Fill and Sign the Summons Notice Form

B 250C (8/96) United States Bankruptcy Court ________________ District Of ________________ In Re       , ) Debtor ) Case No.       )       , ) Chapter       Plaintiff ) ) v. ) )       , ) Adv. Proc. No.       Defendant ) SUMMONS AND NOTICE OF TRIAL IN AN ADVERSARY PROCEEDING YOU ARE SUMMONED and required to file a motion or answer to the complaint which is attached to this summons with the clerk of the bankruptcy court within 30 days after the date of issuance of this summons, except that the United States and its offices and agencies shall file a motion or answer to the complaint within 35 days. Address of Clerk       At the same time, you must also serve a copy of the motion or answer upon the plaintiff’s attorney. Name and Address of Plaintiff’s Attorney       If you make a motion, your time to answer is governed by Fed. R. Bankr. P. 7012. YOU ARE NOTIFIED that a trial of the proceeding commenced by the filing of the complaint will be held at the following time and place. Address       Room       Date and Time       IF YOU FAIL TO RESPOND TO THIS SUMMONS, YOUR FAILURE WILL BE DEEMED TO BE YOUR CONSENT TO ENTRY OF A JUDGMENT BY THE BANKRUPTCY COURT AND JUDGMENT BY DEFAULT MAY BE TAKEN AGIANST YOU FOR THE RELIEF DEMANDED IN THE COMPLAINT. Clerk of the Bankruptcy Court By: Date Deputy Clerk CERTIFICATE OF SERVICE I,       , certify that I am, and at all times during the (name) service of process was, not less than 18 years of age and not a party to the matter concerning which service of process was made. I further certify that the service of this summons and a copy of the complaint was made       by:       (date) Mail Service: Regular, first class United States mail, postage fully pre-paid, addressed to:       Personal Service: By leaving the process with defendant or with an officer or agent of defendant at:       Residence Service: By leaving the process with the following adult at:       Certified Mail Service on as Insured Depository Institution: By sending the process by certified mail addressed to the following officer of the defendant at:       Publication: The defendant was served as follows: [Describe briefly]       State Law: The defendant was served pursuant to the laws of the State of       , as follows: [Describe briefly] (name of state)       Under penalty of perjury, I declare that the foregoing is true and correct. ____________________________ ____________________________________________ Date Signature Print Name       Business Address       City       State       Zip