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Home My WebLink About13-6837 COMMONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS NOTICE OF APPEAL Judicial District, County Of �(,�{`�� Q'1� FROM MAGISTERIAL DISTRICT JUDGE JUDGME T COMMON PLEAS No. l(/� NOTICE OF APPEAL Notice is given that the appellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the Magisterial District Judge on the date and in the case referenced below. NAME OF APPELLANT MAG. DIST. NO. NAME OF MDJ O uc �� - \ _ 0\ CK'ia A . olvxnY 4 --)( . ADDRESS OF A ELLANT CITY STATE ZIP CODE K CC \ A DATEOFJUDGMENT am n an DOCKET No. SIGNATURE OF APPELLANT OR A ORNEY OR AGENT cs- t This block will be signed ONLY when this notation is required under Pa. If appellant was Claimant (see Pa. R.C.P.D.J. No. 1001(6) in action R.C.P.D.J. No. 100813. This Notice of Appeal, when received by the Magisterial District Judge, will before a Magisterial District Judge, A COMPLAINT MUST BE FILED operate as a SUPERSEDEAS to the judgment for possession in this case. within twenty (20) days after filing the NOTICE of APPEAL. Signature of Prothonotary or Deputy PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE (This section of form to be used ONLY when appellant was DEFENDANT (see Pa. R.C.P.D.J. No. 1001(7) in action before Magisterial District Judge. IF NOT USED, detach from copy of notice of appeal to be served upon appellee. PRAECIPE: To Prothonotary Enter rule upon Q� ��l..�Q appellee(s), to file a complaint in this appeal Name of appellee(s) (Common Pleas No. pg3 ) within twenty (20) days after service of rule or suffer entry of judgment of non pros. \ f� - 0 , -/�� Signature of appellant or attorney or agent �2obF �, 1Clin�ens�►tls�. RULE: To -�-- V na) Ql Q � appellee(s) Sne or appe ee s (1) You are notified that a rule is hereby entered upon you to file a complaint in this appeal within twenty (20) days after the date of service of this rule upon you by personal service or by certified or registered mail. (2) If yuu do not file a complaint within this time, a JUDGMENT OF NON PROS MAY BE ENTERED AGAINST YOU. (3) The date of service of this rule if service was by mail is the date of the mailin . Date: &20 �3 � �f� r� : �l Iv U .1 l �� s �� t ' i " Signature of Prothonotary or Deputy YOU MUST INCLUDE A COPY OF THE NOTICE OF., FORM WITH THIS NOTICE OF APPEAL. )1 �44 AOPC 312 -05 12# c)q,� 3SH COMMONWEALTH OF PENNSYLVANIA Notice Of Judgment/Transcript Civil COUNTY OF CUMBERLAND Case Mag. Dist. No: MDJ- 09 -1 -01 Sterling Jewelers A Delaware Corp. DBA Kay MDJ Name: Honorable Charles A. Clement Jr. Jewelers Address: 920 Linda Lane V. Camp Hill, PA 17011 Kelly S Duck Telephone: 717- 737 -3434 Kelly S Duck Docket No: MJ- 09101 -CV- 0000339 -2013 1178 Kingsley Rd Case Filed: 9/9/2013 Camp Hill, PA 17011 Disposition Summary (cc - Cross Complaint) - Docket No Plaintiff Defendant Disposition Disposition Date MJ- 09101 -CV- 0000339 -2013 Sterling Jewelers A Delaware Kelly S Duck Default Judgment for Plaintiff 10/25/2013 Corp DBA K ay Jewelers Judgment Summary Participant Joint/Several Liability Individual Liability Amount Kelly S Duck $0.00 $3,313.32 $3,313.32 Sterling Jewelers A Delaware Corp. DBA Kay $0.00 $0.00 $0.00 Jewelers Judgment Finding ( * Post Judgment) - -- In the matter of Sterling Jewelers A Delaware Corp. DBA Kay Jewelers vs. Kelly S Duck on MJ- 09101 -CV- 0000339 -2013, on 10/25/2013 the judgment was awarded as follows: Judgment Component Joint/Several Liability Individual Liability Deposit Applied Amount Civil Judgment $0.00 $3,196.96 $3,196.96 Costs $0.00 $116.36 $116.36 Grand Total: $3,313.32 ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENT BY FILING A NOTICE OF APPEAL WITH THE PROTHONOTARY /CLERK OF COURT OF COMMON PLEAS, CIVIL DIVISION. YOU MUST INCLUDE A COPY OF THIS NOTICE OF JUDGMENTITRANSCRIPT FORM WITH YOUR NOTICE OF APPEAL. EXCEPT AS OTHERWISE PROVIDED IN THE RULES OF CIVIL PROCEDURE FOR MAGISTERIAL DISTRICT JUDGES, IF THE JUDGMENT HOLDER ELECTS TO ENTER THE JUDGMENT IN THE COURT OF COMMON PLEAS, ALL FURTHER PROCESS MUST COME FROM THE COURT OF COMMON PLEAS AND NO FURTHER PROCESS MAY BE ISSUED BY THE MAGISTERIAL DISTRICT JUDGE. UNLESS THE JUDGMENT IS ENTERED IN THE COURT OF COMMON PLEAS, ANYONE INTERESTED IN THE JUDGMENT MAY FILE A REQUEST FOR ENTRY OF SATISFACTION WITH THE MAGISTERIAL DISTRICT JUDGE IF THE JUDGMENT DEBTOR PAYS IN FULL, SETTLES, OR OTHERWISE COMPLIES WITH THE JUDGMENT. 10/25/2013 Date Magisterial District Judge Charles A. Clement Jr. certify that this is a true and correct copy of the record of the proceedings containing the judgment. Date Magisterial District Judge MDJS 315 Page 1 of 2 Printed: 10/28/2013 8:55:39AM • 641rling Jewelers A Delaware Corp. DBA Kay Docket No.: MJ-091 01 -CV-0000339-2013 Jewelers V Kelly S Duck Participant List Plaintiff(s) Sterling Jewelers A Delaware Corp. DBA Kay Jewelers 375 Ghent Road Akron, OH 44333 Defendant(s) Kelly S Duck 1178 Kingsley. RO. Camp Hill, PA 17011 Complainant's Attorney(s) Attorney Michael F. Ratchford, Esq. Edwin A. Abrahamsen & Associates, PC 120 North Keyser Ave Scranton, PA 18504 MDJS 315 Page 2 of 2 Printed: 10/28/2013 8:55:39AM i 1 PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT (This proof of service MUST BE FILED WITHIN TEN(10)DAYS AFTER filing of the notice of appeal. Check applicable boxes.) COMMONWEALTH OF PENNSYLVANIA COUNTY OF C`XMV,)(2_(`Q,)Q ;ss AFFIDAVIT: I hereby(swear)(affirm)that I served a copy of the Notice of Appeal,Common Pleas No,��_�uppon the Magisterial District Judge designated therein on (date of service)L LL L,20 ❑ by personal service I by(certified)(registered)mail, sender's receipt attached hereto,and upon the appellee,(name) `Q�\on 20 ❑by personal service by(certified)(registered)mail, sender's receipt attached hereto. (S MED)AND SUBSCRIBED BEFORE ME T IS DAY OF b�W,20 a igna ure o official before whom affidavit was made - Signature of alfiant n/I f official L / My commission expires on/ a 20 j 7 TH OF PENN S NtA COMMONda1 Sea► pubilC ]ennifer M.Kepnells fit Co"bt MY GomMlssl E�J► Mara!30r Q�4 Member,Pennsoyania Ass ration of farz ries AOPC 312A-05 cc • rl i).kb Postage $ RSETpq cD Postma Cooled Fee ,�( Here I7 Retum Receipt Fee C3 (Endorsement Required) ? �n13 � (EndorsementiReq fired) i1 f 1f X313 C3 $ 4t's,1 e&Fees .� Total postage w �� ------------- Sent To - --d--t-- - ru t i40. ._...- - -treet,Ap• 1 !1 V- N or PO Box No. 5 �.!1� .... ...- ,djj�State, 1111111111111111 I'll!!!!l!111111111111111111 U.S. Postal ServiceTIM CERTIFIED MAILT,, RECEIPT Q� (Domestic Mail Only, r- N r� Postage $ vi.4 G SoM1ERSFT co r-1 Certified Fee »6.1U A� 0 Return Receipt Fee b�, Postmark 0 (Endorsement Required) Nov e Restricted Delivery Fee $Ij,Ij{ Q (Endorsement Required) Total Postage&Fees $ fU Sent To � `---- ---- a-,—)------------------------------------trees,Apt.No. [,- or PO Box No. _ Vl City State,ZIP+4 .!�.15` °.°. ---- °- PS Form :i0 August 2006 See Reverse for Instr Postal uctions CERTIFIED E rR RECEIPT (Domestic Provided) Ln t A L r 1 17- Postage $ $jj,� 0064 W r i CerBfied Fee 3=!t' `� -ME�''SF� O Return Recelpt Fee r Post O (Endorsement Requ 5 red) Here Restricted Delivery Fee y0V C3 (Endorsement Required) 1•{Ij 2 1,9 rya Total Postage&Fees $ 6 ! 11/:!/?F).3 rU Sent To S4NoC reet:p -... ....-- °-»...---...-..°--- (t or PO ��(� PS Form :0. August 2006 �` See Reverse for Instructions IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA • Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS : CIVIL ACTION - 3 75 Ghent Road : ' ' Akron, Ohio 44333 Ytrn r t Plaintiff : c°a N is • vs. • NO: 13-6837 CIVIL b-c-s a-. -- KELLY S DUCK • • 1178 KINGSLEY RD • CAMP HILL PA 17011 Defendant : NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice to Defend are served, by entering a written appearance personally or by an attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the plaintiff You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ON AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT REDUCED FEE OR NO FEE. MIDPENN LEGAL SERVICES 401 EAST LOUTHER STREET CARLISLE, PA 17013 717-243-9400 AK13008 L. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Sterling_Jewelers Inc. a Delaware corporation DBA KAY JEWELERS : CIVIL ACTION 375 Ghent Road Akron, Ohio 44333 - Plaintiff : vs. : NO: 13-6837 CIVIL KELLY S DUCK • 1178 KINGSLEY RD CAMP HILL PA 17011 • Defendant : . COMPLAINT Plaintiff, Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS, by and through its attorneys, Edwin A. Abrahamsen& Associates, P.C., complains of the Defendant as follows: 1. Plaintiff, Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS, (hereinafter "Plaintiff') is a corporation with a principal place of business located at 375 Ghent Road Akron, Ohio 44333. 2. The Defendant KELLY S DUCK(hereinafter "Defendant") is an adult individual residing at 1178 KINGSLEY RD CAMP HILL PA 17011. 3. Defendant applied for and received a credit card issued by Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS with the account number ending in 6519. 4. Use of the Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS credit card was subject to the terms and considerations of the Cardmember Agreement (hereinafter "Agreement"), a copy of which was sent to the Defendant along with the credit card. 5. Defendant used the Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS credit card account number ending in 0777, for purchases, cash advances and/or balance transfers. 6. The Defendant defaulted under the terms of the Agreement by failing and refusing to make monthly payments on the account as they became due. 7. The Defendant last made payment on January 15, 2012. 8. The total amount due and owing the Plaintiff, including interest, is $3,196.96. WHEREFORE, Plaintiff requests judgment in its favor and against Defendant in the amount of$3,196.96 plus costs of suit and any other relief as the Court deems just and appropriate. Respectfully submitted, /14° flAar chap . Ratchfor., Esquir- Attorney I.D. Nos: :6285 120 N. Keyser A e Scranton, PA 1 : 04 mratchford@eaa-law.com Phone: 800-503-1665 Fax: 570-558-5511 VERIFICATION I, Michael F. Ratchford, attorney for Plaintiff, Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS, am fully familiar with the facts set forth in the within Complaint and am authorized to make this Verification on behalf of Plaintiff. I Verify that the facts set forth in the within allegations are true and correct to the best of my knowledge, knowing that any false statements are punishable by law pursuant to 18 C.S.A. 4904. ii,,„/411110 Michael F. Ratchford, .quire IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS, : CIVIL DIVISION Plaintiff : vs. : NO: 13-6837 CIVIL KELLY S DUCK, Defendant CERTIFICATE OF SERVICE I, Michael F. Ratchford, Esquire, hereby certify that I caused a true and correct copy of Plaintiffs Complaint was served via first class United States Mail, postage prepaid on the date set forth below upon the following: Robert D. Klingensmith, Esq. 209 West Patriot Street Somerset PA 15501 Edwin A. Abrahamsen&Associates, P.C. Date: November 25, 2013 le,dj ichael ' . Ratchford, Es,,uire Attorney I.D.Nos.: 862 I 5 120 N Keyser Avenue Scranton, PA 18504 (570) 558-5510 Page 1 of 2 2714000006 K A .......... zc ::: .:::::::::;;>:;;::,;:y;:: ;;;>::>;::<:•:::;;:;:;::: �: :':a: 2: :::5: x : : :: New Balance $2,628.32 _ Balance Payable To Avoid Further Interest Charges $2,628.32 E W E t-. r R o Minimum Payment $150.00 -- Every kiss begins with Ka'yr' Pas;.put; $945.00 Tot Due $^,095.00 a y { (}€') Payment Due Daly 09i17/2012 Customer Name Kelly S Duck Late Payment Warning:If we do not receive your minimum payment Account# 3101356519 by the payment due date listed above,you may have to pay a late fee of upto$35.00. Questions?-Visit us at kay.com Minimum Payment Warning:If you make only the minimum Please send billing inquiries and correspondence to: payment each period,you will pay more in interest and it will take you (do not send payments to this address) longer to pay off your balance.For example: P.O. Box 3680 Akron,OH 44309 Previous Balance $2,582.77 - Payments $0.00 Other Credits $0.00 y.. Purchases and Other Charges $0.00 Fees Charged $0.00 Only the minimum 22 MONTHS $3,219.31 Interest Charged $45.55 payment New Balance $2,628.32 If you would like information about credit counseling services,call Statement closing date 08/22/2012 1-866-477-6322 Days in billing cycle 31 Your Transactions test C-..;:.::,-;•;: ::>:>::>:::>:::>:::>::::::>::>:::>::>:::>:>':>:>:::»<:>«:>:::>::>:>:::>:::>:::>:>:>'•:<>:>::::::::::::::::::>:::::::::. Trans Date I Post Date I Description I Amount 08/22/2012 08/23/2012 Interest Charges $45.55 TOTAL INTEREST FOR THIS PERIOD $45.55 Total fees charged in 2012 $197.66 Total interest charged in 2012 $404.29 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE DETACH AND RETURN THIS POR77ON WITH YOUR PAYMENT New Balance..,,;......................:.•••$2,628.32... Zc��,ch '[ ': ; .;:::..t;,,•:.•<.:...t1...::: 271431013565190010950000150002628321 Total Due $1.095.00 iYt'�yOS:e:G;if.;yes;;:•:::•:::::' Please make your check payable to KAY JEWELERS 1 .. , Payment mailing address is for remittance only 000006 #BWNCKTF KAY JEWELERS # 1301081325635195 It Kelly S Duck P.O.Box 740425 209 West Patriot St Cincinnati OH 45274-0425 Somerset PA 1 5501-1 563 To review important notices,click here Address or Employment Payment Mailing Address: Change?Check Box and P.O.Box 740425 complete Reverse Side Cincinnati.014 4 5274-04 25 Page 2 of 2 2714000006 Interest Charge Calculation Your Annual Percentage Rate(APR)is the annual interest rate on your account. Your Monthly Periodic Rate(MPR)is the monthly interest rate on your account. ::;:;:;:;::::: :c:� :�:�:�::::?i:<�::::::�:�:��: ::: ::::::?: :ii:�£ :�:�:�:�:�::c:$::::::::?;:iii r`�:�:�:� iiii:ai::::::??:`•:'•:c?:::�::�:� :::3!'�.:::::::::::::.::::::::::::::::::::::::::::::::::..:::et!c�r�#8��:;R�E�(J►k�€�h:.::::.t�ls�n;k�ly::#ter�c►dr�:ft;}t.i�3�:::::::::... :.::::::::: .:::::::: ::::::::::::::::::::::::.�:::::::::.....................::.:::::.::::::::::.�::::::::::.:::::::::::::::.�._.�:::.:.......:.:::.::::::::::.::::�.:::::::�::::::::.3�o•trtitsr�st:l2a .......:::::::::::� ��:C�rtt!�.:::::::. Purchases: Regular 24.99% 24.99% 2.0825% $1,980.02 $41.23 Regular 22.9% 22.90% 1.9083% $226.68 $4.32 Messages: You may pay by phone to receive immediate credit to your account at 1-800-877-3616. To take advantage of the pay by phone option,your complete account number and the last 4 digits of your social security number will be required. By providing this information to us, you are authenticating your authorization to an immediate withdrawal from your deposit account. You will have the option to cancel the payment prior to completing the transaction. To review important notices.click here Page 1 of 2 2714000006 '4 µ • New Balance $2,582.77 -- _ Balance Payable To Avoid Further Interest Charges $2,582.77 1's•' L F R :> Minimum Payment $150.00 E'!E•r}+ kiss begins wi... Kay:' Peet Due $795.00 Total Due, $945.00 k y.cL.+I.3 3 Pcvfnvnt Due Date (18i1712012 Customer Name Kelly S Duck Late Payment Warning:If we do not receive your minimum payment Account# 3101356519 by the payment due date listed above,you may have to pay a late fee of up to$35.00. Questions?-Visit us at kay.com Minimum Payment Warning:If you make only the minimum Please send billing inquiries and correspondence to: payment each period,you will pay more in interest and it will take you (do not send payments to this address) longer to pay off your balance.For example: P.O. Box 3680 Akron,OH 44309 Previous Balance $2,537.22 Payments $0.00 Other ::::::.:::.:::::::::::............................ h Credits 0.00 z:p Purchases and Other Charges $0.00 Fees Charged $0.00 Only the minimum 21 MONTHS $3,149.09 Interest Charged $45.55 payment New Balance - $2,582.77 If you would like information about credit counseling services,call Statement dosing date 07/22/2012 1-866-477-6322 Days in billing cycle 30 Your Transactions i> : :: :: :: ::::: : ::::i:::i::: ::i : : : : :::::::: :: t i:; :i: :: :;s:2:iiii::i::iii::i:: 6i::ii::iii::ii::i::i::i::iiiii::ii::::::::::;: :::;::;;;;: ;:::ii::::i::i:i:.�E1# 1:�st.�C�ar • '1�............._......._................................_._..... Trans Date I Post Date ' Description I Amount 07/22/2012 07/23/2012 Interest Charges $45.55 TOTAL INTEREST FOR THIS PERIOD $45.55 Total fees charged in 2012 $197.66 Total interest charged in 2012 $358.74 NOTICE: SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT .............................................................................. New Balance....................................$2,582,77... 271431013565190009450000150002582779 Total Due $945.00 $ Please make your check payable to KAY JEWELERS K\ , Payment mailing address is for remitance only 000006 #BWNCKTF KAY JEWELERS # 1301071325635196 # P.O.Box 740425 Kelly S Duck Cincinnati OH 45274-0425 209 West Patriot St To review important notices,click here Somerset PA 15501-1563 Address or Employment Payment Mailing Address: Change? Check Box and P.O.Box 740425 complete Reverse Side Cincinnati,OH 4 5274-0425 Page 2 of 2 2714000006 Interest Charge Calculation Your Annual Percentage Rate(APR)is the annual interest rate on your account. Your Monthly Periodic Rate(MPR)is the monthly interest rate on your account. .Qf:mare.:::::::::::::::�r�tluAt::p >::::>::»:: ... .... .., ::>::::>::::::;::>�.;::.»<::;:;>::.::.;;::.:•:•:•::•;:•::::;:;;•;:;•:;.�:.:.:..::...; ..:::..::.:>::>::»> e{...............:..:1:n:�tt3t�r.Est.lta�•:::::::::::::::.::::.::::::::::::::::::�:::::::::.. Purchases: Regular 24.99% 24.99% 2.0825% $1,980.02 $41.23 Regular 22.9% 22.90% 1.9083% $226.68 $4.32 Messages: You may pay by phone to receive immediate credit to your account at 1-800-877-3616. To take advantage of the pay by phone option,your complete account number and the last 4 digits of your social security number will be required. By providing this information to us, • you are authenticating your authorization to an immediate withdrawal from your deposit account. You will have the option to cancel the payment prior to completing the transaction. • To review important notices.click here Page 1 of2 2714000005 New Balance ......................................................................$2,537.22.... -- K Balance Payable To Avoid Further Interest Charges $2,537.22 J 1r g° L E R :> Minimum Payment $150.00 -- Every kiss begins with Past Due Tetel Due Kai`'co rn P 1vment Due Dete 07/'17/20'12 Customer Name Kelly S Duck Late Payment Warning:If we do not receive your minimum payment Account# 3101356519 by the payment due date listed above,you may have to pay a late fee of up to$35.00. Questions?-Visit us at kay.com Minimum Payment Warning:If you make only the minimum Please send billing inquiries and correspondence to: payment each period,you will pay more in interest and it will take you (do not send payments to this address) longer to pay off your balance.For example: P.O. Box 3680 Akron,OH 44309 .................. .......................... :»:>:.:,.: ::::..:::::::. .::::.::::. ArQ. au: uslrrdt� >; Previous Balance $2,491.67 " Payments $0.00 Y eaC�rrbtf�YESS�> :::::>::»:«:;:>:;:>::>::>:>::::>::::>::::>::::><::?;:es.Fib I;: <•;: .:atzcf:tvta,:pt,,;s Other Credits $0.00 Purchases and Other Charges $0.00 Fees Charged $0.00 Only the minimum 21 MONTHS $3,080.28 Interest Charged $45.55 payment New Balance $2,537.22 If you would like information about credit counseling services,call Statement dosing date 06/22/2012 1-866-477-6322 Days in billing cycle 31 Your Transactions Trans Date I Post Date I Description Amount 06/22/2012 06/23/2012 Interest Charges $45.55 TOTAL INTEREST FOR THIS PERIOD $45.55 Total fees charged in 2012 $197.66 Total interest charged in 2012 $313.19 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT ACCF3ut3#1�isis a?>aasi>1'i1'i1>:':1>1:'::55i�>><l�`:%'Si XX34XZCX�<r113i�5ili New Balance $2,537.22 ;<�:^<i`f2z<22iiiiii:?i:isi`??il?il: ''?I"33ii� .t�r:.t,<,.,:;:.;::•:»:;•:;;:.;:.»:.;:.;:.>:.:;.;;:.;:.:�:.;:.;:;1.sr;:.•:t...,t�i:..>:.> 271431013565190007950000150002537220 T,ttt+.l i•r;e $795.00 Please make your check payable to KAY JEWELERS K 6 Payment mailing address is for remdtance only 000005 I:a'�•��. :nr #BWNCKTF KAY JEWELERS # 1301061325635197 # Kelly S Duck P.O.Box 740425 209 West Patriot St Cincinnati OH 45274-0425 Somerset PA 15501-1563 To review important notices,click here Address or Employment Payment Mailing Address: Change? Check Box and P.O.Box 740425 complete Reverse Side Cincinnati,01-145274-0425 Page 2 of 2 2714000005 Interest Charge Calculation Your Annual Percentage Rate(APR)is the annual interest rate on your account. Your Monthly Periodic Rate(MPR)is the monthly interest rate on your account. :.7 .e..dd'lnr�.::::::.�::::..:�irsx'iuA,E.;��' nt�gE�,lia��.(�tAt�t.:::::::�l cutfi.x::._:?F»#dr�.._:::.e{.:::.:�:3...•:::::::.�a.at�r�st..ga :::::•:.::::::.............:............................ . Purchases: Regular 24.99% 24.99% 2.0825% $1,980.02 $41.23 Regular 22.9% 22.90% 1.9083% $226.68 $4.32 Messages: You may pay by phone to receive immediate credit to your account at 1-800-877-3616. To take advantage of the pay by phone option,your complete account number and the last 4 digits of your social security number will be required. By providing this information to us, you are authenticating your authorization to an immediate withdrawal from your deposit account. You will have the option to cancel the payment prior to completing the transaction. To review important notices.click here KAY JEWELERS #2714 SILVER SPRINGS SQUARE 6416 Carlisle Pike, STE 3100 MECHANICSBURG, PA 1 70500000 Date: 06102/2011 Time: 10:42:43 Sales Slip ID: 23168 Cardholder: DUCK, KE Account loo: >X ', . 6516 Purchase Price: $56.26 Down Payment: $0.00 Credit Plan: REG YOU MAY RETURN YOUR PURCHASE WITHIN 60 DAYS OR EXCHANGE WITHIN 30 DAYS.WATCHES CAN BE EXCHANGED OR RETURNED WITHIN 30 DAYS,MUST BE UNWORNAND UNALTERED WITH ORIGINAL PACKAGING,INSTRUCTION,AND WARRANTY DOCUMENTS.CUSTOM DESIGNED JEWELRY AND SPECIAL ORDERED WATCHES CANNOT BE RETURNED OR EXCHANGED. Total: $56.20 Cardholder agrees to .pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail Installment Charge Agreement, the terms of which are incorporated by reference. v4.7"."7 607 KAY JEWELERS #277 CAPITAL CITY MALL 3538 CAPITAL CITY MALL DR #40 CAMP HILL, PA 170110000 Date: 10/14/2011 Tire: 12:17:35 Sales Slip Ifs:* 31660 Cardholder: DUCK. KE Account No: >000=6519 Purchase Price: $323.27 Down Payment: $0.00 Credit Plan: REG YOU MAY RETURN YOUR PURCHASE WITHIN 60 DAYS OR EXCHANGE IT WITHIN 90 DAYS OF PURCHASE.WATCHES MAYBE EXCHANGED OR RETURNED WITHIN30 DAYS PROVIDED THEYARE IN ORIGINAL CONDITION(UNWORN AND UNALTERED)AND ACCOMPANIED BYTHE ORIGINAL PACKAGING,INSTRUCTIONSAND WARRANTYDOCUMENTS. CUSTOM DESIGNED MERCHANDISE,CLASS RINGS, SPECIALORDEREDWATCHESAND ITEMS ENGRAVED WITH PERSONALIZED INFORMATION CANNOT BE RETURNED OR EXCHANGED. Total: $323.27 Cardholder agrees to ,pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail Installment Charge Agreement, the terms of which are incorporated by reference. 11.:61-11, • • KAY JEWELERS #1091 Point at Carlisle Plaza BOOE High St, STE426 CARLISLE. PA 170100000 Date: 12/13/2011 Time: 14:47:19 Sales Slip ID: 89251 Cardholder: DUCK KE Account No: >X<>=6519 Purchase Price: $237.12 Down Payment: $0.00 Credit Plan: REG YOU MAY RETURN YOUR PURCHASE WITHIN 60 DAYS OR EXCHANGE IT WITHIN 90 DAYS OF PURCHASE.WATCHES MAYBE EXCHANGED OR RETURNED WITHIN90 DAYS PROVIDED THEYARE IN ORIGINAL CONDITION(UNWORN AND UNALTERED)AND ACCOMPANIED BYTHE ORIGINAL PACKAGING,INSTRUCTIONSAND WARRANTYDOCUMENTS.CUSTOM DESIGNED MERCHANDISE,CLASS RINGS, SPECIALORDEREDWATCHESAND ITEMS ENGRAVED WITH PERSONALIZED INFORMATION CANNOT BE RETURNED OR EXCHANGED. Total: $237.12 Cardholder agrees to.pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail installment Charge Agreement, the terms of which are incorporated by reference. • KAY JEWELERS #1091 Point at Carlisle Plaza 800 E High St STE 426 CARLISLE, PA 1701 30000 Date: 12113/2011 Time: 14:49:49 Sales Slip ID: 89253 Cardholder: DUCK. KE Account No: >C*0.M8519 Purchase Price: $27.54 Down Payment: $0.00 Credit Plan: REG YOU MAY RETURN YOUR PURCHASE WITHIN 60 DAYS OR EXCHANGE IT WITHIN 90 DAYS OF PURCHASE.WATCHES MAYBE EXCHANGED OR RETURNED}THIN30 DAYS PROVIDEDTHEYARE IN ORIGINAL CONDITION(UNWORN AND UNALTERED)AND ACCOMPANIED BYTHE ORIGINAL PACKAGING,INSTRUCTIONSAND WARRANTYDOCUMENTS.CUSTOM DESIGNED MERCHANDISE,CLASS RINGS, SPECIALORDEREDWATCHESAND ITEMS ENGRAVED WITH PERSONALIZED INFORMATION CANNOT BE RETURNED OR EXCHANGED. Total: $27.54 Cardholder agrees to pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail Installment Charge Agreement, the terms of which are incorporated by reference. CUSTOMER FEIEPMONE NO ADDRESS Ms,..tin ASt .SOURCE CODE Y N • CRY STATE LP MUA DC0IJ KAY' EARL 01 4BE J E W E L E R S 1 CASH CHI Y W.ACARD VtAAAy RC1UW1 1 RP/C.10 Evo'Y 1•,51 bepm5 won hay' SALESPERSON NO .a....t.r.e. kay.com ESP SKU NUMBER DISC. SOLD FOR I Li I I I I I I THANK Y O U 11 I I 1 1 1 1 12f11/09 11 :17 1 1 1 1 1 1 I 1 2 714 1 3869 010207 1 1 1 1 1 1 1 1 I ��toer Nam : KELLY s I i i I I I Opt Ski Dsc Retail Bold 1 I I I I 1 I _ Gua�3n 1 48 6 100.00 32.00 S5LU DIAMOND RING . I I I I I I I_ I 1 4 391711405 ADV 149.00 71.99 . PAYMENT PROTECTION PLAN 14K2 EARRINGS BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE,I ACKNOWLEDGE THAI.I DO NOT 1 11 900149408 AD' 80.00 19.99 NEED TO PURCHASE THIS INSURANCE TO GET CREDIT AND I CAN GET SIMILAR COVERAGE.INCLUDING 0$13 tee #5503.4904 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES 5V CR WHITE SA PENDANT CREDIT LIFE,DISABILITY,INVOLUNTARY UNEMPLOYMENT,PROPERTY.JOB RETRAINING AND LEAVE OF ABSENCE TO THE EXTENT AVAILABLE IN MY SLATE AS DESCRIBED IN THE SUMMARY OF INSURANCE 0.00NT 123.981 Si1BTOT 123.98 COVERAGES'.I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF SALES TAX 6.O7. 7.44 INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE TOTAL 131.42 AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE,I MAY CANCEL ANY TIME. TOTAL DOM PAYMENT 0.00 'PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON!HE REVERSE SIDE. NUCCO 6519 REG CREDIT PLAN 131.42 YES.PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE SLSPRSN 114709 TAX TYPE 1 STANDARD DATE OF BIRTH DATE YOU MAY RETURN YOUR PURCHASE WITHIN 60 SIGNATURE _ ____'—__/— __ /—__i— DAYS OR EXCHANGE WITHIN 90 DAYS. WATCHES NO.DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE CAN BE EXCHANGED OR RETURNED WITHIN 30 DATE HAYS, POST BE UWORN AND MALTESE) WITH SIGNATURE __J—/___ ORIGINAL PACKAGING, INSTRUCTION, AND N1990.0299 NonSt ID gig iiARROITY DOCIIINTS. CUSTOM EESIGNED ■ AUTHORIZATION CODES JEWELRY AND SPECIAL- ORDERED WATCHES SECURITY AGREEMENT CANNOT BE RETURNED OR EXCHANGED. ' BUYER AGREE$T^AT h Tr(RE IS AN AMOUNT C.ARGED TO MY'JEWEL E RS REVOLYJG CHARGE SHOWN ABOVE T. SELLER HEREBY REGINS A SECURITY INTEREST IN THE GOODS DESCRIBED ABOVE(ESCFPI IN CI.MO(ON ANY PURCHASE UNDER$1501 AND NY ION ANY TURCHASE UNDER SOOT,UNTN IHE UNF'AJO BALANCE 9E SUCH DONS IS GA LT PAID AND II 3 F YPRESSLA AGREED AND UNDERSTOOD THAT.IN THE EVENT OE DEFAULT,SELLER SHALL BE ENTITLED TO POSSESSION OF TLE GOODS ANLYOR THE INIIRF UNPAID BALANCE SHALL BECOME DUE AND PAYABI E IN THE MANNER MD TO TIR tariff PERMITTED BY APPLICABLE LAW. 7. IN ADDITION T^E IERMS.DE THE OA. TWED FR5 RE Rq'NSIALLMLNTCREDIT AGREEMENT SIGNED BY BUYER PREVIOUSLY SHALL ALSO GOVERN THIS PURCHASE AND ALL THE TERMS AND CONDITIONS Of THAT AGREEMENT ME INCORPORARD IN AND SEMI L BT A PART OF THIS SECURITY AGREEMENT KAY'JEWELERS P O BOX 3880,AKRON..OHIO 44398-9914 / •.-4I . .._ . ../ A /e?. /L// B Ea 0• E CO-BUYER DATE Air CE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION ORIGINAL ORIGINAL ORIGINAL SALCS SUP DATF SALESPERSON , ■ REASON MANAGER • FOR RETURN SIGNATURE CUSTOMER SIGNATURE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 08/09 SEE BACK FOR REFUND INFORMATION. 1 , (P•R:08T09) I GUS.I,MLR TELEPHONE NO. ' ADDRESS AESt MIpMY SOURCE CODE N I CETY STATE JP I PARSER OF K AY' EMAIL - UM M[1 A A SALESPERSON NO uv- :tLN aw.LYC U.•+ar .701.01.1 RN C.,-n: J E W E L E R S Even 4iSS beyin5++rn Kay ��--��• kay.com ESP SKU NUMBER DISC. SOLD FOR I I 1 1 I I I I I I I I I I I I TFIAII+! K Y 0 U 1 1 1 1 1 1 1 1 • 03/25/10 20:01 1 1 1 1 1 1 1 1 2714 1 7344 013301 1 1 I 1 I I I O ti>rel E i S PURCHASES/RETURNS 1- 11 1 1 I I 1 �2 132441508 ADV Retail. 91.00 1 1 1 1 1 1 1 1 Guarantee OYG LAB-CREATED RUDlrtU1 PD PAYMENT PROTECTION PLAN 0.00NT 91.O0T SUI3TOT 91.00 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE.I ACKNOWLEDGE THAT:I DO NOT SALES TAX 6.07. 5.46 NEED TO PURCHASE IHIS INSURANCE TO GET CREDIT AND I CAN GET SIMILAR COVERAGE.INCLUDING TOTAL 96.46 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES TOTAL DOM PAYMENT 0.00 RETRAINING AND LEAVE OF ABSENCE TO OL EAEXT NT AVAILAB ERN MY S1ATTE AS DESCRIBED JTOHE SUMMARY OF INSURANCE 11.cOOC(f.6.119 REG CREDIT PLAN 96.46 COVERAGES'. I READ AND I MEET IHE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF SLSf1 E 1 1.14709 TAX T'A'PE 1 STANDARD INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE YOU MAY KETU1 H YOUR PURCHASE t!ITHUI 60 AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE I MAY CANCEL ANY TIME DA'I'S OR EXCHANGE 'WITHIN 90 DAYS. i1ATCH3 -PLEASE SFF IHE SUMMARY OF INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. CAN BE EXCHANGED OR RETURNED WITHIN 30 YES,PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE PAYS, BUST HE UNWORN AND UNALTERED Iona DATE OF BIRTH DATE ORIGINAL PACY,AGING, INSTRUCTION, AND SIGNATURE . J_!_ _1_1_ :JARRANTY DOCUMENTS. CUSTOM DESIGNED NO,DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE k:'LRY AND SPECIAL ORDERED WATCHES • DATE CANNOT BE RETURNED OR EXCHANGED. SIGNATURE _/____J, N1990-0299 NonStd ID 119 AUTHORIZATION CODES — SECURITY AGREEMENT BUYER AGREES THAI IF THERE IS ANAMOuNT CHARGED TO KAY.Niel E.RSREVOLVNC CHARGE SHOWN AroVE. I. SELLER HEREBY RETAINS A SECURITY INTEREST III THE GOODS DESCRIBED ABOVE IL(CTPI IN CC MO iON ANY PURCHASE UNDER SI SOI AND NT ION AN.,PURCHASE UNDER I20011 UN1IL DO UNPAID BALANCE OF SUCH GOODS IS FULLY PAID AND IT IS EAPRESSIY AGREED AND UNDER7000 IFNI IN THE(VINT Or DETAULT SEI ITR SHAH BE ENTITI ED TO POSSESSION OF THE GOODS.AND.DR THE ENTIRE UNPAID BALANCE S+ALL BECOME DUE AND NA+ABLE+N 1HE MANNER AND TO THE EYTTNT PERM TTEO By APPI ICABI F LRW 2 IN ADDITION,THE TERMS OE THE RAY'JFWELERS RETAIL INSIALLMEN1 CREDIT AGREEMENT SIGNED BY BUYER PRIVIDUSIYS-'AU.ALSO GOVERN THIS PURCHASE AND Al I THE TTRMS AND CONDITIONS DE THAI AGREEMENT ARE INCORPORATED IN AND SHALL BE A PAR1 OE THIS SECURi TY AGREEMENT KAY•JEWELERS P EiOX 3680, KRON,011I0 44398-9914 r Ai ��5 /C) SIGNAT - .-DA ' CO-BUYER DATE NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION ORIGINAL ORIC tAYL ORIGINAL SAES SUP DATE SALESPERSON REASON MANAGER FOR RETURN SIGNATURE CUSTOMER , SIGNATURE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 08/09 SEE BACK FOR REFUND INFORMATION. IP-R:08/09) CUSI(MEP TELEPHONE NO. ADDRESS AMA RIMY SOURCE CODE Y N CITY STATE :+P ENBc or K AY' IA • Roil pAA EM D OUNC6 a AAVA.CA J E W E L E R S SALESPERSON NO. CAS. cLrcrr AMA CAM u•A><AY RrTUrw RLV cu;, Every h,7•J bygrns with hay. 1.Drawl N-e■t• kay,CO ESP SKU NUMBER DISC. SOLD FOR I. I I I I I I • T H A N K Y o U I I I 1 • 04/21/10 L.Z5.24 _ {1 I I I f ( I Q977 8687 010486 1 i 1 1 I I i I '.ustoner Na,^e: KELLY S DUCK I 1 1 1 I I 1 1 0 N PUR A ES/RETUNS 1 1 1 1 1 1 1 Opt Sku I Retail Sold . 3 281611602 A1!1 265.00 185.50 CITIZEN ;PATCH 2 372716903 AIN 129.00 109,65 PAYMENT PROTECTION PLAN I I I • SV AMETHYST FENI TNT BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE.I ACKNOWLEDGE THAT:I DO NOT 0.00NT 295.15T SUBT0T 295.15 NEED TO PURCHASE PHIS INSURANCE TO GET CREDIT AND I CAN GE-1 SIMILAR COVERAGE.INCLUDING SALES TAX 6.OX 17.71 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES TOTAL 3312.06 CREDIT LIFE,DISABILITY,INVOLUNTARY UNEMPLOYMENT,PROPERTY,JOB RETRAINING AND LEAVE OF TOTAL DC N PAYMENT 0.00 ABSENCE TO THE EXTENT AVAILABLE IN MY STATE AG DESCRIBED IN THE SUMMARY OF INSURANCE 17t)OOcXJtd5I9 &ES COEDIT PLAN 312.96' COVERAGES'. I READ AND I MEET THE ELIGIBILITY REOUIREMENTS SHOWN IN 1HE SUMMARY OF INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARF BASED ON THE ACCOUNT BALANCE E " •.0 941815 TAX TYPE 1 STANDARD AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. •CU HAY OURN YOUR PURCHASE UITHIN 60 •PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. AYS CR EXCHANGE WITHIN 90 DAIS. WATCHES YES,PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE :AN DE EXCHANGED CR RETURNEIT WITHIN 30 DATE OF BIRTH DALE LAYS, MUST BE UNILORN AND UNALTERED UITH SIGNATURE- _ _ / /� __r____J__ 1RIGINAL PACKAGING, INSTRUCTION, AND NO,DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE ARRANTY DOCUMENTS. EUSTON DESIGNED - DATE 'EL''D_RY AND SPECIAL' ORDERED UATCPES SIGNATURE /_ j MOT LE RETIRED OR EXCHA1lGED. N1990.0299 NonStd ID 119 AUTHORIZATION CODES latur3l ge,astcrres may have been treated or en- ' SECURITYAGRFEMENT anted by heating (generally), oiling (eceralds) RL'fLP AGREES ItmT IT TREAT LS AN AYDUNT CHANGED TO KAY`JEW'TN;MAN AND CHARGE SHOWN*PONT: lr irradiating blue t0 az). Treated emerald:: T. SRI FR HEREBY DETANS A STCIPP F+INIkHFST IN TNT GOODS DFSLPIBFD ABOVE IDICEPI U7 CT.MD ION MIT PURCHASE uNDFR ST SOT '� E p -AND hi ION ANY PURCHASE 9NC IR S>O011 UNrII TIE UNPAID BALAkCE Or SIC-GOODS,S IlW I f PAID AND II IS FxPRESSI f AGREES AHD equire special care in cleaning and repair. It UNDERSTOOD•-A'M 7N'-IVENT DF DNAUI T SELL OR SO:L RE ENT'LED ID POSSESS ON DE'.E.GOODS.POOR Ti C%7IRE:AIMED BALANCE SHALL BECOME DUE AND PAYABLE iN I HI MANNFR AND TO THE EATTNI I•ERMITTCD BY APPLICABI E LAW s our policy not to sell or trade in gemstones 2. INADOIriOV.THE TERMS Or THE M'JEWFLCR ORLE SRETAILINSTAILMENT CREST IAMENTSIGNEDBYBUYERPR EVIOUSIIS••ALLAlSO hat have lien; treated with diffusion ur vapor GOVERN LIDS PDRCMSEANDA:I THE a 9MSAVC CONmJIONS t AMTADREEAICNT ART INCORPORATED IN AND.S+A:1 BE A PART W P•IS SECURITYAGRFEMENT. Ieposition enhancements. KAY'JEWELERS I PO.BOX 3680.A RO OHIO 44398-9914 i.1'6 —J .1 44.aW 0 BU ER, IGNA •E- .•TE GO-BUYER DATE / •()TICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION ORIGMAL ORIGINAL ORIGINAL SAi ES SUP GATE SALESPERSON REASON MANAGER i FOR RETURN SLGHAYURE CUSTOMER SIGNATURE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. •^"T' Ccp pbry Eno oIFI IEsI•-1 Iv=f11:I.EAATION,„ l.US1OMLr. TELEPHONE NO • ADDRESS MS'PLDGE tSE SOURCE CODE Y N CITY STATE TEP K A YO MEDERT EMAJL DIAMOND ME J E W E L E ? 5 SALESPERSON NO GUr� CJr[{r. SO"CAW AATAM+V ARUM RY.G10 Every Liss begins wrlh Kay! -rte--� kay.com ESP SKU NUMBER DISC SOLD FOR I I I II II l i l l l l l l THANK Y O U I I. I I I I 07/26/10 15:39 I I I I 1 I I I 0277 2 2327 013566 ›stol er Nze: KELLY S DUCK I 1 I I I I .0 PURCHASES/RETURNS I I l I I l I I E 0917906 ADM Retail • 157692 l01iG CR OPAL DIA RING I I I I I I I I O.00NT 157.92T SUBTOT 157.92 PAYMENT PROTECTION PLAN SALES TAX 6.OX 9.40 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE.I ACKNOWLEDGE THAT.I DO NOT TOTAL. 167.40 NEED TO PURCHASE THIS INSURANCE TO GET CREOII AND I CAN GET SIMILAR COVERAGE.INCLUDING TOTAL D( N PAYMENT 0.00 • PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES #XIcXXXX6519 REG CREDIT PLAN 167.40 CREDIT LIFE.DISABILITY.INVOLUNTARY UNEMPLOYMENT.PROPERTY.JOB RETRAINING AND LEAVE OF ILgPR91 922224 TAX TYPE 1 STANDARD ABSENCE TO THE EXTENT AVAILABLE IN MY STATE AS DESCRIBED IN THE SUMMARY OF INSURANCE a MAY RETURN YOUR PURCHASE WITHIN 60 COVERAGES'. I READ AND 1 MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE1AYS OR EXCHANGE WITHIN 90 DAYS. WATCHES AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. ';AN PE EXCHANGED OR RETURNED WITHIN 30 'PL EASE SFE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. ?AYS. MOST PE UNWORN AND UNALTERED WITH YES.PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE 1RIGINAI- PACKAGING, INSTRUCTION, AND DAIEOFBIRTH DALE JARRANTY DOWNS. CUSTOM DESIGI$D SIGNATURE _ J J I 'JEWELRY AND SPECIAL ORDERED WATCHES NO.DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE '.ANNOY PE RETURNED OR EXCHANGED. DATE SIGNATURE /_ /_ iatural stones may have been treated or en- N1990-0299 NorStdID119 lanced by heating (generally), oiling (emeralds) Y), AUTHORIZATION CODES ,r irradiating (blue topaz). Treated emeralds SECURITY AGREEMENT 'eallire special care in cleaning and repair. It BUYER AGREES THAT If THI RI IS AN AMOuNr CHARGE 0101UY•JI WLLE RS REVOLVING CHARGE SHOWN ABOVE is our policy not to sell or trade in gemstones I. SELLER HEREBY RETAINS A SECURITY INTEREST IN TIE GOODS OCSCRIBED ABOVE(FIG PT IN Cf.MD ION ANY PURCH*ST LMDCR$1501 yy 1- gem AND N.ION ANY PUPCNASE UNDER MPION UNIR THE UNPAID BALANCE OF SUCH GOODS IS FULLY PAID AND IT IS EOPPESSLY AGRLFD AND Tat have been treated mitt diffusion or vapor UNOrRS1000 THAT.IN THE EVENT or OCTAUIT.SOLI CR SHALL BI Dill ILED I0.OSSFSSION OF Thi GOODS.AND GFI THE ENTIBE!rNPArO BALANCE SHALL BECOME DUE AND PAYABLE WINE MANNER AND TO THE EXTENT PERMITTED BY APPLICABLE LAW iepoS1t iCWI eftancer.ents. IN ADD 10N THr Tr FMS OF THE FA..JLWLLEP5 RETAIL thSTALLM WICREDIT AGREEMENT SIGNED BY BUYER PREVIOUSLY SHALL ALSO GOVFRNTNISPURCr f,ISEANDAILTHETERMSANDCONDITIONSOFTHAIALRELMEWTARFINCO RPORAIFOrNANOSHAILBEAPARI OF INS SECURITY AGREEMENT KAY`JEWELERS P.O.BOX 3680,AKRON.OHIO 44398-9914 BUYER'S SIGNATURE DATE CO•BUYER DATE NOTICE SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION ORIGINAL ORIGINAJ. ORIO Fu1L SALES SLIP WEE SALESPERSON REASON MANAGER FOR RETURN SIGNATURE CUSTOMER SIGNATURE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 08/D9 SEE BACK FOR REFUND INFORMATION. (P-R:08J09) CLIS(QMER I 111 LEPHCWE NO. AQOnE55 na'•LPGIA T SOURTC CQDE Y N _ CITY SLATE ZIP MEMBER Of EMAIL p K A Y' A dAUVWI A J E W E L E R S SALESPERSON NO I cHLU am,CAN) w.f., RETURN NEr 0-0 Evew tIs,bens wur A.ey n--^�--� kay.com ESP S)CU NUMBER DISC. SOLD FOR 11 1 1 1 1 1 1 T H A N K Y o u 1 1 1 1 1 1 1 1 08/21/10 16:47 1 1 1 1 I 1 I 1 _ 1108 3 0027 092671 I [ 1 1 -1 1 1 1 customer Naze: (KELLY S DUCK 1 1 1 1 1_ 1 1 i LO Y �S/RETURNS II wit S{a, Dec Retail sold I I I L 1 I iCITIZEENNIWWAATC H Aw 315,00 236.25 11 1 i I i_ I °'00NTSAL.ES2 TAX 6.�°T 4.18 PAYMENT PROTECTION PLAN TOTAL 250.43 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE I ACKNOWLEDGE 1HAP l DO NOT TOTAL DOWN PAYMENT 0.00 NEED TO PURCHASE THIS INSURANCE TO GET CREDIT AND I CAN GET SIMILAR COVERAGE,INCLUDING y519 REG CREDIT PLAN 250.43 PROPERTY COVERAGE FROM ANY INSURER f CHOOSE. PAYMENT PROTECTION PLAN INCLUDES CREDIT 111E.DISABILITY,INVOLUNTARY UNEMPLOYMENT,PROPERTY,JOB REFRAINING AND LEAVE OF SLSPFSN 176509 TAX TYPE 1 STANDARD ABSENCE TO THE EXTENT AVAILABLE IN MY STATE AS DESCRIBED IN THE SUMMARY OF INSURANCE YOU MAY RETURN YOUR PURCHASE WITHIN 60 COVERAGES•. I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN 1HE SUMMARY OF DAYS OR EXCHANGE WITHIN 90 DAYS. 1dATCHES INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE CAN DE EXCHANGED OR RETURNED WITHIN 31) AND THE RATE SHOWN I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. DAYS MUST BE UNWORN AND UNALTEFED WITH PL EASE SEE THE SUMMARY Of INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. ORIGINAL PACKAGING, INSTRUCTION, AND YES PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE WADY DOCUMENTS. CUSTOM DESIGNED DATE Of BIRTH ) DATE JEWELRY AND SPECIAL ORDERED WATCHES sIGNATURE_ ----1----/---- CANNOT BE RETURNED OR EXCHANGED. NO.DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE DATE SIGNATURE _ NI990-0299 NanStd ID/19 AUTHORIZATION CODES SECURITY AGREEMEN r • BAYER AGRILS THAT IF!HERE IS AN AMOUNT CHARGED TO KAY"JEWELERS REVOLVING CHARGE SHOWN ABOVE T. SELL fR HfREV RETAINS A SECURITY INTERFSI IN THE GOODS OESCR1510 ABOVE(EXCEPT 14101.MOON ANY RJRCNA.Sf 11NOER$ISO1 AND Nr ION AN.PURC.&SE UNDER 5'00+1 UNTIL IHI uNPkO BALANCE 01 SuCH 000D5 0 FULLY PAID AND IT IS EXPRESSLY AGREED AND UNI)IRS1000 THAT IN THE WENT O1 Dk1AULI Sfl LEE S*ALL Bf ENT11l1D 10 POSSESSION OF IRE GOODS ANDtiR THE ENTIRE INPAID R4LANCE SHALL BECOME DUE AND PiYA91E UE lNE MANNER AND 10 THE UTE1141 PERMITTED BY APP!11481E LAW 2. IN ADDIT,ON Ty(TERMS Or n.Y'.AY`JI WEI IRS RCTA'L INS Al WI NT CREDIT AG BEE MEM:101110 BY BUYER PREVIOUSLY SHALE ALSO GOVERN THIS PURCNP •ANO ALI THE TERMS ARO CONDITIONS Or THAT ACREEAIENT API INCORPORATED 14 MID SNAIL BC A BARI 01 THIS SECURITY AGREEM4 NT. KAY•JEWELERS P 0.=•X 3680.AKRON.OHIO 44398.9914 i H 'GNATup DATE — CQL.BUYER DATE NO r E:SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION ORIGI104. QPIGBIAL °MGM 4, SALES SLIP DATE SALESPERSON REASON MANAGER f0R RE TILMN SIGNATURE CU;TOMCR SIGNATURE - �— .,,QT e"fl" Q N"/411 fiXCHANGES/REFUNDS. CUSTOMER TELEPHONE NO. ADDRESS MST ROOM& SOURCE CODE Y N CRY STATE: LP MDABQI OF K Y• EMAIL DAME1C L Err S SALESPERSON NO �• orku - ILMM-- . u••NaY a(11AN ' acv C.a Every JEWELERS ELs Elm KeS' ,I,n........dm.. kay,com ESP SKU NUMBER DISC. SOLD FOR I I I 1 I I I I I T H A N K Y O U 1 1 1 1 1 1 ` 1 10/15/10 14:59 I I 1 1 1 1 1 1 2714 1 2626 016925 I I I 1 I_ I I I Customer Nacre: rIE1LY S DUCK 1 1 1 1 1 1 1 ! LO Dpt SwU Dsc Retail s _ I I I I { ! I I lSV 7.5 8AM PS PRL NECK129.00 109.65 I I I I I I I I 1SV 4 FAIR BX ST PRL EA1 59.99 PAYMENT PROTECTION PLAN 0.00N1 169.641 St3BTOT 169.64 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE.I ACKNOWLEDGE THAT: I DO NOT SALES TAX 6.OX 10.18 NEED TO PURCHASE THIS INSURANCE TO GET CREDI I AND I CAN GET SIMILAR COVERAGE.INCLUDING TOTAL 179.82 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES TOTAL PAYMENT 0.00 CREDIT LIFE.DISABILITY.INVOLUNTARY UNEMPLOYMENT.PROPERTY.JOB RETRAINING AND LEAVE OF ABSENCE TO THE EXTENT AVAILABEF IN MY SLATE AS DESCRIBED IN THE SUMMARY OF INSURANCE BXOOO X6519 REG MIT PLAN 179.87 COVERAGES'. I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF SLSPRSN 138961 TAX TYPE 1 STANDARD INSURANCE COVERAGES' MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE you NAY RETURN YOIAi Pt1RCFIA`E MITHIN 6O • AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE I MAY CANCEL ANY TIME. DAYS EXCHANGE WITHIN 90 DAYS. IdATCHES PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON I HE REVERSE SIDE. CAN BE EXCHANGED OR REM ED WITHIN 30 YES.PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE DAYS, RUST BE UNWORN AND UNALTERED WITH . DATE OF BIRTH DATE ORIGINAL PACKAGING, INSTRUCTION, AND • SIGNATURE- _ -,J--1-- --1--1— QTY DOCUMENTS. CUSTOM DESIGNED NO.DO NOI ENROLL ME IN PAYMENT PROTECTION PLAN CREDI I INSURANCE JEWELRY AND SPECIAL ORDERED WATCHES DATE CANNOT BE RETURNED OR EXCHANGED. SIGNATURE --1 /� N1990-0299 NBnStd ID 119 AUTHORIZATION CODES SECURITY AGREEMENT BUYER AGREES THAT IF TwERE IS AN AMOUNT CHARGED 10 RAY`JEWEL IRS REVOLVING CHARGE SHOWN ABOVE 1. SI I1ER HEREBY RETAINS A.SECUR'TI'INTEREST IM THE GOODS DESCRIBED ABOVE(MERE IN Cl MO ION ANY PURCHASI UNDER TSB) AND NY(ON ANY PURCHASE UNDER S.'OOI UNI'L T.IE UNPAID RALANLE OE SUCH COOLS IS Rh T r PAD• AND 11,5 EXPRESSLY AGREED AND UADL';STOCD•HAT.1V THE EVENT D•MIALJI).SEIIFR Ml I t BE ENO TIED TO POSSESSION Of'HE GOCJS.ANDCR THE EOTIRI UNPAID • BALANCE SHALE BECOME DUD AND PAYABLE IN THE MMiNER AND TO 1HE EXTENT PERMITTED BY APPLICABLE LAW ' 7 INADOITION THE TERMS OfTHEAAY JEWELERS RETAIL IN5IAaMU(L CREDIT AGREEMENT StIlLED BY BUYER PREVTOUSL'(SHALT.&sO GOVERN I HIS PURCHASE AND AT I THE TERMS AND COVDllONS OF T HAT AGREEMENT ARE INCORPORATED IN AND SHAT L BE A PARE OF T N S SE6uRITY AGRI(MINT • KAY.JEWELERS P O BOX 3680.AKRON OHIO 44398-9914 BUYER'S SIGNATURE DATE CO-BUYER DATE NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION . RETURN INFORMATION ORIGINAL ORIGINAL ORIGINAL SALES SLIP DATE SALESPERSON REASON MAI.AGLR FOR RETURN SIGNATURE ' CUS FOMER ' SIi.NAT LIRE i - RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 08/09 SEE BACK FOR REFUND INFORMATION. (P-R:OBr09I UJS.C/MER TELEPISO NE NO. ADDRESS FRATPIJr]WBE SOURCE CODE Y N CITY STATE DP ME NBEAOF KAY' EMAIL pA oepMStl � SALESPERSON NO, w.+ C ECn BAIAlCoto 1w* W W I. r e td. J E W E L E R S E.ery M ee e iln hay. kay.com ESP SKU NUMBER + DISC SOLD FOR • . 1 1 1 1 1 1 1 1 THANK YOU I I I_ V I I I 10/27/10 13:01 11 1 1 1 1 1 1 1091 2 3919 075863 1 11 1 1 1 1 1 1 Customer Name: KELLY S DUCK J I I I I I I I LO # Pi1RCHASES/RETI.RNS Apt Sku Dsc Retail Sold I I 1 I I I I I 1 4 811287705 29.99 29.99 SSIL MURANO DEAD PROGRM 1 I 1 1 _I 1 1 1 0.00NT 29.99T 5(18TOT 29.99 SALES TAX 6.OZ 1.80 PAYMENT PROTECTION PUN • TOTAL 31.79 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE.I ACKNOWLEDGE THAT:I DO NOT TOTAL DOWN PAYMENT 1.00 NEED TO PURCHASE THIS INSURANCE 10 GET CREDIT AND I CAN GET SIMILAR COVERAGE,INCLUDING PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES #)00000(6519 REG CREDIT PUN 31.79 CREDIT LIFE,DISABILITY,INVOLUNTARY UNEMPLOYMENT.PROPERTY,JOB RETRAINING AND LEAVE OF 9SPRSH 1490$9 TAX TYPE 1 STANDARD ABSENCE TO THE EXTENT AVAILABLE IN MY STATE AS DESCRIBED IN THE SUMMARY OF INSURANCE YOU MAY REIM YOUR PURQ1gSE WITHIN 60 COVERAGES'. I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF ExCHA WITHIN BATS. MATCHES INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE DAYS AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME_ CAN BE EXQ 46ED OR REIIIRNTc) WITHIN 30 'PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. DAYS, MUST RE UNORW AND UNALTERED WITH YES PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE ORIGINAL PACKAGING, INSTRUCTION, ACID DAT RAN E DATE WARRANTY Df W1ENTS. Cl1STOM DESIGNED SIGNATURE !/____L____ _i_,-. JEWELRY AND SPECIAL ORDERED WATCHES NO,DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE CANNOT DE RETURNED OR EXCHANGED. DATE SIGNATURE _—__/.____J . N1990-0299 NonStd ID/19 AUTHORIZATION CODES SECURITY AGREEMENT BUYER AGREES TIU1 IF THERE IS AN AMOUNT CHARGED ID MY•JEWELERS REVOLVING CHARGE SHOWN ABOVE' I SELLER HEREBY RETAINS A SECURITY INTEREST IN THE GOODS DESCRIBED ABOVE(EXCEPT IN CT.MO(ON ANY PURCHASE UNDER 01501 AND NY(ON ANY PURCHASE UNDER 12031)UNTIL THE UNPAID BALANCE OF SUCH GOODS IS FULLY PAID AND IT*EXPRESSLY AGREED AND UNDERSTOOD THAT.IN THE EVENT OF OEIAULI.SELLER Swua BE ENTITLED TO PUSSFtTION OF THE GOODS.ANOVR THE ENTIRE UNPAID BAMAFE SHALL BECOME DUE AND PAYABLE IN THE MANNER AND I O THE EXTENT PE fAIHIED BY APPLICABLE LAW 7 IN ADDITION.THE TERMS OF THE KAY•JEWELERS REMIT INSTALLMENT CREDIT AGREEMENT SIGNED BY BUYER PREVIOUSLY SHALL ALSO GCNETM THIS PUROMSE AND AIL THE TERMS AND CONDITIONS OF MAT AGREEMENT ME INCORPORATED IN AND SHALL BE A PART OF THIS SECURITY AGREEMENT KAY*JEWELERS P.O.BOX 3680,AKRON.OHIO 44398.9914 BUYER'S SIGNATURE DATE CO-BUYER DATE . NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION ORIGINAL ORIGINAL ORIGINAL SALES SUP DATE SALESPERSON REASON MANAGER FOR RETURN SIGNATURE CUSTOMER SIGNATURE 1 RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 08109 SEE BACK FOR REFUND INFORMATION. (P-R veros) 11 KAY JEWELERS #277 CAPITAL CITY' MALL 3530' CAPITAL CITY MALL DR #40 CAMP HILL PA 1 70110000 Date: 05103/2011 Time: 17:10:11 Sales Slip ID: 25794 Cardholder: DUCK VIE Account No: X (0519 Purchase Price: $190.70 Down Payment: $0.00 Credit Plan: REIN YOU MAY RETURN YOUR PURCHASE WITHIN 80 DAYS OR EXCHANGE WITHIN 90 DAYS.WATCHES CAN BE EXCHAN ED OR RETURNED WITHIN 30 DAYS,MUST BE UNWORNAND UNALTERED WITH ORIGINAL PACKAGING, INSTRUCTION, WARRANTY DOCUMENTS.CUSTOM DESIGNED JEWELRYAND SPECIAL ORDERED WATCHES CANNOT BE RETUR D OR EXCHANGED. Total: $190.70 Cardholder agrees to .pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail installment Charge Agreement, the terms of which are incorporated by reference. /41 . 7 Account Mester•Yii `aFr:` - %ix° -0. „§.-• 4 `x. 'id ,. .ar,, - 5.- '•i e!=; :Fr DD :. oti5: el .� c� .rk - P• ' 310135651 9 `-AC • '•� .fs.::?� COUNT IN..;: GOLLEGTION3.• •-1 ` • -::KELLY S DUCK R `:.000-00044444321 C: : i.:..: :i';CM7::•::::'':',•,, •:•::.''`:' '..:'':.;::5:,' `.!.- 209 WEST PATRIOT ST ,.'..S tt:2714-KY ',:01s 22-.::.::':.'01,1::.000 0000000 _..r.-.Co B;aj;''.:.`: 2,628.32 :;-.....f....SOMERSET PA 1 5501-1 563 ;:;':Vit:{:a 02/01/2012' fit>}:.814 4440500 '•1 '::Pa;t;D ipr...•-.' 1,095.00 : Pcv$ it!P O.:: 150.00 -ctT :pof.:.000 0000000 fl I..... '';•:90.6ti i rate:::; 05/09/08. .: est Prtt 1; 10/17112'.;: ie, :Liirc <::'' 0 i I' d tF?u+ef�.'.".' :' 12/13/11 °°:DP':Iild;Ela . :N DF I,::�:'.• 00: :i .1• :::ilsgp it�[7 e 150.00 ....Stiiiita r'':::: 0.00 -.::.••..•<:. " ' , i '::L di.i'Zin'4rr 27.54 • ` Ftr t:IPut'.. 05/28/08 ; it Fi T$:�`':•':.' SUPPRESSED t:5tittk:...- :':;",..; 09J23J1 ':....T.1.... •,: :[ra:,.: :":. j PA 24983795:;.:..!...!....-: ...I.Lac¢..e01:13t`•::' 01/15/12':x:.:A:r`bt:Firr`:;.:.: 000 • . .... 1 363 57•:�C�st:'Ct.T� `I'M i:P5iiii6.4::::- 2,628.32-":'•,,�:Pntt.Arpp grit:.: 150.00-...:506;.:-..-,-°>. .:;'i ";...:#�i�P°s1�h''[k+�•J`:t`1' 08J2Q12':`."�.!:� :•':.i�J5•';,:L �:�05/29J08 ; •: . .. ... : . ...14'e±15,4 6 5,632.13'�-.tiiWs:' ....;'..''W BA - L1 BA:..09/22/12.' :.�-1 I :R ;U.rbdf:'.,:::.:, 0.00 . :'Whi P j ch s.'.%:-• 33'..00.0.;:,,:;::,:s- :: 10/27/7 :............:.....................t:!:: .�i�',°.�:'.:�:":':•":.. 02-62-199 �f1C: 'x.°_: • • .2013':`i:•-:�1�`�1�ail - . :i .';k;a .d F82010 cxari�.rri a. t f ,�:.t,sized�• - UH#..,. .. •.•::.::: %:. ..,G"d . 60FI'';',.:'- 174fif`-:.;.'.17fia171t,: 0 R• ':.SiO E:`•.:':,"SIl #:�::::•00USt -:7;:::- :.: ,..... 08/22/12 AG F= 45.55 2,628.32 y -1i.-% :..:•:.i 07/22/12 AG F= 45.55 2,562.77 • '•i •:' . 06/22/12 AG F= 45.55 2,537.22 : •i:•. 05/22/12 AG F= 45.55 2,491.67 .r 04/22/12 AG F= 45.55 Ir' 2,446.12 �_ � •. '..'� 03/22/12 AG 0= 8.40 U= 14.20 P= 10.85 C= 1.43 L= 35.00 F= 44.62 2,400.57 02/22/12 AG 0= 8.27 U= 13.97 P= 10.66 C= 1.41 L= 25.00 F= 44.11 2,265.87 :-!. 01/22/12 AG D= 6.44 U= 14.27 P= 10.91 C= 1.44 F= 44.94 2,162.43 .,J....-. :.: 01/15/12 ISPMT 150.00- 2724 1020 219101 2,102.43 • 12/22/11 AG D= 8.04 U= 13.59 P= 10.39 C= 1.37 F= 42.67 2,252.43 :, _. :1 12/15/11 ISPMT 150.00- 6751 1020 224143 2,176.37 -i• . , 12/13/11 PURCH 237.12 9669 REG 1091 089251 2,326.37 �..• 12/13/11 PURCH 27.54 9670 REG 1091 089253 2,069.25 '1 ,:'�. 11/22/11 AG 0= 7.99 U= 13.50 P= 10.32 C= 1.36 F= 42.24 2,061.71 •y.'. -'i• 11/14/11 ISPMT 150.00- 7302 1020 210259 1,986.30 � •i•.• `0 0:35 � E .t+k1.J `. mri f)atss •` SE l3 tr'J' i fx. ._/w �s.«.�. ...•Y..,..:;••••i..yL.,.Y .Ti'y...�,..I.�..,.5...�...>...t..r.l.a>..;.._. .I.tea. e,,..•*, >�i'ai:"::rtf _z._a-:.:v..:.ti..; .�.: i�v.s�;.✓d: w:�_ �r .. ..MF. ��> -1 S`•.� a.:•�r„ .a...:a. .�<�. T..,... n !. ..Yv S.. ,I: e.l�� •':r... .Yr_ �-:i:lr: .:-•1:`�:l':..�•:�::.-•1.: '.t ..C R��-��!• F.- .:'!:n h'2. :�`l'� 9. <•.4:1::.� •i•. ♦i\•�'��✓Y�'t`'� �.C'-'•r �J r .M.. \:f[. .•i,��f :�l•�: �S.r.:i `�l-.l - _�< .I....r n•1•- •.i.: .!.?-.'4.••ft:t 1. •f� •N jb' ::�•: icS.:::.Y::.a File• Functions•• Help Y•�� , . 3 Account Number.13101356511 -� : •• As of Closing D'ay O5122J J12'• • - • : .'� • • ri 'First/Lest Name' KELLY S DUCK Store tJbr 2714 _'Logo• KY Cycle:22 . 'Credit. Plan: .: .Open. Last Aging,'. Current •• • Closing'.: Avg.Daily :PPP',4rrg`.. Finance : .` Schedule.'. Plan . •Rate' ' : Date'. ••• Date.' :', Balance • •: Balance' Balance_ Daily Bat -Charge_• • •Payment' 1 t : i' 2499 24.99% 03/26/10 09/22/12 2,366.03 2,366.03 1,980.02 0.00 i ' , 249R 22.90% 06/28/08 09/22/12 262.29 262.29 226.68 0.00 :a j Balance Termed Total 2,628.32 2,628.32 2,206.70 0.00 0.00 150.00 j ' ; 1NO3 00.00% 07/15/08 09/22/12 0.00 0.00 0.00 0.00 'a ", i INFR 00.00% 05/29/08 09/22/12 0.00 0.00 0.00 0.00 Credit Plan Total 2,628.32 2,628.32 2,206.70 2,206.70 0.00 150.00 I: a •a r :a s :2 ' :3 Z :t J JJJ Y G ;. tfl•_.�5'G.nN >.%fs.i/.c>.aa'<ay.//:Rri�i��;R`r..nr.",VicL. il.Y.r.�-vi, e. 1.,.. 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' • - - i IN N OPEN L A Y A W A Y 0. 00 •• • • y • LIa } Iil1r -{..�aar�—ei�ti - r. ' • 1 004 391711405 ADV 149 . 00 104. 30 • • . 1- ' . ' . ••14K2 EIT ▪ • •' • • • ' I 1 P'F� I L 11 70 • • • . ' . ' • IT SUBTOT 10 . 00 • SALES TAX 6 0000 6. 26• TOTAL 110. 56 . 1 • ' ' PPP=L TOTAL DOWN PA ME1T O . 0 O ' ' .• • . r ,. •• ******6519 PEG CI EDIT PLAN 110 a 56 ' CREDIT AUTHORIZATION AA00 55 . ` 7021108845# LAYAWAY A' UAL DUE O. O . • j•r:1L • tttttttttttttttttttttttttttttttt tttirt-A tt . . • • •WEB ORDER # 0000000000006066469 - • • • • • .. . . • •' SHIP METHOD U42 ▪ • ' ' • tttttttttttttttt�ttytttttl'tt�t**t�ttt ttltitttt • - ;• S • SLSPRSNN 999997 . : • ' . 4834 12,/07/2009 D ACCT 70 1108845L j.• •• ACCT NAME RE DUCK . • • : •• • •▪ n ' • Print • i •I PICKUP DATE 120909 ' • 'iYa_• • a..,1..xa_aa-- 1 •,7. 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Type- CHARGE. ' •. • : .. •• .' - • • •. _'' • ; ' Iat d lips• ,. • . • .• . • • • . . • • ' • •• • ■ ' • • • • • • . - • ' ' ' • ' ' •• • . ••• ' • Fr •� . .. ••. ' • . • • .1.1iVL'+-▪ �L..Li+Lira<, • S •• ' Last •.J�L+..r'LL.i'L_•ii+J ii+i 1JL.YL.Y.n_na.. ..iva -aa•' • . , ••F 'HMI d.ii Wi• J .• r' N aim C Ll , ; . Initial : Customer. t . • . • - . •' . . . . ' • ' •• • •.J p •, n_j�Li l.rl• . • .• ; 06/02/2011 10: 4 -3 Warranty ••:'• • 1 2714-2-6603-023168 ' • . - .• ' •u 'P • n ti '. Gust Name : ICE DUCK '• 0 N PURCHASE S/PETt STS .• • . LT 'Battery • -•Dpt Sku D3c Retail Sold ' ; ••• • . , •i • • 1 004 811297504 24. 9 9 24. 99 . . Credit Draft .• • r '• • SV SEA STAR BEAD . • �..-L,.L,':. L_ a..L«...A• Y. • SLSPRSN 155358 • • . • . • 1 004 811287705 29 . 99 29. 99 • - ▪• . r• • SSIL MTLIPANO BEAD PROD . • :' . . . . •.• , SLSPRSN 155358 • • ` SUBTOT 54. 98 • • • SALES TAX 16 . 0000 3. 30 . •• • TOTAL 58 . 28 TOTAL • • • • •r . •PPP=N 1 P PAYMENT i. • .• • ' • • ' * *1 51 1E CPEL'IT PLAN 58. 2 y•t• CREDIT AT.JTHORIZATION 0O255S r• -.• SLSPRSN 155358 r . 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SALES TAX 6. 0000 14. 18 TOTAL 250 . 43 • -• • - • • a•• •• • PPP=N TOTAL DOWN PA LENT 0 . 00 . • *I. 1-6519 REG CREDIT PLAN 250. 43 ••r- . - CREDIT ALTI'HOPIZATION AA00O5O0 • • • - ' 5LSPPSH 176509 - - • • . z ▪ • • . • • • •• •' Print' • +., •. • .111.E a�11..—aJ.J.Y araL • V•• • :. . . Exik • . f P'rcducticr i D at b ae HAR T 5 H O R N .. ;sis da • • • •~• - : : ' • I1ti r`i.1••:.i'• •1 •...Ls-L•u..Os: ¢.a's- a i1+_a,-IL o-11 • e-• Ci-17 1 I. uJ1._.SI1_A.i"al.'uti..a7a L Ja ti'1J1 L •_ .5 •PYAI' .....":,.•,'•'7:7:-;•-•;•••".."'.7 LC-..s.."'"•-•Lf••.71.:47::-;;:e 4.7.•:;:;.:,:-•_-_,-;I:e..--7:,-;:.e..0::::7,2%.,-....--;7,:ii.::;-::-;;_f:ci::::;,7:-.1.:7::::::;(•:•,;:.:.;,.,:,747.-•..:•::::7-.2::::::•:::::••••••••:::' P.`4",..:14'.i!,!-1:4:::•4Y:::("1::;.e."0:"4-'"--'sA„:":-.:k."--"::--;:. r,......!..1-,%...-...-...:.--,..:77:-.4-ipA...-..y.::—...?.-:;.:.,.--.L.2.1.i...d... 2.J.;?.....41....:.,:.,--%„..--.:T.41 a .r- •_,1 i-=;me I 1.1.j'f:..r j.,...-,3„.7.,:e.,....,..;. .,..,-;:j iji..„:);,/....„....E:...1.;:, .. ....::,. ..:...,,:a.c:::.:....--..).R:2;i5.:>‘5:::.?:: :c.-,:e.;,...,....:::z-,..%,,.% :u,z.....,:i:fla":2;1/- r.::::•,‘::„r•'''••••"„ :...."..; •'-- • • •.• .. .1-7•"•P,....••.- :.i....•w.:ie.Seia-"aye;'....icers(,,..2•„,12.4:....:,;•.::.....,.4-...:.:7.1-.:L.Anl:5 na•■■•..;1 os:14::••1..••.••.;:••••••.;•:.,1..11• - ••1 r.,%;•-ja:14.:•'t;re;:II,::;--ai e..r.7-1.41-1-L•1,..r..-;:•;:.,-71:.%..,:...../...1,,....•;.•...........%..•.-6 • . . . . . . . . . . . I i • '• : Nite: -1.0/15/2010. . ••• • •.' - .' .• •• - •• • ' • . • '• • • • . •• : • .. • • . ] •• •Slip Image • . .' ,.• • • lir • r:S. .." ...Ty Pe.' 1CHA 1-RGE- • -• • .• .'• • • • • ' • - - - • . - • . .- - •' •• . • • .. • • : • Related Slips' .1 1 • • . • . • . . .14Y-a.-•- _A . • • • • • . . • • • . . . 71 "• " List-n-1• • • . • •. . " • • • • • - a- . • • . * •• ••Fifsi a' . • • - • • . - - • • -. ... "Name 1DU . . Initial K . . .. Customer. • • i 1 • . ._ • • • " • •• • • • I: • . 10/15/2010 14: 59 - . • - : • . • • WarraMy • •• m. - • • • • • . • . • • • .. • . _ r: .. 2714-1-2626-016925 •• .• • •• • • :• . • . .UWP j: - -• • 3 .. - . . a .1 ; • fi. .. Cust Name: FE DUCK : •• • • - • -• • •• • • - " • . 1, •.• LO N PURCHASES/RETURNS - • . • • • : LT .Battery ..• -1 , . . •• • ._...,—.--._......:..........__.,; •,] :; • Dpt Sku DSC Retail Sold • • - - • • • • - • • •• - • • • •- . . . 1 ••1 :i • 1 002 360515908 ADV 129 . 00 109 65 - • . Credit.braft. ;• . :•• . SY 7. 5-81111 FW PRL NEC • .• • —•-- .-—:---`""1". 1 k; - • ' • LSPRSN 136961 . • . •. .• . • . • . . • 2 . • 1 002 360499103 59 . 99 59 . 99 • - • . • .• / • • • • . : •• • i .. . • - SY 4 PAIR BX ST PRL E • • " : ••• •• -• •• • - • - •• i .. . .. . . . . . .. . . . . i SLSPRSN 138961 . . • . " . . . • . ;:▪• • - SUBTOT 169. 64 . . . r.' •• SALES TAX 6 . 0000 10 18 •• . - • • • •• • - • • • •. • •• -1 0000 . .. .. . . . . r 0 • ••• ;, '• • TOTAL 179 . 82 •• • • • • •• • • •• . • •• •- . ' .. . ;:• • PPP=N TOTAL DOWN PAYEENT 0 00 - • • •• •• • • • • • •. • • ••• 1 ; • • • • •• : • •- . . • . • • ••• • . . • . 7.- • # ******6519 PEG CREDIT PLAN 179 . 82 '• • • • ••• • • • -- • ••• • .2 •• • - . • •. •• - . . . ✓ .• CPEDIT AUTHORIZATION AA000136 • •• - • *- • • : : • - • • -" - i • SLSPPSN 138961 •• • • ..- • • • • •• • • • • •• 3 II. • • • • • • .• .• • . . .. . . . . • . •• .• .. . • . . . • • . . . • . . . • . . I• : '• • • • Print- - - ..1 •. • . • • 4 ‘1 L' • .• a...ea-I—al—a-.-1...La a.-11..........4 V: . . .a •E . . . • • • • LZ• • . ... . • • • . • Exit iiProdu6tiOn Databae . !AHAR T SHORN• -• i'sisdla • - : • ••• • ' • • ' • : -• ••.• • .• • ••• ' .•• • '...•• • •• •••• ' -1 . . . . ".-...a I-4.1 m-U I 11 tAIL-L....S L.-'-e'-e om I•U..-16-IC-r-1:16...al-1,..e.-1-11L'a-a:.,' i a-La In-L...EL,m-11.-1..li.-.......---mL,i+e... 11.- -1.st,-1.i,1,..-0:-.ji.-111-JL 112 al't.-fti-L.I.IS I.:L.1..-,[..-n1-11e.. .L-a-It I s Li-.:-..a'- 4.;;:r; r1 i -•vii• y •{iti.. .. 1".. -1 Y Sl p;yfr 1 9i r- + ■ ,�•'-ji:ZO;•V5.�.,ti'..7�1 4r :' }/r • sf.e., ~'13•,!'•11 •'7:1 1.11■ ". - y ,•%';'1.+'.y1y 1 2i j`,j1'i 1 ii .lf•,�": 154.77 l•'r 1.'S{-- ■ t J.l�14'••1-..4. -s{1.1,�ryV=�'+1 r•:',•re:74AL 1'•�v •'�■ �7: -'+t-'y1 ,' •�:r r•1-+ • , Fl �, }-7"1 1 {- F x;••-:. .ij• F .+ . ti 'V 11 �1�1•7' 11 14 r .}j- 4��. 1".17r11■ .-1 r• •+ Ryr•r'k,- "v- ••J!� r' I J•' I. 1 ' I I' 1 F r� 1-:?.t...':', 1- '.:•Y .-'-•• 'c:31.,.�ii } '" Ss 7..L 2., '"..Z' . 'y:'•• --'•"'}"..••"• .-'--+ '' -r-y-*{• .=�•� -'..f.s :• L .•-6x{1`9 • ;L:'.:!.'",:;.;. . ..1 '1v�.: .1,0' ••'.-... r r} 1.ru,�+ 1r r. s n•r.,yv,;.,... tiv•v:r '•i1 rtiS. r -J i1-c vlla.n 1}ii..4;. •1 .if:: ..!Jsl%.••;•-1••;,!f arLSU slisa:■i:;.7.7lx•Ily;a%;-:.:li-:+• •v:11- 4.a. . N'r�.Y:v•,i,... •r.ti}Drat.:•ZWC�i.n,11:i■ilima•++.•a::�■raCJ.In 1..tiYS1.n•.•v:LI•': '. • - Date_..a10 ' 7 X010 ? .. .• ' • - . , •.• , .• • , •• • '. -: ' -• • • . Slip.Image ' i'•• �1� IYiiyllLi�liLi1 •• T � � a-IA GE' • • • •• - • . • • • • ••. • . R± LPi ••„ ' • -"Last •1--LI J • . • •• --■ii • - YV■- • .■First ' . •. . ,• - • • • • •, • - • • • • •1 � • : Name I D U C • . . • ... . . •' : Initial - 1 W. . . • :• Cu tomor ' .1 I-• I 1 10/27/2010 13: 01 • • ••:• Warranty .: 1 1 091-2-3919-075863 '• '• ' • : ' ' . LI'', P - - •'1- . .• - •• - _i;1.i.. - ?,a lr i2 �1 • • Cust Hie : ICE DUCK ' • • ' , •• . • i. • ' • LO H PTJP.CHASE S/RETtI IiTS • ' ' •LT•B a(tery' •, , , •i�}i�ii�ii ' Dpt Sku D c Retail Soli • • • •• • • )' 1 004 811287705 29 . 99 9. 9 r L ' SSIL JFOBE FROG •. i , . a+mod • j . SL5PRSN 149009 •' ST.TBT0T 29. 99 r • •', •• . S• c • SALES TAX 5 . 0000 1 . 80 .• • '. . -• • • • } TOTAL 31 . 7' - • - - • -' •. -• • -•. a•PPP=X TOTAL D0iT IT PATENT 0. 00 - - : $1 ******6519 REG CREDIT PLAN 31■ 79 •- • r • CREDIT AI]THOHIZATIgild 001525 - • 0 . • SLSPPSN 149089 ••. .”Pririt- •. r ea.as. i...■.11- 4 LV ... q • L } �.. . .1 Exile • • •P'Fc'ductionDataba i e.' ,LlHARTSHEHH - i dta . •' = • : . : : :. • •• • g ...•LhiG•..3.7• •+-m2 u U...L.11.—..1}i L.ai.aS;w_+Lit.1rY iC•a.1-•i in•i k:a,IL._1 u.a.s-1•iSi--.L u I i-1.1.J•1'1-.:-.1.2.SJ.l..1Lr_ki'i•L'uli-ner.L 1[i 112..G J•-lL.L 3'_—'70.1. �'.i•i:eC}s'ar 1.,•_ r{✓...ssl,s r..•ten•• •i r.. .•••.s.;•+rti.•Lals✓••":••••"•;'•••z:. ...' t-•_ I �• :A p1 r •_'7Ni".• a-.:•z:''.sr.', •s r✓i•' :,A.?•.,W.••'....•;:....• s... ,.. 1 s.••,•.. hr .-.. _iT -,:e7.. •''....q..:-...,:j r✓ .a_• s�.I. tut ar ep1. •Z.V...._•., •-■•'�ti e..,�; ;1......:•I.rr i. LI•_?i'+J L:4r,L 1�• ate. , ; t5 sk.,_. ?r - �•" - - ; A}�. A '•rh• ,7 I 1 171 .+. .el. .M.�',. �s.. ,sss� st•,..dr,1i„ •• ✓ •.s•#:..r.. I.•, f.1 j'• ry{,r { _tis:r SFr.ntia.{1r.7isa•IS_r!am-u-0..--o iv•nel.-1.1...ai-alrr I_.a•s-_svv..n:•fv'In'.• �I'ours...C.:as m.n.•It'-.d.i x✓x e�r+:al�as..r:r.�-IE++:S.aimr�: .%Iay.:s,:.i.11.1t.rar:r r.1. � l• jrJ.a.�rJ U" _a irilurJr , , • • .•t Date: T�j r5 �} ,12I'0�jy . , S m e .71�#��L.!31��!J I 1, •• .• •, r ••. . • ▪ •s.!II� Image I IagS.• `• • f " • • '. '• '{LiiL LLii iL ii.�iLLLLL I' • ',• , '. .' ', , ' .• " . • ' .• .• • • • . • • • • • • •Type •JiCH RGE.• • . - • • , '. • • - • • • • • • . • F elated Sli �• I .▪' Last'.' _ �,• sa.e�+�al •-JY.Laii11.1....u��n.L-u✓ial.L�• • ]DLICr- . . . • • : K . 1: • Iwl • ame: I nikla iC� t m r' • 05/03/2011 17 : 19 • • . . " • Warranty- • - r . . . . • • 0277-1-9107-025794 • • • ✓ • • LI'' F •. .1. 1 • - ' • L■_L J. L I..Ja.1...�1,1. Z •▪ • Cust Naga : ICE DUCK • • • • • • • • • :• .. LO N PTTRCHA.SES/RETtIRI�" • • . - .• LT Battery. - •• . Dpt Sku Dec Retail Sold • : . ' , • 1 01 172105807 7 99 . 99 89!. 99 : ? = •' . . Credit•b raft .1 •1 • . GUARANTEE #3360-1964 : I• . �L.LiJ LLL JY Jd iL" .J • . • SSIL LE ILIA NECKLACES • ▪ : .' •• . • - • • • • 2• SLSPPSLT 972318 : . 1 001 172185807 ADV 99 . 99 89 . 9 ;; . GUARANTEE 43360-1972 , • . . • . '. .• ^• ' SSIL LE ILIA NECKLACES - - • • • ' ' . °• J • • SLSPRSN 972318 • UBTOT 179 . 98 "• • •• • • • • SALES TAX 6. 0000 10. 80 1 .' : • • ••. 4• TOTAL 190 . 78 ▪ • ' ••. • 1 1 I: • • v PPP=N TOTAL D0ITIiT PAYMENT 0 . 00 - S •• 7t**7ti•Irt6519 PEG CREDIT PLAN 1900. 78 f • r . . . 1 • CREDIT AUT1HORIZATION AA002576 '. .• • . •' ; I I: - SLSPPSN 972318 • . . • .. .I ". : • •• - • • rint• : • l• -,2 . ��' • • ' ' . • • ' ' • . • ' • • • L▪ ' j1i1 LLi L1.LLL—i.i L�LJ' Produrtioi D a taba a • : HAR T S H O R N •• ••• :i db •• - - • • . - • • •• •• •• ' • • • - • ' ,,. • ita_r1.1. _..luiutdv Lu•.1 1-.1,..x..••1-4-Nan: iLs-L.1.a.L1u-1._S,r_._.....L._.lL:ri"Cia.-:-.J _I-a_L.✓.iLA L1.:uu,LuaJLtOiitaSia:_..ti StiaJI_ Per CB ac has currant MTE ran search un Accurint- - - Parcel Neer - 13-23-0545-121 Owner Nerve: KELLY S DUCK LexIi}_ 0005E267CC/S Praperty Address: - 117B KINGSLEY RD, CAMP HILL PA 17011-6110 CUHEERLAND COUNTY Owner Address_ 117B i IN1 SLEY RD, CAMP HILL PA 17011-6110, CUMBERLAND COUNTY • • • • 4=a --i' r f.i. rT %r5 -tiFi��•' •-!! "ri.•„G�'� •:i.'r.. •'i" ..d -",`..>'T!C �LS^'.t'Ti.':Cif .6T'ai'r'rK%.. %' fT w•'�_ r r : t't �o?1Jyi� 3 ��`�s Tti� ,�r`j4 � rr is d (i: la �. r• a y Zi .fir_r.x�: 145.n^.i'.. :�v'` .�,'°' tea;r {.;• __J I_t, ,,�� 4a;=�,,.,'„�1 r 1: •?`� Ut r F":A ;" u*?w>,s,1 �yr9:`.;- t�:L +., l,.. 3�- 6. 1 ':f•,: :i': ��r _- i iI:FXotF� L--k....- ;?r `.:_�•_".t�;,-t:r ds.? �a�,)._ y�o_......c. •..;�-.:: ,�,era+?+:. .;; ' �..._rr..o�..,T?:,..,.v+...-,,. :>..�s�:ifFl.� a�: lA l�..ri. ..� ,-r..l.. r:,1!• -.G::<r:... _ _ .:'``- ..:1,; :.);.a:1;:xr: .:?;/:i. ` ' EMPLOYMENT INFO FLeEn Fields marked with an asterisk;s;arw required. . .yy ii $:.gPJtTNIRYFDSPt g•';••ic :'::.QE' S3Y•H .A2,TFF':•:;':•::;.: PRIMARY OCCUPATION �� PR�S!►?It7f HiP ADDS PRIMARY EMP CITY • PRZ�fARYP S�KFE PRIftARY EMP Z1P PRD A4SY SELF P.!NDICATDR: :.2d ':.:. . .. . .. . . . . . . : . .. : . . .. . . . . .. : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . SECONDARY EMPLOYER . . . . . . . . . . . . . . i ARY PATi ' SECOtlUU :�;. liW • 1s •�� A Y. JEWELERS 16 SSN e.ry.n.dean.0 Kau �' _ kay.com - " A l ( I INDIVIDUAL ACCOUNT:In one name and based I I JOINT ACCOUNT:Is based on credit worthiness of both I I COSIGNED ACCOUNT:Cosigner and applicant must each C Y solely on your own credit worthiness.Applicant if applicant and joint applicant.Both may use the account and will complete separate applicator*.Only applicant will be permitted to C P married.may apply for an individual account. be liable and responsible for payments.Both must sign below. use the account,but both wit be liable and responsible for payments. T E HOME: 'Alimony,child support or separate rumour.,need not be revealed d you do Oct rich to rely on u to obtain Crada. (1 I .r 1.Are you a U.S Citizen? Y N 2.Are you in the miliary? Y N Name: I { 5 0 �)�� vac l 3.Do you have estabfshed credit? Y N Home p Address: 1 `1 ( l S l: City: Q Imp OIL.: 1 A- Code:LrQ 1 1 Name Pt w Rent/Buy/ Length R• Phone:(1('}) c L5G2 149 Billed Under. c.empPGYISL Other Phone:( ) Other. t ,� I of Time:(O III(nu 5 Statement Mailing Address: O (If different than above) N L (If at• l turret address less than 3years) r l v..�Q�` KQ4—S icy:Neu)Q)'r tats: c� Code:'�joidof Time:ally SSN: ' DOB: 101a11 gLe: i c l(3'33 3 7 Q E-Mall Address: - Nearest g Wilve San�e� OJ1Sk>1 1 Residence: P ,I Phone:( �L(1) -Oq- 3ci c1 Not Living Wllb You: tE Em'l, or. it LrAI' t��t♦ • • SG 0---\ Position:An C�. 1 Self-Employed? y IAddress: vl ct.ct 0 TYe l 6--1 -,_ City: c Ste: `P4 eoee: t1 C) t 1 0 sr- Phone:(ill1) (s2Ac�.— I&t)O Gross Monthly Salary: LI 5 00 Length of Time: 1 PQI,1r E Previous Employer: Prev. N (If with current employer less Nan 1 year) -Length Cl Time: T 'Other Income Amount: Somee: Name: aehte e ery/ IAre yolua U.S.pCitizen? Home Address Length (If different fr primary applica r) City: -State Zip ode: of Time: J P 0 I. Phone:( ) SSN: r 1B: DLO: I I N L' Employer Name T A and Add es: Sell-Employed? r N N 7 Phone: ) Grass Monthly Salary: length of Time: 'Other looms Amount: Source: You may Imlestigate my credit record and obtain a consume :.r rt in corn••,..n with this application and later in connection with an update,renewal,extension of credit or collection of the account.Upon request.I will be told whether or not a . , mer report was requested and,if such a report was requested,I will be told the name and address . of the reporting agency that furnished that report. (f0 FIND OUT ABOUT CHANGES IN THE INFORMATION IN THE AGREEMENT ACCOMPANYING THIS APPLICATION, WRITE TO US AT P.O. BOX 3680.AKRON, OH 44309-3680). STATE LAW REQUIRES US TO GIVE THE FOLLOWING NOTICES: California Residents:After credit approval, each applicant may be liable for all amounts of credit extended under this Account to any joint applicant.Ohlo Residents:THE OHIO LAWS AGAINST DISCRIMINATION REQUIRE THAT ALL CREDITORS MAKE CREDIT EQUALLY AVAILABLE TO ALL CREDITWORTHY CUSTOMERS, AND THAT CREDIT REPORTING AGENCIES MAINTAIN SEPARATE CREDIT HISTORIES ON EACH INDIVIDUAL UPON REQUEST. THE OHIO CIVIL RIGHTS COMMISSION ADMINISTERS COMPLIANCE WITH THIS LAW. New York Residents: We have a security interest in goods costing more than$200.00 until the full payment price of those goods Is paid.Wisconsin Residents:It you are married and are applying for an individual Account,combine your and your spouse's financial information above.Marital Agreement Notice•No provision of marital property agreement,unilateral statement under Sec.766.59 Wis.Stats.,or court decree under Sec.766.70 Wis.Stats.,will adversely affect our rights unless we are furnished a copy of the agreement,statement or decree. or we have actual knowledge of its terms,)tt 1QCe credit is granted or the account is Opened.We are required to ask married residents of Wisconsin for the following information: Name of Spouse: Address of Spouse: BEFORE SIGNING BELOW, I (WEI HAVE READ THE DISCLOSURES THAT APPEAR ON THIS APPUCATION AND THE KAY JEWELERS RETAIL YISTAIURENT(EDIT AGRWI BIT, THE TEIIMS Of WHICH ARE INCORPORAIM BY REFERENCE IN AND MADE A PART OF THIS APP , I AND 1 HAVE RECEIVED A. ?OPT OFf?NAT AGREEiJIBIi"...° Yy Applicant:X �{ Date:s/g Joint Applicant:X Credit line:' ('--' Account Number. 31 0l 35L17 9 0300.135.0000(R:OB/05) 680891 COIV PIONWEALTH OF PENNSYLVANIA COURT OF COMMON PLEAS NOTICE OF APPEAL Judicial District, County Of( __Af-Y QQf FROM MAGISTERIAL DISTRICT JUDGE JUDGMENT COMMON PLEAS No. ) 3- 1 O 37 '(ut NOTICE OF APPEAL Notice is given that the appellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the Magisterial District Judge on the date and in the case referenced below. NAME OF APPELLANT ' MAG.DIST.NO. NAME OF MDJ ADDRESS OF APPL.L.,-,NT CITY STATE ZIP CODE DATE OF JUDGMENT • • 'an, ae:n.an CO\ _ f( •23 1K_Q 1U, OLAc_r DOCKET No. SIGNATURE OF APPELLANT OR TORNEY OR AGENT 0:11—DD Yj7-1 C12-0 \f/ `U c• ` ill ut,1.,1,t, This block will be signed ONLY when this notation is required under Pa. If appellant was Claimant (see Pa. R.C.P.D.J. No. 1001(6) in action R.C.P.D.J. No. 1008B. This Notice of Appeal, when received by the Magisterial District Judge, will before a Magisterial District Judge, A COMPLAINT MUST BE FILED operate as a SUPERSEDEAS to the judgment for possession in this case. within twenty (20)days after filing the NOTICE of APPEAL. Signature of Prothonotary or Deputy PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE (This section of form to be used ONLY when appellant was DEFENDANT(see Pa.R.C.P.D.J. No. 1001(7)in action before Magisterial District Judge. IF NOT USED,detach from copy of notice of appeal to be served upon appellee. PRAECIPE: To Prothonotary Enter rule upon\ 9f. \ . , ( appellee(s),to file a complaint in this appeal Name of appellee(s) (Common Pleas No. % •l.![ 0 )within twenty(20)days after service of rule or suffer entry of judgment of non pros. \f.,04) Signature of appellant or attorney or agent RULE: To° x1',fl-, >Qt� ,appellee(s) Name oFappei ee(s) (1) You are notified that a rule is hereby entered upon you to file a complaint in this appeal within twenty(20)days after the date of service of this rule upon you by personal service or by certified or registered mail. (2) If you do not file a complaint within this time,a JUDGMENT OF NON PROS MAY BE ENTERED AGAINST YOU. (3) The date of service of this rule if service was by mail is the date of the mailin . te Date: )1_118.2013 .01\1:/\:111`S- 2',"106, (i -t f Signature of Prothonotary or Deputy YOU MUST INCLUDE A COPY.OF_.Th-IE NOTICE OF JUDGMENT/TRANSCRIPT FORM WITH THIS NOTICE OF APPEAL. AOPC 312-05 COMMONWEALTH OF PENNSYLVANIA ' , . Notice of Judgment/Transcript Civil R(4,COUNTY OF CUMBERLAND t; ai�` Case Mag. Dist. No: MDJ-09-1-01 Sterling Jewelers A Delaware Corp. DBA Kay MDJ Name: Honorable Charles A. Clement Jr. Jewelers Address: 920 Linda Lane V. Camp Hill, PA 17011 Kelly S Duck Telephone: 717-737-3434 Kelly S Duck Docket No: MJ-09101-CV-0000339-2013 1178 Kingsley Rd Case Filed: 9/9/2013 Camp Hill, PA 17011 Disposition Summary (cc-Cross Complaint) Docket No Plaintiff Defendant Disposition Disposition Date MJ-09101-CV-0000339-2013 Sterling Jewelers A Delaware Kelly S Duck Default Judgment for Plaintiff 10/25/2013 Corp.DBA Kay Jewelers Judgment Summary • Participant Joint/Several Liability Individual Liability Amount Kelly S Duck $0.00 $3,313.32 $3,313.32 Sterling Jewelers A Delaware Corp. DBA Kay $0.00 $0.00 $0.00 Jewelers • Judgment Finding (*Post Judgment) In the matter of Sterling Jewelers A Delaware Corp. DBA Kay Jewelers vs. Kelly S Duck on MJ-09101-CV-0000339-2013, on 10/25/2013 the judgment was awarded as follows: Judgment Component Joint/Several Liability Individual Liability Deposit Applied Amount Civil Judgment $0.00 $3,196.96 $3,196.96 • Costs $0.00 $116.36 $116.36 Grand Total: $3,313.32 ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENT BY FILING A NOTICE OF APPEAL WITH THE PROTHONOTARY/CLERK OF COURT OF COMMON PLEAS, CIVIL DIVISION. YOU MUST INCLUDE A COPY OF THIS NOTICE OF JUDGMENT/TRANSCRIPT FORM WITH YOUR NOTICE OF APPEAL. EXCEPT AS OTHERWISE PROVIDED IN THE RULES OF CIVIL PROCEDURE FOR MAGISTERIAL DISTRICT JUDGES,IF THE JUDGMENT HOLDER ELECTS TO ENTER THE JUDGMENT IN THE COURT OF COMMON PLEAS, ALL FURTHER PROCESS MUST COME FROM THE COURT OF COMMON PLEAS AND NO FURTHER PROCESS MAY BE ISSUED BY THE MAGISTERIAL DISTRICT JUDGE. UNLESS THE JUDGMENT IS ENTERED IN THE COURT OF COMMON PLEAS, ANYONE INTERESTED IN THE JUDGMENT MAY FILE A REQUEST FOR ENTRY OF SATISFACTION WITH THE MAGISTERIAL DISTRICT JUDGE IF THE JUDGMENT DEBTOR PAYS IN FULL,SETTLES, OR OTHERWISE COMPLIES WITH THE JUDGMENT. eit\ft,A et.. Ofh Date Magisterial District Judge Charles A.Clement Jr. 4 I certify that this is a true and correct copy of the record of the proceedings containing the judgment. Date Magisterial District Judge MDJS 315 Page 1 of 2 • Printed: 10/28/2013 8:55:39AM Sterling Jewelers A Delaware Corp. DBA Kay Docket No.: MJ-09101-CV-0000339-2013 Jewelers v. Kelly S Duck Participant List Plaintiff(s) Sterling Jewelers A Delaware Corp. DBA Kay Jewelers 375 Ghent Road Akron, OH 44333 Defendant(s) Kelly S.Duck Camp Hill, PA 17011 Complainant's Attorney(s) Attorney Michael F. Ratchford, Esq. Edwin A.Abrahamsen&Associates, PC 120 North Keyser Ave Scranton, PA 18504 _.;_:,.:r..: ,. _ MDJS 315 Page 2 of 2 Printed: 10/28/2013 8:55:39AM IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Sterling Jewelers Inc. a Delaware • corporation DBA KAY JEWELERS : CIVIL ACTION 375 Ghent Road Akron, Ohio 44333 • Plaintiff : • vs. : NO: 13-6837 CIVIL KELLY S DUCK 1178 KINGSLEY RD • CAMP HILL PA 17011 • Defendant : NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice to Defend are served, by entering a written appearance personally or by an attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the plaintiff You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ON AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT REDUCED FEE OR NO FEE. MIDPENN LEGAL SERVICES 401 EAST LOUTHER STREET CARLISLE, PA 17013 717-243-9400 AK13008 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA 110:11-2.14'?" Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS : CIVIL ACTION 375 Ghent Road Akron, Ohio 44333 • Plaintiff : vs. : NO: 13-6837 CIVIL KELLY S DUCK • 1178 KINGSLEY RD CAMP HILL PA 17011 • • Defendant : - COMPLAINT Plaintiff', Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS, by and through its attorneys, Edwin A. Abrahamsen& Associates, P.C., complains of the Defendant as follows: 1. Plaintiff', Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS, (hereinafter "Plaintiff') is a corporation with a principal place of business located at 375 Ghent Road Akron, Ohio 44333. 2. The Defendant KELLY S DUCK(hereinafter "Defendant") is an adult individual residing at 1178 KINGSLEY RD CAMP HILL PA 17011. 3. Defendant applied for and received a credit card issued by Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS with the account number ending in 6519. 4. Use of the Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS credit card was subject to the terms and considerations of the Cardmember Agreement(hereinafter "Agreement"), a copy of which was sent to the Defendant along with the credit card. 5. Defendant used the Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS credit card account number ending in 0777, for purchases, cash advances and/or balance transfers. • 6. The Defendant defaulted under the terms of the Agreement by failing and refusing to make monthly payments on the account as they became due. 7. The Defendant last made payment on January 15, 2012. 8. The total amount due and owing the Plaintiff, including interest, is $3,196.96. WHEREFORE, Plaintiff requests judgment in its favor and against Defendant in the amount of$3,196.96 plus costs of suit and any other relief as the Court deems just and appropriate. Respectfully submitted, //0/�' i / M cha l r. Ratchfor•, Esquire' Attorney I.D. Nos: :6285 120 N. Keyser A e Scranton, PA 1 ,' 04 mratchford@eaa-law.com Phone: 800-503-1665 Fax: 570-558-5511 • VERIFICATION I, Michael F. Ratchford, attorney for Plaintiff, Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS, am fully familiar with the facts set forth in the within Complaint and am authorized to make this Verification on behalf of Plaintiff. I Verify that the facts set forth in the within allegations are true and correct to the best of my knowledge,knowing that any false statements are punishable by law pursuant to 18 C.S.A. 4904. /J 1' a /. do \. Michael F. Ratchford, quire IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Sterling Jewelers Inc. a Delaware corporation DBA KAY JEWELERS, CIVIL DIVISION Plaintiff : vs. • : NO: 13-6837 CIVIL KELLY S DUCK, Defendant CERTIFICATE OF SERVICE I, Michael F. Ratchford, Esquire, hereby certify that I caused a true and correct copy of Plaintiff's Complaint was served via first class United States Mail, postage prepaid on the date set forth below upon the following: Robert D. Klingensmith, Esq. 209 West Patriot Street Somerset PA 15501 Edwin A. Abrahamsen&Associates, P.C. Date: November 25, 2013 ichael '. Ratchford, Es uire Attorney I.D. Nos.: 862:5 120 N Keyser Avenue Scranton, PA 18504 (570) 558-5510 Page 1 of2 2714000006 y- New Balance $2,628.32 -- ' Balance Payable To Avoid Further Interest Charges $2,628.32 E \N E. _. E I S Minimum Payment $150.00 EvOry kiss bagino `Jvi.., Kay,' : ::st Due $045.00 ) Total Due $1,005.00 Kdyr.L,(_?Ii3 P. N 7r. J dVFi18i1fD!tsL,nl6 il;,'!": /.3t2 Customer Name Kelly S Duck Late Payment Warning:If we do not receive your minimum payment Account# 3101356519 by the payment due date listed above,you may have to pay a late fee of up to$35.00. Questions?-Visit us at kay.com Minimum Payment Warning: If you make only the minimum Please send billing inquiries and correspondence to: payment each period,you will pay more in interest and it will take you (do not send payments to this address) longer to pay off your balance.For example: • P.O. Box 3680 Akron,OH 44309 e $2,582.77 :`';:sc #tt#>>:«><:»:•>: :<;<:>:>:::;::;::<:<>:;.>::>:;:_»>:: n:;::;;:.;::: Previous Balanc ;•:;;; Payments $0.00 Other Credits s�<; >>;,<�::y:::::::::::::::::.„>:;;:::::.;,::;,;.;:.>::;,.,::•;:;::.:.:::.::,,.�::.........::::............. Purchases and Other Charges $0.00 Fees Charged $0.00 Only the minimum" 22 MONTHS $3,219.31 Interest Charged $45.55 payment New Balance $2,628.32 If you would like information about credit counseling services,call Statement dosing date 08/22/2012 1-866-477-6322 Days in billing cycle 31 -.Your Transactions ' Trans Date 1 Post Date .1 Description Amount 08/22/2012 08/23/2012 Interest Charges $45.55 TOTAL INTEREST FOR THIS PERIOD $45.55 Total fees charged in 2012 $197.66 Total interest charged in 2012 $404.29 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT ?i`i:ixX74 x3C80.1:i:i New.Balance......•.•_____,••.,.. $2,628.32:•: 271431013565190010950000150002628321 ''cZ:tie:;l%t�:�S:�:�:�:�:�`3`:'?•`:�:�:':�:�:� ::�:':::::':>:`•?:•;::;.,...<.....z..�:{•�.... Total Due $1.095.00 Please make your check payable to KAY JEWELERS " -` •' , Payment mailing address is for remAlance only E W E 000006 #BWNCKTF KAY JEWELERS # 1301081325635195 it Kelly S Duck P.O.Box 740425 209 West Patriot St Cincinnati OH 45274-0425 Somerset PA 15501-1563 To review important notices.click here Address or Employment Payment Mailing Address: Change? Check Box and P.0 Box 740425 complete Reverse Slde Cincinnati,0H4 5274-0425 Page 2 of 2 2714000006 9nterestCharge Calculation• Your Annual Percentage Rate(APR)is the annual interest rate on your account. Your Monthly Periodic Rate(MPR)is the monthly interest rate on your account. <:�Ji?e;:cfl:;$;�dnre ... .::.. �tn+t�t p��ces?#��: te{A1'.ftj.::::::::i�#nth3y{'!e�n4��.:;:.;:�.ef�.::.:,�.......�o.;=nt�rest.3�at� ::. .::::::::::•:.::::::::.:::�::.:::::::. Purchases: Regular 24.99% 24.99% 2.0825% $1,980.02 $41.23 Regular 22.9% 22.90% 1.9083% $226.68 $4.32 Messages: You may pay by phone to receive immediate credit to your account at 1-800-877-3616. To take advantage of the pay by phone option,your complete account number and the last 4 digits of your social security number will be required. By providing this information to us, you are authenticating your authorization to an immediate withdrawal from your deposit account. You will have the option to cancel the payment prior to completing the transaction. To review irroortent notices.click here Page i of 2 _ 2714000006 e \ :` ?::<r: ;:; '>;, s.;.:::i ,>;::A y .. \\ New Balance:;:: $2,582.77 --- '� Balance Payable To Avoid Further Interest Charges $2,582.77 J =- i E. L R S Minimum Payment $150.00 Every kiss begins iA,,., ric3L r'iM Dl... x:795.00 3 To;;l Due $9.5.00 Kay.L or l Payment Due tats 0E+172012 Customer Name Kelly S Duck Late Payment Warning:If we do not receive your minimum payment Account# 3101356519 by the payment due date listed above,you may have to pay a late fee of up to$35.00. Questions?-Visit us at kay.com Minimum Payment Warning:If you make only the minimum Please send billing inquiries and correspondence to: payment each period,you will pay more in interest and it will take you (do not send payments to this address) longer to pay off your balance.For example: P.O. Box 3680 Akron,OH 44309 ,�i'.11iT1Fi#�. .o€.,�ccc►�trit:.�ctlial. ;< I I. r Previous Balance $ 2 7.22 ,53 Payments $0.00 r ' Othe r Credits $0.00 0 Purchases and Other Charges $0.00 Fees Charged $0.00 Only the minimum 21 MONTHS $3,149.09 Interest Charged $45.55 payment New Balance $2,582.77 If you would like information about credit counseling services,call Statement closing date 07/22/2012 1-866-477-6322 Days in billing cycle • 30 Your Transactions . siiiiii>1tit2r Trans Date I Post Date I Description Amount 07/22/2012 07/23/2012 Interest Charges $45.55 TOTAL INTEREST FOR THIS PERIOD $45.55 cr 1s: ear:Tc.-Sate>::: :::>::::>::::::::;> ::'>:s>:»:::: Total fees charged in 2012 $197.66 Total interest charged in 2012 $358.74 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT :ACFOf3: i?'Fii?iY22? k?3'i"£iYc [:i XX�.i47(X� 1i.9,.i'£i New Balance 2714 31013 5 6 519 0 0 0 9 4 5 0 00 015 0 0 0 2 5 8 2 7 7 9 Total t\i.G $:'.445.00 Please make your check payable to KAY JEWELERS K Payment mailing address is for remtltance only 000006 W Ei E. #BWNCKTF KAY JEWELERS # 1301071325635196 # P.O.Box 740425 Kelly S Duck 209 West Patriot St Cincinnati OH 45274-0425 To review important notices,click here Somerset PA 15501-1563 Address or Employment Payment Mailing Address: Change? Check Box and P.O.Box 740425 complete Reverse Side Cincinnati,OH 4 5274-0425 i Page 2 of 2 2714000006 7'..'iiit'a ie.Cl arge`'CareCtiitiOta Your Annual Percentage Rate(APR)is the annual interest rate on your account. Your Monthly Periodic Rate(MPR)is the monthly interest rate on your account. �Pg.:�', ...:�.................................:.......::..�::...::::f:.::::::�.::::::::.�:.::.:::Y.::::::.::::::.::..::.......:................3alnt�resi.ttat�......::.............:......::.....:::::..:::....:::::: Purchases: Regular 24.99% 24.99% 2.0825% $1,980.02 $41.23 Regular 22.9% 22.90% 1.9083% $226.68 $4.32 Messages: You may pay by phone to receive immediate credit to your account at 1-800-877-3616. To take advantage of the pay by phone option,your complete account number and the last 4 digits of your social security number will be required. By providing this information to us, • you are authenticating your authorization to an immediate withdrawal from your deposit account. You will have the option to cancel the payment prior to completing the transaction. To review important notices.click here Pagel of 2 2714000005 K44 New Balance $2,537.22 Balance Payable To Avoid Further Interest Charges $2,537.22 17.kfvf E L. E. R Minimum Payment $150.00 Evory.kiss begins ‘ivith Kay,' 'Dt;f5 $645.00 To;.81 Due kay.c om Payment Due Dsts a7i7i2o12 Customer Name Kelly S Duck Late Payment Warning:If we do not receive your minimum payment Acc by the payment due date listed above,you may have to pay a late ount# 3101356519 fee of up to$35.00. Questions?-Visit us at kay.com Minimum Payment Warning:If you make only the minimum Please send billing inquiries and correspondence to: payment each period,you will pay more in interest and it will take you (do not send payments to this address) longer to pay off your balance.For example: P.O. Box 3680 Akron,OH 44309 ...........................,.......... Aummitiaw Previous Balance $2,491.67 This statement in Payments $0.00 Other Credits $0.00 ............................................................................................................„. Purchases and Other Charges $0.00 Fees Charged $0.00 Only the minimum 21 MONTHS $3,080.28 Interest Charged $45.55 payment New Balance $2,537.22 If you would like information about credit counseling services,call Statement dosing date 06/22/2012 1-866-477-6322 Days in billing cycle 31 Your Transactioni - . • , - Trans Date I Post Date I Description I Amount 06/22/2012 06/23/2012 Interest Charges $45.55 TOTAL INTEREST FOR THIS PERIOD $45.55 Total fees charged in 2012 $197.66 Total interest charged in 2012 $313.19 NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION PLEASE DETACH AND RETURN THIS PORTION WITH YOUR PAYMENT New Balance $2,537.22 271431013565190007950000150002537220 Total Dix '4.3795.00 Please make your check payable to KAY JEWELERS K A Y. Payment maHo add ens is for renitiance only 000005 #BWNCKTF KAY JEWELERS # 1301061325635197 # Kelly S Duck P.O.Box 740425 209 West Patriot St Cincinnati OH 45274-0425 Somerset PA 15501-1563 To review imuortant notices.click here Address or Employment Payment Mailing Address: Change? Check Box and P.O.Box 740425 complete Reverse Side Cincinnati:OH 45274-0425 Page 2 of 2 2714000005 :,Interest Charge Calculation , Your Annual Percentage Rate(APR)is the annual interest rate on your account. Your Monthly Periodic Rate(MPR)is the monthly interest rate on your account. t��afa.L"8...............�r?ltu�t.Per..$I31a '': '::>::::»» �:.:,: ..:�.:.:.;.,:�""` :>:::::<?:::.;:;:::>�::;::<:>::>�::.;:.:::.;::>::;>:::::;':<::::::»>;•:...::::.::}:...:.::::.«<:>::>: :::3r#?.::::::.::::.:.::::::•::•:::::::::.::::::::::::::::::::::::.:::.:t-?�.a�a��(A±fE�1.::::::::fi9#ntf?11y;�ed?C:::�te(3V13'�}..�.::::... ::::::::::::::.::.#?�te��t.G3xarr .:::::::: ......xa•irst�xest.3tai:e::::•:::::.::::::::::::::::.:............9�.:.::::: Purchases::.�................................................................................................................................................................................................................................. Regular 24.99% 24.99% 2.0825% $1,980.02 $41.23 Regular 22.9% 22.90% 1.9083% $226.68 $4.32 Messages: You may pay by phone to receive immediate credit to your account at 1-800-877-3616. To take advantage of the pay by phone option,your complete account number and the last 4 digits of your social security number will be required. By providing this information to us, you are authenticating your authorization to an immediate withdrawal from your deposit account. You will have the option to cancel the payment prior to completing the transaction. To review important notices.click here • KAY JEWELERS #2714 SILVER SPRINGS SQUARE • 6415 Carlisle Pike, STE 3100 MECHANICSBURG, PA 170500000 Date: 0610212011 Time: 10:42:4 - Sales Slip IQ: 20163 Cardholder: DUCK. KE Account No: f f,0510 Purchase Price: $58.28 Down Payment: $0.00 Credit Plan: REG YOU MAY RETURN YOUR PURCHASE WITHIN SD DAYS OR EXCHANGE WITHIN 300 DAYS.WATCHES CAN BE EXCHANGED OR RETURNED WITHIN 30 DAYS,MUST BE UNWORNAND UNALTERED WITH ORIGINAL PACKAGING, INSTRUCTION,.AND WARRANTY DOCUMENTS. CUSTOM DESIGNED JEWELRYAND SPECIAL ORDERED WATCHES CANNOT BE RETURNED OR EXCHANGED. Total: $58.28 Cardholder agrees to .pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail Installment Charge Agreement, the terms of which are incorporated by reference. ! r1 r rf Y KAY JEWELERS #277 CAPITAL CITY MALL 0530 CAPITAL CITY MALL DR#40 CAMP HILL, PA 170110000 Da#e 1 011 41201 1 Time: 12:17:35 Sales Slip ID: 31660 Cardholder:: DUCK KE ,Account Ho: B519 Purchase Price: $323.27 Down Payment: $0.00 Credit Plan: PEG - YOU MAY RETURN YOUR PURCHASE WITHIN 60 DAYS OR EXCHANGE IT WITH IN 90 DAYS OF PURCHASE.YVATCHES MAYBE EXCHANGED OR RETURNED WITHIN3E DAYS PRO /IDED THEYARE IN ORIGINAL CONDITION(UNWORN AND UNALTERED)AND ACCOMPANIED BYTHE ORIGINAL PACKAGING, INSTRUCTIONSA.ND WARRANTYDOCUMENTS. CUSTOM DESIGNED MERCHANDISE,CLASS RINGS, SPECIA:LORDEREDW ATCHESr".ND ITEMS ENGRAVED WITH PERSONALIZED INFORMATION CANNOT BE RETURNED OR EXCHANGED. Total: $323.27 Cardholder agrees to ,pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail Installment Charge Agreement, the terms of which are incorporated by reference. 117-619 . • KAY JEWELERS #1 l 0!31 Point at Carlisle Plaza 800 E High St STE 426 CARLISLE, PA 170130000 Date: 12/13120111 Time: 14:47:19 Sales Slip ID: 89251 Cardholder: DUCK. K.E Account No: `X X 0510 Purchase Price: $237.12 Down Payment: $0.00 Credit Plan: REG YOU MAY RETURN YOUR PURCHASE WITHIN 60 DAYS OR EXCHANGE IT WITH IN 90 DAYS OF PURCHASE.WATCHES MAYBE EXCHANGED OR RETURNED WITHIN30 DAYS PROVIDED THEYARE IN ORIGINAL CONDITION(UNWORN AND UNALTERED)AND ACCOMPANIED BYTHE ORIGINAL PACKAGING,INSTRUCTIONS/ND WARRANTYDOCUMENTS. CUSTOM DESIGNED MERCHANDISE,CLASS RINGS, SPECIPLORDEREDWATCHESAND ITEMS ENGRAVED WITH PERSONALIZED INFORMATION CANNOT BE RETURNED OR EXCHANGED. Total: $237.12 Cardholder agrees to .pays the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail Installment Charge Agreement, the terms of which are incorporated by reference. eeas77, KAY'' JEWELERS #1091 Point at Carlisle Plaza 800 E High St STE 426 CARLISLE, PA 170130000 Date: 1 211 31201 1 Time: 14:49:49 Sales Slip ID: 89253 Cardholder: DUCK KE Account No: r,;:K `,XFj 510 Purchase Price: $27.54 Down Payment: $0.00 Credit Plan: PEG . YOU MAY RETIJRN YOUR PURCHASE WITHIN 60 DAYS OR EXCHANGE ITWITHIN90 DAYS OF PURCHASE.WATCHES MAYBE EXCHANGED OR RETURNED WITHIN30 DAYS PROVIDEDTHEYARE IN ORIGINAL CONDITION(UNWORN AND UNALTERED)AND ACCOMPANIED BYTHE ORIGINAL PACKAGING, INSTRUCTIONSAND WARRANTYDOCUMENTS. CUSTOM DESIGNED MERCHANDISE,CLASS RINGS, SPECIALORDEREDWATCHES ND ITEMS ENGRAVED WITH PERSONALIZED INFORMATION CANNOT BE RETURNED OR EXCHANGED. Total: $27.54 Cardholder agrees to.pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail Installment Charge Agreement, the terms of which are incorporated by reference. 2-,&1"." aro' " -111111 CUSTOMER TELEPHONE NO ADDRESS ns'nuW+aUC SOURCE CODE Y N • CITY STATE LP y• MEMBER OF ICAWL aAAADr+DCoJI L of AMUKA SALESPERSON NO G A S H CHt EAC.WD MfAIMY RCTJ N RFV DVIA J E W E L E R S Jv I La won kaY.kay.com SKU NUMBER DISC. _ SOLD FOR I I L 1 I I 11 I I THANK Y O U 1 1 1 1 1 1 I I 12/11/09 11 :17 11 I 1 1 1 I I 27 14 1 3869 010207 • • 1 1 1 1 1 1 1 1 Customer Name: KELLY S TRUCK 1 1 1 1 1 1 I l L°Dpt Sku Dsc Ret�S/I 1 11 1 1 J 1 1 1 I 1 Guarantee -4896 ee13 100.00 32.00 DIAMOND 5A 1 I 1 I I 1 4 391 711ADV 149.00 71.99 PAYMENT PROTECTION PLAN 14K2 EARRINGS BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE, I ACKNOWLEDGE THAI.I DO NOT 1 11 900149408 ADV 80.00 19.99 NEED TO PURCHASE THIS INSURANCE TO GET CREDIT AND I CAN GET SIMILAR COVERAGE.INCLUDING Guarantee #5503-4904 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES SV CR WHITE SA PENDANT CREDIT LIFE,DISABILITY,INVOLUNTARY UNEMPLOYMENT,PROPERTY.JOB RETRAINING AND LEAVE OF ABSENCE TO THE EXTENT AVAILABLE IN MY STATE AS DESCRIBED IN THE SUMMARY OF INSURANCE 0.00NT 123.921 SUBTOT 123.98 COVERAGES•-I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF SALES TAX 6.0?' 7.44 INSURANCE COVERAGES•. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE TOTAL 131.42 AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. TOTAL DOT 1 PAYMENT 0.00 'PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON IHE REVERSE SIDE. KXXXXXX6S19 REG CREDIT FLAN 131.42 YES.PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE SLSPRSN 114709 TAX TYRE 1 STANDARD DATE OF BIRTH DATE YOU HAY RETURN YOUR PURCHASE WWITHIN 60 SIGNATURE /— 1- —/-1— DAYS OR EXC,WINCE WITHIN 90 DAYS. WATCHES ND.DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE CAN BE EXCHANGED OR RETURNED WITHIN 30 DATE DAYS, POST BE UWACRN AND UNALTERED WITH SIGNATURE �J—f_ ORIGINAL PACKAGING, INSTRUCTION, AND N1990-0299 NonStU ID f19 WARRANTY DOCLHENTS. CUSTOM DESIGNED AUTHORIZATION CODES JEWELRY AND SPECIAL ORDERED MATCHES SECURITY AGREEMENT CANNOT BE ROWED OR EXDWEED. BJYIR AGRIIS T. R TM RE IS AN AMOUNT C■tAFIGED TO AAY•JI WEI FRS REVOLVING CHARGE SHOWN ABOVE T. SELLER HEREBY RETAINS A SECURITY INTEREST IN THE GOODS DESCRIBED ABOVE(Mr PI IN CI.MO(ON ANY PURCHASE UNDER$1501 AND NY ION ANY TTURCHASE UNOER 520011 UNTN IHE UHFAIO BALANCE OE SUCH GOODS IS TUI1Y PAD AND IT S LYPRESSLY AGREED AND UNDERSTOOD THAT.IN THE EVENT OE DEFAULT,SELLER SHALL BI ENTITLED 10 POSSESSION OF TnE G0005 ANDOR THE(MIRE UNPAID BALANCE SHALL BECOME DUI Ammo PATABt E IN THE MANNER MD TO THE FYTrmL PERMUTED BY APPLICABLE LAW. 2 INADDI'ION T-E fERMT OF THE KAY•JFWEI IRS RI TAIL∎NSIALLMLNT CREDITAGRIEMENT SIGNED BY BuYLR PREVIOUSLY SHALL ALSO GOVERN THIS PURCHASE AHD ALL IHE TERMS AND CONDITIONS Of THAT AGREEMENT ARE INCORPORATED IN MAO SIW L BD A PART Of CMS SECURITY AGREEMLNT KAY'JEWELERS PO BOX 3680,AKRON.OHIO 44398.9914 ♦_/ / /2.11 A /1y. /07 BU 0 E CO-BUYER DATE ICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION ORIGINAL ORIGINAL ORIGINAL SALES SUP DATE SALESPERSON REASON MANAGER FOR RETURN SIGNATURE CUSTOMER SIGNATURE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 0SL09 SEE BACK FOR REFUND INFORMATION. GUS,IJMLR TELEPHONE NO. ' ADDRESS n431'AUP00,L SOURCE.CODE Y N c17Y STATE JP D COUACEIL �� MEMBER EMAIL J E W E L E R S SALESPERSON NO GAS- C%-FLA B.N.G.10 LAT./MY aCTI RN Ca-n; Every tii39DEyL Ern S *-�--• - kay.com ESP------- --- ----SKU-NUMBER-.:'.--__-_ ___ _-'-DISC.__- _-SOLD TOR -- IIIIIIII I I I I I I I 1 / THANK Y © U 1 1 1 1 1 1 1 f 03/25/10 20=01 11 I I I 1 I 2714 1 7344 013301 1 I I 1 1 1 I LCustomer Efts CH SES/RETURNS 1 I I 1 1 I 1 I I Opt 2 132441509 AD Retail. 91.00 1 1 1 1 1 i l l Guarantee 149404-7 10YG LAB-CREATED RUBY FD PAYMENT PROTECTION PLAN 0.00NT 9I.00T SUI3TOT 91.0 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE.I ACKNOWLEDGE THAI:I DO NOT SALES TAX 6.OZ 5.46 NEED TO PURCHASE 1 HIS INSURANCE TO GET CREDIT AND I CAN GET SIMILAR COVERAGE.INCLUDING TOTAL 96.46 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES TOTAL DOILY FAYI€NT 0.00 CREDIT ABSENCE TO THE DISABILITY. AEXIENT AVAILABLE RIN MY STATE AS I,PROPER TY. JOB REFRAINING SUMMARY OF AND LEAVE OF INSURANCE h.IG00Cdf.6.J19 KG CREDIT FIAT 96..6 COVERAGES'. I READ AND I MEET IHE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF SLSE'REi! 114709 TAX TYPE I STANDARD INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE YOTJ KAY RETURN YOUR PURCHASE t.IITHItW 60 AND THE RATE-SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE I MAY CANCEL ANY TIME DAYS OR EXCHPAGE 'WITHIN 90 DAYS. WATCHIS 'PLEASE SFF THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. CAN BE EXCHANGED OR RETURNED WITHIN 30 YES.PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE DAYS, MUST BE UNWORN AND UNALTERED WITH DATE Of BIRTH DATE ORIGINAL PACKAGING, INSTRUCTION, AND SIGNATURE ._./-1— ____I______L_ 'ARRANT/ [JOJ LENTS. CLSTO1 DESIGNED NO,DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE JCaELRY AND SPECIAL ORDERED WATCHES • DATE CANNOT BE RETURNED OR EXCHANGED. SIGNATURE /,J N1990-0299 NonStd ID#19 AUTHORIZATION CODES SECURITY AGREEMENT BUYER AGREES INA/IF MERE IS AN AMOuNT CHARGED TO KAs".inkrt ITS REVOLV,NO OIARGE SHOWN ABOVE. I. SELLER HEREBY RETAINS A SECURITY INTEREST IA THE GOODS DESCRIBED ABOVE I&CCFPI INCT.MD CON ANY PURCHASE UNDERSI}01 AND NY ION ANY PURCHASE UNDER 520011 MIL ENE UNPAID BALANCE OE SUCH GOODS IS R1tI Y PAID AND IT IS EMPR1-55IY AGREED AND UNDERSTOOD IHAI IN ME nit NT Or DT AULT SIltED WI BF MDR FD TO POSSESSION OE THE GOODS.ANO.OR THE ENTIRE UNPAID BALANCE S•,ALL BECOME DUE AND r'A+ABLE.N IHL LEARNER AND TO THE ETITNT PfRM■TFtO RY APPI!CAM F LAW 2 IN AUDIT ION.ENE TERMS OF THE Or JEWELERS RFIA15 INS IAUJAENI CREDIT AGREEMENT SIGNED BY BUYER PREVIOUSLY SnALL ALSO GOVERN THIS PURCHASE AND All THE TERMS AND CONDITIONS Of THAI AGREIMENI ARE IT ORPORATED IN AND SHALL BE A PART OF THIS SECUR,EY AGR[EMLH r KAY•JEWELERS P BOx 3880. KRON,O 10 44308-9914 P �� T Y SIGNAT • `�A -FDA • CO-BUYER DATE J NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION - ORIGINAL ORE SIAL ORIGINAL SALES SUP DAT5 SALESPERSON REASON MANAGER FOR RETURN SIGNATURE. CUSI OSIER E SIGNATURE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 08109 SEE BACK FOR REFUND INFORMATION. OUST(MLR TELEPHONE NO. , ADDRESS mm.I..Apc.AAsE SOURCE COL* Y N _ PITY STATE :P • MEMBER Or KAY' a EMAIL pAmoN ,t -- J E W E L E R S SALESPERSON NO. Cllr cum, RUIIeO IF RITrW HEN,c . ' - Evert/kris ygins with Kew' - •- - lb.D.•-•N••■. kay.corn ESP+ r- wW`- SKU NUMBERA fxe a u iDISC . . �v`� 'r-`SDLDFDA'1"; ,s. L I I I I T H A N K Y a U 1 I I 1 1 11 I 04/77 1/10 87 15.•4 1 I I 1 E I I I 0 Jt 86 ©Y�4s , • ! t I 1 1 1 i I ' stoner Na-..e: KE LY s DUCK /T•,�' 1 1 1 1 I I I I 0 N PURCHASES/'1{LTUMS L Dpt Sku I� Retail. Sold L 1 I I I I 1 1 3 281611602 AN 265.00 185.50 CITIZEN WATCH 1 1 1 1 _1 1 1 1 2 372716908 Arru 129.00 109065 PAYMENT PROTECTION PLAN - SV AMETHYST FENTh t BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE,I ACKNOWLEDGE THAI:I DO NOT O'00NT 295.15T 5U8T0T 295.15 NEED TO PURCHASE THIS INSURANCE TO GET CREDIT AND I CAN GP SIMILAR COVERAGE.INCLUDING SALES TAu 6.0X 17.71 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES TOTAL 312.06 CREDIT LIFE,DISABILITY,INVOLUNTARY UNEMPLOYMENT,PROPERTY,JOB RETRAINING AND LEAVE OF TOTAL DOWN F'AlMNI O.GO ABSENCE TO THE FXTENJ AVAILABLE IN MY STATE AS DESCRIBED IN THE SUMMARY OF INSURANCE 17L7C0(X3{6SI9 FAG CREDIT Pt-AM 312.04' COVERAGES•. I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN 1HE SUMMARY OF INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNI BALANCE I+ " N 941815 TAX TYPE 1 STANDARD AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. 'Ol7 MAY RETURN YOUR PURCHASE WITHIN 60 'PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. ;AYS OR EXCHANGE WITHIN 90 DAYS. WITCHES YES,PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE 'A EE EXCHANGED OR RETUNED WITHIN 30 DATE OF BIRTH DALE LAYS, MUST BE UNUIRU AND UNALTEFJD WITH SIGNATURE _ _ / /� _ /____/____ IRIGIHAL PACKAGING, INSTRUCTION, AND NO,DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE )ARRANT] DOCU1€NTS. CUSTOM DESIGNED -• DATE Ek'Q-RY AND SFECIEI` ORDERED UATCIS SIGNATURE - ,/_ / _ *NOT DE RETRIED OR UCNANGED. N1990-0299 NonS)dID 119 AUTHORIZATION CODES tatural geastawes may have basn treated or en- SECURITYAGREEMENT arl(ed by heating (Generally'), oiling {eoeralds) At,TEPAGRFIS THAT Tr,HE.r)SAN AUOIINTCHARGED JD Or'JIM)IRS RrlTI VONG CJAIRG!•SHCWNADOVF: Jr irradiating (blue topaz). Treater] emeralds 1. SR I FR HERE BY RETANS A 5TCIJAIY M 1EHTST IN MI GOODS MSLRIBT0 ABOVE It'CEP11N CE MO ION ANT PURCHASE uNDTR 51501 1 440 NY ION ANY'UPCHASC CINDER S%00 1I UNTIL THE UHPHO BALANCE OF S,./C^GOODS 15 rut I T APO ANo 11 I$TAPRESSI Y AGREED AHD equire special care in cleaning and repair. It UNDLR$1COD'-5T IN RIL FVINI OFCEUUII SLIER S•1A:L BE ENT TLED IC VSSESSDR 71.'-F COCAS.AYD{1R PC MIDI-ANPAR, HALANCE SHALL BECOME DUE AND PAYABLE IN UHT MANNED AND TO THE EOM I VERMITT[D BY APPLICARC LAW S our policy not to sell or trade 14 gemstones 2. INADDIT,0N.THETEAMSOFIHEMY`JEWFLC RSRETAIL INSTALLMENTCRED,IAGRLEMENTSIGNEDNYBUYFRPRLVIOUSII'S"ALL AI SD hat have been treated with diffusion or vapor GOVERN THIS PURCHASE AND A:I Pt FE.9MS ANC CONDITIONS OF NAT AGREEMINT ARC INCOR.DRATED IN AND SO:I BO A PART Of 1'•15 SECIJAITY AGREEMENT. leposition enhancements. KAY'JEWELERS / PO.BOX 3680.A RO OHIO 44398-9914 k_...1'''''/4 Jas .460 .&/2C:r0 BU ERIE IGNA •E'er t-TE CO-BUYER DATE / •OTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION • t'viE ,fief ,-0,;:,;t`ii•„o': ?iRETURN,INFORMATION ,, •?a 0 ° 5 ' 1~: . ORIGINAL GQIGIMAL OR,G.NAL SA■ES SLIP GATE SALESPERSON REASON MANAGER FOR RETURN SIGNATURE i CUSTOMER SIGNATURE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. GUS IOME,. TELEPHONE NO ADDRESS HRS`.LPc•ma SOURCE CODE Y N CT' STATE Z P • MEND C O »J F Ic A Y EMAIL dANL)CA SALESPERSON NO CASH CnG. W.G A D IAA.., r¢11144 R N.CHU J E W E L E R S Every•l)3bevels r.lA Kay! kay,com ESP— SKU NUMBER -_ _-_. ---- --DISC.- --- -----SOLD TOR__ - IIIIIIII I I I I I I I T H A N K Y O U 07/26/10 15:39 11 I I. I l l 1 0277 2 2327 013566 l 1 1 1 1 1 1 1 ;Lamer Nz e: KELLY S DUCK 1 1 1 I. 1 1 I I _ - .0 PURCHASES/RETURNS 1 Ipt S u Dsc Retail Sold 1 1 1 1 1 1 1 k 2 490917806 AIIV 329.00 - 157.92 1OLC CR OPAL DIA RING 1 1 1 1 1 1 1 - O.00NT 157.921 SUBTOT 157.92 PAYMENT PROTECTION PLAN SALES TAX 6.0X 9.48 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE,I ACKNOWLEDGE THAT.I DO NOT TOTAL 167.40 NEED TO PURCHASE THIS INSURANCE TO GET CREDI I AND I CAN CET SIMILAR COVERAGE.INCLUDING TOTAL INN PAYMENT 0.00 • PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES #XID(Xc66519 REG CREDIT NAN 167.40 CREDIT LITE.DISABILITY,INVOLUNTARY UNEMPLOYMENT.PROPERTY.JOB RETRAINING AND LEAVE OF is 922224 TAX TYPE 1 sTAKIA n ABSENCE TO THE EXTENT AVAILABLE IN MY STATE AS DESCRIBED IN 1HE SUMMARY OF INSURANCE �� tiAY fti£T1Jt;�t YOUc F'URC1tASE WITHIN 60 COVERAGES'. I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE DAYS OR EXL'H1llE WITHIN 90 DAYS. WATCHES AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. :AN BE EXCHANGED OR RETUNED WITHIN 30 'PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. !AYS. MUST BE UNWORN AND UNALTERED WITH YES.PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE 1FI161UA_ PACKAGING, INSTRUCTION, AND DAIEOFBIRTH DALE iF RARITY DOCUMENTS. CUSTOM DESIGNEI1 • SIGNATURE J J _I 1 TEWELRY AND SPECIAL ORDERED ITCHES NO.DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE .ANA"OT PE RETURNED OR EXCHANGED. DATE SIGNATURE / / latural gmstones may have been treated or en- N1990-0299 NonSEd ID 119 iznced by heating (generally), oiling (emeralds) AUTHORIZATION CODES Tr irradiating (blue topaz). Treated emeralds SECURITY AGREEMENT rei wire special care in cleaning and repair. It BUYER AGREES THAI IT THI RI U AN AMOUNT CHARGE0 10 KAY•JI WLLEAS REVOLVING CHARGE SHOWN ABOVE is our policy not to sell or trade in stories I. SELLER HEREBY RETAINS A SECURITY INTEREST IN THE GOODS DESCRIBED ABOUT(MI PT IN CI.MO ION ANY PURCHASE UUCP f I SD) g__' AND NY ION ANY AUPCHASI UNDER SPOTH UNIT THE UNFAIR BALANCE OF SUCH GOODS IS HILLY PAID AND IT IS ELPAESSLY AGREED AND That have been treated with diffusion or vapor UNDERSTOOD THAT,IN THE EVENT or orrAUtT.SELLER SHALL NI Pill ILED 10 POSSESSION OF+n1 GOODS,ANCOR THE ENTRE UNPAID iap�JSi.tlon enharaCet:Ients. BALANCE SHALL BECOME DUE AND PAYABLE IN THE M AN ANNCR MD TO THE EXTENT P1 RMJTTED BY APPLICABLE LAW IN ADDITION THE TERMS OF THE KA,`JEWELERS RETAIL INSTALLMFIJTCREDIT AGREEMENT SIGNED BY BUYER PREVIOUSLY SHALL ALSO GONE RN THIS PURCHASE AND Al L THE TERMS AND CONDITIONS OF THAI At:REEMINT ARE INCORPORATED III AND SHAT L BE A PARI Of IH S SECURITY AGREEMENT • KAY JEWELERS P.O.BOX 3680.AKRON.OHIO 44398-9914 BUYER'S SIGNATURE DATE CO-BUYER DATE NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION - , - RETURN INFORMATION .• - - oRIGIHAL. ORIGINAL ORIO•NAL SALES SLIP DATE SALESPERSON RE- SONJ MANAGER FOP RETURN SIGNATURE CUSTOMER SIGNATURE • RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. Q$1D9._ , SEE BACK FOR REFUND INFORMATION. • CUSTOMER / 7F LEPNOIJE NQ. AOCKTE:S ntI•uncrita. SOURCE CPOE Y N cm' SIATE ZIP MEMBER GE f( /\ v fJIM O4 [GONER. FATALE of AMERICA _;r_ _ ,1 E W E L E R S SALESPERSON NO GASH GHLL• B.M•CA40 U.+W RETION 4E4 0.0 'ft- :�.;�:-' Eve'Y EIS%beylm wun kBY• w R.�+4 kaV.C.Or ESP a t i.; -.41 'SKu NIJMBERjy A'r TDISC. °�.-` 1 SPLDif-7ALrm I 1 J 1 1 1 1 1 TfriAt4K Y ® L! I 1 1 i 1 i i l 08/21/10 1647 1 1 1 I 1 1 1 1 _ 1188 3 0027 092671 i 1 1 i 'i i i I _ ,tustoner Ha>e: KELLY S DUCK i i 1 Lill l _ ,1° t ,Y Dsc � 5fRET4U7d 1 3 281645402 AIN 315.00 236.25 1 1 1 I I CITIZEN WATCH O.00NT 236.25T SLIBTOT 236.25 i t 1 i i i- I SALES TAX 6.0X 14.18 PAYMENT PROTECTION PLAN TOTAL 250.43 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE I ACKNOWLEDGE 1HAP I DO NOT TOTAL DUN PAYMENT 0.00 NEED TO PURCHASE THIS INSURANCE TO CET CREDIT AND 1 CAN GET SIMILAR COVERAGE,INCLUDING MOCIf.b5i9 REG CREDIT PLAN 250.43 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES CREDIT LIFE.DISABILITY,INVOLUNTARY UNEMPLOYMENT,PROPERTY,J08 REFRAINING AND LEAVE OF S1.$PFSH 176509 TAX TYPE 1 STANDARD ABSENCE ID THE EXTENT AVAILABLE IN MY STATE AS DESCRIBED IN IHE SUMMARY OF INSURANCE YOU KAY RETURN YOUR PURCHASE WITHIN 64 COVERAGES'. I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN IHE SUMMARY OF DAYS DR MANZ WITHIN 90 DAYS. WATCHES INSURANCE COVERAGES'.MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE cm BE EycHAKED DR 1ET D wimp; 30 AND THE RATE SHOWN I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. DAYS, MUST DE MORN AND UNALTERED WITH •PLEASE GEE THE SUMMARY OI INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. ORIGINAL PACKAGING, INSTRUCTION, Aim YES PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE itAY>'RANTY D ANZ. tUSTD14 DESIG�ttD DATE OF BIRTH ) DATE JEWELRY AND SPECIAL ORDEREI} WATCHES SIGNATURE _ —_J—J__ ---1 _/_ CANT BE RETURNED OR EXCIb 1( D. NO.DO NOT ENROLL ME IN PAYMENT PRTJT ECIION PLAN CREDIT INSURANCE DATE SIGNATURE ---J--_1— N1990-0299 NonStd IQ 419 AUTHORIZATION CODES _ • SECURITY AS REEMEN I- HINER AGRTES[NAT IE INERT IS AM AIaOUN1 CHARGED TO KAY'JEWELERS REVOLVING CHARGE SHOWN ABOVE 1. SW ER edPEBv RETAINS A SECURITY INTERESt it nit GOODS DCSGRIS FDABFJVF 1EYCEPI IN CI.lAO(Ok ANY PURCHASE UNQCRS1501 AND N,ION AN,PURO-ASE UNDER S7001i UNTIL IRE API A D BALANCE 01 SuCN GOODS IS WILY PMT AND IT IS CIIPRESSIY AGREED AND UNDIRS1000 NAT IN IHE EVEN(Or DE*AULT Mart SuALL 81 ENT■11.r0 10 POSSESSION OF IHE GOODS ANOAP THE ENHRE IIAPAND RALNNCE SNAIL BECOAl(DUE AND PAYABLE IN ME MANNER PAD JO ENE ME NI PEAk1REe BY APPI VINE LAW 2. IN ADDIS ION^+f TEAMS Or Off LAY`JE WEI CRS RETAIL INS1M WI In CREDIT ADRWAINT.[GNCD ITY BUYER PREVIOUSLY SHALL ALSO OOvLRN THIA PURCHAf AND AU IHE[ERA'S AND CONDI LIONS Or[HAI AGREEMENT ART INCORPORATED 14 AND SHML HE A MART OI THIS SECURITY AGREEMENT. KAY`JEWELERS .gil (', P O. X 3680.AKRON.OHIO 44390.991 A d RS GNATUR• �if/ DAIS - C.0•BLIYER PATE NO 5:SEE REVERSE SIDE FOR IMPORTANT INFORMATION ' 3;.p..t°* J:^, 4,� qNtry.f --`; RETURN INFORMATION . ;, aea fit '? i €:T a ORIGINAL ORIGINAL ORIGINAL SALES SLIP CATE SALESPERSON REASON MANAGER TOR RETURN SIGNATURE CUSTOMER SIGNATURE - _1 -•---•-- lc T.A"r'" a(\T"al I .XCHANGES/REFUNDS. • CUSTOMER TELEPHONE Eq. ADDRESS s.KTPiPcNAM I SOURCE CDOC CITY STATE DP Y N 1 MEMBER OF K /\ Y' EMAIL DLAMiLAMEAKICA :t 4 9. J J E W E L E R S SALESPERSON NO CAECA 1we, LL•Aw4Y RI-Rnt4 RC,/CQ Every kiss bogus w1111 Key" *-tommn12.1201Erk kay.com ESP ° 1 `¢ai e.,xv r cs. KUfdUMBER -.4>= 2 T • D■SC ':iik:- OLOFOR l `I 1 1 1 If 1 II 1 I I THANK Y 43 U 1 1 II 1 10/15/10 14_59 I 11 f I I 1 I 2714 1 2626 016925 1 1 1 1 1 1 1 1 Customer tom: rTE1.1.Y S DUCK 1 1 1 1 1 ( 1 1 LO �s of DRt SW Dsc Retail Sold 1 1 1 1 1 1 1 1 1 2 360515908 AINJ 129.00 109.65 SV 7.5-8MM FLU PRL NECK I I I I. I I I I 1 1 2 360499103 59.99_ 59.99 SV 4 PAIR BX ST PRL EAFR PAYMENT PROTECTION PLAN 0.00NT 169.641 SUBTOT 169.64 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE.I ACKNOWLEDGE THAT:I DO NOT SALES TAX 6.OX 10.1E NEED TO PURCHASE THIS INSURANCE TO GEl ORE DI I AND I CAN GET SIMILAR COVERAGE.INCLUDING TOTAL 179. PROPERTY COVERAGE FROM ANY INSURER E CHOOSE. PAYMENT PROTECTION PLAN INCLUDES $? CREDIT LIFE.DISABILITY,INVOLUNTARY UNEMPLOYMENT,PROPERTY,JOB RETRAINING AND LEAVE OF TOTAL WAN PAYMENT 0.00 ABSENCE TO THE EXTENT AVAILABI F IN MY STATE AS DESCRIBED IN THE SUMMARY OF INSURANCE (10IXh 6519 REG CRE0I1 NAN 179,62 1 COVERAGES'. I READ AND I MEET THE ELIGIBILITY REQUIREMENTS SHOWN IN THE SUMMARY OF SLSF1 SN 138961 TAX TYPE 1 STANDARD INSURANCE COVERAGES' MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE YOi,I 1IAY RETURN aft pugcHAsE $I THIN 60 - AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. DAYS OR EXCHANGE WITHIN 90 DAYS, i�A1ClE5 'PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON I HE REVERSE SIDE. YES.PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE CAN DAYS, EXCHANGED OR RETURNED WITHIN 30 DAYS, MUST EE UNWORN AND UNALTERED DITI: SIGNATURE DATE OF BIRTH DATE ORIGINAL PAD:ACING, INSTRUCTION, AND f --- —�—J— WARRANTY DOCUMENTS. CUSTOM DESIGI"IED NO.DO NO!ENROLL ME IN PAYMENT PROTECTION PLAN CREDI I INSURANCE JEWELRY AND DIAL ORDERED DITCHES DATE C M OT BE RETURNED DR EXCHANGED. SIGNATURE _J^�, N1990-0299 NonSIdID 119 AUTHORIZATION CODES SECURITY AGREEMENT BUYER AGREES THAT IF MERE IS AN AAIOUN T CHARGED 1D MY•AWN/RS REVOLVING CHARGE SHOWN ABOVE. I. SI I I ER HEREBY RETAINS A SrCUR.TY PVT REST IN THE GOODS MENDED ABOVE IEYCEPI tN CT MO ION ANY PURCHASI UNDER$`STI AND N r(ON ANY PURCHASE UNDER MOD UN.L TIE UNPA,D PALANLE UE SUCH GOODS IS TUi t Y PAID AND it,TS PRTSSLY AGREED AND LINDENS TOED•HAT,!N MO EVEN!Or DE1AUI I.SFI IFR SHALE BC ENT IL TD TO P0SSESS1ON Of:NE GOCJS,ANSCR INE EN11RF WF41J • BALANCE SHALE RI COME DUE AND PAYABLE IN THE WWNCR AND 70 THC EXTENT PERM!RID BY APR(CABLE LAW ' 7 IN ADDITION THE TERNS OF THE KAY`JEWELERS RETAIL INSTALLMENT CREDIT AGREE WENT SIGNED By BUfCR PREVIOUSLY SHALL ALSO GOVERN 1 HIS PURCHASE AND AI I TNT TERMS AND CONDO IONS 1)1 T HAC AGRTTMCNT ARE INCORPORATED IN AND SHAI L BE A PAR I OF I HIS SEI:uRITV AGRI L MCNT • KAY.JEWELERS P O BOX 3680.AKRON 01-110 44398-9914 BUYER'S SIGNATURE DATF CO-BUYER DATE NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION RETURN INFORMATION ORIGINAL ORIGINAL ORIGINAL SALES SOP DATE SALASPE RSON REASON MANAGER TOR RETURN SIGNATURE GUS roMER SICA AT�I RE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 08'04 SEE BACK FOR REFUND INFORMATION. csa•(TER TELEPHONE NO. A9Gfc SS ARP i✓LNONee SOURCE COOE Y N CITY STATE 21P K.• MEMBER OF y• EMAIL DIAMOND OF SALESPERSON AO. w+ v c o h BANK CaO IA?AN.• -FFURM RCV C4. J E W E L E R S E.ery Kam Gegnv*Uri hay? kay.com • Esp. . SEW NUMBER II DISC - SOLD rDR • I I I I I 1 • T H A N K Y O U 11111111 1 1 1 1 1 1 1 1 10/27/10 13:01 I 1091 2 3919 075E163 11 I 1 1 I I 1 Customer Name: KELLY S LUCK I 1 1 1 1 I 1 1 LO H PURCHASES/RUINS Dpt Sku Osc Retail Sold I I I I I I 1 4 811267705 29.99 29.99 SSIL MURANO BEAD PROGR 1 1 1 1 1 1 1 1 O.00NT 29.99T SJBTOT 29.99 PAYMENT PROTECTION PLAN • SALES TAX 6.0Z 1.80 BY ELECTING OPTIONAL PAYMENT PROTECTION PLAN INSURANCE,I ACKNOWLEDGE THAT;I DO NOT AL 31.79 NEED TO PURCHASE THIS INSURANCE 10 GET CREDIT AND I CAN GET SIMILAR COVERAGE,INCLUDING TOTAL DOWN PAYMENT 0.00 PROPERTY COVERAGE FROM ANY INSURER I CHOOSE. PAYMENT PROTECTION PLAN INCLUDES 190003016519 REG CREDIT PLAN 31.79 CREDIT LIFE,DISABILITY,INVOLUNTARY UNEMPLOYMENT.PROPERTY,JOB RETRAINING AND LEAVE OF SLSPRSH 149089 TAX TYPE 1 STANDARD ABSENCE TO THE EXTENT AVAILABLE IN MY STATE AS DESCRIBED IN THE SUMMARY OF INSURANCE You NAY RauRN YOTR PRASE WITHIN 60 COVERAGES'. I READ AND I MEET THE ELIGIBILITY REOUIREMENTS SHOWN IN THE SUMMARY OF DAYS OR EXCHANGE WITHIN 9U1 DAYS. WATCHES INSURANCE COVERAGES'. MONTHLY PREMIUM CHARGES ARE BASED ON THE ACCOUNT BALANCE AND THE RATE SHOWN.I WILL RECEIVE NOTICE OF ANY RATE INCREASE.I MAY CANCEL ANY TIME. CAN BE EXIHNED OR RETTRNED WITHIN 30 'PLEASE SEE THE SUMMARY OF INSURANCE COVERAGES PROVIDED ON THE REVERSE SIDE. HAYS, MUST BE UNION AND UNALTERED WITH YES PLEASE ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE ORIGINAL PACKAGING, 1NSTRUfCTION, AND DATE OF BIRTH DATE WARRANTY DOCUMENTS. CUSTOM DESIGNED SIGNATURE �� JEWELRY AND SPECIAL ORDERED WATCHES NO,DO NOT ENROLL ME IN PAYMENT PROTECTION PLAN CREDIT INSURANCE CANNOT BE RU TlNED OR EXCNAN(F�D. DATE SIGNATURE. N1990-0299 NonStd 10!19 AUTHORIZATION CODES SECURITY AGREEMENT BUYER AGREES THAI IF THERE IS AN AMOUNT CHARGED 10 kAY'JEWLIIRS REWLVING CHARCE SHOWN AWAE. T SELW1 HEREBY RETAINS A SECURITY INEERES1 IN TNT GOODS DESCRIBED ABOVE(EXCEPT W CT.MO(ON ANY PURCHASE UNDER S(501 AND NY EON AM'PURCHASE UNDER$200))UNTIL ME UNPAID!ALARM OF SUCH GOODS IS FULLY PAID AND n IS EXPRFSSIY AGRRO AND UNDERSTOOD THAI.IN THE EVENT OF DEFAULT.SELLER SHAW sr ENTITLED TO POSSESSION OF THE GOODS.AND/OR THE ENTiRE UNPAID BALATCE SHALL BECOME DUE AND PAYABLE IN THE MAI(NER AND TO THE EXTENT PE RUIIRE)BY APPL(GABLE LAW 2 IN AD01110W.1141 TERMS Or THE KAY'JEWELERS ROAR INSTALLMENT CREDIT AGREEMENT SIGNED 6Y(111TH PREVIOUSLY SHALL ALSO GOKRN THIS PURCHASE NO Ali nit tERMS AND CO101110HS OF TWAT AGREEMENT ARE INCORPORATED IN AND SHALL at A PAM OF THIS SECURITY AGREEMENT KAr JEWELERS P.O.BOX 3680.AKRON.01110 44398.8914 BUYER'S SIGNATURE DATE CO-BUYER DATE NOTICE:SEE REVERSE SIDE FOR IMPORTANT INFORMATION .RETURN INFORMATION ORIGRUL ORIGINAL ORIGINAL. SALES SUP OATS SALESPERSON REASON MANAGER FOR RETURN SIGNATURE CUSTOMER SIGNATURE RECEIPT MUST ACCOMPANY ALL EXCHANGES/REFUNDS. 08'09 SEE BACK FOR REFUND INFORMATION. (P-R 03/091 tl KAY JEWELERS #277 CAPITAL CITY MALL 3538 CAPITAL CITY MALL DR#40 CAMP HILL. PA 170110000 Date: 0510312011 Time: 17:10:11 Sales Slip ID: 25794 Cardholder: DUCK KE Account Igo: X'Xx6 510 Purchase Price: $100.70 Down Payment: $0.00 Credit Plan: REG YOU MAY RETURN YOUR PURCHASE WITHIN SO DAYS OR EXCHANGE WITHIN 80 DAYS.WATCHES CAN BE EXCHANED OR RETURNED WITHIN 30 DAYS, MUST BE UNWORNAND UNALTERED WITH ORIGINAL PACKAGING, INSTRUCTION..iZierQ WARRANTY DOCUMENTS.CUSTOM DESIGNED JE WELRY :ND SPECIAL ORDERED WATCHES CANNOT BE RETURN=D OR EXCHANGED. Total: $100.70 Cardholder agrees to.pay the above total according to card issuer agreement. SECURITY AGREEMENT I grant a security interest in these purchased goods pursuant to my KAY JEWELERS Retail Installment Charge Agreement, the terms of which are incorporated by reference. A /9?I I 1 3 L. / . . ..: . .._ .Recount MasteYFl ar :.. .. . ... . ., h !040 M � . .. _-. , , 31 01 35651 9 •6r" :21 .��_� '-AGGOU.� ' � � :'� .t��;:•::�• NT IN COLLECTIONS •:; ' ':•'KELLY S DUCK . ::iRC 4 000-00044444321 C •::::j; i.�{ •::; t.0 '. .:':-,'::'::': • <;2091E S T PATRIOT S T 'i-'5tcft :2714-KY ',:C1 22••°•;:�i;k:'000 D000000 i" •• _ i'..✓bE '';:•� _ e : 2,628.32 :;;•.'..;`•SOMERSET PA 15501-1563 ::V .;* 02/D1/2012' Hm'.814 4440500 .: ::Pest D 1t: 1.095.00 :Pc4?'Strii.t'Pnit::: 1513 00 ; .C6CT3rp . • Ott;:"•.•000 0000000 '' 'i: I.`00e1 ;3Ce',;c 05/09;08'; ::'#e' :fPm D : 10117/12''.:Eie 'LirrG::<.:.:;: D• Lr 3.tF�i,�i F; ....• 12/13/11 :i'sssit:Piint'EJUe 150.00:..".3,1:9(p.:'1131:I` `. 0.00 ; - ' '•L-P r 1 rrtf: 27.54 ; . ' i ir�t:Eu rk�'• > 05/28/08'_: i1iiF.t3).$:: SUPPRESSED;;.' •'• •-:.: ,.:... - : :• ... ., r.:1)i, lri .:;;. PA 24983795;;•::1•.•1•.-- ;• I:•:i:a t..PsritF.t':: 01/15/12 •:;,:Art�t':Firr: 1,3E3.57•':i� LQT�`• J i:B:al ri>.«'e:; 2,628.32• ::Prtit;Atb t':': 150.00-::Fact ;. .•••iI�'S'•-L -05/23/08 t ::. ..;: i at'k 4:* D8/2012 :"'..t+�'et:Pi ret'i`:: 5.632.13•: t4ib1G `.;',•'.`�J BA . L1 '• 8A�.09/22/12 ::;.;•:I °;r M.,U abil[:'.` 0.00 grr:: rc 33'`.:f ::` 10/27/78 .;. :r .. ... . .... 02-.62199 1;1x. 1.•� i. ��F F ;is :';;a. d ::� c' ezD10�'.t e U yt'- �' � - ``e ...4:c>tn:.':��"-_, iiu finiff:..I40t '•.Stoire°':.`.::;-SIz #:;::;:0F'•Diite.:'' • 4lan�d 1-:.� 08/22/12 AG F= 45.55 2,626.32 •. i.-% ':1 07/22/12 AG F= 45.55 2,582.77 • 06/22/12 AG F= 45.55 2,537.22 • .:-. 05/22/12 AG F= 45.55 2,491.67 ▪ I:: 04/22/12 AG F= 45.55 2,446,12 ..1' 03/22/12 AG 0= 8.40 U= 14.20 P= 10.85 C= 1.43 L= 35.00 F= 44.62 2,400.57 _1.:. 02/22/12 AG D= 8.27 U= 13.97 P= 10.66 C= 1.41 L= 25.00 F= 44.11 2,285.87 ?." ' i '-• . 01/22/12 AG D= 8.44 U= 14.27 P= 10.91 C= 1.44 F= 44.94 2,162.43 : ;;1 01/15/12 ISPMT 150.00- 2724 1020 219101 2,102.43 • :- 12/22/11 AG D= 8.04 U= 13.59 F= 10.39 C= 1.37 F= 42.67 2,252.43 �' 12/15/11 ISPMT 150.00- 8751 1020 224143 2,176.37 12/13/11 PURCH 237.12 9669 REG 1091 089251 2,326.37 12/13/11 PURCH 27.54 9670 REG 1091 089253 2,089.25 t:' :.1 • 11/22/11 AG D= 7.99 U= 13.50 P= 10.32 C= 1.36 F= 42.24 2,061.71 ,� .�1� ' ::,' "!• 11/14/11 ISPMT 150.00- 7302 1020 210259 1.966.30 ._:J •i•.• :i .k.fcoCr.CS45+:*(3:.. 0ii,El.5.1J[04 . U ^i ti P• ■ . . • • • • • • .........,..:•:,•„.•,..*,-,::::::::,,...'''''''''' 1WetnilirgIMIIMMOOMPROMMOMMONWOOMMONOWAffeeqPiiiMAg t'--..::••- •••.:71E,••,•••','•:••••-••••• ••1•••gi••--list.•:;%..:::.,. .i.:::::z .-••:.:•.:<;i•'::.:,:4.:',7:::;i4•:.43.: : ::.:::QZ1:;:::::,:c:.:-:•••i,:::.:4:::::::.:4•.-•.:s7iili.L";,',- •-•':'•-•,?.•;-;a-•:..-'-,:.s.:L'41::-:-:•sr. i•i;i.e.r.::=:',.3.•,) 1.:i‹.:•;•:?=,',....,..,..2.1';.:".:',::.W.1 •: • •.• - . , • - • - ; •b t Number,................-.............,............. . .. .. .., •, •. . . . •. • •. • : ... , • . Account .13101356511 '• •• •.. • ••• *. ' '• I •'t '• . ••: As of Cloi:ing Day 03/22122)31 • • • . .'. , .•• • • • • : - . :. .': .• • , . • ••- -. • • . , . . . . . . :, . - • . " - ••• • •• Firit/Last Name.: KELLY S DUCK Store hlbr 2714 .'Logo• KY . •. ••: i • • . • .. • . . • • . . . . . . . . . . . . • ' • . . . . . . ; • . , . . • . . . , . . . ..22 'Credit :•Plan. ' - .Open.•:Last Aging:.•. • .. •Cwrent •• : •.•.Cloiing.-.• • • Avg.D ally':•'...PPP Avg. ..- •. Finance••. : . •.Schedule. i: i " • •. . • . . . . • • . . . . .. . . x. • *.* Plan . •Rate•.' r bate•. .-. Date,' . •• - Balance • ••. %• Balance' .- . •••• Balance-. . ••. Daily BA•-.• .•-• Charge •• • • .•Payment i 1 il ! : 2499 24.99% 03/26/10 09/22/12 2,366.03 2,366.03 1,960.02 0.00 —, 249R 22.90% 06/28/06 09/22/12 262.29 262.29 226.68 0.00 i ' s : ; Balance Termed Total 2,628.32 2,628.32 2,206.70 0.00 0.00 150.00 '1 :•2 3 r ) 1NO3 00.00% 07/15/013 09/22/12 0.00 0.00 0.00 0.00 :: • INFR DD.00% 05/29/08 09/22/12 0.00 0.00 0.00 0.00 i : 1 :i Credit Plan Total 2,628.32 2,628.32 2,206.70 2,206.70 0.00 150.00 :1 ij : i •a :-: :2 :3 OK Cdrlce) rpdridb Y E i i 1 • : 3 4E 1• i'A,-,,*:CA'Alc,E *.::,i1,ZR-,:11,•FinfQ'2:4:: :41.4.:V.,g4.`etilc:•,:•.:W.-1., ,M4':./::.; .=:, :.,e?!=r.h..,‘,Wiy,l,fic.,,,tp,,,,?.!:Kr:p.k,-is..2;yfr;',..,..1z.,,Tise..,.::&,,ZS,,,1-,,,N;.,;?. .! ,•...):5;: .2 . . . . . . . . . . • . . i ' • V • . .• • . . . .....„..,.... .,,,Li.. . slip image: • .1 ... SLSPRSN 999997 ': . • . a . a a • al Lira,La ILLSLLILL111Lai.a II La La. ■ .:74;V:;. ,17:4:-.7•-:'•:,,7•1....,•::77.:,;....::: :::•17:----.:e::: ..-,....;:::•:•.7 :•"4-:7::::'':.::.71.7...;:e••• :7•7::.".7,77:.7. .::...—:: ;',":",•-•-; ::•:: ''''7.".:7.7:: r.. 1 t i...... ,;!,lac-..-,...,,!...::,.... j,-. ..::-..,,i.,--,:,::i..!.;;ft.-,-,,,,,,,y.!.!..171:,ii.,i.... ,,-,:k...r.r.?4:4.4,- ,..e....ce...;-;:.?.)1.1..e.c47r7.r.pe,11,71...... A,,;:i7... ..z.zr::j;17,,,,. ;!) 1.1 tr4,.-',"'.'.`o• 7 i• :.J.I 1 L....I.11 t..`'-...V.:.4-7-., 1..• ....-.--.1 it, i•--. r•III ...ve,,......;-:•• •.e.,...:,,;:.:,..:,..-: r•"1•".•::in'h..f,li:••:',-. ..e'' :•%',..:1071",:•*••.- -- 6' -;•.--•,1 .—'4„ 4,i I • • ,'•-•,..r L 4 P•r':..L./. —",.■•?:,1 i .r.": ..a/" ' J. r%■•••,..•.-',",•,.'.,-"*.',.%-;.•••.'?"71::*.•,•••":::•.(.,..-••••••%•-:07."• %wil%'.•.7-1,.- -A' ''''. LF,.....":...I,7,'•:: ,••:'..,:,. .f. ; .7.' ...,...."...• ir....:,17,7.."' •.''''..r......7 -1.1.-,:t.:7.--,',.r.:....-.2.:•%.,..-:,;'.,t•••,•.-..7", '..,—,. •:,.....:...,r;;;:.:,_:.?,*.mt. , 1.t,...."r+-......r,A.O...•.kr...;Ir..,1-A.m.:irJ 1...m1:Wu e Or...;%Cr..r.:-.....:.;4..;aid.1.!......i.t4.5....1.441.......111.,....%L............r.... .11.:1...Z.W ..... :4,1- ,I nr..,..,...Z.1.14...M.:i........Ig Arr.'-:1-.•... "... . . • • . • • • • • . . . • . " . . . r F. • • MAL IlL,1,.....1.1...1 4.1.1.LW nil.. • . •• •. •. .•• • Date 0602 le011• .••• ,• ,:.. .• . • • • • . . .• .., .•. .•., • .. . . • , p Image i. . . . . . . . • . ..- • • 4 • i ?.••••• •• Type: ACHARGE• •: : • • •• -.., •• •• . • • - •• ••• • . . • • • • • • •". • • • '.. • :'• • • RelatAd Slips .1 1 . • • • .. •. .• . • . •. •• .• . .• . . .• . .. .•. ... . .. .. I . .. .. ... .-.......e.i.s.-1-..ei-u..-1.4a-1.,....1.1.,1 . ■•• • ' . • • , . • • • • . .• •- . • . •. • • ' . . . - 1 , .. ' . . . . •- . ' Name 1DUCA initial : • . C.u•sto' m•.e r 1 • • • •• • • • • I. • .: . .. • • • • .J....4-.....-1—A-16..§...•#.—...41/..,..3 . = • , • , . . • • , ' . . , . . . • • , • . . • • , . . " . • . . • , . . ' . • , . . . . . . • • . • • • • • . • .• , • • . , . . . • • • 2 06/02/2011 10 : 42 • . •:..• •• • • 54arranty: ••• . • • ,....-1-1FL••••-.1.-..-u-iLIL-A-1.....-.4. • 1 . . . . - i' .. • • • • . ' • . . • • +': ' • . • . • . ' L. 2714-2-6603-023168 . . . . . .. • . . 1 ... . ' UWE' • .. . . • . . ,: • ,•• .. • • • • • • • . , • • . .1 . •. Cust Name •. PT DUCK , . • • . 1- . .,) . • 'k -. • LO N PURCHASE s ipErums - .•.- :. LT •Battery • •i . N . . -..a...-a.T..a.....a......,-....:1-.4-......e...i .1 Dpt 5ku E'sc Retail Sold • • •. • • • • • . . . . _ .. . ,..• t• . • 1 004 811297504 24. 99 . . . • •• - - 3 A ., 24. q.9 : : • •• Cre.dit Draft: 1 • -,.' .. • !: ••• . SIT SEA STAR BEAD • • • •■•11.L.I.'Ai.Li..1.1.11.ml...1.1..A.Y.A• , • •• . • • • •• • • SLSPRSN 155358 . • . • • • . •• . • . . • • -.. . ., ;: • • • .;_k: •• 1 004 811287705 g 7 ....,- . - -CM 7 q q q • • . : - , • . • . . . . S IL 11UPANO BEAD PROG i :. • : • . . - ,• -.• ........- •. . . . . . . i• • SLSPRSN 155358 • " r. . •• • • LI ' S1.TBTOT 54. 98 . . . . . . . '..• . . . . • . . . . ' • • SALES TA) 6. 0000 3. 30 . • .• • • • . • . • • • . • • . . . • .' . - ,. • . • • . • . • .. • . . . . . • . TOTAL 59 . 29 . . . . . • . • • . •1 ,••• " • rt PPP=N TOTAL DOTAIN PAYMENT 0 . 00 • • • . . . . - •- . • .• . • , N • . . t.t. 76519 REG CPEDIT PLAN 58. 28 . . t: • CPED IT AUTHORIZATION .AA002558 .? ,!I• ••• SLSPRSN 155358 • • ,.- - • • • • • • • • ✓ . - . • • ..- . . .. .'. ' •. •• : . . . A • ,; • i: • . . ... •i' - • • . • .. . 0 ' ' • • • • •. -. : ••- . -. • . . . . . . . . . .. . 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Dpt Sku Dsc Retail Sold • . .• O. . • . . . 4 • .4 . . 1 001 172173700 A.D'ir 199 g.• • . 00 159. 99 • . .. .. ._ '. • • .. • Credit.Draft I • •••1 r: •• ;: • GUARANTEE #9761-4325 ..._ -.....-........:......,.;-.1 .1 . • . •. . • • . • . . 10VG DIAMOND NECKTITEAP. • -. . • • • - • • ;• • .. . • . • . ,. . • . . .. . ••- .• • • . • ., • .: - ;•-• • )1.,3PPN 478..0,--4b • • . . . . - !:-.. • . . • • • . . . 1 002 372806303 ,: . . 119 . 00 119. 00 • • • • . . • • . • • . ✓ . . . II . '4 ' V CITRINE DIA FEND ,.. i:.• • SLSPRSN 47846 • .. • • . . . .„ . • ...• ri •- 1 901 0 . 00 1',.7 99• -- • - .. •• . - • • . . . • • • •.. . . ',.: '. • . .• .• .. : . - • ,":, • SLSPPZN 473246 •. . . . . . . . .. -• . , . ;• • 1902 ,.... 0. 00 12 ctq _ • - - • • . • •• . .• • . • . .. . . . . •• . • . . . .. .. .• • ,,• • SLSPP' N 4'78246 • • . • - • • • • .•• • - . • ... • .. • . . • . .• .• • . • . ;:. . • . . . . . • • . • T_TBTOT 304 97. .: • • . . .. • ✓ . • . - • . .. • . .• •. . • ... ,. . i• . . • • . SALES TAX 6 n000 18. 30 • • • •• • • . • • • • • • •-• ., • • • • • ..• • .• TOTAL 323. 27 . . • ••: • ',: % • PPP=N TOTAL DOWN PAYMENT 0. 00 . . . . . . . . .. . • . • _ • . ". : • . ✓ ' . ::1. '. .. .• . .. . .• • . " •.' •• . . i 6519 PEG CPED IT P LAI' i '-'9 27 -3 e:.,.... . - • • • • . . . . . . . • . • • ••.• . 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' •' • . • • ,•, ' • • ' .- , • •' • • • • • • i••Type: iC. , • • ' ' • - s ,•- 1. 1 .CHARGE... ` •• •• • - . • • Related lips ': ]711 1•. . . • : , , • , • : , • • . . • . . . , . . :LLi T_■iJL_Li-I•rLir1 . l _ FjIsL i T' , • .• Y.L—L�J iY.a iL di—. •••.LLj lUiiLi JJLIJ• • • • •i ii.aJ. • , '- • - • i . 1 • !_C.K.: •. •' •. . . .. . • • • •. ' • '. Customer- ■ .y - N afire: Pt1�1+3� _ • 12 113/2 nil 14: 47 • ' • .'',1 rrari • .'� i ✓ . • 1091-1-9669-089251 • LIWF. •I i • : Cust t Name : a DUCK :: -. L 0 N PURCHASE S/ ET PE • . • •• ., • LT. 0 attery •• . 4. ._ ,. ' Dpt. Sku Dsc Retail Sold ' ' • • . ; • . .• i•• '. .• • 1 t00l 880100805 � 179 . 00 53. 70 ' Credit.Dr fk 1. ] ti ' ' GUL ]TEE €574a 60 ...:L■J.1L i..L Lail a;J.. •• . ✓ . • 2• • • 1 G PREOWNED D IA PI "' : 5L 5PP N 458106 165100 • • • • . • 1 001 181119506 ADV 219 . 00 169. 99 : GUARAITTEE #5748-7613 . . 1 oiiiG DIAMOND EARP.INGS • • • . • . , •• - . • : - ] J. •• SL5PP 1N 458105 165100 • • .• • • •.• • • TOTAL 237. 1'2 •.• ' : • .. .• „ • PPP=N TOTAL I}OWN PAYNET11T 0 . 00 - • • - # *'***t--4'6519 PEG CREDIT PLAN 237 . 12 • ' C EDIT AUTHOPIZATI0H AA002875 - •, - L..9_PPS211 450106 165100 - • �. 5 : . . . . . . • .• Prink- : . •, ;'' J I L7 • • .1 a.LL.La-._L La Li J . ■- i.r :. •• • E• x�k. $i .Froduc:kior7 t t bat.:e•. .L,HART:IS HORN: ..:•- "is . • . . • . .. .' . : . ■ ~'~~~~-'-^'''~~~~ '~^^~^^ ~'~~~ ' ^^~^'~~ '~'~'^'^^'~'~~'^^~•^' i ] • • CREDIT AUTHORIZATION H002638 . • • • ,..a ir_'iS •+' y_. +•a a v 4C: :,75.-'- L'em•:7,.x;2•~- •. if r'.�".•Di u■{.}n."4M14 `'•!Y...1.-7.)i i". .4." 1.•:•'_i .•,d:..h:••=.4 r.t "..�., ia.1 r. !,—.' • .:.=.;... . -t•,`'•r'•�°-:a.ti. :�'1 e•.• . _ •. •v r_.'.� . . . , 1r ' '•-_Fw ;.J L..;rt•.t-• -L,�•. . . 5�,r_�f ' 4' ti:r,•i•:a� � ' ..;� 1..)—tp:-c� •i 4. 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Dsc Retail Sold s ; • 1 011 900137908 AIr 1� 100 ■ LJI I .3L■ 00 '• " ' _ i • ••a•t k_•( dlk•If��fk ,• ;: �TTTA •J`'iLY iEE ,#550 3-489!. • �:.■:L—a•ir•iu+a..0 a.+ai• , .� — • SSLTYT DIAMOND RING •• • : . • ..• : L PP1N117 • .: 1 004 391711405 I��f 149 . On .'1 . '49 14K2 EARRINGS !:•• • SLSPPSN 114709 • 1 011 900149408 V 80 . 00 19. 99 . S A 'T �Cl . WHITE SA PEND . T • : . : ' ••• aLSPPS2d 114709 .. • . ' • • • •r. aTJTT0T 123. 98 • • N SALES TAX 6. 00010 ■ 4 • TOTAL 131. 42 . . . is '. • PPP=N TOTAL DOWN PAYMENT 0. 0iii • - . ' • • • i (��T • .- ,• • # ******6519 REG r EI IT PLAN 131. 42■ 42 • 1 ; ' . CREDIT AUTHORIZATION 70 5 70 • •' ' • P'rint •: • . ' • • '1.,1 ,1,P924 114 r 0 •" . ..LLi i..J.LJ L i JL L�..i . =. 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I ki1'd lip.,'••.• • • • • ' .Last. .,iLJJJ •i6i1 � iLi.ta.YLi= • . • •- W-�� I • • , . •Name= f LI L • ' • I nitiaL:• l� • :.- u•-:tom!r• • .1 - Z 10/27/20J.0 1:3 : 01 : . . . .▪ •• :• • Warranty! • • • 4 ▪• ▪ . . . •. 1 ' i•• . 11J !1- - 1 -�� . . • .• • ' _ .LI ,�P . . i • ) •• . . . • • 11°..I IL. - :•44 4a—_• 0 • • Lust Name: IT I)T.JiCK S I. • } ▪ • • LO N PUPCHA5ESPES :LT•Baktery.. . - li,R - r • L'pt Bleu D3c Retail Sufi r• • • 1 11 ' a I r r E r �it rkk • '3• I L MURANO BEAD PRO G ▪ .i J i-i�i.iii YY.LiiA. SUBTOT 99 99 •■ • SALES TAX 6. 0000 1 . 81 •. TOTAL 31 • PPP=N TOTAL DOWN PAYMENT 0 . 00 ' •• '' ' . r. .• 1• • 5519 PEG CREDIT P L N 31 . 79 'r . . .• °i ' C PED IT ATJTHOP•IZATION AA001626• • :BLS PPSN 14906 i • . r }, y n } >• : • ' ' • • • • • • ✓ . • I • , i....i.J L-L4.i L•L 4i L Li LI.1 '1JL .. .' Erik :' . !•ir if r�'r:i1-i1,r•hnr-1 r�`I.a.A.i.=i`_i .6.�"f.-.RT SHUPiI'� '. .. . db. 4 -• . f, j • • . • : • ... •• • .. . • : • . . •: • .•: • •• " • • . . ". : . •• . ' .. i • • • .. . • SSIL LE DIA NECKLACES :: SUBTOT 179. q8 • • • • Per CB ac has current MTG ran eeerh un Accurint_ _ _ Marcel Number - 1S-23-0545-121 Owner Name: FELL' S DUCK LexID: O U O S€2 67 1 7 S Proper-t] Address: - 1178 RINia'SLEY RD, CAMP HILL PA 17011-6110, CUMBERLAND COUNTY Owner Address: 117a RINgSLEY RD, CAMP HILL PA 17011-6110, CUMBERLAND COT_ Y :sir ,,• j' ' ^'%/.' SSF:� '1^'" ��'• J♦Jay•r�(�-.� v V l'1 rr� r:��•'AL.:SSTK.., ii�•i i�`.T r�,J, :•:-• &- -S:rfs 'Yt''''' ''i- re v:v-�r":°L• t�cte7'. �a.v '•fr..r�. ...,,A.t r.F; ,•a.,. ,}ay rr ...' .�riC`'"tSs�i- -r{.^ _rh`::r<. _�o•x,:=srh, ,'.^-.. ��,.�'ti F: ..;±c.•. � :,:!•c�v., r.r-t,,�...c i >.+c�.:Cr.�q..<<,ixio`•v=•�•<Ar.:1�..:...r�:a,..:.r:.-�. rCci ^r• °:F:3 ;r° �7 {'?.• �I 1 1c� i�r -r'if-; �:f:: L 1 II' a,- r.:_ •.i;.::la:' :.i; ,{,{ '��'�QQ T :.) _-! ..,. , ! PLOYME NI. INFO` [ t � ..K r. .� ..yt K'{SMAS., t _., '�".. t- .t •;3��, ..t.. ��,F,'Y :F 4i,:F.,h3..n:iT,i�4.�1.�•_'k'if.-�.'5��-�J�?�a t! Fields marked with an asterisk("3 are required. S i('HEP LTF4" "}iRIS IRY F3�lPti3YE7t ..17.X5 PRIMARY OCCUPATION 42c ;4-6. �tY 4)'ADDR PR3MA 8 PRIMARY EFtP CfTY • •PRIMARY EMP LS P A h` ;: ;_:.PRIMARY U £3lP INDICATCIR;• :•R .':•;`:•:': :' SECONDARY EMPLOYER i • PATI -�'it. SE£4�t?fiRY 4C&il {{�'. J Y. JEWELERS 16 SSh h • e..yrn•o n..hwr kay.com A T i I INDIVIDUAL ACCOUNT:In one name and based ( I JOINT ACCOUNT:is based on credit worthiness of both i I COSIGNED ACCOUNT:Cosigner and applicant must each C y solely on your own credit worthiness.Applicant if applicant and joint applicant Both may use the account and will compMete separate appiicalions.Only applicam wlli be permitted to C P married,may apply for an individual account. be lali'e and responsible for payments.Both must sign below. use the amount,but both win be liable and responsible for payments. T E NOTIEE 'Alimony,rhtd support or somata rrauueroncr reed not be resealed a you do not wish to retr on a to obtain credo .j 1,Are you a U.S Citizen? Y N 2.Are you in the military? Y N Name: 1 a J L l fit 3.Do you have established credit? Y N t p Address: 1 t: City: Q�,mQ 4 le: ?a Code:M'Q l E FFF Rent/Buy/u Len th �r /' Name Prone t/B Y/ R Phone:(I(7) (K -510 1`i�liBilledUnder. Lem()h Q rerPhone:( ) OIGer. b� jot Time:(0 fn1j�1 5 Statement Mailing Address: O (if different than above) A Previous current address r 1 t lox--V j 1 $ IIy:Neu) �tafe: pe code:`iOidof Time:&"ir$ L (!!at current address less than 3 years) 1 M J1 �`G�T L V q 1 SSN: ,__ v __ DOB: 10)a117 gLi: L4�g3 7 QS- E-Mall Address: Nearest Relativa 111 Sttrie� Not rest R 1Hith You: Sal �t �Q.Spey Residence: P—R Phone:( 1 Vi) s s - 3c 1 E Em.I, er. n�L1p&S •1 • SSek.\ fit€, 4l , k I Position:Ga C E-.I, Self-Employed? y P Addrett: t v 1� �1 6- It t . City: e(a T('41 State: pa Code: ` I © I 1 L 0 Phone:(•t 1J) Ca_l .- } pa�0 _Gross Monthly Salary: so() `� Length of Time: , \_t e" M E Previous Employer: Prey, r,!_ (!f with current employer less than 1 year) Length of Time: T 'Other Income Amount: Source: ---"- Rent,Buy/ Are you a U.S.Citizen? Name: Other. Y N nptth A Home Address. State ZI ode: of time: P (If different N primary applira t City: p • P / I DLO: • I. Phone:( ) �SSN: I I N C end Add :in: d?Sell-Employe Y N N 3 Phone: ) Gross Monthly Salary: Length of Time: 'Other Income Amount: Source: You may In-r!stigate ray credit record and obtain a consume in in corm-M-.n with this application and later in connection with an update,renewal,extension of credit or collection of the account.Upon request.I will be told whether or not a • -. mer report was requested and,if such a report was requested.I will be told the name and address of the reporting agency that furnished that report. (10 FIND OUT ABOUT CHANGES IN THE INFORMATION IN THE AGREEMENT ACCOMPANYING THIS APPLICATION, WRITE TO US AT P.O. BOX 3680,AKRON, OH 44309-3680). STATE LAW REQUIRES US TO GIVE THE FOLLOWING NOTICES:California Residents:After credit approval, each applicant may be liable for all amounts of credit extended under this Account to arty joint applicant.Ohio Residents:THE OHIO LAWS AGAINST DISCRIMINATION REQUIRE THAT ALL CREDITORS MAKE CREDIT EQUALLY AVAILABLE TO ALL CREDITWORTHY CUSTOMERS, AND THAT CREDIT REPORTING AGENCIES MAINTAIN SEPARATE CREDIT HISTORIES ON EACH INDIVIDUAL UPON REQUEST.'THE OHIO CiVIL RIGHTS COMMISSION ADMINISTERS COMPLIANCE WITH THIS LAW, New York Residents: We have a security interest in goods costing more than$200.00 until the full payment price of those goods Is paid.Wisconsin Residents:It you are married and are applying for an individual Account,combine your and your spouse's financial information above.Marital Agreement Notice-No provision of marital property agreement,unilateral statement under Sec.766.59 Wis.Stets.,or court decree under Sec:766.70 Wis.Stets.,will adversely affect our rights unless we are furnished a copy of the agreement,statement or decree. or we have actual knowledge of its terms,before credit is granted or the account is opened.We are required to ask married residents of Wisconsin for the following information: Name of Spouse: Address of Spouse: BEFORE SIGNING BELOW, I (WE) HAVE READ THE DISCLOSURES THAT APPEAR ON THIS APPLICATION AND THE NAY IEWHBRS REiAI,UII&TALIMEIIi(IT AIIMII'IBIT, THE iB MS OF WHICH ARE INCORPORAIED BY RIEFERENC1 II AND MADE A PART OF THIS APP , I AHD I (WE)HAVE RECEIVED A TRY(IF THAT AGREEMENT. Applicant:X •�' lire !(i1 Date:c/9,/j7� , Joint Applicant:X Credit Line:'3(-'�''� Account Number. 31 01 35u51 1 0300 135.0000(R:t38J05) 6130891 ■ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STERLING JEWELERS Plaintiff v. KELLY DUCK Defendant CIVIL ACTION -LAW NO: 13-6837 Civil PRAECIPE TO ENTER APPEARANCE Filed on Behalf of Defendant: KELLY DUCK Counsel of Record: Robert D. Klingensmith, Esquire PA I.D. # 313960 HAROLD SHEPLEY & ASSOCIATES, LLC 209 West Patriot Street Somerset, PA 15501 (814) 444-0500 (814) 444-0600 (fax) rklingensmith@shepleylaw.com IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STERLING JEWELERS Plaintiff v. KELLY DUCK Defendant • CIVIL ACTION -LAW NO: 13-6837 Civil PRAECIPE TO ENTER APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of ROBERT D. KLINGENSMITH, ESQUIRE and the law firm of HAROLD SHEPLEY & ASSOCIATES, LLC, on behalf of the Defendant, KELLY DUCK, in the above captioned matter. 3/PK Date Robert D. Klingensmith, Esquire Attorney for the Defendant Harold Shepley and Associates, LLC 209 West Patriot Street Somerset, PA 15501 (814) 444-0500 (814) 444-0600 (fax) rklingensmith@shepleylaw.com IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STERLING JEWELERS Plaintiff v. KELLY DUCK Defendant NOTICE TO PLEAD You are hereby notified that you must file a written response to the within Preliminary Objections within twenty (20) days of service or a judgment may be entered against you. Robert D. Klingensmith, Esq. CIVIL ACTION -LAW C: -7" NO: 13-6837 Civil r— c,r) PRELIMINARY OBJECTION< Q Filed on Behalf of Defendant: KELLY DUCK Counsel of Record: Robert D. Klingensmith, Esquire PA I.D. # 313960 (1) rn rn Jc (Ji —c C3 • r" A- rTh HAROLD SHEPLEY & ASSOCIATES, LLC 209 West Patriot Street Somerset, PA 15501 (814) 444-0500 (814) 444-0600 (fax) rklingensmith@shepleylaw.com IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STERLING JEWELERS Plaintiff v. KELLY DUCK Defendant CIVIL ACTION -LAW NO: 13-6837 Civil NOTICE TO PLEAD You are hereby notified that you must file a written response to the enclosed Preliminary Objections within twenty (20) days of service or a judgment may be entered against you. Robert D. Klingensmith, Esq. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STERLING JEWELERS Plaintiff CIVIL ACTION -LAW v. NO: 13-6837 Civil KELLY DUCK Defendant DEFENDANT'S PRELIMINARY OBJECTIONS PURSUANT TO PA.R.C.P. 1028 AND NOW, comes the Defendant, Kelly Duck, by and through her attorney, Robert D. Klingensmith, Esquire of Harold Shepley & Associates, LLC, and files the following Preliminary Objections to Plaintiff's Complaint: 1. Plaintiff filed a Complaint in Civil Action against Defendant demanding damages in an amount unknown to the Defendant. 2. Plaintiff's Complaint was not served on the Defendant nor his counsel and therefore is subject to Pa. R.C.P. 1028(a)(1) for insufficient service. Objection I Pa.R.C.P. 1028(a)(1) 3. Pa.R.C.P. 440 proscribes rules how service is to be made on a Defendant. 4. In this case the Plaintiff filed a suit in the magisterial district court. The Defendant appealed the decision from the magisterial district court and it was not until the Defendant tried to file its praecipe for non pros until she found out a Complaint had in fact been filed. 5. Defendant was unable to pull a copy of the Complaint electronically and contacted the Plaintiff on three occasions to ask for a copy of the Complaint. Defendant's counsel contacted Plaintiff's counsel via e-mail as well as twice by phone. It was made mention back in February of 2014 that a time stamped copy of the Complaint is being obtained and will be sent to Defendant's counsel. 6. As of this date, the Complaint has yet to be received by Defendant's counsel. 7. The Defendant wishes to proceed and litigate the case and get some resolution. 8. The Defendant reserves any future Preliminary Objections to the Complaint for when the Defendant has the opportunity to review Plaintiff's Complaint. WHEREFORE, Defendant respectfully requests that the Court order Plaintiff to serve its Complaint on the Defendant or dismiss this action with prejudice. Respectfully submitted, Robert D. Klingensmith, Esquire PA I.D.# 313960 Harold Shepley & Associates, LLC 209 West Patriot Street Somerset, PA 15501 Attorney for Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STERLING JEWELERS Plaintiff v. KELLY DUCK Defendant CIVIL ACTION -LAW NO: 13-6837 Civil CERTIFICATE OF SERVICE I served this Petition to Enter Appearance, Preliminary Objections and Brief in Support of Preliminary Objections by U.S. Mail, postage prepaid, at 120 N. Keyser Avenue, Scranton, PA 18504 on Michael F. Ratchford, Esquire, the Attorney for the Plaintiff, Sterling Jewelers on September 23, 2014. I declare under penalty of perjury that this information is true. Date: September 23, 2014 Server's Signature Gretchen Giles — Legal Assistant Printed Name and Title Harold Shepley & Associates, LLC 209 West Patriot St. Somerset, PA 15501 Server's Address IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA STERLING JEWELERS Plaintiff CIVIL ACTION -LAW v. NO: 13-6837 Civil KELLY DUCK Defendant Order of Court On this day of , upon consideration of defendant's preliminary objections, it is hereby ORDERED that plaintiff shall have complaint on the defendant. If the plaintiff files to serve its complaint within Prothonotary, shall dismiss the case with prejudice. BY THE COURT days to serve its J. days, the