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PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT
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COMMONWEALTH OF PENNSYlVANIA
COUNTY OF
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AFFIDAVIT: '"e,.b, swea< ora""'" mat' s~..~d
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JOEANN HENRY
201 1ST STREET
P,O. BOX 505
SUMMERDALE, PA 17093-0505
RESIDENTIAL LEASE
THIS IS TO NOTIFY YOU THAT:
Judgment: FOR PLAINTIFF
00 Judgment was entered lor: (Name) WERNER, JEN
D Judgment was entered against: (Name)
in the amount 01 S on: (Date 01 Judgment)
00 Judgment was entered against HENRY. JOEANN
Lanc:llofdfTenant action in the amount 01 S _ 00 on 8/2 7 /9 (,
The amount 01 rent per month, as established by the District JustICe. IS S
o Damages will be "5f'9S$ed on: (Date & TIIllll)
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF: CUMBERLAND
Mag Olll No
09-1-02
OJ..........
ROBERT V. MANLOVE
....- 1901 STATE STREET
CAMP HILL, PA
,_ 17171 761-0583
17011-0000
o This case dismissed Wllhol.a prejudice.
00 Possession granted.
O Possession granted '1TlOIllIy jI.dgf.lIll. is not
satisfied by tme 01 8Yiclion.
o Pon'!JSSlO"l not granted.
o Levy is stayed lor _ days or 0 generally stayed.
o Objeaion 10 IeYy has been IiIed and twmlg will be held:
Date: Place:
TIIllll:
NOTICE OF JUDGMENT/TRANSCRIPT
PLAINTIFF: NAME and AOORtSS
!WERNER, JEN
201 1ST ST APT.' 394
P.O. BOX 394
~UMMERDALE, PA 17093-0394
VS,
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-1
DEfENDANT
,- kAME Md ADDRESS
'HENRY, JOE, ET AL,
201 1ST STREET
P.O. BOX 505
~UMMERDALE, PA 17093-0505
..,
-1
Docket No.: LT-0000261-96
Date Filed: 8/19/96
ina
(Dateol~
Rent in arrears S
Damages Un,usl Detention S
Damages to Propertyl
Resident.al Lease : S
less A/TU Due Defendant - S
Amount 01 Judgt1 MlfIl = S
Judgment Costs S
Interest on JIodgnMlfll S
Attorney Fees S
U .l.L
C), ( l
i.l . ( (
ill i
TOTAl
S
.00
.00
.00
.00
.00
ANY PM rr HAS me RIGHT TO APPEAL A JtlOGIrIfNT /M'O(. VING A RESIOCNT/AL lEASe AND N'FECfWG THE
()fLMRY OF POSSESSION OF REAL PROPfRN WITHIN 10 o.YS OF mE 0. TE OF Jf.JOGMEHT 8't FlUNG A
NOTICE OF APPfAL WITH THE PROTHONOTA/tfICtERJ( OF THE COURT OF COMMON PlEAS. CMl DMSION
ANY PAATY AGGAIIVtD IT A 01.100..., FOR MOHIY OR A -IIDGM(NT tIM)l,.W<<a A ~ lI.Ua
MAT APfaIAL WlTHlIII3D DAYS 0. I"",,, 0. Tl4l J'JOaMlHT.., ,1l1NG A HOTICI 0. ~,~ ~
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,COMMONWEALTH OF PENNSYLVANIA
COUNTY OF: CUMBERLAND
NOTICE OF JUDGMENTrrRANSCRIPT
17011-0000
PLAINTIFF, ....,...."""""..
!WERNER, JEN
201 1ST ST APT.' 394
P.O, BOX 394
~UMMERDALE, PA 17093-0394
VS,
OEFENDANT:
...... .... allOREllS
ruENRY, JOE, ET AL,
201 1ST STREET
P.O, BOX 505
~UMMERDALE, PA 17093-0505
Docket No.: LT-0000261-96
Date Filed: 8/19/96
--,
.... "'" No
09-1-02
ll.J__
ROBERT V. MANLOVE
~ 1901 STATE STREET
CAMP HILL, PA
-l
,_ (717) 761-0583
--,
JOE HENRY
201 1ST STREET
P,O. BOX 505
SUMMERDALE, PA 17093-0505
-l
RESIDENTIAL LEASE
THIS IS TO NOTIFY YOU THAT:
Judgment: FOR PLAINTIFF
00 Judgment was entered lor. (Name) WERNER. JEN
D Judgment was entered against: (Name)
in the amount 01 S on: (Date 01 Judgment)
[!] Judgment was entered againsl HENRY. JOE
LandIordITenant action in the amount 01 S . 00 on A /2 71 9 "
The amount 01 rent per month, as established by the District Justice. is S
o Damages will be assessed on: (Date & TIITl8)
ina
(Date 01 Judgrnert)
o This case dismossed witI10IA prejudice,
[!] Possession granted.
O Possession nranted if money jt.dgl'lllIl is IlOl
satISfied by time 01 eviction.
o Possession IlOl granted,
o Levy is stayed for _ days or 0 generally stayed
o ObjectJon to levy has been filed and ~ will be held
Date: Place:
Rem in arrears S
Damages UI1pJSl Detention S
Damages to Propertyl
Residertial Lease : S
Less Amt Due OeIendanl - S
Amount 01 Judgment _ $
Judgmell Costs $
IntenlSt on J\,dghl8ll $
Anomev Fees $
.00
.00
.00
.00
TOTAL
$
.00
Tme:
ANY PARTY HAS THE RIGHT ro APPEAL A .JtJOGMfNT INVOl. VlNG A RESIDENTIAL Lf.ASE NiO AFFf.CTWG THt:
DHMRY OF POSSESSION OF REAl.. PROP'f.RTY WITHIN 1004t'$ OF THE 04Tf OF .JtJDGMf.NT BY FlUNG A
NOTICE Of. APPf. urn ~.nbK)T .1Cl.f.RI\<JF TNf.. COURT OF COMAION PlEAS, CNl. LYVrSION.
AKf PARTY AGGAlIVtD Iff A NT ~l JUCXlMlNT 1HYOI.W<<l A ~.....
MAY APNAl WlTHIN:ICl DA" Of . TlilE ~ 1IY f1UNQ A NOncl OF UNAl. WhW tMl' .
m'.' ,T~YIClPKOf ,PI.. ~~o,.~CJyllDMllOft "', .,~.
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. , Date . \ '. .. . -r:...,.H... ' 0Islnd Justa _.'
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IN THE COURT OF COMMON PLEAS OF
Cumberland COUNTY, PENNSYLVANIA
Jen Werner, 9'- ~9{'P Cui I '--If R ~
Plaintiff : Case No.
:
v, .
.
.
,
Joseph Henry and ,
.
Joanne Henry, ,
.
Defendants .
,
AFFIDAVIT
1, I, Joseph Henry, am the defendant in the above-
captioned action, which is an appeal from a judgment rendered by
District Justice Manlove on August 27, 1996, awarding the
Plaintiff possession of the house in which I reside,
2, The rent for my home, located at 201 First Street, ~
L jj.",. '5. ~ -.r,j,,).... 1 J ~il'~(' "1]'
(' ~iA=ll..,-CUaberland county, Pennsylvania, is 'G~8'_Bg per month,
and becomes due on the 1st day of each month.
3. My September rent is currently due and the next rent
payment will be due on or before the 1st day of october, 1996,
4. I verify that the statements aade in this Affidavit are
true and correct. I understand that false statements herein are
made subject to the penalties of 18 Pa. C,S, 4904, relating to
unsworn falsification to authorities.
Date: 9- c,- ?h
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COMMO_TN or PIHNIYLVAHIA
COUIT or C_N PUAS
NOTICE OF APPEAL
- .
FllOM
DISTRICT JUSTICE JUDGMENT
C_PUAS_ 91.- '-I9l.P Q;vd ftA.ft]
NOTICE OF APPEAL
Notice i. ~ that 1M appelb~ has liItd in 1M abawe Ccul of Common Pleas an appeal from 1M Judtln-t ...ldered by 1M District Justice an 1M
dale and in 1M <me n_ilio. oed bolcM
IUDlCW DlnllCT
Joe and Joaooe Heury
.0. 011
201 lst Street,... , _S'OS
, J
JIlD Verner
09-1-02 Robert V. Manlove
A
S_rdale
PA
..J
.. Joe and JoaJUle Heo
17093-0394
CV 19.
IT 19 (
This bIoclt will be ~ ONI.Y.-MJ....dIlllI~is """,,,,69" Po.
1008& '
This Notice of . wI........... by 1M DistriCt Justice, will __ .. 0
Sl.ftRSEOEAS 10 ~ Ie< poueuian In .... coie.
,~ G"
IMANT (see Pa. RC.P .J.P. No.
fOOf(6} in action bebe District.AJstice. he MUST
Fl.E A COMPtAlllT within twenty (20} days after
filing his NOTICE 01 APPEAL
,
,.AlOPE TO ENnR RULE TO FILE COMPLAINT AND RULE TO FILE
(TNs sectm d bm t) be rJS<<1 OILY ootlen ___ was DEFODANT (see Pa RCPJP, No. 1001(7).. action IleItwe 0U1d .A.5tce
IF NOT USED, detach /10m ~ d noIJCe d appeal 10 be served LJlOI1 /Jf~ ,lIee)
PRAECIPE. To Plolho....1ol J
f1lIet ruIt '4>"" J.. Werner
ICcmman Pleas No 2J,. - ~I.P
RULI. To
Jell Wansar
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uu U!dJdl.jl ptl';plolfi"Utp 8:ltllnf lJUt'iIO ..41 uodn ._~ S I.jbJ,- <'l J ON "'-f''''d iAUJU.lt'!-:) ;~.j.,'(f .'j ~'.1'F.~N "'"'...;;. i'-' .'..L:; If C
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-----.'.~-.._..'..-,._._'-',.,~_._____..__._:__......_~__.._,,.c.__
Salary or wages per month:
$1275.00
Type of work:
Forklift ODerator
ec) Other income within the past twelve months
Business or profession:
Other self-employment:
Interest:
N/A
N/A
N/A
Dividends:
N/A
N/A
N/A
Pension and annuities:
Social Security benefits:
Support payments:
Disability payments:
Unemployment compensation and
supplemental benefits:
Workaan's compensation:
N/A
N/A
N/A
N/A
Public Assistance:
$316,00 (11/95 to 1/96\
Other:
N/A
(d) Other contributions to household support
(Wife)(Husband) Haae: Joanne Henry
If your (husband) (wife) is e.ployed, .tate
Employer:
East penn.boro School oiat,
Salary or wage. per month:
$683.00
Type of work: custodian
contributions froa children: H/A
(e) Property owned
Cash: So
Checltinq Account: H/A
Savlnqa Account: MIA
Certificate. of Depoait: H/A
Real Estate (including home): N/A
Motor vehicle: Make Dodae Shadow
'lear
1989
Cost $400.00 Amount owed $0
Stocks; bonds: N/A
Other: N/A
(f) Debts and obligations
Mortgage: N/A
Rent: $500,00
Loans: N/A
Monthly Expenses: Groceries $300,00: TeleDhone $50,00:
Electric $70.00: Gas $60.00: Auto insurance $35.00:
School lunches $52,00:
(g) Persons dependent upon you for support
(Wife) (Husband) Name:
Children, if any:
Na..: JOB.Dh W. Henry
Age: 9 vrs
banda N. Henrv
8 years
I understand that I have a continuing obligation to
infora the court of improve.ent in my financial circumstances
which would perait .e to pay the costs incurred herein.
WHEREFORE, the petitioner requests that the court allow
hi. to proceed in this matter in torae paUDttris,
I verify that the state.ents aede in this affidavit
are true and correct. I understand that false stat...nts her.in
are ..de subject to the penalti.. of 11 Pa, C,S. 4904, relatinq
to unsworn falsification to authorities.
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