USM-285 is a 5-part form. Fill out the form and print 5 copies. Sign as needed and route as specified below.

U.S. Department ofJustice

United States Marshals Service - .- . : PROCESS RECEIPT AND RETU

See "Inslmctions for Setyice ofProcess bv U.S. Ma , _ • ( ( /

; 1 LU

PLAINTIFF ... r •

MABO MUANZA ^^ ^ . r -] \ "C• COURT CASE NUMBER

C 17-909 JSC

DEFENDANT i-w•' - CITY OF HERCULES, et al. ^

-v

TYPE OF PROCESS

Summons, Order and Complaint

{ SERVE J Cityof Hercules

AT ADDRESS (Street or RFD, Apartment No., City, State and ZIP Code)

Mayor's Office, Civil Hall, 111 Civic Drive, Hercules, CA 94547

SEND NOTICE OF SERVICE COPY TO REQUESTER AT NAME AND ADDRESS BELOW

^Law Office ofStanley Goff

15 Boardman Place

San Francisco, CA 94103

Number of process to be

served with this Form 285 4

Number of parties to be

served in this case 2

Check for service

on U.S.A.

SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WFl.I. ASSIST IN EXPEDITING SERVICE (Include BusMesEaudl

Signature ofAttofta/othgi^riglnalor rnuestWi{ ceonbeiialf of:

L

la PLAINTIFF

• DEFENDANT

?Du

TELEPHONE NUMBER

(415) 522-2099

DATE

6/26/17

Fold

PACE BELOW FOU USE OF U.S. MARSHAL ONLY - DO NOT WRITE BELOW THIS LINE

I acknoWedp receipt for the total Slgn^re ofAuth^ized USMS Deputy or Clerk

number of process indicated.

(Sign onlyfor USM 285 ifmore

than one USM 285 is submitted)

Total Process District of District to

Origin Serve

No No

Date

kj^gIhereby certify and return that iJH'Slave personally served .LJ have legal evidence ofservice. CD have executed as shown in "Remarks", the process described

on the individual, company, corporation,etc., at the address shown above on the on the individual. company, corporation,etc. shown at the address inserted below.

CD Ihereby certifj- and return that Iam unable tolocate the individual, company, corporation, etc. named above (See remarks below)

Name and title of individual served (if not shown above)

C(TY

Address (complete only different than shown above)

Service Fee

REMARKS:

Total Mileage Charges

including endeavors)

Ce> hc-o

Forwarding Fee Total Charges Advance Deposits

PRINT 5 COPIES: 1. CLERK OF THE COURT

2. USMS RECORD

3. NOTICE OF SERVICE

4. BILLING STATEMENT*: To be returned to the U.S. Marshal with payment,

if any amount is owed. Please remit promptly payable to U.S. Marshal.

5. ACKNOWLEDGMENT OF RECEIPT

Q Aperson ofsuitable age and discretion

then residing in defendant's usual place

of abode

Date

7/^6. • Pm

jgnature of U.S. MarshSTSV Deputy

Amount owed to U.S. Marshi

(/\mounl of Refund*)

$0.00

PRIOR EDITIONS MAY BE USED

Fonti USM-285

Rev. 12/80

Case 3:17-cv-00909-JSC Document 17 Filed 07/03/17 Page 1 of 2
USIVl-285 is a 5-part form. Flirout the form and print 5 copies. Sign as; needed and route as specified below.

U.S. Department ofJustice

United States Marshals Service

PROCESS RECEIPT AND RETUl^lNl r^

See "Instructions for Sen'ice ofProcess bv U.S. Mar\W^f ^

PLAINTIFF

MABO MUANZA

DEFENDANT

CITY OF HERCULES, et al.

rb-ir

1 f

) .... LI r

g T I,: 1 :•

COURT CASE NUMBER

C 17-909 JSC

TYPE OF PROCESS

Summons, Order and Complaint

{

NAME OF V(JOMPANV.CORPORATION. ETC. TO SERVE OR DESCRIPTION OF PROPERTYTO SEIZE OR CONDEMN

SERVE / Hercules Police Officer Aaron Tan

1 ADDRESS (Slreel or RFD, Apartment No.. City, Slate and ZIP Code)

•Hercules City Hall, 111 Civic Drive, Hercules, CA 94547

SEND NOTICE OF SERVICE COPY TO REQUESTER AT NAME AND ADDRESS BELOW Number of process to be

served with this Form 285 4

Law Office of Stanley Goff

15 Boardman Place

San Francisco, CA 94103

Number of parties to be

served in this case 2

Check for service

on U.S.A.

SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE /Include Busines esses.

All Telephone Numbers, and Estimated Times Availablefor Service):

Fold

lEl PLAINTIFF

• DEFENDANT

TELEPHONE NUMBER

(415) 522-2099

Fold

6/26/17

S^ACE 9ELOW FCf(usiS0F U.S. MARSHAL ONLY-JQQ^NOTWRITE BELOW THIS LINE

I acknowledge receipt for the total 1

number of process indicated.

(Sign onlyfor VSM 285 ifmore

than one USM 285 is submitted)

Total P

V

'rocess District of

Origin

No 1I

District to

Serve

No 11 (

^^t^tu^^^fM^oi^^ SMS Deputy orClerk Date

\l>

Ihereby certify and return that 1^l^ave personally served .D have legal evidence ofservice. D have executed as shown in "Remarks", the process described

on theindividual. company, corporation, etc.,at theaddress shown above ontheon the individual, company, corporation, etc.shown at theaddress inserted below.

n I hereby certify and return that Iam unable tolocate the individual, company, corporation, etc. named above (See remarks below)

Name and title of individual served (ifnot shown above)

^;eS\J Lfy C/^

Address(complete onlydifferentthan showi above) twdab

• Aperson ofsuitable ageanddiscretion

then residing in defendant's usual place

of abode

Date Time

D pm

lure of U.S. MarsM or Deputy

Service Fee Total Mileage Charges

including endeavors)

Fonvarding Fee Total Charges Advance Deposits Amount owed to U.S. MarshalVrt^i^

{Amount of Refund*)

«5:» l^Sd 7fSO $0.00

REMARKS:

PRINT 5 COPIF.SI 1. CLERK OF THE COURT • 2. USMS RECORD

3. NOTICE OF SERVICE

4. BILLING STATEMENT*; To be returned to the U.S. Marshal with payment,

if any amount is owed. Please remit promptly payable to U.S. Marshal.

5. ACKNOWLEDGMENT OF RECEIPT

PRIOR EDITIONS MAY BE USED

Form USM-285

Rev. 12/80

D

Case 3:17-cv-00909-JSC Document 17 Filed 07/03/17 Page 2 of 2