DPR MODIFIED PROMESA B2500A (Form 2500A) (06/17) 

UNITED STATES DISTRICT COURT

DISTRICT OF PUERTIO RICO

PROMESA

Title III

No. 17 BK-3283-LTS

(Jointly Administered)

Adv. Proc. No. 18- ___-LTS

SUMMONS IN AN ADVERSARY PROCEEDING

To: Financial Oversight and Management Board for Puerto Rico

Edificio World Plaza, A2 Piso 11

268 Avenida Muñoz Rivera

San Juan, PR 00918 

 

1 The Debtors in these Title III Cases, along with each Debtor’s respective Title III case number listed as a 

bankruptcy case number due to software limitations and the last four (4) digits of each Debtor’s federal tax 

identification number, as applicable, are the (i) Commonwealth of Puerto Rico (Bankruptcy Case No. 17 BK 3283-

LTS) (Last Four Digits of Federal Tax ID: 3481); (ii) Puerto Rico Sales Tax Financing Corporation (“COFINA”) 

(Bankruptcy Case No. 17 BK 3284-LTS) (Last Four Digits of Federal Tax ID: 8474); (iii) Puerto Rico Highways 

and Transportation Authority (“HTA”) (Bankruptcy Case No. 17 BK 3567-LTS) (Last Four Digits of Federal Tax 

ID: 3808); (iv) Employees Retirement System of the Government of the Commonwealth of Puerto Rico (“ERS”) 

(Bankruptcy Case No. 17 BK 3566-LTS) (Last Four Digits of Federal Tax ID: 9686); and (v) Puerto Rico Electric 

Power Authority (“PREPA”) (Bankruptcy Case No. 17 BK 4780) (Last Four Digits of Federal Tax ID: 3747).

In re: 

THE FINANCIAL OVERSIGHT AND 

MANAGEMENT BOARD FOR PUERTO RICO, 

as representative of 

THE COMMONWEALTH OF PUERTO RICO1

Debtor

HERMANDAD DE EMPLEADOS DEL FONDO DEL 

SEGURO DEL ESTADO, INC ; UNIÓN DE 

MÉDICOS DE LA CORPORACIÓN DEL FONDO 

DEL SEGURO DEL ESTADO CORP; ASOCIACIÓN 

DE EMPLEADOS GERENCIALES DEL FONDO 

DEL SEGURO DEL ESTADO CORP

Plaintiffs,

v.

GOVERNMENT OF THE UNITED STATES OF 

AMERICA; THE FINANCIAL OVERSIGHT AND 

MANAGEMENT BOARD FOR PUERTO RICO; 

COMMONWEALTH OF PUERTO RICO; 

RICARDO ANTONIO ROSSELLÓ NEVARES 

Defendants

Case:17-03283-LTS Doc#:3190-3 Filed:05/30/18 Entered:05/30/18 17:23:00 Desc:

Exhibit Summons Financial Oversight and Management Board for Puerto Rico Page 1 of 3
DPR MODIFIED PROMESA B2500A (Form 2500A) (06/17) 

YOU ARE SUMMONED and required to file a motion or answer to the complaint which is attached 

to this summons with the clerk of the district court within 30 days after the date of issuance of this summons, 

except that the United States and its officers and agencies shall file a motion or answer to the complaint within 

35 days. The answer or motion must be served on the plaintiff or plaintiff`s attorney, whose name and address 

are:

Rolando Emmanuelli Jiménez

PO Box 10779

Ponce, PR 00732

If you make a motion, your time to answer is governed by Fed. R. Bankr. P. 7012. 

If you fail to respond to this summons, your failure will be deemed to be your consent to entry of a 

judgment by the district court and judgment by default may be taken against you for the relief demanded in the 

complaint.

FRANCES RIOS DE MORAN, ESQ. 

CLERK OF COURT 

Date: ________________________________________ 

 Signature of Clerk or Deputy Clerk

Case:17-03283-LTS Doc#:3190-3 Filed:05/30/18 Entered:05/30/18 17:23:00 Desc:

Exhibit Summons Financial Oversight and Management Board for Puerto Rico Page 2 of 3
DPR MODIFIED PROMESA B2500A (Form 2500A) (06/17) 

CERTIFICATE OF SERVICE

I, __________________________(name), certify that service of this summons and a copy of 

the complaint was made ______________________(date) by: 

 Mail service: Regular, first class United States mail, postage fully pre-paid, addressed 

to: 

 Personal Service: By leaving the process with the defendant or with an officer or agent 

of defendant at: 

 Residence Service: By leaving the process with the following adult at: 

 Certified Mail Service on an Insured Depository Institution: By sending the process by 

certified mail addressed to the following officer of the defendant at: 

 Publication: The defendant was served as follows: [Describe briefly] 

 State Law: The defendant was served pursuant to the laws of the State of ________, as 

follows: [Describe briefly] 

If service was made by personal service, by residence service, or pursuant to state law, I further 

certify that I am, and at all times during the service of process was, not less than 18 years of age and 

not a party to the matter concerning which service of process was made. 

Under penalty of perjury, I declare that the foregoing is true and correct. 

Date ___________ Signature ___________________________________

Print Name: _________________________

Business Address: _________________________

 ___________________________

Case:17-03283-LTS Doc#:3190-3 Filed:05/30/18 Entered:05/30/18 17:23:00 Desc:

Exhibit Summons Financial Oversight and Management Board for Puerto Rico Page 3 of 3