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,
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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
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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:
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(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:
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Richard Burkholder
Doris Burkholder
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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
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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
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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.
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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.
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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.
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Date Doris Burkholder
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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
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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
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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
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