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AO 111 (Rev. 12/89) Subpoena to Testify before Grand Jury RETURN OF SERVICE RECEIVED Date Place BY SERVER SERVED Date hoo2|a1|h Place Los ArglesL 90024 SERVED ON (PRINT NAME) SERVED BY (PRINT NAME) TITLE b6 peciaLapgt b7C STATEMENT OF SERVICE FEES TRAVEL SERVICES TOTAL DECLARATION OF SERVER' 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 ar e Fees is true and correct.. b6 y|16{o4 b7C Executed on Date Signature dr HOoo W|s ce Bwd LA7CA-9v0zy Address of Server ADDITIONAL INFORMATION are unable to pay such costs (28 USC 1825, Rule 17(b) Federal Rules of Criminal Procedure)".