State of Wisconsin

Circuit Court

Burnett County

St. Croix Regional Medical Center

235 State St

St. Croix Falls, WI 54024

Plaintiff

vs.

Robert L. Holmstrom

5698 N Markville Rd

Danbury, WI 54830

Defendant

Summons

Money Judgment: 30301

Case Number 2021CV29

The State of Wisconsin

To each person named above as a Defendant:

You are hereby notified that the plaintiff named above, St. Croix Regional Medical Center, filed a lawsuit or other legal action against you. The Complaint, which is attached, states the nature and basis of this legal action.

Within 20 days of receiving this Summons, you must respond with a written answer, as that term is used in Chapter 802 of the Wisconsin Statutes, to the Complaint. The Court may reject or disregard an answer that does not follow the requirements of the statutes. The answer must be sent or delivered to the Court, whose address is: Burnett County Courthouse, 7410 County Road K, Siren, WI 54872, and to the plaintiff’s attorney, Michael C. Koehn, PO Box 92, Eau Claire, wI 54702. You may have an attorney help or represent you.

If you do not provide a proper answer within 20 days, the Court may grant judgment against you for the award of money or other legal action requested in the Complaint, and you may lose your right to object to anything that is or may be incorrect in the Complaint. A judgment may be enforced as provided by law. A judgment awarding money may become a lien against any real estate you own now or in the future, and may also be enforced by garnishment or seizure of property.

Dated this 22nd day of March, 2021.

/s/ Michael C. Koehn, S.C.

SBN 1006590

PO Box 92

Eau Claire, WI 54702-0092

Tel: (715) 832-5074

This is an attempt to collect a debt by a debt collector and any information obtained will be used for that purpose.

WNAXLP

(July 21, 28, August 4)