Free Summons Returned Unexecuted - District Court of Connecticut - Connecticut

Case 3:03-cv-01027-JBA Document 6 Filed 10/14/2003 Page 1 of 1 I
us. Department of rttetree ., ;§g$E§S §El§E¥*’TI.g"D b }';[§I*IM I I
• . I -· srucrons or ervrce 0 ocess y t e . . ars a "
UH1`[Cd States Marshals S€I`VlC€ on thereversc of this form.
PLMNTIFF courzr case NUMBER
AQWES KOLE 3:03CV1027 WWE EBF
DEFENDANT TYPE OF PROCESS
KUMA DEBOO, WARDEN me- it COMPLAINT
NAME OF INDIVIDUAL, COMPANY, CORPORATION, ETC., TO SERVE OR DESCRIPTION OF PROPERTY TO SEIZE OR CONDEMN
» KUMA DEBOO, WARDEN

. ADDRESS (Streetpr RFD, Apartment No., City, State and ZIP Code)
AT FEDERAL CORRECTIONAL INSTITUTION
PEMBROKE STATION RT. 37, DANBURY, CT 06811
QENILILULIQQPEQEQICE COPY TO REQUESTER AT NAME AND ADDRESS BELOW:
"""" *”**”'* '*'*·*··· ——————— -··——····· -———— I Number Of process to be
F I served with this Form - 285
AGNES KOLE #19423-050 I .
FEDERAL CORRECTIONAL INSTITUTION |N¤mb¢t ttf l¤¤¤i¤¤ ¤¤ bs I
PEMBROKB STATION RT. 37 |S°w°d In thm msc
DANBURY, CT 06811
I ICheck for service `
____ ____ _,_______ _,_-.... ____...... -......... ,.... Ion U-S-A X
SPECIAL INSTRUCTIONS OR Oil`]-IER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and Altemate Addresses, All I
ggéephene Numbers, and Estimated 'llmes Available For Service); I
_ Peru I
-,50//A/O / I
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Signature of Attome or other Originator requesting service on behalf of: M PLAINTIFF TELEPHONE NUMBER DATE
. I;] DEFENDANT NONE JULY O9, 2003 `
SPACE BELOW FOR USE OF U.S. MARSHAL ONLY -DO NOT WRITE BEIIOW 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 Hrst USM 285 if more I » pf
than one USM 285 is submitted) II No. / A! No./4 * A W fc?
I hereby certify and return that l III have 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.
B I hereby certify and retum that I am unable to locate the individual, company, corporation, ctc., named above (See remarks below)
I
ame and title of individual, served (if not shown above) A person of suitable age and dis- t
ff-ZJ re., EI crelion then residing in the defendant`s
___ {1;%; usual place of abode.
Address (compl ¤ I {yi · .‘f`ele1;lt>tQ`§?r shown above) Date of Service Time am
I LJ in "° °` in Ie·~ ..
·—~J te. iii P"`
L`;"“"* tf. 2;; Sig ture of U.S. Marshal or Deputy
Service Fee ToI§__i:l\/Iiléag harges Forwarding Fee Total Charges Advance Deposits Amount owed to U.S. Marshal or Amount of Refund _
{ir?él'uding'·endeavors) I
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REMARKS: 1
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FORM USM-285 (Ren I2JI5l8|I
****0** E m°NS 1. CLERK OF THE COURT ’
MAY BE USED I
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