NYC 9/11 Public Portal Document
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AFFIDAVIT OF SERVICE
STATE OF NEW YORK, COUNTY OF /V~ ~'`~ r
The undersigned being duly swvms, 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 .OAM /P.M at Lh Q Al b Y Yo U S"# •
deponent served the within ORDER on the respondent named therein.
1. Individual personal service
I` D'by delivering a true copy to said respondent personally
2. Individual substitued service ,y~`
I l by delivering a true copy fo f" o h r i,_ ,h K S h .. p Y` f ~M ~j P
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 ry~ f f
ivering a true copy to f /1O N 14 A. ~ h of P Y So h , _____1W5 ~/~ cv ffI' HP Y' ,o n d
d ,0 f3. C' cl /o: P n. b B. at said ooporation.
(Position)
4. Delivery to employee at premises S 23 pZ 1
l t /:In A` G/P.M on at £ L• tr Y Y n t.
I attempted to personally serve the herein ORDER on the respondent named herein but was unable t do because:
0 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
(Name)
❑ unable to secure 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:
OEmployee 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 ❑ 14 - 20 yrs ❑ Under 5 ❑ Under 100 lbs
n( female ❑ black skin ❑Brown hair 021-35 ❑ 5'0"-5'3" 0101-130
❑ yellow skin h.Blond hair `Ps 36 -50 ❑ 5'4"-5'8" 2Y131 - 160
❑ brown skin 0 Red hair 051-65 f5'9" -6"0" 0161-200
❑ red skin 0 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 BEFORE ME ON THE
,JA. C4
SIGNATURE M. /1 !
DAY OF 19_ d 4bP 1 i. r9 . C., r'L~
PRINT NAME
DERTA — White LEGAL — Pink
J
NYC-WTC 000100388
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