Free Waiver of Service Unexecuted - District Court of Connecticut - Connecticut

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1 Case 3:03-cv-00678-AWT Document 9 Filed O2/O2/2004 Page 1 of 1 1
1 us. Department of Justice PROCESS RRFRTRT AND RETURN e
U - d S , _See Instructions for Service of Process by the U.S. Marshal"
1 I'lltC TEIYCS Marshals SBTVICG on the reverse of this form. 1
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1 PLAINTIFF, Q 1111 1: :·. yy cousr case NUMBER 1
1 2 E QZ i1" 111 ., L [ In _ — J · 1
1 DEFENDANT 1 1 11 mlm 1
· • _§`YPE PROCESS t
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1 NAME FINDIFIDUAL, COMPANY, CORPORATION, ., O SERVE OR DESCRIPTION OF PRO RTY TO SEIZE OR CONDEMN
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SEND NOTICE OF SERVICE COPY TO REQUESTER AT NAME A ADDRESS BELOW:
"""‘"' ''*'“ ‘"' *—*· ‘··· ———— ····—·-— —-————- - —-—- --·—-| Number of process to be
T g A) Iserved with this Fom1 - 285 /
{Number of parties to be
,»» Iserved in this case
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SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and Altemate Addresses, All
Flggephone Numbers, and Estimated Times Available Fbr Service):
1 Fold
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Signature rney or other Originator requesting service on behalf of: MPLMNTIFF TELEPHONE NUMBER R
ii; A /1/"’* tj DEFENDANT 5 Z1 — al
SPA I EIJOW FOR USE OF U.S. MARSHAL ONLY- DO NOT WRITE BELOW T 1 LINE
I acknowl e receipt for the total Total Process District District Signature of Authorized USMS Deputy or Clerk Date
number of process indicated. of Origin to Serve '
(Sign only first USM 285 if more l E G/Q3
1 than one USM 285 is submitted) No. No, A A =» M) c.. ..1 3
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I hereby certify and fetum that I [1 have personally served, 1] have legal evidence of service, ghave executed as shown in "Remarks", the process described 1
on the individual, company, corporation, etc., at the address shown above or on the individual, company. corporation, etc., shown at the address inserted below. |
1:1 I hereby certify and retum that I am unable to locate the individual, company, corporation. etc., named above (See remarks below) 1
Name and title of individual served (if not shown above) A person pf Suitable age and dis-
1:1 cretion then residing in the defendants
usual place of abode.
Address (complete only if different than shown above) Date of Service Time am 1
Pm 1
Signa rc of U.S. Marshal or Deputy
Q. tw
Service Fee Total Mileage Charges Forwarding Fee Total Charges Advance Deposits Amount owed to U.S. Marshal or Amount of Refund 1
(including endeavors) ‘ t
REMARKS:
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- FORM USM-285 (Rent 12/15/80
’R'°:EE3;g?NS .l. CLERK OF THE COURT )
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