Moriarity v. Henriques et al

Filing 11

ORDER Directing Clerk to Issue Summons; ORDER Directing Plaintiff to Complete and Return Service Documents, signed by Magistrate Judge Jennifer L. Thurston on 10/24/11. (Attachments: # 1 First Amended Complaint, # 2 USM Instructions, # 3 Summons)(Gonzalez, R)

OAO 440 (Rev. 8/01) Summons in a Civil Action

UNITED STATES DISTRICT COURT
Eastern

District of

California

SUMMONS IN A CIVIL CASE
V.

CASE NUMBER:

1:

-cv-

TO: (Name and address of Defendant)

YOU ARE HEREBY SUMMONED and required to serve on PLAINTIFF’S ATTORNEY (name and address)

an answer to the complaint which is served on you with this summons, within
days after service
21
of this summons on you, exclusive of the 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 filed with the
Clerk of this Court within a reasonable period of time after service.

Victoria C. Minor
CLERK

(By) DEPUTY CLERK

DATE

OAO 440 (Rev. 8/01) Summons in a Civil Action

RETURN OF SERVICE
Service of the Summons and complaint was made by me(1)

DATE
TITLE

NAME OF SERVER (PRINT)

Check one box below to indicate appropriate method of service
G Served personally upon the defendant. Place where served:

G 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:
G Returned unexecuted:

G Other (specify):

STATEM ENT OF SERVICE FEES
TRAVEL

SERVICES

TOTAL

DECLARATION OF SERVER
I declare under penalty of perjury under the laws of the United States of America that the foregoing information
contained in the Return of Service and Statement of Service Fees is true and correct.

Executed on
Date

Signature of Server

Address of Server

(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure.