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Home My WebLink About04-0388IN THE 'COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW Defendant : IN DIVORCE Civil Term NOTICE TO DEFEND AND CLAIM RIGHTS YOUtIA VE BEENSUED 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/he Plainti~ You may lose money or property or other rights important to you, kncluding custody or visitation of your children. When the ~ound 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, Cumberland County Courthouse, 1 Courthouse Square, Carlisle, Pennsylvania. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DMSION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE TIlE 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, PA 17013 (717) ¢4;9r3166 Plaintiff Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA No. 04- C~vm TeRM IN DIVORCE COMPLAINT UNDER §3301(c) or (d) OF THE DIVORCE CODE , who currently resides at who currently resides at 3. Plaintiff has been a bonafide resident of the Commonwealth of Pennsylvania for at least the six months prior to the filing of this Complaint. 4. Plaintiff and Defendant were married on ~O~fl~ {q4~l~ tq~O at Lo ille "¢e_ no.. 5. The marriage is irretrievably broken, and the parties separated on 6. There have been no prior actions of divorce or annulment between the parties. 7. Plaintiff, to the best of his/her knowledge and belief, avers that defendant is not in the military service of the United States of America, but is in fact living at the address given in Paragraph 2 above. 8. Plaintiff has been advised of the availability of counseling and that Plaintiff may have the right to request that the Court require the parties participate in counseling. WHEREFORE, Plaintiffrequests the Court to enter a Decree of Divorce. Date t~2 Plglntiff, Pro Se ~'~ , verify that the statements made in this Complaint are true and correct to the best of my knowledge, information, and belief. 1 understand that false statements made herein are subject to the penalties for unsworn falsification to authorities as provided in 18 Pa. C.S. §4904. Date: Assisted by: MIDPENN LEGAL SERVICES PRO SE DIVORCE CLINIC 8 Irvine Row Carlisle, Pennsylvania 17013 (717) 243-9400 Plaintiff Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA No. CIVIL ACTION - LAW 1N DIVORCE PETITION TO PROCEED IN FORMA PAUPERIS The Petitioner, ~.~"6rr', 6 L(e.. '~r~[~ a~ , is the Plaintiff in this action. On the petitioner's behalf, MidPenn Legal Services does hereby certify that the Petitioner is indigent according to the poverty guidelines of MidPenn Legal Services. MidPenn Legal Services is assisting the Petitioner in filing a divorce case pro se. The Petitioner's Financial Affidavit showing inability to pay the costs of litigation is attached hereto. Petitioner requests leave to proceed without payment of fees or costs. Pamela G. Smith Attorneys for Plaintiff MidPenn Legal Services Pro Se Divorce Clinic 8 Irvine Row Carlisle, PA 17013 (717) 243-9400 Plaintiff VS. Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : : NO. CIVIL TERM AFFIDAVIT IN SUPPORT OF PETITION TO PROCEED IN FORMA PAUPERIS 1. I amthe ~]~[ ~q~4~ inthe above matter and because of my financial condition am unable to pay the fees and costs of prosecuting, defending, or appealing the action or proceeding. 2. I am unable to obtain funds from anyone, including my family and associates, to pay the costs of litigation. 3. I represent that the information below relating to my ability to pay the fees and costs is true and correct. (a) Name: (b) Address: (c) Social Security Number: If you are presently employed, state Employer: nempl ed Address: Salary or wages per month: Type of work: If you are presently unemployed, state Date of last employment: Salary or wages per month: Type of work: (c) Other income within the past twelve months Business or profession: Other self-employment: Interest: Dividends: Pension and annuities: Social Security benefits: /'- Support payments: /~ Disability payments: / Unemployment compensation and supplemental benefits: ~' Workman's compensation: f Public Assistance: / Other: j (d) Other contributions to household support (Wife)(Husband) Name: If your (husband) (wife) is employed, state Employer: Salary or wages per month: Type of work: Contributions from children: (e) Property owned Cash: fl/ Checking Account: Savings Account: Certificates of Deposit: Real Estate (including home): Motor vehicle: Make Cost Stocks; bonds: Other: (f) Debts and obligations Mortgage: ~ Rent: Loans: Monthly Expenses: Year Amount owed (g) Persons dependent upon you for support (Wife) (Husband) Name: Children, if any: Name: Age: 4. I understand that I have a continuing obligation to inform the court of improvement in my financial circumstances, which would permit me to pay the costs incurred herein. 5. I verify that the statements made in this affidavit are true and correct. 1 understand that false statements herein are made subject to the penalties of 18 Pa. C.S. 4904, relating to unsworn falsification to authorities. Date: Jerde Lee Holstine Plaintiff V. Richard Lee Holstine, Jr. Defendant IN THE COURT OF COMIVION PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO. 04-388 CIVIL TERM IN DIVORCE AFFIDAVIT OF SERVICE BY MAIl, I,~-6rr'(~/~'n~ ~r~tn~ ,do hereby swear ~at I se~ed ~ch~d Lee Holstine, Jr., with a Complaint under Section 3301(c) or (d) of the Divorce Code pursuit to Pa.R.C.P. 1920.42(a)(2) on the ~ day of ff~ ,200~, by certified mail, remm receipt, res~cted delivew, to the person ~d ad,ess below: I, O~r-r-i~L [-'{-~lS~r/~_. , verify that the statements made in this Affidavit of Service are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. Date: lerde Lee Holstine, Plaintiff Richard Lee Defendant Holstine, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY '.pENNSYLVANIA No. 04-388 CIVIL TERM : IN DIVORCE AFFIDAVIT OF CONSEh[__T 1. A complaint in divorce under §3301(c) of the Divorce Code was filed on January 30, 2004. 2. The mamage °f plaintiff and defendant is irretrievably br°ken' and ninety days have elapsed from the date of 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 divorce. I verify that the statements made in this affidavit are tree and correct. I understand that false staten~ents herein are made subject to the penalties of 18 Pa.C.S. Section 4904 to unsworn falsification to authorities. relating e ~' l Jerfie Lee Holstine, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COLrNTYPENNSYLVANiA No. 04-388 CIVIL TERM Richard Lee Holstine, Defendant DIVORCE WAIVER OF NO~TICE OF~INTENTION TO :~ A DIVORCE DECREE UNDER ~.3301(c) O~I'HE DIVORCE 1. I consent to the entry ora final decree of divorce wi'thout notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses ifI do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce 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 verify that 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 unswom falsification to authorities. Signature~~ __~/5~ Jer//e Lee I~6t~e, Plaintiff Jerrie Lee Holstine, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANL~ No. 04- 388 CIVIL TERM Richard Lee Holstine, Defendant IN DIVORCE PRAEC1PE 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 Section 3301(c) of the Divorce Code. 2. Date and Manner of service of the Complaint: Defendant signed the Certified Mail, Restricted Delivery Return Receipt on February 13, 2004; Plaintiff executed the Affidavit of Service by Mail form on February 21, 2004. 3. Date of execution of the Affidavit of Consent required by Section 3301(c) of the Divorce Code: by Plaintiff, July 12, 2004; by Defendant, July 7, 2004. 4. Related claims pending: There are no outstanding claims. 5. (a) Date Plaintiff's Waiver ofNotice in Section 3301(c) Divorce was filed with the Prothonotary: July 12, 2004. (b) Date Defendant's Waiver of Notice in Section 3301(c) Divorce was filed with the Prothonotary: July 8, 2004. Plaintiff's Social Security Number: 161-60-8150 Defendant's Social Security Number: 179-50-8358 Jessica Diamondstone Geoffrey Biringer Attorneys for Plaintiff MidPenn Legal Services 8 Irvine Row Carlisle, PA 17013 (717) 243-9400 IN THE COURT OF COMMON PLEAS Jerrie Lee Holstine OF CUMBERLAND COUNTY STATE OF PENNA. VERSUS Richard Lee Holstine N O. 04-388 Civil DECREE IN DIVORCE AN= NOW, i,,t 1 DECREED THAT aerrie Lee Holstine AND Richard Lee Holstine , /--~ (__,IT IS ORDERED AND , PLAINTIFF, , DEFENDANT, ARE DIVORCED FBOM THE BONDS OF MATRIMONY, THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE BEEN RAISED OF RECOi:tD IN THIS ACTION FOR WHICH a FINAL ORDER HAS NOT YET BEEN ENTERED; ALL CLAIMS ~{AVE BEEN RESOLVED. THE COURT: Jerrie Lee Holstine Plaintiff In the Corot of Common Pleas of Cumberland County Pennsylvania vs Richard Lee Holstine Defendant 04 - 388 Civil Term Civil Action - In Divorce Notice of Intention to Resume Prior Name Notice is hereby given that the plaintiff in the abow~ captioned matter, having been granted a final decree in divorce on the 23~a day of July, 2004, hereby intends to resume and hereafter use the previous name of Jerrie L. Burd, and gives this written notice avowing her intention in accordance with the provisions of 54 P.S. § 704. / JerrieC/L.'Holstine T~; KNOWN AS: ,, /~ '-~// Jerrie L.~t~rd COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND On this the 7h day of October, 2004, before me, the undersigned officer, personally appeared Jerrie L. Holstine t/b/k/a Jerrie L. Burd, known to me (or satisfactorily proven) to be the person whose name appears subscribed to the within instrument, and acknowledged that she executed same for the purposes herein contained. IN WITNESS WHEREOF, I hereunto set my h~k_,,~,~L~~,~_~official sial.~ ~ ~ Notary Public I~lotarial Seal Anne M. Cox, Notary Public Carlisle Borough, Cumberland County "~]',,,: Commission Expires July 14, 2005