Free Waiver of Service Executed - District Court of Connecticut - Connecticut

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- I I Case 3:03-cv-00944-RNC Document 27 Filed 08/05/2004 Page 1 of 1
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I I WAIVER OF SERVICE OF SUMMONS
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I I I (NAME OF PLAlNTIFF’S ATTORN · OR UNREPRESENTED Ptarrvrtrr)
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II I’ OI acknowled ' t f
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I I DEFENDANT 1 Mt, Y -.»
1 I ‘ NME) I·<1.Ine-.IrtIt:r IZGIIIII I
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that I waive service of summon ` ` C ‘ I_ `I`
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I I m Umted States Di '
I I (DOCKET NUMBER) strict Court I
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1 D¤St¤¤t of CONNECTICUT _ I
I I 11 l I have also recerved a copy ofthe complaint m the action, two copies of this mstrument, and a means by I
w .uch I can rctum the signed waiver to you without cost to me. I
I b I agree to save the cost of service of a summons and an additional copy ofthe complaint in this lawsuit I
I y not requrrmg that I (or the entity on whose behalf I am acting) be served with judicial process in the manner I
I provided by Rule 4. ,

I I I·(or the entity on whose behalf I am acting) will retain all defenses or objections to the lawsuit or to the
I jurisdiction or venue of the court except for objections based on a defect in the summons or in the service of
I the summons.
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II I understand that a judgment may be entered against me (or the party on whose behalf I am acting) if an
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answer or motron under Rule 12 rs not served upon you within 60 days alter ` °"’ I saw. -.
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I or 90 days after that date if the request was sent outside the United States. L 1 2
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I -_I-I (DATE) SIGNATURE)
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Printedffyped Name: I
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I {TITLE) qcorurosars oarsunrorrj I
I Duty to Avoid Unnecessary Costs of Service of Summons
I Rule 4 ofthe Federal Rules of Civil Procedure requires certain parties to cooperate in saving unnecessary costs of service ofthe summons and
complaint. A defendant located in the United States who, after being notified of an action and asked by a plaintiff located in the United States to waive
service of summons, fails to do so will be required to bear the cost of such service unless good cause be shown for its failure to sign and retum the waiver.
I I It is not good cause for a failure to waive service that a party believes that the complaint is unfounded, or that the action has been brought in an
improper place or in a court that lacks jurisdiction over the subject matter ofthe action or over its person or property. A party who waives service ofthe
summons retains all defenses and objections (except any relatingto the summons orto the service ofthe summons), and may later object to the jurisdiction
ofthe court or to the place where the action has been brought.
A defendant who waives service must. within the time specified on the waiver form serve on the plaintiffs attorney (or unrepresented plaintiff) a
` response to the complaint and must also tile a signed copy ofthe response with the court. lf the answer or motion is not served within this time, a default
I judgment may be taken against that defendant. By waiving service, a defendant is allowed more time to answer than if the summons had been actually I
I served when the request for waiver of service was received. I
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