Page:United States Statutes at Large Volume 96 Part 2.djvu/1167

 PUBLIC LAW 97-462—JAN. 12, 1983

96 STAT. 2529

"FORM 18-A.—NOTICE AND ACKNOWLEDGMENT FOR SERVICE BY MAIL.

"United States District Court for the Southern District of New York "CSvil Action, File Number "A. B., Plaintiff V.

"C. D., Defendant

Notice and Acknowledgment of Receipt of Summons and Complaint "NOTICE

"To: (insert the name and address of the person to be served.) "The enclosed summons and complamt are served pursuant to Rule 4(c)(2)(C)(ii) of the Federal Rules of Civil Procedure. "You must complete the acknowledgment part of this form and return one copy of the completed form to the sender within 20 days. "You must sign and date the acknowledgment. If you are served on behalf of a corporation, unincorporated association (including a partnership), or other entity, you must indicate under your signature your relationship to that entity. If you are served on behalf of another person and you are authonized to receive process, you must indicate under your signature your authority. "If you do not complete and return the form to the sender within 20 days, you (or the party on whose behalf you are being served) may be required to pay any expenses incurred in serving a summons and complaint in any other manner permitted by law. "If you do complete and return this form, you (or the party on whose behalf you are being served) must answer the complaint within 20 days. If you fail to do so, judgment by default will be taken against you for the relief demanded in the complaint. "I declare, under penalty of perjury, that this Notice and Acknowledgment of Receipt of Summons and Complaint was mailed on (insert date). Signature Date of Signature

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