On October 29, 2018 a
Summons
was filed
involving a dispute between
Healtheast Care System,
and
Anderson, Sarah,
for Conciliation
in the District Court of Crow Wing County.
Preview
18-CO-18-417
Filed in District Court
State of Minnesota
10/29/2018 3:39 PM
State 0f Minnesota Conciliation Court
County CROW WING Judicial District: NINTH
Court File Number:
STATEMENT OF CLAIM AND SUMMONS
Plaintiff #1 Plaintiff #2
Name HEALTHEAST CARE SYSTEM P Name
Address c/o RIVERVIEH LAu OFFICE, PLLc [E4 Address
225 N. BENIou DR., STE. 209 Po Box 57o
A
City/State/Zip SAUK RAPIDS, MN 56379
S City,State/Zip
E
V. VS
Defendant #1 P Defendant #2
Name R Name
SARAH ANDERSON
Address 11o 1ST ST sw APT t.
I Address
N
T - .
Ciry/State/Zip CROSBY, MN 56441-1435 Cny/State/le
PLAINTIFF’S STATEMENT OF CLAIM
Defendant owes me 137188 80'00 1453'“
l. $ ,plus filing fees and costs of$ ,for a total of$ because on or
-
05/10/17 05/10/17
about:
The Plaintiff provided valuable goods and services to the Defendant(s). Defendant(s) has failed to pay the outstanding
balance despite Plaintiff's demand. Charges for such goods and services are reasonable and Defendant“) now owes
the Plaintiff $ 1373.88, plus costs and disbursements. File Nmnber:CIU457-(COC)
2. Ibelieve the person(s) Iam suing is/are at least 18 years old and not in the military service.
Defendant #1 date of binh: 10/14/77 Defendant #2 date of binh:
3. Defendant(s) is/are not in the military service.
4. Iunderstand that ifl d0 not come t0 court on my hearing date, my case may be dismissed and l may have to pay money
to the Defendant(s) 0n any counterclaim that has been filed.
I declare under penalty of perjury that everything
Date
Oct
Benton,
29, 2018
Minnesota
lh a e stated 1n this
"‘2.
Attorney Signature
Christina
/\/ m
document
C
lstrue and correct.
‘\
§V\/
Sandy #0392436 / Jana Kern #0392287
A_,
I/
\‘x
Minn. Stat § 358. l 16.
Teng Wang #0399029 /Amber Stavig #0399419
Name of county and state where signed Address: 225 N Benton Dr, Ste 209
City/Statc/Zip: Sauk Rapids, MN 56379
Phone: 320-229-2403
SUMMONS: IMPORTANT NOTICE T0 THE PARTIES
You are hereby summoned t0 appear at the hearing ofthc above entitled case. See the attached Notice of I[caring for time
and location. Ifnot attached, callConciliation Court.
Failure 0f defendant t0 appear at the hearing may result in a default judgment being entered for the plaintiff.
Failure of the plaintiff t0 appear may result in dismissal of the action or a default judgment being entered in favor
of the defendant on any counterclaim that has been filed.
The Defendant may bring a counterclaim against the Plaintiff. See “Information About Conciliation Court” (court form
CC'I‘I 0|) on the court forms webpage at www.mncourts.gov/forms.
NOTICE OF SETTLEMENT
'l‘hcabovc-cntitlcd case having been settlecL thesame may be and hereby is dismissed with my consent.
Date:
Plaintiff‘s Signature
Document Filed Date
October 29, 2018
Case Filing Date
October 29, 2018
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18-CO-18-417 Filed in District Court State of Minnesota 10/29/2018 3:39 PM State 0f Minnesota Conciliation Court County CROW WING Judicial District: NINTH Court File Number: STATEMENT OF CLAIM AND SUMMONS Plaintiff #1 Plaintiff #2 Name HEALTHEAST CARE SYSTEM P Name Address c/o RIVERVIEH LAu OFFICE, PLLc [E4 Address 225 N. BENIou DR., STE. 209 Po Box 57o A City/State/Zip SAUK RAPIDS, MN 56379 S City,State/Zip E V. VS Defendant #1 P Defendant #2 Name R Name SARAH ANDERSON Address 11o 1ST ST sw APT t. I Address N T - . Ciry/State/Zip CROSBY, MN 56441-1435 Cny/State/le PLAINTIFF’S STATEMENT OF CLAIM Defendant owes me 137188 80'00 1453'“ l. $ ,plus filing fees and costs of$ ,for a total of$ because on or - 05/10/17 05/10/17 about: The Plaintiff provided valuable goods and services to the Defendant(s). Defendant(s) has failed to pay the outstanding balance despite Plaintiff's demand. Charges for such goods and services are reasonable and Defendant“) now owes the Plaintiff $ 1373.88, plus costs and disbursements. File Nmnber:CIU457-(COC) 2. Ibelieve the person(s) Iam suing is/are at least 18 years old and not in the military service. Defendant #1 date of binh: 10/14/77 Defendant #2 date of binh: 3. Defendant(s) is/are not in the military service. 4. Iunderstand that ifl d0 not come t0 court on my hearing date, my case may be dismissed and l may have to pay money to the Defendant(s) 0n any counterclaim that has been filed. I declare under penalty of perjury that everything Date Oct Benton, 29, 2018 Minnesota lh a e stated 1n this "‘2. Attorney Signature Christina /\/ m document C lstrue and correct. ‘\ §V\/ Sandy #0392436 / Jana Kern #0392287 A_, I/ \‘x Minn. Stat § 358. l 16. Teng Wang #0399029 /Amber Stavig #0399419 Name of county and state where signed Address: 225 N Benton Dr, Ste 209 City/Statc/Zip: Sauk Rapids, MN 56379 Phone: 320-229-2403 SUMMONS: IMPORTANT NOTICE T0 THE PARTIES You are hereby summoned t0 appear at the hearing ofthc above entitled case. See the attached Notice of I[caring for time and location. Ifnot attached, callConciliation Court. Failure 0f defendant t0 appear at the hearing may result in a default judgment being entered for the plaintiff. Failure of the plaintiff t0 appear may result in dismissal of the action or a default judgment being entered in favor of the defendant on any counterclaim that has been filed. The Defendant may bring a counterclaim against the Plaintiff. See “Information About Conciliation Court” (court form CC'I‘I 0|) on the court forms webpage at www.mncourts.gov/forms. NOTICE OF SETTLEMENT 'l‘hcabovc-cntitlcd case having been settlecL thesame may be and hereby is dismissed with my consent. Date: Plaintiff‘s Signature