Free PDF Format - West Virginia


File Size: 110.5 kB
Pages: 2
Date: March 22, 2007
File Format: PDF
State: West Virginia
Category: Court Forms - Federal
Author: ras
Word Count: 317 Words, 1,894 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.wvnd.uscourts.gov/Forms/Civil%20Summons%20-%20Fillable.pdf

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AO 440 (Rev. 8/01) | WVND (02/07) Summons in a Civil Action

UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF WEST VIRGINIA
AT

SELECT ONE:

Select one:

V.

SUMMONS IN A CIVIL CASE CIVIL ACTION NO.

Select one:
TO [Name and address of defendant]:

YOU ARE HEREBY SUMMONED and required to serve on [Name and address of Attorney(s) for Plaintiff(s)]:

an answer to the complaint which is served on you with this summons, within Select one: service of this summons days after on you, exclusive of the day of service. If you fail to do so, judgment by default will be taken against you for the relief demanded in the complaint. Any answer that you serve on the parties to this action must be filed with the Clerk of this Court within a reasonable period of time after service.

Wally Edgell, Ph.D., CLERK OF COURT
BY: ______________________________ DEPUTY CLERK

Clerk's Office will insert Date DATE: _________________________

AO 440 (Rev. 8/01) | SDWV/CIV-004 (4/05) Summons in a Civil Action

RETURN OF SERVICE
Service of the Summons and complaint was made by me(1)
NAME OF SERVER (PRINT) DATE TITLE

Check one box below to indicate appropriate method of service

G Served personally upon the defendant. Place where served: G Left copies thereof at the defendant's dwelling house or usual place of abode with a person of suitable age and
discretion then residing therein. Name of person with whom the summons and complaint were left:

G Returned unexecuted:

G Other (specify):

STATEMENT OF SERVICE FEES
TRAVEL SERVICES TOTAL

DECLARATION OF SERVER
I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct.
Executed on
Date Signature of Server

Address of Server

(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure.