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Home My WebLink About08-4331IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff No. ?? - -11,3-31 &I-t/ VS. JUSTIN K WORMER Defendant COMPLAINT IN CIVIL ACTION FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: WILLIAM T. MOLCZAN, Esquire PA I.D. #47437 WELTMAN, WEINBERG & REIS CO., L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 (412) 434-7955 WWR#06601824 IN THE COURT OF COMMON PLEAS CUUMBS OANDCOUNTY, PENNSYLVANIA CIVIL INTERNATIONAL PORTFOLIO INC. Plaintiff a ?- y3 3 r «,,1 4U^ Civil Action No. vs. JUSTIN K WORMER Defendant COMPLAINT AND NOTICE TO DEFEND You have been sued in court. If you wish to defend against the claims set forth in the following enterin pages, you must take action within twenty (20) days after this c nmpt ?? the court your defenses og a written appearance personally or by an attorney and filing writing 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 O TO OR TELEPHONE THE OFFICE SET HAVE A LAWYER OR CANNOT AFFORD ONE, G FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP LAWYER REFERRAL SERVICE CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 (717) 249-3166 COMPLAINT Plaintiff is a corporation with offices at 7465 N.W. 49TH ST, LAUDERHILLE, FL 33319- 0000. 2. Defendant is an adult individual residing at 182 KERRSVILLE RD, CARLISLE,PA 17013. 3. At the specific instance and request of Defendant, Carlisle Regional Medical Center, provided certain medical services to Defendant. 4. This obligation was subsequently assigned to Plaintiff for value. 5. Defendant, JUSTIN K WORMER, received and accepted the aforementioned medical services which were provided by Plaintiff's assignor 6. The prices charged by Plaintiff's assignor were the prices that Defendant, JUSTIN K WORMER, agreed to pay. 7. Plaintiff avers that there is a balance due and owing from Defendant, JUSTIN K WORMER, in the amount of $7,839.69 as of MAY 23, 2008. r Plaintiff claims interest at the legal rate of six (6%) percent per annum from MAY 23, 2008 9. Although repeatedly requested to do so by Plaintiff, Defendant has willfully failed and/or refused to pay the aforementioned balance, or any part thereof to Plaintiff. WHEREFORE, Plaintiff demands Judgment in its favor and against Defendant, JUSTIN K WORMER, in the amount of $7,839.69 with continuing interest thereon at the rate of 6% per annum from MAY 23, 2008 and costs. THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED SHALL BE USED FOR THAT PURPOSE. WELTMAN, WEINBERG & REIS, CO., L.P.A. WILLIAM T. MO ZAN, Esquire PA I.D. #47437 WELTMAN, WEINBERG & REIS CO., L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 (412) 434-7955 W WR#:06601824 05/09/08 PAGE 001 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 AS OF 05/08/08 CARLISLE REGIONAL MEDICAL CTR PA 17015 PHONE (717) 960-1680 161 ALEXANDER SPRING RD CARLISLE --- --------- _ -------------------------------------------------- PATIENT: WORMER, JUSTIN K FIONP/07/20/06. 9DI344695 00%21/06 T0: WORMER, JUSTIN K ADMISS 182 KERRSVILLE RD CARLISLE PA 17013 DEPARTMENT AMOUNT 650.00 60.48 355.15 354.51 2,239.12 775.65 997.48 2,582.30 175.00- 7,839.69- ----------------------------------------TOTAL----=-*--- T0.00 = SELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= 7=RETURN,8=BACKWARD, ENTER=FORWARD CMD:I=DAR,2=PAT 4=DETAIL EXHIBIT . s The undersiped does hereby rift' subject to the penaifi+s oT 18 PA.C.S. 14 relating to unsworn falsifications to authorities, that she is tt t A ?,rn R (Name) RATIONS of 'TF I .> plaintiff y 11s,? r ?)1L ?'I'itl?e) (Company) (Title) ?r herein, that she is duly authorized to male this Verification, and that the fasts set forth in the foregoing Complaint in Civil Action are true and correct to the best of her knowledM information and belief. WWPI v? cm -TI co \ _:' j £ ?' SHERIFF'S RETURN - NOT FOUND CASE NO: 2008-04331 P COMMONTWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND INTERNATIONAL PORTFOLIO INC VS WORMER JUSTIN K R. Thomas Kline Sheriff or Deputy Sheriff, who being duly sworn according to law, says, that he made a diligent search and inquiry for the within named DEFENDANT WORMER JUSTIN K but was unable to locate Him in his bailiwick COMPLAINT & NOTICE , He therefore returns the NOT FOUND , as to the within named DEFENDANT WORMER JUSTIN K 182 KERRSVILLE RD CARLISLE, PA 17015 PER FATHER, MOVED TO 6407 RUTHERGLEN DRIVE, FAYETTEVILLE, NC 28304. Sheriff's Costs: Docketing Service Affidavit Surcharge Not Found f,/0yfot ` • r? So answers i 18.00 9.00 .00 R. ThomasKline 10.00 Sheriff of Cumberland County 5.00 v'42.00 WELTMAN WEINBERG & REIS 08/04/2008 Sworn and Subscribed to before me this day of A. D. I . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC Plaintiff vs. No. 08-4331-CIVIL PRAECIPE TO SETTLE, DISCONTINUE AND END WITHOUT PREJUDICE TO REFILE JUSTIN K WORMER Defendant FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: William T. Molczan, Esquire PA I. D. #47437 WELTMAN, WEINBERG & REIS CO., L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 (412) 434-7955 WWR#06601824 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC Plaintiff vs. Civil Action No. 08-4331-CIVIL JUSTIN K WORMER Defendant PRAECIPE TO SETTLE. DISCONTINUE AND END WITHOUT PREJUDICE TO REFILE TO THE PROTHONOTARY OF CUMBERLAND COUNTY: SIR: Settle, Discontinue and End the above-captioned matter upon the records of the Court without prejudice to refile and mark the costs paid. WELTMAN, WEINBERG & REIS CO., L.P.A. By: Attorney for Plaintiff 2718 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 (412) 434-7955 WWR#06601824 SWORN TO AND SUBSCRIBED E it'z. yGo;nrrissb, , °:xu `Jov.,4 LM Member. Pennsl hvani, A ci _"'Ion of Nc'r '-a before me this I q day 4s ' '. _? :? ni:7 4-_.? _ i,'r` . ? ? _ n' ` '? %`j