HomeMy WebLinkAbout01-7181 FX
CECILIA BROADWATER,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
vs.
: NO.: 01-7181
GEORGE BROADWATER,
Defendant
: CIVIL ACTION - LAW
: IN DIVORCE
AFFTOA VTT OF SF.RVTC'F.
TO THE PROTHONOTARY:
I, Marlin 1. Markley, Esqnire, verifY that the Notice of Intention to Request Entry of
3301(d) divorce decree and Counter-Affidavit under S 3301(d) of the divorce decree has
been served upon the Plaintiff's attorney by first class, certified mail # 7000-1670-0005-
2769-4545, postage prepaid, return receipt requested, pursuant to the requirements ofPa.
R.C.P. 1930.4.
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.. .-. - ,i$t8'. 1 an4'or 2 for addlllonal seMoeB.
'ii "C<imfjl8t& Items 3, 4a, and 4b.
I -Print Your name and address on the reverse of this form 10 that we can retumthis
_ card to you.
I -Attach this fann to the front of the mallp1ece, or on the back if space does not
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at -Write-Return Receipt Requsstecl- on themallplece.belC?Vi the article number.
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Respectfully submitted,
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'Date: 7 - 2. 2. . G 0 (J )
. Markley, Esquire
Law ces of Patrick F. Lauer, Jr., LLC
2108 Market Street, Aztec Bnilding
Camp Hill, Pennsylvania 17011-4706
ID# 84745 Tel. (717) 763-1800
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CECILIA BROADWATER,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
VS.
: NO.: 01-7181
GEORGE BROADWATER,
Defendant
: CIVIL ACTION - LAW
: IN DIVORCE
AFmnAVTT OF SF.RVTCF
TO THE PROTHONOTARY:
I, Marlin 1. Markley, Esquire, verifY that the Affidavit under 11 3301(d) of the
divorce code has been served upon the Plaintiff's attorney by first class, certified mail #
7000-1670-0005-2769-4538, postage prepaid, retnrn receipt requested, pursuant to the
requirements ofPa. R.C.P. 1930.4.
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11 .Com~,ilIlms 3. 48. and 4b.
CD -Print your name and address on the reverse of this form 80 that we' can retum this
l!- oard 10 you.
! -Attach this form to the front of the rnallpi8C8, or on the back if space does not
~ permit.
!II 'W!ilIl.Retum Recelpt~' on \he moIIpieco below the _ number.
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102595-97.8-0179
itted,
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:: Date: 7-2-'2.. - Lt?05
Marlin arkley, Esquire
Law Offi es of Patrick F. Lauer, Jr., LLC
2108 Market Street, Aztec Building
Camp Hill, Pennsylvania 17011-4706
ID# 84745 Tel. (717) 763-1800
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CECILIA BROADWATER,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
vs.
:NO.: 01-7181
GEORGE BROADWATER,
Defendant
: CIVIL ACTION - LAW
: IN DIVORCE
PR A F.C:TPF. TO TR A NSMTT RF.C:ORO
To the Prothonotary:
Transmit the record, together with the following information, to the Conrt for entry
of a divorce decree:
1. Ground for Divorce: Irretrievable breakdown under S 3301(,,) S 3301(d)(l) of the
Divorce Code. (Strike out inapplicable section)
2. Date and Manner of service of the Complaint: nefenchnt "~~eptecl .ervi~e nf the
~nmphint in ne~emhp.r nf?OOl
3. (Complete either paragraph (a) or (b).)
(a) Date of execution of the affidavit of consent required by S 3301(c) of
the Divorce Code: by the Plaintiff : by the Defendant
(b) Date of execution of the affidavit required by S 3301(d) of the
Divorce Code: M"y?6 ?OO~
Date of filing of the FlaillGff',/Defendant's affidavit upon the
respondent: Tnne '. ?OO~
Date of service of the FlaillGff',/Defendant's affidavit upon the
respondent: Tnne 9. ?OO~
4. Related claims pending:
N()n~ No c:bim" r~i"p.i1
5. (Complete either paragraph (a) or (b).)
(a) Date and manner of service of the Notice of Intention to File
Praecipe to Transmit Record, a copy of which is attached, SeTVecl ~ertifiecl
m"ilnpnn Phintiff'. "ttnmey nn Tnly 1. ?OO~
(b) Date Plaintiffs Waiver of Notice in S 3301(c) Divorce was filed with
the prothonotary:
Date Defendant's Waiver of Notice in S 3301(c) Divorce was filed
with the prothonotary:
/ /.,...----,
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ad' . Markley, Esquire
Law 0 ces of Patrick F. Lauer, Jr., LLC
2108 Market Street, Aztec Building
Camp Hill, Pennsylvania 17011-4706
ID# 84745 Tel. (717) 763-1800
Date: '7- 22 - 2.. 1J Ii S-
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CECILIA BROADWATER,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Vs.
NO. 01 - 7181 CIVIL
GEORGE BROADWATER,
Defendant
IN DIVORCE
ORDER OF COURT
AND NOW, this
f9~ ~
,;7' day of ~
having been filed December 27,
2005, a divorce complaint
2001, and no economic claims having been raised in the
proceedings, and the parties having been separated for a period
in excess of two years as averred in the affidavit under
Section 3301(d), there being no matters, therefore, pending
before the Master, the appointment of the Master is vacated.
BY THE COURT,
cc: u(arlin L. Markley
Attorney for Plaintiff
.)fryan S. Walk
Attorney for Defendant
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CECILIA BROADW AlBR,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: Cillv1BERLAND COUNTY, PENNSYLVANIA
v.
: N.o. 01-7181
GEORGE BROADWATER,
Defendant
: CIVIL ACTION - DIVORCE
NOTICE OF INTENTION TO REQUEST ENTRY
OF ~ 3301(d) DIVORCE DECREE
TO: CECILIA BROADWATER, Plaintiff
cIa Bryan S. Walk, Esquire
PO Box 650
Hershey, P A 17033
You have been sued in an acti.on far diy.orce. Y.ou have failed to answer the complaint or
file a c.ounter-affidavit t.o the S 3301(d) affidavit. Theref.ore,.on.or after the 22nd day of July
2005, the .other party can request the conrt t.o enter a final decree in div.orce.
Ify.ou do n.ot file with the Proth.on.otary .oftheC.onrt an answer with y.our signature
notarized or verified .or a c.ounter-affidavit by the above date, the c.onrt can enter a final decree in
diVorce. A c.ounter-affidavit which y.ou may file with the Proth.on.otary .of the Court is attached t.o
this notice.
Unless y.ou have already filed with the c.onrt a written claim far ec.on.omic relief, y.ou must
d.o sa by the above date, .or the c.onrt may grant the div.orce and you will lase f.orever the right t.o
ask far econ.omic relief. The filing of the attached fonn c.ounter-affidavit alone does n.ot protect
your economic claims.
YOU SHOULD TAKE TIDS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT
t _ '.
HAVE ALA WYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TOFlND OUT WHERE YOU CAN GET LEGAL HELP.
Cillv1BERLAND COUNTY BAR ASSOCIATION
32 souIiI BEDFORD STREET
CARLISLE, P A 170.13
(717)249-3166
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CECILIA BROADWATER,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
. : CUMBERLAND COUNTY, PENNSYLVANIA
v.
: No. 01-7181
GEORGE BROADWATER,
Defendant
: CIViL ACTION - DIVORCE
COUNTER-AFFIDAVIT UNDER ~ 3301(d) OF tHE DIVORCE CODE
1. Check either (a) or (b):
D (a)I do not oppose the entry of a divorce decree.
D (b) I oppose the entry of a divorce decree because:
Check (i), (ii), or both:
. D (i) The parties to this action have not lived separate and apart for a period of
at least tWo years. .
D (ii) The marriage is not irretrievably broken.
2. Check either (a) or (b): .
D (a) I do not wish to make any claims for economic relief. I understand that I may lose rights
concerning alimony, division of property , lawyer's fees, or expenses if I do not claim them before
a divorce is granted. .
D (b) I wish to claim economic relief which may inclnde aIimony, division of property,
lawyer's fees, or expenses or other important rights.
I understand that in addition toc)1ecking (b) above, I must also file all of my economic
claims with the prothonotary in writing and serve J:4em on the other party. If I fail to do so before
the date set forth on the Notice of Intention to Request Divorce Decree, the divorce decree may
be entered without further delay.
I verify that the statements made in this counter-affidavit are true and correct. I
understand that false statements herein are made subject to the penalties of 18 Pa. C.S. S 4904
relating to unsworn falsification to:authorities.
Date:
Cecilia Broadwater, Plaintiff
. .
NOTICE: m'YOUDONOT WISH TO OPPOSE THE. ENTRY OF.A DIVORCE
. - . ., ' - . - . .
DECREE AND YOU DO NOTWis:u'roMAKE ANY CLAIM FOR ECONOMIC
. RELffiF, YOU SHOULD NOT FILE TillS COUNTER"AFFIDAVIT
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
STATE OF
CECILIA BROADWATER,
VERSUS
Plaintiff
GEORGE BROADWATER,
Defendant
AND NOW,
PENNA.
No.
01-7181
DECREE IN
DIVORCE
.
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3dor, IT IS ORDERED AND
~
DECREED THAT
CECILIA BROADWATER
, PLAINTIFF,
AND
GEORGE BROADWATER
, 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;
NONE.
.
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PROTHONOTARY
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JUL-25-2005 01:31 PM PATRICK LAUER
P.01
THE LAW OFFICES OF PATRICK F. LAUER, JR., L.L.C.
2108 MARKET STREET, AZTEC BUILDING
CAMP HILL, PENNSYLVANIA 17011
(717) 763-1800 FAX (717) 763-4247
Illlply to Camp Hill Addr"..
Patrick F. Lauer, Jr., Eaq.'
Marlin L. Markley, E.q."
Jo.eph D. Caraclolo, E.q.
1-800-822.4.LAW
Satellite om..:
8 S. Hanover Slre.1
Carll.le, PA 17015
WUf- .1..1 pOI /'OA_
TELEFAX DOCUM.ENT INFOIlMATION SHEET
TO:
E. Robert Elicker. II
FAX:
240.7890
FROM:
Marlin 1" Markley, Esquire
DATE:
July 25, 2005
RE:
Broadwater Divorce; 01.7181
Nwnber of pages including cover sheet:
[fyou have not received all pages, plellSe conlact: Shelby @ 717-763-1800
Additional Comments:
I have filed the necessary documents to finalize the above caption
divorce with the prothonotary's office. The prothonotary's office has
informed me you currently nave the file in your possession and are
unable to proceed with their documents until they receive the file back
from your office.
Can you please vacate your position in this case as no
economical issues have been raised. If you have any further questions
or concerns, please do not hesitate to contact me.
.1I!i/)Ooard CtrliJied~' Q Cl'lmhlUl Tr;,,' Advocme by tlht ."-'llIiQflUI Board a/Tri(JI AdvtJcac.v.
.. ,eft). Member: Nalirm(l( AssoclatJm, n/Crimina( /)ejimse Low.vtr~
NOTICE: TI-IE INFORMATION CONTAINED iN TillS fACSIMILE TRANSMISSION IS ATTORNEY I'RIVILEOr;D AND CONFIDENTiAl.
INFORMATioN INTl:NDllO ONLY FOR nil: US!; OF TH~ ABOVE.NAMEl) AllllIIESSr:iE. IF THE RMUER 15 NIYI' 'I1-IE INTENDI!I>
RECIPmN'f. YOU ARE I..UJRP.9V N()TIPI1~O n'IA'l' ANY l')lSSliMIN^'I'ION, [)IS'rI(IUUTION OR COl~y Ol' TI'I1S f'A,CSIMILP. IS STR./CT1.Y
I'ROflllll'rml. If" YOU HAve IlfiCRIV[iJ> '1'IilS TIIANSMISS,()N IN EIIIIOII. I'LE^,E NOTIFY US IMMm>IATI:LY BY Tf:LLI'IiONE AND
I\ETUIIN '1'''1' ORIGINAL MES....GE TO US AT TIll; AI>lJ/\l'-:S.S SET FORTI'I ABOVE
';,
CECILIA BROADWATER
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION LAW
:
VB.
.
.
N'Ol _ 7181
IN DIVORCE
CIVIL
19
GEORGE BROADWATER
Defendant
STATUS SHEET
DATE:
ACTIVITIES:
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CECILIA BROADWATER,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
vs.
No. 01-7181 CIVIL TERM
GEORGE BROADWATER,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
NOTICE TO THE DEFENDANT
IF YOU WISH TO DENY ANY OF THE STATEMENTS SET FORTH IN THIS
AFFIDAVIT, YOU MUST FILE A COUNTERAFFIDAVIT WITHIN. TWENTY (20)
DAYS AFTER THIS AFFIDAVIT HAS BEEN SERVED ON YOU OR THE STATEMENTS
WILL BE ADMITTED.
AFFIDAVIT UNDER SECTION 3301Cd) OF THE DIVORCE CODE
1. The parties to this action separated on or about December
2001, and have continued to live separate and apart for a period
of at least two years.
2. The marriage is irretrievably broken.
3. I understand that I may lose rights concerning alimony,
division of property, lawyer's 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. 5 4904 relating to unsworn
falsification to authorities.
DATE: rife t1ftY ().5
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CECILIA BROADWATER
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
v.
No. O~~ 11ft
CiLJ{ '1-\
CIVIL ACTION - DIVORCE
GEORGE BROADWATER
Defendant
NOTICE TO DEFEND AND CLAIM RIGHTS
YOU 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 of 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 Plaintiff. 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
Prothonotary Dauphin County Courthouse, Harrisburg, P A.
IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY
LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED,
YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM.
YOU SHOULD TAY.E THIS 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.
CUMBERLAND COUNTY LAWYER REFERRAL SERVICE
2 LIBERTY AVENUE
CARLISLE, PA 17013
(717) 249-3166
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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
No. 01 - 7/J' ( <21~~ L 't-<rt"l-L
CECILIA BROADWATER
Plaintiff
GEORGE BROADWATER
Defendant
CIVIL ACTION - DIVORCE
COMPLAINT UNDERSECTION 3301(c)
OF THE DIVORCE CODE
TO THE HONORABLE, JUDGES OF SAID COURT:
AND NOW, comes Plaintiff, Cecilia Broadwater, by Bryan S. Walk Esq., and represents
as follows:
COUNT I
DIVORCE UNDER SECTION 3301(c)
OF THE DIVORCE CODE
I. Plaintiff is Cecilia Broadwater, who currently resides at 108 Rear South 16th Street,
Camp Hill, Cumberland County, Pennsylvania, and has resided there for approximately 11
(eleven) years.
2. Defendant is George Broadwater, who currently resides at 108 Rear South 16th Street,
Camp Hill, Cumberland County, Pennsylvania, and has resided there for approximately 11
(eleven) years.
3. Plaintiff has been a bona fide resident in the Commonwealth for at least six (6)
months immediately previous to the filing of this Complaint.
4. The Plaintiff and Defendant were married on, November 17, 1990 in Corriganville,
Maryland.
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5. There have been no prior actions of divorce or annulment between the parties.
6. The Plaintiff is a citizen of the United States of America.
7. The Defendant is not a member of the Armed Services of the United States of
America or its Allies.
8. The marriage is irretrievably broken.
9. The Plaintiff has been advised that counseling is available and that Plaintiff may have
the right to request that the Court require the parties to participate in counseling.
WHEREFORE, Plaintiff requests the Court to enter a Decree in Divorce pursuant to
Section 330 I (c) of the Divorce Code dissolving the marriage between the Plaintiff and the
Defendant.
/
Bry alk
I. .# 63881
108 - 112 Walnut Street
Harrisburg, P A 171 0 1
(717) 238-5113
ATTORNEY FOR PLAINTIFF
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VERIFICATION
The undersigned verifies that the statements made in the foregoing Petition are true and
correct. I understand that false statements herein are made snbject to the penalties at 18 Pa.C.S.
A., ,\':4904 relating to Unsworn Falsification to Authorities.
DATE: I)-fe-or
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Cumberland County Prothonotary's Ottice
Case Entries
2001-07181 BROADWATER CECILIA
Filed Date: 12/27/2001 Time:
Search Date:
(vs) BRAODWATER GEORGE
10:37 Case Type: COMPLAINT - DIVORCE
Page
2 of
2
-------------------------------------------------------------------
7/22/05 NOTICE OF INTENTION TO REQUEST ENTRY OF 3301 (D) DIVORCE DECREE
-------------------------------------------------------------------
7/22/05 COUNTER-AFFIDAVIT UNDER 3301 (D) OF THE DIVORCE CODE
-------------------------------------------------------------------
7/22/05 AFFIDAVIT OF SERVICE
7/22/05 AFFIDAVIT OF SERVICE
7/22/05 PRAECIPE TO TRANSMIT RECORD
- - - - - - - - - - - - - - LAST ENTRY - - - - - - - - - - - - - -
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PYS510D
Cumberland County Prothonotary's Ottice
Case Entries
2001-07181 BROADWATER CECILIA (vs)BRAODWATER GEORGE
Filed Date: 12/27/2001 Time: 10:37 Case Type: COMPLAINT - DIVORCE
Search Date: Page 2 of 2
- - - - - - - - - - - - - FIRST ENTRY - - - - - - - - - -
12/27/01 COMPLAINT - DIVORCE
-------------------------------------------------------------------
4/27/04 AFFIDAVIT OF CONSENT - DEFENDANT
4/12/05 MOTION FOR APPOINTMENT OF DIVORCE MASTER - BY MARLIN L MARKLEY ESQ
4/13/05 ORDER APPOINTING MASTER DATED 04-13-05 - E ROBERT ELICKER II IS
APPOINTED MASTER IN DIVORCE BY THE COURT GEORGE E HOFFER PJ -
COPIES MAILED 04-13-05 AND ORIG PLACED IN ELICKERS FILE
6/03/05 AFFIDAVIT UNDER SECTION 3301D OF THE DIVORCE CODE - BY GEORGE
BROADWATER
6/03/05 PETITION FOR CONTEMPT/MODIFICATION OF CUSTODY - BY DIANE S BAKER
ESQ +
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CECILIA BROADWATER,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
vs.
: No. 01-7181 Civil
GEORGE BROADWATER,
Defendant
: CIVIL ACTION - LAW
: IN DIVORCE
ORnRR
AND NOW, this /3 -tit dayof 4~ ,2005,E.ROBERT
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ELICKER, II, is hereby appointed Master in Divorce.
BY THE COURT:
f. J.
. Distribution:
I~~arlin 1. Markley, Esq., 2108 Market St., Camp Hill, PA 17011
1~ans. Walk, Esq., 114 West Chocolate Ave., Hershey, PA 17033
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CECILIA BROADWATER,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
vs.
: No. 01-7181 Civil
GEORGE BROADWATER,
Defendant
: CIVIL ACTION - LAW
: IN DIVORCE
MOTION FOR A PPOTNTMF.NT OF M ASTRR
AND NOW COMES, the Defendant, George Broadwater, by and through his attorneys, The
Law Offices of Patrick F. Lauer, Jr., and moves the Court to appoint a Master with respect to the
following claims;
(X) Divorce ( ) Distribution of Property
( ) Annulment ( ) Support
( ) Alimony ( ) Counsel Fees
( ) Alimony Pendente Lite () Costs and Expenses
and in support of the Motion states:
I. Discovery is complete as to the claims for which the appointment of a master is
requested;
2. The Plaintiff has appeared in the action by counsel Bryan S. Walk, Esquire.
3. The statutory grounds for divorce are 330I(c) and 3301 (d).
4. The action is contested and no agreement has been reached with respect to the
claim.
5. The action does not involve complex issues oflaw or fact.
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6. The hearing is expected to take one (1) day.
Respectfully submitted,
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Date: April 12, 2005
"Marl' L. arkley, Esqnire
2108 Mar et Street, Aztec Building
Camp Hill, Pennsylvania 17011-4706
ID# 84745 Tel. (717) 763-1800
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CECILIA BROADWATER,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
vs.
: No. 01-7181 Civil
GEORGE BROADWATER,
Defendant
: CNIL ACTION - LAW
: IN DNORCE
CF:RTIFTCA TF: OF SF:RVTCF.
I, Marlin L. Markley, Esquire, hereby certiJy that on the below-noted date, served a true and
correct copy of the foregoing Motion for Appointment of Master upon the following named counsel
by depositing same, postage prepaid, in the United States Mail, addressed as follows:
. Bryan S. Walk, Esquire
114 West Chocolate Avenue
Hershey, PA 17033
arlin L. arkley, Esquire
2108 Market Street, Aztec Bnilding
Camp Hill, Pennsylvania 17011-4706
ID# 84745 Tel. (717)763-1800
Date: April 12, 2005
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CECILIA BROADWATER,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
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vs.
: No. 01-7181
GEORGE BROADWATER,
Defendant
: CIVIL ACTION - DNORCE
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DEFENDANT'S AFFIDAVIT OF CONSENT
UNDER SECTION 3301(c) OF THE DIVORCE CODE
1. A complaint in divorce under Section 3301(c) of the Divorce Code was filed on
December 27,2001.
2. The marriage of the Plaintiff and the Defendant is irretrievably broken and ninety days
have elapsed from the date of the filing and 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 verilY 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. ~ 4904 relating to unsworn
falsification to authorities.
Date: I{ - J../~ C1 t{
Signature: ~/:AAM/~
George Broadwater
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