HomeMy WebLinkAbout11-02-12IN THE MATTER OF THE ESTATE OF
FRED MCGILLVRAY IV, DECEASED Case No. 2012-0806
STATEMENT OF CLAIM
The undersigned hereby presents for filing against the above estate this statement of claim and alleges:
1. The basis for the claim is a revolving account with FPC Financial, f.s.b., and more particularly
described as follows:
a. Account #59100 05361, with an outstanding balance of $17,098.85* plus interest at the rate of
5.9%, account statement attached hereto as Exhibit a;
2. The name and address of the claimant are John Deere Financial Multi-use Account is a service of
John Deere Financial, f.s.b. formerly known as FPC Financial, f.s.b., 6400 NW 86th Street, Johnston, Iowa
3. The claim is not contingent or unliquidated.
4. The claim is due and unpaid and there are no offsets or counterclaims thereto.
Under penalty of perjury, I declare that I have read the regoing, and the facts alleged are true, to the
best of my kno d e and belief.
Signed on , 2012.
Amy Keeling, Cl imant
Probate Customer Relationship Manager
John Deere Financial, f.s.b.
P.O. Box 6600
6400 NW 86th Street
Johnston, Iowa 50131
800-597-5255 x74102
*The balance stated above is as of the last billing date on the account, John Deere Financial, f.s.b. will accept
the amount to pay the claim in full provided the funds are received on or within 40 days from the date this
claim was notarized.
STATE OF IOWA )
SS.
COUNTY OF POLK )
On this ~ day of , 2012, sworn to before me, a Notary Public in and for the
State of Iowa, personally appeared Amy Keeling, to me known to be the person named in and who executed
the foregoing instrument, and acknowledged that she executed the same as her voluntary act and deed.
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PROOF OF SERVICE
A copy of the foregoing was sent by United States Postal Service to Jessica Nailor/
M n Law Office, Personal Representative, 10 E High St, Carlisle, Pa 17013, this~~ day
of ~~, 2012.
1
Amy Keeling, C aimant
Probate Customer Relationship Manager
SICMC095 ACCOUNT STATEMENT HISTORY - MULTI-USE(US)
10/20/12 REQUESTED BY: SI00556
ACCOUNT
NUMBER NAMfi
___________________ _________________________
59100-05361 MCGILLVRAY IV, FRED
PAGE: 1
11:50 AM
STMT DATE INV NUM ORIG INV TRAM DATE POST DATE TRAN CODE-DESCRIPTION DEALER NAME TRAM AMT
PREVIOUS BALANCE 7,910.57
2010-07-14 0574426 2010-06-26 2010-06-26 025-PURCHASE PARTS LANDMARK EQUIPMENT LLC CA 95.87
0574427 2010-06-26 2010-06-26 025-PURCHASE PARTS LANDMARK EQUIPMENT LLC CA 141.10
0574720 2010-07-03 2010-07-03 025-PURCHASE PARTS LANDMARK EQUIPMENT LLC CA 39.20
0360146 2010-07-06 2010-07-06 025-PURCHASH PARTS LANDMARK EQUIPMENT LLC CH 79.00
1-111877 2010-07-07 2010-07-07 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC 284.00
0574878 2010-07-08 2010-07-OB 025-PURCHASE PARTS LANDMARK EQUIPMENT LLC CA 31.78
TOTAL INTEREST 101.78
NEW BALANCE 8,678.30
2010-08-14 0575293 2010-07-23 2010-07-23 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 74.95
0575353 2010-07-26 2010-07-26 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 36.60
0575352 2010-07-26 2010-07-26 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 117.00
1-113910 2010-07-26 2010-07-26 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC 23.09
0575658 2010-OB-03 2010-08-03 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 316.60
106AR 2010-07-15 2010-07-15 003-PAYMENT - THANK YOU 791.06CR
112AZ 2010-07-27 2010-07-27 003-PAYMENT - THANK YOU 867.83CR
TOTAL INTEREST 98.32
NEW BALANCE 7,685.97
2010-09-14 0576170 2010-OB-19 2010-OB-19 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 16.81
0362359 2010-OB-28 2010-OB-28 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA 57.92
0362359 2010-OB-28 2010-08-28 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA 57.92
1-116237 2010-OB-30 2010-08-30 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC 590.80
0362543 2010-09-01 2010-09-01 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA 22.25
0362570 2010-09-02 2010-09-02 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA 146.69
0576827 2010-09-07 2010-09-07 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 74.94
0362359 0362359 2010-OB-28 2010-OB-28 004-CREDIT MEMO BILLING CORRECT SMITHS IMPLEMENTS INC CHA 57.92CR
167AD 2010-09-07 2010-09-07 003-PAYMENT - THANK YOU 768.60CR
TOTAL INTEREST 101.97
NEW BALANCE 7,928.75
2010-10-14 1-117890 2010-09-15 2010-09-15 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC 116.51
0577214 2010-09-21 2010-09-21 025-PURCHASB PARTS SMITHS IMPLEMENTS INC CAR 13.45
29706 2010-09-30 2010-09-30 025-PURCHASE PARTS MARTINS AG 131.25
30598 2010-09-30 2010-09-30 025-PURCHASE PARTS MARTINS AG 1,678.77
30017 2010-09-30 2010-09-30 025-PURCHASE PARTS MARTINS AG 1,394.24
30724 2010-09-30 2010-09-30 025-PURCHASE PARTS MARTINS AG 795.74
1-118763 2010-30-09 2010-10-04 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC
54.77
0577649 2010-10-06 2010-10-06 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 393.00
214AW 2010-10-04 2010-10-04 003-PAYMENT - THANK YOU 792.88CR
TOTAL INTEREST 123.22
NEW BALANCE 11,836.82
SICMC095 ACCOUNT STATEMENT HISTORY - MULTI-USE~US)
10/20/12 REQIIESTED BY: SI00556
ACCOi1NT
NUMBER NAME
___________________ _________________________
59100-05361 MCGILLVRAY IV, PRED
PAGE: 2
11:50 AM
STMT DATE INV NUM ORIG INV TRAN DATE POST DATE TRAM CODE-DESCRIPTION DEALER NAME TRAM AMT
2010-11-14 1-120675 2010-10-22 2010-10-22 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC 22,gg
0578066 2010-10-23 2010-10-23 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 27,70
1-121296 2010-11-12 2010-11-12 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC 1,780.75
259AQ 2010-11-01 2010-11-01 003-PAYMENT - THANK YOU 1, 183.68CR
TOTAL INTEREST 148.03
NEW BALANCE 12,632.50
2010-12-14 103AM 2010-12-01 2010-12-01 003-PAYMENT - THANK YOU 1,263.25CR
TOTAL INTEREST 149.86
NEW BALANCE 11,519.11
2011-01-14 1-124730 2010-12-22 2010-12-22 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC 58.60
29234 2010-12-28 2010-12-28 025-PURCHASE PARTS MARTINS AG 920.00
0010611 2011-01-06 2011-01-06 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 223.32
1-125925 2011-01-07 2011-01-07 025-PURCHASE MILKING PARTS & AGRI SERVICE LLC 398.04
117AI 2010-12-31 2010-12-31 003-PAYMENT - THANK YOU 1, 151.91CR
TOTAL INTEREST 150.59
NEW BALANCE 12,117.75
2011-02-14 110374 2011-02-04 2011-02-04 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC 592.12
1-128061 2011-02-11 2011-02-11 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC 109.70
202AD 2011-01-31 2011-01-31 003-PAYMENT - THANK YOU 1,211.78CR
TOTAL INTEREST 151.15
NEW BALANCE 11,758.94
2011-03-14 0580305 2011-02-16 2011-02-16 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 335.59
31090 2011-02-17 2011-02-17 025-PURCHASE PARTS MARTINS AG 405.47
123AC 2011-03-07 2011-03-07 003-PAYMENT - THANK YOU 1,175.89CR
TOTAL INTEREST 140.83
NEW BALANCE 11,464.94
2011-04-14 0581444 2011-04-OS 2011-04-OS 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 13.99
0561540 2011-04-07 2011-04-07 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 71.03
106AW 2011-04-04 2011-04-04 003-PAYMENT - THANK YOU 1, 196.49CR
TOTAL INTEREST 142.49
NEW BALANCE 10,545.96
2011-OS-14 0372243 2011-OS-13 2011-OS-13 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA 429.42
0372259 2011-OS-14 2011-OS-14 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA 58.00
201AQ 2011-OS-02 2011-OS-02 003-PAYMENT - THANK YOU 1, 054.60CR
TOTAL INTEREST 125.90
NEW BALANCE 10,104.68
2011-06-14 14661 2011-OS-17 2011-OS-17 025-PURCHASE PARTS MARTINS AG
624.70
SICMC095
10/20/12
ACCOUNT
NUMBER NAME
___________________ _________________________
59100-05361 MCGILLVRAY IV, FRED
ACCOUNT STATEMENT HISTORY - MULTI-USE(US)
REQUESTED BY: SI00556
STMT DATE INV NUM ORZG INV TRAM DATE POST DATE TRAN CODE-DESCRIPTION DEALER NAME
14872 2011-OS-17 2011-05-17 025-PURCHASE PARTS MARTINS AG
0372945 2011-OS-24 2011-OS-24 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA
1-136830 2011-06-14 2011-06-14 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC
0584804 2011-06-19 2011-06-14 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR
140AP 2011-06-06 2011-06-06 003-PAYMENT - THANK YOU
TOTAL INTEREST
N8W BALANCE
2011-07-14 1-137892 2011-06-20 2011-06-20 025-PURCHASE MILKING ROUTS S AGRI SERVICE LLC
0374731 2011-06-23 2011-06-23 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA
0374675 2011-06-24 2011-06-29 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA
0585443 2011-06-27 2011-06-27 025-PURCHASB PARTS SMITHS IMPLEMENTS INC CAR
14920 2011-07-07 2011-07-07 025-PURCHASE PARTS MARTINS AG
143AD 2011-06-24 2011-06-24 003-PAYMENT - THANK YOU
TOTAL INTEREST
NEW BALANCE
2011-OB-14 0376297 2011-07-29 2011-07-29 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA
666944 2011-08-02 2011-08-02 025-PURCHASE PARTS MARTINS AG
0586630 0586630 2011-08-01 2011-OB-O1 004-CREDIT MEMO RETIIRNED MERCHA SMITHS IMPLEMENTS INC CAR
123AC 2011-07-29 2011-07-29 003-PAYMENT - THANK YOU
TOTAL INTEREST
NEW BALANCE
2011-09-14 0587307 2011-08-20 2011-08-20 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR
0567356 2011-OB-22 2011-08-22 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR
0377679 2011-09-03 2011-09-03 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA
0377787 2011-09-07 2011-09-07 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA
0090911 2011-09-09 2011-09-09 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR
120AA 2011-09-01 2011-09-01 003-PAYMENT - THANK YOU
TOTAL INTEREST
NEW BALANCE
2011-10-14 62327 2011-09-27 2011-09-27 025-PURCHASE
FISHER & THOMPSON INC
1-147233 2011-10-07 2011-10-07 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC
1-147294 2011-10-07 2011-10-07 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC
1-141302 2011-10-14 2011-10-14 025-PURCHASE
AGRI SERVICE LLC
1-142912 2011-10-14 2011-10-14 025-PURCHASE
AGRI SERVICE LLC
lOlAZ 2011-10-06 2011-10-06 003-PAYMENT - THANK YOU
TOTAL INTEREST
NEW BALANCE
2011-11-14 1-142412 2011-10-17 2011-10-17 025-PURCHASE S
UPPLIES STORE AGRI SERVICE LLC
PAGE: 3
11:50 AM
TRAN AMT
1,054.09
816.28
111.95
52.68
1, 010.49CR
153.86
11,907.75
535.31
1,005.60
88.02
41.90
1,077.99
1, 190.78CR
157.25
13,623.04
73.87
1,060.28
21.OSCR
1,362.30CR
171.73
13,595.57
78.72
206.40
437.12
151.22
655.16
1,354.56CR
173.55
13,893.18
110.24
368.26
309.73
325.17
379.05
1,389.32 CR
171.08
14,167.39
379.05
_ __ ~
SICMC095 ACCOUNT STATEMENT HISTORY - MULTI-USE(US) PAGE: 9
10/20/12 REQUESTED BY: SI00556 11:50 AM
ACCOIINT
NUMBER NAME
___________________ _________________________
59100-05361 MCGILLVRAY IV, FRED
STMT DATE INV NUM ORIG INV TRAM DATE POST DATE TRAM CODE-DESCRIPTION DEALER NAME TRAM AMT
1-146352 2011-10-18 2011-10-18 025-PURCHASE MILKING PARTS & AGRI SERVICE LLC 2g,57
1-146315 2011-10-18 2011-10-18 025-PURCHASE MILKING PARTS & AGRI SERVICE LLC 996.02
0589267 2011-10-18 2011-10-18 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 34.70
1-148924 2011-10-28 2011-10-28 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC 32.38
0122825 2011-11-11 2011-11-11 025-PURCHASE SHOP WORK SMITHS IMPLEMENTS INC CHA 54.73
0380412 2011-11-11 2011-11-11 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA 47.35
0590056 2011-11-19 2011-11-14 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR 53.90
1-14241 1-142412 2011-10-18 2011-10-18 004-CREDIT MEMO BILLING CORRECT AGRI SERVICE LLC 379.OSCR
110AS 2011-11-01 2011-11-01 003-PAYMENT - THANK YOU 1,416.74CR
TOTAL INTEREST 186.89
NEW BALANCE 14,185.19
2011-12-14 1-146914 2011-11-16 2011-11-18 025-PURCHASE MILKING PARTS & AGRI SERVICE LLC
300.11
1-150628 2011-11-21 2011-11-21 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC 364.03
0360738 2011-11-22 2011-11-22 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA 45.92
1-151796 2011-12-07 2011-12-07 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC
723.93
106AQ 2011-12-OS 2011-12-OS 003-PAYMENT - THANK YOU 1,918.52CR
TOTAL INTEREST 180.48
NEW BALANCE 14,381.14
2012-01-19 1-152263 2011-12-16 2011-12-16 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC
40.58
lOlAL 2012-01-03 2012-01-03 003-PAYMENT - THANK YOU
1,938.11CR
TOTAL INTEREST 178.02
NEW BALANCE 13,161.63
2012-02-14 1-155002
0382214
1-155554
98733
48729
OH FP
1-156490
1-157000
1-157250
1-157249
190AJ
0210090
0504400 2012-01-18 2012-01-18 025-PURCHASE MILKING ROUTE
2012-01-23 2012-01-23 025-PURCHASE PARTS
2012-01-26 2012-01-26 025-PURCHASE MILKING ROUTE
2012-01-27 2012-01-27 025-PURCHASE PARTS
2012-01-27 2012-01-27 025-PURCHASE PARTS
2012-02-08 2012-02-08 025-PURCHASE SUPPLIES STORE
2012-02-08 2012-02-OB 025-PURCHASE SUPPLIES STORE
2012-02-10 2012-02-10 025-PURCHASE MILKING PARTS
2012-02-14 2012-02-14 025-PURCHASE SUPPLIES STORE
2012-02-14 2012-02-14 025-PURCHASE SUPPLIES STORE
2012-02-06 2012-02-06 003-PAYMENT - THANK YOU
2012-02-06 2012-02-14 029-NSF CHECK - PAYMENT REVERSAL
2012-02-13 2012-02-13 028-NSF CHECK CHARGE ASSESSMENT S AGRI SERVICE LLC
SMITHS IMPLEMENTS INC CHA
S AGRI SERVICE LLC
MARTINS AG
MARTINS AG
AGRI SERVICE LLC
AGRI SERVICE LLC
& AGRI SERVICE LLC
AGRI SERVICE LLC
AGRI SERVICE LLC
GRI SERVICE LLC
144.33
226.47
54.73
890.64
119.22
2,082.14
52.16
704.39
53.28
1.17
1,316.16CR
1,316.16
35.00
TOTAL INTEREST
188.70
NEW HALANCE 17,713.86
2012-03-14 1-158627
1-158380 2012-03-12 2012-03-12 025-PURCHASE SVPPLIES STORE
2012-03-12 2012-03-12 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC
AGRI SERVICE LLC
10.18
2.34
SICMC095
10/20/12
ACCOIINT
NUMBER NAME
___________________ _________________________
59100-05361 MCGILLVRAY ZV, FRED
ACCOUNT STATEMENT HISTORY - MULTI-USE SUS)
REQUESTED BY: SI00556
STMT DATE INV NUM ORIG INV TRAM DATE POST DATE TRAM CODE-DESCRIPTION DEALER NAME
IV059 2012-02-23 2012-02-23 003-PAYMENT - THANK YOU
O15CE 2012-03-06 2012-03-06 003-PAYMENT - THANK YOU
TOTAL INTEREST
NEW BALANCE
2012-04-14 1-160344 2012-03-21 2012-03-21 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC
0385009 2012-04-04 2012-04-04 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CHA
49190 2012-04-09 2012-04-04 025-PURCHASE PARTS MARTINS AG
1-161881 2012-04-04 2012-04-04 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC
51036 2012-04-10 2012-04-10 025-PURCHASE PARTS MARTINS AG
IV090 2012-03-30 2012-03-30 003-PAYMENT - THANK YOU
TOTAL INTEREST
NEW BALANCE
2012-OS-14 1-163035 2012-04-17 2012-04-17 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC
1-163391 2012-04-24 2012-04-24 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC
51544 2012-OS-02 2012-OS-02 025-PURCHASE PARTS MARTINS AG
0594734 2012-OS-03 2012-OS-03 025-PURCHASE PARTS SMITHS IMPLEMENTS INC CAR
1-1696D5 2012-OS-07 2012-OS-07 025-PURCHASE SUPPLIES STORE AGRI SERVICE LLC
1-164703 2012-OS-09 2012-OS-09 025-PURCHASE MILKING ROUTE S AGRI SERVICE LLC
IV122 2012-OS-O1 2012-OS-O1 003-PAYMENT - THANK YOU
TOTAL INTEREST
NEW BALANCE
2012-06-14 52794 2012-06-11 2012-06-11 025-PURCHASE PARTS MARTINS AG
52794 2012-06-11 2012-06-11 025-PURCHASB PARTS MARTINS AG
52794 52794 2012-06-11 2012-06-14 004-CREDIT MEMO BILLING CORRECT MARTINS AG
IV157 2012-06-OS 2012-06-OS 003-PAYMENT - THANK YOU
TOTAL INTEREST
NEW BALANCE
2012-07-19
TOTAL INTEREST
NEW BALANCE
2012-OB-19
TOTAL LATE FEES
TOTAL INTEREST
NEW BALANCE
2012-09-14
TOTAL LATE FEES
TOTAL INTEREST
NEW BALANCE
2012-10-14
TOTAL LATE FEES
PAGE: 5
11:50 AM
TRAM AMT
1,316.16CR
1,771.OOCR
194.53
14,833.75
600.00
137.21
888.80
10.00
483.40
1,483.77CR
192.36
15,661.75
13.31
31.01
1,327.00
48.28
137.66
591.00
1,566.18CR
189.15
16,382.98
1,500.99
1,500.99
1,500.99CR
1,638.30CR
187.99
16,433.66
176.65
16,610.31
39.00
184.66
16,833.97
39.00
186.88
17,059.85
39.00
SICMC095
10/20/12
ACCOUNT
NUMBER NAME
___________________ _________________________
59100-05361 MCGILLVRAY IV, FRED
ACCOUNT STATEMENT HISTORY - MULTI-USE~US)
REQUESTED HY: SZ00556
STMT DATE INV NUM ORIG INV TRAN DATE POST DATE TRAM CODE-DESCRIPTION
DEALER NAME
PAGE: 6
11:50 AM
TRAM AMT
NEW BALANCE 17,098.85