Fill and Sign the Changing Your Name as an Adult Mt Judicial Branch Form

Notice and Acknowledgment, Page 1 of 3 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 7/24/02 _______________________________ Name _____________________________________ Address_____________________________________ City State Zip Code _____________________________________ Phone Number PETITIONER PRO SE MONTANA _______________ JUDICIAL DISTRICT COURT_____________________ COUNTY In re the Parenting of: mino r child(ren); ________________________, Petitioner, and ________________________, Respondent. Cause No.: _________________ Notice and Acknowledgment of Receipt of Summons and Petition for Establishment of Permanent Parenting Plan NOTICE To: ______________________________, the Respondent herein: The following documents are served pursuant to Rule 4(D)(1)(b) of the Montana Rules o f Civil Procedure: [X] Summo ns [X] Pet it io n fo r Est ablishment o f Permanent Parent ing Plan [X] Petitioner’s Proposed Parenting Plan [ ] Notice and Acknowledgment to Child Support Enforcement Division [ ] No t ice o f Filing Mo nt ana Child S upport Guidelines Financial Affidavit [ ] __________________________________________ If you want to avoid having the sheriff serve you with the documents enclosed, y ou may complete the acknowledgment part of this form and return the completed form to t he sender within Notice and Acknowledgment, Page 2 of 3 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 7/24/02 20 days after the date it was mailed to you, as shown below. You may retain the other en closed copy of this form for your records. By signing the Acknowledgment, you are agreeing to be served by mail instead of by th e sheriff. It does not mean that you agree to the contents of the Petition, and it do es not take away any of your rights to contest the Petition. If you decide to complete and return this form, you must sign and date the A cknowledgment below, and return it in the enclosed stamped return envelope. If you do not complete and return this form to the sender within 20 days after the date it was mailed to you, as shown below, you may be required to pay any expenses incurred i n serving the enclosed documents in any other manner permitted by law. If you do complete and return this form, you must answer the Petition within 20 days after the date of signature which you place on the Acknowledgment below. If you fail to answer the complaint within the foregoing 20 day period, judgment by default w ill be t aken against yo u fo r t he relief demanded in t he Pet it io n. CERTIFICATE OF MAILING I declare under penalty of perjury that two copies of this Notice and Acknowledgment of Receipt of Summons and Petition, a stamped return envelope, and the following documen ts: [X] Summo ns and Tempo rary Eco no mic Rest raining Order [X] Pet it io n fo r Est ablishment o f Permanent Parent ing Plan [X] Petitioner’s Proposed Parenting Plan [ ] Notice and Acknowledgment to Child Support Enforcement Division [ ] No t ice o f Filing Mo nt ana Child S upport Guidelines Financial Affidavit [ ] __________________________________________ were sent to the Respondent by first class mail, postage prepaid on the _______ day of __________________________, 20___. ____________________________ _______________________________ Date of Signature Petitioner Pro Se Signature _______________________________ Print Name Notice and Acknowledgment, Page 3 of 3 Approved by the Montana Supreme Court Commission on Self-Represented Litigants and Montana Legal Services Association, 7/24/02 ACKNOWLEDGMENT OF RECEIPT I declare, under penalty of perjury, that I am the Respondent and that I accept service in this action of the following: [X] Summo ns and Tempo rary Eco no mic Rest raining Order [X] Pet it io n fo r Est ablishment o f Permanent Parent ing Plan [X] Petitioner’s Proposed Parenting Plan [ ] Notice and Acknowledgment to Child Support Enforcement Division [ ] No t ice o f Filing Mo nt ana Child S upport Guidelines Financial Affidavit [ ] __________________________________________ and that I received a copy of these documents in the above-captioned matter at ( address): _________________________________________________________________________on the _____ day of __________________________, 20___. __________________________ _______________________________ Date of Signature Respondent’s Signature _______________________________ Print Name