JV-021 (Rev. 12/18/2013)APPOINTMENT OF AGENT(SEALED)Trial Court of MassachusettsJuvenile Court DepartmentI, of appoint ofas my agent and do stipulate and agree that service of legal process against me by ofseeking enforcement of the post-adoption agreement entered into onshall have the like effect as if made on me personally. I hereby revoke any previous appointment of agent.Signed in the presence of(Name)(Street and No.)(City or Town)(County)(State)(Zip Code)(Street and No.)(Name)(Zip Code)(State)(County)(City or Town)(Zip Code)(State)(County)(City or Town)(Street and No.)(Name)Date:Signature:(PRINCIPAL)Signature:(WITNESS)DivisionACCEPTANCEI, of acceptthe appointment.If the agent is no longer able to serve, the person nominating the agent must name a new agent by completing anotherappointment of agent form and filing the form with the court.(AGENT)Signature:Date:(Street and No.)(Name)(Zip Code)(State)(County)(City or Town)(Name and Address of Witness)(Date) American LegalNet, Inc. www.FormsWorkFlow.com