Summons For Dissolution Of Marriage Or Legal Separation Page 3
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4District Court ___________________________ County, Colorado
Court Address:
In re the Marriage of:
Petitioner: ______________________________________
COURT USE ONLY
Case Number:
and
Respondent:____________________________________
Division
Courtroom
WAIVER AND ACCEPTANCE OF SERVICE
I declare under oath that I am the Respondent in this case, that I have received and accept service of the Summons, a copy of
the Petition, and if applicable the
Case Management Order,
Notice of Initial Status Conference, and
Other (Please
identify): ___________________________________________________________________________________in this case.
This waiver of service shall not be construed as an admission by me of the truth of the allegations in the Petition
and I reserve the right to receive notices of settings and the right to respond and appear in person.
Note: If you are in the active military service of the United States of America, you may be entitled to request a temporary
suspension of these proceedings under the Servicemembers Civil Relief Act (50 U.S.C. §520, et seq.). Please consult with
your base legal officer or the attorney of your choice.
I have decided to waive the stay provisions of the Servicemembers Civil Relief Act (50 U.S.C. §520, et seq.) as
well as my right to court-appointed counsel under the Act and permit the action to proceed. This waiver of service
shall not be construed as an admission by me of the truth of the allegations in the Petition.
Date: ____________________________
________________________________________________
Signature of Respondent
_______________________________________________________
Address
_______________________________________________________
Phone Number
Subscribed and affirmed, or sworn to before me by
in
the
County
of
______________________, State of _________________, this ___________ day of ______________, 20 _______.
My Commission Expires: ________________________
___________________________________
Notary Public/Clerk
Page 3 of 4
JDF 1102
2-12
SUMMONS FOR DISSOLUTION OF MARRIAGE OR LEGAL SEPARATION
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