Affidavit of Service, World Trade Center matter, undated

NYC 9/11 Public Portal Document

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' AFFIDAVIT OF SERVICE

STATE OF NEW YORK, COUNTY OF t_E W IZ1ti The undersigned being duly swains, deposes and says: The deponent is party to the a~sis over 18 years of age. That on 5-2 3 19 C) Z at l0 A at LLL 1 i1V S~'' /l' t/1201 !1 !L~?1N~ /1 deponent se v~-within ORDER on the respondent named therein. 1. Individual personal service ❑ by delivering a true copy to said respondent personally 2. Individual substitued service Pby delivering a tare copy to REV I 3AM5 NIC G7AW 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 coporation. (Poiti®) 4. Delivery to employee at premises ❑At AM/P.M on 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 found the premises locked and no one responded to any bells, knocks, or calls; ❑ having entered the premises and having identified myself I was: ❑ advised by _ that the respondent was not then present (Na) ❑ unable to secure identification of the person(s) present; ❑ advised by that no officer, director, managing (Na) 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: DEmployee 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 ❑Black hair 014-20 yrs 0 Under 5' ❑ Under 100 lbs ❑ female ❑ black skin ❑Brown hair 021-35 ❑ 5'0"-5'3" 0101-130 ❑ yellow skin ❑ Blond hair 036-50 ❑ 5'4"-S8" ❑ 131-160 ❑ brown skin ❑ Red hair X51 - 65 %5'9"-6"0' 0161-200 ❑ red skin 'Gray hair ❑ Over 65 ❑ Over 6' ~~Over 200 ❑ White hair ❑ 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 BEFOREME ON THE %U sr A E DAY OF 19_ AZT FEilECi~ PR1NT NAME

DERTA — White RESPONDENT — Yellow LEGAL — Pink

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