STATE OF SOUTH DAKOTA COUNTY OF ______________ __________________________ Plaintiff/Petitioner/Respondent v. ___________________________ Defendant/Petitioner/Respondent. ) )SS. ) ) ) ) ) ) ) ) ) IN CIRCUIT COURT __________ JUDICIAL CIRCUIT No. _________ ADMISSION OF SERVICE OF PETITION I, _________________________, admit personal service of the Petition and Notice of (person receiving Petition & Notice) Petition in the above-entitled action at ________________________, ______________ (City) (State) on this _____ day of _______________, 20_____. __________________________________ Signature (person receiving Petition & Notice) Signed and sworn to before me this _______ day of _________________, 20___. ______________________________________ Notary Public/Clerk of Court Commission Expires: (SEAL) You must sign and date the admission part of this form in front of a notary or Clerk of Court and return one copy of the completed form to the sender within twenty days (you may want to keep a copy for your records). If you are served on behalf of another person and you are authorized to receive process, you must indicate under your signature your authority. If you do not complete and return the form to the sender within twenty days, you may be required to pay any expenses incurred in serving a summons in any other manner permitted by law. If you wish to file Objections you must do so within 10 days or the Court will enter an Order implementing the Guidelines. Objection forms are available from the Clerk of Court or on the UJS website at http://ujs.sd.gov/. American LegalNet, Inc. www.FormsWorkFlow.com Form UJS-368 Rev. 09/2010