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AFFIDAVIT
I, Shaun J. Mumford, an attorney of the law firm of Margolis Edelstein, being duly sworn
according to law, deposes and says that I am the attorney for Plaintiffs, Perry D. and Judy Forney,
and that on February 1, 1999, a Judgment was entered against Defendant, Jason Brandt, Docket
No. CV -585-98, in the amount of One Thousand, Five Hundred Sixty-Seven Dollars and 75/1 00,
($1,567.75). I depose and say that said Judgment has arisen out of a motor vehicular accident.
MARGOLIS EDELSTEIN
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Shaun J. um rd, Esqmre
Attorney LD. No. 84176
P.O. Box 932
Harrisburg, P A 17108-0932
(717) 975-8114
Sworn to and subscribed
bef~re!lie <this c:2./.d
day
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MY COMMISSION EXPIRES:
Notarial Seal .
JoAnn E, Nelson, Notary Public
Camp Hill Boro, Cumbe~and County
My Commission Expires June 19, 2004
Member, Pennsylvama Association of Notaries
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COMMONWEALTH OF PENNQvANIA
COUNTY OF: CUMBERLAND
Mag. Dist. No.:
09-2,-01 \~
I, OJ Name: Hon.
PAULA P. CORREAL
Add'''" EAST WING - COURTHOUSE
1 COURTHOUSE SQUARE
CARLISLE, PA
T"'phoo. (717) 240-6564 17013-0000
ATTORNEl' FOR PLAINTIFF :
MICHELEJ. THORP
101 PINE ST.
HARRISBURG,'PA 17108
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THIS IS TO NOTIFY YOU THAT: " ,
Judgment:
[i] Judgment was entered lor:
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NOTICE .JUDGMENTITRANSCRIPT
PLAINTIFF: CIVIL CASE
NAME a.nd ADDRESS
'FORNEY, PERRY D. AND JUDY
63 MCALLISTER
CHURCH ROAD
~ISLE, PA 17013
VS.
DEFENDANT: NAME and ADDRESS
'BRANDT, JASON
110 S.HANOVER ST.
CARLISLE, PA 17013
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Docket No.: cv- 0000585 - 98
Date Filed: 12/29/98
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DEFAtJI.T JtJ1JGMEN'r PLT'F
(Name)
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Ox Judgment was entered aga, inst: (Name) 'R~
LeJ H'l1'tJnTr .T"RON
in the amount 01 $
1 , "67 7" on:
D Delendantsare jointly and severa.lly liable.
D Damages will be assessed on:
D This case dismissed without prejudice.
D Amount 01 Judgment Subject to
Attachment/Act 5 01 1996 $
D Levy is stayed lor
days or D generally stayed,
D Objection to levy has been filed and hearing will be held:
(Date 01 Judgment)
2/01 IQQ
. .
(Date & Time)
Amount 01 Judgment $ 1. 514 .25
Judgment Costs $ 53.50
Interest on Judgment $ .00
Attorney Fees $ .00
Total $ 1.567.75
Post Judgment Credits $
Post Judgment Costs $
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Certified Judgment Total $
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Date: Place:
Time
ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENT BY FILING A NOTICE
OF APPEAL WITH THE PROT!;!pN6fA~YI LERK OF}HE'COU~F COMMON EAS, CIVIL DIVISION. YOU
MUST INCLVDEA COp,Y O~HIS NOTli, O;JUrMEttS~T FO: ' ITH YOUR NOT:I~~~~~~,~EAL.
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Ice, rtily that this is a true ,~d co" rre,! ~opy ~Iithe r1cord',"ll th~;pr{J,'%~" ings cont ~I)i~g',fhe" jUdgrhe, n, t,',
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1-1-'9 Date ,,?' cv.t,,/., ',....,~ '-,^r .V""~'- ..' ',DistnctJu,~\lce
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My commission expires lirst Monday 01 January,
AOPC 315.96
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