On October 23, 2017 a
Proof of Service
was filed
involving a dispute between
Jefferson Capital Systems, Llc,
and
Daniel Joseph Totzke,
for S15 - Small Claims - Small Claims - Collection - Purchase Debt
in the District Court of New Haven County.
Preview
STATEMENT OF SERVICE — (DELIVERY)
SMALL CLAIMS
JD-CV-123 New 1-11
Instructions
Fill out 1 form for each defendant. Attach all documents that show how the Small Claims Writ and
Notice of Suit and related documents were served on (delivered to) the defendant, and check the box
below that applies. Keep all receipts that show how much you paid to have the Small Claims Writ and
Notice of Suit and related documents served on (delivered to) the defendant.
For service on (delivery to) the Defendant:
DANIEL JOSEPH TOTZKE
(Write name of Defendant)
The attached Small Claims Writ and Notice of Suit with related documents, if any, were served on
(delivered to) the defendant named above by:
(Check the box that applies)
1.) priority mail with delivery confirmation; delivery confirmation is attached. I paid $ for this, or
2.) [ ] certified mail, return receipt requested; signed return receipt is attached. I paid $
3.) a nationally recognized courier service providing delivery confirmation; tracking information showing delivery
is attached. I paid $ for this, or
4.) X a proper officer in the manner in which a writ of summons is served in a civil action; officer's return of service
filed with the court.
Signature of Plaintiff or Plaintiff's Representative
(Check one)
Plaintiff X Plaintiff's representative
Type or print name of signer Date
Kimberly A. Peterson, Esq. 10/17/2017
The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act
(ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court
clerk or an ADA contact person listed at www.jud.ct.gov/ADA/.
Document Filed Date
October 23, 2017
Case Filing Date
October 23, 2017
Category
S15 - Small Claims - Small Claims - Collection - Purchase Debt
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Preview
STATEMENT OF SERVICE — (DELIVERY) SMALL CLAIMS JD-CV-123 New 1-11 Instructions Fill out 1 form for each defendant. Attach all documents that show how the Small Claims Writ and Notice of Suit and related documents were served on (delivered to) the defendant, and check the box below that applies. Keep all receipts that show how much you paid to have the Small Claims Writ and Notice of Suit and related documents served on (delivered to) the defendant. For service on (delivery to) the Defendant: DANIEL JOSEPH TOTZKE (Write name of Defendant) The attached Small Claims Writ and Notice of Suit with related documents, if any, were served on (delivered to) the defendant named above by: (Check the box that applies) 1.) priority mail with delivery confirmation; delivery confirmation is attached. I paid $ for this, or 2.) [ ] certified mail, return receipt requested; signed return receipt is attached. I paid $ 3.) a nationally recognized courier service providing delivery confirmation; tracking information showing delivery is attached. I paid $ for this, or 4.) X a proper officer in the manner in which a writ of summons is served in a civil action; officer's return of service filed with the court. Signature of Plaintiff or Plaintiff's Representative (Check one) Plaintiff X Plaintiff's representative Type or print name of signer Date Kimberly A. Peterson, Esq. 10/17/2017 The Judicial Branch of the State of Connecticut complies with the Americans with Disabilities Act (ADA). If you need a reasonable accommodation in accordance with the ADA, contact a court clerk or an ADA contact person listed at www.jud.ct.gov/ADA/.