Fill and Sign the Acknowledge Receipt of a Copy of the Complaint for Divorce Filed in This Case and the Summons Form

Acknowledgement and Acceptance of Service February 2011 Page 1 of 2 STATE OF WYOMING ) IN THE DISTRICT COURT ) ss COUNTY OF ________________ ) _______________ JUDICIAL DISTRICT Plaintiff:____________________________, ) Civil Ac tion Case No. ___________ (Print name of person filing) ) ) vs. ) ) Defendant: __________________________. ) (Spouse) (Print name) ACKNOWLEDGEMENT AND ACCEPTANCE OF SERVICE I, ____________________________________________________ , hereby (Print Defendant’s Name) acknowledge receipt of a copy of th e Complaint for Divorce filed in this case and the Summons issued by the clerk. I waive any requirement for other service of process (Rule 4(m)(2)(v), Wyoming Rules of Civil Procedure ). I agree to answer or otherwise plead within 20 days from this date (3 0 days if copies of the papers were received outside of Wyoming). I understand that if I fail to file an answer or other pleadings with the clerk of this court and ser ve the same upon the Plaintiff in accordance with the Wyoming Rules of Civil Procedure within the time limits stated, I will be in default and Plaintiff may be affo rded the relief demanded in the Complaint for Divorce without a trial or other hearing. DATED this _________ day of __________________________, 20____. Defendant’s Signature Defendant’s Phone Number : Defendant’s Address: Defendant’s City/State/Zip Code: Subscribed and sworn to before me on this ________ day of ____________________, 20_____. WITNESS my hand and notary seal. ____________________________________ Notary Public / Court Clerk My Commission Expires: Acknowledgement and Acceptance of Service February 2011 Page 2 of 2 CERTIFICATE OF SERVICE I certify that on (date) the original of this document w as filed with the Clerk of District Court; and, a true and accurate copy of th is document was served on the other party by Hand Delivery OR Faxed to this number OR by placing it in the United States mail, postage pre -paid, and addressed to the following: TO: ______________________________________ ______________________________________ ______________________________________ Your signature Print name