(Process Server)
IN THE ______________ COURT OF ____________________ COUNTY, MISSISSIPPI
A. B., Plaintiff(s)
v.
Civil Action, File No.____________________
CD. , Defendant(s)
SUMMONS
THE STATE OF MISSISSIPPI
TO: (Insert the name and address of the person to be served)
NOTICE TO DEFENDANT(S)
THE COMPLAINT WHICH IS ATTACHED TO THIS SUMMONS IS IMPORTANT AND
YOU MUST TAKE IMMEDIATE ACTION TO PROTECT YOUR RIGHTS.
You are required to mail or hand deliver a copy of a written response to the Complaint to _________, the attorney for the Plaintiff(s), whose post office address is _____________________ and whose street address is ___________________. Your response must be mailed or delivered within (30) days from the date of delivery of this summons and complaint or a judgment by default will be entered against you for the money or other things demanded in the complaint.
You must also file the original of your response with the Clerk of this Court within a reasonable time afterward.
Issued under my hand and the seal of said Court, this _______ day of _________________, 19_______.
________________________________
Clerk of ________________ County, Mississippi
____________________________________
____________________________________
(Seal)
______________________________
[This form shall appear on the reverse side of Form 1A. Summons (Process Server)]
PROOF OF SERVICE–SUMMONS
(Process Server)
[Use separate proof of service for each person served]
_____________________________________________
Name of Person or Entity Served
I, the undersigned process server, served the summons and complaint upon the person or entity named above in the manner set forth below (process server must check proper space and provide all additional information that is requested and pertinent to the mode of service used):
_____ FIRST CLASS MAIL AND ACKNOWLEDGEMENT SERVICE. By mailing (by first class mail, postage prepaid), on the date stated in the attached Notice, copies to the person served, together with copies of the form of notice and acknowledgement and return envelope, postage prepaid, addressed to the sender (Attach completed acknowledgement of receipt pursuant to M.R.C.P. Form 1B).
_____ PERSONAL SERVICE. I personally delivered copies to ___________________ on the _____ day of ___________________________, 19______, where I found said person(s) in ______________ County of the State of ________________________.
_____ RESIDENCE SERVICE. After exercising reasonable diligence I was unable to deliver copies to said person within ____________________ county, (state). I served the summons and complaint on the _________ day of __________________, 19_________, at the usual place of abode of said person by leaving a true copy of the summons and complaint with ____________________________- who is the ________________ (here insert wife, husband, son, daughter or other person as the case may be), a member of the family of the person served above the age of sixteen years and willing to receive the summons and complaint, and thereafter on the ____________ day of ___________________, 19___________, I mailed (by first class mail, postage prepaid) copies to the person served at his or her usual place of abode where the copies were left.
_____ CERTIFIED MAIL SERVICE. By mailing to an address outside Mississippi (by first class mail, postage prepaid, requiring a return receipt) copies to the person served. (Attach signed return receipt or the return envelope marked “Refused.”)
At the time of service I was at least 18 years of age and not a party to this action.
Fee for service: $___________________
Process server must list below: [Please print or type]
Name_______________________
Social Security No.________________________
Address_____________________________
_________________________________
Telephone No.________________________
State of ____________________)
County of _______________________)
Personally appeared before me the undersigned authority in and
for the state and county aforesaid, the within named ___________________ who being first by me duly sworn states on oath that the matters and facts set forth in the foregoing “Proof of Service-Summons” are true and correct as therein stated.
_________________________________
Process Server (Signature)
Sworn to and subscribed before me this the _____ day of __________________19_______.
_______________________________
Notary Public
(Seal) My Commission Expires:_____________________