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Home My WebLink About01-06957 -s~~~; ""~'_'~', . . . . . . . . . . . . . . . . . . . . " . " " " " " " " . . . .. . IN THE COURT OF COMMON P4EAS OF CUMBERLAND COUNTY STATE OF -d qU-t e. ~ f1- ' O""\t,~ <, P\E'th'L ~( C~1tt\ VERSUS R. ()\.-vlJ~~J tJ e+~,9~\ AND NOW, ~~ DECREED THAT -.::r- Ci>\)-res- AND C~-r41 <<I PENNA, No.6 \... ~9 b -L DECREE IN DIVORCE , 1001, IT IS ORDERED AND \:1-, air-ii- ~ , b\J-..\r-~ \. , PLAINTIFF, , DEFENDANT, ARE DIVORCED FROM THE BONDS OF MATRIMONY. THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT YET BEEN ENTERED; ,. . . .. ,<_'.'_---c, _ ,,_~ - F~-'" ^ r, 'W" .~._ ,. " _ _ !_" . . . . . .. . -,t- ~ ,~ ',,' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . " . . . . . . . . . . . . . . . . . . . " . . . J. . . . . . . . ;t: ;+:1f,'fi _~~~~"~j~'i:~'1<i::.t1bi',,"%~~.djt'~'-"-O. ~..;,,,,,>,,.~..,,...,..,..L, < " 'I f:r~ rr ""',,-,",. ~ ._~, -~~, ~.-~,., ..". .!,. --> ~ 11"" ''''- :d 5/~/~ M'~~ :-..~~ ~~ ..5/'/1>3 ~ /U~?1,~ ."h'.~ "" iIlliiiffi'. *'i.; ~r:~_&\ti::::~\ ii;:.jS\;f,",!X(},~;?l'-;'.:)j51~,"WB,?"}':~o",i~' :~~j0~:J IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JAMES A. ORRIS, Civil Action-Law Plaintiff vs, 01-6957 CATHY R. ORRIS, Defendant Divorce PRAECIPE TO TRANSMIT RECORD To the Prothonotary: Transmit the record, together with the following information to the Court for Entry of a Divorce Decree: 1. Grounds for Divorce: Irretrievable Breakdown under ~3301(c) of the Divorce Code. 2, Date and manner of the Service of the Complaint: By Certified mail, R!RIR., Restricted Delivery, as signed for by the Defendant on the 28th day of December 2001. 3, Complete either paragraph ( a) or (b). (A) Date of execution of Affidavit of Consent required by ~3301(c) of the Divorce Code, By Plaintiff: 28th day of March 2003 By Defendant: 28th day of March 2003 (B) (I) Date of execution of the Affidavit required by ~3301(d) ofthe Divorce Code; (2) Date offiling and service of the Plaintiffs' Affidavit upon Defendant; 1 "~ll:'1 ,,' ",-, ~'\,''',.'~':',''~ _ ~o~~".r .,,~,_ '_.".-"<,_ ~,__ ," ,--",_'r.:-"',,'.!,-,~ ,'::',",0.-" ,'. ,0 I_''',"o~*'''''' .,_, ,~""" __~" '-,_">'_C'.,,,,, ;""hT,,~_" _' ,,_ _ . --, .= ,," .. -'Jf:"h-.i"!'\:~~-{-9;-:"li:_:b" ' , 4. Related Claims pending: There have been no Claims raised allld/or Pending in this instant action. 5. Complete either (a) or (b), (A) Date and manner of Service of the Notice ofIntention to file Praecipe to Transmit Record, a copy of which is attached: (B) Date Waiver of Notice in ~3301(c) Divorce was filed with the Prothonotary: Plaintiff: 1" day of April 2003 Defendant: 1'1 day of April 2003 Respectfully Submitted, ~.f(- arley G olt, squire ID# 59920 34 North Queen Street York, Pennsylvania 17403 (717) 846-0550 Dated this 2nd day of April 2003 2 ,.~_." -- ~~',"- _w --"",,,,,'.'-,,,,,,::\-,'_'I:I,,:,,;.:,/,-,~'f";",,_-.'"~'';"""""')"'1 '__ ," "'';<'~''~''-' -, ~,,~ _."~",,", ..~"',,~"",,~-- ... ..... -- ~...."'~- ,^,.-- n_ ',~',,, M'_~~ - ,-, '- "" ~ =, -'''-~~~ ~, - - -. -~.. , ~ ' ....."~ "' . ~ ~, '" .'~' "'~-. d^,~ -' ',.-, ,,-,,,, -,"',"',~- ' "'<~"~-"'---~'~W~It:;'ltbifu11-,;;~))~<r~' . ~~:'illrlrill':r , 0 ~, C :';c; $: .~ -0'''' -'~ ~,:j 52ri'j :CJ'lI ~e "I' zc. ~i ; ~C., 'oj ~c , ".;-; C) ;;;;:0 IT) ~C Z :'V ~i ::;? ~ (J1 -< >. ~","";lIfl!llJJ.l!!!f.J\ml~~~~f\l1!~,-;: "':"':~"~'~'~-'_ .y" -~)~I;J!1:JAE1D1-~":">?' ,,",.', ,<~r(~_ -:'l~f ~~~t;l.,~ . , . . I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No, 01 - t..oI.r7 c.~{;); ( T~ JAMES A ORRIS, Plaintiff, vs. CIVIL ACTION-Law In Divorce CATHYR. ORRIS, Defendant. NOTICE TO DEFEND AND CLAlM RIGHTS .y ou have been sued in Court. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree in divorce or annulment may be entered against you by the Court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Petitioner. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary at: Cumberland County Courthouse 1 Courthouse Square Carlisle,PA 17013 IF YOU DO NOT FILE A CLAIM FOR ALIMONY, MARITAL PROPERTY, COUNSEL FEES OR EXPENSES BEFORE THE FINJU, DECREE OF DIVORCE OR ANNULMENT IS ENTERED. YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE TffiS 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. Court Administrator of Cumberland County Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 (717) 240-6100 "" '." "} '-'-, ,- ~ - - I'" , " .' ------- . ; '. '- .: '.': ~~~~"~=~~1.tf',~~" ~:.: ~.,;. . '. .. ,. ..~ . < ~~,i~;?rn_".I i;,;~ c- ~. : ~ :. - ,~ ~ ~:~, :i;;*i ~11 NO'!'"!CI:;\ '. .-.,,;. ",: :, U "1:Ia..." d~."dado a. uste:i en l.i corta. 5i usted ciui~.. de~and~r3e de estas d~."das e~uestas en las paqinas siquia ustad. tiane viante. (~O) dias de plaza al :parti: da 1a ~ac=.a' demanda y 1a notiticacicn. Usted dabe prasentar una apa:ia~. escrita 0 en persona 0 por abcdago y arcl:U.v'!.r en 1a co:::-te I!l..-o. !or:a eserita BUS de!ensas o~us'objQciones alas de:andas ~ contra de au peraona. Sea &visado Ci'la .i ustad no sa de!iar.c 1a corte tomara medidas y puede antrar una.orden centra ustac p::avio aviso e noti!icaeicn y por C'.Jalqu.!,ar g;uej a 0 all vio c:r~ pedide en la peticion de de=anda. usted puede per~e= diner~ sus propiedades 0 ostros darachos ~porta..."tes pa=a ustad. LJ:Z"n::' ESTA DE::<..},,-"DA A L~ A-SCCAGO !~DIA'!.A.~"':E.. s= NO -: A3OGADO 0 SI NO TZ~~ EL D!N~RO SV?ICI~~E DE PA~~~ ~>~ SE~V=C=O, VAYA E-" P~ONA 0 LL&~ PCR TELZ:OHC A ~ CF!C:~A C D!RZCC!ON SE E~CU~~RA ESCR~T~ A3)~~ ?~~_~ A;~~~G~~2~ pc,~~E SZ PGEOE CONSEGUI~ AS=STE~CL~ LEGA~. ~. , , Court Administrator of Cumberland County Cumberland County ClYUrtiuHlse 1 Courthouse Square Carlisle, PA 17013 (717) 240-6100 , IN THE COURT OF COMMON PLEAS OF CUMBERLAl'ID COUNTY, PENNSYLVANIA JAMES A. ORRIS, No, Dl- 1c,9~7 CI;'( '--r~ Plaintiff, vs. CIVIL ACTION-Law In Divorce CATHY R. ORRIS, Defendant. COMPLAINT IN DIVORCE AND NOW, TO WIT, this 6th day of December, 2001, Comes the Plaintiff, James A. Orris, by and through his attorney, Farley G Holt, Esquire, and files the within Complaint in Divorce to which the following is a statement: I. The above-captioned Plaintiff, James A. Orris, is an adult individual who currently resides at 800 Rosemont Avenue, New Cumberland, Cumberland County, Pennsylvania 17070. 3. 2. The above-captioned Defendant, Cathy R. Orris, is an adult individual who currently resides at 202 Bosler Avenue, Lemoyne, Cumberland County, Pennsylvania 17043, 3. The above-captioned parties were married on or about October 2, 1993 in New Cumberland, Cumberland County, Pennsylvania. 4. Both parties have been bona fide residents of the Commonwealth of Pennsylvania for the last six (6) months immediately previous to the filing of this Complaint. ~.""""'-'Wr,m'. . ~. . _ liT , ~" .. ,'-' ~ , . 5. There have been no prior actions of Divorce between the parties in this or any other state. COUNT I Divorce Pursuant to Section 3301(C) of the Divorce Code and Divorce Pursuant to Section 3301(0) of the Divorce Code 6. Paragraphs one (1) through five (5) of this Complaint are incorporated herein by reference as if set forth in full. 7. Plaintiff avers that the marriage is irretrievably broken. 8. The Plaintiff has been advised of the availability of marital counseling and that the Defendant may have the right to request that the Court require the parties to participate in counseling. 9. The above-captioned parties have been living separate and apart and not as husband and wife, since on or about September 9,1996. 10. The Plaintiff and Defendant are not in the military or naval forces of the United States, WHEREFORE, the above-captioned Plaintiff, James A Orris, respectfully requests this Honorable Court to enter a Decree in Divorce in this matter. 't'P'4f.. '^: ~,_,' _ ~L, . ~ ,," .- ' " , , "'4*"'<:!\lrITJ.~__ ..~_. ~~~ ~ .' / <-- I~ ,- '" c Respectfully submitted, -~~ Far oIt, ESqU~ I.D. #59920 34 North Queen Street York, Pennsylvania 17403 (717) 846-0550 Attorney for Plaintiff ---"<.... . 1-. ~ "+"'"I~" "r _<_~" .. ~. ^~ , . ), VERIFrc.~ no-,- r, \c... ILI!LLJ a.o :-e"~;"v "e"';;'; .:...'] ~ -:"..lo n. .~ ._..J~ ~ ...~ '.'-~'~._ --'r.a-....~r- ,..............,;...e...; ;... ahe '.-or~~Ct'na :H.... _.......> ~ '-....lH._~~ .... ...~ 10. .... _.= '"; !:-e -..,.. ::l' .....l....... ..~ -:.. ~ _ :_~ T_ ,..i rf ~ :_--.... ']..: ,.J.' /;,.;a,:" ~.I....e ll":.... "-vr:"ec~ '.0 :.J.~e ,..es... VI. l~.l.f .:c.O N.e....g... l.l.1,;.lJr.7!_l..cn an.... tJ~......",. .. . . L ~r:C=:"3~1r:::: :.":.:1: false 5r.!ce:ne::rs ue s1.:.cie::::o :he oe::alr:es of L3 ?:l.C.S. Scc::orl ~9C~ :"e:~!::::g:o . . llns~),(cC7l fa1siEc:!.c:on co al..:.:.hor:r:es. /J It/ /Oi D.-l.L::~ ;'1- ( l ~.//"'6 <'"'>""~,;: ,'~. . ~~ ",., " _~ .7 ,. . ._ I"-~; r, ~~ ~ " " , .~~ ~^".." t1 ~ ^ . ~,.,e~,,,<==,,,",_ ,~~ "'. .'.,'''' ~ '" ". :C""~ ,rrii!!!i-I!1!'J!"~l~~~'. ~ ......... "- -.a G' C0 JTIlm'l1J}'~, ;," ^ D '1i: --- ~ -- ~ ~ ~ ' h.~ ~ (j & ~ }J ! (); $~ "OW" ."~" "~"",~.'" II _. .='" .,~ L^ ::1) f"::~: : ~-- ' Z;.- ~f~ :~ -- < < r=i Q t") \-~) :,) h,) ," "1""".4J~~,~Ii1!l~-~V-'l""]ry,-"p,r'r,<i\~"f'~"'~,,jMtI-~~ 1t~J!t.f#ij,t~. ~ ,. ~. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JAMES A ORRIS, Civil Action-Law Plaintiff vs, 01-6957 CATHY R. ORRIS, Defendant In-Divorce '!J ~I AFFIDAVIT OF SERVICE COMM01VWEAJ;TH OF PENNSYLVANIA COUN1YOF YORK 55 ~j 11 'I ~'j h 1.1 )j ;~ r; n ~l )! II ~l ~, AND NOW, TO WIT, I Farley G Holt, Esquire, being sworn according to law, says that he mailed by Certified Mail, Restricted Delivery, return receipt requested, a true and correct copy of the Complaint in this instant action to Cathy R. Orris at place. of residence, and that the Defendant did receive the same, as evidenced by the signed receipt as returned by the Postmaster dated December 28, 2001, said receipt is attached hereto as Exhibit "N'. if ~~4i) Farl Got, Esquire 34 North Queen Street York, Pennsylvania 17403 jj ::j II Sworn to and Subscribed before me this 3trsl day of ;(J;eflfjJJ.Jv, 20o,t. . Notarial Seal Nicole M. Holt, Notary Public York, York County My Commission Expires Feb. 17, 2003 ~:~::-,;m" -"."" - -<r/'7','::':';;:""--,~~?:,, .;-'L/1"':"',~:'" !-R,",,:.':- f':;_~'''''~w' '1t~:',A''-^ ',". ."H""_ .~;. ." ,,' ~','f_~O>'___ . ""'.-, ',,' ~-" ',-".-:< '"':'_'_'" _, _ _,~P"__",",,,.~ . _ ,,,,",_ ,"~ _"'"',,_x., " .,- Compiet~ ftemsl"~~~2; ~~a1!3. '1\I'$b 'dPtn1jT~t~ item 4 if Re$jri~ed D$livery is desired. . Print your name and add~ss on -the reverse so that we,-can return 'the card to you. . Att~ch this card to the back of the mail piece, or on the front-if space permits. 1. Article Addressed to: c.~ '< 0 <. \8o~\e- l~ 1M.u .t',~.,€( :P 1\ \ ~"\)L{ R. 6~~ ~f' 2. Article ~ 1sp~ P.l! f\'!'" , ".",;\'. ,-""" , T~ ,'-." ----", ,-,-. l',~_ -'.~,!"'lJ ~"7"_' -,~, _~," "O~, :'~lo''-'__"''',,, ',"';'_0"'.' '_':"-._~',~,L':)>",;, c'. _'.,"_ ~__'_""'_ :5 \,\ A ..x .wUO o Agent o AddreSsee o V.. ON<> D. Is delivery add ifferElnt from iteri11!? If YES, enter delIvery address below: \.~rvice Type ~ Certified Mail o Registered . D Express Mail eturn Receipt'for Merchandise , , --~ 4. ~':l:!r:!.~_ed__ DellvelY? (Ext'!1 Fee) \,1 "-'-."'=. ~M'09S2 I " "'~ ~, . ,,-, ".".N'.. 0 ~ CJJ ~ 0 c .:r::. ~ $: l"JOJ .-:, ~ f" Iii fTl -::J Z Z:JJ "J Zt;:: K --c. ~ ~:Z GC .',', '- :3 ---I'- ~O < -..0 :D ;PC ~ Z . - ~ ~ .;.. -C:: ..r: ~ _.~_"H < <~_~_~._'^, :'! ,_~",_"<,, V-'''''I'__-'^'__:c''~,;~~''::'''_ ,<_~__~1~_~!'lT_,,:,~_\:, ,'. , ~7",:,;:,'T::~_~;-_?',: .'__ ,._~_.~_,~Jrr:'(1l.":)-_ .; r --<)k~?,,~. ,,"~<_'''',. ", '"or IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JAMES A. ORRIS, Civil Action-Law Plaintiff vs. 01-6957 CATHY R. ORRIS, Defendant Divorce AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under ~3301 (c) of the Divorce Code was filed on December 10, 2001. 2. The marriage of the Plaintiff and the Defendant is irretrievably broken and ninety days have elapsed from the date of filing and the date of service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. 4. I understand that I may lose rights concerning alimony, division of property, lawyers' fees or expenses if I do not claim them before a divorce is granted, I verify that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 PA. C.S.A. ~4904 relating to unsworn falsification to authorities, vflq\...! 2 S) Q~o 3 ~d(L~ J s A. Orris, Plaintiff -. " .,.t", ." , .",:,' _'. ,-'l~, - _,<" - - ~? - " _., "_,~'.O . , o. _ JL ""'~' ^'. e.^< e.," _ "". ~,~, ~,,~ ~n' "~~-, ^~, ~'~~_". ~^",""-..,,.~ (] $= ~r; _e'" '_' ~~. -~( ! )>(~. ...::;; :3 - ~~ ~_'Mo,.~ .~ __w,_ _ ",";" C.i C<) ~~ ~Or> ""'";J ::0 J::T~ -~;--., Sf~ , '')~n -:;:~r.) ~-~;n'1 :::.' :5J -< '-.0 :'V ~~ -., ~-'," ~.. __j~IT,-:-,~_.-,?,,'e,rrnJ~~~~~!i"Y'*'l'*';"i!!l'!"'''/W~~w~]!!ll. ,~"-~ ,,_;~~fjWJ\'J.!1:~~1~~; IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JAMES A ORRIS, Civil Action-Law Plaintiff vs, 01-6957 CATHY R. ORRIS, Defendant Divorce WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DNORCE DECREE UNDER S3301 (C) OF THE DNORCE CODE 1. I consent to the entry of a final decree of Divorce without notice, 2. I understand that I may lose rights concerning alimony, divisio:t\.property, lawyer's fees or expenses if! do not claim them before a Divorce is granted. 3. I understand that I will not be Divorced until a Decree is entered by the Court and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. I hereby verifY that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 PA C.S.A ~4904, relating to unsworn falsification to authoriti6ll. C?~\--ck 28) ~"o3 J es A Orris, Plamtiff \;'-OJ!'~I(!,,~l '0 "."., '""_~_""_'~_' I~,,__~ .,_._ ~ '-"r"' '-" _. e "',, ~ ., . , '~._<"'->,-._-~ --~ """"""''--' ~> . 7_ ., ~ ,,,,,,,,,,,",-",~- O~_, a~ o f; ..:'c v(:Ti ~~f: (/1,,:" ~i'; ,,:::- PC' Z{< :PC" z =< ~) ~~ o ~"I ),~_.. :':-~1 ;::.;-._" -:'L LQ :" ./,1'W:~__.~,~,; _.. _~~M!!i~~r,~'!J]!~~+"!'~f'.."'~',~:f~~~~i-\;m~~""..;;t'ffi'i'!@r!; ,,,:, --~!I!Pf~~)j IN THE COURT OF COMMON PLEAS CUMBERLAND COUNlY, PENNSYLVANIA JAMES A. ORRIS, Civil Action-Law Plaintiff vs. 01-6957 CATHY R. ORRIS, Defendant Divorce AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under 93301 (c) of the Divorce Code was filed on December 10, 2001. 2. The marriage of the Plaintiff and the Defendant is irretrievably broken and ninety days have elapsed from the date of filing and the date of service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree, 4. I understand that I may lose rights concerning alimony, division of property, lawyers' fees or expenses if! do not claim them before a divorce is granted. I verifY that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 PA. C,S.A. 94904 relating to unsworn falsification to authorities, yY)ctl,...~ '( ~ I 1..~~ 3 ~11.~ Cathy R. 0 s, efendant c2ol- &A-78 j () ;;;"c'_;-'_"''''_" - ,~ - '-, . <c" _ ~ c" "'I_ ' . "'.-, - '~'F"'" 'r~- - ' ",." ,,"-,~ , -:::-:: ~.~~"-..."'-~~""~,,, J --.....~::":'c __ "A'_^'"''''''''''' ""~ .~.__ ~~ (") C' C) C CJ '< ~'!1 VCCl ::::0.. -, rnrT' ~g Z::;;' , ~~~-- _D r--"- (:1 <'-- "Tl ):<'C. - .. ~:IJ be. C) Pc V) -; iTi ::::: ,'\.) :l~" =2 'n :.< (5 M~ ~"""",~_~'f''',_''1,~.{i1'J~l'P'~',(~;:'~?'~'l'''''?o'lI[<IM"HJ!!'l1i,il!j!1I!:!H~;'!i!~~~r~ IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JAMES A ORRIS, Civil Action-Law Plaintiff vs. 01-6957 CATHY R ORRIS, Defendant Divorce WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DNORCE DECREE UNDER S3301 (C) OF THE DNORCE CODl;j l, I consent to the entry of a final decree of Divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if! do not claim them before a Divorce is granted. 3. I understand that I will not be Divorced until a Decree is entered by the Court and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. I hereby verify that the statements made in this Affidavit are true and correct, I understand that false statements herein are made subject to the penalties of 18 PA C.S.A ~4904, relating to unsworn falsification to authorities. ~A.~ Cathy R ms, Defendant VV(q~~ ~ ~ ilJo rs J j,OI-u,4-7 g 36 , '''.<'!';!J!i4 ~ . , "~"'" '.,_ '"~ ," 1 r _''f' ~, --r'_ .-,~--, ,,,~" ~-~""~, ~ " ,~,c "~ ...,... i ,~, iJ[ _ ~~, o ~ ~W: (n "':- -<~~ L<Cc ......"",~'. ~~~i:' "7" -I .-.:. ~~ f;1J .J ;.Ci ~"J' ~. "'im<~~',W,~"~~~1"r,'f-l'-"f','*,~ifl'.~~~,1~,"Il)<'~~if!I'~'*F"1t'!. '('~V-"--_" SOCIAL SECURITY INFORMA nON SHEET PURSUANT TO 23 Pa. C.S.A. SECTION 4304, 1 (a) (3), ALL DIVORCES MUST INCLUDE THE PARTIES SOCIAL SECURITY NUMBER. PLEASE FILL IN THE APPROPRIATE INFOR.'vfATION AND RETTJR.."i THIS FO&\f TO THE PROTHONOTARY'S OFFICE. Date: ~?\-.:\ '< \ ~ DO '3 DOCKET NUMBER: 0 l - \.9 '1 S 1- PLAlNTIFF/PETITIONER NAME: d~~e..:,~' ()\J-.v.-::~ SOCLAL SECURITY # \ l,;,C't - S g - o.s 3, 2 DEFENDAt'IT/RESPONDENT NAt\fE: c=: ~ T'i 1 SOCIAL SECURITY # ~ I ()lrl-':- ~ ':2D l -l. \..f - t 8.30 c,', _ '-'1-' ,'co, - ,~ .j1--! , ~-' . r-,r-~_ -, .~" ,",'"""