`STATE OF CONNECTICUT
`sOeOe
`FINANCIAL INSTITUTION EXECUTIONPROCEEDINGS
`SUPERIOR COURT PoP
`JUDGMENT DEBTOR WHO IS A NATURAL PERSON,
`seven
`nnd
`eben Nerake
`APPLICATION AND EXECUTION
`Syts
`sreayudcigay
`JECV28 Rey.14-2
`CGS. GEE2SSGh52-3876
`{Sea page 2 for instructions tofinancial instituvon andADA Notice}
`instructions - Judgment Creditoyor Atomey
`instrantions » Glerk
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`ig fom. a8 Exemptioa Chile fom,
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`insltoiion Executor (amJO-Cre2dal
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`+ ig overeat) combineaio otePEEdeetmod:ityokpaperwapareodpna!machfem Geeks Me'ze sasuretha fsomavon on tke anpsraton 1s cove
`AD-DV244 and fie the pelattalwatt ibe glee? Kean 1 copy for vou toczedls.
`2 Sige negina’ exacuton
`
`3. Anpttatizes nmust be anesciggnted bp the statutoryfon set in General Statuias 4 EE-28Th,
`a. Uploadthe ongingtto 26s Hie.
`““ "Sides:teu — ey doaiat isnt|Dechelnunber
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`Meriden Judicial District, 54 West Main St., Meriden CT.064524
`{7} HousingSavion, NNI-CV2060191785
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`ieeelenetain
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`Narea dagmoding address of fudonent Cradior sr Atomeay
`[Murder greet fawn, stele zip rods} (To be completed by Judgment Creedton (Prantl)
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`
`
`Application
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`
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`TLVNV Funding LLC. as Assignee of Capital One, NA.
`COURT LISE ONLY
`C\O SCHREIBER LAW, LLC
` APFEA
`ss
`53 Stiles Road,Suite A102
`APrEABA
`Exee
`Salem, NH 03079
`LUE) OIE
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`
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`Humber, steal, for, Fp coma
`is ve
`Hasna (ay ors? adiragsies) of Jud moat Crediter(ay
`(Pariy
`lo Waern
`meaner
`4078216
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`
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`JudgRa or eeite™ jof orn severing?besteeBey Aerediterla) (Party P )
`6803 §. Cimarron Road Suite 424-]
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`Nummatsland gdeiasdies[ol Judgment Debialte) (Partyano OWES MONeyLMaunbar,sinsan Fave, 2D SOUR)
`
`Jaseph E Santamaria
`405 Cherry StApt 46
`Wallingford,CT 06492-3575
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`
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`Baclude, btiert apgiigatte,: 2. Aancunt of costs and [aes
`3. Total pment ofjodgmernt, vosth wad fees paid 2 at 2)
`Date: ofjucgptiont
`4. Ament of gedaan
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`reuadanent Mtetest ay
`
`$102.35
`$1658.46
`03/10/20
`$1556.11
`preset
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`
`
`
`"e AppLGatan tee Tet Enaredalinditaton exesullon (ividlwaved Optne Coun
`dl Totah amount pact (i any
`EeTaalshaiunsield (Snuacl @ wai3}
`
`
`$0.08
`$1658.46
`$105.00
`
`* renasheeipiirratnalscaetaecoaeeae
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`aTotal of far &, 6, F ands
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`B. OUP oat Seren peslMamien enEts aad taza
`TEPIGEA TEEDDAfal Prof eneculieve on tesjadgmene
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`. $1763.46
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`$0.00
`50:00
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`
`
`“Sehet fappleable:
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`Is this judgniantarising out.of services rendered at a hospital?........
`[x] Na
`7} “vos
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`0 Postjudgment interest was
`orderad by tha court
`
`teraeeareeatnemegneedaaicraaden
`ifyes ebove, has a slay of 2 financial institution exaoalicn haan
`PT
`an
`Lorterad pursuant toan installment payment Order? ...... eseeena eee
`[J Yes
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`
`.
`,
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`lia stayeel a financeinsttabon execation has been entered, has the
`1X} Yes (Specifyy Defendant Defaulled on Payment
`Jsdgenent Dabtor delaultad.on ai instalmentpayment order? ........ C] No
`
`Hale sighed
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`Telephone suinber
`Sigped adement Zao er atameyy (Paryio chor money Soawed?
`i_S/NS/22. o.4{800)423-8142
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`araareamnearrsattenuate
`
`lantitall,
`Financial institution Execution
`To any properofficer,
`By authority of ie State of Comiécticu,. and pursuant to General Stntuies § 62-3676 you ate ordered agfollawa: Within 7 days, make demand for
`payment fo.yau ef any nonexemintdebt awed by the Judgment Debtarfa}, Make thls demand uponthe mainoffice of any finangjalinstiution having
`iis main officeWithin your county. if the. main. office is not within your county,bul s braach office ofthe inatiution fs within your county, make
`dematid da af employee ofsucti branch office as long the employer-and the branch offca haved teen designated by the financial institution in
`accorddave with regulations adopted b+the commissioner af banking. Only upon demand ofa financial ifsttution which dos ned have any main
`office or branch office inthis stale, demand may be made by certified mail, return receipt requested,
`Allerhaving madé dereand you are directéd 14 serve a fue. and attested ecayef thle éxceutian, together with the avachod affidavitand Exemption
`Claim term, Finaaeial Execttion (form JE-CV-244), with yourdoings endereed thereon, upon the-fpancial institution officer upon vom the demand
`yeemade, Recaive the sum paid by thefinancisl institution and apply ton this execution in accordance yaththa provisions of General Statules §
`AGT
`h.
`‘Do nof serve: more than anefinancialinslituticn execution per Judgment Debtor ot a tins, including copies.
`
`Fer Gouit Use Qaly
`Afar -sorvige of ab @xccution on one financial Inaitution, do not serve the sane execution ar a Copy onanathar
`financial iesitutionunt! receiving continnation from the preceding linancialinstitution that the Judgment
`
`Debtor hadinsufficient tunds available for cellectian to satisfy he execution. However, any addilianal service
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`ofan exacuticn mugt not ba made later than 45 days-fram-your inifial receipt of the execution.
`Also, after service of an execution, de nol serve the same execuiion ara copy on the fnanelal institution ifan
`electronic direct deposit jrama readily idantifiable source desctibed in General Statutes § 52-3765 {c} was
`made tothe Judgment Debtor's account within the loolt-backperiod described in GendralSlatutes § 52-3765
`fe}{2 months-or, vith regard tofedaral banwfits, uch groaled portod gs required by federal law). l(rie Such
`deposll was wiade, pou may subsequently serve the same executionif ine exertion has not expired ct
`ilnanvise become unenforceabic,
`Hereol fail ‘not, and make due return-ofhlswrit with your dongs thercon, according to law.
`tndinacccg
`tate signed
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`=
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`“I
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`ix] No
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` cementert
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`NOTE:The provisions of General Statutes § 52-367b, as amended, take precedence over these instructions.
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`instructions to Financial Institution Upon Receipt of a Financial institution Execution Wien Judgment
`Debtor is a Natural Person
`1. Ifany funds are removed from the Judgment Debtor's account pursuant to General Statutes § 52.367b{(c}, complete
`section Ii of the attached Exemption Claim Form, Financlal institution Execution (form JD-CV-24A) andtake the follawing
`actions: (1) Send 2 copies of both this form and the Exemption Claim Farm, FinancialInstitution Execution form to lhe
`Judgment Debtor and any secured party that Is 2 party lo a control agreementbetween you and ihe secured party under
`article 9 of title 42a of the General Statutes. Copies must be sent postagepre-paid, to the last known addressin your
`records of the recipient; and (2) Issue notice to the account bolder, or to a fiduciary whe administers the account and
`receives communications on behalf of the account holder,in the time and mannerstated in Federal Regulations
`a4 OFR 212.6 and 212.7.
`2. Remove from theJudgment Deblor's account the amountof any debts due from you to theJudgment Debtor not exceeding
`the total amountIncluded in box9.of the application on page 1 of this form, plus postjudgmentinterest, If ordered by the
`court, and the serving officer's fee. You musttake this action before your midnight deadline, as defined In General Statutes
`§ 42a-4-104.
`Leavein the Judgment Debtor's account(A} the full amountof electronic direct deposits that arereadily identifiable as
`exempt federal veterans' benefits, Social Security benefits, including, but not limitedto, retirement, survivors’ and disability
`benefits, supplemental security income benefits, exempt benefits paid by the federal Rallroad Retirement Board or the
`federal Office of Personnel Management, unemployment compensation benefits exempt under General Statutes § 52-352b
`child support payments processed and received pursuantto Title IV-D_of the Social Security Act, and (B} the amountof the
`elactroni¢ direct deposits, not to exceed $1,000,that are readlly identifiable as.wagesprovided such deposits were Made to
`the account during the lnok-back period of lwo months preceding the datethat the execution was setved.onthe financial
`institution, or, with regard to federal benefits, such greater time as required by federal law. If no such deposits have been
`made to the Judgment Debtor's account during the jook-backperiod,or ifsuch readilyidentifiable funds ate-less ihan
`$1,000,leave in the account as exempt pursuant to Genel Statutes § 52-352b(18),tiie tesser of the account balance or
`$1,000 in the aggregate. To the extent that such funds are left in the account as exemptpursuant to General Stalules §
`§2-362b(18}, the provisions ofthat section shall not be the basis for a clalmof exemption pursuantto this section in
`respanse to a levy ofexecution. However, nothingin thisparagraph shall be construedte limit yourrightor obligation to
`remove such fundsfrom the Judgiient Debtor's accountif requiredby any other provision of law or by a court order. The
`Judgment Debtor shall havefull and’ customary access to any fundsleft Inthe account. You may nolify the Judgment
`Créditer that funds ‘have bearleft in the Judgment Debtofs account pursuant te this provision. Alse, nothing in this
`paragraph shall alter the exempl status of funds which are exempt from execullon under Genetal Statutes § 2-367 b{a) or
`under atiy other provision of state or federal Jaw, or the right of a Judgment Debtorto claim such exemiption. Further,
`nothing in this paragraph shall be construedto affect any otherrights or obligations-of the financial institulion with regard te
`the funds in the Judgment Debtor's account.
`8. Hald ihe amount removed from the Judgment Debtors account pursuantto this execution for 15 daysfrom the dale you
`mall the copies of this form and the Exemption Claim Form, Financial institution Execution form to the Judgment Debtor
`and any secured party. During the 15 day period you mustnat pay the officer serving this executloh.
`4. Ifthe Judgment Debtorreturns the Exemption ClaimForm, Financial Institution Executionform or other written notice that
`an exemption is being clalmed orif any securedparty delivers to you written natice of‘thelr claim of a prior-perfected
`securilyinterest In the account, you must,within 2 business days of receipt of such holice, send a copy of such natice io
`the clerk of the courtthal issued the execution. Continue to hold the amount removedfrom the Judgment Debtor's accotnt
`for 45 daysor until you receive-a courl order regarding disposition of the funds, whicheveroccurs first. If no order is
`receivedwithin 45-days.ofthe date you send a copy ofthe Exemption Claim Form, Financial (nstitution Execution form or
`notice of exemption or a sécured party claim notice to the clerk ofthecourt, return the fundsto the Judgment Debtor's
`account
`6. Ifyou do nobreceive the Exemption Claim Form, Financial ingttution Execution form or secured party tlalm notice withla 15.
`days of mailing the required documents to the Judgment Debtor and any securedparty, you must, Upon demand, pay the
`serving officer the amount removed from the Judgment Debtor's account.
`6. If{no Exemption Claim Form, Financialinstitution Executionform or secured partly claim notleeis filed or if the court orders
`you to pay the serving officer an amount removed from the Judgment Deblor's account hol exceeding the amount due on
`theexecution and youfail or refuse to do so, you shall be llable in arvactlon to the Judgement. Creditor(s} named in the
`execution for the amount of nonexempl monies which youfail or refuse.to pay, excluding funds of up to $1,000 which you
`In good faith allowed the JudgmentDebtor to access pursuant to General Statutes $.52-367h(c).
`7. if you-pay exempt monles from the accountofthe Judgment Debtor contrary to theseInstructions, or the provisions of
`General Statutes § 52-367b, you shall beliable in an action to the Judgment Debtorfor any exempt monies pald and you
`shall refund or waive any chargesof fees byyou, including, but notlimitedto, dishonored checkfees, overdraft of minimum:
`balance service charges and legal process fees, which were assessed as a result of such payment of exernpl monles.
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` 1 For Information on ADA accommodations,
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`contacta court clerk or go ta; wwe jod. cf.
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`JDOW2E Rey, 11-24
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`Page 2 of 2
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`Section 1 - {fo be completed byjudgmentcreditor)
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`Hane aC ASE OF COUN (NUMOer, Sieet Tawnand 2p Code)
`
`xhSstriet J Session
`Meriden Judicial District, 54 West Main St., Meriden CT 06451
`Gocect Auber
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`
`
`Name of Judgment Debsor
`LNFunding LLC v. Joseph E Santamaria
`
`NNI-CV206019178S
`Joseph E Santamaria
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`Section 2- (fo be completed by financial institution - sea instructions on back/page 2)
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`Kame and Sdaese of financial Insuullon toWir GuaniptonGaim /P anygie 1 5e relumed
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`a
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`Last4 Digits of Ge Account NUMbDETS}
`AMIDE afd 3.00 Of 2X227eit 2GNGs MOL TEMG
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`AMTUTL RETIOVEd PUrSlant 1p ExXecuLon
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`EXEMPTION CLAIM FORM
`FINANCIAL INSTITUTION EXECUTION
`JDOV2EA Ber 1021
`CES. §31-58523214, £23502, 520520, 525614,
`EO-SETb 28 U.S.C. SIBINT 1)
`
`SEE INSTRUCTIONS ON BACKIPAGE 2
`
`SUPERIOR COURT
`wwejud.ct.gov
`
`STATE OF CONRECTICUT
`
`
`Name and adress ofJudgment DebiorAttorney
`COURT USE ONLY
`(To d8 complafed byjeagmentcredieror atomney}
`;|MXMPEX
`To:
`Tjoseph £ Santamaria
`|
`. _ .
`40 § Cherry St Apt 40
`TEE
`Wallingford, CT 06492-3575
`
`
`
`L
`
`J
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`Judicial
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`Housing
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`Odie dt mading to tucgmers Deblor
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`
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`|| Additional sheet(s) attached hereto and made.a part hereof (ifmecessary).
`Section 3 ~ Notice to Judgment Debtor
`As 2 result of a judgment entered against you, the attached execution has been issued againstfunds deposited by you tn the
`financial Institution named above. To comply with this execution,the financialinstituifon has removed the amount of moneyindicated
`above from the account(s) listed above.
`THE MONEY IN YOUR ACCOUNT{S) MAY BE EXEMPT FROM EXECUTION - The money in-your account(s) may be protected fram
`execution by state statutes-or by other laws orregulations of Connecticut or of the United States. A ehecklist.and a description of the mosi
`common exemptions established by Jaw are set forth below.
`HOW TO CLAIM.AN EXEMPTION ESTABLISHED BY LAW. Ifyou wishto claim thatthe money removed from your account(s} pursuant
`to this execution is exempt by law from eecution, you must fill aut-and sige before.a-proper official the Atidavit ofClaim of Exemption
`below and mail or deliver this exemptionclaim formtothe financialinstitutionatthe above address. This form must be received by the
`financial institutionnolater than 45 days trom the DATE GF MAILING TO THE JUDGMENT DEBTOR indizatedabove.
`Upon receipt of this form the financial-insttution will send itto the Superior Caurt and the court dlerck will notify you and the judgment
`creditor of the date on which a hearing willbe.held bythe court to determine the issues raised by your claim.
`
`
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`SECTION - AFFIDAVIT OF CLAIM OF EXEMPTIONESTABLISHED BY LAW
`L thejudgment debtor named above, claim and certify undérthe penalty offalse statement that the money in the above account is
`exempt by faw from execution a5 follows: {celect.all iiat apply fo the funds contained in this account)
`[[] Social Security benefits [section 52-352b(7})
`[7] Private pension, trust, retirement, ar medical savings account
`[_] Unemployment benefits (section 82-352b(7})
`payments (sections 52-3214, 52-352b(13})
`[_] Werker's Compensation benefits (section 52-352b(7)}
`[] Heath or disability insurance payments {section 52-352b(5})
`LJ Veteran's benefits (section 52-352b(7)}}
`LE] Other claim ofexempt funds (Eynek bastsforclaim of exemption
`[_} Public Assistance payments (section 52-352b(4)}
`
`P| Wages.eamed by a public assistance recipient under an
`incentive eamingsorsimilar program:{section 52-352b(4}}
`E] Courtordered child suppor payments (section 52-352b(8)}
`[_] Alimony and support other than child suppart' {section 62-352b(74)}
`+See Nola Regarding Exemption forAlimony and Support on backbage 2.
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`Amount claimed to be exempt
`ifless than the entre amount:
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`=
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`Comper mating aldress of iusgment Debicr
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`_—
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`Signed (Notary Pubic, Commissioner ofSuperar Coun) Subscribed and swom
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`to: before me-on >
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`Page tofZ
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`Instructions
`
`To FinancialInstitution
`4. Complete section 2 of this farm and {1} send 2 copies
`of this form and the financial institution execution form
`tothejudgment debtor and to any secured party that is
`partyto a contral agreement bétween the financial
`institution and such secured party under antictle 9 of
`tile 42a pursuantto General Statutes § 52-387b and
`(2) mail notice to judgment debtor as required by
`31CFR212.6 and 212.7.
`
`2 2Ethis claim of exempiion is retumed completed, fil out
`Section 6 of this form and mail, within bvo businass
`days, to the issuing clerk's office at the address of
`court indicated on the front side. See additional
`instructions on the financial institution execution form.
`
`To Clerk
`4. Attach this formta each financialinstitution execution issued in a civil or
`family matter against a judgment debtor thatis 3 naturat person.
`2. Deliver the execution along with this form to the judgment creditor
`requesting the execution.
`3. ff judgment debtor completes and retumsthisform claiming an exemption,
`anter the appearance of the judgment debtor with address set forth on
`page tf.
`4, Set matter. down for hearing.
`5. Complete Section 7 below.
`§. Send filo-stamped eapy of this farm te judgment debtor and judgment
`crediior.
`7. After hearing, sendcopy of any order entered tothe financial institution.
`
`Note Regarding Exemption for Alimony and Support
`Alimony and Support, other than child support, ane exempt onlyto the’ folowing extent:
`The amount ofalimony and support, otferihanchild support, that-may be subject.to javyorofher widtholdingforpayment ofajudgmentix
`ihe leccer-of (1) iventydive percentofihe individual's disposable eamings for that week, or{2) tie amount by which the individuals
`disposable eamingsfor that week exceed tary times the higherof (A}the federalminimum hourly wage underSecfien G(aj(1) ofthe Fair
`Labor Standards Act of 1933, U.S.C. Tite 29, Section 206{a)(1}, or (B), the state mitimum hourly wage un ter subsechon (} of Section
`31-58. in effect at the ime the eamings are payable.
`General Statvies § 52-350a(4) defines ‘dispozabla samings” ae.that part of the eamings ofanindividual remaining affer ie deduction from
`those eamiages ofamounts required to be withheld for payment of federal income and employment taxes, normalredirement conirbuione,
`union dues and initiation fees, group life incurance premiums, health insurance premiums endfederaltax levies.
`
`Section 5 - Proper Officer Must Complete this Section
`Name and tte 67priges officer
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`Dale oYseivice on finance, stitution
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`Telephone hanger
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`Section 6- (To be completed.by financial institution upon return of exemption claim form)
`Gate clam recenved
`Date maiied to ‘court
`NOME OfSviancal insuinzon
`
`
`Section 7 - Notice to Judgment Debtor and Judgment Creditor
`The money removedfrom your acceunt(s) pursuant to this execution fs being held for (1) forty-five days from the date the
`exemption claimform was teceived bythe financial insbtution designated on the: front of this form or {2} until.disposition is
`ordered bythe court at a hearingfo be held at.onthe date set forth below, whichever occurs earlier.
`
` TREphOne Mune
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`reeeseee|| p.m.
`Signed fAssiiantCieri
`=sled
`
`Order
`TheCourt/Magisirate, having helda hearing to.determine the issues raised by this cdaim, hereby orders that
`
`
`By ie Coun[rameofLugeFanily Suppant Magistratetdapssirata)
`[_] Magistrate
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`Bigned (edgeremy Supporiagivaledeagicraleacsichant CRI
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`ADA NOTICE
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`The JudicialBranch of the State. of Connecticut complies with the Americans with Disabilities Act (ADA}.if you need 2 Tessonable
`
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`accommodation in acepmance with the ADA, contact a-court clerk or an ADA contact person listed at wivufindci.gaWADA,
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`_aEHCV-244 {page2) Rew. 10-21
`Page 2 of2
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