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 Out of 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 E. 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 within 30 days after service of this summons upon you. If you do not file a written response, you or your attorney must appear 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 filing a written answer or by appearing on the date and time listed above, judgment by default will be taken against you for the relief demanded in the petition. Date: 8/10/04 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 Out of 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 E. 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 Party (Pla) 3rd Prty Add Line1 3rd Prty City Line 2 3RD PRTY ST 3RD PRTY ZIP ZIP within 30 days after service of this summons upon you. If you do not file a written response, you or your attorney must appear at the Limited Civil Answer Docket, TIME a.m. on DATE, in the Pro Tem Division Courtroom of the Judicial Center, 111 E 11th, Lawrence, Kansas. If you fail to respond to the attached petition, either by filing a written answer or by appearing on the date and time listed above, judgment by default will be taken against you for the relief demanded in the petition. Date: 8/10/04 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 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: _______________________________________________________________________. DECLARATION I declare (or verify, certify or state) under penalty of perjury that the foregoing return of service is true and correct. Executed on__________________________ COMPLETE AND RETURN TO: Douglas County District Court Office of the Clerk of the Court 111 E. 11th St. Lawrence, Kansas 66044 ____________________________________ Signature of Law Enforcement Officer ____________________________________ Sheriff American LegalNet, Inc. www.USCourtForms.com