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

Case 1 :07-cv-00387-JJF Document 4 Filed 08/22/2007 Page 1 of 3
¤¤,AO 440- (Rev. 8/01) Summons in a Civil Action
UNITED STATES DISTRICT COURT
District of Delaware
DELSIE . E. EROOKENS,
SUMMONS IN A CIVIL CASE
V. p
GENERAL MOTORS, PLAN ADMINISTRATOR,
CASE NUMBER: (;_A_ 07..357
GM~HOURLY—RATE EMPLOYEES PENSION PLAN,
P . O. BOX 300 MC: 482-C26-A68
300 Renaissance Center
Detroit, MI 48265-3000 1
_ TOS (Name and address of Defendant)
Plan Administrator, GM Hourly—Rate
Employees Pension Plan _
Z GM Corporation
P . O. Box 300 MC: 482-—C26—-A68
't MI 48265-3000
3 O O R€¥G)Uq¤HH-E`: HERE%$tS€J`lCl’I]l\/[ONED and required to serve on PLAINTIFFS ATTORNEY (name and address)
JOHN M. STULL, ESO.
1300 N. MARKET ST., STE 700
WILMINGTON, DE 19801
_ - 2 0
an answer to the complaint which is served on you with this summons, within days after service
of this summons on you, exclusive of the day of service. If you fail to do so, judgment by default will be taken against you
for the relief demanded in the complaint. Any answer that you serve on the parties to this action must be tiled with the
Clerk of this Court within a reasonable period of time after service.
EEIER I. EAEAEG Aus 0 s Mt?
crsnx DATE
I Eag ile lm "V_a, as I
(By) nswrv crsmr

Case 1 :07-cv-00387-.1.1 F Document 4 Filed 08/22/2007 Page 2 of 3
h QAO 4-40 (Rev. 8/Ol) Summons in a Civil Action
· RETURN OF SERVICE
DATE
Service of the Summons and complaint was made by mei') Augfgst 1 3 I 2 () () 7
NAME on senvnn (PRINT) TITLE
l D v k U 5 • { \
Check one box below to indicate a ro riate method 0 service
El Served personally upon the defendant. Place where served:
El Left copies thereof at the defendant’s 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:
El Returned unexecuted:
[X Other (specify): CERTIFIED MAIL? RETURNQOF SERVICE REQUESTED

I STATEMENT OF SERVICE FEES
y TRAVEL SERVICES TOTAL
1 •• •• 30.00
DECLARATION OF SERVER
l 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 s true and correct.
Executedon ALIQUSTL 20, 2007 I I _
· Date Signatu rver
W EKOHN M. STULL, ESQ. .
1300 N. Market Street, STE 700
Wmlmington, EE 19801
Address of Server
(1) As to who may serve a summons see Rule 4 ofthe Federal Rules of Civil Procedure. I J " 4 I I; ' ‘ , _
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