Free Complaint - District Court of Delaware - Delaware

Case 1:05-cv-00922-JJF Document 1-3 Filed 05/30/2005 Page 1 of 1
AO pom as 1tEcErPTgREv.9/042
United States District Court for the District of Delaware
Civil Action No. C ` U 2 2
ACKNOWLEDGMENT
OF RECEIPT FOR AO FORM 85
NOTICE OF A VAILABILI T Y OF A
UNITED STA TES MAGISTRATE JUDGE
TO EXERCISE J URISDI C T I ON
I HEREBY ACKNOWLEDGE RECEIPT OF Q COPIES OF AO FORM 85 .
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(Date forms issued) (Sign re of Party or eir Representative) ‘
. CA94/I
‘ T ‘p_(Printed ame of Party or t eir Representative)
Note: Completed receipt will be tiled in the Civil Action