In The District Court of ______ County, Kansas Plaintiff’s name (Revised 7/10) Plaintiff vs. Case No. ______ Defendant’s name Defendant’s address Defendant Pursuant to Chapter 61 of Kansas Statutes Annotated Type of Service Requested: ______ by ______ SUMMONS To the above-named defendant(s): You are hereby notified that a lawsuit commenced against you will be on this court's docket at _____ o'clock _____ M., on the _____ day of _______________, ______, to be held at the following location: _______________________________. If you do not appear before this court or file an answer at such time, judgment by default will be taken against you for the relief demanded in the petition. If you intend to appear at such time and dispute the petition, you must file an answer with the clerk of this court within 14 days thereafter. If you are not represented by an attorney, the answer shall be signed by you. The answer shall state the following: (1) what the dispute is; (2) any affirmative defenses you have to the claim; and (3) your (or your attorney’s) current address, phone number, {fax phone number, and e-mail address}. You must also promptly send a copy of your answer to the plaintiff’s attorney or the plaintiff, if the plaintiff has no attorney. To the sheriff or process server: This summons must be served and your return of service made promptly; in any event, your return is due no later than ___________________, _____. Dated: _______________ _______________________________ Clerk’s signature American LegalNet, Inc. www.FormsWorkFlow.com (Name and address of plaintiff or plaintiff’s attorney) Reasonable accommodations will be provided in accordance with the Americans with Disabilities Act. RETURN ON SERVICE OF SUMMONS I hereby certify that I have served this summons in the following manner: (1) Personal Service. By delivering a copy of such summons and petition to each of the following defendants on the dates indicated: _______________ _______________, ______ _______________ _______________, ______ (2) Residence Service. By leaving a copy of such summons and petition at the usual place of residence of each of the following defendants with some person of suitable age and discretion residing therein on the dates indicated: ____________________ ____________________ ___________, ______ ____________________ ____________________ ___________, ______ (Name) (Address) (Date) (3) Agent Service. By delivering a copy of such summons and petition to each of the following agents authorized by appointment or by law to receive service of process on the dates indicated: ____________________ _______________, ______ ____________________ _______________, ______ (Name) (Date) (4) Residence Service and Mailing. By leaving a copy of such summons and petition 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: ____________________ ____________________ ____________, ______ ____________________ ____________________ ____________, ______ (Name) (Address) (Date) (5) Service by Return Receipt Delivery. By causing to be delivered on the _____ day of _______________, ______, a copy of the summons and petition by return receipt delivery to each of the following defendants at the following address: ______________________________________________________________________________ ______________________________________________________________________________ with such delivery made by the following person or entity: _______________________________. Attached hereto is a copy of the return receipt evidencing such delivery. (6) Return Receipt Delivery Refused. By mailing on the _____ day of _______________, _____, American LegalNet, Inc. www.FormsWorkFlow.com a copy of the summons and petition by first-class mail, postage prepaid, addressed to the following at the following address.: _____________________________________________________________________________ _____________________________________________________________________________ (7) No Service. The following defendants were not served: ______________________________________________________________________________ Pursuant to K.S.A. 53-601, as amended, I declare under the penalty of perjury that the foregoing is true and correct. EXECUTED on __________________, ______. _______________________________ Signature & Title of Officer or Process Server American LegalNet, Inc. www.FormsWorkFlow.com