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UNITED STATES DISTRICT COURT EASTERN DISTRICT OF NEW YORK

x

Plaintiff, -against-

Affirmation of Service

CV Defendant.

(

)

x

I, served a copy of the attached upon whose address is:

, declare under penalty of perjury that I have

Dated: , New York

Signature

Address

City, State, Zip Code

Affirmation of Service (USDC-EDNY) - January 2003