Free Complaint - District Court of Delaware - Delaware

Case 1:05-cv—00891-SLR Document 1-3 Filed 12/27/2005 Page 1 of 1
AO FORM S5 RECEIPT SREV. 9/O4!
United States District Court for the District of Delaware
_ Civil Action N0. i ll; M ll 1
ACKNOWLEDGMENT
OF RECEIPT FOR AO FORM 85
NOTICE OF A VAILABILI T Y OF A
UNITED STA TES MA GIST RA TE JUDGE
T O EXERCISE J URISDI CT I ON
I HEREBY ACKNOWLEDGE RECEIPT OF COPIES OF AO FORM 85.
/Z/E 7/0J”
(Date forms issued) . " (Signature of Party or their Representative)
;.;Y~L~~ M» L-¤~ Ec-M
‘ ‘ it I f_(Printed name of Party or their Representative)
Note: Cornpleted receipt will be tiled in the Civil Action