IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS Seventh Judicial District Plaintiff Plaintiff, vs. Case No. caseno Defendant Def Add Ln 1 Def Add Ln 2 Def City, DEF ST DEF ZIP ZIP Defendant SUMMONS In State To the above named defendant: You are notified that an action has been filed against you in this court. You are required to file a written response to the petition with the Clerk of District Court and to serve a copy of that response upon the plaintiff’s attorney: 3rd Prty (Pla Atty) 3rd Prty Add Line1 Line 2 3rd Prty City, 3RD PRTY ST 3RD PRTY ZIP ZIP within 20 days after service of this summons upon you. Any related claim that you have against the plaintiff may be stated as a counterclaim in your written response. If you fail to do so, judgment by default will be taken against you for the relief demanded in the petition. Date: 8/10/2004 Clerk Clerk of the District Court Official Seal of the District Court Douglas County, Kansas By ________________________________, Deputy American LegalNet, Inc. www.USCourtForms.com IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS Seventh Judicial District Plaintiff Plaintiff, vs. Case No. caseno Defendant Def Add Ln 1 Def Add Ln 2 Def City, DEF ST DEF ZIP ZIP Defendant SUMMONS In State To the above named defendant: You are notified that an action has been filed against you in this court. You are required to file a written response to the petition with the Clerk of District Court and to serve a copy of that response upon the plaintiff’s attorney: 3rd Party (Pla) 3rd Prty Add Line1 Line 2 3rd Prty City, 3RD PRTY ST 3RD PRTY ZIP ZIP within 20 days after service of this summons upon you. Any related claim that you have against the plaintiff may be stated as a counterclaim in your written response. If you fail to do so, judgment by default will be taken against you for the relief demanded in the petition. Date: 8/10/2004 Clerk Clerk of the District Court Official Seal of the District Court Douglas County, Kansas By ________________________________, Deputy American LegalNet, Inc. www.USCourtForms.com Case No.case no *********************RETURN OF SERVICE ON SUMMONS********************* I Hereby certify that I have served this summons: Personal Service: By delivering a copy of such summons and a copy of the petition to the defendant on ___________________,____________ . Residence Service: By leaving a copy of such summons and a copy of the petition at the usual place of residence of the defendant on ________________,_______ with__________________________________, person of suitable age and discretion residing therein, at ____________________________________________________________________________________. Agent Service: By delivering a copy of such summons and a copy of the petition to the agent ___________________________________________________, authorized by appointment or by law to receive service of process on _______________________, __________. Residence Service and Mailing: By leaving a copy of such summons and a copy of the petition at the usual place of residence of the defendant and mailing by first-class mail a notice that such copies have been left on ______________________, ___________ at_________________ _______________________________________________________. Certified Mail Service: By mailing a copy of such summons and a copy of the petition certified mail return receipt requested to the above named defendant on _________________, ______. The name and address on the envelope was as follows: ______________________________________________________________________________________ Certified Mail Return Was Refused: A copy of the summons and petition were mailed by first class mail, postage prepaid on ___________________, _______ addressed to the above named defendant at __________________________________________________________________. No Service: The party was not found in this county. ********************************************************************************************* DECLARATION I declare (or verify, certify or state) under penalty of perjury that the foregoing return of service is true and correct. Executed on_______________________________ ___________________________________________ Signature of Law Enforcement Officer ___________________________________________ Sheriff American LegalNet, Inc. www.USCourtForms.com