Waiver of Service Template

[Name of Court]
[County / District]
[State]

[Petitioner / Plaintiff Name],
Petitioner / Plaintiff,

v.

[Respondent / Defendant Name],
Respondent / Defendant.

Case No.: [Case Number]

WAIVER OF SERVICE

1. Person Signing Waiver

My name is [Full Legal Name].

I am the:

☐ Respondent
☐ Defendant
☐ Other party authorized to waive service in this case: [Describe]

My current mailing address is:

[Street Address]
[City, State, ZIP Code]

My email address is: [Email Address]
My phone number is: [Phone Number]

2. Acknowledgment of Case

I acknowledge that a case has been filed in the court identified above.

I have received a file-stamped copy of the following document or documents:

☐ Petition
☐ Complaint
☐ Application or motion
☐ Citation or summons copy, if applicable
☐ Other filed papers: [Describe]

Date documents were received: [Date]

3. Waiver of Formal Service

I understand that I have the right to be formally served with legal process as required by applicable law.

I do not want formal service by sheriff, constable, process server, or other authorized officer.

I voluntarily waive formal service of process in this case.

4. Scope of Waiver

This waiver applies to:

☐ The initial petition or complaint only
☐ The filed documents identified above only
☐ Additional documents listed here: [Describe]

Unless expressly stated otherwise in this document, I do not waive:

• my right to receive notice of future hearings or settings as required by law;

• my right to file an answer, response, objection, or other pleading;

• my right to contest the claims in this case;

• any objection to jurisdiction or venue that is not waived by law; or

• any right not specifically waived in writing.

5. No Promise About Outcome

I understand that signing this Waiver of Service does not mean I agree with everything requested in the case.

I understand that this document only waives formal service to the extent stated above unless I separately sign another document providing broader consent or agreement.

6. Contact Information and Notice

I understand that I should keep the court and the other party informed of any change in my mailing address, email address, or other contact information if required by law or court rule.

My preferred contact information for notice is:

Mailing Address: [Address]
Email Address: [Email]
Phone Number: [Phone Number]

7. Voluntary Signature

I am signing this Waiver of Service voluntarily.

I have had the opportunity to read the filed papers and decide whether to sign this document.

I understand that court-specific rules may require this waiver to be notarized or filed in a particular form.

8. Signature

Signature: __________________________
Printed Name: [Full Legal Name]
Date: [Date]

9. Notary Acknowledgment

State of [State]
County of [County]

On this [Day] day of [Month], [Year], before me, the undersigned notary public, personally appeared [Name of Signer], known to me or satisfactorily proven to be the person whose name is subscribed to this document, and acknowledged that they executed it for the purposes stated herein.

Notary Public Signature: __________________________
Printed Name: [Notary Name]
My Commission Expires: [Date]
Notary Seal: __________________________

10. Optional Certificate of Delivery

A copy of this signed Waiver of Service was provided to:

Name: [Other Party or Attorney Name]
Method: [Email / Mail / Hand Delivery / E-Filing / Other]
Date: [Date]