SUMMONS IN THE MARION IN RE: THE MARRIAGE CIRCUIT AND SUPERIOR COURTS OF Petitioner and CAUSE NO Respondent TO RESPONDENT: (Name) (Address) You are hereby notified that you have been sued by the Petitioner for (Dissolution of Marriage) (Legal Separation) (Paternity) (Child Support) in the Court indicated above. YOu MUST complete the attached Financial Declaration Form and file it with the Court within ten (10) days after receipt of this summons. If this summons is accompanied by an Order to Appear, you must appear in Court on the date and time stated in the Order to Appear. If you do not appear, evidence may be heard in your absence and a determination made by the Court. If a Temporary Restraining Order is attached, it is effective immediately upon your receipt or knowledge of the Order: If you wish to retain an attorney to represent you in this matter, it is advisable to do so before the date stated in the Order to Appear. If you take no action in this case after receipt of this summons, the Court can grant a Dissolution of Marriage (Legal Separation) or make a determination regarding any of the following: paternity, child custody, child support, maintenance, visitation, property division (real or personal) and any other distribution of assets and allocation of debts. Dated: Clerk, Marion County (The following manner of Service of Summons is hereby designated. Registered or Certified Mail Service on Individual Service at place of employment, to-wit: Private Service Attorney for Petitioner Address Marion County Superior Court 200 East Washington Street Indianapolis, IN 46204 Telephone Telephone Form #210 American LegalNet, Inc. www.FormsWorkflow.com SHERIFF'S RETURN OF SERVICE OF SUMMONS I hereby certify that I have served this summons on the . ( 1) By delivering day of a copy of the Summons and a copy of the complaint to the defendant, (2) By leaving a copy of the Summons and a copy of the complaint at which is the dwelling place or usual place of abode of and by mailing a copy of said summons to said defendant at the above address. (3) Other Service or Remarks: Sheriff's Costs Sheriff By: Deputy CLERK'S CERTIFICATE OF MAILING I hereby certify that on the day of , , I mailed a copy of this Summons and a copy of the complaint to the defendant, ,by mail, requesting a return receipt, at the address furnished by the plaintiff. Clerk, Marion County Dated: By: Deputy RETURN ON SERVICE OF SUMMONS BY MAIL I hereby certify that the attached receipt was received by me showing that the Summons and a copy of the complaint mailed to defendant was accepted by the defendant on the day of I hereby certify that the attached return receipt was received by me showing that the Summons and a copy of the complaint was returned not accepted on the day of , . ~ Clerk, Marion County American LegalNet, Inc. www.FormsWorkflow.com By: Deputy