Free Summons Issued - District Court of California - California

Case 3:07-cv-04832-PJH
AO 440 (Rev. 10/93) Summons in a Civil Action

Document 6

Filed 09/28/2007

Page 1 of 2

United States District Court
NORTHERN DISTRICT OF CALIFORNIA
Michael Hiscox

SUMMONS IN A CIVIL CASE
CASE NUMBER: CV-07-4832 PJH (PR) V.

Sergeant Gibson

TO: Sergeant Gibson San Quentin State Prison San Quentin, CA 94964 YOU ARE HEREBY SUMMONED and required to serve upon PLAINTIFF'S ATTORNEY Michael Hiscox, V-20848 Mule Creek State Prison, C13-240U P.O. Box 409060 Ione, CA 95640-9000
an answer to the complaint which is herewith served upon you, within 20 days after service of this summons upon you, exclusive of the day of service. If you fail to do so, judgement by default will be taken against you for the relief demanded in the complaint. You must also file your answer with the Clerk of this Court within a reasonable period of time after service.

September 28, 2007
CLERK DATE

Felicia Reloba
(BY) DEPUTY CLERK

AO 440 (Rev. 10/93) Summons in a Civil Action

Case 3:07-cv-04832-PJH

Document 6

Filed 09/28/2007

Page 2 of 2

RETURN OF SERVICE
DATE

Service of the Summons and Complaint was made by me 1
Name of SERVER (PRINT)
TITLE

Check one box below to indicate appropriate method of service

9 9 9 9

Served Personally upon the Defendant. Place where served: ______________________________________ ______________________________________________________________________________________ Left copies thereof at the defendant's dwelling house or usual place of abode with a person of suitable age and discretion then residing therein. Name of person with whom the summons and complaint were left: _________________________________ ______________________________________________________________________________________ Returned unexecuted: ____________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ Other (specify): __________________________________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________

STATEMENT OF SERVICE FEES
TRAVEL SERVICES TOTAL

DECLARATION OF SERVER

I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct.

Executed on

___________________________
Date

______________________________
Signature of Server

______________________________
Address of Server

(1)

As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure.