STATE OF SOUTH DAKOTA ) ) COUNTY OF __________________ ) _____________________________, Petitioner -vs_____________________________, Respondent IN _____________ COURT _______ JUDICIAL CIRCUIT TPO NO. ______________________ NOTICE OF HEARING ON MOTION TO MODIFY AND SUMMONS TO APPEAR (VULNERABLE ADULT ABUSE) TO THE PARTIES: YOU ARE NOTIFIED that a Motion to Modify has been filed with this Court seeking a modification of the permanent protection order filed against you, according to the provisions of SDCL chapter 21-65. A copy of the Motion to Modify is attached to this Summons and is served upon you. There will be a hearing on the Motion on the _______ day of ________________, 20_____, at ______ __M. in the _______________________ County Courthouse in ____________________ (Courtroom) in _____________________________, South Dakota. IF YOU FAIL TO APPEAR AT THE HEARING AND ANSWER THE MOTION, THE ORDER OF PROTECTION MAY BE MODIFIED AS REQUESTED. DATED: ____________________________ Service of this notice is authorized on any day including Sunday. Judge Attest:___________________, Clerk of Courts by: _____________________, Deputy Form UJS-120H (Vulnerable Adult) Notice of Hearing to Modify Permanent Order Rev. 6/16 American LegalNet, Inc. www.FormsWorkFlow.com ACKNOWLEDGMENT OF PERSONAL SERVICE I acknowledge receipt of a copy of this Notice of Hearing. Petitioner / Substitute Petitioner (circle one) Date Respondent Date Form UJS-120H (Vulnerable Adult) Notice of Hearing to Modify Permanent Order Rev. 6/16 American LegalNet, Inc. www.FormsWorkFlow.com