MORT et al v. LAWRENCE COUNTY CHILDREN AND YOUTH SERVICES et al

Filing 1

COMPLAINT against JAMESON HEALTH SYSTEM, LAWRENCE COUNTY CHILDREN AND YOUTH SERVICES, CHRISSY MONTAGUE (Filing fee $350, receipt number 0315-1765213), filed by ELIZABETH MORT, ALEX RODRIGUEZ. (Attachments: # 1 Exhibit A, # 2 Civil Cover Sheet, # 3 Summons for Lawrence County Children and Youth Services, # 4 Summons for Chrissy Montague, # 5 Summons for Jameson Health System) (ksa)

MORT et al v. LAWRENCE COUNTY CHILDREN AND YOUTH SERVICES et al

Doc. 1 Att. 5

Case 2:05-mc-02025 Document 1368-5

Filed 10/28/10 Page 1 of 2

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

UNITED STATES DISTRICT COURT
for the
Western Distrct of

Pennsylvania

Elizabeth Mort and Alex Rodriguez
)

Plaintiff

v.

Lawrence County Children and Youth Services,
Chrissy Montague and Jameson Health System

) ) ) ) )
)

Civil Action No.

Defendnt

SUMMONS IN A CIVIL ACTION
To: (Dejčndants name and addess)

Jameson Health System

454 Chestnut Street New Castle, Pennsylvania 16101

A lawsuit has been fied against you.

you 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
Within 21 days after service of ths summons on you (not counting the day you received it) - or 60 days if are the United States or a United States agency, or an offcer or employee of

the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintis attorney,

whose name and address are: MEYER, UNKOVIC & SCOTT, LLP
AMERICAN CIVIL LIBERTIES FOUNDATION Patricia L. Dodge

OF PENNSYLVANIA Quinn A. Johnson Witold J. Walczak Antoinette C. Oliver

S13 aAtwood StreetSmithfield Street ar J. Rose 535 Suite 1300 3

Pittsburgh, PA 15213 Pittsburgh, PA 15222

If you fail to respond, judgment by default wil be entered against you for the relief demanded in the complaint. You also must fie your answer or motion with the court.

CLERK OF COURT

Date:
Signature of

Clerk or Deputy Clerk

Dockets.Justia.com

Case 2:05-mc-02025 Document 1368-5

Filed 10/28/10 Page 2 of 2

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

Civil Action No.

PROOF OF SERVICE
(This secton should not be filed with the court unless required by Fed. R. Civ. P. 4 (1))
This summons for (name of

individual and tile, if an)

was received by me on (date)

n i personally served the summons on the individual at (place)
on (date)

; or

n 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

n i served the summons on (name of individual)
designated by law to accept service of process on behalf of (name of organization)

, who is

on (date)
o I retuned the summons unexecuted because

; or ; or

n Other (specif):

My fees are $

for travel and $

for services, for a total of $

0.00

I declare under penalty of perjur that this information is tre.

Date:
Server's signture

Printed name and title

Server's adress

Additional inormation regarding attempted service, etc: