Ark. R. Civ. P. Form of Summons
The Supreme Court of Arkansas has adopted the following form of summons for use in all cases in which personal service is pursuant to Rule 4(c), (f), and (h) of the Arkansas Rules of Civil Procedure. The form incorporates a proof of service to be made by a sheriff, deputy sheriff, or other person, as appropriate, in accordance with Rule 4(g).
The form may be modified as needed in special circumstances, and additional notices, if required, should be inserted as appropriate. Examples include the notices required by statute in unlawful-detainer and replevin actions, see Ark. Code Ann. §§ 18-60-307(a) and 18-60-808(a), and the notice of the consent jurisdiction of a state district court that must be included pursuant to Ark. Sup. Ct. Admin. Order No. 18(6)(d)(1).
This form is not for use in cases of constructive service pursuant to Rule 4(g)(3). The adoption of this form is in compliance with Rule 4(b) and does not modify or amend any part of that rule.
Effective July 1, 2012
Corrected August 14, 2012
Revised January 1, 2019
Reporter's Notes (2019 Amendment): In the introduction to the summons form, the second paragraph now provides that the form "may be modified as needed in special circumstances." It also states that "[a]dditional notices, if required, should be inserted as appropriate." The revised form combines these sentences and adds a sentence listing examples of the notices that may be "inserted as appropriate," including the notice of consent jurisdiction that is required by Administrative Order No. 18(6)(d)(1).
THE CIRCUIT COURT OF ___________COUNTY, ARKANSAS
________DIVISION [Civil, Probate, etc.]
Plaintiff
v. No. _______________
Defendant
SUMMONS
THE STATE OF ARKANSAS TO DEFENDANT:
____________________ [Defendant's name and address.]
____________________
[Defendant's name and address.]
A lawsuit has been filed against you. The relief demanded is stated in the attached complaint. Within 30 days after service of this summons on you (not counting the day you received it) - or 60 days if you are incarcerated in any jail, penitentiary, or other correctional facility in Arkansas - you must file with the clerk of this court a written answer to the complaint or a motion under Rule 12 of the Arkansas Rules of Civil Procedure.
The answer or motion must also be served on the plaintiff or plaintiff's attorney, whose name and address are: ______________________________________
If you fail to respond within the applicable time period, judgment by default may be entered against you for the relief demanded in the complaint.
Additional Notices Included: _________________________________
CLERK OF COURT
Address of Clerk's Office
____________________
____________________
____________________
[Signature of Clerk or Deputy Clerk]
Date: ____________________________
[SEAL]
No. ________ This summons is for ____________________(name of Defendant).
PROOF OF SERVICE
On ________________[date] I personally delivered the summons and complaint to the defendant at __________[place]; or
After making my purpose to deliver the summons and complaint clear, on _____________________[date] I left the summons and complaint in the close proximity of the defendant by ______________________________________[describe how the summons and complaint was left] after he/she refused to receive it when I offered it to him/her; or
On ________________[date] I left the summons and complaint with _______________, a member of the defendant's family at least 18 years of age, at _______________________ [address], a place where the defendant resides; or
On________________________[date] I delivered the summons and complaint to ___________ [name of individual], an agent authorized by appointment or by law to receive service of summons on behalf of ________________________ [name of defendant]; or
On __________________ [date] at __________________ [address], where the defendant maintains an office or other fixed location for the conduct of business, during normal working hours I left the summons and complaint with__________________________________________
[name and job description]; or
I am the plaintiff or an attorney of record for the plaintiff in a lawsuit, and I served the summons and complaint on the defendant by certified mail, return receipt requested, restricted delivery, as shown by the attached signed return receipt.
I am the plaintiff or attorney of record for the plaintiff in this lawsuit, and I mailed a copy of the summons and complaint by first-class mail to the defendant together with two copies of a notice and acknowledgment and received the attached notice and acknowledgment form within twenty days after the date of mailing.
Other [specify]:
I was unable to execute service because:
My fee $ ________________
To be completed if service is by a sheriff or deputy sheriff:
Date: _________________
SHERIFF OF ___________ COUNTY, ARKANSAS
By: ________________________________________
[signature of server] _____________________________________
_____________________________________
[printed name, title, and badge number]
To be completed if service is by a person other than a sheriff or deputy sheriff:
Date: ________________
By:____________________________________
[signature of server] ___________________________________
_____________________________________
[printed name]
Address: ___________________________________________
Phone: _____________________________________________
Subscribed and sworn to before me this date: ______________
Notary Public __________________________________
My Commission Expires: ______________________________
Additional information regarding service or attempted service: ___________________________
_____________________________________
Ark. R. Civ. P. Form of Summons