Free Complaint - District Court of Delaware - Delaware

Case 1:05-cv—00921-SLR Document 1-3 Filed 12/30/2005 Page 1 of 1
AO FORM 85 RECEIPT (REV, 9/04)
United States District Court for the District of Delaware
Civil Action No. ( 1 U q ·
ACKNOWLEDGMENT
OF RECEIPT FOR AO FORNI 85
NOTICE OF A VAILABILI T Y OF A
UNITED STATESMAGISTRATE JUDGE a
TO EXERCISE J URISDI CTI ON
I HEREBY ACKNOWLEDGE RECEIPT OF Ll COPIES OF AO FORM 85.
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Q; Lv — 6, A l /)/ »’» 4. ij {iff/ifsw
(Date forms issued) (Sig tur "f Party or their Representative) ‘
‘ y!‘i-(PIi11tGd name of Party or their Representative)
Note: Comgleted receigt will be filed in the Civil Action