COURT COUNTY .OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ......... .. : : DUT 43 1/96 Index No. Calendar No. WAIVER OF SERVICE OF SUMMONS : JUDICIAL SUBPOENA Plaintiff(s) -against- : TO:_____________________________________________________ (Name of Plaintiff's Attorney of Plaintif Pro Se) : : I, _______________________________________, acknowledge receipt of your request that I waive (Name of Defendant) Defendant(s) : . .service. .of . a . . . . . . . . . . in . the. .case . of . ________________________________________________ v. . . . . . . . summons . . . . . . . . . . . . . . . . . . . . . . . . . . . ____________________________________________, case number ___________________________, in the United States District Court for the District of Utah. I also have received a (i) copy of the complaint in the action, (ii) two copies of this form, and (iii) a means by which I can return the signed waiver to you without cost to me. THE PEOPLE OF THE STATE OF NEW YORK I agree to save the cost of service of a summons and an additional copy of the complaint in this lawsuit TO by not requiring that I (or the entity on whose behalf I am acting) be served with judicial process in the manner provided by Federal Rule of Civil Procedure 4. GREETINGS:the entity on whose behalf I am acting) will retain all defenses or objections to the lawsuit or to I (or the jurisidiction or venue of the court except for objections based on a defect in the summons or in the service WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before of the summons. , the Honorable at the Court located be County ofI understand that a judgment may at entered against me (or the party on whose behalf I am acting) if inan answer or motion under Federal Rule of Civil Procedure ,12 is not served uponthe within sixty (60) any recessed room , on the day of , 20 at o'clock in you noon, and at days orafter ________________________ (date requestawas sent), or within ninety (90) daysthe that date if the adjourned date, to testify and give evidence as witness in this action on the part of after request was sent outside the United States. ________________ _________________________________________________________ Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to Date the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply. Printed/Typed Name: ________________________________________ AS __________________________ OF __________________________ Witness, Honorable , one of the Justices of the Court in County, day of , 20 ____________________________________________________________________________________ DUTY TO AVOID UNNECESSARY COSTS OF SERVICE OF SUMMONS (Attorney must sign above and type name below) Federal Rule of Civil Procedure 4 requires certain parties to cooperate in avoiding unnecessary costs of service of the summons and complaint. A defendant located in the United States who, after being notified of an action and asked by a plaintiff located in the United States to waive service of a summons, fails to do so will be required to bear the cost of such service unless good cause be shown for its failure toAttorney(s) for the waiver. sign and return A party's belief that the complaint (i) is unfounded, (ii) that the action has been brought in an improper place, or (iii) that the action has been brought in a court that lacks jurisdiction over the subject matter of the action or over its person or property, does not constitute good cause for failure to waive service. Parties who waive service of Office and to the service summons retain all defenses and objections (except any relating to the summons or P.O. Addressof the summons) and later may object to the jurisdiction of the court or to the place where the action has been brought. A defendant who waives service must (i) serve, within the time specified on the waiver form, on the plaintiff's Telephone No.: attorney or plaintiff pro se a response to the complaint, and (ii) file a signed copy of the response with the court. If the Facsimile No.: response is not served within this time, a default judgment may be taken against that defendant. E-Mail Address: Mobile Tel. No.: American LegalNet, Inc. www.USCourtForms.com