Superior Court of Washington County of In re: No. Petitioner(s), and Notice Re: Dependent of a Person in Military Service (Optional Use) (NTDMP) Respondent(s). Notice: State and federal law provide protections to defendants/respondents who are on active duty in the military service, and to their dependents. This notice only pertains to a defendant/respondent who is a dependent of a member of the National Guard or a military reserve component under a call to active service for a period of more than thirty (30) consecutive days. Other defendants/respondents in military service also have protections against default judgments not covered by this notice. Dependents of a service member are the service member’s spouse, a service member’s minor child, or an individual for whom the service member provided more than one-half of the individual’s support for one hundred eighty days (180) days immediately preceding an application for relief. One protection provided is the protection against the entry of a default judgment in certain circumstances. If you are the dependent of a member of the National Guard or a military reserve component under a call to active service for a period of more than thirty (30) consecutive days, you should notify the plaintiff/petitioner or, if the plaintiff/petitioner is represented by an attorney, the plaintiff/petitioner’s attorney in writing of your status as such within twenty (20) days of the receipt of this notice. If you fail to do so, then a court or an administrative tribunal may presume that you are not a dependent of an active duty member of the National Guard or reserves, and proceed with the entry of an order of default and/or a default judgment without further proof of your status. Your response to the plaintiff/petitioner or plaintiff/petitioner’s attorney about your status does not constitute an appearance for jurisdictional purposes in any pending litigation, a waiver of your rights or a response to the petition, complaint or other application for relief that was filed against you. _____________________ Date ____________________________ Signature of Petitioner __________________________ Print or Type Name Notice re: Dep. of Person in Military Service (NTDMP) - Page 1 of 1 WPF DRPSCU 01.0185 (6/2006) – Laws of 2006, ch. 80 § 1(3) American LegalNet, Inc. www.USCourtForms.com