalNet, Inc. www.FormsWorkFlow.com [check all that apply]: I am not in the uniformed services as defined by the Servicemembers Civil Relief Act of 2003, or I am in the uniformed services as defined by the Servicemembers Civil Relief Act of 2003. I understand and waive my rights under the Act. I submit to the jurisdiction of this court, decline to plead, waive hearing, and agree that a final decree be entered. CERTIFICATION UNDER PENALTY OF PERJURY I certify under penalty of perjury pursuant to the law of the State of Idaho that the foregoing is true and correct. Date: Typed/Printed Name Signature ACKNOWLEDGEMENT OF SERVICE BY RESPONDENT CAO FL 2-1 7/01/2016 PAGE 2 American LegalNet, Inc. www.FormsWorkFlow.com