State of Minnesota County Select County
District Court Judicial District: Court File Number: Case Type: Dissolution with Children
In the Matter of:
Petitioner
and
Admission of Service of Summons and Petition for Dissolution of Marriage
Respondent
I, the undersigned Respondent, acknowledge that I have personally received a copy of the Summons and Petition for Dissolution of Marriage. I understand that: 1. 2. Signing this document starts the divorce/dissolution process; Signing this document does not mean that I agree with everything in the Petition for Dissolution of Marriage. It only means that I have received a copy of the Summons and Petition; I have thirty (30) days from the date of signing this document to serve on the Petitioner an Answer to the Petition; If I do not serve an Answer within thirty (30) days, I will be found in default and Petitioner may ask the Court to give him/her everything (s)he has asked for in the Petition for Dissolution of Marriage; I do not have to sign this Admission. But if I do not sign, Petitioner can commence the divorce/dissolution by having the Summons and Petition for Dissolution of Marriage personally served upon me and I may have to pay the cost of Petitioner doing this.
3.
4.
5.
I declare, under penalty of perjury, that I personally received a copy of the Summons and Petition , on . at
(City) (State) (Month/Day/Year you received the papers).
Dated:
Signature (Sign only in front of notary public or court administrator.)
Name: Sworn/affirmed before me this day of , . Address: City/State/Zip: Telephone:
Notary Public \ Deputy Court Administrator
DIV805
State
ENG
Rev 11/01-D
www.courts.state.mn.us/forms
Page 1 of 2
State of Minnesota County Select County
District Court Judicial District: Court File Number: Case Type: Dissolution with Children
In the Matter of:
Petitioner
and
Respondent
Affidavit of Personal Service
STATE OF MINNESOTA COUNTY OF
(County where Affidavit signed)
) ) SS ) , being sworn, state that I am at least 18 years of age
I,
(Name of person who hand-delivered documents)
having been born on
, and that on
,
(Name of other party)
I served the Summons and Petition for Dissolution of Marriage upon by handing a true and correct copy of the documents to him/her at:
street address city state
Signature of Person who Served the Documents Dated:
Signature (Sign only in front of notary public or court administrator.)
Name: Sworn/affirmed before me this day of , . Address: City/State/Zip: Telephone:
Notary Public \ Deputy Court Administrator
DIV805
State
ENG
Rev 11/01-D
www.courts.state.mn.us/forms
Page 2 of 2