Free AO 440 - Summons in a Civil Action - New York


File Size: 165.3 kB
Pages: 2
Date: December 20, 2007
File Format: PDF
State: New York
Category: Court Forms - Federal
Author: US Courts
Word Count: 315 Words, 1,855 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://www.nynd.uscourts.gov/documents/SummonsUSAO.pdf

Download AO 440 - Summons in a Civil Action ( 165.3 kB)


Preview AO 440 - Summons in a Civil Action
OAO 440 (Rev. 8/01) Summons in a Civil Action

UNITED STATES DISTRICT COURT
NORTHERN

District of

NEW YORK

SUMMONS IN A CIVIL ACTION
V.
Commissioner of Social Security

CASE NUMBER:

TO: (Name and address of Defendant)
United States Attorney 100 South Clinton ., PO Box 7198 Syracuse, NY 13261-7198

YOU ARE HEREBY SUMMONED and required to serve on PLAINTIFF'S ATTORNEY (name and address)

100 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 filed with the Clerk of this Court within a reasonable period of time after service.

CLERK

DATE

(By) DEPUTY CLERK

OAO 440 (Rev. 8/01) Summons in a Civil Action

RETURN OF SERVICE
Service of the Summons and complaint was made by me(1)
NAME OF SERVER (PRINT) DATE TITLE

Check one box below to indicate appropriate method of service

G Served personally upon the defendant. Place where served:

G 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:

G Returned unexecuted:

G Other (specify):

STATEMENT OF SERVICE FEES
TRAVEL SERVICES TOTAL

$0.00

DECLARATION OF SERVER
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 true and correct.
Executed on
Date Signature of Server

Address of Server

(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure.

Print

Save As...

Export as FDF

Retrieve FDF File

Reset