Affidavit of service form regarding 114 Liberty Street

NYC 9/11 Public Portal Document

t AFFIDAVIT OF SERVICE

STATE OF NEW YORK, COUNTY OF NEW &K The undersigned being duly swoons, deposes and says: The rs a party to the } rs 8 of age. That on S 2 ~' at A at l~ s',f s de T within ORDER on respondent named therein. 1. Individual personal service 0 by delivering a true copy to said respondent personally 2. Individual substitued service ).by delivering a true copy to RZ?I.S a person of suitable age and discretion. Said premises is respondent's actual place of business-duelling 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 (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 heroin ORDER to whom I believe to be an employee of respondeent at the premises because: ❑Employce so identified ❑Employee was performing work himselftherself consistent with being employed by the respondent

Description of individual - (this must be completed for all types of service except corporation) Deponent describes the imlividjM as follows: Xmale 0 yhite skin lack hair 014-20 yrs ❑ Under 5' 0 Under 100 lbs 0 female black skin ❑Brown hair K21- 35 ❑ 5'0"-5'3" ❑ 101 - 130 ❑ yellow skin 0 Blond hair 036-50 ❑ 5'4"-58" 0131-160 ❑ brown skin 0 Red hair 051-65 ,5'9" .6"0" 161 -200 ❑ red skin 0 Gray hair 0 Over 65 ❑ Over 6' 0 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 sl ATURE DAY OF 19_ &I ci PRWNT NAME

DERTA — White LEGAL — Pink

NYC-WTC 000100840