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HomeMy WebLinkAbout00-05156 ::: '-:, F:\FILES\DATAFILE\DONBGAL.DOC\I66-com ~ 071I11OO10:49:15AM Revised; 07/111OO11:0S:SSAM JOANNA DANNER, Plaintiff v. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW - NO. 06-5/SIiOvU JURY OF TWELVE DEMANDED KEVIN ULSH, Defendant, NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take 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 Plaintiffs. You may lose money or property or other rights important to you. YOU SHOULD TAKE TillS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE ALA WYER 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 Association 2 Liberty Avenue Carlisle, Pennsylvania 17013 Telephone (717) 249-3166 LIAMS & OTTO By Ge . Faller, Jr., Esquire I.D. Number 49813 Ten East High Street Carlisle, P A 17013 (717) 243-3341 Attorneys for Plaintiff Date: July 22, 2000 -,i"j,o~ , '-'Z,.- JOANNA DANNER, Plaintiff v. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. (J-O- :)/.5-(.. &;;;e I~ KEVIN ULSH, Defendant, JURY OF TWELVE DEMANDED COMPLAINT 1. Plaintiff is a married adult individual residing at 129 Bridge Street #2, New Cumberland, Cumberland County, Pennsylvania 17070. 2. Defendant is an adult individual residing at 409Y:. South 4th Street, New Cumberland, Cumberland County, Pennsylvania 17070. 3. On or about February 17,2000, Defendant owned and operated a 1988 Ford Festiva. 4. On or about February 17,2000, Defendant Ulsh was operating his 1988 Ford Festiva when he removed his eyes from the road, not noticing traffic had stopped, and collided into the back of Plaintiff Joanna Danner's 1991 Ford Ranger, which was stopped on the roadway. S. The aforesaid collision occurred solely as a result of the negligence, recklessness and carelessness of Defendant Ulsh and was due in no manner whatsoever to any act or failure to act on the part of the Plaintiffs. 6. The aforementioned negligence, recklessness and carelessness of Defendant Ulsh consisted of the following: a. failure to operate his vehicle in such a manner as to avoid striking the Plaintiffs' vehicle; b. failure to have his vehicle under proper control; c. driving his vehicle in a reckless and careless manner; and d. failure to exercise reasonable care in the operation and control of his vehicle. 7. Ai; a direct result of the aforesaid negligence, recklessness and carelessness of Defendant Ulsh, the Plaintiffs' vehicle was damaged in the amount of $1,620.03. , . ",--'-, - 'M: WHEREFORE, Plaintiffs demand judgment against Defendant Kevin Ulsh in the amount of$I,620.03, plus interest and costs as allowed thereon by law. MARTSON DEARDORFF WILLIAMS & OTTO By Georg .' aller, Jr., Esquire 1.0. Number 49813 Ten East High Street Carlisle, P A 17013-3093 (717) 243-3341 Attorneys for Plaintiff Date: July 21, 2000 ~,>~~ ,- ,. ,,~ """~,' .' . VERIFICATION The foregoing Complaint is based upon information which has been gathered by my counsel in the preparation of the lawsuit. The language of the document is that of counsel and not my own. I have read the document and to the extent that it is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the content of the document is that of counsel, I have relied upon counsel in making this verification. This statement and verification are made subjectto the penalties ofl8 Pa. C.S. Section 4904 relating to unsworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. F:\FILES\DATAFILB\DONEGAL.DOC\I66-cmn "" "~'.' lItml...JI:W.lI!ill*~~~'~'o~;f MU'fj(m~liI!Jlf""~""'~~~lIIi~naii:ll!l~HMfjj "'1ll!-.~'1 ::;\)~ ~J'" ~ ~ ~:t -SD-C) t)-l) ~\9t.~ ~~~ ~ j- S \:::J ~ ~ o 1III!R1i1lililllil-1lII o c: :;;:: urn j,~! ~f~~.i ~~~C" L_ {-~, >c ~ ~: ilMtOIIiIdi" (:"',J c:> '- c ,- ", ""D 'I' . '. "",,"". o -on .--J ,':-r - --.L,..' r:- ~ -~ ,.!.., ':j:./- :.\'-~ p-;", j (j\-n c::> ~.-\ dO ==-< {..J RECEIVED JUL 1 7 2000 IVIOW0 .' " SHERIFF'S RETURN - REGULAR CASE NO: 2000-05156 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND DANNER JOANNA VS ULSH KEVIN DAWN L. KELL , Sheriff or Deputy Sheriff of Cumberland County, Pensylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon ULSH KEVIN the DEFENDANT , at 1953:00 HOURS, on the 27th day of July , 2000 at 409 1/2 SOUTH 4TH STREET NEW CUMBELAND, PA 17070 by handing to KEVIN ULSH a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 18.00 10.54 .00 10.00 .00 38.54 So Answers: ?'"~ ~~~ R. Thomas Kline Sworn and Subscribed to before 07/28/2000 MARTSON DEARDORFF WILLIAMS \J~ ih~r~ By: me this J~ day of (Lr;::< .;:L1JV7) A.D. Qx.,Q. /u,~;~; othonotary / ~.' " ',' " F:\FILESIDATAFILE\DONEGAL.DOC\166_pra.1 Created 09/18/011O:50:39AM Revised: 09/18/01 11:42:31 AM 3050.166 JOANNA DANNER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. 2000-5156 KEVIN ULSH, Defendant, JURY OF TWELVE DEMANDED TO: KEVIN ULSH, DEFENDANT You are hereby notified that on~~ 19 ,2001, the following Judgment has been entered against you in the above-captioned case. Date: 5:e...p1- 19/ J..o() I e.d-~~~.~ Prothonotary I hereby certifY that the name and address of the proper person to receive this notice under Pa. R. Civ. P. 236 is: Mr. Kevin Ulsh 409 - Yz S. 4th Street New Cumberland, P A 17070 JOANNA DANNER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA v. CIVIL ACTION - LAW NO. 2000-5156 KEVIN ULSH, Defendant, JURY OF TWELVE DEMANDED PRAECIPE TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Enter default judgment in the above-captioned action in favor of Plaintiff and against Defendant in the amount of 1,620.03, plus interest and costs of suit, as prayed for in the Complaint for failure to file an answer to Plaintiff's Complaint. I do hereby certify that a written notice of intention to file this Praecipe (in the form attached hereto) was mailed to the Defendant at the address indicated thereon, on April 25, 2001, which date was subsequent to the date default occurred and at least ten (10) days prior to the date of the Praecipe. MARTS ON DEARDORFF WILLIAMS & OTTO By George . Faller, Jr., Esquire J.D. Number 49813 Ten East High Street Carlisle, P A 17013 (717) 243-3341 Attorneys for Plaintiff Joanna Danner Dated: September 18, 2001 (?2) ~=:>) c::g ~ "'_d"" F:\FILES\DA Tf,FILE\DONEGAL.DOC\166_def.lImah Created: 04/25/01 04:21:34 PM Reville<!: 09/18/0111:03:49AM 3050.166 JOANNA DANNER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. CNIL ACTION - LAW NO. 2000-5156 KEVIN ULSH, Defendant, JURY OF TWELVE DEMANDED TO: KEVIN ULSH, DEFENDANT IMPORTANT NOTICE YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO TAKE ACTION REQUIRED OF YOU IN TillS CASE. UNLESS YOU ACT WITHIN TEN (1 0) DAYS FROM THE DATE OF TillS NOTICE, A JUDGMENT MAYBE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE TillS NOTICE TO A LA WYERAT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE FOLLOWING OFFICE TO FIND OUT WHERE YOU CAN GET LEGAL HELP: Cumberland County Bar Association 2 Liberty Avenue Carlisle, Pennsylvania 17013 Telephone (717) 249-3166 MARTSON DEARDORFF WILLIAMS & OTTO b By George . Faller, Jr., Esqu' LD. Number 49813 Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff Joanna Danner Dated: April 25, 2001 ~- ~ F:\FlLES\DATAFlLE\DONEOAL.DOOI66-aff.app Crealed 07l1ll0010:49:ISAM Revised: 03l1210104:16:S9PM JOANNA DANNER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA v. CIVIL ACTION - LAW NO. 2000-5156 KEVIN ULSH, Defendant, JURY OF TWELVE DEMANDED AFFIDAVIT OF APPRAISER COMMONWEALTHOFPENNSYLVANIA ), : SS. COUNTY OF ) Personally appeared before me, a Notary Public in and for the said Commonwealth and County,M,(Ia.~.s. V, Snt-tI S/""JC- who, being duly sworn according to law, does depose and state that he is a licensed appraiser; that the appraisal of $/ (. Z~ O...littached hereto is true and . correct and accurately sets forth the damages to the value oftheJ 991 Ford Ranger owned by Joanna Danner and; that he has been engaged in the appraisal bus~ess for 11- years and is qualified and capable to evaluate the appraisal as attached; and value indicated thereon was the amount by which the damages to this automobile would fairly and reasonably have been evaluated. YI,tf1l .~ Sworn to and subscribed before ( . me this 3A"day of fl-P':- IL I '3;-cl rJ &1~A-b f-I .~Zlv/xk Notarial Seal Eug",e A. Kostelac, Sr., Notary PubHe lMeellon Bor~ "puphin Caunty . My Commlssicf. 'ores July 7, 2003 ___.w_ ~ """,J ~TARSINIC APPRAISAL SERVICE Auto .. HeavyEquipment . Home' . . ,. , POST OFFICE BOX 7462 . . STEEL TON, PA J7113-0462 7~8Q1, FAX 717.9$1a9~.. DaIllBg. "'..seed By: Nicholes V. Slarsinic Condition CocIs: Goad ~olLoas: 2/17/00 C_D8te: ~ D.ductib/s: UNKNOWN F//e"'umber: A8<<Il!l-48 ClaIm Hum"": PAElJ52205G.4O Appralsscl Far: STEVE DONEGAL ":...~" 1M DaIs: 2/BIOO 12:12 PM EstI_ID: A&03214 EstImate Version: 0 ~' PraliIs 10: CUSTOMIZED Type 01 Lase: ColJi8ion Insured: JOANNA DANNER Address: 129 BRIDGE STR.1I2 NEW CUMBERLAND, PA 17070 T.leph.....: Work Phan.:(717) 772-21123 Home Phone: (117) 7704454 O_plion: e"", SlyI.: VlN: Mileage: OEM/ALT: Color: Optiona: M_II Servic.: 914620 1991 Ford Asnger 20 Pkupl(Cb 6' B.d 125" _ DrI\Isr",ln: ~.lIL lni 6 Cyf 2WD ~=4UOMPA91oo1 ~''qi~ PA A Saen:h Cod.: Bl7113 ~J~~":LS, POWEll SfEERING; po. BRAKES,,~ ~~o CASlii~~}~ 4 SPEED MANUAL lRAJrISMISSION, V6 OveR 4 CV42-DOOR P1CKilP ,', .'Co ..' Une Entry Labor Item Number 1YJIe REF BOY. FRY. MCH. BOY. BDY. BOY REF BOY. BOY. BOY BOY BOY BOY. REF BOY BOY BOY BOY BOY BOY BOY ,-- 426510 2 900500 3 900500 4 900500 5 900500 6 !lOCl5OO 7 429470 8 AUTO 9 900500 10 900500 11 430470 12 430560 13 432750 14 900500 15 16 17 18 19 20 21 22 AUTO 433140 433190 433210 433220 433230 433240 Operation REFINISH REMOVEIAEPLACE REPAIR REMOYe/AEPLACE REMOVEIAEPLACE ADD'L LABOR OP REPAIR REFINISH REMOVE/lNSTALL REPAIR REMOVE/lNSTALL REMOVE/lNSTALL REMOVEJREPLACE REPAIR REFlNISHIAEPAlR OVERHAUL REMOVEJREPLACE REMOYe/AEPLACE REMOVEJREPLACE REMOYe/AEPLACE REMOYe/AEPLACE REMOVE/AEPLACE "r,.;-:t, Lini> Item .~_:._,_,.,..i. " It CAB CORNER PANEL 2 SPLAsH GUARDS . SET-UP,PULL & SQUARE FRAME FOUR WHEELAUGNMENT CAR COVER EXTERIOR STRIPING R PICKUP BOX SIDE PANEL R BED SIDE PANEL OUTSIDE BED ASSY. FOR REPAIRS AT CAB CORNER TAILGATE ASSEMBLY TAILGATE FINISH PANEL R UCENSE LAMP ASSEMBLY TAILGATE - LOWER TAILGATE - LOWER REAR BUMPER ASSY REAR BUMPER FACE BAR REAR BUMPER STEP PAD R REAR 01l'l BUMPER MOUNTING ARM L REAR 01l'l BUMPER MOUNTING ARM R REAR INR BUMPER MOUNTING ARM L REAR INR BUMPER MOUNTING ARM ESTIMATE RECALL NUMBER: 2/28/00 12:11;55 AS-0321-49 UItraMate is . Tr.d.mark af Mitch.lllnternelianet Mitchell O.ta V.rsion: FEB_OO_A Copyright (C) 1994 -1999 Mitch.lllntern.tionsl All Rights Res.rved ,,,.ftpw 'l!'lcisllng Subl.t Sublet Subl.t Exieting Dotlsr Labor Amaunt Unila 2.0 17.54 * 0.4* 6.0* 59.95 .. 0.0* -, 3.00. 0.0* 35.00 . 0.3* 5.0*. 2.8 1.5* 2.0* 0.2 0.6* 5.87 INC. 2.5* 1.0" 1.3 200.95 INe 55.55 INC 11.57 INC B.57 INC 12.47 INC 12.47 IHC Existing ExIsting ExIsting N.w Existing New New New New N.w N.w Page 1 af 3 -,.".~ .~~,' ~~ ~ " "~- " "'i'Mm- .~STARSI , Auto." '.,' . A. t-'t't'<AI::iAL ::iI=KVIL;t:. .' rl1iJipfrJ"nt ., f'!or(J/J' " ''''CEi6X1462 , . '. ..; '11'113-0462 . " f~t;;0j',\,FAX;l~!~1't~;, . ~!~:'.. 23 93_ 24 93300D REF 25 933002 REF 28 AUTO 27 AUTO ADD'L COST ADD'L OPR ADD'LOPA ADD'LCOST ADD'L COST RUST COATING lWO TONE CLEAR COAT PAlNT/MAT1alIALS HAZARDOUS WASTE DISPOSAL Date: W28/OO 12:12 PM Estlmat8 10: AB-032t_ Estimate Version: 0 eamm_ . ProliI.,D: CUSTOMIZED 10.00 - 1.0* 1.0* 129.20- 3.IlD - -. Judgement Item ". Labor Note Applies Aemarks LKO PARtS NOT COST EFFECTIIIE Prior DBmagl AT BED SIDE. UPPER. 4.0 .;,.Ik... ;,,' ",.......,c:;:., ,. ,l.',;,',''::u_'':' , . · ,P~ ' <>UDN' ...j, ~~ ~';fi~!.~~,~:.r~~::: T..::Jf~ .,...,. . .0:00, ti'~~.i':T;l~...Ti LlIbar Tax .,;;, 6.lICID 'l(, 62.00 "f~':, ':'<,.-', I. I..8bor Sublolllla Blidy Rlnnish Frame Arnou @ 8JlCIO'l(, - ~ 3:11 I 21 i 372 I --~,_.. ,-, --J;: I..8bor Summary :l7A 1,095.40 \D. Additillll8lCosts T_IICoa1s SIll.. Tax @ 6.1KIO'lI. Amount 142~ B.53 IV. Adjuolmlnts CUstom.. A8BpDn1ibHitJ Arnou c TDIlII Additionll COBia 150.73 I. II. m. TDlIII Labar: Tolal A~mlnt Parts: Total AddItion" Costs: GrDB8 Talal: 1,09!i i 3'7.3 i 1541. l,62C' IV. Total Adjustmlnts: Nat Total: C l,62C PDint!a) 01 Impact 6 RIBr Clnter (P) ESTlMA TIE RECALL NUMBER: 2/28/00 12:11:55 A8-0321-49 UltraMate is a Trademerk al Mltc:helllntemationa' Mitchell Oeta Versian: FEB_OO_A Copyright (C) 1994 .1999 Mitchelllntomlllional All Riglrts Reserved Page 2 of 3 ,",i~__'"'"""~' - . ,". '. ~. ~~'l1k!I~' ',STARSINIC APPRAISAL SERVICE . . . Auto. HeavyEqu;pment . Home' POSTOFftCE BOX 7462 " ,$TEElToN~ PA ~7113-0462 &-9891!.;;"" FAX 717~39-1992 .,. DatIt: 2128/00 12:12 PM EsllmatelD: A8-03214 Eatlmate VarsiDn: D Commltlad Profile ID: CUSTOMIZED Inspac:tlan Sibt: RESIDENCE Inspac:tlan Date: ~ BodyShop: LS SMITH FORD Address: 12111 a MARKET STR. LEMOYNE, PA 17043 TJi"phGne: (717) 761-6700 ffW ..., bf - c'fi' ~ '1 UPAnl COST DISCLOS1JR&:: Costs above the appraised amount _y be the responsibil.ity of the vehicl.e owner regarding ol.d/unrel.ated items, dep:r:eciation/betterment or any amountS' above "hat is :r:easonabl.y necessary to restore the vehicl.e to pre-l.oss coDdition. PENNSYLVANIA DISCLOS1JR&:: AU'l'BOlUZATIOH TO RBJ'AIll: This is not an aq~riZati,oA to ~~! veblcil.e' Me:'~ responsibl.e for authorizing !!ihbp to ~in repairs'. If vehic1e owne~~ls a third party or cl.aimant:i,' the inS1U:~el;<l~y sJloul.ci!llEt goq~~~d to confirm l.iabili t1' coverage before aut:norilllUl9~i.:ts \" &. , CUSTOMER. CHOICE OF SHOPS: Selection of the repair shop is the responsibil.i ty of the vehicle owner. Vehicl.e owner is under no obl.iqation to use any specific repair shop. Starsinia Appr. ",ill. provide, upoa request, infolmation regarding repair facilities that "il.l be abl.e to repair the vehicl.e for the appraised amount. - APPJ<ll...Jlf/ ~ PH<c:tt:/ ....vy-kIP a.i<-4 ~ 1 q COpy TO: INS. C - 0 UPAl DATBO< .....;l u:....uo ~ . ESTIMATE RECALL NUMBER: 2128/00 12:11,55 AB-0321-49 UIlraMata la a Trademark af Mitchelllnternalianal Mitcholl Data Vorsian: FEB_oo_A Capyright (Cl 1994 .1999 Mitcholllntarnatianal All Rights Resarwd pag03"'3 COMMONWEALTH OF PENNSYL VANIA S.S. COUNTY OF CUMBERLAND George B. Faller, Jr., being duly sworn according to law, deposes and says that he is an employee of MARTS ON DEARDORFF WILLIAMS & OTTO, attorneys for the Plaintiff in the above captioned matter and that pursuant to the provisions of the Pennsylvania Rules of Civil Procedure, a notice of intention to assess damages against the Defendant was given to him via first class mail on April 25, 2001. Attached is a true and correct copy of said letter. Sworn to and subscribed before me this day of ,2001. Notary Public ~ (q ~ ~ . - - i,j~: " ' \ M~&:6 AlTORNEYS & COUNSELLORS AT lAw W,LUAM F. MARTSON JOHN B. FOWLER III EDWARD L. SCHORPP DANIEL K. DEARDORFF THOMAS J. W'ULWS . lvo V. Orro III GEORGE B. FAUERJR.. CARL C. RJSCH MARK A DENLINGER "BOAIlO CERTIFJEO CML TIUAL SPECIAUST TEN EAsT HIGH STREET CARLISLE, PENNSYLVANIA 170 I3 TELEPHONE (717) 243'3341 FACSIMILE (717) 243-1850 INTERNET www.mdwo.com April 25, 2001 Mr. Kevin Ulsh . 409-112 S 411t Street New Cumberland, P A 17070 RE: Joanna Danner v. Kevin Ulsh No. 2000-5156 - Cumberland County C.C.P. Our File No. 3050.166 . Dear Mr. Ulsh: Enclosed please find a Notice of Intention to file a Default in the above referenced matter. Please note that you have ten days from the date of this letter to respond or a Judgment may be entered against you. . . Very truly yours, MARTS ON DEARDORFF WILLIAMS & OTTO George B. Faller, Jr. GBF/mah Enclosure cc: Ms. Christine E. Myers (PAE 052 20 56 [62]) F:\FJ.LESIDA TAFILE\DONEGAL.LTR\166-ku_1 INFORMATION. ADVICE. ADVOCACy'M , ~ n__ ' :;; CERTIFICATE OF SERVICE I, Melinda A. Hall, an authorized agent for Martson Deardorff Williams & Otto, hereby certify that a copy of the foregoing Praecipe was served this date by depositing same in the Post Office at Carlisle, P A, first class mail, postage prepaid, addressed as follows: Mr. Kevin Ulsh 409 - Y2 S. 4th Street New Cumberland, P A 17070 MARTSON DEARDORFF WILLIAMS & OTTO By / f!U~ () uM1 Melind A. Hall Ten East High Street Carlisle, PA 17013 (717) 243-3341 Dated: September 18,2001 Hi--' ~'~~~':\i.f-'~~~~~~1~1iI.~.1-'-~""''''"",<'''I' ~~I.~-^ ~..~""'" ~ .- -. -~ " """...... - 0 - ~- .~~ .- - 0 CO r' ,.' ~ ,e.> (.) ~ c: ~n :?: V) "-.-! fi:- ~ -oeD f"'1 ,. . mr;-\ " r ~ Z:I7 -Yjrn - ~~~~ \.,C: -;-'\f~J r ..Q ~-{)~ ~ ()U <CJ ~ ;;-p "'- ec' ~" )-:G ...... "::"c:" ~ ,.... ~ >c '"' ell" r 0;::1 {' Z r- ~ =< ()1 :< AJ -' - Ct, Ri' r . ~' ~~ -,,' ~mli',~ .. I. F:\FILES\DATAFIl..E\DONEGAL.D00166_aff.l/nlm Created: OII3l/0201:58:46PM Revised: 0l/3110202:02:02PM 3050.166 JOANNA DANNER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA v. CNIL ACTION - LAW NO. 2000-5156 KEVIN ULSH, Defendant, JURY OF TWELVE DEMANDED AFFIDA VII The judgment in the above captioned action arose from a motor vehicle accident. By George B. Faller, Jr., E e LD. Number 49813 Ten East High Street Carlisle, P A 17013-3093 (717) 243-3341 Attorneys for Plaintiff Joanna Danner Date: January 31,2002 ,~~, " ~~ . ~--~~- ""'" ,. "%,- . ~~(O)(P)l DL-201 (10-97) CERTIFICATION OF COURT INFORMATION Bureau of Driver Licensing COURT Civil Action P.O. Box 60037 ' MOTOR VEHICLE JUDGMENT Harrisburg, PA 17106-0037 COUNTY Cumberland TO THE SECRETARY OF TRANSPORTATION NUMBER 2000-5156 September 19, 2001 YEAR 2000 This is 10 cerli Ihalon 'ud tor $ fy $1,620.03 (AMOUNT) I $ interest pus (COST) (Please use a separate form for each) JUDGMENT DEBTOR (Please Print or Type) a J gmenl and costs was enlered againsllhe following: NAME SEX DATE OF BIRTH FIRST I M~DDLe LAST MONTH I DAY I, YEAR Kevin . Ulsh M 110 03 69 ADDRESS 409- 1/2 S. 4th Street CITY STATE ZIP CODE SOCIAL SECURITY NUMBER New Cumberland PA P070. 119121-51 2 I-I 6 1112 16 DRIVER NUMBER ,. . ST4TE DATE .OF ACCIOENT . CLAIM NUMBER 221 05 906 PA February 17, 2000 IPAE0522056 (62) o Check this block if defendant is a resideht of another state (CITY & STATE) (7 P) 426-1931 (ZIP) REPRESENTATIVE FOR THE JUDGMENT CREDITOR (If applicable) George B. Faller, Jr., Esquire MARTSON DEARDORWNWtLLIAMS & OTTO Ten East High Street (STREET ADDRESS) Carlisle, PA 17013 (CITY & STATE) (ZIP) (717) 243-3341 "- 'Ch f' JUP~MENT CREDITOR ,..s. rs,t1fleUMyell!s c/o Donegal Companies (NAME) 1195 River Road, P.O. Box 302 (STREET ADDRESS) Marietta, PA 17547 (TELEPHONE NUMBER) (TELEPHONE NUMBER) THE ABOVE MENTIONED JUDGMENT AROSE FROM A MOTOR VEHICLE ACCIDENT. SIXTY DAYS HAVE ELAPSED SINCE THE ENTRY OF SAID JUDGMENT, AND THE SAME HAS NOT BEEN SATISFIED OF RECORD AND NO APPEAL HAS BEEN TAKEN THEREFROM. IN WITNESS WHEREOF, I have hereunlo affixed my hand and seal of the caurt this Day at 19_ (SIGNATURE OF CLERK OR JUDGE OF THE COURT IN WHICH THE JUDGMENT WAS RENDERED) SEAL {TYPE OR PRINT N"'ME) RETURN COMPLETED FORM TO: Bureau of Driver Licensing, P.O, Box 60037, Harrisburg, Pennsylvania 17106-0037 ilI1B1 '~_.~'=",ji;lll!I\ll;lihfjilj>1lii1 -^....~"""""",,~~~~~t~. -~.. '.'11:....'.,;.- -'~ ~-, '......iliIIMllj (") <::) -c> C N r:~ ~ <'" "" "1Ji-r .." -_.~ 79 !>v nlr-r": CT1 -.,-. ~l G:] f->1~ h- e> Z~]> ~~~ I ~g~ "- 0 I ,_1 <C) '~:j.Q .\': -- ="" ~ ...- ,~ c~-H ~ -V ~7C) "-:;t'" ..-{-." -"-0 >'--' '2 Ci01 ~ F c )... ~ -; Si ".. e 0'" (::> ::n - , -< .~ ) .