eine 440 (Rev. 8/Oli Summons in a Civil Action
RETURN OF SERVICE rr y .A4· . il e —_' t _; ‘¥' si
DATE ` I ' L- ` `S
Service of the Summons and complaint was made by mem 24 4 7
NAME OF SER? (PRINT) TITLE
ZEZJ Q- t N0 rc » or wz
Check one box below to indicate a » ro riare method o service
i 1·e.i=i ri. ti:
—¢‘Sen.red personal y upon tie deien ant ace w ere serve b Kg r
Left copies thereof at the defendanfs dwelling house or usual place of abode with a person of suitable age and
discretion then residing therein, `
Name of person with whom the summons and complaint were left: EIQC. 120;;;,,] Q { ‘·· Ml\t»i|§g€Q-
E] Returned unexecuted: 6-7'iq V Jn {LE
El Other (specify):
i STATEMENT OF SERVICE FEES
TRAVEL V SE.RVlCE.S TOTAL
DECLARATION OF SERVER
I declare under penalty of perjury under the laws ofthe United States of America that the foregoing information
contained in the Return of Service and Statement of Service Fees is true and correct.
Executed on
Date iqiarizrtre rJServcr "
Inltirmaiiow "···‘r?#>“··ci Services
_ etorttzil r Jutril, BEJLQQ4? p
` A¢I¢lr·es
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(I) As to who may serve a summons see Rule 4 ofthe Federal Rules of Civil Procedure.