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\AO 440 (Rev. 10/93) Summons in a Civil Action
·` RETURN OF SERVICE
DATE .
Service ofthe Summons and complaint was made by me") { /2 rb
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Ch one box below to indicate a ro riate method o eniice
f§`$erved personal@pon the defendant. Place where served: E I Q 45 L7 XD F
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Left copies therecg at‘iii‘§g}(ei?daZ’s ci/welling housgor usual p ace of abo e wi h person of suitable age and
discretion then residing therein.
Name of person with whom the summons and complaint were left:
[1 Retumed unexecuted:
[1 Other (specify):
STATEMENT OF SERVICE FEES
TRAVEL SERVICES TOTAL
DECLARATION OF SERVER
I declare under penalty of perjury under the laws ofthe United States of America that the foregoing information
contained in the Retum of Service and Statement of Service Fees is tmc and correct.
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Executed on ® 7 / J6
Date · ture ofServer , §V ’
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Address ofServer
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RICHARD W. tNlEl·
l`.lORTHl?RN DlS`fHlCl` GF (5·Ai;tFC·iii*i§7t
(l) As to who may serve a summons see Rule 4 ofthe Federal Rules ofCivi| Procedure. "
Case 3:07-cv-02400-SI
Document 26
Filed 09/24/2007
Page 1 of 1