Affidavit of Service form, 1 Park Row, undated

NYC 9/11 Public Portal Document

% • y.Od AFFIDAVIT OF SERVICE

STATE OF NEW YORK, COUNTY OF NEW r K 13m undersigned beingduly ffi says to as I8 years of That '~ tg ®•Z

UMM~z ORDER the respande ti mmed t1mrein. 1. hhdividual personal service D by delivering a true copy to said respondent personally 2. Individual sabditued service ~bydeliveriesatithecopydo £tLtG R/EJ)E'FS)TtA/ ` S`TORE MANAC, EA. a person of suitable age and discretion. Said premises is respondent's actual place of bus dwelling house ore cal place ofabode withinthe state. 3. Corporation D by delivering a true copy to at said coparation. (Po~ttan) 4. Delivery to employee at premises DAL A.M/PM on et I attempted to personally serve the herein ORDER an She respCadent named lherein bnt was unable to do because: D having attempted enhy to the premises, I found She premises locoed and nD one responded to any balls. k , or call 0 having entered the premises anal having ids ad iml myself, I was: 0 advised by that tin respondent was not Shenpresent ( ) 0 unable to sea identtfcaticn of the person(s) pry 0 advised by that rho officer, director. managing (NM) aged or agent (w general loft respondent was pxesent 0 service could not be made be"mare

Thereupon, I delivered a copy of the herein ORDER to whom I believe to be an empl~ee of respondeent attire premises because: DEmployee so identifed DFanplcyee was perfanamgwork DOther hmseWhemelf amaisteat with being emplayod bytharespondact Descaiptim of individual - (this mast be ocanpieted for all types of service except corporation) Deponent describes the individual as follows: male ,fw uite skin DBiack hair 014 -20 yrs D Under S ❑ Under 1001bs D Raaale 0 black stets Prownhair D 21-35 D 5'0"-5'3' 0101-130 D yellow skin D Blondhair 036-50 C15'4"-5' 0131-160 D brown skin D Red hair x.'51- 65 )r S9" 5'0' J661-200 0 red skin 0 Gray hair D Oher 65 D Over e D Over 200 0 White hair ❑ Balding Other i 5. Service byMail OBy ~1{ng a true copy to respondent by depodting ar' causing m be depo~ted t1w same, in a post laid wrapper, in a post office statieflre gularly maiatahhed by the U.S. Postal Service..

SWORN TO BEFORE NX ON THE " - T 4E DAY OF 19_ ~ PED NAME

DERTA — White LEGAL — Pink

NYC-WTC 000115770