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`NO. CV 2015-]062’2
`This Summons is for Gloria Spring Peterson, Tax Collector
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`PROOF OF SERVICE
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`3 I
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`1
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`'Z'Cfi/lrtPf ETC THIS SECTION ON HELD/FRY
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`SENDER; COMPLETE THIS SECHDN
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`I Complete items 1. 2, and 3. Also complete
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`item 4 'rl Restricted Delivery is desired.
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`‘ I Print your name and address on the reverse
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`1 I
`so that we can return the card to you.
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`‘ l Attach this card to the back of the mailpiece.
`or on the front if space permits.
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`D. is delivery address different from item 1? El Yes
`1. Article Addressed to:
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`If YES, enter delivery address below:
`El No
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`3. Service Type
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`grammes Mail
`I: Express Mail
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`Registered
`eturn Receipt for Merchandise f
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`_ CI Insured Mali
`6.0.D.
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`4. Restricted Delivery? (Extra Fee)
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`fl‘mnsfer from service label)
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`PS Form 381 1 ,_ February 2004
`Domestic Fletum Receipt
`rezsesoz-M-isao 5'
`X I am the plaintiff or an attorney of record for the plaintiff in this lawsuit, and I
`served the summons, complaint, declaration of taking, and order of possession on
`the defendant by certified mail, return receipt requested, restricted delivery, as
`shown by the attached signed return receipt.
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`Gloria Spring Peterson
`Benton County Tax Collector
`Admin. Bldg, 215 E. Central Street
`Bentonville, AR 72712
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`El
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`1
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`D I am the plaintiff in this lawsuit, and I mailed a copy of the summons and
`complaint by first-class mail to the defendant together with two copies of a notice
`and acknowledgment and received the attached notice and acknowledgment form
`within twenty days after the date of mailing.
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`El Other [specify]:
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`:l
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`I was unable to execute service because:
`__________________________—____—..————————
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`My fee is $
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`HOLMES83080338GNV28310smaiusanmuses
`’HV'AiililOC)
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`5-2OIUH02StillSIUZ
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`Gil—Hi
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