On June 17, 2019 a
Miscellaneous
was filed
involving a dispute between
Janeczek, Gary,
and
Spfld Parking,
for Administrative Civil Actions
in the District Court of Hampden County.
Preview
|
DOCKET NUMBER Trial Court of Massachusetts
CIVIL ACTION COVER SHEET 49° 435 The Superior Court
a
rans: (oPRY A] fine . [county
ADDRESS: [AS a
Bow al etcl aw 0 leap DEFENDANTS: ~ — ‘ Kw
NB= A Tt ee rs}
ATTORNEY: 1
ADDRESS: ADORE: aw t
Prin kelp Mb. Oi O23
4 = 72 -m0 &
BeO:
TYPE OF ACTION AND TRACK DESIGNATION (see reverse side)
EO NO. TYPE OF ACTION ef es dite. HAS x wey ow SEEN MADE?
"If “Other” please describe:
Is there a claim under G.L. c. 932
[] ves NO
‘senna veg ened sass. R. Giv. P. 23?
STATEMENT OF DAMAGES PURSUANT TO GIL. ¢, 212, § ve
The fallowing is a full, itemized and detailed statement of the facts on which the undersigned plaintiff or plaintiff's counsel reiles to determine money damages.
IFor this form, disregard double or treble damage claims; indicate single damages only. .
TORT CLAIMS:
(attach additional sheets as necessary)
A. Documented medical expenses to date:
1. Total hospital expenses
2. Total doctor expenses
3. Total chiropractic expensi
4. Total physical therapy expenses:
5, Total other expenses (describe below) ..
1B. Documented lost wages and compensation to date ..
IC. Documented property damages to date .... 8
ID. Reasonably anticipated future medical and hospital expenses go
g
IE. Reasonably anticipated lost wages ...
IF. Olher documented items of damages (describe below)
IG. Briefly describe plaintiffs injury, including the nature and extent of injury: :
TOTAL (A-F):$
* GONTRAC Claims
(attach additional sheets as necessary)
This action includes a claim involving collection of a debt incurred pursuant to a revolving credit agreement. Mass. R. Civ, P. 8.1(@).
Provide a detailed description af claim(s):
: : TOTAL: $
Signature of Attomey/ Unrepresented Plaintiff: X Date: era / 7 { {7
[RELATED ACTIONS: Please provide the case number, ca8e nante, andGounty of any relied actlans pending in the Superior Court? "7
CERTIFICATION PURSUANT TO SJC RULE 1:18
| hereby certify that I have complied with requirements of Rule 5 of the Supreme Judicial Court Uniform Rules on Dispute Resolution (SUC
Rule 1:18) requiring that ! provide my clients with information about court-connected dispute resolution services and discuss with them the
ladvantages and disadvantages of the various methods of dispute resolution. | u
[Signature of Attorney of Record: X Date:
Document Filed Date
June 20, 2019
Case Filing Date
June 17, 2019
Category
Administrative Civil Actions
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| DOCKET NUMBER Trial Court of Massachusetts CIVIL ACTION COVER SHEET 49° 435 The Superior Court a rans: (oPRY A] fine . [county ADDRESS: [AS a Bow al etcl aw 0 leap DEFENDANTS: ~ — ‘ Kw NB= A Tt ee rs} ATTORNEY: 1 ADDRESS: ADORE: aw t Prin kelp Mb. Oi O23 4 = 72 -m0 & BeO: TYPE OF ACTION AND TRACK DESIGNATION (see reverse side) EO NO. TYPE OF ACTION ef es dite. HAS x wey ow SEEN MADE? "If “Other” please describe: Is there a claim under G.L. c. 932 [] ves NO ‘senna veg ened sass. R. Giv. P. 23? STATEMENT OF DAMAGES PURSUANT TO GIL. ¢, 212, § ve The fallowing is a full, itemized and detailed statement of the facts on which the undersigned plaintiff or plaintiff's counsel reiles to determine money damages. IFor this form, disregard double or treble damage claims; indicate single damages only. . TORT CLAIMS: (attach additional sheets as necessary) A. Documented medical expenses to date: 1. Total hospital expenses 2. Total doctor expenses 3. Total chiropractic expensi 4. Total physical therapy expenses: 5, Total other expenses (describe below) .. 1B. Documented lost wages and compensation to date .. IC. Documented property damages to date .... 8 ID. Reasonably anticipated future medical and hospital expenses go g IE. Reasonably anticipated lost wages ... IF. Olher documented items of damages (describe below) IG. Briefly describe plaintiffs injury, including the nature and extent of injury: : TOTAL (A-F):$ * GONTRAC Claims (attach additional sheets as necessary) This action includes a claim involving collection of a debt incurred pursuant to a revolving credit agreement. Mass. R. Civ, P. 8.1(@). Provide a detailed description af claim(s): : : TOTAL: $ Signature of Attomey/ Unrepresented Plaintiff: X Date: era / 7 { {7 [RELATED ACTIONS: Please provide the case number, ca8e nante, andGounty of any relied actlans pending in the Superior Court? "7 CERTIFICATION PURSUANT TO SJC RULE 1:18 | hereby certify that I have complied with requirements of Rule 5 of the Supreme Judicial Court Uniform Rules on Dispute Resolution (SUC Rule 1:18) requiring that ! provide my clients with information about court-connected dispute resolution services and discuss with them the ladvantages and disadvantages of the various methods of dispute resolution. | u [Signature of Attorney of Record: X Date: