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ae ~~ CERTIFICATE OF SUBPENA (Pursuant to Public Law No. 513, 91st Cong., 2nd Session) {21 U.S.C. 876} | hereby certify that | served the subpena on the reverse hereof DATE SUBPENA SERVED {Day, month, year) TIME Oph (5 199: Jo°52 @n, HOW SUBPENA [I I handed an attested copy thereof to the person to whom it was directed. WAS SERVED . 1 handed an attested copy thereof to an officer or agent of the company authorized to receive (Check one} service of process. - SIGNATURE , TITLE b6 / a4) bB7C