H.E.R.O., Inc. et al v. Self

Filing 1

COMPLAINT for Declaratory Judgment and Other Relief against Ida C. Self. Filing fee $ 350.00 receipt number 113C-4359496, filed by H.E.R.O., Inc., PromiseCare Pharmacy, LLC. (Attachments: # 1 Civil Cover Sheet, # 2 Summon(s))(Tschupp, Michael)

AO 440 (Rev. 12/09) Summons in a Civil Action

UNITED STATES DISTRICT C OURT
for the

SOUTHERN DISTRICT OF FLORIDA

H.E.R.O., INC., a Tennessee corporation and,
PROMISECARE PHARMACY, LLC, a
Tennessee Limited liability company,
Plaintiff(s),
v.

)
)
)
)
)
)
)
)

Civil Action No.

IDA C. SELF, an individual,
Defendant(s).
SUMMONS IN A CIVIL ACTION
TO:

(Defendant’s name and address)

Ms. Ida C. Self
3435 Hamberton Circle
Murfreesboro, TN 37128
A lawsuit has been filed against you.

Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you
are the United States or a United States agency, or an office or employee of the United States described in Fed. R. Civ.
P. 12 (a) (2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of
the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney,
whose name and address are:
Jorge Espinosa
Michael E. Tschupp
Espinosa | Trueba PL
3001 S.W. 3rd Avenue
Miami, FL 33129
Tel: [phone]
If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint.
You also must file your answer or motion with the court.

CLERK OF COURT

Date: _________________

_______________________________________
Signature of Clerk or Deputy Clerk

AO 440 (Rev. 12/09) Summons in a Civil Action (Page 2)

PROOF OF SERVICE
(This section should not be filed with the court unless required by Fed. R. Civ. P. 4(i))

This summons for (name of individual and title, if any) ______________________________________________________
Was received by me on (date) _____________________.
I personally served the summons on the individual at (place) ________________________________________
__________________________________________________ on (date) _____________________; or
I left the summons at the individual’s residence or usual place of abode with (name) _____________________
__________________________________, a person of suitable age and discretion who resides there,
on (date) _____________________, and mailed a copy to the individual’s last known address; or
I served the summons on (name of individual) ____________________________________________, who is
designated by law to accept service of process on behalf of (name of organizational) ____________________________
__________________________________________________ on (date) _____________________; or
I returned the summons unexecuted because ________________________________________________; or
Other (specify):

My fees are $ ______________ for Travel and $ ___________ for services, for a total of $ ______________.
I declare under penalty of perjury that this information is true.

Date: __________________

_______________________________________________________
Server’s signatures

_______________________________________________________
Printed name and title

_______________________________________________________
Server’s address

Additional information regarding attempted service, etc: