E-FILED 2013 DEC 20 10:38 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY SMALL CLAIMS DIVISION
L. F. NOLL, INC. 705 DOUGLAS STREET, SUITE 344 SIOUX CITY IA 51101 PLAINTIFF

VS
JODYL. STRANDBERG

ORIGINAL NOTICE AND PETITION FOR A MONEY JUDGMENT

NO.

700S13THST

SAC CITY IA 50583-2512 ERICA STRANDBERG 700 S 13TH ST SAC CITY IA 50583-2512 DEFENDANT(S) To Defendant(s): 1. You are notified that the above-named Plaintiff demands of you the amount of $1563.41. This claim is based on the value of goods and/or services supplied by the following persons or businesses in the amounts indicated below. Said claims are assigned to Plaintiff. CREDITOR LORING HOSPITAL PRINCIPAL $1527.04 PRE-FILING INTEREST $36.37

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 amount requested plus interest and court costs 3. You must electronically file the Appearance and Answer using the Iowa Judicial Branch Electronic Document Management System (EDMS) at https://www.iowacourts.state.ia.us/EFJIe. 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 electronic 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.

E-FILED 2013 DEC 20 10:38 AM SAC - CLERK OF DISTRICT COURT

/E&SICA R. NOLL AT0008873 765 Douglas St., Ste 502 Sioux City IA 51101 Phone (712) 224-2675 Fax (712) 252-4497 irn(o)decklaw.net ATTORNEY FOR PLAINTIFF 0002929548 DECEMBER 12, 2013

E-FILED 2013 DEC 20 10:38 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY SMALL CLAIMS DIVISION
VERIFICATION OF ACCOUNT L. F.NOLL, INC.

PLAINTIFF

IDENTIFICATION OF JUDGMENT DEBTOR AND CERTIFICATE RE

MILITARY SERVICE

VS NO.
JODYL. STRANDBERG ERICA STRANDBERG

For Defendant: JODY L. STRANDBERG

DEFENDANT(S)

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 sum of $1563.41 is the balance due and owing as of DECEMBER 12, 2013 from Defendant(s) to Plaintiff(s) and any interest amount owing is accurately stated in the Petition and Original Notice. 2. I further state that Defendant, JODY L. STRANDBERG. resides at 700 S 13TH ST SAC CITY IA 505832512, is employed at VT INDUSTRIES 100O INDUSTRIAL PARK HOLSTEIN !A 51025. and Defendant's occupation is . 3. Check A, B, or C for Defendant; A. X Defendant is not in the military service of the United States government, I have verified this fact by (check one): X Checking the Defense Manpower Data Center (DMDC) (requires name and SSN or name and date of birth) https://www.dmdc.osd.miI/appi/scra/scraHome.do. n Contacting Defendant who informed me, or n Regularly seeing Defendant and 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 and correct.
LF. NOLL, INC.

T. L. NOLL, VICE PRESIDENT 705 Douglas St., Suite 344 Sioux City, IA51101 712-252-0583 0002929548

NCS, INC E-FILED 2013 DEC 20 10:38 AM DBA SAC - CLERK OF DISTRICT COURT NOLL COLLECTION SERVICE "A Professional Debt Collection Service Since 1965" 705 DOUGLAS STREET SUITE 344 SIOUX CITY IOWA 51101 (712) 252-0583 FAX (712) 233-3404

FEBRUARY 21, 2013 ERICA STRANDBERG JODY L STRANDBERG 700 S 13TH ST SAC CITY IA 50583-2512 CREDITOR: LISTED BELOW IF MORE THAN ONE LORING HOSPITAL ACCOUNT NO. 0002927568 TOTAL AMOUNT DUE: $273.57 AMOUNT IN DEFAULT: $273.57 YOD ARE IN DEFAULT ON THIS CREDIT TRANSACTION. YOU HAVE A RIGHT TO CORRECT THIS DEFAULT. IF YOU DO SO, YOU MAY CONTINUE WITH THE CONTRACT AS THOUGH YOU DID NOT DEFAULT. YOUR DEFAULT CONSISTS OF: FAILURE TO PAY AS AGREED CORRECT THIS DEFAULT BY: PAYING THE AMOUNT IN DEFAULT, $273.57 TO NOLL COLLECTION SERVICE, AGENT FOR THE ABOVE CREDITOR. IF YOU DO NOT CORRECT THIS DEFAULT WITHIN 30 DAYS, WE MAY EXERCISE OUR RIGHTS AGAINST YOU UNDER THE LAW. IF YOU DEFAULT AGAIN WITHIN THE NEXT YEAR, WE MAY EXERCISE OUR RIGHTS WITHOUT SENDING YOU ANOTHER NOTICE LIKE THIS ONE. IF YOU HAVE ANY QUESTIONS, WRITE OR TELEPHONE PROMPTLY. SINCERELY, NOLL COLLECTION SERVICE UNLESS YOU DISPUTE THE VALIDITY OF THE DEBT OR ANY PORTION THEREOF, WITHIN 30 DAYS AFTER RECEIPT OF THIS NOTICE, WE SHALL ASSUME THE DEBT TO BE VALID. IF YOU NOTIFY US IN WRITING OF YOUR DISPUTE WITHIN THIS 30 DAY PERIOD, WE WILL OBTAIN VERIFICATION OF THE DEBT AND WILL MAIL YOU A COPY. UPON YOUR WRITTEN REQUEST WITHIN A THIRTY DAY PERIOD WE WILL PROVIDE YOU WITH THE NAME AND AN ADDRESS OF THE ORIGINAL CREDITOR IF DIFFERENT FROM THE CURRENT CREDITOR. THIS IS AN ATTEMPT TO COLLECT A DEBT ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE CLIENT LORING HOSPITAL PRINCIPAL $264.86 INTEREST $8.71 OTHER $0.00 TOTAL $273.57

DOCTOR
GYANO , B . K . BILLING DATE 05/31/12 PAGE

' Lorin# TELEPHONE E-FILED 2013 DEC 20 10:38 AMHospital SAC - CLERK OF DISTRICT COURTNO,
J?/sX( /\ \/ 1 j

EXTENSION

?/~**~$ V^x^
) \.

712-283-5303 R E C . NO. / ADMISSION NO. [ 33084 / PLAN 540908

211 Highland Ave< Sac City, IA 50583 POLICY NUMBER NTI165AD9926 484761651 POLICY HOLDER STRANDBERG, STRANDBERG, JOD JOD

NO.

INSURANCE COMPANY

07 BLUE CROSS 140 05 SELF-PAY

GUARANTOR JODY 700 STRANDBERG SOUTH 13TH STREE IA 50583

PATIENT NAME JODY STRANDBERG

PATIENT
TYPE
f

MED. REC. NO. / ADMISSION NO. 33084 / BIRTHDATE SEX 540908 AGE

VDMISSION DATE DISCHARGE DATE 05/24/12 05/24/12

SAC CITY

24

/67 M

45

GUARANTOR IS RESPONSIBLE FOR ANY AMOUNTS DUE AFTER THE INSURANCE COMPANIES MAKE THEIR PAYMENTS DATE 05-24 CHARGE CODE DESCRIPTION QUANTITY CHARGE 329.670 DEPT 05-24 TOTAL
CPT

' ^^KfTFWtnl^^l AMOUNT

3 2 9 . 67
329.67

1497.000 DEPT TOTAL

1497 .00 1497 . 00

SUMMARY OF CHARGES RADIOLOGY , PROFESS IONAL 329.67

MR I
TOTAL CHARGES

1497 .00
1826.67

BALANCE

1826.67

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E-FILED 2013 DEC 20 10:38 AM SAC NCS, INC DBA - CLERK OF DISTRICT COURT NOLL COLLECTION SERVICE "A Professional Debt Collection Service Since 1965" 705 DOUGLAS STREET SUITE 344 SIOUX CITY IOWA 51101 (712) 252-0583 FAX (712) 233-3404 FEBRUARY 21, 2013 ERICA STRANDBERG JODY L STRANDBERG 700 S 13TH ST SAC CITY IA 50583-2512

CREDITOR: LISTED BELOW IF MORE THAN ONE LORING HOSPITAL ACCOUNT NO. 0002927569 TOTAL AMOUNT DUE: $107.50 AMOUNT IN DEFAULT: $107.50 YOU ARE IN DEFAULT ON THIS CREDIT TRANSACTION. YOU HAVE A RIGHT TO CORRECT THIS DEFAULT. IF YOU DO SO, YOU MAY CONTINUE WITH THE CONTRACT AS THOUGH YOU DID NOT DEFAULT. YOUR DEFAULT CONSISTS OF: FAILURE TO PAY AS AGREED CORRECT THIS DEFAULT BY: PAYING THE AMOUNT IN DEFAULT, $107.50 TO NOLL COLLECTION SERVICE, AGENT FOR THE ABOVE CREDITOR. IF YOU DO NOT CORRECT THIS DEFAULT WITHIN 30 DAYS, WE MAY EXERCISE OUR RIGHTS AGAINST YOU UNDER THE LAW. IF YOU DEFAULT AGAIN WITHIN THE NEXT YEAR, WE MAY EXERCISE OUR RIGHTS WITHOUT SENDING YOU ANOTHER NOTICE LIKE THIS ONE. IF YOU HAVE ANY QUESTIONS, WRITE OR TELEPHONE PROMPTLY. SINCERELY,

NOLL COLLECTION SERVICE UNLESS YOU DISPUTE THE VALIDITY OF THE DEBT OR ANY PORTION THEREOF, WITHIN 30 DAYS AFTER RECEIPT OF THIS NOTICE, WE SHALL ASSUME THE DEBT TO BE VALID. IF YOU NOTIFY US IN WRITING OF YOUR DISPUTE WITHIN THIS 30 DAY PERIOD, WE WILL OBTAIN VERIFICATION OF THE DEBT AND WILL MAIL YOU A COPY. UPON YOUR WRITTEN REQUEST WITHIN A THIRTY DAY PERIOD WE WILL PROVIDE YOU WITH THE NAME AND AN ADDRESS OF THE ORIGINAL CREDITOR IF DIFFERENT FROM THE CURRENT CREDITOR. THIS IS AN ATTEMPT TO COLLECT A DEBT ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE CLIENT LORING HOSPITAL PRINCIPAL $104.00 INTEREST $3.50 OTHER $0.00 TOTAL $107.50

DOCTOR JENSEN, BILLING DATE '08/06/12 PAGE WADE K

Loring" TELEPHONE E-FILED 2013 DEC 20 10:38 AMHospital SAC - CLERK OF DISTRICT COURT NO.

EXTENSION

o }r*~\y
1 POLICY NUMBER NTI165AD992G 484761651

v?r
^^y'-t

712-334-OS25 MED. REG. NO. / ADMISSION NO.

211 Highland Ave- Sac City, IA 50583

POLICY HOLDER STRANDBERG, STRANDBERG, JOD JOD

33084 /
PLAN

542075

NO.

. INSURANCE COMPANY 140

07 BLUE CROSS 05
SELF -PAY

^YCLE

-0002

GUARANTOR' JODY 700 STRANDBERG SOUTH 13TH STREE 50583

PATIENT NAME JODY STRANDBERG PATIENT TYPE

32

MED. REC. NO. / ADMISSION NO. 33084 BIRTHDATE / SEX 542075 AGE

\DMISSION DATE DISCHARGE DATE 06/19/12

SAC CITY IA

7 *sT ( "V__

/67 M
!

45

GUARANTOR IS RESPONSIBLE FOR ANY AMOUNTS DUE AFTER THE INSURANCE COMPANIES MAKE THEIR PAYMENTS DATE 07-02 07-05 07-02 07-05
v-

PAY LAST BALANCE AMOUNT 100.00 100.00 50.00 50.00

CHARGE CODE
'

DESCRIPTION -----

QUANTITY

CHARGE 50.00C 50.00C 50.00C 50.000

CPT

2
2 1 1

DEPT

TOTAL

300.00

SUMMARY OF CHARGES PHYSICAL THERAPY

3 0 0 . 00 3 0 0 . 00

TOTAL CHARGES

PREV.

BALANCE

n. i i-.

i"in

BALANCE

Scexco

pCP '
L

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NCS, DBA - CLERK OF DISTRICT COURT E-FILED 2013 DEC 20 10:38INC AM SAC NOLL COLLECTION SERVICE "A Professional Debt Collection Service Since 1965" 705 DOUGLAS STREET SUITE 344 SIOUX CITY IOWA 51101 (712) 252-0583 FAX (712) 233-3404

AUGUST 13, 2013 ERICA SUE STRANDBERG 700 S 13 ST SAC CITY IA 50583 JODY STRANDBERG

CREDITOR: LISTED BELOW IF MORE THAN ONE LORING HOSPITAL ACCOUNT NO. 0002939651 TOTAL AMOUNT DUE: $387.89 AMOUNT IN DEFAULT: $387.89 YOU ARE IN DEFAULT ON THIS CREDIT TRANSACTION. YOU HAVE A RIGHT TO CORRECT THIS DEFAULT. IF YOU DO SO, YOU MAY CONTINUE WITH THE CONTRACT AS THOUGH YOU DID NOT DEFAULT. YOUR DEFAULT CONSISTS OF: FAILURE TO PAY AS AGREED CORRECT THIS DEFAULT BY: PAYING THE AMOUNT IN DEFAULT, $387.89 TO NOLL COLLECTION SERVICE, AGENT FOR THE ABOVE CREDITOR. IF YOU DO NOT CORRECT THIS DEFAULT WITHIN 30 DAYS, WE MAY EXERCISE OUR RIGHTS AGAINST YOU UNDER THE LAW. IF YOU DEFAULT AGAIN WITHIN THE NEXT YEAR, WE MAY EXERCISE OUR RIGHTS WITHOUT SENDING YOU ANOTHER NOTICE LIKE THIS ONE. IF YOU HAVE ANY QUESTIONS, WRITE OR TELEPHONE PROMPTLY. SINCERELY,

NOLL COLLECTION SERVICE UNLESS YOU DISPUTE THE VALIDITY OF THE DEBT OR ANY PORTION THEREOF, WITHIN 30 DAYS AFTER RECEIPT OF THIS NOTICE, WE SHALL ASSUME THE DEBT TO BE VALID. IF YOU NOTIFY US IN WRITING OF YOUR DISPUTE WITHIN THIS 30 DAY PERIOD, WE WILL OBTAIN VERIFICATION OF THE DEBT AND WILL MAIL YOU A COPY. UPON YOUR WRITTEN REQUEST WITHIN A THIRTY DAY PERIOD WE WILL PROVIDE YOU WITH THE NAME AND AN ADDRESS OF THE ORIGINAL CREDITOR IF DIFFERENT FROM THE CURRENT CREDITOR. THIS IS AN ATTEMPT TO COLLECT A DEBT ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE CLIENT LORING HOSPITAL PRINCIPAL $377.75 INTEREST $10.14 OTHER $0.00 TOTAL $387.89

DOCTOR MEYER, BILLING DATE 01/10/13 PAGE STEVEN

LoringTELEPHONE E-FILED 2013 DEC 20 10:38 AMHospital SAC - CLERK OF DISTRICT COURT NO.
0-^-^0 ' j\\ 1 712-334-0825 MED. REC. NO. / ADMISSION NO. { 25235 PLAN 1

EXTENSION

211 Highland Ave- Sac City, !A 50583 POLICY NUMBER NTI165AD9926 480868392 POLICY HOLDER STRANDBERG , JOD STRANDBERG, ERI

550757

NO.

INSURANCE COMPANY 140

07 BLUE CROSS 05 SELF -PAY

GUARANTOR ERICA 700 STRANDBERG

PATIENT NAME ERICA STRANDBERG

PATIENT

MED. REC. NO. / ADMISSION NO. 25235 BIRTHDATE / SEX 550757 AGE

S 13TH STREET 50583

TYPE

ADMISSION DATE DISCHARGE DATE 01/02/13 01/02/13

SAC CITY IA

22

'/74 F

38

GUARANTOR IS RESPONSIBLE FOR ANY AMOUNTS DUE AFTER THE INSURANCE COMPANIES MAKE THEIR PAYMENTS DATE
01-02 01-02

^^H:fTFw*^^^l AMOUNT

CHARGE CODE

DESCRIPTION

QUANTITY

CHARGE 47.63
SO .12

CRT

1 1

47 . 63 60.12
DEPT TOTAL 107.75 135.00

01- 02 01-02

1 1

135.000 135.000 DEPT TOTAL

135 .00
270.00

SUMMARY OF CHARGES RADIOLOGY, RADIOLOGY, PROFESSIONAL TECH 107.75

270. 00
377.75

TOTAL CHARGES

BALANCE

^
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fe>

* ^ ^

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r**$*
[rr**-1

377 .75

X
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NCS, DBA - CLERK OF DISTRICT COURT E-FILED 2013 DEC 20 10:38 INC AM SAC NOLL COLLECTION SERVICE "A Professional Debt Collection Service Since 1965" 705 DOUGLAS STREET SUITE 344 SIOUX CITY IOWA 51101 (712) 252-0583 FAX (712) 233-3404 AUGUST 13, 2013 ERICA SUE STRANDBERG 700 S 13 ST SAC CITY IA 50583 JODY STRANDBERG

CREDITOR: LISTED BELOW IF MORE THAN ONE LORING HOSPITAL ACCOUNT NO. 0002939652 TOTAL AMOUNT DUE: $175.79 AMOUNT IN DEFAULT: $175.79 YOU ARE IN DEFAULT ON THIS CREDIT TRANSACTION. YOU HAVE A RIGHT TO CORRECT THIS DEFAULT. IF YOU DO SO, YOU MAY CONTINUE WITH THE CONTRACT AS THOUGH YOU DID NOT DEFAULT. YOUR DEFAULT CONSISTS OF: FAILURE TO PAY AS AGREED CORRECT THIS DEFAULT BY: PAYING THE AMOUNT IN DEFAULT, $175,79 TO NOLL COLLECTION SERVICE, AGENT FOR THE ABOVE CREDITOR. IF YOU DO NOT CORRECT THIS DEFAULT WITHIN 30 DAYS, WE MAY EXERCISE OUR RIGHTS AGAINST YOU UNDER THE LAW. IF YOU DEFAULT AGAIN WITHIN THE NEXT YEAR, WE MAY EXERCISE OUR RIGHTS WITHOUT SENDING YOU ANOTHER NOTICE LIKE THIS ONE. IF YOU HAVE ANY QUESTIONS, WRITE OR TELEPHONE PROMPTLY. SINCERELY,

NOLL COLLECTION SERVICE UNLESS YOU DISPUTE THE VALIDITY OF THE DEBT OR ANY PORTION THEREOF, WITHIN 30 DAYS AFTER RECEIPT OF THIS NOTICE, WE SHALL ASSUME THE DEBT TO BE VALID. IF YOU NOTIFY US IN WRITING OF YOUR DISPUTE WITHIN THIS 30 DAY PERIOD, WE WILL OBTAIN VERIFICATION OF THE DEBT AND WILL MAIL YOU A COPY. UPON YOUR WRITTEN REQUEST WITHIN A THIRTY DAY PERIOD WE WILL PROVIDE YOU WITH THE NAME AND AN ADDRESS OF THE ORIGINAL CREDITOR IF DIFFERENT FROM THE CURRENT CREDITOR. THIS IS AN ATTEMPT TO COLLECT A DEBT ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE CLIENT LORING HOSPITAL PRINCIPAL $171.93 INTEREST $3.86 OTHER $0.00 TOTAL $175.79

DOCTOR GYANO, BILLING DATE 02/07/13 PAGE B. K.

Loring- Hospital TELEPHONE NO. E-FILED 2013 DEC 20 10:38 AM SAC - CLERK OF DISTRICT COURT 3 712-334-0825 o Jr

EXTENSION

^AA/r

MED, REC. NO. / ADMISSION NO. 25235 PLAN / 551882

21 1 Highland Ave Sac City, !A 50583 POLICY NUMBER NTI165AD9926 480858392 POLICY HOLDER STRANDBERG, STRANDBERG, JOD ERI

NO.

INSURANCE COMPANY 140

07 BLUE CROSS 05
SELF -PAY

GUARANTOR ERICA STRANDBERG 700 S 13TH STREET 50583

PATIENT NAME ERICA STRANDBERG

PATIENT TYPE 23

MED. REC. NO. / ADMISSION NO. 25235 BIRTHDATE '/74 / SEX F 551882 AGE 38 1

ADMISSION DATE DISCHARGE DATE

02/01/13

SAC CITY IA

02/01/13

GUARANTOR IS RESPONSIBLE FOR ANY AMOUNTS DUE AFTER THE INSURANCE COMPANIES MAKE THEIR PAYMENTS DATE CHARGE CODE ..
-

BALANCE AMOUNT 153.56

DESCRIPTION

CHARGE

CPT

02-01 02-01

1 1

153.560 153.560 DEPT TOTAL

153 . 5 6
307.12

_ ..

- - -

" 1 1 231. 0 0 0 294 .0 0 0

DEPT TOTAL

02-01 02-01

231. 00 2 9 4 . 00
525.00

SUMMARY OF CHARGES RADIOLOGY, ULTRASOUND TOTAL CHARGES PROFESSIONAL 307.12

5 2 5 . 00
832.12

BALANCE

8 3 2 .12

2,0^ \
^ )^l)l

3
,*

_ \Y

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S^.x^

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t^>-* - -*-jO.

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NCS, DBA - CLERK OF DISTRICT COURT E-FILED 2013 DEC 20 10:38INC AM SAC NOLL COLLECTION SERVICE "A Professional Debt Collection Service Since 1965" 705 DOUGLAS STREET SUITE 344 SIOUX CITY IOWA 51101 (712) 252-0583 FAX (712) 233-3404

OCTOBER 10, 2013 JODY L STRANDBERG ERICA STRANDBERG 700 S 13 ST SAC CITY IA 505830092

CREDITOR: LISTED BELOW IF MORE THAN ONE LORING HOSPITAL ACCOUNT NO. 0002943643 TOTAL AMOUNT DUE: $326.76 AMOUNT IN DEFAULT: $326.76 YOU ARE IN DEFAULT ON THIS CREDIT TRANSACTION. YOU HAVE A RIGHT TO CORRECT THIS DEFAULT. IF YOU DO SO, YOU MAY CONTINUE WITH THE CONTRACT AS THOUGH YOU DID NOT DEFAULT. YOUR DEFAULT CONSISTS OF: FAILURE TO PAY AS AGREED CORRECT THIS DEFAULT BY: PAYING THE AMOUNT IN DEFAULT, $326.76 TO NOLL COLLECTION SERVICE, AGENT FOR THE ABOVE CREDITOR. IF YOU DO NOT CORRECT THIS DEFAULT WITHIN 30 DAYS, WE MAY EXERCISE OUR RIGHTS AGAINST YOU UNDER THE LAW. IF YOU DEFAULT AGAIN WITHIN THE NEXT YEAR, WE MAY EXERCISE OUR RIGHTS WITHOUT SENDING YOU ANOTHER NOTICE LIKE THIS ONE. IF YOU HAVE ANY QUESTIONS, WRITE OR TELEPHONE PROMPTLY. SINCERELY, NOLL COLLECTION SERVICE UNLESS YOU DISPUTE THE VALIDITY OF THE DEBT OR ANY PORTION THEREOF, WITHIN 30 DAYS AFTER RECEIPT OF THIS NOTICE, WE SHALL ASSUME THE DEBT TO BE VALID. IF YOU NOTIFY US IN WRITING OF YOUR DISPUTE WITHIN THIS 30 DAY PERIOD, WE WILL OBTAIN VERIFICATION OF THE DEBT AND WILL MAIL YOU A COPY. UPON YOUR WRITTEN REQUEST WITHIN A THIRTY DAY PERIOD WE WILL PROVIDE YOU WITH THE NAME AND AN ADDRESS OF THE ORIGINAL CREDITOR IF DIFFERENT FROM THE CURRENT CREDITOR. THIS IS AN ATTEMPT TO COLLECT A DEBT ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE CLIENT LORING HOSPITAL PRINCIPAL $321.78 INTEREST $4.98 OTHER $0.00 TOTAL $326.76

DOCTOR LANKFORD, BILLING DATE 05/30/13 NO. PAGE

Loring" Hospital

^'TELEPHONE NO.

EXTENSION

TONYA E-FILED 2013 DEC 20 10:38 AM SAC - CLERK OF DISTRICT 7 1 2COURT -845-6031
MED. REC. NO. / ADMISSION NO.

21 1 Highland Ave Sac City, !A 50583 POLICY NUMBER NTI165AD9926 479373311 POLICY HOLDER STRANDBERG. JOD. KIES, Hi

33229

556785

INSURANCE COMPANY

PLAN

07 BLUE CROSS 140 05 SELF-PAY

c4cJ'>?S?O'Au

; / fj o o^ft Lp
PATIENT NAME H'
PATIFNT TYPE

GUARANTOR JODY STRANDBERG 700 SOUTH 13 TH ST SAC CITY IA 5 0 5 8 3

MED. REC. NO. / ADMISSION NO. A KIES 33229 /

BIRTHDATE SEX

556785
AGE

ADMISSION DATE DISCHARGE DATE

25

05/23/13

05/23/13

/06 F

GUARANTOR IS RESPONSIBLE FOR ANY AMOUNTS DUE AFTER THE'INSURANCE COMPANIES MAKE THEIR PAYMENTS DATE

PAY LAST BALANCE

AMOUNT 190.41

CHARGE CODE

DESCRIPTION

UANTITY

CHARGE
190.410

CPT

05-23

DSPT TOTAL

190.41 612.00

05-23

410015

612 . 0 0 0
DEPT TOTAL

612.00

SUMMARY OF CHARGES RADIOLOGY, PROFESSIONAL CT SCANS TOTAL CHARGES

190.41 612.00 802.41

BALANCE

8 0 2 .41

0
/ ^O.Lff

U-;>.o^
k>-(Q-/3

&>

J^t^
1-5 .DQ

T>A*

NCS, INC DBA - CLERK OF DISTRICT COURT E-FILED 2013 DEC 20 10:38 AM SAC NOLL COLLECTION SERVICE "A Professional Debt Collection Service Since 1965" 705 DOUGLAS STREET SUITE 344 SIOUX CITY IOWA 51101 (712) 252-0583 FAX (712) 233-3404

OCTOBER 10, 2013 ERICA STRANDBERG JODY L STRANDBERG 700 S 13 ST SAC CITY IA 505830092 CREDITOR: LISTED BELOW IF MORE THAN ONE LORING HOSPITAL ACCOUNT NO. 0002943644 TOTAL AMOUNT DUE: $291.90 AMOUNT IN DEFAULT: $291.90 YOU ARE IN DEFAULT ON THIS CREDIT TRANSACTION. YOU HAVE A RIGHT TO CORRECT THIS DEFAULT. IF YOU DO SO, YOU MAY CONTINUE WITH THE CONTRACT AS THOUGH YOU DID NOT DEFAULT. YOUR DEFAULT CONSISTS OF: FAILURE TO PAY AS AGREED CORRECT THIS DEFAULT BY: PAYING THE AMOUNT IN DEFAULT, $291.90 TO NOLL COLLECTION SERVICE, AGENT FOR THE ABOVE CREDITOR. IF YOU DO NOT CORRECT THIS DEFAULT WITHIN 30 DAYS, WE MAY EXERCISE OUR RIGHTS AGAINST YOU UNDER THE LAW. IF YOU DEFAULT AGAIN WITHIN THE NEXT YEAR, WE MAY EXERCISE OUR RIGHTS WITHOUT SENDING YOU ANOTHER NOTICE LIKE THIS ONE. IF YOU HAVE ANY QUESTIONS, WRITE OR TELEPHONE PROMPTLY. SINCERELY, NOLL COLLECTION SERVICE UNLESS YOU DISPUTE THE VALIDITY OF THE DEBT OR ANY PORTION THEREOF, WITHIN 30 DAYS AFTER RECEIPT OF THIS NOTICE, WE SHALL ASSUME THE DEBT TO BE VALID. IF YOU NOTIFY US IN WRITING OF YOUR DISPUTE WITHIN THIS 30 DAY PERIOD, WE WILL OBTAIN VERIFICATION OF THE DEBT AND WILL MAIL YOU A COPY. UPON YOUR WRITTEN REQUEST WITHIN A THIRTY DAY PERIOD WE WILL PROVIDE YOU WITH THE NAME AND AN ADDRESS OF THE ORIGINAL CREDITOR IF DIFFERENT FROM THE CURRENT CREDITOR. THIS IS AN ATTEMPT TO COLLECT A DEBT ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE CLIENT LORING HOSPITAL PRINCIPAL $286.72 INTEREST $5.18 OTHER $0.00 TOTAL $291.90

E-FILED 2013 DEC 20 10:38 AM SAC - CLERK OF DISTRICT COURT

Loting Hospital

TELEPHONE NO.

EXTENSION

\LUNG_0 A.TE

\3

BASE

211 Highland Ave S3C City, !A 50583 POLICY NUMBER

POLICY H O L D E R STRAJSIDBERG, STRANDBERG, JOD JOD

\ [ 33034 /
PLAN

555667

M0\E COMPANY 07 BLUE CROSS 05 SELF -PAY 140

NTI165AD9926 484751651

:YCLE -0001

GUARANTOR JODY STRANDS ERG 700 SOUTH 13TH ST SAC CITY IA 50S83

PATIENT NAME JODY STRANDBERG

PATIENT TYPE

MED. REC. NO. / ADMISSION NO. 33084

31RTHDATE

/
SEX

555667
AGE

ADMISSION DATE DISCHARGE DATE

1 1

04/28/13

~"

/67 M

46

GUARANTOR IS RESPONSIBLE FOR ANY AMOUNTS DUE AFTER THE INSURANCE COMPANIES MAKE THEIR PAYMENTS DATE CHARGE CODE DESCRIPTION
:

fflS^slwHPrMM ' AMOUNT

- QUANTITY

CHARGE
405 .000

.-.-'

. CPT

04-28
"
" "

.-

DEPT TOTAL
1 18. 000 36.240 36.400

4 0 5 . 00 405 .00 18 . 00 36.24 3S.40 64.52 44.00

04-28 04-28 04-28 04-28 , 04-28.. 04-28 04-28 04-28

: -

1 1 1 1 1 1 1

64 . 5 2 0 44 . 000 55.000 91.000 38.480

D5PT TOTAL

55 . 00 91. 00 38.48 383.64 '

i04-28
1

169 . 0 0 0
DSl'T TOTAL

iey .00
169. 00 14 . 04 14.04
47.63 47 .63 135.00 135.00 125.00 97.00 2 2 2 . 00

-- . - -04-28

-- - " - "

....._.

14.040 DEPT TOTAL

04-28

- -

--

47.630 DEPT TOTAL

04-28

135.000 DEPT TOTAL

04-28 04-28

1 1

125.000 97.000 DEi?V TOTAL

__

-^

Lon'ncj Hospital AM SAC - CLERK OF DISTRICT COURT DOCTORE-FILED 2013 DEC 20 10:38 TELEPHONE NO.
PEK, Z. L.
712-662-8080: BILLING DATE 05/06/13 PAGE 2 7 7 Highland Ave Sac City, IA 50583 POLICY NUMBER POLICY HOLDER

EXTENSION

MED. REC. NO. / ADMISSION NO. 33084 / PLAN ?YCLE -0001 555667

NO

INSURANCE COMPANY

BLUE CROSS 140 SELF-PAY

NTI165AD9926 434761651

STRANDBERG, JOD STRANDBERG, JOD

UARANTOR

PATIENT NAME JODY STRANDBERG

PAT1FMT

MED. REC. NO. / ADMISSION NO. 33084

IRTHDATE

JODY STRANDBERG 700 SOUTH. 13TH ST SAC CITY IA 50583

CHARGE CODE TYPE

/
SEX

555657
AGE

ADMISSION DATE DISCHARGE DATE

1 1

04/28/13

/67

46

GUARANTOR IS RESPONSIBLE FOR ANY AMOUNTS DUE AFTER THE INSURANCE COMPANIES MAKE THEIR PAYMENTS DATE

DESCRIPTION

SUMMARY OF CHARGES EMERGENCY ROOM LABORATORY EKG PHARMACY RADIOLOGY, PROFESSIONAL RADIOLOGY, TECH RESPIRATORY THERAPY
TOTAL CHARGES

BALANCE

E-FILED 2013 DEC 20 10:38 AM SAC - CLERK OF DISTRICT COURT

NCS, INC DBA

NOLL COLLECTION SERVICE "A Professional Debt Collection Service Since 1965" 705 DOUGLAS STREET, SUITE 344 SIOUX CITY, IA 51101 (712) 252-0583
DATE: NOVEMBER 7, 2013

LORING HOSPITAL ATTN JAN WISEMAN 211 HIGHLAND AVE SAC CITY IA 50583 ATTENTION: RE: JODY L STRANDBERG

014345

540908 ' $1527.04 02/19/13 The 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 the original . 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 SUIT For valuable consideration, receipt hereby acknowledged, the undersigned hereby assign, transfer, and set over unto L.F. Noll, Inc. that certain claim against
JODY L STRANDBERG

ERICA STRANDBERG for goods, wares and merchandise sold and delivered or services rendered and performed in the principal amount of $1527.04 lawful interest thereon; and does hereby authorise said assignee to do and perform all acts necessary for collection; commencement of suit in the name of the assignee, settlement, adjustment, compromise or satisfaction of said claim. Assignor hereby certifies that said claim is justly due and owing and warrants compliance with requirements of the Iowa Consumer Credit Code as well as disclosure and other provisions of truth in lending, and that same is free of set-offs and other defenses. Dated this ^6
LORING HOSPITAL

day of

, 20 I'b

By:

Name and Official Title) THIS IS AN ATTEMPT TO COLLECT A DEBT, ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE 0002927S6S

E-FILED 2013 DEC 20 10:38 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY SMALL CLAIMS DIVISION
L F. NOLL, INC.

PLAINTIFF

VERIFICATION OF ACCOUNT IDENTIFICATION OF JUDGMENT DEBTOR AND CERTIFICATE RE

MILITARY SERVICE

VS
NO.
JODY L. STRANDBERG ERICA STRANDBERG DEFENDANT(S)

For Defendant: ERICA STRANDBERG

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 sum of $1563.41 is the balance due and owing as of DECEMBER 12, 2013 from Defendant(s) to Plaintiff(s) and any interest amount owing is accurately stated in the Petition and Original Notice. 2. I further state that Defendant, ERICA STRANDBERG. resides at 700 S 13TH ST SAC CITY !A 50583-2512. is employed at PARKVIEW CARE CENTER 601 PARK AVE SAC CITY IA 50583. and Defendant's occupation is. . 3. Check A, B, or C for Defendant: A. X Defendant is not in the military service of the United States government, I have verified this fact by (check one): X Checking the Defense Manpower Data Center (DMDC) (requires name and SSN or name and date of birth) https://www.dmdc.osd.mil/appi/scra/scraHome.do. n Contacting Defendant who informed me, or D Regularly seeing Defendant and 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 and correct. L.F. NOLL,

T. L. NOLL, VrCE PRESIDENT 705 Douglas St., Suite 344 Sioux City, lA 51101 712-252-0583 0002929548

E-FILED 2014 JAN 22 12:17 PM SAC - CLERK OF DISTRICT COURT

E-FILED 2014 JAN 22 4:10 PM SAC - CLERK OF DISTRICT COURT

Notice Id: 2JUDFL IOWA DISTRICT COURT FOR SAC COUNTY

LF NOLL, INC Plaintiff(s), vs. JODY L STRANDBERG ERICA SUE STRANDBERG Case No: 02811 SCSC015384 Judgment by Default in an Action For Money Judgment Iowa Code Section 631.5(6)

Defendant(s).

Proper notice of this action has been provided to the defendant(s). An appearance has not been filed and the Court is able to determine the appropriate relief from a review of the filings. Default judgment should be entered pursuant to Iowa Code Section 631.5(6).

IT IS THEREFORE ORDERED that judgment is entered in favor of the plaintiff and against the defendants, jointly and severally, in the amount of $1,563.41 with interest at the rate of 2.12% from 12/20/2013, and court costs.

Docket Code = JDEF

1 of 2

E-FILED 2014 JAN 22 4:10 PM SAC - CLERK OF DISTRICT COURT

State of Iowa Courts Case Number SCSC015384 Type: Case Title L.F. NOLL, INC. VS STRANDBERG, JODY L AND ERICA JUDGMENT DEFAULT So Ordered

Electronically signed on 2014-01-22 16:10:58

2 of 2

E-FILED 2014 FEB 07 9:03 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY SMALL CLAIMS DIVISION Plaintiff L. F. NOLL, INC.
Vs

Request for General Execution

(Praecipe) (Iowa Code Section 626.12)

Defendant(s) JODY L. STRANDBERG ERICA STRANDBERG

Small Claim No. SCSC015384

TO THE CLERK OF COURT FOR SAC COUNTY: Please issue a writ of General Execution to the Sheriff of IDA County, in the case against JODY L. STRANDBERG: for the balance owing on the judgment in this matter Date of Judgment 01/22/14 Original amount of judgment $1563.41 Original amount of court costs $123.94 Original amount of attorney fees $0 Interest accrued to JANUARY 29, 2014 Interest rate per annum: 2.12% Effective from 12/20/13 Total amount due $1715.86 Interest amount per diem $.09 I certify under penalty of perjury and pursuant to the laws of the State of Iowa that the preceding is true and correct. Dated: JANUARY 29, 2014 Balance due on judgment $1563.41 Balance due on court costs $148.94 Balance due on attorney fees $0 Amount of interest accrued $3.51

E-FILED 2014 FEB 07 9:03 AM SAC - CLERK OF DISTRICT COURT

0002929548

/S/ Jessica R. Noll JESSICA R. NOLL AT0008873 705 Douglas St., Ste 502 Sioux City, IA 51101 Phone (712) 224-2675 Fax (712) 252-4497 jrn@decklaw.net ATTORNEY FOR PLAINTIFF

E-FILED 2014 FEB 07 9:28 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY

LF NOLL, INC Plaintiff/Petitioner vs. JODY L STRANDBERG ERICA SUE STRANDBERG Defendant/Respondent TO THE SHERIFF OF IDA COUNTY, IOWA: YOU ARE HEREBY COMMANDED TO LEVY ON THE FOLLOWING JUDGMENT DEBTOR(S): Issued against JODY L. STRANDBERG as described in the "Dictation for Execution". Date of Judgment 1/22/14 Original Amount of Judgment $1563.41 Original Amount of Costs $123.94 Original Amount of Attorney Fees $0 Interest Rate Per Annum 2.12% Effective From 12/20/13 Pre-judgment Accrued Interest Dated: February 7, 2014 Balance Due on Judgment $1563.41 Balance Due on Court Costs $148.94 Balance Due on Attorney Fees $0 Interest Accrued to 1/29/14 Total Interest Due $ 3.51 Interest Per Diem $ .09

Case No. 02811 SCSC015384

General Execution

Docket Event Code: EGEN

/s/ Brenda McClure Clerk of Court/Designee SAC County

Requested by: Jessica Noll 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 FEB 07 9:28 AM SAC - CLERK OF DISTRICT COURT

IN THE IOWA DISTRICT COURT FOR SAC COUNTY

LF NOLL, INC Plaintiff/Petitioner vs. JODY L STRANDBERG ERICA SUE STRANDBERG

Case No. 02811 SCSC015384

Return of Service of General Execution

Under Iowa Code 626.12

Docket Event Code: RSEX Defendant/Respondent

Execution Issued by Clerk February 7, 2014 Issued Against Amount Collected _______________ Date Served ______________________ Who Served _______________________ Where Served ______________________ Date Received______________________ Amount Retained ________________ Amount to Clerk _________________

Sheriff, ___________________________ County, Iowa

By _______________________________ Deputy