HomeMy WebLinkAbout01-2304 FX
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09-1-01
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NOTICE OF JUDGMENT/TRANSCRIPT
PLAINTIFF: RESIDE~!!~A~D1;s~ASE
'BRo.SSo., LINDA,"
1292 Lo.WTHER ROAD
CAMP HILL, PA 17011
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COMMONWEALTH OF PENNSYLVANIA
COUNTY OF: CUMBERLAND
Mag. Disl. No,;
OJ Name: Hon.
CHARLES A. CLEMENT, JR.
"
Add"" 1106 CARLISLE Ro.AD
CAMP HILL, PA
~
VS,
T",phoo", (717.) 761-4940
17011
DEFENDANT: NAME and ADDRESS
!MARTIN, ZACKERY, ET AL.
200 S. 16TH ST
C/o. BERNETTA MARTIN
~P HILL, PA 17011
Dockel No,: LT- 0000123 - 01
Date Filed: 2/28/01
I
LINDA BROSSO.
1292 Lo.WTHER Ro.AD
CAMP HILL, PA 17011
~
THIS IS TO NOTIFY 'ljOU THAT:
Ju~ment: r .1 "Fo.~ PLAINTIFF
.[!] ~lI0111lT(mrW~em(Jred'iOr:"~~~'t~mer'J:lRO'S'SCl;-L'INl1A:"
Judgment was entered againS\',\ MARTIN, ZACKERY
[i] Landlord/Tenant action inthe amount of $ 8,106.50 on 3/19/01
The amount of rent per month, as established by the District Justice, is $
The total amount of the Security Deposit is $ .00
Total Amounl Established by. DJ Less. Security Deposit Apll.lifJd _; Adjudicated Amou8b
Rent in Arrears $ 2t47. 00 - $ .'00 - $ 247.
Physicai Damages Leasehold Property $ .00 - $. 00 $ .00
Damages/Unjust Detention $ 7.753_00 -$ 00 $ 7,753.00
. Less Amt Due Defendant from Cross-Complaint - $ .00
Interest (if provided by leaSe) . $ 00
UT Judgment Amount $ g. 000.00
Judgment Costs $ 106'.50
Attorney Fees $ 00
Total Judgment $ 8,106.50
Po.st Judgment Credits $
Posl Judgment Costs $
Certified Judgment Total $
y Ime 0 eVlc Ion.
D Defendants are jointly and severally'liabfe.
in a
. (Dale of Judgmenl)
510.00.
D
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Aitachmenl Prohibited/
Victim of Abuse (Act 5,1996)
This case dismissed without prejudice.
Possession granted.
D
D
o LE>yyis sl<lyed for. days,orDgenerally slayed.
o .:Objection to Levy has been filed and h~aring will be held:
Possession granted if money judgment is no sa IS Ie
Possession not granted.
,.
Date: Place:
Time:
I~ A~ ACTIO~ INVOLVING A RESIDENTIAL LEASE; ANY PARTY HAS THE RIGHT TO APPEAL FROM A JUDGMENT FOR POSSESSION WITHIN
TEN DAYS AFTER THE DATg OF ENTRY OF JUD\:;lMENT BY FILING A NOTICE OF APPEAL WITH THE PROTHONOTARY/CLERK OF COURTS
OF THE COURT OF COMMON pLEAS, CIVIL DIVISION. THIS APPEAL VVILL INCLUDE A"IAPPEAL OF THE MONEY JUDGMEN'F,IF ANY. IN
ORDERTOOBTAIN A SUPEFlSEDEAS.THEAP~ELLANT MUST DEPOSIT WITH THEPROTHONOTARY/CLERK OFCOU,RTS :THE LESSER OF
THREE MONTHS RENT OR THE RENT ACTUALCY IN ARREARS ON THE DATE THEI\PPEAL IS FILED,'. ...., '" , .' '. '.
IF A PARTY WISHES TO APPEAL ONLY THE MONEY PORTION OF A JUDGMENT INVOLVING A RESIDENTIALLEASE';.THE' PARTY HAS,
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30 DAYS AFTER THE DATE OF ENTRY OF JUDGMENT INWHICHTOFILE A NOTICE OF APPEAL WiTH THi= I'ROTHONOTARY/CLERK OF
COURTS OF THE COURT OF C. O.MMON PLEAS, CIVIL DIVI~I.ON. ."... .' '.,. .
THE PARTY FILING AN AppgA.L M~T f'lClUqf A CPfY NO, ." MENT/TRANSCRIPT FORM WITH THE NOTICE OF APPEAL.
3/19/2001 Date ~ l,f. , .... , District Ji:Jstice
certl y t at t IS IS a true an r ct cop 0 t c r. '() t'eprbc ontalnlng t e.w gmerit.' . .,
4J.19/2001 Date ";<'::" . ,
, District-1ustice
My commission expires first Monday of January, 2002. SEAL
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NOTICE OF JUDGMENT/TRANSCRIPT
""'.""'" P'L"'IMT'IFF' RESIDENTIAL LEASE
M I'l> . NAME and ADDRESS
fBROSSO\~'''L~'' ,-,~,r,\
1292 LOWTHER ROAD
CAMP HILL, PA 17011
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DEF~t'lDANT: '.. NAM'-er6~DDREs~
;,:IMMTIN, ZAC:KERY,~ Ab,3
.... 2.00 ~. 16TH ST 2.:: \JC'
C/OBERNETTA HARm
~P HILL,. PA 17~~,
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Docket No.: LT- 00001 :3 '1
Date Filed: 2/28/01 ~
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, ,. t qOMMONWEALTH OF PENNSYLVANIA
"'i . COUNTY OF: CpMBERLAND . ,.
\t:; ~ Mag. Dist. No.:
I." 09-1-01
OJ Name: Hon.
CHARLES A. CLEMENT, JR.
Add"" ll06'WLISLE ROAD
CAMP HILL, PA
.J
~~~_~17) 761-4940
17011\
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LIm>A BROSSO
1292 LOWTHER ROAD
CAMP HILL, PA 17011
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THIS IS TO NOTIFY Y;pU THAT:
~G;N Judgment: '. ~. ". .. \,:OR 'P~~1\l;l'I.7- . .' ........... ~ . ._~"'~'..,_._~~_~
._~,.~iI"'6~...@"t .VliIS "':'(~e"'*if"., __""~c ElittlSSO;JmN.IJ) _''_..__.._.'_,'.'.' "..' ,'0<, ..
. Judgment was entered against "SELLERS, RACHEL
[i] Landlord/Tenanlaclionintheamountof$ 8.106.50 on 3/19/01
The amount of rent permonth, as established by the District Justice, is $
Thetbtal amount of the Security Deposil is $ .00
,,- : Total Amount Established by. OJ Less' Security Deposit Apo./ifld _ - Adjudicated2Amouoto
Rent in Arrears . $ "" 2!l7. 00 ?:$': . UO - $ .47.0
PhYSical Damages Leasehold Pro. per' y::(:. $ /'.. /. 00' .. . . 00 $ , . . 00
Damages/Unjust Detentil(;!l,- ,"-' ?-$ ". _ 00 $ 7 ,753 _ 00
{y' 'Ii'~ LeAmt ue Defend I fr~m Cross Complaint - $ ,,00'
tv ~.' . "c)'" d Intef'lst (If provided by lease) $ 00
v ,,(' UhfudgmentAmount $ II. 000 _ 00
o Attachmenl Prohibiteda . 2+ ~ujllment Cosls . $ 106 _ 50
Victim of Abuse (Act~ 199$7 7' ~ney Fees $ 00
o Thiscasedismissecf~houtPre~ce, ~IJUdgment $ 8,106.50
Ivl' Po$'tJudgment Credits $
L!J Possession granted, Q I"Osi Judgment Costs $
Certified Judgment Total $
y Ime 0 eVlc lon,
o Defendants are jointly and severally liable.
in a
. (Date of Judgment)
510.00.
o
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o Levyis-stllyed fOf~days'Gr'EJ .g_ral!y,&tay~.
D Objection to Levy has been filed and hearing will be'held:
Possession granted if money judgment is no sa IS Ie
Possession not granted.
_~_. _ ",_O="::--;;='~~=-",,~
Date:
Place:
Time:
IN AN ACTION INVOLVING A RESIDENTIAL LEASE, ANY PARTY HAS THE RIGHT TO APPEAL FROM A JUDGMENT FORPOSSESSION WITHIN
TEN DAYS AFTER THE DATE OF ENTRY OF JUDGMENT BY FILING A NOTICE OF APPEALWITH THE PRO);I:l.O.l'!~TARY/CLERK OF COURTS .
()F THECOUFtT9f C'()I1IIMOI'!.P~EAS,CIVIL DIVISION. THIS APPEAL WILL INCLIJDE AN A,PPEAL OF THE MQI'!~Y JUOGMENT,IF ANY. IN
ORDER TO OBTAIN A SUPERSEDEAS, THE APPELLANT MUST DEPOSIT WITH THE PROTHONOTAf\Y/CkEFlK'PF COURIS THE LESSER OF
THREE MONTHS RENT OR THE RENT ACTUALLY IN ARREARS ON THE DATE THE APPEAL IS .fIL€D: .' . '.' ..../ . ".
IF A PARTY WISHES TO APPEAL ONLY THE MONEY PORTION OF A JUDGMENT INVO~VING A,RE~IDENTIAL LEASE, Tf:lE I'ARTY HAS
30 DAYS AFTER THE DATE OF ENTRY OF JUDGMENT IN WHICH TO FILE A NOTICE OF'APPEAL'W!Tf!THE PROTHON01ARY/CLERK OF
COURTS OF THE COURT OF COMMON PLEAS, CIVIL DIVI~ION'.. ' . ~~ .
THE PARTY FILING AN APPEAL M~T ~CLU9f A CPfY NO MENTlTR1.NSC.~1.PT FORM'v;'ITH THE"NOTICE OF APPEAL.
3/19/2001 Date ~ L{. , '.. :DistrictJustice
certl y t at t IS IS a true an e qopy 1 e r. procee I, nln9't e)u glnent: '
4/~"/2001 Date ',."O,!slrict'~\.lstfce
My commission expires first Monday of January, 2002,
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. OOMMONWEA~tH O~ PENNSYLVANIA 1\;tlr~~~ ." NOTICE OF JUDGMENTITRANSCRIPT
COUNTY OF: CUMBERLAND 'I"'" PLAINTIFF: RESIDE~!!~A~DkfsASE
Mag. Dist. No.:
09-1-01 'BROSSO, LINDA
1292 LOWTHER ROAD
CAMP HILL, PA 17011
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DJNama: Hon.
Address:
CHARLES A. CLEMENT,
1106 CARtISLE ROAD
CAMP HILL, PA
JR.
-'
VS.
T"'phoo", (717) 76.1-4940
17011
DEFENDANT: NAME 'and ADDRESS
IMARTIN, ZACKERY ,ET AL.
200 S. 16TH ST
C/O BERNETTA MARTIN
~P HILL, PA 17011
Docket No.: LT- 0000123 - 01
Date Filed: 2/28/01
--,
-'
LINDA BROSSO
1292 LOW'l'IIER1~OAD
CAMP HILL, PA, 17.011
THIS IS TO NOTiFY YOOTflAT::" .'
I"" ~.~"i!t~=~~~~~le;,le~~'~4Nam:ef.C;.~~~~~~~i..=.c'"'~''''~': .. .'=".'" ".c_~;>._ .'
Judgment was entered against MARTIN, ZACKERY
[i] Landlord/Tenant action inthe.amountof$ 8.106.50 on 3/19/01
The amount of rent per month, as established by the District Justice, is $
(" The total amount of the Security Deposit is $ '.00.
. Tolal Amount Establishedbv.. DJ Less' Security Deposit Aprlli.f!d _ - . Adjudicated AmouBb
Rent In Arrears $ 2117.00-$ . .UU - $ 247.
Physical Damages Leasehold Property $ 7 .753 .00 - $ ..00$ . . 7 ,753.00
Damages/Unjust Detention $ .' . ..00 - $' .00 '. $ . . .00
Less Amt Dye n'elendant from Cross Complaint -$ . .00
.. ,:.Interest(if provided by lease) $ . 00 .
Ii~LFP~~dgmentAm0Unt'~"..+<. '$""'8-,000. 'On
. . ..... . JudgmenjCosts $ 106.50
. Attorney Fees . .$ 0.0
')otaIJudgment $ 8;106.50
Post Judgment Credits $
Post Judgment Costs $
Certified Judgment Total $
Ime 0 eVlc Ion.
D Defendant~ are jointly and severally liable,
i
in a
, (Date of Judgment)
510.00.
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Attachment Prohibited!
Victim. of Abuse (Act 5,1996) .
This case dismissed without prejudice.
Possession granted.
D
D
D Levy is stayed for qays or D general!ystayed. -.1
DObjeciion to Levy has beenliled and hearing will be held:
Possession granted if money judgment is no sa IS Ie
Possession not granted.
Date: Place: .
Time:
..'
. .
lfoj. AN ACTION INVOLVING A RESIDENTIAL LEASE, ANY PARTY HAS THE RIG.HT TO APPEAL FROM A JUDGMENT FOR POSSESSION WITHIN
TE;NDAYS AFTER THE DATE OF ENTRY OF JUDGMENT BY FILING A NOTJCE.OFAPPEAL WITH THE PROTHONOTARY/CLERK OF COURTS.
OF THE COURT OF COMMON PLEAS, CIVIL DIVISION: THIS APPEAL WILL.INCLUPE ANAPPEA~pF THE MONEY JUDGMENT, IF ANY. IN
ORDER Tp.OBTAINASUPERSEDEAS, THE APPELLANT MUST DEPOSIT WITH THE PROTHOt>lOTARY/CLERK OF COURTSTHELESSEROF
THREE MONTHS RENT OR THE RENT ACTUALLY IN ARREARS ONTHE DATETHEAPPEI\L IS FiliED; . .. . _ . . .' .
IF A PARTY WISHES TO APPEAL ONL YTHE MONEY PORTION OF A JUDGMENT INVOLVING AHESIDEfojTIAL LEASE, THE PARTY HAS
30 DAYS AFTER THE DATE OF ENTRY OF JUDGMENT IN WHICHTO FILE A NOTICE'OF APPEAL WITH THE'PROTHONOTAFiY/CLERK OF'
COURT.S.OFTHEGOURT. OFCOM.M. ON p.L.'.E. AS. 'CIVILDIVI~'O.N.... ...... . ..........'. ." '
THE PARTY FILING AN APPEAL M~T~CLU9f A CPfY . NO . MENTITRANSCRIPTFORM WITH THE NOTICE OF APPEAL.
3/19/2001 Date ~ L{. .' .' . . I
certl y t at t IS IS a true an c re .copyo e re r rocee.
5/17/2001 Date
My commission expires first Monday of January, 2002.
A()Pr.::\1-"A.GA
SEAL
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NOTICE OF JUDGMENTITRANSCRIPT
RESIDENTIAL LEASE
PLAINTIFF: NAME and ADDRESS
'BROSSO, LINDA
1292 LOWTHER ROAD
CAMP HILL, PA 17011
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;'e6MMONWEAL TH OF PENNSYLVANIA
COUNTY OF: CUMBERLAND
,
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Mag. Dis\. No.:
.
09-1-01
OJ Nama: Hon.
CHARLES A. CLEMENT,
Add,,,,, 1106 CARLISLE ROAD
CAMP HILL, PA
JR.
.J
VS.
T,I'phoo, (717) 761-4940
17011
DEFENDANT: NAME and ADDRESS
IMARTIN, ZACKERY, ET AL.
200 S. 16TH ST
C/O .BERNETTA MARTIN
~P HILL, PA 17011
Docket No,: LT- 0000123 - 01
Date Filed: 2/28/01
I
.J
LINDA BROSSO
1292. LOWTHER ROAD
CAMP HILL, PA 17011
-,,~
THIS IS TO NOTIFY Y6I>U THAT:. I
'.. ..., 'rn 5'Q~~~:m\va~ehiere(hor: " "(Namej'-~~~~tftifi~i
Judgment was entered against SELLERS, RACHEL
Ii] Landlord/Tenant action in the amount of $ 8 .106 . 5.0 on 3/19/01
The amount of rent per month, as established by the District Justice, Is $
C The total amount of the Security Deposit is $ .00
- Total Amount Established b~ OJ. Less' Security Deposit ApQ,lifld _ = Adjudicated2AmOUonto
Rent in Arrears $ 2<!l7.00-$ .UO - $ . t47.
Physical Damages Leasehold Property $ 7.75.3.00 $ .00 $ 7.75.3.00
. ~ Damages/Unjust Detention $ _ 00 - $ .00 $ 00
J", Less Amt Due Defendant from Cross Complaint - $ .00
" Interest (if provided by lease) $ 00
.~ 'VTJudgmenlAmount $ .. '8.000.00
D Attachment Prohibiled/ Judgment Costs $ 106.50
,/ Victim of Abuse (Ac15, 1996) Atlorney Fees $ 00
.~:. D This case dismissed without prejudice. Total.Judgment $ 8,106.5.0
~ [!] Possession granted. Post Judgment Credits $
Post Judgment Costs $
Certified Judgment Total $
y Ime 0 eVlc Ion.
D Defendanls. are jointly and severally liable.
in a
, (Date of Judgment)
5.10.00.
~........\
:D
D
D
D
Possession granted if money judgment is no sa IS Ie
Possession not granted,
Levy Is stayed for days or Dgenerally stayed.
Objection to Levy has been filed and hearing will be held:
Date: Place:
.
Time:
. ... ."
IN AN ACTION INVOLVING A..RESIDENTIAL LEASE, ANY PARTY HAS THE R!.GHT TO APPEAL F.ROM A ~U[)GMENT.FOR POSSESSION WITHIN
TEN DAYS AF.TER THE DATE OF. ENTRY OF. JUDGMENT BY F.ILING A NOTICE OF. APPEAL WITH THE PROTHONOTARY/CLERK OF. COURTS
OF. THE COURT OF. COMMON PLEAS,CIVIL DIVISION, THIS APPEAL WILL INCLUDE AN APPEAL OF. THE MONEY JUDGMENT, IF. ANY. IN
ORDER TO OBTAIN A SUPERSEDEAS, THE APJ:>ELLANT MUST DEPOSIT WITH THE PROTHONOTARY/CLERK OF. COURTS THE LESSER OF.
THREE MONTHS RENT OR THE RENT ACTUALLY IN ARREARS ON THE DATE THE APPEALIS F.ILED. .. . .
IF. A PARTY WISHES TO APPEAL ONLY THE MONEY PORTION OF. A JUDGMENT INVOLVING A RESIDENTII\.L LEASE, THE PARTY HAS
30.DAYS AFTER THE DATE OF. ENTRY OFJlJDGMENT IN WHICH TO F.ILE A NOTICE OF. APPEAL WITH THE PI10TH()NOTARY/CLERK OF.
COURTS OF. THE COURT OF. COMM.ON. PLE.. A.S, CIVI.L D1VI~IO. N. '. '.
THE PARTY F.ILlNG AN APPEAL M~T rCLU9f A C?fY NO MENT/TRANSCRIPT F.ORMWITH THE NOTICE OF. APPEAL,
3./19/2001 Date ~ L{,
certl y t at t ISIS a true an I ct copy' 0 t re t e ee
5/23/2001 Date
My commission expires first Monday of January, 2002.
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IN THE COURT OF COMMON PLEAS
:
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CUMBERLAND COUNTY, PENNSYLVANIA
:
:
CIVIL DIVISION
:
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:
NO. 0 \ - d 3 () L\-
CIVIL TERM
Ue.\ Se.I\ers
PRAECIPE FOR WRIT OF ATTACHMENT
TO THE PROTHONOTARY:
Please issue a Writ of Attachment to attach the ~ages of
STftN
2f'tC\-\ERA'j T Mi\RT\N
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ARO\.uSt<.L IIANAG-ER. OKolNlO S
(na e & address f employer) )
, at/from
Defendant,
37;;),.\
M}::IR\<.ET
3TJ
LA-V'f\P H\LL. J Pf\,
\'7011
so as to satisfy the damage portion of that final judgment entered
in the above-captioned matter in the amount of $ 70,; iJ~a~:CL~
said damages arising out of a residential lease between the
Plai~tiff and the Defendant for that leasehold premises l0cated at
;),10- c...
L,ow+\i\€, <5-+, Le'VY\l:>'(lI/\~, PA,
(address of premises where'damage
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occurred)
said wage attachment being requested pursuant to 42 PA C.S.A. S8l27,
as amended by House Bill No. 908, Act No. 5 of J_~96, effect:l.ve
February 15, 1996. All such attached wages should be sent to the
LIN1:JP>. 'BRoSSD S"n<.o~12.
(name & add'ress)
W'LC;O",S GRDve R,,) M~\eS:"VR&, FA. \"JDSS.
DATE: S'ei'T, \:!,J ~OO\ Signature: ~'4d.ct1= ~
Print Name: LNDfJ ~ R.05S D $ rRoe../2
Address: "8/5 /J'I--LIJ'tI'YJS G-RPvE. RD,
M[EtJHftfVJ(!.SBVRG- Pit. J 71)$"" S-
7/7- '715 - I '1 D if
Plaintiff
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Telephone:
Supreme Court ID No.:
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",j!Ii!Oi~~J~~'p."""".W"TQ,'",,<pl!~i!>i,,,,1t0;!r;'$'l''''I'1,,,g~;!\<f~~'i#J<l!I~I!t~';jMl!,>,,''''I'''>F''~"~"; ''''F~~'''';'H''''-'''-"'U'.'''~''''' ,., .:, ~1" ~".k-"'J-f':\,~,~"9'iJ-"::\~j'~'~""'wt',:>-""'~;;.,"-';;<i'<'j18';~i1!R',*,,'ffffl>Di-;m'i~~~1~.Ili'lI!!lFr;:
Linda Brosso
1292 Lowther Rd. :
Camp Hill, PA 17011 :
Vs. :
Zachery Martin :
Rachel Sellers :
c/o BernettaMartin
200 S. 16th St., Camp Hill, PA 17011
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL DIVISION
No', 01-2304
CIVIL TERM
TO:
Kokomo's
stan Barowski, Manager
3721 Market st.
Camp Hill, PA l70ll
,
RE:
Zachery Martin
WRIT OF ATTACHMENT
The above employer shall attach and deduct fran the wages of the above employee
a sun not to exceed ten (10% I of the net wages per pay period of said employee or a
sun not to place employee's net incane below the poverty:lncane guidelines as provided
annually by the Federal Office of Management and Budget, whichever is less. "Net
wages" shall mean all wages paid, less only the following items:
1. Federal, state and local incane taxes;
2. F.LC.A. payments and non-voluntary retirement payments;
3. Union dues; and,
4. Health insurance premiums
The amount of wages to be attached shall total $ 7,7" nn (plus costs)
The employer shall send the attached wages to the Prothonotary, CUmberland County
Courthouse, 1 Courthouse Square, Carlisle, PA 17013, payable to Plaintiff-Creditor:
Linda Brosso Strock within fifteen (IS) days from the close
of the last pay period in each month. The employer shall be entitled to deduct from
the wages collected from the employee pursuant hereto the costs incurred fran the
extra bookkeeping necessary to implement the teims within the Writ of Attachnent, not
exceeding $5.00 of the amount of the wages so deducted. If you, the employer, are
served with more than one Writ of Attachnent for damages arising out of a resider-tial
lease against the same employee, then the wage attacbnents shall be satisfied in the
order in which said Writs of Attachnent were served. Each prior wage attachnent
shall be satisfied before any effect is given to a subsequent attachnent.
You shall not take any adverse action against the employee solely because his
wag<>.-S, s31aries or ccmnissions have heen attached. Violat:,qns may result in (i) you
being adjudged in contempt and carmitted to jail or fined by the court and (HI an
action against you by the employee for damages.
Willful failure to canply with this Writ of Attachnent may result in (il you
being adjudged in contempt of court and ccmnitted to jail or fined by the court;
(HI yeu being held liable for any amount not withheld, or withheld but not fOIWaLded
to the prothonotary's Office; and, (iHI attacbnent of your funds or property.
This Writ of Attachnent has been entered pursuant to 42 PA. C.S.A. S8127 , as
amended by House Bill 908. Act 5 of 1996. effective February 15. 1996. A copy of this
writ of Attachnent has been sent by U.S. Mail. postage prepaid. to the employee's
last known address at:
r/n R~rn~rr~ M~rr~M 200 ~ l~ta Et.. C3mp will. rA 17nl]
Any questions should be directed to the Plaintiff-Creditor:
Linda Brosso Strock 815 Williams Grove Rd., Mechanicsburq. PA 17055
Date: seotember 13. 2001
Prothonotary:
C'nrti!=< R Long
Costs:
$15.00
By DepUty:
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IOII0wing services (lor an
extre lEIe):
1. [J Adljressee's Address
2. 0 Restricted Delivery
Cons~n postmaster for fee,
48. ArIIels Number
7099 3400 0018 5004 8075
. 4b. Service Type
o Reg~tered
o Express Mall
o Retum Receip! for r,terchandlse
7, 'Date of Dillivery
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. ThEl'R8tl.Im Rec8lpt will show to Whom the article was delivered and the dat8
dBr~.
3. Ailii:Ie Addressed to:
Kekomo's
Stan Barowski, Manager
3121 Market St.
Camp Hill, PA 17011
Gl ClIrtifiild
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and rea is paid)
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Restricted Delivery Fee
(EndorsemBntRequired)
Cl ,_ Total Postage & Fees $
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.::r-' Recipient's Name (Please Print Clearly) (to be completed by mailer)
TTl _..._J~Q~9mQ_I__~_____$.~_~!!___~~~Q~.f?!<;~_I___~9:~_~9~f___________
tr - Street, Apt No.; or PO Box No.
~ 3721 Market st.
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I'- CHill PA l70l1
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