Form or log page, 148 Chambers Street, July 2002

NYC 9/11 Public Portal Document

AFFIDAVIT OF SERVICE

STATE OF NEW YORK, COUNTY OF New Yo" K The undersigned being duly sw~encdns, deposes and says: ex 0 0 ~acon 5 ~ ~ _ .fir_ ait W3 rn .M /' ' bt ~ S -f- • deponent served the within ORDER on the respondent named therein. 1. Individual personal service O by delivering a true copy to said respondent personally 2. Individual substitued service O by delivering a true copy to a person of suitable age and discretion. Said premises is respondent's actual place of bus dweelling house or usual play of abode within the state. 3. Corporation ❑ by delivering a true copy to at said copaation. O 4. Delivery to emploryee at pr nines I ~dAr s'4-. I attempted to personally serve the herein O ER on the respondent named herein but was unable to do because: O having attempted entry to the premises, I found the premises locoed and no one responded to any bells, knocks, or calls; O having entered the pcemisea 6aviirg myself, I was: O advised by to z e flat the respondent was not then present

❑ unable to sense identification oldie person(s) present; O advised by that no officer, dhectcw, maasging QNMA) agent or general agent cfthe respondent was present; ❑ service could not be made because

Thereupon, I delivered a copy of the h rein ORDER to i►7 C wlrom I believe to be an employee of responeent at the premises because: i himselflherself consistent with be loyed ~ ter< SS o LL'I m aT r i'r' rl 00 by the respondent

Desexiptioo of individual - (this must be completed for all types of service except corporation) Depoomnt describes the individual as fdlows: 'male l 'white skin CBlack hair 014-20 yrs 0 Under 5' O Under 100 lbs 0 female ❑ black skin OBrmwn hair 021-35 0 5'0"-5'3" 0101-130 D yellow skin O Blood hair ' 36-50 ❑ 5'4"-5'S" ❑ 131-160 O brown skin ❑ Red hair ❑ 51 -65 '5'9".6"0" 1(161-200 ❑ red skin 1d'Gray hair O Over 65 O Over 6' ❑ Over 200 0 White hair %Bdhlg Other identifying chara ristic:

5. Service by Mail OBy mailing a true copy to respondent by depositing or enuring to be deposited the same, in a post paid mapper, in a post office station regularly maiiined by the U.S. Postal Service.

SWORN TO BEFORE ME ON THE 4~ ' --Z DAY OF 19_ .5u' PRINT NAME m. C tc a a

DERTA - White LEGAL - Pink

J NYC-WTC 000127150