THE STATE OF INDIANA, DELAWARE COUNTY, SS:

To the Sheriff of Delaware County, Greetings:

You are hereby commanded to notify

that vs

Cause No. in the Delaware County Circuit Court No. is set for

hearing at o’clock . M. on the day of , 20,

at the Justice Center, 3100 S. Tillotson Avenue, Muncie, Indiana, 47302, before the Honorable

, Judge of said Court.

WITNESS, the Clerk of said Court, and the seal thereof, hereunto affixed, at the City of

Muncie, this day of , 20.