Free Complaint - District Court of Delaware - Delaware

Case 1:05-cv—00531-JJF Document 1-3 Filed 07/25/2005 Page 1 of 1
AO FORM 85 RECEIPT 9/O4!
United States District Court for the District of Delaware
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Civil Action No. _ _1 `
ACKNOWLEDGMENT
OF RECEIPT FOR AO FORM 85
NOTICE OFA VAILABILITY OFA
UNITED STATES MAGISTRATE JUDGE
T O EXERCISE J URISDI C T I ON
1 HEREBY ACKNOWLEDGE RECEIPT F i ` COPIES OF AO FORM 85.
2 5 us e i
(Date forms i isu ) T a n ( ignature l Party or their Dsw tative)
(Printezlg grne of Party or their Representative)
Note: Comgleted receipt will be filed in the Civil Action