UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF TEXAS Plaintiff(s), CIVIL ACTION NUMBERversus ___________________________________ Defendant(s). NOTICE AND ACKNOWLEDGMENT FOR SERVICE BY MAIL TO DEFENDANT: ____________________________________________________________ (Name and Address) The summons and complaint are served under Rule 4 of the Federal Rules of Civil Procedure.You must sign and date the acknowledgment below and return one copy of it to the sender within 20days. If you received the papers for a corporation, unincorporated association, partnership, or otherentity (including another person), you must indicate under your signature your relationship to it. If you do not return the completed form to the sender within 20 days, you may be required topay the expenses of serving a summons and complaint in another way under the law. If you do return the completed form, you must answer the complaint within 20 days. If you failto file an answer, a judgment will be taken against you for the relief demanded in the complaint. I declare, under the penalty of perjury, that this notice and acknowledgment will have beenmailed on _______________________________________. __________________________________________ Signature of Plaintiff __________________________________________ Date of Signature ACKNOWLEDGMENT OF RECEIPT I declare, under penalty of perjury, that I received a copy of the summons and complaint in thismatter on _____________________ at _______________________________. (date) (location) __________________________________________ Signature __________________________________________ Name Typed _________________________________________ Relationship or Authority SDTX(mail.svc) 02/03/98