Affidavit of service form regarding 114 Liberty Street

NYC 9/11 Public Portal Document

t ,N AFFIDAVIT OF SERVICE

STATE OF NEW YORK, COUNTY OF NEW '/DtK The undersigned being duly sworn, deposes and says: The deponent is not a party to the action d is vc,18y, age. That on k9 O.Z at (7 t aM/I.lvl at ,'/L/ L/l ~t—F.''T _< 7`_ deponent servedthe within ORDER on the respondent named therein. 1. Individual personal service ❑ by delivering a true copy to said respondent personally 2. Individual substitued service i by delivering a true copy to C V' V IS 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 OAt 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 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: male ❑ white skin lack hair ❑ 14 - 20 yrs ❑ Under 5' ❑ Under 100 lbs 0 female T- 'black skin ❑Brown hair p, 21-35 ❑ 5'0"-5'3" 0101-130 ❑ yellow skin ❑ Blond hair 036-50 ❑ 5'4"-5'S" 0131-160 ❑ brown skin 0 Red hair 051-65 p 5'9" -6"0" %61 - 200 ❑ red skin 0 Gray hair 0 Over 65 0 Over 6' 0 Over 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 l's _ -

SIGNATURE I v r DAY OF 19_ Y ►^- PRINT NAME

DERTA — White LEGAL — Pink

NYC-WTC 000100842