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

Case 1 :05-cv-00067-SLR Document 22 Filed 08/16/2006 Page 1 of 2
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RETURN OF WAIVER OF SERVICE OF SUMMONS
I acknowledge receipt of the request that I can waive service of summons in the matter of
C.A. No.05-67 in the United States District of Delaware. I have also received a copy ofthe
complaint in the action, two copies of this form, a copy of the Order of the Court authorizing
service and a means by which I can return the signed waiver without cost to me.
I agree to save the cost of service of a summons and an additional copy of the complaint
in this lawsuit by not requiring that I be served with judicial process in the manner provided by
Rule 4. I will retain all defenses or objections to the lawsuit or to the jurisdiction or venue of the
Court, except for objections based on a defect in the summons or in the service of the summons.
I understand that a judgement may be entered against the party on whose behalf I am
acting ifa response is not served and filed within 60 days after: July ll, 2006.
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Si W, of Defendant Printed or Typed Name C0 jj-Y·_ .
DUTY TO AVOID UNNECESSARY COST OF SERVICE OF SUMMONS ij
Rule 4 ofthe Federal Rules of Civil Procedure requires certain parties to cooperate in sac-épingl i V
unnecessary cost of service ofthe summons and the complaint. A defendant located in the g
United States, who, after being notified of an action and asked to waive service of summons
on behalf of a plaintiff located in the US, fails to do so will be required to bear the cost of
such service unless good cause be shown for that defendant's failure to sign and return the
waiver.
It is not good cause for a failure to waive service that a party believes that the complaint is
unfounded, or that the action has been brought in an improper place or in a court that lacks
jurisdiction over the subject matter of the action or over defendant's person or property. A
defendant who waives service of summons retains all defenses and objections, except any
relating to the summons or the service of summons, and may later object to the jurisdiction of the
Court or to the place to where the action has been brought.
A defendant who waives service must within the time specified on the "Return of Waiver"
form served on plaintiff, if unrepresented or on plaintiffs attomey, a response to the Complaint
and must also tile a signed copy ofthe response with the Court. Ifthe answer or a motion is not
served within this time, a defaultjudgement may be taken against that defendant. By waiving
service, a defendant is allowed more time to answer than if the summons had been actually
served when the request for waiver of service was received.

Case 1 :05-cv-00067-SLR Document 22 Filed 08/16/2006 Page 2 of 2
U S De artment of Justice PROCESS RECEH I lll JD RETURN
' _ ' p ` _ See Instructions for "Service of Process by the U.S. Marshal"
United States Marshals Service on the mma Or this ram.

PLAINTIFF I ..1.....-- COURT CASE NUMBER
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DEFENDA)NT _ » TYPE OF PROCESS / `
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AME OF INDIVII?AL. MPANY, CORPORATION, ET `. TO SERVE OR DESCRIPTION OF P PERTYTO SEIZE OR CONDEMN
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_ {A R SS greet or RFD, flpartme N3;.-City, State and ZIP Code)
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SEND NOTICE OF SERVICE COPY TO REQUESTER AT NAME AND ADDRESS BELOW:
------—— - -—--—--———-—--—--—-— »- -—----- I Number of process to be /
,7- l f" I . . · I served with this Form - 285
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ry [H ;· (7 @>ff‘1J(·,% if.} i·— 1|,*»(-J,/I _ -/_ " Number of panics to be
, ` I l I .- I/_ y' " . ··’l I. I (__ ·/` fr I served in this case `_,·
* » · ··' Check for service
......... l ..._..... { on u.s.A.
SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE (Include Business and Altemate Addresses, All
Telephone Numbers, and Estimated "limes Available For Service):
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0/ P · H / /Ol'»#/S ’——~
Signature of Attomey or other Origin • e. esting service on behalf of: TELEPHONE NUMBER DATE
I _ _ J C-! . PLAINTIFF I .
TT I . » /*/~··’ { E l"l DEFENDANT {QQ/(2 el"'/{-, "“(Q;g
E. _` ’ - ·. ·. 1 - :.... _
SPACE BELOW FOR USE OF U.S. MARSHAL ONLY — DO NOT WRITE BELOW THIS LINE
I acknowledge receipt for the total Total Process District District Signature of Authorized USMS Deputy or Clerk Date
number of process indicated. of Origin to Serve I _
(Sign only first USM 285 if more K ,{ _» _Z) l
than one USM 285 is submitted) No. No. _?, n / . l {-’
I hereby certify and return that I I-] have personally served, have legal evidence of service, Q have executed as shown in "Remarks", the process described
on the individual, company, corporation, etc., at the addre . sl wn above or on the individual, company, corporation, etc., shown at the address inserted below.
Cl I hereby certify and retum that I am unable to locate the individual, company. corporation. etc., named above (See remarks below)
Name and title of individual served (if not shown above) A pgyggn Of Sugmbm age and dis.
l_l cretion then residing in the defendants
usual place of abode.
Address (complete only ifdifferenr than shown above) Date of Service Time am
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g Signature U.S. arshal or Deputy
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Service Fee Total Mileage Charges Forwarding Fee Total Charges Advance Deposits Amount owed to U.S. Marshal or Amount of Refund
(including endeavors)
REMARKS:
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‘ ' -285 IMS/80
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