F 3.405(F)(2) IN THE DISTRICT COURT OF SHAWNEE COUNTY, KANSAS ) ) ) ) ) ) ) ______________________________ **CAPTION** vs. ______________________________ Case No. Document No. _____________ SUMMONS TO APPEAR FOR REVIEW YOU ARE HEREBY SUMMONED TO APPEAR AT the Kansas Expocentre, Heritage Hall (enterthrough west doors), 1 Expocentre Drive, Topeka, Kansas, on the following six (6) dates: ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ 8:30 8:30 8:30 8:30 8:30 8:30 a.m. a.m. a.m. a.m. a.m. a.m. No No No No No No appearance appearance appearance appearance appearance appearance required required required required required required if if if if if if full full full full full full payment payment payment payment payment payment made. made. made. made. made. made. Full payment means the amount of your current support order, including any arrearage payment included in that order. By your signature you acknowledge receipt of a copy of this Summons to Appear for Review, and you agree to appear at the above dates unless full payment is made. __________________________________ Name / Signature __________________________________ Date __________________________________ Street Address __________________________________ Social Security Number __________________________________ City, State and Zip Code __________________________________ Employer __________________________________ Telephone Number __________________________________ Employer's Address YOU MUST APPEAR IN COURT AT THE ABOVE TIMES, UNLESS FULL PAYMENT IS MADE PRIOR TO THE DATES INDICATED. IF YOU FAIL TO APPEAR, A CITATION IN CONTEMPT MAY BE ISSUED Personal service on: [SUPPORT OBLIGOR'S NAME] American LegalNet, Inc. www.FormsWorkFlow.com RETURN OF SERVICE I hereby certify that I have served this document: (1) PERSONAL SERVICE: By delivering a copy of said document to each of the following defendants on the date indicated: (2) RESIDENCE SERVICE: By leaving a copy of said document at the usual place of residence of each of the following defendants with some person of suitable age and discretion residing therein on the date indicated: (3) AGENT SERVICE: By delivering a copy of said document to each of the following agents authorized by appointment or by law to receive service of process on the date indicated: (4) RESIDENCE SERVICE AND MAILING: By leaving a copy of said document at the usual place of residence of each of the following defendants and mailing by first-class mail on the dates indicated a notice that such copy has been so left: (5) CERTIFIED MAIL SERVICE: I hereby certify that I have served the within document: (1) By mailing on the ___ day of ___________, 20__ , a copy of the said document in the above action as certified mail return receipt requested to each of the within-named defendants: (2) the name and address on the envelope containing the process mailed as certified mail return receipt requested were as follows: (6) FIRST CLASS MAIL SERVICE: I hereby certify that I have served the documents described (or listed on the attached list) by first class mail, postage prepaid, to each of the named defendants: (7) CERTIFIED MAIL SERVICE REFUSED: I hereby certify that on the ___ day of ___________, 20__ , I mailed a copy of the said document in the above action by first-class mail, postage prepaid, addressed to: (8) AVOIDANCE OF SERVICE: After diligent effort, I am satisfied that the following defendants are secreting themselves in order to avoid the process of the court: (9) NO SERVICE: The following defendants were not found in this county: Date Served:______________________ Return to: Clerk of the District Court 200 SE 7th, Suite 209 Topeka, Kansas 66603-3968 (785) 233-8200 Ext. 5159 ________________________________ (Signature and Title of Officer) Case No. [Case Number Served] SUMMONS TO APPEAR FOR REVIEW American LegalNet, Inc. www.FormsWorkFlow.com