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Home My WebLink About07-4451r IN THE COURT OF COMMON PLEAS OF Gu^^'`~``''~-~~ COUNTY, PENNA. CIVIL DIVISION Plaintiff vs. . ~t ~ G'. tn/I iv T~ Defendant ro.: 07 y'15/ CIVIL ACTION -LAW IN DIVORCE PETITION FOR LEAVE TO PROCEED IN FORMA PAUPERIS TO THE HONORABLE, THE JUDGES OF THE SAID COURT: Petitioner respectfully represents that: 1. Petitioner, ~G.T(I.l CK (!J J~1~4~25 is the plaintiff in the above captioned action for divorce. 2. Petitioner's Social Security Number is: ~9~ :S6 ' 3 ~/r~ 3. Petitioner's address is: The State Correctional Institution at Camp Hill, P.O. Box 200, Camp Hill, PA 17001-0200. 4. Petitioner's income information is fully and accurately set forth on the attached In Forma Pauperis Statement. 5. In addition to the petitioner, the following are dependent on such income: (a} Child(ren) of this marriage: ~ `~~ GW ~~ W) N 1-£~2S C ~~GNr~) (b) Others: f~h~c.~J11~ C~~4~25~~ C7r.~,~.,GNt~2) ~-'19~,~ ~tViyO (SoN) (relationship to Petitioner and Respondent). 6. Respondent, ~ t N G• w t nJ ?~4~f is the defendant in the above captioned action for divorce. 7. Respondent's Social Security Number is: ~/t NIC.NOW,J 8. Respondent's address is: ~i ~~ G`ta.l~'4.r2 X21 V~ ~ ~/ r c~c~- . P~-~ 1 ~ ~ 9. Respondent's income and source are believed to be: _~ ~ S 3, ~ ,~ y„~~~ t~ 10. (If unemployed, state when and where respondent was last employed.) lS~.rc-S.rZ ~~r~-.,,,rL~c.~ !,-bsP~1~~ ,~,~v /`~~~ ~ 11. A support complaint was filed against respondent on or about the day of . 20 (a) The Domestic Relations number is: /~ D ra ~ (b) Petitioner receives support from respondent totaling week/month. ~ o~a~ per (c) Petitioner (has) as not assigned support rights to the Department of Public Assistance. 12. After talking with an attorney, Petitioner is of the opinion that he has a good and just cause against the above named respondent on the grounds of T~~ 1'~ ctn22i c G~ ! S t /~R 4.T~L! 4~/~~-~ /,' /tvKs~ 13. Petitioner is unable to pay any of the necessary costs, or give security for the fees, costs and expenses, necessary to prosecute said action without substantially impairing his ability to provide the necessities of life for himself and his children}. 14. WHEREFORE, Petitioner respectfully requests your Honorable Court to enter an Order granting Petitioner leave on filing the Complaint in Divorce as an indigent party and to proceed In Forma Pauperis ,without prepayment of costs or fees. Respectfully submitted, Petitioner I understand that the statements in the foregoing Petition for Leave to Proceed In Forma Pauperis are made under the penalties provided by 18 Pa. C.S.A. § 4904 (relating to unsworn falsification to authorities). Date: ~/6 ~ ~~~%~~~~~,. Petitioner 2 Name: _ ~~'fR-I ClC ~.Jin~1'~L.S Address : ~~' /~~~Q ,~ JC 1- C~,.,..~ fl jc-[. City/State: C~~ /~llL~, ~~ zip Code: f ? yv l - o ;`~ Phone No.: /yDl~'~ ( Prisoner I D#) : G ~ G ~ ~ ~ 3 I s IN THE COURT OF COMMON PLEAS OF CUM-.l3 ~2L~N.~ CIVIL DIVISION ~C~12t CK yJ ~ ,.l 14~2.f Plaintiff vs. 1tN~ W-n~~~I Defendant CASE NO.: COUNTY, PENNA. CIVIL ACTION -LAW IN DIVORCE INFORMA PAUPERIS STATEMENT I, ~(~-T/~ACx ~1 ~l T ~t„2S ,state under penalties provided by 18 Pa.C.S.A. § 4904 relating to unsworn falsification to authorities that: 1. I am the plaintiff in the above captioned civil action and because of my financial condition I am unable to pay the court costs or fees to file the Complaint of Divorce. 2. My responses to the questions below relating to ability to pay the fees and cost are true and correct. (A) Are you presently employed YES NO (1) If the answer is "yes," state the amount of your salary or wages per month, and give the name and address of your employer. (List both gross and net salary. ) (2) If the answer is "no," state the date of last employment and the amount of the salary and wages per month which you received. +~ ~ ;Lug ~ ~ ~ ~ ~o. ~ ~.-. ~,~,~-~~, (B) Have you received within the past twelve months any money from and of the following sources? (1) Business, profession or other form ofself-employment? YES (2) Rent payments, interest or dividends? YES (3) Pensions, annuities or life insurance payments? YES NO (4) Gifts or inheritances? YES i (5) Any other sources? YES NO If the answer to any of the above is "yes," describe each source of money and state the amount received from each during the past twelve months. (C) D ou ow-n any cash, or do you have money in checking or savings accounts? ES NO {Include any funds in prison accounts.) If the answer is "yes," state the total value of the items owned. ~ y~~-TV Coppr~w.) (D)Do you own or have any interest in any real estate, stocks, bonds, notes, automobiles or other valuable property (excluding ordinary household furnishin s and clothing)? YES NO If the answer is "yes," describe the property and state its approximate value. (E) List the persons who are dependent upon you for support, state your relationship to those persons, and indicate how much you contribute toward their support. Nvr~~ 3. I understand that a false statement or answer to any question in this verified statement will subject me to penalties provided by law under 18 Pa. C.S.A. § 4904. Executed on ~4 ~ / / ~ ( ate) `~ Signature of Applicant Name: '1~a.T2 (c,~ G,! 1 n~ t 4.~Lf Inmate ID No.: G XJ (, ~ ~ 3 SCI-Camp Hill, PO Box 200 Camp Hill, PA 17001-0200 Phone No.: NONE 2 ~.~ = _..., t.i t -.- 1_ 4...... r- ,_.__ - JEFFREY A. BEARD, Ph.D. SECRETARY DONALD L. KELCHNER SUPERINTENDENT ROBERT G. (aIMBLE BUSINESS MANAGER JOHN O. NWOKEJI HUMAN RESOURCES DIRECTOR o7-Y9s) PENNSYLVANIA DEPARTMENT. OF CORRECTIONS STATE CORRECTIONAL INSTITUTION AT CAMP HILL P.O. BOX 8837, CAMP HILL, PA 17001-8837 (717) 737-4531 ADDRE33 ALL REPUE3•TO SUPERINTENDENT EUGENE J. BRANNIGAN DEPUTY SUPERINTENDENT. FAGLITY MANAGEMENT DAVID E. PATTON DEPUTY SUPERINTENDENT CENTfiAUZED SERVICES JEFFREY K. DITTY DEPUTY SUPERINTENDENT DIAGNOSTIC CENTER I certify that this report is an accurate reflection of the subject's inmate account activity and balance for the period indicated on the In Forma Pauperis Form. At Camp Hill Inmate Account Date:~~/~~~ °'°r~~ Personal/vvplcert.letters Our mission is to protect the public by confining persons committed to our custody in safe, secure facilities, . and to provide opportunfties for inmates to acquire the skills and values necessary to become productive law-abiding citizens, while respecting the rights of crime victlms. PA DEPT. OF CORRECTIONS INMATE ACCOUNTS SYSTEM BUREAU OF COMPUTER SERVICES PARTIAL ACCOUNT LISTING REMOTE' PRIN"I' TIME 7:39 FROM PURGE FILE INMATE NAME NUMBER LAST FIRST MI GX6823 WINTE RS PATRICK BATCH DATE # MO DY YEAR TRANSACTION DESCRIPTION 0 01-17-2007 00 OPEN NEW ACCOUNT 80 GREENE 7809 01-17-2007 13 PERSONAL GIFT FROM BUTLER CO. J458800 0 01-23-2007 82 TRANSFER OUT GREENE 0 01-25-2007 81 TRANSFER IN CAMP HILL 1369 01-30-2007 13 PERSONAL GIFT FROM 431902 TINA 8032 02-01-2007 32 CAM COMMISSARY FOR 2/01/2007 8039 02-08-2007 32 CAM COMMISSARY FOR 2/08/2007 1374 02-16-2007 50 ACT 84 TRANSACTION 2248/04 02/16/07 1374 02-16-2007 60 VCF DEDUCTION 2248-04 02/16/07 8047 02-16-2007 32 CAM COMMISSARY FOR 2/16/2007 8054 02-23-2007 32 CAM COMMISSARY FOR 2/23/2007 1535 02-26-2007 13 PERSONAL GIFT FROM 580785 FRIEND 1535 02-26-2007 50 ACT 84 TRANSACTION 2248/04 02/26/07 1535 02-26-2007 60 VCF DEDUCTION 2248-04 02/26/07 8060 03-01-2007 32 CAM COMMISSARY FOR 3/01/2007 1620 03-06-2007 13 PERSONAL GIFT FROM 555223 LISA 1620 03-06-2007 50 ACT 84 TRANSACTION 2248/04 03/06/07 1620 03-06-2007 60 VCF DEDUCTION 2248-04 03/06/07 8067 03-08-2007 32 CAM COMMISSARY FOR 3/08/2007 1667 03-09-2007 13 PERSONAL GIFT FROM 554615 TINA WINTERS 1667 03-09-2007 50 ACT 84 TRANSACTION 2248/04 03/09/07 1667 03-09-2007 60 VCF DEDUCTION 2248-04 03/09/07 RUN IAS365 DATE 7/24/2007 PAGE 1 STARTING BALANCE .00 TRANSACTION BALANCE AFTER AMOUNT TRANSACTION 38.18 38.18 100.00 138.18 -41.32 96.86 -30.45 66.41 -13.28 53.13 -5.31 47.82 -21.56 26.26 -25.65 .61 20.00 20.61 -4.00 16.61 -2.00 14.61 -12.82 1.79 20.00 21.79 -4.00 17.79 -2.00 15.79 -1.62 14.17 100.00 114.17 -20.00 94.17 -10.00 84.17 PA DEPT. OF CORRECTIONS INMATE ACCOUNTS SYSTEM RUN IAS365 BUREAU OF COMPUTER ' SERVICES PARTIAL ACCOUNT LISTING DATE 7/24/2007 REMOTE' PRII~ I' TIME 7:39 FROM PURGE FILE PAGE 2 INMATE NAME NUMBER LAST FIRST MI GX6823 WINTERS PATRICK BATCH DATE TRANSACTION BALANCE AFTER # MO DY YEAR TRANSACTION DESCRIPTION AMOUNT TRANSACTION 1667 03-09-2007 13 PERSONAL GIFT FROM 554616 TINA WINTERS 100.00 184 17 1667 03-09-2007 50 ACT 84 TRANSACTION . 2248/04 03/09/07 -20.00 164 17 1667 03-09-2007 60 VCF DEDUCTION . 2248-04 03/09/07 -10.00 154 17 8074 03-15-2007 32 CAM COMMISSARY . FOR 3/15/2007 -.12 154 05 8074 03-15-2007 32 CAM COMMISSARY . FOR 3/15/2007 -129.21 24 84 8081 03-22-2007 32 CAM COMMISSARY . FOR 3/22/2007 -15.30 9 54 8088 03-29-2007 32 CAM COMMISSARY . FOR 3/29/2007 _6.69 2 85 BALANCE AFTER THESE TRANSACTIONS------> 2.85 PA DEPT. OF CORRECTIONS INMATE ACCOUNTS SYSTEM BUREAU OF COMPUTER SERVICES PARTIAL ACCOUNT LISTING REMOTE'PRII~T TIME 7:39 FROM ACTIVE FILE INMATE NAME NUMBER LAST FIRST MI GX6823 WINTERS PATRICK BATCH DATE # MO DY YEAR TRANSACTION DESCRIPTION 9094 04-04-2007 10 INMATE EMPLOYMENT CAM PAYROLL 2007 - 03 GRP 1 9094 04-04-2007 50 ACT 84 TRANSACTION 2248/04 04/04/07 8095 04-05-2007 32 CAM COMMISSARY FOR 4/05/2007 1847 04-06-2007 13 PERSONAL GIFT FROM 418781 TINA WINTERS 1847 04-06-2007 50 ACT 84 TRANSACTION 2248/04 04/06/07 1847 04-06-2007 60 VCF DEDUCTION 2248-04 04/06/07 8102 04-12-2007 32 CAM COMMISSARY FOR 4/12/2007 8102 04-12-2007 32 CAM COMMISSARY FOR 4/12/2007 8109 04-19-2007 32 CAM COMMISSARY FOR 4/19/2007 8116 04-26-2007 13 J-PAY BOWERS PATRICIA 8116 04-26-2007 50 ACT 84 TRANSACTION 2248/04 04/26/07 8116 04-26-2007 60 VCF DEDUCTION 2248-04 04/26/07 8116 04-26-2007 32 CAM COMMISSARY FOR 4/26/2007 9122 05-02-2007 10 INMATE EMPLOYMENT CAM PAYROLL 2007 - 04 GRP 1 9122 05-02-2007 50 ACT 84 TRANSACTION 2248/04 05/02/07 9122 05-02-2007 60 VCF DEDUCTION 2248-04 05/02/07 2074 05-09-2007 13 PERSONAL GIFT FROM 578425 TINA WINTERS 2074 05-09-2007 50 ACT 84 TRANSACTION 2248/04 05/09/07 2074 05-09-2007 60 VCF DEDUCTION 2248-04 05/09/07 8129 05-09-2007 32 CAM COMMISSARY FOR 5/09/2007 9135 05-15-2007 10 INMATE EMPLOYMENT CAM PAYROLL 2007 - 04 GRP 3 9135 05-15-2007 50 ACT 84 TRANSACTION 2248/04 05/15/07 RUN IAS365 DATE 7/24/2007 PAGE 1 STARTING BALANCE 2.85 TRANSACTION BALANCE AFTER AMOUNT TRANSACTION 7.20 10.05 -1.44 8.61 -2.43 6.18 60.00 66.18 -12.00 54.18 -6.00 48.18 -9.58 38.60 -35.99 2.61 -2.12 .49 25.00 25.49 -5.00 20.49 -2.50 17.99 -13.66 4.33 15.12 19.45 -3.02 16.43 -1.51 14.92 130.00 144.92 -26.00 118.92 -13.00 105.92 -14.79 91.13 .38 91.51 -.08 91.43 PA DEPT. OF CORRECTIONS INMATE ACCOUNTS SYSTEM BUREAU OF COMPUTER SERVICES PARTIAL AC COUNT LISTING REMOTE'PRIN~'I' TIME 7:39 FROM A CTIVE FILE INMATE NAME NUMBER LAST FIRST MI GX6823 WINTE RS PATRICK BATC H DATE # MO DY YEAR TRANSACTION DESCRIPTION 9135 05-15-2007 60 VCF DEDUCTION 2248-04 05/15/07 9135 05-15-2007 10 INMATE EMPLOYMENT CAM PAYROLL 2007 - 04 GRP 3 9135 05-15-2007 50 ACT 84 TRANSACTION 2248/04 05/15/07 9135 05-15-2007 60 VCF DEDUCTION 2248-04 05/15/07 8136 05-16-2007 32 CAM COMMISSARY FOR 5/16/2007 2033 05-23-2007 86 ADJUST PAYMENT 60 VCF PAID IN FULL 2033 05-23-2007 14 MISCELLANEOUS VCF PAID IN FULL REFUND CTY 8143 05-23-2007 32 CAM COMMISSARY FOR 5/23/2007 2208 05-30-2007 37 POSTAGE 8151 05-31-2007 32 CAM COMMISSARY FOR 5/31/2007 8151 05-31-2007 34 CAM CABLE TV FOR 5/31/2007 9156 06-05-2007 10 INMATE EMPLOYMENT CAM PAYROLL 2007 - 05 GRP 1 9156 06-05-2007 50 ACT 84 TRANSACTION 2248/04 06/05/07 8157 06-06-2007 32 CAM COMMISSARY FOR 6/06/2007 8164 06-13-2007 32 CAM COMMISSARY FOR 6/14/2007 9166 06-15-2007 10 INMATE EMPLOYMENT CAM PAYROLL 2007 - 05 GRP 3 9166 06-15-2007 50 ACT 84 TRANSACTION 2248/04 06/15/07 8171 06-20-2007 32 CAM COMMISSARY FOR 6/20/2007 8178 06-27-2007 32 CAM COMMISSARY FOR 6/27/2007 8179 06-28-2007 34 CAM CABLE TV FOR 6/28/2007 8184 07-03-2007 13 J-PAY BOWERS PATRICIA 8184 07-03-2007 50 ACT 84 TRANSACTION 2248/04 07/03/07 RUN IAS365 DATE 7/24/2007 PAGE 2 TRANSACTION BALANCE AFTER AMOUNT TRANSACTION -.04 8.36 -1.67 -.84 -27.30 15.39 8.50 -16.99 -.17 -11.16 -15.75 1.44 -.29 -16.70 -12.32 25.08 -5.02 91.39 99.75 98.08 97.24 69.94 85.33 93.83 76.84 76.67 65.51 49.76 51.20 50.91 34.21 21.89 46.97 41.95 -10.91 -9.79 -15.75 30.00 -6.00 31.04 21.25 5.50 35.50 29.50 PA DEPT. OF CORRECTIONS INMATE ACCOUNTS SYSTEM RUN IAS365 BUREAU OF COMPUTER SERVICES PARTIAL ACCOUNT LISTING DATE 7/24/2007 REMOTE' P'RII~T TIME 7:39 FROM ACTIVE FILE PAGE 3 INMATE NAME NUMBER LAST FIRST MI GX6823 WINTERS PATRICK BATC H DATE TRANSACTION BALANCE AFTER # MO DY YEAR TRANSACTION DESCRIPTION AMOUNT TRANSACTION 8186 07-05-2007 32 CAM COMMISSARY FOR 7/05/2007 -2.97 26.53 2475 07-09-2007 13 PERSONAL GIFT FROM 559541 TINA WINTERS 100.00 126 53 2475 07-09-2007 50 ACT 84 TRANSACTION . 2248/04 07/09/07 -20.00 106 53 2475 07-09-2007 13 PERSONAL GIFT FROM . 559551 PATRICIA 20.00 126.53 2475 07-09-2007 50 ACT 84 TRANSACTION 2248/04 07/09/07 -4.00 122.53 2487 07-10-2007 38 INSIDE PURCHASES LIBRARY VENDACARD -4.00 118.53 8192 07-11-2007 32 CAM COMMISSARY FOR 7/11/2007 -20.96 97.57 9197 07-16-2007 10 INMATE EMPLOYMENT CAM PAYROLL 2007 - 06 GRP 3 25.46 123.03 9197 07-16-2007 50 ACT 84 TRANSACTION 2248/04 07/16/07 -5.09 117.94 2535 07-16-2007 41 MEDICAL 12 JULY 2007 -10.00 107.94 2546 07-17-2007 38 INSIDE PURCHASES LIBRARY VENDACARD -4.00 103.94 2548 07-17-2007 37 POSTAGE .8199 07-18-2007 32 CAM COMMISSARY -6.95 96.99 FOR 7/18/2007 -18.51 78.48 8199 07-18-2007 32 CAM COMMISSARY FOR 7/18/2007 -.78 77.70 BALANCE AFTER THESE TRANSACTIONS- -----> 77,70 ~ _. cc; - ~. c~ - - _ - _ - :JE.= _ t ~_. L (~ L.:_ 12 '..~j _.. ., 11. . ~ `" `9 _ __ rte- - o~ i IN THE COURT OF COMMON PLEAS OF C~1~ `~-L~-.~~ CIVIL DIVISION 1~~r2'' c l~ W I ~T~,21' Plaintiff vs. Tt,~ c. W ~ r~ l ~f , Defendant COUNTY, PENNA. ~~Eno. o~-yy51 CIVIL ACTION -LAW IN DIVORCE 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 n v ~°~ 1 '~--0 8' the Prothonotary at 3 0~ f . r~ ~ - ~ f T1'~-'4.-~T ~ vt T t ~,/C /~a, (G c+v ~ - l ~, ~ 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, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR N4 FEE. "P~rJty.Lv~r/~r..., /~~- GtjvLC ~T,u~ (Name) LcH,,,~4„~` /l,~ F~„2.n-~~. Irv, L~ /~o /3u3D /,~~ (Street Address) (City) (State) (Zip Code) (Telephoee Number) Date: l~- (1 ~" ~ ' .~ Plaintiff, pro se (signature) Name: ~l..1"f1.1C«- ~~l n/T4~ Street: ~D ,/~v;~ ,2vo SC!- r.~,p ~l/LC. City: CG"~""-~ ~/Lt'_ State/Zip Code: ~~ ! ? ~'v 1- r ~-u~ Phone Number: ~vN~ Prisoner ID#: G ~ C^ iT = 3 2 w IN THE COURT OF COMMON PLEAS OF Cu„~-.~ ~,2 ~~,~~ CIVIL DIVISION ~G.tR-I CrC W l n~T~v,2f P1Aintiff vs. Tr~t~ W ~ Nt~-S Defendant NO.: COUNTY, PENNA. CIVIL ACTION -LAW IN DIVORCE COMPLAINT IN DIVORCE UNDER SECTION 3301(c) OR 3301(d) OFnTHE DIVORCE CODE AND NOW COMES, the Petitioner, C ~TfZ~ C~_ w ~ ~ T~~ by FILING PRO SE, who files this Complaint in Divorce a statement of which is as follow: 1 2. The at an adult indi~zdual currently residing -, . .., 3. The Petitioner has been a bona fide resident of the Commonwealth of Pennsylvania for at least six (b) months previous to the filing of this Complaint. ~. The Petitioner and Respondent were married on date: U C~TO~ 4~ au, ~+uy in the State of ~ 4.~n/J~yLVAnI I C~ 5. There (is) are 1 child(ren) born of this marriage. Name(s) C.~IF'~'-•G (~,~ ~ yJ (,~/ 1 ~,/ 1c~f' Birthdate(s): W1G~./~~-f( ~(, ~Z~o ~ b. Neither party is a member of any branch of military. 7. The marriage is irretrievably broken. g. The Petitioner, '~t^._T2lC I~ ~,J) r/ j'~~~ f r~p~lly requests this Honorable Court to grant this Divorce pursuant to Section 3301(c), or in the alternative, Section 330I(d) of the Divorce Code. R 1 sub 'tted, i~ ~~ Name: ~~-•-?2t GK ~,/! n114,~•~f G)((~~, 3 Full Address: I~0 ~ ~;d aZ.~ , f C / - C~ p /~/ l ~~ C ~;,~.^. p r11 LC_ 1~r7, 17 ~*v I - c~ a ~ Telephone: ~ ~ ~ L I verify that the statements made in the Complaint are true and correct. I understand that false statements made herein are subject to penalties of 18 Pa. C.S.A. Section 4904, rely ' g to unsworn fals' lion to authorities. Dated: ~~/a (~~ ~' laintiff, Pro-Se The Defendant is T ~ ~ L,/ t N T 4~ f an adult individual currently residing at ~ ~-p' C f f,-'t' ~2 ~RlJ~, C /-((GVf~ G P~-. 16o:-S /~ w IN THE COURT OF COMMON PLEAS OF C (~/'~ /3 4,2 L~ ~.`~ COUNTY, PENNA. CIVIL DIVISION l~C--T~ACJc I~in~T~j CASE NO.: Plaintiff . CIVIL ACTION -LAW vg• IN DIVORCE Ti~~ Wt~~~,2f Defendant VERIFICATION TO COMPLAINT IN DIVORCE Plaintiff verifies that the statements made in this complaint are true and correct. Plaintiff Date: --~~/ d~ Plaintiff, pro se (signature) Name: ~~ i/~lC/~- W1~~4~-21' street: J~y ~i~jG' ~, SLr- ~_G~p l~iL-L City: _CG,,,,.,~ t~l u- State/Zip Code: '~~ 17 cTU 1' ~~~-~ Phone Number: //0 ~l ~ Prisoner m#: G k C ~,Z3 understands that false statements herein aze made subject to the penalties of 18 Pa.C,S.A. § 4904, (relating to unsworn falsification to authorities). T'-_.: ~/ ~. .+ 7 ;~J ~ __ ~~ ,.. _... 1 `~ Ti ~:~ _~i~ x_j , t ~ _~1 ~,.._. ~, ~ ~ . . e -~~~ ~` PATRICK WINTERS, IN THE COURT OF COMMON PLEAS OF PLAINTIFF :CUMBERLAND COUNTY, PENNSYLVANIA ~/. NO. 07-4451 CIVIL TINA WINTERS, DEFENDANT IN DIVORCE ORDER OF COURT AND NOW, this 1st day of August, 2007, upon consideration of the Petition for Leave to Proceed In Forma Pauperis, and pursuant to Pa. R. Civ. P., Rule 1920.62, Petitioner is granted leave to file the Complaint in Divorce without payment of court costs or fees. The Complaint shall be served as provided in Pa. R. Civ. R., Rule 142; provided, however, that Petitioner shall attempt personal service by return receipt requested, registered mail, restricted delivery, before requesting the Sheriff to make service of the Complaint in this action without fee. IT IS ORDERED AND DIRECTED that the Petitioner may proceed In Forma Pauperis until further Order of Court. By the Court, I~G V\ "Yq R+,-~ M. L. Ebert, Jr., J. 0 'dl~ ~',~1~1,51`JPJ~~~N(i`J XiNf~~,. . ~ ~ ~~ ~~ ~ - ~n~ ~~at ~a~~.a ~~ ~o~i~ ~o ~ 2 ~ a9 IN THE COURT OF COMMON PLEAS OF ~~~ ~ ~~"'~~ CIVIL DIVISION ~~.~~t c1C !e/ I r~7~Si~-S Plaintiff vs. , ~,~~ w~~~~,~-S Defendant , COUNTY, PENNA. CASE NO.: d ~ ~ ~ 1, j CIVIL ACTION -LAW IN DIVORCE ACCEPTANCE OF SERVICE I accept service of the COMPLAINT IN DIVORCE in the above-captioned matter. I certify that I am the Defendant named above. Date:.~ ~G Q ,o endant Street: r'` ~ ,r1 ,S f " city: l.~c/T`6''IL /,9~ 1600_/- - - - State/Zip Code: ~ ~ Q 0 . ,. r ~-, f-.~ ;~- ` ~ ._a ;,~ - <r~ ~# _ a `; ~f __ ;_.... ~, ~ I`. C j~ -µ C,=: ~: