New York
New York lawyers serving the public good.

United States District Court

                        SOUTHERN               DISTRICT OF                        NEW YORK                          

Plaintiff’s Name

 

 

SUMMONS IN A CIVIL CASE

v.

CASE NUMBER:  LEAVE BLANK

Defendant’s Name

 

 

 

TO: (Name and address of defendant)

LEAVE BLANK

YOU ARE HEREBY SUMMONED and required to serve upon PLAINTIFF’S ATTORNEY (name and address)

Attorney’s Name and Address

 

 

 

an answer to the complaint which is herewith served upon you, within  20 or 30 or 60*    days after service of this summons upon you, exclusive of the day of service. If you fail to do so, judgment. by default will be taken against you for the relief demanded in the complaint. You must also file your answer with the Clerk of this Court within a reasonable period of time after service.

* choose one:

60 = federal agencies or employees
30 = Freedom of Information Act actions
20 = all others

 

                                                                                               
CLERK

                                                                                               
DATE

                                                                                               
(BY) DEPUTY CLERK

 


 


RETURN OF SERVICE

 

Service of the Summons and Complaint was made by me1

DATE

NAME OF SERVER (PRINT)

 

TITLE

Check one box below to indicate appropriate method of service

 

¨

Served personally upon the defendant. Place where served:                                                                                                                                                                                                                                                                       

 

 

¨

Left copies thereof at the defendant’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):                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                           

 

STATEMENT OF SERVICE FEES

TRAVEL

 

SERVICES

TOTAL

DECLARATION OF SERVER

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

                                                                                               
Signature of Server

 

 

 

 

                                                                                               
Address of Server

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) As to who may serve a summons see Rule 4 of the Federal Rules of Civil Procedure.

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