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Receipt tor Certified Mail
No Insurance Coverage Provided.
00 not use for InlernationaJ Mail See reverse
~~ George M. Wingard, III
~& '1:'''t'ewisberry Road
Po51 OItioe~tate, & ZIP Code
Lewiscerry, PA ~7339
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fl\div\consent.aff
GEORGINE U. WINGARD,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
NO. 99-2626 CIVIL TERM
GEORGE M. WINGARD, III,
Defendant
CIVIL ACTION - IN DIVORCE
AFFIDAVIT OF CONSENT
1. A complaint in divorce under 5 3301(c) of the Divorce Code
was filed on May 3, 1999.
2. The marriage of plaintiff and defendant is irretrievably
broken and ninety (90) days have elapsed from the date of filing the
complaint 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 understand that I may lose rights concerning alimony,
division of property, lawyer's fees or expenses if I do not claim them
befor'e 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 falsifica-
tron to authorities.
J" -,3.0';-?
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WINGA~I, Defendant
Date
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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 INFORMATION AND RETURN TO THE
PROTHONOTARY'S OFFICE
DATE:
&- 31-1j
DOCKET NUMBER: 99-2626 Civil Action Tn nivn,.~p
PLAINTIFF!l'~ SS# 210- 36- 3lj();l
NAME: GEORGINE U. loJINGARD
DEFENDANT~RXMl!~ SS # 184-28-2072
NAME:
GEORGE M. WINGARD. III
f1 \div\ltrnamlt .pCp\ 7. en
GEORGINE U. WINGARD,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
NO. 99-2626 CIVIL TERM
GEORGE M. WINGARD, III,
Defendant
ACTION IN 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. Ground for divorce: irretrievable breakdown under ~ (3301(c))
(3301(d) (1)) of the Divorce Code. (Strike out inapplicable section).
2. Date and manner of service of the complaint: Mav 6, 1999, US Certified
Mail. Restricted Deliverv, Return Receipt Reauested, .Postaqe Prepaid
3. Complete either paragraph (a) or (b).
(a) Date of execution of the affidavit of consent required by
~ 3301 (c) of the Divorce Code: by Plaintiff August 3D, 1999 by
Defendant August 3D, 1999 .
(b) (1) Date of execution of the affidavit required by ~ 3301(d) of the
Divorce Code:
(2) A. Date of filing of Plaintiff's affidavit upon respondent:
B. Date of service of Plaintiff's affidavit upon respondent:
4. Related claims pending:
NO CLAIMS RAISED
5. Complete either (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:
the
(b) Date Plain~itf's Waiver of Notice
Prothonotary: <::s 11 \ I ~ ?
in ~ 3301(c) Divorce was filed with
Date Defendan 's Waiver of Notice in ~ 3301 reI Divorce was filed with
C' 1 \ I {,:/<"'j
the Prothonotary: ' ~ ,
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