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HomeMy WebLinkAbout08-53100 RICHARD BURKHOLDER, Plaintiff V. DORIS BURKHOLDER, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 08 53 b CIVIL TERM IN DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS You have been sued 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 the Plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground 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, Carlisle, Pennsylvania, 17013. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. 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 INFORMMTION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 Phone: (717) 249-3166 (800) 990-9108 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of Cumberland County, Pennsylvania, is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the Court, please contact our office. All arrangements must be made at least 72 hours prior to any hearing or business before the Court. Richard Burkholder V. Doris Burkholder IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 08-5310 DIVORCE DECREE AND NOW, /'P7" 3- , Z'0e 9 , it is ordered and decreed that Richard Burkholder plaintiff and Doris Burkholder bonds of matrimony. defendant, are divorced from the Any existing spousal support order shall hereafter be deemed-an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") None. By the Court, A44 r1vuwnvlaly Gh f4v • • )" 1. q RICHARD BURKHOLDER, Plaintiff V. DORIS BURKHOLDER, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 08 - .-3 (a CIVIL TERM IN DIVORCE COMPLAINT UNDER SECTION 3301(c) OF THE DIVORCE CODE 1. Plaintiff is Richard Burkholder, an adult individual, who resides at 783 Longs Gap Rd., Carlisle, Pennsylvania, 17013. 2. Defendant is Doris Burkholder, an adult individual, who resides at 3329 Jasper St., Philadelphia, Pennsylvania, 19134. 3. Plaintiff and Defendant have both been bona fide residents in the Commonwealth for at least six months immediately previous to the filing of this Complaint. 4. Plaintiff and Defendant were married on November 3, 2003 in Carlisle, Cumberland County, Pennsylvania. 5. There have been no prior actions of divorce or for annulment between the parties hereto in this or any other jurisdiction. 6. The marriage is irretrievably broken. 7. Plaintiff has been advised that counseling is available and that Plaintiff may have the right to request that the Court require the parties to participate in counseling. 8. Plaintiff requests the Court to enter a Decree in Divorce. WHEREFORE, Plaintiff respectfully requests this Honorable Court to enter a Decree in Divorce and such other Orders as may be just and appropriate. Date: Respectfully submitted, BAYLEY & MANGAN Mark F. Bayley, Esquire 17 West South St. Carlisle, PA 17013 (717) 241-2446 Supreme Court I.D. # 87663 Attorney for Plaintiff RICHARD BURKHOLDER, Plaintiff V. DORIS BURKHOLDER, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 08 - CIVIL TERM IN DIVORCE VERIFICATION I verify that the statements made in this Complaint are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to unworn falsification to authorities. Date: 0l Richard Burkholder, Plaintiff C M' =` i CDO P 1 1 y -411 W p MARITAL SEPARATION AGREEMENT THIS AGREEMENT, entered into on the specified date below, by and between Richard Burkholder, (hereinafter referred to as "HUSBAND") and Doris Burkholder, (hereinafter referred to as "WIFE"). WI TNESSETH: WHEREAS, HUSBAND and WIFE were lawfully married on November 3, 2003; and WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of HUSBAND and WIFE to live separate and apart for the rest of their natural lives, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other, including, without limitation by specification; the settling of all matters between them relating to the ownership and equitable distribution of real and personal property; the settling of all claims and possible claims by one against the other or against their respective estates and equitable distribution of property and alimony for each party. NOW, THEREFORE, in consideration of the promises and the mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound, hereby covenant and agree as follows: 1. The parties intend to maintain separate and permanent domiciles and to live apart from each other. It is the intention and purpose of this agreement to set forth the respective rights and duties of the parties while they continue to live apart from each other. 2. The parties have attempted to divide their matrimonial property in a manner that conforms to a just and right standard, with due regard to the rights of each party. It is the intention of the parties that such division shall be final and shall forever determine their respective rights. The division of existing marital property is not intended by the parties to constitute in any way a sale or exchange of assets. 3. Further, the parties agree to continue living separately and apart from each other at any place or places that he or she may select. Neither party shall molest, harass, annoy, injure, threaten or interfere with the other party in any manner whatsoever. Each party may carry on and engage in any employment, profession, business or other activity, as he or she may deem advisable for his or her sole use and benefit. Neither party shall interfere with the uses, ownership, enjoyment or disposition of any property now owned and not specified herein or property hereafter acquired by the other. 4. The consideration for this contract and agreement is the mutual benefits to be obtained by both of the parties hereto and the covenants and agreements of each of the parties to the other. The adequacy of the consideration for all agreements herein contained is stipulated, confessed, and admitted by the parties, and the parties intend to be legally bound hereby. 5. Each party to this agreement acknowledges and declares that he or she, respectively: A. Enters into this agreement voluntarily after receiving the advice of counsel or after having fair opportunity to obtain the advice of counsel and voluntarily declining to do so; B. Is fully and completely informed of the facts relating to the subject matter of this agreement and of the rights and obligations of the parties; C. Has given careful and serious thought to the making of this agreement; D. Has carefully read each provision of this agreement; and E. Fully and completely understands each provision of this agreement, both as to the subject matter and legal effect. 6. Each party represents and warrants that he or she has made a full and fair disclosure to the other of all of his or her property interests of any nature, including any mortgage, pledge, lien, charge, security interest, encumbrance, or restriction to which any property is subject. Each party further represents that he or she has made a full and fair disclosure of all debts and obligations of any nature for which he or sheds currently liable or may become liable. Each further represents and warrants that he or she has not made any gifts or transfers of Marital Property for inadequate consideration without the prior consent of the other. Each party acknowledges that, to the extent desired, he or she has had access to all of the above information from the other party. Each party acknowledges that, to the extent desired, he or she has had access to all joint and separate state and federal tax returns filed by or on behalf of both parties during the marriage. 7. DEBTS AND LIABILITIES: a. It is mutually agreed by and between the parties that HUSBAND will be responsible for the following debts, liabilities, contracts and payments and will indemnify and hold harmless WIFE in relation to these items: 2 (1) The property at 783 Longsgap Road, Carlisle. (2) Any other items which HUSBAND assumes ownership of pursuant to the within agreement. (3) Any debt or liability in HUSBAND's name at the effective date of the with agreement and not otherwise mentioned by the within agreement. b. HUSBAND agrees to continue making timely payments on the loan associated with WIFE's Toyota Camry until said loan is satisfied in full. HUSBAND also agrees to maintain WIFE's automobile insurance policy under its current terms and rate up and through 2011. WIFE will be responsible for any premium associated with said policy that exceeds $150. over the current yearly premium rate. WIFE will be responsible for any and all other costs associated with said vehicle other than those set forth in the within paragraph. C. It is mutually agreed by and between the parties that WIFE will be responsible for the following debts, liabilities, contracts and payments relating to the same and will indemnify and hold harmless HUSBAND in relation to these items: (1) Any items which WIFE assumes ownership of pursuant to the within agreement subject to 2(b) above. (2) Any debt or liability in WIFE's name at the effective date of the with agreement and not otherwise mentioned by the within agreement. 8. CASH ASSETS AND RETIREMENT/PENSION ACCOUNTS: The parties have previously divided cash assets to their satisfaction; the respective party possessing any such asset at the effective date of the within agreement shall assume full ownership of said asset. 9. RETIREM ENT/PENSION ACCOUNTS/BENEFIT ENTITLEMENTS: a. HUSBAND shall assume full ownership of any and all retirement/pension accounts and benefit entitlements currently in his name including but not limited to his Army pension, VA disability entitlements, and Social Security entitlements. b. WIFE shall assume full ownership of any and all retirement/pension accounts and benefit entitlements currently in her name including but not limited to her Social Security entitlements and Local 690 benefits. 3 10. PERSONAL PROPERTY, VEHICLES, ETC.: a. WIFE shall assume full ownership of the 2002 Toyota Camry. b. WIFE maintains full ownership of the items that she purchased and/or possessed prior to the date of marriage including but not limited to her furniture. C. The parties have previously separated all other items of personal property, vehicles, etc. not otherwise mentioned within to their satisfaction. The party in possession of said items at the effective date of the within agreement shall assume full ownership of said items. d. The parties agree to transfer all contracts and legal title associated with the above items of personal property to the party assuming ownership as soon as possible. 11. REAL ESTATE: a. HUSBAND shall assume full ownership of the property located at 783 Longsgap Road, Carlisle. HUSBAND shall remove WIFE from any and all financing relating to said property as soon as possible if equal or more favorable financing terms can be acquired or upon selling said property. b. The parties agree to transfer all contracts, deeds and legal title associated with the above properties to the party assuming ownership as soon as possible pursuant to the terms within. 12. SPOUSAL SUPPORT AND ALIMONY: HUSBAND and WIFE agree to waive any and all financial and material spousal support and agree not to request or seek to obtain alimony, alimony pendent elite, and/or spousal support. 13. WAIVER OF CLAIMS AGAINST THE ESTATES: Except as otherwise provided herein, each party may dispose of his or her property in any way, and each party hereby waives and relinquishes any and all rights he or she may now have or hereafter acquire, under the present or future laws of any jurisdiction, to share in the property or the estate of the other as a result of the marital relationship, including without limitation, dower, curtesy, statutory allowance, widow's allowance, right to take in intestacy, right to take against the Will of the other, and right to act as administrator or executor of the other's estate, and each will, at the request of the other, execute, acknowledge and deliver any and all instruments which may be necessary or advisable to carry into effect this mutual waiver and relinquishment of all such interests, rights and claims. Additionally, each party waives and relinquishes any and all rights to share in any estate inheritances or bequests the other may receive and/or be entitled to. 4 14. INCOME TAX RETURNS: All future income tax returns will be filed separately and the parties will each retain any refund due to them. 15. DIVORCE: HUSBAND and WIFE agree to voluntarily execute all necessary documents to finalize a divorce upon execution of the within agreement or, otherwise, no later than seven (7) days after the effective date of the within agreement. 16. BREACH AND ENFORCEMENT: In the event of the breach of this agreement by either party, the nonbreaching party shall have the right to seek monetary damages for such breach, where such damages are ascertainable, and/or to seek specific performance of the terms of this agreement, where such damages are not ascertainable. All costs, expenses and reasonable attorney fees incurred by the successful party, whether petitioner or respondent, in any litigation to obtain monetary damages and/or specific performance of this agreement shall be recoverable as part of the judgment entered by the court. The parties agree that any enforcement action may be filed under the Cumberland County Civil Docket Number 08-5310. 17. ADDITIONAL INSTSRUMENTS: Each of the parties shall from time to time, at the request of the other, execute, acknowledge and deliver to the other party any and all further instruments that may be reasonably required to give full force and effect to the provisions of this agreement. Each party shall execute documents relating to this paragraph no later than seven (7) days after being requested to do so by the other party. 18. ENTIRE AGREEMENT: This agreement contains the entire understanding of the parties and there are no representations, warranties, covenants or undertakings other than those expressly set forth herein. 19. APPLICABLE LAW: This agreement shall be construed under the laws of the Commonwealth of Pennsylvania. 20. PRIOR AGREEMENTS: It is understood and agreed that any and all property settlement agreements which may or have been executed or verbally discussed prior to the date and time of this agreement are null and void and of no effect. 21. DATE OF EXECUTION: The "date of execution" or "execution date" of this Agreement shall be defined as the date upon which it is executed by the parties if they have each executed the Agreement on the same date. Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. 22. MARITAL DEBT: Each party hereby confirms they have not incurred any additional debt since their separation that has in any way obligated the other party. Neither 5 party will take any action to incur additional debt of any nature whatsoever in the other party's name from the date of execution of this Agreement forward. 23. EQUITABLE DISTRIBUTION: It is specifically understood and agreed that this Agreement constitutes an equitable distribution of property, both real and personal, which was legally and beneficially acquired by Husband and Wife or either of them during the marriage as contemplated by The Act of April 2, 1980 (P.L. No. 63, No. 26), known as "The Divorce Code," 23 P.S. 101 et seq. of the Commonwealth of Pennsylvania, and as amended. 24. SUMMARY OF EFFECT OF AGREEMENT: It is specifically understood and agreed by and between the parties hereto, and each party accepts the provisions herein made in lieu of and in full settlement and satisfaction of any and all of the said parties' rights against the other for any past, present and future claims on account of support, maintenance, alimony, alimony pendente lite, counsel fees, costs and expenses, equitable distribution of marital property and any other claims of each party, including all claims raised by them in the divorce action pending between the parties. 25. RECONCILIATION: The parties shall only effectuate a legal reconciliation which supersedes this Agreement by their signed agreement containing a specific statement that they have reconciled and that this Agreement shall be null and void; otherwise, this Agreement shall remain in full force and effect. Further, the parties may attempt a reconciliation, which action, if not consummated by the aforesaid agreement, shall not affect in any way the legal affect of this Agreement or cause any new marital rights or obligations to accrue. 26. SEVERABILITY: If any term, condition, clause or provision of this Agreement shall be determined or declared to be void or invalid in law or otherwise, then only that term, condition, clause or provision shall be stricken from this Agreement and in all other respects this Agreement shall be valid and continue in full force, effect and operation. Likewise, the failure of any party to meet her or his obligations under any one or more of the paragraphs herein, with exception of the satisfaction of the conditions precedent, shall in no way void or alter the remaining obligations of the parties. 27. NO WAIVER OF DEFAULT: This agreement shall remain in full force and effect unless and until terminated under and pursuant to the terms of this Agreement. The failure of either party to insist upon strict performance of any of the provisions of this Agreement shall in no way affect the right of such party hereafter to enforce the same, nor shall the waiver of any breach of any provision hereof be construed as a waiver of any subsequent default of the same or similar nature, nor shall it be construed as a waiver of strict performance of any other obligations herein. 28. INTEGRATION: This Agreement constitutes the entire understanding of the 6 parties and supersedes any and all prior agreements and negotiations between them. There are no representations or warranties other than those expressly set forth herein. This Agreement shall survive integration by any court into any judgment for divorce and shall continue to have independent legal significance as a written contract separate from such judgment for divorce and may be enforced as an independent contract. 29. EFFECT OF DIVORCE DECREE: The parties agree that unless otherwise specifically provided herein, this Agreement shall continue in full force and effect after such time as a final Decree in Divorce may be entered with respect to the parties. 30. WAIVER OR MODIFICATION TO BE IN WRITING: No modification or waiver of any of the terms hereof shall be valid unless in writing and signed by both parties and no waiver of any breach hereof or default hereunder shall be deemed a waiver of any subsequent default of the same or similar nature. 31. AGREEMENT BINDING ON HEIRS: This Agreement shall be binding and shall insure to the benefit of the parties hereto and their respective heirs, executor, administrators, successors and assigns. 7 32. EFFECTIVE DATE: This agreement shall become effective immediately upon its date of execution as defined above. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals on the date indicated below. WITNESSES: ?u Richard Burkholder Doris Burkholder vti v Date iaed 9 to COMMONWEALTH OF PENNSYLVANIA ?Un,L:UjC0CA : ss COUNTY OF ; PERSONALLY,YPEARED-BEFORE ME, a notary public for Cumberland County Pennsylvania, this ATday of e 1 , 20Richard Burkholder, known to me (or satisfactorily proven) to be the person whe name is subscribed to the within agreement, and acknowledge that he executed the same for the purposes therein contained. IN WITS' pMh 0ftdrl» to set my hand and official seal. Notarial Seal Julie M. Good, Notary PUNG Cadisle Bona. WnberlaW COU* ?U - My Corrmis oec s, 2011 N Public Member, Pennsylvania Association of Notaries COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF PVO? ?J , PERSONALLY A PPE4RED BEFO VMME, a notary public for County, Pennsylvania, this ?day of , 20, Doris Burkholder, known to me (or satisfactorily proven) to be the person w ose name s subscribed to the within agreement, and acknowledge that she executed the same for the purposes therein contained. IN WITNESS WHREOF, I have rotA?aw< ?, DAME AtDAMi ftk CARI.w IOIIO?CiiA?EpWID CPA" br CMMMMiNt =p i, 401! hand and official seal. Public 8 f'?'S rd3-.-i NOW 30AL vVes 3jou ]MW3 RICHARD BURKHOLDER, Plaintiff V. DORIS BURKHOLDER, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 08 - 5310 CIVIL TERM IN DIVORCE ACCEPTANCE OF SERVICE I hereby accept service of the Divorce Complaint on behalf of the Defendant, Doris Burkholder, in the above-captioned action and I certify that I am authorized to do so. Date BY: Vatz; Doris Burkholder, Defendant ? Sri ?.? ?y ;,'. 4e° + +.?. u .?. : : RICHARD BURKHOLDER, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW DORIS BURKHOLDER, NO. 08 - 5310 CIVIL TERM Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A complaint in Divorce under §3301(c) of the Divorce Code was filed on September 5, 2008. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of the filing of the Complaint. 3. I consent to the entry of the final Decree in Divorce after service of Notice of Intention to request entry of the decree. I VERIFY THAT THE STATEMENTS MADE IN THE FOREGOING 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 UNSWORN FALSIFICATION TO AUTHORITIES. `z t o 40i?z-. D to Richard Burkholder ? ?--> ? ?? :? '.? ^" --, r-'? ;`:i-?? ._ ??> ?7 _ ; ._a _.. =?_ 'i..) RICHARD BURKHOLDER, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : CIVIL ACTION - LAW DORIS BURKHOLDEP, NO. 08 - 5310 CIVIL TERM Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A complaint in Divorce under §3301(c) of the Divorce Code was filed on September 5, 2008. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of the filing of the Complaint. 3. I consent to the entry of the final Decree in Divorce after service of Notice of Intention to request entry of the decree. I VERIFY THAT THE STATEMENTS MADE IN THE FOREGOING 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 UNSWORN FALSIFICATION TO AUTHORITIES. Date Doris Burkholder RICHARD BURKHOLDER, Plaintiff V. DORIS BURKHOLDER, Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 08 - 5310 CIVIL TERM IN DIVORCE WAIVER OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER 93301(C) OF THE DIVORCE CODE 1. I consent to the entry of a final Decree of Divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I 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 THATT EH STATEMENTS MADE IN THE FOREGOING 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 UNSWORN FALSIFICATION TO AUTHORITIES. Z- /-z-3/0 q 4??- D to Richard Burkholder r_, --, ? ' ""? <:,1 .:.? ? P ? ?+ ?,, ?? -.... .? -?;-> , ._..: :: RICHARD BURKHOLDER, Plaintiff V. DORIS BURKHOLDER, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION -LAW : NO. 08 - 5310 CIVIL TERM : IN DIVORCE WAIVER OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER &3 OW) OF THE DIVORCE CODE 1. I consent to the entry of a final Decree of Divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I 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 THATT EH STATEMENTS MADE IN THE FOREGOING 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 UNSWORN FALSIFICATION TO AUTHORITIES. a:act ID - a /;j??? Date Doris Burkholder r%,,, 10 RICHARD BURKHOLDER, Plaintiff V. DORIS BURKHOLDER, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : NO. 08 - 5310 CIVIL TERM : IN DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry of a divorce decree: 1. Grounds for divorce: irretrievable breakdown under § 3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: filed on September 5, 2008 and Acceptance of Service signed on September 15, 2008. 3. Date of execution of the Affidavit Of Consent required by § 3301(c) of The Divorce Code: by the Plaintiff February 23, 2009; by the Defendant February 20, 2009. 4. Related claims pending: None 5. Date Plaintiff s Waiver Of Intention To Request Entry Of A Divorce Under §3301(c) Of The Divorce Code was filed with the Prothonotary: on February 27, 2009; a copy of which is attached. Date Defendant's Waiver Of Intention To Request Entry Of A Divorce Under §3301(c) Of The Divorce Code was filed with the Prothonotary: on February 27, 2009; a copy of which is attached. Date: 01) XAZ---, ark F. Bayley, Es ire BAYLEY & MANGAN 17 W. South St. Carlisle, PA 17013 (717) 241-2446 Supreme Court I.D. # 87663 Attorney for Plaintiff 77 Cl IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA 01011) e Plaintiff T 4? d Vs File No. IN DIVORCE ?ls 00r-k & be Defendant NOTICE TO RESUME PRIOR SURNAME Notice is hereby given that the Plaintiff/ defendant in the above matter, [select one by marking'Yj prior to the entry of a Final Decree in Divorce, or after the entry of a Final Decree in Divorce dated o 9 hereby elects to resume the prior surname of r ,x u' [ C , and gives this --.T written notice avowing his / her intention purs t to the provisions of 54 P.S. 704. Date: Signature Signature of name being resumed COMMONWEALTH F PENNSYLVANIA COUNTY OF P k: ) On the _?fday of 92 007 before me, the Prothonotary or the notary public, personally appeared the above affiant known to me to be the person whose name is subscribed to the within document and acknowledged that he / she executed the foregoing for the purpose therein contained. In Witness Whereof, I have hereunto set my hand hereunto set my hand and official seal. Notary Public Notarial iNNSYLVANIA AWN own city a "' NOWY PUNIC county 9. M. 2011 Nolarks `1 cr- ,t939?