On December 13, 2022 a
Party Statement
was filed
involving a dispute between
Keodouangdy, Justin Thomas,
and
Ramos, Abrianna Marie,
for Conciliation
in the District Court of Martin County.
Preview
46-CO-22-79
Filed in District Court
State of Minnesota
12/13/2022 10:00 AM
State of Minnesota Conciliation Court
County of: Judicial District: I- rflh
ffl C.cl rl Court File Number:
Case Type: Conciliation
PLAINTIFF'S STATEMENT OF CLAIM
Ptaintiff #l Plaintiff #2
'\1S[
Name: ,n h pCnht,t n nqOl,vr Name: A
Address: J u Address: I V +
Citylstatelzip itylStatelZip:
f r \oflc^
: 133,5 .fshn
itytst:ltetziptFC.,,r 5 ( 0?
crr=^l fnfv
E Check box if there are more than two plaintiffs or more than two defendants. List
information for the other parties on the Additional Litigants Form, CCT702.
lnformation about the Defendant
t
1. How many defendants are there? )
a. Defendant # 1
;;;.- Au., cgoc^ Ro.r,,,
$mairiaual
(Person) ! Business
If Defendant # I is an individual:
i. I believe Defendant #1 is at least 18 years old.
o/
Date of Uint , 13 t lUnknown.
ii. About military service:
! Defendant #1 is in the military service
I Defendant #l is not in the military service
! Unknown.
b. Defendant# 2
Name:
! Individual (Person) lBusiness
If Defendant # 2 is an individual:
i. I believe Defendant #2 is at least 18 years old.
Plaintiffs Statement of Claim
CCT102 State ENG Rev 10/20 www.mncourts.gov/forms Page 1 of 3
46-CO-22-79
Filed in District Court
State of Minnesota
12/13/2022 10:00 AM
Date of birth: I lTUnknown.
ii. About military service:
E Defendant# 2 is in the military service
E Defendant# 2 is not in the military service
! Unknown.
If there are more than2 defendants, use the Additional Litigants Form (CCT702).
Information about the Claim
2.I am filing this claim against Defendant for: (check all that apply)
Money
ffin. Defendant owes me S l,( 5 O , plus filing fees and costs in the amount of
$ KQ , so my total claim is for $ /r7 3 C
Document Filed Date
December 13, 2022
Case Filing Date
December 13, 2022
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46-CO-22-79 Filed in District Court State of Minnesota 12/13/2022 10:00 AM State of Minnesota Conciliation Court County of: Judicial District: I- rflh ffl C.cl rl Court File Number: Case Type: Conciliation PLAINTIFF'S STATEMENT OF CLAIM Ptaintiff #l Plaintiff #2 '\1S[ Name: ,n h pCnht,t n nqOl,vr Name: A Address: J u Address: I V + Citylstatelzip itylStatelZip: f r \oflc^ : 133,5 .fshn itytst:ltetziptFC.,,r 5 ( 0? crr=^l fnfv E Check box if there are more than two plaintiffs or more than two defendants. List information for the other parties on the Additional Litigants Form, CCT702. lnformation about the Defendant t 1. How many defendants are there? ) a. Defendant # 1 ;;;.- Au., cgoc^ Ro.r,,, $mairiaual (Person) ! Business If Defendant # I is an individual: i. I believe Defendant #1 is at least 18 years old. o/ Date of Uint , 13 t lUnknown. ii. About military service: ! Defendant #1 is in the military service I Defendant #l is not in the military service ! Unknown. b. Defendant# 2 Name: ! Individual (Person) lBusiness If Defendant # 2 is an individual: i. I believe Defendant #2 is at least 18 years old. Plaintiffs Statement of Claim CCT102 State ENG Rev 10/20 www.mncourts.gov/forms Page 1 of 3 46-CO-22-79 Filed in District Court State of Minnesota 12/13/2022 10:00 AM Date of birth: I lTUnknown. ii. About military service: E Defendant# 2 is in the military service E Defendant# 2 is not in the military service ! Unknown. If there are more than2 defendants, use the Additional Litigants Form (CCT702). Information about the Claim 2.I am filing this claim against Defendant for: (check all that apply) Money ffin. Defendant owes me S l,( 5 O , plus filing fees and costs in the amount of $ KQ , so my total claim is for $ /r7 3 C