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Norwest Mortgage, Inc.
-vs-
Harold Booth Jr. and
Dcbbie K, Booth
In the Court of Common Picas of
Cumberland County, Pennsylvania
No. 98-1400 Civil
David McKinney, Deputy Sheriff, who being duly swom according to law, says on July
15,1999 at 4:00 o'clock P.M. EDST, he posted a copy of Real Estate Writ Notice Poster
and Description in the above entitled action on the property of Harold Booth and Debbie
Booth located at 3159 Ritner Highway, Newville, Cumberland County, Pennsylvania,
according to law.
Dawn L. Kell, Deputy Sheriff, who being duly sworn according to law, says on July
12, 1999 she served a true copy of Real Estate Writ Notice Poster and Description in the
above entitled action upon one of the within named defendants to wit: Harold Booth JR
by making known unto Joann Booth wife at 24 North Enola Drive, Enola, Cumberland
County, Pennsylvania, its contents and at the same time handing to her personally the
said (rue and attested copiers of the same.
Dawn L. Kell, Deputy Sheriff, who being duly sworn according to law, says on July
12,1999 at 5:52 o'clock P.M. she served a true copy of Real Estate Writ Notice Poster
and Description in the above entitled action upon one of the wihtin named defendants to
wit: Debbie K. Booth by making known unto Jeremy Booth, son at 120 Linden Drive Apt
3A, Camp Hill, Cumberland County, Pennsylvania, its contents and at the same time
handing to him personally the said true and attested copies of the same.
R. Thomas Kline, Sheriff, who being duly sworn according to law, says he served the
above Real Estate Writ Notice Poster and Description in the following manner: The
Sheriff mailed a notice of the pendency of the action to one of the within named
defendants to wit: Harold Booth Jr. by regular mail to his last known address, 24 North
Enola Drive, Enola, Pennsylvania. This letter was mailed under the date of July 13, 1999
and never returned to the Sheriffs Office.
R. Thomas Kline, Sheriff, who being duly sworn according to law, says he served the
above Real Estate Writ Notice Poster and Description in the following manner: The
Sheirffmailed a notice of the pendency of the action upon one of the wihtin named
defendants to wit: Debbie Booth by regular mail to her last known address 120 Linden
Drive Apt 3A, Camp Hill, Pennsylvania. This letter was mailed under the date of July 13,
1999 and never returned to the Sheriffs Office.
R. Thomas Kline, Sheriff, who being duly sworn according to law, says that after due
and legal notice had been given according to law, exposed the within described premises
at public venue or outcry at Court House, Carlisle, Cumberland County, Pennsylvania, on
_ September I, 1999 at 10:00 o'clock A.M. and sold the same for the sum of$ 1.00 to
(Attorney Dale Shughart, Jr. for Norwest Mortgage, Inc who assigned the bid to
Secretary of Veterans Affairs, an Officer of the United States of America. It being the
,JI-ighest bid and best price quoted for the same Secretary of Veterans Affairs, of Va
Regional Office & Insurance Center, P.O. Box 8079, Philadelphia being the buyer in this
execution paid to SheriffR. Thomas Kline the sum of$ 967.31 it being costs.
'~'
You may need an attorney to assert your rights. The sooner
you contact one, the more chance you will have of stopping the
sale. (See notice on page two on how to obtain an attorney.)
YOU MAY STILL BE ABLE TO SAVE YOUR PROPERTY AND YOU HAVE OTHER
RIGHTS EVEN IF THE SHERIFF'S SALE DOES TARE PLACE.
2.
sale if
of your
If the Sheriff's Sale
to the highest bidder.
(2151 563-7000.
You may be able to petition the Court to set aside the
the bid price was grossly inadequate compared to the value
property.
is not stopped, your property will
You may find out the price bid by
1-
be sold
calling
3. . The sale will go through only if the buyer pays the
Sheriff the full amount due in the sale. To find out if this has
happened, you may call (215) 563-7000.
4. If the amount due from the Buyer is not paid to the
Sheriff, you will remain the owner of the property as if the sale
never happened.
5. You have the right to remain in the property until the
full amount due is paid to the Sheriff and the Sheriff gives a deed
to the buyer. At that time, the buyer may bring legal proceedings
to evict you.
6. You may be entitled to a share of the money which was paid
for your house. A schedule of distribution of the money bid for
your house will be filed by the Sheriff on This
schedule will state who will be receiving that money. The money
will be paid out in accordance with this schedule unless exceptions
(reasons why the proposed distribution is wrong) are filed with the
Sheriff within ten (10) days after
7. You may also have other rights and defenses, or ways of
getting your home back, if you act immediately after the sale.
YOU SHOULD TARE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT
HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE
LISTED BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
CUMBERLAND COUNTY ATORNEY REFERRAL
CUMBERLAND COUNTY BAR ASOCIATION
2 LIBERTY AVENUE
Cumberland county Courthouse
CARLISLE, PA 17013
(717) 249-3166
(800) 990-9108
r------"
THE PATRIOT NEWS
THE SUNDAY PATRIOT NEWS
Proof of Publication
"ndefRct No. 587. Rooroued MaU 16. 1929
Commonwealth 01 Pennsylvania, County 01 Dsuphln} ss
Af/chse/Aforrow being duly sworn according to law, deposes and says:
That he Is the Assistant Controller 01 THE PA TRIOT.NEWS CO., a corporallon organized and existing under the laws
01 the Commonweallh 01 Pennsylvania, with Its principal olllce and place 01 business at 812 to 818 Market Street, In
the Clly of Harrisburg, County of Dauphin, State 01 Pennsylvania, owner and publisher 01 THE PATRIOT-NEWS and
THE SUNDAY PATRIOT-NEWS newspapers 01 general circulation, printed and published at 812 to 818 Market Street,
In the City, County and Stale aforesaid; that THE PATRIOT.NEWS and THE SUNDAY PATRIOT.NEWS were established
March 4th, 1854, and September 18th, 1949, respectively, and all have been continuously published ever since;
That the printed notice or publication which is securely attached hereto is exactly as printed and publlehed in
their regular dally and/or Sunday and Metro editions/Issues which appeared on the 27th day(s) of July and the 3rd
and 10th day(s) 01 August 1999. That neither he nor said Company Is Interested In the subject matter of said printed
notice or advertising, and that all 01 the allegallons 01 this statement as to the lime, place and character of
publication are true; and
That he has personal knowledge 01 the facts aforesaid and Is duly authorized and empowered to verily this
statement on behalf of The Patrlot.News Co. aforesaid by virtue and pursuant to a resolution unanimously passed and
adopted severally by the stockholders and board 01 directors 01 the said Company and subsequently duly recorded in
the office lor the Recording of Deeds In and lor said Co ty I Dauphin in Miscellaneous Book "M",
Volume 14, Page 317. I
PUBLICATION
COpy
SALE 1123
CUMlERLAND COUNTY SHERIFFS OFFICE
COURTHOUSE
CARLISLE, PA. 17013
Statement of Advertlslna Costs
To THE PATRIOT-NEWS CO., Dr.
For publishing the notice or publlcallon allached
hereto on the above stated dates $
Probating same Notary Fee(s) $
T~~ $
376.14
1.50
377.64
Publisher's Receipt for Advertising Cost
THE PATRIOT.NEWS CO., publisher 01 THE PATRIOT.NEWS and THE SUNDAY PATRIOT-NEWS, newspapers of general
circulation, hereby acknowladge receipt 01 tha aforesaid notice and plJbllcatlon costs and certifies that the same have
been duly paid. THE PATRIOT. NEWS CO.
By......................................,.............................
,
,
"
PROOF OF PUBLICATION OF NOTICE
IN CUMBERLAND LAW JOURNAL
(Under Act No. 587, approvcd May 16, 1929), P. L.1784
STATE OF PENNSYLVANIA :
ss,
COUNTY OF CUMBERLAND :
Roger M. Morgenthal, Esquire, Editor of the Cumberland Law Joumal, of the County
and State aforesaid, being duly swom, according to law, deposes and says thut the Cumberland
Law Joumal, a legal periodical published in the Borough of Carlisle in the County and State
aforesaid, was established January 2, 1952, and designated by the local courts as the official legal
periodical for the publication of all legal notices, and has, since January 2, 1952, been regularly
issued weekly in the said County, and that the printed notice or publication attached hereto is
exactly the same as was printed in the regular editions and issues of the said Cumberland Law
Joumal on the following dates,
viz:
JULY 23, 30, AUGUST 6, 1999
Affiant further deposes that he is authorized to verify this statement by the Cumberland
Law Joumal, a legal periodical of general circulation, and that he is not interested in the subject
matter of the aforesaid notice or advertisement, and that all allegations in the foregoing
statements as to time, place and character of publication arc true.
REAL ESTATE !IALE NO, 23
Wrll No. 98-1400 Civil
Nonvcst Mortgage. Ine,
vs.
Harold BOOU1. Jr. and
Debbie K. BooU.
Ally.: Frank Federman
DESCRIPTION
ALL THAT CERTAIN 101. lract of
land. parcel. piece of ground WIth the
buildings and Improvements thereon
erected. sHuate In West Pennsboro
TownslUp. Cumberland County. Penn-
sylvania. bounded and described In
accordance Mil, a plan prepared by
Staller & Brehm Assoclales daled
Janumy 12. 1995 and recorded In
the Officeonhe RccorderorDeeds for
Cumberland Counly In Plan Book 69
Page 93 as follows:
BEGINNING at a pOint In dedi-
cated rlghl of way line of the RItner
Highway. U.S, Roule II. at corner of
lands now or formerly of Ray K.
Jumper; lhence along right of way
line of said Rllner Highway. Soulh 65
degrees 07 minutes 31 seconds West.
141.53 feel 10 a point; thence by a
cUlVe having a radIus of 25.00 feet
and an arc length of 39.21 fcet to a
point: thence conUnulng along other
lands of Owen Meals. el al.. Norlh 25
degrees 01 mJnute 00 seconds West.
149.88 feel 10 an exIsting Iron pin;
thence conlJnuln~ aJonn same North
25 degrees 0 1 nUnute 00 seconds West
197.18 feet to n concrete JIIomuncnt:
thence along olher Jands of Meals.
North 44 degrees 59 minutes 00 sec-
onds East 188,78 feet to a polnl:
lhence still along same North .12 de.
grees 51 minutes 15 seconds East
67.10 feet to n pulnt: thence along
lands of Palm.lown Gospel Chopel
Soulh41 degre.s 13 minutes 3D sec-
onds East 97,48 feel 10 a point;
I
I
Roger
SWORN TO AND SUBSCRIBED before me this
-Ldayof AUGUST. 1999
,,). ~
':> 7. " A / ,C
Nota
NOTARIAL SEAL
LOf6 e, SNYDER. Notary Pvbllc
Corn". Bore. Cumb.rJ.ai'1d County, fA
My Commiuion Expir.. March~. 'lOO1
---
lhence along same South 41 degrees
52 minutes 25 seconds East 34.59
~~et t_~ nn. eJclsllng iro_" pin: thence
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1 Page 93 fig follows:
UEGINNING at II point In dedi-
cated nght of way line of the Rltncr
Highway, U.S. Route II. at corner of
lands now or formcrly of R.1Y K.
Jumper: thence alonl( nght of way
line of said Rltller Hlghwny, South 05
degrees 07 III1nules31 seconds West.
141.53 feet (0 n point: thence by n
tUlVc having n rndlUS of 25.00 feet
and an are length of 39.21 feet 10 a
point: thence cnntlnulnA: nlo"1( oUler
lands ofOwcn Menls. et nl., North 25
degrcesOlllllllllte 00 seconds Wcst,
140.88 rcel 10 0111 existing Irol1 pin:
thcllCC COlllJnulng nlong sallie Nortll
25 degrees 0 1 mlnutcOO seconds West
197.18 feet to a concrele monument:
thence along other lands of Mcals.
North 44 degrecs 59 minutes 00 sec-
onds Easl 188.78 feel to a point:
U,ence sUlI ..long SlIme NOl1h 42 de-
grees 51 mtnules 15 seconds East
07.10 feet to a point: thence along
lands of palmstown Gospel Chnpet
South 41 degrees 13 minutes 30 sec-
onds East 97.48 feel to a point:
,~'
1 thence along same Soulh 41 degrees
f 52 mlnul.s 25 seconds East 34.59
feel to an ""tsllng Iron pin: thence
along lands of Ray K. Jumper, South
54 degrees 10 minutes 00 secouds
West. a distance of 97.00 fcetto nn
existing Iron Illn: thcncr along Illnds "
of Ray K. Jumper, South 20 degrees ,
10 mInutes 05 seconds East, 200.22 .'
feetlo a point. THE I'LACE OF BE- ...~~{,
GINNING. , .,~'.
TAX I'ARCEL NUMBER: 40.09- , ';'}1(.
0519-000. ,I};.' '.
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TITLE TO SAID I'REMISES IS '~...
VESTED IN Harold Booth, Jr. by rea- , ,',
': ,~l
son of the follOwing: , ,
.' '..'
BEING the same premises which ->1 f,"
Owen E. Meals, Sr.. Owen E. Meals,
Jr.. and Koren D. Neals by Deed dat- .
cd 3/2/1995 and l'Cl'Orded 3/3/1995 . , ,
In the County of Cumberland la Deed F''''
Book 11 9 Page 175 conveyed unto 'J ,
Harold Booth. Jr. and Debbie Booth,
his wife. :
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You may need an attorney to assert your rights. The sooner
you contact one, the more chance you will have of stopping the
sale. (See notice on page two on how to obtain an attorney.)
U Y STILL BE ABLE TO SAVE YOUR PROPERTY AND YOU HAVE OT E
RIGHTS EVEN IF THE SHERIFF'S SALE DOES TAKE PLACE.
"
1.
be sold
calling
is not stopped, your property will
You may find out the price bid by
2.
sale if
of your
If the Sheriff's Sale
to the highest bidder.
(2151 563-7000.
You may be able to petition the Court to set aside the
the bid price was grossly inadequate compared to the value
property.
3. 'The sale will go through only if the buyer pays the
Sheriff the full amount due in the sale. To find out if this has
happened, you may call (215) 563-7000.
4. If the amount due from the Buyer is not paid to the
Sheriff, you will remain the owner of the property as if the sale
never happened.
5. You have the right to remain in the property until the
full amount due is paid to the Sheriff and the Sheriff gives a deed
to the buyer. At that time, the buyer may bring legal proceedings
to evict you.
_6. You may be entitled to a share of the money which was paid
for your house. A schedule of distribution of the money bid for
your house will be filed by the Sheriff on This
schedule will state who will be receiving that money. The money
will be paid out in accordance with this schedule unless exceptions
(reasons why the proposed distribution is wrong) are filed with the
Sheriff within ten (10) days after
7. You may also have other rights and defenses, or ways of
getting your home back, if you act immediately after the sale.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT
HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE
LISTED BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
CUMBERLAND COUNTY ATORNEY REFERRAL
CUMBERLAND COUNTY BAR ASOCIATION
2 LIBERTY AVENUE
Cumberland County Courthouse
CARLISLE, PA 17013
(717) 249-3166
(800) 990-9108
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6. The following amounts are due on the mortgage:
Principal Balance
Interest
7/1/97 through 3/1/98
(Per Diem $28.97)
Attorney's Fees
Cumulative Late Charges
3/2/95 to 3/1/98
Cost of suit and Title Search
$119,200.76
7,068.68
5,960.00
261. 80
750.00
Subtotal
133,241.24
Escrow
Credit
Deficit
Subtotal
TOTAL
0.00
14.45
14.45
$133,255.69
7. The attorney's fees set forth above are in conformity with
the Mortgage documents and Pennsylvania Law, and will be
collected in the event of a third party purchaser at
Sheriff's Sale. If the Mortgage is reinstated prior to the
Sale, reasonable attorney's fees will be charged.
8. This action does not come under Act 6 of 1974 because the
original mortgage amount exceeds $50,000.00.
9. This action does not come under Act 91 of 1983 because the
mortgaged premises is not the principal residence of the
defendant(s).
10. Pursuant to the Fair Debt Collection Practices Act, 15
U.S.C. S 1692 et seq. (1977), Defendant(s) may dispute
the validity of the debt or any portion thereof. If
Defendant(s) do so in writing within thirty (30) days
of receipt of this pleading, counsel for Plaintiff will
obtain and provide Defendant(s) with written
verification thereof; otherwise, the debt will be
assumed to be valid. Likewise, if requested within
thirty (30) days of receipt of this pleading, Counsel
for Plaintiff will send Defendant(s) the name and
address of the original creditor if different from
above.
WHEREFORE, PLAINTIFF demands Judgment against the Defendant(s)
in the sum of $133,255.69, together with interest from 3/1/98
at the rate of $28.97 per diem to the date of Judgment, and other
costs and charges collectible under the mortgage and for the
foreclosure and sale of the mortgaged property.
::;~~~ :j~jZ~IL-~.
Isl Frank Federman
FRANK FEDERMAN, ESQUIRE
Attorney for Plaintiff
6. The following amounts are due on the mortgage:
principal Balance
Interest
7/1/97 through 3/1/98
(Per Diem $28.97)
Attorney's Fees
cumulative Late Charges
3/2/95 to 3/1/98
Cost of suit and Title search
$119,200.76
7,068.68
5,960.00
261.80
750.00
Subtotal
133,241.24
Escrow
Credit
Deficit
Subtotal
0.00
14.45
14.45
TOTAL
$133,255.69
7. The attorney's fees set forth above are in conformity with
the Mortgage documents and Pennsylvania Law, and will be
collected in the event of a third party purchaser at
Sheriff's Sale. If the Mortgage is reinstated prior to the
Sale, reasonable attorney's fees will be charged.
8. This action does not come under Act 6 of 1974 because the
original mortgage amount exceeds $50,000.00.
9. This action does not come under Act 91 of 1983 because the
mortgaged premises is not the principal residence of the
defendant(s).
10. Pursuant to the Fair Debt Collection Practices Act, 15
U.S.C. S 1692 et seq. (1977), Defendant(s) may dispute
the validity of the debt or any portion thereof. If
Defendant(s) do so in writing within thirty (30) days
of receipt of this pleading, Counsel for Plaintiff will
obtain and provide Defendant(s) with written
verification thereof; otherwise, the debt will be
assumed to be valid. Likewise, if requested within
thirty (30) days of receipt of this pleading, Counsel
for Plaintiff will send Defendant(s) the name and
address of the original creditor if different from
above.
WHEREFORE, PLAINTIFF demands Judgment against the Defendant(s)
in the sum of $133,255.69, together with interest from 3/1/98
at the rate of $28.97 per diem to the date of Judgment, and other
costs and charges collectible under the mortgage and for the
foreclosure and sale of the mortgaged property.
Isl Frank Federman
FRANK FEDERMAN, ESQUIRE
Attorney for Plaintiff
..
B&R
1Ie1Yl... ror Pror...lo.oIo ID.,
235 SOUTH 13TH STREET
PHILADELPHIA, PA 19107
PHONE: 12151546.7400
FAX: 215.965.0169
.1'1111,..1..11'11101
. ------- ^UU.:!;IHI.n,l
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.
AFFIDAVIT OF SERVICE
CASE NO,
DEFENDANTlS)
Debbie K. Booth
SERVE AT
2024 S. 327th Lane
Apt. Z 202
Federal Way WA 98003
Court of COMMon Pleas
of CUMberland Count
Type of Service
Civil Action CaMp/Foree
COMPANY CONTROL NO.
CS102386A
REFERENCE NO,
SERVE BY: June 12, 1998
Served end mede k~own to Deb b i e K. Booth
Accepted By:
davol
,19_.8t
o'clock.
ot,
Commonweallh 01 PennsVlvanla. In the manner described balow: UNABLE TO MAKE SERVICE XXX FOR THE FOLLOWING ATTEMPTS:
8 DelendanUs' parsonaHv servad.
AdullfamHv member with whom sold DalendanUs' resldels). Relationship Is 5-19-98 @ 5:03 PM No answer, patio door open.
D Adult In charge 01 Delendant's residence who rafused to give nama or relationship. Server retul;11ed later that evening and
D Manager/Clerk 01 placing 01 lodging In which DelendanUs' rasldelsl. was told by an Hispanic female occupant, subject
D Agent or person In charge 01 Dalendant's offica or usual place 01 buslnass. was previous occupant. No further attempts
D Posted were made.
@Other
DESCRIPTION AGE HEIGHT WEIGHT RACE SEX
-====================================================================================
On the _____ day of ________________, 19____, at __________ O'Clock, ____M.,
Defendant not found: Moved ___Unknown ___No Ans ___Vacant ___Other ___________
====================================================================================
DEPUTIZED SERVICE
Now, this _____ day of __________, 19____, I do hereby deputize the Sheriff of
______________ County to serve this ___SuMMons ___CoMplaint ___Other _____________
and Make return therof and according to Law.
By (Corlpetent Adult) ______________________ County Sheriff's Check $ __________
====================================================================================
*** Special Instructions ***
NAME OF SERVER C. MILBRADT KCR#9709B44
PI"OCeSS Server
Sworn to &: subscribed before me this
11th dav 01 June
being dulV sworn according to law.
depolel and saVI that ho/lhe Is process servor horoln names: and
that the facta herein set forth aboya are true and correct to the boat of
their knowledge.lnformsllon and belief.
~
Process Server I
Competent Ad
Law Firm Federrlan ~ Phelan
ttorney'sName Frank Feder"Plan. ESQui,'"e
ddress Su i te 900
Philadelphia PA 19102
elephone # ~3-7000
1890 Phlledelphle ~.oc. 01 Profelllonel ProclII SeNerl Rey 1
For Plaintiff
Two Penn Center Plaza
PRO PROTHY
Idanlllicatlon # 12248
March 13, 1998
DATE
c.. 5) 0 d.-3 g (., A-
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B&R
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. Court Filfn2 .
235 SOUTH 11TH STREET
2IS.9i1S..Q!..fi'1
POSlm..t.r&d-era!Cuv...C ,uJ.4 9J1t103
ell)', Slat., ZIP Cod. V
- REQUEST FOR CHANGE OF ADDRESS OR BOXHOLDER
INFORMATION NEEDED FOR SERVICES OF LEGAL PROCESS
Pl.... furnish the new address or the name and street llddress (if a Boxholder) for the fallowing:
Name:JJe.iJ/;ie,. K ,BOd-t~ pr
Addre..: do J. tf. s. .3~ 7 >'4;7' MU- ~ BOdo .
NOTE: The name and I..t known address are required for change of address infonnatlon. The nam., if known. and post office
box address are r.quired for box holder infonnallon, '
The following infonnalion Is provided in accordance with 39 CFR 26S.8(d;(6)(u). There is no fee for providing boxholder
infonn:llion. The f.. for providing change ofllddr.ss infonnation is waived in accordanc. with 39 CFR 26S,6(d)(I) and (2) and
corresponding Administrative Support Manua13S2,44a and b.
Prnte~$ Servinll . COUrt Reoortinll .
PHII.A~~;:HISP:;)9 R (? I 5\546.7400 FAX'
I, Capacity ofr.questetis a process server
2,
4.
SlaNte or regulation that empow.rs me to serve process is P.R.C,P. 400.1
The nam.s ofa1l known parties to the litigation: Akt-{J)est ;1lorlga,; e ~ '
The Court in which the case h.. b.en or will beheard:('C,o {'um b{?/~K"L. V.5I..J:;e/;6/e k 60d ~
The dock.t or other identifying number if one h.. been issued: 9,f,.. / lfCM -c. iv, c....
3,
S.
6, The capacity in which this individual is to be served is a defendant.
WARNING
THE SUBMISSION OF FALSE INFORJ\<IATION TO OBTAIN AND USE CllANGE OF ADDRESS INFO&'IATION
OR BOXHOLDERlNFO&'lATION FOR ANY PURPOSE OTHER THAN THE SERVICE OF LEGAL PROCESS IN
CONNECTION WITH ACTUAL OR PROSPECTIVE LITIGATION COULD RESULT IN CRIMINAL PENALTIES
INCUDING A FINE OF UP TO 410,000 OR IMPRISONMENT OR (2) TO AVOID PAYMENT OF THE FEE FOR
CHANGE OF ADDRESS INFORl'oIATlON OF NOT MORE THAN S YEARS, OR BOTH (TITLE 18 U.S.C. SECTION
1001)
I CERTIFY THAT THE ABOVE INFO&'L\ TION IS TRUE AND THAT THE ADDRESS INFO&"IA 1'10.'1 IS
NEEDED AND WILL BE USED SOLEY FOR SERVICE OF LEGAL PROCESS IN CONNECTION WITH ACTUAL
OR PROSPECTIVE LITIGATION. .
cm~ J:VM-~ .
Signa~ / .
I .c.r/"'/7~ Se,rl'CJt::C-o
Printed Name
":;'3 tJ- ..1- /3 'fr'l ~a:-
Add~ @ 1'7
., 1". /9/0/
City, Slale and Zip Code
FOR POST OFFICE USE ONLY
_No change of address ord.r on file.
NOl known at addr.ss given.
- Mov.d, len no forwarding address.
No such address.
NEW ADDRESS OR BOXHOLDER'S POSTMARK
NAME AND STREET ADDRESS
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