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Case 9:10-cv-81111-WPD Document 5 Entered on FLSD Docket 10/29/2010 Page 1 of 1



    A0440(Rft. 12f09> Summons in a Civil ActKl1t(hae 1)

     Civil Action No.

                                                          PROOF OF SERVICE
                         (T1tis seetion should not be flied willi tlu, eourt ""'- rettulretl by Fed. R. Ch. P. 4 (1))

              This summons for (namt ofiodMdw,J and 11d,. l/..yJ      JEFFREY EPSTEIN
     was re.,-eived by me on(~            Sf/>~ol ;;41r:3·-=--"'----=-----------------
             o I personally served the summons on the individual at fp/ua,J
                                                                                  Oll{dot,J                           ; or

            )J I left the summons at the individual's residence o.-usual place ofabode with /.,,...J -· -· /111'!.~/!_k~---
                                                               ' a person of suitable age and discretion who resides there,
            -~~ (daJe/    QC r;__...,8~(}.-'o-10-_-,an-d-ma-iled- a copy to the individual's last known address; or

             0 I served the summons on ( ~ ofindirid,,afJ                                                                       • who is
              designated by law to accept service of process on behalf of r..,., oforganizatlo•J
                                                                                  on (date)                           ;or
             CJ l rerumed the summons unexecuted because
                                                                     ------------------ ;or
            CJ Other !,p,c!/J'k



             My fcesareS                          for tr,vel and S                 for services,. for a total of S           0.00




    Date:




   Additional information regarding attempted service, etc:


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