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  • RTG MANAGEMENT LLC v. ELDESOUKY, ANHARS55 - Small Claims - Small Claims - Tort - Other document preview
  • RTG MANAGEMENT LLC v. ELDESOUKY, ANHARS55 - Small Claims - Small Claims - Tort - Other document preview
						
                                

Preview

STATEMENT OF SERVICE (DELIVERY) — STATE OF CONNECTICUT SMALL CLAIMS SUPERIOR COURT JO-CV-123 Rev. 419 www jud ct gov PB. § 24-10 Sc Instructions If filed 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) MRSOS: 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. AULA 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: Anhar Eldesovky (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 fo) the defendant named above by: (Check the box that applies) 1) (1 priority mail with delivery confirmation; delivery confirmation is attached. | paid $ for this, or 2) gi certified mail, return receipt requested, or with electronic delivery confirmation, signed return receipt, or electronic delivery confirmation, is attached. | paid $ q 4 qd for this, or 3.) [Ja nationally recognized courier service providing delivery confirmation; tracking information showing delivery is attached. | paid $ for this, or 4.) (Ja 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. odd Ati hrive Tedd Sh vvMineie fio /23 ‘Signed (Plamtiff or plambiff's representative) TPitnt ame Date signed TaN e) SS Wlerel yak ie enon) Rese hae aac on lolol =O= URS orsCRT ol 8 Complete items 1, 2, and 3. A. Signature 7 esaa a ens) el oo 8 OAgent | Print your name and address on the reverse so that we can return the card to you. x. D1 Addressee ee 1 TTT §t Attach this card to the back of the mallpiece, or on the front if space permits. Ty Article Addressed to: B. POBLD D. Is delivery address diferent ©, Date of Delivery Slee from item 17. I Yes A ru mu Hang ora: «7 paras Ted Mall Foo 7 = a IFYES, enter delivery address below: 1] No A10nhav Eldesovky ( Pearl St sio eeemaa Reture Racaipt return Receipt tectonic) 3 z a AR AVE, | Ccertied Mat Rectited Deivey $b Hero the + 40e Py | Coadut sonata Rogured 8 rt BA CT 0603 Try | ladun sinature Restricted Devry $ Postage $1.59 a 3. Service Type AUG 29 a, HORA A 1D Adult Registered Mail™ 9 [rota Oe a Aci Signature Restricted Dotvery 1 Registered Mall Restricted ols Certified Mail Restricted Delivery Signature Confirmation™ [Sent To 9590 9402 7522 2098 3893 68 1G Collecton: ro CiFi Collect 9 ISiréat arid) ABE'NG., oF PO BOK NG. 2. Article Number (Transfer from service label) inevendonBe Delivery Restricted Delivery Detivery Usps. i Restricted Delivery OF [ei States Zi Ta" 9589 O?710 5270 LObe 2437 69 >S Form 3811, July 2020 PSN 7530-02-000-8053 Domestic Return Receipt | ms tere e ea z couergnnsy = —— ee