Affidavit of Service, World Trade Center matter, undated

NYC 9/11 Public Portal Document

AFFIDAVIT OF SERVICE

STATE OF NEW YORK,COUNTY OF FLE.W The undersigned being duly swo ns, deposes and says: 52 ®2 The ns a party to on and is over 18 years of age. tan ` /) deponent within ORD on the respondent named therein I. Individual personal service ❑ by delivering a true copy to said respondent personally 2. b Individual substitued %bY vexing athcopyroPY V. JAMES A4c CA4%V a person of suitable age and discretion. Said premises is respondent's actual place of business-dwelling house or usual place of abode within the state. 3. Corporation ❑ by delivering a true copy to at said copaation. (Position) 4. Delivery to employee at premises ❑At AM/P.M. an at I attempted to personally serve the herein ORDER on the respondent named herein but was unable to do because: ❑ having attempted entry to the premises, I fend the premises locked and no one responded to any bells, knocks, or calls; D having entered the premises and having identified myself, I was: ❑ advised by that the respondent was not then present (Name) D unable to segue identification of the person(s) present; ❑ advised by that no officer, director, ma ng (Name) agent or general agent of the respondent was present; ❑ service could not be made because

Thereupon, I delivered a copy of the herein ORDER to whom I believe to be an employee of respondeent at the premises because: DFmployee so identified ❑Employee was performing work ❑Other himself/herself consistent with being employed by the respondent

Description of individual - (this must be completed for all types of service except corporation) Deponent describes the individual as follows: 'male ►white skin OBlack hair 014-20 yrs 0 Under 5' 0 Under 100 lbs 0 female D black skin ❑Brown hair 021-35 ❑ S0"-5'3" 0101-130 ❑ yellow skin ❑ Blond hair 036-50 ❑ S4"-5'8" 0131.160 ❑ brown skin 0 Red Bair ' ,51 -65 >(S9" -6"0" 0161-200 ❑ red skin Gray hair D Over 65 ❑ Over 6' KUOver 200 0 White hair 0 Balding Other identifying characteristic:

5. Service by Mail ❑By mailing a true copy to respondent by depositing or causing to be deposited the same, in a post paid wrapper, in a post office station regularly maintained by the U.S. Postal Service.

SWORN TO BEFORE ME ON THE SI TURE DAY OF 19_ b PRINT NAME

DERTA — White LEGAL — Pink

NYC-WTC 000092986