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Home My WebLink About08-2723THIS IS AN ARBITRATION MATTER ASSESSMENT OF DAMAGES HEARING NOT REQUIRED TABAS & ROSEN, P.C. BY: LEWIS C. TRAUFFER, ESQUIRE Attorney for Plaintiff Attorney I.D. #60267 1601 Market Street, Suite 2300 Philadelphia, PA 19103 (215) 569-5050 THE MILTON S. HERSHEY MEDICAL CENTER P.O. Box 853 Hershey, PA 17033 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 6? a'Jo13 VS BARBARA COOPER 16 Buttonwood Lane Carlisle, PA 17013 CIVIL ACTION COMPLAINT - CIVIL ACTION NOTICE Ct d i t 1tr1ox You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. 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. 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 NO FEE. Cumberland County Bar Association 2 Liberty Avenue Carlisle, Pennsylvania 17013 (717)249-3166 or(800)990-9108 COMPLAINT - CIVIL ACTION THE MILTON S. HERSHEY MEDICAL CENTER VS. BARBARA COOPER 1. Plaintiff is a non-profit corporation located at the address indicated in the caption hereof. 2. Defendant is an individual who resides at the address indicated in the caption hereof. 3. As the result of a certain medical condition, defendant was treated by the plaintiff on Sept. 29, 2006 thru Feb. 24, 2007. 4. The amounts, quantities and nature of said medical care, the dates on which said medical care was rendered, and the charges therefore are set forth in Exhibit "A" which is incor- porated herein as if set forth at length. 5. Said medical care was commensurate with the condition of defendant and was necessary for the health and welfare of defendant. 6. At or about the time of defendant's treatment by plain- tiff, implied, constructive and oral contracts arose between defendant and plaintiff by the terms of which defendant became obligated to pay plaintiff the charges for the medical care rendered by plaintiff to defendant. 7. Defendant refuses to pay the balance due although plaintiff has made demand that defendant do so. 8. As a result of the foregoing, there is due and owing from defendant to plaintiff the sum indicated in Exhibit "A". WHEREFORE, plaintiff demands judgment against defendant for the sum of $23,959.87 plus six percent (6%) interest per annum from the date of discharge to the date of judgment, record costs and non-record costs. TABAS & ROSEN, P.C. LEWI C. TRAU FER, ESQUIRE Attorney for Plaintiff MS HERSHEY MEDICAL CENTER PAGE: 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 02/22/07 at 01:42 PM Guarantor: COOPER BARBARA L 16 BUTTONWOOD LANE CM CARLISLE, PA 17015-0000 Patient: COOPER BARBARA L Visit #: 7592911 ------------------------------------------------- Date Svc Code Description I Units 09/29/06 42102 T INTERMEDIATE CARE U 1 09/29/06 46472 EMERGENCY VISIT, LEVE 1 09/29/06 46620 ROUTINE VENIPUNCTURE 1 09/29/06 46712 12 LEAD EKG-TRACING O 1 09/29/06 46717 NONINVAS PULSE OX MU 1 09/29/06 104001 , ACETONE, BLOOD 1 09/29/06 104014 ALKALINE PHOSPHATASE 1 09/29/06 104016 BILIRUBIN TOTAL 1 09/29/06 104049 TROPONIN 1 09/29/06 104156 SGPT (ALT) 1 09/29/06 104433 BASIC METABOLIC PANEL 1 09/29/06 105052 PARTIAL THROMBOPLAS T 1 09/29/06 105059 PROTHROMBIN TIME 1 09/29/06 105657 CBC W/PLT/DIFF AUTO 1 09/29/06 106011 URINALYSIS-BASIC & MI 1 09/29/06 111001 GLUCOSE BEDSIDE MONIT 2 09/29/06 274346 INSULIN R INJ 2 09/29/06 310501 CT HEAD UNENHANCED 1 09/29/06 3.47062 MRI BRAIN UNENH & ENH 1 09/29/06 347192 MRA HEAD UNENHANCED 1 09/29/06 600510 PULSE OXIMETER SNSR A 1 09/29/06 621055 KIT ER IV START 2 09/30/06 10376 T ADULT MONITOR CARE 1 09/30/06 17770 SPEECH/HEARING EVAL 1 09/30/06 104068 GLYCOHEMOGLOBIN 1 09/30/06 104102 LIPID PROFILE 1 09/30/06 104106 MAGNESIUM 1 09/30/06 104433 BASIC METABOLIC PANEL 1 09/30/06 104568 TSH THYROID STIM HORM 1 09/30/06 105067 SEDIMENTATION RATE (E 1 09/30/06 105656 CBC W/PLT AUTO 1 09/30/06 111001 GLUCOSE BEDSIDE MONIT 4 09/30/06 251959 ZOCOR 20MG 1 09/30/06 621044 I V SODIUM CHLORIDE 0 1 10101106 10376 T ADULT MONITOR CARE 1 10/01/06 104106 MAGNESIUM 1 10101106 10/01/06 104433 1 BASIC METABOLIC PANEL 1 10/01/06 05656 1 CBC W/PLT AUTO 1 10/01/06 11001 2 GLUCOSE BEDSIDE MONIT 3 10/01/06 51251 251959 KDUR 20MEG UD ZOCOR 20MG 2 10/02/06 10223 P PRIVATE MED/SURG RM 1 1 Debits 1580.00 587.00 17.00 117.00 95.00 36.00 14.00 14.00 60.00 15.00 42.00 38.00 23.00 48.00 38.00 56.00 3.00 755.00 2038.00 1117.00 11.00 20.00 1580.00 310.00 62.00 64.00 16.00 42.00 79.00 21.00 30.00 112.00 10.65 6.00 1580.00 16.00 42.00 30.00 84.00 6.00 10.65 1240 00 1 Credits ------------- --------------------------------------- - Continue - Iq - l MS HERSHEY MEDICAL CENTER PAGE: 2 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 02/22/07 at 01:42 PM Guarantor: COOPER BARBARA L 16 BUTTONWOOD LANE CM CARLISLE, PA 17015-0000 Patient: COOPER BARBARA L Visit #: 7592911 - ------------------------------------------------ ---------------------------- I---Date----I-Svc-Code-I--------Description- I Units Debits I Credits ------------------------------------ 10/02/06 104433 BASIC METABOLIC PANEL 1 10/02/06 105657 CBC W/PLT/DIFF AUTO 1 10/02/06 111001 GLUCOSE BEDSIDE MONIT 5 10/02/06 251251 KDUR 20MEG UD 2 10/02/06 251959 ZOCOR 20MG 1 10/02/06 310501 CT HEAD UNENHANCED 1 10/02/06 621100 CANISTER SUCT HARDSHE 1 10/03/06 10223 P PRIVATE MED/SURG RM 1 10/03/06 17775 DYSPHAGIA TX 60 ST 1 10/03/06 111001 GLUCOSE BEDSIDE MONIT 5 10/03/06 251251 KDUR 20MEG UD 2 10/03/06 251959 ZOCOR 20MG 1 10/03/06 274018 INSULIN GLARGZNE 10 M 4 10/04/06 111001 GLUCOSE BEDSIDE MONIT 3 10/04/06 251251 KDUR 20MEG UD 1 10/04/06 732960 INPT DIABETES ED, 15 5 12/31/06 980090 HOSPITAL BAD DEBT W/O -1 12/31/06 980091 HOSPITAL BAD DEBT PLA 1 42.00 48.00 140.00 6.00 10.65 755.00 5.00 1240.00 200.00 140.00 6.00 10.65 214.62 84.00 3.00 200.00 15170.22 15170.22- - - - ------------------------------------------------ * - Not posted Balance: I 15170.22 -------------------------- h -)-- MS HERSHEY MEDICAL CENTER PAGE: 1 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 04/13/07 at 11:44 AM Guarantor: COOPER BARBARA L 16 BUTTONWOOD LANE CM CARLISLE, PA 17013-0000 Patient: COOPER BARBARA L Visit #: 7896113 --------------------P------------------------ Date Svc Code Description Units Debits Credits 01/10/07 104014 ALKALINE PHOSPHATASE 1 14 00 ---- ---------- 01/10/07 104016 BILIRUBIN TOTAL 1 . 14 00 01/10/07 104068 GLYCOHEMOGLOBIN 1 . 62 00 01/10/07 104102 LIPID PROFILE 1 . 64 00 01/10/07 104156 SGPT (ALT) 1 . 15 00 01/10/07 104327' MICROALBUMIN 1 . 60 00 01/10/07 109804 VENIPUNCTURE 1 . 17 00 03/31/07 980090 HOSPITAL BAD DEBT W/O -1 . 246 00- 03/31/07 980091 HOSPITAL BAD DEBT PLA 1 246.00 . * - Not posted Balance: 246.00 --------------------- A ?3 MS HERSHEY MEDICAL CENTER PAGE: 1 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 04/13/07 at 11:45 AM Guarantor: COOPER BARBARA L 16 BUTTONWOOD LANE CM CARLISLE, PA 17013-0000 Patient: COOPER BARBARA L Visit #: 8055962 --------------------------------------------------------------------------------- I---Date----I-Svc-Code-I--------Description---I -Units---Debits---I---Credits 02/07/07 46471 EMERGENCY VISIT, LEVE 1 02/07/07 46620 ROUTINE VENIPUNCTURE 1 02/07/07 46712 12 LEAD EKG-TRACING 0 1 02/07/07 46716 NONINVAS PULSE OX, SI 1 02/07/07 104014 ALKALINE PHOSPHATASE 1 02/07/07 104016 BILIRUBIN TOTAL 1 02/07/07 104049 TROPONIN 1 02/07/07 104156 SGPT (ALT) 1 02/07/07 104433 BASIC METABOLIC PANEL 1 02/07/07 105657 CBC W/PLT/DIFF AUTO 1 02/07/07 1060.11 URINALYSIS-BASIC & MI 1 02/07/07 246706 MORPHINE SULFATE 2 MG 1 02/07/07 274470 VICODIN 5/500MG 1 02/07/07 307220 PELVIS 1-2 VIEWS 1 02/07/07 307301 HIP 2 VIEWS LEFT 1 02/07/07 307331 ABDOMEN 1 VIEW AP 1 02/07/07 600510 PULSE OXIMETER SNSR A 1 03/31/07 980090 HOSPITAL BAD DEBT W/O -1 03/31/07 980091 HOSPITAL BAD DEBT PLA 1 373.00 17.00 117.00 62.00 14.00 14.00 60.00 15.00 42.00 48.00 38.00 3.00 9.65 158.00 155.00 166.00 11.00 1302.65 1302.65- ------ - ------------------------------------- ' ----------------------- * - Not posted 1 Balance: I 1302.65 -------------------------- I4 _y MS HERSHEY MEDICAL CENTER PAGE: 1 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 04/13/07 at 11:45 AM Guarantor: COOPER BARBARA L 16 BUTTONWOOD LANE CM CARLISLE, PA 17013-0000 Patient: COOPER BARBARA L Visit #: 7793669 ----------------------- Date Svc Code ---------- ------------------------ Description ---- -------- Units -- --------------- Debits --- --- Credits -- 02/23/07 102214 -------------------- CULTURE, URINE QUANT ------ 1 -- ------------------------- 40.00 02/23/07 106011 URINALYSIS-BASIC & MI 1 38.00 03/31/07 980090 HOSPITAL BAD DEBT W/O -1 78.00- 03/31/07 980091 HOSPITAL BAD DEBT PLA 1 78.00 Not post * - posted --------- -------- - - Balance: --------- 78.00 ------------------------- 4 - -S? MS HERSHEY MEDICAL CENTER PAGE: 1 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 04/13/07 at 11:45 AM Guarantor: COOPER BARBARA L 16 BUTTONWOOD LANE CM CARLISLE, PA 17013-0000 Patient: COOPER BARBARA L Visit #: 8115000 ---Date----I-Svc-Code- --------Description I Units Debits Credits 02/24/.07 3,10518 --- -- CT ABDOMEN UNENHANCED - - 1 -- _ --------------------- 885 00 02/24/07 310566 CT PELVIS UNENHANCED 1 . 815 00 03/31/07 03/31/07 980090 98009 HOSPITAL BAD DEBT W/O -1 . 1700.00- 1 HOSPITAL BAD DEBT PLA -------- 1 1700.00 * - Not posted ------------- -------- - ------------------------- Balance: 1700.00 ------------------------- IF ANY QUE »> PA : 09/29/06 992M 09/29/06 7055326 09/29/06 7054426 09/29/06 7045026 09/30/06 99223 10/01/06 99232 101/02/06 7045026 10/02/06 99232 10/03/06 99232 10/03/06 99254 10/D4/06 99238 10/04/06 99232 10/27/06 99215 10/30/06 99215 10/30/06 12121/06 99204 Medical Center PLEASE CONTACT: CARLISLE PA 17015-7801 ACCOUNT # 1805279 STATEMENT DATE: 08127107 LAST STATEMENT DATE: 01122107 FED TAXIDA2 7592911 PERFORMED BY: CRAIG T LAADER DD DIV OF EWA ROM PLACE OF SVC: EMERGENCY ROOM 431 EMERGENCY VISIT 338.0D PERFORMED BY: KHURAM S KAW MD DIV OF DIAL RADIOLOGY PLACE OF SVC: INPATIENT 431 MRI BRAIN LINEN ENH 687.00 431 KRA HEAD UNDRIANCED 349.00 431 CT HEAD INENNANCED 278.00 PERFORMED BY: GARY A THOMAS NO DIVISM OF NEUROLOGY 431 INITIAL HOSPITAL CARE 403.00 431 DAILY HOSPITAL CARE 144.00 PERFORMED BY: KHLIRAM S KAZMI MD DIV OF DIAL RADIOLOGY 432.9 CT HEAD UNR:MANCED 278.DD PERFORMED BY: RAYMOND K REICHNEIN MD DIVISION OF MUROLW 431 DAILY HOSPITAL CARE 144.00 431 DAILY HOSPITAL CARE 144.00 PERFORMED BY: CHRIS FAN MD DIV OF ENDOCRINOLOGY 250.00 INITIAL INPT CD1MTATIDN 355.00 PERFORMED BY: RAYMOND K REICHMEIN MD DIVISION OF NEUROLOGY 431 HOSP.DISC DAY MGT <30, MIN 172.00 PERFORMED BY: CHRIS FAN MD DIV OF ENDOCRINOLOGY 250.011 HOSP VISIT INTER M 144.00 7610367 PERFORMED BY: ROBERT A GMBH MD DIV OF ENDOCRINOLOGY PLACE OF SVC: OP PHYSICIAN 250.00 OUTPATIENT VISIT EST 195.00 20.00 OUTPATIENT VISIT EST 195.00 OUTPATIENT VISIT EST 195.00- 7793623 PERFORMED BY: MATTHEN A ECCHER MID DIVISION OF NEUROLOGY PLACE OF SVC: op PHYSICIAN 432.9 OUTPATIENT VISIT MEN 222.00 7793669 ] CHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK 338.00 687.00 349.00 278.00 403.00 144.00 278.00 144.00 144.00 355.00 172.00- -- 144.00 1%.DO 0.00 222.00 ACCOUNT # 1605279 IF ANY QUESTIONS, PLEASE CONTACT: STATEMENT DATE 08127107 LAST STATEMENT DATE 01122/07 * 02/23/07 99213 599.0 rrKruwtu BY: MARY C DAVIES HD lR IiTT"j?AS PLACE OF SVC: OP PHYSICIAN OUTPATIENT VISIT EST 87.00 87.00 7896113 DVID/07 99205 250.00 PERFORMED BY: ALI BAHADORI MD HERSHEY IN' MED ASSOC PLACE OF SYC: DP PHYSICIAN OUTPATIENT VISIT HEN MAO 285.00 BMW * 02/07107 7217026 719.45 PERFORMED BY: ERIC A WALKER MD DIY OF DIAL RADIOLOGY PLACE OF SVC: EMERGENCY ROOM PELVIS ANTERPOSTER 57.00 57.00 II 02/07/07 7351026 719.45 HIP COMPLETE STUDY 69.00 69.00 w 02/07/07 7400026 789.0 ABDOMEN SINGLE VIER WAD 60.00 If 02/D7/97 99284 719.45 PERFORMED BY: CRAIG T LAUDER DO DIV OF EMER£ ROOM EMERGENCY VISIT 243:00 243.DD m 02/07107 93010 786.50 ECG ELECTROCARDIOGRAM 68.00 68.00 8115000 If 02/24/07 7415026 573.9 PERFORMED BY: TMRA L WJ ERT MO DIY OF DIAL RADIOLOGY PLACE OF SVC: EMERGENCY ROOM C T ABDOMEN UNEMUNCED 387.00 387.00 IE 02/24/07 7219226 562.10 CT PELVIS UNEWAHCED 3%.00 BALANCE: BARBARA L CODER &R"Z_nn 354.00 If INDICATES NEi FINANCIAL ACTIVITY SINCE LAST BILL. IF YOU HAVE ANY QUESTIONS ABOUT THE AlNOUNT YOUR IMIAME COMPANY PAID, CONTACT THEM DIRECTLY. FOR ANY OTHER QUESTIONS REGARDING YOUR BALANCE, PLEASE CONTACT MIR OFFICE. IF PAYMENT HAS BEEN MADE, THANK YOU AND DISREGARD THIS BILL. RNS THANK YOU FOR USING MSHNC PHYSICIANS GROUP FOR YOUR PHYSICIAN SERVICES. IF YOU HAVE ANY QUESTIONS REGARDING THIS BILL, PLEASE CONTACT US AT 717-531-5069 OR 800-254-2619, BETNE N M ODAN AND 5:3011M NOWAY THROUGH NEDNESDAY OR BETMEEN 8:OOAH AND 4:30PH THURSDAY AND FRIDAY. C HECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK NO, -mono Ui ?? ACCOUNT ¢# 1805279 IF ANY QUESTMM. PLEASE CONTACT: IBS ?_- IMPORTAMP- PLEas neraru eun nc. n o?? j PORTION OF STATFAIENT M7 TN YOLK PAYii h? B? STATEMENT DATE GUARANTOR RESPONS1a1LITY;? MINIMUM PAYMEMTz MSHMC PHYSICIANS GROUP 03/27107 $ 5488.00 $ 548$.00 BIWNG SERVICES P O BOX 854 HERSHEY PA 17033-0854 00001605279 UP 0000000000546300032707 1...II?I?III?I?I?11u?InIlRll???llnull?:11?::?1lI111?1:?1?1 nrpr NSHNC PHYSICIANS GROUP BARBARA L COOPER PO BOX 643313 16 BUTTONWOOD LN PITTSBURGH PA 15264-3313 CARLISLE PA 17015-7801 OFFICE USE ONLY CNECK ONE FOR CREDIT CARD PAYMENT, PLEASE FILL IN INFORMATION BELOW -VISA I I I I 1_H 1805279 VISA CARD NUMBER EXP DATE HC ; F8$0 _DISC CARDHOLDER NAME (PRINT) 5483.00 04!171 rYP : nMNn CREDIT CARP SIGNATURE MSHMC PHYSICIANS GROUP STATEMENT DATE: W27107 LAST STATEMENT DATE: 01122107 CHECK BOX AND ENTER ANY ADDRESS OR INSURANCE CORRECTIONS ON BACK mrR COOPER,,,BARBARA #1605279 $18,496.87 (Hosp) 5,463.00 (Phys) VERIFICATION LINDA SCHLADER hereby states that she is the Team Manager, Customer Service of the Milton S. Hershey Medical Center and verifies that the statements made in the foregoing pleading are true and correct to the best of her knowledge, information and belief. The undersigned understands that the statements therein are made subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. 4?'LINDA SCHLADER DATE : 4 t` 0 c `o b co OM SHERIFF'S RETURN - REGULAR CASE NO: 2008-02723 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND MILTON S HERSHEY MEDICAL THE VS COOPER BAR DENNIS FRY Cumberland C says, the wi COOPER BARBA Sheriff or Deputy Sheriff of nty,Pennsylvania, who being duly sworn according to law, in COMPLAINT & NOTICE was served upon the DEFENDANT at 16 B at 1325:00 HOURS, on the 30th day of April , 2008 CARLISLE. PA117013 JASON COOPERI, SON by handing to a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 5.00 Affidavit .00 Surcharge 10.00 00 33.00- Sworn and Su scibed to before me this day of , So Answers: R. Thomas Kline 05/01/2008 TABAS & ROSEN By: i ---3 /'ir Dep ty Sher' f A. D. TAPAS & ROSEN, P.C. BV : LENVIS C. TRAUFFER, ESQUIRE ID NO.: 60267 x_601 Market Street, Suite 2300 PHILADELPHIA, PA 19103 215-i69-5050 The Milton S. Hershey Medical Center P.O. Box 853 Hershey, PA 17011 VS. Barbara Cooper 16 Buttonwood Lane CM Carlisle, PA 17013 COURT OF COMMON PLEAS CUMBERLAND COUNTY NO.: No.: 08-2723 ORDER FOR JUDGMENT FOR WANT OF AN ANSWER AND ASSESSMENT OF DAMAGES TO THE PROTHONOTARY: Kindly enter judgment in the sum of $25,786.14 in favor of the Plaintiff(s) in the above entitled matter for failure of the Defendant(s) to file an Answer to Plaintiff(s) Complaint in Civil Action and assess Plaintiff(s) damages as follows: Amount of Claim: Interest at 6% per annum from date of discharge 2/24/07 $ 23,959.87 $ 1,826.27 Total: $ 25,786.14 Attorne or Plaintiff(s) I assess damages as above P6 Prothonot ?. .. r..-hereby certify that the 10 day letter nder R.C.P.R. 237.1 was forwarded to Defendant Barbara Cooper Address 16 Buttonwood Lane, CM, Carlisle, PA 17013 Date May 21, 2008 I . .......... ? .................cer y that the above n es are correct and the Precise Residence Address of the Judgment creditor is Address: Same Address of Defendants: Same The Milton S. Hershey Medical Center P.O. Box 853 Hershey, PA 17011 COURT OF COMMON PLEAS CUMBERLAND COUNTY VS. Barbara Cooper 16 Buttonwood Lane CM Carlisle, PA 17013 NO.: No.: 08-2723 AFFIDAVIT OF NON MILITARY SERVICE COMMONWEALTH OF PA COUNTY OF CUMBERLAND LEWIS C. TRAUFFER being legally sworn, deposes and says: (a) that the defendant (s) is/are not in the Military or Naval Service of the United States or or of its allies, or otherwise within the provisions of the Soldiers' and Sailors' Civil relief action of Congress of 1940 as amended; (b) that defendant Barbara Cooper is over 21 years of age and resides at: 16 Buttonwood Lane CM, Carlisle, PA 17013 and is employed in Private Business. (c) that defendant is over 21 years of age and resides at: and is employed in Private Business. Affidavit has ascertained the foregoing information by inquiry and belief and makes this Affidavit with due authority. LEWIS C. UFFER, ESQUIRE Attorney for the Plaintiff Sworn to and subscribed before me on this 2nd day of June, 2008. G iegw2r?oN sa,?dx3 uoi961* :) AVy +AO? e?ryd 'e?ud?apel!gd to Apo E 11 1oN ' xS1?nfl?S .? H13NND h Ht??r wc?o? TABAS & ROSEN, P.C. BY: LEWIS C. TRAUFFER, ESQUIRE ID No.: 60267 - '1601 Market Street, Suite 2300 Philadelphia, PA 19103 (215)569-5050 The Milton S. Hershey Medical Center : Court of Common Pleas P.O. Box 853 Hershey, PA 17033 : Cumberland County VS. : No.: 08-2723 Barbara Cooper 16 Buttonwood Lane CM Carlisle, PA 17013 NOTICE OF INTENTION TO TAKE DEFAULT JUDGMENT TO: Barbara Cooper 16 Buttonwood Lane CM Carlisle, PA 17013 DATE OF NOTICE/FECHA DEL AVISO: May 21, 2008 IMPORTANT NOTICE YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGEMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. 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 NO FEE. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 Phone No.: (717) 249-3166 or (800) 990-9108 AVISO IMPORTANTE USTED SE ENCUENTRA EN ESTADO DE REBELDIA POR NO HABER PRESENTADO UNA COMPARECENIA ESCRITO CON ESTE TRIBUNAL SUS DEFENSAS U OBJECTIONES A LOS RECLAMOS FORMULADOS EN CONTRA SUYO. AL NO TOMAR LA ACCION DEBIDA DENTRO DE DIEZ DIAS DE LA FECHA DE ESTA NOTIFICATION, EL TRIBUNAL PODRA, SIN NECESIDAD DE COMPARECER LISTED EN CORTE U OIR PREUBA ALGUNA, DICTAR SENTENCIA EN SU CONTRA Y USTED PODRIA PERDER BIENES U OTROS DERECHOS IMPORTANTES. USED DEBE LLEVAR ESTE AVISO A UN ABOGADO ENSEGUIDA. SI USTED NO TIENE ABOGADO, VAYA PERSONALMENTE O LLAME POR TELEFONO A LA OFICINA MENCIONADA A CONTINUACTION. ESTA OFICINA LE PUEDE PROVEER LA INFORMACION NECESARIA PARA CONTRATAR A UN ABOGADO. SI USTED CARECE DE LOS MEDIOS NECESARIOS PARA CONTRATAR A UN ABOGADO, DICHA OFICINA LE PUEDE SUMINISTRAR LA INFORMACION NECESSARIA ACERCA DE AQUELLAS AGENCIAS QUE OFRECEN SERVICIOS LEGALES A LAS PERSONAS QUE TIENEN DERECHO A RECIBIR TAL AYUDA GRATIS 0 A UNA CUOTA REDUCIDA. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 Phone No.: (717) 249-3166 or (800) 990-9108 LEWIS C. TRAUFFER, ESQUIRE ATTORNEY FOR THE PLAINTIFF THIS CORRESPONDENCE IS BEING USED TO COLLECT A DEBT AND THE INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. -F ems- 4t, oo Q ?. O j) yam' f r° ra cs co MM R Fti iC) 3C ' a r A. - A OFFICE OF THE PROTHONOTARY CUMBERLAND COUNTY COURT HOUSE ONE COURTHOUSE SQUARE CARLISLE, PA 17013 TO: Barbara Cooper 16 Buttonwood Lane CM Carlisle, PA 17013 The Milton S. Hershey Medical Center P.O. Box 853 Hershey, PA 17011 VS. Barbara Cooper CUMBERLAND COUNTY No.: 08-2723 NOTICE Pursuant to Rule 236-of the Supreme Court of Pennsylvania, you are hereby not ied that a Judgment has been entered against you in the above proceedin s i low. CUR G PROTHONOTAR Y X JUDGMENT BY DEFAULT MONEY JUDGMENT JUDGMENT IN REPLEVIN JUDGMENT FOR POSSESSION JUDGMENT ON AWARD OF ARBITRATION TRANSFER OF JUDGMENT IF YOU HAVE ANY QUESTIONS CONCERNING THIS NOTICE, PLEASE CALL: ATTORNEY LEWIS C. TRAUFFER, ESQUIRE AT THIS TELEPHONE NUMBER: 215-569-5050 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND THE MILTON S. HERSHEY MEDICAL CENTER P.O. BOX 853 HERSHEY, PA 17011 V. BARBARA COOPER 16 BUTTONWOOD LANE CM CARLISLE, PA 17013 COURT OF COMMON PLEAS CUMBERLAND COUNTY NO.: 08-2723 PRAECIPE FOR WRIT OF EXECUTION TO THE PROTHONOTARY: ? Issue writ of execution in the above matter, directed to the Sheriff of Cumberland County; (1) against BARBARA COOPER (2) against defendant(s) and WACHOVIA BANK ACCT#: 00000001014211671378 SIXTH STREET FINANCIAL CENTER 35th N. SIXTH STREET READING, PA 19601 arty arid all agse4s, ir+pk?di Without limi tafi'on, Ch Writ oueco0 3owin9s 0.eeoUn+s , Cer- f J- tits 'f 6epasi+ aAd sae deposi+ boxes ep 16 d 4odu t 1n Ae Possession oP 4e, garnishee(s). (3) AMOUNT DUE INTEREST FROM 02/24/07 AT 6% PER ANNUM $23,959.87 $ 1,826.27 (COSTS TO BE ADDED) $ TABAS & ROSEN, P.C. LEWIS C. TRAU R, I.D. No. 60267 1601 Market Street, 2300 Philadelphia, PA 19103 (215) 569-5050 Attorney for Plaintiff ao d 00 00 6` dk ?L +?+ Q IV s ° b lp, ?.5. [> C CAD WRIT OF EXECUTION and/or ATTACHMENT COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND) NO 08-2723 Civil CIVIL ACTION - LAW TO THE SHERIFF OF CUMBERLAND COUNTY: To satisfy the debt, interest and costs due THE MILTON S. HERSHEY MEDICAL CENTER, Plaintiff (s) From BARBARA COOPER, 16 Buttonwood Lane Cm, Carlisle, PA 17013 (1) You are directed to levy upon the property of the defendant (s)and to sell (2) You are also directed to attach the property of the defendant(s) not levied upon in the possession of GARNISHEE(S) as follows: WACHOVIA BANK, Sixth Street Financial Center, 35th Sixth Street, Reading, PA 19601 Any and all assets, including, without limitation, checking accounts, savings accounts, certificates of deposit and safe deposit boxes of the defendant in the possession of the Garnishee. ACCT #00000001014211671378 and to notify the garnishee(s) that: (a) an attachment has been issued; (b) the garnishee(s) is enjoined from paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant (s) or otherwise disposing thereof; (3) If property of the defendant(s) not levied upon an subject to attachment is found in the possession of anyone other than a named garnishee, you are directed to notify him/her that he/she has been added as a garnishee and is enjoined as above stated. Amount Due $23,959.87 L.L. $.50 Interest from 2/24/07 at 6% per annum - $1,826.27 Atty's Comm % Due Prothy $2.00 Atty Paid $152.50 Plaintiff Paid Date: 6/26/08 (Seal) REQUESTING PARTY: Other Costs To Be Added C is R. Long, P onotary By: Deputy Name LEWIS C. TRAUFFER, ESQUIRE Address: TABAS & ROSEN, PC 1601 MARKET STREET, 2300 PHILADELPHIA, PA 19103 Attorney for: PLAINTIFF Telephone: 215-569-5050 Supreme Court ID No. 60267 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND THE MILTON S. HERSHEY MEDICAL CENTER P.O. BOX 853 HERSHEY, PA 17011 COURT OF COMMON PLEAS CUMBERLAND COUNTY V. BARBARA COOPER 16 BUTTONWOOD LANE CM CARLISLE, PA 17013 NO.: 08-2723 AMENDED PRAECIPE FOR WRIT OF EXECUTION TO THE PROTHONOTARY: Issue writ of execution in the above matter, directed to the Sheriff of Cumberland County; (1) against BARBARA COOPER (2) against WACHOVIA BANK CARLISLE FINANCIAL CENTER 604 E. HIGH STREET CARLISLE, PA 17013 defendant(s) and ACCT#: 00000001014211671378 (3) AMOUNT DUE INTEREST FROM 02/24/07 AT 6% PER ANNUM (COSTS TO BE ADDED) garnishee(s). $23,959.87 $ 1,826.27 TABAS & ROSEN, P.C. L W S C. TRAUFFER, I.D. No. 60267 1601 Market Street, 2300 Philadelphia, PA 19103 (215) 569-5050 Attorney for Plaintiff 4 ?, C= _. , ?-- ,r:? C_ ;?- c 14, MCAJ eJ- WRIT OF EXECUTION and/or ATTACHMENT COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND) NO 08-2723 Civil CIVIL ACTION - LAW TO THE SHERIFF OF CUMBERLAND COUNTY: To satisfy the debt, interest and costs due THE MILTON S. HERSHEY MEDICAL CENTER, Plaintiff (s) From BARBARA COOPER, 16 Buttonwood Lane Cm, Carlisle, PA 17013 (1) You are directed to levy upon the property of the defendant (s)and to sell (2) You are also directed to attach the property of the defendant(s) not levied upon in the possession of GARNISHEE(S) as follows: WACHOVIABANK„ Cell-iisIc- a cz« 1 Ce, +cr,) (o F, 8191. St"rQt -, C?Arslc, Pk 17 013 Any and all assets, including, without limitation, checking accounts, savings accounts, certificates of deposit and safe deposit boxes of the defendant in the possession of the Garnishee. ACCT #00000001014211671378 and to notify the garnishee(s) that: (a) an attachment has been issued; (b) the garnishee(s) is enjoined from paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant (s) or otherwise disposing thereof, (3) If property of the defendant(s) not levied upon an subject to attachment is found in the possession of anyone other than a named garnishee, you are directed to notify him/her that he/she has been added as a garnishee and is enjoined as above stated. Amount Due $23,959.87 L.L. $.50 Interest from 2/24/07 at 6% per annum - $1,826.27 Atty's Comm % Due Prothy $2.00 Atty Paid $152.50 Plaintiff Paid Other Costs To Be Added Date: 6/26/08 (Seal) Cuitis R. Long, P onotary By: Deputy REQUESTING PARTY: Name LEWIS C. TRAUFFER, ESQUIRE Address: TABAS & ROSEN, PC 1601 MARKET STREET, 2300 PHILADELPHIA, PA 19103 Attorney for: PLAINTIFF Telephone: 215-569-5050 Supreme Court ID No. 60267 SHERIFF'S RETURN - GARNISHEE CASE NO: 2008-02723 P COMMONWEALTH OF PENNSLYVANIA COUNTY OF CUMBERLAND MILTON S HERSHEY MEDICAL THE VS COOPER BARBARA And now MARK CONKLIN Sheriff or Deputy Sheriff of Cumberland County of Pennsylvania, who being duly sworn according to law, at 0009:10 Hours, on the 17th day of July , 2008, attached as herein commanded all goods, chattels, rights, debts, credits, and moneys of the within named DEFENDANT , COOPER BARBARA , in the hands, possession, or control of the within named Garnishee WACHOVIA BANK 604 EAST HIGH ST CARLISLE, PA 17013 Cumberland County, Pennsylvania, by handing to JILL MANLEY (MANAGER) , personally three copies of interogatories together with 3 true and attested copies of the within WRIT OF EXECUTION and made the contents there of known to Her . Sheriff's Costs: So answer' Docketing .00 Service .00 Affidavit .00 R. Thomas Kline' Surcharge .00 Sheriff of Cumberland County .00 ?- 00 07/17/2008 Sworn and Subscribed to before me this day of By Deputy Sheriff A.D SIRLIN GALLOGLY & LESSER, P.C. By: Jon C. Sirlin, Esquire Identification No.: 17498 1529 Walnut Street, Suite 600 Philadelphia, PA 19102 (215) 864-9700 Attorney for Garnishee THE MILTON S. HERSEY MEDICAL CENTER COURT OF COMMON PLEAS COUNTY OF CUMBERLAND VS. BARBARA COOPER NO. 08-2723 and WACHOVIA BANK, N.A., GARNISHEE ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter my appearance on behalf of Wachovia Bank, N.A., Garnishee, in the above-captioned matter. Date: -i CA) r` CYO •-?' ' SIRLIN GALLOGLY & LESSER, P.C. By: Jon C. Sirlin, Esquire Identification No.: 17498 1529 Walnut Street, Suite 600 Philadelphia, PA 19102 (215) 864-9700 Attorney for Garnishee THE MILTON S. HERSEY MEDICAL CENTER COURT OF COMMON PLEAS COUNTY OF CUMBERLAND vs. BARBARA COOPER and NO. 08-2723 WACHOVIA BANK, N.A., GARNISHEE ANSWERS TO INTERROGATORIES IN ATTACHMENT TO: THE MILTON S. HERSEY MEDICAL CENTER, Plaintiff 1. No. 2. No, Defendant has no relationship with Wachovia Bank, N.A. 3.- 6. No. 7. (Q) If you are a bank or other financial institution, at the time you were served or at any subsequent time did the defendant have funds on deposit in an account in which funds are deposited electronically on a recurring basis and which are identified as being funds that upon deposit are exempt from execution, levy or attachment under Pennsylvania or federal law? (A) No. 8. (Q) If you are a bank or other financial institution, at the time you were served or at any subsequent time did the defendant have funds on deposit in an account in which the funds on deposit, not including any otherwise monetary exemption under 42 Pa.C.S. § (A) No. Dated: ;eneral ? Legal Order Processing 104 Independence Mall East 11th Floor - PA4418 Philadelphia, PA 19106 VERWFICA-rU ---- ----- Sehr C7'Ll-lonnell, being duly sworn according to law, deposes and says that he is the Writ of E <cfution Administrator of Wachovia National Bank, Garnishee herein, and verifies that the statements made in the foregoing Answers to Interrogatories are true and corr::c;:i to the best of his knowledge. Said Garnishee understands that false statcrients herein are made subject to penalties of 18 Pa. C.S. Sect ion 4904, renting to swore falsification to authorities. ohn O'Donnell Manager Datec : i' ?? d c s Film CC) -m a IR .. U4 TABAS & ROSEN, P.C. BY: LEWIS C. TRAUFFER I.D. #60267 1601 Market Street, Suite 2300 Philadelphia, PA 19103 (215)569-5050 Attorney for Plaintiff MILTON S. HERSHEY MEDICAL CENTER : COURT OF COMMON PLEAS VS. BARBARA COOPER AND WACHOVIA BANK Garnishee : CUMBERLAND COUNTY : NO.: 08-2723 PRAECIPE TO DISSOLVE WRIT OF ATTACHMENT TO THE PROTHONOTARY: Kindly dissolve the Writ of Attachment regarding the above captioned case against Wachovia Bank only, Garnishee. LEWI C. TRA FER, ESQUIRE Attorney for Plaintiff s 'PJ ? " ? ?.-? ? -?". t ? ' -r r ? ..?. t f-- 'C} x'79 a ? 4 ..? ?y ` 0 _ ^?y. r. ? 7 {..: `? rt`I ?_? ?- ? ? V r' ?v 1 =, ?Ia C, R. R. Thomas Kline, Sheriff, who being duly sworn according to law, states i Writ is returned ABANDONED, no action taken in six months. Sheriff's Costs: Docketing Poundage Advertising Law Library Prothonotary Mileage Surcharge Levy Postpone Sale Certified Mail Postage Garnishee co c„ Cz? _. U 18.00 1.71 Advance Costs: 150,00 Sheriff's Costs: 87.0q 62.R t Refunded on 0181 .50 2.00 5.00 30.00 20.00 .88 9.00 87.09 So Answers, r?2 R. T omas line, Shy By 'a "gel Sharon R. Lantz _0 a `70 O - -µ So .E ci Lz Or HOZ uz L 95T 2.1 N ? X53/3 14mt.%4eA WRIT OF EXECUTION and/or ATTACHMENT COMMONWEALTH OF PENNSYLVANIA) NO 08-2723 Civil COUNTY OF CUMBERLAND) CIVIL ACTION - LAW TO THE SHERIFF OF C L&-16,: r 1aa COUNTY: To satisfy the debt, interest and costs due THE MILTON S. HERSHEY MEDICAL CENTER, Plaintiff (s) From BARBARA COOPER, 16 Buttonwood Lane Cm, Carlisle, PA 17013 (1) You are directed to levy upon the property of the defendant (s)and to sell (2) You are also directed to attach the property of the defendant(s) not levied upon in the possession of GARNISHEE(S) as follows: WACHOVIA BANK, C&A, s(c rro%c&a6wJ Ce?1w1 Go y C 4,yk S4-,xx-+ , &, 4,sl - ? PAS ) 7o 43 Any and all assets, including, without limitation, checking accounts, savings accounts, certificates of deposit and safe deposit boxes of the defendant in the possession of the Garnishee. ACCT #00000001014211671378 and to notify the garnishee(s) that: (a) an attachment has been issued; (b) the garnishee(s) is enjoined from paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant (s) or otherwise disposing thereof; (3) If property of the defendant(s) not levied upon an subject to attachment is found in the possession of anyone other than a named garnishee, you are directed to notify him/her that he/she has been added as a garnishee and is enjoined as above stated. Amount Due $23,959.87 L.L. $.50 Interest from 2/24/07 at 6% per annum - $1,826.27 , Atty's Comm % Due Prothy $2.00 Atty Paid $152.50 Other Costs To Be Added Plaintiff Paid Date: 6/26/08 (Seal) 2"- ey?4 0 4 Curtis . Long, Pro By: Deputy REQUESTING PARTY: Name LEWIS C. TRAUFFER, ESQUIRE Address: TABAS & ROSEN, PC 1601 MARKET STREET, 2300 PHILADELPHIA, PA 19103 Attorney for: PLAINTIFF Telephone: 215-569-5050 Supreme Court ID No. 60267