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, JNWEALTH Of!PENNSYLVANIA
CO RT of COMMON PLEAS
NOTICE OF APPEAL
FROM
JUOICIAL DISTRICT
DISTRICT JUSTICE JUDGMENT
COMMON PLEAS No. \~2l)~D-d'#1I UiJiQ
NOTICE OF APPEAL
Nofice is g;..", that the appellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the District Justice on the
date and in the case menfioned below;
T~&J1~
824 Allenview Drive
DATE Of AJDGMENT IN THE CASe OF (Plaintiff)
OTY
I MNJ. "'ST. NO 0. NAME OF 0,1
Thomas A. Placev
STATE
ZIP CODE
NAME OF AI'PEUANT
M
(Defendant)
4 11-00
Cl.AlMNO
vs.
SlGNA~U Of APPEllANT HIS
(.^ Legal Services
CV II!
U19 Philip C. Brig ti 8 Irvine Row
This black will be ~gr1ed ONLY when thisnotafion is required under Po. R.C.PJ.P. No. If appellant was CLA MAN (see Pa. R.C.P.J.P. No.
1008B.
This Notice of Appeal, when received by the District Justice, will operate as a 1001 (6) in action before District Justice, he MUST
SUPERSEDEAS 10 the judgment for possession in this case. FILE A COMPLAINT within twenty (20) days after
filing his NOTICE of APPEAL.
r
Signature 01 Prothonotaly 01 Deputy
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This section of form to be used ONLY when appellant was DEFENDANT (see Pa. R.CP.J.P. No. 1001(7) in action beta", District Justice.
IF NOT USED, detach 110m copy of notice of appeal to be served upon appellee).
PRAECIPE: To Prothonotary
Enter rule upon
Gertrude
stoner
Name of appeIlee(s)
(' .AAJr'1 ) within twenty (20) days after s
, appellee(s), 10 file a complaint in this appeal
(Cammon Pleas No. 'dDO()- :;l'!U
RULE: To
Gertrude stoner
Name 01 appeIfoe(s)
, appellee(s).
of judgment of non pros.
(1) You are notified that a rule is hereby entered upon you 10 file a camplaint in this appeal within twenty (20) days after the date of
service of this rule upan you by personal service or by certified or registered mail.
(2) If you do nc>t file a complaint within this time, a JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOU.
Date: ~ :~i!ir,: ~~:: if ser.;ce was by mail is the date of ma~ I. #.',.. ,1~, L
~- .~V 'lWO tUL__lli1{p_
AOPC 312-84
COURT FILE TO BE FILED WITH PROTHONOTARY
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PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT
(This proof of service MUST BE FILED WITHIN TEN (10) DA YS AFTER filing the notice of appeal, Check applicable boxes)
COMMONWEALTH OF PENNSYLVANIA
COUNTY 01'___
; fiS
AFFIDAVIT: I hllreby swear or affirm that I served
o a copy 01 the Notice of A.ppeal, Common Pleas No, , upon the District Justice designated therein on
(date of service) 0 by personal service 0 by (certified) (registered) mail, sender's
receipt attached hereto. and upon the appellee, (name) , on
.___ , 19__ 0 by personal service 0 by (certified) (registered) maii, sender's receipt attached hereto.
o and fu'ther that I served the Rule to Filea Compiaintaccompanying the above Notice of App,aal upon the appellee(s) to whom
the Rule was addressed on , 19_ 0 by personal service 0 by (certified) (registered)
mail, s€'nders receipt attached hereto,
SWORN (AFFIRMED) AND SUBSCRIBED BEFORE ME
THIS
DAY OF
, 19_
Signatu,e of affiant
Signa.ture of affiehi' before whom affidavit was made
Title of officiaf
My commission expires cn
, 19_
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF: CUMBERLAND
09-3-04
NOTICE OF JUDGMENTITRANSCRIPT
PLAINTIFF' RESIDENTIAL LEASE
r.:;. NAME and ADDRESS
STONER, GERTRUDE M
395 RICH VALLEY RD.
CARLISLE, PA 17013
L
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Mag. Dls!. No.:
OJ Name: Hon.
THOMAS A. PLACEY
Add",,, 10,4 S. SPORTING HILL RD.
MECHANICSBURG, PA
.J
VS.
,17055
DEFENDANT:
'MYERS, TINA
257 TEXACO RD.
MECHANICSBURG,
L
Docket No.: LT-0000121-00
Date Flied: 4/04/00
NAME and ADDRESS
Teleph,"" (717) 761-8230
I
PA 17055
THOMAS ,A. PLACEY
104 S. SPORTING HILL RD.
MECHANICSBURG, PA 17055
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THIS Isfo NOTIFY y;aU THAT:
Judgment: FOR PLAINTIFF
[!] Judgment was entered for: (Name) STONER, GERTRUDE M
Cl Judgment was entered against MYERS, TINA
I.XJ Landlordrrenant action in the amount of $ 5.491.00 on 4/11/00
The amount of rent per month, as established by the District Justice, is $
The total amount of the Security Deposit Is $ .00
. Total Amount Established by. DJ Less. Security Deposit Aplllis>d _-Adjudicated AmouBb
Rent m Arrears $ 4,925.00 -$ .uu - $ 4,925.
Physical Damages Leasehold Property $ .00 $ .00 $ .00
Damages/Unjust Detention $ 00 - $ 00 $ 00
Less Amt Due Defendant from Cross Complaint - $ _ 00
Interest (if provided by lease) $ 4'>0 00
UT Judgment Amount $ '> . ~ 7 '> _ 00
Judgment Costs $ 116 _ 00
Attorney Fees $ 00
Total Judgment $ 5,491. 00
Post Judgment Credits $
Post Judgment Costs $
Certified Judgment Total $
8 Possession granted if money judgment Is nOl SallSTleO oy lime OT eVICTion.
Possession not granted. 0 Defendants are jointiy and severally liable.
o Levy is stayed for days or 0 generally stayed.
o Objection to Levy has been filed and hearing will be held:
in a
. (Date of Judgment)
600.00.
O Attachment Prohibited/
Victim of Abuse (Act 5.1996)
o This case dismissed without prejudice.
~ Possession granted.
Date:
Piace:
Time:
IN AN ACTION INVOLVING A RESIDENTIAL LEASE, ANY PARTY HAS THE RIGHT TO APPEAL FROM A JUDGMENT FOR POSSESSION WITHIN
TEN DAYS AFTER THE DATE OF ENTRY OF JUDGMENT BY FILING A NOTICE OF APPEAL WITH THE PROTHONOTARYICLERK OF COURTS
OF THE COURT OF COMMON PLEAS, CIVIL DIVISION. THIS APPEAL WILL INCLUDE AN APPEAL OF THE MONEY JUDGMENT, IF ANY. IN
ORDER TO OBTAIN A SUPERSEDEAS, THE APPELLANT MUST DEPOSIT WITH THE PROTHONOTARYICLEl1\SpF COURTS THE LESSER OF
THREE MONTHS RENT OR THE RENT ACTUALLY IN ARREARS ON THE DATE THE APPEAL IS FILE~"''''',\'ll/'''''''",
IF A PARTY WISHES TO APPEAL ONLY THE MONEY PORTION OF A JUDGMENT INVOLVING A 'i~~ll/TllIJ;.tIi:AsF' 1'J;IE PARTY HAS
30 DAYS AFTER THE DATE OF ENT.!!y'QE.JUDGMEN:J:.1N.lNHIGtt.TO FILE A NOTICE OF APPEJ\!!'~&~'r~.~FlRP'l'HPN01';RYICLERK OF
COURTS OF THE COU.!!T"OFCOMMON PLEAS, CIVIL DIVISION. ..,. ~' ...... /<'/".~ .. ."",'" " ~
THE PARTY FILING AN APPEAL Musr INCL-lJDE A COpy OF THIS NOTICE OF JUDGMENTIT~~CI'\!PVF9BM'WITH ~ NOTICE OF APPEAL.
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L. I - (l; i Date '1 .,' -, oJstJ9t'JU~tiae; ~
, certl y t at t IS IS a true an corr\3ct copy 0 te recor ; 0 t proceel!Jgs:cont, Inlf.l ,e JU . Qlflen1;' .' ,~
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My commission expires first Monday of January, 2004\ '.', 'SEAL .. \ "".,
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IN THE COURT OF COMMON PLEAS OF
Gertrude Stoner,
Plaintiff
v.
CUMBERLAND COUNTY, PENNSYLVANIA
NO.2000 -:YII! CIVIL TERM
Tina Myers,
Defendant
PRAECIPE TO PROCEED IN FORMA PAUPERIS
To the Prothonotary:
Kindly allow, Tina Myers, defendant, to proceed in forma pauperis.
I, Philip C. Briganti, attorney for the party proceeding in forma pauperis, certify that I
believe the party is unable to pay the costs and that I am providing free legal services to the
party. The party's affidavit showing inability to pay the costs of litigation is attached hereto.
~~
Attorney for Defen ant
LEGAL SERVICES, INC.
8 Irvine Row
Carlisle PA 17013
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IN THE COURT OF COMMON PLEAS OF
Gertrude Stoner,
Plaintiff
v.
CUMBERLAND COUNTY, PENNSYLVANIA
NO.2000 -;)4 II CIVIL TERM
Tina Myers,
Defendant
AFFIDAVIT IN SUPPORT OF PETITION
FOR LEAVE TO PROCEED IN FORMA PAUPERIS
1. I am the defendant in the above matter and because of my financial condition am
unable to pay the fees and costs of prosecuting, defending, or appealing the action or
proceeding.
2. I am unable to obtain funds from anyone, including my family and associates, to
pay the costs of litigation.
3. I represent that the information below relating to my ability to pay the fees and
costs is true and correct.
(a) Name: Tina Lvnn Mvers
Address: 824 Allenview Drive. Mechanicsburl!: PA 17055
(b) Social Security Number: 201-62-6903
If you are presently employed, state
Employer: Hardees
Address: Simpson Ferry Road.
Mechanicsburl!: PA 17055
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Salary or wages per month: $ 835.00 (!!1'oss)
Type of work: Cook
If you are presently unemployed, state
Date of last employment:
Salary or wages per month:
Type of work:
(c) Other income within the past twelve months
Business or profession: $570.00
Other self-employment:
Interest:
Dividends:
Pension and armuities:
Social Security benefits:
Support payments:
Disability payments:
Unemployment compensation and
supplemental benefits:
Workman's compensation:
Public Assistance:
Other:
(d) Other contributions to household support
(Wife)(Husband) Name: N/A
If your (husband) (wife) is employed, state
Employer:
Salary or wages per month:
Type of work:
Contributions from children:
(e) Property owned
Cash: None
Checking Account: - ($495.00)
Savings Account:
Certificates of Deposit:
Real Estate (including home):
Motor vehicle: Make
Year
Cost
Amount owed
Stocks; bonds:
Other:
(f) Debts and obligations
Mortgage:
Rent: $ 0 looking for aoartment
Loans: $2600.00 automobile loan
Monthly Expenses: electricity $25.00Imo: travel $80.00: groceries $400/mo:
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Clothing $50.00: Car ins $90.00/mo: fme $50.00/mo: Storage $160.00: rent
(unknown-looking for aoartment)
(g) Persons dependent upon you for support
(Wife) (Husband) Name:
Children, if any:
Name:
Age:
4. I understand that I have a continuing obligation to inform the court of improvement
in my financial circumstances which would permit me to pay the costs incurred herein.
5. I verifY that the statements made 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.
nf/7~fl1~
Tina Lynn Myers
DateH< / J-- '00
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Return Rec~t Fee
(Endors~ent R~uired)
Restricted Dellv~ry Fee
(Endorsement Required)
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Total Postage & Fees $
Name (please Print Clearly) (to be completed by maifer)
'sr;;.~I~Jr~ox~o'rQNER"''''''.............m .... ..........
:.~}.9..~...g;r.CH VALLEY ROAD
City, State, ZlP+4 ____.__n_..____.~---..----..--~...---.-----------"------------------
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Total Postage & Fees $
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Name (please Print Clearly) (to be completed by mailer)
TB@mas A p.l.acey.................................................
.s"ii-eet, Apt. No.; .0; Pd-Sox No. d
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City. State, ZIP+4
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COMMONWE4i~,Of"~NSYLVANIA
COURJ Of CoMMoN PLEAS
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, ' , , NOTICE OF APPEAL
fROM
JUDiCIAL DISTRle'T
DISTRICT JUSTI(E JUDGMENT
COMMONPLEASN.. J60o-d'l1I uvJ
NOTICE OF APPEAL
No6ce is given that the appellant has filed in the above Court of Camman Pleas an appeal from the judgment rendered by the District Justice an the
dale and in, the case men6aned belew.
NAME APPELLANT
MAG. DIST. NO OR NAME OF OJ.
ADDRESS OF LLfNT
824 A11e view
DATE OF JIJDGMENT
~
4-11-00
ClAIM NO
aTY
Thomas A. place
STATE
ZP CODE
Drive
IN THE CASE OF (Plaintiff)
Mechanicsbur ..
PA
1
(Defendant)
Gertrude stoner
N OR AGENT
Legal Ger.ices
CV 12 , .. ..
IT 19 P ~l~p c. Br~g ti 8 Irvine Row
This black will be signed ONLY' when this' naia6an is required under Pc. R.cP JP. No. Ifappellilnt was CLAIMANT (see Pa. R.C.P.J.P. No.
1008& '
This I>!atice of Appeal, when received by the District Jus6ce, will aperale as a 1001(6) inaction before District Justice, he MUST
SUPERSeDEAS ia the judgment for possession in this case. FILE A COMPLAINT within twenty (20) days after
filing his NOTICE of APPEAL.
Signature 01 Prothonotaly or Deputy
'." -', '. ", "
''-.,PRAEOIPE TO'EN1ER RULE TO FILE COMPLAINT AND RULE TO IFILE
(This section of 101m to b&used ONLY whlih, appellant was DEFENDANT (see Pa. R.C.P.J.P. No. 1001 (7) in action before District Justice.
IF NOT USED, detach from copy of noliceof appeal to be served upon appellee}.
PRAECIPE: To Prathanaiary
Enler rule upan Ger,trude
(Comman Pleas No. (). ()O(J- ~'tU
Stoner , appellee(s), ta file a complaint in this appeal
Name 1 appel/ee(s)
UAJ-r.' ) within twenty (20) days after s,,-:ice of rule or suffer en
t.
RULE: To ,Gertrude stoner
Name 01 appelfee(s)
, appellee(s).
(1) You are natified that a ruie is hereby enlered upan you to file,a c;m.plaint in this appeal within twenty (20)daYsafte,-the dale of
service of this rule upan you by personal service or by certified or regislered mail. . , .
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(2) ff you do nat file a complaint within this, 6me, a.JUDGMENT OF NON PROS WILL BE ENTER~!AlG~tll$T.yOU-. '
^'-':"-~',,':,:.<, ,,':\ "-, ",\:,' :fil:,\';\.)
(3) The date of Service of this rule.if. service ,wcs by mail is the dale of maili ..';.,' .,'
Date:~ /7, -dL'{10 '..'
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NJf>C 312-84
,COURT FILE
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PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE tMPtAtfirp
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(This proof of sSTvieD MUST BE FiLED WITHIN TEN (10) DA YS AFTER filing the notice of appeal, Che k apj;lrcabiiJi!t!oxes)
"
COMMONWEALTH OF ;PENNSYlVANIA
~ '
COUNTY
Cumberland
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AFFIDAVIT: I hereby swear or affirm that I served
. 2000-2411 Civil Term" " '
XJ a copy of the Nolice of Appeai, Common Pleas No, ' , upon me ulstnct Justice deSignated there," on
(date of service) April 17. 2000 , 0 by personal service I:X by (certified) (JeJlil!tlinllil:mail~sender's
receipt attached herelo, and upon the appellee, (name) c.;",rtrllnp 1';tonpr ,on
AQril 17 21ll.llCL-_ 0 by personal service ex by (certified) ~kmail, sender's receipt attached fl;lreto.
XJ and turtherthat I served tile Rule to FHe a Complaint accompanying the above Notice at Appeal upon theappellee(s) to whom
the Rui," was addressed on April 17 ,411JllL, 0 by personal service I:X by (certified) lr~
mail, sender's receipt attached hereto, /'
SWORN (AFFIRMED) AND SUBSCRIBED BEFORE ME , /'
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Y -.-
THIS.
,19__
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__.DAYOF
--
Signature of official before whom affidavit was made
Title of official
My commlssJon 8:l<,plres on
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I verify that the information in this Affidavit is true and correct. I
understand that false statemnts henan are made subject to the penalties
of 18 P.S. Section 4904, relating to unsworn falsification to
authorities.
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