Page 1 of 1 Stip DNC Form 5/Rev May 2018 IN DISTRICT COURT, COUNTY, NORTH DAKOTA , } Plaintiff, } } vs. } ADMISSION OF SERVICE } } Civil No. , } Defendant. } I, , (Defendant name) hereby admit receipt of a copy of the Summons and Complaint in the above entitled action on , 20, along with a copy of the Settlement Agreement and a copy of Exhibit A: Confidential Division of Property and Debts and Values. I understand that this admission merely acknowledges receipt of the papers; it does not admit or deny any of the statements contained in the papers. Dated this day of , 20. (Signature of Defendant) (Typed or Printed Name of Defendant) (Address) , (City) (State) (Zip Code) () (Telephone Number) American LegalNet, Inc. www.FormsWorkFlow.com