Preview
INDEX NO. 001069-2019
NYSCEF DOC. NO. 5 RECEIVED NYSCEF 12/10/2020
GESTION &
SS
Mary F. Strickland , County Clerk
Livingston County Government Center
=e 6 Court Street, Room 201
AY
Geneseo, New York 14454
1821
(585) 243-7010 ~ Fax (585) 243-7928
KY
or
‘OR!
Livingston County Clerk Recording Page
Received From: Return To:
KEITH H. ROTHMAN KEITH H. ROTHMAN
1787 VETERANS HWY 1787 VETERANS HWY
ISLANDIA, NY 11749 ISLANDIA, NY 11749
Document Type: CIVIL ACTION - MISC Document Desc: AFFIDAVIT
Plaintiff Defendant
DEPARTMENT STORES NATIONAL BANK CAREY DAWN E
Recorded Information:
State of New York
Index #: 001069-2019
Tag
County of Livingston
EFiling through NYSCEF
Livingston County Clerk
This sheet constitutes the Clerk's endorsement required by section 319 of the Real Property Law of the State of New York
AKB Do Not Detach
= V ON OUN NK WV IND&6xI80:.009 0498912019
woh 8
NYSCEF BOC. NO. 5
SUPREME COURT OF THE STATE OF NEW YORK R & R File No. 1320517
COUNTY OF LIVINGSTON
Doe eee eee eeeeee eee s 051
DEPARTMENT STORES NATIONAL BANK
Plaintiff
-against-
DAWN E CAREY
Index No 001069-2019
wee eee ee eee eee ee eee
Defendant (s)
eee
2 of 11
wen
Been 8:.0090698012 01
NYSCEF DOC. NO. 5 INWBLER
UI HIME 0/2020
000005765214
SUPREME COURT OF THE STATE OF NEW YORK Our File No. 1320517
COUNTY OF LIVINGSTON
wee eee e en eee ee ene eee eee eee
DEPARTMENT STORES NATIONAL BANK
Plaintiff,
-against-
Index No. 001069-2019
DAWN E CAREY
Defendant.
eee e ee ee eee - eee ee eee --
COVER SHEET
TO BE ATTACHED
AFFIDAVIT OF MERIT
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INDBeN8:.0090698919.019
FILED: LIVINGSTON COUNTY CLERK 12/10/2020 11:58 Atl
NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF LIVINGSTON
Department Stores National Bank
INDEX NO.: 001069-2019
Plaintiff,
vs.
Case No
DAWN E CAREY
Defendant.
AFFIDAVIT OF FACTS BY ORIGINAL CREDITOR
STATE OF KENTUCKY )
)ss.
COUNTY OF BOONE )
The undersigned, being duly sworn, deposes and says:
| am an employee of Citibank N.A., and | have personal knowledge of and access to Plaintiff's books and records
("Business Records"), including electronic records, relating to the account ("Account") of DAWN E CAREY. The last four
digits of the Account number are 2507. In my position, | have personal knowledge of Plaintiff's procedures for creating
and maintaining its Business Records. Plaintiff's Business Records were made in the regular course of business and it
was the regular course of such business to make the Business Records. The records were made at or near the time of
the events recorded. Based on my review of Plaintiff's Business Records, | have personal knowledge of the facts set forth
in this affidavit.
Plaintiff and Defendant entered into a credit agreement ("Agreement"), the terms of which Agreement are reflected in the
periodic statements delivered to Defendant by Plaintiff. Defendant agreed to pay Plaintiff for all goods, services and cash
advances provided pursuant to the Agreement. The amount of the last payment, if any, made by Defendant was $27.00,
made on 12/22/2018. Defendant is now in default and demand for payment has been made. A true and correct copy of
the charge-off statement is attached as an exhibit to this affidavit.
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NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020
3. At this time, Defendant owes $2,450.61 on the Account. This amount includes a charge-off balance of $2,450.61, post-
charge-off interest of $0.00, post-charge-off fees and charges of $0.00, less any post-charge-off credits or payments
made by or on behalf of the Defendant of $0.00.
WHEREFORE, deponent demands judgment against Defendant for $2,450.61, (plus interest from N/A, if applicable),
together with the costs and disbursements of this action. The above statements are true and correct to the best of my
personal knowledge.
J solemnly affirm under the penalties of perjury and upon personal knowledge that the contents of the foregoing paper are true.
EXECUTED on {a 2 20_)F
Osiithalee Welhre
Signature
Christopher Rothfuss
Name
STATE OF KENTUCKY )
) ss.
COUNTY OF BOONE )
Subscribed and sworn to before me by _Christopher Rothfuss_this ab day of D ec ool
DLa
Notary Public
(bv [SEAL]
Notary Public, 1D NO, 631735
My commission expires:
September26, 2023 My Commission Exp Sapte 6, 2008
Personally known OR
—
Produced identification
Type of identification produced:
Citi Employee Badge
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NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020
SUPPLEMENTAL AFFIDAVIT OF FACTS BY ORIGINAL CREDITOR
(Original Creditor Actions)
Before me, the undersigned authority, personally appeared the person identified below, who being by me duly sworn,
deposed as follows:
1. My name is Christopher Rothfuss . |am of sound mind, lawful age and capable of making this Affidavit. The
statements set forth in this affidavit are true and correct based on my personal knowledge and review of the business
records described herein. | am authorized to make this affidavit on behalf of Plaintiff, Department Stores National Bank
(referred to herein as "DSNB"). DSNB is a National Bank located in Sioux Falls, South Dakota.
Department Stores National Bank is a subsidiary of Citibank, N.A. (referred to herein as "Citibank").
|! am employed by Citibank. My job title is Document Control Officer. My employment duties include being a custodian of
records with respect to accounts owned by DSNB and Citibank. As a custodian of records, | have knowledge of, and
access to, account information and records concerning the defendant's DSNB account number currently ending in 2507,
which is the subject of this lawsuit (the "Account"). As a result, | am competent to testify to the matters contained in the
Affidavit of Facts by Original Creditor executed by me contemporaneously with my signing of this affidavit.
| solemnly affirm under the penalties of perjury and upon personal knowledge that the contents of the foregoing
Paper are true.
Dated: /d- 4 - 019 Dristyele Pllfao
STATE OF KENTUCKY )
ss.
COUNTY OF BOONE )
Sworn to before me this AG day
of EC , 20, 19
Notary Publi, 1D NO. 631735
AL
Notary Public
Un ‘My Commission
Expires Septer mber
26, 2023
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NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020
CERTIFICATE OF CONFORMITY
I, Kyle Michael, an attorney-at-law of the State of Kentucky who is licensed to practice law in the State of
Kentucky and is fully acquainted with the laws of the State of Kentucky pertaining to the acknowledgement or
proof of deeds of real property to be recorded therein, do hereby certify that I am duly qualified to make this
certificate of conformity pursuant to Section 299-a of the Real Property Law of the State of New York and
hereby certify that the acknowledgement or proof upon the foregoing document was taken by Devin Clark,
notary public in the State of Kentucky, in the manner prescribed by the laws of the State of Kentucky and
conforms to the laws thereof in all respects.
IN WITNESS WHEREOF, I have hereunto set my signature, this 26" day of
December 2019.
Kyle Michael
Kentucky Bar #97520
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: INDBXeN8:.0090698919.019
NO. 5 RECEIVED NYS! 7/10/2020
macys AMERICAN]
ESS
Macy's American Express® Account statement
Questions or lost/stolen card? Call Customer Service 1-800-782-7756 DAWNE CAREY
i Go to macys.com/creditto manage and pay your account online. Account Number:2507
Summary of Account Activity (Payment Information
Previous Balance $2,355.57_ New Balance $2,450.61
Payments. -$0,00, Minimum Payment Due $1,252.39
Other Credits -$0.00, Payment Due Date September 2, 2019
Purchases/Other Debits +$0.00
Fees Charged. +$38.00. Late Payment Warning: If we do not receive your minimum payment by the date
Interest Charged +$57.04 listed above, you may have to pay alate fee up to $38.
© New Balance $2,450.61 Minimum Payment Warning: If you make only the minimum payment each
Past Due Amount $681.74) period, you will pay more in interest and it will take you longer to pay off your
balance. For example:
(Credit Limit $0.0
Fi lf our
oe en= iorad io SU will
a
Offthe ae = ae nd
aa
i § will:
Available Credit. __$0.00 ge: iSil Care e shi on,on —- Paying
ea OUou pa ent a Bishof
Amount Over Credit Limit on $450.61_| stlst
Statement Cl ig Date 08/06/2019 _ Only the minimum payment 10 years "$4,936
Next Statement Closing Date 09/05/2019 | $100 3 years $3,613
\Days in Billing Cycle 32_) (avings=$1,323)
if you would like information about credit counseling services, call 1-877-337-8188,
New York residents may contact the New York State Department of Financial Services by telephone, 1-800-342-3736, or visit its website, www.dfs.ny.gov,
for free information on comparative credit card rates, fees and grace periods.
Please note that if we received your pay by phone or online payment between § p.m. ET and midnight ET on your Statement Closing Date identified on your
last statement, that payment will appear on your next statement.
¥e macys star rewards
PLEASE SEE IMPORTANT INFORMATIONON REVERSE SIDE. Page 1 of 4 This Accounts Issued by Department Stores National Bank.
ae cet nee o os nanan wae BMA
kmacys
P.O. BOX 8052
a Macy’s American Express Account
Payment Due Date
Account Number: E2507
MASON, OH 45040-8052
September 2, 2019
Please return this slip with payment. Write account
number on front of check. You can pay at any Macy's New Balance $2,450.61
store, online at macys.com/credit, or by mail. Minimum Payment Due $1,252.39
Payments receivedby mail by 5:00 pm local time
Your Statement Enclosed
at the address shown below will be credited as of wees
the date received. t
Amount Enclosed:
Use reverse side for address changes.
aia
Make Check Payable to: Macy's
‘v Mail to address beloww
Macy's American Express Account
DAWN E CAREY PO BOX 9001108
7133 W SWAMP RD LOUISVILLE, KY 40290-1108
CONESUS, NY 14435-9707
EXHIBIT A
o?401 01252349 O24S0b1 0002700 DSO? O213
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NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020
Information About Your Account. ‘Ifyou send an eligible check with this payment coupon, you authorize us to complete your
How to Avoid Paying Interest on Purchases. Your payment due date is at least 25 days after payment by electronic debit. If we do, the checking account will be debited in the amount.
the close of each billing cycle. We will not charge you any interest on purchases it you pay your New ‘on the check, We may do this as soon as the day we receive the check. Also, the check
Balanceby the payment due date each month, This is called a grace period on purchases, Thereis no will be destroyed.
«rave period on excluded promotional balances.
if you have a balance subject to a Special Event promotion and that promotion does not expire before if
Disputed Amounts. All communications conceit disputed amounts, including any check or other
yayment instrument in an amount less than the full amount due that you send to us marked “paid
in full” or which you otherwise tender as full satisfaction of a disputed amount, must be sent to us at
the payment due date, that balance (an “excluded promotional balance”) is excluded fram the amount
you mist pay in fll to get a grave period on a purchase balance. In alton, if you have a Club Plan P.O, Box 8097, Mason, Ohio 45040, Z
balance, that balance (an “excluded promotional balance") is excluded from the amount you must pay Credit Reporting Disputes. We may report information about your account to crecit bureaus.
in full to get a grace period on a purchase balance, However, you must still pay ary separately required Ifyou tink we reported inaccurate information toa credit bureau write us at: Credit Bureau Dispute
payment on the excluded promotional balance. In bili cycles in which payments are allocated to Verification, P.0. Box 8218, Mason, OH 45040.
‘Special Event balances first, the Special Event balance will be reduced before any other balance on the
account. However, you will continue to get a grace period on purchases, so long as you pay the New Bankruptey Notices. if you send any natice for bankruptcy purposes relating to this account, you
‘must mail it to the following address: Bankruptcy Processing, P.0. Box 8053, Mason, OH 45040.
Balance (less any excluded promotional lance, plus any separately required payment on an excluded Report a Lost or Stolen Card Immediately. Call the Customer Service number shown on page 1 of this
promotional balance) in full by the payment due date each biling cycle. ‘statement. For TDD/TTY (Telecommunications Device for the Deaf} assistance, call 1-800-281-082¢
Other promotional offers not described above may also allow you to have a grace period on purchases. ‘What To Do If You Think You Find A Mistake On Your Statement, If you think there is an error on
‘without having to pay all or a portion of the promotional balance by the payment due date. If either is ‘your statement, write to us at: Department Stores National Bank, P.O. Box 8097, Mason, Ohio 45040.
the case, the promotional offer will describe what happens.
How We Calculate Your Balance Subject to Interest Rate. We use a daily balance method
In your letter, give us the following information
{including current transactions) to calculate interest charges. To find out more information about the © Account information: Your name and account number.
balance computation method
for your account
and how the resuiting interest charges were determined, amount: The dollar amount of the suspected error.
contact us at the Customer Service number on the front of this statement. * Description of Problemy: Ifyou think thee isan error on you bil, describe whatyou belive is wrong
Other Account and Payment Information. ‘and why you believe it s a mistake,
Payment Amount. You may pay all or part of your account balance at any time. However, you must You must contact us within 60 days after the error appearedon your statement.
pay, by the payment due date at least the minimum payment due You must ntify us of any potential erors in writing. You may callus, but if you do we are nol required
When Your Payment Will Be Credited. I we receive your payment in proper form a our processing to investigate any potential errors and you may have to pay the amount in question
facility by 5 p.m, local time ther, it wil be credited as of thal day. A payment received there in proper ‘While we investigate ther of not there fas been an error, the following are true:
form after that time will be credted as ofthe next day. Alow 5 to 7 cays for paymentsby regular mail ‘© We cannot try to collect the amount in question, or report you as delinquent on that amount.
to reach us. There may be a delay of up to 5 days in crediting a payment we receive that is notin ‘© The charge in question may remain on your statement, and we may continue to charge you interest
Proper form or is not sent to the correct address. The correct address for regular mail is the address ‘on that amount. But, if we determine that we made a mistake, you will not have to pay the amount
on the fron of the payment coupon, The correct address for express mai fs shown in the Express in question or any interest or other fees related to that amount.
‘Mail section.
Proper Form. For a payment sent by maior courier to bein proper form, you must: «While you do not have to pay the amount in question, you ae responsible for the remind of your balance,
* Enclose a valid check or money order. No cash, gf cards, or foreign currency please. * We can apply any unpaid amount against your ere
Your Rights If You Are Dissatisfied With Your Credit Card Purchases. if you are dissatisfied
* Include your name and the last four digits of your account number. with the goods or services that you have purchased with your creditcard, and you have tried in good
Document Production Fee. We may charge you a fee of $3,00 per item f you request conies faith to correct the problem with the merchant,you may have the right not fo pay the remaining amount
of previously provided records, such as Statements and sales checks, We will not charge you for
documents produced in connection with a Billing Error investigation.
due on the purchase.
To use this right, all of the following must be true:
Payment Other Than By Mail. 1, The purchase must have been made in your home state or within 100 miles of ur current mailing
* In-Store. Any payment in proper form accented in-store will be credited as ofthat day. However, adress, and the purchase price must have been more than $50. (Note leither of these are
credit avallabity maybe subject to verification of funds, ‘necessary if your purchase was based on an advertisement we mailed to you, or if we own the
. Online/AutoPay. Go to the URLon Page 1 of your statement to make a payment online. You can company that sold you the goods or services.)
also enroll in AutoPay and have your payment amount automatically deducted each month from the 2. You must have used your credit card for the purchase. Purchases made with cash advances from
‘payment account you choose. ‘an ATM or with a check that accesses your credit card account do not qualify.
Phone. Call the number on Page 1 of your statement to make @ payment by phone. For phone 3. You must not yet have fully paid for the purchase.
payments, you authorize Department Stores National Bank to electronically debit your specified {fall of the criteria above are met and you are still dissatisfied with the purchase, contact us in yariting
bank account an ACH transaction in the amount and on the date that you indicate on the phone.
You may cancel a phone payment by caling us al the Customer Service number atthe lop of Page at: Department Stores National Bank, P.0. Box 8097, Mason, OH
+ within the time period disclosed to you onthe phone. There is no fee for makinga payment using ‘While we investigate, the same rules apply to the disputed amount as discussed above. Afterwe finish
‘our automated voice response syste our investigation, we will tell you our decision, At that point, if we think you owe an amount and you do
Express Mail. Send! payment by express rail fo: Consumer Payment Dept, 6716 Grade Lane, ‘not pay, we may report you as delinquent.
The Bloomingdale's American Express Card program and Macy's American Express Card program
Building 9, Suite 910, Louisville, KY 40213.
Crediting Payments other than by Mail. The payment cutoff time for Online bill payments, are issued and administered by Department Stores National Bank. American Express is a federally
fegistered service mack of American Express and is used by Department Stores National Bank
Phone payments, and Express Mail payments is midnight Eastern time. This means that we ill pursuait toa license
credit your account as of the calendar day, based on Eastern time, that we receive your payment
request ‘AmexSLAPRI9
1A/- -71-N-D 19. + 1962
a 6026. 7700-0000 X-25-10/-P
- - -0-N-1D/-7- + + -0-0-0-JE/- 01/07/19 - 12/01/18-
8 - March 3, 2019
- July 5, 2019
0+ = MX7B-V-D- . Vv oon nN -
Page2of 4
Hew information? For new address, telephone or email, goto macys.com/credit *Phone: By giving us a cell numberor a number later converted
‘renter the new information below. fo change your name, please indicate the new name below.
<
toa cell number, you agree that we or our service providers can
7 T contact you at that number by autodialer, recorded or artificial
[NAMECHANGE! 1 1 voice, or a text. Your phone plan charges may apply.
HpaI T r T r
r
to **Enter Email Address If you provide your email address, you
authorize 1) the account issuer for this account to contact you
cayDt a sme ah |~ about your account and tell you about useful products and
services; and 2) Macy's to email you information about receiving
3 rer
(Ce deb AO M ae L
promotions, sales, special events and other offers.
EMAIL”
Sign up for electronic statements.
It’s fast, easy and convenient.
Make the switch today!
Go to macys.com/gopaperless
0 RECYCLABLE
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NYSCEF DOC. NO. 5_ RECEIVED NYSCEF: 12/10/2020
macys Account number ending in 2507
Fees
Transaction Date Description . Amount
ug 02 LATE FEE $38.00
TOTAL FEES FOR THIS PERIOD $38.00
Interest Charged
Transaction Date ___ Description. Amount
‘Aug06 INTEREST CHARGE ON PURCHASES. $57.04
TOTAL INTEREST FOR THIS PERIOD $57.04
a ae
3 pet
Total Fees Charged in 2019 $255.00
Total Interest Charged in 2019 $371.78
Activity and Promotions Detail
Original Purchases,
Promotion Promotion Payments Cash Adv, Promotion Deferred Promotion
Trans Trans Previous. & Other Fees & Interest New Minimum Interest Expiration
Amount Date Balance Credits Other Debits Charged Balance Payment Due Charges Date
TRANSACTIONS.
REGULAR
$2,355.57 $38.00 $57.04 $2,450.61
CASH ADVANCES. ~
REGULAR:
- - -
TOTAL $2, 3ST $0.00 Gano $57.04 Bass $0.00 $0.00
Interest Charge Calculation Your Annual Percentage Rate (APR) is the annual interest r fate on your account
iTa ype lal (Annual Percentage Rate (APR): Balance Subject to Interest Rates. Inte
TRANSA\ TIONS
REGULAR 27.24% (V) $2,388.96 $57.04
CASH ADVANCES,
REGULAR 27.24% (V) $0.00 $0.00
(W)= Variable Rate
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macys :
Account number ending in 2507
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INDEX NO. 001069-2019 NYSCEF DOC. NO. 5 RECEIVED NYSCEF 12/10/2020 GESTION & SS Mary F. Strickland , County Clerk Livingston County Government Center =e 6 Court Street, Room 201 AY Geneseo, New York 14454 1821 (585) 243-7010 ~ Fax (585) 243-7928 KY or ‘OR! Livingston County Clerk Recording Page Received From: Return To: KEITH H. ROTHMAN KEITH H. ROTHMAN 1787 VETERANS HWY 1787 VETERANS HWY ISLANDIA, NY 11749 ISLANDIA, NY 11749 Document Type: CIVIL ACTION - MISC Document Desc: AFFIDAVIT Plaintiff Defendant DEPARTMENT STORES NATIONAL BANK CAREY DAWN E Recorded Information: State of New York Index #: 001069-2019 Tag County of Livingston EFiling through NYSCEF Livingston County Clerk This sheet constitutes the Clerk's endorsement required by section 319 of the Real Property Law of the State of New York AKB Do Not Detach = V ON OUN NK WV IND&6xI80:.009 0498912019 woh 8 NYSCEF BOC. NO. 5 SUPREME COURT OF THE STATE OF NEW YORK R & R File No. 1320517 COUNTY OF LIVINGSTON Doe eee eee eeeeee eee s 051 DEPARTMENT STORES NATIONAL BANK Plaintiff -against- DAWN E CAREY Index No 001069-2019 wee eee ee eee eee ee eee Defendant (s) eee 2 of 11 wen Been 8:.0090698012 01 NYSCEF DOC. NO. 5 INWBLER UI HIME 0/2020 000005765214 SUPREME COURT OF THE STATE OF NEW YORK Our File No. 1320517 COUNTY OF LIVINGSTON wee eee e en eee ee ene eee eee eee DEPARTMENT STORES NATIONAL BANK Plaintiff, -against- Index No. 001069-2019 DAWN E CAREY Defendant. eee e ee ee eee - eee ee eee -- COVER SHEET TO BE ATTACHED AFFIDAVIT OF MERIT 3 of 11 INDBeN8:.0090698919.019 FILED: LIVINGSTON COUNTY CLERK 12/10/2020 11:58 Atl NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020 SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF LIVINGSTON Department Stores National Bank INDEX NO.: 001069-2019 Plaintiff, vs. Case No DAWN E CAREY Defendant. AFFIDAVIT OF FACTS BY ORIGINAL CREDITOR STATE OF KENTUCKY ) )ss. COUNTY OF BOONE ) The undersigned, being duly sworn, deposes and says: | am an employee of Citibank N.A., and | have personal knowledge of and access to Plaintiff's books and records ("Business Records"), including electronic records, relating to the account ("Account") of DAWN E CAREY. The last four digits of the Account number are 2507. In my position, | have personal knowledge of Plaintiff's procedures for creating and maintaining its Business Records. Plaintiff's Business Records were made in the regular course of business and it was the regular course of such business to make the Business Records. The records were made at or near the time of the events recorded. Based on my review of Plaintiff's Business Records, | have personal knowledge of the facts set forth in this affidavit. Plaintiff and Defendant entered into a credit agreement ("Agreement"), the terms of which Agreement are reflected in the periodic statements delivered to Defendant by Plaintiff. Defendant agreed to pay Plaintiff for all goods, services and cash advances provided pursuant to the Agreement. The amount of the last payment, if any, made by Defendant was $27.00, made on 12/22/2018. Defendant is now in default and demand for payment has been made. A true and correct copy of the charge-off statement is attached as an exhibit to this affidavit. 4 of 11 = INDBXeN8:.0090698919.019 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020 3. At this time, Defendant owes $2,450.61 on the Account. This amount includes a charge-off balance of $2,450.61, post- charge-off interest of $0.00, post-charge-off fees and charges of $0.00, less any post-charge-off credits or payments made by or on behalf of the Defendant of $0.00. WHEREFORE, deponent demands judgment against Defendant for $2,450.61, (plus interest from N/A, if applicable), together with the costs and disbursements of this action. The above statements are true and correct to the best of my personal knowledge. J solemnly affirm under the penalties of perjury and upon personal knowledge that the contents of the foregoing paper are true. EXECUTED on {a 2 20_)F Osiithalee Welhre Signature Christopher Rothfuss Name STATE OF KENTUCKY ) ) ss. COUNTY OF BOONE ) Subscribed and sworn to before me by _Christopher Rothfuss_this ab day of D ec ool DLa Notary Public (bv [SEAL] Notary Public, 1D NO, 631735 My commission expires: September26, 2023 My Commission Exp Sapte 6, 2008 Personally known OR — Produced identification Type of identification produced: Citi Employee Badge 5 of 11 INDBXeN8:.0090698919.019 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020 SUPPLEMENTAL AFFIDAVIT OF FACTS BY ORIGINAL CREDITOR (Original Creditor Actions) Before me, the undersigned authority, personally appeared the person identified below, who being by me duly sworn, deposed as follows: 1. My name is Christopher Rothfuss . |am of sound mind, lawful age and capable of making this Affidavit. The statements set forth in this affidavit are true and correct based on my personal knowledge and review of the business records described herein. | am authorized to make this affidavit on behalf of Plaintiff, Department Stores National Bank (referred to herein as "DSNB"). DSNB is a National Bank located in Sioux Falls, South Dakota. Department Stores National Bank is a subsidiary of Citibank, N.A. (referred to herein as "Citibank"). |! am employed by Citibank. My job title is Document Control Officer. My employment duties include being a custodian of records with respect to accounts owned by DSNB and Citibank. As a custodian of records, | have knowledge of, and access to, account information and records concerning the defendant's DSNB account number currently ending in 2507, which is the subject of this lawsuit (the "Account"). As a result, | am competent to testify to the matters contained in the Affidavit of Facts by Original Creditor executed by me contemporaneously with my signing of this affidavit. | solemnly affirm under the penalties of perjury and upon personal knowledge that the contents of the foregoing Paper are true. Dated: /d- 4 - 019 Dristyele Pllfao STATE OF KENTUCKY ) ss. COUNTY OF BOONE ) Sworn to before me this AG day of EC , 20, 19 Notary Publi, 1D NO. 631735 AL Notary Public Un ‘My Commission Expires Septer mber 26, 2023 6 of 11 INDBXeN8:.0030692012.019 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020 CERTIFICATE OF CONFORMITY I, Kyle Michael, an attorney-at-law of the State of Kentucky who is licensed to practice law in the State of Kentucky and is fully acquainted with the laws of the State of Kentucky pertaining to the acknowledgement or proof of deeds of real property to be recorded therein, do hereby certify that I am duly qualified to make this certificate of conformity pursuant to Section 299-a of the Real Property Law of the State of New York and hereby certify that the acknowledgement or proof upon the foregoing document was taken by Devin Clark, notary public in the State of Kentucky, in the manner prescribed by the laws of the State of Kentucky and conforms to the laws thereof in all respects. IN WITNESS WHEREOF, I have hereunto set my signature, this 26" day of December 2019. Kyle Michael Kentucky Bar #97520 7 of 11 : INDBXeN8:.0090698919.019 NO. 5 RECEIVED NYS! 7/10/2020 macys AMERICAN] ESS Macy's American Express® Account statement Questions or lost/stolen card? Call Customer Service 1-800-782-7756 DAWNE CAREY i Go to macys.com/creditto manage and pay your account online. Account Number:2507 Summary of Account Activity (Payment Information Previous Balance $2,355.57_ New Balance $2,450.61 Payments. -$0,00, Minimum Payment Due $1,252.39 Other Credits -$0.00, Payment Due Date September 2, 2019 Purchases/Other Debits +$0.00 Fees Charged. +$38.00. Late Payment Warning: If we do not receive your minimum payment by the date Interest Charged +$57.04 listed above, you may have to pay alate fee up to $38. © New Balance $2,450.61 Minimum Payment Warning: If you make only the minimum payment each Past Due Amount $681.74) period, you will pay more in interest and it will take you longer to pay off your balance. For example: (Credit Limit $0.0 Fi lf our oe en= iorad io SU will a Offthe ae = ae nd aa i § will: Available Credit. __$0.00 ge: iSil Care e shi on,on —- Paying ea OUou pa ent a Bishof Amount Over Credit Limit on $450.61_| stlst Statement Cl ig Date 08/06/2019 _ Only the minimum payment 10 years "$4,936 Next Statement Closing Date 09/05/2019 | $100 3 years $3,613 \Days in Billing Cycle 32_) (avings=$1,323) if you would like information about credit counseling services, call 1-877-337-8188, New York residents may contact the New York State Department of Financial Services by telephone, 1-800-342-3736, or visit its website, www.dfs.ny.gov, for free information on comparative credit card rates, fees and grace periods. Please note that if we received your pay by phone or online payment between § p.m. ET and midnight ET on your Statement Closing Date identified on your last statement, that payment will appear on your next statement. ¥e macys star rewards PLEASE SEE IMPORTANT INFORMATIONON REVERSE SIDE. Page 1 of 4 This Accounts Issued by Department Stores National Bank. ae cet nee o os nanan wae BMA kmacys P.O. BOX 8052 a Macy’s American Express Account Payment Due Date Account Number: E2507 MASON, OH 45040-8052 September 2, 2019 Please return this slip with payment. Write account number on front of check. You can pay at any Macy's New Balance $2,450.61 store, online at macys.com/credit, or by mail. Minimum Payment Due $1,252.39 Payments receivedby mail by 5:00 pm local time Your Statement Enclosed at the address shown below will be credited as of wees the date received. t Amount Enclosed: Use reverse side for address changes. aia Make Check Payable to: Macy's ‘v Mail to address beloww Macy's American Express Account DAWN E CAREY PO BOX 9001108 7133 W SWAMP RD LOUISVILLE, KY 40290-1108 CONESUS, NY 14435-9707 EXHIBIT A o?401 01252349 O24S0b1 0002700 DSO? O213 8 of 11 INDBXeN8:.0030692012.019 NYSCEF DOC. NO. 5 RECEIVED NYSCEF: 12/10/2020 Information About Your Account. ‘Ifyou send an eligible check with this payment coupon, you authorize us to complete your How to Avoid Paying Interest on Purchases. Your payment due date is at least 25 days after payment by electronic debit. If we do, the checking account will be debited in the amount. the close of each billing cycle. We will not charge you any interest on purchases it you pay your New ‘on the check, We may do this as soon as the day we receive the check. Also, the check Balanceby the payment due date each month, This is called a grace period on purchases, Thereis no will be destroyed. «rave period on excluded promotional balances. if you have a balance subject to a Special Event promotion and that promotion does not expire before if Disputed Amounts. All communications conceit disputed amounts, including any check or other yayment instrument in an amount less than the full amount due that you send to us marked “paid in full” or which you otherwise tender as full satisfaction of a disputed amount, must be sent to us at the payment due date, that balance (an “excluded promotional balance”) is excluded fram the amount you mist pay in fll to get a grave period on a purchase balance. In alton, if you have a Club Plan P.O, Box 8097, Mason, Ohio 45040, Z balance, that balance (an “excluded promotional balance") is excluded from the amount you must pay Credit Reporting Disputes. We may report information about your account to crecit bureaus. in full to get a grace period on a purchase balance, However, you must still pay ary separately required Ifyou tink we reported inaccurate information toa credit bureau write us at: Credit Bureau Dispute payment on the excluded promotional balance. In bili cycles in which payments are allocated to Verification, P.0. Box 8218, Mason, OH 45040. ‘Special Event balances first, the Special Event balance will be reduced before any other balance on the account. However, you will continue to get a grace period on purchases, so long as you pay the New Bankruptey Notices. if you send any natice for bankruptcy purposes relating to this account, you ‘must mail it to the following address: Bankruptcy Processing, P.0. Box 8053, Mason, OH 45040. Balance (less any excluded promotional lance, plus any separately required payment on an excluded Report a Lost or Stolen Card Immediately. Call the Customer Service number shown on page 1 of this promotional balance) in full by the payment due date each biling cycle. ‘statement. For TDD/TTY (Telecommunications Device for the Deaf} assistance, call 1-800-281-082¢ Other promotional offers not described above may also allow you to have a grace period on purchases. ‘What To Do If You Think You Find A Mistake On Your Statement, If you think there is an error on ‘without having to pay all or a portion of the promotional balance by the payment due date. If either is ‘your statement, write to us at: Department Stores National Bank, P.O. Box 8097, Mason, Ohio 45040. the case, the promotional offer will describe what happens. How We Calculate Your Balance Subject to Interest Rate. We use a daily balance method In your letter, give us the following information {including current transactions) to calculate interest charges. To find out more information about the © Account information: Your name and account number. balance computation method for your account and how the resuiting interest charges were determined, amount: The dollar amount of the suspected error. contact us at the Customer Service number on the front of this statement. * Description of Problemy: Ifyou think thee isan error on you bil, describe whatyou belive is wrong Other Account and Payment Information. ‘and why you believe it s a mistake, Payment Amount. You may pay all or part of your account balance at any time. However, you must You must contact us within 60 days after the error appearedon your statement. pay, by the payment due date at least the minimum payment due You must ntify us of any potential erors in writing. You may callus, but if you do we are nol required When Your Payment Will Be Credited. I we receive your payment in proper form a our processing to investigate any potential errors and you may have to pay the amount in question facility by 5 p.m, local time ther, it wil be credited as of thal day. A payment received there in proper ‘While we investigate ther of not there fas been an error, the following are true: form after that time will be credted as ofthe next day. Alow 5 to 7 cays for paymentsby regular mail ‘© We cannot try to collect the amount in question, or report you as delinquent on that amount. to reach us. There may be a delay of up to 5 days in crediting a payment we receive that is notin ‘© The charge in question may remain on your statement, and we may continue to charge you interest Proper form or is not sent to the correct address. The correct address for regular mail is the address ‘on that amount. But, if we determine that we made a mistake, you will not have to pay the amount on the fron of the payment coupon, The correct address for express mai fs shown in the Express in question or any interest or other fees related to that amount. ‘Mail section. Proper Form. For a payment sent by maior courier to bein proper form, you must: «While you do not have to pay the amount in question, you ae responsible for the remind of your balance, * Enclose a valid check or money order. No cash, gf cards, or foreign currency please. * We can apply any unpaid amount against your ere Your Rights If You Are Dissatisfied With Your Credit Card Purchases. if you are dissatisfied * Include your name and the last four digits of your account number. with the goods or services that you have purchased with your creditcard, and you have tried in good Document Production Fee. We may charge you a fee of $3,00 per item f you request conies faith to correct the problem with the merchant,you may have the right not fo pay the remaining amount of previously provided records, such as Statements and sales checks, We will not charge you for documents produced in connection with a Billing Error investigation. due on the purchase. To use this right, all of the following must be true: Payment Other Than By Mail. 1, The purchase must have been made in your home state or within 100 miles of ur current mailing * In-Store. Any payment in proper form accented in-store will be credited as ofthat day. However, adress, and the purchase price must have been more than $50. (Note leither of these are credit avallabity maybe subject to verification of funds, ‘necessary if your purchase was based on an advertisement we mailed to you, or if we own the . Online/AutoPay. Go to the URLon Page 1 of your statement to make a payment online. You can company that sold you the goods or services.) also enroll in AutoPay and have your payment amount automatically deducted each month from the 2. You must have used your credit card for the purchase. Purchases made with cash advances from ‘payment account you choose. ‘an ATM or with a check that accesses your credit card account do not qualify. Phone. Call the number on Page 1 of your statement to make @ payment by phone. For phone 3. You must not yet have fully paid for the purchase. payments, you authorize Department Stores National Bank to electronically debit your specified {fall of the criteria above are met and you are still dissatisfied with the purchase, contact us in yariting bank account an ACH transaction in the amount and on the date that you indicate on the phone. You may cancel a phone payment by caling us al the Customer Service number atthe lop of Page at: Department Stores National Bank, P.0. Box 8097, Mason, OH + within the time period disclosed to you onthe phone. There is no fee for makinga payment using ‘While we investigate, the same rules apply to the disputed amount as discussed above. Afterwe finish ‘our automated voice response syste our investigation, we will tell you our decision, At that point, if we think you owe an amount and you do Express Mail. Send! payment by express rail fo: Consumer Payment Dept, 6716 Grade Lane, ‘not pay, we may report you as delinquent. The Bloomingdale's American Express Card program and Macy's American Express Card program Building 9, Suite 910, Louisville, KY 40213. Crediting Payments other than by Mail. The payment cutoff time for Online bill payments, are issued and administered by Department Stores National Bank. American Express is a federally fegistered service mack of American Express and is used by Department Stores National Bank Phone payments, and Express Mail payments is midnight Eastern time. This means that we ill pursuait toa license credit your account as of the calendar day, based on Eastern time, that we receive your payment request ‘AmexSLAPRI9 1A/- -71-N-D 19. + 1962 a 6026. 7700-0000 X-25-10/-P - - -0-N-1D/-7- + + -0-0-0-JE/- 01/07/19 - 12/01/18- 8 - March 3, 2019 - July 5, 2019 0+ = MX7B-V-D- . Vv oon nN - Page2of 4 Hew information? For new address, telephone or email, goto macys.com/credit *Phone: By giving us a cell numberor a number later converted ‘renter the new information below. fo change your name, please indicate the new name below. < toa cell number, you agree that we or our service providers can 7 T contact you at that number by autodialer, recorded or artificial [NAMECHANGE! 1 1 voice, or a text. Your phone plan charges may apply. HpaI T r T r r to **Enter Email Address If you provide your email address, you authorize 1) the account issuer for this account to contact you cayDt a sme ah |~ about your account and tell you about useful products and services; and 2) Macy's to email you information about receiving 3 rer (Ce deb AO M ae L promotions, sales, special events and other offers. EMAIL” Sign up for electronic statements. It’s fast, easy and convenient. Make the switch today! Go to macys.com/gopaperless 0 RECYCLABLE 9 of 11 =: INDBXeN8:.0030692012.019 NYSCEF DOC. NO. 5_ RECEIVED NYSCEF: 12/10/2020 macys Account number ending in 2507 Fees Transaction Date Description . Amount ug 02 LATE FEE $38.00 TOTAL FEES FOR THIS PERIOD $38.00 Interest Charged Transaction Date ___ Description. Amount ‘Aug06 INTEREST CHARGE ON PURCHASES. $57.04 TOTAL INTEREST FOR THIS PERIOD $57.04 a ae 3 pet Total Fees Charged in 2019 $255.00 Total Interest Charged in 2019 $371.78 Activity and Promotions Detail Original Purchases, Promotion Promotion Payments Cash Adv, Promotion Deferred Promotion Trans Trans Previous. & Other Fees & Interest New Minimum Interest Expiration Amount Date Balance Credits Other Debits Charged Balance Payment Due Charges Date TRANSACTIONS. REGULAR $2,355.57 $38.00 $57.04 $2,450.61 CASH ADVANCES. ~ REGULAR: - - - TOTAL $2, 3ST $0.00 Gano $57.04 Bass $0.00 $0.00 Interest Charge Calculation Your Annual Percentage Rate (APR) is the annual interest r fate on your account iTa ype lal (Annual Percentage Rate (APR): Balance Subject to Interest Rates. Inte TRANSA\ TIONS REGULAR 27.24% (V) $2,388.96 $57.04 CASH ADVANCES, REGULAR 27.24% (V) $0.00 $0.00 (W)= Variable Rate Page 3 of 4 10 of 11 =: =: INDBXeN8:.0090698919.019 NYSCEF DOC. NO. 5_ RECEIVED NYSCEF: 12/10/2020 macys : Account number ending in 2507 THIS PAGE INTENTIONALLY LEFT BLANK Page 4 of 4 11 of 11