On March 10, 2019 a
Statement of Claim and Summons Index #1
was filed
involving a dispute between
Range Credit Bureau Inc.,
and
Boorman, Nicholas,
for Conciliation
in the District Court of Koochiching County.
Preview
36-CO-19-31
Filed in District Court
State of Minnesota
3/10/2019 10:08 AM
State of Minnesota Conciliation Court
County Judicial District: NINTH
'
_
Court File Number:
KOOCHICHING Case Type: COIICiliaIion
STATEMENT OF CLAIM AND SUMMONS
Plaintiff #1 Plaintiff #2
Name RANGE CREDIT BUREAU INC P Name
Address Po Box 706 Address
:5
A
City/State/Zip HIBBING, MN 55746 s City/State/Zip
E
vs vs
Defendant #1 p Defendant #2
Name NICHOLAS BOORMAN R Name
Address 221 FRONT ST Address
l£
T
City/State/Zip LITTLEFORK MN 56653 City/State/Zip
PLAINTIFF’S STATEMENT OF CLAIM
U 1. The Defendant(s) owe(s) me $ 1766.84 ,
plus filing fees and costs of $
85.00 ,
for a total of $ 185 1 .84 because on or about_
MULTI (state month and. year) the following event occurred
(briefly describe the event): SEE ATTACHED
”IN REGARDS TO INTEREST SEE NIN STATUTE 334.01
“IN REGARDS TO NSF & CIVIL PENALTIES SEE NIN STATUTE 604.113
**IN REGARDS T0 HUSBAND AND WIFE LIABILITY SEE lVIN STATUTE 519.05
D 2. The Defendant(s) has/have the following property that belongs to me (list property),
valued at S , plus filing fees and costs of $
for a total of $ . I want the court to order this property returned t0
me or make the Defendant(s) pay me money for the value 0f the property.
CCT102 State ENG Rev 8/15 www.mncourts.gov/forms Page 1 of 2
36-CO-19-31
Filed in District Court
State of Minnesota
3/10/2019 10:08 AM
3. Ibelieve the person(s) I am suing is/are at least 18 years old and not in the military service.
Defendant #1 date of birth 12/09/1992 Defendant #2 date of birth
4. I understand that if I do not come to court on my hearing date, my case may be dismissed
and I may have to pay money to the Defendant(s) on any counterclaim that has been filed.
I declare under penalty of perjury that everything I have stated in this document is true and
correct. Minn. Stat. § 358.1 16.
12/13/2018
"'
c i:
SAC—“V
'1
Date Signature
-
-~
w
ST. LOUIS
Name of county and state Where signed
Printed Name: S. H. CAUCCI
Title, if any: PRESIDENT
Address: P. O. BOX 706
City/State/Zip: HIBBING. MN 55746
Telephone: 218-263-8886
Plaintiff #1 date of birth
Plaintiff #2 date of birth
E-mail address: ad1nin@rcbcollections.com
SUMMONS: IMPORTANT NOTICE TO THE PARTIES
You are hereby summoned t0 appear at' the hearing 0f the above entitled case. See the attached
Notice of Hearing for time and location. If not attached, call Conciliation Court.
Failure 0f defendant to appear at the hearing may result in a default judgment being
entered for the plaintiff. Failure of the plaintiff to appear may result in dismissal of the
action or a default judgment being entered in favor 0f the defendant on any counterclaim
that has been filed.
The Defendant may bring *a counterclaim against the Plaintiff. See “Information About
Conciliation Court” (Court form CCTlOl) on the court forms webpagc at
www.mncourts.gov/forms.
NOTICE OF SETTLEMENT
The above-entitled case having been settled, the same may be and hereby is dismissed with
my consent.
Date:
Plaintiff s Signature
CCT1 02 State ENG Rev 8/15 www.mncourtsgov/formé Page 2 of 2
36-CO-19-31
Filed in District Court
State of Minnesota
3/10/2019 10:08 AM
STATEMENT OF CLAIMS ATTACHMENT
COUNTY: KOOCHICHING COUNTY
DEBTOR: NICHOLAS RYAN BOORMAN l2/2ND LOC:
DEBTOR #2: BOORMAN
ADDRESS: 221 FRONT ST
LITTLEFORK MN 56653
NOTICE WAS MAILED TO THE DEFENDANT ADVISING OF COLLECTION ACCOUNTS AND/OR
DISHONORED CHECKS, SERVICE CHARGES AND PENALTIES. DEMAND IS HEREBY
MADE AS FOLLOWS:
LIST OF ACCOUNTS
CLIENT PRINCIPAL NSF FEE CIVIL PNL INTEREST COURT TOTAL DUE
MEDICAL IMAGING N $28.75 $0.00 $0.00 $4.00 $85.00 $117.75
DAVID C WOHLRABE $1,496.97 $0.00 $0.00 $215.56 $0.00 $1,712.53
MEDICAL IMAGING N $20.52 $0.00 $0.00 $1.04 $0.00 $21.56
TOTAL: $1,546.24 $0.00 $0.00 $220.60 $85.00 $1,851.84
THIS IS AN ATTEMPT TO COLLECT A DEBT.
ANY INFORMATION OBTAINED WILL BE USED FDR THAT PURPOSE.
Document Filed Date
March 10, 2019
Case Filing Date
March 10, 2019
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36-CO-19-31 Filed in District Court State of Minnesota 3/10/2019 10:08 AM State of Minnesota Conciliation Court County Judicial District: NINTH ' _ Court File Number: KOOCHICHING Case Type: COIICiliaIion STATEMENT OF CLAIM AND SUMMONS Plaintiff #1 Plaintiff #2 Name RANGE CREDIT BUREAU INC P Name Address Po Box 706 Address :5 A City/State/Zip HIBBING, MN 55746 s City/State/Zip E vs vs Defendant #1 p Defendant #2 Name NICHOLAS BOORMAN R Name Address 221 FRONT ST Address l£ T City/State/Zip LITTLEFORK MN 56653 City/State/Zip PLAINTIFF’S STATEMENT OF CLAIM U 1. The Defendant(s) owe(s) me $ 1766.84 , plus filing fees and costs of $ 85.00 , for a total of $ 185 1 .84 because on or about_ MULTI (state month and. year) the following event occurred (briefly describe the event): SEE ATTACHED ”IN REGARDS TO INTEREST SEE NIN STATUTE 334.01 “IN REGARDS TO NSF & CIVIL PENALTIES SEE NIN STATUTE 604.113 **IN REGARDS T0 HUSBAND AND WIFE LIABILITY SEE lVIN STATUTE 519.05 D 2. The Defendant(s) has/have the following property that belongs to me (list property), valued at S , plus filing fees and costs of $ for a total of $ . I want the court to order this property returned t0 me or make the Defendant(s) pay me money for the value 0f the property. CCT102 State ENG Rev 8/15 www.mncourts.gov/forms Page 1 of 2 36-CO-19-31 Filed in District Court State of Minnesota 3/10/2019 10:08 AM 3. Ibelieve the person(s) I am suing is/are at least 18 years old and not in the military service. Defendant #1 date of birth 12/09/1992 Defendant #2 date of birth 4. I understand that if I do not come to court on my hearing date, my case may be dismissed and I may have to pay money to the Defendant(s) on any counterclaim that has been filed. I declare under penalty of perjury that everything I have stated in this document is true and correct. Minn. Stat. § 358.1 16. 12/13/2018 "' c i: SAC—“V '1 Date Signature - -~ w ST. LOUIS Name of county and state Where signed Printed Name: S. H. CAUCCI Title, if any: PRESIDENT Address: P. O. BOX 706 City/State/Zip: HIBBING. MN 55746 Telephone: 218-263-8886 Plaintiff #1 date of birth Plaintiff #2 date of birth E-mail address: ad1nin@rcbcollections.com SUMMONS: IMPORTANT NOTICE TO THE PARTIES You are hereby summoned t0 appear at' the hearing 0f the above entitled case. See the attached Notice of Hearing for time and location. If not attached, call Conciliation Court. Failure 0f defendant to appear at the hearing may result in a default judgment being entered for the plaintiff. Failure of the plaintiff to appear may result in dismissal of the action or a default judgment being entered in favor 0f the defendant on any counterclaim that has been filed. The Defendant may bring *a counterclaim against the Plaintiff. See “Information About Conciliation Court” (Court form CCTlOl) on the court forms webpagc at www.mncourts.gov/forms. NOTICE OF SETTLEMENT The above-entitled case having been settled, the same may be and hereby is dismissed with my consent. Date: Plaintiff s Signature CCT1 02 State ENG Rev 8/15 www.mncourtsgov/formé Page 2 of 2 36-CO-19-31 Filed in District Court State of Minnesota 3/10/2019 10:08 AM STATEMENT OF CLAIMS ATTACHMENT COUNTY: KOOCHICHING COUNTY DEBTOR: NICHOLAS RYAN BOORMAN l2/2ND LOC: DEBTOR #2: BOORMAN ADDRESS: 221 FRONT ST LITTLEFORK MN 56653 NOTICE WAS MAILED TO THE DEFENDANT ADVISING OF COLLECTION ACCOUNTS AND/OR DISHONORED CHECKS, SERVICE CHARGES AND PENALTIES. DEMAND IS HEREBY MADE AS FOLLOWS: LIST OF ACCOUNTS CLIENT PRINCIPAL NSF FEE CIVIL PNL INTEREST COURT TOTAL DUE MEDICAL IMAGING N $28.75 $0.00 $0.00 $4.00 $85.00 $117.75 DAVID C WOHLRABE $1,496.97 $0.00 $0.00 $215.56 $0.00 $1,712.53 MEDICAL IMAGING N $20.52 $0.00 $0.00 $1.04 $0.00 $21.56 TOTAL: $1,546.24 $0.00 $0.00 $220.60 $85.00 $1,851.84 THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINED WILL BE USED FDR THAT PURPOSE.