Rev. 3/2017 251 KSJC Page 1 of 2 IN THE DISTRICT COURT OF COUNTY, KANSAS Case No. (Name of person who filed the Petition) and (Name of person who did not file the Petition) REQUEST AND SERVICE INSTRUCTION FORM 223Petitioner224 means the person who filed the Petition (the first document in the case). 223Respondent224 means the person who did not file the Petition. To: Clerk of the District Court - the following forms are filed for service: (check all applicable forms to be served) 1. Motion to Modify Child Support and Notice of Hearing 2. Child Support Worksheet 3. Short Form Domestic Relations Affidavit of Petitioner Respondent 4. Motion to Establish Parenting Time and Notice of Hearing 5. Motion to Enforce Parenting Time and Notice of Hearing 6. Motion to Modify Parenting Time and Notice of Hearing 7. UCCJEA Affidavit 8. Proposed Parenting Plan of Petitioner Respondent 9. Other (name of form to be served) Name of person to be served: (You must complete one request for EACH person to be served.) Address of person to be served: Service is requested by ONE of the following methods: a. Service by U.S. Mail 226 I mailed (postage pre-paid) the documents to the other person222s last known address. b. Service by Certified Mail 226 I mailed the documents by certified mail, and I understand that I must file the receipt for certified mail service (green card or electronic confirmation) with the Clerk222s office. American LegalNet, Inc. www.FormsWorkFlow.com Rev. 3/2017 251 KSJC Page 2 of 2 c. Service by Sheriff by Certified Mail - Certified mail service by the office of the Sheriff of County, State of Kansas. I understand that the responsibility for obtaining service and filing the return of service shall be on the Sheriff. d. Personal Service by Sheriff (inside Kansas)- Personal service through the office of the Sheriff of County, State of Kansas. e. Personal Service by Sheriff (outside Kansas) 226 Personal service through the office of the Sheriff of County, State of , which I MUST ARRANGE WITHOUT ASSISTANCE OF THE COURT. X Signature Name (Print): Address 1: Address 2: City, State, Zip: Telephone Number: American LegalNet, Inc. www.FormsWorkFlow.com