Free Acknowledgment of Receipt - District Court of Delaware - Delaware

Case 1:05-cv-00654-JJF Document 6 Filed 10/21/2005 Page1 of 2
AO rom as Racsm (mw. 9/04)
United States District Court for the District of Delaware
` Civil Action No. is ip- ( mg ir
ACKNOWLEDGMENT
OF RECEIPT FOR AO FORM 85 , OFT 9 1 I i
NOTICE OFAVAILABILITY OFA u1s.¤¤stsic1`egi_.qT j
UNITED STA TES MA GISTRA TE JUD E~‘m‘£L€’€i‘5M*€—E
T O EXERCISE J URISDI CTI ON
I HEREBY ACKNOWLEDGE RECEIPT OF Elf COPIES OF AO FORM 85.
( . _,- [ T- 3/ ° 7
(Date forms issued) (Si na re of my or their presentative)
a i ld) r‘~ _ ’
1 ( C (Piinte name of Party or their Representative)
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Note: Comgleted receipt will be tiled in the Civil Action

Case1:O5—cv-00654-JJF D0cument6 Fi|ec|10/21/2005 Page20f2
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