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Page 1 of 12 PageID 20
v.
Goodwin Orthodontics, PLLC, et al
Defendant
)
)
)
)
)
)
)
CLERK OF COURT
DATE: 03/06/2012
Signature of Clerk or Deputy Clerk
Page 2 of 12 PageID 21
I left the summons at the individual's residence or usual place of abode with (name) ___________________________
____________________________________________________, a person of suitable age and discretion who resides there,
on (date) __________________________________________, and mailed a copy to the individual's last known address; or
Date: ______________________
______________________________________________________
Server's signature
______________________________________________________
Printed name and title
______________________________________________________
Server's address
Page 3 of 12 PageID 22
v.
Goodwin Orthodontics, PLLC, et al
Defendant
)
)
)
)
)
)
)
CLERK OF COURT
DATE: 03/06/2012
Signature of Clerk or Deputy Clerk
Page 4 of 12 PageID 23
I left the summons at the individual's residence or usual place of abode with (name) ___________________________
____________________________________________________, a person of suitable age and discretion who resides there,
on (date) __________________________________________, and mailed a copy to the individual's last known address; or
Date: ______________________
______________________________________________________
Server's signature
______________________________________________________
Printed name and title
______________________________________________________
Server's address
Page 5 of 12 PageID 24
v.
Goodwin Orthodontics, PLLC, et al
Defendant
)
)
)
)
)
)
)
CLERK OF COURT
DATE: 03/06/2012
Signature of Clerk or Deputy Clerk
Page 6 of 12 PageID 25
I left the summons at the individual's residence or usual place of abode with (name) ___________________________
____________________________________________________, a person of suitable age and discretion who resides there,
on (date) __________________________________________, and mailed a copy to the individual's last known address; or
Date: ______________________
______________________________________________________
Server's signature
______________________________________________________
Printed name and title
______________________________________________________
Server's address
Page 7 of 12 PageID 26
v.
Goodwin Orthodontics, PLLC, et al
Defendant
)
)
)
)
)
)
)
CLERK OF COURT
DATE: 03/06/2012
Signature of Clerk or Deputy Clerk
Page 8 of 12 PageID 27
I left the summons at the individual's residence or usual place of abode with (name) ___________________________
____________________________________________________, a person of suitable age and discretion who resides there,
on (date) __________________________________________, and mailed a copy to the individual's last known address; or
Date: ______________________
______________________________________________________
Server's signature
______________________________________________________
Printed name and title
______________________________________________________
Server's address
Page 9 of 12 PageID 28
v.
Goodwin Orthodontics, PLLC, et al
Defendant
)
)
)
)
)
)
)
CLERK OF COURT
DATE: 03/06/2012
Signature of Clerk or Deputy Clerk
Page 10 of 12 PageID 29
I left the summons at the individual's residence or usual place of abode with (name) ___________________________
____________________________________________________, a person of suitable age and discretion who resides there,
on (date) __________________________________________, and mailed a copy to the individual's last known address; or
Date: ______________________
______________________________________________________
Server's signature
______________________________________________________
Printed name and title
______________________________________________________
Server's address
Page 11 of 12 PageID 30
v.
Goodwin Orthodontics, PLLC, et al
Defendant
)
)
)
)
)
)
)
CLERK OF COURT
DATE: 03/06/2012
Signature of Clerk or Deputy Clerk
Page 12 of 12 PageID 31
I left the summons at the individual's residence or usual place of abode with (name) ___________________________
____________________________________________________, a person of suitable age and discretion who resides there,
on (date) __________________________________________, and mailed a copy to the individual's last known address; or
Date: ______________________
______________________________________________________
Server's signature
______________________________________________________
Printed name and title
______________________________________________________
Server's address