Stipulation for Settlement Agreement and Release — No. 4:23-cr-00067 (Dkt. 70-2, W.D. Mo.)

Summary

This stipulation in United States v. Mirza Michael Reazuddin (W.D. Mo., Case No. 23-00067-CR-W-BP) settles a petition by Mahreen Husain, Reazuddin's spouse, claiming an interest in a house in Lawrenceville, Georgia. Reazuddin was indicted on April 4, 2023 on four counts of wire fraud and seven counts of money laundering, agreed on February 5, 2024 to plead guilty to one count of each and to forfeit the property, and the court entered a Preliminary Order of Forfeiture on July 24, 2024. Once a Final Order of Forfeiture is entered and the property is sold, the United States will pay Husain $20,000 from the net proceeds. Husain releases all other claims to the property. Attached are Husain's claim form and a Kansas divorce affidavit listing a money judgment of $804,100 in the criminal case.

Summary drafted by a model from the document's text below and checked by script against that text before publication. It is a navigation aid, not a reading of what the document proves. Where AI is used

Record facts

Full text

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ID: 2e43fc3e-8403-45dc-8702-ea41 5230add4

IN THE UNITED STATES DISTRICT COURT FOR THE
WESTERN DISTRICT OF MISSOURI
WESTERN DIVISION
UNITED STATES OF AMERICA,
Plaintiff,
v. Case No. 23-00067-CR-W-BP

MIRZA MICHAEL REAZUDDIN,

Defendant.

STIPULATION FOR
SETTLEMENT AGREEMENT AND RELEASE

It is hereby stipulated by and between the United States of America, by and through the
United States Attorney for the Western District of Missouri, and Mahreen Husain (hereinafter “Ms.
Husain”), by and through her attorney, Vanessa M. Riebli, as follows:

l. On April 4, 2023, Defendant Mirza Michael Reazuddin (hereinafter “Defendant’”)
was charged in an Indictment with four counts of wire fraud, in violation of 18 U.S.C. § 1343, and
seven counts of money laundering, in violation of 18 U.S.C, § 1957. (Doc. 1.)

2. The Forfeiture Allegation of the Indictment sought forfeiture, pursuant to 18 U.S.C.
§ 981(a)(L)(C) and 28 U.S.C. § 2461, of any property, real or personal, constituting or derived
from proceeds traceable to the wire fraud. Jd. The Forfeiture Allegation further sought forfeiture,
pursuant to 18 U.S.C. § 982(a)(1), of any property, real or personal, involved in money laundering
activity, and any property traceable to such property. Id.

3. On December 21, 2023, the United States filed a Notice and Bill of Particulars for
Forfeiture of Property, giving notice that it was seeking forfeiture of the real property located at

1925 Severbrook Place, Lawrenceville, Georgia, more fully described as:

ID: 2e43fc3e-8403-45dc-8702-2a415230add4

All that tract or parcel of land lying and being in Land Lot 83, of the
7th District, Gwinnett County, Georgia, being Lot 71, Block A,
Clairemont F.KK.A. Sever Creek, as per plat recorded in Plat Book
107, Page 300, and £08, Page 1, Gwinnett County, Georgia records,
said plat being incorporated herein and made a part hereof by
reference.

(hereinafter the “Property”). (Doc. 36.) The Bill of Particulars advised that the United States was
seeking forfeiture of the Property as constituting or derived from proceeds Defendant obtained
directly and indirectly as a result of wire fraud, and/or as property involved in money laundering
activity or property traceable to such property. Id.

4, On December 21, 2023, the United States filed a Lis Pendens as to the Property,
giving notice that the United States is seeking forfeiture of the Property in the above-captioned
action, (Doc. 37.) The Lis Pendens was recorded with the Clerk of the Superior Court of Gwinnett
County, Georgia on or about December 26, 2023.

5. On February 5, 2024, Defendant entered into a plea agreement with the United
States, pursuant to which he agreed to plead guilty to one count of wire fraud and one count of
money laundering. (Doc. 42.) In the plea agreement, Defendant agreed to forfeit his interest in the
Property. Jd,

6, On July 24, 2024, the Court entered a Preliminary Order of Forfeiture, which
included the Property. (Doc. 63.)

7. Ms, Husain submitted a petition asserting an interest in the Property, which the
Government has construed as a third-party ancillary petition to determine the validity of her
interest in the Property (hereinafter the “Petition”).

8. To avoid the delay, uncertainty, inconvenience, and expense of litigation,
Ms. Husain and the United States agree to settle and compromise Ms. Husain’s Petition pursuant

to the terms set forth herein.


ID; 2e43fc3e-8403-45dc-8702-ea415230add4

9, The United States agrees that after a Final Order of Forfeiture is entered by the
Court and the Property has been sold, the United States shall pay Ms. Husain the sum of $20,000
from the net proceeds of the sale.

10. Ms. Husain understands and agrees that the United States shall incur costs
associated with sale of the Property. Ms. Husain agrees that she will not contest or object to the
United States’ costs to dispose of the Property and she further agrees that all costs of sale will be
paid in full first from gross proceeds of the sale.

11. Ms. Husain agrees that payment to her is conditioned upon the United States
prevailing against any competing claims and conditioned upon net proceeds resulting from the
sale, In the event the net proceeds from the sale are not sufficient to satisfy the payment
contemplated by Paragraph 9 of this Agreement, and any other payment(s) to resolve any other
claim(s) made to the Property in connection with the above-captioned action, the Parties agree that
this Agreement will be void and will have no force or effect.

12. Ms. Husain agrees that payment pursuant to Paragraph 9 of this Agreement shall
be in full settlement and satisfaction of all claims by Ms. Husain arising from and resulting from
the forfeiture of the Property, Ms, Husain agrees that by entering into this Agreement, she waives
any right to further litigate against the United States her interest in the Property and understands
and agrees that this waiver includes, but is not limited to, litigation regarding the Property in the
above-captioned case.

13, Ms. Husain hereby releases and forever discharges the United States; its officers,
agents, servants, and employees; and its heirs, successors, or assigns; ftom any and all actions,
causes of action, suits, proceedings, debts, dues, contracts, judgments, damages, claims, and/or

demands whatsoever in law or in equity which they, their heirs, successors, or assigns ever had,

3


ID: 2e43fc3e-8403-45dc-8702-ea415230add4

now have, or may have in the future in connection with the seizure, detention, and forfeiture of the
Property,

14. This Agreement does not bind the Parties on any matters not directly related to the
seizure, detention, and forfeiture of the Property.

15. | The United States and Ms. Husain each agree to bear their own costs and attorney’s
fees incurred in connection with the forfeiture and disposition of the Property, Ms, Husain further
waives any and all claims or rights she has or may have pursuant to 28 U.S.C, § 2412 (the Equal
Access to Justice Act) for attorney’s fees or other costs involving the Property, arising out of the
above-captioned criminal investigation and case and the forfeiture of the Property.

16. This Agreement, and any dispute arising therefrom, shall be governed by the laws
of the United States. The Parties agree that, should any judicial action be required to enforce or
interpret this Agreement, or to resolve any dispute hereunder, the exclusive venue for such an
action shall be in the United States District Court for the Western District of Missouri.

17. For purposes of construction, this Agreement shall be deemed to have been drafted
by both the Government and Ms, Husain and shail not be construed against any party for that
reason in any subsequent dispute.

18. It is contemplated that this Agreement may be executed in several counterparts,
with a separate signature page for each party. All such counterparts and signature pages together
shall be deemed one document.

19, This Agreement comprises all the provisions stipulated by and between the Parties
in full and complete settlement of Ms. Husain’s Petition in the above-captioned action.

20. This Agreement cannot be modified or amended except by an instrument in writing,

agreed to and signed by the parties, nor shall any of its provisions be waived other than by a written

4


ID: 2e43fc3e-8403-45dc-8702-ea415230add4

waiver, signed by the Parties.

21. The Parties acknowledge that they have: (a) consulted with counsel before
executing this Agreement; (b) have been afforded a reasonable time to consider this Agreement
before executing it; (c) are competent and of sound mind and able to understand the provisions of
this Agreement; (d) have read and understood the Agreement’s provisions; and (e) have executed

the Agreement knowingly, voluntarily, and of their own free will.


ID: 2e43fc3e-8403-45dc-8702-ea415230add4

For the United States:

Date: October 57, 2025

By:

R. Matthew Price
United States aid

Stephanie Bradshaw

Assistant United States Attorney

400 E. 9th Street, Fifth Floor

Kansas City, Missouri 64106
Telephone: (816) 426-3122

E-mail: stephanie. bradshaw@usdoj.gov
Counsel for Plaintiff

United States of America


ID: 2e43fc3e-8403-45dc-8702-ea415230add4

For Petitioner:

Date: October 29, 2025

Date: october (IY, 2025

Mahreen Husain

Petitioner QM

Riebli Law LLC lh

100 E. Park Street, Suite 210 Lol PB INO
Olathe, KS 66061

Telephone: (913) 351-1880

E-mail: vanessa@rieblilaw.com

Counsel for Petitioner


CLAIM FORM

YOU MUST COMPLETE ALL PARTS OF THIS FORM FOR THE ASSETS YOU ARE CLAIMING.

Note: There is no legal form or format required for filing a claim; this document is provided for your convenience.
Please visit httos://Awww.forfeiture.gov/FilingClaim.htm for more specific guidance on filing your claim with the
appropriate seizing agency.

Frivofous Claim Statement: If a court finds that a claimant's assertion of an interest in property was frivolous, the
court may impose a civil fine. Title 18 United States Code, Subsection 983(h). A false statement or claim may subject
a person to criminal prosecution under Title 18 United States Code, Sections 1001 and 1621.

Privacy Act Notice: The Department of Justice is collecting this information for the purpose of processing your claim.
Providing this information is voluntary; however, the information is necessary to process your application. Information
collected is covered by Privacy Act System of Records Notice Department of Justice (DOJ), DOJ-002-DOJ Computer
Systems Activity & Access Records, Federal Register (71 FR 29170). This information may be disclosed to contractors
when necessary to accomplish an agency function, to law enforcement when there is a violation or potentia! violation
of law, or in accordance with other published routine uses. For a complete list of routine uses, see the system of
records notice listed above.

Standard Claim Form August 26, 2024 Page 1


SECTION | —- CONTACT INFORMATION

“CLAIMANT INFORMATION

"Claimant/Gontact Name: (Last, First)

Husain, Mahreen

Business/Institution Name: {if applicable) | Prisoner !D: {if applicable)

Address: (Include Street, City, State, and Zip Code)

BE O vertand Park, KS 66223

Social Security Number/Tax Identification Number: (Enter N/A if you do not have one)

GE 4559

Please provide an explanation why you do not have a Social Security Number, if above is N/A:

Phone: ata

ATTORNEY INFORMATION (if applicable) -

‘Attorney Name: (Last, Firs)
Riebli, Vanessa

Attorney Title:

Firm Name: (if applicable)
Bath & Edmonds PA

Attorney Address: (include Street, City, State, and Zip Code)

4000 W. 114" Street, Suite 210
Leawood, KS 66211

Are you an attorney filing this claim on behalf of your client? xO YES O NO

Attorney Phone: (optional) Attorney Email: (optional)
(913) 652-9800 vanessa@bathedmonds.com

any of this information changes, you are responsible for notifying the agency of the new information.

SECTION Il - ASSET LIST

List each asset ID and asset description that you are claiming.

# | ASsetID- | Asset Description
4 1925 Severbrook Place, Lawrenceville, Georgia

All that tract or parcel of land lying and being in Land Lot 83, of the 7th

| District, Gwinnett County, Georgia, being Lot 71, Block A, Clairemont F.K.A.
Sever Creek, a per plat recorded in Plat Book 107, Page 300, and 108,
Page 1, Gwinnett County, Georgia records, said plat being incorporated
herein and made part of hereof by reference. ECF No. 36

Standard Claim Form August 26, 2024 Page 2


SECTION ill—- INTEREST IN PROPERTY

Identify your interest in each of the assets you are claiming. If you are filing for multiple assets and the responses
are not the same for each asset, please print out multiple copies of this page to submit with the claim. If you have
documentation that supports your interest in the claimed assets (e.g., bill of sale, retail installment agreements,
contracts, titles or mortgages), please include copies of the documents with the submission of the claim.

fn INTEREST.IN PROPERTY INFORMATION
Asset ID Asset Description

1925 Severbrook Place, Lawrenceville, Georgia

All that tract or parce! of land lying and being in Land Lot 83, of the 7th District, Gwinnett

County, Georgia, being Lot 71, Block A, Clairemont F.K.A. Sever Creek, a per plat

recorded in Plat Book 107, Page 300, and 108, Page 1, Gwinnett County, Georgia

records, said plat being incorporated herein and made part of hereof by reference. ECF

No. 36

In the space below, please explain why you have a valid, good faith, and legally recognizable interest in this
asset:

Claimant, Mahreen Husain, is the spouse of Mirza Michael Reazuddin. The property was acquired after the date of
marriage and Claimant believes the property is considered marital property in Kansas. A divorce between the parties
is pending in Johnson County, Kansas, Tenth Judicial District, case number 23CV2226.,

In the space below, please list any documents you are including in support of your interest in the ® asset(s). If
none are included, please explain why.

Second Amended Domestic Relations Affidavit — filed in Johnson County case number 23CV2226 — sets forth in
paragraph 15 a list of real property — which includes above-described property.

Standard Claim Form August 26, 2024 Page 3


SECTION IV- RECOVERY OF LOSS

Complete this section for assets you have recovered ail or a portion of your losses either via an insurance claim and/or
via some other source of recovery. [If you have more recovery of loss information than may fit on this page, print out
multiple copies of this page to attach with the claim and indicate which assets apply to each page. If you have not
received any recovery of your losses, then leave this section blank.

RECOVERY OF LOSS INFORMATION
Asset ID Asset Description
nia

INSURANCE CLAIM INFORMATION (if applicable)

Name of Insured: (Last, First)

Policy Number: Claim Number:

Name of Insurance Company: Name of Insurance Agent: (Last, First)

Insurance Company Address: (Include Street, City, State, and Zip Code)

Phone: (optional) Email: (optional)

Have you received compensation from the insurance | Amount of Compensation:
company? (1 YES ONO

If other sources of recovery exist (e.g., restitution, returns on investment or other settlements), please list and
describe the details below.

ae OTHER SOURCE(S) OF. RECOVERY (if.applicable) ae
Source of Recovery 1: Amount of Recovery:

Source of Recovery 2: Amount of Recovery:

In the space below, please list any documents you are including in support of your claim of recovery of loss. If
none are included, please explain why.

n/a

Standard Claim Form August 26, 2024 Page 4


SECTION V — DECLARATION

The following declaration must be completed by the claimant.
| attest and declare under penalty of perjury that my claim is not frivolous and the information provided in suppert

of my claim is true and correct to the best of my knowledge and belief. . A
i ah vc3on theesaln—°

Signature

Mahyoen tHucon ~

Printed Name

ate

If a court finds that a claimant's assertion of an interest in property was frivolous, the court may impose a civil fine.
Title 18 United States Code, Subsection 983(h). A false statement or claim may subject a person to criminal ©
prosecution under Title 18 United States Code, Sections 1001 and 1621.

Standard Claim Form August 26, 2024 Page 5


VERIFICATION

State of Kansas )
) SS.
County of Johnson _)
I have read the above and to the best of my knowledge believe that the

information is accurate and complete.
Woh Yeey) Hie x ayy)

ahreen Husain

Dei snck (3th

Notary Pyblic

Subscribed and sworn this 26th day of August, 2024


23CV02226
Divl

IN THE DISTRICT COURT OF JOHNSON COUNTY, KANSAS

CIVIL COURT DEPARTMENT
In the Matter of the Marriage of: )
)
MAHREEN HUSAIN )
) Case No: 23CV02226
and ) Division: 1
) K.S.A. Chapter 23 & 60
)
MIRZA REAZUDDIN )

SECOND AMENDED DOMESTIC RELATIONS AFFIDAVIT OF PETITIONER, MAHREEN

HUSAIN
1, Wife/Mother Residence: “Overland Park, Kansas
xx/xx/1976 XXX-XX- 4559 XXX-XXX-7958
Birth Social Security Telephone
Month/Year - Number

2. Husband/Father Residence: USP Leavenworth

XXX-XX-
Birth Social Security Telephone
Month/Y ear Number
3. Date of Marriage: 07/01/2017
4, Number of Marriages: Wife/Mother; —2 Husband/Father:
5. Number of children of the relationship: 0
6. Names, Social Security Numbers, the month and year of each child’s birth and ages of minor children of the

relationship: (DO NOT list full social security numbers - only last 4 digits (example XXX-XX-1234)

Name Social Security Number Birth Age Custodian
Month/Year Mother/Father

“Only City and state provided pursuant to Kansas Supreme Court Rule 24.

Clerk of the District Court, Johnson sera mea
7877304v3 ‘Page iM


7.

Names, Social Security Numbers, and ages of minor children of previous relationships and facts as to custody and
support payments paid or received, if any: (DO NOT list full social security numbers - only last 4 digits (example

XXX-XX-1234)
Name Social Security No. Age Monthly Support Paid or
Payment Received
$
$
8. Wife/Mother is employed by: Walmart
Address: 15700 Metcalf Ave., Overland Park, KS 66223
Telephone:

Husband/Father is empioyed by:

Address:

Telephone:

With monthly income as follows:

A. Wage Earner:

AYNP

eC eANau

Gross Income

Other Income:
Subtotal Gross Income
Federal Withholding
(Claiming —_—s exemptions)
State Withholding
Medicare (OASDHI)
Social Security
Retirement/401(k)
Subtotal Deductions
NET INCOME:

B. Self-Employed:

PYNE

Nw

Gross Income from Self-Employment
Other Income:

Subtotal Gross Income

Reasonable Business Expenses
(Itemize and attach Exhibit)
Self-Employment Tax

Estimated Tax Payments

t $14/nr x 80 x 26 divided by 12

78773043

Wife/Mother Husband/Father
$ 2,426" $
$ $
$ 2,426 $
$ (147) $
$ $
$ (94) $
$ (38) $
$ (161) $
$ (155) $
$ $
$ 1,831.00 $
Wife/Mother Husband/Father
$ $
$ $
$ $
$ $
$ $
$ $
$ $


(Claiming ___ exemptions) $ $
8. State Withholding $ $
9. Subtotal Deductions $ $
NET INCOME: $ $
Pay Period: State whether paid weekly/every other week/twice per month/monthly
Wife/Mother Clweekly & every other week Otwicepermonth 0 monthly
Husband/Father Olweekly Olevery other week Otwicepermonth OO monthly
9. The liquid assets of the parties are:
A, Checking Accounts: (DO NOT list account numbers - only last 4 digits of account):
Ttem Balance Date Owner/Name/Joint/Individual
Bank of America $ 1,998 1/23/24 Petitioner
Bank of America $ Petitioner’s Son
Wells Fargo #4088 $ 08/23/2023 Petitioner’s - Closed
$
B. Savings Accounts: (DO NOT list account numbers - only last 4 digits of account)
Item Balance Date Owner/Name/Joint/Individual
Chase Bank #9698 $ 595,000,00 1/23/24 Petitioner
Bank of America $ 6,951.46 1/23/24 Petitioner
$
$
oF Cash:
Wife/Mother $
Husband/Father $
D. Other: (DO NOT list account numbers - only last 4 digits of account)
Item Balance Date Owner/Name/Joint/Individual
See attached list of additional closed $
accounts.
Cashier checks made payable to KB December
California Realty Group $ _1,573,801.50 2022
$
$
10. The monthly expenses of each party are: (please indicate with an asterisk (*) all figures which are estimates

rather than actual figures taken from records.)

Clerk of the District Court, Johnson ae Rapsas
7877304V3 ‘Page iM


A. Item, Wife/Mother Husband/Father
{Actual or Estimated) (Actual or Estimated)

Rent/Mortgage $ $
.  Food/Dining Out $ 1,000 $
3. Utilities/Services:

Ne

Trash Service $ $
Newspaper $ $
Telephone $ $
Mobile Phone $ 106 $
Cable/Internet $ 78 $
Gas $ 400 $
Water $ 130 $
Electricity $ 202 $
Other $ 400 $
4. Insurance
Life $ $
Health $ 74 $
Car $ $
House/Rentzl $ $
Other $ $
5. Medical and Dental $ 68 $
6. Prescription Drugs $ 200 $
7. Child Care (work related) $ $
8. Child Care (non-work related) $ $
9. Clothing $ 250 $
10. School Expenses $ $
11. Hair Cuts and Beauty $ 350 $
12. Car Repair $ $
13. Gas and Oil $ 600 $
14. Personal Property Tax $ $
15. Miscellaneous (Specify)
$ $
$ $
$ $
$ $
16. Debt Payments (Specify)
$ $
$ $
$ $
$ $
TOTAL $ 3,858 $

*Show house payments, mortgage payments, etc. in Section 10B.

B. Monthly payments to banks, loan companies or on credit accounts: (Indicate actual or estimated monetary
amount in each column, use asterisk for secured) DO NOT LIST ANY PAYMENTS INCLUDED IN
PART 1-.A, ABOVE

Clerk of the District Court, Johnson rs Kansas
7877304V3 ,


Creditor When debt | Amount | Date of Last Balance Responsibility | Responsibility
Incurred of Payment Wite/Mother | Husband/Father
Payment
Goldman Sachs 428 9/5/2023 Revolving 428
TOTALS
C. Total Living Expenses Wife/Mother Husband/Father

(Actual or Estimated) (Actual or Estimated)

1. Total funds available to Mother and Father

(from No. 8) $ 1,831 $

2. Total Needed (from No. 10.A and B) $ 3,858 $

3. Net Balance’ $ (2,027) $

4. Projected Child Support $ $

D, Payments or contributions received or paid for support of others. Specify source and amount.
Source Paid or Received Wife/Mother Husband/Father
11, How much does the party who provides health insurance pay for the family coverage?
$ Cweekly Clevery other week Otwice permonth O monthly

How much does it cost the provider to furnish health insurance only on the provider?
$ 34.00 Olweekly every other week UO twice permonth 0 monthly

FURNISH THE FOLLOWING INFORMATION IF APPLICABLE:

12. Income and financial resources of children.
Income/Resources Amount
$
$
$
13. Child support adjustments requested. Wife/Mother Husband/Father
Long Distance Parenting Time Costs $ $
Parenting Time Adjustments $ $
Special Needs $ $
Support Beyond the Age of Majority $ $
Overall Financial Condition $ $

Clerk of the District Court, sonny ae Kansas
7877304v3 i R iM


14, All other personal property including retirement benefits Gncluding but not limited to qualified plans such as
profit sharing, pension, IRA, 401-K, or other savings-type employee benefits, nonqualified plans, and
deferred income plans), and ownership thereof (joint or individual), including policies of insurance,
identified as to nature or description, ownership (joint or individual), and actual or estimated value.

Valuation Joint or Individual
Description of Item Value Date (Specify)
BMW X5 $ Unknown Respondent
Mercedes-Benz GL450 $ Unknown Respondent
Tesla $ Unknown Respondent
Chrysler Sedan $ Unknown Respondent
Cadillac SUV $ Unknown Respondent
Believe vehicle

was foreclosed by

Ghost Rolls Royce $ Unknown public sale

THE FOLLOWING NEED NOT BE FURNISHED IN POST JUDGMENT PROCEDURES

15, List real property identified as to description, ownership {joint or individual) and actual or estimated value.
Actual/Estimated Valuation Date
Property Description Ownership Value
1925 Sever Brook Pl, Lawrenceville,
GA Joint $ TBD TBD
RR Ov erdand Park, KS Joint $ TBD TBD
$

16. Identify the property, if any, acquired by each of the parties prior to the marriage or acquired during the
matriage by loan, gift, will or inheritance,

Actual/Estimated Value Date Prior
Property Description Ownership Source of Ownership Value to Marinas
$
$
$
17. List debt obligations, including maintenance, not listed in Section 10.A or 10.B above, identified as to name
or names of obligor or obligors and obligee, balance due and rate at which payable; and if secured, identify
the encumbered property.
Debt/Obligation Obligor Balance Due Payment Rate Encumbered
Husband/Witfe Property
Georgia Homeowners Association Joint $ Unknown
Georgia Back Taxes Joint $ Unknown
Lionsgate Area Home Association
Inc. Joint $ 0 $10,615.21

Johnson County Treasurer Joint $ 0 $32,889.67


Money Judgment in amount of
$804,100 in US v. Mirza Reazuddin
23-00067-01-CR-W-BP

Forfeiture of Respondent’s interest
in the real property known as 1925
Severbrook Place, Lawrenceville,
Georgia that is jointly titled with
Petitioner

18. List health insurance coverage and the right, pursuant to ERISA §§ 601-608, 29 U.S.C. §§ 1161-1168
(1986), to continued coverage by the spouse who is not a member of the covered employee group.

Insurance Company:

Aetna

Address:

Telephone Number:

Health Insurance

Name of Insured:

COBRA Continuation

OYes [CINo Unknown
OYes OINo UO Unknown
OYes CNo O Unknown
OYes OONo OO Unknown
OYes OONo QO Unknown

Respectfully Submitted,

McDOWELL, RICE, SMITH &
BUCHANAN, P.C.

/s/ Susan Saper Galamba

Susan Saper Galamba, KS #14766
605 W. 47th Street, Suite 350
Kansas City, MO 64112

Phone: (816) 753-5400

FAX: (816) 753-9996

sgalamba@mecdowellrice.com
ATTORNEY FOR PETITIONER

Clerk of the District Court, sunee sue Kansas
7877304v3 ‘Pa M


Additional bank accounts that were closed

Asset Two Hospitality, LLC Wells Fargo account ending in #9231 — Closed April 2023

Silver Spoon Hospitality, LLC
dba Best Host Inn General Wells Fargo account ending in #2373- Closed June 2023

Silver Spoon Hospitality, LLC
dba Best Host Inn Payroll § Wells Fargo account ending in #0940 — Closed June 2023

Silver Spoon Hospitality, LLC dba.
Best Host Inn Merchant Wells Fargo account ending in #0957 — Closed June 2023

Mahreen Husain Wells Fargo account ending in #4400 — Closed January 2023

Mahreen Husain U.S. Bank account ending in #7571 — Closed January 2023

Clerk of the District Court, Johnson County Kansas
03/01/24 09:58am MM


DECLARATION’ -

her Second Aitnended Domestic Relations ‘Affidavit of Petitioner, Mahreen Husain is true aind
" correct according to the undersigned’s best knowledge aid: belief, under penalty of ‘Perjury for’
- making a: false affidavit or declaration. Co

a Petitioner 7

Clerk of the District Court, Johnson County Kansas
: 03/01/24 09:58am MM


CERTIFICATE OF SERVICE
I hereby certify that a copy of the above and foregoing Seconded Amended Domestic

Relations Affidavit was sent via e-mail, this Ist day of March, 2024, to:

Jessica J. Sokoloff

SOKOLOFF LAW FIRM, LLC

142 N Cherry St.,

Olathe, KS 66061
jessica@sokolofflawfirm.com
ATTORNEY FOR RESPONDENT

/s/ Susan Saper Galamba
Susan Saper Galamba

Clerk of the District Court, Johnson ae hi
78773043 . age M

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