Free Acknowledgment of Service - District Court of Connecticut - Connecticut

Case 3:03-cv-00453-JCH Document 9 Filed O2/13/2004 Page 1 of 2 {
U S De an f J · PROCESS RECEIPT AND RETURN
. . p ment 0 usttce S . ., . ,, t
. , ee Instructions for Service of Process by the U.S. Marshal [
UH1t€d SIZHIZBS Marshals SCYVICC on the reverse of this form.
PLAINTIFF H I COURT CASE NUMBER
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DEFENDANT ____ 44 A TYPE OF PROCESS l
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SERVE NAME OF INDIVIDUAL, COMPANY, CORPORATION, ETC., TO SERVE OR DESCRIPTION OF PROPERTY TO SEIZE OR ONDEMN
· ADDRESS (Street or RFD, Apartment No., C3); State and ZIP Code)
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§F§[L*i.U£‘2i££ EEYISE 9.O£U`2 EIQEEETEEE E·‘!YlE £"lP..éQDL*'§§*`;*1':i@lVE. ... Number of pmccs, ,0 bg l
F ,»·• I served with this Form - 285 2
Him: I. `letk , 61 ,
ILM I Number of patties to be
gl ° Iserved in this case I
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Check for service
..... ........ .... .... _...... ..,, ...._ .,, ___.________ { on U.S.A. Iz.
SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and Altemate Addresses, All
Figlephone Numbers, and Estimated Times Available For Service): i
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Signature of Attomey or other Originator requesting service on behalf of: |%]NTIFF TELEPHONE NUMBER KjDATt?_f;:Ea`
M amaétaa _,_ .__, / El DEFENDANT (@] 5 Hg {if;. :>¥” 3.%% ·O 3 l
SPACE BELOW FOR USE O U.S. MARSHAL ONLY — DO NOT WRIT fj; _ § 6 _mk LINE
Iacknowledge receipt for the total Total Process District District Signature ofAuthori . d USM I · · I · lerkjw Rs]; Datc
number of process indicated. ofOrigin to Serve _ `QQ *1%; f
(Sign only Hrst USM 285 rt more _, y ; I gg; ·
than mc USM gs5n,~ut,m;t.»ar) / Ne, _ Ne. (v 3 O 3 i
I hereby certify and return that I K] have personally served, [I have legal evidence of service, I] have executed as shown in "Remarks7Z, the procassglescrtbcd
on the individual, company, corporation, etc., at the address shown above or on the individual. company, corporation, etc., shown ar the address tiiiierted below.

Ci I hereby certify and return that I am unable to locate the individual, company, corporation, etc., named above (See remarks below)
Name and title of individual served (lf not shown above) A pqrggn Of Suiwbkg ag.; and dis- i
Ei cretion then residing in the defendant`s
usual place of abode. i
Address (complete only if different than shown above) Date of Service Time am
3 zr 0 f?·/to in
Signature of U.S. Marshal.-qt: Eeputy )
Service Fee Total Mileage Charges Forwarding Fee Total Charges Advance Deposits Amount owed to U.S. Marshal or Amount of Refund
(including endeavors)
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REMARKS: I
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MOR ¤¤¤‘¤¤~S 1 CLERK or THE COURT “"“‘ USMS me ”""°°’
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I aQIal§gI§Z0é`T0y-09453-JCH D<>¤¤me¤t 9PRdIIESS)
I U.S. Dep us ICC . ,_ .
I . _ See Instructions for Service of Process by the [LS. Marshal"
I United States Marshals Service on me reverse Oman sm.
[ PLMNTIFF I COURT CASE NUMBER
I Eat · . Pact. :e3 I DEFENDANT (_,, TYPE or PROCESS
9-LM 4 - I » x I I
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SERVE NAME F INDIYIDUA , co PANY, CORPORATION, ETC., TO SERVE OR DESCRIPTION OF PROPERTY TO SEIZE OR CON EMN
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ADDRESS (Stree or RFD, Apartment No., City te and ZIP Code)
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SEND NOTICE OF SERVICE C0 TO REQUESTER AT NAME AND ADDRESS BELOW;
———— —-·- ——-——————— — -—--—-—— — —---- ·-— -—--- —| Number of process to be
I-; · 7 6 Iscrved with this Fom1 - 285 2
iillawn "l~ uk i·· (
' . - I Number of panics to be I
I
fl Q Iserved in this case I I
I r U- ICheck for service
_.._; _______ E ____ ‘,__E_ ___________________ Ion u.s.A. ,/ ·
SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST [N EXPEDITING SERVICE (Include Business and Altemate Addresses, All
gegephone Numbers, and Estimated Times Available For Service):
` Fold
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Signature of Attorney or other Originator requesting service on behalf of: TELEPHONE NUMBER ~ DATE`? I
, - rr RLAINTIEF G I—t[3] I
; - . { , I _,__ _ lj DEFENDANT II.
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SPACE BELOW FOR USE I- U.S. MARSHAL ONLY—D0 NOT WRITE B E IT THIS LINE
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Iacknowledge receipt for the total Total Process District District Signature of Authorized U ~· Deput 0 rk SI ""“‘ gx;. Date '
number of process indicated. -- of Origin to Serve _ I" I
(Sign only Hrst USM 285 if more ` I _ · I
than one USM 285 is submitted) No. No. __ ,;____._._ f J 0
_ I
I hereby certify and return that I [I have personally served. I] have legal evidence of service, lj] have executed as shown in "Rcmarkzs", the process described I
on the individual, company, corporation, etc., at the address shown above or on thc individual. company, corporation, etc., shown at the address inserted below. ;
!
lj I hereby certify and return that I am unable to locate thc individual, company. corporation, etc., named above (See namarks below) I
Name and title of individual served (if not shown above) A person of suitable age and dis- I
lj cretion then residing in the defencIant’s
usual place of abode.
Address (complete only if different than shown above) Dato of Service Time am
S zz 03 it O, I · » I
tgnaturt: of UIISI Marshal or Deputy
.»·l“ ` __ me I
I T I
Service Fee Total Mileage Charges Forwarding Fee Total Charges Advance Deposits Amount owed to U.S.;·Mar§hal or nt of Refund
/__ (including endeavors) I ` Ig cx I I ··~·— ~
f *'__ /-· I .I ,...
REMARKS: A {F /4 ZY _ Q *"f"`_ I ·~—-r- I
Sew 7 l/I4 Gert Hr-/atb /7»¢re Je? 77 élgg? ~· ~
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P¤¤¤¤ ¤¤¤‘¤¤NS 1 CLERK or THE c0URT mm “SI“·”’ M '”""°’ I
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