This re copy is provided a a courtesy by Jack Jaffa & Associates Rat Estare Consuurasts FDNY SUMMONS + FOR CIVIL PENALTIES ONLY Ns]8 (SS @ muaguu sunnwons numpen: esos a Ee aeunliense xu pHone: DATE OF OCCURRENCE: Gut ruc orinsrecypy LZ, 2D pat om puace or occunnence: 6 SC Cinsvertl€ Ave sonoust: e we ‘You must respond to this shmnmons ou can appear atthe bearing date and octiontblow or choose another option For ther options ‘on how to respond, see the back of hs po8e wearin pate: Cf) C15 w-.30.0m wot YG JOCATION: OFFICE OF ADMINISTRATIVE TRIALS AND HEARINGS. 25" [Boruah (server 2 or ade) Prone (a8) 628-4852 RGFERTO THE SUMMONS NUMBER ABOVE ON ALL CORRESPONDENCE. \antui:youdoraresnatotinsunmons, ec leds theSunmons eget youanapenates bese. Faetopsy acpenty eetednlon tanto *erminstionorteocaton os cy kara, perorepsaionnsdavon Me May ers ager apt youl cout. ‘OER TO CORRECT AND CERF CORRECTON PEASE TARE ONCE ht tho promis cd show bn vation othe furans fw Re Scene ara Seeantel en eaten rea os ame Pr tha 35 deol hone of fovanes Se bck of summon or further ntruction®. Se aes [counnertS. ISAS rearenan he ben seo vauton eens Ee tae pas Te (ican mrt cy en Os etpearr pete eer ‘menor — cee ee rh anana a neko eee Our SERRE ET a a ee —= once Sor maman fess ers) ose rte Inston} VEN age aces = = Isletas te abtlecoreierall) i raaraisaraelnmeaten eek ns tr tig Seated a st Sa al lator OF Rare Aon TF ea Tod Wa Wiedtscnaceqouiens{e mde sbeestetcrgeocrsion’ .— QVGSERaral aa ‘cat ey wae deanna keen ra oie et descr or sto: rnp nr a a noes ete yen er | ae OPE ce enero ran orate Intrdnening orden ‘Sate cinargicrnawaToateshaacns towns CFG Ot ons wed mean fae hinge ons re PDH oeen REACT: (Weds been setpoint) OVER er ee i eee a _— Scene” : Vilna prove andr marth qed read conaructon of fare cere er eae eee ome am cm i tenner tS earner Compe ee sre ms Te Seat moss pace anced Spies See TosfeUeheaSrezT — (enone atc er pon oe a a pe Wn SH DLE tin 2 PH HOE OBSENE wa AOL Tack Jaf & Asocater nova verament agency and doce noe represent «goverment agency any form or manne“This ice copy is provided as a courtesy by Jack Jaffa & Associates Rat Estare Consuurasts AFFIDAVIT (CERTIFICATE*) OF SERVICE : arn “srare oF NEW yi > county oF Bion Fa & 255 Pet Bac uersiand being ly sworn ae cighesa SCC at [asa] 1 did Respondent EET tt SYS by delivering a re copy 4 inset name oe who i the exponen Race 2 Partneiip Respdideat 1 by delivering ue copy to inser ames} FS ‘who isthe fist poston 3. Corporate Respondent by dene «wy py erp npg ALY ales. =, ihe inthe lien postion (SS CEF est respondent "4." ~Aftixing of Summons and Hearing A. _| steed to personaly serve the attached Summons onthe respondent named hein but was unable t do so because, having ented he premise and having ‘Meniied myself, was 1. advise by iso same tha the respondent wate present ‘a ahibeu by linen ake 7 Riiowthip o building} that a appropri reesenative of the pate respondent or pure teapondeat was nx presen 3. unable o locate anyone witha the premises to inform ae whether an appropiate representative ofthe respondent was present. Noone responded wo any bells, knocks ‘orcallsand there wer. sgn visibly posed reflecting any cnt nfm 4, caved by fnser name’ elaionship to building} ‘hat 00 officer, decor, managing agent. agent or parr of respondent artneshipicorporation Was present B. 0 Thereupon, affixed the Summons at he foregoing location ja - the folowing pace: [Tee following ist be completed if person way served withthe Surmons} Description of Individual. eponeat describes the indvidal served a follows: Male Fait Compleon 21420 yrs Under! Under 100 tbs. Female Medium Complexion 2135 ye aS0"-S3" 100-130 Is [SDagk Completion” GBload Halt 036-0 yo Sse G31 is Gry Hair 51-65 yr 59" 60". 161-200 hs While Hair Over 6S yen Over GO ver 200 Ths. ‘er ideniyingcharaierisis: Inspector's Memfetion Nembe fot sworn, ths statement shal onsite certificate of service Signatre of Cenfyng Of ‘eck Jaffa Assoces enor «government agency apd doe not Repent a RoveTEDE AGENCY I any Form oF BAARSE