Case Number: 97D 00114
File Date: 08/20/1997
ST OF KS EX REL SRS ET AL
Address:
DOB:
Attorney:
PARRACK, RICHARD P
Address:
315 SPRUCE
WAMEGO KS 66547
DOB:
Attorney:
| Docket Number | Date | Docket Entry |
|---|---|---|
| 1 | 03/16/1998 | CERTIFICATE OF MAILING-(IWO BY SRS UPON METHODIST HOMES) |
| 2 | 06/11/1998 | CERTIFICATE OF MAILING-(IWO BY SRS UPON MANPOWER) |
| 3 | 06/23/1998 | EMPLOYER ANSWER (CC: MS.NAAB) |
| 4 | 06/25/1998 | NOTICE OF TERMINATION OF EMPLOYMENT-(EFF 5-20-98)-CC:MS.NAAB |
| 5 | 05/25/1999 | CERTIFICATE OF MAILING--(IWO BY SRS ON ROYAL TIRE/ROSE MUFF) |
| 6 | 06/09/1999 | EMPLOYER ANSWER, COPY TO SRS |
| 7 | 01/19/2000 | NOTICE OF TERMINATION OF EMPLOYMENT--(CC: MS.NAAB) |
| 8 | 01/25/2000 | CERTIFICATE OF MAILING-(IWO BY SRS ON RICHARDS AUTO SERV.) |
| 9 | 02/02/2000 | EMPLOYER ANSWER--(CC: MS.NAAB) |
| 10 | 02/24/2000 | CHANGE OF EMPLOYEE ADDRESS/STATUS--(EMPL. TERM. 2-11-00) |
| 11 | 02/24/2000 | COPY TO SRS |
| 12 | 03/13/2000 | EMPLOYER ANSWER---(CC: SRS) |
| 13 | 04/09/2001 | CERTIFICATE OF MAILING--(IWO BY SRS ON RICHARDS AUTO SERV) |
| 14 | 04/18/2001 | EMPLOYER ANSWSER |
| 15 | 02/20/2002 | RENEWAL AFFIDAVIT |
| Receipt Number | Receipt Date | Payor Name | Total Amount |
|---|---|---|---|
| 49773 | 10/17/1997 | PARRACK,R/C.R.TIRE&MUFFLR | 46.16 |
| 50031 | 10/24/1997 | PARRACK,R/C.R.'S TIRE&MFL | 46.16 |
| 50881 | 11/13/1997 | PARRACK,R/C.R.TIRE & MUFF | 92.32 |
| 50958 | 11/14/1997 | PARRACK,R/C.R.TIRE&MUFFLR | 46.16 |
| 51189 | 11/21/1997 | PARRACK,R/CR TIRE&MUFFLER | 46.16 |
| 51733 | 12/05/1997 | PARRACK,R/C.R.TIRE&MUFFLR | 92.32 |
| 56139 | 03/26/1998 | PARRACK,R/UNTD METH HOMES | 100.00 |
| 57970 | 05/05/1998 | PARRACK,R/UNTD METH HOMES | 200.00 |
| 58888 | 05/28/1998 | PARRACK,R/UNITED METHODST | 200.00 |
| 60176 | 06/25/1998 | PARRACK/UNITED METHODIST | 100.00 |
| 61190 | 07/20/1998 | PARRACK,R/MANPOWER T.S. | 46.15 |
| 62457 | 08/14/1998 | PARRACK,R/MANPOWER T.S. | 184.60 |
| 75928 | 06/09/1999 | PARRACK, R/ROYAL TIRE | 46.15 |
| 76209 | 06/16/1999 | PARRACK,R/ROYAL TIRE TOPE | 46.15 |
| 76505 | 06/24/1999 | PARRACK,R/ROYAL TIRE TOPK | 46.15 |
| 76786 | 06/30/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 77105 | 07/07/1999 | PARRACK/ROYAL TIREOF TOP. | 46.15 |
| 77394 | 07/14/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 77727 | 07/21/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 78030 | 07/28/1999 | PARRACK,R/ROYAL TIRE TOP. | 46.15 |
| 78400 | 08/04/1999 | PARRACK, R/ROYAL TIRE | 46.15 |
| 78737 | 08/12/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 79018 | 08/18/1999 | PARRACK, R/ROYAL TIRE | 46.15 |
| 79459 | 08/26/1999 | PARRACK/ROYAL TIRE TOPEKA | 46.15 |
| 79733 | 09/01/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 80019 | 09/08/1999 | PARRACK, RICHARD/ROYAL TI | 46.15 |
| 80339 | 09/15/1999 | PARRACK,R/ROYAL TIRE,TOP. | 46.15 |
| 80634 | 09/22/1999 | PARRACK/ROYAL TIRE,TOPEKA | 46.15 |
| 81349 | 10/06/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 81633 | 10/13/1999 | PARRACK, R ROYAL TIRE | 46.15 |
| 81975 | 10/21/1999 | PARRACK, R/ROYAL TIRE | 46.15 |
| 82207 | 10/27/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 82544 | 11/03/1999 | PARRACK,R/ROYAL TIRE TOP. | 46.15 |
| 82842 | 11/10/1999 | PARRACK/ROYAL TIRE TOPEKA | 46.15 |
| 83086 | 11/17/1999 | PARRACK/ROYAL TIRE TOPEKA | 46.15 |
| 83396 | 11/24/1999 | PARRACK/ROYAL TIRE TOPEKA | 46.15 |
| 83637 | 12/01/1999 | PARRACK,R/ROYAL TIRE TOP. | 46.15 |
| 83958 | 12/08/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 84253 | 12/15/1999 | PARRACK,R/ROYAL TIRE,TOP. | 46.15 |
| 84513 | 12/22/1999 | PARRACK/ROYAL TIRE OF TOP | 46.15 |
| 84912 | 12/31/1999 | PARRACK, R/ROYAL TIRES | 46.15 |
| 85110 | 01/05/2000 | PARRACK/ROYAL TIRE TOPEKA | 46.15 |
| 86399 | 02/02/2000 | PARRACK,R/RICHARDS AUTO | 46.15 |
| 86400 | 02/02/2000 | PARRACK,R/RICHARDS AUTO | 46.15 |
| 86646 | 02/08/2000 | PARRACK, RICHARD P | 46.15 |
| 87023 | 02/16/2000 | PARRACK/RICHARDS AUTO SRV | 46.15 |
| 88163 | 03/13/2000 | PARRACK,R/JBS PAINT&BODY | 46.15 |
| 89380 | 04/08/2000 | PARRACK, R/JB'S PAINT | 138.45 |
| 90181 | 04/27/2000 | PARRACK, RICHARD/JB PAINT | 138.45 |
| 91695 | 05/31/2000 | PARRACK, RICHARD/JB PAINT | 138.45 |
| 92843 | 06/26/2000 | PARRACK,R/JB'S PAINT&BODY | 184.60 |
| Description | Transation Date | Amount Paid | Payor |
|---|---|---|---|
| 19971016 #13460 | 10/17/1997 | 46.16 | PARRACK,R/C.R.TIRE&MUFFLR |
| 19971021 #13482 | 10/24/1997 | 46.16 | PARRACK,R/C.R.'S TIRE&MFL |
| 19971108 #13538 | 11/13/1997 | 92.32 | PARRACK,R/C.R.TIRE & MUFF |
| 19971112 #13545 | 11/14/1997 | 46.16 | PARRACK,R/C.R.TIRE&MUFFLR |
| 19971120 #13559 | 11/21/1997 | 46.16 | PARRACK,R/CR TIRE&MUFFLER |
| 19971204 #13592 | 12/05/1997 | 92.32 | PARRACK,R/C.R.TIRE&MUFFLR |
| 19980325 #107418 | 03/26/1998 | 100.00 | PARRACK,R/UNTD METH HOMES |
| 19980504 #107895 | 05/05/1998 | 200.00 | PARRACK,R/UNTD METH HOMES |
| 19980527 #108198 | 05/28/1998 | 200.00 | PARRACK,R/UNITED METHODST |
| 19980624 #108561 | 06/25/1998 | 100.00 | PARRACK/UNITED METHODIST |
| 19980716 #34036 | 07/20/1998 | 46.15 | PARRACK,R/MANPOWER T.S. |
| 19980812 #34134 | 08/14/1998 | 184.60 | PARRACK,R/MANPOWER T.S. |
| 19990608/CK#1039 | 06/09/1999 | 46.15 | PARRACK, R/ROYAL TIRE |
| 19990615 #1053 | 06/16/1999 | 46.15 | PARRACK,R/ROYAL TIRE TOPE |
| 19990622#1064 | 06/24/1999 | 46.15 | PARRACK,R/ROYAL TIRE TOPK |
| 19990629#1075 | 06/30/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19990705#1081 | 07/07/1999 | 46.15 | PARRACK/ROYAL TIREOF TOP. |
| 19990713#1091 | 07/14/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19990720#1106 | 07/21/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19990727#1116 | 07/28/1999 | 46.15 | PARRACK,R/ROYAL TIRE TOP. |
| 19990803/CK#1124 | 08/04/1999 | 46.15 | PARRACK, R/ROYAL TIRE |
| 19990810#1144 | 08/12/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19990817/CK#1150 | 08/18/1999 | 46.15 | PARRACK, R/ROYAL TIRE |
| 19990824#1158 | 08/26/1999 | 46.15 | PARRACK/ROYAL TIRE TOPEKA |
| 19990830#1164 | 09/01/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19990907/CK#1181 | 09/08/1999 | 46.15 | PARRACK, RICHARD/ROYAL TI |
| 19990914#1189 | 09/15/1999 | 46.15 | PARRACK,R/ROYAL TIRE,TOP. |
| 19990921#1199 | 09/22/1999 | 46.15 | PARRACK/ROYAL TIRE,TOPEKA |
| 19991005#1216 | 10/06/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19991012 #1226 | 10/13/1999 | 46.15 | PARRACK, R ROYAL TIRE |
| 19991020/CK31245 | 10/21/1999 | 46.15 | PARRACK, R/ROYAL TIRE |
| 19991026#1252 | 10/27/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19991102#1261 | 11/03/1999 | 46.15 | PARRACK,R/ROYAL TIRE TOP. |
| 19991109#1269 | 11/10/1999 | 46.15 | PARRACK/ROYAL TIRE TOPEKA |
| 19991116#1279 | 11/17/1999 | 46.15 | PARRACK/ROYAL TIRE TOPEKA |
| 19991123#1289 | 11/24/1999 | 46.15 | PARRACK/ROYAL TIRE TOPEKA |
| 19991130#1295 | 12/01/1999 | 46.15 | PARRACK,R/ROYAL TIRE TOP. |
| 19991207#1303 | 12/08/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19991214#1313 | 12/15/1999 | 46.15 | PARRACK,R/ROYAL TIRE,TOP. |
| 19991221#1322 | 12/22/1999 | 46.15 | PARRACK/ROYAL TIRE OF TOP |
| 19991230/CK#1331 | 12/31/1999 | 46.15 | PARRACK, R/ROYAL TIRES |
| 20000104#1337 | 01/05/2000 | 46.15 | PARRACK/ROYAL TIRE TOPEKA |
| 20000130#1235W/E1-21 | 02/02/2000 | 46.15 | PARRACK,R/RICHARDS AUTO |
| 20000130#1234W/E1-28 | 02/02/2000 | 46.15 | PARRACK,R/RICHARDS AUTO |
| 20000204#1245 | 02/08/2000 | 46.15 | PARRACK, RICHARD P |
| 20000214#1260 | 02/16/2000 | 46.15 | PARRACK/RICHARDS AUTO SRV |
| 20000308#2576 | 03/13/2000 | 46.15 | PARRACK,R/JBS PAINT&BODY |
| 20000407/CK#5101 | 04/08/2000 | 138.45 | PARRACK, R/JB'S PAINT |
| 20000425/CK#5153 | 04/27/2000 | 138.45 | PARRACK, RICHARD/JB PAINT |
| 20000512/CK#5179 | 05/31/2000 | 138.45 | PARRACK, RICHARD/JB PAINT |
| 20000619#5261 | 06/26/2000 | 184.60 | PARRACK,R/JB'S PAINT&BODY |