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`July 15, 2019
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`Jenny
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`Kiry Gray
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` Jennylam
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`/s/
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`Case 8:19-cv-01151-JLS-DFM Document 14 Filed 07/15/19 Page 2 of 2 Page ID #:83
`Case 8:19-cv-01151-JLS-DFM Document 14 Filed 07/15/19 Page 2 of 2 Page ID #:83
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`A0 440 (Rev. 06! 12) Summons in a Civil Action (Page 2)
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`Civil Action No. 8:19-CV-01151 —JLS—DFM
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`(This section should not befilea' with the cow: unless required by Fed. R. Civ. P. 4 (1))
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`PROOF OF SERVICE
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`This summons for (amaze of individual and title, :j’any)
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`was received by me on (date)
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`I3 I personally served the summons on the individual at (place)
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`on (date)
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`; or
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`D I left the summons at the individual’s residence or usual place of abode with (flame)
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`on (date)
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`, and mailed a copy to the individual’s last known address; or
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`, a person of suitable age and discretion who resides there,
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`Cl
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`I served the summons on meme ofindividuay
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`, who is
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`designated by law to accept service of process on behalf of (name oforganization)
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`on (date)
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`; or
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`Cl
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`I returned the summons unexecuted because
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`; or
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`D Other fis-pecifir):
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`My fees are $
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`for travel and $
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`for services, for a total of $
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`0.00
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`I declare under penalty of perjury that this information is true.
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`Date:
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`Server ’5 signature
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`Printed name and title
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`Server '5 address
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`Additional information regarding attempted service, etc:
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