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

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, _ Case 3:03-cv-0061§;AVC Document 8 Filed 01/12/2004 Page 1 of 1 1i I
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‘ ' waives OF SERVICE OF SUMMONS V- Y)
‘ TO: 5C53Q \ QQ §§)§§\§ my ml I2 in 3° II \
{mus OF PLAlNTiFF'$ ATTORNEY OR UNREPHESEMED PLAINTIFFI 1; I
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I. gémkl l MM E bm}? . . ,acknowiedBéIii%€l:ittifijbtifiequest
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that I waive service of summons In the action cf
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whichiscasenumber Q — UnttsdSta1esDis¤ictCoun
terms oisuiet ot C gms; .
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_ lhaveaisoreceivedacopy¤ttheoomplaintinttieactionQtwcc¤pies otthis instrument, and ameans I
bywhichlcanretumthesignedwaivertoyouviititoutoosttome.
. I agree to save the cost ot ot a summons and an additional copy of the complaint in this
lawsuit by not requiring that I (orthe entity on whose behalf I am acting) be served withjudicial process in.
the manner provided by Rule 4.
I (¤rI¢he entity on whose behalf I am acting) will retain eil defenses or obieclions to lite lawsuit orto the i
jurisdiction orvenue ofthe court exceptfor objections based on a deiectin the summons orin the service 1 1
of the summons.
I understand thatajudgmentnmay be entered against me (or the pany on whose behalf I am acting) i
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if an answer or motion under Ruie I2 ls not served upon you within 60 days after 1 i
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_ or within 90 days after that date it the request was sent outside the United States. , . __ I
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ancponnn complaint unwind Munras ' the thoamwuror ' I
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