On June 18, 2024 a
Summons
was filed
involving a dispute between
Polezoes, Therese,
and
American Family Insurance,
for CT - Civil Tort
in the District Court of Lake County.
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45D01-2406-CT-000770 Filed: 6/18/2024 11:50 AM
Clerk
Lake Superior Court, Civil Division 1 Lake County, Indiana
STATE OF INDIANA ) IN THE LAKE CIRCUIT/SUPERIOR COURT
) ss
COUNTY OF LAKE ) SITTING AT LAKE COUNTY, INDIANA
THERESE POLEZOES,
Plaintiff,
Vv. CAUSE NO.:
AMERICAN FAMILY INSURANCE,
Defendant.
SUMMONS
THE STATE OF INDIANA TO THE DEFENDANT: American Family Insurance
c/o Highest Executive Officer
6000 American Parkway
Madison, WI 53783
You have been sued by the person(s) identified as “Plaintiffs” in the Court stated above.
The nature of the suit against you is stated in the COMPLAINT which is attached to this SUMMONS. It also states the
demand which the Plaintiff has made against you.
You must either personally or by your attorney file your written answer to the COMPLAINT with the Clerk within twenty
(20) days commencing the day after this SUMMONS and the COMPLAINT were personally served upon you or your agent
or left for you by the Sheriff or other process server.
In the event the SUMMONS and COMPLAINT were left for you and you then receive by first class mail (not certified) a
copy of the SUMMONS alone, this mailing is merely a confirmation that the SUMMONS and COMPLAINT were
previously left for you. You should not consider the date on which you receive the mailed SUMMONS as the
commencement date for the time period allowed for your answer. Rather, the time period allowed for your written answer
commences on the date when the SUMMONS and COMPLAINT were first personally served upon you or your agent or
left for you by the Sheriff or other process server.
However, if you or your agent first received the SUMMONS and the COMPLAINT by certified mail, you have twenty-
three (23) days from the date of receipt to file your written answer with the Clerk. If you fail to answer the COMPLAINT
of the Plaintiff within the times prescribed herein, judgment will be entered against you for what the Plaintiff has demanded.
If you have a claim against the Plaintiff arising from the same transaction or occurrence, you may be required to assert such
claim in writing together with your written answer.
=
The following manner of service is hereby designated co
Attorney for Plaintiff:
Brock P. Alvarado
le: *
| hy)
Ind. Atty. No.: _16348-45
1524 West 96th Avenue fete IT ANI MAPERIOR COURTS
Crown Point, Indiana 46307
Tel. No.: (219) 662-6400 Deputy Cle
SADIAN
CLERK’S CERTIFICATE OF MAILING
Thereby certify that on the day of 2024, I mailed a copy of this SUMMONS and a copy
of the COMPLAINT to the Defendant, by mail, requesting a return receipt, at the address furnished by the Plaintiff.
CLERK, LAKE CIRCUIT AND SUPERIOR COURTS
Dated: —— BY:
Deputy Clerk
RETURN SERVICE OF SUMMONS BY MAIL
Thereby certify that the attached return receipt was received by me showing that the SUMMONS and a copy of the
COMPLAINT mailed to Defendant was accepted by the Defendant on the
day of
CLERK, LAKE CIRCUIT AND SUPERIOR COURTS
Dated: BY:
Deputy Clerk
RETURN OF SERVICE OF SUMMONS BY SHERIFF
Thereby certify that I have served the within SUMMONS:
1. By delivering on > a copy of this SUMMONS, a copy of the COMPLAINT
and all other materials filed the same date of each of the within named person(s).
2. By leaving on > for each of the within named person(s)
a copy of the
SUMMONS, a copy of the COMPLAINT and all other materials filed the same date at the respective dwelling house or
usual place of abode of in Indiana,
with a person of suitable age and discretion residing within, whose usual duties or activities include prompt
communication of the person served, or by otherwise leaving such process thereat, and by mailing a copy of the
SUMMONS without the COMPLAINT to the said named person(s) at the address listed herein.
3. This SUMMONS came to hand this date, . The within named
was not found in my bailiwick this date,
ALL DONE IN LAKE COUNTY, INDIANA.
SHERIFF OF LAKE COUNTY, INDIANA
BY:
SERVICE ACKNOWLEDGED
A copy of the within SUMMONS, a copy of the COMPLAINT and all materials filed the same date attached thereto were
received by me at in
Indiana, on this date,
Signature of Defendant
Document Filed Date
June 18, 2024
Case Filing Date
June 18, 2024
Status
06/18/2024 , Pending (active)
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45D01-2406-CT-000770 Filed: 6/18/2024 11:50 AM Clerk Lake Superior Court, Civil Division 1 Lake County, Indiana STATE OF INDIANA ) IN THE LAKE CIRCUIT/SUPERIOR COURT ) ss COUNTY OF LAKE ) SITTING AT LAKE COUNTY, INDIANA THERESE POLEZOES, Plaintiff, Vv. CAUSE NO.: AMERICAN FAMILY INSURANCE, Defendant. SUMMONS THE STATE OF INDIANA TO THE DEFENDANT: American Family Insurance c/o Highest Executive Officer 6000 American Parkway Madison, WI 53783 You have been sued by the person(s) identified as “Plaintiffs” in the Court stated above. The nature of the suit against you is stated in the COMPLAINT which is attached to this SUMMONS. It also states the demand which the Plaintiff has made against you. You must either personally or by your attorney file your written answer to the COMPLAINT with the Clerk within twenty (20) days commencing the day after this SUMMONS and the COMPLAINT were personally served upon you or your agent or left for you by the Sheriff or other process server. In the event the SUMMONS and COMPLAINT were left for you and you then receive by first class mail (not certified) a copy of the SUMMONS alone, this mailing is merely a confirmation that the SUMMONS and COMPLAINT were previously left for you. You should not consider the date on which you receive the mailed SUMMONS as the commencement date for the time period allowed for your answer. Rather, the time period allowed for your written answer commences on the date when the SUMMONS and COMPLAINT were first personally served upon you or your agent or left for you by the Sheriff or other process server. However, if you or your agent first received the SUMMONS and the COMPLAINT by certified mail, you have twenty- three (23) days from the date of receipt to file your written answer with the Clerk. If you fail to answer the COMPLAINT of the Plaintiff within the times prescribed herein, judgment will be entered against you for what the Plaintiff has demanded. If you have a claim against the Plaintiff arising from the same transaction or occurrence, you may be required to assert such claim in writing together with your written answer. = The following manner of service is hereby designated co Attorney for Plaintiff: Brock P. Alvarado le: * | hy) Ind. Atty. No.: _16348-45 1524 West 96th Avenue fete IT ANI MAPERIOR COURTS Crown Point, Indiana 46307 Tel. No.: (219) 662-6400 Deputy Cle SADIAN CLERK’S CERTIFICATE OF MAILING Thereby certify that on the day of 2024, I mailed a copy of this SUMMONS and a copy of the COMPLAINT to the Defendant, by mail, requesting a return receipt, at the address furnished by the Plaintiff. CLERK, LAKE CIRCUIT AND SUPERIOR COURTS Dated: —— BY: Deputy Clerk RETURN SERVICE OF SUMMONS BY MAIL Thereby certify that the attached return receipt was received by me showing that the SUMMONS and a copy of the COMPLAINT mailed to Defendant was accepted by the Defendant on the day of CLERK, LAKE CIRCUIT AND SUPERIOR COURTS Dated: BY: Deputy Clerk RETURN OF SERVICE OF SUMMONS BY SHERIFF Thereby certify that I have served the within SUMMONS: 1. By delivering on > a copy of this SUMMONS, a copy of the COMPLAINT and all other materials filed the same date of each of the within named person(s). 2. By leaving on > for each of the within named person(s) a copy of the SUMMONS, a copy of the COMPLAINT and all other materials filed the same date at the respective dwelling house or usual place of abode of in Indiana, with a person of suitable age and discretion residing within, whose usual duties or activities include prompt communication of the person served, or by otherwise leaving such process thereat, and by mailing a copy of the SUMMONS without the COMPLAINT to the said named person(s) at the address listed herein. 3. This SUMMONS came to hand this date, . The within named was not found in my bailiwick this date, ALL DONE IN LAKE COUNTY, INDIANA. SHERIFF OF LAKE COUNTY, INDIANA BY: SERVICE ACKNOWLEDGED A copy of the within SUMMONS, a copy of the COMPLAINT and all materials filed the same date attached thereto were received by me at in Indiana, on this date, Signature of Defendant