Commonwealth of Virginia
In the..........Court of the..........of...............
SUMMONS
Civil Action No. . . .
The party upon whom this summons and the attached complaint are served is hereby notified that unless within 21 days after such service response is made by filing in the clerk's office of this court a pleading in writing, in proper legal form, the allegations and charges may be taken as admitted and the court may enter an order, judgment or decree against such party either by default or after hearing evidence.
Appearance in person is not required by this summons.
Done in the name of the Commonwealth of Virginia, this.....day of.....................20..... ..................................., Clerk.
Va. Sup. Ct. 3:5