Preview
STATEMENT OF SERVICE — (DELIVERY) . ; 17-14987
SMALL CLAIMS Tracking Number: 9405515901047000440798
JD-CV-123 New 1-11
Instructions
Fill out 1 form for each defendant. Attach all documents that show how the Small Claims Writ and
Notice of Suit and related documents were served on (delivered to) the defendant, and check the box
below that applies. Keep all receipts that show how much you paid to have the Small Claims Writ and
Notice of Suit and related documents served on (delivered to) the defendant.
For service on (delivery to) the Defendant:
MATTHEW BARKS _
(Write name of Defendant)
et
The attached Small Claims Writ and Notice of Suit with related documents, if any, were served on
(delivered to) the defendant named above by:
(Check the box that applies)
4.) EX priority mail with delivery confirmation; delivery confirmation is attached. |paid$ 5.95 for this, or
2.) C1 certified mail, return receipt requested; signed return receipt is attached. | paid $ . for this, pr
3.) [1] anationally recognized courier service providing delivery confirmation; tracking information showing delivery
is attached. | paid $ for this, or
4.) (1a proper officer in the manner in which a writ of summons is served in a civil action; officer's return of service
filed with the court. 2
2 Signature of Plaintiff or Plaintiffs Representative
(Check one)
(7 Plaintiff Plaintiff's representative
Type or print name of signer
. vay be
Toby J. Rhinesmith
Date Aug 0 9 2017
The Judicial Branch of the State of Connecticut complies with the ‘Americans with Disabilities Act
(ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court
clerk or an ADA contact person listed at www.jud.ct.gov/ADA/.
a :Endicia Account - Tools -" kup Package - Detail
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Package Status
Details Notifications
” Bhi Weight: 4 Lbs.
hip To rom Mail Class: Priority Mail Flat Rate Envelope
MATTHEW BARKS London & London Delivery Confirmation
524 PROVIDENCE PIKE Russell London Postage: $5.95
PUTNAM, CT 06260-2515 48 ChristianLane Declared Value $0.00
Newington, CT 06111-6111 Package JD: 9405515901047000440798
(880) 668-400 Printed on: 08/04/17 - 12:37:24 PM
Group Code: SAmosd04y17hm25s
Description: 17-14987°
Refund Request Status: Unknown
Estimated Date: N/A
Form ID: N/A
Summary Status .
Your item was delivered in or at the mailbox at 11:47 am on August 7, 2017 in PUTNAM, CT 06260.
Detailed Results
Postmarked: 08/04/17 Reference ID: 17-14987
Page | of 1
@
| Your tem was deliveredin or at the mailbox at 11:47 am on August 7, 2017 In PUTNAM, CT 06260.
Out for Delivery, August 7, 2017, 8:49 am, PUTNAM, CT 06260
Sorting Complete, August 7, 2017, 8:39 am, PUTNAM, CT 06260
| Arrived at Post Office, August 7, 2017, 6:51 am, PUTNAM, CT 06260
“| Departed USPS Regional Facility, August 6, 2017, 3:47 am, SPRINGFIELD MA NETWORK DISTRIBUTION CENTER
Artived at USPS Regional Facility, August 6, 2017, 12:57 am, SPRINGFIELD MA NETWORK DISTRIBUTION CENTER
Accepted at USPS Origin Facility, August 5, 2017, 11:42 pm, NEWINGTON, CT 08114
Shipping Label Created, USPS Awaiting ifn, August 4, 2017, 11:37 am, NEWINGTON, CT 06141
View USPS Details
Become an Affiliate
Eam cash for referrals ~
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© Copyright 2000 - 2017, Endicia, All rights reserved.
https://www.endicia.com/Account/Ti ools/LookupPackage/Detail/default.cfin?Tracki
1-800-876-3279 | PRIVACY POLICY | USPS GUIDELINES
8/9/2017
Preview
STATEMENT OF SERVICE — (DELIVERY) . ; 17-14987 SMALL CLAIMS Tracking Number: 9405515901047000440798 JD-CV-123 New 1-11 Instructions Fill out 1 form for each defendant. Attach all documents that show how the Small Claims Writ and Notice of Suit and related documents were served on (delivered to) the defendant, and check the box below that applies. Keep all receipts that show how much you paid to have the Small Claims Writ and Notice of Suit and related documents served on (delivered to) the defendant. For service on (delivery to) the Defendant: MATTHEW BARKS _ (Write name of Defendant) et The attached Small Claims Writ and Notice of Suit with related documents, if any, were served on (delivered to) the defendant named above by: (Check the box that applies) 4.) EX priority mail with delivery confirmation; delivery confirmation is attached. |paid$ 5.95 for this, or 2.) C1 certified mail, return receipt requested; signed return receipt is attached. | paid $ . for this, pr 3.) [1] anationally recognized courier service providing delivery confirmation; tracking information showing delivery is attached. | paid $ for this, or 4.) (1a proper officer in the manner in which a writ of summons is served in a civil action; officer's return of service filed with the court. 2 2 Signature of Plaintiff or Plaintiffs Representative (Check one) (7 Plaintiff Plaintiff's representative Type or print name of signer . vay be Toby J. Rhinesmith Date Aug 0 9 2017 The Judicial Branch of the State of Connecticut complies with the ‘Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA/. a :Endicia Account - Tools -" kup Package - Detail (800) 576-3278 | sienouT {| —@) | Home Products Store Partners Developers Support ‘My Account Account Summary Update Profile v Software 7 Tools * Reports Help Track your Package Status Details Notifications ” Bhi Weight: 4 Lbs. hip To rom Mail Class: Priority Mail Flat Rate Envelope MATTHEW BARKS London & London Delivery Confirmation 524 PROVIDENCE PIKE Russell London Postage: $5.95 PUTNAM, CT 06260-2515 48 ChristianLane Declared Value $0.00 Newington, CT 06111-6111 Package JD: 9405515901047000440798 (880) 668-400 Printed on: 08/04/17 - 12:37:24 PM Group Code: SAmosd04y17hm25s Description: 17-14987° Refund Request Status: Unknown Estimated Date: N/A Form ID: N/A Summary Status . Your item was delivered in or at the mailbox at 11:47 am on August 7, 2017 in PUTNAM, CT 06260. Detailed Results Postmarked: 08/04/17 Reference ID: 17-14987 Page | of 1 @ | Your tem was deliveredin or at the mailbox at 11:47 am on August 7, 2017 In PUTNAM, CT 06260. Out for Delivery, August 7, 2017, 8:49 am, PUTNAM, CT 06260 Sorting Complete, August 7, 2017, 8:39 am, PUTNAM, CT 06260 | Arrived at Post Office, August 7, 2017, 6:51 am, PUTNAM, CT 06260 “| Departed USPS Regional Facility, August 6, 2017, 3:47 am, SPRINGFIELD MA NETWORK DISTRIBUTION CENTER Artived at USPS Regional Facility, August 6, 2017, 12:57 am, SPRINGFIELD MA NETWORK DISTRIBUTION CENTER Accepted at USPS Origin Facility, August 5, 2017, 11:42 pm, NEWINGTON, CT 08114 Shipping Label Created, USPS Awaiting ifn, August 4, 2017, 11:37 am, NEWINGTON, CT 06141 View USPS Details Become an Affiliate Eam cash for referrals ~ apouTus | contactus | Joss | siTE MAP © Copyright 2000 - 2017, Endicia, All rights reserved. https://www.endicia.com/Account/Ti ools/LookupPackage/Detail/default.cfin?Tracki 1-800-876-3279 | PRIVACY POLICY | USPS GUIDELINES 8/9/2017