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IN TIlE COJRT OF C01'lOO PLEAS OF
CLMBERLAND CCA.MrY. PENNSYLVANIA
~'>tN ~~Il:\ C,)Q.<t'C(>
00. ~2.1
CIVIL
19 <1?
vs.
t-(~'\;~~ A..+-...l e.~:Iu
PRAECIPE TO TRANSMIT RECORD
To the Prothonotary:
Transmit the record, together with the following information. to the court
for entry of a divorce decr'?e:
1. Grounds for divorce: irretrievable breakdown under Section 3301 (p)(,)
_I/'l'!#- of the Divorce Code. (Strike out inapplicable section)
2. Date and manner of service of the canplaint: ---tiJ!fJ'Il By (rt:..ml:t-ny.
&M.~
3. Canplete either Paragraph A. or B.
A. Date of execution of the affidavit of cons/nt required by Section
3301 (c) of the Divorce Code: by the plaintiff Cf(:;i:?("17
by the defendant 4('}7(CI7
B. (1) Date of execution of
Section 3301 (d) of the Divorce Code:
the plaintiff's
Il~/~7
affidavit required by
(2)
Date of service of the plaintiff's affidavit upon the defendant:
'/,.,1
((Et-( ~7
4. Related claims pending:
t'\fo~~
5. Indicate date and manner of service of the notice of intention to file
praecipe to transmit record, and attach a copy of said notice under Section
3301 (d)(l)(i) of the Divorce Code
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M'- J__, L Plaintifft~' ,,"t
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AND NOW,
this
I .-) I J \
\ day
ORDER
.1 ~- ~U CV'-(f 1~91. -,."
Petition for Leave to Proceed l!!. Forma
conlliderat ton
of the at tached
Pal!l!.~ lInd the IIlJppOrllllK In Forma Pauperis, IT IS HEREBY ORDERED that
the petition 111 GRANn:D.
p P C\ ( 1--( t I r--F
shall be permitted
to proceed ~ .f~J! pnuperill without the prepayment of fees and costs
In the purllult of this matter,
BY THE COURT:
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IN TIlE mUR'f OF COI1HON PLJ-:AS Of (!~IXA~
CIVIL DIVISION
mUNTY, PENNSYLVANIA
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PI~inl iff
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Defendanl
V E RIP I CAT ION
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T, 5w_X',\_(?":;f.!.~_(0:tSZj __, Iif'rch)' y,'rify lhat I ~m the Pli1inllff
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herein and as such "crill thill the jnfol'll'''lion cont~ined in the foregoing
petition is tn ,1nd corn'cl 10 1Ill' best of my knO\;Il'dgl', informalion "nd helil'r.
This YL'rificill
" made subjl'ct to Ihe I" ".111 it'S of lq Pa.C.S.A. 11 1.904,
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rl'lating to un,
,lsific~tion to ~uthorities.
D~tl'd:
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Plainl iff Pro Sf' r.J';')
1",,1' 1111 i(;,\~umber Y.J!..-CJ.?7Jl
,', 'IIlP IIi 11
'ox .'00
, 11, P,I 17001-0200
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IN 'l1IE roURT OF C<J1HON PLEAS OF c.<)"'~RL-.v>~
CIVIL DIVISION
COllNTY I PENNSYLVANIA
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~,~'.0 ~(l,C(IT ~0~-;.o,
Plaintiff
NO. :J2~~.gJ ~ -X..',^,,,",
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VS.
\1 r-~Tllr-I:" ^^,,'v (\:,~,""
Defendant
NOTICE TO DEFEND AND CLAIM RIGIITS
You h.l\'c bL'l'l1 sued in ((l,rt. If \'OU '"l:;~: to!(.il'llil ~lo.;'lill<.;t Ih(' claims Sl't
forth in tht:! following IJiI,l'S, you mli,t LIke prompt .let iOIl. You art:! warned ~hat
if you fail to do SO, tLc C.L":(' m.l',' jHoe's""1 ',,'~l!lOut YOIl and a decfL'(' of divorce
or ann I; !~ll~nt milY be l'fltt'f'.'d ~2,1:n:it ...,~.~ ~~,,; :he (rJ';.r:. \ judgmt.'l1t rnil~' :Jl:...;n ~'-'
entf~rcJ agdinst you for ,111',' ':O'.,l('r clJ:::; 'Jr :-.::-lle:' ri'lp,t.>:jt.ed in lhl'::'c IUPPfS by
the plaintiff. You :nay lnse -:;:<",C\' or f;.':':r~.:; r'r (':~,':'r f;ghts irr.pnr'Jnt t'J \,illl,
including custody or vlsi:dtl:~ )f YIJUr ~~~:~:-~~.
\o.'hen the ground for dl'.0rce :s ir.d:;~:l:l(,S ..:.r irrctrlc\':lblc Jreilk,io.....n of
the marriage, ~'ou may requl'st l1arrl.J";c ci)L;.n:;eltl1'3. .\ 1 ist of m;uriage counselors
is available in the Office of the Prothonotary at
IF YOt' DO NOT FILE A eL.WI FOR ALI~IO~;Y. DIVISIO:-l OF PROPERTY, LA.YER'S FEES
OF EXPE:-ISES BEFORE A DI\'ORCE OR A,:iU.'.IE:;r is GRA:iTED. YOl' ~IAY LOSE THE RiGHT
TO CLAI~I A:-IY OF THE.'I.
YO[; SHOL'lD LIKE THIS 1'.11',3 TO YfkR ~.;'.,':ER .1:- l)~;CE. IF Y,;[' DO ,OT 1i..\';E .\
L.I\;YER OR CO:i:iOT AFFr1RJ I):;', ;) 1') OR ;:::'.;-"1.1:;;:: ::;:- OFF:CE SET FORT!! ~ELO\, TO
FI ~;D on I,HERE YOl' ;:,,:; GET Ltt; \L HELi'.
IN nm COURT OF COMMoN PLF.AS OF ~V>\i:,tRt.>\v.l9
CIVIL DIVISION
COUNTY, PF~NSYLVANrA
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Plaint i ff
NO. 9? - :V./ c.~'a.1.. .:r.t~
VS.
-1IYuUC1LA~,~
e..:.~~'tO
De f enda 11 t
COMPLAINT IN DIVORCE PURSUANT TO 23 PA.C.S.A. !i 3301
1 Th 1'1' 'ff' <:
. e nUlll IS ~,:.<,\:>
\f[.:r~;:,,;,,,'r (' ...JD07"f".
, who currently resides
at Camp Hill State Prison, P.O. Box 200, Camp lIill, PA 17001-0200.
2. The Defendant is Jlr;\TI;r~ h . . (l ,'2~ fG who currently
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resides at :),0 ^\Ara:' :=:\. Avr tl~ 'U , 0.1.Al)r~;lo ?A \(" (.:.,
3, The Plaintiff docs not know the latest address of the Defendant. The
name and address of the Defendant's nearest relative and/or other person who
would be likely to know the whereabouts of the Defendant are:
,. Tho PI"'""" eod ",Co"d"", "'0 ~'''od"" S<",."".
at I<\CJ(~4'" ('" ""4rL - 1:>:-:"';'01:'1'. ...,-'~~"~ .:.'\r..'" ~~.,,<.'O
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5. The Plaintiff has reSided within this Commonwealth for at least six months
immediately prior to the commencement of this divorce action.
6. The Defendant has resided within this Commonwealth for at least six months
immediately prior to the commencement of this divorce action.
7. The Plaintiff seeks a .-lil'nrc,' based upon the following grounds:
[CIRCLE LETTER(S) \-IIIICII Ai<r: !'HE GROnDS YOU ARE SEEKTSC TilE DIVORCE ON J
a. Willful and maliciolls desertion, und :i"','nce from the habitation
of the injured and innocent Spollse, ..-itL')lIl rp,lsoc,aldo )Ustili,:"tion or any calise
for a period from
to
~ Adultery.
-1-
c. The Defendant knOWingly entered into unlawful bigamous marriage,
while the former marriage is still subsisting,
d, Cruel and bnrbarous treatment tbat endangered the life of the
Plaintiff or the heal th of the injun'd l'lainl iff,
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The f~aintiff\ or the Defendant
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convicted
nod HPIl l enc t.d
in a court of 10" to a term of imprisonml'nt of more than two y<>ars,
1". The Defendant offered such indignities to the innocl'nt and injured
spouse, so as to render the spouse's condition intolerable nnd life burd<>nsom<>.
8. To the best of the Plaintiff's knlJwl"dge, information and belief, tlu're
has not been any previous action of divorce filed eit.h<>r in this Common""alth
or any other state.
9. The Plaint iff does have knowledge of a pending divorce action filed in
County,
Cnsc
Caption
Case :-lumber
10. The Plaintiff has been advised of the availability of counseling and
that either party has the right to request that the Court require the parties
to participate in counseling.
WHEREFORE, the Plaintiff request that the court enter a decree of divorce.
Dated:
Ir7
4~ (2, t~
Plaintiff Pro se 12
Institution :-lumber 17 -D'I''O~
SCI -Camp Hill
P.O. Box 200
Camp Hi II, Pol 17001-0200
-2-
IN TIlE COURT OF COMMON I'LP.AS OF c"-MeLl?u(..oi;)
CIVIL DIVISION
~
COUNTY I I'ENNSYI.V ANIA
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Dl'fl'ndant
AFFIDAVIT
I. The Plaint i ff aVl'rs that he is the Plailltiff ill t.he ahove ..ntitled
divorce action and under 18 Pa.C.S.A. ~ 4904, relating to unsworn falsification
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to authorities, slntes:
il. There is no i....SllC' CIS to al imony or chi Id support;
b, There is no issue as to equitable distribution to material property
or assets.
Dated:
~
4~ ~I (};::
Plaintiff Pro se
---
P.O. Box 200
Camp IIill, PA 17001-0200
-3-
IN 'l1IE roURT OF OOiHON I'J.I'.AS OF CUM~/('U\1\lD
CI VII. DIVISION
roUNTY. PENNSYl.YANIA
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I'lainti ff
NO.
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Defendilnt
A I' I' I D A V I T
I, The Plaintiff avers that he is the l'lainti ff in the auove enti tied
divorce action and under 18 Pa.C.S,A. 94904, relating to unsworn falsification
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to authorities, states:
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a, There is issue as to alimony or child support,
U, There is an issue as to equitaule distriuution of material property
or assets.
Plaintiff Pro ~
P ,0, Box 200
Camp Hill, PA 17001-0200
-4-
IN 'mE COURT m' OO1MON PL~:AS OF ~ul'1I$fIlLA.~
CIVIL DfVISJON
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COUNTY, PENNSYLVANIA
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Pia i nl iff
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VS,
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f)l,fclldant
A F F I D A V I T
23 PA.C.S.A. !'l 3301 ill
I. Both the Plaintiff and the Dl'fendant to this ncl ion seperated on ';)7
~6(~
, 197'-1 and have cont inul'd to I ive s"J1~rilted for a period
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of at Icase two (2) years,
2. The marriage is irretrievably brokpn.
3. I understand that I may lose rights concprnlng alimony, division of
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property, lawyer fees or other expenses, if I do not claim tbem prior to the
divorce being granted by the court.
I verify that the statements made in this affidavit are true and correct.
I understand that any false statements mnde in this affidavit arc subject to
the penalties provided in 18 Pa.C.S.A. 9 4904, relating to unsworn falsification
to authorit ies.
Dated:
/ J 1 h7
( (
4~~,~
Plaintiff Pro se
1'.0, Box 200-
Camp lIill, PA 17001-0200
-6-
IN 11m COURT OF COHMON PI.P.AS m' (!~('{.A~
CIVIL IHVISION
COUNTY, PENNSYLVANIA
c' - f)
--;.:)'~~~V~"ll_~;:("l' t'-,-_
Plaintiff
~O.
VS.
-__JLI\.l2J.'~_AJ.:J.\)--1'.::"k'_D.____
0.. f","lant
Dated:
Ih~7
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V R R T P T C ^ T ION
-------------
I, ~IX"~( (7~sr~t_.C..:.~")r_r;z.
, Ia('l'..hy vl'rify that I am the Plaintiff
her..in and as snch v<'rif, 1!I,lt the infolmation cuntained in tht! foregoing
pet it ion is truc and corrt.'C'l Lo the hest of illY kIlO\,ll'dgp, information ilnd bel jef.
This verification is made suujl'ct to tll(! Pl'llitltil's of 18 l'a.C.S.A. ~ 4904,
relating to unsworn falsification to authorities.
Plaintiff Pro st! 1)D
InstiLut ion :Iumhl'r -CJ./..f}l
Sel-Camp lIill
P.O. Box 200
Camp lIill, Ph 17001-0200
. .
.
IN Tim COURT OF COMMON PI.EAS OF Cvll\P..i~O(WC>
CIVIl. DIVISION
COUNTY, PENNSYLVANIA
~
C-"\~'~F~4.) ~~~(J~~~rli. ....
1'1 a i nt iff
NO.
VS.
_.Jlr.:l~.I:J1...J..\.o<,),~ (l ;c;7~~____
Dl'fendant
Complaint in Divorce
Affidavit pursuant to
23 Pa.C.S.A. 9 3301(C)
Connter Affidavit
pursuant to
23 Pa,C.S.A. 9 3301(c)
Plaintiff's Affidavit
pursuant to
23 Pa.C.S.A. 9 3301(d)
PROOF OI'~i.RVICF.
I, ~\:UEUL_c!Y~
, have sprved a copy of lhe for('going
document upon the person(s) listC'I] hl'low pllrsllant. In Ih,' Pennsylvania Rules
of civil Procedure, hv way of United Stalps Certified Hail, postage prppaid
with a return recei~t..
~ e~'7 '"(<::::> ~
~ ClE'llY, ~ (b)~,
<!..:>>tV7Ee.~~. ~<<.w;E
~ ~CO~ '7.Q~
c.v..~"f.lVtE 1?14 IrD l ~
L ~6rl.( "CD
(.{"[~~R.. l!0lZr..!."D
:;>0 M4rw"'h-c. .4P\. s-i;>
'\3~~y( '\74-
l~7c>,
Dote mailed:
_~~_R~u~
Plaintifrl'rosr, W
Inst ilutic'ii~r.l"''-l'r -O'l.~
SCI -C.,mp Ill' 1
P.O. Rox .:"1')
Camp iI i : I, I ,\ J 7001-0200
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IN 11m COURT OF COMMON PI.EAS OF C~I![{tA,oy
CIVn DIVISION
COUNTY, PENNSYI.VANIA
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1. ^ complnint in divorce has been filed under Title 23 Section 3301(c)
of the Divorce Code on ~, {q{4, , 19lL..
2. The marriage of lh" Plaint iff 10 the Il"fendant is irr<'lrievably broken
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PIa inl iff
YS.
l\.-,....'tICC I~M,~ Qs"u'
Defendant
A F F T 0 A V I T
I~ P^.C.S,~. ~ 3301(C)
and ninety (90) days has "lapsed from the dale the complaint was filed,
3. T do hereby consent to the entry of a final divorce decree,
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I verify that the statements made in this affidavit are true and corrl'ct,
I understand that any fal se statements made in th is affidav i t arc subject to
the penalties provided in 18 Pn.C.S.A. ~ 4904, relating to unsworn falsification
to authorities.
Dated:
!Jf1?97
t,.-:,
4~ e.
PIa int iff Pro se
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