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

UNITED STATES DISTRICT COURT

DISTRICT OF PUERTIO RICO

Case No. 17 BK-3283-LTS

(Jointly Administered)

Chapter PROMESA Title III

Adv. Proc. No. 18- ___-LTS

SUMMONS IN AN ADVERSARY PROCEEDING

To: State Insurance Fund Corporation

Bo. Juan Sánchez PR #2, Km. 8.5

PO Box 248

Bayamón, PR 00960-0248

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

In re: THE FINANCIAL OVERSIGHT AND MANAGEMENT 

BOARD FOR PUERTO RICO, AS REPRESENTATIVE OF 

THE COMMONWEALTH OF PUERTO RICO

Debtor

HERMANDAD DE EMPLEADOS DEL FONDO DEL 

SEGURO DEL ESTADO, INC.; UNIÓN DE MÉDICOS DE 

LA CORPORACIÓN DEL FONDO DEL SEGURO DEL 

ESTADO CORP.

Plaintiffs

v.

COMMONWEALTH OF PUERTO RICO; THE FINANCIAL 

OVERSIGHT AND MANAGEMENT BOARD FOR PUERTO 

RICO; STATE INSURANCE FUND CORPORATION; JESÚS 

M. RODRÍGUEZ ROSA; RICARDO ANTONIO ROSSELLÓ 

NEVARES; GERARDO PORTELA FRANCO; HON. RAÚL 

MALDONADO GAUTIER; JOSÉ IVÁN MARRERO 

ROSADO; NATALIE A. JARESKO

Defendants

Case:17-03283-LTS Doc#:3699-10 Filed:07/25/18 Entered:07/25/18 17:40:18 Desc:

Exhibit Summons CFSE Page 1 of 2
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#:3699-10 Filed:07/25/18 Entered:07/25/18 17:40:18 Desc:

Exhibit Summons CFSE Page 2 of 2