HomeMy WebLinkAbout03-2898BECKY L. W1NKLEMAN,
Plaintiff
THOMAS B. WINKLEMAN, JR.,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL AC...TION - I~W
IN DIVORCE
NOTICE TO DEFEND AND CLAIM RIGHTS
TO:
Thomas B. Winkleman, Jr.
5329 Roxbury Road
Shippensburg, PA 17257
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 judgmem 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 fights important to you.
When the ground for 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 the Cumberland County Courthouse, One Courthouse Square, Carlisle,
Pennsylvania.
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 TAKE 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 BAR ASSOCIATION
2 Liberty Avenue
Carlisle, Pennsylvania 17013-3387
PHONE: (717) 249-3166
BECKY L. WINKLEMAN,
Plaintiff
THOMAS B. WINKLEMAN, JR.,
Defendant
1N THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
IN DIVORCE
COMPLAINT IN DIVORCE
1. The Plaintiff, Becky L. Winkleman, is an adult individual currently residing at 55
Fickes Road, Newville, Cumberland County, Pennsylvania, 17241.
2. The Defendant, Thomas B. Winkleman, Jr., is an adult individual currently
residing at 5329 Roxbury Road, Shippensburg, Franklin County, Pennsylvania, 17257.
3. Plaintiff and Defendant have been bona fide residents of the Commonwealth for
at least six months immediately prior to the filing of this Complaint.
4. Plaintiff and Defendant were married on September 4, 1999, in Cumberland
County, Pennsylvania.
5. Neither Plaintiff nor Defendant is in the military or naval service of the United
States or its allies within the provision of the Soldiers' and Sailors' Civil Relief Act of the
Congress of 1940 and its amendments.
6. Plaintiff's Social Security number is 194-60-2227, and Defendant's Social Security
number is 179-62-2438.
7. There have been no prior actions of divorce or for annulment between the parties.
8. Plaintiffhas 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.
10.
11.
12.
Defendant.
There was one child bom of this marriage, Evan Thomas (d.o.b. 3-21-01).
The marriage is irretrievably broken.
The parties have been living separate and apart since April 11, 2003.
Plaintiff requests the Court to enter a decree of divorce, divorcing Plaintiff and
WHEREFORE, Plaintiff requests that this Court enter a decree in divorce, and emer such
other orders as are appropriate and just.
METZGER, WICKERSHAM, KNAUSS & ERB, P.C.
By
Andrew C. Spears, Esquire
Attorney I.D. No. 87737
P.O. Box 5300
Harrisburg, PA 17110-0300
(717) 238-8187
Attorneys for Plaintiff
Dated:
VERIFICATION
I, Becky L. Winkleman, hereby certify that the facts set forth in the foregoing Complaint in
Divorce are tree and correct to the best of my knowledge, information and belief, and that false
statements herein are made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unswom
falsification to authorities.
Becky L. Wimldo~an
281164-1
BECKY L. WINKLEMAN,
Plaintiff
THOMAS B. WINKI.EMAN, JR.,
Defendant
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND C. OUNTY, PENNSYLVANIA
:
: NO. 2003-2898 CIVIL TERM
:
: CIVIL ACTION - LAW
: IN DIVORCE
BECKY L. WINKLEMAN,
Plaintiff
THOMAS B. WINKLEMAN, JR.,
Defendant
: IN THE COURT O_,F~ COMMON PLF~S
CUMBERLAND LOUNTY, PENN~S
: NO. 2003-2185 CIVIL TERM
:
: CIVIL ACTION - LAW
: ~ CUSTODY
PETITION OF COUNSEL FOR LEAVE TO WITHDRAW
Thomas S. Diehl, Esquire, hereby respectfully petition,', this Honorable Court for Leave
to Withdraw as Counsel for the Defendant, Thomas B. Winkleman, Jr., and in support thereof,
avers as follows:
1. Petitioner is Thomas S. Diehl, Esquire.
2. Respondent is Thomas B. Winkleman, Jr.
3. Petitioner was retained by the Respondent on or about May 14, 2003 to represent
him in the above-captioned actions.
4. Respondent has failed to pay billed fees, and[ has been notified in writing of
Petitioner's intention to withdraw as counsel.
5. Petitioner's continued representation of the Respondent without compensation
would result in an unreasonable financial burden to the Petitioner.
6. Plaintiff, Becky Winkleman, is represented in these matters by Andrew C. Spears,
Esquire.
WHEREFORE, the Petitioner, Thomas S. Diehl, Esquire, respectfully requests this
Honorable Court to issue a Rule upon the Respondent to show cause, if any, why the Petitioner
should not be granted leave to withdraw as counsel.
Respectfully submitted,
One West High Street, Suite 208
Post Office ][tox 1290
Carlisle, Permsylvania 17013
(717) 240-0833
I.D. Number: 78942
VERIFICATION
I verify that the statements made in the foregoing Petition are true and correct. I
understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4909
relating to unsworn falsification' to authorities.
T._hT._hT._hT._hT._~s S. Diehl, EsqXaire
CERTIFICATE OF SERVICE
I hereby certify this 30th day of September 2003, that a true and correct copy of the
foregoing document was served on the following individuals; via first-class mail, postage
prepaid:
Andrew C. Spears, Esquire
Metzger Wickersham
3211 North Front Street
P.O. Box 5300
Harrisburg, PA 17110-0300
Thomas B. Winkleman, Jr.
5349 Roxbury Road
Shippensburg, PA 17257
Legal Assistant
BECKY L. WINKLEMAN,
Plaintiff
THOMAS B. WINKI .I~.MAN, JR.,
Defendant
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: /
: NO. 2003-2898 CIVIL TERM
:
: CIVIL ACTION - LAW
: IN DIVORCE
BECKY L. WINKI .~MAN,
Plaintiff
THOMAS B. WINKI .F. MAN, JR.,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 2003-2185 CIVIL TERM
CIVIL ACTION - LAW
IN CUSTODY
ORDER OF COURT
day of
AND NOW, this ,2003, the within Petition of
Counsel For Leave to Withdraw having been read, considered, and ordered filed, the Court
hereby orders that a Rule be and is issued upon the Respondent, Thomas B. Winkleman, Jr., to
show cause why the Petitioner should not be permitted to withdraw as counsel, said Rule to be
returnable within ] 0 days of service of the date of this Order.
BY THE COURT:
CC:
J~omas S. Diehl, Esquire
Petitioner
~omas B. Winkleman, Jr.
Respondent
~Atndrew Spears, Esquire
C.
torney for Plaintiff
lO- 09
MARITAL SETTLEMENT AGREEMENT
THIS AGREEMENT, made this ~ day of~, 2004, by and between Becky
L. Winkleman (hereinafter "Wife") of Carlisle, Cumberland County, Pennsylvania, and Thomas B.
Winkleman, Jr., (hereinafter "Husband") of Shippensburg, Franklin County, Pennsylvania.
WITNESSETH:
WHEREAS, the parties are Husband and Wife, married on September 4, 1999, in
Cumberland County, Pennsylvania; and
WHEREAS, one child was bom of the marriage: Evan Thomas Winkleman (d.o.b.
3/21/01); and
WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the
parties, and it is the intention of Wife and Husband to live separate and apart, and the parties hereto
are desirous of settling fully and finally the respective financial and property rights and obligations
as between each other, including, without limitation by specification:
Settling of all matters between them in relation to the ownership and equitable
distribution of real and personal property;
Settling of all matters between them relating to the past, present and future support,
alimony and/or maintenance of Wife by Husband or of Husband by Wife;
And, in general, the settling of any and all claims and possible claims by either party
against the Estate of the other party.
WHEREAS, the parties are Plaintiff and Defendant, respectively, in a divorce action filed in
the Court of Common Pleas of Cumberland County, Pennsylvania, to Docket No. 2003-2185;
Document (4:243327
AND NOW, in consideration of the mutual promises, covenants, and undertakings
hereinafter set forth and for other good and valuable consideration, receipt of which the parties
acknowledge, Wife and Husband, each intending to be legally bound, hereby covenant and agree as
follows:
1. SEPARATION
Each party shall have the right to live separate and apart from the other party, free from the
other party's interference, authority, and control. Neither party shall interfere with the other or
attempt to interfere with the other, nor compel the parties' cohabitation.
2. HUSBAND'S AND WIFE'S DEBTS
Except as otherwise set forth in this Agreement, the parties represent and warrant to each
other that they have not incurred and will not contract or incur any debt or liability for which the
other or the other's estate might be responsible. Each party shall indemnify and save harmless the
other party from any and all claims or demands made against the other by reason of debts or
obligations incurred by that party.
3. WAIVER OF RIGHTS AND MUTUAL RELEASES
Except as provided in this Agreement, both parties absolutely and unconditionally release
and forever discharge each other and their heirs, executors, administrators, assigns, property, and
estate from any and all rights, claims, demands, or obligations arising out of or by virtue of the
marital relationship, whether such claims exist now or arise in the future. This release shall be
effective regardless of whether such claims arise out of former or future acts, contracts,
engagements, or liabihties of the parties or by way of dower, curtesy, widow's rights, family
exemption or similar allowance, or under the intestate laws, or the right to take against the spouse's
Document #: 243327
-2-
will, or the right to treat a lifetime conveyance by the other as testamentary, or all other rights of a
surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of
Pennsylvania, any state, commonwealth, or territow of the United States, or other country.
Except for any cause of action for divorce which either party may have or claim to have, and
except for the obligations of the parties contained in this Agreement, each party gives to the other an
absolute and unconditional release and discharge from all causes of action, claims, rights, or
demands whatsoever, in law or in equity, which either party ever had or now has against the other,
including, but not limited to, alimony, alirnonypendente lite, spousal support, equitable distribution
of marital property, counsel fees or expenses.
4. DIVISION OF PERSONAL PROPERTY
The parties have divided all items of personal property, except as otherwise specified herein,
to their mutual satisfaction. All personal property currently in Husband's possession shall be the
sole and separate property of Husband. All personal property currently in Wife's possession shall
be the sole and separate property of Wife.
5. MOTOR VEHICLES
Husband shall retain sole and exclusive ownership of the 1988 Plymouth Voyager and 1998
Dodge Stratus in his possession. Wife shall retain sole and exclusive ownership of the 1998 Ford
Expedtion in her possession. Husband and Wife agree to execute, within thirty (30) days of the date
of this Agreement, any and all forms, titles, and documents necessary to transfer the aforesaid
vehicles from joint ownership to individual ownership, as specified herein.
Document #: 245527
-3-
6. .JOINT DEBTS
The parties acknowledge that they have no debts which were jointly incurred during their
marriage with the exception of the following:
Account
(a) Personal debt to Jim and Vesta Eberly
Approximate
Balance Due
$ 2,200.00
Wife agrees to be responsible for Fifty Percent (50%) of that loan in the amount of
$1,100.00 and shall make payment in full to the Eberlys within twelve (12) months of the signing of
this Agreement. Husband agrees to remain Fifty Percem (50%) liable on this debt in the amount of
$1,100.00 and shall make payment in full to the Eberlys within twelve (12) months of the signing of
this Agreement.
Any debts or obligations incurred by either party in his/her individual name, other than those
specified herein, whether incurred before or after separation, are the sole responsibility of the party
in whose name the debt or obligation was incurred.
7. RETIREMENT BENEFITS
Each of the paxties does specifically waive, release, renounce, and forever abandon ail of
their right, ritle, interest, or claim, whatever it may be, in any pension/retirement/profit sharing plan
of the other party, whether acquired through said party's employment or otherwise, and hereafter
the pension/retirement/profit sharing plan shall be identified above as being either husband's or
wife's and shail become the sole and separate property of the party in whose name or whose
employment said plan is carded.
Document #: 243327
-4-
8. DIVISION OF BANK ACCOUNTS
Husband and Wife acknowledge that all joint bank accounts have been closed or divided to
their mutual satisfaction prior to the execution of this Agreement.
9. AFTER-ACQUIRED PROPERTY
Each of the parties shall own and enjoy, independently of any claims or rights of the other,
all real property and all items of personal property, tangible or intangible, hereafter acquired, with
full power to dispose of the same as fully and effectively as though he or she were unmarried. Any
property so acquired shall be owned solely by that party and the other party shall have no claim to
that property.
10. SPOUSAL SUPPORT, ALIMONY PENDENTE LITE, AND ALIMONY
Husband and Wife waive and relinquish all rights, if any, to spousal support, alimony
pendente lite, and alimony. Any transfer of monies between the parties pursuant to any term of
this Agreement shall not constitute alimony, but is made as part of the parties' equitable
distribution.
11. TAX MATTERS
The parties have negotiated this Agreement with the understanding and intention to divide
their marital property. The parties have determined that such division conforms to a right and just
standard with regard to the rights of each party. The division of existing marital property is not,
except as may be otherwise expressly provided herein, intended by the parties to constitute in any
way a sale or exchange of assets. It is understood that the property transfers described in this
Agreement fall within the provisions of Section 1041 of the Internal Revenue Code, and as such
will not result in the recognition of any gain or loss upon the transfer by the transferor.
Document #: 243327
-5-
12. COUNSEL FEES AND EXPENSES
Except as otherwise specified herein, each party shall be responsible for payment of his/her
own counsel fees and expenses.
13. ADVICE OF COUNSEL
The parties acknowledge that each has received or has had the opportanity to receive
independent legal advice from counsel of their selection and that they have been informed fully as
to their legal rights and obligations, including all rights available to them under the Pennsylvania
Divorce Code of 1980, as amended, and other applicable laws.
Each party confirms that he/she understands fully the terms, conditions, and provisions of
this Agreement and believes them to be fair, just, adequate, and reasonable under the existing
circumstances. The parties further confirm that each is entering into this Agreement freely and
voluntarily and that the execution of this Agreement is not the result of any duress, undue influence,
collusion, or improper or illegal agreement.
14. AFFIDAVITS OF CONSENT
Each party agrees to execute an Affidavit of Consent for the obtaining of a no-fault divorce
under the provisions of the Divorce Code of 1980, as amended.
15. EFFECT OF DIVORCE DECREE ON AGREEMENT
Either party may enforce this Agreement as provided in Section 3105(a) of the Divorce
Code, as amended.
As provided in Section 3105(e), provisions of this Agreement regarding equitable
distribution, alimony, alimony pendente lite, counsel fees or expenses shall not be subject to
modification by the court.
Document #: 243327
16. DATE OF EXECUTION
The "date of execution", "date of this agreement", or "execution date" of this Agreement is
the date upon which it is signed by the parties if they sign the Agreement on the same date.
Otherwise, the "date of execution", "date of this agreement", or "execution date" shall be the date
on which the last party signed this Agreement.
17. HEADINGS NOT PART OF AGREEMENT
The descriptive headings preceding the paragraphs are for convenience and shall not affect
the meaning, construction, or effect of this Agreement.
18. SEVERABILITY AND INDEPENDENT AND SEPARATE COVENANTS
Each separate obligation shall be deemed to be a separate and independent covenant and
agreement. If any term, condition, clause, or provision of this Agreement shall be determined or
declared to be void or invalid in law or otherwise, then only that term, condition, clause, or
provision shall be stricken fi:om this Agreement and in all other respects this Agreement shall be
valid and continue in full force, effect, and operation.
19. AGREEMENT BINDING ON HEIRS
This Agreement shall be binding on and shall enure to the benefit of the parties and their
respective heirs, executors, administrators, successors, and assigns.
20. INTEGRATION
This Agreement constitutes the entire understanding of the parties and supersedes any and
all prior agreements and negotiations between them. There are no representations, warranties,
covenants, or promises other than those expressly set forth in this Agreement.
Doct~ment #: 243327
-7-
21. MODWICATION OR WAIVER TO BE IN WRITING
No modification or waiver of any term of this Agreement shall be valid unless in writing
and signed by both parties.
22. NO WAIVER OF DEFAULT
The failure of either party to insist upon strict performance of any term of this Agreement
shall in no way affect the right of such party hereafter to enforce the term.
23. VOLUNTARY EXECUTION
The parties acknowledge that this Agreement is fair and equitable, and that they have
reached this Agreement fxeely and voluntarily, without any duress, undue influence, collusion, or
improper or illegal agreements.
24. APPLICABLE LAW
This Agreement shall be construed under the laws of the Commonwealth of Pennsylvania
and more specifically under the Divorce Code of 1980, as amended.
25. ATTORNEYS' FEES FOR ENFORCEMENT
If either party breaches any provision of this Agreement, the breaching party shall pay all
reasonable legal fees and costs incurred by the other in enforcing this Agreement, providing that the
enforcing party is successful in establishing that a breach has occurred.
Document #: 243327
-8-
1N WITNESS WHEREOF, the parties have set their hands and seals the day and year first
written above.
W1TNESS:
Becky ~_,~ Wi~l~'~aan
Thomas B. Winldeman, Jr.
Doo~ment #: 243327
-9-
COMMONYVEALTH OF PENNSYLVANIA :
:
COUNTY OF ~/~vf~at~ :
SS
On this, the .~day of ~/*~7/' 2004, before me, the undersigned officer, personally
appeared Becky L. Winkleman known to me or satisfactorily proven to be the person whose name is
subscribed to in the foregoing Marital Settlement Agreement, and acknowledged that he executed
the same for the purposes therein contained.
1N WITNESS WHEREOF, I hereunto set my hand and official seal.
CAROL A. LYTER, Notary
City of Harrisburg, Dauphin County My commission Expireg:
My (~o_.mm~_[~ Exp~es D~c. 20, 2004
COMMONWEALTH OF PENNSYLVANIA :
t
COUNTY OF ~)/~P,~r~) :
$$
On this, the ,2~day of ~'~,~f-~. , 2004, before me, the undersigned officer,
personally appeared Thomas B. Winkleman, Jr., known to me or satisfactorily proven to be the
person whose name is subscribed to in the foregoing Marital Settlement Agreement, and
acknowledged that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
NOTARIAL SEAL '-]
CAROL A. LYTER, Notary Public 1
City of Harrisburg, Dauphin Countyl
~_y Commissi<~ Expires Dec. 28, 2oo41
My Commission Expire~.'
Document #: 243327
BECKY L. WINKLEMAN,
Plaintiff
THOMAS B. W1NKLEMAN, JR.,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. 2003~>
1N DIVORCE
PRAECIPE TO TRANSMIT RECOIlI~
TO THE PROTHONOTARY:
Kindly transmit the record, together with the following in:Formation, to the Court for entry
of a Divome Decree:
1. Ground for divorce:
Irretrievable breakdown under Section 3301(c) of the Divorce Code.
2. Date and manner of service of Complaint: A Complaint in Divorce was filed on
May 8, 2003, and served on Defendant on July 2, 2003.
3. Complete either paragraph (a) or (b):
(a) Date of execution of Plaintiffs and Defendant's Affidavits of Consent
required by Section 3301(c) of the Divorce Code:
Plaintiff: February 15, 2004; March 5, 2004
Defendant: February 13, 2004; March 5, 2004
(b)(1) Date of execution of Plaintiff's Affidavit required by Section 3301(d) of the
Divorce Code: NA
(2) Date of filing and service of the Plaintiff's Affidavit upon the respondent:
Filing: NA
Service: NA
300200-1
Complete the appropriate paragraphs:
(a) Related claims pending: None
(b) Claims withdrawn:
None
(c) Claims settled by agreement of the parties:: All
(d)
State whether any written agreement is to be incorporated into the Divorce
Decree: Marital Settlement Agreement.
(a)
Date and manner of service of the Notice of Intention to File Praecipe to
Transmit Record, a copy of which is attached, if the Decree is to be entered
under Section 3301 (d)( 1 )(i) o f the Divorce Code:
Service: NA
(b)
Date Plaintiff's Waiver of Notice in §3301(c) Divorce was filed with the
Prothonotary: March 5, 2004
Date Defendant's Waiver of Notice in §3301(c) Divorce was filed with the
Prothonotary: March 5, 2004
METZGER, WICKERSH,advl, KNAUSS & ERB, P.C.
Dated:
By
Andrew C. Spears, Esquire
Attorney I.D. No. 87737
P.O. Box 5300
Harrisburg, PA 17110-0300
(717) 238-8187
Attorneys for Plaintiff
300200-1
BECKY L. WINKLEMAN,
Plaintiff
THOMAS B. WINKLEMAN, JR.,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. 2003-2185
IN DWORCE
CERTIFICATE OF SERVICE
AND NOW, this \~l ["day of ~ , 2004, I, Andrew C. Spears, Esquire, of
Metzger, Wickersham, Knanss & Erb, P.C., attorneys for Plaintiff, Becky L. Winkleman, hereby
certify that I served a copy of the Praecipe to Transmit Record ~s day by depositing the same in
the United States mail, postage prepaid, at Harrisburg, Pennsylvmfia, addressed to:
Thomas B. Winkleman
32 Center Street
Lot 8
Mt. Holly Springs, PA 17065
METZGER, WICKERSI-IgdM, KNAUSS & ERB, P.C.
By: ~ --
Andrew C. Spears
300200-1
IN THE COURT OF COMMON PLEAS
OF CUMBERLANDCOUNTY
STATE OF PENNA.
BECKY L. WINKLEMAN
VERSUS
THOMAS B. WINKLEMAN, JR.
No. 20o3
AND NOW,
DECREED THAT
AND THOMAS B. WINKLEMAN, JR.
DECREE IN
DIVORCE
BECKY L. WINKLEMAN
ARE DIVORCED FROM THE BONDS OF MATRIMONY.
, IT IS ORDERED AND
, PLAINTIFF,
, DEFENDANT,
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;
The Marital Settlement A~reement between the ~larttes dated
September 26, 2003 is incor~merged herein.
ATTEST:
PROTHONOTARy
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
j~{J( lu I (
{ )J i (j l/ un ({ )'1
Plaintiff
~ FILE NO. -dJj() ~ . Jg1f. ((I()Jch 20E
VS.
IN DIVORCE
ThDmo::-, 1). {Ol (] Irlemlll 'I 3C
Defendant
NOTICE TO RESUME PRIOR SURNAME
Notice is hereby given that the PlaintifflDefendant in the above matter, having
been granted a Final Decree in Divorce on the //la{ch(;/) day of !J7Cf.J.( h ;;trJ:'/,
hereby elects to resume the prior surname of r; () I d p n
and gives this written notice pursuant to the provisions of 54 P.S. 704.
DATE: j-,i'-l-{)<)
j3UA( 10/ .
{/ Signature
COMMONWEALTH OF PENNSYLVANIA
h~1n J,dcLIcUiL
Signature qJ nalile being resumed
Be(j(~ L. 6o!de.f1
: SS.
COUNTY OF CUMBERLAND
On the 2; FIt.-, day of -0QVI U QV 5 ' 20 6 ~ before me, a
Notary Public, personally appeared the above affiant Imown to me to be the person whose name
is subscribed to the within document and aclmowledged that helshe executed the foregoing for the
purpose therein contained.
In Witness Whereof, I have hereunto set my hand and official seal.
NOTARIAL SEAL
JODY S. SMITH, NOTARY PUBLIC
Carlisle Bora. Cumberland County
. My Co.m.~'ss'on ~ires April 4. 2005
~.' 5,~~-M
~ Notary Public
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