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COMMONWEAL TH OF PENNSYLVANIA
COURT OF COMMON PLEAS
CVI1 Bt.'It..1. Nt} Cc-.It/;'{
JUOICIAL DISTRICT
NOTICE OF APPEAL
fnOM
DISTRICT JUSTICE JUDGMENT
COMMON PLEAS Nu qp ::~2.?_C:LC~
NOTICE OF APPEAL
NotlClI l~ given tlHlI the <lllpcll.1I11 ha~ fill'tl III llw ;IIHlVl' Court III C0l11111011 Ph'il\ .111 .IPpt'.tllrlllllllw Ilulqllll'nf It'ndlHt'd hV till' Di\uiCI JustiCD
on thu rlilll! IIntl in Ihn CiI\l! nWllll()lll,d helow.
"."fI1A~?AN!/ f/UTJ/./{.- IlNi~8~i;;;7..~lo~;~ r L
UDCjii0740"iW'fAtN /(OA D_rn~i!!~,L________)iL FioTt
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/0 q 1&' GI<.OSJ I1AN-(O/'I./ i15'LfiA1E5>,_!'~,/1.I,!.Y A!JIJ lIof.1/IJ{r--. G.7 At...
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This block wW be signed ONLY when ,his notation is rCfIWr;!!l under PlI.
R.C.P,J.P. No, 10088,
This Notice of Appeal, when received bV the District Justice, will operalc as
a SUPERSEDEAS to the judgment for possession in this case.
Mf/$;
II ."",'II'"t P.. R,C.P.J,P.
No. 1001(6) in ,1ction before District Justice; he
MUST FILE A COMPLAINT withill twenty
d.ys .Iter lilillg llis NOTICE 01 APPEAL,
(20/
Slgn.Jturt! of Prorllollotarv or Deputy
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This section of form to be lJsed ONL Y when .1{Jpellont was DEFENDANT (see Pa. R.C.P,J.P. No. 1001(7) in action before District Justice.
IF NOT USED. detach from copy of notice of appeal to be served IIpon appellee).
PRAECIPE: To Prothonotary
Enterrule upon G!<U)) M AN-{Oiltl /1 [foCI A rLS
o ~OfapPf1I1IH1(SJ
(C~mmon Pleas No, 9P -/~], 3 A ;<.0,'/ "'I'ithin twenty (20) d.ys aft
,appellce(s), to Ii Ie a complaint in this appeal
RULE: To rrf.osr 11 All'. (ol/t) Ii )f()C/A f!.S . appelleels)
N,1nw of 8PPI111111.'(S)
{11 You are notified that a rule is hereby entered upon you to file a complaint in this appeal within twenty (20J days after the date of
service of this rule upon you by personal service or by certified or registered mail.
(2) If you do not file a complaint within this time, a JUOGMENT OF NON PROS WILL BE ENTER EO AGAINST YOU,
(3) The date of service of this rule if service was by mail is the date of mailing.
Date.,;().,t I 9 .19Q])
COURT FILE TO BE FILED WITH PROTHONOTARY
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COMMONWEALTH Of I'L:,'\J:jYl'/A!\IIJ\
COUNTY OF__
AFFIDAVIT:
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SWORN (AFFII1MlDI i'\~'JD SUD;-;CHJEL'D r)FTCJH! :',H':
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF: CUMB_~
..... 0..- No
09-1-02
I
NOTICE OF JUDGMENTITRANSCRIPT
CIVIL CASE
PLAINTifF: ~.wr: t1tll1ADOnfSS
fGROSSM.\N-COHN ASSOCIATES .,
BYE . BAR CNTR.
1857 CENTER STREET
~P HILL, PA 17011
VS.
DEFENDANT: "'Ml[ .ndAOORCSS
f1iORTING, MARY ANN, ET AL.
900 MOUNTAIN ROAD
DAUPHIN, PA -17018
L
Docket No.: CV-0000267-98
Date Filed: 6/22/98
OJ..... ....
ROBUT V. MANLOVB
....... 1901 STATE STRBBT
CAMP HILL, PA
......... (717 I 761- 0583
.J
17011-0000
.,
MARY ANN HORTING
900 MOUNTAIN ROAD
DAUPHIN, PA 17018
.J
.
THIS IS TO NOTIFY' YOU THAT:
Judgment:
~ Judgmenl was entered for: (Name)
~ Judgment was entered against: (Name)
.
.
DRFAUY,T ,rrmGMRNT pr.TF
~pnRRMA>>.~nRN ARRn~TA~~~
Fnm.T?, t.-nART.RR R
in the amount of $
1 qnn An on:
(Dale 01 Judgment)
1 n/nq /qA
o Def~ndants are jointly and severally liable.
o Damages will be assessed on:
(Date f3. Time)
Amount of Judgment
Judgment Costs
Interest on Judgment
Allorney Fef.s
Total
$ 1.715.00
$ 185.80
$ .00
$ .00
$ 1.900.80
o This case dismissed without prejudice.
'.\
O Amount of Judgment Subject to
AllachmenVAct 5 of 1996 $
Post Judgment Credits $
Post Judgment Costs $
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o Levy is stayed for
days or 0 generally stayed.
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o Objection to levy has,been filed anQhearing will be held:
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Date: Place:
Certified Judgment Tolal $
Time:
ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE EN;'RY OF JUDGMENT BY FILING A NOTICE
O~ APPEAL WITtI THE PROTHONOTARY/C ERK OF THE COURT 0 OMMON PLEAS, CIVIL DIVISION. YOU
S IPT FORM WITH YOUR NOTICE OF APPEAL.
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My commission expires first Monday of January,
Aope 3 t 5,96
NOTICE OF APPEAL
COMMONWIALTH OF PINNSYLVANIA
COURT OF COMMON PLEAS
C()MIJI:.~{,Aw" Cill/WrY
JUOICIAL OISTRICT
FROM
DISTRICT JUSTICE JUDGMENT
COMMONPLEAS~:!-,-qe_ tr,2_~() CUI ./ T~
NOTICE OF APPEAL
~;> llco Is given that the "ppullan1 h..s hIed in llw ..hove COUlt uf Commun Ph!ilS an aPPc,lllrulI1 tht: judgment Hmdcled hy the District Justice
~L; 00 thu date .mlln tho caso mcnti"nl1d Imluw.
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~~;if11A~tANlI /(Cf:(JII6- "NO BJ< IAN ( (OUI. il.
~~t7:..~oo7:t(7)NrAIN !,Ollf) _~~/I//AI /JA /,#;it
,<_,":,' g"l'. 1II1"V a.c ,. IN 1'"_ CA.. 0,. "'...,_,'" ,t~......._"
, fa q 11 GIt. SJI1AN'{OI/N I1S5wA{E.S_voNAI.'I ANN //o/lIA/ff, (;.1 Ilt..
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!::} ,~~This block will be signed ONL V when thi!t notation is required under Pa.
R.C,P.J,P. No. 1008B,
: ,This Notice of Appeal, when received by the District Justice, will operate as
'i.a;SUPERSEOEAS to the judgment for pO'Ssession in this case.
M..\g.~;;O.-O" "'I". ... u.'.
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If appellant was Claimant (see
No. 100116} in action belore District Justice, he
MUST FILE A COMPLAINT within twontY (201'
days of tor filing his NOTfCE of APPEAL.
Signature of ProthUflotaf'l Of Deput'l
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~gt;.' " PRAECIPE TO,ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
i~F}T~ls:soction "f form,to b~ usod ONL Y weon appol/ant was DEFENDANT (soo Po, R.C.P,J.P. No. 1001171 in action boforo District Justice,.,,;,
~i).;'r,NOT USED, riotach fro"'.~opy of notice of 01'1'001 to bo served upon oppel/eel. I "
~g'iPRAECIPE: To Prothonota,y , ,
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~;K.", ,Enter rule uponGi<Orr tV AN-{oll/v /1 Ho( I A 1L S
~(: ~,:"",,:,:_,,,,,,_, _, '/'1 ~e 01 iJPpe/ft1tds)
~;~>lco~m~n 'Pleas No.9? -1_'3?' (') V;u; I /. Ill'lf-"ithin tw"nty (201 days af rv of judgment of non pros.
i~iC- ."gent,
'J.j':RULE:TOG-f<Or;rMAfJ'(OfIN l1r;r{)(IAfL) ,appelleels) \.,,' . ";,
~;:;:.. Name.f appellocl,)'\-'.'" "~ '- '\- - .....,.,~~I',-f; .l..:>---.;. ,
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~~~:,,()) You, ~re notified that a rule is he,eby entered upon you to file a comPlai~t in this app;ai'~;thin' t~'c\ntv'(20) davslalter the d~te ~I"A
,rtfservlce 01, this rule upon you by personal service or by ce'tified or registe,ed\ ~~:.L':',:" ;:. '::'::',',::!,;~; ',~ ,- ,; ",1 "
~}(,:" (21 II;jO~ do no\ li!e a~omPlaint within this time. a JUDGMENT OF NON PROS WI LL BEENillEi:iAGAINsi:you:;J
t~':<~'::" (3) The_.~ate of service of this rule if service was by mail is the date of mailing.
~fGh,Date' /l },r q ,19QQ
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, appellee{sl. to file a complaint in this appeal
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COURT FILE
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PROOF OF SERVICE OF NOTICE OF APPEAL ANO RULE TO FILE COMPLAINT
(Thlsprool 01 servire MUSr BE FILED WITllIN rlvr t!ij [).l L,)' 1--1F rf:R fillllY tilt.' notlcf' uf "I'lll.'.,/. Clwck. .1fJ1JI/ColIJ/O IJOxo!i)
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\~OMMONWEAL T(f.F PENNSYLVANIA
.:~UNTYOF 'Auf M~c;(
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:#' AFFIDAVIT: IIH!fl'hy ~Wl!,)r or ;:lfllHll fh,;!l I served
o "copy 01 the ~!.;ce oJ.Appe.I, Coon m"o ~il' N:!,tj{::~'f}j(2, 01';0' II", D os'"ct Ju tice d sit n led therein on,
(date ofs/,'rvice)_EW._V . 19~'i-. LJ IV personal "{~rVlce f~ ercd)mail,sendcr.~s:
~li.1Ched Iwn:to, ilnd ll~l thl! lIppdl,!t~, (II,Jlm..)...... "::_.__.___~____~__. ... . on "
- 0/ . 19!!f- [J hy pmsollalservlcP [(.1 hy Icl!/ldicd) 1~;_ll,.".lIJlililil. semler's receipt attachrn.l'hc':'f;!fa.L.;"
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and furthur thJt I served tht' Rule ~ Curnpl.:lIllt aCCOI~)~1I1~_ ,the above Notice 01 Appeal upon t!l~ OPpcll~ols) to r"
whom the Rule W,IS addressed 011___ --~ -1- u_ __, 19 7-tf, l J by pl!rSOnill service rJ1 hy (certified) (.UI!j nt..,..~ \*
mail,.semler's receIpt attachlld hereto i'Y. ( :)j ,',)
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NOTARIAL l
ONORA+.Nrrr. NOTAR': PIlBUO
, , C~RUSlE BORO, CUMBERLANO COUNTY
, '~e~~ISSfON EXPIRES NOVEMBER \~ 1999
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OIlSlll Q. Alford, Esquire
Surremc Court I.D. '38~90
OOSWEl.I., TINTNER,I'ICCOI.A & WICKERSIlAM
31~ N. front Sncct
PO 00.74\
Harrisburg. PA 1710lHJ741
(717) 231>-9377
Allomc~ for Pbiotitf
GROSSMAN.cOIlN ASSOCIATES,
PLAINTIFF
: IN TIlE COURT 01' COMMON PLEAS
: CUMBERLAND COUNTY, PENNSYLVANIA
: NO, 9~330 CIVIL TERM
v.
BRIAN FOUL TZ &
MARY ANN HORTING,
DEFENDANTS
: CIVIL ACTION - LAW
NOTICE
YOU HAVE BEEN SUED IN COURT. If you wish to defend against the
claims set forth in the following pages, you must lake action within twenty (20) days after
this Complaint and Notice are served, by entering a written appearance personally or by
attorney and filing in writing with the Court your defenses or objections to the claims set
forth against you. You are warned that if you fail to do so. the case may proceed
without you and a judgment may be entered against you by the Court without further
notice for any money claimed in the Complaint or for any other claim or relief requested
by the Plaintiff. You may lose money or property or other rights important to you,
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
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5, On July 18, 1996, Defendanl had surgery, performed by Grossman-Cohn
Associates, the charge for which totalled $1,600.00.
6, Thc total bill for services rendcred by Plaintiff Grossman,Cohn Associall:s
to Brian Foullz on 7/2/96 & 7/18/96 was $1,715,00,
7, Despite Plaintiffs numerous attempts to collect this amount duc,
Defendant Brian C. Foullz has continuously failed and rcfuscd to make any paymcnt to
Plaintiff.
8. Defendant is liable to Plaintiff for breach of contract for his failurc 10 pay
professional serviccs rendered by Grossman-Cohn Associates on July 2 & July 18, 1996.
WHEREFORE, Plaintiff requests judgment in its favor and against Defendant
Brian C. FouJtz, in the amount of $1,715.00, which amount does not exceed the
compulsory arbitration limits of Cumberland County, plus costs of suit.
RESPECTFULLY SUBMITTED,
BOSWELL, TINTNER, PICCOLA & WICKERSHAM
B l. /,7 ~ . ,
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Brigid Q/ Alford, squi
Attorney for Plaintiff
Grossman-Cohn Associates
DATE: November 30, 1998
,,,.
11/30/98 11:12
'5'717 236 9316
DTP&W
~003/003
GROSSMAN-COHN ASSOCIATES,
PLAINTIFF
v.
: IN TIlE COURT OF COMMON PLEAS
: CUMBERLAND COUNlY, PENNSYLVANIA
: NO. 98~30 CML TERM
BRIAN FOULTZ &
MARY ANN HORTING,
DEFENDANTS
:
: CML ACTION - LAW
VERIFICATION
I, Ronald Grossman, M.D., hereby verify that the facts contained in the foregoing
Complaint are true and correct to the best of our knowledge, information and belief. I
understand that false statements herein are subject to the penalties of 18 Pa.C.S.A. ~4904
relating to unsworn falsification to authorities.
~~ '
ONALD GROSSMAN, M.D.
DATE: 11- Jo -qy
Recieved Time Nav.3D. 12:06PM
,
. CompI.e It;,", t ancVOt 2 lor additional ..Nice..
'~It. Il,/'nf 3, .... and <lb.
'Prll'lI youtname and add'.1I on the reveraa ollhlalorm 10 thai we can retum lhill
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Anach tN, form to ,,,. fronl ollhe ma/lplece, or Olllhe bact it lPiOtl doflI not
. rlt.oR.wm ReceIpt RsqUftted" onlhe mal/piece below the attlcle nutnbor.
. Return Receipt wi" Ihow 10 whom the 11flchl wa. delivered 4Ild the dale
dellvettd.
I also wiSh 10 receive the
following selVfces (for an
extra fee): .
1. 0 Addressee's Address .f
2. 0 Restricted Delivery 1
Consult POSbnaster for foe. S.
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o Reglste,ed
o Express Mall 0 Insured
o Relum Race/plfor Merchandise 0 COD
7. Dale of DeliverY ~/
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B. Addressee's Address (Only If requBsted
and fee Is paid)
~ed
10'59597.017' Domestic Return Receipt
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Brigid Q. Alford, E"luire
Suprcmc Courl LD. #38590
BOSWELL. TINTNER, PICCOLA & WICKERSHAM
315 N. Frolll Slrccr
PO Box 741
Harrishurg, PA 17108'(]74I
(717) 23b-9377
Allorncys for PlailllilT
GROSSMAN-COHN ASSOCIATES,
PLAINTIFF
v.
: IN TilE COURT OF COMMON PLEAS
: CUMBERLAND COUNlY, PENNSYLVANIA
: NO, 98~330 CIVIL TERM
BRIAN FOULrl,
DEFENDANT
: CIVIL ACTION - LAW
CERTIFICATE OF NOTIFlCATlON
I, Denise L. Foster, Paralegal, do hereby eertify that I served the Defendant
Brian Foultz, with the Notice of Intelllto Take Default Judgment, sending same by first-
class mail, postage prepaid to his attorney, George W. Porter, Esquire, and his last
known address:
GEORGE W. PORTER, ESQUIRE
909 E. Chocolate Ave,
Hershey, PA 17033
BRIAN FOULTZ
900 Mountain Road
Dauphin, PA 17018
A eopy of said Notice is attaehed hereto,
BOS L, TINTNER, PICCOLA & WICKERSHAM
By:
DATE: January 13, 1999
OIWSSMAN,COHN ASSOCIATES,
Plailltiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
NO. lJH,r>3JO CIVIL TERM
BRIAN FOULTZ
Dcfclldallt
CIVIL ACTION - LAW
NOTICE
YOU HAVE BEEN SUE)) IN COURT. If YOII wish to defclld agaillst Ihc claims sct
forth in the following pagcs, YOII must lakc actioll withill twcllty (20) days after Ihc Complaint
and Notice are served, by ellterillg a written appcarance pcrsonally or by allorncy alld liIillg in
wrilillg wilh thc COllrt YOllr defcllses or objeclions 10 thc claims set forth .Igainsl YOII. Yon arc
warncd thaI if you fail to do so, thc case may procecd without you and judgmcllt may hc enlcrcd
against you by the court without further notice for any money clairncd in thc Complainl or for
any other claim or relief requestcd by thc Plainliff. You may losc moncy or property or othcr
rights important to you.
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.
Cumberland County Bar Associution
2 Liberty A venue
Carlislc, Pcnnsylvania 17013
Telephone (717) 249-3166
AMERICANS WITH DISABILITIES ACT OF 1990
TIle Court of Common Picas of Cumberland County is required by law to comply with
the Americans with Disabilities Act of 1990. For infonnation about aceessible facilities and
reasonable accommodations available to disabled individuals having business before the court,
please contact our office. All arrangements must be made at least 72 hours prior to any hearing
or busincss before the court. You must attend the scheduled conference or hearing.
James J. Kayer, Esquire
Altomey for Plaintiff
Liberty Loft
4 E. Liberty A venue
Carlisle, P A 17013
(717) 243-7922
thc cxtcnt th.11 a rcsponsc is decmcd ncccssary, Dcfcllllant dcnies Iiahility dnc to Ihe facl thaI
he was not a contractual party for scrvices rcudercd ou his hehalf hy thc Plaiuliff.
WHEREFORE, Dcfemlulll rcqucsts that this Houonlhlc Court rulc in his favor ami
dismiss thc Complaiul.
Nf:W MATTER
9. TIle Dcfcudant iueorporatcs by rcfcrcucc thc avcnncnts sct forth in Para~n1phs
Ihrou~h 8 of his Answcr as if fully sct forth hcrcin at Icngth.
10. TIlt: Defcndalll at thc time that profcssional scrviecs were rendered upon him was
a high school student, eighteen (18) years of agc, and living primarily with his mothcr, Mary
Ann Horting.
II. Defendant did not initially select Grossnmn-Cohn Associates to perform thesc
services, did not initiatc contact with Grossman-Cohu Associutes for serviecs, did not execute
any contract or agrecment for paymelll of scrviccs to Grossman-Cohn Associates and at no
time has undertaken any affinnative action that would indicate his agreement to accept
liability for services rendered by Grossman-Cohn Associates.
12. Defendant's mother, Mary Ann Horting, cxecuted all documents requested by the
Plaintiff with regard to contracting for serviccs, as well as provided the Plaintiff with
information pertaining to her hcalth insurance providcr, and the health insurance provider
cOlllracted by Defendant's natural father.
13. Defendant's mother, Mary Ann Horting, submilled insurance documents to her
provider, Keystone Health Plan as well as the Defendant's father's provider, Central
Pennsylvania Teamsters Health and Welfare Fund (hereafter referred to as "Teamsters").
14, Defendant's mother, Mary Ann Honing, provided the Plaintiff with the specific
",.
documents requested by Plaintiff with regard to the profcssional scrvices that Plaintiff
would provide. Denied that Mary Ann Honing providcd Plaintiff with information
regarding her health insurance,
13. Denied, Plaintiff. on behalf of Defendant and as a courtcsy to him,
submitted the information to Defendant's natural father's health insurancc provider
(hereinafter referred to as "Teamstcrs').
14. Admitted in part and Denied in part, It is admitted that Mary Ann
Horting supplied Plaintiff with the information regarding the Teamsters insurance, It is
denied that she provided information regarding her insurance to Plaintiff at Defendant
Brian Foultz's initial office visit. Plaintiff further denies any implication in this
paragraph or in any previous paragraphs that it has received insurance payments on
account of any of the services provided to Defendant; it has not.
15, Admitted.
16. Denied, Defendant willingly presented himself for surgical procedure and
received a benefit from the same. The balance of Paragraph 16 sets forth a conclusion
of law to which is response is required.
WHEREFORE. Plaintiff respectfully requests that this Honorable Court enter
judgment in its favor and against the Defendant, Brian Foultz.
RESPECTFULLY SUBMITTED.
BOSWELL, TINTNER, PICCOLA & WICKERSHAM
BY:
DATE: February /.2, 1999
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