On September 01, 2021 a
Clerk Notice
was filed
involving a dispute between
Neurotech Family & Physical Medicine A A O Kimberly Nathoo,
and
State Farm Mutual Automobile Insurance Company,
for Small Claims $0-$99
in the District Court of Clay County.
Preview
Clay County Clerk of Circuit Court
Clay County Receipt of Transaction
Receipt #105037 Tara S. Green
Clerk of Court
Clay County, Florida
Created by: HELMERA
Melissa Winer Cashiered by: HELMERA
10245 Centurion Parkway On: 09/02/2021 8:07 am
Suite 305 Transaction # 3872306
Jacksonville, FL 32256
CaseNumber 2021SC002340
Action:
Judge: MOBLEY, KRISTINA K.
Received From: Melissa Winer
10245 Centurion Parkway
Suite 305
Jacksonville, FL 32256
Fee Description Fee Waived Due Paid Balance
Claims Less Than $100 55.00 0.00 55.00 55.00 0.00
Summons Fee 10.00 0.00 10.00 10.00 0.00
Total 65.00 0.00 65.00 65.00 0.00
Grand Total 65.00 0.00 65.00 65.00 0.00
PAYMENTS
Payment Type Reference Amount Refund Overage Change Net Amount
E-PORTAL SUB TOTAL 65.00 0.00 0.00 0.00 65.00
$65.00
CONVENIENCE FEE $2.28
E-Portal Reference CREDIT CARD CHARGE $67.28
133893862 REMAINING BALANCE $0.00
ORD #32241379
I AGREE TO PAY THE ABOVE CREDIT CARD AMOUNT
ACCORDING TO ISSUER AGREEMENT INCLUDING
THE CREDIT IPASS CONVENIENCE FEE.
OK
133893862
ORD #32241379
65.00 0.00 0.00 0.00 65.00
Page 1 of 1
Document Filed Date
September 02, 2021
Case Filing Date
September 01, 2021
Category
Small Claims $0-$99
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Clay County Clerk of Circuit Court Clay County Receipt of Transaction Receipt #105037 Tara S. Green Clerk of Court Clay County, Florida Created by: HELMERA Melissa Winer Cashiered by: HELMERA 10245 Centurion Parkway On: 09/02/2021 8:07 am Suite 305 Transaction # 3872306 Jacksonville, FL 32256 CaseNumber 2021SC002340 Action: Judge: MOBLEY, KRISTINA K. Received From: Melissa Winer 10245 Centurion Parkway Suite 305 Jacksonville, FL 32256 Fee Description Fee Waived Due Paid Balance Claims Less Than $100 55.00 0.00 55.00 55.00 0.00 Summons Fee 10.00 0.00 10.00 10.00 0.00 Total 65.00 0.00 65.00 65.00 0.00 Grand Total 65.00 0.00 65.00 65.00 0.00 PAYMENTS Payment Type Reference Amount Refund Overage Change Net Amount E-PORTAL SUB TOTAL 65.00 0.00 0.00 0.00 65.00 $65.00 CONVENIENCE FEE $2.28 E-Portal Reference CREDIT CARD CHARGE $67.28 133893862 REMAINING BALANCE $0.00 ORD #32241379 I AGREE TO PAY THE ABOVE CREDIT CARD AMOUNT ACCORDING TO ISSUER AGREEMENT INCLUDING THE CREDIT IPASS CONVENIENCE FEE. OK 133893862 ORD #32241379 65.00 0.00 0.00 0.00 65.00 Page 1 of 1