UNITED STATES DISTRICT COURT WESTERN DISTRICT OF MISSOURI NOTICE OF LAWSUIT AND REQUEST FOR WAIVER OF SERVICE FOR SUMMONS Plaintiff v. Case Number: Defendant TO: (A) as (B) of (C) A lawsuit has been commenced against you (or the entity on whose behalf you are addressed.) A copy of thecomplaint is attached to this notice. It has been filed in the United States District Court for the Western Districtof Missouri and has been assigned docket number (E) .This is not a formal summons or notification from the court, but rather my request that you sign and return theenclosed waiver of service in order to save the cost of serving you with a judicial summons and an additionalcopy of the complaint. The cost of service will be avoided if I receive a signed copy of the waiver within (F) days after the date designated below as the date on which this Notice and Request is sent. I enclose a stampedand addressed envelope (or other means of cost-free return) for your use. An extra copy of the waiver is alsoattached for your records. If you comply with this request and return the signed waiver, it will be filed with the court and no summons willbe served on you. The action will then proceed as if you had been served on the date the waiver is filed, exceptthat you will not be obligated to answer the complaint before 60 days from the date designated below as the dateon which this notice is sent (or before 90 days from that date if your address is not in any judicial district of theUnited States.) If you do not return the signed waiver within the time indicated, I will take appropriate steps to effect formalservice (in a manner authorized by the Federal Rules of Civil Procedure and will then, to the extent authorized bythose Rules, ask the court to require you (or the party on whose behalf you are addressed) to pay the full costs ofsuch service. In that connection, please read the statement concerning the duty of parties to waive the service ofthe summons, which is set forth on the reverse side (or at the foot) of the waiver form.I affirm that this request is being sent to you on behalf of the plaintiff, this day of , 19 . Signature of Plaintiffs Attorney or Unrepresented PlaintiffA - Name of individual defendant (or name of officer or agent of corporate defendant) B - Title or other relationship of individual to corporate defendant C - Name of corporate defendant, if any D - District E - Docket number of action F - Addressee must be given at least 30 days (60 days if located in foreign country) in which to return waiver:not&waiv.int