Claim, Kramer, Gene A.CLERK OF DISTRICT COURT
720 Central Avenue
Dubuque, Iowa 52001.7063
RETURN RECEIPT
REQUESTED
7099 3400 0006 8760 7332
RESTRICTED
DELIVERY
RESTF
DEL
IN TI4E IOWA DISTRICT COURT FOR DUBUQUE COUNTY
Plaintiff(s) Name: Gene A. Kramer
Address: 2940 Central Ave.
Diubuque, IA
DOB 8-24-57
SMALL CLAIMS
ORIGINAL' NOTICE
(Action for Money Judgment)
Case NO. 01311 SCSC0 45046
Defendant(s): Name City of Dubuque, 50 W. 13th St., Dubuque, IA
EIN/PIN* DOB** )
VS.
YOU ARE HEREBY NOTIFIED THAT THE PLAINTIFFS DEMANDS FROM YOU THE AMOUNT OF
$2222.96 based on negligence on the part of the City to remove snow that was obstructing vision and cuased by automobile
to be damaged at 9th St. and Hwy 151 intersection on Dec. 30, 2000.
/s/ Gene A. Kramer
EIN/PIN* DOB** )
De f~pd~e~n, t.{.s ) Name: )
Address: ' : )
)
EIN/PIN* DOB** )
)
If yOU require the
assistance of auxiliary
aids or services to
participateincourt
because of(a disability,
immediately cal~
~distrlct ADA coordinator
at (~19)589-4448. (If
you are hearing i~p~ired~
call Re%aY~ Iowa TTY at
1-S00-735--2942-
TO THE ~BOVE NAb~D DEFENDANT (S),
YOU ARE HEREBY NOTIFIED that the Plaintiff(s] demand(s) from you the ~nt of
~SS X~ ~PE~ by complY:Lng
the CIerk of the District Court
i~wa 52001-7063, within 20 days after ~ ,of this
sh~il be rendered aga~st yOU upon Plaintiff s~ claim t0g~her
IF YOU DENY TH~ CLAIM AND APPEAK b~
20 ~ays after service of
notification from the Clerk of ~
upon
office of the
ANSWER
EIM = F~MPLOY~R IDENTIFICATION NUMBER (To be furnished, on fais OP. iG]~;JL NOTICE, by palfie~ who are buskncsses or'other entities.)
PIN ---- PFA~SONAL IDENTIi-1CATION NUMBE~ (Will be furnished by fi~e Clerk of District Court forpartles who are appeaxing as individuals afar such
IN THE IOWA DISTRICT COURT FOR DUBUQUE COUNTY
Plaintiff(s) Name: )
EIN/PIN* )
SM~T.?. CLAIMS
APPEARANCE AND ANSWER
Plaintiff(s) Name: )
~/PI~* )
VS.
OF DEFENDANT
case ~o. 01311 SCSCO
Defendant(s) Name: )
Address: )
)
EIN/PIN* DOB** )
Defendant(s) Na~e:
Address:
EiN/PIN* DOB**
I HEREBY F~'&~-R MY APPEARANCE and
DENY / ADHIT
(choose
the clalm of the Plaintiff(s).
Signature(s) of Defendam(s) or D~f~ndant's(s') A~om~y
Attorney's Add.ss
The Court's address is:
Clerk of District Court
Small Claims Division
Dubuque County Courthouse
720 Central Avenue
Dubuque, Iowa . 52001-7063
* BIAI = EMPLOyEP. IDEI~ II~ICATION NUMBER (To bc ~, on this APPEARANCE AND ANSVg~R FORM, by pa~ies who are businesses
or othot
IN TLW. IOWA DISTRICT COURT FOR DUBUQUE COUNTY
VS.
Pla~nt[~f/Pe't~t~oner, )
)
)
)
)
De~endant/Respondeht. '))
Name
Pla~n~f~(s)/
Petitioner(s)
2.
3.
4.
) Case Number 01311 ,a'~'~' ~'-~-~'.~'
CONFIDENTIAL INFORMATION
FOR~
personal ldentificaC£on Number
De~endant(s)/
Respondont(s)
2.
3.
4.
5.
Okher Pa~cy(£es)
information supplied by
' (p~ink Or type)
signature .........
Date