NDLSHC Stip DWC Form 6/Rev Jun 2018 STATE OF NORTH DAKOTA IN DISTRICT COURT COUNTY OF JUDICIAL DISTRICT ) ) (Plaintiff) ) Case No. PLAINTIFF, ) ) Vs ) ADMISSION OF SERVICE ) ) (Defendant) ) DEFENDANT. ) I, , hereby admit receipt of a copy of the Summons and Complaint for divorce and a copy of Exhibit A: Confidential Division of Property and Debts and Values for the above entitled case on, 20. 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. Signature of Defendant Typed or Printed Name of Defendant Address , City State Zip Code () Telephone Number American LegalNet, Inc. www.FormsWorkFlow.com