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coo 0'~" / lvc CASE NUMBER: / ' {J 1 - C V 6 6 7 -cc f( G v
YOU ARE HEREBY SUMMONED and required to serve on PLAINTIFF'S ATTORNEY and address)
Do N. n r o lUIV ~ S
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k'~~ - a 6 iC G P 3 0 ) -f z
an answer to the complaint wh i ch is served on you w ith this summons, w ithin _ %7 d _ days after service .
of this summons on you, exclusive of the day of serv ice. Ifyou fail to do so, j udgment by default will ~e taken against you
for the rel ief demanded in the complaint. Any answer that you serve on the parties to this action m ast be filed w ith the
Clerk of this Court within a reasonable period of time after service .
0 .1 sm MM
CLERK DATE
~-~
RETURN OF SERVICE
BATE 6
Service of the Summons and complaint was made by me ( `) U.S. [? . C,
D Left copies thereo f at the defendant's dwell ing hous e or u sual place of abode with a person of suitable age and
d iscreti on then resid ing therein.
Name of person with whom the summons and complaint were left :
I declare under p enalty of perjury under the laws of the United State s o f Am eric a that the foregoing infor mation
co ntai ned i n the Return o f Service and Statement of Service Fees is true and co
Executed on t ~
Date r of n~er
Address of Server
(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure .