IIIIU S D Int f J - _ PROCESS RECEIPT AND RETURN
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. . Sec Instructions for Service of Process by the US. Marshal
UH1ICd States IVIEITSIIIHIS Servtce on the reverse of this form.
PLAINTIFF y COURT CASE NUMBER
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DEFENDANT `TYPE OF PROCESS
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iw NAMEMOF INDIVIDUAL, COM ANY. CORPORA ON, E'TC.,TO SERVE, QR DESCRIPTION OF PROP R YTO/SEIZE OR _ is.! ·· · g
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ADDRESS (Srreer or RFD, Apartment No., Cir); Srare and ZIP Code) _ 'I HECENED COPY
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SEND NOTICE OF SERVICE COPY TO REQUESTER AT NAME AND ADDRESS BELOW: = A ' . 4 I I II
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T L N ` ` I ` · ‘ _ Iscrved with this Form - 28 H C ERK L§-DIS-il-F“C]r
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SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and IT rnate Addre§es, All
Telephone Numbers, and Estimated Tlrnes Available For Service); _ -. 5
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Signature oi Attorney or other Originator requesting service on behalf pf; I: . . ¤PLA;N_¥IFF -l ’IELEg,0NE_NUMBBR p , . DATE
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g SPACE BELOW FOR USE OF,].I._S. NIARSHAL ONLY ;WR1TE BELOW THIS LINE,
— I acknowledge receipt for the total - Total Process Districr Distric I Signature of Auth rized USM.S_Deputy or Clerk \ I ’ Dew ’
number of process indicatedf OIIOTI I. I0 5 · 7 _ » ’ - “ `· Q- . · -·:-< _ ,. V ,./
_ (Sign only Grsl USM 285 if mvfc I ·. I ~ If · I II
man are usrvrzssn submitted) Nc. Q Nc. -¤“¢'¤·¤i' · ' —·= * '" ' Q... I
I hereby certify and return Ithat I [J have personally serv ve legal evidence of service, ljhave executed as shovvn in "Rei·narks'°;_thr’§§g`rocEeQ`,; escribfid Q ` y
. . . on the individual, company. corporation, etc., at the add V . own above or on the individual, company, corporation, exc., shown bt theI?°5'd'di·ess inserteQ.b€I0W· ` .
CI I hereby certify and retum that I am unable to locate the individual, company. corporation. etc., named above (See remary$;lQi§lIr3I£v}< X I A _
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Name and title of individual served (if not shown above) A person otIIl=iaiIIaIjle_,age aridiaiis-
III cretion then resiI;IIitr§“tIj,n_·tljte_g:le%ndant`s
usual place of abo é‘l*I{§;g§}g ` -.
Address (complete only ifdlfferenr than shown above) Dale GT $€1"*·*i¢€ Tll'¤¢ I am I
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ture shul or Depu;3
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Service Fee Total Mileage Charges Forwarding Fee Total Charges Advance Deposits Amount owed t U.S. Marshal or Amount of`_Refund
` ( including endeavors)
REMARKS:
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I MAY BE ustzn ‘
·. RECQIVED SEP 0 72005
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‘$ t ` " · I = ' WAIVER OF SERVICE OF SUMMONS
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. TO: .\‘\\`$\ '¥fC5\$L ..`..'.‘.». . *•·-. -32.-.-. . \s r. e so- - `..•». -. Ten,. .u•-nr,-
[NAME OF PIAINTIFPS ATTORNEY OR I·NI'ED P
» gig as 0 I I _
I, _ at }<_ , acknowledge receipt of your request
(DEFENDANT NAME)
that I waive service of summons in the action of L tutor .r‘_r ` _ ..e•:s . _ -. ,¤ .:_·!:.r -..... r 3* our -4. ,- .
p {cartoon or ACTION)
which is case number gs- B3-·£¤g: &% é S D in the United States Disuict Court
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I have also received a copy ofthe complaint in the action, two copies of this instrument, and a means by which I can
return the signed waiver to you without cost to me.
I agree to save the cost of service ofa summons and an additional copy ofthe complaint in this lawsuit by not requiringi
that I (or the entity on whose behalfl am acting) be served with judicial process in the manner provided by Rule 4.
· I (or the entity on whose behalfl am acting] will retain all defenses or objections to the lawsuit or to tl1ejur·isdiction·
or venue ofthe court except for objections based on a defect in the summons or in the service of the `summons- e
I understand that a judgment may be entered against me (or the prty on whose behalf I am acting) if an
S? *1 · NE 7
answer or motion under Rule 12 is not served upon you within 60 days after _ , , `
j _ (DATE Request was sewn
orawitbin 90 days after that date if the request was sent outside the United States.
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Duty to Avoid Unnecessary Costs of Service of Summons
~ Rule 4 of the Federal Rules of Civil Procedure requires certain parties to cooperate i.n saving unnecessary costs of service ofthe summons and complaint. A
defendant located in the United States who, after being notified of an action and asked by a plaintiff located in the United States to waive service of sumrnons, fails to
do so will be required to bear the cost of such service unless good cause be shown for its failure tc sign and neurrn the waiver.
It is not good cause for a failure to waive service that a party believes that the complaint is u.n.f0rmded, or that the action has been brought in an improper place
or in a court that lacks jurisdiction over thesubject matter ofthe action or over its person urprcperty. A party who waivesservice ofthe stunmons retains all defenses
and objections (except any relating to the surrunons orto the service ofthe summons), and may later object to the jurisdiction ofthe court or to the place where the action
has been brought.
A defendant who waives service must within the time specified on the waiver form serve on the plaintiff s attorney (or unrepresented plaintiff) a response to the
complaint and must also iile a signed copy cftheresponse with the court If the answer orrnotion is not served within this time, a default judgment may be taken against
that defendant By waiving service, a defendant is allowed more time to answer than if the summons had been actually served when the request for waiver ofservioe
· was received. _
_ Case 2:03-cx/-01 928-ROS-IVI EA Document 15 Filed O9/16/2005 Page 2 of 2 _
Case 2:03-cv-01928-ROS-MEA
Document 15
Filed 09/16/2005
Page 1 of 2
Case 2:03-cv-01928-ROS-MEA
Document 15
Filed 09/16/2005
Page 2 of 2