Official Form 410 Proof of Claim page 1

Official Form 410

Proof of Claim 04/19

Read the instructions before filling out this form. This form is for making a claim for payment in a bankruptcy case. Do not use this form to 

make a request for payment of an administrative expense. Make such a request according to 11 U.S.C. § 503.

Filers must leave out or redact information that is entitled to privacy on this form or on any attached documents. Attach redacted copies of any 

documents that support the claim, such as promissory notes, purchase orders, invoices, itemized statements of running accounts, contracts, judgments, 

mortgages, and security agreements. Do not send original documents; they may be destroyed after scanning. If the documents are not available, 

explain in an attachment.

A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both. 18 U.S.C. §§ 152, 157, and 3571.

Fill in all the information about the claim as of the date the case was filed. That date is on the notice of bankruptcy (Form 309) that you received.

Part 1: Identify the Claim

1. Who is the current 

creditor? ___________________________________________________________________________________________________________

Name of the current creditor (the person or entity to be paid for this claim) 

Other names the creditor used with the debtor ________________________________________________________________________

2. Has this claim been 

acquired from 

someone else?

 No

 Yes. From whom? ______________________________________________________________________________________________________

Where should notices to the creditor be sent? Where should payments to the creditor be sent? (if 

different)

_____________________________________________________

Name

________________________________________________________

Number Street

________________________________________________________

City State ZIP Code 

Contact phone ________________________

Contact email ________________________

_____________________________________________________

Name

______________________________________________________

Number Street

______________________________________________________

City State ZIP Code 

Contact phone ________________________

Contact email ________________________

3. Where should notices 

and payments to the 

creditor be sent?

Federal Rule of 

Bankruptcy Procedure 

(FRBP) 2002(g)

Uniform claim identifier for electronic payments in chapter 13 (if you use one):

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

4. Does this claim amend 

one already filed?

 No

 Yes. Claim number on court claims registry (if known) ________ Filed on ________________________

MM / DD / YYYY

5. Do you know if anyone 

else has filed a proof 

of claim for this claim?

 No

 Yes. Who made the earlier filing? _____________________________

Debtor 1 ________________________________________________________________

Debtor 2 ________________________________________________________________

(Spouse, if filing)

United States Bankruptcy Court for the: ______________________ District of ________

(State)

Case number ___________________________________________

 Fill in this information to identify the case:

MERRICK BANK

SOUTHERN

JOSEPH AMODIO

FL

1922407

Resurgent Capital Services

PO Box 10368

Greenville, SC 29603-0368

(866) 572-0265

RSG-02230-686383439

askbk@resurgent.com

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Official Form 410 Proof of Claim page 2

Part 2: Give Information About the Claim as of the Date the Case Was Filed

6. Do you have any number 

you use to identify the 

debtor?

 No

 Yes. Last 4 digits of the debtor’s account or any number you use to identify the debtor: ____ ____ ____ ____

7. How much is the claim? $_____________________________. Does this amount include interest or other charges?

 No

 Yes. Attach statement itemizing interest, fees, expenses, or other 

charges required by Bankruptcy Rule 3001(c)(2)(A).

8. What is the basis of the 

claim?

Examples: Goods sold, money loaned, lease, services performed, personal injury or wrongful death, or credit card. 

Attach redacted copies of any documents supporting the claim required by Bankruptcy Rule 3001(c).

Limit disclosing information that is entitled to privacy, such as health care information. 

______________________________________________________________________________

9. Is all or part of the claim 

secured?

 No

 Yes. The claim is secured by a lien on property. 

Nature of property:

 Real estate. If the claim is secured by the debtor’s principal residence, file a Mortgage Proof of Claim 

Attachment (Official Form 410-A) with this Proof of Claim.

 Motor vehicle

 Other. Describe: _____________________________________________________________

Basis for perfection: _____________________________________________________________

Attach redacted copies of documents, if any, that show evidence of perfection of a security interest (for 

example, a mortgage, lien, certificate of title, financing statement, or other document that shows the lien has 

been filed or recorded.)

Value of property: $__________________

Amount of the claim that is secured: $__________________

Amount of the claim that is unsecured: $__________________(The sum of the secured and unsecured 

amounts should match the amount in line 7.)

Amount necessary to cure any default as of the date of the petition: $____________________

Annual Interest Rate (when case was filed)_______% 

 Fixed

 Variable

10. Is this claim based on a 

lease?

 No

 Yes. Amount necessary to cure any default as of the date of the petition. $____________________

11. Is this claim subject to a 

right of setoff?

 No

 Yes. Identify the property: ___________________________________________________________________

1570

Credit Card

2,356.23

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Official Form 410 Proof of Claim page 3

 No

 Yes. Check one: Amount entitled to priority

 Domestic support obligations (including alimony and child support) under 

11 U.S.C. § 507(a)(1)(A) or (a)(1)(B). $____________________

 Up to $3,025* of deposits toward purchase, lease, or rental of property or services for 

personal, family, or household use. 11 U.S.C. § 507(a)(7). $____________________

 Wages, salaries, or commissions (up to $13,650*) earned within 180 days before the 

bankruptcy petition is filed or the debtor’s business ends, whichever is earlier. 

11 U.S.C. § 507(a)(4). 

$____________________

 Taxes or penalties owed to governmental units. 11 U.S.C. § 507(a)(8). $____________________

 Contributions to an employee benefit plan. 11 U.S.C. § 507(a)(5). $____________________

 Other. Specify subsection of 11 U.S.C. § 507(a)(__) that applies. $____________________

12. Is all or part of the claim 

entitled to priority under 

11 U.S.C. § 507(a)?

A claim may be partly 

priority and partly 

nonpriority. For example, 

in some categories, the 

law limits the amount 

entitled to priority.

* Amounts are subject to adjustment on 4/01/22 and every 3 years after that for cases begun on or after the date of adjustment.

Part 3: Sign Below

The person completing 

this proof of claim must 

sign and date it. 

FRBP 9011(b).

If you file this claim 

electronically, FRBP 

5005(a)(2) authorizes courts 

to establish local rules 

specifying what a signature 

is. 

A person who files a 

fraudulent claim could be 

fined up to $500,000, 

imprisoned for up to 5 

years, or both. 

18 U.S.C. §§ 152, 157, and 

3571.

Check the appropriate box:

 I am the creditor. 

 I am the creditor’s attorney or authorized agent. 

 I am the trustee, or the debtor, or their authorized agent. Bankruptcy Rule 3004.

 I am a guarantor, surety, endorser, or other codebtor. Bankruptcy Rule 3005.

I understand that an authorized signature on this Proof of Claim serves as an acknowledgment that when calculating the 

amount of the claim, the creditor gave the debtor credit for any payments received toward the debt. 

I have examined the information in this Proof of Claim and have a reasonable belief that the information is true 

and correct.

I declare under penalty of perjury that the foregoing is true and correct. 

Executed on date _________________

MM / DD / YYYY

________________________________________________________________________

Signature

Print the name of the person who is completing and signing this claim:

Name _______________________________________________________________________________________________

First name Middle name Last name

Title _______________________________________________________________________________________________

Company ___________________________________________________________________________________________

Identify the corporate servicer as the company if the authorized agent is a servicer.

Address _______________________________________________________________________________________________

Number Street

_______________________________________________________________________________________________

City State ZIP Code

Contact phone _____________________________ Email ________________________________

PO Box 10368

Greenville, SC 29603-0368

(866) 572-0265 askbk@resurgent.com

Resurgent Capital Services

Claims Processor

David Lamb

/s/ David Lamb

10/10/2019

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Proof of Claim

Account Supplemental Data 

Bankruptcy Case Information

Case Number: 1922407 District: SOUTHERN DISTRICT OF FLORIDA

Chapter: 13 Filer: JOSEPH AMODIO

Petition Date: 09/18/2019 Co-Filer:

Creditor Information

Current Creditor*: MERRICK BANK

Original Creditor: Merrick Bank Corp

Alternative Names (if any) for this creditor: Merrick Consumer

Creditor at time of last transaction: Merrick Bank Corp

Account Information

Account Number (redacted): 1570

Amount due as of the date the bankruptcy case was filed**: $2,356.23

Principal**: $2,356.23 Charge Off Date: 09/30/2016

Interest**: $0.00 Last Payment Date: 02/09/2016

Fees**: $0.00 Last Transaction Date:

* Resurgent Capital Services services this account on behalf of the current creditor. Please send any bankruptcy or related 

notices on this account to our attention at the following address:

Resurgent Capital Services

PO Box 10368

Greenville, SC 29603-0368

Telephone No. (866) 572-0265

** Information on this account was obtained from the data files received from the assignor and other information such as 

Bankruptcy Court records. Interest may include other finance charges.

*** Please call Resurgent for additional information.

PO Box 10368

Greenville, SC 29603-0368

Phone: (866) 572-0265

Email: askbk@resurgent.com

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Account Event History

AccountID: 686383439

Account Number: 1570

Start Date: 7/20/1920

End Date: 7/20/2020

Seq Date SSN Prefix First Name Middle Last Name Suffix DOB

Debtor 2/25/2020 3340 Joseph G Amodio /1955

Borrower - Demographics - Current

No Demographic History Found

No Phone Numbers Found

No Phone Number History Found

Seq Address Address 2 City State Zip Zip4

Debtor 2383 Bronze Oak Ln Braselton GA 30517 4094

Borrower - Address - Current

No Address History Found

No Account Notes Found

No Contact Information Found

No Contact History Found

No Letters Found

No Payments Found

Resurgent Capital Services - CONFIDENTIAL AND PROPRIETARY

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Account Event History

AccountID: 686383439

Account Number: 1570

Start Date: 7/20/1920

End Date: 7/20/2020

Date Type Placement Balance System Servicer

2/25/2020 Returned to Client $2,356.23 EXT Merrick\CWS

2/25/2020 Recall $2,356.23 SHR Resurgent - House

10/8/2019 Bankruptcy $2,356.23 ATL Resurgent - BK

10/8/2019 Recall $2,356.23 SHR Resurgent - House

10/7/2019 ReadyForPlacement $2,356.23 SHR Resurgent - House

Placement History

Date Collection Status Account Status User ID App Name

2/25/2020 RTN - Returned To Client(Rank: 5) Closed (60) SHERMAN\pstasyncservice PSTAsyncService

2/24/2020 CRC - CLIENT OR SELLER REQUESTS ACCOUNT BACK(Rank: 5) Putback (40) SHERMAN\cgrayson .Net SqlClient Data Provider

10/8/2019 BCO - Bankruptcy Notification(Rank: 1) BK - Potential (20) SHERMAN\pstasyncservice PSTAsyncService

10/7/2019 BAN - BANKRUPTCY (ANY CHAPTER)(Rank: 2) BK - Potential (20) SfgToAmAsyncService SFGtoAM Async Service

Collection Status History

No ACDV Records Found

Seq File Date Chptr Status Status Date Bar Date Case Trustee Claim 

Num Secured

Trustee Claim 

Num 

Unsecured

Court Claim 

Num Secured

Court Claim 

Num 

Unsecured

Tru Acct num

Debtor 9/18/2019 13 15 1/21/2020 12/31/2019 1922407 9

Borrower - Bankruptcy

No Disputes Found

No Dispute Queue Records Found

No CBR Last Reported Data Found

No CBR History Found

Resurgent Capital Services - CONFIDENTIAL AND PROPRIETARY

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Account Event History

AccountID: 686383439

Account Number: 1570

Start Date: 7/20/1920

End Date: 7/20/2020

Funding Ending Batch Type Owner Funding Source Description

10/7/2019 Purchase Merrick\CWS Merrick\CWS Portfolio 36100 Purchase

Ownership Information

No OnBase Documents Found

No Legal Information Found

No Legal Suit Records Found

No Judgment Records Found

No Balance History Records Found

Additional Account Data

Resurgent Capital Services - CONFIDENTIAL AND PROPRIETARY

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Account Event History

AccountID: 686383439

Account Number: 1570

Start Date: 7/20/1920

End Date: 7/20/2020

Total Current Balance: $2,356.23

Last Letter Date: Last Call Date: Last Skip Date: 

Last Pmt Date: 2/9/2016 Current Owner: Merrick\CWS Last Purchase Date: 

Last Pmt Amt: 0.0000 Current Interest Rate: 0.0700 Last Purchase Amt : 

Last NSF Amt: Daily Interest: 0.37 Interest Effect: Do Not Accrue Interest

Last NSF Date: Interest Effective Date: 07/20/2020 Last Interest Update: 10/7/2019

Total Pmt Txns: Total NSF and Rev Txns: Net Pmt Amt: 

Chg Off Date: 9/30/2016 Purchase Date: 10/7/2019 Funding Date: 10/7/2019

Chg Off Balance: Out of Statute Date: 3/30/2022 Funding Source: Merrick\CWS

Orig Placement Balance: $2,356.23 Date of first Delinq: 3/30/2016 Misc Data 1: 

Putback Deadline: Account Type: Bankcard Misc Data 2: 

Origination Date: 3/26/2013 Original Creditor: Merrick Bank Corp Misc Data 3: Merrick Bank Corporation

Original Merchant: Merrick Consumer Misc Data 4: 2337805

CCA Number: CCA Proposed Pmt: CCA Accepted Pmt: 

CCA Start Balance: CCA Phone: 

Interest Accrual Start Date: Servicer Interest Date: Network Sub Servicer: 

Resurgent Capital Services - CONFIDENTIAL AND PROPRIETARY

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FileName LineNumber Merchant AccountNumber CurrentBalance PrincipalBalance InterestBalance

20191007084748MerrDMLFile 53 [Redacted] [Redacted]8347 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 54 [Redacted] [Redacted]5381 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 55 [Redacted] [Redacted]2510 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 56 [Redacted] [Redacted]0595 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 57 [Redacted] [Redacted]7530 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 58 [Redacted] [Redacted]4292 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 59 [Redacted] [Redacted]5810 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 60 [Redacted] [Redacted]1455 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 61 [Redacted] [Redacted]8054 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 62 [Redacted] [Redacted]8946 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 63 Merrick Consumer 1570 2356.23 1927.24 428.99

20191007084748MerrDMLFile 64 [Redacted] [Redacted]1889 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 65 [Redacted] [Redacted]9076 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 66 [Redacted] [Redacted]1518 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 67 [Redacted] [Redacted]5985 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 68 [Redacted] [Redacted]3865 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 69 [Redacted] [Redacted]0640 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 70 [Redacted] [Redacted]8298 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 71 [Redacted] [Redacted]0051 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 72 [Redacted] [Redacted]4173 [Redacted] [Redacted] [Redacted]

20191007084748MerrDMLFile 73 [Redacted] [Redacted]2991 [Redacted] [Redacted] [Redacted]

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PrincipalBalance_Chargeoff InterestBalance_Chargeoff FeesBalance_Chargeoff InterestRate LastPaymentAmount LastPaymentDate ChargeOffDate

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1927.24 428.99 0.0000 0.00 0.0000 20160209 20160930

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DebtorName Address1 Address2 City State ZipCode SocialSecurityNumber DateofBirth HomePhone EmployerAddress1

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AMODIO,JOSEPH G 2383 BRONZE OAK LN BRASELTON GA 305174094 3340 1955 9999999999

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WorkPhone Misc3 DateOpened Misc4 AcctTypeID

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MERRICK BANK CORPORATION 20130326 2337805 1

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