Case 1:05-cv-00705-JJF Document 1-3 Filed O9/27/2005 Page 1 of 1
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United States DistrietCou1t for the District of Delaware
Civil Action No. O ‘ G 5
AQKNOWLED GIIQENT
OF RECEIPT FOR AO FORM 85
N O T I CELQEA VAILAEJLITY OF A
UNITED STAYEES MAGISTRATE Jlillfglf
T0 EXEKQISE JURISDICTION
I HEREBY ACKNOVVLEDGE RECEIPT OF 3 COPIES OF AO FORJVI 85.
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(D te forms issued) ( ignature of P` I their Representative)
j·_(Printed name of PEE or their Representative) `
Note: Comgleted reeeigt will be tiled in the Civil Action