HomeMy WebLinkAbout96-04203
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JUDGMI::N'r NOTE
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tJtt!lw:aw.lL- -.. lJnl1l111ylvo\n1a, .~ 1.9....Jlli_., ~ I, :iCJ9,:ll
(lJ1I<.1.) (dato) (atnoUlIt)
fan VALUI!: RF.Cl::IVEO, I/We PI:Ollll.o. to pay 1:0 I:h" ord~l' ot !;"lIL.l.ubllUJJc~ '.r~uv
the uwu 01' 6Wll,~ ___., flllld Bum 1:0 b. PllYAb1Q (15 CallOW/II
~:lIVl!lLM\lIJJ1J;illl. ,dollan, ($ 1.O.lWliLl on I:h~1 llill_ dny or J.luul_--...J.:>'l.tL
Iltld QnJJ...lliuu1u~ dOllnl:lJ, (~IQ.O".ll.Q.._J 011 thll ,4Qth _ dny "1: llolloh (Ill'!
evury liorllJL__ th(ll:enCter untO tho ent.iro UIUl'JUllt 15 pu1d ill tull.
U1'Ol'l k'^lLUTU:: to lIl(\Ke payment.s f:lG htil'o1n 4l,Jrolld, t:h j ~I llote ISh,\ 11,
at th(\ opt:ion 0' itfl hCJlrll.lL', beCCJm(J illlll\l~dL!,tely due o'I.nd pOYdblll,
without. demund or notio(l.
AND FUR'!'HEk, I/w(J do hlil'<:'lJy C1uthol'i~e (Inri empowor, the ProtllCJnol;crry
or /lny uttu1'UOY ut (IOY Court. of ROc'1rd of l'ellhlSYlvDniu ot.
ClIII(!whol'e, to UpP/EIlr tor and Conf(11li1S jUrlgment for t.he UUln dun and
payable het"con, with or Idthout. doulaI'ettion, with o::o!Otn of ISUit:,
rolllllBC or nt'rox-u, wIthout st.C\y ot oxecut Ion; .,nd u intI w.live tlllt
ri'ilht ot: inqu.luit.i.oll on (\ny 1'11111 llutatll that: may lJ'~ hlVifld upon
to colleot this notul ana uv Illft'oby vol\lntnl:' lly Cl1ndelnn thE UUl1Ill
',AlId authoi'i;l,,<l' the' l:'ro,thono1;a1-y "to ,o)rltet' fHdd VlIlurlto.t'y
cutldamnat.ion upon 'any 1"10ri f'acius thnt:' Illay ill,) i,.BUEd to collll(lt'
soid jUdgJnent; llnd furtlwr agroe t.hut Isaid ent:utl.! mAY lJr~ sold on It
fieri f'acias, and do hereby W~iVA aIld roleaue all relief tram any
i\nd all upprniflelllent, lIt.ay of /1)(ocution, lQXllmpt.ioll at. b<llikruPtoy
laws of thifl or any other. st.(lte now ill t'1rce~or her:/,! uftliL' to kI.
PUllol,)d. .01..
'4.:J:J. tit ;c.litat...<.,_____ (L. S. )
-,,-,--- -_,__,_,_,__(L. S.)
This nota io given und el(~~cutQd without duresu Ol" COF.l::ciOll und
w1th fUll and COll1pletc undorstanding that. upCJn !(\i!ura to make
paYl!lent 1111 agt'eed, thut my operating Privlleqoli lI1ay be oUspenClud.
further, r do he:r~bY}lcknowledge that the damago!) jl1eUt'rod in t.;he
accidont at -''---':~.......J.i4.::._,_ for whi.<.:h thin l\l1tlll 1m givell
rQflultod trODI my negligonoe lInd faUlt, and r do hen~by ackl10wladlJe
and wuive my right to uny hearin!] or tr,ial on that iosue.
DRIVER DATE OF IlIJ:('r!l
DRIVER OPERATOR NO.
OWNtR DNl'E OF flIRTH
OWNER OPERATOR NO.
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