IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS Seventh Judicial District Plaintiff Plaintiff, vs. Defendant Def Add Ln 1 Def Add Ln 2 Def City, DEF ST DEF ZIP ZIP Defendant Case No. caseno Division No. Div SUMMONS In State To the above named defendant: You are notified that an action has been filed against you in this court. You, or your attorney, are required to file a written response to the attached petition. This response is to be filed with the Clerk of District Court at 111 East 11th St., Lawrence, Kansas, 66044. Please print the case number on your answer. Any related claim that you may have against the plaintiff may be stated as a counterclaim in your written response. You must also serve a copy of your written response upon the plaintiff’s attorney: 3rd Prty (Pla Atty) 3rd Prty Add Line1 3rd Prty City Line 2 3RD PRTY ST 3RD PRTY ZIP ZIP prior to TIME a.m. on DATE. If you do not file a written response by the date listed above, you or your attorney must appear in person at the Limited Civil Answer Docket, TIME a.m. on DATE, in the Hearing Room of the Judicial Center, 111 E 11th, Lawrence, Kansas. If you fail to respond to the attached petition, either by submitting a written answer before the date listed or by appearing in person on that date and time, judgment by default will be taken against you for the relief demanded in the petition. Date: 8/10/2004 Official Seal of the District Court Douglas County, Kansas Clerk Clerk of the District Court By ___________________________________, Deputy American LegalNet, Inc. www.USCourtForms.com IN THE DISTRICT COURT OF DOUGLAS COUNTY, KANSAS Seventh Judicial District Plaintiff Plaintiff, vs. Defendant Def Add Ln 1 Def Add Ln 2 Def City, DEF ST DEF ZIP ZIP Defendant Case No. caseno Division No. Div SUMMONS In State To the above named defendant: You are notified that an action has been filed against you in this court. You, or your attorney, are required to file a written response to the attached petition. This response is to be filed with the Clerk of District Court at 111 East 11th St., Lawrence, Kansas, 66044. Please print the case number on your answer. Any related claim that you may have against the plaintiff may be stated as a counterclaim in your written response. You must also serve a copy of your written response upon the plaintiff’s attorney: 3rd Prty (Pla Atty) 3rd Prty Add Line1 3rd Prty City Line 2 3RD PRTY ST 3RD PRTY ZIP ZIP prior to TIME a.m. on DATE. If you do not file a written response by the date listed above, you or your attorney must appear in person at the Limited Civil Answer Docket, TIME a.m. on DATE, in the Hearing Room of the Judicial Center, 111 E 11th, Lawrence, Kansas. If you fail to respond to the attached petition, either by submitting a written answer before the date listed or by appearing in person on that date and time, judgment by default will be taken against you for the relief demanded in the petition. Date: 8/10/2004 Official Seal of the District Court Douglas County, Kansas Clerk Clerk of the District Court By ___________________________________, Deputy American LegalNet, Inc. www.USCourtForms.com Case No.case no *****************RETURN ON SERVICE OF SUMMONS******************* I hereby certify that I have served this summons: Personal Service: By delivering a copy of such summons and 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 Receipt 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 defendant was not found in this county. No Service: _______________________________________________________________. I declare (or verify, certify or state) under penalty of perjury that the foregoing return of service is true and correct. Executed______________________ ________________________________________ Signature and Title of Officer COMPLETE AND RETURN TO: Douglas County District Court, Office of the Court Clerk 111 E. 11th St Lawrence, Kansas 66044 American LegalNet, Inc. www.USCourtForms.com