Case 1:05-cv-00518-KAJ Document 1-6 Filed 07/22/2005 Page 1 of 1
AO FORM as RECEEPT (REV. 9/04]
United States District Court for the District of Delaware
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Civil Action N0. _ ___; W
ACKNOWLEDGMENT
OF RECEIPT FOR AO FORM 85
NOTICE OF A VAILABILI T Y OF A
H UNITED STA TES MA GIS TRA TE JUDGE
Q T O EXERCISE J URISDICT ION
I HEREBY ACKNONVLEDGE RECEIPT OF 3. COPIES OF AO FORM 85.
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(Date forms issued) (t. `gnature t y or ` e' epresentative)
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q (Printed name of Party o their Re resentative)
Q Note: Comgleted receipt will be filed in the Civil Action
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