Free Complaint - District Court of Delaware - Delaware

Case 1:05-cv-00890-GI\/IS Document 1-3 Filed 12/27/2005 Page 1 of 1
AO FORM 85 RECEIPT (REV. 9/O4)
United States District Court for the District of Delaware
. O 5 8 9 0
Civil Action No.
ACKNOWLED GMENT
OF RECEIPT FOR AO FORM 85
NOTICE OF A VAILABILI T Y OF A
UNITED STATES MAGISTRATE JUDGE
T O EXERCISE J URISDI C T I ON
I HEREBY ACKNOWLEDGE RECEIPT OF i 1 COPIES OF AO FORM 85.
_ (Date forms issued) (Sign ture of Party or their Representative) ‘
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Note: Completed receipt will be filed in the Civil Action