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ALIAS NOTICE OF CLAIM STATE OF INDIANA ) IN THE Lake Sup. Court, County Div 2 ) SS: 2293 N. Main Street COUNTY OF LAKE ) Crown Point, IN 46307 Plaintiff ELLIS ORTHODONTICS, LLC % Burke Costanza & Carberry LLP Attorneys for Plaintiff CAUSE NO. 45D08-1911-SC-007195 9191 Broadway Merrillville, Indiana 46410 Telephone: (800) 769-0588 -vs- Defendant #1 Khalilah Omar 4811 S Tripp Ave Chicago IL 60632 TO THE DEFENDANT(S): You have been sued by the Plaintiff whose name appears above. You must appear in the Lake Sup. Court, County Div 2 at the above address for a initial hearing upon this claim on November 18, 2021 @ 8:45 a.m. A BRIEF STATEMENT OF THE NATURE OF THE PLAINTIFF'S CLAIM AGAINST YOU IS AS FOLLOWS: Balance due on agreement, a copy of which is attached hereto, labeled Exhibit "A" and incorporated herein by reference. The Plaintiff demands judgment in the amount of $1,383.00, plus interest and/or late charges at the rate of 18 percent per annum from April 30, 2019, plus reasonable attorney fees in the amount of $375.00; all without relief from valuation and appraisement laws, and for the costs of this action. The Plaintiff demands judgment in the amount of $2,586.65, plus the costs of this action, and additional interest and attorney fees accruing after September 24, 2021. ELLIS ORTHODONTICS, LLC By: /s/ Chad W. Nally Chad W. Nally - Atty. #29407-64 BURKE COSTANZA & CARBERRY LLP 9/22/21 Manner of Service: Service by Publication Clerk: Lorenzo Arredondo 50438 10/7, 10/14, 10/21/2021 7051054 HSPAXLP

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