AO 441 (Rev. 07/10) Summons on Third-Party Complaint UNITED STATES DISTRICT COURT for the __________ District of __________ Plaintiff v. Defendant, Third-party plaintiff v. Third-party defendant ) ) ) ) ) ) ) Civil Action No. SUMMONS ON A THIRD-PARTY COMPLAINT To: (Third-party defendant's name and address) A lawsuit has been filed against defendant , who as third-party plaintiff is making this claim against you to pay part or all of what the defendant may owe to the plaintiff . Within 21 days after service of this summons on you (not counting the day you received it) -- or 60 days if you are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ. P. 12 (a)(2) or (3) -- you must serve on the plaintiff and on the defendant an answer to the attached complaint or a motion under Rule 12 of the Federal Rules of Civil Procedure. The answer or motion must be served on the defendant or defendant's attorney, whose name and address are: It must also be served on the plaintiff or plaintiff's attorney, whose name and address are: If you fail to respond, judgment by default will be entered against you for the relief demanded in the third-party complaint. You also must file the answer or motion with the court and serve it on any other parties. A copy of the plaintiff's complaint is also attached. You may ­ but are not required to ­ respond to it. Date: CLERK OF COURT Signature of Clerk or Deputy Clerk American LegalNet, Inc. www.FormsWorkFlow.com AO 441 (Rev. 07/10) Summons on Third-Party Complaint (Page 2) Civil Action No. PROOF OF SERVICE (This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l)) This summons for (name of individual and title, if any) was received by me on (date) . ' I personally served the summons on the individual at (place) on (date) ' I left the summons at the individual's residence or usual place of abode with (name) , a person of suitable age and discretion who resides there, on (date) , and mailed a copy to the individual's last known address; or , who is on (date) ' I returned the summons unexecuted because ' Other (specify): . My fees are $ for travel and $ for services, for a total of $ . ; or ; or ; or ' I served the summons on (name of individual) designated by law to accept service of process on behalf of (name of organization) I declare under penalty of perjury that this information is true. Date: Server's signature Printed name and title Server's address Additional information regarding attempted service, etc: American LegalNet, Inc. www.FormsWorkFlow.com