Preview
FILED: TIOGA COUNTY CLERK 03/17/2023 03:33 PM INDEX NO. 2023-00062871
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 03/17/2023
..............................................................................................................................................................................................................
PAGE 1OF2
Summa of account activit Payment information
Accountno. ****-****-****-1998 Newbalance $1,462.41
Minimumpaymen1due $345.00
Previousbalance $1,386.46 Paymentduedate 04/19/2022
Payments 0.00
Othercredits 0.00 -ate payment warning:
Purchases 0.00 Ifwe do notreceiveyourminimumpaymentby 04/19/2022you may
Otherdebits 0.00 haveto payup to a $40.00latefee.
..--------..........................................................................................................
Feescharged 40.00 Minimumpaymentwarning: If youmakeonlythe minimum
Interestcharged 35.95 paymentfor eachperiod,youwill pay morein interestandit willtake
Newbalance $1,462.41 youlongerto pay off yourbalances.Forexample:
Pastdueamount 293.00 If you makeno additional
Youwill pay off Andyou will
Creditlimit $1,250.00 chargesusing this card the balanceshown end up payingan
Availablecredit $0.00 andeachmonthyou pay: on thestatement estimatedtotal
Statementclosingdate 03/24/2022 in about: of:
Daysin billingcycle 31 Onlytheminimumpayment 7 years $3410
Forinformationregardingcreditcounselingservices,
call 1-800-284-1706.
Details of your transactions
TRANS DATE______TRANSACTION
_____................_ DESCRIPTION/LOCATION
_____......................................................................................_ AMOUNT
___________.....................................................................
Fees
03/19/2022 LATEFEE 40.00
Total fees chargedfor this period $40.00
interest charged
Interestchargeon purchases $35.95
Total interestfor this period $35.95
2022totals yearto date
Totalfeeschargedin 2022 $120.00
Totalinterestchargedin 2022 $98.92
lIterest charee calculation
YourAnnualPercentageRate(APR)is the annualinterestrateonyouraccount.SeeBALANCECOMPUTATION METHOD
on page2 for moredetails.Minimuminterestchargemayexceedinterestchargebelow,peryourcreditcardagreement.
TYPEOF BALANCESUBJECT INTEREST
BALANCE APR TOINTERESTRATE CHARGE
Purchases 29.9900%(v) 1,411.44 35.95
Additional important messa"es
IMPORTANT INFORMATION ABOUT LATE FEE CREDITS
We may occasionally provide a credit for the amount. part or all, of a late fee charged to your account. If
we do, we will charge a fee of up to $40.00 for any subsequent late payment. In addition. we may reverse
the credit and repost the charge to your account if you fail to make the minimum payment due on or
before the due date in the next billing period.
-----------
________- ______-______ _CEeereverse
sideforimpoantinformation
Please
tearatperforation
above
Account
number ****-****-****-1998
B DTSf 994
;=
ailedpaymentsmustreachus by 6pmET
Yes,I havemovedor updatedmy Amount on04/19/2022.
e-mailaddress- seereverse. enclosed:
$ Pleasemakecheckpayableto:
I' I' II I II I" "" 'I " I I " I
Pleasereturnthisportionalongwithyourpaymentto:
LISANORTON-STAFFORD
4613N UNIVERSITYDR# 211 PO BOX 650967
CORALSPRINGSFL33067-4602 DALLAS TX 75265-0967
lill i I lill@11¹¹¹1l@"lillli III"ili Illill I lili
FILED: TIOGA COUNTY CLERK 03/17/2023 03:33 PM INDEX NO. 2023-00062871
NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 03/17/2023
..........................................................____________................____________......................................................................................____________..........
Keep thisportion foryourrecords. CREDIT REPORTING. Wemayreportinformation about youraccount to
What ToDoif YouThinkYouFindAMistake OnYour Statement credilbureaus. Latepayments, missed payments, orotherdefaults onyour
Ifyouthinkthereisanerroronyourstatement, writetousat:Comenity account inaybereflected inyourcreditreport.
Capital BankPOBox182620, Columbus, OH43218-2620. NOTICE OFCREDIT REPORT DISPUTES
Inyourletter,giveusthefollowing information: Ifyoubelieve theaccount information wereported toaconsumer reporting
" Account intnrmation: Yourname andaccount number. agency isinaccurate, youmaysubmiladirectdispute LoComenity Capital
" Do|lar amount: Ihedollaramount ofthesuspected error. BankPOBox182120, Columbus, OH43218-2120. Yourwritten dispute
" Description ofProblem: Ifyouthinkthereisanerroronyourbill, mustprovide sufficientinformation toidentify theaccount andspecify why
describe Ihatyoubelieve iswrong andIhy youbelieve it isamistake. theinformation isinaccurate:
" Account Information: Yourname andaccount number
Youmustcontact uswithin60days aftertheerrorappeared onyour " Contact Information: Youraddress andlelephone number
statement. " Disputed Information: Identify theaccount information disputed and
Youmustnotifyusofanypotential errors inwriting. Youmaycallus,butif explain whyyoubelieve it isinaccurate
youdowearenotrequired toinvestigate anypotential errors andyoumay " Supporting Documentation: It available, provide a copy ofthesection of
havetopaytheamount inquestion. thecreditreport showing theaccount information youaredisputing
Whileweinvestigate whether ornottherehasbeenanerror,thefollowing Wewillinvestigate thedisputed information andreport theresults toyou
aretrue: within30days ofreceipt oftheinformation needed torourinvestigation. It
" Wecannot trytocollecttheamount inquestion, orreport youas wefindthattheaccount information wereported is inaccurate, wewill
delinquent onthatamount. promptly provide thenecessary correction toeachconsumer reporting
" Thecharge inquestion mayremain onyourstatement, andwemay agency towhichwereported theinformation.
continue tocharge youinterest onthatamount. But,if wedetermine that PAYMENTS MARKED "PAID INFULL". Allwritten communications
wemade a mistake, youwillnothavetopaytheamount inquestion or regarding disputed amounts thatinclude anycheckorotherpayment
anyinterest orotherfeesrelated tothatamount. instrument marked with"payment infull''orsimilarlanguage, mustbesent
" While youdonothavetopaytheamount inquestion, youareresponsibleto:3000Kellway Drive, Suite120Carrollton, TX75006.
fortheremainder ofyourbalance. DONOTUSE THEENCLOSED REMITTANCE ENVELOPE.
" Wecanapplyanyunpaid amount against yourcreditlimit. Wemayaccept payment senttoanyotheraddress without losing anyof
ourrights.
YourRights lf You AreDissatisfied WithYour Credit CardPurchases Nopayment shalloperate asanaccord andsatisfaction Iithoutprior
Ifyouaredissatisfied withthegoods orservices thatyouhavepurchased written approval.
withyourcreditcard,andyouhavetriedingoodfaithLocorrect the CUSTOMER SERVICE. Visitcomenity.net/biglots orcall1-888-b66-/13b3
problem withthemerchant, youmayhavetherightnotto paytheremaining(TDD/TTY 1-888-819-1918).
amount dueonthepurchase.
TELEPHONE MONITORING. Toprovide youwithhigh-quality seivice,
Tousethisright,allofthefollowing mustbetrue: phone communication withusismonitored and/or recorded.
1.Thepurchase musthavebeenmade inyourhome stateorwithin100 ADDITIONAL INFORMATION. lhetollowing designations, when appearing
milesofyourcurrent mailing address, andthepurchase pricemusthave onthefrontofyourstatement, mean thefollowing: Vmeans variable rate
beenmorethan$50.(Note: Neither oftheseis necessary ifyourpurchase (thisratemayvary); WVINTPAYRQmeans WAlVE INTEREST, PAYMENT
wasbased onanadvertisement wemailed toyou,orit weownthecompany REQUIRED; WVINTEQPYmeans WAlVE INTEREST, EQUAL PAYMENT; WV
thatsoldyouthegoods orservices.) INTLOW PMTmeans WAlVE INTEREST, LOW PAYMENT; DFINTPYRQ
2.Youmusthaveusedyourcreditcardforthepurchase. Purchases made means DII I RINIIRI SI,
. PAYMI NI RIQlJIRI D; DII INII QPY means
withcashadvances tromanal Morwithacheckthataccesses yourcredit DEFER INTEREST, EQUAL
IOWPAYMFNT
PAYMENT;
andIOWAPRFQPAY
DFINTLOW PMTmeans
means IOWAPR,
DEFER
FQlJAI
cardaccount donotqualify. INTFRFST,
PAYMENT. Ifyouhaveavariable rateaccount, yourperiodic ratesmayvary.
3.Youmustnotyethave fullypaidforthepurchase. YoumaypayallofyourAccount balance atanyLime without penally.
Ifallofthecriteriaabove aremetandyouarestilldissatisfied withthe Sendallinquiries to:CUSTOMER SERVICE, POBox183003, Columbus, OH
purchase, contact usinwritingat: Comenity Capital BankPOBox182620, 43218-3003.
Columbus, OH432182620. .
Send all bankruptcy notices andrelated correspondence toComenity
Whileweinvestigate, thesame rulesapplytothedisputed amount as CapitalBank,Bankruptcy Department, POBox183043, Columbus, OH
discussed above. Afterwetinishourinvestigation, wewilltellyouour 43218-3043.
decision. Atthatpoint,if wethinkyouoweanamount andyoudonotpay
wemayreport youasdelinquent. NOTICE ABOUT ELECTRONIC .CHECK .CONVERSION. When. you provide a
checkaspayment, youauthorize useither touse.information fromyour
HOW TOAVOlD PAYING INTEREST. Yourduedateisatleast2bdaysafter checktomake a one-time electronic tundtransfer tramyouraccount orto
thecloseofeachbillingcycle.Wewillnotcharge youinterest onpurchasesprocess thepayment asachecktransaction. When weuseinformation from
ifyoupayyourentirebalance bytheduedateeachmonth. Wewillbeginlo yourchecktomake anelectronic tundtransfer, tundsmaybewithdrawn
charge interest onnewpurchases made under aLoI APR,EqualPayment fromyouraccount assoonasthesame dayIc receive yourpayment, and
orBudget Payment CreditPlanfromthedateofpurchase. youwillnotreceive yourcheckbackfromyourfinancial institution.
BALANCE COMPUTATION METHOD. Wecalculate interestseparately
l3alance" for
eachtypeofbalance onyouraccount using a "Daily todetermine
interest charges foreachbillingperiod. Wefiguretheinterest chargeon
youraccount byapplying theperiodic ratetothe"dailybalance"
balance"ofyour
account forcachdayinthebillingcycle.Togetthe"daily we
Lake thebeginning balance ofyouraccount eachday,addanynew
purchases andfees,andsubtract anypayments orcredits (treating anynet
creditbalance asazerobalance). Thisgivesusthedailybalance.
PAYMENTS. PayyourAccount bythepayment duedatebythetimelistedbelow. Ifwedonotreceive yourpayment inacorrectformat (outlined
helow)it
maynothecredited toyourAccount foruptofivedays, ormayberejected.Also,yourpaymentmustreach usbythepayment cutofftimethatappliesto
thepayment methodyouselect.
Correct
Format.Correct formatfordifferent
payment methods include:
orOvernight:
Mailing Send a personalcheck,money traveler's
order, checkorcashier'scheckpayable inlJ.S.dollars,
tothename andaddress shownon
thisStatement
inthepayment stubareacontainingyourbalance andminimum payment amount.Besuretoinclude yourpayment stub,donotstaple or
clipyourpaymenttothestub,include youraccountnumber onyourcheck, usetheenvelope providedwithyourStatement, sendonepayment withone
paymentstubanddonotsendanycorrespondence withyourpayment. Youshould ovemightapayment lo3000Kellway Suite120Carrollion,
Drive, TX
75006andtheadditional formatrequirementsarethesame asothermailedpayments unless
thereisadispute, inwhichcaseyoufollowthePayments
Marked"PaidInI ull" sectionabove.Donotsendcashorgiftcertificates.
PayByPhone: Youcancallustolltreeat1-888-b66-d353 (IDD/IIY
1-888-819-1918)tomake a payment whichmayinclude
bytelephone, afee.Online: Youcanmake a payment onlineatcomenity.net/biglots.
PaymentCutoffTimes. Payment cutofftimes/deadlines
forustoreceivepayments arebytheduedateonthisStatement inthepayment stubareaatthe
times:
following Mailingand Overnight:
By 6:00pmEastern Time (ET);PayByPhone: By 5:00pm (ET); Online:
By5:00pm(ET).
NewInformation
Title(optional)_______________
FirstName MI
LastName Soc.Sec.No. _____________
StreetAddress
Apt.No. RR____________ POBox
City ___________ State ZipCode ForeignMapCode
HomePhone WorkPhone
EmailAddress
Preview
FILED: TIOGA COUNTY CLERK 03/17/2023 03:33 PM INDEX NO. 2023-00062871 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 03/17/2023 .............................................................................................................................................................................................................. PAGE 1OF2 Summa of account activit Payment information Accountno. ****-****-****-1998 Newbalance $1,462.41 Minimumpaymen1due $345.00 Previousbalance $1,386.46 Paymentduedate 04/19/2022 Payments 0.00 Othercredits 0.00 -ate payment warning: Purchases 0.00 Ifwe do notreceiveyourminimumpaymentby 04/19/2022you may Otherdebits 0.00 haveto payup to a $40.00latefee. ..--------.......................................................................................................... Feescharged 40.00 Minimumpaymentwarning: If youmakeonlythe minimum Interestcharged 35.95 paymentfor eachperiod,youwill pay morein interestandit willtake Newbalance $1,462.41 youlongerto pay off yourbalances.Forexample: Pastdueamount 293.00 If you makeno additional Youwill pay off Andyou will Creditlimit $1,250.00 chargesusing this card the balanceshown end up payingan Availablecredit $0.00 andeachmonthyou pay: on thestatement estimatedtotal Statementclosingdate 03/24/2022 in about: of: Daysin billingcycle 31 Onlytheminimumpayment 7 years $3410 Forinformationregardingcreditcounselingservices, call 1-800-284-1706. Details of your transactions TRANS DATE______TRANSACTION _____................_ DESCRIPTION/LOCATION _____......................................................................................_ AMOUNT ___________..................................................................... Fees 03/19/2022 LATEFEE 40.00 Total fees chargedfor this period $40.00 interest charged Interestchargeon purchases $35.95 Total interestfor this period $35.95 2022totals yearto date Totalfeeschargedin 2022 $120.00 Totalinterestchargedin 2022 $98.92 lIterest charee calculation YourAnnualPercentageRate(APR)is the annualinterestrateonyouraccount.SeeBALANCECOMPUTATION METHOD on page2 for moredetails.Minimuminterestchargemayexceedinterestchargebelow,peryourcreditcardagreement. TYPEOF BALANCESUBJECT INTEREST BALANCE APR TOINTERESTRATE CHARGE Purchases 29.9900%(v) 1,411.44 35.95 Additional important messa"es IMPORTANT INFORMATION ABOUT LATE FEE CREDITS We may occasionally provide a credit for the amount. part or all, of a late fee charged to your account. If we do, we will charge a fee of up to $40.00 for any subsequent late payment. In addition. we may reverse the credit and repost the charge to your account if you fail to make the minimum payment due on or before the due date in the next billing period. ----------- ________- ______-______ _CEeereverse sideforimpoantinformation Please tearatperforation above Account number ****-****-****-1998 B DTSf 994 ;= ailedpaymentsmustreachus by 6pmET Yes,I havemovedor updatedmy Amount on04/19/2022. e-mailaddress- seereverse. enclosed: $ Pleasemakecheckpayableto: I' I' II I II I" "" 'I " I I " I Pleasereturnthisportionalongwithyourpaymentto: LISANORTON-STAFFORD 4613N UNIVERSITYDR# 211 PO BOX 650967 CORALSPRINGSFL33067-4602 DALLAS TX 75265-0967 lill i I lill@11¹¹¹1l@"lillli III"ili Illill I lili FILED: TIOGA COUNTY CLERK 03/17/2023 03:33 PM INDEX NO. 2023-00062871 NYSCEF DOC. NO. 2 RECEIVED NYSCEF: 03/17/2023 ..........................................................____________................____________......................................................................................____________.......... Keep thisportion foryourrecords. CREDIT REPORTING. Wemayreportinformation about youraccount to What ToDoif YouThinkYouFindAMistake OnYour Statement credilbureaus. Latepayments, missed payments, orotherdefaults onyour Ifyouthinkthereisanerroronyourstatement, writetousat:Comenity account inaybereflected inyourcreditreport. Capital BankPOBox182620, Columbus, OH43218-2620. NOTICE OFCREDIT REPORT DISPUTES Inyourletter,giveusthefollowing information: Ifyoubelieve theaccount information wereported toaconsumer reporting " Account intnrmation: Yourname andaccount number. agency isinaccurate, youmaysubmiladirectdispute LoComenity Capital " Do|lar amount: Ihedollaramount ofthesuspected error. BankPOBox182120, Columbus, OH43218-2120. Yourwritten dispute " Description ofProblem: Ifyouthinkthereisanerroronyourbill, mustprovide sufficientinformation toidentify theaccount andspecify why describe Ihatyoubelieve iswrong andIhy youbelieve it isamistake. theinformation isinaccurate: " Account Information: Yourname andaccount number Youmustcontact uswithin60days aftertheerrorappeared onyour " Contact Information: Youraddress andlelephone number statement. " Disputed Information: Identify theaccount information disputed and Youmustnotifyusofanypotential errors inwriting. Youmaycallus,butif explain whyyoubelieve it isinaccurate youdowearenotrequired toinvestigate anypotential errors andyoumay " Supporting Documentation: It available, provide a copy ofthesection of havetopaytheamount inquestion. thecreditreport showing theaccount information youaredisputing Whileweinvestigate whether ornottherehasbeenanerror,thefollowing Wewillinvestigate thedisputed information andreport theresults toyou aretrue: within30days ofreceipt oftheinformation needed torourinvestigation. It " Wecannot trytocollecttheamount inquestion, orreport youas wefindthattheaccount information wereported is inaccurate, wewill delinquent onthatamount. promptly provide thenecessary correction toeachconsumer reporting " Thecharge inquestion mayremain onyourstatement, andwemay agency towhichwereported theinformation. continue tocharge youinterest onthatamount. But,if wedetermine that PAYMENTS MARKED "PAID INFULL". Allwritten communications wemade a mistake, youwillnothavetopaytheamount inquestion or regarding disputed amounts thatinclude anycheckorotherpayment anyinterest orotherfeesrelated tothatamount. instrument marked with"payment infull''orsimilarlanguage, mustbesent " While youdonothavetopaytheamount inquestion, youareresponsibleto:3000Kellway Drive, Suite120Carrollton, TX75006. fortheremainder ofyourbalance. DONOTUSE THEENCLOSED REMITTANCE ENVELOPE. " Wecanapplyanyunpaid amount against yourcreditlimit. Wemayaccept payment senttoanyotheraddress without losing anyof ourrights. YourRights lf You AreDissatisfied WithYour Credit CardPurchases Nopayment shalloperate asanaccord andsatisfaction Iithoutprior Ifyouaredissatisfied withthegoods orservices thatyouhavepurchased written approval. withyourcreditcard,andyouhavetriedingoodfaithLocorrect the CUSTOMER SERVICE. Visitcomenity.net/biglots orcall1-888-b66-/13b3 problem withthemerchant, youmayhavetherightnotto paytheremaining(TDD/TTY 1-888-819-1918). amount dueonthepurchase. TELEPHONE MONITORING. Toprovide youwithhigh-quality seivice, Tousethisright,allofthefollowing mustbetrue: phone communication withusismonitored and/or recorded. 1.Thepurchase musthavebeenmade inyourhome stateorwithin100 ADDITIONAL INFORMATION. lhetollowing designations, when appearing milesofyourcurrent mailing address, andthepurchase pricemusthave onthefrontofyourstatement, mean thefollowing: Vmeans variable rate beenmorethan$50.(Note: Neither oftheseis necessary ifyourpurchase (thisratemayvary); WVINTPAYRQmeans WAlVE INTEREST, PAYMENT wasbased onanadvertisement wemailed toyou,orit weownthecompany REQUIRED; WVINTEQPYmeans WAlVE INTEREST, EQUAL PAYMENT; WV thatsoldyouthegoods orservices.) INTLOW PMTmeans WAlVE INTEREST, LOW PAYMENT; DFINTPYRQ 2.Youmusthaveusedyourcreditcardforthepurchase. Purchases made means DII I RINIIRI SI, . PAYMI NI RIQlJIRI D; DII INII QPY means withcashadvances tromanal Morwithacheckthataccesses yourcredit DEFER INTEREST, EQUAL IOWPAYMFNT PAYMENT; andIOWAPRFQPAY DFINTLOW PMTmeans means IOWAPR, DEFER FQlJAI cardaccount donotqualify. INTFRFST, PAYMENT. Ifyouhaveavariable rateaccount, yourperiodic ratesmayvary. 3.Youmustnotyethave fullypaidforthepurchase. YoumaypayallofyourAccount balance atanyLime without penally. Ifallofthecriteriaabove aremetandyouarestilldissatisfied withthe Sendallinquiries to:CUSTOMER SERVICE, POBox183003, Columbus, OH purchase, contact usinwritingat: Comenity Capital BankPOBox182620, 43218-3003. Columbus, OH432182620. . Send all bankruptcy notices andrelated correspondence toComenity Whileweinvestigate, thesame rulesapplytothedisputed amount as CapitalBank,Bankruptcy Department, POBox183043, Columbus, OH discussed above. Afterwetinishourinvestigation, wewilltellyouour 43218-3043. decision. Atthatpoint,if wethinkyouoweanamount andyoudonotpay wemayreport youasdelinquent. NOTICE ABOUT ELECTRONIC .CHECK .CONVERSION. When. you provide a checkaspayment, youauthorize useither touse.information fromyour HOW TOAVOlD PAYING INTEREST. Yourduedateisatleast2bdaysafter checktomake a one-time electronic tundtransfer tramyouraccount orto thecloseofeachbillingcycle.Wewillnotcharge youinterest onpurchasesprocess thepayment asachecktransaction. When weuseinformation from ifyoupayyourentirebalance bytheduedateeachmonth. Wewillbeginlo yourchecktomake anelectronic tundtransfer, tundsmaybewithdrawn charge interest onnewpurchases made under aLoI APR,EqualPayment fromyouraccount assoonasthesame dayIc receive yourpayment, and orBudget Payment CreditPlanfromthedateofpurchase. youwillnotreceive yourcheckbackfromyourfinancial institution. BALANCE COMPUTATION METHOD. Wecalculate interestseparately l3alance" for eachtypeofbalance onyouraccount using a "Daily todetermine interest charges foreachbillingperiod. Wefiguretheinterest chargeon youraccount byapplying theperiodic ratetothe"dailybalance" balance"ofyour account forcachdayinthebillingcycle.Togetthe"daily we Lake thebeginning balance ofyouraccount eachday,addanynew purchases andfees,andsubtract anypayments orcredits (treating anynet creditbalance asazerobalance). Thisgivesusthedailybalance. PAYMENTS. PayyourAccount bythepayment duedatebythetimelistedbelow. Ifwedonotreceive yourpayment inacorrectformat (outlined helow)it maynothecredited toyourAccount foruptofivedays, ormayberejected.Also,yourpaymentmustreach usbythepayment cutofftimethatappliesto thepayment methodyouselect. Correct Format.Correct formatfordifferent payment methods include: orOvernight: Mailing Send a personalcheck,money traveler's order, checkorcashier'scheckpayable inlJ.S.dollars, tothename andaddress shownon thisStatement inthepayment stubareacontainingyourbalance andminimum payment amount.Besuretoinclude yourpayment stub,donotstaple or clipyourpaymenttothestub,include youraccountnumber onyourcheck, usetheenvelope providedwithyourStatement, sendonepayment withone paymentstubanddonotsendanycorrespondence withyourpayment. Youshould ovemightapayment lo3000Kellway Suite120Carrollion, Drive, TX 75006andtheadditional formatrequirementsarethesame asothermailedpayments unless thereisadispute, inwhichcaseyoufollowthePayments Marked"PaidInI ull" sectionabove.Donotsendcashorgiftcertificates. PayByPhone: Youcancallustolltreeat1-888-b66-d353 (IDD/IIY 1-888-819-1918)tomake a payment whichmayinclude bytelephone, afee.Online: Youcanmake a payment onlineatcomenity.net/biglots. PaymentCutoffTimes. Payment cutofftimes/deadlines forustoreceivepayments arebytheduedateonthisStatement inthepayment stubareaatthe times: following Mailingand Overnight: By 6:00pmEastern Time (ET);PayByPhone: By 5:00pm (ET); Online: By5:00pm(ET). NewInformation Title(optional)_______________ FirstName MI LastName Soc.Sec.No. _____________ StreetAddress Apt.No. RR____________ POBox City ___________ State ZipCode ForeignMapCode HomePhone WorkPhone EmailAddress