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· , o Case 3:03-cv-00944-RNC Document 29 Filed 08/05/2004 Page 2 of 3
{ t sito 398 (Rev. 12/93)
i NOTICE OF LAWSUIT AND REQUEST FOR
WAIVER OF SERVICE OF SUMMON S
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TO: (A) S G D O
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A lawsuit has been commenced against you (or the entity on whose behalf you are addressed). A l
copy of the complaint is attached to this notice. It has been tiled in the United States District Court for the
(D) XXXXXXXXXXXXXXX District of CO ECTICUT r
and has been assigned docket number (E) . _ ‘
803CV()n94 {ace)
This is not a formal summons or notification from the court, but rather my request that you sign and
retum the enclosed waiver of service in order to save the cost of sewing you with a judicial summons and an ,
additional copy ofthe complaint. The cost of service will be avoided if I receive a signed copy ofthe waiver
‘ within G`) Eg Q days after the date designated below as the date on whichthis Notice and Request
· is sent. I enclose a stamped and addressed envelope (or other means of cost-free retum) for your use.
An extra copy of the waiver is also attached for your records.
Ifyou comply with this request and return the signed waiver, it will be filed with the court and
no summons will be served on you. The action will then proceed as if you had been served on the date {
‘ the waiver is filed, except that you will not be obligated to answer the complaint before 60 days from the y
date designated below as the date on which this notice is sent (or before 90 days from that date if your
address is not in any judicial district of the United States). l
If you do not return the signed waiver within the time indicated, I will take appropriate steps to i
effect formal service in a manner authorized by the Federal Rules of Civil Procedure and will then, to the
extent authorized by those Rules, ask the court to require you (or the party on whose behalf you are
addressed) to pay the full costs of such service. In that connection, please read the statement concerning |
the duty of parties to waive the service ofthe summons, which is set forth at the foot of the waiver form.
` I I
G ( .
I affirm that this request is being sent to you on behalf of the plaintiff this g
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JU UL 1 4 Zfitlt. if f *7iit’»*lr%l~ l
L E he ·> in p
Sigma e of P1aintifl"s Attomey #1
or epresented Plaintiff
l
A—l*·lame of individual defendant (or name of oiiicer or agent of corporate defendant) l
B——']'itle, or other relationship of individual to corporate defendant ·
C-Name of corporate defendant, if any I
o—r>tnn¢r
E—Docket number of action l
F—A.ddressee must be given at least 30 days (60 days if located in foreign country) in which to retum waiver
i ·_ ( "* ` Case 3:03-cv—00944—FiNC Document 29 Filed 08/05/2004 Page 3 of 3
p uno 399 (Rev. totes)
WAIVER OF SERVICE OF SUMMON S
re:
2 (NAME OF PLAl'N'I`IFF’S ATTORNEY OR UNREPRESENTED P TIFF) i
L eekrrewledse reeeipt ef your request i
· (DEFENDANT NAME) I
. _ _ _ _ C- K J ` i
thatlwaiveservtceofstmmmonsmtheactionof l ll lnlll)[| ye I (gl QT-E E
3 @ Q C V 0 Q 9 (CAPTIONOFACION) J "‘ l
which is ease number ° @ in the United States District Court E
(DOCKET NUMBER) '
. for the XXXX XXX District of CONNECTICUT . l
‘ l
I have also received a copy ofthe complaint in the action, two copies of this mstrument, and a means by
which I can return the signed waiver to you without cost to me.
· I agree to save the cost of service of a summons and an additional copy ofthe complaint in this lawsuit
‘ by not requiring that I (or the entity on whose behalf I am acting) be served with judicial process in the maxmer
Z provided by Rule 4.
U I (or the entity on whose behalf I am acting) will retain all defenses or objections to the lawsuit or to the
jurisdiction or venue of the court except for objections based on a defect in the summons or inthe service of I
the summons.
I understand that a judgment may be entered against me (or the patty on whose behalf I am acting) if an
. g Q é ¥ fg yi`- .t·*z·;E1(>·§ It F
answer or motion under Rule 12 is not served upon you within 60 days mc; . te t at ..¤ r·.» , l
(DATE REQUEST was sam) _;
or within 90 days after that date if the request was sent outside the United States. J I 4 2
‘• I `1 n 3
— (DATE) (SIGNATURE)
. Printed/Typed Name: l
As of l
(Tires) (EORPORATE DEFENDANT) '
Duty to Avoid Unnecessary Costs of Service of Summons
Rule 4 ofthe Federal Rules of Civil Procedure requires certain parties to cooperate in saving umtecessary costs of service of the 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
i 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 rctum the waiver.
l
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 relating to the summons or tothe 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 thc waiver form serve on the plaintiffs attomey (or unrepresented plaint.iH) a
response to the complaint and must also file a signed copy ofthe response with t.he court Ifthe answer or motion is not served within t.his time, a default
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
served when the request for waiver of service was received. l
l
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