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1 <br /> PROOF OF SERVICE OF PROCESS <br /> I[hereby certify and return that on ,20 ,1 served a copy of the <br /> within summons, together with a copy of the complaint in this action, upon the within-named defendant, in the <br /> following manner(See Mass.R.Civ.P.4(d)(1-5): <br /> Dated: ,20 <br /> N.B. TO PROCESS SERVER. <br /> PLEASE PEACE DATE YOU MAKE SERVICE ON DEFENDANT IN <br /> THIS PDX ON THE ORIGINAL AND ON COPY SERVED ON DEFENDANT. <br /> 2® <br /> r1 <br /> 0 <br /> 0 <br /> 0 <br /> Q <br /> 0 U b <br /> U z <br /> Cn <br /> R+ <br /> C-11 Q4Z <br /> f� ® H ® 4 <br /> ® ° ° 1 � <br /> o <br /> ® <br /> ° -+ <br /> x � <br /> ® ° <br /> U w N <br /> a1 <br /> 04 <br /> cn v <br /> rts � <br /> h rti <br />