Free Summons Returned Executed - District Court of Delaware - Delaware

gp Case 1 :07-cv-00066-G MS Document 17 Filed 04/20/2007 Page 1 0f 1
*` =Q=¤A0"4d0 (Rev. SIOI) Surnmons in aCivil Action
RETURN or SRRVI · - a i. » ¤ g , t
. me A
Service of the Summons and complaint was made by me"’ __g
NA sor senveiz (PRINT) , ‘ _ _ TITLE Q O
uri as Fhdii J {e·;.,e.>> gem:-—»‘
Check one box below ro indicczre a » ro » riare method 0 service
[3 Served personally upon the defendant. Place where served;
%Left copies thereof at the defendant’s dwelling house or usual place of abode with a person of suitable age and ‘
discretion then residing therein. _ _ . _
Nilmc of pB1‘SOH with whom the summons and complaint were left; $$5 Pro \·¤Q-·\(-·»\ (gx ·
EI Returned unexecuted: _
l
El Other (specify):
STATEMENT OF SERVICE FEES
TRAVEL SERVICES TOTAL
i DECLARATION OF SERVER
I declare under penalty of perjury der the laws of the United St · — of America that the foregoing information
contained in the Retum of Service and State R- of Service Fees is true » orrect.
3 N n S · M i .
Executed on gu O !\ · 1
Date Sig e ·e
information F£€fE‘lE*!&l Service?
P.o. Box 268
k Ei}E·3RGE1`OVJN, DE 1994}*
rers ry"Server _
(1) As to who may serve :1 summons see Rule 4 of the Federal Rules of Civil Procedure.