Case 1:05-cv-00854-JJF Document 1-4 Filed 12/12/2005 Page 1 of 1
AO som as ascsmr gruav. 9/04)
United States District Court for the District of Delaware
Civil Action No. I `D`. i in
OF RECEIPT FOR AO FORM 85
NOTICE OFA VAILABILITY OFA
UNITED STATES./IJAGISTRATE JUDGE .
TO EXIERACISE J URISDI C TI ON
I HEREBY ACKNOWLEDGE RECEIPT F l COPIES OF AO FORM 85.
I Y gg `yl 1., R- si" I .c E . I
n (Date forms issued) (Signature of Party or their Representative)
e1.s . ..»; Mum ‘“E¤*x~%)=2/V
fi \;:_;€_(Printed name of Party or their Representative) `
Note: Comgleted recei t will be tiled in the Civil Action