eForm 3.

1: Original Notice and Petition for a Money Judgment

In the Iowa District Court for Sac County
Plaintiff(s)
Farmers StateBank
(Name)
401 Main Street. Lake View. IA 51450
(Address)
(Name)
(Address)
vs.
Defendant(s)
Audie Kramer
(Name)
P.O. Box 325
(Address)
Wall Lake, IA 51466
(Name)
(Address)
Original Notice and Petition
for a MoneyJ udgment
To Defendant(s):
1. You are notified that Plaintiff(s) demand(s) from you the amount of $,; ; .2c z .:,2:..::.3.:; .,5.:.:; ,5.:...9 plus court
costs based on (state briefly the basis for the demand, not to exceed $5000):
Unpaid promissory note of $2,235.59
2. J udgment may be entered against you unless you file an Appearance and Answer within 20 days
of the service of the Original Notice upon you. J udgment may include the amount requested plus interest
and court costs.
3. You must electronically file the Appearance and Answer using the Iowa J udicial Branch Electronic
Document Management System (EDMS) at https:llwww.iowacourts.state.ia.us/EFile. unless you obtain
from the court an exemption from electronic filing requirements.
4. If your Appearance and Answer is filed within 20 days and you deny the claim, you will receive
electronic 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 the
attorney(s) for Plaintiff(s). The Notice of Electronic Filing will indicate if Plaintiff(s) is (are) exempt from elec-
tronic filing, and if you must mail a copy of your Appearance and Answer to Plaintiff(s).
6. You must also notify the clerk's office of any address change.
151 J oni Heun
Filing Plaintiff or Attorney
Farmers StateBank
Law firm, or entity for which filing is made, if applicable
eForm 3.1, page 1 of 3
15/ _
Second Plaintiff, if applicable
l.aw firm, or entity for which filing is made, if applicable
E-FILED 2014 AUG 07 3:05 PM SAC - CLERK OF DISTRICT COURT
Mailing address Mailing address
Telephone number Telephone number
Email address Email address
Additional email address, if applicable Additional email address, if applicable
eForm 3.1, page 2 of 3
E-FILED 2014 AUG 07 3:05 PM SAC - CLERK OF DISTRICT COURT
In the Iowa District Court for
eForm 3.27: Verification of Account, Identification of Judqment Debtor, and Certificate Re Military
Service
County
Plaintiff( s)
Farmers StateBank
(Name)
(Name)
vs.
Defendant( s)
Audie Kramer
(Name)
(Name)
Sac
Verification of Account,
Identification of J udgment
Debtor, and Certificate
ReMilitary Service
Small Claim No. _
For Defendant: . ~~--~77-~~~~~
(This form required for each Defendant.)
1. I , J oni Heun, Cashier , am a party or an employee of
Plaintiff(s) 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 sum of $2,235.59 is the
balance due and owing as of 8-7-14 from Defendant(s) to Plaintiff(s)
and any interest amount owing is accurately stated in the Petition or Original Notice.
2. I further state that Defendant resides at 305 Center Street, Wall L ake, I A 51466
is employed at ...::;s.::;el:.:..f..::;em=pl:..:;:0..l...y.::..:ed::.-- . _
and Defendant's occupation is ~e~le::!::c.!:!.tr~ic:!!ia~n~ _
3. Check A, B, or C for Defendant:
A. 0Defendant is not in the military service of the United States government, I have
verified this fact by (check one):
oChecking the Defense Manpower Data Center (DMDC) (requires name and SSN
or name and date of birth) at https:llwww.dmdc.osd.mil/appj/scra/scraHome.do.
DContacting Defendant who informed rne.
[{]Regularly seeing Defendant and believing Defendant is not active in the U.S.
military.
OR B. 0I have investigated, and I am unable to determine whether or not Defendant is in
the military service of the United States government.
OR c. 0Defendant is in the military service of the United States government.
4. I also state to the best of my knowledge (check one):
Defendant 0is 0is not under a disability or confined in a 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 and correct.
Date: 8-7-14
712-657-8525
Phone #
fsblv@iowatelecom.net
EMaii adress
Additional email address, if appilcable
~~~e~
Is/ J oni Heun, Cashier
Filing Plaintiff or Attorney
Farmers State Bank
Law firm, or entity for which filing is made, if applicable
401 Main Street, L ake View, I A 51450
Mailing Address
E-FILED 2014 AUG 07 3:05 PM SAC - CLERK OF DISTRICT COURT
E-FILED 2014 AUG 20 10:50 AM SAC - CLERK OF DISTRICT COURT
Form 3.18: Dismissal

In the Iowa District Court for ________________ County
Plaintiff(s)
________________________________________
(Name)

________________________________________
(Name)
vs.
Defendant(s)
________________________________________
(Name)

________________________________________
(Name)



Dismissal

Small Claim No. _______________




By this filing, I (we) dismiss my (our) claim(s) (check onl y one of the following):

With prejudice (I (we) cannot refile the claim(s)).

Without prejudice (I (we) may refile the claim(s)).



/s/ ________________________________ /s/ ________________________________
Filing Plaintiff or Attorney Second Plaintiff, if applicable
___________________________________ ___________________________________
Law firm, or entity for which filing is made, if applicable Law firm, or entity for which filing is made, if applicable
___________________________________ ___________________________________
Mailing address Mailing address
___________________________________ ___________________________________
Telephone number Telephone number
___________________________________ ___________________________________
Email address Email address
___________________________________ ___________________________________
Additional email address, if applicable Additional email address, if applicable





E-FILED 2014 AUG 25 2:37 PM SAC - CLERK OF DISTRICT COURT
Sac
Farmers State Bank
Audie Kramer
SCSC015478
Joni Heun
401 Main Street Lake View, IA 51450
712-657-8525
fsblv@iowatelecom.net