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RETURN OF WAIVER OF SERVICE OF SUMMONS
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complaint in the action, two copies of this form, a copy of the Order of the Court authorizing
service and a means by which I can·return the signed waiver without cost to me.
I agree to save the cost of service of a summons and an additional copy of the complaint
in this lawsuit by not requiring that I be served with judicial process in the manner provided by
Rule 4. I will retain all defenses or objections to the lawsuit or to the jurisdiction or venue of the
Court, except for objections based on a defect in the summons or in the service of the summons.
I understand that a judgement may be entered against the party on whose behalf I am
acting if a response is not served and Bled within 60 days after: May l0, 2007.
Date: ( iff! fj]
.7 :’ xl ’i¢’4»/g5 L &V"*¢l
Signature of Defendant Printed or Typed Name
DUTY TO AVOID UNNECESSARY COST OF SERVICE OF SUMMON S
Rule 4 of the Federal Rules of Civil Procedure requires certain parties to cooperate in saving
unnecessary cost of service of the summons and the complaint. A defendant located in the
United States, who, after being notified of an action and asked to waive service of summons
on behalf of a plaintiff located in the US, fails to do so will be required to bear the cost of
such service unless good cause be shown for that defendant's failure to sign and return the
waiver.
It is not good cause for a failure to waive service that a partybelieves that the complaint is
unfounded, or that the action has been brought in an improper place or in a court that lacks
jurisdiction over the subject matter of the action or over defendant's person or property. A
defendant who waives service of summons retains all defenses and objections, except any
relating to the summons or the service of summons, and may later object to the jurisdiction of the
Court or to the place to where the action has been brought. .
j A defendantwho waives service must within the time specified on the "Return of Waiver"
form served on plaintiff if unrepresented or on plaintiffs attorney, a response to the Complaint
and must also file a signed copy of the response with the Court. If the answer or a motion is not
served within this time, a default judgement may be taken against that defendant. By waiving O 7¢ v ff J'J‘F
service, a defendant is allowed more time to answer than if the summons had been actually
served when the request for waiver of service was received. ‘ E
Case 1 :07-cv-00015-JJF Document 14 Filed 05/17/2007 Page 2 of 2
U.S. Department of Justice PROCESS RECEIPT M JD RE I URN
_ _ See Instructions for "Serv1ce of Process by the US. MarshaI"
United States Marshals Service on are reverse of this form.
PLAINTIFF , ' COURT CASE NUMBER I
l J
Y 're, 7 V., ‘ 7 9 r -
DEFENDANT TYPE OF PROCESS
1 I n Ori A 1.; cl ·
NAME OF INDIVIDUAL, COMPANY, CORPORATION, ETC., TO SERVE OR DESCRIPTION OF` PROPERTY TO SEIZE OR CONDEMN
IA; E li?. I r 0 E I Q .
» ADDRESS (Street or RFD, Apartment No., City State and ZIP Code)
I » r ` ’ A z ~ _ I i 1a;
AT 6 3; xo Of. A I ezrlsl rg L! _ .. lll ._.. I
E§'2.l`@EQ€..9.E §i‘§’E§QO£Y.T2 BIEQILEETEILE NW2 £"£2;*2DB§iEE@1’L...t Number of process to be 1
r r 4 I served with this Form - 285
I W//mi—?m Franc/S, Jr: I I
#· I Number of parties to be 5
ISCTVC ll`] I IS CBSC
I I k |Check for service
._..__. S[I7.);[email protected]_E;jj2/Z2 .._.._....... { on usa.
SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and Altemate Addresses, All
Flgsephone Numbers, and Estimated Times Available For Service): F
old
‘ 0 •‘$ 4 .r d ry d g - » _`
SOA. 6*53 ·.?Zéâ€l; IVIOVIH cry +0 l:l"`/ Q)/) @[77, -·
Signature of At 0 other Originator requesting service on behalf of: i%LAINTIFF 'LELEPHONE NUMBER DATE
,4 engl g A I., ¤ DEFENDANT 502-653. $2261 5 Z O7
SPACE BELOW FOR USE OF U.S. MARSHAL ONLY — DO NOT WRITE BELOW TTHS LINE
I acknowledge receipt for the total Total Process District District Signature of Author zed USMS Deputy or Clerk Date
number of process indicated. of Origin to Serve . _ .
(Sign only hrst USM 285 if more
than one USM 285 is submitted) No. No.
I hereby certify and return that I I] have personally served, ghave legal evidence of service, I] have executed as shown in "Remarks", the process described
on the individual, company, corporation, etc., at the addres shown above or on the individual, company, corporation, etc., shown `at the address inserted below.
lj I hereby certify and retum that I am unable to locate the individual, company, corporation, ctc., named above (See remarks below)
Name and title of individual served (if not shown above) I I I A person of suita le age and dis-
lj cretion then residing in the defendant’s
usual place of abode.
Address (complete only if different than shown above) I Date of Service Time am
S / 07 Pm
Signature of? Marshal or Deputy
Service Fee j Total Mileage Charges ~ Forwarding ee Total Charges Advance Deposits Amount owed to U.S. M a h l or Amount of Ref nd I l
(including endeavors )
REMARKS: I I I I I I l
MEL! (/df fehxxb/LLM
- . /
PRI0:EE3;;lI?NS 1. FORM USM 285 (Rev I2/15 80)
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