Free Complaint - District Court of Delaware - Delaware

Case 1:05-cv-00880-Gl\/IS Document 1-4 Filed 12/21/2005 Page 1 of 1
AO Foam as mscerpr gusv. 9/04)
United States District Court for the District of Delaware
Civil Action No. in " 5 3 Cl
ACKNOWLED GMENT
OF RECEIPT FOR AO FORIVI 85
NOTICE OFA VAILABILITY OFA
UNITED STATESlMAGISTRA TE JUDGE
T O EXERCISE J URISDI C T I ON
I HEREBY ACKNOWLEDGE RECEIPT OF (ED COPIES OF AO FORM 85.
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_ (Date forms issued) ( ignature of Party or their Representative)
I; ’ F; Igrinted of Party or their Representative) `
Note: Completed receipt will be tiled in the Civil Action