PVAC Backup 05/04/2009
Public Vehicle
Advisory Committee
Backup Documents
May 4, 2009
COLLIER COUNTY PUBLIC VEHICLE ADVISORY COMMITTEE
AGENDA
Date: May 4, 2009 at 9:30 A.M.
Location: Collier County Community Development Services Building, 2800 N. Horseshoe Dr. Naples, FL.
Conference Room # 609 / 610
NOTICE: PERSONS WISHING TO SPEAK AT THE MEETING NEED TO COMPLETE A "REQUEST
TO SPEAK" FORM. SPEAKERS MAY BE LIMITED TO THREE (3) MINUTES FOR DISCUSSION
UNLESS ADDITIONAL TIME IS GRANTED BY THE COMMITTEE.
ALL PARTIES PARTICIPATING IN THE PUBLIC MEETING NEED TO SPEAK ONE AT A TIME AND
STATE THEIR FULL NAME AND COMPANY THEY REPRESENT, IF APPLICABLE, SO THAT THE
COURT REPORTER CAN RECORD ALL STATEMENTS BEING MADE.
ANY PERSON WHO DECIDES TO APPEAL A DECISION OF THIS BOARD WILL NEED A RECORD
OF THE PROCEEDINGS PERTAINING THERETO, AND THEREFORE MAY NEED TO ENSURE THAT
A VERBATIM RECORD OF THE PROCEEDINGS IS MADE, WHICH RECORD INCLUDES THAT
TESTIMONY AND EVIDENCE UPON WHICH THE APPEAL IS TO BE BASED.
PLEASE ENSURE ALL PAGERS AND CELL PHONES ARE OFF OR IN A QUIET POSITION.
I. Call Meeting to Order
n. Attendance
In. Approval of Agenda
IV. Approval of Minutes
A. April 6, 2009
V. New Business
A. New Applications
1. Limotions Inc
2. Sanibel Taxi
3. Bravo Taxi, Inc
4. Bumble Bee School Transportation
5. Collier Shuttle Services
6. Exodus Limousine and Transport, LLC
7. J aquelin Diaz
8. Comfort Transportation, LLC
B. Driver Id Appeal
1. Thomas J. Casey
2. Edouard Jeantoy
VI. Old Business
Staff Comments
VII. Public Comment
VIII. Next Meeting Date
IX. Adjournment
COLLIER COUNTY PUBLIC VEIDCLE ADVISORY
COMMITTEE
ATTENDANCE SHEET
Date s- cr-09'
NAME
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1 CTe Active LC2007oooo02 A eK Transportation, Inc. 710 Elkcam Circle East
2 CTa Active LC2oo7000003 A-Action Transportation 581 Diplomat CT
3 CTa Active LC2007000004 At Your Service of SW FL 7140 Appleby DR
4 CTa Active LC2007000005 T J's Assistant Care Svc 1724 Santa Barbara BLVD, Unit A
5 CTa Inactive LC2007000008 Advanced Transportation 171 COMMERCIAL BLVD #23
6 CTa Active LC20070oo010 Metro Cab 16991 US HWY 19 N
7 CTa Active LC2007000013 Fantastic Limousine, Inc. 15470 Los Reyes LN
8 CTe Active LC200700oo15 Aristocrat Luxury Transportation, Inc. 1985 Timberline DR
CTa Active LC2oo700001B Saco Valley Trader dbal Southwest 27150 Driftwood DR.
9 Transportation
10 CTa Active LC2007000019 All Aboard Airport Transportation 1923 Terrazzo LN
11 CTe Active LC2007oooo20 ALPC, Inc (A Lincoln Private Car) PO Box 770093
12 CTe Active LC2oo7000021 Aaron Airport Transp 13233 Greywood Cir
13 CTa Active LC2007000025 New Pelican Transp Service, Inc. 1304 Wildwood Lakes BLVD, Unit 6
14 CTa Active LC2007000026 Class Act Limousine 2180 Corporation BLVD
15 CTe Active LC200700oo29 Carway Town Car 275 Goodlette Rd N.
CTa Active LC2oo7000030 Regency Executive Services & 6561 Taylor RD, Unit 1
16 Transportation, fnc
CTO Active LC200700oo33 Cerreal Company, Inc. dba Non Emergent 2910 4th ST NE
17 Transport
18" "" CTa Active LC2007000034 Hollywood Limos Of Naples LLC 5560 JaNQUIL LN # 204
19 CTa Inactive LC2007000035 Carey Limousine Florida, Inc. 280 VANDERBILT BEACH ROAD
20 CTO Active LC2oo700oo37 Corporate Cab, Inc. 100 Aviation S Suite# 103
CTO Active LC2007000038 Naples Chauffeur Service, Inc. 15405 Cederwood Ln # 303 --- pe
21 BaX 8904
22 CTa Active LC2007000040 Big Shotz Limousine, Inc. 500931 st AVE SW
23 CTO Active LC2oo7000042 Elite Limousine Service of SW Florida, 11910 Palomino Lane
24 CTa Active LC20070oo044 Naples Transportation & Tours, Inc. 1010 6th Ave. South
25 CTa Active LC2007000045 Naples Taxi 3047 Terrace AVE, Unit C
26 CTa Active LC2oo7000046 Naples Shuttle, Inc. 44361Bth AVE SW
27 CTe Active LC2oo70oo047 Rogers Limo Service, Inc. 7048 Falcons Glen Blvd
28 CTa Active LC200700004B Naples Airport Shuttle, Inc. 2900 14th St. North Ste 22
29 CTa Active LC2007000049 Maxi Taxi of Florida, Inc. 5910 Taylor RD, Unit 110
30 CTe Active LC2007oo0OS0 Majestic Limo Services 15501-5 Old Mc Gregor Blvd
31 CTe Active LC2007oooo51 LA Limousine Service, Inc. 3280 17th AVE SW
32 CTa Active LC2007000052 Superior Airport Shuttle LLCmba.0/8 2900 14th ST N, Unit 1
33 CTa Active LC2007000053 Royal Roridian Transportation, Inc 10490 Deer Run Farms Rd
34 CTe Active LC2007oo0054 Rockefeller Limo of Florida, Inc. 859 Tanbark DR, Unit 102
35 CTa Active LC2oo7000055 Private Car Luxury Transportation, Inc. PO Box 8453
36 CTa Active LC2oo7000056 Prestige Transportation 310 Melrose PL
37 CTe Active LC2oo7000057 Platinum Limousine, Inc 17355 Meadow Lake Circle
CTe Active LC2007000058 A-1 Communications Specialists, Inc. 4884 Napoli DR
38 DBA A-1 Limo of Naples
39 CTa Active LC20070oo062 Callatran Chauffeured Services PO Box 10246
40 CTe Active LC2007000064 Charles Limousine Service, LLC 1049 N Town & River Dr
41 CTa Active LC2007000065 A + Airport Transportation, Inc. 222 Industrial Blvd, Unit 104
42 CTO Active LC2007000067 Florida Airport Transportation 27499 Rlvervlew Ct
43 CTa Inactive LC2007oo0068 Checker Cab 3047 TERRACE AVE UNITB
44 CTa Active LC2007000076 Easy Come Easy Go Limo 441 Pheasant CT
45 CTe Active LC2oo70oo082 Luxury Limousine of Naples 16020 CALDERA LN
46 CTe Inactive LC2007000083 Bonita Bee Airport Express 8841 W TERRY ST
47 CTO Active LC2oo7000087 NAV - LLC (Non-Medical Trans) 3906 Tamiami Trall East
48 CTO Inacttve LC2007000089 MM Fast Limo Corporation 559 E ELKCAM CIA #B -- 9380
MAINO CIR # 204 34174
49 CTO Active LC2oo7oo00SO Royal Palm Limo 659 10Bth Ave N
50 CTO Active LC200700oo91 A Touch Of Class Transportation & Limo. 1890 Elsa St
51 CTO Active LC2007000092 Men In Black. LLC 13625 Leslna Court
52 CTO Active LC2007000093 Naples Limousine Service 5051 Castello Dr # 26
53 CTO Active LC2oo70oo097 Aangel Airport Transportation 8856 New Castle Dr
54 CTO Active LC2007oo01oo Racing Limos of SW Florida, Inc. 12670 Trade Way Four #108
55 CTO Active LC20070oo101 Accent Transportation Services, 'nc 553 Landmark DA
56 CTO Active LC2007000103 Canary Transportation, Inc 731 W Elkcam Clr # B109
57 CTO Active LC2oo7000106 Arkway Taxi, Inc 222 INDUSTRIAL BLVD # 169
58 CTO Active LC2007000111 Ion Transportation 21560 Windham Run
59 CTO Active LC2007000113 Custom Limousine Services 1275 Solana Rd
60 CTO Inactive LC2007000114 MAXIMUM LIMOUSINE 110n LAKELAND CIRCLE
61 CTO Active LC2oo70oo117 Unlimited Airport Rides, LLC 812 E Elkcam Clr
62 CTO Active LC2007000122 Dolphin Transp Specialist, Inc. 3963 Progress AVE
63 CTO Active LC2007000124 PALM AIR TRANSPORTATION LLC 13968 AVON PARK CIRCLE
64 CTO Active LC2007000136 Doino Classic Transportation, Inc. 960 Chalmers Dr
65 CTO Active LC2oo7000139 Sunshine Cab 171 Commercial BLVD, Unit 12
66 CTO Active LC2007000141 Taxi Time, Inc. 2669 Davis Blvd #2
67 CTO Active LC2007000145 Union Taxi 103 Leawood CIR
68 CTO Active LC2007oo0146 Atlantis Cars & limousines, Inc 1650 Tarpon Bay DR S, Unit 101
69 CTO Active LC2007000148 Preferred Shuttle LLC 2800 Rlverview DR
70 CTO Active LC2007000149 David's Livery 2655 Sailors WAY
CTO Active LC2007000152 Five Seas Enterprises, Inc. DBA Cruisers 3220 Palm Ave
71 Charters & Tours
CTO Active LC2007000153 Paradise Limousine Service, LLC DBA 2110 PondeUa Rd
72 Affordable limousine
73 CTO Active LC2007000155 Fly Ride Transportation, LLC 1801 Mission DR
74 CTO Active LC2oo7000156 Mexi-Taxl, Corp 1279 ALLEGIANCE WAY
75 CTO Active LC2007000158 First Choice Transport, Inc 4300 Pine Ridge RD
76 CTO Active LC2oo7oo0159 Carriage Limo. LLC 678 Bald Eagle Dr # 4
77 CTO Active LC2oo70oo166 J Limo 4575 Dorando DR
78 CTO Active LC2007000168 Yellow Cab of SW FL, 'nc 6100 Adkins AVE
79 CTO Active LC2007000172 A-l Cadillac Airport Transportation 27683 Suffridge Dr
CTO Active LCCT02007oo02567 Island Coast Transportation PO Box 9248
80
CTO Active LCCT020070oo2591 Prince Giovanni's of Collier County, Inc. 5613 Eleuthera WAY
81
CTO Active LCCT020070002637 Above Comfort Non-Emergency Medical 4100 Corporate SQ, Unit 116
82 Transport
CTO Active LCCT02oo70002656 Auto on Demand 8235 Potomac Ln
83
CTO Active LCCT02007oo02657 Advanced Transportation 3279 Boca Clega DR
84
CTO Active LCCT02008oo0oo21 Luxury Taxi 1320 Henley St #2001
85
CTO Active LCCT020oaooOOO34 Always On Time Limo, LLC 14904 Indigo Lakes DR
86
CTO Active LCCT02oo80oo0079 Bonita Bee Airport Express Service, LLC 25820 Hickory Blvd
87
8B CTO Active LCCT02oo80000080 MBA Airport Transportation 15501-5 Old McGregor Blvd
CTO Active LCCT0200SOOOO084 Red Rover Charter Service 2324 Kings Lake BLVD
89
CTO Active LCCT02008oo00086 TLC Non-Emergency Medical Transport, 3B93 Mannix DR, Unit 519
90 Inc.
CTO Active LCCT0200BOOOOO93 American Taxi 5250 23rd PL SW
91
CTO Active LCCT020080000094 Doris limousine Service 23280 Abeline Ave
92
CTO Active LCCT020080000095 Express Taxi 191840th TER SW
93
CTO Active LCCT02oo800oo097 SW Cab 3080 Peters St
94
CTO Active LCCT02008oo00103 American Comfort Limo, Inc. 3084 Terrace Ave
95
CTO Active LCCT020080000108 Airport to Airport Shuttle, LLC DBA 315 3rd Ave N
96 Alligator Alley Express
CTO Active LCCT0200BOO00110 Naples Hotels Transportation, LLC 2656 Fountafnview Ln
97
CTO Active LCCT0200BOOOO172 Gulfcoast Airport Transportation & Limo 12950 Posltano Circle Apt. 306
98 Service
CTO Active - LCCT0200BOOO0173 Palm Coast Transportation, LLC 441 27th ST SW
99
CTO Active LCCT02ooBOOOO223 Gulf Shore Transportation 7893 Umberto CT
100
CTO Active LCCT020080000254 24-7 Airport Transportation Inc 2101 19Th Lane S.E.
101
CTO Active LCCT020080000265 Carey Limousine Florida, Inc 4595 Oakes Rd
102
CTO Active LCCT020080000267 USA Transportation 171 Commercial Blvd S #23
103
CTO Active LCCT02008oo00320 Fancy Cab 2900 14th ST N, Unit 19
104
CTO Active LCCT020080000321 Bravo Taxi, Inc. 5447 Sholtz ST
105
CTO Active LCCT020080000413 Maximum Ventures of SW FI, LLC DBA 13650 Fiddlesticks Blvd # 202339
106 Maximum Limousine
CTO Active LCCT0200B0000415 Freedom Taxi PO Box B596
107
CTO Active LCCT020080000454 Taxi Man 3867 Mannix DR
108
CTO Active LCCT0200BOOOO465 Frank Midland, lnc d.b.a. EZ Journey 4852 Tahiti LN
109
CTO Active LCCT0200BOOO0555 William A. Lakman Services 4 Santa Fe Trail
110
CTO Active LCCT020080000556 Wheelchair Transport Service, Inc. 7411114thAveN.Ste309
111
CTO Inactive LCCT020080000621 Comfort Transportation 865 Kings WAY
112
CTO Active LCCT0200BOOOO622 Eagle Taxi 2880 44th TER SW
113
CTO Active LCCT02oo60000676 Blue Bird Taxi of Lee County, Inc. 3252 Palm Ave
114
CTO Active LCCT0200Boo00677 Sun Coast Taxi 1967 River Reach DR, Unit 251
115
116 CTO ActIve LCCT020080000679 Excellent Transportation, LLC. 1490 8TH Street NE
117 CTO Active LC2007152565 APPLE TRANSPORTATION 15501-6 OLD MCGREGOR BLVD.
118 CTO Active LCCT0200800oo737 Gulf Coast Non-Emergency Transport, 22118 Seashore Circle
LLC.
119 CTO Active LCCT0200BOOO0738 Verve Limo Services, LLC. 6849 Grenadier BLVD, Unit 2003
120 CTO Active LCCT020060000950 Solana Villas PO Box 60195
121 CTO Active LCCT0200800009B7 Aafordable Tours 1083 N. Collier Blvd #201
116 CTO Active LCCT02oo60000679 Excellent Transportation, LLC. 1490 8TH Street NE
117 CTO Active LC2007152565 APPLE TRANSPORTATION 15501-6 OLD MCGREGOR BLVD.
CTO Active LCCT0200800oo737 Gulf Coast Non-Emergency Transport, 22118 Seashore Circle
118 LLC.
CTO Active LCCT020080000738 Verve Limo Services, LLC. 6849 Grenadier BLVD, Unit 2003
119
CTO Active lCCT0200BOOO0950 Solana Villas PO Box 60195
120
CTO Active LCCT020080000987 Aafordable Tours 1083 N. Collier Blvd #201
121
CTO Active LCCT02oo80000988 Guiampu Corp dba Naples Premium 7791 lonio Ct
122 Transport
CTO Active LCCT020090oooo12 Aorida Transportation Specialists Inc 20097 Saraceno Dr
123
CTO Active LCCT020090000040 EZ Joumey lnc 4852 T ahitl Lane
124
CTO Active LCCT020090000041 Gennaro V. Cangiano 4451 Gulfshore Blvd #605
125
CTO Active LCCT02009000oo50 Pelican Shuttle, LLC. 720 Lambton LN
126
CTO Active LCCT02009000oo51 Advanced Quallty Transport Service 2717 SW 11th Court
127
CTO Active LCCT020090000069 Naples Transportation & Tour, LLC 1010 6th Ave South
126
CTO Active LCCT020090000120 Taxi Hispano 4245 Heritage CIR #101
129
CTO Active LCCT020090000145 R.E.A.L Transportation 1141 Cooper DR
130
CTO Active LCCT0200900oo278 E & M School Transportation 3765 20th AVE SE
131
CTO Active LCCT02oo90000284 Ocean Line Transportation inc. 3670 Grand Cypress DR
132
COLLIER COUNTY PUBLIC VEHICLE ADVISORY COMMITTEE
AGENDA
Date: May 4,2009 at 9:30 A.M.
Location: Collier County Community Development Services Building, 2800 N. Horseshoe Dr, Naples, FL,
Conference Room # 609 / 61 0
NOTICE: PERSONS WISHING TO SPEAK AT THE MEETING NEED TO COMPLETE A "REQUEST
TO SPEAK" FORM. SPEAKERS MAY BE LIMITED TO THREE (3) MINUTES Fo.R DISCUSSION
UNLESS ADDITIONAL TIME IS GRANTED BY THE COMMITTEE.
ALL PARTIES PARTICIPATING IN THE PUBLIC MEETING NEED TO SPEAK ONE AT A TIME AND
STATE THEIR FULL NAME AND COMPANY THEY REPRESENT, IF APPLICABLE, SO THAT THE
COURT REPORTER CAN RECORD ALL STATEMENTS BEING MADE.
ANY PERSON WHO DECIDES TO APPEAL A DECISION OF THIS BOARD WILL NEED A RECORD
OF THE PROCEEDINGS PERTAINING THERETO, AND THEREFORE MAY NEED TO ENSURE THAT
A VERBATIM RECORD OF THE PROCEEDINGS IS MADE, WHICH RECORD INCLUDES THAT
TESTIMONY AND EVIDENCE UPON WHICH THE APPEAL IS TO BE BASED.
PLEASE ENSURE ALL PAGERS AND CELL PHONES ARE OFF OR IN A QUIET POSITION.
I. Call Meeting to Order
II. Attendance
III. Approval of Agenda
IV. Approval of Minutes
A. April 6, 2009
V. New Business
A. New Applications
1. Limotions Inc
2. Sanibel Taxi
3. Bravo Taxi, Inc
4. Bumble Bee School Transportation
5. Collier Shuttle Services
6. Exodus Limousine and Transport, LLC
7. Jaquelin Diaz
8. Comfort Transportation, LLC
B. Driver Id Appeal
1. Thomas J. Casey
2. Edouard Jeantoy
VI. Old Business
Staff Comments
VII. Public Comment
VIII. Next Meeting Date
IX. Adjournment
COLLIER COUNTY PUBLIC VEmCLE ADVISORY
COMMITTEE
ATTENDANCE SHEET
Date s- cr- of'
NAME
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LCCT020090000353
LIMOTIONS INC
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
PUBLIC VEHICLE ADVISORY COMMITTEE
2800 NORTH HORSESHOE DRIVE
NAPLES, FL 34104
APPLICATION FOR CERTIFICATE TO OPERATE
DATE:
l1J L9lQ9
,
The undersigned hereby makes application for a Certificate to Operate vehicles "for hire" within
Collier County under Code of Laws and Ordinance Chapter 142, and respectfully submits the
follov..mg information i...'1 support of this application.
FEES: Non-Refundable Application Fee
Certificate to Operate Issuance Fee (Yearly)
Vehicle Decal Permit Fee (Per Vehicle / Yearly)
Driver ID Fee
$ 200.00
$ 325.00
$ 50.00
$ 75.00
NOTE: Please make check / money order payable to the BOARD OF COUNTY COMMISSIONERS
1. Name of Applicant:-.LA!J. S
Address: 0 L
(Number & Street)
Home Telephone: (J"") J 33 I b I 0 E- Mail
Date of Birth: /0/11/72. s.s. #:
Driver's License #: If 2 '10- 5J.O-7Z-,;7/- 0
Fl
(State)
d3 Of{
(Zip Code)
2. If Partnership:
Business Name:
Business Address:
(Number & Street)
(City)
(State)
(Zip Code)
Business Telephone: (
E- Mail
List of Partners:
A.
(Name)
(Address)
o
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
) .
(Home:;pJ'tot;l,v #)
--:::.;;~:~~- .,' v.
(Date of Birth)
(Social Security #)
3. If Manager:
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
Copies of Articles of Incorporation, all amendments thereto, and a certified copy of the Certificate of
Incorporation must accompany this application.
4. If Corporation/Fictious Name:
Exact Corporate/Business Name: /,./ J1 () Tlnltl.\ I / Ale
Business Telephone number: () YJ) r; If () Li i7/ E- Mall / AI FO i) l LI1 Of! 0 A/S . COJt
Business Address:d.ilf3 CLeVE/lAID illE/ rtl2r/vtll32S, t:L 3 "60;10 I
(Number & Street) I (City) , (State) (Zip Code)
List of Directors / Officers:
A.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
5. List any and all persons holding a ten percent (10%) or greater beneficial interest in applicant's
business or company.
A.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
2
6. If applying for Sub-Certificate name(s):
a. Name
Date of application
b. Approved
Rejected
REASON:
c. Name
Date of application
d. Approved
Rej ected
REASON:
7. Trade Name (if any)
8. List all criminal convictions for which the applicant, owners, managers, directors, and any
officers have been found guilty or convicted regardless of adjudication, in the United States
indicating the offense, the date, and the state.
9. Has Certificate to Operate ever been revoked? Yes @
If yes, please explain the reason, the year, city, state, and the previous issued Certificate to Operate
number, of revocation:
3
('f com
llMorioNS
DRIVEN BY COMFORT
Professional Limousine Service
2243 Cleveland Ave - Fort Myers FL 33901
(239) 645-4878 Fax (425) 645-4878 info@limotions.com
Experience Statement
I, Lars Hackl, was the owner and operator of a limousine Service in Germany from 1995
until 2004. Than I have owned and operated limotions, Inc in Fort Myers since
September 2006. Also I worked for Premier limousine Service as a office and dispatch
Manager in 2005, a well established New York Corporation who serve New York City
and Long Island.
A(j _)M .1/ J1/ Of
CONSTRUCTION
~~-
COSTOMHIME BIIIDING
&
REMODEliNG
1345 OLD PONDELLA RD., CAPE CORAL, FLORIDA 33909-5121
PHONE: 239 574-6306 FAX 239574-1752
Date: 3/19/2009
To Whom It May Concern: Collier County
This letter is to inform you that Limotions Inc. has been doing business with our
Company since October 2006. All of his/her accounts have been in
good standing. Should you require any further assistance, please contact me at
(239) 233-0298
Sincerely,
Print Name: Ralf Dletz
Signature:
~._)
/
c ,~;:'_"'-".'--'-
Title: Vice President
--
{m
FIFTH THIRD BANK
---
To Whom It May Concern:
Re: Lars Hackl
3/19/09
This letter is to inform you that Lars Hackl has an active checking
account with Fifth Third Bank. The account was opened on 11/19/1999 at
our Cape Coral Parkway Office. If you have any questions please let me
know at the number listed below.
Thank you, 0-
J ,>-" ;if ..",;c, ---".-- .
'. /" J/ ?~ ' c,.../.,.,~ _ /./ _' .
i',' /i,,,,?-t,,, \..... // ~ ~.-
William Howard
Customer Service Manager
239-549-9500 option 3
TM
Know your Score~M
Credit Report Prepared For:
LARS HACKL
Report as Of: 3/1912009
. .. .
.... .
.: :: Expenan-
. ....
. . .
Personal & Confidential
Please Keep in a safe place for your records.
,
LARS HACKL
Report As Of: 3/19/2009
."-~'---_._---'-'---'-'-------_._------ Table of Contents -----------.------
Personal Profile
Credit Summary 2
Public Records 3
Cred"rt Inquires 4
Account History 6
Credit Score 9
Experian 10
FreeCreditReport.com I A Part of Experian
LARS HACKL
Report As Of: 3/19/2009
_.w
~-""---'""-'--'~"--"---"~-'---'-"------ Personal Profile------~--.------------------------
Here you will find the personal infonnation contained in your credit file, including your legal name(s), current and previous Dddresses, current ;;nd previous
emplovers, and date of birth.
. .... .
Profile .:-.:: Experian' Equifax "V" TransUnion
. ....
~-=, Name LARS HACKL
{;JJ (Also Known As) AKA
Year of Birth 1972 What's missing from this picture?
Address(es} 2930 SE 1ST AVE, CAPE CORAl, Fl
33904-3401 See your Experian@, Equifax@ and Log In Now!
3890 COTTON GREEN PATH DR, TransUnion@ Credit Reports and Scores www.FreeCreditReport.com
NAPLES, Fl34114-9446 at a special "Members Only' price.
Current Employer
Previous Employer ^
..
Personal Statement
This space is reserved for statements of dispute. For most consumers, no infonnalion appears in this section.
Personal Profile Page 1 of 1
Credit Summary
Public Records
Credit Inquires
Account History
Credit Score
LARS HACKL
Report As Of: 3/19/2009
" .
. . .
Credit Summary
This section gives you a broad look at your current and past credit status. Here you'll find the tota! number of open and c!esed 8cceunts in jour nams, l:-iS lola!
balance on those accounts. and delinquencies.
V"
0:7:;'. Real Estate
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Count
Balance
Current
Delinquent
Other
,~:..i' Revolving
l~ Current Account(s)
Count
Balance
Current
Delinquent
Other
(:;-~', Installments
~)
Count 0
Balance $0.00
Current 0
Delinquent 0
Other 0
Count 0
Balance $0.00
Current 0
Delinquent 0
Other 0
,;' Other
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.;~~CC;~ Collections
ll!,'Jrm,J)
Count
Balance
Current
Delinquent
Other
. .. .
"r":: Experian.
. :-:. .
EQuifax
TransUnion
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$0.00
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4
$1,993.00
4
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What.s missing from this picture?
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only" price.
Log In Now!
www.FreeCreditReport.com
o
$0.00
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l~) Current Account(s)
Count
Balance
Current
Delinquent
Other
Personal Profile
Credit Summary Page 1 of 1
.. .. .
"in:: Experian.
. ....
EQuifax V" TransUniol1
What's missing from this picture?
4
$1,993.00
4
o
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See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only" price.
A.
Log In Now!
www.FreeCreditReport.com
Public Records
Credit Inquires
Account History
Credit Score
LARS HACKL
Report As Of: 3/19/2009
.
Public Records
The information in this section comes from fedem! district o,mi,rup;cy ;'c~x::c:, '.:''''~
overdue child support records. Public records remain on your credit report ior f -1 U years. Most consumers 00 nOl nave PUDIIC recoros InformallOil Oil iiluii Ci00il
iepuliS. i fl8f8 is no nf:f:u iO De COnL;.8fneG il no in,Offi-idtiOfl is avaiiBDi8.
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There are no PubrlC Records on your credIt
report at this time.
No H"1StoIy
What's missing from this picture?
See your Experian@, Equifaxil!) and
TransUnion@Credit Reports and Scores
at a special .Members Only. price.
Log In Now!
www.FreeCreditReport.com
^
'-
Personal Profile
Credit Summary
Public Records Page 1 of1
Credit Inquires
Account History
Credit Score
Personal Profile
Credit Summary
Public Records
Credillnquires Page 1 of 2
Account History
Credit Score
LARS HACKL
Report As Of: 3/19/2009
Credit Inquiries
This section contains specific information on each ::ccc:.:r:t yc;.;\': c;::;-::d ';-: th,: ;:::::t. ".:::'ti..': ';-:;:~~::':~ :::~:.':...~ ::::...;-::: ::~::;-:: _..
We have provided creditor contact infonnation in order to make it easier for you to reSOlve any Issues. Use 1M adaresses aM pncr:e numcers lC ccmaCI memo
MACYS/DSNB
~
I~
Business Name
Inquiry Date
Business Type
800-243-6552
9111 DUKE BLVD
MASON, OH 45040
,. .a .
.:":: ExperialY
.....
MACYSJDSNB
101812OO8
Department And Variety Stores -
non specific
Equifax
"V
TransUnion
What's missing from this picture?
Equifax
"V
Log In Now!
www.FreeCreditReport.com
j
^
l
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only" price.
KROLL FACTUAL DATAl060
g
Business Name
Inquiry Date
Bus"'" Type
970-663-5700
5200 HAHNS PEAK DR
LOVELAND, CO 80538
. .. .
.r":: Experian.
. ....
KROll FACTUAL DATA/060
5I1flOO8
Mortgage Reporter.;
TransUnion
What's missing from this picture?
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only" price.
---
_J\.
Log In Now!
www.FreeCreditReport.com
AMEX
~.-i1
l~
Business Name
Inquiry Date
Business Type
800-874-2717
PO BOX 981537
EL PASO, TX 79998
.. .. .
.:":: Experian'
......
AMEX
41812008
Bank Credit Cards
Equifax "V TransUnion l
What's missing from this picture?
See your Experian@, Equifax@and Log In Now!
TransUnion@ Credit Reports and Scores www.FreeCrediIReport.com
at a special "Members Only" price.
BANK OF AMERICA
g
Business Name
Inquiry Date
Bus"'" Type
800-444-8430
PO BOX 1598
NORFOLK, VA 23501
:::::; Experian'
. ....
BANK OF AMERICA
41812008
AD Banks - non specific
Eq uifax
v
-
TransUnion
What's missing from this picture?
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special -Members Only" price.
A
Log In Now!
www.FreeCreditReport.com
LARS HACKL
Report As Of: 3/19/2009
Credit Inquiries
This section contains specific information on each account you\:c opcn'2'-' '" ""~ ;:,,~,. ".~~o:,.:c ,'''c'''''..o:'c' -''-'c'-:,c~: .:__~~:'_
We have provided creditor contact infonnation in order to make it easier for you to resolve any Issues. Use me aooresses ana pnonc nurr:::crz :0 :;0:;:3:;: morr:o
BANK OF AMERICA
. .. .
.ro:: Experian'
.....
Equifax
v
TransUnion -
(GJ
Business Name
Inquiry Date
Busi_ Type
BANK Of AMERICA
1rT/2008
Bank Credit CanIs
What's missing from this picture?
800-421-2110
PO BOX 17054
WILMINGTON, DE 19884
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only" price.
Log In Now!
www.FreeCreditReport.com
l
^
J
"
Personal Profile
Credit Summary
Public Records
Credit Inquires Page 2 of 2
Account History
Credit Score
LARS HACKL
Report As Of: 3/19/2009
Account History
This section contains specific information on each account you've opened in the p;:::t. P:::::ti':c :~fc~o::;::i::~ ::::::,,: /::", ":~~~c;": C:",~,>,: uu . uuu.,
We have provided creditor contact information in order to make it easier for you to resolve any issues. Use the addresses and phone numbers to con!.act them.
BANK OF AMERICA
"
:i==i; Experian"
. ....
Equifax
TransUnion
I~ Current
800-421-2110
POB 17054
WILMINGTON, DE 19884
Account Name
Account'
Account Type
Balance
Past Due
Date Opened
Account Status
Mo. Payment
Payment Status
High Balance
Limit
Tenns
Comments
BANK OF AMERICA
...
Credit Card - Revolving Terms
$633.00
What's missing from this picture?
111/2008
Open
$15.00
Current
$842.00
$800.00
Revolving
See your Experian@, Equifax@ and I Log In Now!
. @ . I www.FreeCreditReportcom
TransUmon Credit Reports and Scores
at a speCial "Members Only" price.
^
24/Mo Payment History
2007 2008 2009
Month MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB
Experian OK OK OK OK 01< OK OK OK 01< OK OK OK OK
"
~
CHASE
V"
IfF,~, Current
-.:."!::...."*::;!!!J
800-955-9900
800 BROOKSEDGE BLVD
WESTERVILLE, OH 43081
24/Mo Payment History
2007
Month APR MAY JUN
Experian
Account Name
Account.
Account Type
Balance
Past Due
Date Opened
Account Status
Mo. Payment
Payment Status
High Balance
Limit
Tenns
Comments
. .. ..
.r.:: Experian
. ....
Equifax
TransUnion
CHASE
Credit Card - Revolving Terms
$1,202.00
What's missing from this picture?
2/112009
Open
$24.00
Current
$1,202.00
$1,600.00
Revolving
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only" price.
Log In Now!
www.FreeCreditReport.com
^
2008 2009
JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR
OK
Personal Profile
Credit Summary
Public Records
Credit Inquires
Account History Page 1 of 2
Credit Score
LARS HACKL
Report As Of: 3/19/2009
Account History
.
This section contains specific infonnalion on each account you've opened in the past. Positive information about your account: rc~a:nc cr. i'cur rcpcrt :r.::jc;:~:tc'j'
We have provided creditor contact infonnation in order to make it easier for you to resolve any issues. Use the addresses and phone numbers to contact them.
FIRST PREMIER BANK
I~ Current
605-357-3440
601 5 MINNESOTA AVE
SIOUX FALLS, SO 57104
24/Mo Payment History
2007
Month APR MAY JUN
Experian
"
MCYDSNB
It'>;'''''"!!: Current
\:~~..I
800-458-6229
91110UKEBLVD
MASON, OH 45040
24/Mo Payment History
2007
Month APR MAY JUN
Experian
Personal Profile
Account Name
Account ..
Account Type
Balance
Past Due
Date Opened
Account Status
Mo. Payment
Payment Status
High Balance
Limit
Tenns
Com~
:::::; Experian-
.....
Equifax
TransUnion
v
Credit Card - Revolving Terms
$158.00
What's missing from this picture?
. .. .
:~:;~: Experian
Equifax
FIRST PREMIER BANK
9/1/2008
Open
$25.00
Current
$269.00
$275.00
Revolving
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only. price.
Log In Now!
www.FreeCreditReport.com
2008 2009
JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR
OK OK OK OK OK OK
Account Name
Account ..
Account Type
Balance
Past Due
Date Opened
Account Status
Mo. Payment
Payment Status
High Balance
Limit
Tenns
Comments
.A
"V
TransUnion
MCYDSNB
jI'
RlMlIving Charge Account
$0.00
What's missing from this picture?
10/1/2008
Open
$5.00
Cunent
$91.00
$100.00
Revolving
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only. price.
Log In Now!
www.FreeCreditReport.com
2008 2009
JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC JAN FEB MAR
OK OK OK OK OK OK
Credit Summary
^
Public Records
Credit Inquires
Account History Page 2 of 2
Credit Score
LARS HACKL
Report As Of: 3/19/2009
.
Account History
This section contains specific information on each account you've opened in the past. Positive ido~mo!:cr. o!::c~! JC~~ ;J(;(;Ol1:::~ "'~"'",;':i "", , ~ _' -r~. _ .. ._-''' ",e:: ,'.
We have provided creditor contact infonnation in order to make it easier for you to resolve any issues. Use the addresses and phone numbers to contact them.
~
Payment History Legend
OK Cunent
30 30 Days Late
60 60 Days Late
90 90 Days Late
120 120 Days Late
KD Key Derogatory**
r'lD No Data*
RF Repossession or ForecIoswe
PP Payment Plan
'Sometimes the credit bureaus do not have information from a particular month on file.
*' For additional information on Key Derogatory, please see your Credit Report Guide.
Account Status Legend
Current
Current Closed
iii) Unknown
lEJ Potentially Negative
I~..,""I Potentially Negative Closed
,';~
Personal Profile
Credit Summary
Public Records
Account History Page Legend
Credit Score
LARS HACKL
Report As Of: 3/19/2009
Credit Score
A PLUS Score is a numerical representation of your credit worthiness. The majority of lenders use some sort of credit scoring mode! to help predict what kind of credit
risk you may be. For each bureau's score and score explanation, click on the colored tabs below.
~bo~..!)'our PLU~ Score:
Your PLUS Score is fonnulated using the infonnation in your credit file. Your score helps potential lenders, landlords, and employers quickly gauge your credit
history and decide what kind of a risk they are taking if they approve your application. Your PLUS Score can range between 330 and 830, with R higher !':r:orP.
indicating a lower risk. There are many scoring models used in the marketplace. The type of score used, and its aS5ueia:ad ii<.i~ ;S., ,,;::., ii,':, ',:"-; frc;;', ;':iiCC: tc
lender. But regardless of what scoring model is used, they all h,pitO one PUiP']:'O. ~,~. :;u,"-,;"e'.'",,'O ~,~,:.". '. ,,,,<',,.,,,,,:,,::.,,,""".c .'. "'-;.' . . ,.
factor used in the application process. Other factors, such as your annual salary and length of employment, may also be considered by lenders w~;en YOli apply
for a loan.
What this means to you:
Credit scoring can help you understand your overall credit rating and help companies better understand how to serve you. Overall benefits of credit scoring have
included faster credit approvals, reduction in human error and bias, consistency, and bp!tAr tprm" ",nrl ,.",1",,, fnr Am",ri""" ,.,...,,,,,..m,,,",, '''ml!!J'' """""",,-f ,..,.,,,,,,
and losses for lenders. While lenders may use different scoring models to determine how you score, and each major credit bureau has its own meU.od for
calculating credit scores, the scoring models have been fairly 'lie!! ::!::~=:::':'::::::::: ::::. ,!::o:: ::: :C'::":': ::' ':.. . __. .~_ '" ,_ _~,., .. ,_H _.... .. .., ._.... 'n.' _.
another.
DISCLAMER
The PLUS ScoreSM, developed by Experian, is not an endorsement or guarantee of your credit worthiness as seen by lenders. The different risk levels presented here are for
educational use only. Your PLUS Score can help you understand what factors impact your credit score.
Please be aware that there are many scoring models used in the marketplace, and each lender's scoring model has its own set of factors. How each lender weighs their chosen
factors may vary. but the exact formula used to calculate your score is proprietary, In general, the higher your score. the better your chances ilre of obtaining favorable rates and
terms
Your PLUS Score was calculaled using your ilctUAI rlAtil from your credit file on the day thaI you requested your report. making it comparable to most scoring models in the industry.
Keep in mind howRver that other factors, such as length of employment and annual salary. are often taken Into consideration by lenders when making decisions "bout you.
Also note that each bureau hClS its own set of data, resulting in a separClte PLUS Score for each of your credit files.
LARS HACKL
Report As Of: 3/19/2009
.
Credit Score
A PLUS Score is a numerical representation of your credit worthiness. The majority of lenders use some sort of credit scoring model to help predict what kind of credit
risk you may be. For each bureau's score and score explanation, click on the colored tabs below.
. .1 .
.r":: Experian-
.....
697
Credit
330
580
830
Equifax v TransUnion
What's missing from this picture?
See your Experian@, Equifax@ and
TransUnion@ Credit Reports and Scores
at a special "Members Only" price.
Log In Now!
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Percentile: Your credit rating ranks higher than 39.77% of U.S. consumers.
What factors RAISE you PLUS Score:
. You have paid your bills on time and currenUy do not have any overdue
accounts or derogatory information, such as a collection, charge-off, or
bankruptcy, on your report.
. You have a good cushion of available credit between your current
balance and your credit limits on all open trades. This has a positive
affect on your credit score. This cushion shows lenders that you are
unlikely to overextend yourself financially.
. You have no open installment loans, such as auto loans, on your
credit report. This positively influences your credit score because
lenders feel you are more likely to pay your other bills without the fixed
monthly payment attached to an installment loan.
. You have at least 2 or more open major credit cards, such as
Discover, American Express, VISA, or MasterCard, on your credit
report. This often tells lenders that you are a responsible borrower
and they may be more likely to see you as a good credit risk and
extend you credit.
What factors ~ you PLUS Score:
. On average, many of your accounts have been open less than 3 years.
Having long tenn credit accounts that you consistenUy pay on time is
an important indicator of stability to lenders.
. Your overall balances are close to your overall credit limits, which may
be lowering your score. Having high credit limits shows lenders that
you are responsible with your credit, but when your balances are also
high, it can indicate to lenders that you are likely to overextend yourself.
. Having low credit limits on your accounts and loans counts negatively
against your credit score. Having a high amount of credit is a positive
factor because it indicates to lenders that other creditors have trusted
you by lending you money in the past. However, since your major
credit card limits are generally low, lenders may think you dont have
enough experience with high limits.
. Each time a potential lender or landlord pulls your credit report for
review, an inquiry is placed on your fife. Inquiries stay on your credit
report for up to 2 years. Having several inquiries on your credit report
is negatively affecting your score. They are not necessarily negative
information, but too many inquiries may indicate to lenders that you
are hying to take on more new debt or possibly overextending yourself.
Personal Profile
Credit Summary
Public Records
-'
Credit Inquires
Account History
Credit Score Page 1 of 1
. ______ --y.... _.. _w___
August 18, 2006
;~~ri.~r~~
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LIMOTIONS INC.
1722 p]H.~ GRANDE PKWY
CAPE CORAL, FL 33904
FLORIDA DEPARTMENT OF STATE
DMsicm. ofCotpOTltioos
The Articles of Incorporation for LIMOTIONS INC. were filed on
August 17, 2006, and assigned document nulrlber P06000107876. Please refer
to this number whenever corresponding with this office.
This document was electronically received and filed under FAX audit number
H06000206615.
A corporation annual report/uniform business report will be due this
office between January 1 and May 1 of the year following the calendar year
of the file/effective date. A Federal Employer Identification (FEI)
number will be required before this report can be filed. Please apply NOW
with the Internal Revenue Service by calling 1-800-829-3676 and requesting
form S8-4 or by going to their ....ebsite at WWIf.lrs.ustreas.gov.
Please be aware if the corporate address changes, it is the re~nsibility
of the corporation to notify this office.
Should you have any questions rega~nq corporations, please contact this
office at the acidress qiven below.
Sincerely,
Dale White
Document Specialist
New Filings Section
Division of Corporations
Letter Humber: 90&),00051084
P.O BOX6327-TalJahassee.FIonda 32314
H06000206615 3
',,-
State of Florida
Articles of Incorporation of
Limotions Inc.
A Stock Corporation
FIRST:
The name of the Corporation shall be: Limotions Inc.
SECOND: The principal and mailing address of this company is:
1722 Palaeo Grande Pkwy
Cape Coral, FL 33904 us
THIRD: This Corporation is organized for the purpose of transacting any and ail
lawful business for which a Corporation may be formed under Florida general
Corporation law.
FOURTH: The total number of shares of stock which the Corporation is authorized
to issue is 1,000,000 shares of common ~tock having no par value.
FIFTH: The name(s), title(s) and addressees) of the initial Director(s):
Lars Hackl, President; 1722 Palaeo Grande Pkwy Cape Coral, FL 33904 us
SIXTH: The name and address of the registered agent is: Business Filings
Incorporated, 1203 Governors Square Blvd., Suite 101, Tallahassee, Florida 32301:-
2960
I
\
"-
SEVENTH: The name and address of the incorporator is: The Florida Incorporating
Company, 6096 Buckeye Court, Suite C, Tamarac, Florida 33319.
EIGHTH: To the fullest extent permitted by law, no Director of this Corporation
shall be personally liable to the Corporation or its stockholders for monetary damages
for breach of fiduciary duty of such Director.
The undersigned incorporator executed these Articles of Incorporation on August 16,
2006, and hereby acknowledges that the Articles are the act and deed of the
undersigned and that the facts contained herein are true.
Registered Agent:
Business Filings Incorporated
Incorporator:
The Florida Incorporating Company
i/~ fe(
N\
Meaghan
'-
cKaige, President
Mark Schiff, Assistant VP
\.-.-
H060002066153
www.sunbiz.org - Department of State
Page 1 01'2
. ,..<!,.\:I:~t~ .
FLORIDA DEPARTMENT OF STATE _ ^ ,l,J;~'..l~;;.~ l
D IVISlO!\ OF C ORPORJTlO~S ,/;mblZ ~ :;~i~[;:-4
~- ~-.:""f'>?:""~'.. ,I:;
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er:ljl~vlQ\JJLQI1~l,i~ N~x1-Q_I1_l,[!:i! Retum To Li$!
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Detail by Officer/Registered Agent Name
Florida Profit Corporation
L1MOTIONS INC.
Filing Information
Document Number P06OO0107876
FEIIEIN Number 205434009
Date Filed 06/1712006
State FL
Status ACTIVE
Last Event CANCEL ADM DISSIREV
Event Date Filed 11/03/2006
Event Effective Date NONE
Principal Address
2243 CLEVELAND AVE
FORT MYERS FL 33914
Changed 1010712007
Mailing Address
2930 SE 1 ST AVENUE
CAPE CORAL FL 33904
Changed 11/03/2008
Registered Agent Name & Address
HACKL, LARS
2930 SE 1ST AVENUE
CAPE CORAL FL 33904 US
Name Changed: 10/0712007
Address Changed: 11/03/2008
Officer/Director Detail
Name & Address
TitleDP
HACKL, LARS
2930 SE 1 ST AVENUE
CAPE CORAL FL 33904
Annual Reports
Report Year Filed Date
2007 10/07/2007
2006 11/0312006
Document Images
11/03/2008 -- REINSTATEMENT
10/07/2007 -- REINSTATEMENT
View image in PDF format
View image In PDF format
http://www.sunbiz.org/scripts/cordet.exe?action=DETFIL&in'L doc _ number=P06000 1 078... 3/30/2009
www.sunbiz.org - Department of State
Page 2 of2
08/17/2006 -- Domestic Profit
View image in PDF format
Note: This is not official record. See documents if question or conflict.
PrElvi()!.I.s O!LLiJilt
NEllCt on_I..Jst Rltll.t[n ToJ"i~t
~y~nts
No Name History
IOfficer/RA Name Search
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Copyright and Privacy Policies
Copyright @ 2007 State of Florida, Department of State.
http://www.sunbiz.org/scripts/cordet.exe?action=D ETFIL&in<L doc _ number=P06000 1078... 3/30/2009
FLORIDA DEPARTMENT OF STATE
Division of Corporations
March 30, 2009
L1MOTIONS
2930 SE 1 ST AVE
CAPE CORAL, FL 33904
Subject: L1MOTIONS
REGISTRATION NUMBER: G09089900609
This will acknowledge the filing of the above fictitious name registration which
was registered on March 30,2009. This registration gives no rights to
ownership of the name.
Each fictitious name registration must be renewed every five years between
January 1 and December 31 of the expiration year to maintain registration.
Three months prior to the expiration date a statement of renewal will be mailed.
IT IS THE RESPONSIBILITY OF THE BUSINESS TO NOTIFY THIS OFFICE IN
WRITING IF THEIR MAILING ADDRESS CHANGES. Whenever corresponding
please provide assigned Registration Number.
Should you have any questions regarding this matter you may contact our office
at (850) 245-6058.
Fictitious Name Section
Division of Corporations
LetterNo.009A00010695
Division of Corporations - P.O. BOX 6327 -Tallahassee, Florida 32314
SUOC0429
Lee County Tax Collector
2480 Thompson Street
Fort Myers, Florida 33901
www.leetc.com Tel: (239) 533-6000
Local Business.:l'ax.Account: 0700405
Dear Business Owner:
Your 2008-2009 Lee County Local Business Tax Receipt is attached below. Please detach the
receipt and display it in a place that is visible to the public and available for inspection. The Lee
County Local Business Tax Receipt is in addition to any other license or certificate that may be
required by law and does not signify compliance with zoning, health or other regulatory requirements.
The Lee County Local Business Tax Receipt is non-regulatory and is not an endorsement of work
quality.
Your 2008-2009 Local Business Tax Receipt is valid from October 1 , 2008 through September
30, 2009. Annual account notices are mailed in August to the address of record at that time.
Please follow the instructions on the back of this letter to transfer your Local Business Tax Account.
due to a change of business name, ownership, physical address or you are closing your business.
I hope you have a successful year.
/~ ?'~
Lee County Tax Collector
Detach and display bottom portion and keep upper portion for your records
LEE COUNTY LOCALBUSINESS TAX RECEIPT
2008 -2009
ACCOUNT NUMBER: 0700405
ACCOUNT EXPIRES SEPTEMBER 30, 2009
May engage in the business of:
TRANSPORTATION COMPANY
Location
2243 CLEVELAND AVE
FT MYERS FL 33901
....:..-:--- .
I TH!S LOCAL BUS!NESS TAX RECE!PT IS NON REGULATORY
L1MOTIONS INC
L1MOTIONS INC
4703 SW 25TH CT
CAPE CORAL FL33914
THIS IS NOT A BILL ~ DO NOT PAY
PAID 248336-202-1
WEB
09/29/200808:43 PM
$50.00
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.~..com
liONS
D RIVEN BY COM FO RT Logo on front License plate
Logo and pnone # 866-4511MOS on back of the cars
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INSTRUCTIONS FOR A IT ACHJNG DECAL
1. Clean area where new annual decal is to be affixed.
2. Peel decal from this document.
3. Affix decal in the upper right comer of license plate.
IMPORT ANT_INFORMATION
SECTION 320.0605, Florida Statutes, requires this registration certificate or an official
.copy or a true copy of a rental or lease agreement issued for the motor vehicle described be
in possession of the operator or carried in the vehicle while the vehicle is being used or
operated on the highways or streets of this state.
r
,
SECTION 316.613, Florida Statutes, requires every operator of a motor vehicle while
transporting a child in a passenger car, van or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide for protection of the child by properly using a crash-tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat, for children aged 4 through 5 years,
a separate carrier or seat belt may be used.
L
...I
SECTION 627.733, Florida Statutes, requires mandatory Florida No-Fault Insurance to
be maintained continuously throughout the entire registration period; failure to maintain the
required coverage could result in suspension of your driver license and registration.
Mail To:
L1MOTIONS INC
2930 SE 1ST AVE
CAPE CORAL, FL 33904
Important note: If you cancel the insurance for this vehicle,
immediately return the license plate from this registration to a Florida
driver license or tax collector office or mail it to: Dept. of Highway
Safety, Return Tags, 2900 Apalachee Parkway, Tallahassee, FL 32399.
Surrendering the plate will prevent your driving privilege from being
suspended.
l
_ _ ~ 4 _ _ . .
CO/AGY 18 /2 T# 571820680
FLORIDA VEIDCLE REGISTRATION B# 685057
., PLATE LMOTNS DECAL 18547485 Expires Midnight Thu 12/31/2009
>\... (}>
YR/MK 2001/CADI BODY lM COLOR BlK Reg. Tax Class Code
VIN 1 GEEH90Y31 U550271 TITLE 101979690 Init. Reg. Tax Months
Plate Type RGP NET WT 4421 County Fee Back Tax Mos
Mail Fee Credit Class
DL'FEID Sales Tax Credit Months
Date Issued 2/10/2009 Plate Issued 2/10/2009 Voluntary Fees
Grand Total 0.00
L1MOTIONS INC
2930 SE 1ST AVE
CAPE CORAL, Fl 33904
IMPORT ANT INFORMATION
1. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
replacement vehicle.
3. The registration must be surrendered when requesting a change of address.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 30-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
RGP - FLORIDA PERSONALIZED
PLATE ISSUED X
lNSTRUCnONS 1<01<. ATIACHLNli UcCAL
I. Clean area where new annual decal is to be affixed.
2. Peel decal from this document.
3. Affix decal in the upper right comer of license plate.
r-
,
L.
-'
Mail To:
L1MOTIONS INC
2930 SE 1ST AVE
CAPE CORAL, FL 33904
llVlYUK 1 AJ'Il_U'I t'UKlVIA 11 Ul'l
SECTION 320.0605, Florida Statutes, requires this registration certificate or an official
copy or a true copy of a rental or lease agreement issued for the motor vehicle described be
in possession of the operator or carried in the vehicle while the vehicle is being used or
operated on the highways or streets of this state.
SECTION 3'16.613, Florida Statutes, requires every operator of a motor vehicle while
transporting a child in a passenger car, van or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide for protection of the child by properly using a crash-tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat, for children aged 4 through 5 years,
a separate carrier or seat belt may be used.
SECTION 627.733, Florida Statutes, requires mandatory Florida No-Fault Insurance to
be maintained continuously throughout the entire registration period; failure to maintain the
required coverage could result in suspension of your driver license and registration.
Important note: If you cancel the insurance for this vehicle,
immediately return the license plate from this registration to a Florida
driver license or tax collector office or mail it to: Dept. of Highway
Safety, Return Tags, 2900 Apalachee Parkway, Tallahassee, FL 32399.
Surrendering the plate will prevent your driving privilege from being
suspended.
FLORIDA VElllCLE REGISTRATION
CO/AGY 18 I 2
T# 574983015
B# 691311
PLATE
N697FW
DECAL 18792344
YRIMK 20031LINC BODY LM
VIN 1 L 1 FM81 W93Y640193
Plate Type RGR NETWT 4156
DUFEID
Date Issued 3/9/2009
Plate Issued 3/912009
L1MOTIONS INC
2930 SE 1ST AVE
CAPE CORAL, FL 33904
RGR - FLORIDA REGULAR PLATE ISSUED X
Expires Midnight Thu 12/31/2009
&
Reg. Tax 75.60 Class Code
Init. Reg. Tax Months
County Fee 3.00 Back Tax Mos
Mail Fee Credit Class
Sales Tax Credit Months
Voluntary Fees /::-:::-)
Grand Total ~
IMPORTANT INFORMATION
1. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
replacement vehicle.
3. The registration must be surrendered when requesting a change of address.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 30-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
COLOR
TITI..E
WHI .
102235317
INSTRUCTIONS FOR AITACHING DECAL
1. Clean area where new annual decal is to be affixed.
2. Peel decal from this document.
3. Affix decal in the upper right comer of license plate.
IMPORTANT _INFORMATION
SECTION 320.0605, Florida Statutes, requires this registration certificate or an official
copy or a true copy of a rental or lease agreement issued for the motor vehicle described be
in possession of the operator or carried in the vehicle while the vehicle is being used or
operated on the highways or streets of this state.
r
,
SECTION 316.613, Florida Statutes, requires every operator of a motor vehicle while
transporting a child in a passenger car, van or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide for protection of the child by properly using a crash-tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat, for children aged 4 through 5 years,
a separate carrier or seat belt may be used.
L
.J
SECfION 627.733, Florida Statutes, requires mandatory Florida No-Fault Insurance to
be maintained continuously throughout the entire registration period; failure to maintain the
required coverage could result in suspension of your driver license and registration.
Mail To:
L1MOTIONS INC
2930 SE 1ST AVE
CAPE CORAL, FL 33904
"
CO/AGY 18 /2 T# 564705893
FLORIDA VElllCLE REGISTRATION B# 671632
PLATE 655KKD DECAL 16980669 Expires Midnight Thu 12/31/2009
YRlMK 2000lFORD BODY LM COLOR WHI Reg. Tax 123.60 Class Code (j
VIN 1 FMNU41 S8YEC99684 TITLE 100042932 Init. Reg. Tax. Months
Plate Type RGS NET WT 10240 County Fee 3.00 Back Tax Mos
Mail Fee Credit Class
DUFEID Sales Tax Credit Months
Date Issued 12/12/2008 Plate Issued 1/25/2008 Voluntary Fees
Grand Total 126.60
L1MOTIONS INC
2930 SE 1ST AVE
CAPE CORAL, FL 33904
IMPORTANT INFORMATION
I. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
replacement vehicle.
3. The registration must be surrendered when requesting a change of address.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 3D-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
RGS - SUNSHINE STATE
IMPORTANT _INFORMATION
SECTION 320.0605, Florida Statutes, requires this registration certificate or an official
copy or a true copy of a rental or lease agreement issued for the motor vehicle described be
in possession of the operator or carried in the vehicle while the vehicle is being used or
operated on the highways or streets of this state.
SECTION 316.613, Florida Statutes, requires every operator of a motor vehicle while
transporting a child in a passenger car, van or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide for protection of the child by properly using a crash-tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat, for children aged 4 through 5 years,
a separate carrier or seat belt may be used.
SECTION 627.733, Florida Statutes, requires mandatory Florida No-Fault Insurance to
be maintained continuously throughout the entire registration period; failure to maintain the
required coverage could result in suspension of your driver license and registration.
Mail To:
L1MOTIONS INC
2930 SE 1ST AVE
CAPE CORAL, Fl 33904
Important note: If you cancel the insurance for this vehicle,
immediately return the license plate from this registration to a Florida
driver license or tax collector office or mail it to: Dept. of Highway
Safety, Return Tags, 2900 Apalachee Parkway, Tallahassee, FL 32399.
Surrendering the plate will prevent your driving privilege from being
suspended.
'RfMK 200O/MERZ BODY 40
fIN WDBNG70J6Y A067614
'late Type RGP NET WT 4133
)UFEID
)ate Issued 12/12/2008
COLOR
TITLE
BlK
94106452
Reg. Tax
Init. Reg.
County Fee
Mail Fee
Sales Tax
Voluntary Fees
Grand Total
T# 575492672
B# 692090
Class Code ~
Tax Months
3.00 Back Tax Mos
Credit Class
Credit Months
3.00
CO/AGY 18 12
~ORIDA VElllCLE REGISTRATION
>LA TE
L1MOTN
DECAL 16999893
Expires Midnight Thu 12/31/2009
Plate Issued 12/1 012007
.lMOTIONS INC
~930 SE 1ST AVE
;APE CORAL, Fl 33904
IMPORTANT INFORMATION
1. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
replacement vehicle.
3. The registration must be surrendered when requesting a change of address.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 30-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
IGP - FLORIDA PERSONALIZED
I
AGDBD '"
Dl,f Et~.~~.\:JL-"'( ((( I
CERTIFICATE OF LIABILITY INSURANCE 4/29/2009
THIS CERTIFICATE IS ISSUED AS A I'MITER OF INFORMATIOt~
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
I
Fi\i";j'_..'CEi~
Public TranDportatlon Specializt, lna
! HI00 Palmetto Frontage Rd It 210
Miami Lakes, Fl 33016
305-818-9544
. ".:;I-"r-o--Limotions
Inc.
INSURERS AFFORDING COVERAGE NAIC:I
--I/,su;;~,-Northfand Insurance- ----.-----
-111~UIlI;;.Il-Scottsdaie Insurance
2243 Cleveland Ave
Fort Myers, FL 33901
!!tSI)i~:.i~ c
Ir;S."E;~ L
IriSJiEH l
COVERAGES
T liE POLICIES OF II.SURMJ::;E LISTED BELOW HAVE UEErlISSU[[) TO THE IIISUHlO IJAI.IEU I\!JOVE FOIlIIIE POLICY PERIOD INDICATED, NOT'NITHSTAIWING
/dlY R::QUIIlEI.'ENT. 1 EfH.l OR co/mITlOI. OF At,Y CONTrv\Cr Of{ OTHER DOCUI.IEIH ','.'ilH liESPECT TO '!/HICH IIlIS CERTIFICATE 1.IAY BE ISSUED Oil
1.0\Y PERTAlll, HIE INSUIlMJCE AFFORDED BY TIlE POLICIES [)ESCHmED liEllElrllS SUBJIC J 10 ALL I /IE TEfU.IS, EXCLUSIONS MiD CONDiTi(H;:'; OF sue,1
POLICIES ^GGflEG^ TE lIl,11 TS SHO\Vr< 1,'01\ Y HAVE BEEn flEDUCED [H 1'/"0 CL^JI.\~;
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09/28/08
09/28/09
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(Pili il::cljenl)
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, L I ill:;EASE: - l'A EMPLOYEI! S
i I: l OISEr.SE. POLICY 1I1.11T r;---
:;'1" ~;lfnp 1 iO ~J 01 OIIEHA TlOI.'S Il OCA T JOt; S I VEt lie l.E S I [.xCI USllHJ5 :..!>()[ 1) l!Y E I mOR SI '-'1 n' ! SP[ (1:.1 I'HOVI~;lor~s
Limousine Operation:
2003 Lincoln 'l'ownCar VUIII lL1FH81H93YG'10193 2001 Cad~llac Vinll 1GEEli90Y31U550271
2000 Ford Excursion Vin# 1FMNU41S8YEC99684
2000 Morcedez Benz Vin# WDBNG70J6YA067614
2004 Hummer Vinit SGRGN23U84H118104
CERTIFICATE HOLDER
Collier County Board of County
Commissioners
2800 Hourseshoe Drive
Naples, FL 34104
CANCELLA TION
I
~1I001lJ ,\flY or THf ,dIOVI lJESCfll/II'il POIIClf'S IlE CAtJCELLEO UU OllE Till E/f""id"):,
DAlE III! HLOI THE 1~,S1JU~G 1.'~SUi\Ut \".'ill E~~D[.\VOl( 10 !.tAlL 30 0.:'.'.5 'o'.idr1! t;
"O";"I\...': 10 r'il: Cf.H T il" 1C':. 1 E HO!...OfH ~UI..'.!ED TO HIE U:F f. f:lU r F,\:l UHE ro :c S~) ::tt";.L:
H.1PO~;:: no tHlLlG/,fIUfI (J1( lI/,EHLJry Of l\rjY KINO UPCHJ IHE It~$lJHLH ITS ;,~,r'iT:, OJ,
IlEf'HL sun fd IVES ~- J .._____-
,\Ult\Clil/! D I\[PHE.SErJl;.1J'':E''--~;..~~..~~-':
~- ;::-~-<~/ =~-.-~
::;c.-::::/
6ACORD CORPORATIOU 198U
ACORD 25 (2001/00)
AFFIDAVIT
Before me this day personally appeared .1J /} oS H ~ t k L who swears or affirms
that the vehicle(s) to be permitted meet(s) the safety standards as set forth in Code of Laws
and Ordinance Chapter 142.
It is understood and aclmowledged by the Code Enforcement Department and myself that if
my vehicle(s) that is/are permitted fail(s) to meet(s) the safety standards as required by this
Ordinance, the vehicle(s) must be removed from service until all violations are corrected.
BUSINESS NAME II ,.., 0 T 10 AI,! I I AI ("
I
SIGNATURE OF APPUCANT c::;. =>.-.e~
DATE J/ZJ/()?
, .
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and swom to before me this t1 ~:q day of /J/CJ/U,
20t!9.by L 4/5 ~/
( Name of person aclmowledging)
who is personally lmown or has
produced
as identification and who did.
GEHl-lc~ tU c E /;J() ( (,
PRINT NAME OF NOTARY
NOTARY PUBLIC COMMISSION # -p D 7 ~ ? cf,5- 7
NOTARY'S SEAL
COMMISSION EXPIRES: ~ ,()) f)() I 'l..
ct
~ GERALDINE E WOLF
l'A "\ Notary Public, Slate of Florida
a Commls$ion# 00768457
My comm. expires May 2, 2012
4
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
provisions.
~~~
(Si ure of Applicant)
I LARS It4C.KI. swear or affIrm that all information on this Application
for Certificate to Operate is true.
~cant)
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and sworn to before me this ~ ;J3; ~()()9
L ~ . b. D (Date,
By ~ . >)() who has produced -- /-- R...;":' { e.-
(Name of person ackrlowledging) (Type of identification)
As identification and who did take an oath.
.B
Signature of Notary
GBA-!~jtJ6 E ~/F'
Print of Notary
NOTARY'S SEAL
Notary Public Commission # V 1> 7 (p ~ t( \ 7
Commission Expires ~ ~ :'2./ ,f2 () J iIJ-
~~\
GERALDINE E WOLF
Notary Public. Stale of Florida
Commission# 00768457
My comm. expires May 2, 2012
5
S "T L 1\ I, I i\J C~
DATE
\~/lJIOq
CONSENT AND DISCLOSURE ~
LOCATION ~ "
:3jJ
I understand that Collier County Code Enforcement will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New
York, NY 10011, as part of the procedure for processing my PVAC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further information through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id.
I understand a consumer reporting agency's investigation may include obtaining information covering up to the last seven (7) years regarding, among
other items, references, character, driving record, past employment, work habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and federal law. The investigation also may include obtaining information relating to criminal records without
any time limitations, subject to state and federal law.
In the event an investigative consumer report is conducted, I understand such information may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge conceming my character, general reputation, personal
characteristics or standard of living. I understand such information may also be obtained through direct or indirect contact with former employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
a By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act.
I also understand that before my application is denied based, in whole or part, on information obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the accuracy
of any information in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging information in the report. Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the information
contained in the report.
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
Middle Name/Initial
DO
Male Female
I (010 I
#yrs at this address
[WJ
State
~
~NO. State
Signa~ i/21/h'
Minnesota & Oklahoma applicants Only: I have the right to request a copy of my consumer report from Sterling Testing Systems, Inc. by
checking the box below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make
a written request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report.
a I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
COLLIER COUNTY GOVERNMENT
CRIMINAL mSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date: 3/23/09
Pursuant to provisions of Chapter 119, F.S., and procedures outlined under Rule
Chapter llC-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
Name: LARS
First
Middle (full)
ff .,fC,k'L
Last
Maiden
Address:2QJO Sf? Isr AVe, CA f'/3 CfJl"Al, ~(" Y..?9tJ<-{
(Number & Street) (City) . (State) (Zip Code)
Social Security No.:
DOB: !()-/ p- 7'2
Height: '5-f!J ~
Sex: A-
Weight: ISo lbs.
Age: ~
DL No.: 1121/0 --S'ZV-72- 371-0
I~/It-(
Race: yY
Hair: 6 CtPttt?(
(Color)
Eye: ~ (((jIf
(Co or)
Name:
DOB:
Sex:
Last Maiden
City State Zip Code
DL No.:
Age: _ Race:
Eye: Hair:
(Color) (Color)
First
Middle (full)
Address:
Number & Street
Social Security No.:
Height:
Weight:
lbs.
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
I LfiR S ff,ACJ(L
, have read and understood the paragraph
~Iicanl
,J/2s/&J9
Date
ecim~T County
, . ".--- ;.., ,~
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Overage Amount:
Contact:
FEES:
Description
Certificate to Operate
Application
Cashier Name:
Batch Number:
levy _m
157
Development and Environmental Services
RECEIPT OF PAYMENT
2009009602
2009-002105
04/16/2009
Check
1057
$200.00
$200.00
$0.00
Limotions Inc
2243 Cleveland Ave
Ft Myers, FL 33901
Reference Number Original
Fee
LCCT020090000353 $200.00
Amount
Paid
$200.00
2800 Horseshoe Drive N
Naples, FL
34104
239-252-2400
Account
111-138911-321241
PrintResults
Page 1 of3
STERLING
DIRECT
Code Enforcement Div. Collier County
Order#: 9407270
LARS HACKL
PO#
Last Name
First Name
-.---------...----...---
Middle Name
Dale of Birth (mm/ddlyyyy)
Phone
--.-..---..---.-------------------
Projected Salary
Job State
Subject Profile
NA
HACKL
______.____.______I!-B?_____._______.__________________
1011811972
NIA
Current Address
--------.---------.-----------------...---.---.-.--.----.......-..----.------------------
Address
Apartment Number
_.5:i!.L...._.______________
State
Zip
2930 SE 1ST AVE
CAPE CORAL
....------------.-----------------------.---.----.--.-.--..----.--.-----....-----.----..--..-----.......
FL
33904
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Comp8ny
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
Status
3 CLOSED
Findings
Clear
MOTOR VEHICLE REPORT (MVR)
1 CLOSED
See Results Below
SEXUAL OFFENDER DATABASE SEARCH
1 CLOSED
Clear
SOCIAL SECURITY TRACE SEARCH
1 CLOSED
CRIMINAL RECORD SEARCH
The criminal information reported on this website appears exactly as it is received from the local jurisdictions and may contain information
which would be prohibited for use in making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: State: NW Zip: County: NATIONWIDE t..-----
Status: CLOSED
FINDING: Clear
*************************************************************************
. THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND .
. HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
. CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
No criminal convictions found.
City: CAPE CORA~ State: FL Zip: 33904 County: LEE
Status: CLOSED
.._.__.._.._....._-_...._~........_--_.__.__._.._-_.._--_.------..-.--------..---..-.....-.-
FINDING: Clear
No criminal convictions found.
L----
_E.!.!L~!....t.".'...~~~!.P~ 34~!~~~".~ty..=_~_l!:I~~___________~__________
Status: CLOSED
FINDING: Clear
No criminal convictions found.
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
'-~
FLORIDA Driver Record - 88178
Order Date: 04/16/2009
Host Used: Online
Reference: 9407270_3
Period: THREE YEAR
License: H240520723780
Heport Cleay:NO
Name: P...;n.CKL, Ll\RS
Address:
City, St:
As of:
'ht-trllC'.//"'rl C'+a-rl~'Y\rr+cH"'+~rIlN ""'^'t'V\/n:rohr1~'t'"a.n+'1: 1...a.,.,Hl+,...fl)....~.......+Dc:H....lll+.... ,.".........,,') ^ ...........l-..:....H....-
A I') () I') ()()()
PrintResults
Page 2 of3
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 05/06/2008
Exp Date: 05/06/2009
AGE:
Year License First Issued: 07/23/1993
STATUS: VALID
MVR Score
SCORE:
ELIGIBLE
Violations/Convictions And Failures to Appear And Accidents
~
TYPE VIOL
CONV
ACD AVD V /C
DESCRIPTION
CONV 06/09/08 07/03/08 511 SAIl 575 SPEEDING 15 OVER THE LIMIT
SPEED:85/70 LOCATION/DOCKET: SOUTH CAROLINA/9272 PTS: 3
Suspensions/Revocations
/'
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
NO ACTIVITY
License and Permit Information
License: PERSONAL Issue:05/06/2008 Expire:05/06/2009
License Status Explanation: ELIGIBLE
C1ass:E REGULAR OPERATOR
Miscellaneous State Data
.. ENTRIES BELOW COVER THE PAST 3 YEARS ..
MISC: DUPLICATE LIC ISS. 02/02/07 ,OFFICE NO~N76
MISC: EXAMS VISION~l ROAD SIGN=l ROAD RULES~3 DRIVING=l
MISC: EXAMS MCYCLE RULES~O MCYCLE SKILL~O
BLOCK PERSONAL INFORMATION ..
BLOCK FOR MAILING LIST ..
THIS PERSON HAS A DIGITAL IMAGE
I FOR STATED BUSINESS
IPURPOSES ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
Issue Date:
/ /
Control Number: ATAM8H
END OF DRIVING RECORD
Back to Findings
~:t~~~~L~~:~~~~~ DA TABASE SEARCH ~
Status: CLOSED
FINDING: Clear
~_'_""__H___'_'_'__'_...._____._...__._.._____._._.______..._________.______________....__.______...._..___.._.____._________.________~______
No Record Found
Back to Findings
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
/
********w*******************
Social Security Trace
********************************************************************************
GENERATED: 04/16/2009 04:26:22 PM
TRANSACTION ID:0017025465-10530
1.
NAME
LARS HACKL
SSN
###-##-####
VALID
YES
STATE ISSUED
FLORIDA
DATE ISSUED
09/01/2006
ADDRESS
2930 SE 1ST AVE CAPE CORAL, FL 33904-3401
1722 PP.LACO GRANDE PKWY CP.PE CORAL, FL 33904-4441
4703 SW 25TH CT CAPE CORAL, FL 33914-6138
FROM
10/2005
08/2006
07/2007
TO
0412009
04/2008
02/2008
2.
NAME
LARS E HACKL
SSN
###-##-####
VALID
YES
STATE ISSUED
FLORIDA
DATE ISSUED
09/01/2006
ADDRESS
3890 COTTON GREEN PATH DR NAPLES, FL 34114-9446
FROM
12/2007
TO
01/2009
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
h++_..... / /........1 ......+....._1;_ .......+.....~+:_....... ..........__ I_H-.1- ;J:_~ ~-4-'1/_~__~~ 1-4-.../n_":_-4-n ~__H 1-4-_ _ _._H() ^ ___1-":_ 4___
A'''''''' ',....AI\A
PrintResults
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY
MAKE AN EMPLOYMENT DECISION.
**END OF NETWORK TRACE**
~k to Findi!:1.9.s
Page 3 of 3
ON HIS/HER EMPLOYMENT
SECURITY NUMBER TRACE
OTHER INFORMATION TO
Copyright Cl2008 Sterling Infosystems. Inc.
hffn<:. / /<:n <:tprlinatP<:tina ('om/uTPhnirp('t~ Irpcnltc/PrintR pcnltc <>"'T'\v') il rr-hiup=
.II /'")0 I'") {){)O
LCCT020090000325
Roger Pritchard LLC
DBA
Sanibel Taxi
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
PUBLIC VEHICLE ADVISORY COMMITTEE
2800 NORTH HORSESHOE DRIVE
NAPLES, FL 34104
DATE:
APP~ICATION FOR CERTIFICATE TO OPERATE
$l5Jlo~
The undersigned hereby makes application for a Certificate to Operate vehicles "for hire" within
Collier County under Code of Laws and Ordinance Chapter 142, and respectfully submits the
following information in support of this application.
FEES: Non-Refundable Application Fee
Certificate to Operate Issuance Fee (Yearly)
Vehicle Decal Permit Fee (Per Vehicle / Yearly)
Driver ID Fee
~ $ 200.00
$ 325.00
$ 50.00 ~;<.
$ 75.00 S-"
NOTE: Please make check / money order payable tQ the BOARD OF COUNTY COMMISSIONERS
1. Name of Applicant: f2c>JP~ 'P1l.fO-ltlll D
)~lll )lSiS Ltv SAN(&l FL
(Number & Street) (City)
Home Telephone: (f~q) \l7l... ').\1 t{
~/OI' 4\
Driver's License #: Pev S-~~ \ l b
Address:
~ 3 q r;7
(State) (Zip Code)
~^I0{fJ.i~ 7i~.I-" gJ fJoc... (c, I),
Date of Birth:
S.S. #:
( O~ tv\
2. If Partnership:
Business Name:
N/A
Business Address:
(Number & Street)
(/&)
~ E-Mail
\.,~\
(State)
(Zip Code)
Business Telephone: (
List of Partners:
(Name)
(Address)
A.
(Home phone #)
(Date of Birth)
,
,
,
\
\
)
l
(Social Security #)
B.
(Name)
(Address)
) .
(HomeY~W!1~ #)
:;~~ei;' '-f
(Date of Birth)
(Social Security #)
3. If Manager:
f( c0 !Av/ LtC
(Name) I
(J~Cf' s~(), SCfS~~
(Home phone #)
'7'78) GiJJ /) I (lt~ J. l>n 1-t 26
(Address)
I 'I ')c
19') , "') 0
(Date of Birth)
(Soci
Copies of Articles of Incorporation, all amendments thereto, and a certified copy of the Certificate of
Incorporation must accompany this application.
4. If Corporation: . .'
Exact Corporate Name:_Q(iq,eil_- Yt2t1Ct\t"pJ LL( pet, S/-J,^Jti€L. 7/ixi
(-r-& tL F~ \ " a) () be ( ?- 'l "';(1, L
Business Telephone number: (IS I) - 0 V'V" .,)/ - 1'9.9'0 E-Mail
Business Address: I 0 ~<; (,p,(( f'c ,) /;;/1 Y "RJlp , l \./lu I U, ((.. S 3 9S 7
(Number & Street) (City) (State) (Zip Code)
List of Directors / Officers:
A.
[2 [If' fiC. PD 1 i (' >-l f,\A J
(Name)
W.1L-~Sq'f 3-11' L[.{
(Home phone #) (Date of Bit I
B. We LL (t\lll L Pn fic UArZdl
(Name)
412, OJ 1-6
(Home phone #)
~-/6' ~~
)~L! ( I ~/_~ (N
(Address)
(Sal S .
OCI ecunty #) .
2loCf? Qu E e e.Lf.e f'hRt2.
(Address)
(Social Security #)
(Date of Birth)
5. List any and all persons holding a ten percent (10%) or greater beneficial interest in applicant's
business or company.
A.
~!A
(Address)
(Name)
(Home phone #)
(Date of Birt~.)
I\){~
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
2
6. If applying for Sub-Certificate name(s):
a. Name
Date of application
Rej ected
REASON:
b. Approved
c. Name
Date of application
Rej ected
REASON:
d. Approved
7. Trade Name (if any)
8. List all criminal convictions for which the applicant, owners, managers, directors, and any
officers have been found guilty or convicted regardless of adjudication, in the United States
indicating the offense, the date, and the state.
9. Has Certificate to Operate ever been revoked? Yes
No
x
If yes, please explain the reason, the year, city, state, and the previous issued Certificate to Operate
number, of revocatioj) )
~ft~iif/~~k:~'.~ 6~ O:R- O~~ ~::~~) JIz~~(- ~6
~l-~;' t:- - 'f' J) ", l
i/,J,-F"'.X- (,,;1.-. \;.J~. I J r I (l,p.... .J G II. ,"2 ll..elJI c~s ' 1,.1.? I~
l::\ ~(lt'l
t. . ..,,1 . \. \\ h
{"j
ill i.. (" j. II'
~ "j ( L_ . "f t". '" \. , I
I
3
Pri~"hlJ""'. ',rc...m AGf',~~"'ht!7 t'Ji'
az ell-:~ ~~ .~ ~~,:[ ~;f~~~ ~~~~
PO. DCiX 207 .. ~v-1dfor(j. Cij--;,~} ,::':~; :::/':: ,,~, '.?,:;e-cJ;~l'_jG 'lo 2.1g-ci607
Experience Statement
William and Roger Pritchard have been in business since 1966, primarily as
Pritchard Brothers, LLC in the Real Estate Development and Retail business.
In Florida, they have been in business since 1972 on Sanibel Island, Fort Myers,
Bonita, and Naples, in real estate development, taxi transportation, and
restaurant business. They have owned seven restaurants. Four on Sanibel
Island, one in Fort Myers, one in Bonita, and one in Naples.
If you need any more information or have any questions, please let us know.
Sincerely,
~-;{ p~r/)J
William L. Pritchard
~ (. {?fl.JHr~ntJ
Roger C. Pritchard
Facsimile Cover Sheet
To:
Phone:
Pages:
L IIV OA
("~9) .252. w 517'7
( I ') (including cover sheet)
'.../
From:
Phone:
Date:
(Q (d t SC,J~ 57:;f
.,.
************************************************************************
Remarks:
r Ai,"'I fNJR. (~i\H'f(~( fJ''1i.;jj','t1jI4<! Ol' ,fAI'-'1 t€'! MX/
" ;-'" / "~I) . I (' /, I .c.'-1I "
{\. JA! ~ /J i,e~ L~ IJ ~ (" n / ,,::!p i,") Jr . 6 >~~'!..[. ~. /\ft.f!.
Pf()p(f/l 7C IV" t11.1.j/MSS h-J.' rr 1('" cF r;;)/~J' tc( ." ~ to
<: I., y' A ^ I -Ip f'c l ) A//?/~::~C"Hr
v w ,'- rUflpOfl-, 0<' l4~/"V. ,-" U' /1);
1/,!At--1'//
IJ ~7 f
i'OA) /11y~r"1..
NOTICE
This message is intended for the use of the individual or entity to which it is addressed
and may contain information that is priviledged, confidential and exempt from disclos.ure under
applicable law. If the reader of this notice is not the intended recipient or the employee or agent
responsible for delivering the message to the intended recipient, you are hereby notified that any
dissemination, distribution or copying of this communication is prohibited. If you have received
this communication in error, please notify us immediately by telephone and return theses papers
to us at the address shown above via first class mail.
695 TARPON BAY ROAD · SUITE 11 · SANIBEL ISLAND, FLORIDA 33957 .941,-472-4160 . FAX 472-6340
~
Jcmibd_O:~
COMMUNITY BANK
Febrncry 26, 2009
To: Whom it may concern
RE: Roger Pritchard, LLC
DBA Sanibel Taxi
695 Tarpon Bay Rd.
Suite 12
Sanibel, FI 33957
We have a banking relationship with the above company. The loans are guaranteed by William
Pritchard and Roger Pritchard. The relationship has performed as agreed.
Should you have any questions please call me.
Simply. A Better Bank.
2475 Library Way' P.O. Box 187 . Sanibel, FL 33957 . (239) 472-6100 . Fax: (239) 472-5678
Scolty's Automotive Inc.
15580-1 McGregor blvd
Fort Myers, Florida
Lee County
33919
(239) 415-1996
March 19, 2009
Sanibel Taxi
695 Tarpon Bay Rd
SanibeL Florida
33957
To whom this may concern,
I'm writing to you regarding Sanibel Taxi svc. I have been in business with them from
05/13/2005 till current date and will continue to do so. They have always maintained
their vehicles very well and their prompt payments are very appreciated. Roger & Bill
Pritchard are the owners and have always been a pleasure to deal with. They make
TWO monthly payments to me on the 15th and 30th of every month and the current
spending YTD is $10,090.39. Since I have been in business with them, they have never
missed a payment and have a current up to date total of $96,270.85 since 5/13/2005. I
service most of Ft. Myers taxi companies and they are by far one of my best accounts.
Thank you for your time.
Sincerely,
Scott Janson - Shop Owner
RECEIVED 04/07/2009 15:52
SANIBELTAXI
2394725340
Apr 07 09 04:17p
04/02/2009 15:35 FAX 2J9 472 567~
~anlDel vSPLLV8 O~
134 Soulll Tampu Stteez
Tam.... fL 33602
b::I:II ..,
~'
Ttl: (800) Z.6.4264
1:1ll; (100) 226-6363
c.Mail: m.S.depl@m.frnorrgoC...com
MAF Mor1gage Services
PJlIlU,RJiO fmt.:
rkrrreaca ,,: _
AVS RefareDcell:
Sanibel-Captiva Community Bank
2475 LIBRAItY WAY MNIBEL f1.. 3J9S7
R.e.._ Due:
ColllPllled Date:
41.Z12009
4l2I.ZOM
Aprlle.lIlt Illlt,rlll.llJlln
AppllClllIt: PR1TCH.\RD. WILLIAM
Co-AppllCllnr
SlrCCI....dcIn:J~; 740S 8A VS W....Tl!1t PlAC<
Cil)', Slale, Zip: C1NC1NNATl, OH 45255
SS'N'_
SSNf:
"eun Inl"rlll.ll1l>n
I'FX FACTA BEACON J n ~(,ORE
ltlnaa JOO 10 850
FOil: PltlTCHAAD, WIl.l.IAM
L
571
S""C DI1<; '~009
II I!IUOtJI Dl!LINQUCNCY. AM) DmllJCAlOllY 'U8LIC I\lXOKD a,; COLL5CTION I'lUD
IJ "JIIoGi SlICI! l)Il.INqU!NCY .~ 'rOO l\IC~ OIl tn<<NCWN
II _ 01' AOCOUNn WITIl' IlCLINQUeNCY
" AMOUN\' OWEX> ON DEJJI>IQUIINT .u:C01JIoft5
NUMIlI!II OP IlIlOUlIUES ADVUSEL Y ..FPIICI'IID 'INI! stOltE BlIT NOT SlONlFIC'ANl1. V
EfoX-!
l'U €lr:n p AS~I'" 9&
POR,; PRrrCHAlUJ. WILUAM
L
S77
Rlllp 136 10 843
.S<"'Da,,:~ m.1
Oil IWUOUS Dl!l.1NQIJl1>ICV. AND rllllLlC JQ!COIlI) OIl COWlcnON PI..eP
OIJ -mm SJ:Na DIIUlIQIJl!l>ItV 18 tOOUCliltTOI\ \1N1OlOW>l
001 Le~ Of DliUNQU1!NCY ON ACcowrr
Ol~ :~OP BAI.Al>ICIIS TDOU!Dn"1.lWT7Il& TOOIllOHONIlANKIU!VOLVNO O. OTHSP. UYDLV1NCl
INQUIlWi5I101P^C11!D mE CafDlUCOUAi'lD llfJIOOATOkV (Al.EII:r) INfOIUolATlON L!i ~O\JND IN ~ PlUI
XPNIFAlIl. iSAACMDDEI II
"OR: PRITCHARD, WILLIAM
l.
+610
RanJlC 300 10 .SO
,....tl.I.: 41VZOO9 XPN-l
II iRlOUS DUlNQUliNCY AM) JlUIIUC l.I!C()lIl) OIl CtlLLScnON f IUD
! t.tvU (7l)I!LlIfQUD/CY ow ACCOlJNT$
13 TlMI! SINCll Del.ll'lOUIil'lC"IIS TOO IU!CI!NT Ok UMtNQWN
10 ",OPORTIO,.()IIIALANCll TO IlIG1l CUOITON aM/ICING kE\'OL VII'O OIl All. REVOLVING ACCOUNT3
I TOO MANY INQUlkIES LAliT Il MD.'IT1IS
\JJn'~UI
SCOIlE tAC'
p. 1
'tl:.;I.........
- 1
RECEIVED 03/20/2009 09:01
2394725340
SANIBELTAXI
Page 6 of 11
0QU I FJl.X1 CREDIT REPOR0
BEACO~ 5.0 AUTO INDUSTRY OPTION~89~~ 00039/00013/00018/00010
S~RJ.OUS DELINQU~NC.Y AND DEROGA10RY PUBL C RECORD OR COLLECTION FILED
TIME SINce DELINQUENCY 18 TOO RECENT 0 UNKNOWN
NUMBER OF. ACCOUNTS WITH DELINQUENCY
PROPORTION OF BALANCES TO CREDJ.T LIMITS, 100 HIGH ON BANK/OTHER REVOLVING ACCTS
SSN ISSlJEP-58
STATE ISSUED-QH
* 344 CSC cREDIT SERVICES - PO BOX 619054
,DALLJI.S TX 75261-9054, (800) 392-7816
*ROGER,PRITCHARD,C SINCE 10/01/65 FAD ).2/09/09
J.B41, IBIS, LN, SANIBEL, FI" 33957, TAPE RPTD 01/09
TELEPHONE NUMBER (239)472-2594 SPBC 02/09
206,N 16TH,ST,DECATUR,IN,46733,TAPE RPTD 02/09
rN-~OGER,C,P. __
BD3-03/J.9/1941,888- .. S8N VE~: Y
*SUN-02/74-02/09,PR/OI-NO,COLI,-YES,FB-NO, ACCTS:65,HC$0-2.1M, 53-ONES,
5-TWOS, i-THREE, '--NINES, 4-0THER3, HIST DEL- 1S-TWOS, 9-THREE:S:,
I-FOUR,
****w* COLLECTION I1EMS ******
LIST ~PTD AMT!BAL
09/0S 12/08 $ 389
$ 389
09/06 08/06 $ 16801
$ J.4 4 3 B
DLA/ECOA
07/08*
I
03/05*
I
AGE'.NCX/CLIENT
~. -
DUKE F.NERGY OHI
1]- -
THE HOR:r. ZON FOU
STATUS/SERIAL
UNPAID
3152430
UNPA!D
2449047
_w*******~ww**~~****~~W.******
FIRM / J.OENT CODE CS RPTD LIMI~
ECOA/ACCOUNT NUMBER OPND p/DuE
flICR BAL $ DLA MR (30-60-90~)MAX/DEL
TERM 24 MONTH HISTORY
---------------------------------------------------------------------------------~-
SANIBELB!\ *1 - fl.l 0Z/09 20000 20000 20000 02/09 38 (01-00-00) 12/0e-R2
I/ 11/05 103 *2*.*~*~**w*I***.**~~ww**
LINE OF CREDIT
AMOUNT IN H/e COLUMN IS CREDIT L1.MIT
rlSBC SANK 1 R1 02/09 10000 834J. 3874 02/09 .1.6 (01-00-00) lO/08-R2
II 03/95 ]29 w~~2******~*/*w~*~*******
CREDIT CAB.D
AMOUNT :r:N H/e COLUMN IS CREDIT LIMIT
SANIBE1"BK R2 02/09 600K 600K 599.5K 02/09 45 (11-01-00) 11/07-R3
II 04/05 3497 3613 **22*2*22*2212*322**2****
LINg, OF C~EDIT
AMOUNT IN H/e eOLUMtJ IS CREDIT LIMIT
SANIBEJ.,BK Rl 02/09 lOOK lOOK 98428 02/09 50 (02-00-00) D2IOS-B.?-
1/ 12/04 741 *****~****~2/*w*2********
LINE OF CREDIT
AtJIOUNT IN H/e COLUMN IS CREDIT LIMIT
BKorAtBUQ[~ l R1 01/09 85000 B4999 78552 01/09 35
J/ 02106 1593
LINE OF CREDIT
AMOUNT IN H/e COLUMtJ IS CREDIT LIMIT
FIA CSNA V' 01/09 12600 18897 0 01109 37 (03-01-01) 04/08-R4
II 07/87 ********432*/**w***w2*+**
ACCOUNT CLOSED AT CONSUMERS REQUEST
CREDr')' CAIto
"SK OF AMER 01/09 10000 8891 8302 01/09 20
II 05/89 192
CREDIT CARD
https:/ /www.deatemack.comlcrerntbureau/CBSummary/PrintNSave.aspx?strType=PRlNT ... 3/20/2009
SAHIBELTAXI
RECEIVED 03/20/200g 0g:01 23g4725340
Page 11 of 11
EXTRACO - 02/02 75000 o ll./01
T/ 08/96 589
CLOSED OR PAID ACCOUNT / ZERO SA.I,ANCE
FANN1E MAE ACCOUNT
WI\MUBNK 1 07/99 615K o 06/99
J.I 08/98 30Y
CL,OSl!:D OR PAlO ACCOUNT /ZERO BAI,ANCE
INsrALL~ENT TOTALS 70521\0 592265
1075 9193
GRAND TOTALS
------------------------------------~----------------------------------------------
1027225 1733298 1502150
4.633 15943
Bt( OF AMER _
/
L_
05/07
05/95
----------------------------------------~------------------------------------------
--- 05/07
LOST OR STOL~N CAR.D
CREDIT CARD
05/07
05/89
BK OF AMER_
/
LOST OR STOLEN CP~D
CREDIT CARD
~INQS-SORETY GRO 59
MERe ASSOC 79
FACT:L DTA 16
CBEJ..LTEL
ADVjl.NCEME J:::l
KEYBANKBUS
BOK-ALBUQ .Jf
NATIONALBt<
MAA FlJEL --
RARVEST
KEY BA.NK L
AMEX _
NATIONALElK
AMBX _
SHERWINm
11/2008
OS/2008
OS/2007
- 12/09/06
oa/15/08
- 06/03/08
l<r 11/01/07
L 09/25/07
T 07/23/07
07/18/07
06/18/07
04/30/07
04/27/07
Tl 04/21/07
03/02/07
--- 05/07
MONE.'tGRAM 55
CDS MORTG 49
i'lESTSl,JRETY 61
TlMEWARNER
FRS TtlLRCHNT
GM:n.C
BO!(-A1BUQ
NATJJ BK&'!'R
1YNKSYSTEM 1
FINL ASST _
CO:r..ONIAL B J-
AMEJ{
AMEX _
AMEX.
0512008
0512007
03/2007
12/09/08
09/12/08
04/03/06
J 10/24./07
"'\l 0813:1./07
07/19/07
06/27/07
05/16/07
04127/07
04/26/07
04/19/07
END OF REPORT EQUIFAX AND AFFI:r..IATES - 02/21/09
SAFE SCANNE D
~ Pnldt~
https:l/www.dealernack.comlcreditbureaulCBSummaryfPrintNSave.aspx?strType=PRlNT ... 3120/2009
RECEIVED 03/20/2009 09:04
2394725340
SAt'HEEL TAXI
Page 6 of 12
<FOR>
(iLl
<SUB NAME>
MONTGOMERY CHtVROLET
CR[.DIT REPO~
<INFJ:LE>
02/80
<DATE>
02/21/09
<TIME>
10:30:37
<SUBJBCT>
PRITCHARD, ROGER C.
<SSN>
"'**-**-9263
<BIRTH DATE>
03/4l.
<CURRENT ADDRESS>
l.BU IBIS LN, SANIBEL, rL 33957
<FORMER ADDRESS>
207 PO BOX 207, MILFORD, OR 45150
206 N 16TH ST, D~CATUR, l.N 46733
<DATE RPTb>
12/08
02/07
/
<CU~ENT EM?LOYER AND ADDRESS>
ROGER PRJ.'l'CHARD
<POSITION>
<VERF>
<RPTD>
08/01
<HIRE>
<FORMER EMPLOYER AND ADDRESS>
SELF
07/01
--------------------------------------------~--------------------------------~--------------
S P E C I A L M E S SAG ~ S
"''''*TRANS-ALERT: INPUT CURRENT ADDRESS HOUSE NUMBER MIS~ATCH***
****HAWK-AJ.,r;RT: CLEAR FOR ALL SEARCHES PE.RF.'ORMED***
--------------------------------------------------------------~-----------------------------
MOD E ~ PRO F I L E ~
:::~::~_~:~~-~~~~~~-~~~~:=:-~~:~-~~---:----..SCORE ~49~~ ___~~::~~:__~:~~~=:~~=~~~~~:_______
CREDIT
PR=O COL-2
S 0 M MAR Y *
NEG-6 HSTNEG=27-B5 TRD=93
HIGH CRED CRED LIM BALANCE
$413.1K $405.6K $l90.9K
$392.0K $0 $164.5K
$3.7M $0 $84.0K
$0 $0 $0
$4.5M $405.6K $439.5K
* * TOT A L F I L E HIS TOR Y
RVL~30 INST-36 MTGc2S OPN=O INQ=22
~~S~ DUE MNTHLY PAY AVA!LABLt
$0 $3278 53%
$1075 $3594 0%
$0 $573 O~
$0 $0 0%
$1075 $7445 0%
REVOLVING:
INSTALLMENT:
MORTGAGE:
CLOSED W/BAL:
TOTAL~:
---------------~~---------~----------------------------------------~------------------------
COLLE C T I o N S
SUBNAME SUJ3CODE ECOA OPENED CLOSED $I?J..ACF.:D CREDITOR MOt>
ACCOUNN VERFIED BALlU'lCE REMJl.RKS
HELVEY' ASSOC ....1 - - I 09/09 $389 10 DUKE ENERGY 0913
12/08A s369 1?J:,ACED li'OR COLL
CCP&MCB CO:r.,l, f . . -.1 I 09/06 $16.8K 12 THE HORIZON 098
08/08A $14.4r< 1?LA-CED fOR COLL
TRADE S
SlTBNAME SOBCODE O~ENE.1) HIGHC~ED TERMS MAXDELQ PAY pAT 1-12 MOP
ACCOUNTlI V1::Rifl:ED CREDLIM PASTDUE AMT-MOP PAY PAT 13-24
ECO"'- CQ:t,l.ATRL/LOANTYPE CL9D/PD BALANCE REMARKS MO 30/60/90
GlJ.AC - lU03 $29. :?J< 60M4 a 6 109
~
02l09A $0
C AUTOMOBILE: 02!09F $0 P AND L WRITEOFF
FIRST DATA ... 06/04 $1773 48M36 12/06 & 105
12106A
I LEASE 31 00/00101
NATL BK I; TR ~ 09/06 $35.1K 36MI075 06/07 I I02
02/09A $1075 ^_.. ^^-- l
:r. BUSINESS $10.SK 2S 07/01/00
GMAC - - 08/04 $54K 48Ml125 11/07 .-: 102
09/08A $0
C AUTO LEASE 09/08C $0 CLOSED 47 15/02/00
https:/ /www.dealertrack.com/creditbureaufCBSummarylPrintNSa ve.aspx?strType=PRINT... 3/20/2009
SANIBELTAXI
RECEIVED 03/20/2009 09:04 2394725340
Page 12 of12
MOl
IolOl
I01
COl
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08/97 $9332 24M
09/99A $0
P AUTOMOBILE 09/99C $0 CLOSED
--------------------------------------------------------------------------------------------
WSHNGTN MUTL rA-- 03/90 $131. 2K 360M902
04/00A $0
C CONVEN~IONAL REAL ES 04/00C $0 CLOSED
N.tI,TL BK &. TR r: - 03/99 HOOK 360M665
03/00A so
I REAL ESTATE MORTGAGE
COLONJ.AL MTG '1 0~/9B $140K 360M1215
02/00A $0
p CONVEN!IONAL REAL ES 02/00C $0 'I'RANSE' TO ANOTRER LENDER
HNTT.NGTN NTL J_ U/97 $125K
Q2/00A $125K $0
I LINE OF CREDIT
NATL BK & TR
I N QUI
DATE
02l2:l.109
02/09/09
09/08/08
08/15/08
oe /12/ 08
07/28/08
OS/21/08
04/03/08
01/28/08
01/23/08
01121/08
01/03/08
12/26/07
10/30/07
10/26/07
09/19/07
09/06/07
OS/24/07
05/1B/0,
OS/M/O,
05/04/07
04/19/07
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SUECODE
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SUBNAME
COLUMBIA CHE
MR
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TYPE
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--------------------------------------------~-----------------------------------------------
END 0 FeR E D I T R E P 0 R T S E R V ICE D BY:
TRANSUNION, 2 BAMDWIN PLACE P.O. BOX 1000, CHESTER, PA_ 19022 800-888-4213
COPYRIGHTED TRANSUNION 1994
https:/ Iwww.dealertrack.com/creditbureauJCBSurnmarylPrintNSave .aspx?strType- PRINT ,.. 3/20/2009
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04/29/2009 14:49 2394(Lb34~ ~ANlb~LIA^l
2009 LIMITED LIABILITY COMPANY ANNUAL REPORT ~/~ifj-'-O--9--
, Mar 27, 20 .
DOCUMENT# LOOOOOOO2349 Secretary of State
Entfty Name: ROGER PRITCHARD, L.L.C. . . .
New Principal PI~ of Business:
Cumnt Prtncipal Plat- of BusinesS:
1523 PERIWINKLE WAY
SANIBEl, FL 33957
New Melling Address:
Current Mailing Address:
1523 PERIWINKLE WAY
SANIBEL, FL 33957
FEI Number App..d1 FOI' ( )
FliIIlumMr Not ~neable ( )
cllltlftCtU of StIllUII Deand ( )
. FEI Number. ~"173D
Name and Address of Nvw Regl.red Agent:
tmM and Add..- of Current Registltred AGent: .
PRITCHARD, WILLIAM L
1523 PERIWINKLE WAY
SANleEL, FL 33957 US
The alxwe named entity submits this statement tor the purpose of changing its registered office or registered agent, or both,
in the SIatB of Ronda.
SIGNATURE:
Date
Electronic Signature of RegiS1lered Agent
MANAGItG Ml!MBEfta.1llANAGEM:
l1lIe :
Name:
1'ddIwn:
Cily'S-Zip:
Tille:
NIme:
~
Clty-Sl-Zip:
Tille:
Name:
Mdres9:
Cily.5t-Zlp:
Title:
Name'.
Addn!!r9:
Cily-Sl-Zip:
Tltle ;
1IIame:
Addles:
CII)o-Sl-lip:
llt..:
Neme;
Address:
Clty-st-Zip;
ADIIIYIONSICMANCJESl:
MGRM ( ) Delete
P~!TCHARD, WILLIAM L
1523 PERIWINKLE WA.V
SANIBEL. FL 331157
TJIl.:
Nlime :
AddreB&:
Clty-St-op:
( ) Change ( ) Adcllion
MGRM ( l 0eJet4!
PRITCHAA.O. ROGER C
1523 PI;:RIWINKLE WAV
SANUIEL, FL 3.)957
MGRM ~)BP
GACTI',P
1523 PERIWINLE WAY
SANIBEL. f'L 33957
MGRM ~
~A, A
1513 PERIWINKLe WAY
SANIBEL, FL ;t39S7
MGRM ~ o.~
SLmlCI(.&"
1523 PERIWINKLE WAY
SANlBEL, FL 33957
MGRM ~~
ROB81NS~
1523 PERIWINKLe WA,V
SANIBEL. Ft.: 33951
n..:
Name:
~M:
C~Y"St-ZJp:
( ) Change ( ) Mdilion
( ) ~ ( ) Addition
. Tit..:
Nwno:
AdCll'eSS:
City-S-Zip:
'I'1tle;
Nam.:
Addrest;
Clty-St-Zip:
( ) a.il\ge ( ) MdItioo
Title:
Name; .
hl~'
City-Stoop:
( ) Changl! ( ) Addition
TIll.:
Name:
Aildre$ll: .
,*y-st-lip:
( ) Cllilnge ( ) MclIUo"
, hereby certify ihat the information supplied with this filing does nof qualify for the elCemption stated in Chapter 119, Florida
stBtutes. I further.certity that ltIe information indicated on this report is lJue end aCCu,..ts and that. my electronic 5ignature
~hllll have ~ 51l\T1e legal effect as if made under oath; 1hat I am a manlilging member or manager of the Iimi1ed liability comPfl"Y
or the recelVEJr or trustee empowered to execute this report ~ required by Chapter 608, Florida Sbrtutes.
SIGNATURE; WILLIAM L. PRITCHARD' MGR. 0'J/2712OO9
Electrl)nic Signl!lture of Signing Managin9 Mamber, Manag&r, Of Authorized Repf868ntative I Data
.
. "
REFERENCE
605747
81Q93A
AUTHORIZATION
COST LIMIT
$ PPD
-------------------------~-----~----7~-~~-~~~~-~-~~:-~~---~~----~~~.
ORDER TIME
February 29, 2000
1.1.:16 AM
ORDER DATE
ORDER:NO.
605747-080
2000p:31 S2892~-,-8
~O~lbl100--0106S--010 .
it3Ief.H60. DO It!lI!lt1*< 125.00.
CUSTOMER NO:
-J
)> 'c.1) 0
CUSTOMER: John F. Stewart I Esg ~~ C?
>:::0 :x
SHEPPARD BRETT STEWART & =cr-1 > ~
SHEPPARD BRETT STEWART & >~. -r"1
ep> I
2121 West First Street ~:;:::) 'r".
P.O. Drawer ~ 00 . .. __ ~ .. -0 ~
Ft. Myers, FL 33901. .....,..., "'X
_ - --- -- - ----~-- - -.- - -..,. ------ ------....,------ -.~l~"""'--- -- ---""--3~---'--
DOMESTIC FILIN"G . :... ~~ ;.
." Oi"l1 -.I
:>
81.093A
NAME :
ROGER PRITCHARD~ L.L.C.
EFFECTIVE DATE:
O'
~o 0
r-U')~' C) ;.0
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en
xx ARTICLES OF INCORPORATION
CERTIFICATE OF L1MI1ED PARTNERSHIP
PLEASE RETURN THE FOLLOWING AS PR09F OF FILING:
CERTIFIED COpy
PLAIN STAMPED cbpY
CERTIFICATE OF GOOD S'rANDING
. .j
i U'or'aLp
1 ... 1._
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Vcrri~
ACkno~
W. p.~r./
~
xx
CONTACT PERSON: Janine Lazzarini
ExAMINER'S INITIALS:
~._~ 7. .-
i ! L. E--- : .~.~..
-~--_. --.----
"',
ARTICLES OF ORGANIZATION
ill:
ROGER PRITCHARD.. L.L.C.
The undersigned, for the purpose of forming a Limited Liability Company under the
Florida Limited Liability Company Act, F.S. Chapter 608, hereby make, acknowledge, and file the
following Articles of Organization.
ARTICLE I
NA.ME
. ...-....
The name of the Limited Liability Company shall be Roger Pritchard~ L.L.C.
("Company"). The mailing and street address principal office of the Company 'shall be 1473
Periwinkle Way, Sanibel, PI.. 33957. .
ARTICLE II. _. .
REGISTERED AGENT
The initial registered agent of the Company is William L Pritchard whose address is 1473
Periwinkle Way, Sanibel, FL 33957.
ARTICLE ill
MANAGEMENT
The Company shall he a member-managed Company. The Operating Agreement may
contain any provisions for the regulation and management of the affairs of the Company not
inconsistent with the law or these Articles of Organization. .
ARTICLE IV .
MEMBERS
The names and addresses of the initial members of the Company are:
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NAME
ADDRESS .
William L. Pritchard
1473 Periwinkle Way
Sanibel, FL 3.3957
Roger C. Pritchard
1473 Periwinkle Way
Sanibel, FL 33957
1473 P~e"Way
Sanibe~"3.1957
1473 Pe,.m..i..Te Way
Sanibel~'i'i957
PanlF. Gcleta ~\1,l\fA " . . - - - -
MargaretaUaeta ) b-1 \ ~ ~
1
.
\
ARTICLE V
EFFECTIVE DATE
The Company's existence shall begin at 12:00 AM. on March 1, 2000.
IN WITNESS WHEREOF, the undersigned members have made and subscribed these
Articles of Organization at Fort Myers, Florida. for the foregoing uses and purposes this
Ol~ day of ~M-(' 2000. .
#'~,{~
William L. Pritchard
,. ~
STATE OF :aORIDA
COUNTY OF LEE
The foregoing instnun~ Wil~ ~owledged before me this ~ day of
feh~ . 2000,. by WILLIAM ;L:. PRITCHARD, who is personally known to me or who
has produc~ as identification.
(Seal)
Notary Public
SHERRY N. SIMES
~(J) 0
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My Commission Expir
\.~~"." sHERRYN.SlMSS nted Notary Signature
lll".~, P.lV COMMISSION It CC 810565
EXPIRES: SeIltember 16, 2000
Bonclld 1!lIUNclaIy pllble U~dsrVJlilelS
2
u
Rog~~~
STATE OF ft.ol484
COUNTY OF ~~t:"...
The foregoing instrument was acknowledged before me this ;{sP!-. day of
PebL1J~ -> 2000, by ROGER C. PRITCHARD, who is personally known to me or who has
produced '.JI ~ - - - - as identification. .. -
.. . . t ~ I. . -'" . .p. _ .',_ ~ Co- I .? --. _' .:::' p :;:':.,r ..:...--
(~011 Ii ,.L~
(Seal): 1'TOtary~-
SHERRY N. SIMES
My Commission Expires:
Printed Notary Signature'
. ~ _6 . _........, _"-'0.-- ..
SHERRYN. SIMES
MY_,ce61"'" ~
EXI'lRES: Seplambar 15. 2000
Bcrlded1bNNGWyPU~\I:ldII'..lIl11lS _' ~~
paUl F. Gaeta .. -' --
- - ..
- -
The
~WAI-J
produced
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foregoing instmment was. acknowl~ge<;i p~~ore me this ~~ d~:of:'
'_~~~O, by PAUL F. GAETA, who is persOnally known to me or wlIi!rs;'
kif '-'to - - - - --. .--- .-. . - _as, identification. 5~ -l
. .. ....... ~_... .... . .-.. .?"~.- ~."-
IA~~~ III __J~
NotaIyPublic~
SHERRY N. SIMES
STATE OF FLORIDA
COUNTY Of LEE
(Seal)
"
-- -------
My Commission Expires:
'''~.. SHEflFlY N. Sf
~ MY COMMISSION tee 810565
~ EXPIRES: Sep1llmber t5. 2000
*.f.l: Ekrld.~ lI1ru NalIIY i'Ibi: lmdeMriblIs
Notary Signature
3
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STATEOF FLORIDA
COUNTY OF LEE .-
'.~/-"--
. ~. ~/'. . ..
The foregoing insJroment was knowledged before me this..;J$1!L day of
fEhuJ?:y .2000, by MARGARET GAETA, who is personally known to me or who has
produced as Identification.
.-
.. SHEMYN. SM!8
~ MYCCI,llll\SSlON fOC610S65
.' EXPIRES: seplember 16, 2000
.~~~ B~1llnINo1a!YNaioU\ldenll'illlrS
( ~fl~
NOtaty Public
SHERRY N. SIMES
. . red Notary Signature
(Seal)
4
.' ..
ACCEPTANCE OF REGISTERED AGENT
Having been nam~ as registered agent and to-accept se.rvic~ of process for Roger
Pritchard, L.LC., at the place designated herein,. I hereby accept the appointment as registered
agent and agJ;ee to act in thj.s capacity. I further_ agree_ to comply with the provisions of all
Statutes relating to the proper and complete performance .of my duties. I am familiar with and
accept the obligations of my position as regi.ster~ agent, as provided for in Chapter 608, Florida
Statues,
~#J"~
William L. Pritchard
Date: _
-.~;5!00
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FLORIDA DEPARTMENT OF STATE
Katherine Harris
Secretary of State
June 4, 2001
SANIBEL TAXI
1473 PERIWINKLE WAY
SANIBEL, FL 33957
Subject: SANIBEL TAXI
REGISTRATION NUMBER: G01155900115
This will acknowledge the filing of the above fictitious name registration which
was registered on June 4, 2001. This registration gives no rights to ownership of
the name.
Each fictitious name registration must be renewed every five years between
January 1 and December 31 of the expiration year to maintain registration.
Three months prior to the expiration date a statement of renewal will be mailed.
IT IS THE RESPONSIBILITY OF THE BUSINESS TO NOTIFY THIS OFFICE IN
WRITING IF THEIR MAILING ADDRESS CHANGES~ Whenever corresponding
'please provide assigned Registration Number.
Should you have any questions regarding this matter you may contact our office
at (850) 488-9000.
Reinstatement Section
Division of Corporations
Letter No. 001 A00033729
Division of Corporations - P.O. BOX 6327 -Tallahassee, Florida 32314
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FLORIDA VEIDCLE REGISTRATION
"",,,VII"'\V~ )0'0
PLATE
RJG2S
DECAL 04876278
YRIMK 2OO2ILINC ... BODY LM
VIN 1L1FM81WX2Y61'6743
Plate Type POR . NET wr 4047
DUFEID -
Dale Issued 3/2512009
SANIBEL T AXJ
695 TARpON BAY RD STe. 12
SANIBEL. FL 33957-3135
"
Plale Is~ued 3J2512D09
Ex pires
u~
Midnight Wed3l31-t2010
,
BLK Reg. Tax .
102:301856 Init Reg.
. Cf)unly Fee
Mail Fee
Sales Tax . .
Voluntary Fees
Grand TOlal
COLOR
TTfLE
.100.60
).00
I" .)llJrYV:)1l
BII 455326
Clas~ Code
Tax MonthS
Back TaJI, Mas
Credil Class
Credit Mooths
9
12
I03.~
IMPORT ANTlNFORMA TION
I. The Florida license piBle muSI remain wilh U~ registrant upon sale of vehicte.
2. The: registration must bedelivcrcd II) a Tall Collector or Tag A~nt for lJ'aI1sfer 10
replacement vehicle.
3. The ~jstratjOl) must be sulTendered whert requt':sLing a change of address.
4. RegiSQ'lltion renewals are lhe respons.ibility orlhe regiSlrant and shall occur durinp
lhe 3O-day period prior 10 (he expiration date shown on this re~istrQlion. .Renewal
nocices ate provided as a courtesy and are nOI required (or renewal pu~~.
.-T"
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FL.ORID~ VEIDCLE REGISTRATION
I
PLATE J 20ZW
COIAGY . 18 18
TH 575109310
B#. 453616
YRIMK 4D COLOR 8u( Reg. Tax. 61.60 Class Code !
VIN Tm..E' . 100131662 Jnjt. Reg. . Tax Months 1:
Ph;~ Type 4009 County Fee J.OO Back Tax Mos (
MAil Fee CIWil Class
~ Sales T~ Credit Months
Plate Is sued 2IIVZOO8 V oluntary Fees
Grand Total 64.60
DECAL 04292262
Expires MidnIght Wed 3/3112010
lMPORTANT.lNFORMATION
1. The Florida Ijcen~ 'plate mist remain with the registrant upon sale of vehicle.
2. The rcgisttalion must be delivered to 8 Tax Colledor or Tag Agent for transfer 10
rcpla.cemcnt vehicle.
3. The registtation must be sum:ndered when ~esting a chllDge of address.
4. RegiStrabon renewals are the responsibility of the registrant and shall occur during
tile 30-<lay period prior to the clIpitaLion dale shown on tbis registt2lion. R,enewal
notices are provided as a COt.D1esy aild axe not required fO( renewal putpOseli.
".
RGR. FLORlt REGULAR.
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COIAGY 18 I 8
TIt" 570850632
B# 449022
)RIDA VEIDCLE REGISTRATION
rE . FEY 468
DECAL 028.11~.
Expires Midntght Wed 3/3112010
~ 2008fCADf . BODY 40
lG6KD57V48U167488
)lpeARR NET WT' 4009
ID
iSUed 21312009
COLOR BLK
Tm.E . . 1 02083402 .
. prate Issued .2/3f2OO9
.it \P~..J
Reg. Tax
[nit. Ref:.
County Fee
Mail fee
Sales Tax
VoJUlllar)' Foes
Orand Total
108.73 C13$s Code
rax Months
3.00 Back Tax Mos
Credit Ow -
Creel it Months
9
.13
r 3EL T~
ARPON BAY RD STE'12
~EL,FL 33957~135
(11.73
.iMPORTANT INFO'RMA TION
1. The.Fforida license plate musl remain with lheregiStranl upon sale ofve/\ic1e.:
2. TIlt regiSlratiOll must be delivered 10 a Ta.' CoUOClOr orTagA~I.ror tTllllsfcr 10
replacement vehicle. . . .
3. Tbe n:giSlrdtion must be surrendered. 'o\<heri r~ue.~ing a change of adcb:ess.
4. Rq;istnuion renewals are th~ responsibiLity of tbe re"l!i..~tr<lJ11 IT1d ~an oct-our during
lhe 3{Htay periOd prior In the Cll:piratioo dale shown on- \.his regi!;(ration. Renewal
.notices an: provided as lI. comlcsy and are "Ill! required for ~waf purpo!;tS.
STATE OF THE ARTS PLATE ISSUED X
04/30/2009 08:52 2394725340 ~AN1~~LIAAl
RECEIVED e4/29/200917:25 239472&3401
From: Irene 08roe At TI6 Tr.nlllH,r18Iion In......noe Bro~ F",,,IO: TIB In""""'o,, Broker To~ Ron ra'jtClt
i
r HOC. tJ.Jf U-'
SANIBELTAXI
Oil,., 4r.l~ 02:40 PM Palle: 2 of 2
ACORD.. CERTIFICATE OF LIABILITY INSU~ ~NCE OP ID I~ [)IIT6 rl.ltNO[lII'\'W)
SANIa-l 04/29/09
PRODUCER THIS CEIlTlfl~ TE IS ,"UED AS A MATTER OF INFORMATION
ONLY AND CO FEllS NO RIGHTS UPOl'I THE Cl!!ftTlflCATE
TIB TraD5portatioD Ina. Brkr/j HOLDeR. Tlil8 ERTIFlCATE'DOE& NOT M'lI!!MD. il,XT~ND 0..
425 Hest Broadway, suit.e 400 AL TEft THE CC ERAGE AFFOR OED BY THE POUCIJS BELOW.
'Glendale CA '1.204
Phone: 818-246-2800 rax:818-246-4690 INSURERS AFFO DING COVERAGE NAIC #
MUllED INSl.l'IER " .... 0 ...tI..... s.... C"'MI)' 1023S
-.
IN5URER 6: Odt .40b bd_ ~...,.
Roger pritchaad+ IDe Dba: INSl"lEli c: '
Sa Lb$l I$lan ax~
695,TafPon aal ~ad. $tEl 12 INSUREli 0:
San1be n. 33 51
1NllUl\E1\ E:
COVERAGES
_ t>QlICIES Of IN6UflANCE llSTEO ~E_OW lo<AVli SEliN ISSUEO TO""" ~B~ _0 AIlOVE FOR n<1i POlIc:T "'R 1\X)INDICAiEO, NOiWliHSrANOI~
:'~':i~:::~;'~I~~~=~~::=;~=~=N~~::J=-~~~~~~:~~~ FICATE "'~V llC ,:;:;utOOli
IONS -'1<0 Cor.omONS Of suo<
POUCIE5. AG~~GArn LIf'~'I-re Sr10WN w...V ~.AVE SC...EN REDUCED ev PAID Ct~JMS
1:'; rtaRi TI1'e Cf IN!\UAANCE I'OI.I<:Y tt\lNDllft ~~',~~f' DA (MI!IDO/"/Yl UMlT3
OENIiRAL U,I,IIIl./FV EACH OCOJRIlENCE S 1,000,000
I--
a ~ Ol1CIAl i:!!Nl!PAl. LIA8lLrTV 01'90050198 05/18/08 S/1.8/09 ~it:Il.(I~e:&: rEa. ~~~':'oi'ec:) S 100,000
I-- Cl.Al"'6 MADE [!] oa::~ IIIED EXP (My 0I1Il "/!OIII' 15.000
PERS~ S KJV INJ..RY I 1,000.000
G~AG(;~ 12,000,000
M'L A~GRE(;ATE LIMIT N'PLIES PEl!: PRODUCTS - CO"I"fOI'l'OO 1 EXCLUDED
. F'OUCY n j~ 'n lOC
~ouoea.E LWULm' I,
CCMlIIoSl 91Nlll.E LIMIT I 1,000,000
A I-- IW"f ,tjJT() 8A720797 05/18/08 5118/09 {Eo _,.../
J.- All OWNED .foIJTOS BODIlY INJJRY $
~ S':HECU\.E" ..uTC'3 ,(Ptr Pt"IO'I)
I-- I1IRED ,ojJTOS 800l y INoUlV
NQN.o'MCD AUTOS (Po, ooG<lOm) I
-
"~.HITU_ I
(P" ,oCfd,nll
RCOI:~NIl.IlY AUTO ONlY . "^ ACCIDENT 1
I'i'Y I>JJfO OTHER 1lW" EAACC I
.foIJTOONlY: AGG I
DE"3~LL.A L1A81UT'< ""-CH OCC~>l:::E $
oCCuA D',CLA',",SMAll€ AGGQ= I
I
R OEDUCTI6LE I
RE'TENTlON 1 I
WOIlKEIla COMI'ElltA"ON AND 1~'yt:Q,~ I I"ER
5M1'I.cm;RS'~
/lNY PROPRlETOIWAA1NfRIEXECLII1YE EL. EACK ACCIDeNT $ .
OFFICEllM.E"'llEl'l EXC\\.oEO? E.L. OI9EA&!.. EA ~OYEE I
llJ~b:'~~v=S ...;0.- n, DlSE,o,sE. POLICY LIt.1IT S
OTlieR,
CE3 :"..nON Of OreRolTIOtl3 I LOtA'lr0N31 Vl!IOICLE3 , !XtLU5IQN3 ADOED BY ENOORllEll NT I SPEcIAL PROVISION
Certifieate Kol~r is. included as Ad41tional Inaured, but ~ml:1' as respect.s
the operations of the Named IDsured
CERTIFICATE HOLDER CANCELLATION
COLLI04 SHOULD AH't OF 111 ABOVE DE$CRI8ED POLICII?S IE CNiCELlED BEfORE "TIlE EXPlRAnON
DAiCTHEIlECF. m 18BUINO IHIURER 'MLL ENDEAVOR TO MAL 30 CAva WR!TT1:H
collier county BOard of HOTle~ TO T" et:1 ll'I(AT! HOLMIlNAMEO TO nlE l~.IlUT ~AIl-;;;;O DO BO BHAj.l..
county camm1$s1.oner$ IWOse NO OIlUGA lOll OR LIA8Il.IlY OF PJI~ KINO UI'Of'l TIlE IHSUIl!ll ITS AGEKT'S OR
2800 North HOr&e&boeTra11 REP.
Naples I'L 34104 AV ..0 eNTATNr
ACORD 25 (2001/081 e ACORD CORPORATION 1988
RECEIVED 02/19/2009 10:51 2394725340
'.'rom: Joni Varnadoe At: TIB Transportation Insurance Brokers FaxlD: TIB Insurance Broker To: Ron Taylor
SAt-lIBEL TAXI
Date: 2/19/09 07:04 AM Page: 2 of 2
Sanibe"s'and Taxi
American Southern Ins. Company
Policy Number BA720797
Effective 05/18/08 to 05/18/09
UNIT# YEAR MAKE MODEL PAX ID#
1 ) 1995 CHEVROLET 5 1 GNDM19WOSB138803
2) 2000 DODGE 15 2B5WB35ZXYK157809
3) 2000 DODGE 15 2B5WB35Z2YK138445
f!e 4) 5 2002 LINCOLN LIMO 8 1 L 1 FMB1WX2Y6167 43..-' -.-
5) 99 2001 FORD F350XL 15 1 FBSS31 L31 HA 10915
6) 33 2005 CHEVROLET Astro 7 1GNDM19X65B119931
7) 88 2005 CHEVROLET Astro 7 1 GN DM19X95B119860
8) 100 1999 LINCOLN TOWNCAR 4 1 LNHM82W2XY652889
9) 55 1992 LINCOLN TOWNCAR 4 1 LNCM81WONY540619
10) 22 2001 FORD 15 1 FBSS31 L71 H B27686
11 ) 10 1997 CHEVROLET ASTRO 7 1 GN DM19W4VB125718
~ 12) 20 2007 CADILLAC DTS 5 1G6RD57Y07U186764 -~
dt 13) 2008 Cadillac 3 1G6KD574480167488 ~
~ ONL Y 0<Je.U? A"f' f/2R.J.O L7 7t N
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
prO"VlSlOns.
~~.~
( ignature of Applicant)
I swear or affIrm that all information on this Application
for Certificate to Operate is true.
~v.~
(8 ature of Applicant)
STATE OF FLORIDA
COUNTY OF 001.l.IER
LEE
The foregoing instrument was subscribed and sworn to before me this _t1A t'. ~ 0 I dcx) C(
(Date)
By ::],rXot2Q... C, ~.,-rJ-lA-2.0. whohasproducedOH. \)~\j~ \ ~ccr.J~
(Name of person acknowledging) (Type of identification)
As identification and who did take an oath.
5.QOMilO e. ~
Signature of Notary
FQ.ANr::cs F. ~VN,'S
Print of Notary
!~~.~~~klrkJa
".. i My Commission DD558017
0." Expires 05130I2010
Notary Public Commission # uD55g0 \ 1
Commission Expires
5/.}Qj;).O 10
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1"
5
'7 ,il')
(JI) i ,-~
A F F I DA\f I T
Before m~ this day personally appeared _'V..o~. <2>Q... C-, 'P'g...1.T~ swears or affirms
that the vehicle(s) to be permitted meet(s) the safety standards as set forth in Code of Laws
and Ordinance Chapter 142.
/'
It is understood and acknowledged by t..~e Code Enforcement Department and myself that if
my vehic1e(s) that is/are permitted fail(s) to meet(s) the safety standards as required by this
Ordinance, the vehic1e(s) must be removed from service until all v:iolations are corrected.
SIGNATURE OF APPLICANT
~ PI), kllUJ".,I L.u:. PM. fA/Vl1Q 7&4 '
DATE 31to IDq
BUSINESS NAME
STATE OF FLORIDA
COUNTY OF COLLn~~
t-eff
The foregoing instrument was subscribed and swom to before me this ;;;dhdayof f.lJAOlCrI
20Q9, by
(
"RCXd~ c.., ~CUA-e.'D
Name of person acknowledging)
who is personally known or has
produced 00 ,\)'{2..:hJ~ ~~St... as identification and who did.
'-~ ~ ~ C(:)0Aw
SIGNATURE OF NOTARY
'F(ZA.lrLOS E "EVAl\.lS
PRINT NAME OF NOTARY
NOTARY PUBLIC COMMISSION # 1)D 5S90J7
~~T_r~XLfFIOrida
;!f.. j My Commission 00558017
..... OF...d" Expires 0513012010
esl?x:>!;)%
I.-J
fi'^
_ ,l.
fJ
COMMISSION EXPIRES:
FR01 : PR ITCHI=lRD EROS
e~/3~/20~9 ~6:15
239472534""
RtC~IVED ~4/3B/2eB9 68:30
PHONE NO. :
~Nlbt:.LIA^l
2394726349
513 248 9~
SANIBELiAXl
23947~Me'
rHl.;n:.. tJJ..1 tJ~
04/30/2009 08:52
SANIBELTAXI
R~r. 30 20~9 09:4S~ Pi
?~t Inial
23'34726340
~.~ z-/3Bi~..a is,se
A",.. 3D 01;1 O",!l~
QAloOIiE1. TAlI. 1
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r...J.:..M;:' ,vil.l
..-:,-
.A.J'I'I D.A 11'1'1'
, BUSINESS NAg
~'
~k~ UL i)
. lit ia wuS.,..tood .a ~DWl.ecised by the Code mdlItClll'M"t De i aM ~ that. if
rQy, ftbic1o!&l tbat ia/are ~ taltJl to ~tctl..l th" ~ , ..r~ by thia
Ordklaaec,tbc on:bi~ol~l .at " ~_4 from Benic;o ~ violatiana ~ c:omctel1.
. '
S~~I tL?'-
OATIt \l13b109
SlG:NA~ OJ' APPU
stA'rS'r:Jr PLOKJt)A
COutm' 0' COLLIER
. , ,..,,, ,.-,.-.. ..,'''' ..
T.b.e foregoinC.iDatNmllllt wall. ~b~e4 ~ swam to be!o~
20M., by Wi/horn L. R-Jlrd1/1.rd . . '~ia
. . ( ,~.... vtp- ~dajDs) , ' "
prOduced
\f3#~~
NOTARY PUilUC COK~ON j
, ~'(
, ' , ' ,
1b1.~d..rot .
,of' . I , .
NOTAlU'& ~ '
comassrolUCXJlfRES: 'Junt JJ. ';J..DIO
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\
,
AFFIDAVIT
I
~ \. "
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
proVlslOns.
~~~
(Signature of Applicant)
I Jt/JIYL ~//,t!~/1Il!)) swear or affrrm that all information on this Application
for Certificate to Operate is t:Iue.
~~-w
STATE OF FLORIDA
COUNTY OF COLLIER
M~e, .';)o,dOo9
. (Date)
l)2:\)J <Ot-S Lx..c.. CZ,J S t::
(Type of identification)
The foregoing instrument was subscribed and sworn to before me this
By W::1:.Ll..:I:..Pt-'\ L. o-e.:rrr klAreDwho has produced
(N ame of person acknowledging)
As identification and who did take an oath.
?S-.o C.tlL&D 2. S\--.xw?
Signature of Notary
Notary Public Commission # 1)D55<00\ -,
Commission Expires
Sl301d.OJO
~1lc;L5 F F\/AdS
Print of Notary
!'.u
,.jl"
'\
5
04/30/200'3 08: 52 :'<3':N Ub,:SQI::l ~1'UOc:.L I"'~J.
RECEIVED 04/30/2089 ee:08 2394726341
Apr 30 09 07:21a
S~IBELTA><I
f' . 1
/.,.... ..;..;:::r
- ~ ., ','" .
AFFIDAVIT
I
for Certificate to Operate is
e0
er tand Code of Laws an~ Ordinance Chapter 142,
a C . . cate to Operate lwf fully cqmply with ~ts .
1 hereby certify that I have read and
"Vehicles for Hire- and if 1 am gran
provisions.
(Signature 0
STATE OF FLORIDA
COUN1YOF COLLIER
The foregoing msttuxnent was subscribed and sworn to before tne
By RonaJd T D...M lor' who has. produced
(Name of person aclqJ;'wledgmg)
As identification and who did take an oath.
~t!for(J AJfrf
NOTARY'S SEAL
Notary Public Commission t# T5D Le 71 (p Yo
KJJeEALY E. COOK
MY COt.lM\SSlON , 00.6711)10
EX1'Ilfi: May 8,201 t
B..... 'Ilotu IIoMIYNlIe~~
Commission Expires Ho..Lf 8;:;20 i (
5
04f29!~~~~ 14:4~
L.:l':l'lILb,;l'll:)
~1-\1~!Ot:.L I H^!
1,...,......1... ....-',......
A .. F 1 D A V IT
Before me this day personally 'W-ed ellhGlj;>~'f /.u1. who swears or sffinns
that the vehicle(s} to be permitted meet(a} the safety standards as set forth in Code of Laws
and Ordinance Chapter 142. .
It is understood and aclmowledged by the Code Enforcement Department and myself that if
my vehic1e{s) that is/are permitted fai1(s) to meet(s) the safety standards as required by this
Ordinance, the vebicle(s) must be removed from service until9.ll violations are corrected.
SIGNATURE OF APPUCANT
LlL.. 0114
S&vl U 1;)( ~ ~
Lit 1-9/of
BUSINESS NAME
DATE
STATE OF FLORIDA
COUNTY OF COLUER
The foregoing inslnllnent :- 8Ub7bed and swom to bef"'}'Y'<'1J.':.' ~ ds,y of Avill.
20Q1. by r z::~ · '.........iO 'lJ RDV\oJd ,. "1 ~o~ ~~
( . ame of person acknowledging) . ---
p:p..ed r (~ identificati~ and :0;. - ( L
~ SIGNA:TU FNOTARY - .J/11tJV!IA e. .00
. PRINT ME OF NOTARY
NOTARY PUBLIC COMMISSION # 1)Dlo I \ lPY 0
NoTARY'S SEAL
COMMISSION ExPIRES: JjC1v~ f, )-011
CDM~ ICIIBERI.V E.COOK
fIi ;<Ii MYOCMISS10fUDOS71&40
. EXP!RfS; May., 2011
. BondId'lln""PIlIIIlo~
4
COLLIER COUNTY GO\rER..'&fiVIENT
CRIMINAL HISTORY I BACKGROUND VERIFICATION REQUEST FORM
\Lv,? f..
\ f1,.' LV
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r
,..
Date:
Pursuant to provisions of Chapter 119, F.S., and procedures outlined under Rule
Chapter 11 C-6, F .A. C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
Name:
Q6Cf .ere
First ~
c,
Pflt ~CIJ0~ ~
Maiden
7 "'? f"'l S' ')
) S'1 /
(State) (Zip Code)
PQ ~tJ012CO (O/.lIO)
Age: ~ CO Race: ( () lA.
Hair: B I? ;..J
(Color)
PL
Address:
Middle (full)
124 { 16tS Lrv
(Number & Street)
Last
(', . ,/) ,
<~ tJ r.;( ~(
(City)
Social Security No.:
"') ... / (
DOB: )" 1(;.;1 ~ \".{ ,
Sex: Yh
Eye: gOt)
(Color)
Height: S' l()' Weight: I ~S- lbs.
Name: W[ L II fA )Y) L \
First Middle (full)
Address: lG '1/ t2lJ.~e. (iOL Y}'~I(
Number & Street
Pr; I~ (~ ~() r)
Last
S tl
J. :. - (
1\ t..) I f .~j) \.
City
Maiden
F'L
?' ? /,"'- "7
" ,-/ \
... .f ~ ....
Social Security No.:
DOB:\ - I ().. 'S S- Sex: rn
Height: 5,t I11I Weight: ~ ~ 0 lbs.
(~
DL No.:
Zip Code
p (g ~2 - qg2 w 3f /700
Age: N Race: Cf3 ~
e fJrJ Hair: ~ f'?/v
(Color) (Color)
State
Eye:
COLLIER COUNTY GOVERNMENT
CRIMINAL WSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date:
Pursuant to provisions of Chapter 119, F.S., and procedures outlined under Rule
Chapter 11C-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
First
(2clU Pt (..0 Gu_
Middle (full)
7r; ~) G l/?{)I() (tI J
(Number & Street)
Maiden
Name:
Address:
DI( t! ib
(City)
f3?of
Social Security No.:
DOB:
(t/fj/I. ~~
Height: ~\) ( I' Weight: '2 2- 0 lbs.
Sex:
tri
Name:
First
Middle (full)
Last
Maiden
Address:
Number & Street
City
State
Zip Code
Social Security No.:
DL No.:
DOB:
Sex:
Age: _
Race:
Height:
Ibs.
Eye:
Hair:
Weight:
(Color)
(Color)
04/13/2009 13:24 2394827452
...-....-.....-..". U-, ""OJ' LUUJ ....&.,. u.
To: 239-472-6340
04/10/09 11:13 AM Page 4 0% 4
PAGE 05/07
L~~~'~Q~~U ~ANl~IAXl
From: "WolfeLinda"
~(I..-
STERLING
DATE
sc
LOCATION
~~ <U1jOl:W ~/);/ pJ fLl2
Cr,m;,nt ~5S
(\- N l..
CJly
I
Pre"'OUll Adae:99
4 S 0
Si~ture DElle
Wnnesota & Oklahoma appkarts Only: I hllve the li!#rt 10 requesI ~ copy 01 my COll9U11ef reoort from stering Testing Syl:ferm, Inll. by checking
tne !>OX belaw. sterling TeSing Systems wiI ma.il the COnsumer reoort dil8ll!ly to me. Minllll!ldtl Applanl9 Only; I ItM! the right to m!llre e. wrttlen
llIlJ.Iest to the COnstfTlel" reporting agency to .,,-ollide me oMtIlll complete 3nd llCCU8te dls:elO$uniI of the ~ fIIld !lCOpe f.lf the c:on5U/'YlE!f report.
o r wish to receive a copy of the consumer report. (Check box only if YOU wish to receive 11 copy)
I LI1derst8nd 1hat CollE!( CoI.f1ty Code Enforcement wil utIRze \he services of STERLING TESTING SYSTEMS, INC., 249 West 1711'1 Street, New York. NY
t0011, 85 ~ of 1he proceclllll for processing rrrt Pl/AG driver Id application. I also l.rlderstat1d if ~ appUcation is lJ"'lij'iad, Coller COlJIty COde
Enfacement may obtain ful1her infOlTlllltion Itrough $lbsequent Il"rYeStigetions by STERLING TESTING SYSTEMS, INC so as to UP~. renew or Bl(tend
frt.J PlJAC diver Id.
I tnders1and a conslnler rapor1ing 8g~ investigation Il'Rly inc:4tde otJtall1flllnfonnation caver1~ ~ to the last sewn (7) years regarding, among other
items, refllf9l'l\;eS. ch8fllctar, aMng record, paS! ell'flloyment, worI( habits. ec1lcafon, general reputation, persol1ll! chWIlCter1SllC&, mode of lYIng. JlJdgment
anll leniS, subject to state llI'ld fedEn! law. The Investigation 81s0 may Incl.lde obtalrl~ Information relating to Ctirrinal records wllI10ut any time Imnations.
subject to slate ~ federaJ law. .
In the event flM Investigative COllS\.rner report is condt.ded, I UOOerstancl Such infOl1'l"Rl1lon may be obhlined by personal interviews I'iith ITr'/ eCqJalntances or
associs,. or wllh olhIlre wt)Qm I Ml acquldnted or W10 may nave knowledg8 conterTing ITr'/ character. general reputation, pel"SOl'lal charactertstics or
stanclard of fMng. I untler!;land such infonnatiorl may also be obIsined 1ITclugl direct or indirect contact with former employers, schoOlS and public agend 91
or QIher person:s 'Af1o may have sucn lO1OWJedge.
IIIld8rstand that J hlMl II'le light to receive notice s,boo.!t 1he na1Uta ~nd seepe of 8rT'J inve6ligative COl1:5t.mIIr report reQ.lestIld v.It1in five (~) dayS after tie
Cotrpany receives my request or five (5) days after the il1ll'QSlIgiltive conslllW report WllS requestad. 'Ahchever is later.
a By filling in this circle, I indicate that I wish to r~eive further disclosure about the nature and $Cope of any Company reqU9$t for
an investigati'lEi consumer report. .
I ac:lG1owledge thlIt I have teceived the llttadled SUITI'flty of ITr'/ tigrts under !he Fair Credit Repor1lng Act
Ill/so llM<:Iefstand the! before my appication Is denied based, in Whole or part, on InrOrmation obtained ill1e investige1tve COI1Sl.I'l1er report. 11M' be pro~dell
Il copy of the rQport and "I desa1p11on in 'Wiling of rrtoj tigh~ under 1I1e FPJjr Coot Flepa1lng Act. I l.f1derstantllf I disagree with 1tIe accuracy of arry
information In fie report, I nurt notify Colier County Code Enforcement wi1hin five (5) busires dllys ct my receipt of the report. If I notify Colier CcuIty
Code Enfon:ernent Wittin fiIIe (5) buS1ness dayS of the receipt oJ ltJB report 11m lam cf1aIqng Information in the report. Coller Col.llly COCle Enforcement,
"";1 not make II nnal decision on my application stahl ~ after I have had a reaSOllllble oppor1l.rlity to 8d<tass !he information cont!Iined in 1he rClpOrt.
I hereby consent to this investigauan and authorIze Coller CotIlty COde Entm:emerrt to procure 8n IrPJeStigative consune; report on my bacltg"ourd as
statod above fn:wn STERLING TESTING SYSTEMS, INC. In on:lar kl vemy my Identity for PlXJlOSBS Qf !he backgrolIld IlNeStigallon I am voIt.r1tarily
relea&ing my date of bIr1n for my own benllfit WId fUly lIIderstand that age Is nota considere1lon Of the application proc;ess.
. 0 ~I q /q
Date of BIItI'I (t,IlMJDONY)
c:.
04/13/200'3
13:24
23'34827452
PAGE 07/07
U".U/~~WJ .~..~
L.:JI::r"'trL.O..:l'~V
;;1H1~.I.ar;;.L..1 HI\.L
Apr 10 09 03:S3p
~/l~/1~~Y lS~~~ 2394729343
IiliCi:I I.E1) B4/1 "naM ~:I,! 01
"I'Q: "9-472-8340'
04/10/09 11:~3 AM Pa&~' of <<
SANIBEl. T~
23lJ4~4a SAtu;1lEl.. TAla:
PrOlll! IlWCJIl1'GLilldll."
p.2
PA6E B1/92
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04/13/2009 13:24
2394827452
PAGE 03/07
~~~~v~ C~'.Q/~OQ~ ~.;~~
L~~q'LO~4~ O~N!~LI~!
From: "W'ol.feLindaJl
{?r'r"
To: 239-472-6340
04/10/09 11;13 AM
page 4 Of 4
e
STERLING
~ C!lfISENT AND DISCLOSORE . /)' ~ : "1
L! too <1 LOCATION b'ir;.1/J~pl.i .1J.t/ r-A!; 2
, I
I undarsI:and 1hat Coller Coonly Code Enforcement WIll utilize ltI$ ~ces of STERLING TESTING SYSTEMS. INC.. 249 yvest 17111 Street New YOiX. NY
10011. as part of 1he procedure for proee$$lng my F'II~ dnver ld application. 1 also lI"lderstllnd if my application is gIllrted, Coller COl.I1ty Code
Eoforeetnenl may obtain lurtt"oar infom'llltion 1hrough sJbsequent irwestiglloons by STERLING TESTING SYSTEMS. INC so as to update, renew or 8ld:enj
my FVAC driver Id.
IlJ'Iderstand II consumer reporting agerqs invesllgation may lnc:Iude obtainll'Q InrOl'lTlatlon cOWl1'll4' to fie Ia$t seven (7) years regarding,. among other
items. references, char8cter. driving record. past eI\1IIOYmenI. work habI1B. ed.lcaI!on. gennI roputa1ion. persooaJ character1S1lCS. ~ Of M'lg, j.Klgment
anI:llens, eullj8ct to state and federal laW. TIle IlTIIestIgelfon alSO Ill8Y inoUde obl8iring information relating to criminal records MIhout any time tinita1ions,
cUlljoct to Il'lato and te&lrlll ~.
In the event M investiQllfive corlSllJJer report is cm:1ded, I undet"Stllnd sueh Inf~on may De ODtahad DY pel'&Ol'\allnterYle.\'15 with my aCQUaintances cx"
associates or 'Iri1h o1hers whom I am acquainted or v.tlo may have knowledge conc:~ my Charade!". genet1lI r~1ion, personal cl1aracreristics or
slamml of IMng. I undenltand such infoonation may lllso be ~.1i'\roud1 cirect or irKirect r;onlact witJ former ~ schools and pubic lloencles
or olher PersOIl$ who may have 8UCh knoMedge.
llJl1der$1and 1I1at I helve 1I1e right 10 receIVe nollce BbOOt 11\8 naIln ancI Stope Of any jnvestigstive ~ report ~ \Ill1tIln l'Ive (:5)llays after 1h8
Corrpany receives rrrt re~ or five (5) days afl9r tha iJ'\Ve$IjgaUVe COfJSI.meI" repat was reqJeSted, wtlicI'lever Is later.
a By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for
an investiga.tive consumer report
I acmooMedge that! have recelved ih& atladled ~ of my rightS U"Ider the Fair Credit Repor1Ing Act
I alac I.I'lClel'8blnd hllJefore my aWiGiltion is denied based, in whole or ~ en information OOIaine4 i)'1 the inYedgillM consUTlef report, I wil be provided
III Ct:1f/'I Of the report and a de5aiption in writing of rfr/ rights lJ'Ider 1I1e Fair CI'edt R~ Act. I urxler5tand if I d:;asree wilh, the llCCU""acy of il1T"/
infOOl'lllfien in 1he report, [ Il'IJSl notifY Coler Colnly COCJe EnfOll:ement >M1tin five (5) business lIays or rrt'i receipt of 1ne report. If II'lOlIfy Cahr Cc>>tf
Code Enforcement: v.flNn tiwt (5) ~1*iS d<Iy5 Of tie receipt of 1he repoct hilI am CI't8lel'llJt'l9 InfOl'TTlallon iJ'llhQ r1ilpoI1. Calier County Code Enforeement,
will nalll'lllke B final deci$ian or) rtrf .-ppIcation sta1US UII1II a1'Iet" II"taIIe hid a rBilaonabIe oppclf11.rity to e<ld1"eelJ 1ho informa1ion contained In !he report.
I hereby consent to this invesligdcln and aulhorlza Coler Ccul1y CO<Je EI1fcrcemenl to prllCIR an irwsligafive CO"I!lIT\er report 0I'l rrt'i baCl<ground as
s1a1ed above from STERLING TESTING SYSTEMS, INC. In order to verify rrf'/ identity for JUPOSElS of lhe background lrNesllgalon I am voImtari~
releasing my date or blr1l1 fOr my own benefit and ftjy lIlderstand !hat age is no! a conslt:lerdon Of 1I'le appncallon prvtess.
W~ 0~ I
FIrst Name DIW of I3irth (MMlDDNY)
E..
DATE
I
SigrellR
Dele
. I have ltle right to requesl ~ COf1Y at Ill' catsumcr n:porl from at8l1lng T~ S}/slems. Inc. by checll.1ng
!he 00x ~"W. stering Test.~ . '4i mIlU tllc COn&lmDr rBpCrt diredl)110 Me. Minr-1CSOta AppiClOits Only; I have ti'le rigllllo rflIlice a wrtnen
requast to the CClrlSIJITlef' ~ J29CI1CY to prm1de ~ WIth a CCIIYlpIetC end BCCLQ!9 rJ1SC1OSl1"e Of me I18l.\.re and SCOpI! of tile COf1SII1leI' report.
o I wish II:> receive a copy of the COnsumer report. (Ch~ box only if you wish to receive" copy)
&xi'll ~ No.
tt/i 0/ () 8'
04/13/2009 13:24 2394827452
~~iVtu ~q/l~f~CC~ ll:Ci Z~~q'~b~qC ~iC~I~l
To: 239-472-6340 From: IIWolieL1ndall
04/10/09 11:13 AM page 3 Ox 4
Social 5eculity Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a departmeri of the Collier COunty Government Agency. is
8i./1horized to oollect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to Ofiminal records
2. Run SOcial Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed'for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Flonda
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
~IotAI2el. have read and understood the paragraph
ttko! C1
Date
PAGE 04/07
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04/13/2009 13:24 239~~279?~
Apr 10 09 03:53p
~qf1~/~~~~ lb:~~
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PAGE 05/07
~HN.U;)c.l.. 11-11\1
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Of/.10109 11: 13 All P-.e 3 tfjl '"
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2SS472534fJ I ' SANIH:l....' AAl.
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. i
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t~
-fJt:""
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I
. i
$ociBI Secu~ '~Olrectlon rnfon/,atiori
Stering Testing Systen'lS, on behaff O;fthe CoIUer ~y 4d' ~cameri
Oepartml!!l'lt, a depllftmert Df ~ COJlier CCUnty Govimme{t AtJerJJy, 1$
a~ to COIIec.t your SocIal Secul1tr Numberi; ~anr.;e of lt$
duties and ~dies as ~ by law.)': Social Sea.lrit)t Number
than be collected for one or mare affhe toIowIro I'd: I .
1. Olltaink1lbnn.lionrelidi~ loaiminal ~ 1
2 Run Socml Se~1y Tra::e Search I!
3.~h SexUBI 0Irerder Danlbasl!l
4. RUI'\ Molar Vehicle Search . . I
Your SOciII SecuritJ NLmber wi only be c:oRected Il~ di~ for these fisted
purposes, and .,. me)' olhefwise be 8U!hotj;ted by~. and once eoIected, will
be manlained tAG a confidBntilI and ecempl J'eCDAI er qhapter 119, FIOIidtt
stfltur~ by this company and the Code ~ Oc~eri on behalf at
the Collier COUf'lY ~ Acrancy.. . f [ .
I fJ}{11h..,. P(UI....~~ . haw! reIld and J,e~d the paJagJaph
I ! dl.
I ! t.tIbh?
Slgl18lUl1 ilPPllCar1l. I Da~ .
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,
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I
04/13/2009 13:24 239~~~Z1~2u
To: 239-472-6340
04/10/09 11;13 AM
~~'~V(LOOJ ~~;o~
Z~~q(Zb~q~ ~ANIBELTAXI
From: IIWolfeLindall
PAGE 02/07
((t,J
pa.ge 3 of 4
Social Security Collection Information
Sterling Testing Systems, on behalf af the Collier County Code Enforcement
Department, a departmert ofthe Collier County Government Agency, is
authorized to collect your Social security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Seourity Number
shall be collected for one or more of the following reasons:
1. Obtain Information relating to criminal records
2. Run Social Security Trace Search
3. Searoh Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be colleded and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
. the Collier County Government Agency."
have read and understood the paragraph
Y)ld)IJf
Date
PrintResults
Page 1 of7
~>STERLI NG
DI
Code Enforcement Div. Collier County
Order#:9391642
ROGER PRITCHARD
PO#
Last Name
First Name
Middle Name
Date of Birth (mmlddlyyyy) 03191941
_~!!.~'__'___""___H___W_______________________'_'__'"--------------------.----------------------...------..--.---------------.--.-..------------
Projected Salary NIA
Job State
5 ubject Profile
na
PRITCHARD
ROGER
-----.-.---.----------
Current Address
1841 IBIS LN
Address
Apartment Number
City SANIBEL
-$t.;;;;-----.----------------.----------------.---FL---------.--.-------------------
Zip 33957
Previous Address
Address
Apartment Number
City
State
Zip
Additional infonnation
Applicant Email Address
Company
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
MOTOR VEHICLE REPORT (MVR)
Status
4 CLOSED
Findings
Alert
1 CLOSED
See Results Below
----.--...-------------------------.-----------.------------
SEXUAL OFFENDER DATABASE SEARCH
SOCIAL SECURITY TRACE SEARCH
1 CLOSED
Clear
1 CLOSED
Alert
CRIMINAL RECORD SEARCH
The criminal information reported on this website appears exactly as it Is received from the local jurisdictions and may contain Information
which would be prohibited for use In making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hirin decisions.
City: State: NW Zip: County: NATIONWIDE
Status: CLOSED
FINDING: Alert
**********k*******************.**.***************************************
* THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE S&~~CH P~D *
. HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
. CRIMINAL BACKGROUND RESEARCH METHODS.
****************************************.....*****.************kk********
CRIMINAL HISTORY SEARCH INFORMATION
CONVICTION RECORD
Name On Court File: ROGER C PRITCHARD
Name Given: ROGER PRITCHARD
AKA:
Date Of Birth On Court File: 03/19/1941
Date Of Birth Given: 03/19/1941
SS # On Court File: NIA
SS # Given: ###-##-####
County: NATIONWIDE
State: NW
Docket # / Case #: 361997CT041551000ACH
Ind #:
~
D~
Arrest/Incident
Charges:
1. DUI (FIRST OFFENSE) 1M)
2. OIL SUSPEND/CIVIL CHARGES (MI
3. DIL/NONE (M)
Disposition Date:
Disposition:
1. DEF SENT/GUILTY - NON JURY TRIAL/ADJ
2. DEF SENTIGUILTY - NON JURY TRIAL/ADJ
3. DEF SENTIGUILTY - NON JURY TRIAL/ADJ
~
/
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4/21/2009
PrintResults
Page 2 of7
Sentence Information:
1. NOT AVAILABLE
2. NOT AVAILABLE
3. NOT AVAILABLE
c~
COUNTY: FL _LEE
REPORT GENERATED: Tuesday, Apr 14 2009
City: Sanibel State: FL Zip: 33957 County: LEE
__!!!,..!,,_..:_c:::!-_q~~~_._.._____..______...________________.-.-.--------.--.--.--.-----------..-.------..--------------.---------
FINDING: Alert
CRIMINAL HISTORY SEARCH INFORMATION
CONVICTION RECORD
MISDEMEANOR CLASS
Name On Court File: ROGER C PRITCHARD
Name Given: ROGER PRITCHARD
AKA:
Date Of Birth On Court File: 03/19/1941
Date Of Birth Given: 03/19/1941
SS H On Court File: NIA
SS H Given: HHH-HH-HHHH
County: LEE
State: FL
Docket H / Case #: 97-CT-041S51
Ind H: /_~,
Arrest/Incident Dat~_
Charges:
DRIVER LICENSE NONE 1M)
Disposition Date: 10/24/1997
Disposition:
GUILTY
Sentence Information:
COUNTY PROBATION FOR 6 MONTHS
Additional Information:
"NOTE: MIDDLE INITIAL ON FILE
CRIMINAL HISTORY SEARCH INFORMATION
CONVICTION RECORD
MISDEMEANOR CLASS
Name On Court File: ROGER C PRITCHARD
Name Given: ROGER PRITCHARD
AKA:
Date Of Birth On Court File: 03/19/1941
Date Of Birth Given: 03/19/1941
SS H On Court File: N/A
SS H Given: HHH-HH-HHHH
County: LEE
State: FL
Docket H / Case H: 97-CT-03560S
Ind H:
Da~
Arrest/Incident
Charges:
DRIVER LICENSE SUSPEND/CIVIL CHARGES 1M)
Disposition Date: 09/02/1997
Disposition:
GUILTY
S~ntence Tnformation:
COUNTY PROBATION FOR 6 MONTHS
Additional Information:
"NOTE: MIDDLE INITIAL ON FILE
httn<:" / /<:rl <:tf'rl in O"tf'.~tin 0". com/wehdirect3/resultslPrintResults.asDx?oDenOrder= Y &Archive=
4/21/2009
PrintResults
CRIMINF~ HISTORY SEARCH INFORMATION
CONVICTION RECORD
MISDEMEANOR CLASS
Name On Court File: ROGER C PRITCHARD
Name Given: ROGER PRITCHARD
AKA:
Date Of Birth On Court File: 03/19/1941
Date Of Birth Given: 03/19/1941
SS # On Court File: NIA
SS # Given: ###-##-####
County: LEE
State: FL
Docket # 1 Case # 97-CT-034971
Ind #:
Arrest/Incident Date: 1997-08-11
/'
/
Charges:
DRIVING UNDER INFLUENCE (FIRST OFFENSE)
Disposition Dat~
Disposition:
GUILTY
(MI
Sentence Information:
COUNTY PROBATION FOR 6 MONTHS
Additional Information:
--NOTE: MIDDLE INITIAL ON FILE
REPORT GENERATED: Wednesday, Apr 15 2009
Page 3 of7
City: State: OH Zip: 45040 County: WARREN
Status: CLOSED
_!:~,,!~I.,,!~,_~~~'!.._._-_._--------------------------------__.___.__._______.
CRIMINAL HISTORY SEARCH INFORMATION
CONVICTION RECORD
MISDEMEANOR CLASS
Name On Court File: ROGER C PRITCHARD
Name Given: ROGER PRITCHARD
AKA:
Date Of Birth On Court File: 03/19/1941
Date Of Birth Given: 03/19/1941
SS # On Court File: ###-##-####
SS # Given: ###-##-####
County: WARREN
State: OH
Docket # 1 Case #: 02TRC02508
Ind #: NIA ~
Arrest/Incident ~te: 04/23/02 ____
Charges:
1. DRIVING UNDER INFLUENCE 2ND OFFENSE WITH JAIL
2. SPEED
~
Disposition Date: 06/18/02
Disposition: ~
1. GUILTY'/
2. DISMISSED
Sentence Information:
1. SIX POINTS ON DRIVERS LICENSE 365 DAY DRIVERS LICENSE SUSPENSION
150 DAYS IN JAIL WITH 140 SUSPENDED
2 YEARS REPORTING PROBATION
FINED S350.00 PLUS COSTS
Additional Information:
--NOTE: MIDDLE INITIAL ON FILE
CRIMINAL HISTORY SEARCH INFORMATION
CONVICTION RECORD
MISDEMEANOR CLASS
Name On Court File: ROGER C PRITCHARD
Name Given: ROGER PRITCHARD
AKA:
Date Of Birth On Court File: 03/19/1944
Date Of Birth Given: 03/19/1941
#-t-
httnc:' IIc:rJ "tp-rlin p"te"ting .com/wehdirect3/resultslPrintResults.asnx?onenOrder= Y &Archive=
4/21/2009
PrintResults
Page 4 of7
SS # On Court File: ###-##-####
SS # Given: ###-##-####
County: WARREN
State: OH
Docket # / Case #: 03TRD00173
Ind #: N/A
Arrest/Incident D
Charges:
1. FAILURE TO STOP AFTER AN ACCIDENT
2. ASSURED CLEAR DISTANCE
Disposition Date: 02/05/03
Disposition:
GUILTY
Sentence Information:
1. FOUR POINTS ON DRIVERS LICENSE
FINED S100.00 PLUS COSTS
2. FINED S20.00 PLUS COSTS
Additional Information:
**NOTE: MIDDLE INITIAL ON FILE
**NOTE: YEAR OF BIRTH DIFFERENT ON FILE
REPORT GENERATED: Tuesday, Apr 21 2009
City: State: OH Zip: 45150 County: CLERMONT
Status: CLOSEp__
FINDING: Clear
No criminal convictions found.
Back to Findings
....-
./'
,
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
_.!..!~I2~~_~_I3!"!!!~_E.!!~'!.._.____.______.________._____._..____-----.-.----.-.-.--.---.---------.-.-..-----.------.--------------.----------------.----
REKLAMI PRINT IMAGE B 0
START OF DRIVING RECORD
/
OHIO Driver Record - 88178
Order Date: 04/17/2009
Host Used: Online
Reference: 9391642_3
License: PQ586128
Report Clear: YES
Name: PRITCHARD, ROGER C
Address:
City, St:
As of:
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 09/04/2007
Exp Date: 03/19/2010
AGE:
STATUS: VALID
MVR Score
SCORE:
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONV
ACD AVD V/C
DESCRIPTION
** NONE TO REPORT
Suspensions/Revocations
----
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
License: PERSONAL
Class:D
Issue:09/04/2007 Expire:03/19/2010
OPERATOR
NO ACTIVITY
License and Permit Information
Miscellaneous State Data
nttn,,' / /w1 . "terlingtestin Q .comlwebdirect3/resultslPrintResults.aspx?openOrder= Y &Archive=
4/21/2009
PrintResults
Page 5 of7
IFOR STATED BUSINESS
I PURPOSES ONLY
I
I
I
Underwriting:
Policy
NONE TO REPORT ***
Control Number: CIN4EP
Date:
1
Issue Date:
/ 1
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
State: FL
_Status: CLOSED ___
FINDING: Clear
No Record Found
Back to Findings
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
-_..!'I!'!.~~II!.~_!l-'!.'!_--------------------------------------
Social Security Trace
GENERATED: 04/14/2009 11:55:20 AM
TRANSACTION ID:0017006445-1681
1.
NAME
ROGER
SSN
###- ##-u##
STATE ISSUED
OHIO
C PR I TCHARD
VALID
YES
ADDRESS
1841 IBIS LN SANIBEL, FL 33957-4000
2 _
NAME
PRITCHARD
SSN
#U-##-#U#
STATE ISSUED
OHIO
C ROGER
VALID
YES
ADDRESS
1841 IBIS LN SANIBEL, FL 33957-4000
479 LEE DR MASON, OH 45040
3.
NAME
PRITCHARD
SSN
###-##-UU
STATE ISSUED
OHIO
C ROGER
VALID
YES
ADDRESS
PO BOX 207 MILFORD, OH 45150-0207
12901 JUNIPER CANYON NE TRL
ALBUQUERQUE, NM 87111-8236
206 N 16TH ST DECATUR, IN 46733-1452
697 STATE ROUTE 28 MILFORD, OH 45150-1801
PO BOX 578 DECATUR, IN 46733-0578
275 DAVENPORT RD LA FOLLETTE, TN 37766-7032
121 LYNNVIEW DR MASON, OH 45040-1819
PO BOX 823 MASON, OH 45040-0823
479 TEE DR MASON, OH 45040-2009
PO BOX 1806 SANIBEL, FL 33957-1806
481 TEE DR MASON, OH 45040-2009
12915 JUNIPER CANYON NE TRL
ALBUQUERQUE, NM 87111-8236
4.
NAME
ROGER
SSN
###-##-####
STATE ISSUED
OHIO
C PRITCHARD
VALID
YES
ADDRESS
12901 JUNIPER CANYON NE TRL
ALBUQUERQUE, NM 87111-8236
PO BOX 578 DECATUR, IN 46733-0578
275 DAVENPORT RD LA FOLLETTE, TN :;//66-1032
121 LYNNVIEW DR MASON, OH 45040-1819
PO BOX 823 MASON, OH 45040-0823
PO BOX 207 MILFORD, OH 45150-0207
479 TEE DR Y~SON, OH 45040-2009
206 N 16TH ST DECATUR, IN 46733-1452
481 TEE DR MASON, OH 45040-2009
12915 JUNIPER CANYON NE TRL
ALBUQUERQUE, NM 87111-8236
204 FOUR SEASONS DR MASON, OH 45040-2826
1345 EAGLE RUN DR SANIBEL, FL 33957-6709
479 LEE DR MASON, OH 45040
5905 SILVER LEAF NE TRL ALBUQUERQUE, NM 87111-8307
NAME
Initials:
DOB
09/1955
DATE ISSUED
01/01/1958
FROM
12/2008
DOB
03/19/1941
DATE ISSUED
01/01/1958
FROM
12/2008
11/1998
DATE ISSUED
01/01/1958
FROM
07/2001
07/2006
08/2006
04/2005
08/2008
02/2008
01/2006
04/2005
09/2006
05/2005
11/2006
06/2004
DATE ISSUED
01/01/1958
FROM
1112005
08/2008
02/2008
01/2006
04/2005
07/2001
01/2005
08/2006
11/2006
06/2004
06/2006
09/2000
11/1998
06/2004
./
~ ---------------------------
TO
04/2009
TO
04/2009
07/2004
TO
04/2009
04/2009
03/2009
01/2009
12/2008
06/2008
04/2008
04/2008
12/2007
08/2007
03/2007
08/2006
TO
04/2009
12/2008
06/2008
04/2008
04/2008
02/2008
12/2007
12/2007
03/2007
08/2006
06/2006
07/2004
07/2004
06/2004
httn<:' II<:rl "tf'rlin ate"tina r.()m/wehrlirect1 IresH lts/PrintResults.asnx?onenOrder= Y &Archive=
4/21/2009
PrintResults
5 _
ROGER E PRITCHARD
SSN VALID
###-##-#### YES
STATE ISSUED
OHIO
ADDRESS
12901 JUNIPER CANYON NE TRL
ALBUQUERQUE, NM 87111-8236
275 DAVENPORT RD LA FOLLETTE, TN 37766-7032
121 LYNNVIEW DR MASON, OH 45040-1819
PO BOX 823 MASON, OH 45040-0823
479 TEE DR MASON, OH 45040-2009
206 N 16TH ST DECATUR, IN 46733-1452
PO BOX 1806 SANIBEL, FL 33957-1806
697 STATE ROUTE 28 MILFORD, OH 45150-1801
481 TEE DR MASON, OH 45040-2009
12915 JUNIPER CANYON NE TRL
ALBUQUERQUE, NM 87111-8236
PO BOX 207 MILFORD, OH 45150-0207
5905 SILVER LEAF NE TRL ALBUQUERQUE, NM 87111-8307
NAME
6. ROGER PRITCHARD
SSN
###-##-####
VALID
YES
STATE ISSUED
OHIO
ADDRESS
1841 IBIS LN SANIBEL, FL 33957-4000
7.
NAME
C PRITCHARD
SSN
###-##-####
STATE ISSUED
OHIO
ROGER
VALID
YES
ADDRESS
PO BOX 207 MILFORD, OH 45150-0207
481 TEE DR MASON, OH 45040-2009
12915 JUNIPER CANYON NE TRL
ALBUQUERQUE, NM 87111-8236
479 LEE DR MASON, OH 45040
392 WALNUT LN MASON, OH 45040-2013
8.
NAME
ROGER
SSN
###-##-####
STATE ISSUED
OHIO
C PRITCHARD
VALID
YES
ADDRESS
PO BOX 1806 SANIBEL, FL 33957-1806
9.
NAME
ROGER
SSN
###-##-####
STATE ISSUED
OHIO
C PRITCHARD
VALID
YES
ADDRESS
697 STATE ROUTE 28 MILFORD, OH 45150-1801
10.
NAME
C PRITCHARD
SSN
###-##-####
STATE ISSUED
OHIO
ROGER
VALID
YES
ADDRESS
479 TEE DR MASON, OH 45040-2009
DATE ISSUED
01/01/1958
FROM
07/2006
TO
03/2009
02/2008
01/2006
04/2005
09/2006
08/2006
OS/2005
04/2005
11/2006
06/2004
06/2008
04/2008
04/2008
12/2007
12/2007
08/2007
08/2007
03/2007
08/2006
08/2004
06/2004
07/2006
06/2004
DATE ISSUED
01/01/1958
FROM
01/2009
TO
01/2009
DATE ISSUED
01/01/1958
FROM TO
01/1994 12/2008
01/2003 03/2007
02/2005 06/2005
1111998 07/2004
09/2002 11/2002
DOB
03/09/1941
DATE ISSUED
01/01/1958
FROM TO
07/2000 08/2007
DOB
10/1941
DATE ISSUED
01/01/1958
FROM TO
05/1992 08/2007
DOB
00/1941
DATE ISSUED
01/01/1958
FROM
02/1985
TO
09/2006
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION_
**END OF NETWORK TRACE**
PLEASE NOTE THAT THE RESULT OF THE SOCIAL SECURITY TRACE SEARCH YIELDED THE
FOLLOWING NAMES IN ADDITION TO THE NAME ORIGINALLY ENTERED FOR THE APPLICANT:
PRITCHARD C ROGER - NAME DOES NOT MATCH. (SEE #2 ABOVE)
PRITCHARD C ROGER - NAME DOES NOT MATCH_ (SEE #3 ABOVE)
C PRITCHARD ROGER - NAME DOES NOT MATCH. (SEE #7 ABOVE)
C PRITCHARD ROGER - NAME DOES NOT MATCH. (SEE #10 ABOVE)
PLEASE REVIEW THE RESULT AND CONTACT OUR CLIENT
AT CLIENTSERVICES@STERLINGTESTING.COM TO CONDUCT
ADDITIONAL NAMES ON THIS REPORT (AN ADDITIONAL CHARGE
NAME) _
ADDITIONAL VALIDATION NOTES:
SERVICES DEPARTMENT
SEARCHES UNDER ANY
WILL APPLY FOR EACH
httn<:' II"rl "tprl in o-te"tinp"com/we hdirect3/resultslPrintResults.asDx?oDenOrder= Y &Archive=
Page 60f7
4/21/2009
PrintResults
Page 7 of?
. THE YEAR OF BIRTH (09/1955) REPORTED DOES NOT MATCH THE INFORMATION
PROVIDED TO STERLING 103/19/19411_
****************************************************************************
__~.EUQ..f~ll.cJ!!!.g~_______________________
Copyright 0 2008 Sterling Info systems. Inc.
nttn,,' / /"r! "terlinptestinQ .com/webdirect3/resultslPrintResults.aspx?openOrder= Y &Archive= 4/21/2009
PrintResults
Page 1 of 10
STERL f\JCJ
Code Enforcement Div. Collier County
Order#: 9391611
William Pritchard
PO #
Last Name
First Name
Middle Name
Date of Birth Imm/ddlyyyy)
Phone
Projected Salary
Job State
Subject Profile
NA
Pritchard
William
05110/1935
N/A
Current Address
4697 Rue Belle Mer
Address
Apartment Number
City
State
Zip
Sanibel
FL
33957
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Coda Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
Status
4 CLOSED
Findings
Clear
MOTOR VEHICLE REPORT (MVR)
1 CLOSED
1 CLOSED
See Results Below
SEXUAL OFFENDER DATABASE SEARCH
Cisar
SOCIAL SECURiTY TRACE SEARCH
1 CLOSED
Alert
CRIMINAL RECORD SEARCH
The criminal infonnatlon reported on this webslte appears exactly as it is received from the local jurisdictions and may contain infonnation
which would be prohibited for use in making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: State: NW Zip: County: NATIONWIDE
Statua: CLOSED
FINDING: Clear
*************************************************************************
* THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND *
* HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
* CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
NO criminal convictions found.
City: Sanibel State: FL Zip: 33957 County: LEE
Statua: CLOSED
FINDING: Clear
~O CRIMINAL CONVICTION FOUND.
../
..,""-
City: State: OH Zip: 45255 County: HAMILTON
Slatus:CLOSED
FINDING: Clear
No criminal convictions found.
../
.-
City: Stale: OH Zip: 45150 County: CLERMONT
Status: CLOSED
FINDING: Clear
No criminal convictions found.
Back to Findings
/
~
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
.--
../
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - B817S
Order Date: 04/14/2009
Host Used: Online
Reference: 9391611_3
nttn,,: //"0 "ter! in ote"tinu _com/wehdirect1/result,,/PrintResults.asnx? Archive=
4/15/2009
PrintResults
Page 2 of 10
Period: THREE YEP~
License: P632932351700
Report Clear:YES
Name: PRITCHARD, WILLIAM L
Address:
City, St:
As of:
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 02/24/2006
Exp Date: 05/10/2010
AGE:
Year License First Issued: 03/04/1994
STATUS: VALID
MVR Score
SCORE:
ELIGIBLE
Violations/Convictions And Failures to Appear And Accidents
.~-
CONV
ACD AVD V /C
DESCRI PTI ON
TYPE VIOL
** NONE TO REPORT
Suspensions/Revocations
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
NO ACTIVITY
License and Permit Information
License: PERSONAL Issue:02/24/2006 Exp1re:05/10/2010
License Status Explanation: ELIGIBLE
C1ass:E REGULAR OPERATOR
RESTRICTION: CORRECTIVE LENSES
Miscellaneous State Data
PREVIOUS LICENSE NUMBER: PX905242 STATE: OHIO
NO ENTRY WITHIN THE PAST 3 YEARS AGAINST RECORD IN ABOVE NAME
MISC: EXAMS VISION~l ROAD SIGN=l ROAD RULES=l DRIVING~l
MISe: EXAMS MCYCLE RULES=O MCYCLE SKILL=O
BLOCK PERSONAL INFORMATION
** BLOCK FOR MAILING LIST **
IFOR STATED BUSINESS
I PURPOSES ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
/
Issue Date:
/ /
Control Number: 64X9WH
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DA TABASE SEARCH
Slate: FL
Status: CLOSED
FINDING: Clear
No Record Found
Back to Findings
...-./
~./
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
FINDING: Alert
//
L/
Social Security Trace *****************************
********************************************************************************
GENERATED: 04/14/2009 11:52:02 AM
TRANSACTION ID:0017006505-290
L
NAHE
WILLV~.M L PRINF..AF.D
SSN VALID
###-##-#### YES
STATE ISSUED
OHIO
DOB
05/1935
DATE ISSUED
01/01/1951
ADDRESS
272 SUNNY ACRES DR CINCINNATI, OH 45255-3903
6874 FARMBROOK DR CINCINNATI, OH 45230-3834
7405 BAYSWATER DR CINCINNATI, OH 45255-3937
FROM
04/1998
12/2007
01/2003
TO
03/2009
06/2008
12/2004
NAME
SSN
###-##-####
VALID
YES
STATE ISSUED
OHIO
DOB
05/10/1935
DATE ISSUED
01/01/1951
WILLI~~ L PRITCHARD
ADDRESS
FROH
TO
httns: / / sd _ ster 1 in Qtesti n Q" _com/we hdirect3/resultslPrintResults.asnx? Archi ve=
4/15/2009
PrintResults
272 SUNNY ACRES DR CINCINNATI, 08 45255-3903
6874 FARMBROOK DR CINCINNATI, OH 45230-3834
PO BOX 207 MILFORD, OH 45150-0207
931 STATE ROUTE 28 APT 207 MILFORD, OH 45150-4918
7405 BAYSWATER DR CINCINNATI, OH 45255-3937
207 POB MILFORD, OH 45150
2477 PERIWINKLE WAY SANIBEL, FL 33957-3230
3015 W GULF DR SANIBEL, FL 33957-5648
110 COMMONS DR MILFORD, OH 45150-1937
2499 PERIWINKLE WAY SANIBEL, FL 33957-3230
PO BOX 1806 SANIBEL, FL 33957-1806
931 STATE ROUTE 28 MILFORD, OH 45150-4918
7045 BAYSWATER PL CINCINNATI, 08 45230
3.
NAME
W L PRITCHARD
SSN VALID
###-##-#### YES
STATE ISSUED
OHIO
ADDRESS
6874 FARMBROOK DR CINCINNATI, OH 45230-3834
272 SUNNY ACRES DR CINCINNATI, OB 45255-3903
4697 RUE BELLE MER SANIBEL, FL 33957-2707
1473 PERIWINKLE WAY SANIBEL, FL 33957-4511
PO BOX 207 MILFORD, OH 45150-0207
7405 BAYSWATER DR CINCINNATI, 08 45255-3937
4.
NAME
WILLIAM
SSN
###-U-#U#
STATE ISSUED
OHIO
L PRITCHARD
VALID
YES
ADDRESS
4697 RUE BELLE MER SANIBEL, FL 33957-2707
931 MILFORD, OH 45150
PO BOX 59 SANIBEL, FL 33957-0059
40292 HIGHWAY 550 DURANGO, CO 81301-8663
5.
NAME
WILLIAM
SSN
###-U-####
STATE ISSUED
OHIO
S PRITCHARD
VALID
YES
ADDRESS
4697 RUE BELLE MER SANIBEL, FL 33957-2707
272 SUNNY ACRES DR CINCINNATI, OH 45255-3903
7405 BAYSWATER DR CINCINNATI, OH 45255-3937
8990 FONTANA SANIBEL, FL 33957
6.
NAME
WILLIAM
SSN
###-u-####
STATE ISSUED
OHIO
L PRITCHARD
VALID
YES
ADDRESS
1473 PERIWINKLE WAY SANIBEL, FL 33957-4511
206 N 16TH ST DECATUR, IN 46733-1452
8990 FONTANA SANIBEL, FL 33957
5855 CINEMA DR MILFORD, OH 45150-1489
7.
NAME
WILLIAM
SSN
#U-U-U##
STATE ISSUED
OHIO
L PRINHARD
VALID
YES
ADDRESS
PO BOX 207 MILFORD, OH 45150-0207
1473 PERIWINKLE WAY SANIBEL, FL 33957-4511
8.
NAME
WILLIAM
SSN
U#-U-##U
STATE ISSUED
OHIO
L PRINHARD
VALID
YES
ADDRESS
4697 RUE BELLE MER SANIBEL, FL 33957-2707
40292 HIGHWAY 550 DURANGO, CO 81301-8663
9.
NAME
WILLIAM
SSN
U'-#l-U##
STATE ISSUED
OHIO
PRITCHARD
VALID
YES
ADDRESS
4697 RUE BELLE MER SANIBEL, FL 33957-2707
1473 PERIWINKLE WAY SANIBEL, FL 33957-4511
10.
NAME
WILLIAM PRICHAP~
SSN VALID
fff-It-fift# YES
STATE ISSUED
OHIO
Jl..DDP.ESS
931 STATE ROUTE 28 MILFORD, OH 45150-4918
04/1998
12/2007
01/2008
10/2000
01/2003
04/1995
06/1994
12/1992
08/1992
02/1990
DATE ISSUED
01/01/1951
FROM
12/2007
07/2004
02/2002
06/2008
01/2008
01/2003
OOB
00/1935
DATE ISSUED
01/01/1951
FROM
08/1997
12/1990
DATE ISSUED
01/01/1951
FROM
02/2002
04/1998
01/2003
09/2001
DATE ISSUED
01/01/1951
FROM
10/2002
12/2007
09/2001
DATE ISSUED
01/01/1951
FROM
01/2008
06/2008
OOB
00/1935
DATE ISSUED
01/01/1951
FROM
02/2002
DATE ISSUED
01/01/1951
FROM
08/1997
10/2002
DATE ISSUED
01/01/1951
FROM
11/1987
Page 3 of 10
03/2009
06/2008
07/2008
10/2005
12/2004
04/1995
06/1994
12/1992
08/1992
12/1990
TO
06/2008
06/2008
01/2009
10/2008
07/2008
12/2004
TO
01/2009
12/1990
TO
01/2009
03/2008
06/2004
09/2001
TO
10/2008
01/2008
01/2002
TO
07/2008
06/2008
TO
OS/2007
TO
09/2003
10/2002
TO
11/1987
httn". / /w1 "tp.rlinote"tino~om/wehrlire~n/rp."111t,,/PrintR e"l1lt".B~nx? A rchive=
4/1,-)12009
PrintResuIts
Page 4 of 10
11.
NAME
VIM L PRI TCHARD
SSN VALID
###-##-#### YES
STATE ISSUED
OHIO
DATE ISSUED
01/01/1951
ADDRESS
7405 BAYSWATER DR CINCINNATI, OH 45255-3937
FROM
04/1986
TO
04/1986
12.
NAME
WILLIAM
SSN
###-##-####
L PRICHARD
VALID
YES
STATE ISSUED
OHIO
DATE ISSUED
01/01/1951
ADDRESS
7605 BAYSWATER CINCINNATI, OH 45230
FROM
TO
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFO~~_TION OBTAINED THROUGH A SOCIAL SF.CUHTTY NUMBER TRAr.F.
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
**END OF NETWORK TRACE**
PLEASE NOTE THAT THE RESULT OF THE SOCIAL SECURITY TRACE SEARCH YIELDED THE
FOLLOWING NAMES IN ADDITION TO THE NAME ORIGINALLY ENTERED FOR THE APPLICANT:
WILLIAM L PRINHARD - LAST NAME DOES NOT MATCH. (SEE #1 ABOVE)
WILLIAM L PRINHARD - LAST NAME DOES NOT MATCH. (SEE #7 ABOVE)
WILLIAM L PRINHARD - LAST NAME DOES NOT MATCH. (SEE #8 ABOVE)
WILLIAM PRICHARD - LAST NAME DOES NOT MATCH. (SEE #10 ABOVE)
WM L PRITCHARD - FIRST NAME DOES NOT MATCH. (SEE #11 ABOVE)
WILLIAM L PRICHARD - LAST NAME DOES NOT MATCH. (SEE #12 ABOVE)
PLEASE REVIEW THE RESULT AND CONTACT OUR CLIENT
AT CLIENTSERVICES@STERLINGTESTING.COM TO CONDUCT
ADDITIONAL NAMES ON THIS REPORT (AN ADDITIONAL CHARGE
NAME) .
SERVICES DEPARTMENT
SEARCHES UNDER ANY
WILL APPLY FOR EACH
.. ll.ac:l<to FJr1ding~_
Copyright C 2008 Ster1lng Infosystems, Inc.
1 ,.
PrintResults
Page 5 of 10
5TERLli\JG
PO#
Last Name
First Name
Middle Name
Date of Birth (mmlddlyyyy)
Phone
Projected Salary
Job State
Code Enforcement Div. Collier County
Order#: 9391509
Ron Taylor
Subject Profile
na
Taylor
Ron
0612111938
N/A
Address
Apartment Number
City
State
Zip
Current Address
7785 Gladiolus
Ft Myers
FL
33908
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
Status
2 CLOSED
1 CLOSED
Findings
Alert
MOTOR VEHICLE REPORT (MVR)
See Results Below
SEXUAL OFFENDER DATABASE SEARCH 1 CLOSED
Clear
SOCIAL SECURITY TRACE SEARCH 1 CLOSED
Alert
CRIMINAL RECORD SEARCH
The criminallnfonnatlon reported on this webslte appears exactly as it Is received from the local jurisdictions and may contain Infonnation
which would be prohibited for use in making hiring decisions. Therefore, It is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: State: NW Zip: County: NATIONWIDE I..-- /
Status: CLOSED
FINDING: Clear
*************************************************************************
* THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND *
* HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
* CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
No criminal convictions found.
City: Ft Myers Slate: FL Zip: 33908 County: LEE _ ..___---
Status: CLOSED
FINDING: Alert
In accordance with Federal and/or State guidelines that pertain to providing
information over 7 years old, we need to verify that this applicant will
earn at least $75,000 per year. If you wish Sterling to provide this
information, please let us know that the applicant meets this earnings
threshold by emailing: SalaryConfirmation@sterlinginfosystems.com
Back to Findings
..------.
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
..------------
':.---
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - B8178
Order Date: 04/14/2009
Host Used: Online
Reference: 9391509_3
Period: THREE YEAR
License: T460732382210
Report Clear:YES
Name: TAYLOR, RONALD L
Address:
City, St:
As of:
httns:/ /sd.sterlim!testinQ . com/we bdirect3/results/PrintResults.asnx? Archi ve=
4/15/2009
PrintResults
Page 6 of 10
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 04/09/2003
Exp Date: 06/21/2009
AGE:
Year License First Issued: 05/31/1988
STATUS: VALID
MVR Score
SCORE:
ELIGIBLE
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONV
ACD AVD V /C
DESCRIPTION
** NONE TO REPORT
Suspensions/Revocations
..----- .
.~
ORDIDATE
EFF/DATE
CLRIDATE
END/DATE
CODE
AVD
ACTIONS
NO ACTIVITY
License and Permit Information
//
SC-------
License: PERSONAL Issue:04/09/2003 Expire:06/2l/2009
License Status Explanation: ELIGIBLE
C1ass:E REGULAR OPERATOR
Miscellaneous State Data
NO ENTRY WITHIN THE PAST 3 YEARS AGAINST RECORD IN ABOVE NAME
MISC: EXAMS VISION~l ROAD SIGN~l ROAD RULES=l DRIVING~l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL=O
BLOCK PERSONAL INFORMATION **
BLOCK FOR MAILING LIST *.
THIS PERSON HAS A DIGITAL IMAGE
[FOR STATED BUSINESS
[PURPOSES ONLY
[
[
I
Underwriting:
Policy
Initials;
Date:
/
Issue Date:
/ /
Control Number: 63WOUP
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
State: FL
Statu.: CLOSED
FINDING: Clear
No Record Found
Back to Findings
l.....---
SOCIAL SECURITY TRACE SEARCH
Statu.: CLOSED
FINDING: Alert
Social Security Trace
----..
~
~
*****************************
GENERATED: 04/14/2009 11:42:37 AM
TRANSACTION ID:0017005605-~270
1.
NAME
RONALD
SSN
###-##-####
L TAYLOR
VALID
YES
STATE ISSUED
INDIANA
DATE ISSUED
01/01/1953
ADDRESS
7785 GLADIOLUS DR APT 26 FORT MYERS, FL 33908-5128
7785 GLADIOLUS DR APT 32 FORT MYERS, FL 33908-5129
3854 KNOLLTON RD INDIANAPOLIS, IN 46228-6365
FROM
08/2004
12/1991
08/1987
TO
03/2009
09/2008
08/1987
2.
NAME
RONALD
SSN
###-##-####
L TAYLOR
VALID
YES
STATE ISSUED
INDIANA
DOB
06/1938
DATE ISSUED
01/01/1953
ADDRESS
3850 CENTRAL AVE APT 105 FORT MYERS, FL 33901-8230
127712 METRO PKWY FORT MYERS, FL 33907
5312 SW 2ND PL CAPE CORAL, FL 33914-7185
FROM
12/1991
08/1988
09/1991
TO
01/1999
12/1992
09/1991
3.
NAME
RON TAYLOR
SSN
###-##-####
VALID
YES
STATE ISSUED
INDIANA
DATE ISSUED
01/01/1953
httm~' /Ieul <:tprlinutp<:tinu rnm/urphclirert'i /re"lIlt"lPrintResllltS.aSnx? Archive=
4/15/2009
PrintResults
Page 7 of 10
ADDRESS FROM
7785 GLADIOLUS DR APT 26 FORT MYERS, FL 33908-5128 08/1997
TO
01/1999
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HISIHER EMPLOYI1ENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
**END OF NETWORK TRACE**
PLEASE NOTE THAT THE RESULT OF THE SOCIAL SECURITY TRACE SEARCH YIELDED THE
FOLLOWING NAMES IN ADDITION TO THE NAME ORIGINALLY ENTERED FOR THE APPLICANT:
RONALD L TAYLOR - FIRST NAME DOES NOT ~~TCH. (SEE #1 ABOVE)
RONALD L TAYLOR - FIRST NAME DOES NOT MATCH. (SEE #2 ABOVE)
PLEASE REVIEW THE RESULT AND CONTACT OUR CLIENT
AT CLIENTSERVICES@STERLINGTESTING.COM TO CONDUCT
ADDITIONAL NAMES ON THIS REPORT (AN ADDITIONAL CHARGE
NAME).
SERVICES DEPARTMENT
SEARCHES UNDER ANY
WILL APPLY FOR EACH
BClck to Findings
Copyrfght C 2008 Ster1ing lnfosystems, Inc.
httr",. 1 I"r! "t""..! inn-t"""tinn- f'ArYl Inr""hrli"""f't1 1"""""lt,,/P..;ntR ,,,,,,,,It,, .,"nv~ A "f'h;"""=
L1./l.::;nooo
'--
LEE COUNTY LOCAL BUSINESS TAX RECEIPT
2008 - 2009
ACCOUNT NUMBER: 8101987
ACCOUNT EXPIRES SEPTEMBER 30, 2009
May engage in the business of:
TRANSPORTATION COMPANY
Location
695 TARPON SAY RD STE 6
SANIBEL FL 33957
THIS LOCAL BUSINESS T AX RECEIPT IS NON REGULATORY
SANISEL ISLAND TA2<IINC
PRITCHARD ROGER
695 TARPON BAY RD STE 6
SANIBEL FL 33957
THIS IS NOT A BILL - DO NOT PAY
PAID 016722-293-1
DP500
08120/200801 :14 PM
S50.00
'..
\
,: '":"..
CaUley County
Receipt Number:
Transaction Number:
Date Pa id:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Overage Amount:
Contact:
FEES:
Description
Certificate to Operate
Application
Cashier Name:
Batch Number:
levy_m
152
Development and Environmental Services
RECEIPT OF PAYMENT
2009009539
2009-002042
04/14/2009
Check
3541
$200.00
$200.00
$0.00
Roger Pritchard LLC dba Sanibel Taxi
695 Tarpon Bay Rd. Ste 12
Sanibelr FL 33957
Reference Number Oriainal
Fee
Amount
Paid
LCCT020090000325 $200.00
$200.00
2800 Horseshoe Drive N.
Naples, FL
34104
239-252-2400
Account
111-138911-321241
LCCT020080000321
BRAVO TAXI, INC
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
PUBLIC VEHICLE ADVISORY COMMITTEE
2800 NORTH HORSESHOE DRIVE
NAPLES, FL 34104
DATE:
APPLICATION FOR CERTIFICATE TO OPERATE
LJ~)-ccr
The undersigned hereby makes application for a Certificate to Operate vehicles "for hire" within
Collier County under Code of Laws and Ordinance Chapter 142, and respectfully submits the
following information in support of this application.
FEES: Non-Refundable Application Fee
Certificate to Operate Issuance Fee (Yearly)
Vehicle Decal Pennit Fee (Per Vehicle / Yearly)
Driver ID Fee
$ 200.00
$ 325.00
$ 50.00
$ 75.00
NOTE: Please make check /
OF COUNTY COMMISSIONERS
Address:
(Number & Street) (City)
Home Telephone: (257) 00(- (/0;-1 F_M~;l
Date of Birth: J~J - l '-5- - 'l"Z- S.S. #.
Driver's License #: g0t 0 - L[ 27) ~5 z.. - t .~-S /0
2. If7ershiP:
Business Name:
Business Address:
(Number & Street)
(City)
(State)
(Zip Code)
Business Telephone: (
E-Mail
List of Partners:
A.
(Name)
(Address)
()
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
) .
(Hom~Y,l?o{)~~ #)
--::'::'~'.';';:~"- - f.
(Address)
(Date of Birth)
(Social Security #)
3. If Manager:
L/-lc;~ '52
(Date of Birth)
/
(Social Security #)
- _/
Copies of Articles of Incorporation, all amendments thereto, and a certified copy of the Certificate of
Incorporation must accompany this application.
4. If Corporation I Fictious Name:
Exact Corporate/Business Name:
Business Telephone number: (1y-t) (;0 ( - CJ L{ -S {-
Business Address: rJ ~ 41 S!lo I ~ CS{ ( ) f;
(Number & Street) (City
lSravo TQ~l l nQ ·
E-Mail
u/~ d Ct
(State)
5(/11 ~
(Zip Code)
List of Dit:ectors/Officers:
, JhCK ~YC\Vf
(Name)
2~q~ b(yl~ W3!f
(Home phone #)
A.
'5W10101-h q, "'\Qr)ct!R6(d~
(Address)
L!--l~ ;e;:;z
(Date of Birth)
(Social Security #)
B.
(N ame)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
5. List any and all persons holding a ten percent (10%) or greater beneficial interest in applicant's
business or company.
A.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
2
6. If applying for Sub-Certificate name(s):
a. Name
Date of application
Rejected
REASON:
b. Approved
c. Name
Date of application
d. Approved
Rejected
REASON:
7. Trade Name (if any)
8. List all criminal convictions for which the applicant, owners, managers, directors, and any
officers have been found guilty or convicted regardless of adjudication, in the United States
indicating the offense, the date, and the state.
9. Has Certificate to Operate ever been revoked? Yes
No
If yes, please explain the reason, the year, city, state, and the previous issued Certificate to Operate
number, of revocation:
3
04/03/2009
To: Whom it May Concern
From: Jonas Brave
RE: Bravo Taxi Inc. Experience Statement
This letter is being written to explain the experience I have had in the taxi industry. I
have been driving taxis for 5 years now. The first four years were with Corporate Cab
Company in Naples Florida. My job performance showed no signs of any complaints, no
tickets or citations, and also a perfect attendance record. For the last year I have been
driving with Bravo Taxi Inc. My job performance here at Bravo is as excellent as my
record with Corporate Cab. With this knowledge and experience I feel able to branch out
into my own company.
04/03/2009
To: Whom it May Concern
From: Jonas Brave
RE: Bravo Taxi Inc. Experience Statement
This letter is being written to explain the experience I have had in the taxi industry. I
have been driving taxis for 5 years now. The first four years were with Corporate Cab
Company in Naples Florida. My job performance showed no signs of any complaints, no
tickets or citations, and also a perfect attendance record. For the last year I have been
driving with Bravo Taxi Inc. My job performance here at Bravo is as excellent as my
record with Corporate Cab. With this knowledge and experience I feel able to branch out
into my own company. Also in regards to other partners or managers, there will be none.
I will be the sole manager and operator of Bravo Taxi Inc.
~dR Afi-t&
Jonas Brt\\,~c-
A F' R - ,) <, - '" '3 09: (] ~ P t" R I C H A R D
3056205894
P.01
~
PRIMERICA J
Amember of CltlCjrOOP
Richnrd TodJ
Nariumjl)"lles Dircclor
April 9,2009
.1349 North University Dr.
Suite I-A
Davie, FL 33024
HilS, (954) 435-0995
Fax (954) 435.5994
To Whom It May Concern:
Re: Jonas Brave
[ have known Jonas Brave for over IS years, and worked with him
in the fin;1n('i~l ~i-"n1j('f'~ lnrllldnr f,",r <;)t'\U'H'f"\V;I"Y'l<3fp.!:s, tU,A li/O.....t. lI.A..
-.-. - ..~~. ......'-I n~JlI"'V'_, ~J.u.:H.YVV1"II] UJl' U\..oUl\..oUl.\,.\J l.V YYl1a.~\"V\"l ~a~l\.
he is assigned. In addition I found him to bc cxtrc111ely coachah1e
and willing to tackle any assignn1ent on a 1110Lllcnt's notice, T have
no doubt Mr. Brave will prove to be a valuable employee and an
asset to your organi7.ation.
Should you require any further information regarding Mr. Brave's
work experience with our organi7.ation~ 1 can be contacted at
(954) 547-3573.
Sincerely,
_{~L~<t&)Je~
Richard "odd
RT/bt
"'t:'~ 'I ~,,~!l:i"1J
P",,,,,:",,,.., lile '. ~L'" .J'1l r' ... :rmr,'di~
~" ,,~.,.. "'I:~, r'vlulh l.iA
An hUlcpendent relJre5enta~ive of Primeri,a Finan,ial Services
Securities one red It,r,Jugt,
f'fS 1r.~slmC'~~ Irl(;
Member of NA.,C;r.1O
ElflCufi.,e Dtfh~~~: O,/Iulll Georgi;, 30099 roJ I
n,m ')D1 1(VV'
/letltesenling
PrimefiC<l Finarx:ial Services
/bile MOI1!P9'~. loc
EQUAl. HOUSING OPP(lATUNHY
REGIONS
04/03/2009
To: Whom it May Concern
From: Richard Young Regions Bank
RE: Jonas Brave/Bravo Taxi Inc.
This letter is to confirm that Mr. Brave is a client at Regions Bank. He has been a
customer since 2/13/2009. Mr. Brave has never had any issues with his checking account
here at Regions. There are no loans outstanding between us and Mr. Brave.
If there is anything else needed to complete the reference, please contact me at 239-417-
3193.
Sincerely,
WJ
Richard P . Young
Assistant Vice President
Regions Bank
12621 Tamiami Trail East
Naples, Florida 34113
CREDIT
BUREAU
SERVICES
CREDIT BUREAU SERVICES, INC.
3503 NORTH DIXIE HIGHWAY
OAKLAND PARK. FL 33334
TEL: 954-561-1400 . 866-561-1400
FAX: 954-567-1441 . 866-567-1441
CREDIT REPORT
IFile#
. 425099
Provided For:
PREMIER FAMILY MDRTGAGE INC
213 AIRPORT RD S
NAPLES, FL 34104
Date Received Date Issued Requested By
4/3/2009 4/3/2009 HENOCK CHERRELUS
Loan Type FNMA # Charqes
425099 $6.80
Sources Reference #
TU
J
GENERAL INFORMATION
Borrower Name BRAVE, JONAS
Co~Borrower Name
Social Security No
Social Security No
Age 01/15/1952
Age
Length
Length
Current Address 5447 SHOLTZ STREET, NAPLES, FL 34113
Previous Address
Marital Status
Dependents
BORROWER CO.BORROWER
Employer Employer
Position Position
Since Income Since Income
Verified By Verified By
. .
E DATE BALANCE HISTORICAL STATUS
C CREDITOR NAME REPORTED DATE HiGH CREDIT PRESENT STATUS
0 ACCOUNT NUMBER DATELAST OPENED TERMS MDS TIMES PAST DUE
A ACTIVITY REV "', 60. 90.
_ ___________________!_____________~------- ________J________L___l_J__~--~------------
I S COR E M OlD E L S I' ,
1 Ij?q;i~ijj~~:ig~ii:i.:;~: j~-~~-::~~~ -:: -~:L -:~,-:~ -;'-:Ei --- -, - - t - -- -- u u -- -
016 - LACK OF RECENT! REVOLVING ACcrOUNT IN ORMATION Ii: I
020 LENGTH OF TIME SINCE DEROGAiORY PUB IC RECORD~OR COLLECTION IS TOO SHORT
0:_3_ _ _ _T_'_"E_ _S_'_N_~E_ ~_E_L~'_NQ_U~d;Y _'_S_ ]d_ _~E_C_E~ t _O_R_ _~_~_O.ll_~ _ _ __ __,_ ___ _ _ _'u: _ _ ~ _ _ _ _ __ _ _ ____
, I I TRADELINES i' :
------------.------~-------------- -----------------------------"------------
P S-~;o"~S-T CU 02/09 i 03/081 $0 $730[ $730! - 1- ! - 'I'
, 09/08 1 INST - i ' I
IPROFIT AND LOSS WRIT~OFF; 9EPOSITIRELATED I I I, _ i
B!ACCT SERVICE 102/09 ! 01/09 I $230 $230 $230! - t- I I
: : I COLL - I
PLACED FOR COLLECTIO~; ORIqINAL C~EDITOR: 10 SUPRA ELECOM
i 1
BiNDC CK SVC 112/08 ! 06/08 i $90 $115 $115 i - - - --
!PROFIT AND LOSS WRIT~~;'~8JETURNEJ CHi~:~ COLLATER~ : NAPA 230 ~ NAPL~S
I, I
BINDC CK SVC 112/08 I 07/08 i IN$7ST3 $98_ $9B i-i ,-
!12/08 I I
IPROFIT AND LOSS WRITEOFF; RETURNED CHECK; COLLATERA : NAPA 230 E N~PLES
~ i 06/08 i 01/06 i C~~~ $7~ I $73 ~
!ACCOUNT INFORMATION DISPUTED BY C~NSUMER; ORIGINAL [REDITOR] SPRINt L~D
T!AMEX 111/01 04/91! $0 $0 $O! 01 ! 0 i 0 O!
i !, OPEN $0 I"
!ACCOUNT CLOSED BY CREDIT GRANTOR
B'CAVALRY PORT 112/07 12/04 $4931 $0 I $0
COLL $0 '
DISPUTED BY CONSUMER; ORIGINAL bREDITOR'
i 05/04 - 02/01 I $8600 $ I $0 23! 0
- 05/04 i AUTO 42 $~
I I
$36981 $01 $0
INST $0
BY CONSUMER; IFACTORING! COMPANY
. I I
ECOA KEY: B=BORROWER; C=CO-BORROWER; S-SHARED; J-JOINT; U-UNDESIGNATED; A-AUTHORIZED USER
The ir'iOfffiilUoo is fumished in resportse 10 an inquiry for the plNpOse 0( evaluating credit ri5ll:... It has been oblained 110m sources deemed reiable. the accuracy of wheh 1m. orgarilalion ooes nol9Uamnlee. The inquirer has agreetllo indermify thai reportirJ}
bureau fOl any damage anSln9 'fOm rnsuse d lhi..,informallOfl, and lhls report 1<' furnl<J1ed In reliance upon th.'11I11delJ1nlfy. ~ frost bl? heklln s!fICI contiderr.e and corrphes wfth the prOW,IM... r.i Public law 91-5GB.the Fair Credit Reponing Act. Reporting bureau
certifies that aJ ReSIdential Mortgage Credd Reports meellhe standards prescnbed by FNMA. FHMC. FHA. VA & the Farmers Home Admirustration.
19
TU
09
TU
19
TU
19
TU
09
TU
01
TU
i i
! - j
09
TU
lACCOUNT INFORMATION
,
!
: . . ,
. , , .
11ISPRINtl' ~CS
i i
, I
i 0 ! 0 I
Il
TU
J[ CNS PORT SVC
, CLOSED
1
I
B[LVNV FUNDING
: 12/08 12/04
i 01/08 :
[ACCOUNT INFORMATION DISPUT~D
i HOUSEHOLD ROOMS TO GO -
19
TU
ACCqUNT; COLLATERAL: 12
; - I
Page 1/3
CREDIT
BUREAU
SERVICES
CREDIT BUREAU SERVICES, INC.
3503 NORTH DIXIE HIGHWAY
OAKLAND PARK, FL 33334
TEL: 954-561-1400 . 866-561-1400
FAX: 954-567-1441 . 866-567-1441
CREDIT REPORT
IFile #
425099
Provided For:
PREMIER FAMILY MORTGAGE INC
213 AI RPORT RD S
NAPLES, FL 34104
Date Received Date Issued Requested By
4/3/2009 4/3/2009 HENOCK CHERRELUS
Loan Type FNMA # Charqes
425099 $6.80
Sources Reference #
TU
GENERAL INFORMATION
Borrower Name BRAVE, JONAS
Co~Borrower Name
Social Security No
Social Security No
_ Age 01/15/1952
Age
Length
Length
Current Address 5447 SHOLTZ STREET, NAPLES, FL 34113
Previous Address
Marital Status
Dependents
. . .
RE:;;;~~EO I DATE I I BALANCE I PAST DUE I HISTORICAL ST A TUS I
DATE lAST I OPENED HIGH CREDIT TERMS AMOUNT I MaS TIMES PAST DUE PRESENT STATUS
ACTIVITY REV 30+ I 60+ 90+
, I I I
ADDRESS: 915 NW 118TH ST, MIAMI, FL 33168 - SINCE 01/99 I i I
I ADDRESS: 4631 LOMBAR DY LN, !NAPLES, FL 34l1J2 ! I !
iEMPLOYER: OUTBACK STEAKHOUSE// I I I
-f - - - - - - - - - - - - - - - - - - - j - - - - - -l- - - - - - - - - - - -~ -.. -.. -,,- -; -; -~ -.. -S- - - + - - _l_ - - -; - - ~ - - - - - - - - - - --
-~-------------------l------~------r-------r--------,--------~---r-'--~--r------------
A~CT SERVICE -I 180? NE LOb. P 410 S; SAN ANTO,NIO, TX p821P 1 : ,210-821-1200
AMEX , P 01 BOX 78m, FORTLAUDERDAL, FL 333~9 i ! ,800-528-4800
C~VALRY INVESTMENTS L!1,C PO \30X 272~8, TEMP~, AZ 852i82! , i800-501-0909
CrS PORT SVC I 163?5 LAGUflA CANYOf IR':'INE, '.CA 92618i[ I, _ 800-365-7285
D~BT REC SOL I 900lMerchants Conc, SU1te 106 I 516-228-7110
MERCURYFINCE II 3587 - 8 9 FO}"LER ST, 1 FT MYERS IFL 3390 1[ I 1
M~DLAND MTG I POBI 26648,1 OKLAHOM-f' CITY, OK 73126 Iii 1800-654-4566
NpC CK SVC I 621j> W HOW!lli-D, NILES, IL 607i14 I I '847-647-1700
N!;;W CNTY MTG 1 177()1 COWAN STREET, SUITE 100:, IRVINE!, CAi 92i614 '800-746-2936
R~HACK/HSB I P OiBOX 8189, GRAY, TN 37615, i i '877-272-5394
SfIERMAN ACQUISITIONS I' PO \30X 7402.81, HOUSTON, TX '.77274 i . , i ,.800-363-3115
SpNCOAST CU PO BOX 119p4, TAMP~, FL 336810 i i 1 i 1813 -621-7511
-~-------------------~------l------L-------l--------J--------l---l-~--J--L-------------
i I M 1 is C E ~ LAN ~ 0 U S f N F 0 ~ M J\. T' 1 P N
-~-------------------l------r------~-------.-----------------~---~-~--,--.------------
:Instant View passwo!: A1-;;l91B2661 i ' I I' I '
ii' 1 I I I i
ITO verify the a~t~e~ ;city ~f thi~ ~redit [report, pteas~ vi4;t I I I i
ihttps://cbs.mer1d1a~11nk.c9m and q11ck on ithe Instant V1ew 11uk! ~nt~r ,report
inumber 425099 and palssword iAl-291~266 to v,iew the r~port. ~or Jnyl inquiries
lregarding this report I or sdrviceslprovideq by CREDIt BUREAUisERtICfs'l INC. please
icontact us at 954-56t-1400.1 i ! ' I I! ! i
- r - - - - - - - - - - - - - - - - - - -1- - - - - - t - - - - - -r - - - -0- -1- !S- -C- -L- -;: -;! -~ ~ -; - -\- - - - r - T - i - - - - - - - - - - - - - - -
- i ~- -;'s-t-e-r-i-s-'; - (-*-)- -f-O-1-11-:i-n-g- -Jhe- -p-a-;J"e-;; -a-~o-J;t- -i-;di-c-Xe-s- -t-he- Je-p-oJi-t-o-r-ib-s- !h-;'v-; -;0- - - - - -
ipayment data and tha~ the amount was automatically calculated a~ a'pe~c~ntage of the
! account balance - I ! _ ! , i li'-
IThiS is a report conbainind inforlation sJpplied by'the repJsitJri~s ~i~ted above.
iTh~ m~rge proce~s.isl autom~~ed an4 t~e repor~ may include s~m~ dUPtic~t~ons and/~r
!Om1SS10ns. Inqu1r1e~ regar~1ng any d1SpUt~d 1tems should beld1rdct~d to ,the cred1tor
[reporting the item, pr to 9he appropriate !repository servic, ce1tet(s~ ~isted below.
! I ! I i I :
,EXPERIAN I 'rRANSUNION !EQu1FAX : 1
IPO BOX 2002 , i PO BOX lqOO ipo SOX, 740256
IALLEN, TX 75013 l ! q:HESTER, IPA 19016 , [ATLMlTA, GA 130374
:888-397-3742 '~00-888-4213 I '8001685-1111
!www.experian. com/rep1 rtaccdss Vifww. tramiunion. coml ,www i eq~if~x _Icom
I : I
, I' ! :
I I! I " I
i I I *,** END Of REPORT 4/3/2009 :10: 30: 03 ~ ***
! ! i i I :
:: !
I i I
I ! ,I
I : i i r I l :
ECOA KEY: B~BORROWER; C~CO-BORROWER; S~SHARED; J~JOINT: U-UNDESIGNATED; A-AUTHORIZED USER
The Infmffi;J\lOn IS furnlsherlm respono;e 10 an 1N)1JIry for the [llJrpose of p.valuallng (fedl! risks. ,II has lle(!n oblil.med from soure!!,; deemed rl!lintk, lhe lIr.CW;Il:y of which \tis. ofg;lI'UZillIon docs not gUfIr(ln!()e. Thl! lnqlllrm has agreed to Il1C1errrify thAt reportlnq
bureau lor any damage ansmg hom IJJsuse 0' !hi:; informatlOll. and thiS repOr1lS furnished In reliance upon Ihal indemnify. It must be held _In slrlCt confidence and cOJrflhes wnh the prow,lons 01 Pub~c Law 91.508, tile F air Credit Reporting Act Reporting bureau
cel1lfle5tll1l1 all Resfdenliat Mongilge Credll Reports meet the 'i\mldau1s prescnoed by F NMA, F HMC, FHA VA & the F mmers Home Admltllstmllon.
Page 3/3
E
C
o
A
CREDITOR NAME
ACCOUNT NUM8ER
CREDIT
BUREAU
SERVICES
CREDIT BUREAU SERVICES, INC.
3503 NORTH DIXIE HIGHWAY
OAKLAND PARK, FL 33334
TEL: 954-561 -1400 . 866-561 - 1400
FAX: 954-567-1441 . 866-567-1441
CREDIT REPORT
IFile #
425099
Provided For:
PREMIER FAMILY MORTGAGE INC
213 AIRPORT RD S
NAPLES, FL 34104
Date Received Date Issued Requested By
4/3/2009 4/3/2009 HENOCK CHERRELUE
Loan Type FNMA # C harqes
425099 $6.80
Sources Reference #
TU
GENERAL INFORMATION
Borrower Name BRAVE, JONAS
Co-Borrower Name
Social Security No 267 - 6 9 - 5 863
Social Security No
Age 01/15/1952
Age
Length
Length
Current Address 5447 SHOLTZ STREET, NAPLES, FL 34113
Previous Address
Marital Status
Dependents
. . .
~I
CREDITOR NAME
ACCOUNT NUM8ER
DATE
REPORTED
OATE lAST
ACTIVITY
DAlE
OPENED
HIGH CREDIT I
8ALANCE
TERMS
I PAS1 OUE
AMOUNT
i i
JiMIDLAND MTG 11/04 i 04/99 $79959! $0 I
_ 11/04 i MTGI360 $0
:CLOSED; FHA REAL ESlrTE M01TGAGE I : i
JLNEW CNTY MTG ~ 12/06 J' 10/04 i $105000 I $0 I
. T 10/06! MTG I 360 $ 0 !
iLate Dates: 11/06-90, 10/0-60, 91:,06-60' V05-30, 6(05-30
!CLOSED; CONVENTIONA REAL EtSTATE ~ORTGAGE ! ;
[ i ~ !
B!R,BHK/CBSD 112/00 104/00 $1600 I
iACCOUNT CLOSED BY CO~SUMER I ! REV:
ii, !
P!MERCURYFINCE !I 06/02 102/01 $12793!
06/02. AUTO I 42
, I ;;
_L_ _ _ _ _ _ __ _ ___ _ _ _ _ _ _ _1_ _ _ _ _ _t_ _ _ _ _ -L __ _ _ _ _ J __ __ _ _ _ -.I. _ _ _ __ __
" I I. '.p U B L 1.1 C REI. COR D s---r----i--~------------
-: - - - .. - - - - - - . . - - - - - - t . - - - - - r - - - - - - t"*-*-*- -;~ .~~~~~; -F-O-utD- -*-*-; - - - - -1- .,- -1- - " - - - - - - - . - - - -
I I! I : , I
_L___________________.,______LI ______~.' _______L.. ________J.------- I. i .
- - .- ---r-~--i--t------------
_ ~ _ _ _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ _ j _ _ _ _1_ -i _Q_ _~ _~ lR__I_ _E__S_ ~ __ ~ _~ _~ _s_I_T_ _ __9_ .0_ _ _D_ L~ I _Sj : _ L _ _ _ _ __ _ _ _ _. .
i I 1*** NO ~ECORD FO~D *** I! I ;
:f::::::::::::::::::: 1 ~~~~;~~::: t~( f~k:: :s~;~! ;~;~;1: ;~J;~~: p: ~~~::::::::
! f:DUCATIbN 0 0 0 0 I 0
OTHER INSTALLMENT 4 1943 163 0 943
k OP!EN l' I 0 0" 0' 0
. I
EVOLVING I! 0 0 P I 0
I OTH!ER 3! 303 303 p. 303
I ' i I
TOTf"L 13 l246 ; 466 ,0" 1246
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, UNSECURED DE\3T t246 ; DEBT/HIGH, CREDIT 10% i .
IIi ! ! ! I i
-~------------------- ______L______~-------L---------!------- ---~--i--~--~-------------
_ ~ _ _ _ . _ _ _ _ _ _ _ _ . . . _ _ _ -1_ _ _ _ _ _ L . _ .0_ _E_l R. _0_ _~ _~ IT_ _0_ _~ _Y_ _ j _s_ _~ _~ _M ~ .R.lY_ _, _ _ J _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
: CHhRGE OF[FS 4. DElrNQ 3 0 D.~yS 1 ~NQUIR~E~ 0
i CO~LECTIO~S 3 i 60 DAYS 1 I
; BANKRUPTCY ACCOUN~S 0 I I. 90 D4YS 1 ! I
i PUBLI RECORfS 0 i I OT~ER 0 I I
- r - - . - - - - - - - - . . - - - - - . t - . - - - - fs- -~ -; .~ .c- -E- - - -9L -F. - - -; -; .~. .0. -; .~ -T- .~L .0-' -; 1- - L - - - - . . - . - - - - -
~! = - ;~~~~~~ . - ~~ i;; J; ~ - - - - r - - - . - T -- . . - - - r -- - - - - - - T - - - -- . - - - - r . -,- -1-- r . - - - - - - - - - - -
,NAME: JONAS 0 BRAVE I ! . .. i
,NAME: DOB: 04/15/52 , '
iSSN: 267-69-5863 I i
ADDRESS: 5447 SHOLTZI ST, NJI'PLES, FL 341131- SINCE 06/99
, !
ECOA KEY, B~BORROWER: C~CO-BORROWER; S~SHARED; J-JOINT; U-UNDESIGNATED; A-AUTHORIZED USER
Thlllnform.1llOn IS IUlnls.hC'llln response to an lrKjUlfy for the purpose of evalilll1lng creelll flSks., It has Deeo obtAinec1 from ~lJrces c1eemed r4'l~ilble, the accuracy of which this OUJillll1:llion does not gU.1filnlee, The inquirer has agreOOlo indenvlly thaI reporting
bureau 1m an~ damage arising lrom misuse 01 this information, and this report IS lumished in re~arn:e upon that indermify. It ITJJSI be held in Slric1 confidence and cOlTlllies with the provisions of Public law 91 -SOB, the Fair Credrt Reponing Act. Reponin9 bureau
cenifiesthat all ReSidential Mortgage Credrt Rep0!1s meet the standards prescribed b~ FNMA, FHMC, FHA. VA & the Farmers Home Adrrillistrillion,
$0
HISTORICAL STATUS I
MOS Tt.lES PAST DUE
REV 30+ 60+ 90+
1- - 1-
! ; !
1
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!
PRESENT STATUS
Ml
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Page 2/3
FLORIDA DEPARTMENT OF STATE
Division of Corporations
March 20, 2008
BRAVO TAXI
5447 SHOLTZ ST.
NAPLES, FL 34113
Subject: BRAVO TAXI
REGISTRATION NUMBER: G08080900246
This will acknowledge the filing of the above fictitious name registration which
was registered on March 20, 2008. This registration gives no rights to
ownership of the name.
Each fictitious name registration must be renewed every five years between
January 1 and December 31 of the expiration year to maintain registration.
Three months prior to the expiration date a statement of renewal will be mailed.
IT IS THE RESPONSIBILITY OF THE BUSINESS TO NOTIFY THIS OFFICE IN
WRITING IF THEIR MAILING ADDRESS CHANGES. Whenever corresponding
please provide assigned Registration Number.
Enclosed is your certificate(s) as requested.
Should you have any questions regarding this matter you may contact our office
at (850) 245-6058.
Fictitious Name Section
Division of Corporations
LetterNo.008A00016953
Division of Corporations - P.O. BOX 6327 -Tallahassee, Florida 32314
Electronic Articles -of Incorporation
For
P08000029967
FILED
March 201f008
Sec. Of Slate
epeterson
BRAVO TAXI INC.
The undersigned incorporator, for the purpose of forming a Florida
profit corporation, hereby adopts the following Articles of Incorporation:
Article I
The name of the corporation is:
BRA VO TAXI INC.
Article II
The principal place of business address:
5447 SHOL TZ ST.
NAPELS, FL. US 34113
The mailing address of the corporation is:
5447 SHOL TZ ST.
NAPELS, FL. US 34113
Article III
The purpose for which this corporation is organized is:
TAXI TRANSPORATION
Article IV
The number of shares the corporation is authorized to issue is:
1
Article V
The name and Florida street address of the registered agent is:
JONAS BRAVE
5447 SHOL TZ ST.
NAPLES, FL. 34113
I certify that I am familiar with and accept the responsibilities of
registered agent.
Registered Agent Signature: JONAS BRAVE
Article VI
The name and address of the incorporator is:
JONAS BRAVE
5447 SHOL TZ ST.
NAPLES, FL. 34114
Incorporator Signature: JONAS BRAVE
Article VII
The initial officer(s) and/or director(s) of the corporation is/are:
Title: P
JONAS BRAVE
5447 SHOL TZ ST.
NAPLES, FL. 34113 US
Article VIII
The effective date for this corporation shall be:
03/20/2008
P08000029967
FILED
March 201~008
Sec. Of Slate
epeterson
.www.sunbiz.org - Department of State
Page 1 of2
FLORlLJA DELHil'\J '\T OJ ~JA' i
D[ij~]('r\ I C()!;J,(:,j\.\ll,J\~
u - -_ __ _ _ .____,_ .__ __ u~ __ ~_
Home Contact Us E-Filing Services Document Searches Forms Help
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No Events No Name History
Detail by Entity Name
Florida Profit Corporation
BRAVO TAXI INC.
Filing Information
Document Number P08000029967
FEIIEIN Number NONE
Date Filed 03/20/2008
State FL
Status ACTIVE
Effective Date 03/20/2008
Principal Address
5447 SHOL TZ ST.
NAPELS FL 34113 US
Mailing Address
5447 SHOL TZ ST.
NAPELS FL 34113 US
Registered Agent Name & Address
BRAVE, JONAS
5447 SHOL TZ ST.
NAPLES FL 34113 US
Officer/Director Detail
Name & Address
Title P
BRAVE, JONAS
5447 SHOLTZ ST.
NAPLES FL 34113 US
Annual Reports
No Annual Reports Filed
Document Images
0:3/20/2Q08 -~ Oomestic; profitL. ...-'~i~'!fJlfl~9,~.\I:lt'.RE/f~m!t~1,. .J
Note: This is not official record. See documents if question or conflict.
previollsQ!1I,.Jst
Nexton.I,.Jst
Rell.lmIQJ.,ist
Entity Name Search
No Events
No Name History
http://www.sunbiz.org/scripts/cordetexe?~ction=l)FTFTT .Rrinn nor nmYlh",r=POQ0000'100t;.
11 Ir;.nnno
,www.sunbiz.org - Department of State
Page 2of2
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http://www.sunbiz.orQ/scrints/cornet PYP')::Jrtinn=T)FTJ:;'TT Rrinn rlf"'lf' nllmhM=D(\Q(\(\(\()')()nt::
It IL {""'''f\r\
LOCATION 5447 SHOLTZ ST
ZONED: HOME OCCUPATION
BUSINESS PHONE: 601-4937
COLLIER COUNTY BUSINESS TAX BUSINESS TAX NUMBER:
COLLIER COUNTY TAX COLLECTOR - 2800 N. HORSESHOE DRIVE - NAPLES FLORIDA 34104 - (239) 252-2477
VISIT OUR WEBSITE AT: www.colliertax.com
THIS RECEIPT EXPIRES SEPTEMBER 30, 2009
DISPLAY AT PLACE OF BUSINESS FOR PUBLIC It~SPECTIOlj i
FAILURE TO DO SO IS CONTRARY TO LOCAL LAWS. .J
073416
LEGAL FORM
....- 'C:. {'......
C9.'~P9Rf\TI0Ni () J}
, .~ II
, ""'~ ~'~ ""'\... ,~f
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. THIS TAX IS NON-REFUNDABLE -
BRA-VO TAXI, INC.
",. -.;/ .~>
'-.",
\;..il ,)BRAVE, JONAS
'I
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5447 SHOL TZ ST
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..'
NUMBER OF EMPLOYEES: OWNER ONL V-NO EMPLOVEES,_ .!I'
CLASSIFICATIONTAXI SERVICE/Ac ~ LCCT020080000321 _!li> (~>
CLASSIFICATION CODE 03705006 . ,)._.... ". ."" "'~ "'. _. .... :''\ ()
This document is a business tax only. This is not certification that licentee Wqu,ali!ied. . c: \..J
It does not permit the licensee to violate any existing regulatory zoning laws'of'th.S s1i3Jelco~ty or cities
nor does it exempt the licensee from any other taxes or permits that may be required by law.
*'
DATE
AMOUNT
RECEIPT
01/13/2)09
16.5)
6991.42
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CO/AGY 64 I 1
T# 577')442-12
B# 1-126509
FLORIDA VEHICLE REGISTRATION
PLA TE
A797PB
DECAL
05304546
YR./M K 1996/CHEV BODY 4D
VrN 1 G1 BL52P6TR146192
PL.ue Type RGR t\ ET 'NT 3575
DlJFEW B610420521350
Date Issued 4/3/2009 Plate Issued 12/2/2004
/----/
JONAS BRAVE ./
5447 SHOL TZ 5T
NAPLES, FL 34113
RGR - FLORIDA REGULAR
Expires
Midnight Thu 4/15/2010
Class Code I,:
Tax \lunlh.i ( 5-.
Back Tax i\los--
Credit CLiss
Credit :--Iclnths
COLOR
TITLE
WHI
89402408
Reg. Tax
fniL Reg.
County Fcc
Mail Fee
Sales Tax
Voluntary Fees
Grand Total
60.10
57.60
2.50
rMPORT ANT INFORMATION
I. The Florida license plate must remain with the registrant upon sale oi vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for lr~msfer tu
replacement vehicle.
3. The registration must be sUITendered when requesting a change of address.
4. Registration renewals are the responsibility of the registrant and shall occur dunnE'
the 30-day period prior to the expiration date shown on this reglstr~i[]un. Renew.!!
notices are provided as a courtesy and are not required for rencvval pu rposes.
VEmCLE LEASE
J
/ .''! 4, 1
This lease is entered into this .~ ~ day Of;,/I:-/ L
~:re f) 19-5 l? (( t9 u ~ Lessor, and
Lessee.
, 20 CJ:7, by and between
\
-/ B f? ;9 1/ () .TIJ /)< IIl/ ~
I
In consideration of the promises herein contained, on the part of the parties to be
performed, Lessor hereby leases to the Lessee the following described motor vehicle:
VIN#
License
Plate #
Make
C\ hf\1 r ulp ~
~
r Type
D~lrt]0f
Year
lfu~Lc;lP0TRI4Mf All-7PS
Jqqb
Lessee to have possession of the vehicle until this lease is terminated. Lessee will pay
To Lessor annual rent of $ (L__ in 12 rent payments of $ I
each month.
Either party may terminate this lease at any time after this vehicle is no longer being
operated subject to the Collier County Vehicle for Hire Ordinance, by giving the other
party written notice of intent to terminate. Lessee agrees during the entire term of
this Lease to continuously maintain insurance on the leased vehicle in not less than
the face amounts and scope of coverage as are then required by the Code of Laws and
Ordinance Chapter 142. Lessee agrees, during the term of this lease to otherwise
hold Lessor harmless from any and all claims arising out of use or operation of the
subject vehicle. Each party to this Lease asserts to the other party that the respective
party has full authority to enter into this Lease in an individual capacity and/or on
behalf of any principle. The Laws of the State of Florida shall control this Lease.
a
Signature of Lessor
;;Ja f.) k!)" ~If IOUE"
Print Name of Lessor
rrd4F~
Ignatu of Lessee
. ~ "-
-43 If ;9 //0 "/ /1 If.
Print rtame of Lessee
ACORDN
CERTIFICATE OF LIABILITY INSURANCE 9f~V~4 I DAT~~M;;;~)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Lutqert Insurance -Marco
740 N. Collier Blvd. Ste 103
Marco Island FL 34145
Phone:239-394-7575 Fax:239-394-7237
I
INSURERS AFFORDING COVERAGE
I
Bravo Taxi Inc.
5447 Sholtz Street
Naples FL 34113
l ~/~
L-/
INSURER A:
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
First Commercial Ins Co.
NAIC#
I
INSURED
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITiON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN:>" ~~~ POLICY NUMBER .P_qLW!'~~~ P9!:-ICrl~~~~N LIMITS
LTR TYPE OF INSURANCE DATE MMlDD DATE MMIODIVY
GENERAL LIABILITY EACH OCCURRENCE $
- ~~~ISES (E~~~~~~nce)
COMMERCIAL GENERAL LIABILITY $
I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
-
- GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
h .nPRO- nLOC //
POLICY JECT
AUTOMOBILE LIABILITY ~ ~. COMBINED SINGLE LIMIT V';
-
A X ANY AUTO TBD 03/20/09 03/20/10 (Ea accident)
- 7
ALL OWNED AUTOS BODILY INJURY
- $ 125,000
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY 7
~ $ 300,000
NON-OWNED AUTOS (Per accidenl) I
~ PROPERTY DAMA~E
~ $ 100,000
(Per accidenl) \
GARAGE LIABILITY - AUTO ONLY - EA ACCIDENt- $
~ ANY AUTO ' I .'
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $
=:J OCCUR o CLAIMS MADE AGGREGATE $
$
---.--
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I T~~l~~Ws I IO~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If ~e!>. describe under
S ECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Taxi Business 1996 Chevrolet #lG1BL52P6TR146192. Certificate holder is
named as additional insured.
COVERAGES
CERTIFICATE HOLDER
CANCELLATION
COLL-14
~/
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI
DATE THEREOF, THE ISSUING INSURER WILL ENDeAVOR TO MAIL 10 DAYS WRITTEI
NOT!CE TO THE CERTIFICATE HOLDER MAMED TO THE LEFT, BUT FAILURE TO DO SO SHAI
Collier County Board of
County Commissioners
2800 N Horseshoe Drive
Naples FL 34104
@ACORDCORPORATION 1!
ACORD 25 (2001/08)
AFFIDAVIT
Before me this day personally appeared)6 nos Sf0\V( who swears or affirms
that the vehicle(s) to be pemntted meet(s) the safety standards as set forth m Code of Laws
and Ordinance Chapter 142.
It is understood and acknowledged by the Code Enforcement Department and myself that if
my vehicle(s) that is/are permitted fai1(s) to meet(s) the safety standards as required by this
Ordinance, the vehicle(s) must be removed from service until all violations are corrected.
BUSINESS NAME
SIGNATURE OF APPLICANT
DATE
L/ - J-- ocr
STATE OF FLORIDA
COUNTY OF COLLIER
. ~~
The fOrego*~~ 'fjs,sUbsCI17'b d and sworn to before me this L day of ,Af~ (
20 cq , by ~a\f" JC>>'1t4j f:>r~ho is personally known or has
( Name of person acknotvledging)
as identification and who did.
SIGNATURE OF NOTARY
NOTARY PUBLIC COMMISSION #
NOTARY'S SEAL
COMMISSION EXPIRES:
~
-.j().lr\ "d--d, '2 0 l(~
4
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
provisions.
I 50 tJ frC;' /3!{ Hue;> swear or affIrm that all information on this Application
for Certificate to Operate is true.
r;.-rJfZ/:; f3-2{iLf
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and sworn to before me this Ll'J. - DC}
/
~ (Date)
FLJ...JL
(Type of identification)
By
:Jo A//lS R!<f:J I/p
(Name of person ac:krlowledging)
who has produced
A~fl:~hp~e =.oalli.
Signature of Notary
1v!l~fN~~ .
......k
--~..., .~. .-...._~. .
~~~~~:;~~-:. . - '~
t~rlltj:~ . . ... OAJNA NURfDl~; =- r
. "'~~;."(i IVI nOMMISSION
f --".r.~'if.~~-:- EXPIIlES' ~. ff 00 750720
_. anullry 22,2012 I
Notary Public Commission #
NOTARY'S SEAL
Commission Expires :1 (AVl d ~ 1201 ?_
5
COLLIER COUNTY GOVERNMENT
CRIMINAL mSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date:
Pursuant to provisions of Chapter 119, F.S., and procedures outlined under Rule
Chapter 11C-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
Name: JOYlus
First Middle (full)
Address: t5U U 1 ~lwl~? q (
(Number & Street)
~(cl\f
d [1 r.2~f( ~ cYn,ll '~L/ n z-
(City) (State) (Zip Code)
DL No.:PJc[O-L(z ()-52--1~o
Race: Hci 1+I~l
Hair: lSla(! l
(Color)
Last
Maiden
Social Security No.:
DOB: Ll ~ I c:; -- 1952- Sex:
Height: .C:;-II Weight: ~ lbs.
~t
Age: _
Eye: ~Tu\;J III
(Color)
Name:
First
Middle (full)
Last
Maiden
Address:
Number & Street
City
State
Zip Code
Social Security No.:
DL No.:
DOB:
Sex:
Age: _
Race:
Height:
Weight:
lbs.
Eye:
Hair:
(Color)
(Color)
< -Ij" F -ill T I .~...1 (.
,_J . ;" \. J." "
/ l' __ ) -- fl CONSENT AND DISCLOSUR~=:.,....">~~. /).., -__. ~/ ~~
DATE l.. . () L( LOCATION.' "( l v:--- ~( j, " /--L
I I / -- \
I understand that Collier County Code Enforcement will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New
Yori<, NY 10011, as part of the procedure for processing my ?VAC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further infonnation through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id_
I understand a consumer reporting agency's investigation may include obtaining infonnation covering up to the last seven (7) years regarding, among
other items, references, character, driving record, past employment, wori< habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and federal law. The investigation also may include obtaining infonnation relating to criminal records without
any time limitations, subject to state and federal law.
In the event an investigative consumer report is conducted, I understand such infonnation may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge conceming my character, general reputation, personal
characteristics or standard of living. I understand such infonnation may also be obtained through direct or indirect contact with fonner employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
jItp By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act_
I also understand that before my application is denied based, in whole or part, on infonnation obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act_ I understand if I disagree with the accuracy
of any infonnation in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging infonnation in the report, Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the infonnation
contained in the report.
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the a plication process.
ITJ
State
ITJ
State Social'Security No.
~"""ro D~ - / ~ 6 '1
(~innesota & Oklahoma applicants Only: I have the right to request a copy of my consumer report from Sterling Testing Systems, Inc. by
:;~hecking the box below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make
a written request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report.
Middle Name/Initial
[00
Male Female
[J]1d
#yrs at this address
---;
-:---:>
Zip Code
ITJ
#yrs at this address
. !
o I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the foilowing reasons:
1 . Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of.
the Collier County Government Agency."
jonG~ \2x~Vt
, have read and understood the paragraph
LI ~ (- () O(
Date
cQ[l1~r County
a ' ........" ~,.."... .....e....... ,_,._
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Overage Amount:
Contact:
FEES:
Description
Certificate to Operate
Application
Cashier Name:
Batch Number:
LauraWells
154
Development and Environmental Services
RECEIPT OF PAYMENT
2009009535
2009-002038
04/14/2009
Check
512
$200.00
$200.00
$0.00
Brave, Jonas
5447 Sholtz St.
Naples, FL 34113
Reference Number Oriqinal
Fee
LCCT020080000321 $200.00
Amount
Paid
$200.00
Account
2800 Horseshoe Drive N.
Naples, FL
34104
239-252-2400
111-138911-321241
PrintResults
Page 1 of3
STERliNG
>.. -
Code Enforcement Div. Collier County
Order#: 9302955
Jonas Brave
PO#
Last Name
First Name
Middle Name
Date of Birth lmmldd/yyyy)
Phone
Projected Salary
Job State
Subject Profile
na
Brave
Jonas
04/15/1952
N/A
Address
Apartment Number
City
State
Zip
Current Address
5447 Shull% St
Naples
FL
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Code Enforcement Dlv. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
Status
3 CLOSED
Findings
Clear
MOTOR VEHICLE REPORT (MVR)
1 CLOSED
1 CLOSED
1 CLOSED
see Resuts Below
SEXUAL OFFENDER DATABASE SEARCH
SOCIAL SECURITY TRACE SEARCH
Clear
CRIMINAL RECORD SEARCH
The criminal Infonnatlon reported on this website appears exactly as It is received from the local jurisdictions and may contain infonnation
which would be prohibited for use In making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: State: NW Zip: County: NATIONWIDE
Status: CLOSED
FINDING: Clear
*************************************************************************
* THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND *
* HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
* CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
No criminal convictions found.
City: Naples Slate: FL Zip: County: COLUER
Statua: CLOSED
FINOING: Clear
No criminal convictions found.
---
----
City: State: FL Zip: 33167 County: DADE
Status: CLOSED
FINDING: Clear
No criminal convictions found.
Back to Findings
--- .
~
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
~....~.
-------
REKLAMI PRINT IMAGE 80
STAHT OF DRIVING RECORD
FLORIDA Driver Record - 88178
Order Date: 03/27/2009
Host Used: Online
Period: THREE YEAR
Reference: 9302955~3
License: B610420521350
Report Clear:NO
Name: BRAVE, JONAS
Address:
City, St:
As of:
https:/ /sd.sterlingtesting.comlwebdirect3/results/PrintResults.aspX? Archive=
4/20/2009
PrintResults
Page 2 of3
Weight:
Height:
DOB
Iss Date: 01/28/2008
Exp Date: 04/15/2012
AGE:
Sex :
Eyes:
Hair:
Year License First Issued: 07/19/1978
STATUS: SEE BELOW
MVR Score
SCORE:
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONY
ACD AVD VIC
DESCRIPTION
CONY 01/20/09 02/20/09 F66 VH07 129 OP MY UNSFAE COND/ IMPROPER EQUIP
LOCATION/DOCKET: COLLIER/8490ROS PTS: 0
Suspensions/Revocations
~---
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
NO ACTIVITY
License and Permit Information
License: PERSONAL Issue:Ol/28/2008 Expire:04/l5/2012 S
License Status Explanation: ELIGIBLE
Class:E REGULAR OPERATOR
License: IDENTIFICATION Issue:Ol/28/2008 Expire:04/15/2012 Status:
Miscellaneous State Data
** ENTRIES BELOW COVER THE PAST 3 YEARS **.
MISC: EXAMS VISION=l ROAD SIGN~l ROAD RULES~O DRIVING~l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL=O
BLOCK PERSONAL INFORMATION **
BLOCK FOR MAILING LIST **
THIS PERSON HAS A DIGITAL IMAGE
IFOR STATED BUSINESS
IPURPOSES ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
/
Issue Date:
/ I
Control Number: VYZLBT
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
Slala: FL
Status: CLOSED
FINDING: Clea.
No Record Found
Back to Findings
,-/
SOCIAL SECURITY TRACE SEARCH
Statu.: CLOSED
llo-/~
****************************
Social Security Trace
*****************************
********************************************************************************
GENERATED: 03/27/2009 10:12:56 AM
TRANSACTION ID:0018271l74-6041
1.
NAME
JONAS 0 BRAVE
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
DOB
04/15/1952
DATE ISSUED
01/01/1976
ADDRESS
5447 SHOLTZ ST NAPLES, FL 34113-8778
5447 SHOLTZ ST 8778 NAPLES, FL 34113-8778
NAPLES, FL 33939
4631 LAMBOY LANE LN NAPLES, FL 34112
12145 NW 20TH CT MIAMI, FL 33167-2038
11622 NORTHWESTTENTH MIAMI, FL 33168
FROM
08/1996
08/1996
01/2001
05/1995
03/1991
09/1989
TO
03/2009
03/2009
01/2001
05/1995
12/1992
12/1990
2.
NAME
JONAS 0 BRAVE
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
DATE ISSUED
01/01/1976
ADDRESS
NOT GIVEN NAPLES, FL 33939
FRQr-.1
01/2001
01/2001
NAME
3. JONAS BRAVE
https://sd. sterlingtesting.comlwebdirect3 /resultslPrintResults.aspx? Archive=
4/20/2009
PrintResults
Page 3 of3
SSN
###-##-####
VALID
YES
STATE ISSUED
FLORIDA
DATE ISSUED
01/01/1976
ADDRESS
5447 SHOLTZ ST NAPLES, FL 34113-8778
FROM
04/1999
TO
2001
4.
NAME
JONAS BRAVE
SSN
###-##-####
VALID
YES
STATE ISSUED
FLORIDA
DOB
04/1952
DATE ISSUED
01/01/1976
ADDRESS
10622 NW 10TH AVE MIAMI, FL 33150-1020
12145 SW 20TH CT MIAMI, FL 33167
915 NW 118TH ST MIAMI, FL 33168-2332
4631 LOMBARDY LN NAPLES, FL 34112-6615
FROM
10/1989
TO
10/1989
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE TNFO~MATION PROVIDED BY THE CONSt~R ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY WUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
'*END OF NETWORK TRACE**
!'lack to .Findings
Copyrighl C 2008 Sterling Infosystems. Inc.
hff",,,'//,,rl ctprl ;nntp"t;nn (v,m /ulPhrl;rp"t~ /rp""lt,,/Pr;ntR p""lt" "''''....v'7 A r"h;up=
L1 /') () /') ()()Q
LCCT020090000334
Deluxe Transportation Services
DBA
Bumble Bee School Transportation
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
PUBLIC VEHICLE ADVISORY COMMITTEE
2800 NORTH HORSESHOE DRIVE
NAPLES, FL 34104
DATE:
APPLICATION FOR CERTIFICATE TO OPERATE
4/iP/Oct .
The undersigned hereby makes application for a Certificate to Operate vehicles "for hire" within
Collier County under Code of Laws and Ordinance Chapter 142, and respectfully submits the
fonowing information in support of this application.
FEES: Non-Refundable Application Fee
Certificate to Operate Issuance Fee (Yearly)
Vehicle Decal Permit Fee (Per Vehicle I Yearly)
Driver ID Fee
$ 200.00
$ 325.00
$ 50.00
$ 75.00
NOTE: Please make check / money order payable to the BOARD OF COUNTY COMMISSIONERS
1. Name of Applicant: ::[() ~ ~ /1-. ~ S ~
Address: 02--'1 ~ :3b '-II, 0t..M..R tJ€., AJ ~ ,I-f .3 cf / d() .
(Number & Street) (City) I (State) (Zip Code)
Home Telephone: ~3~ 'ft.,~-S~dS' E-MailC)L..6rle1NCJ.5/y~t[} 9'1;/tJr!)i" ('(911
Date of Birth: J IILP / b ~ S.S. #:
I
Driver's License #:
2. If Partnership:
Business Name:
Business Address:
(Number & Street)
(City)
(State)
(Zip Code)
Business Telephone: (
E- Mail
List of Partners:
A.
(Name)
(Address)
o
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
) .
(Hom~~}9W #)
",r'
(Date of Birth)
(Social Security #)
3. If Manager:
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
Copies of Articles of Incorporation, all amendments thereto, and a certified copy of the Certificate of
Incorporation must accompany this application.
....
~ .........
4. If Corporation I Fictious Name: 'De /u ~ I (UJlJafOflTCt TlUr1 'deflaJ CJL.s5 .
Exact Corporate/Business Name: ~~A ~rn b.tL. (6.afL ~OO ~-rl2.atl;poa.4Tlon
Business Telephone number: (~3'1) 4lor - 5f:[;;D6 E-M~
Business Address: ~3l) ~~ Clue,J~ (tJ~ ,P1
(Number & Street) (City) (State)
~ 1c9D .
(Zip Code)
List of Directors / Officers:
A. ~rV1 Q.. ~ ~6S
(N~)
f62?>l) lJ<ps-- 9:tJ'; I WJ loS"
~ome phone #) (Date of Birth)
B. N\Pr .
(Name)
zc, ~ ~'#l Clu..o D6 .
(Address)
(Social Security #)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
5. List any and all persons holding a ten percent (10%) or greater beneficial interest in applicant's
business or company.
A.
~\~
(Name)
~ \ 1\
(Home phone #)
~.
(Name)
Nt;
(Home phone #)
(Address)
(Date of Birth)
(Social Security #)
B.
(Address)
(Date of Birth)
(Social Security #)
2
6. If applying for Sub-Certificate name(s):
a. Name
Date of application
b. Approved
Rejected
REASON:
c. Name
Date of application
d. Approved
Rejected REASON:
7. Trade Name (if any)
,jlA '
8. List all criminal convictions for which the applicant, owners, managers, directors, and any
officers have been found guilty or convicted regardless of adjudication, in the United States
indicating the offense, the date, and the state.
9. Has Certificate to Operate ever been revoked? Yes
No X
,
If yes, please explain the reason, the year, city, state, and the previous issued Certificate to Operate
number, of revocation:
3
April 6, 2009
Collier County Community Development
& Environmental Services Division
Operations & Regulatory Management
2800 N. Horseshoe Drive
Naples, Florida 34104
To Whom It May Concern:
I, Jorge A, Ramos stated that I have more than 10 years of driving experiences basic on my
previous job and a delivery truck driver.
If you have any questions or required any further information feel free to contact me.
Sincerely,
ri.~~~ ~
1. JORGE A. RAMOS
LIST OF ALL MANAGERS
ilDFifth Third Bank
April 6, 2009
In Reference:
Deluxe Transportation Service
Bumble Bee Scholl Transportation
Jorge A. Ramos
This letter is to infOlID you that the above mentioned customer has a business checking
account with us for over a year. The account has been always in good standing. For your
reference the account number is
Should you have any question regarding this matter, please feel free to contact us.
Q~
Maria J' oda
Licensed Personal Banker
Golden Gate Financial Center
Ph: 239-455-5357
Fx: 239-455-5368
UNSHINE
INS. U 'R A NeE
April 6, 2009
Collier County Community Development
& Environmental Services Division
Operations & Regulatory Management
2800 N. Horseshoe Drive
Naples, Florida 34104
This letter is to certified that Jorge A. Ramos has been insured with our Insurance Agency for the past 6
years and he is and outstanding customer. He has always made his monthly insurance payment on time.
If you have any questions do not hesitate to contact us.
2595 SW 87 Ave, Miami, Florida 33165
Tel: (305) 559-7873 Fax: (305) 559-2237
FREEDOM TAX SERVICE OF SW FLORIDA
~ CREDIT PLUSINC
.~ MERGED INFILE CREDIT REPORT
FILE#
PREPARED FOR
~ - FNM._
AMERICAN HOME MORT - 10006011
1000 LEE BLVD # 202
LEHIGH ACRES, FL 33936
DATE COMPLETED 4/6/2009
DA TE ORDERED 4/6/2009
REPOSITORIES XPffU/EF
PRICE $10.34
REF. #
RQD' BY OLGA M
RAMOS
PRPD' BY
LOAN TYPE
PROPERTY ADDRESS
APPLICANT
RAMOS, JORGE
DOB 01/16/1965
CO-APPLICANT
APPLICANT
SOC SEC #
MARITAL STATUS
CURRENT ADDRESS
PREVIOUS ADDRESS
CO-APPLICANT
SOC SEC #
DEPENDENTS
2930 NE 35TH AVENUE, NAPLES, FL 34120*
DOB
LENGTH
LENGTH
SCORE MODELS
EQUIFAX/FACTA BEACON 5.0 - JORGE A RAMOS - 591741728
SCORE: 618
00039 - SERIOUS DELINQUENCY
00018 - NUMBER OF ACCOUNTS WITH DELINQUENCY
00013 - TIME SINCE DELINQUENCY IS TOO RECENT OR UNKNOWN
00014 - LENGTH OF TIME ACCOUNTS HAVE BEEN ESTABLISHED
---_._-~-----_._---_._----------^'_._.__._-'--,.--_._--_._-_.._-_.__._---~--
TRANSUNION/FICO CLASSIC (04) - JORGE A RAMOS - 591741728
SCORE: NIA
SC3 - FILE NOT SCORED BECAUSE SUBJECT DOES NOT HAVE SUFFICIENT CREDIT
------_.~--_._-----_..._._-_._._---_._------_._'~------_.~~-,_._---"'--"'._-----'-"-----"
EXPERIAN/FAIR, ISAAC (VER. 2) - JORGE RAMOS - 591741728
SCORE: 565
38 - SERIOUS DELINQUENCY AND PUBLIC RECORD OR COLLECTION FILED
13 - TIME SINCE DELINQUENCY IS TOO RECENT OR UNKNOWN
18 - NUMBER OF ACCOUNTS WITH DELINQUENCY
20 - TIME SINCE DEROGATORY PUBLIC RECORD OR COLLECTION IS TOO SHORT
08 - TOO MANY INQUIRIES LAST 12 MONTHS
OO~
CREDITOR
DATE
DATE OPENED
EPORTED
PAST
DUE
DLA
B B REAL TIME RESOLUTION 03/09 06/06 $44580 $44505 $12264 4 0 0 4 M5
L --1-- MTG 360 $491 XP
Late Dates: 3109-150+, 2109-150+, 1/09-150+, 12/08-150+
CONVENTIONAL REAL ESTATE LOAN, INCLUDING PURCHASE MONEY FIRST
B B AMERICAN QEN(;BAJ..,_flN 08/99 12/96
07/98
$1000
REV
$0
$0
$0 32 0 0 0 R 1
XPffU
J B CHASE MORG
--
FANNIE MAE ACCOUNT
01/03 09/98
05/02
$112000
MTG
$0
360 $0
$0 51 0 0 0 M1
XPffU/EF
B B FIRST PREMIER BANK 12/06 08/06 $300
08/06 REV
ACCOUNT CLOSED AT CONSUMER'S REQUEST
$0
$0
$0 5 0 0 0 R 1
XPffU/EF
ECOA KEY: B=BORROWER; C=CO-BORROWER; J=JOINT; U=UNDESIGNATED; A=AUTHORIZED USER; P=PARTlCIPANT; S=CO-SIGNER
CREDIT PLUS: 31550 WINTERPLACE PARKWAY, SALISBURY, MD 21804 (P) (800) 258-3488 (F) (800) 258-3287
The information is fumished in response to an inquiry for the purpose of evaluating credit risks. It has been obtained from sources deemed reliable, the accuracy of which this organization does not guarantee. The inquirer has agreed
to indemnify that reporting bureau for any damage arising from misuse of this information, and this report is furnished in re~ance upon that indemnity. It must be held in sbict confidence and complies with the provisions of Pubic Law
91-508, the Fair Credit Reporting Act Reporting bureau certifies that all Residential Mortgage Credit Reports meet the standards prescribed by FNMA, FHMC, FHA, VA and the Farmers Home Administration.
4075 PINE RIDGE ROAD STE 6, NAPLES, FLORIDA 34119
FREEDOM TAX SERVICE OF SW FLORIDA
FILE#
PREPARED FOR
- . -.-~ .~ FNMA #1
AMERICAN HOME MORT -1~6011
1000 LEE BLVD # 202
LEHIGH ACRES, FL 33936
DA TE COMPLETED 4/6/2009
DA TE ORDERED 4/6/2009
REPOSITORIES XPfTU/EF
PRICE $10.34
REF.#
PROPERTY ADDRESS
RQD' BY OLGA M
RAMOS
PRPD' BY
LOAN TYPE
CO-APPLICANT
DOB
APPLICANT
SOC SEC #
MARITAL STATUS
APPLICANT
RAMOS, JORGE
DOB 01/16/1965
CO-APPLICANT
SOC SEC #
DEPENDENTS
CREDIT
00
PAST
DUE
CREDITOR
DATE
EPORTE
MO
REV 30
B B EREMONTINV 07/08 06/06 $178320 $0 $0 24 7 8 3 M1
_ 03/07 MTG 360 $0 XPfTUlEF
Late Dates: 6/08-120, 5/08-120, 4/08-90, 5/07-60, 4/07-30, 2/07-30, 1107-30, 12/06-30, 11/06-30, 10/06-30
REAL ESTATE MORTGAGE
$0 31 0 0 0 R1
XP/EE
B B GEMB/CHICAGO HEALTH 12/99 06/95
--1--
$1100
REV
$0
$0
J B NEW CENTURY 10/04 08/03 $175500 $0 $0 13
MORTGAGJ; 07/04 MTG 030 $0
l
Late Dates: 7/04-30
CONVENTIONAL REAL ESTATE LOAN,INCLUDING PURCHASE MONEY FIRST
$5340
REV
$0
$0
$0 99
A B SEARS/CBSD 03/09 03/86
__ 01/05
ACCOUNT CLOSED AT CONSUMER'S REQUEST
--------------------.----------------- COLLECTION-ACCOU NTS----
HI
~D CREDIT OR BALANCE
LIMIT
I ACCT TYPE TERMS
PAST
DUE
CREDITOR
DATE
REPORTED I
B B AFNI, INC. 04/08 03/08 $100 $100 $100 1
08/04 OPEN 001 $100
FACTORING COMPANY; ORIGINAL CREDITOR: AT T FORMERLY BELL SOUTH
B B NCO FIN/99 04/06 04/06 $100
--/-- COLL
ORIGINAL CREDITOR: FLORIDA POWER LIGHT
$100
001 -
$100
05/08 03/06 $400 $81
04/08 REV $81
Late Dates: 5/07-150+,4/07-120,3/07-90,2/07-60,1/07-30,7/06-30
ACCOUNT CLOSED AT CREDIT GRANTOR'S REQUEST
$81 27 2
1 0 0 M1
XPfTU/EE
o
o 0 R1
XP
60 90+ I
I
STATUS
SOURCE
o 0 0 09
~EfTUlEF
o 0 0 09
~.E
3 R9
XPfTU/EF
B B FREMONTINV 10/07 06/06 $44580 $0 $0 15 5 3 4 M8
08/06 MTG 360 $0 XP1IULfE
Late Dates: 9/07-F, 8/07-150+, 7/07-150+, 6/07-120, 5/07-90,4/07-60,3/07-30,2/07-30,1/07-30, 12/06-30,11/06-60,
10106-60, 9/06-30
FORECLOSURE; REAL ESTATE MORTGAGE
ECOA KEY: B=BORROWER; C=CO-BORROWER; J=JOINT; U=UNDESIGNATED; A=AUTHORIZED USER; P=PARTICIPANT; S=CO-SIGNER
CREDIT PLUS: 31550 WINTERPLACE PARKWAY, SALISBURY, MD 21804 (P) (800) 258-3488 (F) (800) 258-3287
The information is fumished in response to an inquiry for the purpose of evaluating credit risks. It has been obtained from sources deemed re~able, the accuracy of which this organization does not guarantee. The inquirer has agreed
to indemnify that reporting bu~au for any damage arising from misuse ot this information, and this report is fumished in reliance upon that indemnity. It must be held in strict confidence and complies with the provisions of Pubic Law
91-508, the Fair Credit Reporting Act Reporting bureau certifies that all Residential Mortgage Credit Reports meet the standards prescribed by FNMA., FHMC. FHA. VA and the Farmers Home Administration.
4075 PINE RIDGE ROAD STE 6, NAPLES, FLORIDA 34119
FREEDOM TAX SERVICE OF SW FLORIDA
OLGA M
RAMOS
w~- FNMA
AMERICAN HOME MORT -10006011
1000 LEE BLVD # 202
LEHIGH ACRES, FL 33936
DA TE COMPLETED 4/6/2009
DATE ORDERED 4/6/2009
REPOSITORIES XP/TUlEF
PRICE $10.34
REF. #
RQD' BY
FILE #
PREPARED FOR
PRPD' BY
LOAN TYPE
PROPERTY ADDRESS
CO-APPLICANT
APPLICANT
RAMOS, JORGE
DOB 01/16/1965
APPLICANT
SOC SEC #
MARITAL STATUS
DOB
W
H
o
S
E
B B L1TONMTGSV 11/08 06/06 $178320
. 0~8 mG
Late Dates: 9/08-120,8/08-120, 7/08-120, 6/08-120, 5/08-120
FORECLOSURE; REAL ESTATE MORTGAGE
DATE
EPORTE
CREDITOR
$0 27
5 M8
XP/TU/EF
$0
360 $0
o
o
$0 5
1 - 19
XP/TU/EF
$0
60 $0
04/98 $861
03/03 AUTO
Late Dates: 7/03-60, 6/03-30, 5/03-30,4/03-30, 3/03-30, 7/02-30
SETTLEMENT ACCEPTED ON THIS ACCOUNT; PAID CHARGE OFF
---------------------------------------------------OTH E R CREDIT H I STORY
*** NONE ***
INQUIRIES (LAST 90 DAYS)
*** NONE ***
PUBLIC RECORDS
*** NONE ***
TRADE SUMMARY
BALANCE HIGH CREDIT
44505 44580
o 0
o 0
o 0
100 100
81 400
1 00 1 00
44786 45180
08/04
S B SUN BK MIA
PAST DUE
12264
o
o
o
100
81
100
12545
PAYMENTS
491
o
o
o
100
81
o
672
#
6
1
o
o
1
5
1
14
MORTGAGE
AUTO
EDUCATION
OTHER INSTALLMENT
OPEN
REVOLVING
OTHER
TOTAL
03/86
l.QQ%
44505 OLDEST TRADELlNE
281 DEBT/HIGH CREDIT
DEROGATORY SUMMARY
1 30 DAYS: 5 INQUIRIES:
2 60 DAYS: 4
o 90 DAYS: 5
o OTHER: 1
ALERT
ADDRESS DISCREPANCY: THERE IS A SUBSTANTIAL DIFFERENCE BETWEEN THE ADDRESS SUBMITTED IN THE
INQUIRY AND THE ADDRESS(ES) ON FILE
TRANSUNION 10 MISMATCH ALERT: CURRENT ADDRESS MISMATCH. INPUT DOES NOT MATCH FILE.
SECURED DEBT
UNSECURED DEBT
CHARGE OFFS:
COLLECTIONS:
BANKRUPTCY:
PUBLIC RECORDS:
o
ECOA KEY: B=BORROWER; C=CO-BORROWER; J=JOINT; U=UNDESIGNATED; A=AUTHORIZED USER; P=PARTICIPANT; S=CO-SIGNER
CREDIT PLUS: 31550 WINTERPLACE PARKWAY, SALISBURY, MD 21804 (P) (800) 258-3488 (F) (800) 258-3287
The information is furnished in response to an inquiry for the purpose of evaluating credit risks. It has been obtained from sources deemed reliable, the accuracy of which this organization does not guarantee. The inquirer has agreed
to indemnify that reporting bureau for any damage arising from misuse of this information, and this report is furnished in reliance upon that indemnity. It must be held in strict confidence and complies with the provisions of Public law
91-508, the Fair Credit Reporting Act Reporting bureau certifies that all Residential Mortgage Credit Reports meet the slandards prescribed by FNMA, FHMC. FHA. VA and the Farma.. Home Administration.
4075 PINE RIDGE ROAD STE 6, NAPLES, FLORIDA 34119
FREEDOM TAX SERVICE OF SW FLORIDA
FILE #
PREPARED FOR
_ FNMA #
AMERICAN HOME MORT - 10006011
1000 LEE BLVD # 202
LEHIGH ACRES, FL 33936
DATE COMPLETED 4/6/2009
DATE ORDERED 4/6/2009
REPOSITORIES XPfTU/EF
PRICE $10.34
REF. #
RQD' BY OLGA M
RAMOS
PRPD'BY
LOAN TYPE
PROPERTY ADDRESS
CO-APPLICANT
SOC SEC #
DEPENDENTS
ALERT
ADDRESS DISCREPANCY: THERE IS A SUBSTANTIAL DIFFERENCE BETWEEN THE ADDRESS SUBMITTED IN THE
INQUIRY AND THE ADDRESS(ES) ON FILE
MISCELLANEOUS INFORMATION
APPLICANT
RAMOS, JORGE
_ DOB 01/16/1965
CO-APPLICANT
APPLICANT
SOC SEC #
MARITAL STATUS
DOB
Instant View Password: AV-46604F
To verify the authenticity of this credit report, please visit https:/lcredit.creditplus.com and click on the Instant View link. Enter
report number 15795530 and password A V-46604F to view the report. For any inquiries regarding this report or services
provided by CREDIT PLUS please contact us at (800) 258-3488.
SOURCE OF INFORMATION
EXPERIAN - PULLED ON: 04/06/09
NM: JORGE RAMOS 591741128 DOB: 01/16/65
NM: GEORGE A RAMOS 591741728 DOB: N/A
SS:
AD: 3750 70TH AVE NE, NAPLES, FL 341202602 - REPORTED 12/05 - 01/09
AD: 4828 LOOP CENTRAL DR, HOUSTON, TX 770812212 - REPORTED 09/08
AD: 2820 42ND ST SW, LEHIGH ACRES, FL 339764745 - REPORTED 07/06
EM:REL~NTINSURANCEAGENC/I-REPORTED01m3
EM: ANGELINE S SEAFO/l- REPORTED 02195
2 TRANSUNION - PULLED ON: 04/06/09 - INFILE DATE: 07/01/91
NM: JORGE A RAMOS
NM: DOB: 01/01/65
SS:_
AD: 2820 42ND WEST ST, LEHIGH ACRES, FL 33971 - REPORTED 07/06
AD: 4828 LOOP CENTRAL DR, HOUSTON, TX 77081 - REPORTED 08/08
AD: 3750 NE 70TH AV, NAPLES, FL 34120
3 EQUIFAX - PULLED ON: 04/06/09 - INFILE DATE: 07/31/91
NM: JORGE A RAMOS DOB: 01/01/65
SS:
AD: 3750 70TH AVE NE, NAPLES, FL 34120 - REPORTED 06/06
AD: 14630 SW 172 ST, MIAMI, FL 33177 - REPORTED 08/99
AD: 2820 42ND ST SW, LEHIGH ACRES, FL 33971 - REPORTED 07/06
EM: UNKNOWN/I
EM:ANGELlNESSSEAF/I
EM: SELF EMPLOYED/I
AFNI
AFNI-BLOOM
AMER GEN FIN
AMERICAN GENERAL FINAN
ANDERSON FIN NETWORK I
BK ONE, NA- L LURIA
CBD
CBUSASEARS
CREDITORS
POB3427, BLOOMINGTON IL 61702
404 BROCK DR, BLOOMINGTON IL 61701
STORE #32, MIAMI FL 33155
7931 BIRD RD, MIAMI, FL 33155
PO BOX 3427, BLOOMINGTON IL 61702
22ND FLOOR KETTERING TOW, DAYTON, OH 45402
530 RIVERSIDE DR, SALISBURY, MD 21801
13200 SMITH RD, CLEVELAND, OH 44130
309-828-5226
888-216-2408
305-266-2627
305-266-2627
888-216-2408
937-449-6952
410-742-9551
800-917-7700
ECOA KEY: B=BORROWER; C=CO-BORROWER; J=JOINT; U=UNDESIGNATED; A=AUTHORIZED USER; P=PARTICIPANT; S=CO-SIGNER
CREDIT PLUS: 31550 WINTERPLACE PARKWAY, SALISBURY, MD 21804 (P) (800) 258-3488 (F) (800) 258-3287
Th~ infom:'stion is fumi~ed in response to an inquiry, f~r the purp,ose of ev~lu~fjng cr~dit risks. It, has bee~ obta~ned ~om sources deemed .refiable, the accuracy of which this organization does not guarantee. The inquirer has agreed
to Indemnify that reporting bureau for any damage anslng from misuse of thiS mformation, and thiS report IS furnished In re6ance upon that Indemnity. It must be held in sbict confidence and complies with the provisions of Public Law
91-508, the Fair Credit Reporting Act Reporting bureau certifies that all Residential Mortgage Credit Reports meet the standards prescribed by FNMA. FHMC, FHA, VA and the Farmers Home Administration.
4075 PINE RIDGE ROAD STE 6, NAPLES, FLORIDA 34119
FREEDOM TAX SERVICE OF SW FLORIDA
FILE #
PREPARED FOR
J FNMA # 11
AMERICAN HOME MORT -10006011
1000 LEE BLVD # 202
LEHIGH ACRES, FL 33936
DA TE COMPLETED 4/6/2009
DA TE ORDERED 4/6/2009
REPOSITORIES XPffU/EF
PRICE $10.34
REF, #
PRPD'BY
LOAN TYPE
PROPERTY ADDRESS
RCD' BY OLGA M
RAMOS
CO-APPLICANT
APPLICANT
SOC SEC #
MARITAL STATUS
APPLICANT
RAMOS, JORGE
_ ... DOB 01/16/1965
CO-APPLICANT
SOC SEC #
DEPENDENTS
CREDITORS
3415 VISION DR, COLUMBUS OH 43219
101 E TOWN STREET, COLUMBUS OH 43215
200 OLD WILSON BRD, WORTHINGTON OH 43085
900 DELAWARE SUITE 7 TAPE ONLY, SIOUX FALLS, SO 57104
601 S MINNESOTA AVE, SIOUX FALLS, SO 57104
POB 8208, ORANGE CA 92864
175 N RIVERVIEW DR, ANAHEIM, CA 92808
175 N RIVERVIEW DRIVE, ANAHEIM, CA 92808
900 W DELAWARE, SIOUX FALLS SO 57104
PO BOX 276, DAYTON, OH 45401
24 GREENWAY PLAZA #712, HOUSTON TX 77046
5373 W ALABAMA, HOUSTON, TX 77056
4828 LOOP CENTRAL DR, HOUSTON TX 77081
911 DUKE BLVD, MASON, OH 45040
9111 DUKE BLVD, MASON, OH 45040
515 PENNSYLVANIA AVE, FORT WASHINGTON PA 19034
CHASE MANHATTAN MTGE
CHASE MORG
CHASE MORT
FIRST PREMIER
FIRST PREMIER CREDITCA
FREMONT INV
FREMONT INVESTMENT & L
FREMONTINV
FST PREMIER
GECCCC/CHICAGO HEALTH
L1TONMTGSV
LITTON LOAN
LITTON LOAN SERVICING
MACY'S/DSNB
MCYDSNB
MEDCLR/NCO FINANCIAL
SVCS
NCM
NEW CENTURY MORTGAGE C 18400 VON KARMAN AVE STE, IRVINE CA 92612
NEW CENTURY MORTGAGE 17701 COWAN STREET SUITE 100, IRVINE, CA 92614
COR
SUN BANK OF MIAMI
SUNTRUST BK
SUNTRUST BK MIAMI NA
3737 NW 87TH AVE. COMMERCIAL LOAN DEPT, MIAMI, FL 33178
POB 524203, MIAMI FL 33152
PO BOX 524203, MIAMI, FL 33152
DISCLAIMER
DOB
800-848-9380
800-848-9136
800-848-9136
605-357-3440
800-987-5521
800-776-7511
800-776-7511
800-776-7511
937-534-6952
800-247-9727
800-888-9646
800-247-9727
800-243-6552
866-593-2543
888-207-3081 cr
bur#
800-561-4567
800-561-4567
800-561-4567
notes
305-591-6000
305-591-6000
305-591-6000
An asterisk (*) following the payment amount indicates the repositories have no payment data and that the amount was
automatically calculated as a percentage of the account balance.
This is a report containing information supplied by the repositories listed above. The merge process is automated and the
report may include some duplications and/or omissions. Inquiries regarding any disputed items should be directed to the
creditor reporting the item, or to the appropriate repository service center(s) listed below.
EXPERIAN TRANSUNION EQUIFAX
PO BOX 2002 PO BOX 1000 PO BOX 740241
ALLEN, TX 75013 CHESTER, PA 19016 ATLANTA, GA 30374
888-397-3742 800-888-4213 800-685-1111
www.experian.com/reportaccess
www.transunion.com
ALERT
www.equifax.com
ADDRESS DISCREPANCY: THERE IS A SUBSTANTIAL DIFFERENCE BETWEEN THE ADDRESS SUBMITTED IN THE
ECOA KEY: B=BORROWER; C=CO-BORROWER; J=JOINT; U=UNDESIGNATED; A=AUTHORIZED USER; P=PARTlCIPANT; S=CO-SIGNER
CREDIT PLUS: 31550 WINTERPLACE PARKWAY, SALISBURY, MD 21804 (P) (800) 258-3488 (F) (800) 258-3287
Th~ info~ation is fumi~ed in response to an inquir>: f~r the purp.ose of ev~lu~ting cre.dit risks. It, has bee~ obta!ned fr,om 5:CIurces deemed .re~able, the accuracy of which this organization does not guarantee. The inquirer has agreed
to Illdemnlfy th~t repo.rting bU~8U foe any d8~age Bnslng fr~m misuse of th~ Inf~ation, and thiS ~eport IS furnished In reliance upon that Indemnity. tt must be held in strict confidence and complies with the provisions of Pubic Law
91-508. Ihe Fair Cred,t Reporting Act Reporting bureau certifies that all Resldentiel Mortgage Credrt Reports meet the standards prescribed by FNMA. FHMC, FHA. VA and the Farme.. Home Administration,
4075 PINE RIDGE ROAD STE 6, NAPLES, FLORIDA 34119
FREEDOM TAX SERVICE OF SW FLORIDA
FILE#
PREPARED FOR
FNMA ..1l
AMERICAN HOME MORT -10006011
1000 LEE BLVD # 202
LEHIGH ACRES, FL 33936
DA TE COMPLETED 4/6/2009
DA TE ORDERED 4/6/2009
REPOSITORIES XPfTU/EF
PRICE $10.34
REF.#
ROD' BY
OLGA M
RAMOS
PRPD' BY
LOAN TYPE
PROPERTY ADDRESS
APPLICANT
RAMOS, JORGE
DOB 01/16/1965
CO-APPLICANT
APPLICANT
SOC SEC #
MARITAL STATUS
CO-APPLICANT
SOC SEC #
DEPENDENTS
ALERT
DOB
INQUIRY AND THE ADDRESS(ES) ON FILE
TRANSUNION 10 MISMATCH ALERT: CURRENT ADDRESS MISMATCH. INPUT DOES NOT MATCH FILE.
ADDRESS DISCREPANCY: THERE IS A SUBSTANTIAL DIFFERENCE BETWEEN THE ADDRESS SUBMITTED IN THE
INQUIRY AND THE ADDRESS(ES) ON FILE
... END OF REPORT 4/6/200912:18:22 PM ...
ECOA KEY: B=BORROWER; C=CO-BORROWER; J=JOINT; U=UNDESIGNATED; A=AUTHORIZED USER; P=PARTICIPANT; S=CO-SIGNER
CREDIT PLUS: 31550 WINTERPLACE PARKWAY, SALISBURY, MD 21804 (P) (800) 258-3488 (F) (800) 258-3287
The information is furnished in response to an inquiry for the purpose of evaluating credit risks. It has been obtained from sources deemed reiable, the accuracy of which this organization does not guarantee. The inquirer has agreed
to indemnify that reporting bureau for any damage arising from misuse of this information, and this report is furnished in reliance upon that indemnity. It must be held in strict confidence and complies with the provisions of Pubic law
91-508, Ihe Fair Credit Reporting Act Reporting bureau certifies that all Residential Mortgage Credit Reports meetlhe standards prescribed by FNMA, FHMC, FHA. VA and the Farme.. Home Administration.
4075 PINE RIDGE ROAD STE 6, NAPLES, FLORIDA 34119
FREEDOM TAX SERVICE OF SW FLORIDA
AMERICAN HOME MORTGAGE OF NAPLES INC
1000 LEE BLVD # 202
LEHIGH ACRES, FL 33936
239-455-6011
NOTICE TO THE HOME LOAN APPLICANT
CREDIT SCORE INFORMATION DISCLOSURE
RAMOS, JORGE
2930 NE 35TH AVENUE
NAPLES, FL 34120
In connection with your application for a home loan, the lender must disclose to you the score that a consumer reporting
agency distributed to users and the lender used in connection with your home loan, and the key factors affecting your credit
scores.
The credit score is a computer generated summary calculated at the time of the request and based on information that a
consumer reporting agency or lender has on file. The scores are based on data about your credit history and payment
patterns. Credit scores are important because they are used to assist the lender in determining whether you will obtain a loan.
They may also be used to determine what interest rate you may be offered on the mortgage. Credit scores can change over
time, depending on your conduct, how your credit history and payment patterns change, and how credit scoring technologies
change.
Because the score is based on information in your credit history, it is very important that you review the credit-related
information that is being furnished to make sure it is accurate. Credit records may vary from one company to another.
If you have questions about your credit score or the credit information that is furnished to you, contact the consumer reporting
agency at the address and telephone number provided with this notice, or contact the lender, if the lender developed or
generated the credit score. The consumer reporting agency plays no part in the decision to take any action on the loan
application and is unable to provide you with specific reasons for the decision on a loan application.
If you have questions regarding the terms of the loan, contact the lender.
Your credit scores were provided by the following credit reporting agencies:
TRANS UNION
PO BOX 4000
CHESTER, PA 19016
866-887-2673
www.transunion.com
EQUIFAX CREDIT
PO BOX 740241
ATLANTA, GA 30374
800-685-1111
www.equifax.com
EXPERIAN
PO BOX 2002
ALLEN, TX 75013
888-397-3742
www.experian.com/reportaccess
The following information about your credit scores was created on 4/6/2009.
Applicant:RAMOS, JORGE
Name of Score:EQUIFAX/FACTA BEACON 5.0
Credit Score:618 Range:300-850
Key Factors affecting the score
. SERIOUS DELINQUENCY
. NUMBER OF ACCOUNTS WITH DELINQUENCY
. TIME SINCE DELINQUENCY IS TOO RECENT OR UNKNOWN
. LENGTH OF TIME ACCOUNTS HAVE BEEN ESTABLISHED
Applicant:RAMOS, JORGE
Name of Score:TRANSUNION/FICO CLASSIC (04)
Credit Score:N/A Range:300-850
Key Factors affecting the score
. FILE NOT SCORED BECAUSE SUBJECT DOES NOT HAVE SUFFICIENT CREDIT
4075 PINE RIDGE ROAD STE 6, NAPLES, FLORIDA 34119
FREEDOM TAX SERVICE OF SW FLORIDA
Applicant:RAMOS, JORGE
Name of Score:EXPERIAN/FAIR, ISAAC (VER. 2)
Credit Score:565 Range:300-850
Key Factors affecting the score
. SERIOUS DELINQUENCY AND PUBLIC RECORD OR COLLECTION FILED
. TIME SINCE DELINQUENCY IS TOO RECENT OR UNKNOWN
. NUMBER OF ACCOUNTS WITH DELINQUENCY
. TIME SINCE DEROGATORY PUBLIC RECORD OR COLLECTION IS TOO SHORT
. TOO MANY INQUIRIES LAST 12 MONTHS
4075 PINE RIDGE ROAD STE 6, NAPLES, FLORIDA 34119
APPLICATION FOR REGISTRATION OF FICTITIOUS NAME
Note: Acknowllldgernents/certlflcates will bB sent to the address In Section 1 only.
1.
DELUXE TRANSPORTA liON SERVICES
Flctltloua Name to be RGglS\eled l- Instruclion& if name InclVoe. "Carp' or'nlfl
DELUXE TRANSPORT A TION SERVICE
2930 35TH AVE NE
This spaoe for office use only
-
C
o
n
CI.'
rn
MIlling Add.- 01 BUSlMB8
NAPLES FLORIDA
Oily State
3. Florida County of principal place of business:
34120
Zip Code
COLLIER
(SlIlI InatnJctioN. if _ then ona county)
A. Owner(s) of Fictitious Name If IndlvldullIl(lS): (Use an at!ochment If necessary):
1. RAMOS JORGE A 2.
laa1 FlIBI ...1_ u,$t
2930 35TH AVE NE
AddrlMlll Addrllaa
NAPLES. FLORIDA 34120
City StIlt8 ZIp 00dII cny
N
r::
o
13
~
Firal M.1.
So ZIp COdIl
B. OWner(A) of Fictitious Name If other than an individual: (Usae attachment if n8C8888ry):
1, 2.
Enllty titunlI
Addr_
CIty SIllte
Florida Registration Number
FEI Number:
o Applied for
ZipCodo
o Not Applicable
Entity Name
Addl1l&a
City stale
Florida Registration Number
FEI Number:
o Applied for
ZIp Code
o Not Applicable
CO)
c
o
~
u
CD
rn
I (we) the undenligned. being Ihll solo (all the) party(ieB) QWning Intereat In the above lIC11110us name. certify thai the infonnation indicated on lhl$ form
Ia tnJe and accurate. In IlOOOrdllllce with $ecllon 865.09, F.S.. I (we) understand that the $ignaturo(s) below snaH have the same legal effed as If
made under oath. (At Leut One Signature Required)
t;:('\ 04/0912009
~lgnatul8 01 0- 0IIl1I SlgnaItlrll of Owner DII1ll
Phone Number: 239-455-6011 Phone Number:
FOR CANCELLATION COMPLETE SECTION 4 ONLY:
FOR FICTTTIOUS NAME OR OWNERSHIP CHANGE COMPLETE SECTIONS 1 THROUGH 4:
od'
C
o
:i:i
u
cZ
I (we) the undersigned, hereby cancel the fictitious name
, which was registered on
registration number
SIgn8IUr1l 01 Owner
DaIB
S1gnawre 01 Ownar
Date
and was assigned
Mark the applicable boxes 0 Certificate of Status - $10 0 Certified Copy - $30
NON-REFUNDABLE PROCESSING FEE: $50
800/600 l2J
Sin\ll8 CR4eoo1 (t 1/(13)
X\I.:l L~:LL !1L06!86!LO
FREEDOM TAX SERVICE OF SW FLORIDA
. .,
"
F t. t) iU IJ A D F P ^ R l'M F f\"j l 0 F ST.",'. ~ t~. t;' ': ~, ., <l~
DJ'~JSJu> dl CUKrllJU.IH1\\ :~I;, -,. ., ';, ;
"" 1 ~ L ,
Jd!lIll" !\l;,. J :,..
Home
Contac:t Us
E.filing Service.
Document Searches
......... .................., ".,...." .....,'Y"....,., ,.' ,..,.,.._' ._.... "' _...... '" ,. . . ......."...... ...... ..................... t. .'...........,..... ....... ,-, ,'.......-....
Fictitious Name Registration Payment
Thank yoU for filing your Fictitious Name Registration online.
Your confirmation number is 100149328849_
Your charge amount is $60.00_
800/800 ffl
4075 PINE RIDGE ROAD STE 6. NAPLES, FLORIDA 341 ] 9
Forms
Help
X~j L9:~L 9~oG/8G/~0
Electronic Articles of Incorporation
For
P09000028282
FILED
March 2612009
Sec. Of Slate
bmcknight
DELUXE TRANSPORTATION SERVICES, INC
The undersigned incorporator, for the purpose of forming a Florida
profit corporation, hereby adopts the following Articles of Incorporation:
Article I
The name of the corporation is:
DELUXE TRANSPORTATION SERVICES, INC
Article II
The principal place of business address:
2930 35TH AVE NE
NAPLES, FL. 34120
The mailing address of the corporation is:
2930 35TH AVE NE
NAPLES, FL. 34120
Article III
The purpose for which this corporation is organized is:
ANY AND ALL LAWFUL BUSINESS_
Article IV
The number of shares the corporation is authorized to issue is:
99
Article V
The name and Florida street address of the registered agent is:
FREEDOM TAX SERVICE OF SW FLORIDA
4075 PINE RIDGE ROAD
6
NAPLES, FL. 34119
I certify that I am familiar with and accept the responsibilities of
registered agent.
Registered Agent Signature: OLGA RAMOS
Article VI
The name and address of the incorporator is:
JORGE RAMOS
2930 3 5TH AVE NE
NAPLES, FLORIDA 34120
Incorporator Signature: JORGE RAMOS
Article VII
The initial officer(s) and/or director(s) ofthe corporation is/are:
Title: P
JORGE A RAMOS
2930 35TH AVE NE
NAPLES, FL. 34120
Article VIII
The effective date for this corporation shall be:
03/25/2009
P09000028282
FILED
March 2612009
Sec. Of Slate
bmcknight
01/28/2015 08:44 FAX
1lI002/004
~~W1'~
FLORIDA DEPARTMENT OF STATE
Division of Corporations
April 9, 2009
DELUXE TRANSPORTATION SERVICE
2930 35TH AVE NE
NAPLES, FL 34120
Subject: DELUXE TRANSPORTAll0N SERVICE
REGISTRATION NUMBER: G09099900351
This.will acknowledge the filing of the above fictitious name registration which
was registered on April 9, 2009. This registration gives no rights to ownership of
the name.
Each fictitious name registration must be renewed every five years between
January 1 and December 31 of the expiration year to maintain registration.
Three months prior to the expiration date a statement of renewal will be mailed.
IT IS THE RESPONSIBILITY OF THE BUSINESS TO NOTIFY THIS OFFICE IN
WRITING IF THEIR MAIUNG ADDRESS CHANGES. Whenever corresponding
please provide -assigned Registration Number.
".
Should you have any questions regarding this matter you may contact our office
at (850) 245-6058. .
Fictitious Name Section
Division of Corporations-'-----.-'
Letter No. 709A00012096
Division of Corporations ~ P.O. BOX 6327 -Tallahassee, Florida 32314
March 26, 2009
BUMBLE BEE SCHOOL TRANSPORTATION
2930 35TH AVE NE
NAPLES, FL 34119
Subject: BUMBLE BEE SCHOOL TRANSPORTATION
REGISTRATION NUMBER: G09085900134
This will acknowledge the filing of the above fictitious name registration which
was registered on March 25, 2009. This registration gives no rights to
ownership of the name.
Each fictitious name registration must be renewed every five years between
January 1 and December 31 of the expiration year to maintain registration.
Three months prior to the expiration date a statement of renewal will be mailed.
IT IS THE RESPONSIBILITY OF THE BUSINESS TO NOTIFY THIS OFFICE IN
WRITING IF THEIR MAILING ADDRESS CHANGES. Whenever corresponding
please provide assigned Registration Number.
Should you have any questions regarding this matter you may contact our office
at (850) 245-6058.
Fictitious Name Section
Division of Corporations
LetterNo.809A00010318
Division of Corporations - P.O. BOX 6327 -Tallahassee, Florida 32314
01/28/2015 08:44 FAX
1tI003/004
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CO/AGY 10 / 6
T# 5744498X5
B# 1053696
FLORIDA VEHICLE REGISTRATION
PLATE N483IX DECAL 04049739 Expires Midnight Sat 1/16/2010
YR/MK 2002/FORD BODY VN Reg. Tax 93.60 Class Code ~
YIN 1 FBSS31 L22HA1 0583 TITLE 83917775 !nit. Reg. Tax Months
Plate Type RGR NET WT 5997 GYW' 9100 County Fee 300 Back Tax Mos
Mail Fee Credit Class
DUFEID R520421650160 Sales Tax Credit Months
Date Issued 3/4/2009 Plate Issued 3/4/2009 Y oluntary Fees
Grand Total 9660
JORGE ANGEL RAMOS
2930 35AVE NE
NAPLES, FL 34120
IMPORT ANT INFORMATION
I. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
replacement vehicle.
3. The registration must be surrendered when requesting a change of address.
4. Registration renewals are the responsibility of the registral1t and shall occur during
the 30-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
RGR - FLORIDA REGULAR
PLATE ISSUED X
----'_.,__._-.1~:Ls:v.+~\L..__:...:.:.:...;.:~~Mnm~WL.~~~.G.~'L".._.._._..".u~_..
.1J:.trllC.b.:rJ;..C.l\1 C.~_OO.L.lnr:7_.T:A.ll.t'''''''-lr_..''_'''''''''~-'''''''''''''''''''''' .",.... .~.' ~ ----- -
-
VEHICLE LEASE
This lease is entered into this ~ day qf-4
~ntP-ee- /6R.e...Sa1CD~7lM and
Lessee.
, 20 0 Cj ., by and between
::b~e.- A, ~dS .
t
In consideration of t...~e promises herein contained, on the part of the parties to be
performed, Lessor hereby leases to the Lessee the following described motor vehicle:
VIN#
License
Plate #
Make
Type
Year
1~tkS2>IL1Zf:fM05~lf
~{2.b
~
02.
Lessee to have possession of the vehicle until this lease is terminated. Lessee 'Will pay
~
To Lessor annual rent of $ ~ in 12 rent payments of $ :J2.. each month.
Either party may terminate this lease at any time after this vehicle is no longer being
operated subject to the Collier County Vehicle for Hire Ordinance, by giving the other
party written notice of intent to terminate. Lessee agrees during the entire term of
this Lease to continuously maintain insurance on the leased vehicle in not less than
the face amounts and scope of coverage as are then required by the Code of Laws and
Ordinance Chapter 142. Lessee agrees, during the term of this lease to otherwise hold
Lessor harmless from any and all claims arising out of use or operation of the subject
vehicle. Each party to this Lease asserts to the other party that the respective party
has full authority to enter into this Lease in an individual capacity and/or on behalf of
any principle. The Laws of the State of Florida shall control this Lease.
JJ~-
..:] Oil5. e 4, t:mn {/ ';. .
Print Name of Lessor
~~~.~~.Q.&.e,'l>~L .
ygnature of Lessee Print Name of Lessee ~ff6t.ST1J>rU1Yl
--J- -YO Id tj 5 jIJ. /;]14 f)J 0 g '.
l
I
: PRODUCER
I
~
I INSURED
Sunshine Insurance Agency
2595 SW 87th Avenue
Miami, FL 33165
Phone (305)559-7873
Fax (305)559-2237
DATE (MM/DDNY)
04/09/09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE ~ NAIC #
! INSURER A: DELOS INSURANCE COMPANY .
I INSURER B:
I
i INSURER C:
! INSURER 0:
INSURER E:
-----.
ACORD~
~
CERTIFICATE OF LIABILITY INSURANCE
DELUXE TRANSPORTATION SERVICES
DBA BUMBLE BEE SCHOOL TRANSPORTATION
2930 35TH AVE NE
NAPLES, FLORIDA 34120
COVERAGES
THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ADD'L TYPE OF INSURANCE I POLICY NUMBER I POL~~i EFFECT1V~ I POLlfrY EXPlRATIO(~ I LIMITS
LTR INSRD DATE MM!DDIYYYY DATE MMIDDIYYYY I
GENERAL LIABILITY i EACH OCCURRENCE
o COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
PREMISES lEa occurrence)
DO CLAIMS MADE 0 OCCUR MED EXP (Anyone person)
A 0 0 PERSONAL & ADV INJURY
0 GENERAL AGGREGATE
GEN'LAGGREGATE LIMIT APPLIES PER: ' PRODUCTS - COMP/OP AGG
o POLICY 0 PROJECT 0 LOC ---
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT If 1,000,000
0 ANY AUTO 03/11/2009 03/11/2010 (Ea accident)
0 ALL OWNED AUTOS L ~/ BODILY INJURY 1"-
B 0 ~ SCHEDULED AUTOS (Per person)
0 HIRED AUTOS BODILY INJURY
0 NON OWNED AUTOS (Per accident)
0 I PROPERTY DAMAGE
In (Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT
0 0 ANY AUTO OTHER THAN EA ACC
I 10 I AUTO ONLY: AGG
EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE
o OCCUR o CLAIMS MADE AGGREGATE
0 I
0 DEDUCTIBLE
0 RETENTION $
I WORKERS COMPENSATION AND o WC STATU- o OTH-
EMPLOYERS' LIABILITY Y/N TORY LIMITS ER
ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT
OFFICER / MEMBER EXCLUDED?
(Mandatory In NH) E.L. DISEASE - EA EMPLOYEE
If pes, describe under E.L. DISEASE - POLICY LIMIT
I S ECIAL PROVISIONS below
I OTHER
f DESCRIPTION OF OPERATIONS / LOCA nONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
. SCHOOL BUS SERVICE
12002 FORD E350 VIN#1FBSS31L22HA10583 $600
I
fTHE CERTIFICATE HOLDER IS ALSO ADDITIONAL INSURED
L
I
~ COLLIER COUNTY BOARD OF
i COUNTY COMMISSIONERS
! 2800 N. HORSESHOE DRIVE
I NAPLES, FLORIDA 34104
I : LISTED AS ADDITIONAL INSURED
ACORD 25 (2009/01) OF
L/
CANCELLATiON
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO
I THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
, OF ANY KIND UPON THE IN URER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED RE~J!!tTIVE _____ .
~ -~---.,:r I
@1988-2009ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
CERTIFICATE HOLDER
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
provisions.
~~LA ~
{J ( gnature of Applicant)
I Qo~.e. A\. ~5.
for Certificate to Operate is true.
swear or aflirm that all information on this Application
tJt 4. ~4/)~
(Signature of Applicant)
STATE OF FWRIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and sworn to before me this 4 \-=t \ a 9
~ A -;}\ \\ ' , (Date)
By. .. \C~ f'fV\ O~ who has produced _ V N u e ( G (etl u?
(Name 0 person ackrlowledging) (Type of identification) '-
As iden . cation ~d W 0 'd take an oath.
I1ArzJA \MobA
Print of Notary
~
NOTARY'S SEAL
Notary Public Commission # ]) D CO 1254-2
\\ )0)2010
\\\\\~~"t.~II"
_--~o<'. - c.:. '-, MARIA JULIA IMO~.-'
.. ~ . ~ <0-:' I u,",
I.' iJ". ~. ,No.!ary Public. Stale of Florid
. ~ .. 1I1Y l-om . . a
~-0:. ",,;.! mlssl~n Expires Nclv 6,2010
"';~'?;'I~~~~"\" CommIssIon # DO 612542
. Bonded Through National NofaryA
ssn.
Commission Expires
5
AFFIDAVIT
Before me this day personally appeared :J..o /l.P; e. ~ . who swears or affirms
that the vehic1e(s) to be permitted meet(s) the safety standards as set forth in Code of Laws
and Ordinance Chapter 142.
It is understood and aclmowledged by the Code Enforcement Department and myself that if
my vehic1e(s) that is/ are permitted fail(s) to meet(s) the safety standards as required by this
Ordinance, the vehic1e(s) must be removed from service until all violations are corrected.
.
BUSINESS NAME 't>6!UXc. ~~TI CJY} :;:O{L(p.'~
SIGNA11JRE OF APPLIC4 llov;ll1 tJ ~ DATE
Y
STATE OF FWRIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and sworn to before me this
~a\~e. A. ThrmClS
Name f person aclmowledging)
\ \f eif V ( en (~ as identification and who did.
=+- day of ~,
Q
20QJ, by
(
who is personally known or has
produced
.f'\A~ A \\1DDA-
PRINT NAME OF NOTARY
~
NOTARY PUBLIC COMMISSION #
ub 6\ 2S4-2
NOTARY'S SEAL
~ - -
~ -
COMMISSION EXPIRES:
\ \
I, I'~ '0
I~ CUI
~ -
....'~~,~~~H.~~<)~...., MARIA JULIA IMOtiA
~ /"~~-~C'\ Notary Public. State of Florida
--(: iJ~'\- .: 1 ..
~ %~~~ . .,ff ~,y CommiSSion Expires Nov 6.2010
~ "':;f~O;~'" COmmission # DD 612542
."......' Bonded Through National Notary Assn.
~
4
COLLIER COUNTY GOVERNMENT
CRIMINAL mSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date:
Pursuant to provisions of Chapter 119, F.S., and procedures outlined under Rule
Chapter IIC-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
Name::TO~~ A. ~oS
First Middle (full) Last Maiden
Address: d-q ~ 3S<#t Gv...R. Ue I N ~ ,4 ~lf I ~ .
(Number & Street) (City) , (State) (Zip Code)
_DLNo.: f!-~~ - 4J1- &&-01(0-0 .
Age: ~ Race: H .
Eye: f3 \ Ie. * Hair: N 0 ~ -
(Color) (Color)
Social Security No.:
DOB:~ Sex: M
Height: (p , b 2, weight~~-o lbs.
Name:
First
Middle (full)
Last
Maiden
Address:
Number & Street
City
State
Zip Code
Social Security No.:
DL No.:
DOB:
Sex:
Age: _
Race:
Height:
Weight:
lbs.
Eye:
Hair:
(Color)
(Color)
lj1n~~i~) :~) ! __
D::';Z-~4r;r~--~-----------CONSENr=,:=--~-~-~-;;~-U 24Ft(
T
I
1 ,
(
I understand that Collier County Code Enforcement will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New
York, NY 10011, as part of the procedure for processing my PVAC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further information through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id.
I understand a consumer reporting agency's investigation may include obtaining information covering up to the last seven (7) years regarding, among
other items, references, character, driving record, past employment, work habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and federal law_ The investigation also may include obtaining information relating to criminal records without
any time limitations, subject to state and federal law.
In the event an investigative consumer report is conducted, I understand such information may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge conceming my character, general reputation, personal
characteristics or standard of living. I understand such information may also be obtained through direct or indirect contact with former employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
a By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act.
I also understand that before my application is denied based, in whole or part, on information obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the accuracy
of any information in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging information in the report, Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the information
contained in the report
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
Ip Code
~ ~
#yrs at this al:ldress
fJ P
City
~lol~~OI ' .,
~' lire"", No. Sod,I Security No.
~ rf< A,~. D'"
Minnesota & Oklahoma applicants Only: I have the nght to request a copy of my consumer report from Sterling Testing Systems, Inc. by
checking the box below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make
a written request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report.
.. I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
Middle Name/Initial
~ Qe
~
#yrs at this address
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
I :Jorqe.. ~(Z)~ .
/l1T(jJ- /J. ~ '
~uff! of applicant
, have read and understood the paragraph
<4/ ~/o~
Date
;;'-!-\li;
C;9l!feI County
..__~ ...... . ...,.' ....."". .~, ...... ...._,,,.--. -0--.....
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Overage Amount:
Contact:
FEES:
Descriotion
Certificate to Operate
Application
Cashier Name:
Batch Number:
LauraWells
148
Development and Environmental Services
RECEIPT OF PAYMENT
2009009484
2009-001987
04/10/2009
Check
1043
$200.00
$200.00
$0.00
Freedom Tax Service of SW Florida Corp
4075 Pine Rd. Ste 6
Naplesr FL 341194004
Amount
Paid
Account
Reference Number Oriqinal
Fee
2800 Horseshoe Drive N.
Naples, FL
34104
239-252-2400
LCCT020090000334 $200.00
$200.00
111-138911-321241
PrintResults Page 1 of 3
STERL i'-JG
PO #
Last Name
First Name
Middle Name
Date of Birth (mmfddfyyyy)
Phone
Projected Salary
Job State
Code Enforcement Div. Collier County
Order#: 9278439
jorge ramos
Subjecl Profile
n.
ramos
jorge
a
01/16/1965
NIA
Address
Apartment Number
City
State
Zip
Current Address
2930 35th Ave N.E.
Naples
FL
34120
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
Status
3 CLOSED
Findings
Alert
MOTOR VEHICLE REPORT (MVR)
1 CLOSED
See Results Below
SEXUAL OFFENDER DATABASE SEARCH
1 CLOSED
Clear
SOCIAL SECURITY TRACE SEARCH
1 CLOSED
CRIMINAL RECORD SEARCH
The criminal information reported on this website appears exactly as it is received from the iocal Jurisdictions and may contain information
which would be prohibited for use in making hiring decisions. Therefore, It is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: Stale: NW Zip: County: NATIONWIDE
Status: CLOSED
FINDING: Alert
*************************************************************************
* THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND *
* HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STru1DARD
* CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
In accordance with Federal and/or State guidelines that pertain to providing
information over 7 years old, we need to verify that this applicant will
earn at least $75,000 per year. If you wish Sterling to provide this
information, please let us know that the applicant meets this earnings
threshold by emailing: SalaryConfirmation@sterlinginfosystems.com
City: Naples State: FL Zip: 34120 County: COLLIER
Status: CLOSED
FINDING: Clear
NO CRIMINAL CONVICTION FOUND.
City: Stsle: FL Zip: 33177 County: DADE
Ststus: CLOSED
FINDING: Alert
In accordance with Federal and/or State guidelines that pertain to providing
information over 7 years old, we need to verify that this applicant will
earn at least $75,000 per year. If you wish Sterling to provide this
information, please let us know that the applicant meets this earnings
threshold by emailing: SalaryConfirmation@sterlinginfosystems.com
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - 88178
Order Date: 03/23/2009
https:/ Isd. sterlimrtestim!.comlwebdirect3/resultslPrintResults.aspx? Archive=
4/13/2009
PrintResults
Page 2 of3
Host Used: Online
Reference: 9278439_3
Period: THREE YEAR
License: R520421650l60
Report Clear:NO
Name: RAMOS, JORGE ANGEL
Address:
City, St:
As of:
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Is" Date: 01/16/2008
Exp Date: 01/16/2012
AGE:
Year License First Issued: 01/31/1989
STATUS: VALID
MVR Score
SCORE:
ELIGIBLE
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONV
ACD AVD V /C
DESCRIPTION
CONV 06/27/06 07/27/06 B70 DA05 625 NO PHYSCL EXAM FORM IN POSSESS-CMV
LOCATION/DOCKET: COLLIER/7706EER PTS: 0
CONV 08/29/06 09/29/06 D36 DE06 280 PROOF OF INSURANCE REQUIRED
LOCATION/DOCKET: NEBRASKA/1645 PTS: 0
CONV 10/12/06 12/23/06 S93 SA01 573 SPEED IN EXCESS OF POSTED MAXIMUM
LOCATION/DOCKET: DADE/9408ETQ PTS: 3
CONV 10/12/06 02/13/07 D36 DE06 280 PROOF OF INSURANCE REQUIRED
LOCATION/DOCKET: DADE/9409ETQ PTS: 0
CONY 01/28/07 05/10/07 S2l SA12 575 SPEEDING 20+ OVER THE LIMIT
SPEED:68/45 LOCATION/DOCKET: COLLIER/5952DTU PTS: 4
CONY 02/19/07 06/28/07 B53 DD03 473 EXPIRED TAG- 6 MOS OR LESS
LOCATION/DOCKET: COLLIER/9625ERW PTS: 0
CONV 05/15/08 06/11/08 E30 EA01 137 DEFECTIVE EQUIPMENT
LOCATION/DOCKET: DADE/1498GAL PTS:
Suspensions/Revocations
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
WITHDRAWAL 10/13/06
DESCRIPTION: FINANCIAL RESPONSIBILITY CONDITION
**TYPE:SUS RSN:FR5A LOC:2006l0140201278148
DE06
License and Permit Information
License: PERSONAL Issue:Ol/16/2008 Expire:01/16/2012 Status:VALID
License Status Explanation: ELIGIBLE
Class:E REGULAR OPERATOR
Miscellaneous State Data
** ENTRIES BELOW CO\~R THE PAST 3 YEF~S **
MISC: EXAMS VISION=l ROAD SIGN=l ROAD RULES=l DRIVING=l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL=O
BLOCK PERSONAL INFORMATION **
BLOCK FOR MAILING LIST **
THIS PERSON HAS A DIGITAL IMAGE
I FOR STATED BUSINESS
IPURPOSES ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
/
Issue Date:
/ /
Control Number: I03VP5
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
Slate: FL
Status: CLOSED
FINDING: Clear
No Record Found
Back to Findings
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
********************.*******
Social Security Trace
********************************************************************************
GENERATED: 03/23/2009 10:50:37 AM
TPANSACTION ID:0018235054-6718
NAME
DOB
httns://sci "terlinote"tino C'f\m/urphrlirpl't1/rp,mlt,,/PrintR """It" ",,,nv') ^ ..,..].,;"",=
II 11 '"l/')f\f\f\
PrintResults
1.
JORGE A RAMOS
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
ADDRESS
3750 70TH NE AVE NAPLES, FL 34120-2602
14630 SW l72ND ST MIAMI, FL 33177-6616
7861 SW 34TH TER MIAMI, FL 33155-3522
8620 SW 21ST ST MIAMI, FL 33155-1033
8321 NW 7TH ST APT 405 MIAMI, FL 33126-3981
117 GRAND CANAL DR MIAMI, FL 33144-2527
2.
NAME
JORGE A RAMOS
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
ADDRESS
2930 35TH NE AVE NAPLES, FL 34120-1582
3667 S MIAMI AVE APT 107S MIAMI, FL 33133-4207
14630 SW 172ND ST MIAMI, FL 33177-6616
9228 SW 36TH ST MIAMI, FL 33165-4118
12361 SW 39TH TER MIAMI, FL 33175-3030
3.
NAME
JORGE RAMOS
SSN
###-##-####
VALID
YES
STATE ISSUED
FLORIDA
ADDRESS
15166 SW l72ND TER MIAMI, FL 33187-6202
3667 S MIAMI AVE APT 107 MIAMI, FL 33133-4207
4.
NAME
JORGE RAMOS
SSN
###-##-####
VALID
YES
STATE ISSUED
FLORIDA
ADDRESS
14630 SW 172ND ST MIAMI, FL 33177-6616
5.
NAME
JORGE A RAMOS
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
ADDRESS
824 SW 66TH AVE MIAMI, FL 33144-4834
6.
NAME
JORGE A RAMOS
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
ADDRESS
8775 PARK BLVD APT 118 MIAMI, FL 33172-5707
Page 3 of3
00/1965
DATE ISSUED
01/01/1988
FROM
06/2006
09/1993
02/1994
07/1996
08/1995
03/1995
TO
03/2009
07/2006
01/1997
07/1996
01/1996
03/1995
DATE ISSUED
01/01/1988
FROM
07/2008
09/1993
09/1993
11/1993
09/1993
TO
08/2008
01/1994
01/1994
11/1993
09/1993
DATE ISSUED
01/01/1988
FROM
07/2005
10/1998
TO
11/2005
02/1999
DOB
00/1965
DATE ISSUED
01/01/1988
FROM
06/1995
TO
08/2004
DOB
01/16/1965
DATE ISSUED
01/01/1988
FROM
01/1999
TO
01/1999
DOB
06/1965
DATE ISSUED
01/01/1988
FROM
07/1991
TO
12/1992
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
**END OF NETWORK TRACE**
.l3a~k.toJil1dings
Copyright C 2008 Slerling Infoeyslems. Inc.
htt't"'\C". / /C"rl C'ta'l'"l;.,... nt.oC't; n rT 1"n.'I"V\ lnT.oh,...J;ra",t1./ro.C'H ltc-fP.....;t"'It D J:t.C'H ltC" ":lcon'V'J ^ ....",1,;., 1I::::a.=
;1 /11 nooo
LCCT020090000339
Collier Shuttle Services
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
PUBLIC VEHICLE ADVISORY COMMITTEE
2800 NORTH HORSESHOE DRIVE
NAPLES, FL 34104
APPLICATION FOR CERTIFICATE TO OPERATE
DATE: ;+- 0;;.~ J.-bD [)
The undersigned hereby makes application for a Certificate to Operate vehicles "for hire" within
Collier County under Code of Laws and Ordinance Chapter 142, and respectfully submits the
following information in support of this application.
FEES: N on- Refundable Application Fee
Certificate to Operate Issuance Fee (Yearly)
Vehicle Decal Permit Fee (Per Vehicle / Yearly)
Driver ID Fee
$ 200.00
$ 325.00
$ 50.00
$ 75.00
NOTE: Please make check / money order payable to the BOARD OF COUNTY COMMISSIONERS
1. Name of APplicant_~J0e6~LLlis ~ l~G.dD
Address:--Y3C') QL)-+~ s+ 02 t0R~lfS I ~\ JL~ld-O
(Number & Street) (City) (State) (Zip Code)
Home Telephone: (d?fl) J.-f5S. <.al S~ E-Mail (Y'l~\\+2b.ckd~r..d-b Jl@y?J~D~es
Date of Birth: 65 ~l (q&~ S.S. #:
Driver's License #: DL/cl~ Lf3;l &;5 a ~ 4D
2. If Partnership:
Business Name:
Business Address:
(Number & Street)
(City)
(State)
(Zip Code)
Business Telephone: (
E- Mail
List of Partners:
A.
(Name)
(Address)
o
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
1 .
(HOmj~JlOl~C #)
(Date of Birth)
(Social Security #)
3. If Manager:
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
Copies of Articles of Incorporation, all amendments thereto, and a certified copy of the Certificate of
Incorporation must accompany this application.
4. If corporationi!:ictio;~
Exact Corporate/Business Name: ~() 1\-\ e r S ~ Q++L~ S e.r \J'j c_e S
Business Telephone number: (2-~q) Z. ~ q . ct S s q E- Mail
Business Address: Lt30 dO+~ 'S \" \.~& W-AQLf~ 1(2-\
(Number & Street) (City) (State)
3q-lz-o
(Zip Code)
List of Directors / Officers:
A.
3"oQ(,t:' L. De\do-c\o
(Name)
q.6b
J(J\ll "ST k~ I-JAnE')', Ft, 3((-.120
(Address)
910. fJ3~ q3~1
(Social Security #)
LI ') {) " _b~l1 <)-r ~e )^ ~\8S f \ . 31.117.1)
(Address)
B.
?~ q. l SS . (0 \ 1):J,.
(Home phone #)
,---\ Q:{t \ -\~~.
(Name)
uYi' crs:s. lot <i d...
(Home phone #)
O-x ~tJ. ~ruo S
(Da e 0 Birth)
t!/,;.,cb
b~lCHR<6
(Date of Birth)
(Social Security #)
5. List any and all persons holding a ten percent (10%) or greater beneficial interest in applicant's
business or company.
A.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
2
6. If applying for Sub-Certificate name(s):
a. Name
Date of application
b. Approved
Rej ected
REASON:
c. Name
Date of application
d. Approved
Rejected
REASON:
7. Trade Name (if any)
8. List all criminal convictions for which the applicant, owners, managers, directors, and any
officers have been found guilty or convicted regardless of adjudication, in the United States
indicating the offense, the date, and the state.
9. Has Certificate to Operate ever been revoked? Yes
No X
If yes, please explain the reason, the year, city, state, and the previous issued Certificate to Operate
number, of revocation:
3
April 6, 2009
Vehicle For Hire Dept
Collier County, Fl.
I Jorge Delgado am applying for my vehicle for hire license, to transport children to and
from school, and also provide transportation services to citizens in the Community, who
render my services. I have 10 years experience with a class A license, and to date hold an
excellent driving record. I currently hold a driver position with Triple J Trucking, I have
been employed with the Company for seven years, and I am highly recogpJzed and
respected for being a very responsible driver. I enjoy driving for a living and therefore
would like to persue my career in opening my own transportation services, I know I will
do my very best when my services are rendered by the Community. I enjoy working with
the public and I am seeking to persevere with my transportation services Company, to be
able to provide for my family a more stable income in hope of being issued my own
vehicle for hire license.
Sincerely, Jorge L. D
April 6th, 2009
Ref: Vehicle For Hire Dept
I Jorge L.Delgado, and Maritza M. Delgado will be the Owner, and Co. Owner of Collier
Shuttle Services.
Sincerely, Jorge L. Delgado, Maritza M. Delgado
11.
g9""nc.
.
.,
March 30th 2009
To Whom It May Concern;
Mr. Jorge Delgado purchased insurance from our agency for his dump truck. This
gentleman began his policy on/9/25/08. To date, all payments have been made either
on time or early, and all payments have been honored by his bank.
If a verbal confi.rmation is required, please do not hesitate to call me.
Sincerely,
Les Newman
Owner / Licen.sed Agent
......J;~___
1344 North State Road 7 . Margate, FL 33063 . Tel: (9S4) 977..0047 . F~: (954) 977-5004
www.rajnbowinsurarice.com-info@rainbowinsurance.com
03-30-2009 16:43 BB BLINDS 239 34B 9304 PAGEl
Cash Register Insurance
4979 Golden Gate Parkway
Naples FL 34116
(239)353-6207
Date: OV -of -- 61
To whom it may concern,
This is to inform yon that ~/;w ~~AJt:-z.. has been insured
with Cash Register Insurance since 07" - 2-0- ?va'p and his! her
payments have been made always in a timely manner.
Any questions feel free to call (239) 353-6207.
arcla
er
egister Auto Insurance
.
Case ID: 0218150309
~OVIA
Wachovia Bank NA
Balance Confirmation Services
PO Box 40028
Roanoke, V A 24022
March 31, 2009
MARITZA MARTINEZ DELGADO
JORGE LUIS DELGADO
430 20TH STREET NE
NAPLES, FL 34120
SUBJECT: Verification / Confirmation of Account and Balance Information provided for:
Customer: MARiTZA MARTINEZ DELGADO ,__.... .___ ,__ .".,
JORGE LUIS DELGADO (l6SR- llil as of March 31, 2009
Deposit Account Information
Account Type Account Number Current Available Average Balance Date Opened Maturity Interest Date Closed
Balance Date Rate
CHECKING r $0.00 $519.45 02/25/2008
CHECKING $911.32 $839.95 02110/2009
Remarks:
Non-applicable fields intentionally left blank
.P~~
Pam Blankenship
Balance Confirmation Services Representative
Phone: (540) 563-7323
Fax: (704) 427-2477
Page 1 of 1
.cyuuax r f\.\.... 1 f\.(;l
ragt: 1 Ul L.V
Equifax Credit Report TM for Maritza M. Delgado
As ot 04109/2009.
Available until~OO9
Confirmation ___
Report Does Not Update
Important. Please print this report as it will only be available for you to view during this
session with Equifax. If you would like to view this credit report online free for 30 days,
1.
2-
3.
Summary of account activity
Detailed account information
Companies that have requested or viewed your credit
information
4.
5.
6.
7.
Bankruptcies, liens, garnishments and other judgments
Personal data, addresses, employment history
How to dispute information found on this credit report
Summary of Your Rights Under the FCRA
8.
9.
Remedying the Effects of Identity Theft
Your Rights Under State Law
Your Equifax Credit Summary highlights the information in your credit file that is most important in
determining your credit standing by distilling key credit information into one easy-to-read summary.
Lenders usually take a positive view of individuals with a range of credit accounts - car loan, credit
cards, mortgage, etc. - that have a record of timely payments. However, a high debt to credit ratio on
certain types of revolving (credit card) accounts and installment loans will typically have a negative
impact
0 $0 N1A N1A N1A $0 0
0 $0 N1A N1A N1A $0 0
7 $27,444 $13,256 $40,700 67% $549
0 $0 N1A N1A N1A $0 0
Total 7 $27,444 $13,256 $40,700 67% $549
https://fact.econsumer.equifax.com/factiviewPopUpDetail.ehtml?prod _ cd=CRD&oi_ num=... 4/9/2009
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hl,:,rt';13'J~I)% InstJ/lmoSllt-O%
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Usually, it is a good idea to keep your oldest credit account open, as a high average account age
generally demonstrates stability to lenders. Also, especially if you have been managing credit for a
short time, opening many new accounts will lower your average account age and may have a
negative impact
Length of Credit History 9 Years, 0 Months
Average Account Age 5 Years, 7 Months
Oldest Account
Most Recent Account
Numerous inquires on your credit file for new credit may cause you to appear risky to lenders, so it is
usually better to only seek new credit when you need it Typically, lenders distinguish between
inquiries for a single loan and many new loans in part by the length of time over which the inquiries
occur. So, when rate shopping for a loan ifs a good idea to do it within a focused period of time.
4
Most Recent inquiry
Late payments, collections and public records can have a negative impact on your credit standing.
The more severe and recent they are, the more negative the potential impact might be.
o
o
Mortgage accounts include first mortgages, home equity loans, and any other loans secured by real
estate you own.
CITIMORTGAGE -
1012003
$0
0412005
$0
PAYS AS
AGREED
$0
https:llfact. econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi_ num=... 4/9/2009
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PO Box 9438
Dept 0251
Gaithersburg, MD-208989438
(800) 283-7918
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Individual Account.
Installment
30 Years
10/2003
04/2005
04/2005
$1,424
$0
$0
N1A
Fannie Mae account
No 81-Month Payment Data available for display.
.~"... .', .,
Current Status:
High Credit:
Credit Limit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of loan:
rag~ .J 01 "'V
PAYS AS
AGREED
$153,400
$0
$0
$0
$0
04/2005
15
Paid and
Closed
Conventional
RE Mortgage
Installment accounts are credit accounts in which the amount of the payment and the number of
payments are predetermined or fixed, such as a car loan.
BENZ
FINANCIAL
SERVI
15301 NW 7th Ave
Miami, FL-331696205
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
K
0412000 $0
03/2001
$0
PAYS AS $0
AGREED
PAYS AS
AGREED
$3,254
$0
$0
$0
https://fact. econsumer.equifax.com/fact/viewPopUpDetail. ehtml ?prod_ cd=CRD&oi _ num=... 4/9/2009
L
Joint Account
Installment
04/2000
0312001
Current Status:
High Credit:
Credit Limit:
Terms Frequency:
Balance:
Amount Past Due:
.cYUlHtX r iH./ 1 ~l.;l
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
$180
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Closed or paid account zero balance
CITIFINANCIAL
JT
No 81-Month Payment Data available for display.
$0
PO Box 499
Hanover, MD-21 0760499
(800) 922-6235
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
0712001 $0
04/2005
Current Status:
Joint Account
Installment
60 Months
07/2001
04/2005
04/2005
$195
High Credit:
Credit Umit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
$0
$0
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
No 81-Month Payment Data available for display.
ra~c '"t Ul kV
$0
0312001
11
N1A
PAYS AS $0
AGREED
PAYS AS
AGREED
$7,536
$0
$0
$0
$0
04/2005
44
Paid and
Closed
Unsecured
Revolving accounts are charge accounts that have a credit limit and require a minimum payment
each month, such as most credit cards.
https:/ Ifact. econsumer.equifax.com/fact/viewPopUpDetail.ehtml ?prod _ cd=CRD&oi _ num=... 4/9/2009
ClIUIH1X r J-\\... 1 J-\101
AMERICAN
EXPRESS
01/2007 $0
PO Box 981537
EIPaso, TX-799981537
(800) 874-2717
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Year
2009
2008
2007
Jan Feb
BANK OF
AMERICA
-
Individual Account.
Revolving
0112007
03/2009
0812008
$0
$0
$0
N/A
Mar Apr May
03/2009 $0
Current Status:
High Credit:
Credit limit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Jun Jul Aug
Sep
534235000089XXXX 0612002 $0
0712002 $0
4060 Ogletown Stanton Rd
Newark, DE-197133102
(800) 421-2110
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount: $0
-
Individual Account.
Revolving
0612002
0712002
-
Current Status:
ragt: .) or kV
PAYS AS $5,000
AGREED
PAYS AS
AGREED
$82
$5,000
$0
$0
$0
0812008
13
N/A
Credit Card
Oct Nov
Dec
High Credit:
Credit limit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
TOO $0
NEW TO
RATE
TOO NEW TO
RATE
$0
$0
$0
$0
$0
07/2002
https:l/fact. econsumer.equifax.com/fact/viewPopUpDetaiI . ehtm 1 ?prod _ cd=CRD&oi_ num=... 4/9/2009
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ragt: 0 01 i.V
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount: $0
Balloon Payment Amount: $0
Date Closed:
Date of First Delinquency: N1A
Comments: Credit card
Months Reviewed: N1A
Activity Description: N1A
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
81-Month Payment History
No 81-Month Payment Data available for display.
GEMB/JC
PENNEYS
0612007 $0
03/2009 $0
PAYSAS $1,000
AGREED
PO Box 981402
EIPaso, TX-799981402
(800) 542-0800
Account Number:
Current Status:
PAYS AS
AGREED
$0
$1,000
Monthly (due
every month)
$0
$0
$0
N1A
21
Account Owner:
Individual Account.
Revolving
High Credit:
Credit Limit:
Type of Account
Term Duration:
Terms Frequency:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount: $0
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
0612007
0312009
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Charge
Account
Date of First Delinquency: N1A
Comments:
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009
2008 *
2007
SEARS/CITIBANK 05J2000 $0 0612007 $0 PAYS AS $3,300
SD,N AGREED
Citi Cards
8725 W Sahara Ave
https:l/fact. econsumer.equifax.com/factiviewPopUpDetail.ehtml ?prod _ cd=CRD&oi_ num=.. . 4/9/2009
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The Lakes, NV-891630001
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Current Status:
rag\:: I 01 LoU
PAYS AS
AGREED
$381
$3,300
Monthly (due
every month)
$0
$0
$0
0812003
76
NJA
Credit Card
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2007
2006
2005
2004
2003
2002
2001
2000 .
SUNCOAST L - 04/2004 $27,444 0312009 $0 PAYS AS $30,000
SCHOOLS FED AGREED
6801 E Hillsborough Ave
Tampa, FL-336104110
(813) 621-7511
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Authorized User
Revolving
High Credit:
Credit Limit:
PAYS AS
AGREED
$27,444
$30,000
Monthly (due
every month)
$27,444
$0
$0
03/2009
31
https:llfact. econsumer.equifax.com/factiviewPopUpDetail.ehtml ?prod _ cd=CRD&oi _ num=... 4/9/2009
Terms Frequency:
OS/2000
0612007
08/2003
$0
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
NJA
Current Status:
Joint Account
Revolving
High Credit:
Credit Limit:
Terms Frequency:
0412004
0312009
1112008
$549
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
.wYUl1a.A .1' n\..,.l 1"1..vL
ra1:5t; 0 Vi ':'V
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
$0
$0
Activity Description: N1A
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan: Credit Card
N1A
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009
2008
2007
2006
2005
2004
TARGET 0312008 $0 03/2009 $0 PAYS AS $200
NATIONAL BANK AGREED
c/o TARGET CREDIT SERVICES
PO BOX 673
MINNEAPOLIS, MN-55440-0673
Account Number:
-
Current Status:
PAYS AS
AGREED
$53
$200
Account Owner:
Individual Account.
Revolving
High Credit:
Credit Limit:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
0312008
0312009
0312008
$0
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
$0
0312009
11
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Credit Card
N1A
81-Month Payment History
Year
2009
2008
Jan
Feb
Mar Apr May
Jun Jul Aug
Sep
Oct Nov
Dec
THE HOME
DEPOT/CBSD
ti
0512002 $0
0712005 $0
PAYSAS $1,200
AGREED
https://fact.econsumer. equifax.com/factiviewPopUpDetai1.ehtml?prod _ cd=CRD&oi _ num=... 4/9/2009
Equifax FACT Act
Pencader Corp Ctr
110 Lake Dr
Newark, DE-197023317
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency: N1A
Comments:
81-Month Payment History
Joint Account
Revolving
OS/2002
0712005
0412005
$0
$0
$0
No 81-Month Payment Data available for display.
BANK OF
AMERICA
0612002 $4,490 0412009
$800 120+ DAYS $4,100
PAST DUE
4060 Ogletown Stanton Rd
Newark, DE-197133102
(800) 421-2110
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Individual Account.
Revolving
0612002
0412009
1112008
$183
Current Status:
High Credit:
Credit Limit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Current Status:
High Credit:
Credit Limit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Page 9 of 20
PAYS AS
AGREED
$589
$1,200
Monthly (due
every month)
$0
$0
$379
0412005
34
N1A
Charge
Account
120+ DAYS
PAST DUE
$4,490
$4,100
Monthly (due
every month)
$4,490
$800
$0
N1A
82
https:/ Ifact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml ?prod _ cd=CRD&oi _ num=... 4/9/2009
DY.UiH1X r 1""\\"'- 1 1""\l;l
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
$0
$0
04/2009
1112008
Account closed by credit grantor,
120 Days past due
rage 1 V VI .4,V
Closed
Credit Card
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009 30 60 90
2008 30
2007
2006
2005
2004
2003
2002
SUNCOAST 0412004 $0 0812008 $0 LOST OR $0
SCHOOLS STOLEN
FED CARD
6801 E Hillsborough Ave
Tampa, FL-336104110
(813) 621-7511
Account Number:
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount: $0
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Current Status:
N1A
High Credit:
Credit Limit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
04/2004
0812008
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
ft,flA
.'IIft
TARGET
--
No 81-Month Payment Data available for display.
$0
0712003 $0
0312009
LOST OR
STOLEN
CARD
$0
$0
$0
$0
$0
07/2008
N1A
LosUStolen
Credit Card
PAYS AS
$200
https://fact. econsumer.equifax.com/fact/viewPop UpDetail.ehtml ?prod _ cd=CRD&oi _ num=... 4/9/2009
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NATIONAL
BANK
CIO TARGET CREDIT SERVICES
PO BOX 673
MINNEAPOLIS, MN-55440-0673
Account Number.
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency: N1A
Comments:
81-Month Payment History
Year
2009
2008
2007
2006
2005
2004
2003
Jan Feb
Current Status:
AGREED
PAYS AS
AGREED
$66
$200
$0
$0
$0
0312009
24
Closed
Charge
Account
Mar Apr May
Sep
Oct Nov Dee
Symbol
Meaning
Individual Account.
Revolving
High Credit:
Credit Limit:
These are all accounts that do not fall into the other categories and can include 30-day accounts such
as American Express.
You have no accounts classified as "Other" on file
Meaning
Pays or Paid as Agreed: .
30--59 Days Past Due: 30
0712003
0312009
1112003
$0
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Symbol
rage 11 or .oW
https://fact. econsumer.equifax.com/fact/vi ewPopUpDetail.ehtml ?prod _ cd=CRD&oi _ num=... 4/9/2009
$0
$0
0112007
Activity DescriptiOn:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Jun Jul Aug
180+ Days Past Due: 180
Collection Account: CA
Equifax FACT Act
Page 12 of 20
60-89 Days Past Due: 60
90-119 Days Past-Due: 90
120-149 Days Past Due: 120
150-179 Days Past Due: 150
Foreclosure: F
Voluntary Surrender. VS
Repossession: R
Charge Off: CO
A request for your credit history is called an inquiry. Inquiries remain on your credit report for two
years. There are two types of inquires those that may impact your credit rating and those that do not.
Inquiries that may impact your credit rating
These inquires are made by companies with whom you have applied for a loan or credit.
CBA::9599613770
08131/07
CBA
4 EXECUTIVE CAMPUS STE 200
CHERRY HILL, NJ 08002
(800) 648-2513
JC PENNYIMONOGRAM
CREDTI
06/15/07
JC PENNYIMONOGRAM CREDTI
PO Box 981402
EI Paso, TX 799981402
(800) 542-0800
SUNCOAST SCHOOLS
FCU
OS/21107
SUNCOAST SCHOOLS FCU
6801 E Hillsborough Ave
Tampa, FL 336104110
SUNTRUST BANK,
ATLANTA
09/04/07
SUNTRUST BANK, ATLANTA
Customer Care
55 Park PI NE
Atlanta, GA 303032529
(877) 844-3620
Inquiries that do not impact your credit rating
These inquires include requests from employers, companies making promotional offers and your own
requests to check your credit. These inquiries are only viewable by you.
AR-CARE CREDIT/GEMB
03113109
https ://fact. econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num=... 4/9/2009
tquuax l' AL 1 Act
t"age lj or LV
AR-CIT BANK/BILL ME LATER 04/22/08
PRM-ELlTE 08115/08
EQUIFAX 04/09/09
AR-GEMB/JC PENNEY 03/17/09
AR-GEMB/JC PENNEYS 03/24/09
AR-GEMBIWALMART DC 04/18/08
AR-SUNCOAST SCHOOLS FCU 01/13/09
PRM-XCELERATEDINVESTMENTS 02105109
PRM
Inquiries with this prefix indicate that only your name and address were
given to a credit grantor so they can provide you a finn offer of eredit or
insurance.(PRM inquiries remain for twelve months.)
Inquiries with these prefixes indicate a periodie review of your credit history
by one of your creditors.(AM and AR inquiries remain for twelve months.)
Inquiries with this prefix indicate an employment inquiry. (EMPL inquiries
remain for 24 months)
Inquiries with this prefix indicate that a creditor reviewed your account as
part of a portfolio they are purchasing.(PR inquiries remain for 12 months.)
Inquiries with these prefIXes indicate Equifax's activity in response to your
contact with us for a copy of your credit file or a researeh request.
Inquiries with this prefix are general inqUiries that do not display to eredit
grantors.(ND inquiries remain for 24 months.)
Inquiries with this prefIX indicate the reissue of a mortgage credit report
containing infonnation from your Equifax eredit file to another company in
connection with a mortgage loan.(ND inquiries remain for 24 months.)
AM or AR
EMPL
PR
Equifax or EFX
ND
NDMR
Accounts that contain a negative account status. Accounts not paid as agreed generally remain on
your credit file for 7 years from the date the account first became past due leading to the current not
paid status. Late Payment History generally remains on your credit file for 7 years from the date of the
late payment.
BANK OF
AMERICA
0612002 $4,490 04/2009
$800 120+ DAYS $4,100
PAST DUE
4060 Ogletown Stanton Rd
Newark, DE-197133102
(800) 421-2110
Account Number:
Current Status:
120+ DAYS
PAST DUE
Account Owner:
Individual Account.
RevoMng
High Credit:
Credit Lim it:
$4,490
$4,100
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Page 14 of20
Type of Account
Tenn Duration:
Terms Frequency:
Monthly (due
every month)
$4,490
$800
$0
N1A
82
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
0612002
04/2009
1112008
$183
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
0412009
1112008
Account closed by credit grantor,
120 Days past due
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Closed
Credit Card
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee
2009 30 60 90
2008 30
2007 . .
2006
2005
2004
2003
2002
("
-\,"
A collection is an account that has been turned over to a collection agency by one of your creditors
because they believe the account has not been paid as agreed.
You have no Collections on file
j,,,,; ~.,.
Public record information indudes bankruptcies, liens or judgments and comes from federal, state or
county court records.
Public record information includes bankruptcies, liens or judgments and comes from federal, state or
county court records.
You have no Public Records on file
The following information is added to your file either when creditors enter requests to view your credit
history, or when you report it to Equifax directly.
Name: Maritza M. Delgado
Social Security Number~
Age or Date of Birth: May ~
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Page 15 of20
Formerly Known As: Maritza Martinez
/.",."
Current
430 20TH ST NE
NAPLES,FL 34120
0112009
You have no other identification on file.
You have no Employment History on file.
You have no Alerts on file.
{~ t
You have no Consumer Statement on file.
,-
,
If you believe that any of the information found on this report is incorrect, there are 3 ways to launch
an investigation about the information on this report.
If you believe that any of the information found on this file is incorrect, you may start a dispute online
about any inaccuracies on your Equifax credit file. The credit reporting company is not required to
remove accurate data from your file unless it is outdated or cannot be verified.
Initiating a dispute online is the easiest and fastest way to dispute credit file information. In addition,
by disputing online you are also provided the ability to check online the status and results of your
dispute.
To initiate a dispute online click on
To check the status or view the results of your dispute click on
As a reminder your Confirmation Number is: . Please keep your confirmation as it may
be needed for future requests that you initiate with Equifax.
?/:: C~
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As stated in the FCRA, you have the right to dispute information that you feel is being reported
incorrectly on your Equifax credit file. You are able to initiate an online dispute immediately or you can
contact our dispute center at 866-224-9235 (changes monthly). You must have a current copy of your
Equifax credit file and your ten-digit confirmation number to complete the dispute process by phone.
Additionally, you can dispute inaccuracies by writing to:
Equifax information Services, LLC
P.O. Box 740256
Atlanta, GA 30374
Click on
You can dispute your personal information, including your name, address, and social security number
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Equifax FACT Act
Page 16 of 20
online. However:
. If you dispute or request a change on your name or date of birth, you will need to send us a
copy of your Driver's License reflecting this change.
. If you dispute or request a change on your Current Address, you will need to send us a copy of
your Driver's License or a utility bill reflecting this change.
. If you dispute or request a change on your Social Security Number, you will need to send us a
copy of your Social Security card or a W-2 form.
Once you have submitted you dispute online, you must provide us with a copy of your document
proof. You can fax your document proof to 888-826-0549 (may change), or, you can mail a copy of
your documents to:
Equifax Information Services, LLC
P.O. Box 740256
Atlanta, GA 30348
To initiate your dispute online click on
By law, you are entitled to obtain your credit score. There is a fee of $ to obtain your credit score from
Equifax Information Services. To request your credit score, please contact:
Equifax Information Services LLC
P.O. Box 105167
Atlanta, GA 30348
or call
1-877 -SCORE-11
If you are in the process of obtaining a mortgage, you may be entitled to free credit score information.
Contact the person making or arranging your loan for further information.
The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of
information in the files of consumer reporting agencies. There are many types of consumer reporting
agencies, including credit bureaus and specialty agencies (such as agencies that sell information
about check writing histories, medical records, and rental history records). Here is a summary of your
major rights under the FCRA. For more Information, including information about additional
rights, go to or write to: Consumer Response Center, Room 130-A, Federal
Trade Commission, 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.
. You must be told if information in your file has been used against you. Anyone who uses a
credit report or another type of consumer report to deny your application for credit, insurance, or
employment - or to take another adverse action against you - must tell you, and must give you the
name, address, and phone number of the agency that provided the information.
· You have the right to know what is in your file. You may request and obtain all the information
about you in the files of a consumer reporting agency (your "file disclosure"). You will be required
to provide proper identification, which may include your Social Security number. In many cases,
the disclosure will be free. You are entitled to a free file disclosure it
o a person has taken adverse action against you because of information in your credit
report;
o you are the victim of identify theft and place a fraud alert in your file;
o your file contains inaccurate information as a result offraud;
o you are on public assistance;
o you are unemployed but expect to apply for employment within 60 days. In addition, by
September 2005 all consumers will be entitled to one free disclosure every 12 months
upon request from each nationwide credit bureau and from nationwide speciatty consumer
reporting agencies. See for additional information.
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. You have the right to ask for a credit score. Credit scores are numerical summaries of your
credit-worthiness based on information from credit bureaus. You may request a credit score from
consumer reporting agencies that create scores or distribute scores used in residential real
property loans, but you will have to pay for it. In some mortgage transactions, you will receive
credit score information for free from the mortgage lender.
. You have the right to dispute incomplete or inaccurate information. If you identify
information in your file that is incomplete or inaccurate, and report it to the consumer reporting
agency, the agency must investigate unless your dispute is frivolous. See for
an explanation of dispute procedures.
. Consumer reporting agencies must correct or delete inaccurate, incomplete, or
unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or
corrected, usually within 30 days. However, a consumer reporting agency may continue to report
information it has verified as accurate.
. Consumer reporting agencies may not report outdated negative information. In most cases,
a consumer reporting agency may not report negative information that is more than seven years
old, or bankruptcies that are more than 10 years old.
. Access to your file is limited. A consumer reporting agency may provide information about you
only to people with a valid need - usually to consider an application with a creditor, insurer,
employer, landlord, or other business. The FCRA specifies those with a valid need for access.
. You must give your consent for reports to be provided to employers. A consumer reporting
agency may not give out information about you to your employer, or a potential employer, without
your written consent given to the employer. Written consent generally is not required in the
trucking industry. For more information, go to
. You may limit "prescreened" offers of credit and insurance you get based on information
in your credit report Unsolicited "prescreened" offers for credit and insurance must include a
toll-free phone number you can call if you choose to remove your name and address from the lists
these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-5-
OPTOUT (1-888-567-8688) .
. You may seek damages from violators. If a consumer reporting agency, or, in some cases, a
user of consumer reports or a furnisher of information to a consumer reporting agency violates the
FCRA, you may be able to sue in state or federal court.
. Identity theft victims and active duty military personnel have additional rights. For more
information, visit
States may enforce the FCRA, and many states have their own consumer reporting laws. In
some cases, you may have more rights under state law. For more information, contact your
state or local consumer protection agency or your state Attorney General. Federal enforcers
are:
Type of Business:
Consumer reporting ageneies, creditors and others
not listed below
National banks, federal branehes/agencies of foreign
banks (word "National" or initials "NA" appear in or
after bank's name)
Federal Reserve System member banks (except
national banks, and federal branches/agencies of
foreign banks)
Savings associations and federally chartered savings
banks (word "Federal" or initials "F.S.B." appear in
federal institution's name)
Federal eredit unions (words "Federal Credit Union"
appear in institution's name)
State-chartered banks that are not members of the
Contaet
Federal Trade Commission: Consumer Response
Center - FCRA
Washington, DC 20580 1-877-382-4357
Offiee of the Comptroller of the Currency
Customer Assistance Group
1301 McKinney Street, Suite 3450
Houston, TX 77010-9050
Federal Reserve Consumer Help
PO Box 1200
Minneapolis, MN 55480
888-851-1920 (TTY: 877-766-8533)
Office of Thrift Supervision
Consumer Complaints
Washington, DC 20552 800-842-6929
National Credit Union Administration
1775 Duke Street
Alexandria, VA 22314 703-519-4600
Federal Deposit Insurance Corporation
Consumer Response Center, 2345 Grand Avenue,
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Page 18 of20
Federal Reserve System
Suite 100
Kansas City, Missouri 64108-26381-877-275-3342
Air, surface, or rail common carriers regulated by
former Civil Aeronautics Board or Interstate
Commerce Commission
Department of Transportation, Office of Financial
Management
Washington, DC 20590 202-366-1306
Department of Agriculture
Office of Deputy Administrator - GIPSA
Washington, DC 20250 202-720-7051
Activities subject to the Packers and Stockyards Act,
1921
Identity theft occurs when someone uses your name, Social Security number, date of birth, or other
identifying information, without authority, to commit fraud. For example, someone may have
committed identity theft by using your personal information to open a credit card account or get a loan
in your name. For more information, visit W'NW. consumer. govlidtheft or write to: FTC, Consumer
Response Center, Room 130-8,600 Pennsylvania Avenue, N.W. Washington, D.C., 20580.
The Fair Credit Reporting Act (FCRA) gives you specific rights when you are, or believe that you are,
the victim of identity theft. Here is a brief summary of the rights designed to help you recover from
identity theft.
1. You have the right to ask that nationwide consumer reporting agencies place ''fraud alerts" in your
file to let potential creditors and others know that you may be a victim of identity theft A fraud
alert can make it more difficult for someone to get credit in your name because it tells creditors to
follow certain procedures to protect you. It also may delay your ability to obtain credit You may
place a fraud alert in your file by calling just one of the three nationwide consumer reporting
agencies. As soon as that agency processes your fraud alert, it will notify the other two, which
then also must place fraud alerts in your file.
o Equifax: 1-800-525-6285; W'NW.equifax.com
o Experian: 1-888-397-3742; W'NW.experian.com
o TransUnion: 1-800-680-7289; W'NW.transunion.com
An initial fraud alert stays in your file for at least 90 days. An extended alert stays in your file for
seven years. To place either of these alerts, a consumer reporting agency will require you to
provide appropriate proof of your identity, which may include your Social Security number. If you
ask for an extended alert, you will have to provide an identity theft report. An identity theft report
includes a copy of a report you have filed with a federal, state, or local law enforcement agency,
and additional information a consumer reporting agency may require you to submit. For more
detailed information about the identity theft report, visit W'NW.consumer.govlidtheft.
2. You have the right to free copies of the information in your file (your ''file disclosure"). An initial
fraud alert entitles you to a copy of all the information in your file at each of the three nationwide
agencies, and an extended alert entitles you to two free file disclosures in a 12-month period
following the placing of the alert. These additional disclosures may help you detect signs of fraud,
for example, whether fraudulent accounts have been opened in your name or whether someone
has reported a change in your address. Once a year, you also have the right to a free copy of the
information in your file at any consumer reporting agency, if you believe it has inaccurate
information due to fraud, such as identity theft. You also have the ability to obtain additional free
file disclosures under other provisions of the FCRA See W'NW.ftc.gov/credit.
3. You have the right to obtain documents relating to fraudulent transactions made or accounts
opened using your personal information. A creditor or other business must give you copies of
applications and other business records relating to transactions and accounts that resulted from
the theft of your identity, if you ask for them in writing. A business may ask you for proof of your
identity, a police report, and an affidavit before giving you the documents. It also may specify an
address for you to send your request Under certain circumstances, a business can refuse to
provide you with these documents. See W'NW.consumer.govlidtheft.
4. You have the right to obtain information from a debt collector. If you ask, a debt collector must
provide you with certain information about the debt you believe was incurred in your name by an
identity thief - Ii ke the name of the creditor and the amount of the debt
5. If you believe information in your file results from identity theft, you have the right to ask that a
consumer reporting agency block that information from your file. An identity thief may run up bills
in your name and not pay them. Information about the unpaid bills may appear on your consumer
report. Should you decide to ask a consumer reporting agency to block the reporting of this
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Equifax FACT Act
Page 19 of 20
information, you must identify the information to block, and provide the consumer reporting
agency with proof of your identity and a copy of your identity theft report. The consumer reporting
agency can refuse or cancel your request for a block if, for example, you don't provide the
necessary documentation, or where the block results from an error or a material
misrepresentation of fact made by you. If the agency declines or rescinds the block, it must notify
you. Once a debt resulting from identity theft has been blocked, a person or business with notice
of the block may not sell, transfer, or place the debt for collection.
6. You also may prevent businesses from reporting information about you to consumer reporting
agencies if you believe the information is a result of identity theft. To do so, you must send your
request to the address spedfied by the business that reports the information to the consumer
reporting agency. The business will expect you to identify what information you do not want
reported and to provide an identity theft report.
To learn more about identity theft and how to deal with its consequences, visit
www.consumer.govlidtheft, or write to the FTC. You may have additional rights under state law. For
more information, contact your local consumer protection agency or your state attorney general.
In addition to the new rights and procedures to help consumers deal with the effects of identity theft,
the FCRA has many other important consumer protections. They are described in more detail at
www.ftc.gov/credit.
'~?t t) t~ t'~ :F;~
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Florida Consumers Have the Right to Place a Security Freeze
You have a right to place a "security freeze" on your consumer report, which will, except as provided by
law, prohibit a consumer reporting agency from releasing any infonnation in your consumer report
without your express authorization. A security freeze must be requested in writing by certified mail to a
consumer reporting agency. The security freeze is designed to prevent credit, loans, and services from
being approved in your name without your consent.
YOU SHOULD BE A WARE THAT USING A SECURITY FREEZE TO CONTROL ACCESS TO
THE PERSONAL AND FINANCIAL INFORMATION IN YOUR CONSUMER REPORT MAY
DELA Y, INlERFERE WIlli, OR PROHIBIT THE TIMEL Y APPROVAL OF ANY SUBSEQUENT
REQUEST OR APPLICATION YOU MAKE REGARDING A NEW LOAN, CREDIT, MORTGAGE,
INSURANCE, GOVERNMENT SERVICES OR PAYMENTS, RENTAL HOUSING,
EMPLOYMENT, INVESTMENT, LICENSE, CELLULAR PHONE, UTILITIES, DIGITAL
SIGNATURE, INTERNET CREDIT CARD TRANSACTION, OR OTHER SERVICES, INCLUDING
AN EXTENSION OF CREDIT AT POINT OF SALE.
When you place a security freeze on your consumer report, you will be provided a personal
identification number or password to use if you choose to remove the freeze on your consumer report or
authorize the release of your consumer report for a designated period of time after the security freeze is
in place. To provide that authorization, you must contact the consumer reporting agency and provide all
of the following:
1. The personal identification number or password.
2. Proper identification to verify your identity.
3. Information specifying the period of time for which the report shall be made available.
4. Payment of a fee authorized by this section.
A consumer reporting agency must authorize the release of your consumer report no later than 3
business days after receiving the above information.
A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on
behalf of the person or entity, with which you have an existing account, that requests information in
your consumer report for the purposes of reviewing or collecting the account. Reviewing the account
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Page 20 of 20
includes activities related to account maintenance, monitoring, credit line increases, and account
upgrades and enhancements.
You have the right to bring a civil action against anyone, including a consumer reporting agency, who
fails to comply with the provisions of s. 501.005, Florida Statutes, which governs the placing of a
consumer report security freeze on your consumer report.
A security freeze request must be mailed via certified mail to:
Equifax Security Freeze
P.O. Box 105788
Atlanta, Georgia 30348
Or, you may contact us on the web at equifax.com or call 800-685-1111.
The fee to place a security freeze is $10.00. If you are a victim of identity theft and you submit a copy of
a valid investigative or incident report or complaint with a law enforcement agency about the unlawful
use of your identifying information by another person, no fee will be charged. If you are sixty -five years
of age or older, no fee will be charged. Include your complete name, complete address, social security
number, date of birth and payment, if applicable.
Written confirmation of the security freeze will be sent within 10 business days of receipt of the request
via first class mail. It will include your unique personal identification number and instructions for
removing the security freeze or authorizing the release of your credit report for a specific period of time.
Equifax offers you personal credit products that enlighten, enable and empower you. Whether you are
understanding your credit, protecting your identity or preparing for a major purchase, Equifax offers
the tools you need to make the smartest choices possible. For more information visit
WNW. Equifax. com.
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cqullax r A'-' 1 1-\(;{
page 1 or jj
Equifax Credit Report TM for Jorge L. Delgado
As of: 03/3112009.
Available until: 0413012009
Confirmation
Report Does Not Update
Important. Please print this report as it will only be available for you to view during this
session with Equifax. If you would like to view this credit report online free for 30 days,
1.
2.
3.
Summary of account activity
Detailed account information
Companies that have requested or viewed your credit
information
4.
5.
6.
7.
Bankruptcies, liens, garnishments and other judgments
Personal data, addresses, employment history
How to dispute infonnation found on this credit report
Summary of Your Rights Under the FCRA
8.
9.
Remedying the Effects of Identity Theft
Your Rights Under State Law
Your Equifax Credit Summary highlights the information in your credit file that is most important in
determining your credit standing by distilling key credit information into one easy-to-read summary.
Lenders usually take a positive view of individuals with a range of credit accounts - car loan, credit
cards, mortgage, etc. - that have a record of timely payments. However, a high debt to credit ratio on
certain types of revolving (credit card) accounts and installment loans will typically have a negative
impact.
0 $0 N1A N1A N1A $0 0
$10,345 N1A $15,131 68% $269
5 $27,444 $34,356 $61 ,BOO 44% $549
0 $0 N1A N1A N1A $0 0
Total 6 $37,789 $34,356 $76,931 49% $818 2
https://fact.econsumer.equifax.com/fact/viewPopUpDetaiLehtml?prod _ cd=CRD&oi _ num... 3/31/2009
cyuuaA 1.'1""\\..,-1 1""\l,l rage.4, Vi.JJ
r.:l';'11'JJ'J-:r-O% In3tJllm~nt-27%
p",,',':.;,l'iin';l" 73% .:)tll",r-O%
%
0 ~o ..j>j 13(' 80 100
I.,fortgage
In;tallment
Pe'.,oL'-ing
('thel
Tot.11
8JI::m.:", .':::,:3 iI 3 tal '"
~ .,~; ~t' iG~,
Usually, it is a good idea to keep your oldest credit account open. as a high average account age
generally demonstrates stability to lenders. Also. especially if you have been managing credit for a
short time. opening many new accounts will lower your average account age and may have a
negative impact
Length of Credit History
Average Account Age
Oldest Account
Most Recent Account
1 0 Years, 3 Months
6 Years, 8 Months
Numerous inquires on your credit file for new credit may cause you to appear risky to lenders, so it is
usually better to only seek new credit when you need it Typically, lenders distinguish between
inquiries for a single loan and many new loans in part by the length of time over which the inquiries
occur. So, when rate shopping for a loan it's a good idea to do it within a focused period of time.
9
Most Recent Inquiry
Late payments, collections and public records can have a negative impact on your credit standing.
The more severe and recent they are, the more negative the potential impact might be.
o
7
o
Mortgage accounts include first mortgages, home equity loans, and any other loans secured by real
estate you own.
COUNTRYWIDE If
HOME LOA
0212001 $0
0712003 $0
PAYSAS $0
AGREED
https://fact. econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
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400 Countrywide Way
Simi Valley, CA-930656298
Account Number. - Current Status: PAYS AS
AGREED
Account Owner: Joint Account High Credit: $121,250
Type of Account Installment Credit Limit: $0
Tenn Duration: Tenns Frequency:
Date Opened: 0212001 Balance: $0
Date Reported: 07/2003 Amount Past Due: $0
Date of Last Payment: Actual Payment Amount: $0
Scheduled Payment Amount: $0 Date of Last Activity: 0512002
Date Major Delinquency First Months Reviewed: 28
Reported:
Creditor Classification: Activity Description: Closed
Charge Off Amount: $0 Deferred Payment Start Date:
Balloon Payment Amount: $0 Balloon Payment Date:
Date Closed: 0612002 Type of Loan: Real Estate
Date of First Delinquency: N1A
Comments: Refinanced
81-Month Payment History
No 81-Month Payment Data available for display.
SUN TRUST
FSB
1112008 $0
1012007 $0
PO Box 85052
Richmond, VA-232855052
(800) 428-4837
Account Number:
Account Owner:
Type of Account:
Tenn Duration:
------
Individual Account.
Line of Credit
Current Status:
High Credit:
Credit Limit:
Tenns Frequency:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
1012007
1112008
0512008
$0
1112008
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$67,239
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Date of First Delinquency:
Comments:
06J2008
Transferred to recovery,
Charged off account
CHARGE- $65,000
OFF
CHARGE-OFF
$0
$65,000
Monthly (due
every month)
$0
$0
$0
N1A
13
T ransferlSold
Home Equity
Line of Credit
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi_ num... 3/31/2009
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81-Month Payment History
Year
2008
2007
Jan
Feb
Mar Apr May
Jun Jul Aug
30 60
Sep
90
Oct Nov
120 150
Dec
TAYLOR,BEAN 767853XXXX
& WHITAK
0412005 $193,208 03/2009 $15,551 120+
DAYS
PAST
DUE
$0
1417 N Magnolia Ave
Ocala, FL-344759078
(888) 225-2164
-.
Account Number:
Current Status:
120+ DAYS
PAST DUE
$200,000
$0
Account Owner:
Individual Account.
Mortgage
30 Years
High Credit:
Credit Umit:
Type of Account
Tenn Duration:
Tenns Frequency:
Monthly (due
every month)
$193,208
$15,551
$0
N1A
46
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
0412005
0312009
03/2008
$1,555
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
$0
$0
Conventional
RE Mortgage
Date of First Delinquency:
Comments:
OS/2008
Freddie Mac account,
Foreclosure process started
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee
2009 180 180
2008 30 30 30 60 90 120 150 180 180
2007
2006
2005
Installment accounts are credit accounts in which the amount of the payment and the number of
payments are predetermined or fixed, such as a car loan.
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CHRYSLER
FINANCIAL
PO Box 9223
Credit Dispute Dept
Farmington Hills, MI-483339223
(800) 334-9200
Account Number.
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinqueney First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Year
2009
2008
2007
2006
Jan Feb
BENEFICIAUHFC -
961 N Weigel Ave
Elmhurst, IL-601261 058
(800) 547-8776
Account Number.
Account Owner:
Type of Account
Tenn Duration:
- 1112006
$10,345 0212009
$0
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PAYS AS
AGREED
$0
.
Current Status:
PAYS AS
AGREED
$15,131
$0
$10,345
$0
$0
0212009
27
N1A
Auto'
Mar Apr May
Sep
Oct Nov Dee
$0
PAYS AS
AGREED
$6,987
$0
https:/ Ifact. econsumer.equifax.com/fact/viewPopUpDetail.ehtml ?prod _ cd=CRD&oi yum... 3/31/2009
Individual Account.
Installment
High Credit:
Credit Limit:
72 Months
1112006
0212009
02/2009
$269
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Jun Jul Aug
1
0112002 $0
1112003 $0 PAYS AS
AGREED
Current Status:
Individual Account.
High Credit:
Credit Limit:
!r-.sta!lment
Tenns Frequency:
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Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
0112002
1112003
07/2003
$200
$0
$0
N1A
No 81-Month Payment Data available for display.
0412000 $0
BENZ FINANCIAL -
SERVI
15301 NW 7th Ave
Miami, FL-331696205
Account Number.
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Joint Account
Installment
0412000
0612001
$180
$0
$0
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
0612001 $0 PAYS AS
AGREED
Current Status:
High Credit:
Credit Limit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Closed or paid account zero balance
No 81-Month Payment Data available for display.
0712001 $0
CITI FINANCIAL
PO Box 499
Hanover, MD-210760499
(800) 922-6235
0412005 $0 PAYS AS
AGREED
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$0
$0
$0
0712003
21
Closed
$0
PAYS AS
AGREED
$3,254
$0
$0
$0
$0
0612001
14
NIA
$0
https:llfact.econsumer.equifax.comlfact/viewPopUpDetaiI.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
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Account Number. Current Status: PAYS AS
AGREED
Account Owner: Joint Account High Credit: $7,536
Type of Account Installment Credit Limit: $0
Tenn Duration: 60 Months Tenns Frequency:
Date Opened: 0712001 Balance: $0
Date Reported: 0412005 Amount Past Due: $0
Date of Last Payment: 0412005 Actual Payment Amount: $0
Scheduled Payment Amount: $195 Date of Last Activity: 0412005
Date Major Delinquency First Months Reviewed: 44
Reported:
Creditor Classification: Activity Description: Paid and Closed
Charge Off Amount: $0 Deferred Payment Start Date:
Balloon Payment Amount: $0 Balloon Payment Date:
Date Closed: Type of Loan: Unsecured
Date of First Delinquency: N1A
Comments:
81-Month Payment History
No 81-Month Payment Data available for display.
FMC-OMAHA
SERVICE CT
$0
0812002 $0
0412005 $0 PAYS AS
AGREED
PO Box 54200
Omaha, NE-681548000
Account Number: L Current Status: PAYS AS
AGREED
Account Owner: Individual Account. High Credit: $16,213
Type of Account Installment Credit Limit: $0
Tenn Duration: 60 Months Tenns Frequency: Monthly (due
every month)
Date Opened: 0812002 Balance: $0
Date Reported: 0412005 Amount Past Due: $0
Date of Last Payment: 0412005 Actual Payment Amount: $9,441
Scheduled Payment Amount: $388 Date of Last Activity: 0412005
Date Major Delinquency First Months Reviewed: 32
Reported:
Creditor Classification: Activity Description: Paid and Closed
Charge Off Amount: $0 Deferred Payment Start Date:
Balloon Payment Amount: $0 Balloon Payment Date:
Date Closed: 0412005 Type of Loan: Auto
Date of First Delinquency: N1A
Comments:
81-Month Payment History
No 81-Month Payment Data available for display.
SUNCOAST
0812005 $12,788 0212009 $0 REPOSSESSION $0
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml ?prod _ cd=CRD&oi _ num...
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SCHOOLS FED
6801 E HiIIsborough Ave
Tampa, FL-336104110
Account Number.
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
-
Individual Account.
Installment
72 Months
0812005
0212009
0812008
$505
0612008
$0
$0
0412008
Involuntary repossession
Current Status:
High Credit:
Credit Umit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
REPOSSESSION
$31,096
$0
Monthly (due
every month)
$12,788
$0
$0
N1A
41
N1A
Auto
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009 R R
2008 30 60 R R R R R R
2007
2006
2005
Revolving accounts are charge accounts that have a credit limit and require a minimum payment
each month, such as most credit cards.
MACY'SIDSNB
9111 Duke Blvd
Mason, OH-450408999
(800) 243-6552
Account Number:
05/1999 $0
-
-j
0312009
$0
PAYS AS $100
AGREED
PAYS AS
AGREED
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Current Status:
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Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Seheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency: N1A
Comments:
81-Month Payment History
Individual Account.
Revolving
05/1999
03/2009
08/1999
$0
$0
$0
High Credit:
Credit Limit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
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$29
$100
$0
$0
$0
0811999
99
N1A
Charge
Account
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009
2008
2007
2006
2005
2004
2003
2002
SUNCOAST 0412004 $27,444 0312009 $0 PAYS AS $30,000
SCHOOLS FED AGREED
6801 E Hillsborough Ave
Tampa, FL-336104110
(813) 621-7511
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Joint Account
Revolving
0412004
0312009
11/2008
$549
$0
$0
Current Status:
High Credit:
Credit Limit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Arnount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
PAYS AS
AGREED
$27,444
$30,000
Monthly (due
every month)
$27,444
$0
$0
0312009
31
N1A
https://fact.econsumer.equifax.com/fact/viewPop UpDetail. ehtml ?prod _ cd=CRD&oi _num... 3/31/2009
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Date Closed: Type of Loan: Credit Card
Date of First Delinquency: N1A
Comments:
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee
2009
2008
2007
2006
2005
2004
SUNCOAST 0412004 $0 0712008 $0 PAYS AS $30,000
SCHOOLS FED AGREED
6801 E Hillsborough Ave
Tampa, FL-336104110
(813) 621-7511
Account Number.
L
Current Status:
PAYS AS
AGREED
$26,125
$30,000
Account Owner:
Joint Account
Revolving
High Credit:
Credit Limit:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
0412004
0712008
0612008
$0
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
$0
0712008
50
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Credit Card
N1A
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2008 .
2007
2006
2005
2004
THE HOME - 0512002 $0 0712005 $0 PAYS AS $1,200
DEPOTlCBSD AGREED
https://fact. econsumer.equifax.com/fact/viewPopUpDetail.ehtml ?prod _ cd=CRD&oi _ num... 3/31/2009
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Pencader Corp Ctr
110 Lake Dr
Newark, DE-197023317
Account Number.
-
-
Current Status:
PAYS AS
AGREED
$589
$1,200
Monthly (due
every month)
$0
$0
$379
0412005
38
Account Owner.
Joint Account
Revolving
High Credit:
Credit Umit:
Type of Account
Tenn Duration:
Tenns Frequency:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinqueney Rrst
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
0512002
07/2005
0412005
$0
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Charge
Account
Date of First Delinquency: N1A
Comments:
81-Month Payment History
No 81-Month Payment Data available for display.
THE SPORTS
AUTHORITY
0912002 $0
10/2003
$0
PAYS AS $500
AGREED
PO Box 29226
Shawnee Mission, KS-662019226
Account Number: ~ Current Status: PAYS AS
AGREED
Account Owner: Individual Account. High Credit: $74
Type of Account Revolving Credit Limit: $500
T enn Duration: Terms Frequency: Monthly (due
every month)
Date Opened: 0912002 Balance: $0
Date Reported: 1012003 Amount Past Due: $0
Date of Last Payment: 0912003 Actual Payment Amount: $3
Scheduled Payment Amount: $0 Date of Last Activity: 0912003
Date Major Delinquency First Months Reviewed: 13
Reported:
Creditor Classification: Activity Description: N1A
. Charge Off Amount: $0 Deferred Payment Start Date:
Balloon Payment Amount: $0 Balloon Payment Date:
Date Closed: Type of Loan: Charge
Account
Date of First Delinquency: N1A
https://fact. econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
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Comments:
81-Month Payment History
No 81-Month Payment Data available for display.
it''':;
BANK OF
AMERICA
041200O $24,407 0212009 $2,612 CHARGE- $0
OFF
4060 Ogletown Stanton Rd
Newark, DE-197133102
(800) 421-2110
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
-
Individual Account.
Revolving
0412000
0212009
1212008
$468
02/2009
$24,407
$0
Current Status:
High Credit:
Credit Limit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
0712008
Charged off aecount,
Account closed by credit grantor
CHARGE-OFF
$0
$0
Monthly (due
every month)
$24,407
$2,612
$325
N1A
84
Closed
Credit Card
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009 180 180
2008 30 60 90 120 150
2007
2006
2005
2004
2003 .
2002
BANK OF 0812006 $0 0512008 $0 PAYS AS $7,000
AMERICA AGREED
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https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi_ num... 3/31/2009
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4060 Ogletown Stanton Rd
Newark, DE-197133102
(800) 421-2110
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Year
2008
2007
2006
Jan
Feb
Individual Account.
Revolving
0812006
0512008
0412008
$0
$0
$0
Current Status:
High Credit:
Credit Limit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Account closed at consumers request
Mar Apr May
BANK OF
AMERICA
12/2001 $0
300 N Wakefield Dr
Newark, DE-197025419
(800) 492-2500
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount: $0
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment ~:
Individual Account.
Revolving
12/2001
0412004
$0
$0
Jun Jul Aug
Sep
PAYS AS
AGREED
$475
$7,000
Monthly (due
every month)
$0
$0
$20
0512008
20
Closed
Credit Card
Oct Nov
Dec
0412004 $0
Current Status:
High Credit:
Credit Limit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
PAYS AS $2,000
AGREED
PAYS AS
AGREED
$0
$2,000
Monthly (due
every month)
$0
$0
$0
0312002
28
Paid and
Closed
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Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
12/2001
N1A
Account closed by credit grantor
Type of Loan:
BP/CITIBANK SD
No 81-Month Payment Data available for display.
03/2004 $0
PO Box 6497
Sioux Falls, SD-571176497
Account Number:
Account Owner:
Type of Account
T enn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
07/1999 $0
Current Status:
Individual Account.
Revolving
High Credit:
Credit Limit:
Tenns Frequency:
07/1999
0312004
0412002
$0
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
$0
$0
0112004
N1A
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
No 81-Month Payment Data available for display.
$0
BP/CITIBANK SD
PO Box 6497
Sioux Falls, SD-571176497
~
07/1999 $0
Credit Card
PAYS AS $125
AGREED
PAYS AS
AGREED
$159
$125
Monthly (due
every month)
$0
$0
$0
0412002
28
Paid and
Closed
Credit Card
PAYS AS $0
AGREED
Account Number: Current Status: PAYS AS
AGREED
Account Owner: Individual Account. High Credit: $0
Type of Account Revolving Credit Umit: $0
Tenn Duration: Tenns Frequency:
Date Opened: 07/1999 Balance: $0
10/2001
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Date Reported:
Date of Last Payment:
Scheduled Payment Amount: $0
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
1012001
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Closed or paid account zero balance,
Account closed by credit grantor
BP/CITIBANK SD
No 81-Month Payment Data available for display.
$0
PO Box 6497
Sioux Falls, SD-571176497
Account Number.
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount: $0
Date Major Delinqueney First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
07/1999 $0
1012001
Current Status:
Individual Account.
Revolving
High Credit:
Credit Limit:
07/1999
1012001
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Dale of Last Activity:
Months Reviewed:
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
N1A
Closed or paid account zero balance,
Account closed by credit grantor
No 81-Month Payment Data available for display.
CHASEICI RCUIT
CITY
800 Brooksedge Blvd
Westerville, OH-430812822
12/1998 $0
0212009 $0
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$0
$0
1012001
N1A
N1A
PAYS AS $0
AGREED
PAYS AS
AGREED
$0
$0
$0
$0
$0
10/2001
N1A
N1A
PAYS AS $2,500
AGREED
https:llfact.econsumer.equifax.comlfact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3131/2009
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(800) 955-9900
Account Number:
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Year
2009
2008
2007
2006
2005
2004
2003
2002
Jan
Feb
CHASE BANK
USA, NA
Joint Account
Revolving
12/1998
02/2009
0312000
$0
$0
$0
1212008
N1A
Mar
Apr May
1012000 $10,829 0312009 $10,829 CHARGE- $9,500
OFF
800 Brooksedge Blvd
Columbus, OH-43081
(800) 955-9900
Account Number.
Account Owner.
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Individual Account.
Revolving
1012000
0312009
1012008
$0
0112009
Current Status:
High Credit:
Credit Umit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Jun Jut Aug
Sep
PAYS AS
AGREED
$531
$2,500
Monthly (due
every month)
$0
$0
$0
0312000
99
Paid and
Closed
Credit Card
Oet Nov
Dee
Current Status:
High Credit:
Credit Limit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
CHARGE-OFF
$0
$9,500
Monthly (due
every month)
$10,829
$10,829
$0
N1A
99
https://fact.econsumer.equifax.com/fact/viewPop UpDetail. ehtml ?prod _ cd=CRD&oi _ num.. .
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3/31/2009
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Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
$10,829
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Closed
Credit Card
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009 180 150
2008 30 60 90 120 150 180
2007
2006
2005
2004
2003
2002
CITIBANK SD, 1012007 $4,470 0312009 $1,581 CHARGE- $3,300
NA OFF
PO Box 6500
CIO Citi Corp
8ioux Falls, 80-571176500
Account Number.
Account Owner.
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Seheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Year
2009
2008
Jan
CO
Feb
CO
0612008
Charged off account,
Account closed by credit grantor
Current Status:
High Credit:
Credit Limit:
CHARGE-OFF
$0
$3,300
Monthly (due
every month)
$4,470
$1,581
$0
N1A
17
Closed
Credit Card
Dec
CO
https:llfact.econsumer.equifax.com/fact/view PopUpDetail. ehtml ?prod _ cd=CRD&oi_ num.. .
Individual Aecount.
Revolving
Tenns Frequency:
1012007
0312009
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$152
1112008
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
0512008
Charged off account,
Account closed by credit grantor
Mar Apr May
Jun Jul Aug
Sep
Oct Nov
60 90
120
150 CO
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3/3 1/2009
EqUlfax FACT Act
2007
DISCOVER
FINANCIAL S
0412000 $4,059 0312009 $914
12 Reads Way
New Castle, DE-197201649
(800) 347-2683
Account Number:
Account Owner:
lIIf-'M"-"~-.="'- - ~
Individual Account.
Revolving
Current Status:
High Credit:
Credit Umit:
Type of Account
Tenn Duration:
Tenns Frequeney:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
04/2000
0312009
1012008
$82
0112009
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
12/2007
Charged off account
81-Month Payment History
page HS or j j
CHARGE- $3,300
OFF
CHARGE-OFF
$4,059
$3,300
Monthly (due
every month)
$4,059
$914
$0
N1A
99
N1A
Credit Card
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee
2009 CO CO
2008 30 60 90 120 120 150 180
2007
2006
2005
2004
2003
2002
HSBC BANK 0112002 $0 05/2003 $0 PAYS AS $1,000
AGREED
PO Box 98706
Las Vegas, NV-891938706
(800) 477-6000
Account Number.
Current Status:
Account Owner.
Individual Account.
Revolving
High Credit:
Credit Umit:
Type of Account
Tenn Duration:
Terms Frequency:
PAYS AS
AGREED
$0
$1,000
Monthly (due
every month)
https:llfact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
.t..qulIax l' AL.l Act
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Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount: $0
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
0112002
0512003
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$0
$0
$0
0212002
15
$0
$0
0512003
N1A
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Closed
Account closed at consumers request
81-Month Payment History
No 81-Month Payment Data available for display.
(':':':.,;-
These are all accounts that do not fall into the other categories and can include 30-day accounts such
as American Express.
You have no accounts classified as "Other" on file
i::;"
Meaning
Pays or Paid as Agreed: ·
Symbol
Meaning Symbol
180+ Days Past Due: 180
Collection Account: CA
Foreclosure: F
Voluntary Surrender. VS
Repossession: R
Charge Off: CO
30--59 Days Past Due: 30
60-89 Days Past Due: 60
90-119 Days Past Due: 90
120-149 Days Past Due: 120
150-179 Days Past Due: 150
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A request for your credit history is called an inquiry. Inquiries remain on your credit report for two
years. There are two types of inquires those that may impact your credit rating and those that do not.
Inquiries that may impact your credit rating
These inquires are made by companies with whom you have applied for a loan or credit.
CBA::
07123107
CBA
4 EXECUTIVE CAMPUS STE 200
CHERRY H!LL, NJ 08002
(800) 648-2513
https:llfact. econsumer. equifax. com/fact/vi ewPopUpD etai 1. ehtml ?prod _ cd=CRD&oi_ num... 3/31/2009
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CHASE CREDIT
RESEARCH, INC.
.
10/31108
CHASE CREDIT RESEARCH, INC.
6350 Laurel Canyon Blvd 4th FI
North Hollywood, CA 916063200
FIRST USA BANK
03/25108, 06/15/07
FIRST USA BANK
800 Brooksedge Blvd
Mailstop OH1-0552
Westerville, OH 430812895
PAC CREDIT
REPORTS::9590303754
04/26/07
PAC CREDIT REPORTS
PO Box 66
Aurora, IL 605070066
(708) 897-6700
SUNCOAST SCHOOLS
FCU
OS/21/07
SUNCOAST SCHOOLS FCU
6801 E Hilfsborough Ave
Tampa, FL 336104110
SUNTRUST BANK
10128/08
SUNTRUST BANK
Cfg Collection - Dept
1001 Semmes Ave
Richmond, VA 232242245
SUNTRUST BANK,
ATLANTA
09/04107
SUNTRUSTBANK,ATlANTA
Customer Care
55 Park PI NE
Atlanta, GA 303032529
(877) 844-3620
CITIBM~K USA, NA
07109107
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
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CITIBANK USA, NA
Pencader Corp Ctr
110 Lake Dr
Newark, DE 197023317
Inquiries that do not impact your credit rating
These inquires include requests from employers, companies making promotional offers and your own
requests to check your credit These inquiries are only viewable by you.
PRM-ALLTEL-UTTLE ROCK 12/16/08,08120108
PRM-AT&T WIRELESS 03126109,02/20109,11/21108
PRM-CAPIT AL ONE 08/07/08
PRM-CAPITAL ONE NTL ASSOC 05109/08
AR-BANK ONE, DELAWARE NA 08120/08
PRM-CHASE MANHATTAN 04108108
AR-CITI CARDS CBSD 02127/09
PRM-CITIFINANCIAL 07102/08
AR-CITI SD- THE HOME DEPOT 02127109
PRM-DIRECT LENDING 07/31/08
PRM-DIRECT LENDING SOURCE 08106/08,07/15/08
INC
EQUIFAX 03131109
AR-FEDERAL HOME LOAN 03103109
MORTGAGE CRP
AR-FNANBlCIRCUIT CITY 06110108
PRM-HOUSEHOLD BANK 08105108
PRM-L1BERTY MUTUAL 05102108
INSURANCE
PRM-L1BERTY ONE FINANCIAL 05116108
PRM-MDA CAPITAL,INC. 03106I09,02/13109,01108109,09109108
PRM-RESIDENTIAL HOME LOAN 10109/08
CENTERS
DTC-SPRINT NEXTEL 03107/09
AR-SUNTRUST 12/02108
PRM-XCELERATED INVESTMENTS 03/10109,02119109
PRM
Inquiries with this prefix indicate that only your name and address were
given to a credit grantor so they can provide you a finn offer of credit or
insuranoe.(PRM inquiries remain for twelve months.)
AM or AR
Inquiries \vith these prefIXes indicate a periodic review of YOUi credit histOiY
by one of your creditors.(AM and AR inquiries remain for twelve months.)
https:llfact.econsumer.equifax.com/fact/viewpop UpDetail. ehtml ?prod _ cd=CRD&oi _ num... 3/31/2009
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EMPL
PR
Equifax or EFX
ND
NDMR
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Inquiries with this prefix indicate an employment inquiry. (EMPL inquiries
remain for 24 months)
Inquiries with this prefix indicate that a creditor reviewed your account as
part of a portfolio they are purchasing.(PR inquiries remain for 12 months.)
Inquiries with these prefIXes indicate Equifax's activity in response to your
contact with us for a copy of your credit file or a research request.
Inquiries with this prefix are general inquiries that do not display to credit
grantors.(ND inquiries remain for 24 months.)
Inquiries with this prefIX indicate the reissue of a mortgage credit report
containing infonnation from your Equifax credit file to another company in
connection with a mortgage 10an.(ND inquiries remain for 24 months.)
Accounts that contain a negative account status. Accounts not paid as agreed generally remain on
your credit file for 7 years from the date the account first became past due leading to the current not
paid status. Late Payment History generally remains on your credit file for 7 years from the date of the
late payment
BANK OF
AMERICA
0412000 $24,407 02/2009 $2,612 CHARGE-OFF
$0
4060 Ogletown stanton Rd
Newark, DE-197133102
(800) 421-2110
Account Number.
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Seheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
Year
Jan
Feb
l
Individual Account.
Revolving
Current Status:
High Credit:
Credit Umit:
CHARGE-OFF
$0
$0
Monthly (due
every month)
$24,407
$2,612
$325
N1A
84
Closed
Credit Card
Oct
Nov
Dec
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https:llfact.econsumer.equifax.com/fact/viewPopU pDetail. ehtml ?prod _ cd=CRD&oi _ num... 3/3 1/2009
Terms Frequency:
0412000
0212009
1212008
$468
0212009
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$24,407
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
0712008
Charged off account,
Account closed by credit grantor
Mar
Apr
May
Jun
Jul Aug
Sep
.t.quuax 1:' 1\C 1 1\Ct
rage L,j or ,j,j
2009 180 180
2008 30 60 90 120 150
2007
2006
2005
2004
2003
2002
CHASE BANK 512257100595XXXX 1012000 $10,829 0312009 $10,829 CHARGE-OFF $9,500
USA, NA
BOO Brooksedge Blvd
Columbus, OH-430B1
(800) 955-9900
Account Number.
Account Owner.
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
~
Individual Account.
Revolving
Current Status:
High Credit:
Credit Limit:
CHARGE-OFF
$0
$9,500
Monthly (due
every month)
$10,829
$10,829
$0
N1A
99
Tenns Frequency:
1012000
0312009
1012008
$0
0112009
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$10,829
$0
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Credit Card
Closed
..
0612008
Charged off account,
Account closed by credit grantor
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee
2009 180 150
2008 30 60 90 120 150 180
2007
2006 .
2005
2004
2003
2002
emBANK SD, ---- 1012007 $4,470 0312009 $1,581 CHARGE-OFF $3,300
NA
PO Box 6500
https://fact. econsumer.equifax.com/fact/viewPopUpDetaiI .ehtml ?prod _ cd=CRD&oi _ num... 3/31/2009
hqUltax l' ALT Act
CIO Citi Corp
Sioux Falls, SD-571176500
Account Number.
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
~ -
Individual Account.
Revolving
1012007
03/2009
$152
1112008
$0
.. $0
Current Status:
High Credit:
Credit Limit:
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
0512008
Charged off aecount,
Account closed by credit grantor
CHARGE-OFF
$0
$3,300
Monthly (due
every month)
$4,470
$1,581
$0
NIA
17
Closed
Credit Card
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009 CO CO
2008 60 90 120 150 CO CO
2007
DISCOVER
FINANCIAL S
04/2000 $4,059
12 Reads Way
New Castle, DE-197201649
(800) 347-2683
Account Number:
Account Owner:
Type of Account
Term Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classifl(:ation:
Charge Off Amount:
Balloon Payment Amount
Date Closed:
Date of First Delinquency:
~
Individual Account.
Revolving
04/2000
0312009
1012008
$82
0112009
$0
$0
1212007
0312009 $914
CHARGE-OFF
$3,300
Current Status:
High Credit:
Credit Limit
Tenns Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
CHARGE-OFF
$4,059
$3,300
Monthly (due
every month)
$4,059
$914
$0
NIA
99
N1A
Credit Card
rClgt: L.'t U1 .).)
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
Equifax FACT Act
6801 E Hillsborough Ave
Tampa, FL-336104110
Account Number:
Account Owner:
Type of Account
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Scheduled Payment Amount:
Date Major Delinquency First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinquency:
Comments:
81-Month Payment History
lU
Individual Account.
Installment
72 Months
0812005
0212009
0812008
$505
0612008
$0
$0
...
0412008
Involuntary repossession
Current Status:
High Credit:
Credit Limit:
Terms Frequency:
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
Activity Description:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
REPOSSESSION
$31,096
$0
Monthly (due
every month)
$12,788
$0
$0
N1A
41
N1A
Auto
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009 R R
2008 30 60 R R R R R R
2007
2006
2005
SUN TRUST 1012007 $0 1112008 $0 CHARGE-OFF $65,000
FSB
Page L) ot j j
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
Equifax FACT Act
PO Box 85052
Richmond, VA-232855052
(800) 428-4837
Account Number:
Account Owner:
Type of Account:
Tenn Duration:
Date Opened:
Date Reported:
Date of Last Payment:
Seheduled Payment Amount:
Date Major Delinqueney First
Reported:
Creditor Classification:
Charge Off Amount:
Balloon Payment Amount:
Date Closed:
Date of First Delinqueney:
Comments:
Page 26 of :;:;
Current Status:
High Credit:
Credit Limit:
Tenns Frequency:
CHARGE-OFF
$0
$65,000
Monthly (due
every month)
$0
$0
$0
N1A
13
Individual Account.
Line of Credit
1012007
1112008
0512008
$0
1112008
Balance:
Amount Past Due:
Actual Payment Amount:
Date of Last Activity:
Months Reviewed:
$67,239
$0
Activity DeSCription:
Deferred Payment Start Date:
Balloon Payment Date:
Type of Loan:
Home Equity
Line of Credit
TransferlSold
0612008
Transferred to recovery,
Charged off account
B1-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee
2008 30 60 90 120 150
2007
TAYLOR,BEAN - 0412005 $193,208 0312009 $15,551 120+ DAYS $0
& WHITAK PAST DUE
1417 N Magnolia Ave
Ocala, FL-344759078
(888) 225-2164
Account Number: - Current Status: 120+ DAYS
PAST DUE
Account Owner: Individual Account. High Credit: $200,000
Type of Account Mortgage Credit Limit: $0
Tenn Duration: 30 Years Tenns Frequency: Monthly (due
every month)
Date Opened: 0412005 Balance: $193,208
Date Reported: 03i2OO9 Amount Past Due: $15,551
Date of Last Payment: 0312008 Actual Payment Amount: $0
Scheduled Payment Amount: $1,555 Date of Last Activity: N1A
Date Major Delinquency First Months Reviewed: 46
Reported:
Creditor Classification: Activity Description: N1A
Charge Off Amount: $0 Deferred Payment Start Date:
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi_ num... 3/31/2009
Equifax FACT Act
Page 27 of33
Balloon Payment Amount:
Date Closed:
$0
Balloon Payment Date:
Type of Loan:
Conventional RE
Mortgage
Date of First Delinqueney:
Comments:
0512008
Freddie Mae account,
Foreclosure process started
81-Month Payment History
Year Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
2009 180 180
2008 30 30 30 60 90 120 150 180 180
2007
2006
2005
(I'
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A collection is an account that has been turned over to a collection agency by one of your creditors
because they believe the account has not been paid as agreed.
You have no Collections on file
~;:;, ~]
Public record information includes bankruptcies, liens or judgments and comes from federal, state or
county court records.
Public record information includes bankruptcies, liens or judgments and comes from federal, state or
county court records.
You have no Public Records on file
M" :;:;{). r'} .a~ Ii
The following information is added to your file either when creditors enter requests to view your credit
history, or when you report it to Equifax directly.
Name: Jorge L. Delgado
Social Security Number: _
Age or Date of Birth: August 4, 1965
t
Current
430 20TH ST NE
NAPLES,FL 34120
0112009
You have no other identification on file.
Last Reported Employment:
DC VENDING WHOLESALERS
https:llfact.econsumer.equifax.com/fact/viewPop UpDetail. ehtml ?prod _ cd=CRD&oi _ num... 3/31/2009
Equifax FACT Act
Page 2~ ot JJ
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You have no Alerts on file.
You have no Consumer Statement on file.
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If you believe that any of the information found on this report is incorrect, there are 3 ways to launch
an investigation about the information on this report.
If you believe that any of the information found on this file is incorrect, you may start a dispute online
about any inaccuracies on your Equifax credit file. The credit reporting company is not required to
remove accurate data from your file unless it is outdated or cannot be verified.
Initiating a dispute online is the easiest and fastest way to dispute credit file information. In addition,
by disputing online you are also provided the ability to check online the status and results of your
dispute.
To initiate a dispute online click on
To check the status or view the results of your dispute click on
As a reminder your Confirmation Number is: . Please keep your confirmation as it may
be needed for future requests that you initiate with Equifax.
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As stated in the FCRA, you have the right to dispute information that you feel is being reported
incorrectly on your Equifax credit file. You are able to initiate an online dispute immediately or you can
contact our dispute center at 866-224-9235 (changes monthly). You must have a current copy of your
Equifax credit file and your ten-digit confirmation number to complete the dispute process by phone.
Additionally, you can dispute inaccuracies by writing to:
Equifax Information Services, LLC
P.O. Box 740256
Atlanta, GA 30374
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Click on
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?
You can dispute your personal information, including your name, address, and social security number
online. However:
. If you dispute or request a change on your name or date of birth, you will need to send us a
copy of your Driver's License reflecting this change.
· If you dispute or request a change on your Current Address, you will need to send us a copy of
your Driver's License or a utility bill reflecting this change.
e If you displlte or request a change on your Social Security Number, you will need to send us a
copy of your Social Security card or a W-2 form.
Once you have submitted you dispute online, you must provide us with a copy of your document
proof. You can fax your document proof to 888-826-0549 (may change), or, you can mail a copy of
your documents to:
Equifax Information Services, LLC
P.O. Box 740256
Atlanta, GA 30348
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
Equifax FACT Act
page 1.':7 ot jj
To initiate your dispute online click on
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By law, you are entitled to obtain your credit score. There is a fee of $ to obtain your credit score from
Equifax Information Services. To request your credit score, please contact:
Equifax Information Services LLC
P.O. Box 105167
Atlanta, GA 30348
or call
1-877-SCORE-11
If you are in the process of obtaining a mortgage, you may be entitled to free credit score information.
Contact the person making or arranging your loan for further information.
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The federal Fair Credit Reporting Act (FCRA) promotes the accuracy, fairness, and privacy of
information in the files of consumer reporting agencies. There are many types of consumer reporting
agencies, including credit bureaus and specialty agencies (such as agencies that sell information
about check writing histories, medical records, and rental history records). Here is a summary of your
major rights under the FCRA. For more information, including information about additional
rights, go to or write to: Consumer Response Center, Room 130-A, Federal
Trade Commission, 600 Pennsylvania Ave. N.W., Washington, D.C. 20580.
. You must be told if information in your file has been used against you. Anyone who uses a
credit report or another type of consumer report to deny your application for credit, insurance, or
employment - or to take another adverse action against you - must tell you, and must give you the
name, address, and phone number of the agency that provided the information.
. You have the right to know what is in your file. You may request and obtain all the information
about you in the files of a consumer reporting agency (your ''file disclosure"). You will be required
to provide proper identification, which may include your Social Security number. In many cases,
the disclosure will be free. You are entitled to a free file disclosure if:
o a person has taken adverse action against you because of information in your credit
report;
o you are the victim of identify theft and place a fraud alert in your file;
o your file contains inaccurate information as a result of fraud;
o you are on public assistance;
o you are unemployed but expect to apply for employment within 60 days. In addition, by
September 2005 all consumers will be entitled to one free disclosure every 12 months
upon request from each nationwide credit bureau and from nationwide specialty consumer
reporting agencies. See for additional information.
. You have the right to ask for a credit score. Credit scores are numerical summaries of your
credit-worthiness based on information from credit bureaus. You may request a credit score from
consumer reporting agencies that create scores or distribute scores used in residential real
property loans, but you will have to pay for it. In some mortgage transactions, you will receive
credit score information for free from the mortgage lender.
. You have the right to dispute incomplete or inaccurate information. If you identify
information in your file that is incomplete or inaccurate, and report it to the consumer reporting
agency, the agency must investigate unless your dispute is frivolous. See for
an explanation of dispute procedures.
· Consumer reporting agencies must correct or delete inaccurate, incomplete, or
unverifiable information. Inaccurate, incomplete or unverifiable information must be removed or
corrected, usually within 30 days. However, a consumer reporting agency may continue to report
information it has verified as accurate.
· Consumer reporting agencies may not report outdated negative information. In most cases,
a consumer reporting agency may not report negative information that is more than seven years
old, or bankruptcies that are more than 10 years old.
https:llfact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi_ num... 3/31/2009
Equifax FACT Act
. Access to your file is limited. A consumer reporting agency may provide information about you
only to people with a valid need - usually to consider an application with a creditor, insurer,
employer, landlord, or other business. The FCRA specifies those with a valid need for access.
. You must give your consent for reports to be provided to employers. A consumer reporting
agency may not give out information about you to your employer, or a potential employer, without
your written consent given to the employer. Written consent generally is not required in the
trucking industry. For more information, go to
. You may limit "prescreened" offers of credit and insurance you get based on information
in your credit report Unsolicited "prescreened" offers for credit and insurance must include a
toll-free phone number you can call if you choose to remove your name and address from the lists
these offers are based on. You may opt-out with the nationwide credit bureaus at 1-888-5-
OPTOUT (1-888-567-8688).
. You may seek damages from violators. If a consumer reporting agency, or, in some cases, a
user of consumer reports or a furnisher of information to a consumer reporting agency violates the
FCRA, you may be able to sue in state or federal court.
. Identity theft victims and active duty military personnel have additional rights. For more
information, visit
States may enforce the FCRA, and many states have their own consumer reporting laws. In
some cases, you may have more rights under state law. For more information, contact your
state or local consumer protection agency or your state Attorney General. Federal enforcers
are:
Type of Business:
Consumer reporting ageneies, creditors and others
not listed below
National banks, federal branches/agencies of foreign
banks (word "National" or initials "NA" appear in or
after bank's name)
Federal Reserve System member banks (except
national banks, and federal branches/agencies of
foreign banks)
Savings associations and federally chartered savings
banks (word "Federal" or initials "F.S.B." appear in
federal institution's name)
Federal credit unions (words "Federal Credit Union"
appear in institution's name)
State-chartered banks that are not members of the
Federal Reserve System
Air, surface, or rail common carriers regulated by
former Civil Aeronauties Board or Interstate
Commerce Commission
Activities subject to the Packers and Stockyards Act,
1921
Contact
Federal Trade Commission: Consumer Response
Center - FCRA
Washington, DC 20580 1-877-382-4357
Office of the Comptroller of the Currency
Customer Assistance Group
1301 McKinney Street, Suite 3450
Houston, TX 77010-9050
Federal Reserve Consumer Help
PO Box 1200
Minneapolis, MN 55480
888-851-1920 (TTY: 877-766-8533)
Office of Thrift Supervision
Consumer Complaints
Washington, DC 20552800-842-6929
National Credit Union Administration
1775 Duke Street
Alexandria, VA 22314 703-519-4600
Federal Deposit Insurance Corporation
Consumer Response Center, 2345 Grand Avenue,
Suite 100
Kansas City, Missouri 64108-2638 1-877-275-3342
Department of Transportation, Office of Financial
Management
Washington, DC 20590 202-366-13OQ
Department of Agriculture
Office of Deputy Administrator - GIPSA
Washington, DC 20250 202-720-7051
Identity theft occurs when someone uses your name, Social Security number, date of birth, or other
identifying information, without authority, to commit fraud. For example, someone may have
committed identity theft by using your personal information to open a credit card account or get a loan
in your name. For more information, visit www.consumer.govlidtheft or write to: FTC, Consumer
page JU ot jj
https://fact. econsumer.equifax.com/fact/viewPopUpDetail.ehtml ?prod _ cd=CRD&oi _ num... 3/31/2009
bquuax 1:' AL 1 Act
rag~ -' i U1 -'-'
Response Center, Room 130-B, 600 Pennsylvania Avenue, N.W. Washington, D.C., 20580.
The Fair Credit Reporting Act (FCRA) gives you specific rights when you are, or believe that you are,
the victim of identity theft. Here is a brief summary of the rights designed to help you recover from
identity theft.
1. You have the right to ask that nationwide consumer reporting agencies place ''fraud alerts" in your
file to let potential creditors and others know that you may be a victim of identity theft. A fraud
alert can make it more difficult for someone to get credit in your name because it tells creditors to
follow certain procedures to protect you. It also may delay your ability to obtain credit You may
place a fraud alert in your file by calling just one of the three nationwide consumer reporting
agencies. As soon as that agency processes your fraud alert, it will notify the other two, which
then also must place fraud alerts in your file.
o Equifax: 1-800-525-6285; www.equifax.com
o Experian: 1-888-397-3742; www.experian.com
o TransUnion: 1-800-680-7289; www.transunion.com
An initial fraud alert stays in your file for at least 90 days. An extended alert stays in your file for
seven years. To place either ofthese alerts, a consumer reporting agency will require you to
provide appropriate proof of your identity, which may include your Social Security number. If you
ask for an extended alert, you will have to provide an identity theft report. An identity theft report
includes a copy of a report you have filed with a federal, state, or local law enforcement agency,
and additional information a consumer reporting agency may require you to submit For more
detailed information about the identity theft report, visit www.consumer.govlidtheft.
2. You have the right to free copies of the information in your file (your ''file disclosure"). An initial
fraud alert entitles you to a copy of all the information in your file at each of the three nationwide
agencies, and an extended alert entitles you to two free fife disclosures in a 12-month period
following the placing of the alert. These additional disclosures may help you detect signs of fraud,
for example, whether fraudulent accounts have been opened in your name or whether someone
has reported a change in your address. Once a year, you also have the right to a free copy of the
information in your file at any consumer reporting agency, if you believe it has inaccurate
information due to fraud, such as identity theft. You also have the ability to obtain additional free
file disclosures under other provisions of the FCRA See www.ftc.gov/credit
3. You have the right to obtain documents relating to fraudulent transactions made or accounts
opened using your personal information. A creditor or other business must give you copies of
applications and other business records relating to transactions and accounts that resulted from
the theft of your identity, if you ask for them in writing. A business may ask you for proof of your
identity, a police report, and an affidavit before giving you the documents. It also may specify an
address for you to send your request. Under certain circumstances, a business can refuse to
provide you with these documents. See www.consumer.govlidtheft.
4. You have the right to obtain information from a debt collector. If you ask, a debt collector must
provide you with certain information about the debt you believe was incurred in your name by an
identity thief - like the name of the creditor and the amount of the debt.
5. If you believe information in your file results from identity theft, you have the right to ask that a
consumer reporting agency block that information from your file. An identity thief may run up bills
in your name and not pay them. Information aboutthe unpaid bills may appear on your consumer
report. Should you decide to ask a consumer reporting agency to block the reporting of this
information, you must identify the information to block, and provide the consumer reporting
agency with proof of your identity and a copy of your identity theft report. The consumer reporting
agency can refuse or cancel your request for a block if, for example, you don't provide the
necessary documentation, or where the block results from an error or a material
misrepresentation of fact made by you. If the agency declines or rescinds the block, it must notify
you. Once a debt resulting from identity theft has been blocked, a person or business with notice
of the block may not sell, transfer, or place the debt for collection.
6. You also may prevent businesses from reporting information about you to consumer reporting
agencies if you believe the information is a result of identity theft. To do so, you must send your
request to the address specified by the business that reports the information to the consumer
reporting agency. The business will expect you to identify what information you do not want
reported and to provide an identity theft report.
To learn more about identity theft and how to deal with its consequences, visit
www.consumer.govlidtheft, or write to the FTC. You may have additional rights under state law. For
more information, contact your local consumer protection agency or your state attomey general.
In addition to the new rights and procedures to help consumers deal with the effects of identity theft,
the FCRA has many other important consumer protections. They are described in more detail at
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
l:'.qUlIax 1" AL- 1 ACT
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www.ftc.gov/credit.
Florida Consumers Have the Right to Place a Security Freeze
You have a right to place a "security freeze" on your consumer report, which will, except as provided by
law, prohibit a consumer reporting agency from releasing any information in your consumer report
without your express authorization. A security freeze must be requested in writing by certified mail to a
consumer reporting agency. The security freeze is designed to prevent credit, loans, and services from
being approved in your name without your consent.
YOU SHOULD BE A WARE THAT USING A SECURITY FREEZE TO CONTROL ACCESS TO
1HE PERSONAL AND FINANCIAL INFORMATION IN YOUR CONSUMER REPORT MAY
DELAY, INTERFERE WITH, OR PROHIBIT THE TIMEL Y APPROVAL OF ANY SUBSEQUENT
REQUEST OR APPLICATION YOU MAKE REGARDING A NEW LOAN, CREDIT, MORTGAGE,
INSURANCE, GOVERNMENT SERVICES OR PAYMENTS, RENTAL HOUSING,
EMPLOYMENT, INVESTMENT, LICENSE, CELLULAR PHONE, UTILITIES, DIGITAL
SIGNATURE, INTERNET CREDIT CARD TRANSACTION, OR OTHER SERVICES, INCLUDING
AN EXTENSION OF CREDIT AT POINT OF SALE.
When you place a security freeze on your consumer report, you will be provided a personal
identification number or password to use if you choose to remove the freeze on your consumer report or
authorize the release of your consumer report for a designated period of time after the security freeze is
in place. To provide that authorization, you must contact the consumer reporting agency and provide all
of the following:
1. The personal identification number or password.
2. Proper identification to verify your identity.
3. Information specifying the period of time for which the report shall be made available.
4. Payment of a fee authorized by this section.
A consumer reporting agency must authorize the release of your consumer report no later than 3
business days after receiving the above information.
A security freeze does not apply to a person or entity, or its affiliates, or collection agencies acting on
behalf of the person or entity, with which you have an existing account, that requests information in
your consumer report for the purposes of reviewing or collecting the account. Reviewing the account
includes activities related to account maintenance, monitoring, credit line increases, and account
upgrades and enhancements.
You have the right to bring a civil action against anyone, including a consumer reporting agency, who
fails to comply with the provisions of s. 501.005, Florida Statutes, which governs the placing of a
consumer report security freeze on your consumer report.
A security freeze request must be mailed via certified mail to:
Equifax Security Freeze
P.O. Box 105788
Atlanta, Georgia 30348
Or, you may contact us on the web at equifax.com or call 800-685-1111.
The fee to place a security freeze is $10.00. If you are a victim of identity theft and you submit a copy of
a valid investigative or incident report or complaint with a law enforcement agency about the unlawful
https:/ Ifact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml ?prod_ cd=CRD&oi_ num... 3/31/2009
nquuax l' AC 1 ACT
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use of your identifying information by another person, no fee will be charged. If you are sixty-five years
of age or older, no fee will be charged. Include your complete name, complete address, social security
number, date of birth and payment, if applicable.
Written confirmation of the security freeze will be sent within 10 business days of receipt of the request
via first class mail. It will include your unique personal identification number and instructions for
removing the security freeze or authorizing the release of your credit report for a specific period of time.
Equifax offers you personal credit products that enlighten, enable and empower you. Whether you are
understanding your credit, protecting your identity or preparing for a major purchase, Equifax offers
the tools you need to make the smartest choices possible. For more information visit
www.Equifax.com.
https://fact.econsumer.equifax.com/fact/viewPopUpDetail.ehtml?prod _ cd=CRD&oi _ num... 3/31/2009
WWW.sunOIZ.org - lJepanmem or ~tate
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Ma.iling Address
430 20TH ST NE
NAPLES, FL 34117
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DELGADO, JORGE LUIS
430 20TH ST NE
NAPLES, FL 34117
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INSTRUCfIONS FOR ATIACHING DECAL \,
I. Clean area where new annual decal isto be affixed.
2. Peel decal from this document.
3. Affix decal in the upper right comer of license plate.
r
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Mail To:
JORGE LUIS DELGADO
430 20TH ST NE
NAPLES, FL 34120
IMPORTANT _INFORM A TION
SECfION 320.0605, Ttorida Statutes, requires this registration certificate or an official
copy or a true copY of a rental or lease agreement issued for the motor vehicle described be
in possession of the operator or carried in the vehicle while the vehicle is being used or
operated on the highways or streets of this state.
SECfION 316.613, Florida Statutes, requires every operator of a motor vehicle while
transporting a child in a passenger car, van or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide for protection of the child by properly using a crash-tested, federally approved chiM
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat, for children aged 4 through 5 years.
a separate carrier or seat belt may be used.
SECfION 627.733, Florida Statutes, requires mandatory Florida No-Fault Insurance to
be maintained continuously throughout the entire registration period; failure to maintain the
required coverage could result in suspension of your driver license and registration.
Important note: If you cancel the insurance for this vehicle,
immediately return the license plate from this registration to a Florida
driver license or tax collector office or mail it to: Dept. of Highway
Safety, Retum Tags, 2900 Apalachee Parkway, Tallahassee, R.. 32399.
Surrendering the plate will prevent your driving privilege from being
suspended.
Expires
COLOR
TITLE
CO/AGY 64 17 T# 577769635
B# 502108
Midnight Tue 8/412009 /)...
WHI Reg. Tax 3.10 Class Code ~.
88516459 Init. Reg. Tax Months
County Fee 2.50 Back Tax Moo
Mail Fee Credit Class 41
Sales Tax Credit Months 8
Voluntary Fees
Grand Total 5.60
FLORIDA VEHICLE REGISTRATION
PLATE
584WXC
DECAL 18966596
YRlMK 20031GMC BODY
VIN 1GJHG39UX31151196
Plate Type RGS NET WT
VN
6279
DUFEID 0423432652840
Date Issued 412/2009 Plate Issued
3/26/2009
JORGE LUIS DELGADO
430 20TH ST NE
NAPLES, FL 34120
Hu~ - ~UN~HINE ~TATE
IMPORT ANT INFORMATION
I. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
replacement vehicle.
3. The registration must be surrendered when requesting a change of address.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 3D-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
~\.D(
VEmCLE LEASE
This lease is entered into this (p-:,J..-.., day of Arc'; \
=3i'U:tl'2- ( ~ \~(t cl 0
Lessee.
~ssor ,
..,....
, 20 6cf , by and between
~_6l\'\-r!( S\\,-,..M-\~ Yr-0\Ce.S,
and
In consideration of the promises herein contained, on the part of the parties to be
performed, Lessor hereby leases to the Lessee the following described motor vehicle:
VIN#
License
Plate #
Make
Type
V A,,-')
Year
1<;3"& G ~ttLtX.3IISll~07 S~ 't L..) XC
MkC-
3-.663
Lessee to have possession of the vehicle until this lease is terminated. Lessee will pay
To Lessor annual rent of $ Llpo in 12 rent payments of $ -L
each month.
x
Either party may terminate this lease at any time after this vehicle is no longer being
operated subject to the Collier County Vehicle for Hire Ordinance, by giving the other
party written notice of intent to terminate. Lessee agrees during the entire term of
this Lease to continuously maintain insurance on the leased vehicle in not less than
the face amounts and scope of coverage as are then required by the Code of Laws and
Ordinance Chapter 142. Lessee agrees, during the term of this lease to otherwise
hold Lessor harmless from any and all claims arising out of use or operation of the
subject vehicle. Each party to this Lease asserts to the other party that the respective
party has full authority to enter into this Lease in an individual capacity and/or on
behalf of any principle. The Laws of the State of Florida shall control this Lease.
(. n ~------- :} atu;f L. 3k\1do
Signatu~r Print Name of Lessor
~\
" ~
SignaUe 0 . ssee
-:<
C.6\\ ie~ ShV\~+le: ~cr \,)\ces
Print Name of Lessee
To:
Page 1 of 1
2009-04-0615:37:17 (GMT)
17862280451 From: Siisi Rodriguez
ACORD,.. CERTIFICA TE OF LIABILITY INSURANCE I DATE (MMlDD/YYYY)
4/6/2009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Public Tran~ortation Specialist ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES' NOT AMEND, EXTEND OR
14100 Palmet 0 Frontage Rd # 210 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Miami Lakes, Fl 33016
305-818-9544 INSURERS AFFORDING COVERAGE NAIC#
INSURED Jorge Delgado & Maritza Martinez . INSURER A: Delos Insurance Company
DBA: COllier Shuttle Services ,'- INSURER B:
430 20th Street NE INSURER C
Naples, FL 34120 INSURER D:
t2392873197 INSURER E'
COVERAGES
THE POLICIES OF INSURANCE LISTED BE LOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORCED BYTHE POLICIES DESCRIBED HEREIN IS SUB,JECT TO ALL THE TERMS, EXCLUSIONS AND CONDrTlONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BYPAID CLAIMS
I'NON ~uu . TYPE OF INSURANCE POLICY NUMBER b~!ftf(fAi\',b'Dc;.;r}jE P8kffi)~~'b~?N LIMITS
LTR SRD
GENERAL LIABILITY EACH OCCURRENCE $
f-- PRE'MiS'Es (8,'~'curence)
COMMERCIAL GENERAL LIABILITY $
I CLAIMS MADE o OCCUR MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
I POLICY n j~2r n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ( ---
- ------ (Ea acel dent) $ 1,000,000
ANY AUTO
-
ALL OWNED AUTOS BODILY INJU RY
- ( $
X SCHEDULED AUTOS (Per pe rson)
- 3/24/2009 3/24/2010
A HIRED AUTOS BODILY INJURY
r- $
NON-OWNED AUTOS (Per eccl dent)
I- --------.1
X pip ----- --..----..-
PROPERTY DAMAGE - $
X ColI/Como (Per accl dent)
GARAGE LIABILITY AUTO ONLY - EAACCIDENT $
=t ANYAUTO OTHER THAN EAACC $
AUTO ONL Y: AGG $
EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $
=t OCCUR D CLAIMS MADE AGGREGATE $
$
==J DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 1r0RYLIMITS I IUER'
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? EL DISEASE - EAEMPLOYEE $
It yes, describe under
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $
OTHER
A coll/cOItp DBP0801366 3/24/2009 3/24/2010 1000 DED $ 5,000
DESCRIPTION OF OPERATIONS /LOCATIONS J VEHICLES/EXCLUSIONS ACOED BY ENDORSEMENT I SPECIAL PROVISIONS
SCHOOL BUS SERVICE
2003 GMC VAN VIN 1GJHG39UX31151196
THE CERTIFICATE HOLDER IS .ALSO ADDITIONAL INSURED
CERTIFICATE HOLDER
CANCELLATION
Collier County Board of Commissioners
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
,/ DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLlGA nON OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATiVES
AUTHORIZED REPRESENTATIVE
~ ACO RD COR PORA TION 1988
3301 E. Tamiami Trail
Naples, FL 34104
ACORD25 (2001/08)
AFFIDAVIT
Before me this day personally appeared
that the vehicle(s) to be permitted meet(s)
and Ordinance Chapter 142.
It is understood and acknowledged by the Code Enforcement Department and myself that if
my vehicle(s) that is/are permitted fail(s) to meet(s) the safety standards as required by this
Ordinance, the vehicle(s) must be removed from service until all violations are corrected.
BUSINESS NAME tDll\--er 5~lt+-\-\~ Se\VJ\ CJ!S
SIGNATURE OF APPUC~'~ ~ --">
DATE 'I~ ~~ ~6D1
STATE OF FLORIDA
COUN1Y OF COLLIER
# .
The foregoing' strument was subscribed and swom to before me this ro day of ~
.'D2
who is personally lrnown or has
as identification and who did.
()!ftr~ .
PRI NAME OF NOTARY
NOTARY PUBLIC COMMISSION #
bD 739~ &7 .
4/le (:M I ~ ·
NOTARY'S SEAL
COMMISSION EXPIRES:
~..~V pUs( OLGA M. RAMOS
~o ....... '" MY COMMISSION # DO 739969
* ~ '" EXPIRES: April 6, 2012
"'~... Bonded Thru Budget Notary Services
!tOFf\.o
4
AFFIDAVIT
Before me this day personally appeared 16 Q 6F~ L . lJELL;AdO who swears or affirms
that the vehicle(s) to be permitted meet(s) the safety standards as set forth in Code of Laws
and Ordinance Chapter 142.
It is understood and aclrnowledged by the Code Enforcement Department and myself that if
my vehicle(s) that is/ are permitted fail(s) to meet(s) the safety standards as required by this
Ordinance, the vehicle(s) must be removed from service until all violations are corrected.
BUSINESS NAME
tDLL\erL
SIGNATURE OF APPLICANT
DATE L/ -(0 -- zct:/i
STATE OF FWRIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and sworn to before me this L day Of~
2nJ't7, bYY~~ ~~ who is personally known or has
~' ( e of person ac ledging)
~{. j) rj 25. f:J.:7- ~~ ~~t;dentification amdrAl'lmdidsTATE OF FLORIDA
~ ~ "'"'''''' Linda C. Wolfe
f~ ~Commission #DD7391S0
\, ./ Expires: DEC. 07, 2011
(? !.e . sow;;' """ ",^""""~",,,o., "'0.
SIGNATURE OF OTARY PRINT NAME OF NOTARY
NOTARY PUBLIC COMMISSION #
NOTARY'S SEAL
COMMISSION EXPIRES:
4
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
provisions.
~ /~
( 1 re of Applicant)
I ~An.;+li} U. D~iacul/) swear or afiirm that all information on this Application
for ertificate to Operat s true.
~~
(Signa of Applicant)
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and sworn to before me this 4 L & /0 't
. _ J 1:\ (Date)j
By ~,-J.zA / afJD who has produced [JR.I lJ€ L ~ .
ame of person ackrI wledging) (Type of identification)
As identifica . n and who did take an oath.
D /~ tlj:"7r1 oS, .
. t of Notary
NOTARY'S SEAL
Notary Public Commission #
b~ ? 3 ']9ee, 7 .
4/e/XI/:>- .
~~RV Pill}
~Q ....... ~~ OLGA M. RAMOS
* * MY COMMISSION # DO 739969
"'", r:," EXPIRES: AprilS, 2012
'l' OF FlO'1-' Bonded Thru Budget Notllly Services
Commission Expires
5
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
proVIsIOns. ~
\.f. 'X
(Signa Ap licant)
I J()RhE L (Jel ~6. J 0 swear or affirm that all information on this Application
for Certificate to Opera. is tru .
'(
STATE OF FLORIDA
COUNTY OF COLLIER
t was subscribed and sworn tO~fore me thiS~~ jJ ~ J ~~
~ .~ (D~
whohas~-&ce zr..~. ~ -2(j'pCd
(Type of identification)
As identification and who did take an oath.
~ l?Jj~
Signature of otary
NOT.'..RY PUBLIC-STATE OF FLORIDA
"",,,. I' d '" W If
/'l.. i'~ '--'i~l ~ C. 0 e
~. ~~j:' COrr~m!S3lOn il DD739150
'",,!3," E:qJ\res: DEC. 07,2011
BONDL) THRJ ATLANTIC 1l0)o,1)!NG co., INC.
Print of Notary
NOTARY'S SEAL
Notary Public Commission #
Commission Expires
5
COLLIER COUNTY GOVERNMENT
CRIMINAL mSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date:
Pursuant to provisions of Chapter 119, F.S., and procedures outlined under Rule
Chapter 11C-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
Name: ~Q;-\Z~ H
First Middle (full)
Address: -.B'JD Q.cr~ \."5+ 0E
(Number & Street)
Maiden
\-. )~'e~
(City)
3~\7.0
(Zip Code)
DL No.: 14 (b3S -StfO- <o~. (dd8-D
Age: _ Race: LD~~te H1'"5fW'\\C'..-
Eye: b-- 0 LV N Hair: .1J oa
(Color) (Color)
Social Security No.: _ _
DOB: 5: - 3- lq Iv ~ Sex: F
Height: S 1I ..) Weight: \d-.D Ibs.
Name:
First
Middle (full)
Last
Maiden
Address:
Number & Street
City
State
Zip Code
Social Security No.:
DL No.:
DOB:
Sex:
Age: _
Race:
Height:
Weight:
lbs.
Eye:
Hair:
(Color)
(Color)
COLLIER COUNTY GOVERNMENT
CRIMINAL mSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date:
Pursuant to provisions of Chapter 119, F.S., and procedures outlined under Rule
Chapter llC-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
Name: ~QGt:; Lu.t 5 JJdt\dO
First Middle (full) . st Maiden
Address: 1.+30 Jo+h ST I~c- 10::;t.DlfS CJ2\ 34' 2-0
(Number & Street) (City) (State) (Zip Code)
Social Security No.:
DOB: ()<~-oL{ -tC{0S
I .
DL No.: D - Lfa 3 ..LJjd- (05~ J~4- 0
C.11 II
Height: 0
Weight:
Sex: ll- Age: _
\'75 '1 Ibs. Eye:-J-tlA; LeL
(Color)
Race: ~\SpAt~iL, ihl-f1+e
Hair: hr bLJ 1J
(Color)
Name:
First
Middle (full)
Last
Maiden
Address:
Number & Street
City
State
Zip Code
Social Security No.:
DL No.:
DOB:
Sex:
Age: _
Race:
Height:
Weight:
lbs.
Eye:
Hair:
(Color)
(Color)
; J , , n T T -:-..
'-" i , r--<,. J 1 1 "~
J , i \.
Lf.-u-JoD1 CONSENT:::=L~~----
I understand that Collier County Code Enforcement will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New
York, NY 10011, as part of the procedure for processing my PVAC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further information through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id.
I understand a consumer reporting agency's investigation may include obtaining information covering up to the last seven (7) years regarding, among
other items,references, character, driving record, past employment, work habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and federal law. The investigation also may indude obtaining information relating to criminal records without
any time limitations, subject to state and federal law.
In the event an investigative consumer report is conducted, I understand such information may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge concerning my character, general reputation, personal
characteristics or standard of living. I understand such information may also be obtained through direct or indirect contact with former employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
a By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act.
I also understand that before my application is denied based, in whole or part, on information obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the accuracy
of any information in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report. If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging infonnation in the report, Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the infonnation
contained in the report.
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
DATE
Other Names Known By
Middle Name/Initial
~D
Male Female
IT]
d-: q 0
~
\ (
\
Minnesota & Oklahoma applicants Only: I have the right to request a copy of my consumer report from Sterling Testing Systems, Inc. by
checking the box below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make
a written request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report.
IT]
State
~
Stale
....J
~oClal ~cunty No.
)<.
Signature
Lf'~ ~ - 2.D:Y1
Date
. I wish to receive a copy of the COnsumer report. (Check box only if you wish to receive a copy)
~tt:l~~~) ,-)
I -
r
I
L .
(
~A:~~.(;~..~~~~.._........-C-6NSEN~:~~~~L"b~~~i;--~~Z?-:--....-
I understand that Collier County Code Enforcement will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New
Yorl<, NY 10011, as part of the procedure for processing my PVAC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further information through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id.
I understand a consumer reporting agency's investigation may include obtaining information covering up to the last seven (7) years regarding, among
other items, references, character, driving record, past employmen~ worl< habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and federal law. The investigation also may include obtaining information relating to criminal records without
any time limitations, subject to state and federal law.
In the event an investigative consumer report is conducted, I understand such information may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge concerning my character, general reputation, personal
characteristics or standard of living. I understand such infonnation may also be obtained through direct or indirect contact with former employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
o By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act.
I also understand that before my application is denied based, in whole or part, on information obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the accuracy
of any information in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report. If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging information in the report, Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the information
contained in the report.
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
Middle Name/Initial
D[x]
Male Female
[QliJ
#yrs at this address
J-O
~OClal ~eUJ(ILY ....u.
Lf)h/ZJ9
Date / /
Minnes & Oklahoma applicants Only: I have the right to request a copy of my consumer report from Sterling Testing Systems, Inc. by
checking the box below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make
a written request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report.
IT]
State
[EIIJ
State
L
~
. I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
tJa~tl.-A H. &\aCldD
I have read and understood the paragraph
X
Sign
1/ h/tJ9
Da I
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
, have read and understood the paragraph
..[
Signature of applican
4-eo-ZMl
Date
~Jli~r _qou~ty
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Change Returned:
Contact:
FEES:
Oeser; ption
Certificate to Operate
Application
Cashier Name:
Batch Number:
levy-m
151
Development and Environmental Services
2800 Horseshoe Drive N.
Naples, FL
34104
239.252.2400
RECEIPT OF PAYMENT
2009009527
2009-002030
04/13/2009
Cash
$200.00
$200.00
$0.00
Delgado, Jorge L
430 20th ST NE
Naplesl FL 34120
Reference Number Original
Fee
LCCT020090000339 $200.00
Amount
Paid
$200.00
Account
111-138911-321241
PrintResults Page 4 of 6
5TL-RL i'-JG
Code Enforcement Div. Collier County
Order#: 9357187
JORGE DELGADO
PO#
Last Name
First Name
Middle Name
Date of Birth (mmldd/yyyy)
Phone
Projected Salary
Job State
Subject Profile
NA
DELGADO
JORGE
LUIS
08104/1965
N/A
Address
Apartment Number
City
State
Zip
Current Address
430 20ST N. E.
NAPLES
FL
34120
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
MOTOR VEHICLE REPORT (MVR)
SEXUAL OFFENDER DATABASE SEARCH
Status
3 CLOSED
1 CLOSED
1 CLOSED
1 CLOSED
Findings
Clear
See Results Betow
CJear
SOCIAL SECURITY TRACE SEARCH
CRIMINAL RECORD SEARCH
The criminal information reported on this website appears exactly as it is received from the local jurisdictions and may contain information
which would be prohibited for use in making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: State: NW Zip: County: NATIONWIDE
Status: CLOSED
FINDING: Clear
*************************************************************************
. THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND *
* HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
* CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
No criminal convictions found.
City: NAPLES State: FL Zip: 34120 County: COLUER
Status: CLOSED
FINDING: Clear
No criminal convictions found.
City: State: FL Zip: 33013 County: DADE
Status: CLOSEO
FINDING: Clear
No criminal convictions found.
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - 88178
Order Date: 04/06/2009
Host Used: Online
Reference: 9357187 3
Period: THREE YEAR
License: D423432652840
Report Clear:NO
Name: DELGADO, JORGE LUIS
~n.ddres s :
City, St:
As of:
https:llsd.sterlingtesting. eom/webdireet3 IresuIts/PrintResults .aspx? Arem ve=
4/13/2009
PrintResults
Page 5 of6
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 05/06/2008
Exp Date: 08/04/2012
AGE:
Year License First Issued: 02/05/1998
STATUS: SEE BELOW
MVR Score
SCORE:
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONV
ACD AVD V/C
DESCRIPTION
CONV 02/18/08 04/01/08 Sll SAIl 575 SPEEDING 15 OVER THE LIMIT
SPEED:50/35 LOCATION/DOCKET: COLLIER/3709FHN PTS: 3
Suspensions/Revocations
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
NO ACTIVITY
License and Permit Information
License: COMMERCIAL Issue:05/06/2008 Expire:08/04/2012 Status:VALID
License Status Explanation: ELIGIBLE
Class:A OVER 26,001 LBS COMB. VEHICLE & OVER 10,000 LBS. TOWED UNIT
License: COMMERCIAL Issue:03/28/2003 Expire:09/24/2003 Status:EXPlRED
Class: CMV TEMP PERMIT
Miscellaneous State Data
*. ENTRIES BELOW COVER THE PAST 3 YEARS
CDL ORIGINAL ISSUE DATE: 06-10-98
MISC: EXAMS VISION=l ROAD SIGN=l ROAD RULES=l DRIVING=l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL=O
BLOCK PERSONAL INFORMATION *'
BLOCK FOR MAILING LIST **
THIS PERSON HAS A DIGITAL IMAGE
IFOR STATED BUSINESS
IPURPOSES ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
/
Issue Date:
/ /
Control Number: LNW041
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DA TABASE SEARCH
Stale: FL
Status: CLOSED
FINDING: Clear
No Record Found
Back to Findings
SOCIAL SECURITY TRACE SEARCH
Stalus: CLOSED
*************w**************
Social Security Trace
*****************************
********************************************************************************
GENERATED: 04/06/2009 02:51:32 PM
TRANSACTION ID:0016944255-1199
1.
NAME
JORGE
SSN
###-##-####
L DELGADO
VALID
YES
STATE ISSUED
FLORIDA
DOB
08/04/1965
DATE ISSUED
02/02/1998
ADDRESS
430 20TH NE ST NAPLES, FL 34120-3645
SO E 35TH ST HIALEAH, FL 33013-2626
FRot-1
12/2002
07/1999
TO
01/2009
07/1999
2.
NAME
JORGE L DELGADO
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
DATE ISSUED
02/02/1998
ADIJRCS S
430 20TH NE ST NAPLES, FL 34120-3645
8892 NW 112TH ST HIALEAH, FL 33018-4531
558 E 21ST ST HIALEAH, FL 33013-4018
FROB
12/2002
01/2001
02/2009
08/2004
----------------------------------------------------------------------------
https:/ Isd. sterlingtesting.com/webdirect3/results/PrintResults.aspx? Archive=
4/13/2009
PrintResults
Page 60f6
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL. REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
-----------------------------------~----------------------------------------
.*END OF NETWORK TRACE**
I!~~.k_ to. FLncj.i~g.~....
COpyright C 2008 Sterling Infosystems. Inc.
hH"t"'\C'. / /~r1 C"+a.,..l~nrT+o.C'I+;nl'T ror'\rt"'\ In;7okr1;"t"'oroi-1./.....o.con lt~fD"";'Y\+D acollltC" ~C"'"v') ^ ....,.... t,;,\: 70.=
II /11/')f'lf'lO
PrintResults
Page 1 of6
5T-RLi.\IG
PO#
Last Name
First Name
Middle Name
Date of Birth (mm/dd/yyyyl
Phone
Projected Salary
Job State
Code Enforcement Div. Collier County
Order#: 9368404
Maritza Delgado
Subject Profile
na
Delgado
Maritza
M
05/0811968
N/A
Address
Apartment Number
City
State
Zip
Current Address
43020 St NE
Naples
FL
34120
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Code Enforcement DiY. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
MOTOR VEHICLE REPORT (MVR)
SEXUAL OFFENDER DATABASE SEARCH
SOCIAL SECURITY TRACE SEARCH
Status
3 CLOSED
1 CLOSED
1 CLOSED
1 CLOSED
Findings
Clear
See Results Below
Clear
Alert
CRIMINAL RECORD SEARCH
The criminal information reported on this website appears exactly as it is received from the local jurisdictions and may contain information
which would be prohibited for use In making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: State: NW Zip: county: NATIONWIDE
Status: CLOSED
FINDtNG: Clear
*************************************************************************
. THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND .
* HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STAliDARD
* CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
No criminal convictions found.
City: Naples State: FL Zip: 34120 County: COLLIER
Status: CLOSEO
FINDING: Clear
No criminal convictions found.
City: Stote: FL Zip: 33018 County: DADE
Status: CLOSED
FINDING: Clear
No criminal convictions found.
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FlNDtNG: See Results Below
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - 88178
Order Date: 04/08/2009
Host Used: Online
Reference: 9368404~3
Period: THREE YEAR
License: M635540686680
Report Clear:NO
Name: MARTINEZ, MARITZA
Addrefls:
City, St:
As of:
https:/ / sd.sterlingtesting.com/webdirect3/results/PrintResults.aspX? Archive=
4/13/2009
PrintResults
Page 2 of6
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 05/06/2004
Exp Date: 05/08/2010
AGE:
Year License First Issued: 03/18/1998
STATUS: VALID
MVR Score
SCORE:
ELIGIBLE
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONY
ACD AVD V/C
DESCRI PTION
CONY 06/06/06 06/19/06 F04 EB02 407 SEAT BELT VIOLATION
LOCATION/DOCKET: COLLIER/1172SFQ PTS:
Suspensions/Revocations
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
NO ACTIVITY
License and Permit Information
License: PERSONAL Issue:05/06/2004 Expire:05/08/2010 Status:VALID
License Status Explanation: ELIGIBLE
C1ass:E REGULAR OPERATOR
Miscellaneous State Data
.. ENTRIES BELOW COVER THE PAST 3 YEARS ..'
MISC: EXAMS VISION=l ROAD SIGN=l ROAD RULES=l DRIVING~l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL~O
BLOCK PERSONAL INFORMATION ..
BLOCK FOR MAILING LIST ..
THIS PERSON HAS A DIGITAL IMAGE
IFOR STATED BUSINESS
IPURPOSES ONLY
I
I
I
Underwriting:
POlicy
Initials:
Date:
/
Issue Date:
/ /
Control Number: RQUJPT
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
Slate: FL
Status: CLOSED
FINDING: Clear
No Record Found
Back to Findings
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
ANDING: Alert
****************************
Social Security Trace *****************************
********************************************************************************
GENERATED: 04/08/2009 01:46:04 PM
TRANSACTION ID:0016965485-7953
1.
NAME
MARITZA M
SSN
###-##-####
DELGADO
VALID
YES
STATE ISSUED
FLORIDA
DATE ISSUED
02/02/1998
ADDRESS
430 20TH NE ST N~~LES, FL 34120-3645
8892 NW 112TH ST HIALEAH, FL 33018-4531
558 E 21ST ST HIALEAH, FL 33013-4018
FROM
07/2002
02/2001
12/1999
TO
03/2009
OB/2004
12/1999
2.
NAME
MARITZA
SSN
###-##-####
MARTINEZ
VALID
YES
STATE ISSUED
FLORI DA
DATE ISSUED
02102/1998
.1I..DDRESS
430 20TH NE ST NAPLES, FL 34120-3645
TO
07/2002
01/2009
, .
NAME
MIIRI1'ZI\
SSN
###-##-####
DELGA..DO
VALID
YES
STATE ISSUED
FLORIDA
DATE ISSUED
02/02/1998
https:// sd. sterlingtesting.com!webdirect3/resultslPrintResults.aspX? Archive=
4/13/2009
PrintResults
Page 3 of 6
ADDRESS FROM TO
430 20TH NE ST NAPLES, FL 34120-3645 01/2004 2008
NAME DOB
4. MARITZA MARTINEZ 00/1968
SSN VALID STATE ISSUED DATE ISSUED
##U-UU-UUUU YES FLORIDA 02/02/1998
ADDRESS FROM TO
8892 NW 112TH ST HIALEAH, FL 33018-4531 01/2001 08/2004
558 E 21ST ST HIALEAH, FL 33013-4018 12/1999 01/2002
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
**END OF NETWORK TRACE**
PLEASE NOTE THAT THE RESULT OF THE SOCIAL SECURITY TRACE SEARCH YIELDED THE
FOLLOWING NAMES IN ADDITION TO THE NAME ORIGINALLY ENTERED FOR THE APPLICANT:
MARITZA MARTINEZ - LAST NAME DOES NOT MATCH. (SEE U2 ABOVE)
MARITZA MARTINEZ - LAST NAME DOES NOT MATCH. (SEE U4 ABOVE)
PLEASE REVIEW THE RESULT AND CONTACT OUR CLIENT
AT CLIENTSERVICES@STERLINGTESTING.COM TO CONDUCT
ADDITIONAL NAMES ON THIS REPORT (AN ADDITIONAL CHARGE
NAME) .
SERVICES DEPARTMENT
SEARCHES UNDER ANY
WILL APPLY FOR EACH
******************************************+*********************************
... ._~ac_k!oFindingl'__ ....
Copyright C 2008 Stertlng Infosystems, Inc.
1_4-+_.-.. II.......J ..............._1=_ ~+..........+~_ ___ ......,."............ I__~.....L ..J:__...................,. /.............~..l-+...... In....:...-..n .....~....1+...... .............__.,..'l ^ _........1-:...7....._
,! /1 ') /"'1 (\(\(\
LCCT020090000357
EXODUS LIMOUSINE AND TRANSPORT, LLC
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
PUBLIC VEHICLE ADVISORY COMMITTEE
2800 NORTH HORSESHOE DRIVE
NAPLES,FL 34104
APPLICATION FOR CERTIFICATE TO OPERATE
DATE: ~.:..J 5 - 09
The undersigned hereby makes application for a Certificate to Operate vehicles "for hire" within
Collier County under Code of Laws and Ordinance Chapter 142, and respectfully submits the
following information in support of this application.
FEES: Non-Refundable Application Fee
Certificate to Operate Issuance Fee (Yearly)
Vehicle Decal Permit Fee (Per Vehicle / Yearly)
Driver ID Fee
$ 200.00
$ 325.00
$ 50.00
$ 75.00
NOTE: Please make check / money order payable to the BOARD OF COUNTY COMMISSIONERS
1. Name of Applicant: (Y\ \C.~o...e l T. S\<.f.CGEC.K-
Address:~L.lCO Gu\.c:s\...ore. b\vc1. N -<003 NAPLE S
(Number & Street) (City)
FL.
(State)
.3~ lC3
(Zip Code)
Home Telephone: (~3' ) q\,\ - '" 3<=\ b
E-Mail t'f".i.<':""oO-c:>..@ Co(\'\.c..a.s-h tJ ET
Date of Birth: 2. - ~ - ~ S S.S. #: -1
Driver's License #: S' 11. - SSg- ~ g - 04 J- - 0
2. If Partnership: NO tv E. - ""'(A-
Business Name:
Business Address:
(Number & Street)
(City)
(State)
(Zip Code)
Business Telephone: (
E-Mail
List of Partners:
A.
(Name)
(Address)
o
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
1 .
(HomM~W~~ #)
,.?~:~~L '.":-..- ~~.
(Date of Birth)
(Social Security #)
erf(). ~ 1\ e r- .
3. If Manager: 0"'\ y 1 ~lI\'t ,,\"\C:lO c-,.A\S'~C>I'~ 'o\vJ...~. .'G3 N~F't..Es ':l. ~q,c
}4e."tY"\e.. - ... ,
fV\~c..""o...e.\ ,- 5'f;.~~ECt::... t"'-A~t\..,~.. ~D. ,;;lOcH" NAf'L(5) eFt.. 3~lol
(Name) (Address)
(:23ct) qlq-C-f3cH. Z-2.-(..~ _
(Home phone #) (Date of Birth) (Social Security #)
Copies of Articles of Incorporation, all amendments thereto, and a certified copy of the Certificate of
Incorporation must accompany this application.
4. If Corporation/Fictious Name:
Exact CorporatejBusiness Name: EXODUS LIMOI..1S\l'\e o-..~ Tro..1\.spor+, \...\.-.C
Business Telephone number: (do 3Cl l 9' C\ - 4 '3CC (Q
Business Address: LltioO c;.u l~hof"c:. \'\vcl. 1\). -<003
(Number & Street) (City)
E-Mail (Y\\~\o~ol 6) COMC.dt. fJE
NA(1L6S FL..
(State)
3Lt\o3
(Zip Code)
List of Directors j Officers:
A. (V\\c..h.(.L~\ \'. "5"RD6EC. \::..
(Name)
f..o. 601< \2.09 ~ NA 'PL6..S FL. 3"110 I
I
(Address)
(:23'1.) q\Cf.-L\~'l~
(Home phone #)
:2..-.z-'~
(Date of Birth)
-
(Social Security #)
B.
(N ame)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
5. List any and all persons holding a ten percent (10%) or greater beneficial interest in applicant's
business or company. ,voN c
A.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
2
6. If applying for Sub-Certificate name(s):
a. Name
Date of application
b. Approved
Rejected
REASON:
c. NaIIle
Date of application
d. Approved
Rejected
REASON:
7. Trade Name (if any)
8. List all criminal convictions for which the applicant, owners, managers, directors, and any
officers have been found guilty or convicted regardless of adjudication, in the United States
indicating the offense, the date, and the state.
9. Has Certificate to Operate ever been revoked? Yes
No NO
If yes, please explain the reason, the year, city, state, and the previous issued Certificate to Operate
number,ofrevocation:
3
Exodus Umousine and
Transport u.c
April 15, 2009
To the board of Collier County Commissioners:
I am requesting an "owner/operator" permit for a small taxi/limo seNice to seNe the people of Naples
with quality seNice. I have resided in Naples since childhood, having lived here for 39 years. I have
worked with the people of Naples as a licensed real estate associate for twenty years.
I have been driving in the taxi/limo business for 6 years, working for various companies such as Airport
Express, Unlimited Airport Rides, A-Plus Airport Transportation, and Taxi Time. I will provide quality
seNice at all facets to this business and will be an asset to the community as a luxury taxi/limo seNice.
I am starting out with one vehicle, an aT Executive at this time and hope to expand rapidly, even in a
"down economy". I will be using the L1NCON EXECUTIVE-L SERIES, which is vey luxurious. I would
be very thankful if EXODUS LIMOUSINE AND TRANSPORT LLC will be granted an owner/operator
permit. Thank you for your time and consideration.
Sincerely,
Michael T. Skrobeck owner/manager
EXODUS LIMOUSINE AND TRANSPORT LLC
~~
Lj !17/tJ1
~ T 0"'" fn.ct.r'\.."'-..Cj E:. f- ~
---.
j ~ fk &l1ly ()1an~3er" o-f'
-fh 0 (! 0 rYl pCUi Y .
(Y1 I C. h o-...e..l S \<- R. 0 \3 c C lz..
c:?'
---------... -
HanKey uroup
q/lq/ZUU~ 11:Ub:lU AM PAU~
Westlake
1-1-
April 14, 2009
MICHAEL SKROBECK
PO BOX 12096
NAPLES FL-34101
Account J _ 1
VTIN#:lJ4GZ58S5VVCI08137
DESC: 1998 JEEP GRAND CHEROKEE
To Whom It May Concern:
Z/UUZ
rax berver
This letter serves as confirmation that the above referenced vehicle has been paid in full,
pending a final audit. Please retain this letter for your records, in the event that your
credit does not reflect the status listed above, please submit your dispute to the credit
agencies in questions. If you have any questions please contact Customer Service at 888-
739-9192 Monday through Thursday, 7am to 9pm, and Friday from 8am to 5pm Pacific
Time.
Sincerely,
Joe Cardona
Westlake Financial Services
Customer Service Department Manager
04/13/09
From: Mark Tomasi
Property owner
Rentals
Naples, FL, 34103
To the Board of Collier County Commissioners:
I, Mark Tomasi have known Michael T. Skrobeck for many years as a renter.
Michael has always paid his rent on time, if not early at other times. He has
been an excellent client.. I own and rent out numerous duplexes and house, I
have experience working with many types of customers, and Michael has
always been a very good tenant.
Michael also possesses excellent communicational skills and exhibits very
professional and friendly attributes. I consider Michael T. Skrobeck a valuable
asset to the collier community. Michael is very affluent and has worked as a
realtor; therefore, he understands the importance of compliance to the laws of
operating a business in Naples. I have seen him interact with clients, and that is
why I am writing this letter of recommendation.
Michael T. Skrobeck has my recommendation to open a limousine and
transportation company, due to his good work ethics and ability to realize what
is required to operate a limousine and transportation company. If you have and
questions feel free to contact me at (239) 821-1788.
Sincerely yours,
Online Personal Credit Reports & Credit Scores - TrueCredit
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EC{UlFAX
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score affect me?
588
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Created on: 04/15/2009
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three credit scores?
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(Higher than 33% of the others)
Compared to the rest of the nation, this is how your credit score ranks. High percentages are better.
HOW LENDERS VIEW YOU
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(Poor)
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httn<:' / /vvUJUJ trllPl'TPnlt rnm/t::lh/nrnnllrt/<:rnrp/tr::ln<:T Tnlnn?rptrlPvp~in(J If'=tnlP
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PERSONAL INFORMATION
?
CREDIT REPORTING
AGENCY:
~
eXperUlIl'
Ea.,U'FAX
TransUnion.
.........................................................................................................................................................................................
CREDIT REPORT
DATE:
................ ......................
NAME:
ALSO KNOWN AS:
04/1512009
04/15/2009
04/15/2009
MICHAEL T. SKROBECK MICHAEL SKROBECK
TODD M. SKROBECK MICHAEL T DOOLEY
MICHAEL SKROBECK
MICHAEL TODD
DOOLEY
TODD M. SKROBECK
MICHAEL T. DOOLEY
MIKE SKROBECK
TODD M. SKROBECK
DATE OF BIRTH: 0211968 1968 02/1968
.........................................................................................................................................................................................
CURRENT ADDRESS: 12096 PO BOX 12096 PO BOX 12096 PO BOX 12096
NAPLES, FL 34101 NAPLES, FL 34101-2096 NAPLES, FL 34101
01/01/2008 02/1998 12/2008
.........................................................................................................................................................................................
PREVIOUS ADDRESS: 4400 N GULF SHORE BV 2102 ALAMANDA DR 4400 GULF SHORE BLVD
NAPLES, FL 34103 #205 N
10/01/2007 NAPLES, FL 34102-4722 NAPLES, FL 34103
03/1993 12/2008
........................ ..................................................................................................................................................
1472 MUREX DR 5850 PAINTED LEAF LN 2425 14TH ST N
NAPLES, FL 34102 NAPLES, FL 34116-7447 NAPLES, FL 34103
06/2003 12/2008
................... .....................................................................................................................................................................
EMPLOYER: PRUDENTIAL FLA WC) WHITNEY COMMERCIAL RICE INS GLASS
04/01/2001 DIVI
01/2008
............................ ..................... ......................................................................................................................................
PREVIOUS KIEFER GLASSS AGII
EMPLOYER: 27591 WOODRIDGE DR
BONITA SPRINGS, FL
11/1994
KIEFFER GLASS INC
Consumer Statement
Experian: 27& 02-22-09 249994710 SECURITY ALERT: FRAUDULENT
APPLICATIONS MAY BE SUBMITTED IN MY NAME OR MY IDENTITY MAY HAVE
BEEN USED WITHOUT MY CONSENT TO FRAUDULENTLY OBTAIN GOODS OR
SERVICES. DO NOT EXTEND CREDIT WITHOUT FIRST VERIFYING THE IDENTITY
OF THE APPLICANT. I CAN BE REACHED AT 239-692-1968. THIS SECURITY ALERT
WILL BE MAINTAINED FOR 90 DAYS BEGINNING 02-22-09.
Refinance Your Mortgage: Get30 Year Fixed Rates as Low as 4.875%. .Terms
SUMMARY
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17
TOTAL ACCOUNTS: 13
Experian
18
OPEN ACCOUNTS: 9
8
9
CLOSED ACCOUNTS: 4
..................... ........
DELINQUENT: 0
10
o
8
. . .. .. ........
o
,,"
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BALANCES:
DEROGATORY: 3
3163
8
3778
256
2
13
8
12031
151
o
8
PAYMENTS:
PUBLIC RECORDS:
218
2
INQUIRIES (2 years): 6
ACCOUNT HISTORY
At-a-glance viewing of your payment history
?
ID I m rm
Payment II Repo$se$$ion Collection
plan foreclo$ure, ChargeofT
Real Estate Accounts: Primary and secondary mortgages on your home
None Reported
CompareO% APR BalanceTransfer Offers
Revolving Accounts: Accounts with an open-end term
TNB - TARGET
Account No.:
Condition:
Balance:
Type:
Pay Status:
TransUnion
6350'
Open
$449
Charge account
Current
Experian
6350.
Open
$449
Charge account
Current
More about this acgount I Dispute
Equifax
63509....
Open
$449
Charge account
Current
Legend
1!131!131!131!131!131!13
I!13l!13l!13rnJl!13l!13l!13
lransUnion
Two Year Payment History:
ExpHian
Equilax
Ap 1,1a'( lun I'll Aug Sep Oel NO'I !lee 'OR Feb Mar Apr Moy jun I'"l Aug Sep Oct NO'1 !lec '09 Feb Mar
FIRST PREMIER BANK
Account No.:
Condition:
Balance:
Type:
Pay Status:
TransUnion
-
Open
$246
Credit Card
Current
Experian
More aboutthis_Bccoynt I Dispute
Equifax
I
Open
$246
Credit Card
Current
-
Open
$246
Credit Card
Current
Legend
[!t)[!tJ[!l3[!IJ[!t)[!t)[!t)[!tJ[!l3[!t)I!13[!t)[!tJ[!l3[!l3
[!t)[!t)[!l3[!tJ[!t)[!l3[!tJI!13[!t)[!tJl!13m[!t)1!131!131!13
TransUnion
Two Year Payment History:
Exp Hia n
Equitax
Mo',' lun I'll Aug Sep Ocl NO'I [)<;c 'OR Feb Mar Ap "'a'( Jun I'll .~ug Sep Ocl NO'I ;}H '09 Feb N.ar Ap
HSBC BANK
Account No.:
Condition:
Balance:
Type:
TransUnion
Experian
More about this account , Dispute
Equifax
Open
$232
Credit Card
1_.L..L__.-. f ,..___ __.- .....-........... ....._.......,.J.:+ ...............- 1___,...1.....,.",+.....1-.... ""_rYi"'Io I'Y r: 1"'10'1'1 TD t::'Io._"",-f ; r'I"'"
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
Page 3 of 13
Pay Status:
Current
1rar,sUnion
Legend
[1!3m:JrnJmJE!.Llm:JrnJmmmJmrnJrnJm3rnJ
Two Year Payment History:
bop Hia n
E.~uit.1X
Mar ,'Ip ',b'( hln I'll Au:;: Sop Oct "0'; uee '08 rob Mar ,~p 1",.( J'Jn I'JI Au:;: Sop Oct No',' Dee '09 fob
TransUnion
Experian
000629....
Open
$232
Credit Card
Current
More about this account I Dispute
Equifax
35000629....
Open
$232
Credit Card
Current
HSBC BANK
Account No.:
Condition:
Balance:
Type:
Pay Status:
Two Year Payment History:
Legend
Trans-Union
E:r:p.erian
m:JE!lJrnJrn:Jl!IImmm:Jl!IIm:Jl!IIrnJ!mrnrn[;1J
E,~u]aJt
l\p ?,la'( Jun I'll Au:;: Sep Oct Noy Dee '08 fob Mar Apr lila',' Jun I'll l\Ug Sep Ocl Noy Dec '09 Feb Mar
CREDIT ONE BANK More about this account I Dispute
TransUnion Experian Equifax
Account No.: ----"L '
Condition: Open Open Open
Balance: $282 $282 $282
Type: Credit Card Credit Card Credit Card
Pay Status: Current Current Current
Two Year Payment History: Legend
Expuian
l!IIml!IlmmmrnmmmmmmrnJmmm
l!IImmmmmmmmmmmmrnJmmmm
lransUnion
E,::;ul:u.
lila'j Jun I'll Aug Sep Oct No'; Gft '08 feb Mar Apr May l'Jn I'll Aug Sep Ocl Noy Du '09 Fob Mar Apr
Closed
$311
Credit Card
Current
Experian
. -
Closed
$311
Credit Card
Current
More about this account I Dispute
Equifax
APPLIED BANK
Account No.:
Condition:
Balance:
Type:
Pay Status:
TransUnion
~
EJtperian
Legend
mrn:Jmmrn:Jmmmmm:Jmmmm:Jmm
m:Jmmmmmmmmm:Jmmm:J[!]Jm:Jm
Two Year Payment History:
lrnnsUn;on
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Ma,' Jun I'll Au:;: Sop Oct Noy Dft '08 Feb Mar l\p May lun lul l\U:;: Sep Oct "0'; Jec '09 F,'b Mar API
TransUnion
Experian
-
More about this account I Dispute
Equifax
'I.. ~l -
Open
$385
Credit Card
Current
CAP ONE
Account No.:
Condition:
Balance:
Type:
Pay Status:
Open
$385
Credit Card
Current
Open
$385
Credit Card
Current
Two Year Payment History:
Legend
mrnJmmrnJmmrnJmrnJmmrn:JmmrnJrnJ
mmmmrn:JrnJmrnJrnJrnJmmrnJmrn:JrnJrnJm
lransUnio!1
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
Page 4 of 13
t~uil3X
N.ar Ap .'kl'; jun lill "\lI~ Sep Oct No',' DEe '08 feb M;Jr Asr M<I'( jurI h.d ,~,Llg Sep Oct Na'l D€'c '09 F('b
IMAGINE/FBOFD More about this account I Dispute
TransUnion Experian Equifax
Account No.: ~'v_v .J.
Condition: Open Open Open
Balance: $497 $497 $497
Type: Credit Card Credit Card Credit Card
Pay Status: Current Current Current
Two Year Payment History: Legend
TransUnion m m [iJ] l!l3 [iJ] m [iJ] [iJ] [iJ] [!!J [!l] m [iJ] [!l] [iJ] [iJ] m m rn:J
~~n [iJ][iJ][iJ][iJ][iJ][iJ][iJ][iJ][iJ][!!J[iJ][iJ][iJ][iJ][!!Jmm[iJ][iJ][iJ]
tQuilax
,~p Ma'; JlW 1,-,1 Au:;, Sep Ocl Na'l Gre '08 Feb ,v,ar Apr '''a'; J'-'n I'll -',ug Sep Ocl Na'l Gte '09 Feb IV,ar
Account No.:
Condition:
Balance:
Type:
Pay Status:
TransUnion
_ ,___vvv 1
Open
$355
Credit Card
Current
Experian
More about this account I Dispute
Equifax
HSBC BANK
Two Year Payment History:
Legend
lrans-Union
mmmm[iJ]mmmmm[iJ]mrn:J[iJ]mmmmm[iJ]
EJCpuian
EquibK
Mar .l\~.r Ma',' jun IIJI ~\ug Sep Oct No',' Dee 'OB Fc.b Mar ;'\;:,1 May J~n I~I J\ug Sep Oct No'_" VEC '09 f('b
TransUnion
Experian
501509....
Open
$355
Credit Card
Current
More about this account I Dispute
Equifax
25501509....
Open
$355
Credit Card
Current
HSBC BANK
Account No.:
Condition:
Balance:
Type:
Pay Status:
Two Year Payment History:
Legend
lransUnion
hpuian
EquifaK
mmmmm[iJ]m[iJ]mmmmmm[iJ]m[iJ]m[iJ]mm
-',p'lla'; Jen i'll Aug Sep Ocl NO'I GEe '08 Fcb N,ar A;:r 'Ila'; Jun I~I Aug Sep Ocl Na'I OH '09 Fob :V,ar
Account No.:
Condition:
Balance:
Type:
Pay Status:
TransUnion
T
Open
$138
Credit Card
Current
Experian
~ Ii..
Open
$138
Credit Card
Current
More about this account I Dispute
Equifax
--
Open
$138
Credit Card
Current
~
FIRST PREMIER BANK
Two Year Payment History: Legend
TransUnion [iJ] m m [iJ] [iJ] [iJ] [iJ] [iJ] [iJ] [iJ] [iJ] m [iJ] m m m rn:J m m l!IJ [iJ] m
~~n mmmm[iJ]m[iJ]m:Jmmmmmmmmm[iJ]~[iJ]~~~
L~ultll
Ma'; Jcn lul ,~ug Sep Oct No',' Dre '08 Feb Mar As.' Ma', Jcn I'll Aug Sep Ocl NOI' DH '09 FE'b Mar Ap
l......._~.lln_._H ~_.~~_~~:~ ~~~/__~~..~~~/~~_~~/..:~'HD~_~.... :~_
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
Page 5 of 13
Find the Credit Card for Your Credit Score Using Reviews & Recommendations
Installment Accounts: Accounts comprised of fixed terms with regular payments
Auto Loan
Current
More about this account I Dispute
Equifax
....
Closed (Paid)
$0
Auto Loan
Current
WESTLAKEFI
Account No.:
Condition:
Balance:
Type:
Pay Status:
TransUnion
--
Closed
$0
Auto Loan
Current
Experian
" -
Closed (Paid)
Two Year Payment History:
TransUn;o]n [iD rn3 m rn:J m [iD m3 [!l3 rnJ mJ rnJ
ExpHian m l'.!IJ m l'.!IJ m 1m 1m 1m 1m 1m 1m m:J m:J rn::J m:J
Legend
EQu:tax
F(.b Mar Ap Mo'; J'Jn lul Aug 5ep Oct NO'I DEe '07 F(.b ,V.ar Apr M"; Jun lul Au:: 5ep Ocl Noy DEe 'OS
TransUnion
Experian
More about this account I Dispute
Equifllx
1448....
Derogatory
$291
Collection
Late 120 Days
NCO FIN/22
Account No.:
Condition:
Balance:
Type:
Pay Status:
Two Year Payment History:
Legend
TransUnion
ExpHia n
Equifax
Jun lul ,\ug Sep Oel Noy D€e '06 Feb iV.ar Apr M;l'; l'~n lul Au:: Sep Ocl NO'1 GEe '07 Feb Mar Apr "'a';
Other Accounts: Accounts in which the exact cateqory is unknown
None Reported
Collection Accounts: Accounts seriously past due
TransUnion
Experian
Equifax
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
108364....
Individual
Derogatory
$508
$508
12/2008
03/2009
Remarks:
[TransUnion]
[Experian]
[Equifax] Medical
Subject has not satisfied debt.
KANSAS COUNSELORS
TransUnion
Experian
.KANSA~SELORS
EMERGENCY PHYS OF
NAPLES
Individual
Derogatory
$275
Equifllx
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
k++_c.... /1.....ru.rn.T .............o,.......o...-t;+ ,.....nml1'...u~^rtn,....tco/'I"'n.&Jr.....nO';.";,:::Jr..n.TD A"'i"'\rt len
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
Page 6 of 13
Balance:
Date Opened:
Date Reported:
$275
06/2008
02/28/2009
Remarks:
[TransUnion]
[Experian]
[Equifax]
KANSAS COUNSELORS
TransUnion
Experian
KANSAS COUNSELORS
EMERGENCt~HYS OF
NAPLES
Individual
Derogatory
$115
$115
06/2008
02/28/2009
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
Remarks:
[TransUnion]
[Experian]
[Equifax]
TransUnion
Experian
PROFESSIONAL ADJMNT
CO
-
NAPLES RADIOLOGISTS
Individual
Derogatory
$30
$30
OS/2008
08/21/2008
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
Remarks:
[TransUnion]
[Experian]
[Equifax] Medical
Subject has not satisfied debt.
KANSAS COUNSELORS
TransUnion
EKperian
KANSAS COUNSELORS
EMERGENCY PHYS OF
NAPLES
Individual
Derogatory
$178
$178
OS/2008
02/28/2009
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
Remarks:
[TransUnion]
[Experian]
[Equifax]
KANSAS COUNSELORS
1_ ..oI........L__ _ _ 11__ __ ___ ....._ _ _ ____ ..J:... _ ~ ___ I___~ ....:Iw~ ~...~ ,___ ......__......1_7: .............. ~n........_.......-+. =...._
Equifax
Equif8X
8516'.
Individual
Derogatory
$30
$30
OS/2008
04/2009
Equif8X
A /1 ,,/"){){)O
Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
Page 7 of 13
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
Remarks:
[TransUnion]
[Experian]
[Equifax]
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
TransUnion
TransUnion
Remarks:
[TransUnion]
[Experian]
[Equifax] Medical
Subject has not satisfied debt.
NCO FIN/22
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
TrilnsUnion
NCO FIN122
NCO ASGNE OF EMBARQ
Individual
Paid
$225
01/10/2007
06/09/2007
Remarks:
[TransUnion] Chapter 7 bankruptcy
[Experian]
[Equifax]
COLLECTION
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
TransUnion
COLLECTION
~
06 PROGRESSIVE
INSURANCE COMPANY
Individual
Derogatory
$268
$268
11/22/2005
06/18/2007
Remarks:
[TransUnion] Placed for collection
Experian
KANSAS COUNSELORS
,_ _ 1
EMERGENCY PHYS OF
NAPLES
Individual
Derogatory
$255
$255
OS/2008
02/28/2009
Experian
PROFESSIONAL ADJMNT
CO
--
NAPLES RADIOLOGISTS
Individual
Derogatory
$30
$30
04/2008
08/21/2008
Experian
Experian
J...U_I"I./I'Il..........."...T +-....n,.........a.rl~+ nA-r'V'\ 1..........r.rh..r...tco/rna....oa/"'T;a''J:TD ~1"'\Arl ;con
Equifax
Equifilx
8394..
Individual
Derogatory
$30
$30
04/2008
04/2009
Equifax
Equifax
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
Page 8 of 13
[Experian]
[Equifax]
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
TransUnion Experian
ALLIED INT ALLIED INTERSTATE INC
~ ~**
EMBARO CORPORATION EMBARO CORPORATION
Individual Individual
Paid Derogatory
$225 $225
$0
01/21/2005 01/2005
05/31/2006 09/26/2005
Remarks:
[TransUnion] Chapter 7 bankruptcy
[Experian] Debt included in or discharged through Bankruptcy Chapter 7,11, or 12.
[Equifax] Subject has not satisfied debt.
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
Remarks:
[TransUnion]
[Experian]
[Equifax] Medical
Subject has not satisfied debt.
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
Remarks:
[TransUnion]
[Experian]
[Equifax] Medical
Subject has not satisfied debt.
TransUnion
Experian
TransUnion
EKperian
PROFESSIONAL ADJMNT CO
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Equifax
...
EMBARO CORPORAT
Individual
Derogatory
$225
$225
01/2005
06/2006
Equifax
-.
Individual
Derogatory
$258
$258
08/2004
06/2005
Equifax
Individual
Derogatory
$7835
$7835
08/2003
06/2005
Experian Equifax
PROFESSIONAL ADJMNT
CO
-
CUSTOM WATER SYSTEM
Individual
Derogatory
$156
$0
TransUnion
t..++_..... I IT"fIi T"I"T ,....... T f.-. ...0."......0.,.1;+ ......",...--I_'9"i""\rl'llni-("I/ma....na/"l710'l"'lTD a......n-rt 1 <:"1"\
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
Page 9 of 13
Date Opened:
Date Reported:
08/2003
09/26/2005
Remarks:
[TransUnion]
[Experian] Debt included in or discharged through Bankruptcy Chapter 7,11, or 12.
[Equifax]
TrilnsUnion
Experian
Equifax
Creditor Name:
Account No.:
Original Creditor:
Responsibility:
Condition:
Original Balance:
Balance:
Date Opened:
Date Reported:
-
Individual
Derogatory
$270
$270
04/2003
12/2004
Remarks:
[TransUnion]
[Experian]
[Equifax] Medical
Subject has not satisfied debt.
A Credit Card for those with less than perfect Credit!
PUBLIC INFORMATION
?
Tax Lien
Dispute
TransUnion
Experian Equifax
Federal Tax Lien
Filed
08/10/2005
Individual
BK3864PG3556SQ36763
COLLIER COUNTY CIVIL C
$10582
Type:
Status:
Date Filed/Reported:
How Filed:
Reference #:
Released Date:
Court:
Amount Owed:
Remarks:
[TransUnion]
[Experian]
[Equifax]
Tax Lien
Dispute
Type:
Status:
Date Filed/Reported:
How Filed:
Reference #:
Released Date:
Court:
Amount Owed:
TnmsUnion
Federal Tax Lien
Filed
08/10/2005
Individual
3676342
Experian
Equifax
Recorder Of Deeds
$10582
Remarks:
[TransUnion]
[Experian]
[Equifax]
L.........__..II...____"'~ ...-.~............_..........J:+ ..............-....I__.......-l"A+n/..-,...,.....~J':"Io/,T;~'...TDo~r'\.,..... ~C".,.....
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
Bankruptcy
Type:
Status:
Date Filed/Reported:
How Filed:
Reference #:
Closing Date:
Court:
Liability:
Exempt Amount:
Asset Amount:
Remarks:
[TransUnion]
[Experian]
[Equifax]
INQUIRIES
Creditor Name
CIT BANKlDFS
CHASE
GEMB/LOWE
TNBTGTVISA
TnmsUnion
Chapter 7 Bankruptcy
Discharged
06/07/2005
Individual
-
09/26/2005
Federal District
$0
$0
?
Dispute
EKperian
Chapter 7 Bankruptcy
Discharged
06/07/2005
Individual
EquifaK
09/26/2005
US BKPT CT FL TAMPA
$0
$0
Date of Inquiry
01/05/2009
Credit Bureau
Experian
09/30/2008
Equifax
08/23/2008
Equifax
08/2312008
TransUnion
FIDELITY INFO CORP
...............................................................................................................,.........................................................,........,......
08/11/2008
Equifax
08/20/2008
Experian
...................................................................................................................,.....................................................................
HSBC/BSBUY
.........................................,........
VERIZON WIRELESS
AT&T-WS
COMCAST
07/28/2008
Experian
07/14/2008
Equifax
07/09/2008
Equifax
................................................... ................. ...............................................................................................
02/28/2008
TransUnion
SEARS/CBSD
04/25/2008
Equifax
..................................................................... ......,........'...................,...........,................................................,.,................
WACHOVIA
...................,.............................................................................................. .................. ..................................
01/17/2008
Experian
FNB OMAHA
WASH MUTUALlPROVIDIAN
1ST PREMIER
01/24/2008
Experian
...................................................................... ..................................................................................................................
01/03/2008
TransUnion
CONRAD COMPA 12/20/2007 TransUnion
.........................................................................................................................................................................................
FIRST EQUITY CARDITSYS 11/21/2007 Experian
.. ................ ........ ... ...... ................ ..... ....... ... .... .... ........ ................ ... ..... . ........... ..... ................... ............... ..... ...........
HSBC BANK 11/19/2007 Experian
APPLIED BANK
CREDIT ONE BANK
CAP ONE
CAP ONE
CAP ONE
IMAG/FBOFD
HSBC NV
CONRAD CR CO
HSBC NV
CASH CALL INC
CREDITOR CONTACTS ?
Creditor Name
ALLIED INTERSTATE
,.,
11/14/2007
Experian
10/29/2007
Experian
09/20/2007
Experian
09/20/2007
Equifax
09/20/2007
TransUnion
08/10/2007
Equifax
08/09/2007
Experian
07/24/2007 TransUnion
07/06/2007 Experian
OS/22/2007
Experian
Address
3000 CORPORATE EXC
COLUMBUS. OH 43231
Phone Number
(336) 333-3100
.<-/
._ _ '-_~____n_____....... ~___
Page 10 of 13
II '1 ~ '''''\A()
Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
ALLIED INTERSTATE INC
(336) 333-3100
435 FORD RD 800
MINNEAPOLIS, MN 55426
......................................................... .................. ........................"................................. "............................................,
601 DELAWARE AVE
WILMINGTON, DE 19801
................ .. . .............................................
601 DELAWARE AVE
WILMINGTON, DE 19801
.... ..................... .... .......... ......... ,... .............., ,- ...', ........ ... ................... ... ,... ...... ............, ... '" ..........." ,.. ........ ..... .... ..-............
4700 EXCHANGE COUR
BOCA RATON, FL 33431
............................. ................................... ..................................................................................................................
PO BOX 85520 BY MAIL ONLY
RICHMOND, VA 23285
.... ..... ..... .... ............. ....... .... .. ..... .....-
1500 CAPITAL ONE DRIVE
RICHMOND, VA 23285
...................,.....,.....,.........................-..........................................................,..............,.....................................................
CAPITAL ONE BANK USA NA PO BOX 30281 (800) 955-7070
SALT LAKE CITY, UT 84130
............................................. .................................................... ................... .................. ................
POB 30281
SALT LAKE CITY, UT 84130
... ... ..... ........ .... ............ ............. ..... ........ ... .................. ................... ...... .... ...... .... ......
1600 S DOUGLASS RD
ANAHEIM, CA 92806
...................................................................................,.....................................................................................................
CIT BANKlDFS 12234 N IH 35 SB B (800) 283-2210
AUSTIN, TX 78753
.......................................
3301 TAMIAMI TRL L 6
NAPLES, FL 34101
.......................................
3301 TAMIAMI TRL
NAPLES, FL 34112
.........................................................................................................................................................................................
CONRAD COMPANIES 476 W VERMONT A
ESCONDIDO , CA 92025
. .. ........... ..... ..... .... ....... ... ......... . ....... ........ . . ..-. ...... .............. .... ........
476 WVERMONT AVE
ESCONDIDO , CA 92025
........................................................................................................
PO BOX 9134 (877) 289-0281
NEEDHAM, MA 02494
.........................................................................................................................................................................................
CREDIT ONE BANK PO BOX 98875 (702) 269-1000
LAS VEGAS, NV 89193
... ................ ....... ..... ...... ...... ....... .... ............ ........ .... .... ................... ...... ...... ... .......................... ......... ...............................
PO BOX 98872 (877) 825-3242
LAS VEGAS, NV 89193
.........................................................................................................................................................................................
FIDELITY INFO CORP 11990 SAN VICENTE BLVD (310) 573-9944
LOS ANGELES, CA 90049
..................................................................................................................................... ...................................................
FIRST EQUITY CARDfTSYS PO BOX 84075
COLUMBUS, GA 31908
.... .... ....... ....... ...................... ... ..... ............ .... ......................... ...... .... ...............
FIRST PREMIER BANK 601 S MINNESOTA AVE
SIOUX FALLS, SD 57104
.........................................................................................................................................................................................
FIRST PREMIER BANK 900 W DELAWARE PO BOX 5114 (605) 357-3440
SIOUX FALLS, SD 57117
. ... ............. ....... ............. ........... ............................... .... ................ ......... .......... ..... ... ............. ....... ... .... ....... ...... ...................
FIRST PREMIER BANK 3820 N LOUISE AVE
SIOUX FALLS, SD 57104
. . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. ..................................................... ........... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .
801 N FLORIDA AVE 727
TAMPA, FL 33634
.....................................................................................................................................................................................-...
FNB OMAHA 1620 DODGE ST BY MAIL ONLY
OMAHA, NE 68197
.............................. ............................... ......................................... .................................................................................
PO BOX 5253 (800) 477-6000
CAROL STREAM, IL 60197
... ............. ............... .... .... ............... ............ ............................ .... ...
PO BOX 19360
PORTLAND, OR 97280
.........................................................................................................................................................................................
HSBC BANK PO BOX 5253 (800) 477.6000
CAROL STREAM, IL 60197
.......... ... ......,.... ........ ......... ....... .................. .... .............. ............................. ..... ....... ............... ............. ..... ......... ... ...............
HSBC NV PO BOX 19360 BY MAIL ONLY
PORTLAND, OR 97280
..................... ................. .................................................................. ...................................
IMAGINE/FBOFD 6 CONCOURSE PKWY 2 (770) 206-6200
.................................................................................... ~ T0~!.~~ .9.~. .~.~.3.2.8..................................................................
Imagine/First Bank of De POB 105555 (800) 348-8783
A TLANT A , GA 30348
. ...... ......... ............................ .... ..' ..... ...... ... ..... ........ ... .. ... ....... ..... ... ........
PO BOX 14765
SHAWNEE MISSION, KS 66285
.... .............................. ....................................... .........
POB 41448 (800) 273.6816
PHILADELPHIA, PA 19101
APPLIED BANK
BY MAIL ONLY
APPLIED BANK
(302) 467-4600
APPLIED BANK
CAP ONE
CAP ONE
(804) 934-2025
CAPITAL ONE BANK USA NA
(800) 955-7070
CASHCALL INC
BY MAIL ONLY
....... ..........
COLLIER COUNTY CIRCUIT C
(941) 774-8800
COLLIER COUNTY CIVIL C
BY MAIL ONLY
CONRAD CREDIT CORP
(619) 735-5000
CREDIT COLLECTION SERVIC
CREDIT ONE BANK
(866) 518-4716
(605) 357-3440
FLORIDA FEDERAL COURT -
(813) 301-5065
HSBC BANK
HSBC BANK
KANSAS COUNSELORS
(913) 541-9925
NCO / NCO PORTFOLIO FUND
PROFESSIONAL ADJMNT CO
14410 METROPOLIS AVE (239) 437-0525
FORT MYERS, FL 33912
................................................... ....................................................
POBOX 9475 MAIL 2BD
MINNEAPOLIS, MN 55440
TARGET NATIONAL BANK
1 "
II. __ ____ ...L._ _ _ __~_ ..J~4-- _ _ ~_ ,~_~ ...J~~ ~...~ 1---. .....__.....I_~: .......... Tn ....._.....--4- :....._
Page 11 of 13
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
TARGET NATIONAL BANK
PO BOX 673
MINNEAPOLIS, MN 55440
..................... ................
PO BOX 673 BY MAIL ONLY
MINNEAPOLIS, MN 55440
.................................................... ............................
711 N TAMPANIA AVE BY MAIL ONLY
TAMPA, FL 33609
.................,............ ....". . ,.. ...........,. ... ............, ..... ..........
2000 CORPORATE DR (800) 723-9195
ORANGEBURG, NY 10962
... ... ......................, .... ..... ...... .....
POBOX 13327
ROANOKE, VA 24040
'" '.. ........ ." ." ... ........... ...... .....,..... .... ........ ,.... ..................
PO BOX 660509 (925) 416-5000
DALLAS, TX 75266
... ... ............. ............... ...... .......................... ... ......... "" ...... ..........
4751 WILSHIRE BVLD (323) 692.8800
LOS ANGELES, CA 90010
..........-.............................-.......... ................ ..................
4751 WILSHIRE BLVD (323) 692-8800
LOS ANGELES, CA 90010
TNB - TARGET
US BKPT CT FL TAMPA
VERIZON WIRELESS
WACHOVIA
WASH MUTUAUPROVIDIAN
WESTLAKE FINANCIAL SERVI
WESTLAKE FINANCIAL SVC
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Page 12 of 13
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Credit Scoring, Online Credit Checks & ID Fraud-Watch - TrueCredit Services
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1.."-'-_.11_______ ...~.~~_~...I:... ~~_I__~...In~"'~ I_~__~ 1..:~n.T>~_~..... :~_
All /;./'){)f'\{)
Electronic Articles of Organization
For
Florida Limited Liability Company
Article I
The name of the Limited Liability Company is:
EXODUS LIMOUSINE AND TRANSPORT, LLC
L09000031290
FILED 8:00 AM
March 3112009
Sec. Of Slate
btadlock
Article II
The street address of the principal office of the Limited Liability Company is:
4400 GULF SHORE BLVD. N
#603
NAPLES, FL. US 34103
The mailing address of the Limited Liability Company is:
4400 GULF SHORE BLVD. N
#603
NAPLES, FL. US 34103
Article III
The purpose for which this Liniited Liability Company is organized is:
ANY AND ALL LAWFUL BUSINESS.
Article IV
The name and Florida street address of the registered agent is:
MICHAEL T SKROBECK
4400 GULF SHORE BLVD. N
#603
NAPLES, FL. 34103
Having been named as registered agent and to accept service of process
for the above stated limited liability company at the place designated
in this certificate, I hereby accept the appointment as registered agent
and agree to act in this capacity. I further agree to comply with the
provisions of all statutes relating to the proper and complete performance
of my duties, and I am familiar with and accept the obligations of my
position as registered agent.
Registered Agent Signature: MICHAEL T. SKROBECK
Article V
The name and address of managing members/managers are:
Title: MGR
MICHAEL T SKROBECK
4400 GULF SHORE BLVD. N
NAPLES, FL. 34103 US
Article VI
The effective date for this Limited Liability Company shall be:
03/25/2009
Signature of member or an authorized representative of a member
Signature: MICHAEL T. SKROBECK
L09000031290
FILED 8:00 AM
March 3112009
Sec. Of Slate
btadlock
State of Florida
Department of State
I certify from the records of this office that EXODUS LIMOUSINE
AND TRANSPORT, LLC is a limited liability company organized
under the laws of the State of Florida, filed on March 31, 2009, effective
March 25,2009.
The document number of this limited liability company IS
L09000031290.
I further certify that said limited liability company has paid all fees due
this office through December 31, 2009, and its status is active.
I further certify that said limited liability company has not filed Articles
of Dissolution.
Given under my hand and the Great Seal of
Florida, at Tallahassee, the Capital, this the Ninth
day of April,2009
~u
Secretary of State
Authentication ID: 900149317539-040909-L09000031290
To authenticate this certificate,visit the following site, enter this
ID, and then follow the instructions displayed.
https://efile.sunbiz.org/certauthver.html
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SECfION 316.613, Florida Statutes, requires every operator of a motor vehicle while
transporting a child in a passenger car, van or pickup truck registered in this state and
operated on the highways of this state, shall, if the child is 5 years of age or younger,
provide for protection of the child by properly using a crash-tested, federally approved child
restraint device. For children aged through 3 years, such restraint device must be a separate
carrier or a vehicle manufacturer's integrated child seat, for children aged 4 through 5 years,
a separate carrier or seat belt may be used.
L.
..J
SECfION 627.733, Florida Statutes, requires mandatory Florida No-Fault Insurance to
be maintained continuously throughout the entire registration period; failure to maintain the
required coverage could result in suspension of your driver license and registration.
Mail To:
EXODUS LIMOUSINE AND TRANSPORT LLC, MICHAEL
TODD SKROBECK
PO BOX 12096
NAPLES, FL 34101
Important note: If you cancel the insurance for this vehicle,
immediately return the license plate from this registration to a Florida
driver license or tax collector office or mail it to: Dept. of Highway
Safety, Return Tags, 2900 Apalachee Parkway, Tallahassee, Fl... 32399.
Surrendering the plate will prevent your driving privilege from being
suspended.
(R/MK 2oo7/LINC BODY 40
fIN 1 LNHM84W87Y61 0028
'late Type WHR NET WT 3800
COLOR
TITLE
BlK
102360993
Reg. Tax
Init. Reg.
County Fee
Mail Fee
Sales Tax
Voluntary Fees
Grand Total
T# 578336191
B# 1427583
73.35 Class Code C~
Tax Months
2.50 Back Tax Mos
Credit Class
Credit Months
75.85
COIAGY 64 I 1
FLORIDA VEillCLE REGISTRATION
>LA TE
WGD8V
DECAL 18996074
Expires Midnight Mon 8/31/2009
)UfEID 352361908-01
)ate Issued 4n/2009 Plate Issued 4f7/2009
2ND DL# S612558680420
--
:XODUS LIMOUSINE AND TRANSPORT llC, MICHAEL
.000 SKROBECK
'0 BOX 12096
IAPLES, FL 34101
IMPORTANT INFORMATION
1. The Florida license plate must remain with the registrant upon sale of vehicle.
2. The registration must be delivered to a Tax Collector or Tag Agent for transfer to
replacement vehicle.
3. The registration must be surrendered when requesting a change of address.
4. Registration renewals are the responsibility of the registrant and shall occur during
the 3D-day period prior to the expiration date shown on this registration. Renewal
notices are provided as a courtesy and are not required for renewal purposes.
IHR. PROTECT FLORIDA WHALES PLATE ISSUED X
04/28/2009 22:05
A...~~bO CERTIFICATE OF LIABILITY INSURANCE 1- DAT~~g~riv)- i
I ""'DUC," EDP'~D"";"~"", · Fi;S.~. I"" ~ ----, . THI5 CE"TlFIe"IE IS ISOUE.D AS A M. A TIER OF INFORMATION I
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
1924 Santa Barbara Blvd #2 I HOLDER.. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Naples, FL 34116' I..--.A!"IER THE CO~RAGE AFFORDED BY THE POUCIES BEl.OW. ,
Pho~a (239)331-7141 Fax (866)504-7135 INSURERS AFFORDING COVERAGE "lNAIC#,
IINSURERA:~'First co.m_~erclal Tr~nsportation & Pro~ ~ ----i
INSURED Exodus Umousine and Transport, LLC ~ I - 1
PO Box 12096 I:~:~::;~~"-' ..- '-- E' '-l
Naples, FL34101- I
1(239~919-4396 _oo ::~~:~:~~oo oo. --~ - -.:J
COVERAGES
THe POLICIES OF INSURANCE LISTED HAVe BEEN ISSUED TO THE iNSURED NAMED ABOVl; fOR' THE POLICY PERIOD INDiCATED. . NOlWITHSTANDING' '-1
ANY REQUIREME",'T, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR J
. MAY PERTAIN. Tl-tE INSUAANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDmONS OF SUCH
r POLICIES, AGGREGATE UMITS SHOWN MAY HAVE B.E EN REDUCED BY PAID CLAIMS.
'i~i,~' .~,::",::::.;,..c, . l ~NU.~~r.~II.~~~~b~ EACHOCCUR~lTS. I" , -~.
[J COMMERCIAL GENERAL LIABILITY : I DAMAGE TO"RENTED - I ,.-
I .PR.5MISES (~ occurren"",) -L- ...-
. ! U L-' CLAIMS MADE D OCCUR MED EXP (Any oneper60n) ----L..-- .._
,......,
; ! '! ! PERSONA~ & ADV INJURY I "_.
::J I GENERALAGGR.l:GAa
i GION'L AGGREGATE LIMIT APPLIES PER: L1PR.OP. .~.UCTS - C()M. P.oo.f.O.,P AGO . _oo~ ....--J.
~.. ... il POU~ n PROJECT [i LOC .-J
I: AUTOMOBD..E LIABILITY Ii! COMBINED SINGLE LIMIT / / '
I I n ANY AUTO I' II 03/3112009 03/31/2010 (E'I~d""t) _
! ,0 AU OWNED AUTOS L- / 8~DIL Y I.NJU~Y'OO -. I / $12'5000
' A 0 'I' lid SCHEDULED AUTOS (Per person) -1.1...
~ D HIREDAlJTOS Ii BODIL~.lI~JURY - I. $3000~
r I NON OWNED AUTOS , (Per =dent) (
. R rp~O-~ERTY DAMAGE \ . -mOOOO
'! GARAG'l"""Lln' I'r.;~:,. "'AccmT'''--;
, n I I AJ<Y AUTO ! Orn'R mAN .EA W: . ~"":":"-l
'0 , AUTO ONLY: .. ._AGG I _ ..
i EXCESS I UM8RELLA ..lABILITY I EACH OOOURRENCE
o OCCUR U CLAIMS MADE AGGREGATE
I ; I
n DeDUCTIBLE L I ~- .-. ,
, 0 RETENTION $ -.- 'j
i WORKERS COMPENSAiJON AND . - .. 0 0 .-;
I .., I we STATU-" OTH-
, EMPLOYER-S'LIABILITY YIN : . TORY UMrr~ER . .. __'
OFFICER/MEMBeR exCLUDED? ~ t . . .
(Mandatory in NH) E.L DISEASE. lOA EMPLOYEE
If yes. describe under "'_ .oo
_ SPECIAL PROVISIONS belOW . .., . i E.L DISEASE - POUCY LIMIT
IOTHEr- ... . . . '.oo .. J ..._-
, DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCL.USIONS AOOE:D BY ENOORS~Mr;NT / SP~CIAL PROVISIONS
2007 Lincolnrrown Car VIN: 1LNHM84W87Y610028 _/
Coli Ded $1000 IComp Oed: $1000
2393317135
EPPERSON INSURANCE
PAGE
01/01
J
CERTIFICATE. HOLDER
CANCELLATION
. """"-"..;.,. OF "'" ..",;. .'."'m'D POu~1ES Be CANCB.Leo oem";; "" I
! - EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
DAY5 WRITTEN NOTICE TO THE CeRTIFICATE HOLDER NAMED TO
THE' lEFT, BUT FAILURe TO DO 50 SHALL IMPOSE NO OBLIGATION OR UABILlTY
, OF ANY KIND UPON TlU! INSURER. ITS AGENTS OR REPRESENTATIVI:5. ,
i- AUTHORIZIm REPRESENTATIVE
I
Callier County Board of Commis$ione~
2800 N Horseshoe DR
Naples, FL 34106
I
ACORD 25 (2009/01) QF ...
--A~ ~ I
", .. ....-..oo-
@1988-2009ACORD CORPORATION. All righis reserved_
The ACORD name and logo are registered ma~ of ACORD
AFFIDAVIT
Before me this day personally appeared M 1< hCLe \ ,.. 5KR~E.C...~ who swears or affirms
that the vehicle(s) to be permitted meet(s) the safety standards as set forth in Code of Laws
and Ordinance Chapter 142.
It is understood and aclmowledged by the Code Enforcement Department and myself that if
my vehicle(s) that is/ are permitted fail(s) to meet(s) the safety standards as required by this
Ordinance, the vehicle(s) must be removed from service until all violations are corrected.
BUSINESSNAME EXODUS \....\Ynou.s~V\.~ ~",J.. \~~"'o.,.+- L-LC..
SIGNATURE OF APPLICANT ~Z---- ~ ---
DATE LI - III - 0 cr
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and sworn to before me this ,.{ day of .~ '
M i C ht1 e-{ 5 I( (oh,- 0k
Name of person aclmowledging)
D(\U(~) t ':(('1- s e.. as identification and who did.
7_~ V,r<1 f!/u1
20oj" by
(
who is personally lmown or has
produced
/2/
SIGNATURE OF NOTARY
PRINT NAME OF NOTARY
NOTARY PUBLIC COMMISSION #
D\)b1/ ~D7
NOTARY'S SEAL
~~y ~j>~
~ ~
~,,~~
("or 1\.1>"
(407) 398-0153
VIRAL PATEL
MY COMMISSION II 1)O697~87
EX I'IIU is: Jul)' 22.2011
Flot1da Notary SlIYIo..oom
COMMISSION EXPIRES:
(Tif,
J
J))
...J-c (I
4
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
provisions.
~ :;J
(Signature of Applicant)
I fill c.~4.e.' T. ~\<\~03E.C\<. swear or affIrm that all information on this Application
for Certificate to Operate is true.
~~~
(Signature of Applicant)
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was subscribed and sworn to before me this
By tv~ ((. k ~ </( 5 k. fe. h uk
(Name of person acknowledging)
who has produced
tJ" ('-I, c) C;
L (Date)
Or,~ ;( e..-. 5 c...
(Type of identification)
As identification and who did take an oath.
?/)/~
l/vtt I !;f/
Print of Notary
Signature of Notary
NOTARY'S SEAL
Notary Public Commission #
121) 61 7 5 K 7
~~"1I~
~~..
"'1"l'OFl\~~
(407) 398.0' 53
VIRAL PATEL
MY COMMISSION I; l)D697~87
I!XI'IIW~: Jul}' 22. 2011
Florida NoIaIY 8wouom
Commission Expires
zfu0
)J
Jt.i il
5
COLLIER COUNTY GOVERNMENT
CRIMINAL IDSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date:
Pursuant to provisions of Chapter 119, F. S., and procedures outlined under Rule
Chapter lIC-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
Name: r11.c,h.o...e.l
First
To olcl
Middle (full)
SKRof3&K.
Last
Maiden
Address:
fO. r,o)O 1 ~ 0 q C.
(Number & Street)
NAP~~S
(City)
FL)
(State)
3'flol
(Zip Code)
Social Security No.:
DL No.: S' 1.<. - S'S8 -c, 8 - O'-l c2.- 0
DOB: .2 -.2 -" 8
Sex: f\1.
Age: ~
Race: W
( ",
Height: 5 f 0 Weight: ) <t S' lbs.
Eye: G-rf\J
(Color)
Hair: b r- WI'\..
(Color)
Name:
DOB:
Sex:
Last Maiden
City State Zip Code
DL No.:
Age: _ Race:
Eye: Hair:
(Color) (Color)
First
Middle (full)
Address:
Number & Street
Social Security No.:
Height:
Weight:
lbs.
t~~~_____~~.:~ ~-_.!---~CONSENTANDDfSC[----..._-_.._._---
DATE LOCATION ~~ ~ . .....~.P.
/
I understand that Collier County Code Enforcement will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New
York, NY 10011, as part of the procedure for processing my PVAC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further infOlTnation through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id.
I understand a consumer reporting agency's investigation may include obtaining infolTnation covering up to the last seven (7) years regarding, among
other items, references, character, driving record, past employment, work habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and federal law. The investigation also may include obtaining infolTnation relating to criminal records without
any time limitations, subject to state and federal law.
In the event an investigative consumer report is conducted, I understand such infolTnation may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge conceming my character, general reputation, personal
characteristics or standard of living. I understand such infolTnation may also be obtained through direct or indirect contact with former employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
a By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act.
I also understand that before my application is denied based, in whole or part, on infolTnation obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the accuracy
of any information in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report. If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging information in the report, Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the infolTnation
contained in the report.
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
Driver's License No.
~~ L/-/tt-oq
s,,-;';:,t- ~.,; - D,t,
Minnesota & Oklahoma applicants Only: I have the right to request a copy of my consumer report frem Sterling Testing Systems, Inc. by
checking the box below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make
a written request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report.
IFILl
State
[flQ
State
a I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
fV"v \ c.. h. oJ!- ~ S kJ<clCS€c:. K I have read and understood the paragraph
4-1.$- oq
Date
Signature of applicant
.~".. :::;..
CgL.lie-r County
,- - --,.",. ",''''n._ . "_.~
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Change Returned:
Contact:
FEES:
Description
Certificate to Operate
Application
Cashier Name:
Batch Number:
levy_m
160
Development and Environmental Services
2800 Horseshoe Drive N
Naples. FL
34104
239-252-2400
RECEIPT OF PAYMENT
2009009641
2009-002144
04/17/2009
Cash
$200,00
$200,00
$0,00
Exodus Limousine and Transport, LLC
4400 Gulf Shore Blvd Unit 603
Naples, FL 34103
Reference Number Oriqinal
Fee
Amount
Paid
LCCT020090000357 $200.00
$200,00
Account
111-138911-321241
PrintResults
Page 1 of3
STERLING
DIRECT
Code Enforcement Div. Collier County
Order#: 9412610
Michael Skrobeck
PO#
Subject Profile
n.
Last Name Skrobeck
First Name Michael
-.-iiiiddi;.N.;;:;;;-.---------.-----------------.----...-.--1'---.-.----.-...-.--.----..--.--------.-----.-.---
Date of Birth (mmlddlyyyy) 02/02/1968
--~~~!:!~_.._-----------_.---------------------------_..-------.--.---------.....-....-------..-..--..-.--------------.--.,-.,.---...---------.-------
Projected Salary N/A
Job Stale
Current Address
.-Ad~..---_._---..-----------------...._._._..--....4400G~i~hO;;_BJ;d-.------------
Apartment Number 603
___.~_i!Y_.._.._...__.______.._._...._....._._______._______.._____.._ ..__....__....__._~~.P!~!__..___...._._.....____.__.__.._... _......__.._.__.._...___.___..._____...______.___.____
State FL
Zip 34103
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
Status
2 CLOSED
Findings
Alert
MOTOR VEHICLE REPORT (MVR)
1 CLOSED
See Results Below
SEXUAL OFFENDER DATABASE SEARCH
1 CLOSED
Clear
SOCIAL SECURITY TRACE SEARCH
1 CLOSED
CRIMINAL RECORD SEARCH
The criminal information reported on this website appears exactly as it is received from the local jurisdictions and may contain information
which would be prohibited for use in making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: Slate: NW Zip: County: NATIONWIOE
Status: CLOSED
FINDING: Alert
...................*...*..*.****-****-*-************.-*.*****************
. THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH N~D *
. HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
. CRIMINAL BACKGROUND RESEARCH METHODS.
***kk******.k.***********_***_._********_.**_*******_***k.*****_*_**.****
CRIMINAL HISTORY SEARCH INFORMATION
NAME ON COURT FILE: MICHAEL TODD SKROBECK
NAME GIVEN: MICHAEL T SKROBECK
AKA:
DATE OF BIRTH ON COURT FILE: 02/02/1968
DATE OF BIRTH GIVEN: 02/02/1968
SS ~ ON COURT FILE: NIA
SS ~ GIVEN: ###-##-####
IND #:
~I
DA~ 03/11/2001
---
/'
COUNTY: NATIONWIDE
STATE: NW
I
DOCKET # 1 CASE #: 01003558CO
ARREST /INCIDENT
CHARGES:
C09051 UNSPECIFIED OFFENSE MISDEMEANOR 2ND DEGREE
DISPOSITION DATE:
DISPOSITION:
ADJUDIC1'.TED GUILTY /DELINQUENT HT TITU rD'1'
SENTENCE INFORMATION:
SENTENCED IMPOSED DATE: 20010410
L.4-.t.__....._ 11_...1 _......_1~__ _+.....~.4-.:__ _ .....".--.1..............1-;];_..............+') 1_...........,..l+.,/n_~_+n ..............1+..... ............._.....0 ^ ..........t..;... T......-
A/'"){) I') {){)O
PrintResults
Page 2 of3
/--------------~
\
~I:NAL INfORMATION: /)
STATE CODE~N~~: LEE ~
OfFENSE CO~
REPORT GENERATED: MONDAY, APR 20 2009
City: Naples State: FL Zip: 34103 County: COLLIER
Status: CLOSED
FINDING: Clear
No criminal convictions found.
.---.
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - 88178
Order Date: 04/17/2009
Host Used: Online
Reference: 9412610_3
Period: THREE YEAR
License: S612558680420
Report Clear:NO
Name: SKROBECK, MICHAEL TODD
Address:
City, St:
As of:
Weight:
Height:
DOB
Iss Date: 11/04/2008
Exp Date: 02/02/2017
AGE:
Sex. :
Eyes:
Hair:
Year License First Issued: 01/19/1984
STATUS: SEE BELOW
MVR Score
SCORE:
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONY
ACD AVD V /C
DESCRIPTION
CONV OS/22/07 06/13/07 F04 EB02 407 SEAT BELT VIOLATION
LOCATION/DOCKET: COLLIER/6985EIM PTS:
Suspensions/Revocations
::.----
ORD/DATE
Eff/DATE
CLR/DATE
END/DATE
CODE
AVD
ACTIONS
NO ACTIVITY
License and Permit Information
License: PERSONAL Issue:11/04/200B Expire:02/02/2017 Stat
License Status Explanation: ELIGIBLE
C1ass:E REGULAR OPERATOR
ENDORSEMENT: MOTORCYCLE
License: IDENTIfICATION Issue:12/10/2003 Expire:02/02/2008 Status:EXPIRED
Miscellaneous State Data
** ENTRIES BELOW COVER THE PAST 3 YEARS **
MISC: EXAMS VISION~l ROAD SIGN=l ROAD RULES~l DRIVING~l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL~O
RECORD APPEARS IN THE NATIONAL DRIVER REGISTER
BLOCK PERSONAL INFORMATION **
BLOCK fOR MAILING LIST *.
THIS PERSON HAS A DIGITAL IMAGE
I fOR STATED BUSINESS
I PURPOSES ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
/
Issue Date:
/ /
Control Number: EOU9X5
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
State: FL
/
1_~_...... II........J ............._1;_ .............""",.........;_........ .....,....__I.......~.....1-..-1.:_...........-+-"} 1_......,..,.....l+,..,/U.....;_+D .....,..,.....1+.... ,.,.,..,_,.,.') ^ .........l-..~... 7.......-
A I") A I") AAO
PrintResults
Page 3 of3
Status: CLOSEO
............-....--......................-......-
FINDING: Clear
No Record Found
Back to Findings
--_._._~--_.
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
Social Security Trace ***
********************************************************************************
GENERATED: 04/17/2009 04:20:34 PM
TRANSACTION ID:0017036165-1511
1.
NAME
MICHAEL
SSN
###-##-####
TODD SKROBECK
VALID
YES
STATE ISSUED
FLORIDA
DOB
02/02/1968
DATE ISSUED
01/01/1984
FROM
PO BOX 12096 NAPLES, FL 34101-2096
1017 COOPER DR NAPLES, FL 34103-3834
1088 HOLLYGATE LN NAPLES, FL 34103-3847
06/1997
12/2004
04/2004
03/2009
08/2006
11/2004
2.
NAME
MICHAEL
SSN
###-##-####
SKROBECK
VALID
YES
STATE ISSUED
FLORIDA
DATE ISSUED
01/01/1984
ADDRESS
2425 14TH N ST NAPLES, FL 34103-4533
4400 GULF SHORE N BLVD NAPLES, FL 34103-2216
1472 MUREX DR NAPLES, FL 34102-5146
320 QUAIL FOREST BLVD NAPLES, FL 34105-5525
FROM
06/1996
11/2007
06/1995
03/1995
TO
12/2008
12/2008
06/1995
03/1995
3.
NAME
MICHAEL
SSN
###-##-####
T SKROBECK
VALID
YES
STATE ISSUED
FLORIDA
DATE ISSUED
01/01/1984
ADDRESS
5737 MANGO CIR NAPLES, FL 34110-3402
1239 COOPER DR NAPLES, FL 34103-3836
FROM
09/2008
03/2007
TO
09/2008
07/2007
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
++END OF NETWORK TRACE+*
___~?~~J.~U::~glr:!9.L._
Copyright Cl 2008 Ster1ing Infosystems, Inc.
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LCCT020090000358
JAQUELIN DIAZ
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
PUBLIC VEHICLE ADVISORY COMMITTEE
2800 NORTH HORSESHOE DRIVE
NAPLES, FL 34104
APPLICATION FOR CERTIFICATE TO OPERATE
DATE: L(I/710~
The undersigned hereby makes application for a Certificate to Operate vehicles "for hire" within
Collier County under Code of Laws and Ordinance Chapter 142, and respectfully submits the
following information in support of this application.
FEES: Non-Refundable Application Fee
Certificate to Operate Issuance Fee (Yearly)
Vehicle Decal Permit Fee (Per Vehicle / Yearly)
Driver ID Fee
$ 200.00
$ 325.00
$ 50.00
$ 75.00
NOTE: Please make check / money order payable to the BOARD OF COUNTY COMMISSIONERS
~
1. Name of Applicant:.:.. \ C\.o.~ J e \ \ () D 0\ ex. 2
Address: \ l d- 5 n\i~\e. Di\\J~ Na9 \,eD ~L 3\.{ \ 2...0
(Number & Street) (City) (State) (Zip Code)
Home Telephone: (0)39) 537- 35' d 5 E-Mail Jo. c..;c.. 'I J,' C\ 2 (d 1101 n7a ;1 co n'l
Date of Birth: 02 - 03 - /q (;J ~
Driver's License #: 1:) 2. D 0 - y 2. 0
S.S. #:
<Ob- 5y~-o
2. If Partnership:
Business Name:
Business Address:
(Number & Street)
(City)
(State)
(Zip Code)
Business Telephone: (
E- Mail
List of Partners:
A.
(Name)
(Address)
()
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
1
(Hom~!tol!~ #)
:;:;-,,:f~~: v;-
;.~ ;..;." .
(Date of Birth)
(Social Security #)
3. If Manager:
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
Copies of Articles of Incorporation, all amendments thereto, and a certified copy of the Certificate of
Incorporation must accompany this application.
4. If Corporation/Fictious Name:
Exact Corporate/Business Name:
Business Telephone number:
E- Mail
Business Address:
(Number & Street)
(City)
(State)
(Zip Code)
List of Directors/Officers:
A.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
5. List any and all persons holding a ten percent (10%) or greater beneficial interest in applicant's
business or company.
A.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
2
6. If applying for Sub-Certificate name(s):
a. Name
Date of application
b. Approved
Rej ected
REASON:
c. Name
Date of application
d. Approved
Rejected
REASON:
7. Trade Name (if any)
8. List all criminal convictions for which the applicant, owners, managers, directors, and any
officers have been found guilty or convicted regardless of adjudication, in the United States
indicating the offense, the date, and the state.
9. Has Certificate to Operate ever been revoked? Yes
No
If yes, please explain the reason, the year, city, state, and the previous issued Certificate to Operate
number,ofrevocation:
3
Collier County Board of County Commissioners
2800 N. Horseshoe Dr.
Naples, FI. 34104
Gentlemen,
My name is Jacquelyn Diaz and I'm applying for a vehicle to hire license to conduct business between
the counties of Collier and Miami Dade.
This business would be to transport foreign from the Miami International Airport to Naples and back
with the purpose of obtaining training in a local business.
I have been a driver for over 15 years in the state of Florida keeping a clean driving record.
For over 15 years I have been able to drive different vehicles, many times for a long distance,
transporting friend and family member and never been involved in a major accident.
My driver license number is 0200-420-66-543-0 in case a driving history needs to be checked out.
If you have any question, please do not hesitate to contact me at (239) 537-3525
Thank you,
:GJ \
9-J~<)\~
Ja~elin Dia\
LIST OF ALL MANAGERS
=l Ct.. "\'1l
Manager is J aquelin Diaz, _ ~ the owner operator.
Bank of America. ~
~
Bank of America
Customer Service & Support
P.O. Box 25118
Tampa, FL 33622
AprillO, 2009
IAQUELIN DIAZ
1725 BIRDIE DR
NAPLES FL 34120-0541
Re: Third Party request for information (COLLIER COUNTY BOARD OF COUNTY)
To JAQUELIN DIAZ
Thank you for your recent request for information regarding the status of your account(s) with Bank of
America. Our records indicate the following status on your account(s):
TYPE OF
ACCOUNT
CHECKING
ACCOUNT
NUMBER
CURRENT
BALANCE
$1,083.02
AVERAGE
BALANCE
$2,382.33
DATE
OPENED
5/10/89
Average balance information for accounts, if reported, is based on the previous three months. Average
balance information is not available for time deposit accounts.
We trust that this confidential information will be of assistance to you.
Sincerely,
~QM/(!t bilrrtiYnh
Bank of America
1.800.862.1111 Option 2
Our response is commensurate with the purpose and amount of your inquiry. The information provided is strictly confidential and intended for use solely
by the requesting party and in reliance on your statement of intended purpose or use. The information is furnished as a matter of courtesy without a duty to
do so and without responsibility, liability or warranty, express or Implied, on the part of Bank of America to you or any third party. Information is obtained
from electronic data sources, which may not contain all information in Bank of America's possession. Information Is not guaranteed to be accurate and may
be a matter of opinion. We do not accept any responsibility for erron, omissions or alterations after delivery. The information is constantly changing and
therefore subject to change without notice. Bank of America will not update this response unless another written inquiry is received. This information
applies to the name of the subject of the inquiry as styled in your request and does not include any indirect or related accounts or obligations, unless
expressly specified in our response. Bank of America encourages you to contact more than one credit reference prior to making any credit decision. As used
herein, Bank or America shall mean BankAmerlca Corporation and its affiliates, subsidiaries and employees. If you received tbls response by FAX, and you
are not the intended recipient or an agent responsible for delivering it io the intended recipient, you are hereby notified that you have received this
document in error, and that any review, dissemination, distribution or copying of the information contained in this message is strictly prohibited. If you
have received this communication in error, please notify us immediately by telephone and return the message to us by mail.
FIRST
FINANCIAL
SVCS., LLC.
t;'illWORKING TOGETHER TO BETTER YOUR BUSINESS'C'!
To whom it may concer,
This letter is to certify that Mrs. Jaquelin Diaz have been a customer of our firm for over four years.
Mrs. Diaz had a personal unsecured loan with our firm for 48 months and always kept her account up to
date and in good standing until recently paid off.
For additional information regarding Mrs. Diaz credit worthiness please contact me at (954) 665-3331
Thank you,
G ==\JO.~"^
Genoveva Barrios
5820 12th Avenue 5W . Naples, Florida 34116 . Colier County (239) 261-7772. Broward County (954) 243.5861 . Voice/Fax (866) 640-7777. email: nobeldiaz@aol.com
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Online Personal Credit Report from Experian for
Experian credit report prepared for Index:
JAQUELlN DIAZ - PgtE:lll~ia"~negCltjy~it~D].?
- AccglJDtsjll go()<:L::;tandlog
- RElglJE3s!~J.9..Lj'9JJ.Lc;redlt hi!;tgry
- f'erso_n_c!IJr1fQ!.m.-9]()n
. Print report
Your report number is
Report date:
04/15/2009
- Imp9r:t.CloLrlJElssagElJrorn e;xp~iao
- ~()D!Clct u~
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Experian collects and organizes information about you and your credit history from public records, your creditors and other
reliable sources. By law, we cannot disdose certain medical information (relating to physical, mental, or behavioral health
or condition). Although we do not generally collect such information, it could appear in the name of a data furnisher (i.e.,
"Cancer Center") that reports your payment history to us. If so, those names display in your report, but in reports to others
they display only as "Medical Information Provider." Consumer statements induded on your report at your request that
contain medical information are disdosed to others.
To retum to your report in the near Mure, log on to www.experian.comlconsumer and select "View your report again" or
"Dispute" and then enter your report number.
If you disagree with information in this report, retum to the Report Summary page and follow the instructions for disputing.
Potentially Negative Items or items for further review
This information is generally removed seven years from the initial missed payment that led to the delinquency. Missed payments and
most public record items may remain on the credit report for up to seven years, except Chapters 7, 11, and 12 bankruptcies, which
may remain for up to 10 years, and unpaid tax liens which may remain up to 15 years. A paid tax lien may remain for up to seven
years. TransfelTed accounts that have not been past due remain up to 10 years after the date the account was transferred.
Credit Items
For your protection, the last few digits of your account numbers do not display.
AMERICAS SERVICING CO
Address: Account Number:
7485 NEW HORIZON WAY
FREDERICK, MD 21703
No phone number available
Address Identification Number:
0643887012
Status: Foreclosed.
Status Details: This account is scheduled to continue on record
until Aug 2014.
Type:
Mortgage
Terms:
30 Years
Monthly Payment:
$0
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Date Opened:
12/2005
Reported Since:
07/2006
Date of Status:
10/2008
Credit Limit/Original Amount:
$316,000
High Balance:
NA
Recent Balance:
$0 as of 10/2008
4/15/2009
Expenan - Pnntable J:"uH Keport
Last Reported: Responsibility:
10/2008 Individual
Creditor's Statement: Foreclosure proceedings started.
Account History:
Foreclosure proceedings started as of Oct 2008, Sep 2008, Aug
2008, Mar 2008, Feb 2008
Foreclosure as of Oct 2008
180 days past due as of Sep 2008, Aug 2008
150 days past due as of Mar 2008
120 days past due as of Feb 2008
90 days past due as of Jan 2008
60 days past due as of Dec 2007
30 days past due as of Nov 2007
AMERICAS SERVICING CO
Address:
7485 NEW HORIZON WAY
FREDERICK, MD 21703
No phone number available
Address Identification Number:
0643887012
Status: Foreclosed.
Account Number:
.- -
Date Opened:
03/2006
Reported Since:
11/2006
Date of Status:
03/2009
Last Reported:
03/2009
Type:
Mortgage
Terms:
30 Years
Monthly Payment:
$0
Responsibility :
Individual
Account History:
Foreclosure as of Mar 2009
Foreclosure proceedings started as of Mar 2008, Feb 2008
180 days past due as of Aug 2008 to Feb 2009
150 days past due as of Mar 2008
120 days past due as of Feb 2008
90 days past due as of Jan 2008
60 days past due as of Dec 2007
30 days past due as of Nov 2007
cm
Address: Account Number:
PO BOX 6241 -
SIOUX FALLS, SD 57117
No phone number available
Address Identification Number:
0643887012
Status: Closed. $3,070 past due as of Apr 2009.
Date Opened: Type:
OS/2001 Revolving
Reported Since: Terms.
06/2001 NA .
Date of Status: Monthly Payment:
04/2009 $837
Last Reported: Responsibility:
04/2009 Individual
Creditor's Statement: Account closed at credit grantor's
request.
Account History:
rage L 01 Lf+
Recent Payment:
$0
Status Details: This account is scheduled to continue on record
until Aug 2014.
Credit LimiUOriginal Amount:
$152,000
High Balance:
NA
Recent Balance:
$0 as of 03/2009
Recent Payment:
$0
Credit LimiUOriginal Amount:
$20,290
High Balance:
$22,759
Recent Balance:
$22,759 as of 04/2009
Recent Payment:
$0
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4/15/2009
Expenan - Pnntable Full Report
90 days past due as of Apr 2009
60 days past due as of Mar 2009
Balance History:
03/2009 $22,149
02/2009 $21,590
01/2009 $21,005
12/2008 $20,368
11/2008 $20,015
10/2008 $19,902
09/2008 $20,113
08/2008 $19,240
07/2008 $19,459
06/2008 $19,648
OS/2008 $19,899
04/2008 $20,106
03/2008 $20,324
02/2008 $20,542
01/2008 $20,764
12/2007 $20,968
11/2007 $21,208
10/2007 $20,239
09/2007 $5,292
08/2007 $914
07/2007 $895
06/2007 $998
05/2007 $1,077
04/2007 $1,185
Between Oct 2008 and Mar 2009, your credit limit/high balance
was $20,290
Between Apr 2008 and Sep 2008, your credit limit/high balance
was $20,840
Between Aug 2007 and Mar 2008, your credit limit/high balance
was $21,600
Between Apr 2007 and Jul 2007, your credit limit/high balance
was $19,600
EASTERN FINANCIAL FL CU
Address: Account Number:
PO BOX 825871 I
SOUTH FLORIDA, FL 33082
No phone number available
Address Identification Number:
0643887012
Status: Account charged off. $16,218 written off.
Date Opened:
09/2004
Reported Since:
09/2004
Date of Status:
03/2008
Last Reported:
03/2008
Type:
Installment
Terms:
1 Months
Monthly Payment:
$0
Responsibility:
Individual
Account History:
Charge Off as of Mar 2008
Repossession as of Feb 2008, Jan 2008
30 days past due as of Dec 2007
LEXUS FINANCIAL SERVICES
Address: ~r:
12735 MORRIS ROAD EXT # ____
ALPHARETT A, GA 30004
No phone number available
rage ,j or L.4
Status Details: This account is scheduled to continue on record
until Sep 2014.
Credit Limit/Original Amount:
$50,699
High Balance:
NA
Recent Balance:
$16,218 as of 03/2008
Recent Payment:
$15,275
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4/15/2009
Expenan - PnntabJe tu1l Keport
Address Identification Number:
0643887012
Status: Open. $522 past due as of Mar 2009.
Date Opened:
07/2006
Reported Since:
08/2006
Date of Status:
10/2008
Last Reported:
03/2009
Type:
Installment
Terms:
72 Months
Monthly Payment:
$522
Responsibility:
Individual
Account History:
30 days past due as of Oct 2008 to Mar 2009, Apr 2008 to Jun
2008, Feb 2008, Jan 2008
OCWEN LOAN SERVICING LLC
Address: Account Number:
12650 INGENUITY DR
ORLANDO, FL 32826
No phone number available
Address Identification Number:
0643887012
Status: Transferred,closed.
Date Opened:
12/2005
Reported Since:
06/2006
Date of Status:
08/2008
Last Reported:
08/2008
Creditor's Statement:
lender.
Type:
Mortgage
Terms:
30 Years
Monthly Payment:
$0
Responsibility:
Individual
Account transferred to another
Account History:
180 days past due as of Mar 2008 to Jul 2008
150 days past due as of Feb 2008
120 days past due as of Jan 2008
90 days past due as of Dec 2007
60 days past due as of Nov 2007
30 days past due as of Oct 2007
WACHRL
Address:
PO BOX 3117
WINSTON SALEM, NC 27102
No phone number available
Address Identification Number:
0643887012
Status: Open. $5,648 past due as of Mar 2009.
Date Opened:
03/2007
Reported Since:
03/2007
Date of Status:
03/2009
Last Reported:
03/2009
Account Number:
y .-
Type:
Mortgage
Terms:
30 Years
Monthly Payment:
$1,129
Responsibility :
Joint with NOBEL DIAZ
page 4 01 L4
Status Details: As of Ju12015, this account is scheduled to go
to a positive status.
Credit Limit/Original Amount:
$28,669
High Balance:
NA
Recent Balance:
$20,281 as of 03/2009
Recent Payment:
$522
Credit Limit/Original Amount:
$79,000
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Status Details: As of Aug 2015, this account is scheduled to go
to a positive status.
Credit Limit/Original Amount:
$139,335
High Balance:
NA
Recent Balance:
$137,820 as of 03/2009
Recent Payment:
$0
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4/15/2009
Expenan - Pnntable tuB Keport
Account History:
150 days past due as of Mar 2009
120 days past due as of Feb 2009
90 days past due as of Jan 2009
60 days past due as of Dec 2008
30 days past due as of Nov 2008
WFFNA TBANK
Address:
PO BOX 94498
LAS VEGAS, NV 89193
No phone number available
Address Identification Number:
0643887012
Status: Open. $1,288 past due as of Mar 2009.
'MIIumber:
Date Opened:
12/2004
Reported Since:
12/2004
Date of Status:
03/2009
Last Reported:
03/2009
Type:
Revolving
Terms:
NA
Monthly Payment:
$429
Responsibility :
Individual
Account History:
60 days past due as of Mar 2009
30 days past due as of Feb 2009
Balance History:
02/2009 $6,922
01/2009 $6,780
12/2008 $6,640
11/2008 $5,068
10/2008 $5,598
09/2008 $5,849
08/2008 $5,810
07/2008 $6,090
06/2008 $6,370
OS/2008 $6,670
04/2008 $7,210
03/2008 $7,486
02/2008 $7,451
01/2008 $7,751
12/2007 $8,025
11/2007 $8,305
10/2007 $8,605
09/2007 $8,905
0812007 $9,205
07/2007 $9,470
06/2007 $9,750
OS/2007 $5,541
04/2007 $5,841
Between Nov 2008 and Feb 2009, your credit limit/high balance
was $5,900
Between Apr 2007 and Oct 2008, your credit limit/high balance
was $10,000
Accounts in Good Standing
rage J 01 L'f
Status Details: As of Nov 2015, this account is scheduled to go
to a positive status.
Credit Limit/Original Amount:
NA
High Balance:
$9,800
Recent Balance:
$7,067 as of 03/2009
Recent Payment:
$280
These items may stay on your credit report for as long as they are open. Once an account is closed or paid off it may continue to
appear on your report for up to ten year.
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4/15/2009
Experian - Printable Full Report
AMERICAN HONDA FINANCE
Address: Account Number:
PO BOX 1027 Y
ALPHARETTA, GA 30009
No phone number available
Address Identification Number:
0071273489
Status: Paid, Closed/Never late.
Date Opened:
10/2002
Reported Since:
10/2002
Date of Status:
10/2004
Last Reported:
10/2004
Type:
Installment
Terms:
66 Months
Monthly Payment:
$0
Responsibility:
Individual
BANK OF AMERICA
Address:
PO BOX 1390
NORFOLK, VA 23501
(800) 441-0130
Address Identification Number:
0643887012
Status: Open/Never late.
Date Opened:
12/1997
Reported Since:
12/1997
Date of Status:
03/2009
Last Reported:
03/2009
Balance History:
02/2009 $14,125
01/2009 $14,315
12/2008 $14,415
11/2008 $13,464
10/2008 $13,553
09/2008 $13,688
08/2008 $13,877
07/2008 $13,983
0612008 $14,117
OS/2008 $13,965
04/2008 $13,683
03/2008 $13,622
02/2008 $13,320
01/2008 $13,482
12/2007 $13,615
11/2007 $13,645
10/2007 $12,562
09/2007 $10,686
08/2007 $9,877
07/2007 $7,415
06/2007 $6,721
OS/2007 $3,074
04/2007 $1,764
Account Number:
--L
Type:
Revolving
Terms:
NA
Monthly Payment:
$229
Responsibility:
Individual
Between Nov 2007 and Feb 2009, your credit limit/high balance
was $14,300
Between Apr 2007 and Oct 2007, your credit limit/high balance
was $16,000
.t"age () or .L~
Status Details: This account is scheduled to continue on record
until Oct 2014.
Credit LimiUOriginal Amount:
$30,548
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Credit LimiUOriginal Amount:
$14,300
High Balance:
$15,328
Recent Balance:
$14,094 as of 03/2009
Recent Payment:
$300
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4/15/2009
Experian - Printable Full Report
BP/CBSD
Address:
PO BOX 6497
SIOUX FALLS, SD 57117
No phone number available
Address Identification Number:
0222565045
~Number:
Status: Paid, Closed/Never late.
Date Opened:
06/1997
Reported Since:
10/2000
Date of Status:
01/2004
Last Reported:
01/2004
Type:
Revolving
Terms:
NA
Monthly Payment:
$0
Responsibility :
Individual
CHASE
Address:
800 BROOKSEDGE BLVD
WESTERVILLE, OH 43081
(800) 955-9900
Address Identification Number:
0071273489
Account Number:
-
Status: Paid, Closed/Never late.
Date Opened:
06/2001
Reported Since:
06/2001
Date of Status:
11/2004
Last Reported:
11/2004
Type:
Installment
Terms:
72 Months
Monthly Payment:
$0
Responsibility:
Joint with NOBEL DIAZ
CHASE
Address:
800 BROOKS EDGE BLVD
WESTERVILLE, OH 43081
(800) 955-9900
Address Identification Number:
0071273489
Status: Paid, Closed/Never late.
Account Number:
"
Date Opened:
12/2000
Reported Since:
12/2000
Date of Status:
06/2003
Last Reported:
06/2003
Your Statement:
Type:
Revolving
Terms:
NA
Monthly Payment:
$0
Responsibility:
Individual
Account closed at consumer's request.
CHASE
page I or LLJ.
Status Details: This account is scheduled to continue on record
until Jan 2014.
Credit Limit/Original Amount:
$300
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Status Details: This account is scheduled to continue on record
until Nov 2014.
Credit Limit/Original Amount:
$23,719
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Status Details: This account is scheduled to continue on record
until Jun 2013.
Credit Limit/Original Amount:
$15,000
High Balance:
$10,996
Recent Balance:
NA
Recent Payment:
NA
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4/15/2009
Experian - Printable Full Report
~:
Address:
800 BROOKS EDGE BLVD
WESTERVILLE, OH 43081
(800) 955-9900
Address Identification Number:
0643887012
Status: Open/Never late.
Date Opened:
06/2004
Reported Since:
06/2004
Date of Status:
03/2009
Last Reported:
03/2009
Balance History:
02/2009 $7,150
0112009 $7,248
12/2008 $7,346
11/2008 $7,445
10/2008 $7,541
09/2008 $7,646
08/2008 $7,748
07/2008 $7,866
06/2008 $7,969
OS/2008 $8,072
04/2008 $8,216
03/2008 $8,326
02/2008 $8,439
01/2008 $8,547
12/2007 $8,662
11/2007 $8,780
10/2007 $8,900
09/2007 $9,036
08/2007 $9,170
07/2007 $9,338
06/2007 $9,557
OS/2007 $9,775
04/2007 $6,862
Type:
Revolving
Terms:
NA
Monthly Payment:
$140
Responsibility:
Individual
Between Feb 2009 and Feb 2009, your credit limit/high balance
was $7,500
Between Aug 2008 and Jan 2009, your credit limit/high balance
was $8,100
Between Jan 2008 and Jut 2008, your credit limit/high balance
was $8,900
Between Apr 2007 and Dec 2007, your credit limit/high balance
was $10,000
CHASE BANK USA, NA
Address:
800 BROOKSEDGE BLVD
WESTERVILLE, OH 43081
(800) 955-9900
Address Identification Number:
0071273489
Status: Paid,Closed/Never late.
Date Opened:
12/1997
Reported Since:
11/1997
Date of Status:
OS/2002
Last Reported:
OS/2002
A~ount Number:
1 I..
Type:
Revolving
Terms:
NA
Monthly Payment:
$0
Responsibility:
Individual
Page ~ ot L4
Credit Limit/Original Amount:
$7,500
High Balance:
$10,149
Recent Balance:
$7,047 as of 03/2009
Recent Payment:
$150
Status Details: This account is scheduled to continue on record
until May 2012.
Credit Limit/Original Amount:
$7,000
High Balance:
$6,674
Recent Balance:
NA
Recent Payment:
NA
https:/ /annualcreditreport.experian.com/ AnnualCreditReport/cac/FullReport.do
4/1512009
Experian - Printable Full Report
Your Statement:
Account closed at consumer's request.
CHASE MANHATTAN MTGE
Address: Account Number:
PO BOX 24696
COLUMBUS, OH 43224
(800) 848-9136
Address Identification Number:
0077124862
Status: Paid,Closed/Never late.
Date Opened:
09/2004
Reported Since:
11/2004
Date of Status:
04/2006
Last Reported:
04/2006
Type:
Mortgage
Terms:
30 Years
Monthly Payment:
$0
Responsibility :
Individual
FORD CRED
Address:
PO BOX 152271
IRVING, TX 75015
(800) 727-7000
Address Identification Number:
0071273489
Account Number:
-
Status: Paid,Closed/Never late.
Date Opened:
12/1996
Reported Since:
12/1996
Date of Status:
06/2001
Last Reported:
06/2001
Type:
Installment
Terms:
60 Months
Monthly Payment:
$0
Responsibility:
Joint with NOBEL DIAZ
FREMONT INVESTMENT & LN
Address: Account Number:
175 N RIVERVIEW DR
ANAHEIM, CA 92808
No phone number available
Address Identification Number:
0077124862
'"
Status: Transferred,c1osed/Never late.
Date Opened:
12/2005
Reported Since:
12/2005
Date of Status:
OS/2006
Last Reported:
OS/2006
Type:
Mortgage
Terms:
40 Years
Monthly Payment:
$0
Responsibility :
Individual
Page \} ot L4
Status Details: This account is scheduled to continue on record
until Apr 2016.
Credit Limit/Original Amount:
$122,050
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Status Details: This account is scheduled to continue on record
until Jun 2011.
Credit Limit/Original Amount:
$17,302
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Status Details: This account is scheduled to continue on record
until May 2016.
Credit Limit/Original Amount:
$316,000
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
https:/ /annualcreditreport.experian.com/ AnnuaICreditReport/cac/FulIReport.do
4/15/2009
Experian - Printable Full Report
FREMONT INVESTMENT & LN
Address: Account Number:
175 N RIVERVIEW DR _
ANAHEIM, CA92808
No phone number available
Address Identification Number:
0077124862
Status: Transferred,c1osed/Never late.
Date Opened:
12/2005
Reported Since:
12/2005
Date of Status:
04/2006
Last Reported:
04/2006
Type:
Mortgage
Terms:
30 Years
Monthly Payment:
$0
Responsibility:
Individual
FREMONT INVESTMENT & LN
Address: Account Number:
175 N RIVERVIEW DR r
ANAHEIM, CA 92808
No phone number available
Address Identification Number:
0077124862
Status: Transferred,c1osed/Never late.
Date Opened:
03/2006
Reported Since:
03/2006
Date of Status:
09/2006
Last Reported:
09/2006
Type:
Mortgage
Terms:
40 Years
Monthly Payment:
$0
Responsibility:
Individual
GEMBlBRANDSMART
Address: Account Number:
PO BOX 981439
EL PASO, TX 79998
(866) 396-8254
Address Identification Number:
0643887012
Status: Open/Never late.
Date Opened:
10/2003
Reported Since:
11/2003
Date of Status:
03/2009
Last Reported:
03/2009
Type:
Revolving
Terms:
NA
Monthly Payment:
$72
Responsibility:
Individual
Page IU ot:l4
Status Details: This account is scheduled to continue on record
until Apr 2016.
Credit Limit/Original Amount:
$79,000
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Status Details: This account is scheduled to continue on record
until Sep 2016.
Credit Limit/Original Amount:
$152,000
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Credit Limit/Original Amount:
$2,500
High Balance:
$3,479
Recent Balance:
$2,400 as of 03/2009
Recent Payment:
$100
Balance History:
02/2009 $2,464
01/2009 $2,513
12/2008 $2.344
11/2008 $2,410
10/2008 $2,113
09/2008 $2,169
08/2008 $2,224
07/2008 $2,279
06/2008 $2,364
05/2008 $2,448
https:/ /annualcreditreport.experian.com/ AnnuaICreditReport/cac/FullReport.do
4/15/2009
bxpenan - pnntable tuB Keport
04/2008 $844
03/2008 $868
02/2008 $951
01/2008 $1,082
12/2007 $908
11/2007 $869
10/2007 $1,069
09/2007 $1,129
08/2007 $1,279
07/2007 $1,429
Between Nov 2008 and Feb 2009, your credit IimiUhigh balance
was $2,500
Between Jul 2007 and Oct 2008, your credit IimiUhigh balance
was $6,500
GEMBlDILLARDS
Address:
PO BOX 981471
EL PASO, TX 79998
(800) 643-8278
Address Identification Number:
0341290966
Status: Paid,Closed/Never late.
Account Number:
- -'
Date Opened:
02/1999
Reported Since:
03/1999
Date of Status:
10/2008
Last Reported:
10/2008
Balance History:
09/2008 $0
08/2008 $0
07/2008 $0
06/2008 $0
OS/2008 $0
04/2008 $0
03/2008 $0
02/2008 $0
0112008 $0
12/2007 $0
11/2007 $0
10/2007 $0
09/2007 $0
08/2007 $0
07/2007 $0
06/2007 $0
OS/2007 $0
04/2007 $0
Type:
Revolving
Terms:
NA
Monthly Payment:
$0
Responsibility:
Individual
Between Jan 2008 and Sep 2008, your credit limiUhigh balance
was $224
Between Apr 2007 and Dec 2007, your credit limiUhigh balance
was $400
MCYDSNB
Address:
9111 DUKE BLVD
MASON, OH 45040
No phone number available
Address Identification Number:
0517903661
Accou~mber:
page 11 or L4
Status Details: This account is scheduled to continue on record
until Oct 2018.
Credit LimiUOriginal Amount:
NA
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
https:/ /annualcreditreport.experian.com/ AnnuaICreditReport/cac/FullReport.do
4/15/2009
1:'.xpenan - pnntable tilll Kepon
Status: Open/Never late.
Date Opened:
11/2002
Reported Since:
11/2002
Date of Status:
04/2009
Last Reported:
04/2009
Balance History:
03/2009 $0
02/2009 $0
01/2009 $0
12/2008 $0
11/2008 $0
10/2008 $0
09/2008 $0
08/2008 $0
07/2008 $0
06/2008 $0
OS/2008 $0
04/2008 $0
03/2008 $0
02/2008 $0
01/2008 $0
12/2007 $0
11/2007 $0
10/2007 $0
09/2007 $0
08/2007 $0
07/2007 $0
06/2007 $0
OS/2007 $0
04/2007 $0
Type:
Revolving
Terms:
NA
Monthly Payment:
$0
Responsibility:
Individual
Between Nov 2008 and Mar 2009, your credit limit/high balance
was $100
Between Mar 2008 and Oct 2008, your credit limit/high balance
was $500
Between Aug 2007 and Feb 2008, your credit limitlhigh balance
was $2,000
Between Apr 2007 and Jul 2007, your credit limitlhigh balance
was $500
VISDSNB
Address: Account Number:
9111 DUKE BLVD _ I
MASON, OH 45040
No phone number available
Address Identification Number:
0071030730
Status: Closed/Never late.
Date Opened:
11/1998
Reported Since:
04/2002
Date of Status:
09/2003
Last Reported:
03/2009
Type:
Revolving
Terms:
NA
Monthly Payment:
$0
Responsibility:
Individual
Account closed at credit grantor's
Creditor's Statement:
request
page 1 L or LLf
Credit Limit/Original Amount:
$100
High Balance:
$668
Recent Balance:
$0 /paid as of 04/2009
Recent Payment:
$0
Status Details: This account is scheduled to continue on record
until Mar 2019.
Credit Limit/Original Amount:
$2,000
High Balance:
NA
Recent Balance:
$0 /paid as of 03/2009
Recent Payment:
$0
Balance Histor/:
02/2009 $0
https:/ /annualcreditreport.experian.com/ AnnualCreditReportlcac/FullReport.do
4/15/2009
txpenan - rnmaOle l' un Kepon
01/2009 $0
12/2008 $0
11/2008 $0
10/2008 $0
09/2008 $0
08/2008 $0
07/2008 $0
06/2008 $0
OS/2008 $0
04/2008 $0
03/2008 $0
02/2008 $0
01/2008 $0
12/2007 $0
11/2007 $0
10/2007 $0
09/2007 $0
08/2007 $0
07/2007 $0
06/2007 $0
OS/2007 $0
04/2007 $0
Between Apr 2007 and Feb 2009, your credit limit/high balance
was $2,000
WFFINANCE
Address: Account Number:
11780 METRO PKWY STE A
FORT MYERS, FL 33966
No phone number available
Address Identification Number:
0077124862
Status: Paid,Closed/Never late.
Date Opened:
06/2006
Reported Since:
0612006
Date of Status:
09/2006
Last Reported:
09/2006
Type:
Installment
Terms:
36 Months
Monthly Payment:
$0
Responsibility:
Individual
WORLD OMNI
Address:
PO BOX 991817
MOBILE, AL 36691
No phone number available
Address Identification Number:
0071273489
Status: Paid, Closed/Never late.
Account Number:
1
Date Opened:
02/2002
Reported Since:
04/2002
Date of Status:
04/2005
Last Reported:
04/2005
Type:
Installment
Terms:
60 Months
Monthly Payment:
$0
Responsibility:
Co-signer with MARIELA 0
CABARCAS
rage 1 j OI L"f
Status Details: This account is scheduled to continue on record
until Sep 2016.
Credit Limit/Original Amount:
$1,090
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
Status Details: This account is scheduled to continue on record
until Apr 2015.
Credit Limit/Original Amount:
$14,044
High Balance:
NA
Recent Balance:
NA
Recent Payment:
NA
https:/ /annualcreditreport.experian.com/ AnnualCreditReport/cac/FulIReport.do
4/15/2009
y ( 2 ~ \ Dc" .
\) ,"-,,,^'':'''\<2- ~ \:, "'- c". .e..:\- R C -<y\ ,'<"-'- '-" \* ~ '" -,,: 3So u= 'n Cs, Ot
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'=-\ ,,~'~~
O Nationwide~
Insurance &
. . Financial Services
HUFF
Insurance & Financial Services
protecting your today ~ securing your tomorrow
April 29, 2009
To Whom it May Concern;
This letter is to confirm that Jacqueline Diaz has an
active commercial policy effective 2119/09- 2/19/2010. The insured is allowed to add any
vehicle/car to the policy at anytime during the policy periods. With the following
coverages:
Bodily Injury (Per accident)
Bodily Injury (per person)
Property Damage (Par accident)
$ 300,000
$ 125,000
$ 100,000
Should you have any questions fell free to contact me
Nationwide MlIlm,l In...ranoe Co...p....y ~ Affiliated C"..UpMj....
Life Insul'W1CC Issued by Nationwide Life Insurance Companies
Home Office, C.olumbus OH 43215-2220
Nationwide /l.lld 111= NlIlionnwide rrarnemark are federally re!!isrered service mHrh nfN~tiM\.Ui/iP MII'nQII..^,,~~~ (".~__~_..
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
provisions.
I -::S~Q.\i l>) ~ZCl.2
for Ce ate to Operate IS true.
swear or affIrm that all information on this Application
~ \.'.\ .
3
"
\), \O;Q;w
licant) '-
STATE OF FWRIDA
COUNTY OF COLLIER
t was subscribed and sworn to before me thiS~! (, J ;;z.o.&Y
7~ 1()~ A , _ (patel' ' 1
who has"Pf(fd~(l t ~~tJl) - q,Lt'J - & 4 -S{/S-CJ
(Type of identification)
NOTARY PUBLIC-STATE OF FLORIDA
.............. Linda C. Wolfe
f l;Jt ~ Commission # DD739150
\~/ Expires: DEe. 07, 2011
BO;WE~ THRTJ ATLA."lTIC BONDING CO., INC.
Print of Notary
NOTARY'S SEAL
Notary Public Commission #
Commission Expires
5
AFFIDAVIT
Before me this day personally appeare~:'~"\ ~ \) ~ G L- who swears or affirms
that the vehicle(s) to be permitted meet(s) the safety standards as set forth in Code of Laws
and Ordinance Chapter 142.
It is understood and acknowledged by the Code Enforcement Department and myself that if
my vehic1e(s) that is/ are permitted fail(s) to meet(s) the safety standards as required by this
Ordinance, the vehicle(s) must be removed from service until all violations are corrected.
BUSINESS NAME
--:SOC\ V<1.--\ ~ (\ '\)\ cA2.
\
SIGNATURE OF APPLIc~1,,~~~\ VJ.'l~
DATE
4//b/OQ
.
STATE OF FWRIDA
COUNTY OF COLLIER
N of person acknowl . g)
])2dl) -t/,2t;-lei ..s{{J id(2tification and who did.
~c?~
SIGNATURE OF NOTARY
The foregoing instrument w
20t2f. by
.a /J A. /}
sub ribed and swom to before me this /,1 day of~
{
who is personally known or has
"II""
f" ,
OF NOTARY
NOTARY PUBLIC COMMISSION #
NOTARY'S SEAL
COMMISSION EXPIRES:
NOTARY pUBLIC-STATE OF FLORIDA
""""'" Linda C. Wolfe
{W\ CcnlmissiQn #DD7391SQ
'-...~/ Expi:es: DEC. 07, 2011
?o~~:ClF;; THR': ATLA"'-rnC BO~1J1KG co.: me
4
COLLIER COUNTY GOVERNMENT
CRIMINAL mSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date:
Pursuant to provisions of Chapter 119, F.8., and procedures outlined under Rule
Chapter 11C-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
cr-:..minal r-Jstory background check viill. be performed in this office. Please fill in the
blanks.
Address:
Middle (full)
S ^ \ ~~\~ 1:)\,
(Number & Street)
u
D \0.. 2.
Last
Maiden
Name:0CN:A0Q.\~ ()
First \
9-L
(State)
~4\20
(Zip Code)
Social Security No.: _ _
DL No.: \) 2.\X) - '-420 - C::>b - SI.{ 3.-0
Sex: ~ Age: .!1.3. Race: ;h' Spc1 t7 j C
I
I g t.j lbs. Eye:DcM "-- bra w n Hair:'~(' v: 6~ vv D
(Color) (Color)
DOB: 02..-0::' -\qb~
5/ , II
Height: .. G:> Weight:
Na~} C\D\ ue-l \ "
First . Middle (full)
Address: \ 1 d- S; \OQ~ \~ \ Q \) "
Number & Street
o
D,CAL
Last
N~{?\UJ Q--l
Ci~ State
Maiden
"34) L()
Zip Code
Social Security No.: _
DOB: 0 2 - 0 .?J - \ C10 (, Sex: t=
Hel.ght.. S. 1_ b (I / \J I I
_ Weight: 0" lbs.
DL No.:
'""" . J? "\ / '--(1
V 200 - Lr-O - (; b - ~ p 3 - 0
Race: ;-h spa 11) C.
Hair: VC-Ul ~ )?}.{) LP (J
(Color)
Age: .!:12
Eye: DaA t. '0 YiJwn
(Color)
Cl:; S I. [ (
:TE ------1-~;{~~;------CONSENT-=:TbSUR51~-:?p-------
I understand that Collier County Code Enforcement will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New
York, NY 10011, as part of the procedure for processing my PVAC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further infolTnation through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id.
I understand a consumer reporting agency's investigation may include obtaining infolTnation covering up to the last seven (7) years regarding, among
other items, references, character, driving record, past employment, work habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and federal law. The investigation also may include obtaining infolTnation relating to criminal records without
any time limitations, subject to state and federallaw.
In the event an investigative consumer report is conducted, I understand such infolTnation may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge conceming my character, general reputation, personal
characteristics or standard of living. I understand such infolTnation may also be obtained through direct or indirect contact with former employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
a By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act.
I also understand that before my application is denied based, in whole or part, on infolTnation obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the accuracy
of any information in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging infolTnation in the report, Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the information
contained in the report.
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
u
...
D Q... S
C
Driver's Ucense No.
~
~
State
1\-111
Stale
.--------
L
I
J
\..
Minneso & Oklahoma applicanm Only: ave lhe right to request a copy of my consumer report from Sterling Testing Systems, Inc. by
checking the box below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make
a wrm.oo request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report.
Social Security No.
'-/ II f>/09
Date ' I
.~ I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
;jODu~l\ fl 1)~Q2..
\
, have read and understood the paragraph
4/1~-!oq.
Date
qql(;~!. County
_._. ...._~. t....,.-.____.. '."_'.'
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Overage Amount:
Contact:
FEES:
Description
Certificate to Operate
Application
Cashier Name:
Batch Number:
levy_m
162
Development and Environmental Services
2800 Horseshoe Drive N.
Naples, FL
34104
239-252-2400
RECEIPT OF PAYMENT
2009009642
2009-002145
04/17/2009
Check
4642
$200,00
$200.00
$0,00
Jaquelin Diaz
1725 BIRDIE DR
Naples, FL 34120
Reference Number Oriqinal
Fee
LCCT020090000358 $200,00
Amount
Paid
$200,00
Account
111-138911-321241
PrintResults
Page 11 of 19
~> ?J~.Eg_~.Lt:L~
DIRECT
Code Enforcement Div. Collier County
Order#: 9407244
DIAZ JAQUELlN
Subject Profile
NA
JAQUEUN
________________.._______________DIAZ __________
PO,
Last Name
First Name
Middle Name
Date of Birth (mmldd/yyyy)
Phone
-Pr;;j;~t.dS;'Ia""rY----------------------NiA-----------
Job State
02103/1966
Current Address ._________________..__
Address 1725 BIRDIE DRIVE
Apartment Number
~'L..___ _ --.-.-------.----.-___.._____._.__.__..__.______.__!'0PLE~.______________._____.._._____.______..__.______
'-State -. .... FL
Zip 34120
Previous Address
Address
Apartment Number
City
State
Zip
Additional infonnation
Applicant Email Address
Company
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
MOTOR VEHICLE REPORT (MVR)
SEXUAL OFFENDER DATABASE SEARCH
SOCIAL SECURITY TRACE SEARCH
Status
4 CLOSED
Findings
Clear
1 CLOSED
See Results Below
1 CLOSED
Clear
1 CLOSED
Alert
CRIMINAL RECORD SEARCH
The criminal information reported on this website appears exactly as it is received from the local jurisdictions and may contain information
which would be prohibited for use in making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: Stale: NW Zip: County: NATIONWIDE
Status: CLOSED
FINDING: Clear
*************************************************************************
. THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND .
* HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
. CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
No criminal convictions found.
-----
City: NAPLES State: FL Zip: 34120 County: COLLIER ___
_ Status: CLOSED__._________..__._____..___.________...__________..__..__.___________.__________.________
FINOING: Clear
No criminal convictions found.
-------
City: State: ~L Zip: 33026 County: BROW~..~_.__.______ ~__.___..._____..._.____.
Status: CLOSED ~..--.
FINDING: Clear
No criminal convictions found.
City: Slate: LA Zip: 71301 County: RAPIDES
Status: CLOSED
FINDING: Clear
No criminal convictions found.
/'
./"
,..,..,
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
.-/
./"
'"
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - B8178
Order Date: 04/16/2009
Host Used: Online
Reference: 9407244_3
h++"t"'\C'. 1 IC'...1 C'+o.rl~nn_+o.cd..~..,...... CT .....f""LrY1 J.n.ro.hrl~ro......+':2 Iro.C'111tC' IDr~nt D oC'"111tc- r) C""t"'\"'V0 ^ ......... h~... ro.::::::
If /')11/')11(\0
PrintResults
Page 12 of 19
Period: THREE YEAR
License: D20042066543Q
Report C1ear:YES
Name: DIAZ, JAQUELIN
Address:
Cit y, St:
As of:
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 02/03/2009
Exp Date: 02/03/2017
AGE:
Year License First Issued: 01/06/1993
STATUS: SEE BELOW
MVR Score
SCORE:
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONV
ACD AVO V/C
DESCRIPTION
.. NONE TO REPORT
~
Suspensions/Revocations
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVO
NO ACTIVITY
License and Permit Information
License: PERSONAL Issue:02/03/2009 Expire:02/03/2017 St
License Status Explanation: ELIGIBLE
C1ass:E REGULAR OPERATOR
License: IDENTIFICATION Issue:12/16/2004 Expire:02/03/2009 Status:EXPIRED
Miscellaneous State Data
.. ENTRIES BELOW COVER THE PAST 3 YEARS ..
MISC: REPLACEMENT LIC ISS. 03/16/07 ,OFFICE NO=N73
MISC: EXAMS VISION=l ROAD SIGN=l ROAD RULES=l DRIVING=l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL=O
04/12/94 DUPLICATE 10 CAP.D ISSUED
BLOCK PERSONAL INFORMATION ..
BLOCK FOR MAILING LIST ..
THIS PERSON HAS A DIGITAL IMAGE
IFOR STATED BUSINESS
IPURPOSES ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
/
Issue Date:
/ /
Control Number: AST001
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
State: FL
Status: CLOSED
FINDING: Clear
No Record Found
Back to Findings
/'
./
..-/
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
FINDING: Alert
t/
****************************
Social Security Trace
*****************************
********************************************************************************
GENERATED: 04/16/2009 04:23:09 PM
TRANSACTION 10:0017026075-224
1.
NAME
JAQUELIN DIAZ
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
DOS
02/03/1966
DATE ISSUED
10/31/1994
ADDRESS
1725 BIRDIE DR NAPLES, FL 34120-0541
1725 BIRDIE DR NAPLES, FL 34120-0541
5820 12TH SW AVE NAPLES, FL 34116-4910
5820 DOGWOOD WAY NAPLES, FL 34116-4910
4195 TREE TOPS RD HOLLYWOOD, FL 33026-1170
FROM
01/2007
06/2007
12/2005
01/2006
07/1999
TO
02/2009
06/2007
01/2007
01/2007
OS/2005
2.
NAME
JACQUELIN DIAZ
SSN VALID
STATE ISSUED
DATE ISSUED
https:llsd.sterlingtesting.com/webdirect3/resul ts/Prin tResults. aspx? Archi ve=
4/20/2009
PrintResults
Page 13 of 19
u#-##-####
YES
FLORIDA
-10/31/1994
ADDRESS
5B20 DOGWOOD WAY NAPLES, FL 34116-4910
FROM
01/200B
TO
09/2008
3.
NAME
JACQUELINE
SSN
###-##-####
DIAZ
VALID
YES
STATE ISSUED
FLORI DA
DATE ISSUED
10/31/1994
ADDRESS
4195 TREE TOPS RD HOLLYWOOD, FL 33026-1170
FROM
0412007
TO
04/2007
4.
NAME
JAQUELIN DIAZ
SSN VALID
###-##-#### YES
STATE ISSUED
FLORIDA
DATE ISSUED
10/31/1994
ADDRES S
6501 TENNYSON OAKS LN ALEXANDRIA, LA 71301-2765
6873 NW 173RD DR APT 4 HIALEAH, FL 33015-5562
FROM
0112005
08/1996
TO
01/2006
08/1996
5.
NAME
JAQUELIN
SSN
#u-##-####
H DIAZ
VALID
YES
STATE ISSUED
FLORIDA
DATE ISSUED
10131/1994
ADDRESS
6980 NW M ST # 186 HIALEAH, FL 33015
FROM
TO
6.
NAME
JAQUELIN
SSN
###-##-####
H DIAZ
VALID
YES
STATE ISSUED
FLORI DA
DOB
02/03/1966
DATE ISSUED
10/31/1994
ADDRESS
69BO NW M 186 HIALEAH, FL 33015
FROM
TO
----------------------------------------------------------------------------
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
----------------------------------------------------------------------------
.*END OF NETWORK TRACE*.
****************************************************************************
PLEASE NOTE THAT THE RESULT OF THE SOCIAL SECURITY TRACE SEARCH DID NOT
YIELD ANY NAMES THAT MATCH THE NAME ENTERED FOR THE APPLICANT. PLEASE
CONFIRM THE CORRECT NAME WITH THE APPLICANT AND NOTIFY OUR CLIENT SERVICES
DEPARTMENT AT CLIENTSERVICES@STERLINGTESTING.COM WHETHER ADDITIONAL SEARCHES
UNDER ANY NAMES ~~E NECESSARY (AN ADDITIONAL CHARGE WILL APPLY FOR EACH
NAME) .
+***************************************************************************
Back to Findill9L-_____.____..
Copyright C 2008 Sterling Infosystems. Inc.
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4I?OI?OOC)
LCCT020090000384
Comfort Transportation, LLC
COLLIER COUNTY
BOARD OF COUNTY COMMISSIONERS
PUBLIC VEmCLE ADVISORY COMMITTEE
2800 NORTH HORSESHOE DRIVE
NAPLES, FL 34104
DATE:
APPLICATION FOR CERTIFICATE TO OPERATE
i - if2 - 6 ?
The undersigned hereby makes application for a Certificate to Operate vehicles "for hire" within
Collier County under Code of Laws and Ordinance Chapter 142, and respectfully submits the
following information in support of this application.
FEES: Non-Refundable Application Fee
Certificate to Operate Issuance Fee (Yearly)
Vehicle Decal Permit Fee (Per Vehicle / Yearly)
Driver ID Fee
$ 200.00
$ 325.00
$ 50.00
$ 75.00
NOTE: Please make check / money order payable to the BOARD OF COUNTY COMMISSIONERS
1. Name of Applicant: Co "" ~o ~ Ir '" ""'i!/ oR:\-...--\- . ~/ tv IfL I K>4f 1:0 f
Address: g (.1 )(, llJr t.J {+v! ~.4(\' \ ~ t F L / 3 \. \ I 0 '-l
(Number & treet) \ (City) (State) (Zip Code)
Home Telephone: (23 9) 2-,=> '2- - t, 0 \ \ E- Mail W)( l"\ ~ \ V'l as <Q.. O..~~ ~ ct=..
Date of Birth: ~-<7 - ~ L S.S. #:
Driver's License #: J( I r 2- - 90 I - S 2... - :l1li9 - 0
2. If Partnership:
Business Name:
Business Address:
(Number & Street)
(City)
(State)
(Zip Code)
Business Telephone: (
E-Mail
List of Partners:
A.
(Name)
(Address)
o
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
(Address)
)
(Hom~1~9~~ #)
:;F(rc;---
(Date of Birth)
(Social Security #)
3. If Manager:
S 11- fY'- ~.
(Name)
A-~
CJ w nw}Aflp/.c..ff
, I
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
Copies of Articles of Incorporation, all amendments thereto, and a certified copy of the Certificate of
Incorporation must accompany this application.
4. If Corporation/Fictious Name:
Exact Corporate/Business Name:
Co /)t F t} e -r !if} AI 5 fJOK- TilT; o~,L 11 {2..
,
Business Telephone number: (-2 3?l Z. 4 Z - 62./ (
Business Address: <is' 4 5 ~ tV G .s u/A Y J
(Number & Street) (City) /
E-Mail
Ni1P(FS . F~
/
(State)
:54/(J'j
(Zip Code)
List of Directors/Officers:
A.
I J.. );;:; L -r KA fJ I;.J O~ <)
(Name)
~7 ~9" .7/jJrZ -c, ,L/I
(Home phone #)
?-?- ~ Z
(Date of Birth)
<6t.DS K/D6-VWe;('
(Address) ;J 11- f..E51 r J...
-g <//(y
(Social Security #)
B.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
5. List any and all persons holding a ten percent (10%) or greater beneficial interest in applicant's
business or company.
A.
(Name)
(Address)
(Home phone #)
(Date of Birth)
(Social Security #)
B.
(Name)
( A ,.1..:1....."'8)
\" .J."'-'I.UJ. '"'U
(Home phone #)
(Date of Birth)
(Social Security #)
2
6. If applying for Sub-Certificate name(s):
a. Name
Date of application
Rejected
REASON:
b. Approved
c. Name
Date of application
d. Approved
Rejected
REASON:
7. Trade Name (if any)
8. List all criminal convictions for which the applicant, owners, managers, directors, and any
officers have been found guilty or convicted regardless of adjudication, in the United States
indicating the offense, the date, and the state.
9. Has Certificate to Operate ever been revoked? Yes
No
If yes, please explain the reason, the year, city, state, and the previous issued Certificate to Operate
number, of revocation:
3
April 28, 2009
To whom it may concern;
My business background is extensive over the past 35 years including being the former President of a
financial group and as a Board of Director on many community groups. I have over the past 3 years
driven airport shuttles not only for a group formerly in New York State but also in Collier and Lee
counties in Southwest Florida.
As a result of a snag in the renewal process within Collier county I am reapplying for my operating
license however based on my overall experience I believe I am more than qualified for your
consideration for approval.
Thank you for your consideration.
Respectfully
,14---- 0 .;
tJ.1Jt- {.k~
Walter A Kapinos
tj/dV/O{
~ ~ h. '^'"'"'- :i: f'vc1 L' ~ I
J- ~ -tk ~;e LnAlVLq / ~-:f-",-I ~ ~
1 CwiLk/~~ ~
j?~ \
wJ!ilvt- q k~~
A -- ...--"
... ~_..'r.l'._.""""
A BEACON
FED ERA. L
230 South James Sf., Rome. NY 13440
E-Mai~ beacOl'l@beaconfederal.com
www.beaconfederal.com
PhOne: (3tS) 272.2360
Fax: (3-t S) 272.2379
Toll Free: 1.888.256.3800
April 20. 2009
To Whom It May Concern:
Walter Kapinos has had numerous loans with Beacon Federal dating back to
1994. All loans were paid os agreed.
Any questions please feel to call Patrick at 315-272-2344.
Sincerely,
~~c-:
Patrick McKenney
A VP Beacon Federal
------
April 22, 2009
To whom it may concem~
I have known Walter A Kapinos for over 20 years and have found him to be honest, compassionate and
to hold the highest degree of integrity in both his personal and business life. He h~ always dealt with
clients and businesses fairly and is a person with whom I can trust on many levels.
Respectfully /lI(~
eiani. President
Syracuse Federal Credit Union
CreditExpert.com - Experian Credit Manager Page 1 of 14
Print Report Close Window
Prepared for: WALTER A KAPINOS Report Date: 4/27/2009
Personal Profile
Here you will find the pers~nallnformatlon contained In your credit file, including your legal name
(5), address(es), current and previous employers, and date of birth.
Name:
Also Known As:
Year of Birth:
EXPERIAN
EQUIFAX
TRANSUNION
WALTER A KAPINOS
1952
865 KINGS WAY, NAPlES,
FL 34104-4931
7221 COLEMAN MILLS RD,
Address(es): ROME, NY 13440-7203
4 WOOD RD, WHITeSBORO,
NY 13492-1434
Current Employer:MARCY FEDERAL CREDIT UN
Previous Employer
(s):
Credit Summary
This section gives you a broad look at your current and past credit status. Here you'll find the total
number of open and closed accounts In your name, the total balance on those accounts, and
dellnquendes.
REAL ESTATE ACCOUNTS:
Count
Balance
Current
Delinquent
Other
REVOLVING ACCOUNTS:
Count
Balance
Current
Delinquent
Other
INSTALLMENT
ACCOUNTS:
,...-..-.
\...UUIU,.
Bala nee
Current
Delinquent
Other
OTHER ACCOUNTS:
Count
Balance
MARCY FCU
EXPERIAN
EQUIFAX
TRANSUNION
6
$170,159.00
4
o
2
11
$521.00
9
o
2
6
$14,867.00
6
o
o
o
$0.00
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CreditExpert.com - Experian Credit Manager
Page 2 of 14
Current
Delinquent
Other
o
o
o
COLlECrION ACCOUNTS:
Count
Balance
Current
Delinquent
Other
o
$0.00
o
o
o
TOTAL ACCOUNTS:
Count
Balance
Current
Delinquent
Other
23
$185,547.00
19
o
4
ACCOUNTS SUMMARY:
Open Accounts:
Closed Accounts:
Public Records:
Inquiries:
Public Records
The Information In this section comes from federal district bankruptcy records, statl! and county
court records, tax liens and monetary judgments, and In some states, overdue child support
records. Public records remain on your credit report for 7-10 years.
There are 0 publiC record Items on your report.
Credit Inquiries
This section contains the names of those who obtained a copy of your credit report. Inquiries
remain on your report up to two years.
5
18
o
1
EXPERlAN
REl REPORTING SVCS /
Mortgage Reporters y
2/18/2009
Account History
This section contains spedfic Information on each account you've opened In the past. Positive
information about your accounts remains on your report Indefinitely.
BANK OF AMERICA
Account
Name:
Account
Number:
Acct Type: Credit Card - Revolving Terms
Acct
Status: Closed
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Umlt:
Past Due:
Payment
Status:
EXPERlAN
EQUIFAX
TRANSUNION
BANK OF AMERICA
-
10/1/1989
$0.00
Revolving
$3,373.00
Current
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CreditExpert.com - Experian Credit Manager
Page 3 of 14
Credit line closed-consumer
Comments: request-reported by subscriber
24~Month Payment History
Date: Apr May Jun Jul Aug Sap Oct Nov Dee Jan Feb Mar Apr May Jun Jul Aug Sap Oct Nov Dec Jan Feb Mar
~W~W~~~WWOO~OOOO~~~~OOOOOOOO~~~
Experlan: OK NO NO OK NO NO NO NO NO NO NO ND OK NO OK OK OK OK OK OK OK OK OK OK
BEACON FEDERAL
EXPERJAN
EQUIFAX
TRANSUNION
Account
Name:
Account
Number:
Real Estate Mortgage - With Or
Acct Type:Wlthout Other Collateral. Usually
A Second Mortgage
Closed
Acct
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Umlt:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul
~~~~~~~OOOOOOOO~OOOOOOOOOO~WWWIDWW
Experlan: OK OK OK OK OK OK OK
BEACON FEDERAL
Account
Name:
Account
Number:
Acct Ty e" Conventional Real Estate Loan,
p "Indudlng Purchase Money Arst
Acct
Status: Oosed
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Umlt:
Past Due:
Payment
Status:
Comments:
24-Month Pilyment History
Date: Aug Sep Oct Nov Dee Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee Jan Feb Mar Apr May Jun Jul
05 05 05 05 OS 06 00 06 06 ~ 06 00 06 00 06 06 06 07 07 07 07 07 07 07
BEACON FEDERAL
b,.
9/1/2006
180 Months
Paid satisfactorily
EXPERJAN
EQUIFAX
TRANSUNION
BEACON FEDERAL
12/1/2004
180 Months
Paid satisfactorily
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Page 4 of 14
Experlan:
BEACON FEDERAL
Account
Name:
Account
Number:
Acct Type:
Acct
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Limit:
Past Due:
Payment
Status:
Comments:
24-Month PByment History
Date: May Jun Jut Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr
~~~WWWWW~OOOOOOOOOOOOOOOOOOOO~~~~~
OK OK OK OK OK OK OK OK OK OK OK
Account
Name:
Account
Number:
Acct Type: Check Credit Or Une Of Credit
Acct 0 n
Status: pe
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Umlt:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: May Jun Jut Aug Sep Oct Nav Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr
WW~WWWWWOOOOOOOOOOOOOOOOOOOOOOOO~~~~
Experlan: OK OK OK OK OK OK OK OK OK OK 01< OK OK OK OK OK OK OK OK OK OK OK OK OK
FIFTH THIRD BANK
Experlan:
BEACON FEDERAL
OK OK OK OK OK OK OK
EXPERIAN
EQUIFAX
TRANSUNION
BEACON FEDERAL
J
Auto Loan
Open
$464.00
5/1/2008
$14,867.00
48 Months
Current
EXPERIAN
EQUIFAX
TRA~5UNION
BEACON FEDERAL
$24.00
8/1/2000
$0.00
Revolving
$203.00
$1,000.00
Current
EXPERIAN
EQUIFAX
TRA8SUNION
Account
Name:
Account
Number:
Acct Type: Credit Line Secured, ReVOlving
Acct
AFTH THIRD BANK
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CreditExpert.com - Experian Credit Manager
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Umlt:
Past Due:
Payment
Status:
Page 5 of 14
Closed
4/1/2004
Revolving
$22,560.00
$22,560.00
Paid satisfactorily
Credit line closed-consumer
Comments: request-reported by subscriber
24-Month Payment History
Date: Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul
~~~~~rororororororororoOOroro~04~040404~
Expwlan: OK OK OK OK
FIRST USA BANK N A
Account
Name:
Account
Number:
Acct Type: Credit Card - Revolving Tenns
Acct
Status: Closed
Monthly
Payment:
Date Open:
Balance:
Tenns:
High
Balance:
Umlt:
Past Due:
Payment
Status:
EXPI!RIAN
EQUIFAX
TRANSUNION
FIRST USA BANK N A
-
-
5/1/1999
Revolving
Paid, zero balance
Credit line closed-consumer
Comments: request-reported by subscriber
24-Month Payment History
Date: Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jut Aug Sep Oct Nov Dec J&n Feb Mar Apr May
~~~~~~~~~~~~~~~~~~~~~~~~
Experlan: OK
GEMBI JCP
Account
Name:
Account
Number:
Acct Type:
Acct
Status:
Monthly
Payment:
Date Open:
Balance:
Tenns:
EXPERIAN
TRANSUNION
EQUIFAX
GEMBnCp
-
Revolving Charge Account
Closed
9/1/2001
Revolving
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CreditExpert.com - Experian Credit Manager
Page 6 of 14
High
Balance:
Umit:
Past Due:
Payment Account transferred to another
Status: office
Account dosed due to transfer
or refinance
Comments:
$100.00
$800.00
24-Montll Payment History
Date: Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct
~~ooooooooooooooooooroooro~~~~~~~~~~
experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK
GEMB/MENS WEARHOUSE
EXPERJAN EQUIFAX TRANSUNION
Account
Name: GEMB/MENS WEARHOUSE
Account
Number:
Acct Type: Revolving Charge Account
Acct
Status: Closed
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Limit:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jut Aug Sep Oct Nov Dec Jan
WWWWWWWWWW~~~~~~~~~~OO~~~
Experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK
MARCY fEDERAL CR UNION
EXPERJAN
3/1/2006
Revolving
$403.00
$0.00
Paid satisfactorily
EQUIFAX
TRANSUNION
Account MARCY FEDERAL CR UNION
Name:
Account
Number:
Real Estate Mortgage - With Or
Acct Type:Wlthout Other Collateral. Usually
A Second Mortgage
Closed
Acct
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Limit:
Past Due:
9/1/2006
180 Months
Payment Account transferred to another
Status: office
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CreditExpert.com - Experian Credit Manager
Page 7 of 14
Transferred to another lender or
Comments: claim purchased
24-Month Pilyment History
Date: Jan Feb Mar Apr May Jun Jut Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jut Aug Sep Oct Nov Dee
~~~~~~~~~~~~~~~~~~~~~~~~
Experlan: OK OK OK OK
MARCY FEDERAL CR UNION
EXPERJAN
Account MARCY FEDERAL CR UNION
Name:
Account
Number:
Aect T pe' Conventional Real Estate Loan,
y 'Indudlng Purchase Money First
Acct
Status: Oased
Monthly
Payment:
Date Open: 1211/2004
Balance:
Terms: 180 Months
High
Balance:
Umlt:
Past Due:
Payment Account transferred to another
Status: office
Transferred to another lender or
Comments: claim purchased
EQUIFAX
TRANSUNION
24-Month Payment HI5tory
Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nav Dee Jan Feb Mar Apr May )un Jul Al,Ig Sep Oct Nov Dec
~~~~~~~~~~~~~M~~~~~~~~~OO
exp.rlan: NO OK OK OK OK OK OK OK OK NO NO OK OK OK OK OK OK OK OK OK OK OK OK OK
MARCY FEDERAL CR UNION
EXPERJAN
EQUIFAX
TRANSUNION
Account MARCY FEDERAL CR UNION
Name:
Account
Number:
Acct Type: Check Credit Or Une Of Credit
Acct
Status: Closed
Monthly
Payment:
Date Open:
Balance:
Tenns:
High
Balance:
limit:
Past Due:
Payment Account transferred to another
Status: office
Transferred to another lender or
Comments: claim purchased
-
8/1{2000
Revolving
$1,000.00
$1,000.00
24-Month Payment History
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CreditExpert.com - Experian Credit Manager
Page 8 of 14
Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct No... Dec Jan Feb Mar Apr May Jun Jul AtJg Sep Oct No... Dec
~~~~~~~~~~~~OOOOOOOOOOOOOOOOOOOOOOOO
Experlan: NO OK OK OK OK OK OK OK OK NO NO OK OK OK OK OK OK OK OK OK OK OK OK OK
MARCY FEDERAL CR UNION
Account
Name:
Account
Number:
Acct Type:
Acct
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Limit:
Past Due:
Payment
Status:
EXPERlA.N
EQUIFAX
TRAHSUNION
MARCY FEDERAL CR UNION
Auto Loan
Closed
11/1/2002
60 Months
Paid satisfactOrily
Credit line dosed-grantor
Comments: request-reported by subscriber
24-Month Payment History
Date: Noy Dee Jan Feb Mar Apr May Jun Jul Aug Sep Oct No... Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct
~~~~~~~~~~~~~~OOOOOOOOOO~OOOOOOOO
ex.-rlan: OK OK OK NO OK OK OK OK OK OK OK OK NO NO OK OK OK OK OK OK OK OK OK OK
MARCY FEDERAL CR UNION
Account MARCY FEDERAL CR UNION
Name:
Account
Number:
Conventional Real Estate Loan,
Acct Type: Induding Purchase Money First
Acct
Status: Closed
Monthly
Payment:
Date Open:
Balance:
Tenns:
High
Balance:
Limit:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: Feb Mar Apr May Jun Jul Aug Sep Oct No... Dee Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan
~rorororororoooooooro~~~~~~~~~~~~~
Experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK NO OK OK OK OK OK
MARCY FEDERAL CR UNION
EXPERlA.N
EQUIFAX
TRANSUNION
6/1/2002
15 Months
Paid satisfactorily
EXPERlA.N
EQUIFAX
TRANSUNION
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CreditExpert.com - Experian Credit Manager
Account
Name: MARCY FEDERAL CR UNION
Account
Number:
Acct Type:
Acct
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Limit:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
mmmmmmmmmmmm~~~m~~~~~~~~
Experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK NO OK OK OK OK OK
MARcY FEDERAL CR UNION
Account MARCY FEDERAL CR UNION
Name:
Account
Number:
Acct Type:
Acct
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
limit:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee Jan Feb Mar Apr May Jun
99 99 99 99 99 99 00 00 00 00 00 00 00 00 00 00 00 00 01 01 01 01 01 01
Experlan: OK OK
MARCY FEDeRAL CR UNION
EXPERIAN
Account
Name:
Account
Number:
Acct Type:
Acct
Status:
Monthly
Payment:
Date Open:
Page 9 of 14
1
Auto Loa n
Closed
10/1/1998
48 Months
PaId satIsfactOrily
EXPERIAN
EQUIFAX
TRANsUNION
Secured Loan
Closed
4/1/2001
Unknown
Paid satisfactorily
EQUIFAX
TRANS UNION
MARCY FEDERAL CR UNION
L
Secured Loan
Closed
3/1/2000
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Page 10 of 14
Balance:
Terms: Unknown
High
Balance:
Umlt:
Past Due:
Payment
Status: Paid satisfactorily
Comments:
24.Month Payment History
Date: Jul Aug Sep Oct Nay Dec Jan Feb Mar Apr May Jun Jul Aug Sap Oct Noy Dee Jan Feb Mar Apr May Jun
~~~~~~~~~~~~~~~~~~OO~OOOOOOOO
Experlan: OK OK OK
MARCY FEDERAL CR UNION
Account MARCY FEDERAL CR UNION
Name:
Account
Number:
Acct Type:
Acct
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
limit:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: Jan Feb Mar Apr May Jun Jul Aug Sep Oct Noy Dee ]an Feb Mar Apr May Jun Jul Al,Ig Sep Oct Noy Dee
~~~~~~~~~~~~~~~~~~~~~~~~
Exper18n: OK OK OK OK OK OK OK OK OK NO NO OK OK OK OK OK OK OK NO OK OK OK OK OK
EXPERIAN
EQUIPAX
TRANSUNION
Unsecured Loan
Closed
7/1/1997
42 Months
Paid satisfactorily
MARCY FEDERAL CR UNION
EXPERlAN
Account MARCY FEDERAL CR UNION
Name:
Account
Number:
Acct Type: Credit Card - Revolving Tenns
Acct
Status: Open
Monthly
Payment:
Date Open:
Balance:
Tenns:
High
Balance:
limit:
Past Due:
Payment
Status:
Comments:
24.Month Payment History
EQUIFAX
TRANSUNION
-
$20.00
6/111995
$521.00
Revolving
$4,364.00
$5,000.00
Current
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Date: r-,ay Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee Jan Feb Mar Apr
mmmmmmmw~~~~~~~oo~~oo~~~~~
Experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK
MCYDSNB
Account
Name:
Account
Number:
Acct Type: Revolving Charge Account
Acct
Status: Open
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Limit:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: May Jun Jul Aug Sep Oct Noy Dee Ja n Feb Mar Apr May Jun Jul Aug Sep Oct Noy Dee Jan Feb Mar Apr
wwmmmwwwoo~oo~~~OO~~~OOOO~~~~
Experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK
SEARS/CBSD
Account
Name:
Account .
Number: - -
Aect Type: Credit Card - Revolving Terms
Acct
Status: Closed
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Limit:
Past Due:
Payment
Status:
EXPERIAN
EQUIFAX
TRANSUNJON
MCYDSNB
9/1/2002
$0.00
Revolving
$429.00
$100.00
Current
EXPERIAN
EQUJFAX
TRANSUNION
SEARs/caSD
2/1/2005
Revolving
$1,364.00
$3,200.00
Paid satisfactorily
Credit line closed-consumer
Comments: request-reported by subscrlber
24-Month Payment History
Date: Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar
wwmwmmwwmooooooooooooOOOO~OOOOOOMW~
Experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK
WACHOVIA BANK NA/FTU
Account
EXPERIAN
EQUJFAX
TRANSUNION
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Name: WACHOVIA BANK NA/FTU
Account
Number:
Acct Type: CredIt Line Secured, Revolving
Acct
Status: Closed
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
LImIt:
Past Due:
Payment
Status:
6/1/2004
Revolving
$29,476.00
$45,000.00
Paid satisfactorily
Credit line dosed-consumer
Comments: request-reported by subscriber
24-Month Payment History
Date: May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dee Jan Feb Mar Apr
~~~~~~~~OOOOOOOOOOOOOOOOOOOOOOOOW~w~
experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK
WELLS FARGO HM MORTGAG
Account WELLS FARGO HM MORTGAG
Name:
Account
Number:
Conventional Real Estate Loan,
Acct Type: Including Purchase Money First
Acct Open
Status:
Monthly
Payment:
Date Open:
Balance:
Terms:
High
Balance:
Limit:
Past Due:
Payment
Status:
Comments:
24-Month Payment History
Date: May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jut Aug Sep Oct Nov qec Jan Feb Mar Apr
~~~~~~~~OOOOOOOOOOOOOOOOOOOOOOOO~~~~
Experlan: OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK OK
EXPERIAN
EQUIFAX
TRANSUNION
-
$989.00
4/1/2004
$170,159.00
360 Months
Current
Legend
OK Current
~ No Data Provided.
30 30 Day. Late
60 60 Day. Late
90 90 Days Late
120 120 Days Late
KD Key Derogatory..
RF Reposseaion or Foredosure
PP Payment Plan
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.Sometlmes the credit bureaus do not have information from a particular month on file.
** For additional Information on Key Derogatory, please see your Credit Report Guide
PLUS Score<!> Report
A PLUS Score Is a numerical representation of your credit worthiness. The majority of lenders use
some s~rt of credit scoring model to help predict what kind of credit risk you may be. For each
bureau 5 Score and explanation, click on the colored tabs below.
PLUS Score from Experian
This PLUS Score is based on Information from your Experlan credit report.
Your PLUS Scor. is calculated using the Information In your !=redlt report. Since Information often differs among your
three bureau reports, your PlUS Scores based on those reports will also vary.
Your PLUS Score Is: 784 on . scale of 330 - 830.
Your Credit Category Is:
Very Poor Poor Fair
Good
Excellent
Percentile: Your credit rating ranks higher than 95.05% of U.S. consumers.
Score Details
About your PLUS Score: [
I~
Your PLUS Score is formulated using the information In your credit file. Your score helps potential
lenders, landlords, and employers Quickly gauge your credit history and decide what kind of a risk
they are taking if they approve your application. Your PLUS Score can range betw~n 330 and 830,
with a higher score Indicating a lower risk. There are many scoring models used In the marketplace.
The type of score used, and Its assodated risk levels, may vary from lender to lend~r. But
regardless of what scoring model Is used, they all have one purpose: to summarize your
creditworthiness. Keep In mind that your score Is just one factor used In the application process.
Other factors, such as your annual salary and length of employment, may also be considered by
lenders when you apply for a loan.
What your PLUS Score means:
Factors in your credit file Indicate you have excellent credit. Lenders will likely offer you the best
rates and terms.
What thl. means to you:
Credit scoring can help you understand your overall credit rating and help companies better
understand how to serve you. Overall benefits of credit scoring have Included faste~ credit
approvals, reduction In human error and bias, consistency, and better terms and rates for American
consumers through reduced costs and losses for lenders. While lenders may use different scoring
models to determine how you score, and each major credit bureau has Its own method for
calculating credit scores, the scoring models have been falrty well standardized so that a score at
one bureau is roughly equivalent to the same score at another.
What factors raise your PLUS Score:
· You have paid your bills on time and currently do not have any overdue accounts or derogatory
Information, such as a collection, charge-off, or bankruptcy, on your report.
· You have a good cushion of available credit between your current balance and your credit limits
on all open trades. This has a pOSitive affect on your credit Score. This cushion shows lenders that
you are unlikely to overextend yourself financially.
· The total balance on al! your credit cards !s relatively low compared to your total availab!e credit
limit. This has a positive Impact on your credit score.
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· You have at least 2 or more open major credit cards, such as Discover, AmerlCCl!n Express, VISA,
or MasterCard, on your credit report. This often tells lenders that you are a responsible borrower
and they may be more likely to see you as a good credit risk and extend you credit.
What factors lower your PLUS Score:
· Credit scores are calculated based on various factors In your credit report. Currently, your credit
report does not show any significant negative or derogatory Information.
Consumer Statement:
Statement: No Statement(s) present at this time
..................'.................................................
DISCLAIMER
The PLUS ScoreSM, developed by Experlan, is not an endorsement or guarantee of your credit worthiness as seen by
lenders. The dift'erent risk levels presented here are for educational use only. Your PlUS Score can help you understand
what factors Impact your credit score.
Please be aware that there are many scoring models used In the marketplace, and each lender's scoring model has Its
own set of factors. How each lender weighs their chosen factors may vary, but the exact formula used to calculate your
score Is proprietary. In general, the higher your score, the better your chances are of obtaIning favorable rates and
terms.
Your PlUS Score was calculated using your ac:tual data from your credit file on the day that you requested your report,
making it comparable to most scoring models in the Industry. Keep In mind how.,ver that other factors, SUCh as length
aI employment and annual salary, a1"8 often taken Into consideration by lenders when making decisions about you.
Also note that each bureau has Its own set of data, resulting In a separate PLUS Score for each of your credit files.
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ARTICLES OF ORGANIZATION
OF
CLASSIC COMFORT TRANSPORTATION, LLC
The undersigned, for the purpose of fonning a limited liability company under the Florida
Limited Liability Company Act, Chapter 608, Florida Statutes, hereby makes, acknowledges,
and files the following Articles of Organization.
ARTICLE I -- NAME
The name of the limited liability company shall be Classic Comfort Transportation, LLC
(the "Company").
ARTICLE II -- ADDRESS
The mailing address of the Company shall be 865 Kings Way, Naples, FIOlida 34104.
The street address of the initial principal office of the Company shall be 865 Kings Way, Naples,
Florida 34104.
ARTICLE III -- DURATION
The Company shall commence its existence on the date these Articles of Organization are
filed by the Florida Department of State. The Company's existence shall be perpetual unless the
Company is earlier dissolved as provided in these Articles of Organization or in the Company's
Operating Agreement.
ARTICLE IV -- REGISTERED OFFICE AND AGENT
The name and street address of the initial registered agent of the Company in the State of
Florida are Gary K. Wilson, 5801 Pelican Bay Boulevard, Suite 300, Naples, Florida 34108.
ARTICLE V -- MANAGEMENT
The Company shall be managed by a Managing Member in accordance with the
Operating Agreement adopted by the members for the management of the business and affairs of
the Company. The Operating Agreement may contain any provisions for the regulation and
management of the affairs of the Company not inconsistent with law or these articles of
organization. At the time that these Articles are executed, the Managing Member is as follows:
Walter A. Kapinos
865 Kings Way
Naples, Florida 34104
IN WITNESS WHERE;r the undersigned organizer has made and subscribed these
Articles of Organization on this day of May, 2008.
I
K. son
Authorized Representative of Member
ACCEPTANCE OF REGISTERED AGENT
The undersigned, being the person named in the Articles of Organization of Classic
Comfort Transportation, LLC as the registered agent of this limited liability company, hereby
consents to accept service of process for the above stated company at the place designated in the
Articles of Organization, and accepts the appointment as registered agent and agrees to act in this
capacity. The undersigned further agrees to comply with the provisions of all statutes relating to
the proper and complete performance of his duties, and is familiar with and accepts the
obligations of the position of registered agent.
Date: May 2!/., 2008.
2
COL1JMBUSI14J2D66..01
OPERATING AGREEMENT
OF
CLASSIC COMFORT TRANSPORTATION, LLC
This Operating Agreement (the "Agreement") is created this
~,2008, by Waiter A. Kapinos (the "Member").
Explanatory Statement
.l Cf '"71... day of
The Member has organized and operated a limited liability company in accordance with
the terms of, and subject to the conditions set forth in the articles of organization and this
Agreement.
Section I
Defined Terms
The following capitalized terms shall have the meanings specified in this Section 1. Other
terms are defined in the text of this Agreement; and, throughout this Agreement, those terms
shall have the meanings respectively ascribed to them.
"Act" means the Florida Limited Liability Company Act, as amended from time to time.
"Agreement" means this Agreement, as amended from time to time.
"Code" means the Internal Revenue Code of 1986, as amended, or any corresponding
provision of any succeeding law.
"Company" means the limited liability company organized In accordance with this
Agreement.
"Interest" means a Person's share of the Profits and Losses of, and the right to receive
distributions from, the Company.
"Interest Holder" means any Person who holds an Interest, whether as a Member or as
an unadmitted assignee of a Member.
"lrzvoluntary flVithdrawal" means, the occurrence of any of the following events:
(i) The Member makes an assignment for the benefit of creditors;
(ii) The Member files a voluntary petition of bankmptcy; or
(iii) The Member is adjudged bankrupt or insolvent or there is entered against
the Member an order for relief in any banklUptcy or insolvency proceeding.
NAPLESi5542(,7 v {):
"l14ember" means the Person signing this Agreement and any Person who subsequently is
admitted as a member of the Company. .
"Membership Rights" means all of the rights of a Member in the Company, including a
Member's: (i) Interest; (ii) right to inspect the Company's books and records; (iii) right to
participate in the management of and vote on matters coming before the Company; and (iv)
unless this Agreement or its articles of organization provide to the contrary, right to act as an
agent of the Company.
"Person" means and includes an individual, corporation, partnership, association, limited
liability company, trust, estate, or other entity.
"Positive Capital Account" means a Capital Account with a balance greater than zero.
"Profit" or "Loss" means, for each taxable year of the Company (or other period for
which Profit or Loss must be computed) the Company's taxable income or loss determined in
accordance with the Code.
"Treasury Regulations" means the income tax regulations, including any temporary
regulations, from time to time promulgated under the Code.
"Department of State" means the Florida Department of State.
"Successor" means all Persons to whom all or any part of an Interest is transferred either
because of (i) the sale or gift by Member of all or any part of his Interest, (ii) an assignment of
Member's Interest due to Member's Involuntary Withdrawal, or (iii) because Member dies and
the Persons are Member's personal representatives, heirs, or legatees. .
"Transfer" means, when used as a noun, any voluntary sale, hypot~ecation, pledge,
assignment, attachment, or other transfer, and, when used as a verb, means voluntarily to sell,
hypothecate, pledge, assign, or otherwise transfer.
"Withdrawal" means a Member's dissociation from the Company by any means.
Section II
.'ormation and Name; Office; Purpose; Term
2.1. Organization. The Member hereby organizes a limited liability company pursuant
to the Act and the provisions of this Agreement and, for that purpose, have caused articles of
organization to be prepared, executed and filed with the Department of State on May ___' 2008.
2.2. Name of the Company. The name of the Company shall be CLASSIC
COMFORT TRANSPORTATION, LLC. The Company may do business under that name and
under any other name or names upon which Member may, in his sole discretion, determine. If
~..\P;.ES/554:!.67 ... 0:
the Company does business under a name other than that set forth in its articles of organization,
then the Company shall file a fictitious name registration as required by law.
2.3. Purpose. Company is organized to own and operate any lawful business in the
State of Florida and to do any and all things necessary, convenient, or incidental to that purpose.
2.4. Term. The term of the Company began upon the acceptance of the articles of
organization by the Department of State and its duration shall be perpetual, unless its existence is
sooner tenninated pursuant to Section VII of this Agreement.
2.5. Principal Office. The principal office of the Company shall be located at 865
Kings Way, Naples, FL 34104, or at any other place which Member, in his sole discretion,
determines.
2.6. Registered Agent/Registered Office. The name and street address of the
Company's registered agent and registered office in the State of Florida shall be Gary K. Wilson,
Esquire, Porter, Wright, Morris & Arthur LLP, 5801 Pelican Bay Boulevard, Suite 300, Naples,
Florida 34108.
2.7. lv/ember. The name, present mailing address, and Percentage interest of the sole
Member is set forth on Exhibit A.
Section III
Capital; Capital Accounts
3.1. Initial Capital Contributions. Upon the execution of this Agreement, Member
shall contribute to the Company the cash and property set forth on Exhibit A.
3.2. No Other Capital Contributions Required. Member shall not be required to
contribute any additional capital to the Company, and except as set forth in the Act, no Member
shall have any personal1iability for any obligations of the Company.
3.3. Loans. Any Member may, at any time, make or cause a loan to be made to the
Company in any amount and on those temlS upon which the Company and the Member agree.
3.4. Capital Accounts. A capital account shall be maintained by the Company for the
Member.
Section IV
Profit, Loss, and Distributions
4. I. Distributions of Cash Flow. Cash Flow for each taxable year of the Company
shall be distributed to Member at such times as determined by Member.
4.2. Allocation of Profit or Loss. All Profit or Loss shall be allocated to Member.
i'\'j\Pl.ESIS:<i41h] v 1)1
4.3. Liquidation and Dissolution. If the Company is liquidated, the assets of the
Company shall be distributed to Member or to one or more Successors.
Section V
Management: Rights, Powers, and Duties
5.1. Management. The Company shall be managed solely by the Member, who may,
but need not be referred to as the Managing Member.
5.2. Personal Services. Member shall not be required to perform services for the
Company solely by virtue of being a Member.
5.3. Liability and Indemnification.
5.3.1. Member shall not be liable, responsible, or accountable, in damages or
otherwise, to the Company for any act performed by his with respect to Company matters, except
for fraud.
5.3.2. The Company shall indemnify Member for any act performed by his with
respect to Company matters, except for fraud.
Section VI
Transfer of Interests and Withdrawals of Members
6.1. Transfers by Member. Member may Transfer all, or any portion of, his interest or
rights in, his Membership Rights to one or more Successors.
6.2. Transfer to a Successor. In the event of any Transfer of all or any part of
Member's Interest to a Successor, the Successor shall thereupon become a Member and the
Company shall be continued.
Section VII
Dissolution, Liquidation, and Termination of the Company
7.1. Events of Dissolution. The Company shall be dissolved if Member determines to
dissolve the Company.
7.2. Procedure for Winding Up and Dissolution. If the Company is dissolved, the
affairs of the Company shall be wound up. On winding up of the Company, the assets of the
Company shall be distributed, first, to creditors of the Company in satisfaction of the liabilities
of the Company, and then to the Person(s) who is/are the Member(s) of the Company in
proportion to his Interests.
7.3. Filing of Articles of Dissolution. If the Company is dissolved, articles of
dissolution shall be promptly filed with the Department of State. If there are no remaining
tv1embers, the articles of dissolution shall be filed by the last Person to be a Member; if there are
NAPLESI~542f,i' ,0.
no remaining Members, nor a Person who last was a Member, the articles shall be filed by the
legal or personal representatives of the Person who last was a Member.
Section VIII
Books, Records, Accounting, and Tax Elections
8.1. Bank Accounts. All funds of the Company shall be deposited in a bank account or
accounts opened in the Company's name. Member shall detennine the institution or institutions
at which the accounts will be opened and maintained, the types of accounts, and the Persons who
will have authority with respect to the accounts and the funds therein.
8.2. Books and Records. Member shall not be required to keep or cause to be kept
complete and accurate books and records of the Company nor supporting documentation of the
transactions with respect to the conduct of the Company's business. The books and records, if
any, shall be maintained in accordance with sound accounting principles and practices.
8.3. Annual Accounting Period. The annual accounting period of the Company shall
be its taxable year. The Company's taxable year shall be selected by Member, subject to the
requirements and limitations of the Code.
Section IX
General Provisions
9.1. Applicable Law. All questions concerning the construction, validity, and
interpretation of this Agreement shall be governed by the internal law, not the law of conflicts, of
the State of Florida.
9.2. Section Titles. The headings herein are inserted as a matter of convenience only,
and do not define, limit, or describe the scope of this Operating Agreement or the intent of the
provisions hereof.
9.3. Terms. Common nouns and pronouns shall be deemed to refer to the masculine.
feminine, neuter, singular and plural, as the identity of the Person may in the context require.
9.4. Separability of Provisions. Each provision of this Agreement shall be considered
separable; and if, for any reason, any provision or provisions herein are detennined to be invalid
and contrary to any existing or future law, such invalidity shall not impair the operation of or
affect those portions of this Operating Agreement which are valid.
IN WITNESS WHEREOF, the Member has executed this Agreement under seal, as of
the date set forth hereinabove.
MEMBER:
tv.$.. ~', k~
Walter A. Kapinos
(SEAL)
NAPLESI5542~1 v 01
EXHIBIT A
CLASSIC COMFORT TRANSPORTATION, LLC
Name and Address Initial Capital Contribution Percenta2e
Walter A. Kapinos
865 Kings Way $1,000.00 100%
Naples, FL 34104
TOTAL $1,000.00 100%
Member and Capital Contributions
NAPLF..$:'554267 v 01
f
{
i'
(
FLORIDA DEPARTMENT OF STATE
Division of Corporations
September 15,2008
COMFORT TRANSPORTATION
865 KINGS WAY
NAPLES, FL 34104
Subject: COMFORT TRANSPORTATION
REGISTRATION NUMBER: G08259900277
This will acknowledge the filing of the above fictitious name registration which
was registered on September 15, 2008. This registration gives no rights to
ownership of the name.
Each fictitious name registration must be renewed every five yearS! between
January 1 and December 31 of the expiration year to maintain re;gistration.
Three months prior to the expiration date a statement of renewal will be:mailed.
I
IT IS THE RESPONSIBILITY OF THE BUSINESS TO NOTIFY THIS OFFICE IN
WRITING IF THEIR MAILING "DDRESS CHANGES. Whenever corr$sponding
please provide assigned Registration Number,
Enclosed is your certificate(s) as requested.
Should you have any questions regarding this matter you may contact I our office
at (850) 245-6058.
Fictitious Name Section
Division of Corporations
Letter No. 208A00050228
Division of Corporations - P.O. BOX 6327 -Tallahassee, Florida 32314
APPLICATION FOR REGISTRATION OF FICTITIOUS NAME
DOCUMENT# G08259900277
Fictitious Name to be Registered: COMFORT TRANSPORTATION
Mailing Address of Business:
865 KINGS WAY
NAPLES, FL 34104
Florida County of principal place of business: COLLIER
FEI Number:
Ownerfs) of Fictitious Name:
CLASSIC COMFORT TRANSPORTATION LLC
865 KINGS WAY
NAPLES, FL 34104 US
Fiorida Registration Number: L08000053120
FEI Number: 26-2730987
FILED
Sep 15, 2008
Secretary of State
I (we) the undersigned, being the sole (all the) party(ies) owning interest in the above fictitious name, certify that the
information indicated on this form is true and accurate. I (we) understand that the electronic signature(s) b~low shall
have the same legal effect as if made under oath.
WALTER A KAPINOS
Electronic Signature(s)
Certificate of Status Requested (X)
Certified Copy Requested (X)
09/15/2008
Date
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REG. IN IT COUNTY MAIL SALES TITLE
) TAX REG. FEE FEE TAX FEE
$155.08 $ $5.00 $ $ $
PLATE DATE INTERNET VOLUNTARY GRAND
ISSUED ISSUED KIOSK FEE CONT.TOTAL TOTAL
X 06/05/08 $0.00 $ $160.08
FLORIDA VEHICLE REGISTRATION
'v
DATE ISSUED: 06/05/08
OL.: 262730987-01
TAG.: 017LUV DECAL.: 00304955 EXP: 07/31/10
VIN:ILNHM84W07Y623551 TC:I00822520 YR/HK:2007 LINC
CLASSIC COMFORT TRANSPORTATION LLC
865 KINGS WAY
NAPLES, FL 34104
L#: 1926198 T#: 542762912 B#: 1331441 R#: 542762912
Motor Vehicle Check Results
Page 1 of 1
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Vehicle Information Check
Vehicle Information
Vehicle Identification Number: 1LNHM84W07Y623551 Year/Make: 2007 UNCOLN
Previous Title State: MASSACHUSETTS Registration Expiration Date: 07/31/2010
Title: 100822520 Title Issue Date: 06/05/2008
Odometer Reading/Status: 50,594 Odometer Date: 06/05/2008
ACTUAL MILEAGE
Color: BLACK Vehicle Type: AUTO
Title Status: ACTIVE Owner Information: 1 owner
~ .~\
Brands: /' TAXI
"- ./
lien Information
Name: BEACON FEDERAL
Address: PO BOX 186 6311 COURT ST RD
E SYRACUSF, NY 13057-0000
Date: OS/22/2008
!f ~r:y ~f ~h:,,:,: !::~:;!.~::~~:;~ :":r: ~!:!~ r~::~:::! :::-:~~:: ~~ ~.:: ~:;:;':-:~'!"~::::!. ,-,!.~-,-,-. .---~~-~~'-~ '.!:'::;:# tax collector ::::,1
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look up another record?
Online Services I Public Recor-ds I Online Forms
About Us I Privacy Statement I Disclamler I Office LocatIOns I Contact Us
Copyright (~}200S State of Florida
AFFIDAVIT
I hereby certify that I have read and understand Code of Laws and Ordinance Chapter 142,
"Vehicles for Hire" and if I am granted a Certificate to Operate I will fully comply with its
provisions.
!~.{Jk a K:~ 0--1
(Signature of ~ plicant)
I . {) ) A- L -ren. f} ~rP 1 ~CJ r swear or aff"rrm that all information on this Application
for Certificate to Operate is true.
w~c~
(Signature of A licant)
STATE OF FLORIDA
COUNTY OF COLLIER
~n=d~o~~e=oafu'
s~otmy
The foregoing instrument was subscribed =d sworn to be~'S.- me thiS~ .zJ(j ~
ByLt-WLi O~ Whohas~r- ~g-<-9J,-L(~-:l$-j
(Name of person aclm wledging) (Type of identification)
NOTARY PUBLIC.STATE OF FLORIDA
"""" L. d
':"Ar.i:~ In a C. Wolfe
~ ~ j Co~mission # DD7391S0
""""..", ExpIres: DEC. 07, 2011
BONDED TIlRU ATLANTIC BONDING CO., !NO
Print of Notary
NOTARY'S SEAL
Notary Public Commission #
Commission Expires
5
AFFIDAVIT
Before me this day personally appeared WA i.-T~ A, k'~ ~^o--'i who swears or affirms
that the vehic1e(s) to be permitted meet(s) the safety standar as set forth ill Code of Laws
and Ordinance Chapter 142.
It is understood and acknowledged by the Code Enforcement Department and myself that if
my vehic1e(s) that is/ are permitted fail(s) to meet(s} the safety standards as required by this
Ordinance, the vehic1e(s) must be removed from service until all violations are corrected.
CQ-M.--&~-t \t<A~'~~
SIGNATURE OF APPLICANT LAjQJ2ff:; C J(~
BUSINESS NAME
DATE
Lf/'?/01
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing in.trument was sub.e 'bed ~d .worn to before me this & day of ~
2d, by who is personally known or has
( Name of person ackn wledging)
pro.;{{j~ I - -~ -,Zf.lid,&iLication and wh~mRR'S1ATEOFFWR1DA
NOTARY . d C Wolfe
.............. L\1: ~ . DD7391S0
[W ~com.mlSSlon!c 07 2011
~ '!i/III. . E plIes' Dr.;. ,
~~ARf~I~O~~G~~~y
NOTARY PUBLIC COMMISSION #
NOTARY'S SEAL
COMMISSION EXPIRES:
4
COLLIER COUNTY GOVERNMENT
CRIMINAL MSTORY I BACKGROUND VERIFICATION REQUEST FORM
Date:
Pursuant to provisions of Chapter 119, F.S., and procedures outlined under Rule
Chapter l1C-6, F.A.C., we request a criminal history record (convictions and arrests)
check of your files.
Criminal history background check will be performed in this office. Please fill in the
blanks.
Name: WAW~
First
A )( A-f2 ' ..;- 0 oS
Middle (full) Last
~v,\ K\-.J1S W~ ~4A
(Number & Street) (City)
Maiden
Address:
pL
(State)
3"\{O~
(Zip Code)
Social Security No.:
DOB: ~",., 9- r L.. Sex: M
Height: {., Weight: ~3 0 lbs.
DL No..
-
Age: ~
Eye: (l r D W".
(Color)
Race: vJ
Hair: tJ r ~ c...) ...J
(Color)
Name:
First
Middle (full)
Last
Maiden
Address:
Number & Street
City
State
Zip Code
Social Security No.:
DL No.:
DOB:
Sex:
Age: _
Race:
Height:
Weight:
los.
Eye:
Hair:
(Color)
(Color)
'" ! , , t ) I I ~; (
,J i f f.. \.. , 1 ... \
CONSENT AND DISCLOSU2Z' -~,
t/-;z!i-b? LOCATION ___
f f
I understand that Collier County Code Enforcement will utilize the services of STERLING TESTING SYSTEMS, INC., 249 West 17th Street, New
York, NY 10011, as part of the procedure for processing my PVAC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further infolTnation through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id.
I understand a consumer reporting agency's investigation may indude obtaining infolTnation covering up to the last seven (7) years regarding, among
other items, references, character, driving record, past employment, work habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and feclerallaw. The investigation also may indude obtaining infolTnation relating to criminal records without
any time limitations, subject to state and feclerallaw.
In the event an investigative consumer report is conducted, I understand such infolTnation may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge concerning my character, general reputation, personal
characteristics or standard of living. I understand such infolTnation may also be obtained through direct or indirect contact with folTner employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
a By tilling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act
I also understand that before my application is denied based, in whole or part, on infolTnation obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the accuracy
of any infolTnation in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report. If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging infolTnation in the report, Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the infolTnation
contained in the report.
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC. In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
DATE
:fLJ
Last Name
Middle Name/Initial
~D
Male Female
[I]
#yrs at this address
Other Names Known By
[I]
City State
I FILl
Driver's License No. State
wJ2f!;: ~ K ~ ~
Signature ~
Social Sewrity No.
'f -Lt'- e) r
Date
Minnesota & Oklahoma applicants Only: I have the right to request a copy of my consumer report from Sterling Testing Systems, Inc. by
checking the box below. Sterling Testing Systems will mail the consumer report directly to me. Minnesota Applicants Only: I have the right to make
a written request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report.
o I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
..
I uJ,q L..-T ~ A k ~ l W 0 J' ,have read and understood the paragraph
w~a~
Signature of applicant
{-- '2...~-o 1--
Date
. COLLIER COUNTY BUSINESS TAX BUSINESS TAX NUMBER: 080809
COLLIER COUNTY TAX COLLECTOR - 2800 N. HORSESHOE DRIVE - NAPLES FLORIDA 34104 - (239) 252-2477
VISIT OUR WEBSITE AT: www.colliertax.com
THIS RECEIPT EXPIRES SEPTEMBER 30, 2009
DISPLAY AT PLACE OF BUSINESS FOR PUBLIC INSPECTION
FAILURE TO DO SO IS CONTRARY TO LOCAL LAWS.
LOCATION: 865 KINGS WAY
ZONED: HOME OCCUPATION
BUSINESS PHONE: 262-6211
LEGAL FORM
LL6.:., 'f~ (; f)"
, i, ;.... ." ~ /
\.' . ..... 'Sf.tw _...1,1 _""
_. "./ "J' .- - ".... J /~>-. CLASSIC COMFORT TRANSPORTATION, LLC
,.._>.1,. ,.,r . . ~ ~ ~ ,,\' .JIZAPINOS, WALTER A
'1
\ 865 KINGS WAY
. THIS TAX IS NON-REFUNDABLE -
1
.. :'It
"
I
,
~
, NAPLES
. "
NUMBER OF EMPLOYEES: OWNER ONLY-NO EMPLOYEES" . J" "
CLASSIFICATiONUMOUSINE/SHUTrU SERVICE .. "'>COLLIER CO Lie #~ceTJ6$800000621
CLASSIFICATION CODE: 03706606. .,( ,_ .... """,. "" ..... ~_ ''''',,; c..,,)
This document is a business tax only. This is not certification that lic;;;i~e !s'qu~Ji{iep. -c; (/\
It does not permit the licensee to violate any existing regulatory zoning laWs'of~ st!!e\.county or cities
nor does it exempt the licensee from any other taxes or permits that may be required by law.
FL 34104
DATE 09/2312008
AMOUNT 10.00
RECEIPT 5221.42
.rifw e~
)1
iJ
PrintResults
Page 1 at 3
STERLING
DIRECT
Code Enforcement Div. Collier County
Order#: 9407099
WALTER KAPINOS
Last Name
First Nam!_______.________._
Middle Name
Date of Birth (mm/ddlyyyy) 08/09/1952
_ Ph~~__...______._______.__.___.__._..___._.._____________._____._______..___.__u________.._..._.
Projected Salary N/A
Job State
Subject Profile
NA
KAPINOS
.___._.._vy!o~I5~..__.__..__.__._________._
PO#
Address
Apartment Number
._~!.lY____...___.._.___.._.______.______._._____._.__.._______._
State
Zip
Current Address
865 KINGS WAY
...._--------_._.._-_..._-----~~~~--_._--_.._--_.._._--.------.---------.----.-.-------.-.---.-------.
FL
34104
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
MOTOR VEHICLE REPORT (MVR)
Status
3 CLOSED
1 CLOSED
Findings
Clear
See Results Below
SEXUAL OFFENDER DATABASE SEARCH
1 CLOSED
Clear
SOCIAL SECURiTY TRACE SEARCH
1 CLOSED
Alert
CRIMINAL RECORD SEARCH
The criminal infonnation reported on this website appears exactly as it is received from the local jurisdictions and may contain information
which would be prohibited for use in making hiring decisions. Therefore, it is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: State: NW Zip: County: NATIONWIDE
Status: CLOSED L------
FINOING: Clear
************...***.************************~***********..**.........*..**
. THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND .
. HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
. CRIMINAL BACKGROUND RESEARCH METHODS.
......*._-*....._*_..*.-*.*...****-****.*.*********_.*****-*******-**..**
No crirrdnal convictions found.
City: NAPLES State: FL Zip: 34104 County: COLLIER
_Stat~":'.c:.hQ~~,?___.__...._______._.......__..__.._____.______ .._~..----....-.---.-.--..-----...-...-.-..-._._.__..___.____.._....._.._..____._.__._._._
FINDING: Clear
No criminal convictions found.
City: State: NY Zip: 13440 County: ONEIOA .
-S~LOSED.._----..----.-...-----------.-.-...--------7-.~7--...--.------.------...----..-.--.-.---.-.-..---
FINOING: Clear -
No criminal convictions found.
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINOING: See Results Below
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
~........
../
FLORIDA Driver Record - BS178
Order Date: 04/16/2009
Host Used: Online
Reference: 9407099_3
Period: THREE YEAR
License: K152901522890
H.eport Clear:YES
Name: KAPINOS, WALTER A
Address:
City, St:
As of:
https://sd.sterlingtesting.com/webdirect3 /resul ts/PrintResults.aspx? Archi ve=
4/28/2009
PrintResults
Page 2 of3
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 08/22/2007
Exp Date: 08/09/2014
AGE:
Year License First Issued: 08/22/2007
STATUS: VALID
MVR Score
SCORE:
ELIGIBLE
..,-
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONV
ACD AVD V/C
DESCRIPTION
.. NONE TO REPORT
Suspensions/Revocations
..---
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
NO ACTIVITY
License and Permit Information
/..
/
Status:VALID
~
L,cense: PERSONAL Issue:08/22/2007 Expire:08/09/2014
License Status Explanation: ELIGIBLE
C1ass:E REGULAR OPERATOR
RESTRICTION: CORRECTIVE LENSES
Miscellaneous State Data
PREVIOUS LICENSE NUMBER: 468505701 STATE: NEW YORK
NO ENTRY WITHIN THE PAST 3 YEARS AGAINST RECORD IN ABOVE NAME
MISC: EXAMS VISION=l ROAD SIGN=l ROAD RULES=l DRIVING=l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL=O
BLOCK PERSONAL INFORMATION ..
BLOCK FOR MAILING LIST ..
THIS PERSON HAS A DIGITAL IMAGE
IFOR STATED BUSINESS
IPURPOSES ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
Issue Date:
Control Number: APT8CH
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
Slale: FL
Slalus: CLOSED
FINOING: Clear
----.------------..-
No Record Found
. /'
t.../
Back to Findings
SOCIAL SECURITY TRACE SEARCH
Slalus: CLOSED
FINOING: Alert
/'"
Social Security Trace
GENERATED: 04/16/2009 04:06:40 PM
TRANSACTION ID:0017026015-765
1.
NAME
WALTER KAPINOS
SSN VALID
###-##-#### YES
STATE ISSUED
NEW YORK
DATE ISSUED
01/01/1969
ADDRESS
865 KINGS WAY NAPLES, FL 34104-4931
FROM
04/2004
TO
03/2009
2.
NAME
WALTER
SSN
###-##-####
A KAPINOS
VALID
YES
STATE ISSUED
NEW YORK
DOB
08/09/1952
DATE ISSUED
01/01/1969
ADDRESS
865 KINGS WAY NAPLES, FL 34104-4931
7221 COLEMAN MILLS RD R ROME, NY 13440-7203
PO BOX 4473 ROME, NY 13442-4473
808 N JAMES ST ROME, NY 13440-3525
PO BOX 566 ROME, NY 13442-0566
717 LEE ST ROME, NY 13440-2550
6552 FAIRVIEW LN ROME, NY 13440-2036
FROM
04/2004
11/1991
01/1999
11/1991
01/1990
04/1985
TO
03/2009
07/2007
02/1999
11/1991
12/1990
04/1986.
https://sd.sterlingtesting.com/we bdirect3 IresultsIPrintResul ts .aspx? Archi ve=
4/28/2009
PrintResults
Page 3 of3
268 GENESEE ST UTICA, NY 13502-4617
3.
NAME
WALT KAPINOS
SSN
###-##-####
VALID
YES
STATE ISSUED
NEW YORK
DATE ISSUED
01/01/1969
FROM TO
OS/2004 09/2004
DOB
11/14/1952
DATE ISSUED
01/01/1969
FROM TO
11/1991 07/2007
ADDRESS
865 KINGS WAY NAPLES, FL 34104-4931
865 KINGS ROME, NY 13440
4.
NAME
WALTER
SSN
###-##-####
A KAPINOS
VALID
YES
STATE ISSUED
NEW YORK
ADDRESS
7221 COLEMAN MILLS RD R ROME, NY 13440-7203
5.
NAME
WALTER
SSN
###-##-####
A KAPINOS
VALID
YES
STATE ISSUED
NEW YORK
DATE ISSUED
01/01/1969
ADDRESS
865 KINGS WAY NAPLES, FL 34104-4931
4 WOOD RD APT C2 WHITESBORO, NY 13492-1435
FROM
04/2004
11/1999
TO
2006
11/1999
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
*+END OF NETWORK TRACE**
PLEASE NOTE THAT THE RESULT OF THE SOCIAL SECURITY TRACE SEARCH YIELDED THE
FOLLOWING N~MES IN ADDITION TO THE NAME ORIGINALLY ENTERED FOR THE APPLIC~RT:
WALT KAPINOS - FIRST NAME DOES NOT MATCH. (SEE #3 ABOVE)
PLEASE REVIEW THE RESULT AND CONTACT OUR CLIENT
AT CLIENTSERVICES@STERLINGTESTING.COM TO CONDUCT
ADDITIONAL NAMES ON THIS REPORT (AN ADDITIONAL CHARGE
NAME) .
SERVICES DEPARTMENT
SEARCHES UNDER ANY
WILL APPLY FOR EACH
_~.~k to FinQ!0.9.~._.___________.___________.________________
Copyright 0 2008 Sterfing Infosystems, Inc.
https:llsd.sterlingtesting.com/we bdirect3 IresultsIPrintResul ts. aspx? Archi ve=
4/28/2009
Co11f~T County
~
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Overage Amount:
Contact:
FEES:
DescriDtion
Certificate to Operate
Application
Community Development & Environmental Services
2800 Horseshoe Drive N.
Naples, FL
34104
239.252.2400
RECEIPT OF PAYMENT
2009009832
2009-002335
04/28/2009
Check
1017
$200.00
$200.00
$0.00
KAPINOS, WALTER A.
865 Kings WAY
Naples, FL 34104
Reference Number Oriqinal
Fee
LCCT020090000384
$200.00
Cashier Name:
Batch Number:
LauraWells
174
Amount
Paid
GL Account
$200.00 111-138911-321241
LCD20090000169
EDOUARDJEANTOY
EDOUARD JEANTOY
P.O. Box 10045
Naples, FL 34101
239537-8451
April 1, 2009
Collier County Government
Naples, FL
A TT: Community Development &
Environmental Services
RE: Decision Letter & Outstanding Fines Due
Dated March 11, 2009
To Whom It May Concern:
This letter is in response to the above that I recently received. I am confused as to the
series of events that have taken place throughout this application process as well as the
files of information discovered. I would like to address and clarify the end result of
my application process. The decision letter stated that lowed some fines that had not
been paid off. Additionally, my license was cancelled for lack of payment. My
understanding was that my insurance company had paid this off.
Enclosed are copies of my receipt of payment as proof that there is no entry where I
owe any additional monies. Please advise me as to the best manner of resolving this
Issue.
Thank: you for your cooperation in this matter. Please feel free to contact me should
the need arise at the above indicated telephone number.
Sincerely,
Notice of Preliminary Intent Not to Issue Driver's 10
March 11, 2009
Dear Edouard, Jeantoy:
When you applied for a Collier County Driver ID, you consented to an independent investigation conducted by a consumer
reporting agency. This investigation may have included obtaining information covering up to the last seven (7) years
regarding, among other items, your credit background, references, character, past employment, work habits, education,
general reputation, personal characteristics, mode of living, judgment and liens, subject to state law. The investigation
also may have included obtaining information relating to criminal convictions without any time limitations, subject to state
law. Collier County Code Enforcement has contracted with STERLING TESTING SYSTEMS, INC., ("STERLING")
STERLING'S Report includes the following disqualifying information:
You are denied due to license suspension for failure to pay fine within the last three years.
Based on this disqualifying information, staff intends to deny issuing your applied-for Driver's 10. STERLING
has no knowledge why this intent to deny 10 has been made by the PV AC staff. If you believe, and think you
can prove to staff, that the disqualifying information is not accurate, AND you believe you ARE QUALIFIED to
be issued your applied-for 10, you can phone the undersigned individual (at 239-252-2473) within five (5)
business days of your receipt of this letter and Report. If you phone within these five (5) business days; staff
will withhold making its Final Decision regarding denial or issuance of your applied-for Driver's 10 to afford you
amply opportunity to try prove to staff that the disqualifying information submitted by STERLING is inaccurate,
and that notwithstanding the Report you are in fact qualified to be issued your applied-for 10.
A copy of the Report and a courtesy copy of your rights under the Federal Fair Credit Reporting Act. You have
the right to obtain a free copy of your file from STERLING TESTING SYSTEMS, INC. if you request the report
within sixty (60) days. You also have the right to dispute directly with STERLING the accur~cy or completeness
of any information provided by STERLING. STERLING'S address and telephone number are 249 West 17th
Street, New York, NY 10011/ Telephone: (800) 899-2272.
7\~cI]eel : 'J
r 1\ ~~)\VW
6fus I Trl'omas
Vehicle for Hire Supervisor
CDES Operations and Regulatory Management
.M: ..'
PV AC Criminal and Motor Vehicle Back round Checks
** TillS RECEIPT IS ONLY PROOF OF PAYMENT FOR APPLICATION"''''
I UNDERSTAND THAT J[ CANNOT DRIVE UNTIL A DRIVER ID HAS BElEN
ISSUED TO M:E BY co IER ",OUNTY CODE ENFORCKMEN'f.
Signatunre: ,/~.z ~-v /":2 Date: 02- 26 -09
.
-- ----, -" .-- .----~ .-- ,--~-.- . ...._.....-----~... -- -._.~.-..-,,~
v
L Initial C Driver Id Card($25.00/optional)
$75.00 APPLICATION FEE (Non Refundable)
Please complete application and Print clearly
Name: 1;:/htlt2t'/:/ '~iU!Adffi/ Phone: 237537 t>4j'/
Last First (;./ Middle/
List all companies you drive llir:
Maiden Name or AKA:
Email:
SS#
..,-~ -
I ':
Sex: --4- Race: (f3/;}('~OB: n.kJ L23-/ a
363 0 -[)State:JiZ.
CUIT
Previous Driver's License #
(If available)
Physical Address (No PO ~ox Address): How long at this address / ~__
Street: ~ ,j7ff ~tt(, Apt#:)2 C
City: . 7 a . - State: p~ Zip Code: 3 Lr /1' 2
State:
Mailing Address (If different from physical address):
Street:
City:
Apt#:
Zip Code: ?
~'.7
" .f~""
"--- L <--.j
J / C)
(; 7
ID #:
Jf9- l-Uo'o-l @
1J- tj 1~;Z11 b ---
_._.,-....--,..--_...--~.~-~.~----_.~.._'
._.--'~"-'" -'-~-"~-- --
AFF!DAVIT
DRIVER ID APPLJICA TI0N
[ hereby certify that I have read and understand Collier County Code of Laws and Ordinance
_ Chapter 142-37, "Vehicles for Hire" and if I am granted a Collier County Driver's
[dentification Card that I will comply fully with its provisions. I further state that if I have
been found to have cornm.itted any act or crime noted in Collier County Code of Laws and
Ordinance _ Chapter 142-37, I will surrender my Collier County Driver's Identification Card
upon demand.
I swear or affirm that I have not been found guilty or
convicted, regardless of adjudication, of any of the crimes or acts listed in collier county Code
of Laws and Ordinall.ce - Chapter 142-37.
STATE OF FLORIDA
COUNTY OF COLLIER
The foregoing instrument was subscribe
and sworn ~~rly me thiOL
who has ~- -
(Type of iden ' lcation) "7 7 --
as identification and who did take an oath.
;-,rOTARY PUBLIC.STATE OF FLORlD.~
..~"\"It",, L'ndrl (I .., 1 l''.:__.)
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CONSENT AND DiSCLOSURE
A) tA~JC0
FL
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estaod that Collier Coumy Code Eof"cameot wm crtm,. tha "NiDe. of STERLING TESTING SYSTEMS, INC., 249 w"t 17th Straet, Naw
<Y 10011, " part of tha pmcadura for pmre"i"g my PV AC dri,er Id applioatiDo. I al,," uodaestaod ri my applioatiDO io graotad, CDllier C"my
=oforrem,ot may obtoi" forthar i"foemaliDO thmogh ouboequa"t i""tigatloo; by STERLING TESTING SYSTEMS, INC OD ao to update, raaow
~nd my PVAC driver Id.
estaod a coO'omar raportlog ageooyo i"aotig"DO may ioduda obtaioiog ioformaliDO ",ari"g op to tha la.t ",eo (7) yeaes cegardiog, amDOg
itam', refare"ces, Dh.raeter, dri,i"g ;erom, p"t amploymeol, WDrt< habi" , adooatiDo, geoaral raputatioo, peesooel Dharactari,tioa, mode Df
judgma"t eod lieoo, ,objact to otata aod foderallaw. Tha i""tigatiDo aloD may iodud. oblaioiog i"foematiDO ralati"g tD orimioel raDOmO without
ne limitations, subject to state and federal law.
, "aot eo I""ligati,. ooo,omar ceport io oo"ductad, 1 pOdarstaod ouch i"formatiDO may ba obtai"od by pe;soool ioleNiaw; with my
,i"taoreo or ao""ciat,, Dr with othaes whom I am aDOpai"tod "whD may h"a kODwledga oooremi"g my ",,;scter, geoa;sl rapotatiDn, peesDool
eterioti., or o""dam Df ",i"g. I uodaestood o"h iofoematio" may aloo ba obtaioad through diract or iodiract OO"toct with formar ampIDya",
lis and public agencies or other persons who may have such knowledge.
,;cteod that I h"a tha right tD rarei" "otire about tha oelUre eod ooopa Df eoy i""tigalNa ooaoumer repDrt raquaotod withi" ,,, (5) dayo after
ompany receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
By "Hog io thio circla, I iodioate that I wioh to rereiva forthar diodooura about tha oature eod OCDpa Df eoy Compeoy raq"ot for eo
investigative consumer report.
lowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act.
, uoda""od that bafora my apelioati" ia da"ied beoad, io whola Dr part, 00 leformati" Dbtaioad i" tha i"eoti9"" oo",umer rapDrt, I will ba
dad a oopY of tha "port a"d a deocriptiDo '" writiog Df my rig"" pOdar tha Fair Cradit RapDrtiog Act. I uoda"ta"d ill diaagrea with tha aDDoracy
,y i"formatiD" 10 tha report, I muat oDlify Colliar CDU"ty Coda E"forremaot with!o "a (5) buoioa" dayo Df my rareipt of tha raport. If I "Dtify
or Cooely Coda EnfolDamaot w'hie ,,, (5) booin"o dayo Df tha recaipt of tha report that I am challeogi"g i"foemaliD" i" tha ;aport, Collier GDUOly
, EefolDame"t, """ ODt make a 'oel daciei" " my ape'caliDo ;;tatua pOtil aftar I ha" had a reaoDoebla DpeortPOily to addre" the ieformalioo
aload io tha report.
,by oo",eot tD thio i"eotigati" eod author"" CDlIiar CDumy Coda E"forremaot to pco"" eo I""tigati" oo",omar report DO my backgroPOd
,lated abC'a from STERLING TESTING SYSTEMS, ING. I" ordar to "rify my ideo,"y for po",oo" Df tha backgrDu"d i""oligatiDo I am
ntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
, e __ . [Ql]1ol,5LW 17111
~~t:tT I liTiTTTTl ~TirT} LLJ
~LI~aIUI41!(lcLu I I W~ Mid~a"oD
rlhar:f1j1 I I ILl 'U l I I I I ,~ Wemale
Current Address #yrs at this address
COy 0 Stata L,P CDde
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I Ipr"il 0 jd;a'i I U I I I I I ] ~~ U I 1 "'r"hii ja"
City State Zip Code
I I I I 1 I I I JI J lULU
Driver's 7ys"f-!D.
A~7f ~ J r""
I
J
State
r mn ota & Oklahoma applicants Only: I have the right to request a copy of my consumer report from sterling Testing Systems, Inc. by
Dhaokieg tha b"" below. Stedieg Teetieg sy,teme will mailth. OO""mer ;aport diradly to me. M""eo" Ape Ii ,,"'a 001, I ha" tha eight to maka
a_~:~ee ;ag,cellO Iha co,",mer ;eporti"g ageecy to prO'ida ma ""CO a oompl'''' eod '''''''e di,oIoo"a oftha "tora acd ,oope oilha DOOwmer
-b O'L -- c?.-o7
ate
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_____.."~.~-M_.__~___'~~_.
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confidential and exempt record under Chapter 119, Florida
statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency,"
, have read and understood the paragraph
oj? -26 ~Dg
Date
Co1ff:l' County
~
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Change Returned:
Contact:
FEES:
Description
Driver ID
Cashier Name:
Batch Number:
LauraWells
83
Development and Environmental Services
2800 Horseshoe Drive N.
Naples, FL
34104
239-252..2400
RECEIPT OF PAYMENT
2009008409
2009-000912
02/26/2009
Cash
$75.00
$75.00
$0.00
Edouard, Jeantoy
PO Box 10045
Naples, FL 34101
Reference Number Original
Fee
LCD20090000169
$75.00
Amount
Paid
Account
$75.00
111-138911-321239
PrintResults
Page 70f8
f~~ L i >~ ~_J
PO #
Last Name
First Name
Middle Name
Date of Birth (mmfddfyyyy)
Phone
Projected Salary
Job State
Code Enforcement Div. Collier County
Order#: 9182110
Jeantoy Edouard
Subject Profile
na
Edouard
Jeantoy
08103/1977
N/A
Current Address
14005 Ave N.
Address
Apartment Number
City
State
Zip
Naples
FL
34102
Previous Address
Address
Apartment Number
City
State
Zip
Additional information
Applicant Email Address
Company
Code Enforcement Div. Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
Status
2 CLOSED
1 CLOSED
1 CLOSED
Findings
Clear
MOTOR VEHICLE REPORT (MVR)
See Results Below
SEXUAL OFFENDER OATABASE SEARCH
Clear
SOCIAL SECURITY TRACE SEARCH
1 CLOSED
Alert
CRIMINAL RECORD SEARCH
The criminal information reported on this website appears exactly as It is received from the local jurisdictions and may contain Information
which would be prohibited for use in making hiring decisions. Therefore, it Is advisable to consult your corporate counsel prior to making any
adverse hiring decisions.
City: State: NW Zip: County: NATIONWIDE "-.~-
status: CLOSED
FINDING: Clear
*************************************************************************
* THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND *
* HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
* CRIMINAL BACKGROUND RESEARCH METHODS.
*************************************************************************
NO CRIMINAL CONVICTION FOUND.
,-~-----
City: Naples State: FL Zip: 34102 County: COLUER
status: CLOSED
FINDING: Clear
No criminal convictions found.
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINOING: See Results Below
- . ------~~_.
REKLAMI PR INT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - 88178
Order Date: 02/26/2009
Host Used: Online
Reference: 9182110_3
Period: THREE YEAR
License: E363420772830
Report Clear:NO
Name: EDOUARD, JEANTOY
Address:
City, St:
As of:
Sex :
Eyes:
Hair:
Weight:
Height:
DOB
Iss Date: 05/16/2006
Exp Date: 08/03/2012
AGE:
httn"./ /"ci ."tprlino-tp"tino-.eom/wphciirpd1/rp"lllt,,/PrintR P"lllt" ::J"nx? A rr.hivp=
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Year License First Issued: 05/16/2006
STATUS: SEE BELOW
MVR Sc'ore
SCORE:
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
V/C
DESCRIPTION
CONV
ACD
AVD
CONV 03/11/07 06/14/07 B26 DB04 609 DRIVE WHILE LIC CANC/REV/SUSP
LOCATION/DOCKET: COLLIER/6489EPP PTS: 3
Suspensions/Revocations
-------------
~-,--_.------
ACTIONS ORD/DATE EFF/DATE CLR/DATE END/DATE CODE AVD
I ~USPENSION 11/13/06 02/06/07 03/30/07 03/30/07 DE05 _'" _ ..------
\ DESCRIPTION: FR SUSP ACCID W/O AUTO LIAS ____-.-
" **11/13/2006 NOTICE REQUIRED B~...liDl~_==---
. -- "--,,
~EQ._pe-~rrrr6imat1on ../-- ....
/
License: PERSONAL Issue:05/16/2006 Expire:08/03/2012 Status:VALID
License Status Explanation: ELIGIBLE l..._________-----
C1ass:E REGULAR OPERATOR
License: IDENTIFICATION Issue:01/25/2006 Expire:08/03/2010 Status:VALID
Miscellaneous State Data
.. ENTRIES BELOW COVER THE PAST 3 YEARS **
MISC: REPLACEMENT LIC ISS. 07/07/06 ,OFFICE NO~N72
MISC: EXAMS VISION~l ROAD SIGN=l ROAD RULES~6 DRIVING~l
MISC: EXAMS MCYCLE RULES~O MCYCLE SKILL~O
03/17/06 DUPLICATE ID CARD ISSUED
.* BLOCK PERSONAL INFORMATION ..
MISC: REPLACEMENT LIC ISS. 09/03/08 ,OFFICE NO=N72
BLOCK FOR MAILING LIST ..
.. THIS PERSON HAS A DIGITAL IMAGE ..
I FOR STATED BUSINESS
I PURPOS8S ONLY
I
I
I
Underwriting:
Policy
Initials:
Date:
/
Issue Date:
/ /
Control Number: OTCBLT
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DATABASE SEARCH
State: FL
Status: CLOSED
FINDING: Clear
No Record Found
Back to Findings
4/'/
/
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
RNDING: Alert
/
_/
Social Security Trace
*****************************
*************************************************
-'.
FOR LEGAL AND PRACTICAL REASONS INFORMATION
H A SOCIAL SECURITY NUMBER TRACE SHOULD BE USED ONLY TO
PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
ICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION.
~:~~~:::~==~====:===============================================~=====~=====
**END OF NETWORK TRACE**
Back to Findings
Copyright C 2008 Sterling Intosyslelll$. Inc.
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Page 1 of 1
.",.,.,
... ' '" Collier County
'\'c,~,.:':f.: CLERK OF THE CIRCUIT COURT
Print Page Close Window
Case Information
Style: STATE OF FLORIDA vs JEANTOY, EDOUARD
Uniform Case Number: 112007TR0154550001XX
Clerks Case Number:
Court Type: TRAFFIC INFRACTION
Case Type: TRAFFIC INFRACTIONS
Judge:
Case Status: DISPOSED
Next Court Date:
Last Docket Date: 06/14/2007
Due Date: 06/12/2007
Filed: 03/12/2007
Citation Number: 6489EPP
Disposition Judge:
Disposed: 06/14/2007
Reopen Reason:
Reopened:
Reopen Close:
Appealed:
Parties
Name
Type
DEFENDANT
WITNESS
DOB
1977
City, State, Zip
NAPLES, FL 34102
JEANTOY, EDOUARD
SMITH, RASHAAD
Dockets
Date Text
06/14/2007 D6 SUSPENSION SATISFIED
06/14/2007 PAID /
06/13/2007 06 SUSPENSION FOR FAILED TO PAY FINE FAILED TO PAY FINE vi'
04/04/2007 MOTION FOR EXTENSION TO PAY 6/12/2007 MOTION GRANTED
03/13/2007 CITATION # 6489EPP FOR UNKNOWINGLY DWLSR (NOT COMMERCIAL DRIVERS
UCENSE) ISSUED ON 03/11/2007 BY CCSO
Events
I There are no Events for this case.
Financials
Charge Number
1
Amount Assessed
Amount Paid
133.50
133.50
Last Payment Date
06/14/2007
Charges
Charge
03/11/2007
Florida Statute
Florida Statute Description
UNKNOWINGLY DWLSR (NOT COMMERCIAL DRIVERS UCENSE)
'-fVtOt/1tV G
322.34(1}
httn://anns.collierclerk.com/nublic inauirv/Case.asnx?UCN= 112007TRO 15455000 1 XX&C... 3/2/2009
Printer Friendly Version
Page 1 of 1
m;'...".
" Collier County
.\.,...,..,,:/.' ,CLERK. OF THE CIRCUIT COURT
Print Page Close Window
Case Information
Style: STATE OF FLORIDA vs EDOUARD, JEANTOY
Uniform Case Number: 112008TR0498480001XX
Clerks Case Number:
Court Type: TRAFFIC INFRACTION
Case Type: TRAFFIC INFRACTIONS
Judge:
Case Status: DISPOSED
Next Court Date:
Last Docket Date: 09/15/2008
Due Date: 10/13/2008
Filed: 09/08/2008
Citation Number: 4526RLF
Disposition Judge:
Disposed: 09/15/2008
Reopen Reason:
Reopened:
Reopen Close:
Appealed:
Parties
Name
Type
DEFENDANT
WITNESS
DOB
1977
City, State, Zip
NAPLES, FL 34101
EDOUARD, JEANTOY
MONROIG, LUIS
Dockets
Date Text
09/15/2008 PAID $10.00 ON RECEIPT 119927, FULLY PAID
09/15/2008 PROVIDED PROOF, CASE DISMISSED: INSURANCE
09/09/2008 PROOF DUE ON 10/11/2008
09/09/2008 PAYMENT DUE ON 10/13/2008
09/09/2008 CITATION # 4526RLF FOR 316.646(1) ISSUED ON 09/06/2008 BY NAPLES
POLICE DEPARTMENT
Events
I There are no Events for this case.
Financials
Charge Number
1
Amount Assessed
Amount Paid
10.00
10,00
Last Payment Date
09/15/2008
Charges
Charge
09/06/2008
Florida Statute
Florida Statute Description
PROOF OF INSURANCE REQUIRED (BY OWNERS/LESSEE OF VEHICLE ONL
316.646(1)
http://apps.colliercIerk.com/public inquiry/Case.aspx?UCN= 1 12008TR049848000 1 XX&C... 3/2/2009
~
..
GAINSCO
Auto Insurance
PO, Box 199022
DALLAS, TEXAS 75219--9023
CL.'\.IMS PHONE: 305,552,0770
CU..IMS PHONE: 800,882,6546
CLAIMS FAX: 305,551.0924
WWW,GAlNSCO,CDM
ARIT You DRrVITN?
March 29, 2007
Florida Department of Highway Safety
and Motor Vehicles
Division of Driver Licenses,
Bureau of Financial Responsibility
2900 Apalachee Parkway
Neil Kirkman Bldg.
Tallahassee, FL 32399-0500
RE:
Insured:
Date of Loss:
Our Claim No:
Your File No:
Our Insured's Drivers License
Edouard Jeantoy
7-8-06
121287
115595984
#J530200772830
To Whom It May Concern:
Please be advised that MGA Insurance Company is the carrier for Edouard Jeantoy, and
insured a 1996 Nissan 200SX, under policy number 0IMGFC0286710-00-01, effective date 5-
24-2006 to 11-24-2006, which provides $10,000,00 for property damage, no bodily injury
coverage chosen by Mr. Jeantoy, and a $1,000.00 deductible for Personal Injury protection.
Enclosed find copy of payment draft issued to Scott Dunayer for property damage and
regarding claimant Juliana McNavehton, we are in negotiations with State Farm Insurance Co.,
under their claim #1269211033.
If you have any questions, do not hesitate to contact the undersigned.
S incerel y,
Miriam Del Risco
Claims Adjuster
MD/jg
Enclosure
~
TilE GAINSCO COMPANI
PAYMENT ENTERED FORM
Date 11/02/2006
AdjusterFM
Claim No. 121287
Date Of Loss 07/08/2006
Payee: SCOTT DUNAYER
Amount $ 1,200.25
(CLAIMANT) Name: SCOTT DUNA YER
Mail To: SCOTT DUNAYER
1468 PALMA BLANCA CIRCLE
NAPLES. FL 34117
Type Of Payment
Final
In Payment Of
PARTIAL PAYMENT
Date Requested Requested B~
11/0212006 FMONCLUS
COLLIER COUNTY CLERK OF COURTS
P.O. Box 413044
Naples, Florida 34101
(239) 774-8105
COMPLIANCE WITH COURT REQUIREMENTS FOR A TRAFFIC VIOLATION OR INFRACTION
C itat ion No.
6.189EPP
Offense Date
03/11/2007
Offense
DRIVING WHILE LICENSE SUSP
/
State Statute
322.34 1
Penalty
133.50
Date Failed To Meet
Court Requirements
06/13/2007
Must Comply By This
Date To Avoid Suspension
N/A
Date Satisfied Court
5-Failed To
Pay Fine IXI
1.Failed To
Appear I I
2-FaiJed To Complete
Court Ordered School I I
3'Election Hade
When Not Eligfble I
~LY-07
Case No,
O'i-15455-TR
Suspension
Rei ssued I I
Court Type
COUNTY
Code
01
County
COLLIER
Code
64
Source Doc,
WH
Dr1ver's License No,
JS30-200-77-293_0
State
FL
Date of Birth
08/03/1977
Name
Ad(lress
EDOUARD JEANTOY
158 JASMINE CR 158
Sex
M
Ci t.v
NAPLES, FL
34102
Ver':le Lie No,
EJ15AB
State
FL
Year
93
Make
NISSAN
Dwight E. Brock
Clerk of the Circuit Court
Da t e (X..-> --- \. II - 0'7
Clerk's Initials ~~
t
REQUIREMENTS POR CLEARANCE OF SUSPENSION IF $47.50 SERVICE FEE FOR
REINSTATEMENT WAS NOT PAID TO COURT.
1. If you art? in the state of Florida and court requirements were not
met prior to suspension date, you should present this notice to any
Driver License Examining Office or Tax Collectorrs Office which
provides driver license services and pay a $47.50 service fee plus any
other applicable fee.
2. If you are an out of state resident and this is not a criminal
violation, contact your licensing state.
3. If you are an out of state resident and this is a criminal
vio~ation, ma:L1 this copy and a $47.50 service fee (cashier's check
or ~oney order) to:
BDI
Post Office Box 5775
Tallahassee, Florida 32314-5775
LCD20080000251
THOMAS J. CASEY
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COMMUNITY DEVELOPMENT
AND ENVIRONMENTAL SERVICES
CDES OPERATIONS DEPARTMENT
2800 N, Horseshoe Drive. Naples, Florida 34104.239-403-2302. FAX 239-403-2420
Notice of Preliminary Intent Not to Issue Driver's 10
March 30, 2009
Dear CASEY, THOMAS J.:
When you applied for a Collier County Driver ID, you consented to an independent investigation conducted by a consumer
reporting agency. This investigation may have included obtaining information covering up to the last seven (7) years
regarding, among other items, your credit background, references, character, past employment, work habits, education,
general reputation, personal characteristics, mode of living, judgment and liens, subject to state law. The investigation
also may have included obtaining information relating to criminal convictions without any time limitations, subject to state
law. Collier County Code Enforcement has contracted with STERLING TESTING SYSTEMS, INC., ("STERLING")
STERLING'S Report includes the following disqualifying information:
You have been denied due to a driver's license suspension on 7/1l/08 for failure to pay a fine and on 8/8/09 for failure to
comply with a traffic summons, per Collier County Ordinance 2006-59.
Based on this disqualirying information, staff intends to deny issuing your applied-for Driver's ill. STERLING has no
knowledge why this intent to deny ID has been made by the PV AC staff. If you believe, and think you can prove to staff,
that the disqualirying information is not accurate, AND you believe you ARE QUALIFIED to be issued your applied-for
ID, you can phone the undersigned individual at 239-252-2473 within five (5) business days of your receipt of this letter
and Report. If you phone within these five (5) business days, staff will withhold making its Final Decision regarding denial
or issuance of your applied-for Driver's ID to afford you amply opportunity to try prove to staff that the disqualifYing
information submitted by STERLING is inaccurate, and that notwithstanding the Report you are in fact qualified to be
issued your applied-for ID.
A copy of the Report and a courtesy copy of your rights under the Federal Fair Credit Reporting Act. You have the right
to obtain a free copy of your file from STERLING TESTING SYSTEMS, INC. if you request the report within sixty (60)
days, You also have the right to dispute directly with STERLING the accuracy or completeness of any information
provided by STERLING. STERLING'S address and telephone number are 249 West 17th Street, New York, NY 10011/
Telephone: (800) 899-2272.
Sincerely,
~'ii~
Consuela Thomas
Vehicle for Hire Supervisor
CDES Operations and Regulatory Management
c::;
<>
[~.
c::;
o
y
~
-
'103- /'/
, ~"
V)
PV A C Criminal and Motor Vehicle Back round Checks
** THIS RECEIPT IS ONLY PROOF OF PAYMENT FOR APPLICATION**
I UNDERSTAND THAT I CANNOT DRIVE UNTIL A DRIVER ID HAS BEEN
ISSUED TO ME BY OLLIER UNTY CODE ENFORCEMENT.
Signature: Date: 3 J 2 h C;
/ ~ ,
P'R.enewal r Driver Id Card($25.00/optional)
$75.00 APPLICATION FEE (Non Refundable)
Please complete application and Print clearly
Name: C/P57} 7/Jdttt.- q-
Last FIrst MIddle
List all comnanies .you drive for: ..
;t1J1-x/- 7A-'X./
r Initial
PhonedJt-d.tfb-6~r ".
, ,
Maiden Name or AKA:
-----
Email:
-
SS~-_-_sex: J&i Race: W
DOB: ----L-; 2-L-I 5 ;J-
Current Driver's License # t:!.-- flt)() - ~1 0- b'J. -0)..). - 0 State: ;:=~
Previous Driver's License #
(If available)
Physical Address (No PO Box Address): How long at this address 6 ~~
Streel:/~.;l.). wAr"'" M 121' Apt#: (g'Y
City: ~/27' 7....-- State: rL Zip Code: ,73 9/
Mailing Address (If different from physical address):
State:
Street:
City:
Apt#:
State: Zip Code:
--- OFFICE USE ONLY ---
'~,"'J ,1' :-..;;~ C:, -- ~
'- 1.../ ,_) "'::'"'\._ 'Y
PHOTO ID #:
f)/I/\ J/n(o 1 t tD(;''A! of s
It' .' /,V...~
~~@~ Iv IJ~ l~r
@ F~~ / 44 .
, ,
,(
ID#:
/.,//
eo- - J~6 0?
# ,902: ~,7~
rn. 7ltt/of
, .
6n. f 08
--- FRONT OFFICE ONLY u__
Date Driver ID issued:
/
/
CSR Initials:
I ~!
AFFIDAVIT
DRIVER ID APPLICATION
I hereby certify that I have read and understand Collier County Code of Laws and Ordinance
- Chapter 142-37, "Vehicles for Hire" and if I am granted a Collier County Driver's
Identification Card that I will comply fully with its provisions. I further state that if I have
been found to have committed any act or crime noted in Collier County Code of Laws and
Ordinance - Chapter 142-37, I will surrender my Collier County Driver's Identification Card
upon demand.
~ejpli~
swear or affirm that I have not been found guilty or
ation, of any of the crimes or acts listed in collier county Code
ter 142-37.
STATE OF FLORIDA
COUN1Y OF COLLIER
QJ
s subscribed and sworn to.~'rJ me this ~~ ;:~..7~.P
_ ~~~ /?,." (Dale~
who ha~roauced ~tJi) <6.3tJ ~~;Z ~ ~O
(Type of identification)
NOTARY PUBUC.STATE OF FLORIDA
...,.,...,.,., Linda C. Wolfe
[~W kommission #DD7391S0
\~./ Expires: DEC. 07, 2011
BOI'<1JED THRU ATLANTIC BOI\1JrnG CO" rnc
as identification and who did take an oath.
Print of Notary
NOTARY'S SEAL
Notary Public Commission #
Commission Expires
e STERLING
DATE
.3 -/,2 -11/
CONSENT AND DISC LOS
LOCATION
I understand that Collier County Code Enforcement will utilize the services of STERLING TES ING SYSTEMS, INC., 249 West 17th Street, New
York, NY 10011, as part of the procedure for processing my PV AC driver Id application. I also understand if my application is granted, Collier County
Code Enforcement may obtain further information through subsequent investigations by STERLING TESTING SYSTEMS, INC so as to update, renew
or extend my PVAC driver Id.
I understand a consumer reporting agency's investigation may include obtaining information covering up to the last seven (7) years regarding, among
other items, references, character, driving record, past employment, work habits, education, general reputation, personal characteristics, mode of
living, judgment and liens, subject to state and federal law. The investigation also may include obtaining information relating to criminal records without
any time limitations, subject to state and federal law.
In the event an investigative consumer report is conducted, I understand such information may be obtained by personal interviews with my
acquaintances or associates or with others whom I am acquainted or who may have knowledge concerning my character, general reputation, personal
characteristics or standard of living. I understand such information may also be obtained through direct or indirect contact with former employers,
schools and public agencies or other persons who may have such knowledge.
I understand that I have the right to receive notice about the nature and scope of any investigative consumer report requested within five (5) days after
the Company receives my request or five (5) days after the investigative consumer report was requested, whichever is later.
a By filling in this circle, I indicate that I wish to receive further disclosure about the nature and scope of any Company request for an
investigative consumer report.
I acknowledge that I have received the attached summary of my rights under the Fair Credit Reporting Act.
I also understand that before my application is denied based, in whole or part, on information obtained in the investigative consumer report, I will be
provided a copy of the report and a description in writing of my rights under the Fair Credit Reporting Act. I understand if I disagree with the accuracy
of any information in the report, I must notify Collier County Code Enforcement within five (5) business days of my receipt of the report. If I notify
Collier County Code Enforcement within five (5) business days of the receipt of the report that I am challenging information in the report, Collier County
Code Enforcement, will not make a final decision on my application status until after I have had a reasonable opportunity to address the information
contained in the report,
I hereby consent to this investigation and authorize Collier County Code Enforcement to procure an investigative consumer report on my background
as stated above from STERLING TESTING SYSTEMS, INC, In order to verify my identity for purposes of the background investigation I am
voluntarily releasing my date of birth for my own benefit and fully understand that age is not a consideration of the application process.
Midl~tial I
Male Female
IT]
Socia ecurity No,
z!yO/
Minnesota & Okla applicants Only: I have the right to request a copy of my consumer report from Sterling Testing Systems. Inc, by
checking the box below, Sterling Testing Systems will mail the consumer report directly to me, Minnesota Applicants Only: I have the right to make
a written request to the consumer reporting agency to provide me with a complete and accurate disclosure of the nature and scope of the consumer
report,
IT]
State
IT]
State
#yrs at this address
a I wish to receive a copy of the consumer report. (Check box only if you wish to receive a copy)
Social Security Collection Information
Sterling Testing Systems, on behalf of the Collier County Code Enforcement
Department, a department of the Collier County Government Agency, is
authorized to collect your Social Security Number for the performance of its
duties and responsibilities as prescribed by law. Your Social Security Number
shall be collected for one or more of the following reasons:
1. Obtain information relating to criminal records
2. Run Social Security Trace Search
3. Search Sexual Offender Database
4. Run Motor Vehicle Search
Your Social Security Number will only be collected and disclosed for these listed
purposes, and as may otherwise be authorized by law, and once collected, will
be maintained as a confid~ntial and exempt record under Chapter 119, Florida
Statutes, by this company and the Code Enforcement Department on behalf of
the Collier County Government Agency."
T!-/" ~ t-. 1< (If:> /)_. have read and understood the paragraph
D7/0f-
Co~'Y County
~
Development and Environmental Services
2800 Horseshoe Drive N.
Naples, FL
34104
239-252-2400
Receipt Number:
Transaction Number:
Date Paid:
Payment Method:
Check Number:
Full Amount:
Amount Tendered:
Overage Amount:
Contact:
FEES:
Description
Driver ID
Cashier Name:
Batch Number:
RECEIPT OF PAYMENT
2009008780
2009-001283
03/12/2009
Check
1128
$75.00
$75.00
$0.00
CASEYr THOMAS J.
10322 Whispering Palms Dr #1804
Ft Myers, FL 33913
Reference Number Oriqinal Amount
Fee Paid
Account
LCD20080000251
murphylinda
102
$75.00
$75.00
111-138911-321239
PrintResults
Page 1 of 4
c;TERLi\JG
,f.::
Code Enforcement Div. Collier County
Order#: 9237536
Thomas Casey
Subject Profile
na
Casey
Thomas
J
01/22/1952
PO#
Last Name
First Name
Middle Name
Date of Birth (mm/dd/yyyy)
Phone
Projected Salary
Job State
NlA
Address
Apartment Number
City
State
Zip
Current Address
10322 Whispering Palm Dr
Ft Myers
FL
33913
Previous Address
Address
Apartment Number
City
State
------------
Zip
Additional information
Applicant Email Address
Company
Code Enforcement Div, Collier County
Results Status
Service
CRIMINAL RECORD SEARCH
Status
4 CLOSED
1 CLOSED
Findings
Alert
MOTOR VEHICLE REPORT (MVR)
See Resutts Below
SEXUAL OFFENDER DATABASE SEARCH
SOCIAL SECURITY TRACE SEARCH
1 CLOSED
Clear
1 CLOSED
CRIMINAL RECORD SEARCH
The criminal information reported on this webslte appears exactly as it is received from the local jurisdictions and may contain Information
which would be prohibited for use In making hiring decisions. Therefore, It is advisable to consult your corporate counsel prior to making any
adverse hiri!!tLdeclslons. ___'
City: State: NW Zip: County: NA TlONWIDE ~
Status: CLOSED
FINDING: Clear
*************************************************************************
. THE INFORMATION IN THIS REPORT IS THE RESULT OF A DATABASE SEARCH AND .
+ HAS NOT BEEN OBTAINED THROUGH STERLING TESTING SYSTEM'S STANDARD
+ CRIMINAL BACKGROUND RESEARCH METHODS,
*************************************************************************
NO CRIMINAL CONVICTION FOUND.
City: Ft Myers Stele: FL Zip: 33913 County: LEE
Status: CLOSED
FINDING: Clear
NO CRIMINAL CONVICTION FOUND,
-,-
~---
'-~~ ---
City: State: OH Zip: 44515 County: MAHONING
Status: CLOSED
FINDING: Clear
No criminal convictions found.
...l..:.:::--____ __
City: State: FL Zip: 34108 County: COLLIER
Status: CLOSED
FINDING: Alert
CRIMINAL HISTORY SEARCH INFORMATION
CONVICTION RECORD
Name On Court File: THOMAS J CASEY
Name Given: THOMAS J CASEY
AKA: N/A
Date Of Birth On Court File: 01/22/1952
Date Of Birth Given: 01/22/1952
55 # On Court File: N/A
SS # Given: ###-##-####
County: COLLIER
State: FL
Docket # / Case #: 0806835CT
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,
Ind #:
/'
ArrestlInciden~~~ ~~::O.:::s...------/'
Charges:
1. DRIVE WHILE LICENSE SUSPENDED/REVOKED 2ND
Disposition t.,~O~::..
Disposition:
1. ADJUDICATED GUILTY
Sentence Information:
L AMOUNT ASSESSED: $557.50 ~
6 MONTHS SUPERVISED PROBATION ,.'
COUNTY JAlL 15 DAYS
CREDIT TIME SERVED
BE SERVED ON WEEKEND WORK PROGRAM
Additional Information:
N/A
REPORT GENERATED: Friday, Mar 13 2009
Back to Findings
MOTOR VEHICLE REPORT (MVR)
Status: CLOSED
FINDING: See Results Below
REKLAMI PRINT IMAGE 80
START OF DRIVING RECORD
FLORIDA Driver Record - B8l78
Order Date: 03/13/2009
Host Used: Online
Reference: 9237536_3
Period: THREE YEAR
License: C200830520220
Report Clear:NO
Name: CASEY, THOMAS J
Address:
City, St:
As of:
Sex :
Eyes:
Hair:
Weight:
Height:
OOB
Iss Date: 09/14/2005
Exp Date: 01/22/2012
AGE:
Year License First Issued: 09/14/2005
STATUS: VALID
MVR Score
SCORE:
ELIGIBLE
Violations/Convictions And Failures to Appear And Accidents
TYPE VIOL
CONV
ACD AVD V/C
DESCRIPTION
CONY 02/23/06 06/01/06 Sll SA10 586
SPEED:74/60 LOCATION/DOCKET:
CON~~~~lQ? M17 MA17532
.--- ,~ ....,LOCATION/DOCKET:
// CONY 10/06/08l!-0/28/08\~6 DB04 609
( ,~~ LOCATION/DOCKET:
" CONV 10/~2/17~.B22 DB04 613
'--- _...---:::::c-. LOCATION/DOCKET:
SPEEDING 10+ OVER THE LIMIT
COLLIER/02l9EMV PTS: 3
FAlL TO OBEY TRAF INSTR SIGN/DEVICE _
OSCEOLA/7049SJP PTS: 3 ______________
DRIVE WHILE LIC CANC/REV/SUSP -----------
LEE/3943ESN PTS: 3
DRIV WHILE LIC-CANC/REV/SUS.__--------
COLLIER/2452FHO PTS: 0
/"
\
Suspensions/Revocations
ACTIONS
ORD/DATE
EFF/DATE
CLR/DATE
END/DATE
CODE
AVD
SUSPENSION 07/11/08 07131/08 0~/26/09 OlJ26/09
DESCRIPTION: FAILED '1'0 PAY 'l'RAFFIC ~PENl!L=)
**07/11/2008 NOTICE REQUIRED BY S.322.25l GIVEN
SUSPENSTON 08/08/08 08/28/08 01/26/09 01/26/09
DESCRIPTTON: FAIL TO COMPLY TRAFFIC SUMMON5-GA
..08/08/2008 NOTICE REQUIRED BY S.322.25l GIVEN
DE~2
UEOl
License and Permit Information
License: PERSONAL Issue:09/14/2005 Expire:01/22/20l2 Status:VALID
License Status Explanation: ELIGIBLE
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Class:E REGULAR OPERATOR
RESTRICTION: CORRECTIVE LENSES
Miscellaneous State Data
.. ENTRIES BELOW COVER THE PAST 3 YEARS ..
MISC: REPLACEMENT LIC ISS. 01/26/09 ,OFFICE NO=N76
MISC: EXAMS VISION-l ROAD SIGN=l ROAD RULES-l DRIVING=l
MISC: EXAMS MCYCLE RULES=O MCYCLE SKILL=O
BLOCK PERSONAL INFORMATION ..
BLOCK FOR MAILING LIST ..
THIS PERSON HAS A DIGITAL IMAGE
IFOR STATED BUSINESS
I PURPOSES ONLY
I
I
I
Underwriting:
POlicy
Initials:
Date:
/
Issue Date:
/ /
Control Number: TEHlMX
END OF DRIVING RECORD
Back to Findings
SEXUAL OFFENDER DA TABASE SEARCH
State: FL
Status: CLOSED
'FiiiiDiNG,Ciii'Or-'
No Record Found
~/ -
------,-+------------
Back to Findings
**************************** Social Security Trace
/
*~*************************
.
SOCIAL SECURITY TRACE SEARCH
Status: CLOSED
********************************************************************************
GENERATED: 03/13/2009 08:45:01 AM
TRANSACTION ID:0018l55844-478
1.
NAME
THOMAS F CASEY
SSN VALID
###-##-#### YES
STATE ISSUED
OHIO
DOB
01/22/1952
DATE ISSUED
01101/1966
ADDRESS
3819 HUNTMERE AVE YOUNGSTOWN, OH 44515-3146
2432 FROSTWOOD DR APT 71 YOUNGSTOWN, OH 44515-5142
2268 SPRUCEWOOD DR YOUNGSTOWN, OH 44515-5156
FROM
06/2006
06/2002
07/1985
TO
2007
08/2004
05/1996
NAME
2. THOMAS F CASEY
SSN VALID STATE ISSUED DATE ISSUED
###-##-#### YES OHIO 01/01/1966
ADDRESS FROM TO
10332 WHISPERING PALM DR APT 180 12/2008 03/2009
FORT MYERS, FL 33913-8409
230 SUGAR PINE LN NAPLES, FL 34108-2569 04/2007 12/2008
28 IROQUOIS ST STRUTHERS, OH 44471-1416 08/2004 01/2008
2432 FROSTWOOD DR YOUNGSTOWN, OH 44515-5142 06/2002 08/2004
NAME
3, THOMAS J CASEY
SSN VALID STATE ISSUED DATE ISSUED
###-##-#### YES OHIO 01/01/1966
ADDRESS FROM TO
10332 WHISPERING PALM DR APT 180 12/2008 12/2008
FORT MYERS, FL 33913-8495
28 IROQUOIS ST STRUTHERS, OH 44471-1416 08/2004 08/2007
230 SUGAR PINE LN NAPLES, FL 34108-2569 04/2007 04/2007
2432 FROSTWOOD DR YOUNGSTOWN, OH 44515-5142 06/2002 08/2004
2268 SPRUCEWOOD DR YOUNGSTOWN, OH 44515-5156 05/1996 05/1996
NAME DOB
4. THOMAS J CASEY 01/22/1952
SSN VALID STATE ISSUED DATE ISSUED
###-##-#### YES OHIO 01/01/1966
ADDRESS
4321 KIRK RD YOUNGSTOWN, OH 44511-1851
2432 FROST WOOD DR APT 71 YOUNGSTOWN, OR 44515-5142
FROM
01/1988
TO
01/2002
5,
NAME
THOMAS C CASEY
SSN VALID
###-##-#### YES
STATE ISSUED
OHIO
DOB
01/22/1952
DATE ISSUED
01/01/1966
ADDRESS
8 SPRUCEWOOD DR YOUNGSTOWN, OH 44415
FROM
06/1993
TO
06/1993
NAME
DOB
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6. THOMAS CASEY 01/22/1952
SSN VALID STATE ISSUED DATE ISSUED
u#-##-u## YES OHIO 01/01/1966
ADDRESS FROM TO
2268 SPRUCEWOOD YOUNGSTOWN, OH 05/1988 05/1988
END-USER IS NOTIFIED THAT FOR LEGAL AND PRACTICAL REASONS INFORMATION
OBTAINED THROUGH A SOCIAL SEC~RITY NUMBER TRACE SHOULD BE USED ONLY TO
VERIFY THE INFORMATION PROVIDED BY THE CONSUMER ON HIS/HER EMPLOYMENT
APPLICATION. INFORMATION OBTAINED THROUGH A SOCIAL SECURITY NUMBER TRACE
SHOULD NOT BE USED ALONE OR IN CONJUNCTION WITH ANY OTHER INFORMATION TO
MAKE AN EMPLOYMENT DECISION,
"END OF NETWORK TRACE"
Back.to Fi~.dings
Copyright C 2008 Sterling Inlosystems, Ine,
httn". 1 I"rl "t""l"l;nn-t"""t;nn- ~r\""/nT""hrl;l"",,~t~ 11"""""lt"/Pr;ntD """"It" Q"nv') A r~h;~T""=
~ 117 /")()()O
rnnler l'nenUlY VerSlUU
.... ~o"" .&. '-'.L -
,~" Collier County
cW:~' CLERK OF THE CIRCUIT COURT
Case Information
Print Page Close Window
Style: STATE OF FLORIDA vs CASEY, THOMAS J
Uniform Case Number: 112008CT0068350001XX
Clerks Case Number: 0806835CT
Court Type: CRIMINAL TRAFFIC
Filed: 11/05/2008
Notice to Appear OR 10/28/2008
Arrest:
Assigned Judge: ROB CROWN
Parties
Name Type DOB City, State, Zip
CASEY, THOMAS J DEFENDANT 01/22/1952 FT MYERS ,FL,339130000
DOHRMANN, MICHAEL IJ!..W ENFORCEMENT OFFICER
PUBUC DEFENDER PUBUC DEFENDER NAPLES ,FL,341120000
Dockets
Date Text
02/17/2009 PLEA FORM .
02/17/2009 JUDGMENT & SENTENCE PAPERS
PROCEEDING: PRETRIAL CONFERENCE ON 02-17-2009 @ 09:00
PRESIDING JUDGE: ROB CROWN
PLED NO CONTEST - ADJUDICATED GUILTY
$250FN+ 5%+20CSTF+200CC+ 50PC+ 25IC
02/17/2009 6 MONTHS SUPERVISED PROBATION
MAY TERMINATE EARLY UPON SUCCESSFUL COMPLETION OF CONDmONS
COUNTY JAIL 15 DAYS
CREDIT TIME SERVED
TO BE SERVED ON WEEKEND WORK PROGRAM, BEGINNING 2/21/09 BY
6:30AM
02/13/2009 AFFIDAVIT OF INDIGENT STATUS-INDIGENT
02/13/2009 NOTICE OF APPEARANCE
02/13/2009 WRITTEN PLEA OF NOT GUILTY BY PUBUC DEFENDER
02/13/2009 NOTICE OF DISCOVERY
PROCEEDING: PRETRIAL CONFERENCE ON 01-06-2009 @ 09:00
PRESIDING JUDGE: ROB CROWN
01/06/2009 PUBUC DEFENDER APPOINTED
WAIVES SPEEDY TRIAL
CONTINUED TO 02-17-2009 @ 09:00AM PRETRIAL CONFERENCE
AT REQUEST OF DEFENSE
01/02/2009 CORRESPONDENCE REGARDING CONTINUANCE
11/20/2008 WRITTEN PLEA NOT GUILTY BY DEFENDANT & WAIVER OF ARRAIGNMENT
PROCEEDING: MISDEMEANOR ARRAIGNMENT ON 11-20-2008 @ 08:30
11/20/2008 PRESIDING JUDGE: MIKE CARR
WRITTEN PLEA OF NOT GUILTY BY DEFENDANT.
SET FOR 01-06-2009 @ 09:00AM PRETRIAL CONFERENCE
11/13/2008 INFORMATION FILED ON DRIVE WHILE UCENSE SUSPENDED/REVOKED 2ND
11/13/2008 NOTICE TO THE CLERK FROM STATE ATTORNEY'S OFFICE
11/05/2008 FILED CITATION # 2452FHO; DRIVE WHILE UCENSE SUSPENDED 1ST
PROCEEDING: NON-COURT
11/05/2008 PRESIDING JUDGE: N/A
SET FOR 11-20-2008 @ 08:30AM MISDEMEANOR ARRAIGNMENT
Events
Docket Type
Judge
Court Date
Court Time
http://apps.collierc1erk.com/public _ inquiry/Case.aspx?UCN= 112008CT006835000 lXX&... 3/18/2009
pnnter .tnenwy versIon
.laz:;"'.L.V.l.L.
PRETRIAL CONFERENCE
ROB CROWN
02/17/2009
0900
Financials
Charge Number
1
999
Amount Assessed
557.50
50.00
Amount Paid
Last Payment Date
0.00
0.00
Charges
Charge
02/17/2009
Florida Statute
322.34 2B
Florida Statute Description
DRIVE WHILE UCENSE SUSP/REVOKED 2ND
Charge Status
Adjudicated Guilty
http://apps.collierclerk.comlpublic _ inquiry/Case.aspx?UCN= 112008CT006835000 1XX&... 3/18/2009
~nlllllli1.l ~i1.:sl;; Ul;;UUl
. uo.... . V. k
Traffic Case Detail Information
* The data displayed below was last modified 1/28/2009 7:33:33 PM
STATE OF FLORIDA VS CASEY, THOMAS J
Defendant Name:
Date of Birth:
Case Number:
Arrest Date:
Appear by Date:
Location:
Case Assigned Judge:
Uniform Case Number:
Issuing Agency:
Offense Date:
Citation Number:
Lead Attorney:
Assessed Payment:
Amount Paid:
Balance Due:
Payment Plan:
Upcoming Hearings:
Casey, Thomas J
1/22/1952
08- TR-088598
11/5/2008
Sturgis, Radford R
362008TR088598000ACH
10/6/2008
3943-ESN
$139.50
$139.50
$0.00
N/A
N/A
I Charges I
ICharge Filing Date: IIStatute: lILevel/Deuree IICharge Number: IIOffense: IIDisposition: I
I 11322.34(1) IIInfractlon 111 !lOlL SUSPENDED (UNKNOWINGLY) IlDef Sent/Cler!< WH Adj I
I 11322.34(1) IIInfractlon 111 IID/L SUSPENDED (UNKNOWINGLY) IlDef Sent/ Adj GuIlty I
II
IComponent:
Sentence Components
lIvalue:
II
I
I
I
I!
I'Transaction Date:
110/9/2008
lICharge Amount:
11$121.50
Assessments
IlFee Code: IlFee Description:
II-TMDL-MOV IIDL Base Fine Moving
http://www.1eec1erk.org/Criminal_ detail_ new.asp?CsNum=08- TR-088598&CsType=Traff... 3/18/2009
cnmmaI. case UeIall
..l "'0.... ~ V~ ...
112/30/2008
11$18.00
U-TF-NC
IINC Non Compliance School Option Only
I Payments I
trransaction Date: !IReceipt Number: IlPayment Amount: !lFee Desaiption:
11/26/2009 1I0rH:C-2009-02746 11$18.00 1
110/28/2008 1I0DFM-2008-194684 11$121.50 I
I
IBond Amount:
IlBond Type:
Bonds
IlBond Status:
IIStatus Date:
IlBond Company:
I Docket Information I
IDocket Date: IIEvent Desaiption: I
110/9/2008 llease Opened by Citation Filed, I
110/28/2008 IIArraignment (Judge:Sturgis, Radford R), lime - 08:00 I
110/28/2008 IIDefendant Elected Traffic School Option, I
110/28/2008 IlCommitment Form Ated, I
110/28/2008 IIAne and/or Court Costs (Judge: Sturgis, Radford R), D/L SUSPENDED (UNKNOWINGLY) I
110/28/2008 l!Traffic Affidavit Aled,. I
110/28/2008 lID1sposition (Judge:Sturgis, Radford R) I
111/7/2008 lICorrespondence Flied, I
112/30/2008 ltm. - 06 Ordered for Failed to Complete Bected School, I
112/30/2008 Itm. - D6 Issued for Failed to Complete Elected School,
112/30/2008 IlDlsposltlon (Judge:Sturgis, Radford R)
11/26/2009 IIDriver's Ucense Qeared PriDr to DHSMV Suspension Date,
11/26/2009 ltm. - 06 Cleared for Failed to Complete Elected School,
11/27/2009 ltm. - 06 Ordered for Failed tD Complete Elected SchODI,
11/27/2009 Itm. - 06 Issued for Failed to Complete Elected School,
11/28/2009 Itm. - 06 Oeared for Failed to Complete Elected School, added and deared same day
End of Traffic Case Detail Information
C;ontCic;tJhe CivjL Traffic Division
http://www.leeclerk.org/Criminal_ detail_ new.asp?CsNum=08- TR-088598&CsType=Traff... 3/18/2009
1 CTO Active LC2007000002 A OK Transportation, Inc. 710 Elkcam Circle East
2 CTO Active LC2007000003 A-Action Transportation 581 Diplomat CT
3 CTO Active LC2007000004 At Your Service of SW FL 7140 Appleby DR
4 CTO Active LC2007000005 T J's Assistant Care Svc 1724 Santa Barbara BLVD, Unit A
5 CTO Inactive LC2007000008 Advanced Transportation 171 COMMERCIAL BLVD #23
6 CTO Active LC2007000010 Metro Cab 16991 US HWY 19 N
7 CTO Active LC2007000013 Fantastic Limousine, Inc. 15470 Los Reyes LN
8 CTO Active LC2007000015 Aristocrat Luxury Transportation, Inc. 1985 Timberline DR
CTO Active LC2007000018 Saco Valley Trader dba/ Southwest 27150 Driftwood DR.
9 Transportation
10 CTO Active LC2007000019 All Aboard Airport Transportation 1923 Terrazzo LN
11 CTO Active LC2007000020 ALPC, Inc (A Lincoln Private Car) PO Box 770093
12 CTO Active LC2007000021 Aaron Airport Transp 13233 Greywood Cir
13 CTO Active LC2007000025 New Pelican Transp Service, Inc, 1304 Wildwood Lakes BLVD, Unit 6
14 CTO Active LC2007000026 Class Act Limousine 2180 Corporation BLVD
15 CTO Active LC2007000029 Carway Town Car 275 Goodlette Rd N,
CTO Active LC2007000030 Regency Executive Services & 6561 Taylor RD, Unit 1
16 Transportation, Inc
CTO Active LC2007000033 Cerreal Company, Inc, dba Non Emergent 2910 4th ST NE
17 Transport
18 CTO Active LC2007000034 Hollywood Limos Of Naples LLC 5560 JONQUIL LN # 204
19 CTO Inactive LC2007000035 Carey Limousine Florida, Inc. 280 V ANDERBIL T BEACH ROAD
20 CTO Active LC2007000037 Corporate Cab, Inc. 100 Aviation S Suite# 103
CTO Active LC2007000038 Naples Chauffeur Service, Inc, 15405 Cederwood Ln # 303 --- PO
21 BOX 8904
22 CTO Active LC2007000040 Big Shotz Limousine, Inc, 5009 31st AVE SW
23 CTO Active LC2007000042 Elite Limousine Service of SW Florida, 11910 Palomino Lane
24 CTO Active LC2007000044 Naples Transportation & Tours, Inc, 1010 6th Ave, South
25 CTO Active LC2007000045 Naples Taxi 3047 Terrace AVE, Unit C
26 CTO Active LC2007000046 Naples Shuttle, Inc, 4436 18th AVE SW
27 CTO Active LC2007000047 Rogers Limo Service, Inc, 7048 Falcons Glen Blvd
28 CTO Active LC2007000048 Naples Airport Shuttle, Inc. 2900 14th St. North Ste 22
29 CTO Active LC2007000049 Maxi Taxi of Florida, Inc, 5910 Taylor RD, Unit 110
30 CTO Active LC2007000050 Majestic Limo Services 15501-5 Old Mc Gregor Blvd
31 CTO Active LC2007000051 L.A. Limousine Service, Inc, 3280 17th AVE SW
32 CTO Active LC2007000052 Superior Airport Shuttle LLCmba.0/8 2900 14th ST N, Unit 1
33 CTO Active LC2007000053 Royal Floridian Transportation, Inc 10490 Deer Run Farms Rd
34 CTO Active LC2007000054 Rockefeller Limo of Florida, Inc. 859 Tanbark DR, Unit 102
35 CTO Active LC2007000055 Private Car Luxury Transportation, Inc. PO Box 8453
36 CTO Active LC2007000056 Prestige Transportation 310 Melrose PL
37 CTO Active LC2007000057 Platinum Limousine, Inc 17355 Meadow Lake Circle
CTO Active LC2007000058 A-1 Communications Specialists, Inc, 4884 Napoli DR
38 DBA A-1 Limo of Naples
39 CTO Active LC2007000062 Call at ran Chauffeured Services PO Box 10246
40 CTO Active LC2007000064 Charles Limousine Service, LLC 1049 N Town & River Dr
41 CTO Active LC2007000065 A + Airport Transportation, Inc. 222 Industrial Blvd, Unit 104
42 CTO Active LC2007000067 Florida Airport Transportation 27499 Riverview Ct
43 CTO Inactive LC2007000068 Checker Cab 3047 TERRACE AVE UNITB
44 CTO Active LC2007000076 Easy Come Easy Go Limo 441 Pheasant CT
45 CTO Active LC2007000082 Luxury Limousine of Naples 16020 CALDERA LN
46 CTO Inactive LC2007000083 Bonita Bee Airport Express 8841 W TERRY ST
47 CTO Active LC2007000087 NAV - LLC (Non-Medical Trans) 3906 Tamiami Trail East
CTO Inactive LC2007000089 MM Fast Limo Corporation 559 E ELKCAM CIR #8 -- 9380
48 MAINO CIR # 204 34174
49 CTO Active LC2007000090 Royal Palm Limo 659 108th Ave N
50 CTO Active LC2007000091 A Touch Of Class Transportation & Limo, 1890 Elsa St
51 CTO Active LC2007000092 Men In Black, LLC 13625 Lesina Court
52 CTO Active LC2007000093 Naples Limousine Service 5051 Castello Dr # 26
53 CTO Active LC2007000097 Aangel Airport Transportation 8856 New Castle Dr
54 CTO Active LC2007000100 Racing Limos of SW Florida, Inc. 12870 Trade Way Four #108
55 CTO Active LC2007000101 Accent Transportation Services, Inc 553 Landmark DR
56 CTO Active LC2007000103 Canary Transportation, Inc 731 W Elkcam Cir # 8109
57 CTO Active LC2007000 108 Arkway Taxi, Inc 222 INDUSTRIAL BLVD # 169
58 CTO Active LC2007000111 Ion Transportation 21560 Windham Run
59 CTO Active LC2007000113 Custom Limousine Services 1275 Solana Rd
60 CTO Inactive LC2007000114 MAXIMUM LIMOUSINE 11077 LAKELAND CIRCLE
61 CTO Active LC2007000117 Unlimited Airport Rides, LLC 812 E Elkcam Cir
62 CTO Active LC2007000122 Dolphin Transp Specialist, Inc, 3963 Progress AVE
63 CTO Active LC2007000 124 PALM AIR TRANSPORTATION LLC 13968 AVON PARK CIRCLE
64 CTO Active LC2007000136 Doino Classic Transportation, Inc, 960 Chalmers Dr
65 CTO Active LC2007000139 Sunshine Cab 171 Commercial BLVD, Unit 12
66 CTO Active LC2007000141 Taxi Time, Inc, 2669 Davis Blvd #2
67 CTO Active LC2007000145 Union Taxi 103 Leawood CIR
68 CTO Active LC2007000146 Atlantis Cars & Limousines, Inc 1650 Tarpon Bay DR S, Unit 101
69 CTO Active LC2007000148 Preferred Shuttle LLC 2800 Riverview DR
70 CTO Active LC2007000149 David's Livery 2655 Sailors WAY
CTO Active LC2007000152 Five Seas Enterprises, Inc, DBA Cruisers 3220 Palm Ave
71 Charters & Tours
CTO Active LC2007000153 Paradise Limousine Service, LLC DBA 2110 Pondella Rd
72 Affordable Limousine
73 CTO Active LC2007000155 Fly Ride Transportation, LLC 1801 Mission DR
74 CTO Active LC2007000156 Mexi-Taxi, Corp 1279 ALLEGIANCE WAY
75 CTO Active LC2007000158 First Choice Transport, Inc 4300 Pine Ridge RD
76 CTO Active LC2007000159 Carriage Limo, LLC 678 Bald Eagle Dr # 4
77 CTO Active LC2007000166 J Limo 4575 Dorando DR
78 CTO Active LC2007000168 Yellow Cab of SW FL, Inc 6100 Adkins AVE
79 CTO Active LC2007000172 A-1 Cadillac Airport Transportation 27683 Suffridge Dr
CTO Active LCCT020070002567 Island Coast Transportation PO Box 9248
80
CTO Active LCCT020070002591 Prince Giovanni's of Collier County, Inc. 5613 Eleuthera WAY
81
CTO Active LCCT020070002637 Above Comfort Non-Emergency Medical 4100 Corporate sa, Unit 116
82 Transport
CTO Active LCCT020070002656 Auto on Demand 8235 Potomac Ln
83
CTO Active LCCT020070002657 Advanced Transportation 3279 80ca Ciega DR
84
CTO Active LCCT020080000021 Luxury Taxi 1320 Henley St #2001
85
CTO Active LCCT020080000034 Always On Time Limo, LLC 14904 Indigo Lakes DR
86
CTO Active LCCT020080000079 Bonita Bee Airport Express Service, LLC 25820 Hickory Blvd
87
CTO Active LCCT020080000080 MBA Airport Transportation 15501-5 Old McGregor Blvd
88
CTO Active LCCT020080000084 Red Rover Charter Service 2324 Kings Lake BLVD
89
CTO Active LCCT020080000086 TLC Non-Emergency Medical Transport, 3893 Mannix DR, Unit 519
90 Inc.
CTO Active LCCT020080000093 American Taxi 5250 23rd PL SW
91
CTO Active LCCT0200BOOOO094 Doris Limousine Service 23280 Abeline Ave
92
CTO Active LCCT0200BOOOO095 Express Taxi 191B 40th TER SW
93
CTO Active LCCT0200BOOOO097 SW Cab 30BO Peters St
94
CTO Active LCCT0200BOOO0103 American Comfort Limo, Inc, 3084 Terrace Ave
95
CTO Active LCCT0200BOOO010B Airport to Airport Shuttle, LLC DBA 315 3rd Ave N
96 Alligator Alley Express
CTO Active LCCT0200BOOO0110 Naples Hotels Transportation, LLC 2656 Fountainview Ln
97
CTO Active LCCT0200BOOOO 172 Gulfcoast Airport Transportation & Limo 12950 Positano Circle Apt 306
98 Service
CTO Active LCCT0200BOOO0173 Palm Coast Transportation, LLC 441 27th ST SW
99
CTO Active LCCT0200BOOO0223 Gulf Shore Transportation 7B93 Umberto CT
100
CTO Active LCCT020080000254 24-7 Airport Transportation Inc 2101 19Th Lane S,E.
101
CTO Active LCCT020080000285 Carey Limousine Florida, Inc 4595 Oakes Rd
102
CTO Active LCCT0200800002B7 USA Transportation 171 Commercial Blvd S #23
103
CTO Active LCCT0200BOOO0320 Fancy Cab 2900 14th ST N, Unit 19
104
CTO Active LCCT0200BOOO0321 Bravo Taxi, Inc, 5447 Sholtz ST
105
CTO Active LCCT0200BOOO0413 Maximum Ventures of SW FI, LLC DBA 13650 Fiddlesticks Blvd # 202339
106 Maximum Limousine
CTO Active LCCT0200BOOO0415 Freedom Taxi PO Box B596
107
CTO Active LCCT0200BOOO0454 Taxi Man 3BB7 Mannix DR
10B
CTO Active LCCT0200BOOO0465 Frank Midland, Inc d,b,a, EZ Journey 4B52 Tahiti LN
109
CTO Active LCCT0200BOOO0555 William A. Lakman Services 4 Santa Fe Trail
110
CTO Active LCCT0200BOOO0556 Wheelchair Transport Service, Inc, 7411114thAveN.Ste309
111
CTO Inactive LCCT020080000621 Comfort Transportation 865 Kings WAY
112
CTO Active LCCT0200BOOO0622 Eagle Taxi 2880 44th TER SW
113
CTO Active LCCT0200BOOO0676 Blue Bird Taxi of Lee County, Inc, 3252 Palm Ave
114
CTO Active LCCT020080000677 Sun Coast Taxi 1967 River Reach DR, Unit 251
115
..
CTO Active LCCT020080000679 Excellent Transportation, LLC, 1490 8TH Street NE
116
117 CTO Active LC2007152565 APPLE TRANSPORTATION 15501-6 OLD MCGREGOR BLVD.
CTO Active LCCT020080000737 Gulf Coast Non-Emergency Transport, 22118 Seashore Circle
118 LLC.
CTO Active LCCT020080000738 Verve Limo Services, LLC, 6849 Grenadier BLVD, Unit 2003
119
CTO Active LCCT020080000950 Solana Villas PO Box 60195
120
CTO Active LCCT020080000987 Aafordable Tours 1083 N. Collier Blvd #201
121
CTO Active LCCT020080000988 Guiampu Corp dba Naples Premium 7791 lonio Ct
122 Transport
CTO Active LCCT020090000012 Florida Transportation Specialists Inc 20097 Saraceno Dr
123
CTO Active LCCT020090000040 EZ Journey Inc 4852 Tahiti Lane
124
CTO Active LCCT020090000041 Gennaro V, Cangiano 4451 Gulfshore Blvd #605
125
CTO Active LCCT020090000050 Pelican Shuttle, LLC, 720 Lambton LN
126
CTO Active LCCT020090000051 Advanced Quality Transport Service 2717 SW 11 th Court
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CTO Active LCCT020090000069 Naples Transportation & Tour, LLC 1010 6th Ave South
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CTO Active LCCT020090000120 Taxi Hispano 4245 Heritage CIR #101
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CTO Active LCCT020090000145 R.E.A.L Transportation 1141 Cooper DR
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CTO Active LCCT020090000278 E & M School Transportation 3785 20th AVE SE
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CTO Active LCCT020090000284 Ocean Line Transportation Inc, 3670 Grand Cypress DR
132