Free Return of Service Executed - District Court of Delaware - Delaware

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Case 1 :07-cv-00804-SLR-LPS Document 4 Filed 12/28/2007 Page 1 of 1
RETURN OF SERVICE
Service of the Sumrnons and complaint was made by mem DATE I Q / I /0 j
IVAME OF SERVER (PRINT) Sc. 1/tm¤ t mj { rr e
ilu C.eit"I“ tz’f' J M\rC.$"Ic{ C wiow I ''£ R~`sGl(`l. lAt?
Check one box below to indicate appropriate method of service
Served personally upon the defendant. Place where served: I
Left copies thereof at the defendanfs dwelling house or usual place of abode with a person of suitable age
and discretion then residing therein.
Name of person with whom the summons and complaint were left: LVM/\ Tggr /t3f“ < Q C >
Returned unexecuted:
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Other (specify): §
1
STATEMENT OF SERVICE FEES 5
TRAVEL SERVICES TOTAL Q
DECLARATION OF SERVER
I declare under penalty of perjury under the laws of the United States of America that the foregoing
information contained in the Return of Service and Statement of Service Fees is true and correct.
E d · "/·r/ary to .J—;‘ EO a »» »
/»’ ~’ et/Y any/e . i.U..t..».t..c€.ta 1
Date Signature of Server L I L! 51 _S` (2 c? ,
Tbovvr "B / 9 € 0 iz
Address of Server
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(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure. 1

Case 1:07-cv-00804-SLR-LPS

Document 4

Filed 12/28/2007

Page 1 of 1