NYC 9/11 Public Portal Document
_ _ -
AI WA VIIOF SERVICE
STATE OF NEW YORK, COUNTY OF
The undersigned being duly sworns, deposes and says: ,,,
The deponent is not a party to the action and is over 18 years of age. That on 1.9=
at I ZO Ac1tUP.M at Yr .t
deponent served the within ORDER on the re named therein.
1. Individual personal service t -
'1 by delivering a true copy to said respondent personally
2. Individual substitued service ~~ee A, r
' by delivering a true copy to xl a i7 tC tJ A n d e° i S o h CO- 00 & 4 Y J /' ►+~e'er P'►P'
~i
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. f +,
3 orionition
b liveringa true copy t Mt3A /-ca #4hf e'Y'~'o h . frr tr S I'G~Aer 0W MPY ePM d
C 0-010 0.1 w r d Mon A .is at said ooporation.
4. Delivery to employee at premises c . 2 Z
1 IA1 /PM on I at 7' / Pt G V Y 4
I attempted to personally serve the herein ORDER on the respondent named herein but was unable Lo do because:
0 having attempted entry to the premises, I found the premises locked and no one responded to any
bells, knocks, or calls; '
0 having entered the premises and having identified myself I was:
0 advised by that the respondent was not then present
(Namc)
❑ unable to segue 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 respondeeat at the premises because:
❑Employee so identified ❑Fmployee was performing work DOther
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 l.white skin ❑Black hair 014-20 yrs ❑ Under 5' ❑ Under 100 lbs
female ❑ black skin ❑Brown hair 021-35 ❑ 5'0"-5'3" ❑ 101-130
❑ yellow skin Blond hair ` Z36-50 ❑ 5'4"-5'8" 1f13l-l60
❑ brown skin ❑ Red hair ❑ 51- 65 1 5'9" -6"0" ❑ 161 - 200 ,?"
❑ red skin 0 Gray hair ❑ Over 65 0 Over 6' ❑ Over 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
/-
7~a" ~- '
SIG A11JRE l
F aber T
M
~1, • <- i Q►
DAY OF 19_
PRINT NAME
DERTA - White RESPONDENT - Yellow LEGAL - Pink
I
J
NYC-WTC 000100387
OCR can misread numbers and units. Confirm readings against the page image before using them.