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Entry Of Appearance And Waiver

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NO. (A) ____________________

JEFFERSON CIRCUIT COURT

FAMILY DIVISION _________

(B)__________________________

PETITIONER

(print name of Petitioner)

SELF HELP FORM #2

ENTRY OF APPEARANCE AND WAIVER

(C)__________________________

RESPONDENT

(print name of Respondent)

* * * * * * * * *

The Respondent comes without counsel and states:

I have read the Petition, have understood it, and do not contest it. I waive service of

summons, enter my appearance, and submit to the jurisdiction of the Court. I understand that, if

my spouse has an attorney, that attorney does not represent me, and that I may hire my own

attorney but choose not to do so. I waive service of any notice of hearing, taking of deposition,

motion to submit for judgment, or entry of judgment. I waive any right of appeal.

(D)

(signature of Respondent)

COMMONWEALTH OF KENTUCKY

)

COUNTY OF _____________________)

Subscribed and sworn to before me by the above-named Respondent on this ________

day of ____________________, 20____.

My commission expires: _________________________.

Notary Public

State at Large, Kentucky or

Deputy

Clerk

Revised 7/18/2007

Entry Of Appearance And Waiver

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