Affidavit of Service, World Trade Center matter, undated

NYC 9/11 Public Portal Document

.----------------- :,_. ,— ----- — — --- --- --

v AFFIDAVIT OF SERVICE

✓ STATE OF NEW YORK, COUNTY OF iLiE W "Ir) r2 Iti The undersigned being duly sworn, deposes and says: 3 1.9 O Z The deponent is not a party to the action and is over 18 years of age. That on at JO AMJ/P.M at L LL CT!) H N S ; f 1—kii/R e- w _vi.' ILTJA/ deponent servel tla within ORDER on the respondent named therein 1. Individual personal service ❑ by delivering a true copy to said respondent personally 2. Individual substitued service Eby delivering a true copy to RE V r f~\M ES MC G MW 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. (Position) 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 (Nano) ❑ unable to seem identification of the person(s) present; ❑ advised by that no officer, director, managing (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: ❑Employee 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: ;I7 male A white skin OBlack hair O14-20 yrs O Under 5' O Under 100 lbs O female ❑ black skin ❑Brown hair O21-35 ❑ 5'0"-53" O101-130 ❑ yellow skin ❑ Blond hair O36-50 O 5'4"-5'8" ❑ 131 - 160 ❑ brown skin ❑ Red hair 51 -65 5'9'-6"0" O161-200 ❑ red skin t15 Gray hair O Over 65 O Over 6' ) bver 200 ❑ White hair ❑ Balding Other identifying characteristic:

5. Service by Mail OBy 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 / g41_(1.F, SIGNATURE U DAY OF 19_ P,1 F Ei IEC1. PRINT NAME

DERTA - White LEGAL - Pink

NYC-WTC 000092988