On June 23, 2022 a
Party Statement
was filed
involving a dispute between
Range Credit Bureau Inc.,
and
Blair, York,
for Conciliation
in the District Court of Hubbard County.
Preview
29-CO-22-59
Filed in District Court
State of Minnesota
6/23/2022 8:04 PM
'
State of Minnesota Conciliation Court
County 0f= HUBBARD _
4
Judicial District: NINTH
Court File Number:
Case Type: Conciliation
PLAIN TIFF 'S STATEMENT OF. CLAINI
Plaintiff #1 Plaintiff #2
Name: RANGE CREDIT BUREAU INC Name:
Address: PO BOX 706 Address:
City/State/Zip HIBBING MN 55746 .
City/State/Zip:
Defendant #1 Defendant #2
Name: York Blair Name:
Address: 23792 590th AVE Address:
City/State/Zip:PARK RAPIDS MN 56470-3000 City/State/Zip
[:| Check box if there are more than two plaintiffs or more than two defendants. List the
information for the other parties 011the Additional Litigcmts Form, CCT702.
Information about the Defendant
1. How many defendants are there? . l
. a. Defendant # ]
..
.
g x}, 4-4;. .....;.
._ ._. :4 ....
pagan.
.Icu’a-A’étwfv
,._..
5:! - -_¢-
- .-
Jaw-41 "vii..'5..r.'—;...A+~u ‘54:: i'vt"--l§"~pA3¢J.11-s&-£L‘u‘¢n
lYorkBlair
53—»: at: .\ .
)‘Z‘g.'._'... .». 2.
1.22.22. '65- -o
”eureka-9*»;
Name
[1 Individual (Person) [:1 Business
IfDefindani #' 1 is an individual:
i.I believe Defendant #1 is at {east 18 years old.
Date ofbirth: 01/11/1972 / DUnknown.
ii. Ahout military service:
D Defendant #1 is in the military service
I Defendant #1 is not in the military service
11 Unknown.
b. Defendant # 2
Name:
[:1 Individuai (Person) E! Business
IfDefimdant # 2 is an individual:
i. I believe Defendant #2 is at least 18 years old.
Plaintifi's Statement of Claim
CCT102 State ENG Rev 10120 www.mneourtsgov/forms Paget of3
29-CO-22-59
Filed in District Court
State of Minnesota
6/23/2022 8:04 PM
Date of birth:
'
/ [Z] Unknown.
ii About military service:
[:3 Defendant # 2 is in the military service
5"; Defendant # 2 is not in the military service
[:I Unknown. .
If there are more than 2 defendants, use the Additional Litigants Form (CCT702).
Information about the Claim
2. I am filing this claim against Defendant for: (check all that apply)
Money
IThe Defendant owes me $ 544-31 ,plus filing fees and costs in the amount of
$ $ 8 0 0 0 $
, so my total. claim is for
-
'—
$$543.1“...(amount Defendant owes plus filing fees and costs). I have a claim for this
amount because in
h
02/ 1 8/201 9 (month and year), the following happened (briefly describe):
SEE ATTACHED
M‘IN REGARDS TO INTEREST SEE MN STATUTE 334.01
**IN REGARDS TO NSF & CIVIL PENALTIES SEE MN STATUTE 604.113
'
‘
1.11.1.1... -1... “wasmnennnnsromsnmn AND vsrrFE .LIABE-IH-SEE wtsrAmIEn-sans: '
.11.... -
:2. .1,
Property
E! The Defendant has the following property that belongs to me (list property):
My property is valued at $ _
. The filing fees and costs for this case are
Plaintiffs Statement of Claim
CCT102 State ENG Rev 10/20 www.mncourtsgovfforms Page 2 of 3
29-CO-22-59
Filed in District Court
State of Minnesota
6/23/2022 8:04 PM
'_';._____. I want the” court to order this property returned to me or make the
'
$
'
Defendant pay me $ (property's value plus the filing fees and costs).
3. I understand that ifl do not come to court on my hearing date; my case may be dismissed and
I may have to pay money to the Defendant on any counterclaim that has been filed.
Important! Each plaintiff must sign the Statement ofClaim form and include the date signed,
the name of the state and county where signed, and provide the following information: title, if
any, telephone number, date of birth, and e-tmai] address.
I declare under penalty of perjury that everything that I have stated in this document is true and
correct. Minn. Stat. § 358.116.
I
Signature (Plaintiff #1) Signature (Plaintiff #2)
OR B There is only 1 plaintiff
DATE: 06/13/2022 DATE:
ST. LOUIS
County and. State where signed County and State where signed
S.H. CAUCCI
Name -
Name
'
PRESIDENT
,.,--.- - . .. -
_-__ . --——
.
--- --- . .é
-:~‘. 1.1
35.. ._' nun-h awe-4;.
...;4.-....'z;..:,[..141t_l__$; )3:- . amt-4..
. ....«x .1- ...... ..i. xix. .1.
»! is...
any; .-..'.__.‘. .:
n.e.$1al.l.‘;fl.1£311y_v..~.g .....~.a 12-1. ,a. ).I.):-.-".' q...
218-263-8886 up;
Telephone Telephone
'
Date of birth Date of birth
legal@rcbcollections.com
Email Address Email Address
NOTE: If there are more than 2 plaintiffs, all of the other plaintiffs must sign the Statement of
Claim form and include the information listed above.
Plaintiff's Statement of Claim .
CCT102 State ENG Rev 10/20 www.mncourts.govlfonns Page 3 of 3
29-CO-22-59
Filed in District Court
State of Minnesota
6/23/2022 8:04 PM
STATEMENT OF CLAIMS ATTACHMENT
COUNTY: HUBBARD COUNTY'
DEBTOR: York Jacob Blair 01/11/192ND LOC:
DEBTOR #2: -
ADDRESS: 23792 590th AVE
'PARK RAPIDS MN 56470—3000
NOTICE WAS MAILED TO THE DEFENDANT ADVISING OF COLLECTION ACCOUNTS AND/OR
.DISHONORED CHECKS, SERVICE CHARGES AND PENALTIES. DEMAND IS HEREBY
MADE AS FOLLOWS:
LIST OF ACCOUNTS
I
CLIENT '
PRINCIPAL -NSF FEE CIVIL PNL INTEREST COURT TOTAL DUE
MINNESOTA POWER $453.94 $0.00
‘
$0.00 $90.37 $80.00 $624.31
as“, 423.
n; .:....-.\‘.i'.,..
.413. ._
-.“":.:j.-1‘4I-"
-. w;.;;:, ‘.‘;Li”; .~_-.'.‘
.-.-:....-..,.-=-'.-.-
.,.r./ w." F“;:1i:-u4<=.a .A-s-s'UZu
a:r_.4"-"«Z‘."‘«.\~
Jfi;m€§13;'-:;;IwfiAL—¢n‘gi:yifl;man“
'.'?»Lht.
Ivy—mag
‘aéivqhfitmfimvfié
THIS IS AN ATTEMPT TO COLLECT A DEBT.
ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.
Document Filed Date
June 23, 2022
Case Filing Date
June 23, 2022
For full print and download access, please subscribe at https://www.trellis.law/.
Preview
29-CO-22-59 Filed in District Court State of Minnesota 6/23/2022 8:04 PM ' State of Minnesota Conciliation Court County 0f= HUBBARD _ 4 Judicial District: NINTH Court File Number: Case Type: Conciliation PLAIN TIFF 'S STATEMENT OF. CLAINI Plaintiff #1 Plaintiff #2 Name: RANGE CREDIT BUREAU INC Name: Address: PO BOX 706 Address: City/State/Zip HIBBING MN 55746 . City/State/Zip: Defendant #1 Defendant #2 Name: York Blair Name: Address: 23792 590th AVE Address: City/State/Zip:PARK RAPIDS MN 56470-3000 City/State/Zip [:| Check box if there are more than two plaintiffs or more than two defendants. List the information for the other parties 011the Additional Litigcmts Form, CCT702. Information about the Defendant 1. How many defendants are there? . l . a. Defendant # ] .. . g x}, 4-4;. .....;. ._ ._. :4 .... pagan. .Icu’a-A’étwfv ,._.. 5:! - -_¢- - .- Jaw-41 "vii..'5..r.'—;...A+~u ‘54:: i'vt"--l§"~pA3¢J.11-s&-£L‘u‘¢n lYorkBlair 53—»: at: .\ . )‘Z‘g.'._'... .». 2. 1.22.22. '65- -o ”eureka-9*»; Name [1 Individual (Person) [:1 Business IfDefindani #' 1 is an individual: i.I believe Defendant #1 is at {east 18 years old. Date ofbirth: 01/11/1972 / DUnknown. ii. Ahout military service: D Defendant #1 is in the military service I Defendant #1 is not in the military service 11 Unknown. b. Defendant # 2 Name: [:1 Individuai (Person) E! Business IfDefimdant # 2 is an individual: i. I believe Defendant #2 is at least 18 years old. Plaintifi's Statement of Claim CCT102 State ENG Rev 10120 www.mneourtsgov/forms Paget of3 29-CO-22-59 Filed in District Court State of Minnesota 6/23/2022 8:04 PM Date of birth: ' / [Z] Unknown. ii About military service: [:3 Defendant # 2 is in the military service 5"; Defendant # 2 is not in the military service [:I Unknown. . If there are more than 2 defendants, use the Additional Litigants Form (CCT702). Information about the Claim 2. I am filing this claim against Defendant for: (check all that apply) Money IThe Defendant owes me $ 544-31 ,plus filing fees and costs in the amount of $ $ 8 0 0 0 $ , so my total. claim is for - '— $$543.1“...(amount Defendant owes plus filing fees and costs). I have a claim for this amount because in h 02/ 1 8/201 9 (month and year), the following happened (briefly describe): SEE ATTACHED M‘IN REGARDS TO INTEREST SEE MN STATUTE 334.01 **IN REGARDS TO NSF & CIVIL PENALTIES SEE MN STATUTE 604.113 ' ‘ 1.11.1.1... -1... “wasmnennnnsromsnmn AND vsrrFE .LIABE-IH-SEE wtsrAmIEn-sans: ' .11.... - :2. .1, Property E! The Defendant has the following property that belongs to me (list property): My property is valued at $ _ . The filing fees and costs for this case are Plaintiffs Statement of Claim CCT102 State ENG Rev 10/20 www.mncourtsgovfforms Page 2 of 3 29-CO-22-59 Filed in District Court State of Minnesota 6/23/2022 8:04 PM '_';._____. I want the” court to order this property returned to me or make the ' $ ' Defendant pay me $ (property's value plus the filing fees and costs). 3. I understand that ifl do not come to court on my hearing date; my case may be dismissed and I may have to pay money to the Defendant on any counterclaim that has been filed. Important! Each plaintiff must sign the Statement ofClaim form and include the date signed, the name of the state and county where signed, and provide the following information: title, if any, telephone number, date of birth, and e-tmai] address. I declare under penalty of perjury that everything that I have stated in this document is true and correct. Minn. Stat. § 358.116. I Signature (Plaintiff #1) Signature (Plaintiff #2) OR B There is only 1 plaintiff DATE: 06/13/2022 DATE: ST. LOUIS County and. State where signed County and State where signed S.H. CAUCCI Name - Name ' PRESIDENT ,.,--.- - . .. - _-__ . --—— . --- --- . .é -:~‘. 1.1 35.. ._' nun-h awe-4;. ...;4.-....'z;..:,[..141t_l__$; )3:- . amt-4.. . ....«x .1- ...... ..i. xix. .1. »! is... any; .-..'.__.‘. .: n.e.$1al.l.‘;fl.1£311y_v..~.g .....~.a 12-1. ,a. ).I.):-.-".' q... 218-263-8886 up; Telephone Telephone ' Date of birth Date of birth legal@rcbcollections.com Email Address Email Address NOTE: If there are more than 2 plaintiffs, all of the other plaintiffs must sign the Statement of Claim form and include the information listed above. Plaintiff's Statement of Claim . CCT102 State ENG Rev 10/20 www.mncourts.govlfonns Page 3 of 3 29-CO-22-59 Filed in District Court State of Minnesota 6/23/2022 8:04 PM STATEMENT OF CLAIMS ATTACHMENT COUNTY: HUBBARD COUNTY' DEBTOR: York Jacob Blair 01/11/192ND LOC: DEBTOR #2: - ADDRESS: 23792 590th AVE 'PARK RAPIDS MN 56470—3000 NOTICE WAS MAILED TO THE DEFENDANT ADVISING OF COLLECTION ACCOUNTS AND/OR .DISHONORED CHECKS, SERVICE CHARGES AND PENALTIES. DEMAND IS HEREBY MADE AS FOLLOWS: LIST OF ACCOUNTS I CLIENT ' PRINCIPAL -NSF FEE CIVIL PNL INTEREST COURT TOTAL DUE MINNESOTA POWER $453.94 $0.00 ‘ $0.00 $90.37 $80.00 $624.31 as“, 423. n; .:....-.\‘.i'.,.. .413. ._ -.“":.:j.-1‘4I-" -. w;.;;:, ‘.‘;Li”; .~_-.'.‘ .-.-:....-..,.-=-'.-.- .,.r./ w." F“;:1i:-u4<=.a .A-s-s'UZu a:r_.4"-"«Z‘."‘«.\~ Jfi;m€§13;'-:;;IwfiAL—¢n‘gi:yifl;man“ '.'?»Lht. Ivy—mag ‘aéivqhfitmfimvfié THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.