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Filing # 54658696 E-Filed 04/05/2017 10:43:12 AM
eV %
VERIFIED RETURN OF SERVICE / ) ip Uy, 03
State of Florida . County of Broward , if 4 Court
Case Number: 16-012554 (18) Court Dale: 2/9/2017
SALINIA SHATTEEN AND SHELTON SHATTEEN, JVS2017000546
vs.
Defendant:
STARBUCKS COFFEE COMPANY ET AL,
For: Eugene K Pettis
Haliczer Pettis & Schwamm
Received by COMPASS INVESTIGATIONS on the 21st day of January, 2017 at 10:18 am to he served on RECORDS CUSTODIAN
MRI IMAGING ON CONYERS, 2287 SALEM ROAD, CONYERS, GA 30013. |, =: \ es » A being duly swom,
depose and say that on the a ofa ea 204 at. Sap exeguied service by delivering a true copy of the
SUBPOENA DUCES TECUM WITHOUT DEPOSITION PURSUANT TO F.RIC.P. 1.251 and CERTIFICATE OF NO OBJECTION and
MAILING LIST in accordance with state statutes in the manner marked below: os 2:
() PUBLIC AGENCY: By serving. ts
() SUBSTITUTE SERVICE: By serving as.
() CORPORATE SERVICE: By serving. as,
() OTHER SERVICE: As described in the Comments below by serving,
‘wig TUAW
goi4a0 NI Gad
(NON SERVICE-For the reason detalied in the Comments below. Zz
CF:
comments: Recor core release cob he of pte ler alSan, Perouse!
mare roated) hemo Bstine pL Sr. et Par menelig |
(orIR= We RBK, Drbown as mecidirscor plc
Age Sex MF Race Height. Weight Hair. Glasses Y N
| certify that | have no interest in the above action, am of legal age and have proper authority in the jurisdiction in which this service
was made. Under penaitles of perjury, | declare that | have read the foregoing document and that the facts stated in il are true.
Subscribed and Swom to before me on the ZIS ey
oft by the affiant who
is Personally Kndwn, R Produced
Identification__
Type of Identification Produced
Z)
COMPASS INVESTIGATIONS
10 South New River Drive, East
Suite 205
Fort Lauderdale, FL 33301
(954) 527-5722
Our Job Serial Number: 2017000546
Ref: 1176.0068 (Eugene K Pettis)P
oo ° Eb
1176.0068 ‘ IN THE CIRCUIT COURT FOR THE
17" JUDICIAL CIRCUIT IN AND FOR
BROWARD COUNTY, FLORIDA
SALINIA SHATTEEN and CASE NO: 16-012554 (18)
SHELTON SHATTEEN,
Plaintiffs,
v. , REC'D ON: aul 7
STARBUCKS COFFEE COMPANY seven: MOM- SE CVE,
and LAKE CITY MALL, LP, ore (/SI1F Te 222 PV
SERVED BY:
Defendants. |
/
SUBPOENA DUCES TECUM
WITHOUT DEPOSITION
PURSUANT TO F.R.C.P. 1.351
MAIL THESE RECORDS ON OR BEFORE
FEBRUARY 9, 2017
THE STATE OF FLORIDA
TO: RECORDS CUSTODIAN
MRI Imaging of Conyers
2287 Salem Road
Conyers, GA 30013
YOU ARE COMMANDED to mail to the LAW OFFICES OF HALICZER PETTIS
& SCHWAMM, P.A., One Financial Plaza, Seventh Floor, Fort Lauderdale, Florida 33394,
the following:
IF THE FEE FOR PHOTOCOPYING EXCEEDS $100.00, PLEASE CONTACT SANDY
IN ADVANCE OF THE PHOTOCOPYING FOR AUTHORIZATION TO DO SO.
MEDICAL/BILLING/RADIOLOGY RECORDS
ANY AND ALL documents relating to SALINIA SHATTEEN, .DOB: SOC SEC#:
XXX-XXK _ 4, including but not limited to medical records, office records, X-RAY FILMS, X-Ray
reports, Magnetic Resonance Imaging films, CT scans, including BILLING statements, ledger cards,
payment records, claim forms, reports of physical examination, charts, notes on attendance and/or
treatment, patient questionnaires, patient information records, medical examinations, medical tests,
diagnostic tests, laboratory reports, consultation reports, progress notes, doctors' orders', nurses notes,reports of operation, pathology slides, pathology reports, histories, insurance reports, memos, clothing
and valuable inventory lists, patient transfer forms, correspondence, physical therapy records and
reports, physical therapy billing records, EMS/Paramedic reports, Workers Compensation records,
Social Service records, Social Security records, HRS records, and all other written documents
whatsoever.
You may mail or deliver the copies to the attorney whose name appears on this subpoena together with
your bill for same. You have the right to object to the production pursuant to this subpoena, at any time
before production, by giving written notice to the attorney whose name appears on this subpoena. If you
object to the subpoena, pursuant to F.R.C.P. 1.310, your formal deposition will be taken as a non-expert
custodian of the records and items being sought. If you fail to furnish the records as provided above, you may
be in contempt of Court. You are subpoenaed by the attorneys whose names appear on this subpoena and
unless excused from this subpoena by the attorneys or the Court, you shall respond to this subpoena as directed.
DATED on the 20 day of January 2017.
EUGENE K. PETTIS
For The Court,
By:
FBN:1508454
HALICZER PETTIS & SCHWAMM, P.A.
Attorneys for Starbucks Coffee Company
One Financial Plaza-7" Floor ~
Fort Lauderdale, FL 33394
(954) 523-9922 Fax (954) 522-2512
IF YOU HAVE ANY QUESTIONS, PLEASE CALL SANDY @ EXT. 151
SENTRIKEN@HPSLEGAL.COM
FACASEFOLDERS\1176.0068\RECORDS\SUB.MRI IMAGING.DOCX
Preview
yn Filing # 54658696 E-Filed 04/05/2017 10:43:12 AM eV % VERIFIED RETURN OF SERVICE / ) ip Uy, 03 State of Florida . County of Broward , if 4 Court Case Number: 16-012554 (18) Court Dale: 2/9/2017 SALINIA SHATTEEN AND SHELTON SHATTEEN, JVS2017000546 vs. Defendant: STARBUCKS COFFEE COMPANY ET AL, For: Eugene K Pettis Haliczer Pettis & Schwamm Received by COMPASS INVESTIGATIONS on the 21st day of January, 2017 at 10:18 am to he served on RECORDS CUSTODIAN MRI IMAGING ON CONYERS, 2287 SALEM ROAD, CONYERS, GA 30013. |, =: \ es » A being duly swom, depose and say that on the a ofa ea 204 at. Sap exeguied service by delivering a true copy of the SUBPOENA DUCES TECUM WITHOUT DEPOSITION PURSUANT TO F.RIC.P. 1.251 and CERTIFICATE OF NO OBJECTION and MAILING LIST in accordance with state statutes in the manner marked below: os 2: () PUBLIC AGENCY: By serving. ts () SUBSTITUTE SERVICE: By serving as. () CORPORATE SERVICE: By serving. as, () OTHER SERVICE: As described in the Comments below by serving, ‘wig TUAW goi4a0 NI Gad (NON SERVICE-For the reason detalied in the Comments below. Zz CF: comments: Recor core release cob he of pte ler alSan, Perouse! mare roated) hemo Bstine pL Sr. et Par menelig | (orIR= We RBK, Drbown as mecidirscor plc Age Sex MF Race Height. Weight Hair. Glasses Y N | certify that | have no interest in the above action, am of legal age and have proper authority in the jurisdiction in which this service was made. Under penaitles of perjury, | declare that | have read the foregoing document and that the facts stated in il are true. Subscribed and Swom to before me on the ZIS ey oft by the affiant who is Personally Kndwn, R Produced Identification__ Type of Identification Produced Z) COMPASS INVESTIGATIONS 10 South New River Drive, East Suite 205 Fort Lauderdale, FL 33301 (954) 527-5722 Our Job Serial Number: 2017000546 Ref: 1176.0068 (Eugene K Pettis)P oo ° Eb 1176.0068 ‘ IN THE CIRCUIT COURT FOR THE 17" JUDICIAL CIRCUIT IN AND FOR BROWARD COUNTY, FLORIDA SALINIA SHATTEEN and CASE NO: 16-012554 (18) SHELTON SHATTEEN, Plaintiffs, v. , REC'D ON: aul 7 STARBUCKS COFFEE COMPANY seven: MOM- SE CVE, and LAKE CITY MALL, LP, ore (/SI1F Te 222 PV SERVED BY: Defendants. | / SUBPOENA DUCES TECUM WITHOUT DEPOSITION PURSUANT TO F.R.C.P. 1.351 MAIL THESE RECORDS ON OR BEFORE FEBRUARY 9, 2017 THE STATE OF FLORIDA TO: RECORDS CUSTODIAN MRI Imaging of Conyers 2287 Salem Road Conyers, GA 30013 YOU ARE COMMANDED to mail to the LAW OFFICES OF HALICZER PETTIS & SCHWAMM, P.A., One Financial Plaza, Seventh Floor, Fort Lauderdale, Florida 33394, the following: IF THE FEE FOR PHOTOCOPYING EXCEEDS $100.00, PLEASE CONTACT SANDY IN ADVANCE OF THE PHOTOCOPYING FOR AUTHORIZATION TO DO SO. MEDICAL/BILLING/RADIOLOGY RECORDS ANY AND ALL documents relating to SALINIA SHATTEEN, .DOB: SOC SEC#: XXX-XXK _ 4, including but not limited to medical records, office records, X-RAY FILMS, X-Ray reports, Magnetic Resonance Imaging films, CT scans, including BILLING statements, ledger cards, payment records, claim forms, reports of physical examination, charts, notes on attendance and/or treatment, patient questionnaires, patient information records, medical examinations, medical tests, diagnostic tests, laboratory reports, consultation reports, progress notes, doctors' orders', nurses notes,reports of operation, pathology slides, pathology reports, histories, insurance reports, memos, clothing and valuable inventory lists, patient transfer forms, correspondence, physical therapy records and reports, physical therapy billing records, EMS/Paramedic reports, Workers Compensation records, Social Service records, Social Security records, HRS records, and all other written documents whatsoever. You may mail or deliver the copies to the attorney whose name appears on this subpoena together with your bill for same. You have the right to object to the production pursuant to this subpoena, at any time before production, by giving written notice to the attorney whose name appears on this subpoena. If you object to the subpoena, pursuant to F.R.C.P. 1.310, your formal deposition will be taken as a non-expert custodian of the records and items being sought. If you fail to furnish the records as provided above, you may be in contempt of Court. You are subpoenaed by the attorneys whose names appear on this subpoena and unless excused from this subpoena by the attorneys or the Court, you shall respond to this subpoena as directed. DATED on the 20 day of January 2017. EUGENE K. PETTIS For The Court, By: FBN:1508454 HALICZER PETTIS & SCHWAMM, P.A. Attorneys for Starbucks Coffee Company One Financial Plaza-7" Floor ~ Fort Lauderdale, FL 33394 (954) 523-9922 Fax (954) 522-2512 IF YOU HAVE ANY QUESTIONS, PLEASE CALL SANDY @ EXT. 151 SENTRIKEN@HPSLEGAL.COM FACASEFOLDERS\1176.0068\RECORDS\SUB.MRI IMAGING.DOCX