Free Complaint - District Court of Delaware - Delaware

Case 1:05-cv-00350-KAJ Document 1-3 Filed 06/O2/2005 Page 1 of 1
AO FORM S5 RECEIPT 9/O4)
United States District Court for the District of Delaware
Civil Action No. _ i i1_; . ;,_ ¢ A, _ g . O
ACKNOWLEDGMENT
OF RECEIPT FOR AO FORM 85
NOTICE OFA VAILABILITY OFA
UNITED STA TES MAGISTRA TE JUDGE
T O EXERCISE J URISDI CTION
I HEREBY ACKNOWLEDGE RECEIPT OF Q COPIES OF AO FORM 85.
O '
(Date forms issued) (Signature of Party or thei I Representative)
I t r . . is / / , I
, (__; _/' i V
· " ' rinted name of Party or their Representative)
Note: Comgleted receigt will be filed in the Civil Action