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Case 1:14-cv-01453-LPS Document 1-4 Filed 12/02/14 Page 1 of 1 PageID #: 51
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`'
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`EIPT FOR AO FORM 85 AND AO FORM 85A
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`United States District Court for the District of Delaware
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`Civil Action No.
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`1 4 - 1 4 5 3
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`ACKNOWLEDGMENT OF RECEIPT
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`A
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`FOR:
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`A0 FORM 85 NOTICE CONSENT AND REFERENCE OF A CIVIL CASE
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`TO A MAGISTRATE JUDGE
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`AND
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`A0 FORM 85A NOTICE. CONSENT AND REFERENCE OF A
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`DISPOSITIVE MOTION TO A MAGISTRATE JUDGE.
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`I hereby acknowledge receipt of 3 copies ofAO forms 85 and 85A.
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`DEC
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`22014
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`I
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`(Date forms provided)
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`9
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`(Signa ure of
`rson receiving forms)
`Y.r‘&&,,,<S¢.,.,_%é'
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`(Printed name of recipient/name of firm
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`NOTE:
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`Signed receipt form will be filed and docketed.

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