Fill and Sign the Ccd No 17 01 United States Courts Form

Waiver of Service Page 1 of 2STATE OF SOUTH CAROLINA)IN THE FAMILY COURT OF THE) JUDICIAL CIRCUITCOUNTY OF ))) and)WAIVER OF SERVICE)AND CONSENT ) Plaintiff(s) ) Docket No. appeared in person before me today and stated under oath: 1.I, , am the Father Mother Guardian other, specify of the minor who is the subject of the above entitled Name Change action. 2. I acknowledge that I have been provided a copy of the Complaint for Name Change and Amendment of Birth Certificate filed in this case. I have read and understand the contents of that document.3. I understand that the §15-49-10(B) of the South Carolina Code entitled me to be served with the Complaint. I do not want to be served with the Complaint and I formally waive service of the Complaint.4. I hereby enter my appearance in this case for all purposes and waive further notice of proceedings in this action.5.I further state that the following information is correct:a. Mailing Address: Street address: City, State, Zip: b. Telephone Number: Signature Type or Print Name Waiver of Service Page 2 of 2STATE OF COUNTY OF The foregoing instrument was acknowledged before me this __________________ (date) by ____________________________________ (name of person acknowledged). ____________________________________Notary Public Print Name: My commission expires: I, the notary public whose signature appears above, certify that I am not an attorney inthis case.Notary