Affidavit of service form, 19 Church Street, Oct 2001

NYC 9/11 Public Portal Document

AFFIDAVIT OF SERVICE

STATE OF NEW YORK, COUNTY OF /1~ ew Y Y k Theimdersigned being duly swurns, deposes and says: The 0C Z rs a party to the action is I8 of age. What on 2 2 at3 a .Mat c S 'v HG ~f deponent served the within ORDER on the respondent named therein. 1. Individual personal service ❑ by delivering a true copy to said respondent personally 2.Individual substitued service Xby delivering a true copy to a person of suitable age and discretion. Said promises is respondent's actual place of business-dvuelling house or usual place of abode within the state. 3. Corporation /,, j /u , Y(by a true copy to L It o,Y t e /'1 K! ii h S 10 / n 4 a` v at said coporation. (Paitioo) 4. Delivery to p VAt at premises bdJPM on a at g I attempted to personally serve the herein O ER 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, '1having entered the lraini1es and having ' fed myself, I was: $advised by C h Qr i s /}? u / /I A s that the respondent was not then present

❑ mable to secure identification of the persoo(s) present; ❑ advised by that no officer, director, managing 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 wham I believe to be an employee of respondeent at the premises because: Employee so identified 'Employee was perfuming work ❑Other himself/llaaeN oomistent with being employed by the respondent

of individual - (this must be completed for all types of service except oerparatioa) Deponent describes the individual as follows: 41male l 'white skin OB1ack hair 014-20 yrs ❑ Under S 0 Under 100 lbs 0 female 0 black skin C]Brown hair 021-35 0 5'0"-5'3" ❑ 101-130 ❑ yellow skin O Blood lair 036-50 D5'4"-5'8' 0131-160 ❑ brawn slap ❑ Red hair *51-65 '5'9"-6'0' aL 161-200 ❑ red skin ) tiGray hair ❑ Over 65 ❑ Over 6' ❑ Over 200 ❑ White hair ❑ Balding Other identifying dmracteristic:

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 42h G%l. u -

DAY OF 19_ • e rT ft A. Can d_ PR1Nf NAt&

DERTA — White LEGAL — Pink

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NYC-WTC 000126949