Case 1 :07-cv—00775—G|\/IS-LPS Document 8 Filed 12/07/2007 Page 1 of 1
RETURN OF SERVICE A
Service of the Summons and complaint was made by mem DATE I /5‘/Or) 4 V I
NAME OF SERVER (PRINT) TITLE ( _ ( . I ‘ . E ’
__ A ' 7 _ ) SQ,‘r»rv~¤ H-—·g .·»H{¢,»
~C§UW
Served personally upon the defendant. Place where served: I
l
Left copies thereof at the defendants dwelling house or usual place of abode with a person of suitable age I
and discretion then residing therein. I
Name of person with whom the summons and complaint were left:
Returned unexecuted: I
Other (specify): . I
STATEMENT OF SERVICE FEES I
TRAVEL SERVICES TOTAL
DECLARATION OF SERVER _ ‘
I declare under penalty of perjury under the laws of the United States of America that the foregoing A
information contained in the Return of Service and Statement of Service Fees is true and correct. _
E"°°““"d°“‘ /,9 /5 /0*7; - ~ to A I
Date Signature of Server { L] S G 41; I
Dot/cf DCS ;‘/6’O/
Address of Server
I
` i
l
l
(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure.
Case 1:07-cv-00775-GMS-LPS
Document 8
Filed 12/07/2007
Page 1 of 1