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    11 views3 pages

    Judgement & Claims PDF

    Uploaded by

    Adam

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
    of 3
    “Benderistrm ca8)S17)397-211 Oeiginal = Cour (ath inructions) Tne ee basen ees ee pie cours saxo, S80 SIS tein GS Se Sey STATEOF WEHIGAN AFROAVIT ANDGLAMH [_CASENO, sth Small Cate | x6-1s05 50 oar oars a a 301 E. Buron St.. Ann Arbor mt 48107 (734) 796-6752" Mee See instructions on the back of plaintiff and defendant copies. senha Zh : Gola Ze NOTICE OF HEARING geo \N euelian Bld, bt + For Court Use Only 2a ; _|Piisinkepixanancesaein se apa den Arbor, (Mt gyjes biP-fites COURT WILL NOTIFY Oy, ant, “Tlephene na AVE OU ENT. nats _ DOWE HAVE YOUR CURRENT 2 Eyres Gu Bi a canna }-S*$—Su——___________ | * appress? ress above. [b44 Chapleau By . Radipad = = vbhey MI File} Fp te 224) wee afte f : Tit Eee EN venn Fee fig: Broseds cervore name (18. Acivil action between thase parties or other parties arising out of the transaction or occurrence alleged in this complaint has been previously filed in. Count. The case number, if known, is= The action remains [Jisnolonger ending. 4 4, pave, knowledge or belief about all the facts stated in this affidavit and! am_ 7 “Wthe pleintif orhis/herguardian, conservater,ornextiriend. [-leparner. _{ ]a fulltime employee of the plain 5. Thepiaintttis — anindividual. (Japarinersnio. [)acomoration. [Jasolepropietor. (7 __ ter 6. Thedefendantis Mi anindividual. | | aparmershi 7. The date(s) the claim aroseislare __ OF/ 32 fovil ( rnov oe wy bug kote ' pha eel amity tot core) =e 8. Amount of money claimed is $_ £2 St fos af ye A (NOTE: Plaintis costs are determined by the cout anc awarded a5 + et Spent, They ovact pat of he epoutcnad) 2. Thoreasonstorthectaimare have thormeght ofeindie partment. where Z live for? yes Lend lord Gel! cle duct $925 from sccunity clepesit, pleas Of le fir wpelilirg gear faucet Liamull @ nach $200 trol Hea on colmg @ phamb ing seyene coher +4 claus worhs eq wih » 2te- (here IS yo Gates, petuanes toy salinity, Lepost as m 40. Tho plaiti understands and acogpts that the claim is limited to $6,500 by law and thatthe plaintif g vos upthé rights ‘0 {@) recover more than ths limit, () en attomey, (c) a jury tral, and (4) appeal the judge's decision. (Jacoperation. Llesolepreprietor. [1] 11. Ibelieve the defendant! is [lis not mentally competent. I believe the defendant | Jis [Xis not 18 years or older. 42, |] Ido not know whether the defendantis in the military service. }Z The defendant is not in the military service. | The defendants inthe miltary sorico. vi Ain ) } tLe. CG ‘Subscribed and swomnto beforemeon {17 14-1 UAE AGLI County, Michigan. My commission expires: ‘]- 2°] ~ 2 Sonature: [Jk ee : date Dapiay davai pubic Notary public, State of Michigan, County of K€ Yr _ ‘Thedefendant(s) mustbeservedby __December 14, 2016 Bxpiaton date Dead (12i14) AFFIDAVIT AND CLAIM, Small Claims NCL 600.8401 sea., MCR 4.992, MCR 4.308, 59 USC 521 Original. Court Sone oo ae STATE OF MICHIGAN CASENO. FA cies hea aba is We-140S ‘Small Claims = ‘Gouri telephone Fo Cou wearess Bel E Hana (00616 d950 , am de, AL 4SIO7 PH - 194-152 i supemenr Pint name and address Giohua Zaha ha thee (156s woed td ye tee, ror Plath hA | Pra Bros ml 43S | _ a | | Personal service paainst: Behe ihont- [sents rare a wos | | Aiqueson

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