K9080

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY

HAWKEYE ADJUSTMENT SERVICE,
Plaintiff,

CASE NO. SCCV

v.

ORIGINAL NOTICE & PETITION

FOR A MONEY JUDGMENT
MICHELE L KOLPIN 309 S MAIN ST #126 PO SCHALLER IA 51053
THOMAS KOLPIN
Defendant(s)
TO DEFENDANT(S):
1. YOU ARE HEREBY NOTIFIED that the Plaintiff demands from you the amount of $3,715.07,
plus court costs, based on accounts with PIERCE STREET SAME DAY SURGERY, $350.31
PRAIRIE PEDIATRICS/ADOLESCENT $365.50 ANESTHESIA CONSULTANTS $2,999.26
2. Judgment may be entered against you unless you file an Appearance and Answer within 20 days
of the service of the Original Notice upon you. Judgment may include the amout requested plus interest
and court costs.
3. You must electronically file an Appearance and Answer using the Iowa Judicial Branch Electronic
Document Management System (EDMS) at http://ww.iowacourts.state.ia.us/EFile, unless you obtain
from the court an exemption from electronic filing requirements.
4. If you 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 for hearing on this matter.
5. If you electronically file an Appearance and Answer, EDMS will serve a copy of the form on
Plaintiff, unless Plaintiff is exempt from electronic filing, or on the attorney for the Plaintiff. The Notice
of Electronic Filing will indicate if you must mail a copy of your Appearance and Answer to Plaintiff.
6. You must also notify the clerks office of any address change.
VAKULSKAS LAW FIRM, P.C.
/s/Molly Vakulskas Joly
MOLLY VAKULSKAS JOLY AT0003980
1721 Jackson Street P. O. Box 1661

Sioux City, Iowa 51102

(712) 252-4344
(712) 252-5003 FAX
Email: molly@vaklaw.com

IN THE
IOWA
DISTRICT
COURT
FOROF
SAC
COUNTY
E-FILED
2014
SEP 23
11:48 AM SAC
- CLERK
DISTRICT
COURT
HAWKEYE ADJUSTMENT SERVICE,
Plaintiff,
v.

CASE NO.
VERIFICATION OF ACCOUNT,
IDENTIFICATION OF JUDGMENT
DEBTOR AND CERTIFICATE RE
MILITARY SERVICE

MICHELE L KOLPIN
THOMAS KOLPIN
FOR DEFENDANT THOMAS KOLPIN
Defendant(s).
1. I, Daniel P. Vakulskas, am the attorney for the Plaintiff, whose claims are shown in the attached statements. I
have personal knowledge that the attached statements are a true copy of the original creditors records showing the
balance due is true and correct. I further state that the sum of $3,715.07 is the balance due and owing as of today
from the Defendant(s) to the Plaintiff and any interest amount owing is accurately stated in the Petition or Original
Notice.
2. I further state that the Defendant, THOMAS KOLPIN resides at 309 S MAIN ST #126 PO SCHALLER IA
51053 is employed at and the Defendants occupation is laborer.
3. Defendant is not in the Military forces of the United States Government. I, or a fellow employee, verified this
fact by checking the Defense Manpower Data Center (DMDC),
http://www.virec.research.va.gov/Non-VADataSources/DMDC.htm.
4. I also state to the best of my knowledge Defendant(s) is/are not under any legal 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 and correct.
Dated: Tuesday, September 23, 2014
VAKULSKAS LAW FIRM, P.C.
/s/Molly Vakulskas Joly
MOLLY VAKULSKAS JOLY AT0003980
1721 Jackson Street P. O. Box 1661

Sioux City, Iowa 51102

(712) 252-4344
(712) 252-5003 FAX
Email: molly@vaklaw.com

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY

HAWKEYE ADJUSTMENT SERVICE,
Plaintiff,
v.

CASE NO.
VERIFICATION OF ACCOUNT,
IDENTIFICATION OF JUDGMENT
DEBTOR AND CERTIFICATE RE
MILITARY SERVICE

MICHELE L KOLPIN
THOMAS KOLPIN
FOR DEFENDANT MICHELE L KOLPIN
Defendant(s).
1. I, Daniel P. Vakulskas, am the attorney for the Plaintiff, whose claims are shown in the attached statements. I
have personal knowledge that the attached statements are a true copy of the original creditors records showing the
balance due is true and correct. I further state that he sum of $3,715.07 is the balance due and owing as of today
from the Defendant(s) to the Plaintiff and any interest amount owing is accurately stated in the Petition or Original
Notice.
2. I further state that the Defendant MICHELE L KOLPIN, resides at 309 S MAIN ST #126 PO SCHALLER IA
51053 is employed at unknown PYLE TRANSPORTATION and the Defendants occupation is unknown.
3. I further state that the Defendant(s) is/are not in the Miliitary forces of the United States Government. I, or a
fellow employee, verified this fact by checking the Defense Manpower Data Center (DMDC),
http://www.virec.research.va.gov/Non-VADataSources/DMDC.htm.
4. I also state to the best of my knowledge Defendant(s) is/are not under any legal 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 and correct.
Dated: Tuesday, September 23, 2014
VAKULSKAS LAW FIRM, P.C.
/s/Molly Vakulskas Joly
MOLLY VAKULSKAS JOLY AT0003980
1721 Jackson Street P. O. Box 1661

Sioux City, Iowa 51102

(712) 252-4344
(712) 252-5003 FAX
Email: molly@vaklaw.com

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 SEP 23 11:48 AM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 OCT 08 12:55 PM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 OCT 21 9:56 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT IN AND FOR SAC COUNTY

Plaintiff(s),
HAWKEYE ADJUSTMENT SERVICE
2300 PIERCE ST
SIOUX CITY IA 51105

SMALL CLAIMS DIVISION

Case: 02811 SCSC015506

vs.
JUDGMENT ENTRY
Defendant(s),
THOMAS E KOLPIN
309 S MAIN ST
SCHALLER IA 51053-0
MICHELE LYNN KOLPIN
309 MAIN STREET BOX 126
SCHALLER IA 51053

The court file shows that the defendants have received proper notice and have failed to answer. The
relief is readily ascertainable from the Original Notice. Pursuant to Iowa Code Section 631.5(6), the
defendant 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 $ 3715.07 with interest at the rate of 2.11 % from the 23rd day
of September, 2014 and court costs.

YOU ARE HEREBY NOTIFIED that you have a right to appeal the decision to the District Court by
giving written notice to the Small Claims Office within 20 days of the filing of this order. Filing Fee for
appeal is $185.00. Appeal Bond is set in the amount of: $3,800.00

1 of 2

E-FILED 2014 OCT 21 9:56 AM SAC - CLERK OF DISTRICT COURT

State of Iowa Courts

Case Number
SCSC015506
Type:

Case Title
HAWKEYE ADJUSTMENT SERVICE V MICHELE L KOLPIN
ORDER FOR JUDGMENT
So Ordered

Electronically signed on 2014-10-21 09:53:49

2 of 2

E-FILED 2014 OCT 21 1:02 PM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY

K9080
HAWKEYE ADJUSTMENT SERVICE,
NO SCSC015506
Plaintiff,
vs.

REQUEST FOR GENERAL EXECUTION

(PRAECIPE)

MICHELE L KOLPIN
THOMAS KOLPIN
Defendant(s).

To the Clerk of the above-named Court: Please issue a writ of General Execution to the Sheriff of SAC County,
Iowa, against MICHELE L KOLPIN for the balance owing on the judgment in this matter.
Date of Judgment

10/21/2014

Balance due on judgment

Original amt. of judgment

Original amt. of costs
Original amt. of atty fees

$3,715.07
$159.78
$0

Interest accrued to

10/21/2014

Balance due on costs

Balance due on atty fees
Amount of interest
accrued
Total amount due

$3,990.87

2.11%

Interest amount per diem

0.2230

Interest rate per annum

Effective from

$3,715.07
$269.78
$0.00
$6.02

09/23/2014

I certify under penalty of perjury and pursuant to the laws of the State of Iowa that the preceding is true and correct.
Date: October 21, 2014
VAKULSKAS LAW FIRM, P.C.
/s/Molly Vakulskas Joly
MOLLY VAKULSKAS JOLY AT0003980
1721 Jackson Street
P. O. Box 1661
Sioux City, Iowa 51102
(712) 252-4344
(712) 252-5003 FAX
ATTORNEY FOR PLAINTIFF

E-FILED 2014 OCT 21 2:19 PM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY

HAWKEYE ADJUSTMENT SERVICE
Plaintiff/Petitioner

Case No. 02811 SCSC015506

General Execution

vs.
THOMAS E KOLPIN
MICHELE LYNN KOLPIN

Docket Event Code: EGEN

Defendant/Respondent
TO THE SHERIFF OF SAC COUNTY, IOWA:
YOU ARE HEREBY COMMANDED TO LEVY ON THE FOLLOWING JUDGMENT DEBTOR(S):
Issued against MICHELE L. KOLPIN as described in the "Dictation for Execution".
Date of Judgment 10/21/14
Original Amount of Judgment $3715.07
Original Amount of Costs $159.78
Original Amount of Attorney Fees $0
Interest Rate Per Annum 2.11%
Effective From 9/23/14
Pre-judgment Accrued Interest 0
Dated: October 21, 2014

Balance Due on Judgment $3715.07

Balance Due on Court Costs $269.78
Balance Due on Attorney Fees $0
Interest Accrued to 10/21/14
Total Interest Due $ 6.02
Interest Per Diem $ .2230

/s/ Brenda McClure

Clerk of Court/Designee
SAC County

Requested by: Molly Vakulskas Joly

Said money to be returned to clerk after one hundred twenty days from date of issuance of this writ.
Return to clerk at:
100 NW STATE STREET, SUITE 12
SAC CITY IA 50583

E-FILED 2014 OCT 21 2:19 PM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY

HAWKEYE ADJUSTMENT SERVICE

Plaintiff/Petitioner

Case No. 02811 SCSC015506

Return of Service of
General Execution

vs.

Under Iowa Code 626.12

THOMAS E KOLPIN
MICHELE LYNN KOLPIN
Docket Event Code: RSEX
Defendant/Respondent

Execution Issued by Clerk

October 21, 2014
Issued Against Michele L. Kolpin
Amount Collected _______________
Date Served ______________________
Who Served _______________________

Amount Retained ________________

Where Served ______________________

Amount to Clerk _________________

Date Received______________________

Sheriff, ___________________________ County, Iowa

By _______________________________ Deputy