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

F ` Case 1 :08-cv—00080-JJF Document 5 Filed 02/ 1 4/2008 Page 1 of 3
%AO 440 (Rev. 8/01) Sumrnons in a Civil Action
UNITED Srrtrss Drsrtucr Cotrnr
District of DELAWARE -
Palamarchoulc
' · SUMMONS IN A CIVIL ACTION
V.
Chertoff, Gonzales, Novak, Mueller
CASE NUMBER: ··~· " 3 " .
I I trr r“E`?Ii§""
TOZ (Name and address of Defendant) U
_ F E D I QOUS
Michael Chertoff, Secretary
U.S. Department of Homeland Security __
Washin ton, D.C. 20528 U.S. DISTRICT Coll.
Q DISTRICT OF DELAMIAIPCE p
Q
· YOU ARE HEREBY SUMMONED and required to serve on PLAINTlFF’S· ATTORNEY (name and address)
VITALY S. PALAMARCHOUK A A .
34 MEADOWBROOK LN -
NEWARK, DE, 19711
Phone: (302)234-1260
Email: [email protected]
an answer to the complaint which is served on you with this summons, within 60 days after service
of this summons on you, exclusive ofthe day of service. If you fail to do so, judgment by default will be taken against you
for the relief demanded in the complaint. Any answer that you serve on the parties to this action must be tiled with the
Clerk of this Court within a reasonable period of time after service.
cram; mm
(By) nrzpurv creme

Case 1 :08-cv—00080-JJ F Document 5 Filed 02/ 1 4/2008 Page 2 of 3
%AO 440 (Rev. SIOI) Summons in a Civil Action
RETURN OF SERVICE ·
DATE
Service ofthe Summons and complaint was made by mem ly 9; `
NAME 0 snnvert RJND ‘ TITLE
a MJ? Swim M
Check one box below to indicate o ro riate method o service ‘
El Served personally upon the defendant. Place where served:
El 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:
El Returned unexecuted:
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Other (specify): { .0
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STATEMENT OF SERVICE FEES . ;
nmrar. ssrwrcss · rorAr.
. V $0.00 l
` ` DECLARATION OF SERVER Q
I declare under penalty of perjury under the laws of the United States of America that the foregoing infomation
contained in the Return of Service and Statement of Service Fees is true and correct. |
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Executed on J pf ` ‘ .
. Date L ·· Signature of Server
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(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure. i i

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Case 1:08-cv-00080-JJF

Document 5

Filed 02/14/2008

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Case 1:08-cv-00080-JJF

Document 5

Filed 02/14/2008

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Case 1:08-cv-00080-JJF

Document 5

Filed 02/14/2008

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