Superior Court of Washington

County of

1.         Acceptance of Service

__________________________ [Name] accepts service of:

            [ ]  the summons and petition in this action.          [ ]  a proposed parenting plan.

            [ ]  a proposed order of child support.                   [ ]  a financial declaration.

            [ ]  proposed Child Support Worksheets.               [ ]  other:

2.         Consent to Personal Jurisdiction

            [ ]  Does not apply.

            [ ]  ________________________________ [Name] consents to personal jurisdiction.

            [ ]  Other

3.         Other

Dated:                                                                                                                                                                                               

                                                                                                Signature of Party or Lawyer /WSBA No.  Accepting Service

                                                                                                Print or Type Name

                                                                                                Notice to party:  You may list an address that is not your residential address where you agree to accept legal documents. Any time this address changes while this action is pending, you must notify the opposing parties in writing and file an updated Confidential Information Form (WPF DRPSCU 09.0200) with the court clerk.

                                                                                                [Address]