On March 03, 2024 a
Statement of Claim Index #1
was filed
involving a dispute between
Range Credit Bureau Inc.,
and
Sirek, Christina,
for Conciliation
in the District Court of Crow Wing County.
Preview
18-CO-24-152
Filed in District Court
State of Minnesota
3/3/2024 1:42 PM
State of Minnesota Conciliation Court
County of: CROW WING Judicial District: NINTH
Court File Number:
Case Type: Conciliation
PLAINTIFF'S STATEMENT OF CLAIM
Plaintiff #1 Plaintiff #2
Name: RANGE CREDIT BUREAU INC Name:
Address: P0 BOX 706 Address:
City/State.-='Zip HIBBING MN 55746 CityfState.»"Zip:
Defendant #1 Defendant #2
Name: CHRISTINA SIREK Name:
Address: 14690 WONDERLAND PARK RD Address:
City/State/Zip: BRAINERD MN 56401-5845 City/State/Zip
E] Check box if there are more than two plaintiffs or more than two defendants. List the
information for the other parties on the Additional Litigants Form, CCT702.
Information about the Defendant
1. HOW' many defendants are there? 1
a. Defendant # 1
Name: CHRISTINA SIREK
fl Individual (Person)
Business
If Defendant # I is an individual.'
i. I believe Defendant #1 is at least 18 years old.
Date ofbirth: 04/07/1969 / DUnknown.
ii. About military service:
D Defendant #1 is in the military service
I Defendant #1 is not in the military service
D Unknown.
b. Defendant # 2
Name:
D Individual (Person) [j Business
If Defendant # 2 is an individual.'
i. I believe Defendant #2 is at least 18 years old.
Plaintiff's Statement of Claim
CCT102 State ENG Rev 10/20 ww.mncourts.govlforms Page 1 of 3
18-CO-24-152
Filed in District Court
State of Minnesota
3/3/2024 1:42 PM
Date of birth: / D Unknown.
ii. About military sewice:
Defendant # 2 is in the militaiy service
l Defendant # 2 is not in the military' service
D Unknown.
If there are more than 2 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
I
The Defendant owes me $ 1149.05 _, plus filing fees and costs in the amount of
$ 8 0 - 0 0 so my total claim is for $
, __
2 2 9 0 5
1 ~ -
(amount Defendant owes plus filing fees and costs). I have a claim for this
amount because in
05/04/2023 (month and year), the following happened (briefly' describe):
SEE ATTACHED
"IN REGARDS TO INTEREST SEE MN STATUTE 334.01
"IN REGARDS TO NSF & CIVIL PENALTIES SEE MN STATUTE 604.113
**IN REGARDS TO HUSBAND AND WIFE LIABILITY SEE MN STATUTE 519.05
Property
D The Defendant has the following property that belongs to me (list property):
My property is valued at $ . The filing fees and costs for this case are
Plaintiff's Statement of Claim
CCT102 State ENG Rev 10/20 www.mncounsgov/forms Page 2 of 3
18-CO-24-152
Filed in District Court
State of Minnesota
3/3/2024 1:42 PM
$ . I want the court to order this property returned to me or make the
Defendant pay me $ (propemr's value plus the filing fees and costs).
3. I understand that if I do not come to court on my hearing date, myr case may be dismissed and
I may have to pay money to the Defendant 0n any' counterclaim that has been filed.
Important! Each plaintiff must sign the Statement of Claim form and include the date signed,
the name of the state and count}? where signed, and provide the following information: title, if
any, telephone number, date of birth, and e-mail address.
I declare under penalty of perjury that everything that i have stated in this document is true and
correct. Minn. Stat. § 358.116.
Signature (Plaintiff #1) Signature (Plaintiff #2)
OR DThere is only l plaintiff
DATEz02/12/2024 DATE:
ST. LOUIS
County and State Where Signed County and State where signed
SH. CAUCCI
Name Name
PRESIDENT
Title, if any! Title, if any
218-263-8886
Telephone Telephone
Date of birth Date of birth
legal@rcbcollections.oom
Email Address Email Address
NOTE: If thereare more than 2 plaintiffs, all of the other plaintiffs must sign the Statement of
Claim form and include the information listed above.
Plaintiff's Statement of Claim
CCT102 State ENG Rev 10/20 www.mnoourts.govlfonns Page 3 of 3
18-CO-24-152
Filed in District Court
State of Minnesota
3/3/2024 1:42 PM
STATEMENT 0F CLAIMS ATTACHMENT
COUNTY: CROW WING COUNTY
DEBTOR: CHRISTINA CATHERINE SIREK 2ND LOC: 9
DEBTOR #2: aka GAU
ADDRESS: 14690 WONDERLAND PARK RD
BRAINERD MN 56401-5845
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
SHANNON'S AUTO BO $1,097.80 $0.00 $0.00 $51.25 $80.00 $1,229.05
THIS IS AN ATTEMPT TO COLLECT A DEBT.
ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.
Document Filed Date
March 03, 2024
Case Filing Date
March 03, 2024
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18-CO-24-152 Filed in District Court State of Minnesota 3/3/2024 1:42 PM State of Minnesota Conciliation Court County of: CROW WING Judicial District: NINTH Court File Number: Case Type: Conciliation PLAINTIFF'S STATEMENT OF CLAIM Plaintiff #1 Plaintiff #2 Name: RANGE CREDIT BUREAU INC Name: Address: P0 BOX 706 Address: City/State.-='Zip HIBBING MN 55746 CityfState.»"Zip: Defendant #1 Defendant #2 Name: CHRISTINA SIREK Name: Address: 14690 WONDERLAND PARK RD Address: City/State/Zip: BRAINERD MN 56401-5845 City/State/Zip E] Check box if there are more than two plaintiffs or more than two defendants. List the information for the other parties on the Additional Litigants Form, CCT702. Information about the Defendant 1. HOW' many defendants are there? 1 a. Defendant # 1 Name: CHRISTINA SIREK fl Individual (Person) Business If Defendant # I is an individual.' i. I believe Defendant #1 is at least 18 years old. Date ofbirth: 04/07/1969 / DUnknown. ii. About military service: D Defendant #1 is in the military service I Defendant #1 is not in the military service D Unknown. b. Defendant # 2 Name: D Individual (Person) [j Business If Defendant # 2 is an individual.' i. I believe Defendant #2 is at least 18 years old. Plaintiff's Statement of Claim CCT102 State ENG Rev 10/20 ww.mncourts.govlforms Page 1 of 3 18-CO-24-152 Filed in District Court State of Minnesota 3/3/2024 1:42 PM Date of birth: / D Unknown. ii. About military sewice: Defendant # 2 is in the militaiy service l Defendant # 2 is not in the military' service D Unknown. If there are more than 2 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 I The Defendant owes me $ 1149.05 _, plus filing fees and costs in the amount of $ 8 0 - 0 0 so my total claim is for $ , __ 2 2 9 0 5 1 ~ - (amount Defendant owes plus filing fees and costs). I have a claim for this amount because in 05/04/2023 (month and year), the following happened (briefly' describe): SEE ATTACHED "IN REGARDS TO INTEREST SEE MN STATUTE 334.01 "IN REGARDS TO NSF & CIVIL PENALTIES SEE MN STATUTE 604.113 **IN REGARDS TO HUSBAND AND WIFE LIABILITY SEE MN STATUTE 519.05 Property D The Defendant has the following property that belongs to me (list property): My property is valued at $ . The filing fees and costs for this case are Plaintiff's Statement of Claim CCT102 State ENG Rev 10/20 www.mncounsgov/forms Page 2 of 3 18-CO-24-152 Filed in District Court State of Minnesota 3/3/2024 1:42 PM $ . I want the court to order this property returned to me or make the Defendant pay me $ (propemr's value plus the filing fees and costs). 3. I understand that if I do not come to court on my hearing date, myr case may be dismissed and I may have to pay money to the Defendant 0n any' counterclaim that has been filed. Important! Each plaintiff must sign the Statement of Claim form and include the date signed, the name of the state and count}? where signed, and provide the following information: title, if any, telephone number, date of birth, and e-mail address. I declare under penalty of perjury that everything that i have stated in this document is true and correct. Minn. Stat. § 358.116. Signature (Plaintiff #1) Signature (Plaintiff #2) OR DThere is only l plaintiff DATEz02/12/2024 DATE: ST. LOUIS County and State Where Signed County and State where signed SH. CAUCCI Name Name PRESIDENT Title, if any! Title, if any 218-263-8886 Telephone Telephone Date of birth Date of birth legal@rcbcollections.oom Email Address Email Address NOTE: If thereare more than 2 plaintiffs, all of the other plaintiffs must sign the Statement of Claim form and include the information listed above. Plaintiff's Statement of Claim CCT102 State ENG Rev 10/20 www.mnoourts.govlfonns Page 3 of 3 18-CO-24-152 Filed in District Court State of Minnesota 3/3/2024 1:42 PM STATEMENT 0F CLAIMS ATTACHMENT COUNTY: CROW WING COUNTY DEBTOR: CHRISTINA CATHERINE SIREK 2ND LOC: 9 DEBTOR #2: aka GAU ADDRESS: 14690 WONDERLAND PARK RD BRAINERD MN 56401-5845 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 SHANNON'S AUTO BO $1,097.80 $0.00 $0.00 $51.25 $80.00 $1,229.05 THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.