SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

Embed Size (px)

Citation preview

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    1/16

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    2/16

    IN THE IOWA DISTRICT COURT FOR SAC COUNTYSMALL CLAIMS DIVISION

    L. F. NOLL INC.705 DOUGLAS STR EET SUITE 344SIOUX CITY IA 51101

    PLAINTIFF

    VS

    RODNEY K. TEGLANDPO BOX 40130 4 WILLOW ST

    ODEBOLTIA 51458BRANDI TEGLANDPO BOX 4013 0 4 W I L L O W S TODEBOLTIA 51458

    DEFENDANT(S)

    ORIGINAL NOTICE AND PETITIONFOR A MONEY JUDGMENT

    NO.

    To Defendant s): You are notified that the above-named Plaintiff demands of you the amount of 1236.97. This claim isbased on the value of goods and/or se rvices supplied by the following persons or businesses in the amountsindicated below. Said claims are assigned to Plaintiff.

    CREDITORPATERA FAMILY DENTISTRY

    PRINCIPAL 1236.97 PRE-FILING INTEREST 0.00

    2 Judgment may be entered against you unless you file an Appearance and Answer within 20 days of theservice of the O riginal Notice upon you. Judgment may include the amount requested plus interest and costs.

    3. You m ust electronically file the Appearance and Answ er using the Iowa Judicial Branch ElectronicDocument Management System EDMS) at https://www.iowacourts.state.ia.us/EFile. unless you obtain fromthe court an exem ption from electronic filing requirements.

    4. If your Appearance and Answe r is filed within 20 days and you deny the claim you will receiveelectronic notification through EDMS of the place and time of the hearing on this matter.

    5. If you electronically file, EDMS will serve a copy of the Appearance and Answer on Plaintiff(s) or on thea torney(s) fo r Plaintiffs). The Notice o f E lectronic Filing will indicate if Plaintiff(s) is (are) exempt fromelectronic filing, and if you must mail a copy o f your Appearance and Answer to Plaintiff(s)

    6. You mu st also notify the clerk's office of any address change.

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    3/16

    c a JESSIC R. NOLL AT0008873705 Douglas St., Ste 502Sioux City IA 51101Phone 712) 224-2675Fax 712) [email protected] FOR PLAINTIFF

    2843 7

    FEBRUARYS, 2015

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    4/16

    IN TH E IOWA DISTRICT COURT FOR SAC COUNTYSMALL CLAIMS DIVISION

    L F. NOLL INC.PLAINTIFF

    MILITARY SERVICE

    NO.RODNEY K TEGLANDBRANDITEGLAND

    DEFENDANT(S)

    VERIFICATION OF ACCOUNT

    IDENTIFICATION OF JUDGMENTDEBTOR A N D CERTIFICATE R E

    For Defendant: BRANDI TEGLAND

    1. I T. L. Noll, Vice President of L. F. Noll, Inc., am a party or employee of Plaintiff whose claim s) is (are)shown in the attached statement(s). I have personal knowledge that the attached statement(s) is (are) a true

    copy of the original creditor's records showing the balance due is true and correct. I further state that the sumof 1236.97 is the balance due and owing as of FEBRUARY 3, 2015 from Defendant(s) to Plaintiff s) and anyinterest amount owing is accurately stated in the Petition and Original Notice.

    2. I further state that Defendant, BRANDI TEGLAND, resides at PO BOX 401 304 WILLOW ST ODEBOLT IA51458, is employed at , and Defendant's occupation is .

    3. Check A, B, or C for Defendant:A. X Defendant is not in the military service o f the United States government, I have verified this factby (check one):

    X Checking the Defense Manpower Data Center (DMDC) (requires name and SSN or nameand date of birth) https://www.dmdc.osd.mil/appi/scra/scraHome.do. Contacting Defendant who informed me, or

    : Regularly seeing Defendant an d believing Defendant is not active in the U.S. military.OR B. O I have investigated, and I am unable to determine whether or not Defendant is in the military

    service of the United States government.OR C. O Defendant is in the military service of the United States government.

    4. I also state to the best of my knowledge (check one):Defendant O is X is not under a disability or confined in any reformatory, jail, or penitentiary.

    I certify under penalty of perjury and pursuant to the laws of the State of Iowa that these facts are true andcorrect.

    L.F. NOLL, INC.

    T.-T NOLL, VICE PRESIDENT705 Douglas St., Suite 344Sioux City, IA51101712-252-0583

    0002843170

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    5/16

    \ CS. I m ; .i lha N o l l C o l l e c t i o n Se rv ice"A P r o f e s s i o n a l Debt C u l l c c l i o n Se rv i ce S i n c e 1965"

    PATF-RA FAMILY DENTISFRY

    0002972688

    S 1 2 3 h . 9 7

    S I 2 3 6 9 7

    October 1 0 , 2 0 1 4

    THIS ACCOUNT H AS BEEN LISTED WITH OUR AGENCY FOR ] COLLECTION_̂ - - — . ? . - ? . - < . • — ^ • —

    D E A R B R A N D I T E G L A N D & R O D N E Y K T E G L A N D .

    Y O U A R E I N D E F A U L T O N T H I S C R E D I T T R A N S A C T I O N . Y O U H A V E A R I G H T T O C O R R E C T T H I SD E F A U L T . I F Y O U D O S O, Y O U M AY C O N T I N U E W I T H T H E C O N T R A C T A S T H O U G H Y O U D I DN O T D E F A U L T .

    Y O U R D E FA U LT C ON S I ST S O F : F A I L U R E T O PAY A S A G R E E D

    C O R R E C T T H I S D E F A U LT BY: PAY I N G T H E A M O U N T E N D E FA U LT , S 12 3 6. 9 7 T O N O L I ,C O L L E C T I O N S E RV I C E , A G EN T F O R T i l l - A B O V E C R E D I T O R .

    IF Y O U D O N O T C O R R E C T T H I S D E FA U L T W I T H I N 3 0 D AY S . W E M AY E X E R C I S E O U R R I G I I T SA G A I N S T Y O U U N D E R T H E L AW.

    I F Y O U D E F A U L T A G A I N W I T H I N T H E N E X T Y E A R , W E M A Y E X E R C I SE O U R R I G H T S W I T H O U TS E N D I N G , Y O U A N O T H E R N O T I C E L I K E T H I S O N E . I F Y O U H AV E A N Y Q U E S T I O N S . W R I T E O RT E L E P H O N E P R O M P T L Y .

    U N L E S S Y O U D I S P U T E T H E VA L I D I T Y O F T H E D E B T O R A N Y P O R T I O N T H E R E O F. W I T H I N 3 0D AY S A F T E R R E C E I P T O F T H I S N O T I C E . W E S H A L L A S S U M E T H E D E B T T O B E VA L I D . I F Y O UN O T I F Y U S I N W R I T I N G O F Y O U R D I SP U T E W I T H I N T H I S 3 0 D AY P E R I O D . W E W I L L O B TA I NV E R I F I C AT I O N O F T l IE D E B T A N D W I L L M A I L Y O U A C O P Y. U P O N Y O U R W R I T T E N R E Q U E S TW I T H I N A T H I R T Y D A Y P E R I O D W E W I L L P R O V ID E Y O U W I T H T H E N A M E A N D A N A D D R E S SO F T H E O R I G I N A L C R E D I T O R I F D IF F E R E N T F R O M T H F : C U R R E N T C R E D I T O R .

    S I N C E R E LY,

    N O L L C O L L E C T IO N S E R V I C E

    W e o f f er c o n v e n i e n t Payment Op t ions

    M a i l p a y m e n t i ne n c l o s e d e n v e l o p e

    P a y o n l i n e :w w w. n c s c o l l e c t s . c o m

    C a l l u s :( 7 1 2 ) 2 5 2 - 0 5 8 3

    THIS IS AN ATTEMP T TO COLLECT A DEBTA N Y I N F O R M AT I O N O B TA I N E D W I L L B E U S E D F O RT F I AT P U R P O S E .

    \CS, I m - . 7 0 5 DO fi l A S S 1 K L I I . S l . l I I U 4. S I O l . X C ' l t V 1 A M 1 0 1 . P H : ( 7 1 2 ) 2S2-05IO. I A X i ( 7 1 J j -213-3404. L m : n l m a i l M C S C O | L : I - N

    P C OX Ws i o i ; x r n V I A 5 1 1 0 2 - 0 5 9 3

    Personal Confidential

    U R A N D I T E G L A N I )R O D N E Y K T L G L A N D304 W I L L O W STK > BO X 4 0 1ODLBOLT. I A 5 1 4 5 S - 0 4 0 I

    NC S IN CP O B O X 593SIOUX C I T Y IA 51102-0593

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    6/16

    NCS, INC DBANOLL COLLECTION SERVICE

    A Professional Debt Collection Service Since 1965705 DOUGLAS STREET, SUITE 344

    SIOUX CITY, IA 51101(712) 252-0583

    DATE: JANUARY 26, 2015

    PATERA FAMILY DENTISTRY 023787

    700 E 2ND STIDA GROVE, IA 51445

    ATTENTION:

    RE : BRANDI TEGLAND

    $1236.97 10/08/14The above debtor refuses to cooperate. We recommend further action, in

    order to enforce collection. Before our attorney can proceed, we will require:* Completion of the assignment at the bottom of this page.* Copy of the itemized statement showing balance due (if not

    previously provided)

    * If the original account is

    a contract or note, we must have theoriginal

    Please return promptly. Court costs will be advanced on your behalf.Do not accept payments or make arrangements, without calling us first.

    THANK YOU FOR YOUR COOPERATION

    ASSIGNMENT FOR PURPOSES OF SUITFor valuable consideration, receipt hereby acknowledged, the undersigned herebyassign, transfer, and set over unto L.F. Noll, Inc. that certain claim against

    BRANDI TEGLANDRODNEY K TEGLAND

    for goods, wares and merchandise sold and delivered or services rendered andperformed in the principal amount of $1236.97 plus lawful interestthereon; and does hereby authorize said assignee to do and perform all actsnecessary for collection; commencement of suit in the name of the assignee,settlement, adjustment, compromise or satisfaction of said claim. Assignorhereby certifies that said claim is justly due and owing and warrantscompliance with requirements of the Iowa Consumer Credit Code as well asdisclosure and other provisions of t-Kuth in lending, and that same is free ofset-offs and other defenses

    THIS IS AN ATTEMPT TO COLLECT A DEBT,ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.

    97 688

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    7/16

    Patera Family Dentistry700 East 2nd Street Ste. 1Ida Grove, IA 51445-9998(712)364-3101

    STATEMENT01/29/2015

    Account Number 7608

    Amount Due0.00

    Date D ueUpon Receipt

    Amount Enclosed

    CREDIT CARD TYPE.

    Rodney K Tegland304 Willow StPO Box 401Odebolt,IA51458

    3 DIGIT CSV.

    EXPIRES

    AMOUNT APPROVED.

    NAME.

    SIGNATURE.

    P L E A S E DET CH ND RETUJIN THE UPPER 1'OflTION WITH YOUR PAYMENT

    0-30 -0.00

    31-600.00

    61-900.00

    over 900.00

    Total: $0.00-Ins Estimate: $0.00

    =Balance: 0.00

    Rodney K TeglandDate

    08/31/2006

    08/31/2006

    09/05/2006

    11/30/2006

    12/28/2006

    01/10/2007

    01/10/2007

    02/01/2007

    03/01/2007

    03/29/200705/01/2007

    05/31/2007

    06/28/2007

    07/31/2007

    08/30/2007

    10/09/2007

    11/19/2007

    03/12/2012

    03/12/2012

    03/12/2012

    03/12/2012

    03/12/2012

    03/20/2012

    03/29/2012

    04/02/2012

    04/02/2012

    04/02/2012

    : • • = : Patient

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod 1Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod1

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod1Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod' A

    Rodney 'Rod1

    Code

    t

    w a r ntmm

    lAdjust

    AdjustAdjust

    Adjust

    Adjust

    Adjust

    Adjust

    Adjust

    Adjust

    Adjust

    Adjust

    Adjust

    Slmt

    PayMM«m umClaim

    Pay »

    Stmtmm

    Tooth

    18

    18

    l

    } • . : • • ; : . : i ^DescriptionBalance Forward

    MMM

    Dentrix Adjustment

    Oentrix Adjustment

    Dentrix Insurance Pay

    Dentrix Insurance Pay

    Dentrix Adjustment

    Dentrix Adjustment

    Oentrix AdjustmentDentrix Adjustment

    Dentrix Adjustment

    Dentrix Adjustment

    Dentrix Adjustment

    Dentrix Adjustment

    Statement-Mail

    Cash 132.67

    •••M•••••••••p HbpPri Claim 82.00 Gomaco Godbersen SmithReceived 04/10/2012Payment: 65.60Cash 10,00

    • • •Statement-Electronic

    ^^^^^^^__^^^^^^^^^^^

    Charges

    27.00

    17.00

    665,00

    9.98

    9.98

    1.62

    1.77

    1.771.82

    1.85

    1.851.90

    1.93

    58.00

    24.00

    0.00

    0.00

    64.00

    109.00

    31.00

    Credits

    532.00

    35.20

    132.67

    10.00

    Balance33.40

    60,40

    77.40

    742.40752.38762.36

    230.36

    195.16

    196.78198.55

    200.32

    202.14

    203.99

    205.84

    207.74209.67

    77.00

    135.00

    159.00

    159.00

    149.00

    149.00

    213.00

    322.00

    353.00

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    8/16

    Date04/02/2012

    04/02/2012

    04/02/2012

    04/02/2012

    04/02/2012

    04/10/2012

    04/17/2012

    04/17/201204/17/2012

    04/17/2012

    04/17/2012

    05/01/2012

    05/07/2012

    05/31/2012

    07/03/2012

    07/03/2012

    07/30/2012

    07/30/2012

    08/30/2012

    08/30/2012

    10/01/2012

    10/01/2012

    10/31/2012

    11/01/2012

    11/27/2012

    11/27/2012

    12/27/2012

    12/27/2012

    01/31/2013

    01/31/2013

    02/28/201302/28/2013

    02/28/2013

    Patient jRodney 'Rod 1

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod1

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    "Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'Rodney 'Rod 1

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod 1Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Code••»

    MPW

    Claim

    PayrStmtInsPay

    /din

    V* ••wClaim

    Stmt

    InsPay

    StmtStmt

    Adjust

    Stmt

    Adjust

    Stmt

    Adjust

    Adjust

    Stmt

    Adjust

    Stmt

    Adjust

    Stmt

    Stmt

    Adjust

    Stmt

    Adjust

    StmtAdjust

    Adjust

    fbbth

    18

    22

    7

    _

    Description

    ^̂̂ _̂_̂— ^̂̂ _̂

    Pri Claim 1,168.00 Gomaco Godbersen SmithReceived 05/07/2012Payment: 934.40Cash 70.00

    Statement- nPerson

    Insurance Payment for Claim 03/12/2012

    Clinical Note (NoBilllns)

    •• t

    •••>MĤr

    Prt Claim 851.00 Gomaco Godbersen SmithReceived 05/07/2012NO PAYMENTStatement- Electronic

    Insurance Payment for Claim 04/02/2012

    Statement-Electronic

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Finance Charge

    Finance Charge

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Finance Charge

    Statement-lnPersonBad Debt Write-Off

    Finance Charge

    Charges^165.00

    799.00

    0.00

    90.00136.00

    625.00

    3.71

    16.47

    16.47

    16.47

    16,77

    16.77

    17.02

    17.52

    17.77

    Credits

    70.00

    65,60

    934.40

    1,236.97

    /Balance518.00

    •\£\7.0Q

    1,247.00

    1,181.40

    1,181.40

    1,271.401,407.40

    2,032.40

    1,098.00

    1,101.71

    1,118.18

    1,134.651,151.12

    1,167.89

    1,184.66

    1,201.68

    1,219.20

    -17.77

    0.00

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    9/16

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    10/16

    fNCS. I n ct i ha N o l l C o l l e c t io n Sen ic e A P r o f e s s i o n a l Debt C o l l e c t i o n S e r v ic e Since 1965

    P T E R- M I L Y D E N H S T R Y0002Q7268K

    1 236.97

    October 10 ,2014

    THIS ACCOUNT H A S BEEN LISTED W ITH O U R A G E N C Y FO R

    COLLECTION.

    D E A R B R A N D 1 T E G L A N D & R O D N E Y K T E G L A N D .

    Y O U A R E I N D E FA U LT O N T H I S C R E D I T T R A N S A C T I O N . Y O U H AV E A R I G H T TO C O R R E C T T H I SD E FA U LT I F Y O U D O S O , Y O U M AY C O N T I N U E W I T H Ti l l - : CONTRACT A S T H O U G H Y O U D I DNOT D E F A U LT .

    YOUR DEFAULT CONSISTS OF: F A I L U R E TO PAY AS A G R E E D

    CORR ECT THIS D E FA U LT BY: PAY I N G THE AMOUNT I N D E FA U LT, SI 236.97 TO N O L LCOLLECTION S E RV I C E , A G E N T FOR THE A B O V E C R E D I T O R .

    I F YOU DO NOT CORRECT THIS D E FA U LT W I T H I N 30 D AY S . WE MAY E X E R C I S E OUR R I G H T SA G A I N S T Y O U U N D E R T H E L AW.

    I F Y O U D E F A U LT A G A I N W I T H I N T H E N l X T Y E A R , W E M AY E X E R C I S E O U R R I G H T S W I T H O U TS E N D I N C i Y O U A N O T H E R N O T I C E L I K E T H I S O N E . I F Y O U H AV E A N Y Q U E S T I O N S . W R I T E O RT E L E P H O N E P R O M P T LY.

    U N L E S S YOU D I S P U T E THE VA L I D I T Y OF THE DEBT OR ANY PORTION T H E R E O F. W I T H I N 30D AY S A F T E R R E C E I P T OF T H I S N O T I C E . WE S H A L L A S S U M E THE DEBT TO BE VA L I D . IF YOUN O T I F Y U S I N W R I T I N G O F Y O U R D I S PU T E W I T H I N THIS 3 0 D AY P E R I O D . W E W I L L O B TA I NV E R I F I C AT I O N OF THE DEBT A ND W I L L M A I L YOU A COPY. U P O N Y O U R W R I T T E N REQUESTW I T H I N A T H I R T Y D AY P E R I O D W E W I L L P R O V I D E Y O U W I T H T H E N A M E A N D A N A D D R E S SO F T H E O R I G I N A L C R E D I T O R I F D I F F E R E N T F R O M T H E C U R R E N T C R E D I T O R .

    S I N C E R E LY,

    N O L L COLLECTION S E RV I C E

    We offer c o n v e n i e n t Payment Options

    M a i l p a y m e n t i nenclosed envelope

    Pa y o n l i n e :w w w. n c s c o l l e c t s . c o m

    C a l l u s :( 7 1 2 ) 2 5 2 - 0 5 8 3

    T H I S I S AN AT T E M P T TO COLLECT A DEBTA N Y I N F O R M AT I O N O B T A I N E D W I L L B E U S E D F O R T H AT P I R P O S E

    V S. I n c . , 70 5 D C ) I ( ,l AS SI K l i l : I . SUM I - 'J4. S I O l ' X C I T Y A 5 1 1 0 1 . P H : | 7 1 2 | 252-05K3. t f\\ (712) -213-3404 . K m a i l m a i l

    PO FiOX

    S I O l i X C I I Y I A 5 I t 02-0593

    Personal Confidential

    HRAN'DI T h G L A N DR O DN E Y K T E G L A N D30 4 W I L L O W S'[PO B OX 4 0 1ODFBOLT IA 5 1 4 5 X 0 4 0 1

    N C S I N CPO BOX 593S I O L ' X C I T Y IA S I 102-0593

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    11/16

    NCS, INC DBANOLL COLLECTION SERVICE

    A Professional Debt Collection Service Since 1965705 DOUGLAS STREET, SUITE 344

    SIOUX CITY, IA 51101(712) 252-0583

    DATE: JANUARY 26, 2015

    PATERA FAMILY DENTISTRY 023787

    700 E 2ND STIDA GROVE, IA 51445

    ATTENTION:

    RE: BRANDI TEGLAND

    $1236.97 10/08/14The above debtor refuses to cooperate. We recommend further action, in

    order to enforce collection. Before our attorney can proceed, we will require:* Completion of the assignment at the bottom of this page.* Copy of the itemized statement showing balance due (if not

    previously provided)

    * If the original account is a contract or note, we must have theoriginal.

    Please return promptly. Court costs will be advanced on your behalf.Do not accept payments or make arrangements, without calling us first.

    THANK YOU FOR YOUR COOPERATION

    ASSIGNMENT FOR PURPOSES OF SUITFor valuable consideration, receipt hereby acknowledged, the undersigned herebyassign, transfer, and set over unto L.F. Noll, Inc. that certain claim against

    BRANDI TEGLANDRODNEY K TEGLAND

    for goods, wares and merchandise sold and delivered or services rendered andperformed in the principal amount of $1236.97 plus lawful interestthereon; and does hereby authorize said assignee to do and perform all actsnecessary for collection; commencement of suit in the name of the assignee,settlement, adjustment, compromise or satisfaction of said claim. Assignorhereby certifies that said claim is justly due and owing and warrantscompliance with requirements of the Iowa Consumer Credit Code as well asdisclosure and other provisions of t-Kjuth in lending, and that same is free ofset-offs and other defenses

    Dated thisPATERA FAMILY DENTISTRY

    By: Name\arfd\Of f i c V e

    j ^ . . J sTHIS IS AH ATTEMPT TO COLLECT A DEBT,

    ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE.

    97 688

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    12/16

    Patera Family Dentistry700 East 2nd Street Ste. #1Ida Grove, IA 51445-9998(712)364-3101

    STATEMENT01/29/2015

    Account Number 7608

    Amount Due0.00

    Date Due :Upon Receipt

    Amount Enclosed

    Rodney K Tegland304 Willow StPO Box 401Odebolt, IA51458

    CREDIT CARD TYPE,

    _

    3 DIGIT CSV.

    EXPIRES

    AMOUNT APPROVED.

    N ME

    SIGNATURE

    PLEASE OETACH AND RETURN THE UPPER PORTION WTH YOUR PAYMENT

    0-300.00

    31-60 -0.00

    81;90 : • - -0.00

    oveffiO0.00

    Total:-Ins Estimate:

    ^Balance

    $0.00$0.00$0.00

    Rodney TeglandDate

    08/31/2006

    08/31/2006

    09/05/2006

    1 1/30/200612/28/2006

    01/10/2007

    01/10/2007

    02/01/2007

    03/01/200703/29/2007

    05/01/2007

    05/31/2007

    06/28/2007

    07/31/2007

    68/30/2007

    10/09/2007

    11/19/2007

    03/12/201203/12/2012

    03/12/2012

    03/12/2012

    03/12/2012

    03/20/2012

    03/29/2012

    04/02/2012

    04/02/2012

    04/02/2012

    Patient

    Rodney 'Rod' ,

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney Rod1Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod 1

    Rodney 'Rod'Rodney 'Rod 1

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney RodRodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney RodRodney 'Rod' 4

    Rodney 'Rod'

    Code

    t

    m rm m mAdjust

    Adjust

    Adjust

    Adjust

    Adjust

    AdjustAdjust

    Adjust

    Adjust

    Adjust

    Adjust

    Adjust

    StmtPayMB« »

    Claim

    Pay »

    Stmt

    m m m

    Tooth

    18

    18

    18

    : - • : ; DescriptionBalance Forward

    entrix Adjustment

    Oentrix Adjustment

    Denlrix Insurance Pay

    Dentrix Insurance Pay

    Dentrix Adjustment

    Dentrix AdjustmentDentrix Adjustment

    Dentrix Adjustment

    Dentrix Adjustment

    Dentrix Adjustment

    Dentrix Adjustment

    Dentrix Adjustment

    Statement-Mat

    Cash $132.67 »

    •ImmmmmmmmimmijPri Claim $82.00 Gomaco Godbersen SmithReceived 04/10/2012Payment: $65.60Cash $10.00 u m M m i m m m m »Statement-Electronic

    mmm

    mm

    Charges

    27.00

    17.00

    665,00

    9.98

    9.98

    1.62

    1.771.77

    1.82

    1.85

    1.85

    1.90

    "1.93

    58.00

    24.00

    0.00

    0.00

    64.00

    109.00

    31.00

    Credits

    532.00

    35.20

    132.67

    10.00

    Balance33,40

    60.40

    77.40

    742.40

    752.38

    762.36

    230.36

    195.16

    196.78

    198.55200.32

    202.14

    203.99

    205.84

    207.74

    ~209.67

    77.00

    135.00

    159.00

    159.00

    149.00149.00

    213.00322.00

    353.00

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    13/16

    Date04/02/2012

    04/02/2012

    04/02/2012

    04/02/2012

    04/02/2012

    04/10/2012

    04/17/2012

    04/17/2012

    04/17/2012

    04/17/2012

    04/17/2012

    05/01/2012

    05707/201205/31/2012

    07/03/2012

    07/03/2012

    07/30/2012

    07/30/2012

    08/30/201208/30/2012

    10/01/2012

    10/01/2012

    10/31/2012

    1 1/61/261211/27/2012

    11/27/2012

    12/27/2012

    12/27/2012

    01/31/2013

    01/31/2013

    02/28/201302/28/2013

    02/28/2013

    PatientRodney Rod1

    Rodney 'Rod'

    Rodney Rod 1

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney Rod1Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod 1

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'

    Rodney 'Rod'Rodney 'Rod 1

    Rodney 'Rod'Rodney 'Rod'

    Rodney 'Rod'

    Codê

    OTMCaim

    Pay

    Stmt

    Inspay

    Zdln

    P

    Caim

    Stmt

    InsPay

    StmtStmt 1Adjust

    Stmt

    Adjust

    Stmt Adjust

    Adjust

    Stmt

    Adjust

    Stmt

    Adjust

    Slmt

    Stmt

    Adjust

    Stmt

    Adjust

    StmtAdjust

    Adjust

    footh

    18 1

    2

    2

    7

    Description

    Pri Caim $1,168.00 Gomaco Godbersen SmithReceived 05/07/2012Payment: $934.40Cash $70.00

    Statement-lnPerson

    Insurance Payment for Caim 03/12/2012

    telinicalNote Noiitllns

    ••••I •• •V&

    Pri Caim $851.00 Gomaco Godbersen SmithReceived 05/07/2012NO PAYMENTStatement-Electronic

    Insurance Payment for Caim 04/02/2012

    Statement-Electronic

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Finance Charge

    Statement-ElectronicFinance ChargeFinance Charge

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Statement-Electronic

    Finance Charge

    Statement-Electronic

    Finance Charge

    Statement-lnPersonBad Debt Write-Off

    Finance Charge

    Charges165.00

    799.00

    0.00

    90.00

    136.00

    625.00

    3.71

    16.47

    16.47

    16.47

    16.77

    16.77

    17.02

    17.52

    17.77

    •Credits-

    70.00

    65,60

    934.40

    1,236.97

    Balance.518.00

    1.3V7.00

    1,247.00

    1,181.401,181.40

    1,271.401,407.40

    2,032.40

    1,098.00

    1,101.71

    1,118.18

    1,134.651,151.12

    1,167.89

    1,184.66

    1,201.68

    1,219.20

    -17.77

    0.00

    E-FILED 2015 FEB 05 10:46 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    14/16

    E-FILED 2015 MAR 03 9:21 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    15/16

    IN THE IOWA DISTRICT COURT IN AND FOR SAC COUNTY

    Plaintiff(s), SMALL CLAIMS DIVISION L F NOLL INCPO BOX 593SIOUX CITY IA 51102

    Case: 02811 SCSC015582

    vs.

    JUDGMENT ENTRYDefendant(s),

    ROD TEGLAND304 WILLOW STODEBOLT IA 51458

    BRANDI TEGLANDPO BOX 401ODEBOLT IA 51458

    The court file shows that the defendants have received proper notice and have failed to answer. Therelief is readily ascertainable from the Original Notice. Pursuant to Iowa Code Section 631.5(6), thedefendant is in default and judgment should enter accordingly.

    It is therefore Ordered that judgment is entered in favor of the plaintiff and against the defendants, jointly and severally, in the amount of $ 1236.97 with interest at the rate of 2.20 % from the 5th dayof February, 2015 and court costs.

    YOU ARE HEREBY NOTIFIED that you have a right to appeal the decision to the District Court bygiving written notice to the Small Claims Office within 20 days of the filing of this order. Filing Fee forappeal is $185.00. Appeal Bond is set in the amount of: $1300.00

    1 of 2

    E-FILED 2015 MAR 04 10:05 AM SAC - CLERK OF DISTRICT COURT

  • 8/9/2019 SCSC015582 - Judgment against Odebolt persons i the amount $1,236.97.pdf

    16/16

    State of Iowa CourtsCase Number Case TitleSCSC015582 L.F. NOLL, INC. V TEGLAND, RODNEY AND BRANDIType: ORDER FOR JUDGMENT

    So Ordered

    Electronically signed on 2015-03-04 10:04:46

    2 of 2

    E-FILED 2015 MAR 04 10:05 AM SAC - CLERK OF DISTRICT COURT