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fan Demand a(Jer dale I & We f?rt?mise Io
Pay fo iSe oroder of William Colello
cs' (,., ?ollar-s
J`?aya6leaf 36 inth Street,Mifflintown, Pa. 17059
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?ilness 6andands¢al ?yG?Zzz ?' ?sE.nt-)
`xn. Due --tom
'4- 30
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FORM 11A WAIVER
EXPLANATION OF RIGHTS IN CONNECTION WITH SIGNING OF
INSTRUMENT CONTAINING CONFESSION OF JUDGMENT, AS
REQUIRED BY OPINION OF SUPREME COURT OF THE UNITED STATES.
The undersigned clearly and specifically understand that by signing the note above referred to, containing'a Confession
of Judgment clause:
1. We and each of us authorize William Colello to enter a judgment against
the undersigned, or either of us, at. its discretion and in its favor without notice and without declaration of
default for non-payment, which entry will give the holder a lien as security for payment upon the-real property (including
the home) owned by the undersigned at the time of entry, and a lien on personal property owned by the under-
signed at the time it is given to the Sheriff for execution.
2. We and each of us waive all right to notice and to have an opportunity to be heard prior to the entry of the
judgment on the Court records, understanding that the only method to challenge this judgment would be by proceedings
in Court to open or strike it, which proceedings would result in substantial attorneys fees which the undersigned -would
have to pay. (Without such. clause containing a Confession of Judgment the holder would have to file suite aplast
the undersigned which would give the undersigned an opportunity for a hearing which the undersigned does not have by eason
of the Confession.)
The undersigned acknowledge receipt of a copy of this affidavit and certify that after reading and fully understanding
.it, the undersigned have signed this affidavit intentionally. understandingly and voluntarily waiving all the above, rights
being willing to sign such note despite the consequences set forth above.
P,
(SEAL)
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In the Court of Common Pleas of
Cumberland County, Pennsylvania
No. -_S .). pCivil. 19
To -?=- 0 Prothonotary
19 1 ^^
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for PIN
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No. T,19
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PRAECIPE
Filed 19
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