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State Marshal RICHARD FRY
P.O. Box 302 ~ Derby, CT 06418
SCHREIBER / COHEN
53 STILES RD, STE A102
SALEM, NH 03079
RETURN OF WAGE EXECUTION
STATE OF CONNECTICUT Date: 9/15/2019
SS: Derby
COUNTY OF NEW HAVEN
In the matter concerning; MIDLAND FUNDING V: ROBERT LEAK
Then and there, by virtue hereof , on January 12, 2018 in the town of WEST HAVEN, CT 06516 I made
service of the within original Wage Execution , by leaving two True and Attest Copies and form for Exemption
with CITY LINE DISTRIBUTORS, INC, 20 INDUSTRY DR EXT, WEST HAVEN, CT 06516, the
defendants employer with my doings thereon endorsed.
The employer notified me that the defendant is no longer employed. .
Therefore, I am returning this wage execution PARTIALLY SATISFIED.
Attest
RICHARD FRY
State Marshal
New Haven CountyPl
WAGE EXECUTION PROCEEDINGS STATE OF CONNECTICUT APPINEX
« APPLICATION, ORDER, EXECUTION SUPERIOR COURT LE
JD-CV-3 Rev. 2-15 www.jud.ct.gov WaGEse
C.GS. §§ 31-68(j), 52-350a, §2-361a, 52-356d,
Zaeisl®
29 U.S.C. 206(a)(1) loye: tru
Instructions AUT
Judgment Creditor or Attomey Clerk Proper Officer
4. Unless fling electronically, prepare original and four coples. 4, Issue execution by signing original. 4. Leave one signed copy with employer.
2. Attach form JD-CV-3a to this form, or Include with execution 2. Enter any court ordered limitation at the bottom of 2, Make return on signed original.
as one PDF electronic form. section Il on page 2. 3. Leave one copy of Modification and Exemption
3, Present original and 3 copies to clerk of court. 3, Return original and 2 coples i on paper. Claim form (JD-CV-3a) with employer and fill in
4. Keep one copy foryour file. . 4, Retain/scan copy for court file. “Date of Service" on form.
Name and mailing address of Judgment Creditor or Attomey
(To be completed by Judgment Creditor or Atomey)
ADA NOTICE
v 71 The Judicial Branch of the State ‘ca
COHEN of Connecticut complies with the Americans
oe oreeR AS HEN LLG: with Disabilities Act (ADA). Ifyou need a
reasonable accommodation in accordance
SUITE A102 with the ADA, contact a court clerk or an ADA.
SALEM NH 03079 Contact petson listed at www.jud.ct.gov/ADA,
L a
SS] Address of count (Number, Seal and Town) Tea Flan Housing Session | Dale ofjudgment | Docket number
is (23 Hhufst chamara CT Gos | ans0i6 keeausesntes
Name(s) and address(es) of Judgment Credior(sy Name(s) and address(es) of Judgment Debtors) FSTOVIGSCLOWICS
MIDLAND FUNDING, LLC ROBERT LEAK
3111 CAMINO DEL RIO NORTH 12 RANSON ST 2
SUITE 103 STAMFORD CT oss02
SAN DIEGO CA 92108 .
5
g
°g_| Name and address of emplayer of Judgment Debtor (ifRnowny & Telephone number of employer (i known)
a City Line Distributors; Inc., 20 Industry Dr West Haven CT 06516
& | *- Amount ofjudament (include where applicable, prejudgment interest and alomay's Tees) 2, Amount of costs and fees
$664.67
$95.05
8. Total amount ofjudgment, costs and fees (Add 7 and a) . Total amount paid (iFany) i §. Total amount unpaid (Subtract 4 from a)
$759.72 $0.00 $759.72
6. Application fee for wage execution (if not walved by the cour) | 7. Application fees pald Tor por @xecutions On this judgment
$105.00 $105.00
8. Other Court ordered postjudgment costs and fees [6 Total oflines 6, 6,7 and SW
$0.00 ‘| $969.72
The above-named Judgment Creditor(s) recovered
failed to pay the total amount due on that judgment.
Pursuant to the Connecticut Generat Statutes, the Court listed above entered an order that the judgment be paid by the above-named
Judgment Debtor(s) in the following installment payments:
Check if applicable
Postjudgment interest was
ordered by the Court
a judgment against the above-named Judgment Debtor(s). The Judgment Debtor(s) has/have
The amount of 35.00 was ordered to be paid in Weekly (weekly, monthly, or other) installment Payments. *See Note below
(Note: This is not the amount the employer must pay. Employer must pay the amount of execution calculated on Page 2 of this form.
The court ordered that installment payments begin on 04/1: 2/2016 (commencement date).
.The Judgment Debtor(s) failed to comply with the Installment Payment Order. =
§ Therefore, the Judgment Creditor(s) applies/apply for this execution upon the wages of the Judgment Debtor(s) for the remaining amount
© | due on the judgment shown in line 9 above Saas
Q | [Sioned (Judgment Creditor or Attorney) On (Date) Telephone Number FSGS your is'nt
le
a 438731 JEFFREY-A SCHREIBER 9/18/2018 800-423-8142
To: Any Proper Officer 3
By the authority of the State of Connecticut, you are ordered to cause any wages due to the Judgment
Debtor(s), not exceeding the Amount of Execution calculated on Page 2, to be pald to the Judgment
Creditor(s) until the Judgment is satisfied, including postjudgment interest as ordered by the court, if
applicable, plus the application fee(s) and other Court ordered pos{judgment costs and fees, and your own
fees or until the execution is modified or set aside. :
Serve this execution within one year of this date, and make return of. Service to this courtwithin thirty days
from satisfaction of the execution, .
Signed (Assistant Clerk of said court) ‘On (Datey
° este 03.0]
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