Free Waiver of Service Executed - District Court of Connecticut - Connecticut

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_ Case 3:03-cv-0.1029-DJS 55%; O2/%C%2004 Page 1 0f 1 K
U.S. Department of Justice ‘ — ’ .. t ,, . IURN ,,
, U . d St t M h 1 S , M See Instrttcliotgs for Service of Process by the UCS. Marshal
N Hite 3 BS HY S El S €I`V1C€ Q gt on the reverse of this form.
, PLA‘NT'F/F , E UiSTta;,g ;- UF wg couar casa NUMBER {
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DEFE DANT TYPE OF PROCESS _
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‘ NAME OF INDIVIDUAL, COMPANY, CORPORATION, ETC., TO SERVE OR DESCRIPTION OF PROPERTY TO SEIZE OR CONDEMN i
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» brian li\5 ADDRESS (Street or RFD,‘ Apart ent N0., City State and ZIP Code)
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AT I`\<\¤tt,%0¤\ · F SEND NOTI OF ` ·
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F Gp-\X..$·.m S`. ?~h¤7—\\°\b I Served wrth this Form - 285 \
“¤Y)\)*°\S·(“ Cr` :· * :Number of panics to be
?¤¤~ %bY~ {QMS Iserved in this case ,
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I |Check for service C; (W, I Q ‘
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SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and‘ tcmatg§7Add_;_es"" 533, All
Telephone Numbers, and Estimated Times Available l%r Service): ·~¤ ‘ " . . E
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Signature of Attomey or other Originator requesting service on behalf of: nd PLAINTIFF TELEPHONE NUMBER DATE
__ hm I] DEFENDANT qqrltg 5»-H .g3
SPACE BELOW FOR USE OF U.S. MARSHAL ONLY — DO NOT WRITE BELOW THIS LINE
I acknowledge receipt for the total Total Process District District Signature of Authorized USMS Deputy or Clerk Date i
number of process indicated. of Origin to Serve
(Sign only first USM 285 if more I { `
than one USM 285 is submitted) / No. A No. A ' ' ° Q 2, 1
I hereby certify and return that I I? ave personally served, I] have legal evidence of service, [I have executed as shown in "Remarks", the process described ·
on the individual, company, corporation, etc., at the address shown above or on the individual, company, corporation, etc., shown at the address inserted below, p
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lj I hereby certify and retum that I am unable to locate the individual, company, corporation, ctc., named above (See remarks below)
Name and title of individual erved if not ·howh above) A person of suitable age and dis.
‘ [ / { lj cretion then residing in the defendant’s
/ ; , _ I · · - OC. usual place of abode. |
Address (complete only if different than shown above) Date of ervice Time
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Service Fee j Total Mileage Charges Forwarding Fee I.: al Charges Advance Deposits Amount owed to U.S. Marshal or Amount of Refund
(incladinge eavors) V VO .
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REMARKS: I
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¤·¤¤¤¤ ¤¤>¤‘¤¤NS 1 CLERK or THE count mm “S‘“·”’ me '”""’°*
MAY IIE USED Q
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