In the _______________ Court for _____________________ County, State of _____________________ Case No.: ____________________ In Re: The Marriage of: ________________________________) and ________________________________)
WAIVER OF SERVICE AND ACCEPTANCE OF THE COMPLAINT/PETITION UNDER PENALTY OF PERJURY I CERTIFY that I am a resident of the State of ____________________. I hereby waive formal service of the Complaint/Petition in this action. I also accept the Complaint/Petition at this time.
____________________________________ Respondent’s Signature ____________________________________ Print or Type Name ____________________________________ Respondent’s Residence Address
Executed this ______ day of ___________, 200__, by __________________________ before me, personally appeared ________________________, personally known to me or produced _______________________________ as identification and who did/did not take a sworn oath. ________________________________
Signature of Notary
(Notary Seal)
Printed Name: ________________________ My Commission Expires:___________________
IF A NONLAWYER ASSISTED YOU FILL OUT THIS FORM, THEY MUST FILL IN ALL THE BLANKS BELOW: I (name of person) _____________________________, am a nonlawyer residing at (street) _______________________, (city) _____________________, (state) _____, (phone) _______ helped (name of spouse) ____________________, who is the _____ petitioner or _____ respondent, fill out this document.