DIV410 State ENG Rev 10/17www.mncourts.gov/formsPage 1 of 1State of Minnesota District Court County of: Select County Judicial District: Court File Number: Case Type: Dissolution without ChildrenIn the Marriage of: Petitioner (first, middle, last)and Respondent (first, middle, last)Affidavit of Default says that:I am the Petitioner in this action. The Summons and Petition were personally served on the Respondent on, (date) as shown by the Affidavit of Service on file. More than (30) thirty days have elapsed since the date service was made. No answer has been served on Petitioner or Petitioner's attorney. Wherefore, Petitioner requests that this action be scheduled for hearing as a default.I declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. 247 358.116. Dated: Signature County and State where signed Name: Address: City/State/Zip: Telephone: E-mail address:NOTICE TO PETITIONER: If Respondent has not served you with an Answer, the court will review your pleading administratively. No court hearing is required. To request an administrative review, wait until 51 days after the date Respondent was served with the Summons and Petition. Then file the scheduling request form, asking for an administrative review-default. American LegalNet, Inc. www.FormsWorkFlow.com