Clemons v. Google, Inc.

Filing 4

Summons Issued, via USMS, as to Google, Inc. (dvanm, )

U.S. Department of Justice

PROCESS RECEIPT AND RETURN

United States Marshals Service

See "Instructions for Sei-vice of Process hv U.S. Marshal"
COURT CASE NUMBER

PLAINTIFF

l:17cv963

Richard Clemens

TYPE OF PROCESS

DEFENDANT

Service of Summons

Google, Inc.

SERVE J Google, Inc.

{

AT I address (Street or RFD. Apartment No., City, State and ZIP Code)
SEND NOTICE OF SERVICE COPY TO REQUESTER AT NAME AND ADDRESS BELOW

Numberof processto be
served with this Form 285

^Richard demons

1

Number of parties to be
1

served in this case

Address Unknown

Check for service
on U.S.A.

SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE

Bmtnm md Alter,Addresses,

All Telephone Numbers, andEstimated Times Availablefor Service):

Fold

Fold

ture ofAttorney other Originator requesting service onbehalf of;

PLAINTIFF

DEFENDANT

DATE

TELEPHONE NUMBER

8/29/17

703-299-2101

BELOW TO USEOF U.S,^MAfe^HAL ONLY- DO NOT WRITE BELOW THIS LINE
I acknowledge receipt forthe total
numberof process indicated.
(Sign onlyfor USM 285if more

District to

Signature ofAuthorized USMS Deputy orClerk

Serve

No

than one USM 285 is submitted)

District of

Origin

Total Process

Nr.

1hereby certify and return that I• have personally served ,• have legal evidence ofservice. • have executed as shown
on the individL ,company, corporation, etc.. at the address shown above on the on the mdividual. company, corporation, etc. shown at the address mserted below.
• Ihereby certify and return that Iam unable to locate the individual, company, corporation, etc. named above (See remarks below)
|~| Aperson ofsuitable age and discretion

Name and title of individualserved (if not shown above)

then residing indefendant's usual place
of abode
Time

Date

Address (complete only different than shown above)

EH am

• pm
Signature of U.S. Marshal or Deputy

Service Fee

Total Mileage Charges
including endeavors)

Forwarding Fee

Total Charges

Advance Deposits

Amount owed to U.S. Marshal* or

(Amountof Refund*)

$0.00
REMARKS:

DISTRIBUTE lO

I 1. CLERK OF THE COURT

PRIOR EDITIONS MAY BE USED

• 2. USMS RECORD
3. NOTICE OF SERVICE

4. BILLING STATEMENT*: To be returned to the U.S. Marshal with payment,

ifany amount isowed. Please remit promptly payable toU.S. Marshal.
5. ACKNOWLEDGMENT OF RECEIPT

Form USM-285
Rev. 11/13

RECEIVED
AO440 (Rev.06/12) Summons in a CivilAction

United States District Court
for the

Eastern District ofVirginia

^UG 2^ P 2* 5
CLERK US DISTRICT COURT
ALEXANDRIA. VIRGINIA

Richard demons

Plaintijf(s)

Civil Action No. 1:17cv963

V.

Google, Inc.

Defendant(s)

SUMMONS IN A CIVIL ACTION

To: (Defendant's mme andaddress) Google, Inc.
1875 Explorer St.
Reston, VA 20190

A lawsuit has been filed against you.

Within 21 days after service ofthis summons on you (not counting the day you received it) —or 60 days ifyou

are the United States or aUnited States agency, or an officer or employee ofthe United States described mFed. RP. 12 (a)(2) or (3) —you must serve on the plaintiffan answer to the attached complaint or amotion under Rule o
the Federal Rules ofCivil Procedure. The answer or motion must be served on the plaintiff or plaintiffs attorney,
whose name and address are:

Richard demons
Address Unknown

Ifyou fail to respond, judgment by default will be entered against you for the reliefdemanded in the complaint.
You also must file youranswer or motion with the court.
CLERK OF COURT

Date:

08/29/2017

Signature ofClerk or Deputy Clerk

AO440 (Rev.06/12) Summons in a Civil Action(Page2)

Civil Action No. 1:17cv963
PROOF OF SERVICE

(This section should not befiled with the court unless required by Fed. R. Civ. P. 4 (I))
This summons for (nameof individual and title, ifany)

was received by me on (date)

• I personally served thesummons onthe individual at (place)
on (date)

; or

• I left the summons at the individual's residence or usual place of abode with (name)

, a person ofsuitable 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 ofindividual)

'

designated by law to accept service ofprocess on behalf of(name oforganization)
on (date)

; or

• I returned the summons unexecuted because
•

Other (specify):

My fees are $

for travel and $

for services, for atotal of$

I declare under penalty of perjury that this information istrue.

Date:

Server's signature

Printed name and title

Server's address

Additional information regardingattemptedservice, etc:

0.00