Preview
@ @
LAS Qe — (DELIVERY)
SMALL CLAIMS
JD-CV-123 New 1-11
Instructions
Fill out 1 form for each defendant. Attach all documents that show how the Smell Claims Whit and.
Notice of Suit and related documents were served on (delivered to) the defendant, and check the box
below that applies Keep al receipts thet show how muoh yo Po ae amen Guim ¥ Wiit'end
Notice of Suit and related documents served on (delivered to) the defendant.
Recap on conor ernment Ham Synth
(Wiite name of Defendant)
‘The attached ginal Claims Writ and Notios of Suit with related documents, if any, were served on:
(delivered to) the defendant named above by:
" (Check the box that applies)
. 1), Bi prorty man with cevery confirmation; delivery confmation fe attached bpaid $ Q. FD >: for this, or
2.) (1 certified mail, retum receipt réquested: signed. return réceipt is attached, I paid $ : for this, or °
xO a nationally recognized:courier service providing delivety confirmation; wacting information showing delivery”
" jsattached. | paid S. . for this, or
4) (a proper officer in the manner in which a writ of sumrtions Is served ina evil action; officer's retum of service
“filed with the court. . *,
~ ignature of Plaintiff or Pléiatifs Representative oe
"(Cheek one)
oO Plaintiff {] Plaintiffs representative .
Type or print name of signer oo Date ¢ ants
Holly Nelen, Esq. . . + 2 8 é g 1h *.
The Judicial Branch of the State of Connecticut t complias w with the Ar ‘Americans with Disabilities Aah
(ADA). If you.need a reasonable accommodation in accordance withthe ADA, contact a court -
Glerk or an ADA contact person listed at www.jud.ct.gov/ADA/.-Endicia Account - Reports - Co - Detail Page 1 of 2
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Package Status
Details Notifications
Ship To From Weight: 1 Lbs.
-Mall Clase: Priority Mail Critical Mail Letter
WILLIAM SMITH Donna Porter . Delivery Confirmation
35 STRONG TER 510 Tolland St Postage: $3.50
WINSTED, CT 06098-6098 East Hartford, CT 06108-2523 Dactared Value $0.00
(860) 528-0991 Package ID: 9476015969005804420924
Printed on: 08/19/14 - 8:21:06 AM
Postmarked: 08/19/14 Reference ID: X39842
Group Code: 0 Description: X39842
: BarfarsiRequest Status:
: Estimated Date: N/A
Form ID: N/A
Summary Status
Your item was delivered at 4:06 pm on August 20, 2014 in WINSTED, CT 06098.
Detailed Results
Your item was delivered at 4:08 pm on August 20, 2044 in WINSTED, CT 06088.
Out for Delivery, August 20, 2014, 8:39 am, WINSTED, CT 06098
| Sorting Complete, August 20, 2014, 8:29 am, WINSTED, CT 06098
| Arived at Post Office, August 20, 2014, 6:39 am, WINSTED, CT 06098
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'
Departed USPS Facility, August 20, 2014, 2:11 am, HARTFORD, CT 06101
| Arrived at USPS Origin Facility, August 19, 2014, 10:14 pm, HARTFORD, CT 06101
: Accepted at USPS Origin Sort Facility. August 19, 2014, 8:59 pm, EAST HARTFORD, CT 06108
| Shipping Label Created, August 19, 2014, 12:21 pm. EAST HARTFORD, CT 06108
View USPS Details
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Eam cash for referrals
Agoutus | coNnTAcTUs | JoBs | SITEMAP 1-800-576-3279 | PRIVACY POLICY | USPS GUIDELINES
https://www.endicia.com/Account/Reports/Transactions/Detail/default.cfm?TrackingNumbe... 9/8/2014
Preview
@ @ LAS Qe — (DELIVERY) SMALL CLAIMS JD-CV-123 New 1-11 Instructions Fill out 1 form for each defendant. Attach all documents that show how the Smell Claims Whit and. Notice of Suit and related documents were served on (delivered to) the defendant, and check the box below that applies Keep al receipts thet show how muoh yo Po ae amen Guim ¥ Wiit'end Notice of Suit and related documents served on (delivered to) the defendant. Recap on conor ernment Ham Synth (Wiite name of Defendant) ‘The attached ginal Claims Writ and Notios of Suit with related documents, if any, were served on: (delivered to) the defendant named above by: " (Check the box that applies) . 1), Bi prorty man with cevery confirmation; delivery confmation fe attached bpaid $ Q. FD >: for this, or 2.) (1 certified mail, retum receipt réquested: signed. return réceipt is attached, I paid $ : for this, or ° xO a nationally recognized:courier service providing delivety confirmation; wacting information showing delivery” " jsattached. | paid S. . for this, or 4) (a proper officer in the manner in which a writ of sumrtions Is served ina evil action; officer's retum of service “filed with the court. . *, ~ ignature of Plaintiff or Pléiatifs Representative oe "(Cheek one) oO Plaintiff {] Plaintiffs representative . Type or print name of signer oo Date ¢ ants Holly Nelen, Esq. . . + 2 8 é g 1h *. The Judicial Branch of the State of Connecticut t complias w with the Ar ‘Americans with Disabilities Aah (ADA). If you.need a reasonable accommodation in accordance withthe ADA, contact a court - Glerk or an ADA contact person listed at www.jud.ct.gov/ADA/.-Endicia Account - Reports - Co - Detail Page 1 of 2 : : : (800) 876-3279 | sicnouT | (0) | © | Home Products : Store Partners Developers Support My Account Account Summary Update Profile ¥ Software ¥ Tools ¥ Reports ¥ Help Track your Package Status Details Notifications Ship To From Weight: 1 Lbs. -Mall Clase: Priority Mail Critical Mail Letter WILLIAM SMITH Donna Porter . Delivery Confirmation 35 STRONG TER 510 Tolland St Postage: $3.50 WINSTED, CT 06098-6098 East Hartford, CT 06108-2523 Dactared Value $0.00 (860) 528-0991 Package ID: 9476015969005804420924 Printed on: 08/19/14 - 8:21:06 AM Postmarked: 08/19/14 Reference ID: X39842 Group Code: 0 Description: X39842 : BarfarsiRequest Status: : Estimated Date: N/A Form ID: N/A Summary Status Your item was delivered at 4:06 pm on August 20, 2014 in WINSTED, CT 06098. Detailed Results Your item was delivered at 4:08 pm on August 20, 2044 in WINSTED, CT 06088. Out for Delivery, August 20, 2014, 8:39 am, WINSTED, CT 06098 | Sorting Complete, August 20, 2014, 8:29 am, WINSTED, CT 06098 | Arived at Post Office, August 20, 2014, 6:39 am, WINSTED, CT 06098 ' ' Departed USPS Facility, August 20, 2014, 2:11 am, HARTFORD, CT 06101 | Arrived at USPS Origin Facility, August 19, 2014, 10:14 pm, HARTFORD, CT 06101 : Accepted at USPS Origin Sort Facility. August 19, 2014, 8:59 pm, EAST HARTFORD, CT 06108 | Shipping Label Created, August 19, 2014, 12:21 pm. EAST HARTFORD, CT 06108 View USPS Details Become an Afflliate Eam cash for referrals Agoutus | coNnTAcTUs | JoBs | SITEMAP 1-800-576-3279 | PRIVACY POLICY | USPS GUIDELINES https://www.endicia.com/Account/Reports/Transactions/Detail/default.cfm?TrackingNumbe... 9/8/2014