EFTA00178528

JAN.86

<table><thead><tr><th colspan="4">RETURN OF SERVICE¹</th></tr></thead><tbody><tr><td>RECEIVED BY SERVER</td><td>DATE</td><td colspan="2">PLACE</td></tr><tr><td>SERVED</td><td>DATE</td><td colspan="2">PLACE</td></tr><tr><td colspan="4">SERVED ON (NAME)</td></tr><tr><td colspan="2">SERVED BY</td><td colspan="2">TITLE</td></tr><tr><th colspan="4">STATEMENT OF SERVICE FEES</th></tr><tr><td>TRAVEL</td><td colspan="2">SERVICES</td><td>TOTAL</td></tr><tr><th colspan="4">DECLARATION OF SERVICE²</th></tr><tr><td colspan="4">I declare under penalty of perjury under the laws of the United States of America that the foregoing information contained in the Return of Service and Statement of Service Fees is true and correct.<br>Executed on ___<br>DATE Signature of Server<br>Address of Server</td></tr><tr><td colspan="4">ADDITIONAL INFORMATION</td></tr></tbody></table>

1.As to who may serve a subpoena and the manner of its service see Rule 17(d). Federal Rules of Criminal Procedure, or Rule 45(c), Federal Rules of Civil Procedure.

2. "Fees and mileage need not be tendered to the witness upon service of a subpoena issued on behalf of the United States or an officer or agency thereof (Rule 45(c), Federal Rules of Civil Procedure; Rule 17(d), Federal Rules of Criminal Procedure) or on behalf of certain indigent parties and criminal defendants who are unable to pay such costs (28 USC 1825, Rule 17(b) Federal Rules of Criminal Procedure)"