Party Notice: PORTFOLIO RECOVERY ASSOCIATES, LLC v. RODRIGUEZ, OSCAR

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                                SMALL CLAIMS WRIT CONNECTICUT SUPERIOR COURT
AND NOTICE OF SUIT SMALL CLAIMS SESSION Fe
‘or Court Use Only
CV. | Rev. 12-17 Do Not Write In This Space
GS. §§ 51-15, 51-
G.G.S. 85 G1-16, 51-348(6) Barcode Label Only
Type or print legibly. This Writ and Notice of Suit must be served on (delivered fo) the defendant(s)
before filing it with the court. See instructions to Plaintiff on reverse. CN é
1,) Location information that will determine where the trial will be: 12.) Case type code (See list on reverse page 1)
BRIDGEPORT CT -
Major: S$ Minor: gy
3.) Is this a claim between a landlord and a tenant (renter)? ("X" one)| 4.) if you answered "yes" to question #3, state the town where the rental premises is
Yes [X] No located:
Parties Name (Last, First, Middle Initial) and Address of Each party (Number; Street; P.O. Box; Town; State; Zip; Country, if not USA)
5) Fit GRTFOLIO RECOVERY ASSOCIATES, LLC (X" One) Xt Cpannersne |, oy
Plaintiff 120 CGRPORATE BLVD Individual [~] DBA [| Corporation
NORFOLK Va i
6.) Name, address and zip code of Attorney for Plaintiff(s) Attorney's Juris number | Telephone number (w/area code) |
Law Offices Howard Lee Schiff, P.C. 419040 (860) 528-9991
P.O. Box 280245, East Hartford, CT 06128-0245
7) First Name: OSCAR RODRIE (°X" One) Lic LPartnesiip |
Defendant |_ Address: X] Individual [] DBA [| Corporation
Telephone: py CT 06604

For more than 1 plaintifffdefendant, attach Continuation of Parties (form JD-CV-67) and "X" box.

8.) If this claim is a consumer debt, which is a debt or obligation made primarily for personal, family or household reasons, give the reasons why you believe

that the stalute oflimitations has notexpired. Tiyics cuit is commenced within the applicable
year statute _ i bie debk was a iihi
th

9.) How did you last gi \dant{s) is accurat
"X" all boxes that apply and provide the dates that the address was checked.
| checked town or city records (for example, checking a street list or tax records); (date checked)
| checked with the Department of Motor Vehicles; (date checked)
[_} | received correspondence (letters or other mail) from the defendant with that return address; (date checked)

CL | received other proof from the defendant that the address is current;

_— (description of proot
‘and date checked)

first class mail, at least 4 weeks before this smail claims action was filed, a letier to the defendant at the
address used and the letter has not been returned to me by the United States Postal Service. tz

x]

ode (last date checked
2OMF GS amed totey

70.) Amount claimed **Plus pre-judgment interest

$49, 2H Plus Costs “*Plus double damages for security deposit withheld

““if you check one or more boxes, you
MUST explain how much you want for
each item in section 11 bélow.

“The Amount Claimed may not be more than $5,000.
Do not include amounts for pre-judgment interest or doubling the security deposit in box 10.

To Defendant(s):

11.) You are being sued. The Plaintiffs) claims you owe the above amount plus costs and pre-judgment interest and/or double damages for a withheld
security deposit (if checked) for thé following reasons:

See Exhibit A, attached hereto and made a part hereof. _
See Attached Military Service Affidavit.

THIS COMMUNICATION IS FROM A DEBT COLLECTOR.

ce
The person signing below, being duly sworn, states that he or she has read the claim above and the information contained in this form and, to the best of his
or her knowledge, information and belief, there is good ground to support the claim and the information is true.
Type in name of person signing at left and title, if applicable | For Court Use Only (Date/Stamp)
tH daesning
bscpbeq and sworn to before me an (Date) SignegClork,
akg fh 7h19

er-of Superior Court)

: INON M, MUPPity
ADA Notice: The Judicial Branch of the State of Connecticut complieg“with the Apiericans wat MERABLIC
(ADA). If you need a reasonable accommodation in acdoxd th ti
or an ADA contact person listed at www.jud.ct gow/ADA. HSSION EXPIRES APR, 39 223
Distribution: Orginal - Court Copy 1 - Defendant ‘Copy 2 - Defendant Copy 3 - Plaintiff

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