Fill and Sign the Mississippi Service Form

IN THE COUNTY COURT OF _____________________ COUNTY, MISSISSIPPI __________________________ PLAINTIFF V. CAUSE NO. ________________ __________________________ DEFENDANT Summons THE STATE OF MISSISSIPPI COUNTY OF ________________ TO: _____________________ (Name) _____________________ (street address) _____________________ (city, state and zip code) NOTICE TO DEFENDANT THE COMPLAINT WHICH IS ATTACHED TO THIS SUMMONS IS IMPORTANT AND YOU MUST TAKE IMMEDIATE ACTION TO PROTECT YOUR RIGHTS. You are required to mail or hand deliver a copy of a written response to the Complaint to ______________________ (attorney’s name) , the attorney for the Plaintiff, whose post office address is _______________________________________ (street address, city, state and zip code) . YOUR RESPONSE MUST BE MAILED OR DELIVERED WITHIN THIRTY (30) DAYS FROM THE DATE OF DELIVERY OF THIS SUMMONS AND COMPLAINT OR A JUDGMENT BY DEFAULT WILL BE ENTERED AGAINST YOU FOR THE MONEY OR OTHER THINGS DEMANDED IN THE COMPLAINT. You must also file the original of your response with the Clerk of this Court within a reasonable time afterward. ISSUED under my hand and seal of said Court, this ____ day of ____________, 20____. COUNTY CLERK OF ___________________ COUNTY, Mississippi (SEAL) By: _________________________ Deputy Clerk PROCESS SERVER’S RETURN I, the undersigned process server, served the summons and complaint upon the person or entity named above in the manner set forth below. (Process server must check proper space and provide all additional information that is requested and pertinent to the mode of service used):______ FIRST CLASS MAIL AND ACKNOWLEDGEMENT SERVICE. By mailing (by first class mail, postage prepaid), on the date stated in the attached Notice, copies to the person served, together with copies of the form of notice and acknowledgement and return envelope, postage prepaid, addressed to the sender (Attach completed acknowledgement of receipt pursuant to M.R.C.P. Form I-B). _______ PERSONAL SERVICE. I personally delivered copies to Defendant Lindsay W. Harris on the ____day of, ____________, 20____, where I found said person in ______________ County of the State of Mississippi. _______ RESIDENCE SERVICE. After exercising reasonable diligence I was unable to deliver copies to said person within _______________ County, Mississippi. I served the summons and complaint on the _______day of _____________, 20____, at the usual place of abode of said Defendant by leaving a true copy of the summons and complaint with _______________________who is the _______________(here insert wife, husband, son, daughter or other person as the case may be), a member of the family of the person served above the age of sixteen years and willing to receive the summons and complaint, and thereafter on the ______day of ____________, 20____, I mailed (by first class mail, postage prepaid) copies to the person served at his or her usual place of abode where the copies were left. ______ CERTIFIED MAIL SERVICE. By mailing to an address outside Mississippi (by first class mail, postage prepaid, requiring a return receipt) copies to the person served. (Attach signed return receipt or the return envelope marked "Refused.") I returned the summons unexecuted because _____________________________________. My fees are $_____________ for travel and $______________ for services, for a total of $_______________ . 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: ______________________ ___________________________________________________________________