Free Acknowledgment of Receipt - District Court of Delaware - Delaware

Case 1:07-cv—00529-l\/IPT Document 6 Filed 09/25/2007 Page 1 of 1
— ,, i OFFICE OF THE CLERK
UNITED STATES DISTRICT COURT _
_ » DISTRICT OF DELAWARE
Peter T. Dalleo LQCKBOX 13
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wrrmmerow, DELAWARE 19801
(sm) 573-6170
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RE: c.A.# -67*yQj {X 3
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ACKNOWLEDGMENT OF RECEIPT FOR F.R.Civ.P. 4
_ I hereby acknowledge receipt of a copy of Rule 4 (Summons) of the Federal
Rules of Civil Procedure, and understand that it is my responsibility to make service of
process on defendants in accordance with this rule.
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Date Reoeived_ _ *3 § [/f Signed;
by Plaintiff: ·: Pro Se Plaintiff
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Date Received {ATT Signed: (L C- --‘?— OL <’§_/_,
by Clerk’s office: Deputy Clerk
Note: lf you received Federal Rule 4 by mail, please sign this receipt and return it to:
Clerk
U.S. District Court
844 N. King Street If applicable, Rule 4 mailed to plaintiff;
Lockbox 18 · _
Wilmington, DE 19801
Date mailed ·
By Deputy Clerk
cc: Docketing Clerk
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Case 1:07-cv-00529-MPT

Document 6

Filed 09/25/2007

Page 1 of 1