HomeMy WebLinkAbout08-3848IN RE: PETITION FOR
CHANGE OF NAME FROM
PHYLLIS J. MINISHAK TO
PHYL J. MINISHAK
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO.
PETITION FOR CHANGE OF NAME
TO THE HONORABLE, THE JUDGES OF SAID COURT:
AND NOW COMES, the Petitioner, Phyllis J. Minishak a/k/a Phyl J. Minisak by and through her
legal counsel, Coyne and Coyne, P.C., and requests that this Court order a change of name for her,
pursuant to 54 Pa. Cons. Stat. Ann. § 701 et., and in support thereof represents the following:
1. Petitioner, Phyl J. Minishak, is an adult sui juris, and resides at 890 Hawthorne Avenue,
Mechanicsburg, Upper Allen Township, Cumberland County, Pennsylvania, and has resided at this
address during the five years preceding the filing of this petition.
2. Petitioner's spouse, Alex J. Minishak, Jr. joins in this Petition.
3. Petitioner was born on May 5, 1951 in York, Pennsylvania and given the legal name of
Phyllis J. Karns which appears on her Birth Certificate. A copy is attached and marked as Exhibit "A."
4. Petitioner's Pennsylvania Driver's License is issued in the name of Phyl J. Minishak. A
copy of which is attached as Exhibit "B."
5. On March 6, 1971, Petitioner, Phyllis J. Karns married Alex J. Minishak, Jr. and her
name was changed through marriage to Phyllis J. Minishak. See Exhibit "C."
6. Petitioner and her spouse's Pennsylvania Motor Vehicle Registration for a 1999 Buick is
in the name of Phyl J. Minishak. A copy is attached and marked Exhibit "D."
7. Petitioner requests that her name be changed from Phyllis J. Minishak to Phyl J.
Minishak.
8. The reasons for the requested change of name are:
(a) To conform Petitioner's name with the name on all other legal documents
namely; bank records, voter registration, vehicle operator's license, vehicle
registration, credit cards, employment records, prescription cards, health care
cards, auto insurance cards and her amended Certificate of Birth in the name of
Phyl Jean Karns issued on May 5, 2005. (Exhibit "E").
(b) The Social Security Administration will not change Petitioner's name to Phyl J.
Minishak unless Petitioner has a Court Order granting to me the name change to
Phyl J. Minishak.
(c) Since Petitioner's years at Mechanicsburg School System, Petitioner has been
known as Phyl and personally prefers the name Phyl and dislikes the name
Phyllis.
9. There are no judgments or adverse decrees of like character of record against Petitioner.
WHEREFORE, Petitioner respectfully requests this Honorable Court enter an Order changing
the Petitioner's name from Phyllis J. Minishak to Phyl J. Minishak.
Dated: 6 z G od
Respectfully submitted:
COYNE & COYNE, P.C.
By: IJLl.?I
G enry F. Co 4, Esquire
3901 Market Street
Camp Hill, PA 17011-4227
(717) 737-0464
Pa. S. Ct. No. 06250
Attorney for Petitioner
DATE OF
BIRTH 05-07-1951
COUNTY OF
BIRTH YORK
NAME
PHYLLIS JEAN KARNS
FATHERS NAME
DEPARTMENT OF HEALTH
VITAL RECORDS
CERTIFICATION OF BIRTH
FILE
06:55 AM NUMBER 0887690-1951
DATE
FILED 05-12-1951
DATE
ISSUED 05-20-2008
SEX FEMALE
RICHARD CHARLES KARNS AGE - -
BIRTHPLACE INFORMATION NOT RECORDED
MOTHERS MAIDEN NAME
VIVIAN MAE EMIG AGE -
BIRTHPLACE INFORMATION NOT RECORDED,-,.,-,
NOTICE
This is not a copy of the birth record as it
is presently filed. This is a copy of the
record prior to the amendment of 05-05-2005.
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department
of Health, in accordance with Act 66, P.L. 304, approved by the General Assembly, June 29, 1953. dd
o -
Calvin B. Johnson, M.D., M.P.H. Frank Yeropoli L * •=
Secretary of Health State Registrar
H105.053 Rev. 6106
i
00 THIS DOCUMENT IS
L1V1L WARNING:
NOT ACCEPT WITHOUTEVEAIFYING THE PRESENCE OF THE WATERMARK. a L r 77
NO: 15 045 358 Dups 00
' W cv DOB: 0510711951 sex F
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• Class: C Eyes: GRN
W Endorse: ---- Height: 5'05°
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V Com/Med Rstr:'/
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J Issued: 06130/2005
Expires. 05/0812009
LAS
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W
> PHYL J MINISHAK
-
JY 890 HAWTHORNE AVE
(n MECHANICSBURG PA 1785?s
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3 REY?REN]?_?ERS?1vtF F, KU-RLANI)
a' y C 6th i ? MARCH _ y '?,j
one
St. THERESA CHURfH
z` NEW CUMBERLAND, PA.
:wi.il 71
ALEX JOHN MINISHAK 4in PHYLLIS JEAN KARNS _
.a i' a?>qL rrayyf
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Division =Mon Ns s O- peens' of r°3 o Cumberland
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---------------------------------
COMMONWEALTH OF PENNSYLVANIA REGISTRATION CREDENTIAL
` -------------------
11/08/07
=EXPIRY: DEC 31, 2008 VALID:
a-PLATE: DDK8153 _ A ?-?
,TITLE: 53203915301 MI -
IGNATURE
C3VIN: 1G4GD2211X4701293
MYR/MAKE : 1999 BUICK I hereby acknowledge this day that I have received
G-TYPE : C P notice of the provisions of Section 3709 of the Vehicle
r-.WID: 07312 1353 000396-001 Code.
V
EMISSIONS INSPECTION REQUIRED/DIESEL VEHICLES EXEMPT COUNTY: CUMBERLAND
1W
LW
PHYL J MINISHAK m
890 HAWTHORNE AVE
MECHANICSBURG PA
17055
FINANCIAL RESPONSIBILITY IDENTIFICATION CARD
INSURANCE COMPANY NAME NAIC CODE
ERIE INSURANCE EXCHANGE 26271
POLICY NUMBER
Q02 2701602 H
99 BUIC
Year Make
DP18-2-F 09107
12029702
1G4GD2211X470
EFFECTIVE UNTIL
02/27/08 08/27/08
NOT VALID MORE THAN SIX
MONTHS FROM EFFECTIVE DATE
61 4
V. I. N. If only 5 digits, they are last 5
NAMED INSURED
ALEX J MINISHAK JR &
PHYL J MINISHAK
890 HAWTHORNE AVE
MECHANICSBURG PA 17055-5729
SEE IMPORTANT MESSAGE ON REVERSE SIDE
YOU NEED THE I.D. CARD FOR VEHICLE
INSPECTION AND OTHER PA. STATE
REQUIREMENTS-SEE BACK OF CARD.
YOUR AUTO POLICY IS EFFECTIVE
FROM 02/27/08 T002/27/09
TO COMPLY WITH PENNSYLVANIA LAW, WE WILL:
1. Issue a 6 month I.D. card on the policy effective date.
2. Six months later issue another 6 month I.D. card.
3. Issue a card for replacement or additional vehicle(s).
OUR AGENT PHONE: 717-737-5405
TROCK INSURANCE AGENCY AA7684
01 SOUTH 32ND STREET
AMP HILL PA 17011
Erie ??? !ed ?
Insurancee G AuthoSignature
¦
}
DATE OF
BIRTH 05-07-1951
NO. 0887690-1951
DATE
FILED 05-12-1951
COUNTY OF
YORK DATE
issUED 05-05- 005
NAM SEX FEMALE
PHYL JEAN KARTS '
FATHERS .NAMJ?,
RICHARD' ,qH)AIt,ES KARN;S
MOTHERS- MAIb6ll) NAME
VI'VIAN MAE'-04"'
This is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health,
in accordance with Act 66, P.L 304, approved by the General Assembly, June 29, 1953.
, ..?
Calvin B. Johnson, M.D., M.P.H. H105.105 Rev.
Secretary of Health 02/04 Charles Hardester
State Registrar
0
LPN
12903882
VERIFICATION
The facts set forth in the foregoing are true and correct to the best of the undersigned's
knowledge, information and belief and are verified subject to the penalties for unsworn falsification to
authorities under 18 Pa. C.S.A. § 4904.
Dated: { r?
Ph llis . Min ak a/k/a Phyl J. Minishak
Dated: 04164-0e 10?- "? d, -
s
Alex J. Minis , Jr.
rNi
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JUL 012008
IN RE: PETITION FOR
CHANGE OF NAME FROM
PHYLLIS J. NIINISHAK TO
PHYL J. MINISHAK
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
NO. 08-3848 Civil Term
NOTICE
NOTICE IS HEREBY GIVEN that on QL& 7 oZ4? , 2008 the Petition of Phyllis J.
Minishak was filed in the above-named court, requesting an Order to change the name of Phyllis J.
Minishak to Phyl J. Minishak.
The Court has fixed the ,0±" day of 1 G& , 2008 at IS' A.M. in
Courtroom No. _V_ of the Cumberland County Courthouse, Carlisle, Pennsylvania, as the time and
place for the hearing on said Petition, when and where all interested parties my appear and show cause, if
any, why the request of the Petitioner should not be granted.
BY THE COURT:
CF: HENRY F. COYNE, Esquire
Attorneys for Petitioner
4-
H
kNnojs E =z Wd L- inr
Dim
SP 4-198 (11-99)
PENNSYLVANIA STATE POLICE
CENTRAL REPOSITORY
1800 ELMERTON AVENUE
HARRISBURG, PA 17110
717-783-3762
PROTHONOTARY
CUMBERLAND CO COURTHOUSE
ROOM 203
CARLISLE, PA 17013
DATE: Tuesday, July 15, 2008
RE: SID:
NAME: MINISHAK PHYLLIS
SOC: 183-42-2078
COURT DOCKET #: 08-3848 CIVIL
In accordance with the Name Change Act of 1998, the fingerprint cards of the above named individual, who
has applied for a name change, has been searched in the files of the Pennsylvania State Police, Criminal Records and
Identification Division Central Repository, and:
( ) This person is not subject to 18 PA C. S. Chapter 91, and the fingerprints have been destroyed.
( ) This person is subject to 18 PA C.S. Chapter 91, and the name change has been noted on the person's
criminal history record information.
( ) A criminal record was revealed containing felony convictions. IN ACCORDANCE WITH THE NAME
CHANGE ACT, THE COURT SHALL NOTIFY THE PENNSYLVANIA STATE POLICE WHEN A NAME
CHANGE FOR A PERSON CONVICTED OF A FELONY HAS BEEN ORDERED. The Pennsylvania State
Police, upon receipt of this notice, shall include the change of name information in the Central Repository as
provided for in 18 PA C.S., Chapter 91 (relating to criminal history record information).
( ) This person has been convicted of felony violation(s) for which the court may not order a change of name.
A criminal record was revealed that might prohibit a name change. Because the subsection(s) of the
affected conviction(s) has not been provided to us, we are unable to determine whether a name change can
or cannot be made. Please provide the subsection(s) of the following crime(s):
if available.
You are also advised that the above response is based on comparison of fingerprints and associated requester-
furnished information against a name index and fingerprints contained in the files of the Pennsylvania State Police
Central Repository - only - and does not preclude the existence of other criminal records which may be obtained in the
repositories of other local, state, or federal criminal justice agencies.
If we may be of any further assistance to you concerning this matter, please contact us at the above address or
telephone number.
Sincerely,
,e 7
Director, Criminal Records
and Identification Division
C P-D
K 4=
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no
?_
IN RE PETITION FOR
CHANGE OF NAME FROM
PHYLLIS J. MINISHAK TO
PHYL J. MINISHAK
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
NO. g - 3 ??/?c fi?•
ORDER
AND NOW, this 1/'° day of /41C..,Y 2008, on consideration of the attached
Petition For Name Change by Phyllis J. Minishak to Phyl J. Minishak, and upon presentation of proof of
publication of notice as required by law together with proof that there are no judgments or decrees of
record or any other matter of like character against the Petitioner, and it appearing that there is no lawful
objection to the request of the Petitioner, it is hereby ORDERED that the name of the Petitioner, Phyllis
J. Minishak is changed to Phyl J. Minishak.
BY THE COURT:
J.
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