Free Acknowledgment of Receipt - District Court of Delaware - Delaware

Case 1:07-cv-00684—G|\/IS Document 4 Filed 11/06/2007 Page 1 of 1
, OFFICE OF THE CLERK
UNITED STATES DISTRICT COURT
DISTRICT OF DELAWARE
Peter T. Dalleo LOCKBOX 18 _
crank 244 rama STREET
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wrrmnioron, DELAWARE razor
(sm) 573-6170
RE: c.A.# @7*6*34
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ACKNOWLEDGMENT OF RECEIPT FOR F.R.Civ.P. 4
I hereby acknowledge receipt of a copy of Rule 4 (Summons) ofthe Federal
Rules of Civil Procedure, and understand that it is my responsibility to make service of
_ process on defendants in accordance with this rule.
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Date Received N O V: _ ‘]..·*?l>“`Z Signed{;.£?,3‘jT°“(f.i~»afrr»¢‘* N`! ,F§j=_;2%¢C;;Qr,D6.·,cr 31- 6/x ;¥
by Plaintiff: I Pro e--Pla ntiff { y
Date Received I l [ O'] Signed; W) Q.1/f\·O/k.» A
by Clerk’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 p
844 N. King Street If applicable, Rule 4 mailed to plaintiff: l
Lockbox 18 E
Wilmington, DE 19801
I Date mailed
~-- —· “ 1 ‘ ‘l · _, By Deputy Clerk
cc: Docketing Clerk NOV T § mm p
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Case 1:07-cv-00684-GMS

Document 4

Filed 11/06/2007

Page 1 of 1