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Commonwealths of Pennsylvania
Department of Education
In recognition of having met the requirements for issuance of the
Commonwealth Secondary School Diploma as set forth in Title 22,
Section 4.72 of the Pennsylvania Code, this diploma is conferred upon
TERRY L. FAUST JR
Date Issued 05/05/2008
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Diploma Number
1260178
DE-101 (4199)
Given under the seal of the
Department of Education
Commonwealth of Pennsylvania
at Harrisburg
Secretary of Education
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INMATE NAME: FAUST, TERRY L JR INMATE #: GQ0093 DOB: 05/27/1986 FACILITY: HOU
Program Name: Violence Prevention Start Date: 01/08/2008 End Date: 04/03/2008
Number of Program Sessions: 26 Number of Sessions Attended: 25 Length of Sessions: 1.5 Hrs
Facilitator: Ginter, Amy R. Evaluated by: Ginter, Amy R. Date: 04/03/2008 Status: Completed
Participation:
Satisfactory (Completes >= 70% of all joumals/homeworks/skill training)
Knowledge Acquired:
Satisfactory (Demonstrates acquired knowledge of >= 70% of group objectives)
Aftercare Recommended:
No
Reason for Failure to Complete the Program:
Reason for Discharge Prior to Completion:
Comments:
Mr. Faust participated and successfully completed Violence Prevention.
cc: Inmate
DC-14(CP tab)
Facility Parole Office
(With ICSA Document)
Page 2 of 3
Number of Program Sessions: 26
Facilitator: Brantner, Angela J / ,
Evaluated by: Brantner, Angela J
Length of Sessions: 2 Hrs
Date: 06/17/2008 Status: Completed
Participation:
Satisfactory (Completes >= 70% of all journals/homeworks/skill training)
Knowledge Acquired:
Satisfactory (Demonstrates acquired knowledge of >= 70% of group objectives)
Aftercare Recommended:
No
Reason for Failure to Complete the Program:
Reason for Discharge Prior to Completion:
Comments:
Mr. Faust completed all three components of the OTT program. He participated and completed homework as
required.
DC-14(CP tab)
Facility Parole Office
(With ICSA Document)
Number of Sessions Attended: 26
Page 2 of 4
ql,. 1RRY 1 JR? DOB: 05/27/1986 FACILITY: HOU
11011111"t " ml-
Program Name: OutPatient Start Date: 05/05/2008 End Date: 06/17/2008
CERTIFICATE OF SERVICE
o8-SyaG
C16L
hereby Certify that I have this
day served a true and correct copy of the foregoing Pleading /
Document upon the persons named below. That service was
effectuated by U.S. mail - First Class delivered to prison
officials at SCI-Houtzdale for proper postage and mailing.
COPIES SERVED UPON:
Opt L WwV K\)yf SWvAi,
Cf\,9qjCqv?,, ?A 1-?O\,2,
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(64VA,E, A13 IPS\160Q?)
14YV?? {P?j pp?J(?V
DATE
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IN THE COURT OF COMMON PLEAS
FOR COUNTY, PENNSYLVANIA
CIVIL DIVISION
Plaintiff
Civil No:
VS.
Hon, 0 1t',> L'? y d1-* V- -3-9-
CIVIL ACTION - LAW
Defendant VERIFIED IFP PETITION
D.0.C.
APPLICATION FOR LEAVE
TO PROCEED IN-FORMA PAUPERIS
1. I am the (plaintiff) (defendant) in the above matter and because of my financial
condition am unable to pay the fees and costs of prosecuting or defending the action or
proceeding
2. I am unable to obtain funds from anyone, including my family and associates, to pay the
costs of litigation.
3. I represent that the information below relating to my ability to pay the fees and costs is
true and correct:
'E,V
(a) Name: V;W1-3r
Address: Iwo
kkov Q 1? M01 q, 000
Social Security Number: x 01A' (P& 01-7 S
(b) Employment
t
If you are presently employed, state
Employer: 1? 1
Address:
Salary or wages per month:
Type of work: 01
If you are presently unemployed, state
Date of last employment:
x005
Salary or wages per month: "TWO -NO05iNN11)
Type of work: CON ?iT?RV (,V-Wtj
(c) Other income within the past twelve months
Business or profession:
Other self-employment:
Interest:
Dividends: _
Pension and annuities:
Social security benefits:
Support payments: Mt
Disability payments: ?-Lfv
Unemployment compensation and supplemental benefits:
Workman's compensation: Imo)
Public assistance: I
n\ ?
Other: `Ufa 1?
i
(d) Other contributions to household support
(Wife)(Husband) Name: N [ ?r
If your (wife)(husband) is employed, state
Employer: 0?
Salary or wages per month:
Type of work: 01
Contributions from children: ?I
Contributions from parents:
Other contributions: N l
(e) Property owned
Cash: ? b N ?-
Checking account:
Savings account:
?I)k
Real estate (including home): IN
Motor vehicle: Make I ,m , Year
Certificates of deposit:
Cost , Amount Owed $
Stocks; bonds: Iv `
Other: 0 l _
(t) Debts andobligations
Mortgage: I"
Rent: Iv
Loans: Iv __
Other: I
(g) Persons dependent upon you for support
(Wife)(Husband) Name: P I
Children, if any: rr
Name: Age: ?O
Other persons:
Name:
Relationship:
4. I understand that I have a continuing obligation to inform the court of improvement in
my financial circumstances which would permit me to pay the costs incurred herein.
5. I verify that the statements made in this 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.
g-Xo -()v
DATE
i Ae4
GQ()Oe?
Q. o . b0f. k,(w
?vV \'?`O PcL`? R i?- `6bq b - \CXX)
N
I'D
TERRY FAUST, JR., IN THE COURT OF COMMON PLEAS OF
Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA
v. CIVIL ACTION - LAW
D.O.C. POLICY S.C.I. :
HOUTZDALE,
Defendant NO. 08-5426 CIVIL TERM
IN RE: PLAINTIFF'S APPLICATION FOR LEAVE TO PROCEED IN FORMA
PAUPERIS
BEFORE OLER, J.
ORDER OF COURT
AND NOW, this 9u' day of October, 2008, upon consideration of Plaintiffs
Application for Leave To Proceed In-Forma Pauperis, and it appearing that this court
lacks jurisdiction over the subject matter of this action,' the Application is denied.Z
?
Terry Faust, Jr. #GQ_0093
P.O. Box 1000
Houtzdale, PA 16698-1000
Pro Se
? Department of Corrections
Chief Counsel's Office
P.O. Box 598
Camp Hill, PA 17001-0598
BY THE COURT,
J d) ?-, ial
J. esley O Jr., J.
0-0 t E,S rn?c CL
4
'See Heath v. W C.A.B. (Pennsylvania Bd. Of Probation and Parole), 580 Pa. 174, 180, 860 A.2d 25, 29
(2004); see also East Stroudsburg Univ. v. Hubbard, 140 Pa. Cmwlth. 131, 137, 591 A.2d 1181, 1185
(1991); see also Com. v. McNeil, 2002 PA Super 311, 115, 808 A.2d 950, 954.
2 See Jae v. Good, 946 A.2d 802, 806-07 (Pa. Commw. Ct. 2008).
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