Free Complaint - District Court of Delaware - Delaware

Case 1:OIO-;cv-OOO29-SLR Document 1-3 Filed O1/13/2006 Page 1 of 1
A0 FORM 85 RECEIPT {REV. 9/O4!
United States District Court for the District of Delaware
_ Civil Action No. 5 O gf
ACKN OWLEDGMEN T O
OF RECEIPT FOR AO FORM 85
NOTICE OF A VAILABILI T Y OF A
UNITED ST A TES.MA GIST RA T E JUDGE 1
T O EXERCISE J URISDI CT I ON
IHEREBY ACKNOWLEDGE RECEIPT OF i I COPIES OF AO FORM 85.
I i s 1 3 EWS 1 »,Y ,1
_ n (Date forms issued) ( e 0 Party or th Representative) o
O -i.o i ..i—; gizsér ( ;>/grr?
I ‘ {Printed name of Party or their Representative) `
Note: Comgleted receipt will be tiled in the Civil Action