IN THE ___________ COURT OF _________________COUNTY, MISSISSIPPI
A. B. Plaintiff
v.
Civil Action, File No. _________________
C. D. Defendant
WAIVER OF PROCESS
The undersigned _____(name )_____, whose post office address is and whose street address is __________________________________, does hereby waive the service of summons and (designate any pleading on which service is being waived ) upon myself in this cause.
In executing this document I certify that I am not an unmarried minor and am not mentally incompetent.
(In addition the person executing the waiver may add any or all of the following to the document:)
[Furthermore, by the filing of this document, I enter my appearance in this cause just as if I had been served more than 30 days prior to this date]
[and agree that this action may be heard and disposed of without further notice to me]
[and join in this action and in the prayer for relief]
This the _______ day of ______________, 20_______.
_____________________________
Name
STATE OF _____________________
COUNTY OF ___________________
Personally appeared before me, the undersigned authority for the jurisdiction aforesaid, the within named _______________ who acknowledged that he signed and delivered the above and foregoing instrument on the day and year therein mentioned.
Given under my hand this the ____________ day of ________________, 20______.
________________________________
Notary Public
My Commission Expires:
________________________
[In lieu of the above acknowledgment the following oath may be used:]
STATE OF ____________________
COUNTY OF __________________
Personally appeared before me the undersigned authority in and for the jurisdiction aforesaid the within named ______________________ who, being first by me duly sworn, states on oath that the matters and facts set forth in the foregoing instrument are true and correct as therein stated.
__________________________________
Name
Sworn to and subscribed before me this the _______ day of __________________, 20______.
____________________________
Notary Public
My Commission Expires:
________________________________