Free Acknowledgment of Service - District Court of Connecticut - Connecticut

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· Case 3:03-cv-00618-AVC Document 5 Filed O1/12/2004 Page 1 of 1 I
U.S. Department of Justice PROCESS RECEH. I AND TURN I
, ` _ See Instructions for “Service of Process by the ILS. Marshal" II I
UHIICd SIEIICS Marshals SCYVICE on the reverse of this form. Ig I
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PLAINT? D COURT ‘ NU · . . I'
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DEFENDAN · TYPE OF PROCE S . _ i
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SERVE NAME OF INDIVIDUAL, CO PANK CORPORATION, ETC., TO SERVE OR DESCRIPTION OF" OPER YTO SEIZE OR CONDEMN I I
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ADDRESS ( meet RFD, A an {N ., Ct, Sr: d ZIP Cod) ' ' " ' . IE
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AT Cac I /1/ is 4-, . fw I /*7 ‘ 1 · » · G/(U I
§.EIS.*Ll`£7’B‘2€.9E E§9°£`LT .E'@EEiTE'L*’£`. .'.`l*°i“.‘?. r EEDBEEEEQEL-; Number of process to be
‘ I served with this Form - 285
* /QK,/lélééz, , __ I I;
__ I ·. Q ,_yI,=_#I INumber of parties to be I· I
rjjj`·,` {gx; I served in this ease N ` I
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y-—~I .’ ' I _: , I ec or service EY, I-- ‘ I'
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SPECIéEzINSTRU¢TIO`.EIS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Businesfgp d jI ,mate-Addiesses, All I
7eleplt6ne.·Numbi:1;sL and-iistimared 'limes Available For Service): Cj ‘ ‘ ,= ‘_ It f
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Signature of · mey or other Originator requesting service on behalf of: _ AINTIFF TELEPHONE NUMBER DATE ~
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A _ L I, / [I DEFENDANT Q ZQ· I EB I
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SPA EIJOW FOR USE OF U.S. MARSHAL ONLY- DO NOT WRITE BELOW THIS LINE II
I acknowl 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 tirst USM 285 if more I { - Il
than Ong js submfrggd) N()_ lL Nt), _&_ J ¢· I I ' I I
I hereby certify and return that I Hhave personally served, [1 have legal evidence of service, I] have executed as shown in "Rcmarks", the process described
on the individual. company, corporation, etc., at the address shown above or on the individual, company. corporation, etc., sltowrt`at the address inserted below.

I;] I hereby certify and return that I am unablc to locate the individual, company. corporation, etc., named above (See remarks below)
Name and title of individual served {if not shown above) A person of suitable age and dis- II
El cretion then residing in the det`endant's II
usual place of abode. i
Address (complete only ifdifferent than shown above) Date of S rvie Time am
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Z hal or Deputy
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Service Fee V Total Mileage Charges Forwarding Fee Total Charges Advance Deposits Amount owed to U.S. Marshal )/ Amount of Refund
, (includin ndeavots) _ . ~
yfsgf ic { 4/{SE? ,, $·j"i1?
nematms;
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PMR ¤¤¤’¤°NS 1 CLERK or me count ”`°'“’ “S”·”’ (M """”* I I
MAY BE USED ' I
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