Admission of Service of Summons and Petition for Dissolution of Marriage
The Plaintiff serves this form to the Defendant of a divorce case. Defendant must accomplish this form and return the completed version to the Petitioner. Upon receipt, Petitioner must file the form with the clerk’s office. Successful filing of this form notifies the court that Defendant has received copies of all the divorce papers.
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State of Minnesota District Court County 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 r eceived a copy of the Summons and Petition for Dissolution of Marriage. I understand that: 1. Signing this document starts th e divorce/dissolution process; 2. Signing this document does not mean that I agree with everything in the Petition for Dissolution of Marriage. It on ly means that I have received a copy of the Summons and Petition; 3. I have thirty (30) days from the date of signing this document to serve on the Petitioner an Answer to the Petition; 4. 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; 5. 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. I declare, under penalty of perjury, that I personally received a copy of the Summons and Petition at , on . (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 Address: day of , . 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 District Court County Judicial District: Court File Number: Case Type: Dissolution with Children In the Matter of: Petitioner and Affidavit of Personal Service Respondent STATE OF MINNESOTA ) ) SS COUNTY OF ) (County where Affidavit signed) I, , being sworn, state that I am at least 18 years of age (Name of person who hand-delivered documents) having been born on , and that on , I served the Summons and Petition fo r Dissolution of Marriage upon (Name of other party) 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 Address: day of , . 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
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