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JUDGMENT NOTE
Mechanicsburg
(place)
,Pemmylvmria,July 18,2000
( date)
, $8000.00
(amount)
FOR VALUE RECEIVED, I/we promise to pay to the order of Erie Insurance Group
the sum of Eight Thousand and 00/100***********"******
said sum to be payable said sum to be as follows: Fi fry
dollars, ($ 'in nn
) on the
18 thdayof Ju1v
2000
and
Fi fry
dollars, ($ 50.00
) on the
18th,
day
of every month thereafter until the entire amount is paid in full.
I1we hereby authorize and empower any attorney of any Court of Record of Pennsylvmria or
elsewhere, to appear for and confess Judgment against me for the sum due and payable hereon,
pursuant to Pa. R.C.P. 2951 (a) (1) with or without declaration, with costs of suit, interest at
the rate of 6% per annnm, an attorney's fee, release of errors, and without stay of execution;
and I/we also waive t1).e right of inquisition on any real estate that may be levied upon to collect
this note; and I1we do hereby voluntarily condemn the same and authorize the Prothonotary to
enter said voluntary condemnation upon any Fieri Facias that may be issued to collect said
Judgment; and I1we further agree that said estate may be sold on a Fieri Facias, and I/we do
hereby waive and release all relief from any and all appraisement, stay of execution, exemption
or bankruptcy laws A~ this or;y oow in force or hereafter to be passed.
~ ~S.)
Glenn S. Bucher
(L.S.)
This note is given executed without duress or coercion and with full and complete understanding
that upon failure to make payment as agreed, that my operating privileges may be suspended.
Further, I do hereby acknowledge that the damage incurred in the accident of
" ,mll" ry 1 q ,Jt92ooo ,for which this note is given resulted from my negligence and
fault, and I do hereby acknowledge and waive my right to any hearing or trial on that issue.
DRIVER DATE OF BIRTH .I'$J <j?;~5 jJr.-. S. I::uJw/ &4..S.)
DRIVER OPERATOR NO. __ _ _ _ Glenn S. Bucher
OWNER DATE OF BIRTH
OWNER OPERATOR NO.
./t
(L.S.)
Glenn S. Bucher
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