Free Acknowledgment of Service - District Court of Delaware - Delaware

_ . H Case 1 :08-cv-00341-JJF Document 6 Filed 06/10/2008 Page 1 of 1
: —_ ., l OFFICE OF THE CLERK
UNITED STATES DISTRICT COURT
_ . DISTRICT OF DELAWARE
Peter T. Dalleo LOCICBOX 18 _
CLERK 844 me STREET
us. counmousu
wrmmerou, DELAWARE isaoi
(sm) 573-6170
RE: C.A.# O3 Gill TK);
cAsE CAPTION: BH WLGY V, New Ozamtn'; Owwy
ACKNOWLEDGMENT OF RECEIPT FOR F.R.Civ.P. 4
I hereby acknowledge receipt of a copy of Rule 4 (Summons) of the Federal
Rules of Civil Procedure, and understand that it is my responsibility to make service of
process on defendants in accordance with this rule.
Date Received Si gned:
by Plaintiff: Pro Se Plaintiff
Date Received Signed:
by C1erk’s office: Deputy Clerk
Note: If you received Federal Rule 4 by mail, please sign this receipt and return it to:
Clerk
U.S. District Court
844 N. King Street lf applicable, Rule 4 mailed to plaintiff:
Lockbox 18 ·
wiimmgm, DE 19801 (2- LO - O (
Date mailed
. r it ¤ 0· 11111* BY D°P“” Cm
cc: Docketing Clerk " U G! W I
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Case 1:08-cv-00341-JJF

Document 6

Filed 06/10/2008

Page 1 of 1