1583097
`SMALL CLAIMS WRIT
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`ANDNOTICEOF SUIT
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`=
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`Ve
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`——————
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`inotherlanaaeae(s).
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`STATE OF CONNECTICUT,
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`SUPERIOR COURT &
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`"\e
`
`1.) Address of Court
`
`BRIDGEPORT J.D. SMALL CLAIMS SESSION AT BRIDGEPORT
`1061 MAIN STREET BRIDGEPORT, CT 06604
`
`2.) Case type code (Seelist on reverse page 1)
`s
`00
`
`4.) If "Yes" to question #3, the rental property is located in the following town:
`
`3.) Is this claim between a landlord and a tenant?
`(Select one)
`[[] Yes
`No
`
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`Name (Last, First, Middle Initial) and Address of Each party (Number;Street;P.O. Box; Town; State; Zip; Country,if not USA)
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`Name: capital ONE, N.A. SUCCESSOR BY MERGER TO CAPITAL ONE BANK (USA),
`
`(SelectOne)
`[7] ttc [[] Partnership
`Address: N.A. 1680 CAPITAL ONE DRIVE MCLEAN, VA 22102
`
`
`[J Individual
`[[] DBA [X] Corporation
`
`Telephone: 804-290-5631
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`
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`Attorney's Juris number
`6.) Name, address and zip code of Attorney for Plaintiff(s)
`438783
`
`
`
`Rubin and Rothman, LLC 1787 Veterans Highway Suite 32 Islandia NY 11749
`
`Name: ASHLEY N DUSHING
`
`
`
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`["] LLC [[]Partnership
`(SelectOne)
`7.) First
`Address: 107 EDNA AVE BRIDGEPORT, CT 06610-1731
`
`
`
`Defendant
`[7] DBA []Corporation
`[XJindividual
`
`
`
`
`Telephone:
`C] For more than 1 plaintiff/defendant, attach Continuation of Parties (form JD-CV-67) and select this box.
`8.) If this claim is a consumer debt, which is a debt or obligation made primarily for personal, family or household reasons, explain why you believe the
`statute oflimitations has not expired.
`Either the last payment made or the account open date was within the last six years as required by C.G.S. §52-576
`
`P-01
`
`Telephone number (w/area code)
`(800) 298-6058
`
`9.) In the last 6 months, how did you verify that the address given for defendant(s) is accurate?
`Select all boxes that apply and provide the dates verified.
`C] | checked townorcity records (for example, checking a streetlist or tax records) on:
`
`Cc]
`
`{ checked with the Department of Motor Vehicles on:
`
`(date)
`
`| received correspondence(letters or other mail) from the defendantwith that return address on:
`L_]
`CI | received other proof from the defendant that the address is current (describe details below)
`
`(date)
`
`(date)
`
`At least 4 weeks beforethis action wasfiled, | senta letter by first class mail to the defendant at the address used and it has not been returned
`to me by the United States Postal Service as of :
`6/25/2024
`(date)
`
`Plus Costs OU
`1,720.86
`Plus pre-judgmentinterest**
`0.) Amount claimed*
`**You MUSTexplain how much you
`C] Plus double damages for security deposit withheld**
`wantfor each item in section 11 below.
`*The Amount claimed cannot exceed $5,000 or $15,000 for a home improvement contract case (S20).
`*If you are claiming pre-judgmentinterest or double damagesfor security deposit withholding, select the box(es). Do not include these amounts in box 10.
`
`To defendant(s):
`
`11.) You are being sued. The Plaintiff(s) claims you owe this moneyfor the following reasons:
`
`*** SEE ATTACHED COMPLAINT ***
`R&R FILE NO. 1583097
`
`OTARYPUBLIC
`AYiY COMMISSION EXPIRES D
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`N. PE
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`
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`The person signing below, being duly sworn, states that he or she has read the claim above and the information contained in this form and,to the bestof his
`or her knowledge, information and belief, there is good ground to Support the claim and theinformationis true.
`
`f X YN
`m\
`om
`A
`reseae
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`12.) Signed at left and title, if applicable|For Court Use Only (Date/Stamp)YN ‘ — JEFSO
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`at OUSHAN, ESCO. x.
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`Subscribed and
`sworn to before
`me on
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`“p4
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`ADA NOTIC \
`The Judicial Branch of the State of Connecticut complies with the Americas with Bisabiiés Act (ADA). If you need a reasonable
`accommodation in accordance with the ADA, contact a court clerk or an ADAcontact personlisted at www.jud.cf.gov/ADA. pe
`
`Docket Number
`
`

`

`CAPITAL ONE, N.A. SUCCESSOR BY
`MERGER TO CAPITAL ONE BANK (USA),
`N.A.
`
`SUPERIOR COURT
`
`BRIDGEPORT J.D. SMALL CLAIMS SESSION
`AT BRIDGEPORT
`
`R&R File No.
`
`1583097
`
`SC6
`
`Plaintif£
`vs
`ASHLEY N DUSHING
`
`Defendant (s)
`
`COUNT I
`
`(BREACH OF CONTRACT)
`
`1. The plaintiff,
`CAPITAL ONE, N.A. SUCCESSOR BY MERGER TO CAPITAL ONE BANK (USA), N.A.
`is a national banking association having a usual place of business at
`1680 CAPITAL ONE DRIVE MCLEAN, VA 22102
`
`2. Defendant(s) used a credit account issued by plaintiff currently
`identified by account No, *******#ee#*0707
`and agreed to make
`payments for goods and services charged and/or cash advances made
`upon such credit account.
`
`3. Defendant(s) failed to make the payments due pursuant to such agreement
`even though they were demanded on or before
`6/25/24
`and
`$1,720.86
`is due and owing to plaintiff from defendant(s).
`
`4, Plaintiff waives any claim to post-judgment interest and attorney's
`fees.
`
`COUNT II (ACCOUNT STATED)
`
`5. Plaintiff hereby incorporates paragraphs 1 and 2 of Count I as set
`forth in full herein.
`
`6. In connection with this account, plaintiff mailed, delivered, sent or
`otherwise transmitted periodic account statements to the defendant setting
`forth all of the charges and credits applicable to the account, as well as
`the balance due.
`
`the defendant received and held these
`7. Upon information and belief,
`statements for an unreasonable time with no known unresolved protest, or
`objection, as defined by the Federal Truth-in-Lending Act, 15 U.S.C.
`1666(a), which requires submission of written notice of objection within
`sixty (60) days of
`transmission of the account statement.
`
`the statements are presumed accurate,
`8. Based on these circumstances,
`and constitute an account stated, which is prima facie evidence of the
`correctness of the account.
`
`indicating a balance
`9, The final statement transmitted to the defendant,
`due and owing, was accepted and held by the defendant for an unreasonable
`time without known unresolved protest or notice of defect.
`
`10. Plaintiff seeks damages for the account stated balance minus any
`eredit(s) on the account occurring after the last statement that was
`transmitted,
`
`6/25/24
`11. Payment was demanded on or before
`is due and owing to plaintiff from defendant(s).
`
`and $1,720.86
`
`12. Plaintiff waives any claim to post-judgment interest and attorney's
`fees.
`
`Page 1 of 2
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`

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`Dated at East Hartford, Connecticut 6/25/24
`
`RER File No.
`
`1583097
`
`SC6
`
` HS vr,
`
`.
`EN,
`NN
`ADAM J. OLSHAN, ESQ.
`RICHARD A. TERRY, ESQ.
`TOBY J. RHINESMITH, ESQ.
`RUBIN & ROTHMAN, LLC.
`JURIS NO. 438783
`1787 VETERANS MEMORIAL HIGHWAY
`ISLANDIA, NY 11749
`(800) 298-6058
`
`THIS COMMUNICATION IS FROM A DEBT COLLECTOR
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`Page 2 of 2
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