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

Case 1 :07-cv—00775—G|\/IS-LPS Document 4 Filed 12/05/2007 Page 1 of 1
_ g RETURN OF SERVICE {
Service of the Summons and complaint was made by mem T
NAME o1=sERvER(P1211vT) TITLE f S- g I l
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Check one box below to indicate appropriate method of service ‘ · ·
Served personally upon the defendant. Place where served:
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Left copies thereof at J e defendants dwelling house or usual place of abode with a person of suitable age ;
and discretion then residing therein.
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Name of person with whom the summons and complaint were left: R A }
Returned unexecuted: ( {P g 64773;/ Aff]
Other (specify): · S
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. STATEMENT OF SERVICE FEES
TRAVEL ————Z‘ SERVICES ···"‘—"‘ TOTAL ·——···‘
DECLARATION OF SERVER
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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 une and correct. , x
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Date Si nat e of Serve l
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Address of Server i
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(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure. _
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Case 1:07-cv-00775-GMS-LPS

Document 4

Filed 12/05/2007

Page 1 of 1