Case 3:20-cv-03678-MCR-EMT Document 12-1 Filed 12/10/20 Page 1 of 2

AO 440 (Rev. 06/12) Summons in a Civil Action

United States District Court

for the

Northern District ofFlorida

)

UNITED STATES OF AMERICA, ex rel. )

ROBERT V. SMITH )

)

Plaintiff(s) )

) v. Civil Action No. 3:20CV3678/MCR/EMT )

)

)

JAY A. ODOM and OKALOOSA COUNTY,

BOARD OF COUNTY COMMISSIONERS )

)

Defendants) )

SUMMONS IN A CIVIL ACTION

To: (Defendant’s name and address) OKALOOSA COUNTY, BOARD OF COUNTY COMMISSIONERS

302 N. WILSON STREET, SUITE 302

CRESTVIEW, FLORIDA 32536

JIM INGLE, JR

A lawsuit has been filed against you.

Within 1 (3nf20 - 60 days after service ofthis summons on you (not countingHhe day you received it) — or 60 days if you

are the United States or a United States agency, or an officer or employee ofthe United States described in Fed. R. Civ.

P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of

the Federal Rules ofCivil Procedure. The answer or motion must be served on the plaintiff or plaintiffs attorney,

whose name and address are: MICHAEL J. SCHOFIELD/AMELIA H. BEARD

CLARK PARTINGTON

125 EAST INTENDENCIA STREET

PENSACOLA, FLORIDA 32591-3010

Ifyou fail to respond, judgment by default will be entered against you for the relief demanded in the complaint.

You also must file your answer or motion with the court.

JESSICA J. LYUBLANOVITS

\ CLERK OF COURT

tW M +

\A\

i ! \ \ 12/10/2020 /s/ Monica Broussard, Deputy Clerk

Signature ofClerk or Deputy Clerk

Date:

i !

u

y

Case 3:20-cv-03678-MCR-EMT Document 16 Filed 12/23/20 Page 1 of 3
Case 3:20-cv-03678-MCR-EMT Document 12-1 Filed 12/10/20 Page 2 of 2

AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2)

Civil Action No. 3:20CV3678/MCR/EMT

PROOF OF SERVICE

(This section should not befiled with the court unless required by Fed. R. Civ. P. 4 (l))

This summons for (name ofindividual and title, ifany)

was received by me on (date)

Utfl 5/_\__ (3■^41 il <Q (pE- dc.U<qjt^ _0/!<

)2_- \ 2~~ Z-Q

□ I personally served the summons on the individual at (place)

on (date) ; or

□ I left the summons at the individual’s residence or usual place of abode with (name)

, a person ofsuitable age and discretion who resides there,

, and mailed a copy to the individual’s last known address; or on (date)

served the summons on (name ofindividual)

^ designated by law to accept service ofprocess on behalf of(name oforganization)

______________

□ I returned the summons unexecuted because

M , who is 1 Avi Aif.

t

12- ~i5~-23 on (date) ; or

; or

m Other (specify):

My fees are $ for travel and $ for services, for a total of $ 0.00

I declare under penalty ofperjury that this information is true.

Server ssignature

Date:

Printed name and title

(all £. jLkJxxtJ /Itjc h/iS,

Server’s addr■,:SS

Additional information regarding attempted service, etc:

Case 3:20-cv-03678-MCR-EMT Document 16 Filed 12/23/20 Page 2 of 3
RETURN OF SERVICE

■r To be served. r> 0^ d

Address A/ kf-/5c-> 5r -

City:

ar«si/$<, 5

______________ Zip:

CASE NOig'- lo£t'-TL:-7^ yn^/L J^r

State: “'X^ -

COURT: US Dibm

.i )/ f-^

COUNTY: U-S Asn/,^ f

CtoiUJ~

p-y o y^f

i/* 5»t/ 7-ii

PLAINTIFF/PET1TIONER //, • rp i i

__ ____ »_ -K i-'.

,-»/ J-! / /* JJ /i<^i

Of(A /uc, S/I ^ L t.A. f

DEFENDANT/RESPONDENT

ffj Li i—;*~^r____ /f,rttAt r S5 fCix /tjt £

7 f.( / l-i /»-? <- ^ >

L) nl r>-i ^ oo <0 tf<-/ /3a/)yl a

?

Type of Writ >0 i

ATTORNEY/FIRM. A1 / ^ ^ Pa ftr/^i ^ o__________________________________

Address i'Z-S- A - 7u^j,vuJ A^^City: A) State: Zip: ?'Z--s~ ”7^

aV.2_ , 2Cgc>, at__^2.: / ,433r>.) or (p.m.) and served the

or(p.m.) on the /^Tday of /)t, t 1QZ\ as follows.

(recipient) as (l, stl /VIA c- •! 6<

Received this writ on the /May of

same at ^!0Q ( a^M

To: kw) 3 ij it n (title)

For T

City Zip At State

___INDIVIDUAL/PERSONAL SERVICE, pursuant to F.S. 48.031

___SUBSTITUTE SERVICE, pursuant to F.S. 48.031

___CORPORATE SERVICE, pursuant to F.S. 48.081-1, 48.08-3 or 48.091.

___GOVERNMENT AGENCY, pursuant to F.S. 48.121 or 48.111

V 48.031-4a bESIGNATED RECIPIENT, pursuant to F.S.,

__POSTED SERVICE: By attaching a copy of this process, together with any attachments to a

conspicuous place on the property described herein after two or more attempts to obtain personal or

substitute service at least six (6) hours apart.

Attempts at service.

___NON-SERVICE: After diligent search and inquiry, I was unable to locate the within names subject

County, Florida.

y____ at (a.m.) or (p.m.) &__/__/_at__:__(a.m. or p.m.)

in

___ OTHER:

MILITARY: YESMARITAL STATUS: NO

I, the undersigned do here by certify that I am competent to serve process, am over eighteen years old, not interested in this

action and duly authorized to serve the above described process.! further certify that I received this process at the time and

dated described above and served a true copy of the same, together with attachments if any, with the date and hour of

service endorsed thereon by me.

Under penalty of perjury, I declare that I have read the foregoing affidavit and the facts contained therein are true and

correct to the best of my knowledge.

____________ID#448 CERTIFIED PROCESS SERVER

FIRST JUDICIAL CIRCUIT OF FLORIDA

NAME;

■

I leTJiV^I, CJ^S #448

Jim Ingle, Jr., 619 E Nelson Avenue, Ste A, Defuniak Springs, Florida 32433

(850)585-5340

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