- RETURN OF SERVICE' RECEIVED BY SERVER DATE of3/ 05/ 6t PLACE w est Re ? ea. . FL SERVED DATE0 ( o ( o PLACE C Val ) SERVED ON (NAM I b3 SERVF RV TITLE F-E 1 S'i ctett_ OF SERVICE FEES STATEMENT TRAVEL SERVICES TOTAL b6 b7C DECLARATION OF SER VICE2 I declare Statement Executed unde