Case 1:05-cv-00347-SLR Document 1-3 Filed 05/31/2005 Page 1 of 1
AO FORM 85 R.ECElP`I` [REV. 9/O4!
United States District Coun for the District of Delaware
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Civil Action No. tttt I __ _ __ _ __ _ F )
ACKNOWLEDGMENT
OF RECEIPT FOR AO FORM 85
NOTICE OF A VAILABILI TY OF A
UNITED STA TES MAGISTRATE JUDGE
TO EXERCISE J URISDI C T I ON
I HEREBY ACKNOWLEDGE IUECEIPT OF 5 COPIES OF AO FORM 85.
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(DQ te or- A s 1ssi1ed) kS` nature of Party or their Representative)
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‘ (Printed name of Party or their Representative)
Note: Completed receigt will be filed in the Civil Action