STATE OF SOUTH DAKOTA COUNTY OF ) ) ) , IN ______________ COURT ________________ JUDICIAL CIRCUIT Petitioner, -vsRespondent TO THE PARTIES: TPO NO._____________________ NOTICE OF HEARING, SUMMONS TO APPEAR, AND ORDER (VULNERABLE ADULT ABUSE) , YOU ARE NOTIFIED that a Petition and Affidavit has been filed with this Court seeking a Protection Order against you according to the provisions of SDCL chapter 21-65. A copy of the Petition and Affidavit together with a copy of an Ex Parte Temporary Order of Protection, if one has been issued, is attached to this Summons and is served upon you. Temporary Order of Protection denied. Hearing only. There will be a hearing on the Petitioner/Substitute Petitioner's Petition on the _________ day of ________________, ______, at _______________ o'clock _______ (am/pm), in the _________________________________ County Courthouse (Courtroom # ___________) in _________________________________, South Dakota. IF YOU FAIL TO APPEAR AT THE HEARING AND ANSWER THE PETITION, AN ORDER OF PROTECTION MAY BE ENTERED AGAINST YOU AS REQUESTED. DATED / / . Service of this notice is authorized on any day including Sunday. Judge Attest: By: , Clerk of Courts , Deputy Form UJS-120B (Vulnerable Adult) Notice of Hearing 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-120B (Vulnerable Adult) Notice of Hearing Rev. 6/16 American LegalNet, Inc. www.FormsWorkFlow.com