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STATEMENT OF SERVICE (DELIVERY) —
STATE OF CONNECTICUT
SMALL CLAIMS
JD-CV-123 Rev. 4-19 SUPERIOR COURT
P.B.§ 24-40 www. jud.ct.gov
21-61370
Instructions
if fled on paper, fill out one (1) form for each defendant. Attach all documents showing how the Small COURT USE ONLY
Claims Writ and Notice of Suit (form JD-CV-40) and related documents were served on (delivered to) SMRSOS
the defendant, and check the box below that applies. Keep all receipts showing how much you paid
to have the Small Claims Writ and Notice of Suit and related documents served on the defendant. {i LAU al
if filed electronically, follow the instructions above and ensure that you select the appropriate name of
the document you are filing.
For service on (delivery to) the defendant:
Grace Britton
(Write name of defendant above)
The Small Claims Writ and Notice of Suit (form JD-CV-40) and related documents, if any, were served on (delivered to) the
defendant named above by:
(Check the box that applies)
1.) IX priority mail with delivery confirmation; delivery confirmation is attached. | paid $ 7.40 for this, or
2.) (certified mail, retum receipt requested, or with electronic delivery confirmation; signed return receipt, or electronic
delivery confirmation, is attached. | paid $ for this, or
3.) () anationally recognized courier service providing delivery confirmation; tracking information showing delivery
is attached. | paid $ for this, or
4.) [a 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.
igned (Plaintif 9x plains represertehiva) Printname Date signed
Joane R. Mueller-London JUN 2 1 2021
Tracking Number: 9405516901047000466719
Delivered to:
Grace Britton
55 Hotchkiss PI Torrington CT 06790-4814
ADA NOTICE
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.gow/ADAEndicia Tracking Page 1 of 3
PACKAGE STATUS
PACKAGE ID: 9405516901047000466719
Delivered, In/At Mailbox June 10, 2021, 11:43 AM, TORRINGTON, CT 06790
Out for Delivery June 10, 2021, 07:58 AM, TORRINGTON, CT 06790
Arrived at Post Office June 10, 2021, 07:47 AM, TORRINGTON, CT 06790
Departed USPS Facility June 10, 2021, 05:56 AM, WATERBURY, CT 06701
Arrived at USPS Facility June 10, 2021, 04:41 AM, TORRINGTON, CT 06790
Arrived at USPS Facility June 10, 2021, 02:01 AM, WATERBURY, CT 06701
Arrived at USPS Regional Facility June 09, 2021, 09:34 PM, SPRINGFIELD MA NETWORK
DISTRIBUTION CENTER
Arrived at USPS Facility June 09, 2021, 05:47 PM, WATERBURY, CT 06701
Departed USPS Regional Facility June 09, 2021, 04:02 PM, SPRINGFIELD MA NETWORK
DISTRIBUTION CENTER
Arrived at USPS Regional Facility June 09, 2021, 01:28 AM, SPRINGFIELD MA NETWORK
DISTRIBUTION CENTER
USPS picked up item June 08, 2021, 01:22 PM, NEWINGTON, CT 06111
Shipping Label Created, USPS Awaiting Item June 07, 2021, 08:45 PM, NEWINGTON, CT
06111
Important Note:
This package tracking Web page was generated by Endicia Internet Postage at the sender's
request. If you have questions about the package delivery, please contact the sender or the
U.S. Postal Service directly. The U.S. Postal Service can be reached at 1-800-ASK-USPS, Endicia
will not be able to answer any delivery questions, as we do not have any information other
than what is shown on this page.
https://www.endicia.com/Tracking 6/16/2021Instructions
1. Piease use a laser or taser-quality printer.
2. Adhere shipping abel to package with tape or glue-
DO NOT TAPE OVER BARCODE. Be sure all edges
are secure. Self-adhesive label is recommended.
3. Place label so it does not wrap around the edge of
the package.
4, Each shipping !abel number is unique and can be
used only once ~ DO NOT PHOTOCOPY,
6. Please use this shipping label on the “ship date”.
6. Ifa mailing receipt is required, present the article
and online label record at a post office for postmark.
Customer Online Label Record
USPS TrackIng® Service Number:
4200 6790 [940 5516 9010 4700 0466 719
Priority Mail, Flat Rate Env with electronic USPS Tracking Service*
Electronic Option USPS Tracking Service Fee: $ 0.00
Total Cost & Fees: $7.40
Weight: 1 lo
Printed: 06/07/2021
PO ZIP Code:: 06111
Ship Date: 06/07/2021
FROM: Russell London
London and London
48 CHRISTIAN LN
NEWINGTON, CT 08111-5481 Usps
Postmark
TO; Grace Britton Here
55 Hotchkiss PI
Torrington, CT 06790-4814
*Postmark required if fee refund requested. Delivery information is not
availabla by phone for the electronic option,
This item was printed using Endicia Internet Printing (www.endicia.com) for account 778446 (Device ID ts 062810895517)
Description: 21-61370
Reference ID: 21-61370
Print 1D: 0
U.S, Postal Service Status:
Unabte to obtain the track/confirm status. The Postal Service Server returned the error: A status update is not yet available on
your Priority Mail® package. It will be available when the shipper provides an update or the package is
delivered to USPS. Check back soon. Sign up for Informed Delivery® to receive notifications for packages
addressed to you,
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STATEMENT OF SERVICE (DELIVERY) — STATE OF CONNECTICUT SMALL CLAIMS JD-CV-123 Rev. 4-19 SUPERIOR COURT P.B.§ 24-40 www. jud.ct.gov 21-61370 Instructions if fled on paper, fill out one (1) form for each defendant. Attach all documents showing how the Small COURT USE ONLY Claims Writ and Notice of Suit (form JD-CV-40) and related documents were served on (delivered to) SMRSOS the defendant, and check the box below that applies. Keep all receipts showing how much you paid to have the Small Claims Writ and Notice of Suit and related documents served on the defendant. {i LAU al if filed electronically, follow the instructions above and ensure that you select the appropriate name of the document you are filing. For service on (delivery to) the defendant: Grace Britton (Write name of defendant above) The Small Claims Writ and Notice of Suit (form JD-CV-40) and related documents, if any, were served on (delivered to) the defendant named above by: (Check the box that applies) 1.) IX priority mail with delivery confirmation; delivery confirmation is attached. | paid $ 7.40 for this, or 2.) (certified mail, retum receipt requested, or with electronic delivery confirmation; signed return receipt, or electronic delivery confirmation, is attached. | paid $ for this, or 3.) () anationally recognized courier service providing delivery confirmation; tracking information showing delivery is attached. | paid $ for this, or 4.) [a 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. igned (Plaintif 9x plains represertehiva) Printname Date signed Joane R. Mueller-London JUN 2 1 2021 Tracking Number: 9405516901047000466719 Delivered to: Grace Britton 55 Hotchkiss PI Torrington CT 06790-4814 ADA NOTICE 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.gow/ADAEndicia Tracking Page 1 of 3 PACKAGE STATUS PACKAGE ID: 9405516901047000466719 Delivered, In/At Mailbox June 10, 2021, 11:43 AM, TORRINGTON, CT 06790 Out for Delivery June 10, 2021, 07:58 AM, TORRINGTON, CT 06790 Arrived at Post Office June 10, 2021, 07:47 AM, TORRINGTON, CT 06790 Departed USPS Facility June 10, 2021, 05:56 AM, WATERBURY, CT 06701 Arrived at USPS Facility June 10, 2021, 04:41 AM, TORRINGTON, CT 06790 Arrived at USPS Facility June 10, 2021, 02:01 AM, WATERBURY, CT 06701 Arrived at USPS Regional Facility June 09, 2021, 09:34 PM, SPRINGFIELD MA NETWORK DISTRIBUTION CENTER Arrived at USPS Facility June 09, 2021, 05:47 PM, WATERBURY, CT 06701 Departed USPS Regional Facility June 09, 2021, 04:02 PM, SPRINGFIELD MA NETWORK DISTRIBUTION CENTER Arrived at USPS Regional Facility June 09, 2021, 01:28 AM, SPRINGFIELD MA NETWORK DISTRIBUTION CENTER USPS picked up item June 08, 2021, 01:22 PM, NEWINGTON, CT 06111 Shipping Label Created, USPS Awaiting Item June 07, 2021, 08:45 PM, NEWINGTON, CT 06111 Important Note: This package tracking Web page was generated by Endicia Internet Postage at the sender's request. If you have questions about the package delivery, please contact the sender or the U.S. Postal Service directly. The U.S. Postal Service can be reached at 1-800-ASK-USPS, Endicia will not be able to answer any delivery questions, as we do not have any information other than what is shown on this page. https://www.endicia.com/Tracking 6/16/2021Instructions 1. Piease use a laser or taser-quality printer. 2. Adhere shipping abel to package with tape or glue- DO NOT TAPE OVER BARCODE. Be sure all edges are secure. Self-adhesive label is recommended. 3. Place label so it does not wrap around the edge of the package. 4, Each shipping !abel number is unique and can be used only once ~ DO NOT PHOTOCOPY, 6. Please use this shipping label on the “ship date”. 6. Ifa mailing receipt is required, present the article and online label record at a post office for postmark. Customer Online Label Record USPS TrackIng® Service Number: 4200 6790 [940 5516 9010 4700 0466 719 Priority Mail, Flat Rate Env with electronic USPS Tracking Service* Electronic Option USPS Tracking Service Fee: $ 0.00 Total Cost & Fees: $7.40 Weight: 1 lo Printed: 06/07/2021 PO ZIP Code:: 06111 Ship Date: 06/07/2021 FROM: Russell London London and London 48 CHRISTIAN LN NEWINGTON, CT 08111-5481 Usps Postmark TO; Grace Britton Here 55 Hotchkiss PI Torrington, CT 06790-4814 *Postmark required if fee refund requested. Delivery information is not availabla by phone for the electronic option, This item was printed using Endicia Internet Printing (www.endicia.com) for account 778446 (Device ID ts 062810895517) Description: 21-61370 Reference ID: 21-61370 Print 1D: 0 U.S, Postal Service Status: Unabte to obtain the track/confirm status. The Postal Service Server returned the error: A status update is not yet available on your Priority Mail® package. It will be available when the shipper provides an update or the package is delivered to USPS. Check back soon. Sign up for Informed Delivery® to receive notifications for packages addressed to you,