Civil No.: MC09-00xxxx

NAME OF SERVER:                                          TITLE: 
Joe Patriot                                              PETITION TO QUASH
                                                         3RD PARTY SUMMONS

The above referenced document for: United States Attorney

was received by me on July 31, 2009.

Check one box below to indicate appropriate method of service:

□ Served personally upon the defendant. Place where served:___________

□ Left copies thereof at the Respondent’s dwelling house or usual place of abode with a person of suitable age and discretion then residing therein. Name of person with whom the summons and complaint were left:____________

□ Returned unexecuted:

□ Other (specify):

Process server has caused to be sent by certified mailing, return receipt requested (see attached below), postage prepaid, a true and correct copy thereof, to:

United States Attorney
Two Renaissance Square
Central Avenue, Ste 1200
Phoenix, AZ 85004

My fees are $_0.00___for travel and $_0.00______ for services for a total of $__0.00.


I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct.

Executed on:

Date:________________________                             ________________________ 
                                                          Server Signature 
                                                          Joe Patriot 
                                                          Anytown, USA