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appears, be sure to uncheck the 

AD 399 (Rcv. 05/00) 

Annotations option. 

UNITED STATES DISTRICT COURT 

NORTHERN DIsTRICT OF ILLJNOIs 

Waiver of Service of Summons 

TO: Complex Litigation Group, LLC 

(NAME OF PLAINTIFF’S ATTORNEY OR UNREPRESENTED PLAINTIFF) 

, Coca-Cola Company ,acknowledge receipt of your request 

(DEFENDANT NAME) 

Davis, et al. v. The Coca-Cola Company 

that I waive service of summons in the action of 

(CAPTION OF ACTION) 

which is case number - 12-cv-2391 in the United States District Court 

(DOCKET NUMBER) 

for the Northern District of Illinois. 

I have also received a copy of the complaint in the action, two copies of this instrument, and a means 

by which I can return the signed waiver to you without cost to me. 

I agree to save the cost of service of a summons and an additional copy of the complaint in this lawsuit 

by not requiring that I (or the entity on whose behalf I am acting) be served with judicial process in the 

manner provided by Rule 4. 

I (or the entity on whose behalf I am acting) will retain all defenses or objections to the lawsuit or to the 

jurisdiction or venue of the court except for objections based on a defect in the summons or in the service 

of the summons. 

I understand that ajudgment maybe entered against me (or the party on whose behalf I am acting) if 

an answer or motion under Rule 12 is not served upon you within 60 days after 03/30/12 

(DATE REQUEST WAS SENT) - 

or within 90 days after that date if the re9st was sent outde the United States. 

4/9/2012 

(DATE) 

Printed/Typed Name: via J 

As Counsel of - The CoeaCJ.a Company -- 

(TITLE) (CORPORATE DEFENDANT) 

Duty to Avoid Unnecessary Costs of Service of Summons 

Rule 4 of the Federal Rules of Civil Procedure requires certain parties to cooperate in saving unnecessary coats of service of the 

summons and complaint. A defendant located in the United Slates who, after beingnotit’ied of an action and asked by a plaintifflocated 

in the United States to waive service of summons, fails to do so will be required to bear the cost of such service unless good cause be shown 

for its failure to sign and return the waiver. 

It is not good cause for a failure to waive service that a party believes that the complaint is unfounded, or that the action has been 

brought in an improper place or in a court that lacks jurisdiction over the subject matter of the action or over its person or property. 

A party who waives service of the summons retains all defenses and objections (except any relating to the summonsor to the service 

of the summons), and may later object to the jurisdiction of the Court OF to the place where the action has been brought. 

A defendant who waives service must within the time specified on the waiver form serve on the plaintiff’s attorney (or 

unrepresented plaintiff) a response to the complaint and must also file a signed copy of the response with the court, If the answer or 

motion is not served within this time, a default judgment may be taken against that defendant. By waiving service, a defendant is allowed 

more time to answer than if the summons had been actually served when the request for waiver of service was received. 

Case: 1:12-cv-02391 Document #: 9 Filed: 04/23/12 Page 1 of 1 PageID #:44