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Case 3:08-cv-03073-JSW
O AO 440 (Rev. 03/08) Civil Summons (Page 2)
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Proof of Service
I declare under penalty of perjury that I served the summons and complaint in this case on by: (1) personally delivering a copy of each to the individual at this place, (2) leaving a copy of each at the individual's dwelling or usual place of abode with who resides there and is of suitable age and discretion; or (3) delivering a copy of each to an agent authorized by appointment or by law to receive it whose name is ; or (4) returning the summons unexecuted to the court clerk on My fees are $ for travel and $ . for services, for a total of $
0.00 0.00
,
; or
.
Date:
Server's signature
Printed name and title
Server's address
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