Free Complaint - District Court of Delaware - Delaware

Case 1:05—cv—00861-KAJ Document 1-3 Filed 12/13/2005 Page 1 of 1
AO FORM 85 RECEIPT (REV. 9/O4!
United States District Court for the District of Delaware
Civil Action No. -·> cj A Et 4
ACKN OW LEDGMEN T
OF RECEIPT FOR AO FORM 85
NOTICE OF A VAILABIL1 TY OF A
UNITED STA TES MA GIS TRA TE J UD GE
TO EXERCISE J URISDI CTI ON
I HEREBY ACKNOWLEDGE RECEIPT OF COPIES OF A ORM 85.
12./.3/OS I QQ,
(Date forms issued) ature of Party or their Representative)
I \g G VWQ ES ( GA
‘ U _ _‘_ (Printed name of Party or their Representative) `
Note: Completed receipt will be tiled in the Civil Action