DIV1305 State ENG Rev 10/17www.mncourts.gov/formsPage 1 of 2State of Minnesota District Court County of: Select County Judicial District: Court File Number: Case Type: FamilyIn the Marriage of: Petitioner (first, middle, last)and Respondent (first, middle, last)AFFIDAVIT OF DEFAULT (Without Children) , says the following:1. I am the Petitioner in this action. 2. Respondent has been served with the Summons and Petition for Marriage Dissolution. 3. Respondent has not served an Answer on me or my attorney, and the time to Answer has passed. Therefore, I request that this action be scheduled as a default. Respondent was served with the Summons and Petition in the following way: (Check all that apply) The Summons and Petition were served on Respondent on , (date) as shown by the Affidavit of Service Admission of Service filed with the court. Today is at least 50 days after the date ofservice of the Summons and Petition or the date Respondent signed the Admission of Service. I have an Order for Service by Alternate Means.That Order requires publication. The Summons was published in a legal newspaper on (list all three dates of publication) as shown by the Affidavit of Publication on filewith the court. Today is at least 71 days after the first date of publication. I have an Order for Service by Alternate Means.That Order requires service by mail. The Summons and Petition were mailed to Respondent on(date) as shown bythe Affidavit of Service by Mail on file with the court. Today is at least 71 days after the date the Summons and Petition were deposited in the mail. American LegalNet, Inc. www.FormsWorkFlow.com DIV1305 State ENG Rev 10/17www.mncourts.gov/formsPage 2 of 2 Signature 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: County and State where signedNOTICE TO PETITIONER: If Respondent has not served you with an Answer, the Court will review your pleading administratively. No court hearing is scheduled. To request an administrative review, wait until 50 days after the date Respondent was personally served with the Summons and Petition or 50 days after the date Respondent signed an Admission of Service, or 71 days after the first date the summons was published in a newspaper, or 71 days after the summons was mailed to Respondent. Then file the Default Scheduling Request form, asking for an administrative review 226 default with no children. American LegalNet, Inc. www.FormsWorkFlow.com