Free Acknowledgment of Receipt - District Court of Delaware - Delaware

_ p Case 1 :07-cv-00273-JJF A Document 6 Filed 06/O4/2007 Page 1 of 1
t — ., K OFFICE OF THE CLERK
UNITED STATES DISTRICT COURT _
_ ¤ DISTRICT OF DELAWARE
_ Peter T. Dalleo _ LOCKBOX 18
CLERK 844 me smear
us. comvmousa
wiuumcron. DELAWARE 19201
(302) 573-6170
RE: c.A.# Q f I f "
CASE CAPTION: Cc».1`\l'€\ . v. Qt} l;1CiY\, gl- gr
ACKNOWLEDGMIENT OF RECEIPT FOR F.R.Civ.P. 4
I hereby acknowledge receipt of a copy of Rule 4 (Summons) of the Federal
Rules of Civil Procedure, and understand that it is my responsibility to make service of
V process on defendants in accordance with this rule. .
. J. I /4 , 1· .1
Date Received S ~· TL if ` 7 Signed;
by Plaintiff: Pro Se Plaintiff
Date Received Signed: - L
by Clerk’s office: Deputy Clerk
Note: If you received Federal Rule 4 by mail, please sign this receipt a11d return it to:
Clerk I
U.S. District Court 1
844 N. King Street If applicable, Rule 4 mailed to plaintiff:
Lockbox l8 ‘ ·
wi1miiigi¤ii,nti 19801 p MAY 2 1 2l][|7 c
Date mailed `
I · `By Deputy Clerk
cc: Docketing Clerk F I L E
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