HomeMy WebLinkAbout96-05142
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CI.AIM 0010170184851 M.G.
JUDGMENT NOTE
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Mech.nicsburg
(place)
Pennsylvania, 2-2-96
(date)
, $ 4,633.25 )
(amount
FOR VALUE RECEIVED, I/we promise to pay to the order of Erie Insurance Exchangl
the sum of $4 , 633.25
, said s~m to be payable as follows:
Fi fty
dollars, ($ 50.00 ) on the 21
day of February
1996
and Fi fty
dollars, ($ 50.00) on the 15th
day of each and
everyM~_ thereafter until the entire amount is paid in full.
UPON FAILURE to make payments as herein agreed, this note shall,
at the option of its holder, become immediately due and payable,
without demand o. notice.
AND FURTHER, I/we do hereby authorize and empower the Prothonotary
or any attorney of any Court of Record of Pennsylvania or
elsewhere, to appear for and confess judgment for the sum due and
payable hereon, with or without declaration, with costs of suit,
release of errors, without stay of execution; and also waive the
right of inquisition on any real estate that may be levied upon
to collect this note; and do hereby voluntarily condemn the sa.e
and authorize the Prothonotary to enter said voluntary
condemnation upon any Fieri Facias that may be issued to collect
said judgment; and further agree that said estate may be sold on a
Fieri Facias, and do hereby waive and release all relief fro. any
and all appraise.ent, stay of execution, exemption or bankruptcy
laws of this or any other state now in force or ereafter to be
passed. ..... tl
_ l' . (L.S.)
(L.S. )
This note is qiven and executed without duress or coercion and
with full and cOIlplete understanding that upon failure to llake
pa)'llent as aqreed, that .y operating privileqes _y be suspended.
Further, I do hereby acknowledge that the da_qes incurred in the
accident ot S"rlt'.bl>r :5, . 19<15 for vhich this note is qiven
resulted trOll .y neqliqence and fault, and I do hereby acknowledqe
and vaive .y right to ~~y heari"? or tr!al on th~~ issue"'J
DR1VER DATE or BIRTHI'~' '; > ." XJ:.i,l>'-t'\.. f ~<<....~(L.s.)
DRIVER OPERATOR NO. _. i:; :,,: _ ~ y
OWNER DATE or BIRTH (L.S.)
OWNER OPERATOR NO.
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