Proof of Service: Velazquez-Daniels, Nancy vs. Geico General Insurance Company et al

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                                LU PLAIN Tier > AL LUFUNE                EPL,                          Yt UP AUIUIN UNV UL Y BU.
                        TORT - MOTOR VEHICLE TOR                          - CONTRACT -         EQUITABLE RELIEF - OTHER:

                                       COMMONWEALT:                             OF MASSACHUSETTS

                                                HAMPDEN COUNTY
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                                                                                             - SUPERIOR COURT
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we A                                                                                   DEPARTMENT OF THE TRIAL COURT
                                                       MAR‘ 5 2021
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                                                                                            ‘CIVIL ACTION NO,
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           Nana                Volare                   ee                       PLAINTIFF(S)
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                                                                                                               SUMMONS
Qa          "GEICO Genera) ‘oasuan ea. com
           _ GEICO casvallyy              Company;
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Ba                                                                               DEFENDANT(S)
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           To the above named defendant:                 Ge wO                  Corn por ah 0 h
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                     ‘You are hereby summoned and required to serve upon fai AK J. McHugh, ES.
Bg         plaintiff's attomey, whose address is }                             PVC, Hex                                ios,
Ba          an answer to the complaint which is herewith served upon you, within 20 days           setvice of ie summons
           upon you, exclusive of the day of service. If you fail to'do so, judgment by default will be taken-against-you
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           for thetfelief ‘demanded in the complaint. You are also required to file your answer to the complaint in the
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           office Of the Clerk of this court at Springfield either before service upon the plaintiff's attorney or within a
go         reasonable time thereafter.
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                     Unless otherwise provided by rule 13(a), your answer must state as a counterclaim any claim which you
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           may have against the plaintiff which arises out ofthe transaction or occurrence thatis the subject matter of the
qe         plaintiff's claim or you will thereafter be barred from making such claim in any, ofher action.
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            .
22                 Witness, Judith Fabricant, Esq., at Springfield the                         a aed.     day of Beemer
           in the year of our Lord two thousan
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By

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                                                                                  Laura S. Gentile, Esquire
                                                                                  CLERK OF COURTS
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AB         NOTES:
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           1, This summons is issued pursuant to. Rule 4 ofthe Massachusetts Rules of Civil Procedure
           2, When more than one‘defendant is involved, the names of all such defendants should appear in the caption.   Ifa separate summons is used
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           for cach defendant, each should be-addressed to the particnlar defendant.
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Be         FORM No.        1
96
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                                    PROOF OF SERVICE OF PROCESS


  wl hereby certify and retum that on    Mearat ged                   , 20 24 , Iserved a copy of the-within
   summons, together with'a. copy of the complaint, in this action, upon the within named defendant, in the
   following manner (See Mass. R. Civ. P. 4 (d)(1-5):

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 Dated:                                      , 20

                                                                                            :
 NB. 0 PROCESS SERVER;
 PLEASE PLACE DATE YOU MAKE SERVICE ON: DEFENDANT: IN THs BOX ON THE
                                                                 THE
 ORIGINAL AND ON COPY SERVED ON DEFENDANT.



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