Acknowledgement of Service Form - Georgia

Acknowledgment of Service Only — Rev. July 31, 2005

Provided by the Family Law Clinic

IN THE SUPERIOR COURT OF GWINNETT COUNTY

STATE OF GEORGIA

,

Plaintiff,

vs.

I am the Defendant in this case. I hereby acknowledge that I have received a copy

of the Complaint for Divorce, and the following other documents:

I waive formal process, but I do not waive further notice, or my right to raise any

defenses I may have in this action.

Should further notice be required for any reason, the notice should be mailed to me

at the following address: