Free Form 6 - North Dakota

IN DISTRICT COURT, ____________________ COUNTY, NORTH DAKOTA ______________________________, Plaintiff, vs. ______________________________, Defendant. } } } } } } }

ADMISSION OF SERVICE Civil No. _________________

I, ____________________, hereby admit receipt of a copy of the Summons and Complaint in the above-entitled action on ________________, ______, along with a copy of the Settlement Agreement.

________________________________ Defendant Subscribed and sworn to before me on ______________, _____.

________________________________ Notary Public (SEAL)