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 SUMMONS Out of 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 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 30 days after service of this summons upon you. If you fail to do so, judgment by default will be taken against you for the relief demanded in the petition. Any related claim which you have against the plaintiff may be stated as a counterclaim in your written response. 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 SUMMONS Out of 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 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 30 days after service of this summons upon you. If you fail to do so, judgment by default will be taken against you for the relief demanded in the petition. Any related claim which you have against the plaintiff may be stated as a counterclaim in your written response. 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 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 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 by 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 defendant 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