Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 1 of 10 PageID 269

Civil Action No.

3:

l2-cv-0325 l-P

PROOF OF SERYICE

(This section should not bettletl wtth the court unless required by Fed R, Civ, P. 4 (I)) This summons for (name of
was received by me on

indivifiol an/ titte, if

Ur,q

f{/.iA' /l

/') .'l / I any) l::-rui*zt >t hgl* z-

|*

I personally served the summons on the individual at Qtlace)

I te1 the summons

at the individual's residence or usual place

of abode with (name)

a person

on (dute)

, and

mailed a gopy to the individual's last known address; or

Fo g
on (date)

f*

I served the summons on {name of indiridual)

by law to accept service ofprocess cn behalfof(name of organi:ation)

bo w.
on (date)

ofsuitable age and discretion who resides there,

l"-

I returned the sumntons unexecuted because

ffiu tpf"
My
fees are $

Th e

ff" fi{)

for travel and $

{'},

.t;lt

for services, for

I declare under penalty of perjury that this information is true'

of

signature

nd

Y,r,'{ra
Printed name and title

ie

SYrr; trl {ios*,ho w*.

Server's address

Fr

Additional information regarding attempted service, etc:

co m
;or
who is designated

;or

total af

s #

"

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l,!LL,

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Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 2 of 10 PageID 270

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Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 3 of 10 PageID 271

-" ---**--f1-0_-41-0_(R.9", -"-"'"-.-*

l2109) Surnmons in a Civil Action (page 2)

Civil Action No. 3;12-cv-0325 i-p

PROOF OF SERVICE
(This section should not beJilerl wirh the court unless required fut Fed. R. This summonsfor {name of indiuiQuat anl tirle, if any) was received by me on (dare) /{/il /ktfl

ciu p. 4 (I))

fT

I personalty served the summons on the individ

ual at

(place)

la

t ten the summons

at the individual's residence or usual place

of abode with (name\

a person

on (dute)

and mailed a copy to the individual's last known address; or

f*

I served the summons on (name af individuat)

Fo g
on {date)

by law to accept service ofprocess on behalfof(name oforgani:ation)

bo w.
on {date\

of suitable age and discrelion who resides there,

I returned the summons unexecuted because

F*{n,ifir
My
fees are $

0. t'['

Th e

for travel and $

t?. *P

for services, for

total of

I declare under penalty of perjury that this information

of

is true.

nd

Y'4;a

Yura

Server's signature

Printed name and title

ie

?t/w #,fio**rhr we
Servels address

Fr

Additional information regarding attempted service, etc:

co m
who is designated

;or

$ # . M)

/**&,*

t# #x*r

Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 4 of 10 PageID 272

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Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 5 of 10 PageID 273

AO

4;10

(Rev. l2109) Sunrrnons in a Civil Action (Page 2) 3;

Civil Action No.

l2-cv-03251-P

PROOF OF SERVICE
(This section should not befiled with the court unless requiretl by Fed. R, This sunrmonsfor (name of
was received by nre on @orq

in/iy

title, if any)

-JE

I personally served the surnmons on the individual at Qtlace)

on (date)

t tet the summons

at the individual's residence or usual place

of

abod e

,
on Qlate)

a person

and mailed a copy to the individual's last known address; or

f,*

I served the summons ot (ndme of indi.ridual)

Fo g
on (date)

by law to accept service ofprocess on behalfof(name oforganization\

I returned the summons unexecuted

because

Th e

her f;peeifi,)

.ll:r:r'

'
M1, fees are
S

{kc.{ i fr 't""/,xf{Au:
ti"

t{'

for travel and $

fr.

{;(,'

I declare under penalty of perjury that this inforrnation is trr.re

of

nd

Y*t

ie

7Vty, 4/ {fu,per$.ot *ae r$,te&n

Server's address

bo w.
with (nante)

f*'

ofsuitable age and discretion who resides there,

for services, for

total of

Y'q
Printed name and title

Fr

Additional information regarding attempted service, etc:

co m
who is designated

;or

;or

$ f . &)

t'//

F,,o*"'tt

Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 6 of 10 PageID 274

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Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 7 of 10 PageID 275

t "

AO

4,10

'''--

(Rev. l2109) Surnrnons rn a Civil Action (Page 2)

Civil Action No. 3:12-cv-03251-P

PROOF OF SERVICE

(This section should not befiled with the court unless rcqulred by Fed R. Civ. P. a This summons for (name of indh,i$ul an/ title, if any)
was received by me on

Vr,q ff#l' /,&Yl

fi.rra, frz**,
on (date)

(ieBmc,r*/

f*

I personally served the summons on the individual at $rlace)

t ten the summons

at the individual's residence or usual place of abode

,
on (date)
,

a person ofsuitable age and discretion who resides there,

and mailed a copy to the individual's last known address; or

Fo g
on (date)
S

I served the summons on (name of individual)

by law to accept service ofprocess on behalfof(name oforgani;ation)

bo w.
wilh (name) for services, for a total ot s

f*

I returned the sumntons unexecuted because

{kor ip'r
My fees are $

(). {,['

Th e

for travel and

0. C' t'

of

I declare under penalty of perjury that this information is true.

Server's signature

nd

Y,r,{ia

Yuq
Printed name and title

ie

7'ttw F/-ff*r".rfu, *se /,e*.&,n

Server's address

Fr

Additional information regarding attempted service, etc:

co m
(l)
who is designated

;or

lor

"

M)

--2

tfr, f;"rrr

Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 8 of 10 PageID 276

AO 410 (Rev. I2109) Surnrnons in a Crvil Action (Page 2)

Civil Action No.

3:

l2-cv-03251-P

PROOF OF SERVICE
(This section should not
be

Jiled with the court unless required by Fed R. Civ. P. a

This summons for (name of indit'iQaal and title, if any)

was received by me on

(drtd

/f/i.i

kt sottt

/k'|L

I personally served the sumurons on the individual at (place)

f*

I teft the summons

at the individual's residence or usual place

of abode with (narne)

a person

on (date\

and mailed a copy to the individual's last known address; or

f-

Fo g
on (date)

I served the summons on (name of indtuidual)

by law to accept service ofprocess on behalfof(name of organi:ation)

bo w.
on (date)

f*

ofsuitable age and discretion who resides there,

f*

I returned the summons unexecuted because

Pttt
My
fees are $

tpf o'ti'

Th e

for travel und

fi. d/ ('i

for services, for

I declare under penalty of perjury that this information is true.

of

nd

Yt

,t

You,
Printed name and title

ie

1,Fm

d {/*prrfut

aa< /,qu./n,a

Server's address

Fr

Additional information regarding attempted service, etc:

co m
(l)
who is designated

;or

;or

total

off

C - @)

(F

f;.rnt

Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 9 of 10 PageID 277

l9--1f*$"":. i?t02"-l-y*yrn g lg i:rl-l:lipr-(f Civil Action No. 3:12-cv-0325I-P

ugt U^*_*_

"*

PROOF OF SERVICE

(This section should not befiled with the court unless reguired by Fed. R, ctv, p, a $)) This summonsfor (name of inditifiml anf, title,
was received by nrc

on(dctte') fff';;i

/*n

r*,t b*{{.&xt, 5e#4'us

on (date)

I personally served the summons on the individual at Qtlace)

f*

t teft the summons

at the individual's residence or usual place

of

abod

,
on {date)

a person

and mailed a copy to the individLral's last known address; or

f*

I served the summons on {name oJ'inditidual'1

Fo g
on (date)

by law to accept service ofprocess on behalfof(name oforganization)

bo w.
e with (name\ for services, for
a

of suitable age and discretion who resides there,

I returned the summons unexecuted because

{t{r-1,
My
fees are $

ifrf
uL

{/.

Th e

for travel and $

#.tt'

total

I declare under penalty of perjury that this information

of

is true.

s signature

nd

Y,r,{ra
Printed name and title

ie

SYrw

#"ff*gr.rfur *sa
Server's address

Fr

Additional information regarding attempted service, etc:

co m
who is designated

;or

;or

of$

,{rcu.&;ra

{:,6 fw*r

Case 3:12-cv-03251-P Document 10 Filed 09/04/12

Page 10 of 10 PageID 278

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