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Persons dependent uoon 'IOU for suooort
(Wife) (Husband)
llame:
Children, if any:
llame:' V-~-~-~~~' ~ n~:
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Age: l(> rYYln+h',)
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Other persons:
llame:
Relationship:
4. r underscand that r 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. r verify that the statements made in this 3ffidavit are true and
correct. r understand that false statements herein are made subject to
to the penalties of 18 Pa. C.S. ~ 4904, relating to unsworn falsification
,
to authorities.
~-r~) ILJp:/.J
Pet tioner
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III TilE COURT OF COMMON PLEAS OF
Plil intifr
v.
CUl-lUEHLAND COUNTY, PENNSYLVANIA
110. 98- '5/"/3 CIVIL TERM
'1Zu.5)('JI It, !.t:fl/c
Defendilnt
CUSTODY
ORDER OF COURT
AND NOW, upon consideration of the attached complaint, it is
hereby directed that the pilrties ilnd their respective counsel
appear before illil\- X. (';'\[("'1' L..,.Cl. , the conciliator, at
""'c L\~ n .\->r'l\')cI,'o<-rn\,n, \1,,",,\ 1 \
(,,J('(,\'<'>er\n:,r,(().(nA'\kr.0-.(" on the ~ day of \'Y((""("('\I.,p\
199a" at "1' \J\) C\.m., for a Pre-Hearing custody Conference. At
such conference, an effort will be made to resolve the issues in
dispute; or if this cannot be accomplished, to define and narrow
the issues to be heard by the court, and to enter into a
temporary order. Failure to appear at the conference may provide
grounds for entry of a temporary or permanent order.
By the court,
~1:-\H O'ieAX: Y- . <~ j) J\ M-- F~.
Custody Conciliator \J 'C~~
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 SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
COURT ADMINISTRATOR, 4th FLOOR
CUMBERLAND COUNTY COURTHOUSE
CARLISLE, PENNSYLVANIA 17013
TELEPHONE NUMBER: (717) 240-6200
1..Q
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!if1<'\ (Yl UdUCJh (lJ, Plaintiff
] II TilE COUll']' OF COI1MOII PLEAS OF
CUl1J1JmLAlIO COUNTY, PEII/lSYLVANIA
v,
110, 9(;-
CIVIL TERM
!j),US5c1/ It ltlrl L
Defendant
CUSTODY
COMPLAINT FOR CUSTODY
1. The Plaintiff is' I-;-;,() (\\ \ \C\UC)\,'. , residing at _
j1Q:1 ~0 T r\t'\,.(\, \.' \Ie \):\ I) Jcf/
2. The Defendant is 'Ru. 'S .)( II f\ Le' n I ( , residing at
IlJ LJ l3.;::>t n e uw,{ I(~ U),,) I ")J(f /
r~
3. Plaintiff seeks ~) (partial custody) (visitation)
of the following child(ren):
NAME
Y0\'~i(l\.\ 'R Lt'(\ \ L
PRESENT ADDRESS AGE
jut/ l)<)t IkLL'l,lle ~\J 17JI/I l/ft]Of/tA5
The Child(ren)~/was not born out of wedlock.
The child (ren) is presently in the custody Of-rfl ;) (Yj / !A(Ji.D
h . at /I.l//3:;f f)(k)U,/lr' PJ /7C}11;
, w 0 resl.des LV ( 7,
During the past five years, the child(ren) has resided with
the following persons and at the following addresses:
LIST ALL PERSONS
ADDRESSES DATES
JIJLj /351 NCLJOi//t' IcJ 1/11'5 lo~d ~ *
I-fplf 65 f !Vel-vI)' /1 f' pc] '1/Y/ is /o~*.:7 - : I
/lv1jf.J,jj- f'JC'wd'/lr- Pel Ljhhfl%/~98"1
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The mother of the child (ren) is 0 no") (Y\ I) UI-\aft 10 . I
(j
,
26
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currently reciding nt
j\) / /a</I
Jilt!
;-1jf
Jl (({'C'/ //f'
She ic cingle) (mul'ried) (divorced) ,
-----/ 1 )
The fnther of the chilcl(ran) i::; IIU"')I!/
currently reGiding nt /(11/ ;;3,:) I II (L( '(,/It'
~---~~,-.....
lie is e:;) (mnrried) (divorced) .
4. The relntionship of Plnintiff to the child(ren) is
1f:i-k-ey, (1\(',1 ~C;~
NAME
T:rif;J'o7Yrr rJ1JTf}Ilt8
J,Ll[W/'JlCill ') I ) (J u c( It /L)
<i) i./
kWYy; 0 0 fl / Cn/T
;1 / (lJI,'
;<JI/J'I/
The Plnintiff currently resides with:
5. The relationship of
trrtJU..JL'
with: .
NAME
/;/1 CJ m
~UOOCUlOL{)
is
't<' II
The Defendant currently resides
RELATIONSHIP
gl/d [;Zd'nd
,9' )z/ hz, Clld1
I) c7 uCt It Il)
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c) IJUCj ~ t1J
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f,"J/cUL. .
6.
Plaintiff (haS)~ ~particiPated as a party or
or in another capac~ty, in other litigation concerning
witness,
the custody of this minor child(ren) in this or another court.
The court, term and number, and its relationship to this action
is:
Plaintiff (haS)~ ~nformation of a custody proceeding
concerning the child(ren) pending in a court of this
27
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to this action is:
Commonwe,11 th. 1'he court, term ilnd number, and its relationship
Plaintiff (knQ"wn) (doen not know) of iI pcrson not a party to
'. ...-'------.---,.
the PI.'oceedings who has phydcal custody of the child (ren) or
Claims to have cuntody or vinitation rightn with respect to the
child(ren). The name and address of such person is:
7. The best interent and permanent welfare of the
child(ren) will be served by granting the relief requested l
fi, . . . hJ ~ ~r\~
because: ill! I\[ \l VV", \cd((l\ (' L ,\r\ (1-"0.) bflYl 1Y11i'JO.,;?,\ UI (;
8. Each parent whose parental rights to the child(ren) 1iave
not been terminated and the person who has physical custody of
the child(ren) have been named as parties to this action. All
other persons, named below, who are known to have or claim a
right to custody or visitation of the child(ren) will be given
notice of the pendency of this action and the right to intervene:
NAME
ADDRESS
BASIS OF CLAIM
WHEREFORE, Plaintiff requests this court to grant
(custody) (temporary custody) (visitation) of the child(ren) to the
Plaintiff.
II) - C/. 9'if
Date
Respectfully submitted,
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11Ft: ,7 1998,
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TINA /-.1. V Al )(jIlN,
Plaintiff
IN TIlE ('(ll/In OF ('():-'lMON PI.I:AS OF
('( JMIlERI.ANI) ('( lllNTY, PENNSYI.V ANIA
\
CIVIl. ACTION - I.A \\'
RIJSSI'I,I. A,I.ENTZ.
Ddendant
NO, 1)8 - 5793 CIVIl.
IN ('(ISTony
4't'Vr.
AND NOW, this \ day of December. 1998. the Conciliator having eon\'Cned a Conciliation
Conference and none of the parties having attended the Conference. the Conciliator relinquishes
jurisdiction. Eithcr part may requcst another Conciliation Conference by Jiling the appropriate
petition.
COllRT ORnER
Hubert X. Gilroy. E'
Custody Concili r
ec: Tina M. Vaughn
Russell A. Lentz
Ct.fL'-~1 t?l\.~
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