`Case 1:16-cv-00480-RGA Document 5 Filed 06/30/16 Page 1 of 1 PageID #: 244
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`At) 440 (Rev (tn/12; Summons in a Civil Action (Page 2)
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`Civil Action No. 16—480
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`(This section should not befiied with the court unless required by Fed. R. Civ. P. 4 (1))
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`PROOF OF SERVICE
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`This summons for (Home ul‘iml'iririimi cmdtitt'e. (four) Acuity Brands Lighting, Inc.
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`was received by me on (time)
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`0612712016
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`CI
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`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 (mune)
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`, a person of suitable age and discretion who resides there,
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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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`er served the summons on (name ofind'ivict'uut') Dionne Mills
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`, who is
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`designated by law to accept service ot‘process on behalt'ofnmnw qt'mgam‘mtmu) Corporation Service Company
`:01’
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`Agent for Acuity Brands Lighting, Inc.
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`served @ 8:53am
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`on (time)
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`06128/2016
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`El
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`I returned the summons uncxecutcd because
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`;or
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`l3 Other (speeifti):
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`My fees are S
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`for travel and $
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`for services, for a total of S
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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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`/
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` ‘ m’ver s .s'igimtm'e
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`Adam Golden
`Primed name and title
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`( D
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`M Professional Services
`501 Silverside Rd. Ste 72
`Wilmington DE 19809
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`Date:
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`06l2812016
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`Additional infonnation regarding attempted service. etc:
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`Server '.r address
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