Free Summons Returned Executed - District Court of Connecticut - Connecticut

i Case 3:02-cv-021 47-J BA Document 20 Filed 12/12/2003 Page 1 of 1
1 \AO440 (Rev. 3/Ol) Summons inaCivil Action fp ye CJ 56**
RETURN OF SERVICE `
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Service ofthe Summons and complamt was made by mem \ / O 3 Jer __ f.f·· Q; V
NAME or senvsn (Pmvn
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C eck one box below to indicate a » ro riare method o service ' ' ` g
El Served personally upon the defendant. Place where served: \ _ W {jj;} aj; Ly - _f_ · __ p _ L I 25 5
(A _ _ pa , Q! SE E . g Q ;dHkg,,,y-i·-;g,—»“ =e>gyz.Q E _.—.___ i
El Lett copies thereof at the defendant’s dwelling house or usual place of abode with a person of suitable age and a
discretion then residing therein.
Name of person with whom the summons and complaint were left:
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El Returned unexecuted:
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dOthcr(specify): amd E Hg: is Eggs 1; M ming EM): t E _ ua D [ \ ·
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STATEMENT OF SERVICE FEES
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DECLARATION OF SERVER i
I declare under penalty of perjury under the laws ofthe United States of'Amei1ca that the foregoing infomation
contained in the Retum of Service and Statement of Service Fees is true and correct.
Executedon \AL£ cx/Oi 7)% . !eFLSooc<2
Date Srgrmture of Se er
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. Address of Server \
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{1) As to who may serve a summons see Rule 4 ofthe Federal Rules of Civil Procedure. A
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