NYC 9/11 Public Portal Document
AFFIDAVIT OF SERVICE
STATE OF NEW YORK, COUNTY OF We ` u Y r k
The undersigned being duly swvrns, deposes and says: 2 Go -
The deponent is not a party to the and is over 18 of age. That on 1#
at 1 3 O./P.M. at L Yr ,
deponent served the within ORbER on the respckent named therein.
1. Individual personal service
"by delivering a true copy to said respondent personally
2. Individual substitued service
) .by delivering a true copy to Il e n t C ti A fi e NS o h Co-op ~O r 4 /" v QY
a person of suitable age and discretion. Said premisessi respondent's actual place of business-dwelling
house or usual place of abode within the state.
3. Corporation a 1
a copy m a h lea. A h dI e r So h ~i r s< P~n r Qty d?P'r a nL
delivering tru
O — O ,O g n ctr e N+ _ . r at said coporation.
4. Delivery to employee at premises dZ `
t%A1 / : 3O ?!F/P.M at '7'9 /Q M4vV&lf
4
I attempted to y serve the herein ORDER on the respondent named herein but was unable io 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 baring identified myself, I was:
❑ advised by that the respondent was not then present
(Name)
❑ unable to secure identification of the person(s) present;
❑ advised by that no officer, director, managing
,me
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:
0 male , '¢white skin DBlack hair 014-20 yrs ❑ Under 5' ❑ Under 100 lbs
female 0 black skin ❑Brown hair 021-35 0 5'0"-5'3" 0101-130
❑ yellow skin Blond hair `f 36-50 ❑ 5'4"-5'8' 131- 160
❑ brown skin 0 Red hair 051-65 ' '5'9" d"0" 0161- 200
❑ red skin 0 Gray hair 0 Over 65 0 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 BEFORE ME ON THE
DAY OF 19_ ~.+~ 0rey f_ C
PRINT NAME
DERTA — White LEGAL — Pink
.1
NYC-WTC 000100386
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