STATE OF SOUTH CAROLINA COUNTY OF ______________________ vs. ) ) ) ) Plaintiff, ) ) ) ) ) Defendant. ) IN THE FAMILY COURT ____ JUDICIAL CIRCUIT ACCEPTANCE OF SERVICE Docket No. ___________________________ Pursuant to Rule 4(j), SCRCP, I certify that I received a copy of the following: Family Court Cover Sheet, Certificate of Exemption, Summons and Complaint Other: _____________________________________________________________ in this action on at the following location: ______________________________________________________________________________ _____________________________________________________________________________. Date:_____________________, 20____ _________________________, S.C. _______________________________________ Signature SCCA 407 (12/2009) American LegalNet, Inc. www.FormsWorkFlow.com