ACCEPTANCE/WAIVER OF SERVICE OF PROCESS AND WAIVER OF FUTURE SERVICE OF PROCESS AND NOTICE Case No. ............................................................. COMMONWEALTH OF VIRGINIA ................................................................................................................................................................................................................................. ..................................................................................................................... v. Circuit Court ..................................................................................................................... PLAINTIFF DEFENDANT I, the undersigned party named below, swear under oath/affirm the following: 1. I am a party [ ] plaintiff [ ] defendant in the above-styled suit. 2. I have received a copy of the following documents on this date: [ ] Complaint filed on .................................................................................................................................................................................................... DATE [ ] Summons with copy of Complaint filed on ................................................................................................................................. attached DATE [ ] Other – Describe: .............................................................................................................................. filed on ..................................................... DATE I understand that my receipt of these copies and my signature below constitute [ ] the acceptance of service of process of these copies, or [ ] a waiver of service of process and notice which may be prescribed by law. 3. I agree to voluntarily and freely waiver any future service of process and notice as checked below in this case: [ ] a. any further service of process. [ ] b. notice of the appointment of a commissioner in chancery and hearings held by such commissioner in chancery, if a commissioner in chancery is appointed. [ ] c. notice of the taking of depositions. [ ] d. notice of the filing of any reports by a commissioner in chancery of the filing of depositions. [ ] e. notice of testimony to be given orally in open court. [ ] f. notice of entry of any order, judgment or decree, including the final decree of divorce. I understand that, by waiving service of process, I am giving up my right to be notified of the events described immediately above. ........................................................................ _______________________________________________________________________ DATE [ ] DEFENDANT [ ] PLAINTIFF TO DEFENDANT: Notify the Court in writing of any changes of your address while this case is pending. State/Commonwealth of ................................................................... , [ ] City [ ] County of Subscribed and sworn to/affirmed before me this by .......................... .................................................................................. day of .................................................................................... , 20 ................ ....................................................................................................................................................................................................................................................... NAME ........................................................................ _______________________________________________________________________ DATE [ ] CLERK [ ] DEPUTY CLERK [ ] NOTARY PUBLIC (My commission expires ................................................................ ) Registration No. ................................................................................................................. FORM CC-1406 MASTER 05/08 VA. CODE §§ 8.01-327; 20-99.1:1 Rules 3:5, 3:8 American LegalNet, Inc. www.FormsWorkflow.com