HomeMy WebLinkAbout09-0712Lindsay Gingrich Maclay, Esquire
DALEY ZUCKER MEILTON
MINER & GINGRICH, LLC
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
lmac1U((dzmmg1aw.com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KRISTINE M. SERAFIN,
Plaintiff
V.
CHRISTOPHER J. SERAFIN,
Defendant
CIVIL ACTION-LAW
No. J 9_"71,?-- C?v l 4e-1
(In Custody)
NOTICE
YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the
following pages, you must take action within twenty (20) days after this Complaint and Notice
are served, by entering a written appearance personally or by attorney and filing in writing with
the Court your defenses or 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 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 INFORMATION 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, Pennsylvania 17013
(717) 249-3166
Lindsay Gingrich Maclay, Esquire
DALEY ZUCKER MEILTON
MINER & GINGRICH, LLC
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
lmaclaya,dzmmalaw.com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KRISTINE M. SERAFIN,
Plaintiff CIVIL ACTION-LAW
V. No. u 9- 7 / a ?' ?rvC `TGrr,^
CHRISTOPHER J. SERAFIN, (In Custody)
Defendant
COMPLAINT FOR CUSTODY
AND NOW, this day of R bN 6,v , 2009, comes Plaintiff, Kristine
M. Serafin, by and through her attorneys, Daley Zucker Meilton Miner & Gingrich, LLC, and
files the following Complaint for Custody and in support thereof avers as follows:
1. Plaintiff, Kristine M. Serafin, an adult individual, is the mother of one (1) minor
child, namely, Nathan Patrick Serafin, whose date of birth is January 16, 2003 (hereinafter
referred to as the "Child")
2. Defendant, Christopher J. Serafin (hereinafter "Father"), an adult individual, is the
natural father of the Child.
3. The parties currently reside together, with the Child, at 2 Pine Ridge Circle,
Enola, Pennsylvania 17025.
4. Simultaneously herewith, Plaintiff, Kristine M. Serafin (hereinafter "Mother"), is
filing a Divorce Complaint.
5. The Child was born in wedlock.
6. Mother has been the primary custodian of the Child.
7. Mother has no information of any other custody proceeding concerning the Child
pending in any court of this Commonwealth.
8. Mother does not know of any other person not any party to the proceedings,
besides those who have been notified by this Complaint, who has physical custody of the Child
or claims to have custody or visitation rights with respect to the Child.
9. Each parent whose parental rights to the Child have not been terminated and the
persons who have physical custody of the Child have been named as a party to this action. There
are no other persons who are known to have or claim to have a right to custody or visitation of
the Child.
10. Mother desires that a parenting plan and custodial arrangement be memorialized
as a Court Order granting her primary physical custody of the Child and granting Father periods
of partial custody, thereby enabling the parties to take the necessary steps to proceed with the
Divorce.
11. The Child's best interests and permanent welfare will be best served by granting
the relief requested because:
a) Mother has been the primary custodian of the Child; and
b) Mother has a strong bond with the Child; and
C) Mother has taken an active interest in and has actively participated in the
Child's life and activities; and
d) Mother will provide the Child with a home with more than adequate
moral, emotional and physical surroundings as required to meet his needs;
and
e) Mother continues to exercise parental duties and responsibilities and
continues to enjoy the Child's love and affection; and
f) Mother will foster a loving, meaningful relationship between Father and
the Child.
WHEREFORE, Plaintiff/Mother, Kristine M. Serafin, respectfully requests this
Honorable Court grant the parties shared legal custody of the Child and grant Mother primary
physical custody of the Child with periods of partial custody to Father.
Respectfully submitted,
DALEY ZUCKER MEILTON
MINER & GINGRICH, LLC
Date: 41 p By:
1029 Scenery Drive
Harrisburg, Pennsylvania 17109
(717) 657-4795
Attorneys for Plaintiff
VERIFICATION
I, Kristine M. Serafin, verify that the statements made in this Complaint for Custody are
true and correct to the best of my knowledge, information and belief. I understand that false
statements herein are made subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn
falsification to authorities.
Kristine M. Serafin, Plainti
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KRISTINE M. SERAFIN IN THE COURT OF COMMON PLEAS OF
PLAINTIFF CUMBERLAND COUNTY, PENNSYLVANIA
V. 2009-712 CIVIL ACTION LAW
CHRISTOPHER J. SERAFIN
IN CUSTODY
DEFENDANT
ORDER OF COURT
AND NOW, Tuesday, February 17, 2009 , upon consideration of the attached Complaint,
it is hereby directed that parties and their respective counsel appear before Dawn S. Sunday, Esq. , the conciliator,
at 39 West Main Street, Mechanicsburg, PA 17055 on Tuesday, March 17, 2009 at 9:00 AM
for a Pre-Hearing Custody Conference. At such conference, an effort will be made to resolve the issues in dispute; or
if this cannot be accomplished, to define and narrow the issues to be heard by the court, and to enter into a temporary
order. Failure to appear at the conference may provide grounds for entry of a temporary or permanent order.
The court hereby directs the parties to furnish any and all existing Protection from Abuse orders,
Special Relief orders, and Custody orders to the conciliator 48 hours prior to scheduled hearing.
FOR THE COURT.
By: /s/ Dawn S. Sunda Es q.
Custody Conciliator
The Court of Common Pleas of Cumberland County is required by law to comply with the Americans
with Disabilites 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. You must attend the scheduled
conference or hearing.
YOU SHOULD TAKE THIS PAPER TO YOUR ATTORNEY AT ONCE. IF YOU DO NOT
HAVE AN ATTORNEY OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET
FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
32 South Bedford Street
Carlisle, Pennsylvania 17013
Telephone (717) 249-3166
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KRISTINE SERAFIN
Plaintiff
vs.
CHRISTOPHER SERAFIN
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
09-712
CIVIL ACTION LAW
IN CUSTODY
ORDER OF COURT
AND NOW, this !?y day of 2009, upon
consideration of the attached Custody Conciliation Report, it is ordered and directed as follows:
1. The Mother, Kristine Serafin, and the Father, Christopher Serafin, shall have shared legal
custody of Nathan Patrick Serafin, born January 16, 2003. Major decisions concerning the Child
including, but not necessarily limited to, his health, welfare, education, religious training and
upbringing shall be made jointly by the parties after discussion and consultation with a view toward
obtaining and following a harmonious policy in the Child's best interest. Neither party shall impair the
other party's rights to shared legal custody of the Child. Neither party shall attempt to alienate the
affections of the Child from the other party. Each party shall notify the other of any activity or
circumstance concerning the Child that could reasonably be expected to be of concern to the other.
Day to day decisions shall be the responsibility of the parent then having physical custody. With
regard to any emergency decisions which must be made, the parent having physical custody of the
Child at the time of the emergency shall be permitted to make any immediate decisions necessitated
thereby. However, that parent shall inform the other of the emergency and consult with him or her as
soon as possible. In accordance with 23 Pa.C.S.A. §5309, each party shall be entitled to complete and
full information from any doctor, dentist, teacher, professional or authority and to have copies of any
reports or information given to either party as a parent as authorized by statute.
2. The parties shall have physical custody of the Child in accordance with the following
schedule:
A. The parties shall alternate having custody of the Child on weekends from Friday
after work through Sunday at 7:30 p.m., beginning with the Mother having custody of the Child on
March 27, 2009.
B. The Father shall have custody of the Child every week on Tuesday and Thursday
from after work until 7:30 p.m. During the summer school break, the Father's Tuesday and Thursday
evening periods of custody shall be extended overnight until the following morning when the Father
shall transport the Child to the babysitter or camp. The parties shall make adjustments to the weekday
evening periods of custody to ensure that the parties are equally sharing the Child's non-activity
evening time.
C. The Mother shall have custody of the Child at all times not otherwise specified for
the Father.
3. The parties shall share or alternate having custody of the Child on holidays as follows:
A. Christmas: The Christmas holiday shall be divided into Segment A, which shall run
from Christmas Eve at 12:00 noon or after work until 9:00 p.m., Segment B, which shall run from
Christmas Eve at 9:00 p.m. through Christmas Day at 5:00 p.m., Segment C, which shall run from
Christmas Day at 5:00 p.m. through the halfway point of the remainder of the Child's holiday school
break at 5:00 p.m., and Segment D, which shall run from the halfway point of the remaining school
break at 5:00 p.m. through the last day of the holiday break before school resumes at 7:30 p.m. In odd-
numbered years, the Father shall have custody of the Child during Segments A and C and the Mother
shall have custody during Segments B and D. In even-numbered years, the Mother shall have custody
of the Child during Segments A and C and the Father shall have custody during Segments B and D. In
the event either party is unavailable due to work to provide care for the Child during his or her period
of holiday custody, that parent shall offer the other parent the opportunity to provide care for the Child
during the custodial parent's unavailability. This provision is not intended to limit the ability of either
party to make arrangements for the Child to spend time with grandparents for up to one (1) day during
the holiday. However, the custodial parent shall make every effort to arrange time with grandparents
when the other parent is also working.
B. Thanks iving: The Thanksgiving holiday period of custody shall run from after
school on the Wednesday before Thanksgiving through Monday morning after Thanksgiving. The
Father shall have custody of the Child for Thanksgiving in odd-numbered years and the Mother shall
have custody in even-numbered years.
C. Easter: The Easter holiday shall be divided into Segment A, which shall run from
7:30 a.m. until 2:00 p.m. on Easter Sunday and Segment B, which shall run from 2:00 p.m. until 7:30
p.m. on Easter Sunday. In odd-numbered years, the Father shall have custody of the Child during
Segment A and the Mother shall have custody during Segment B. In even-numbered years, the Mother
shall have custody of the Child during Segment A and the Father shall have custody during Segment B.
D. Mother's Day/Father's Day: In every year, the Mother shall have custody of the
Child on Mother's Day ad the Father shall have custody on Father's Day, with the specific times to be
arranged by agreement between the parties.
E. Memorial Day/Independence Day/Labor Day: The parties shall alternate having
custody of the Child on the Memorial Day, July Fourth and Labor Day holidays equally as arranged by
agreement.
F. The holiday custody schedule shall supersede and take precedence over the regular
and vacation custody schedules.
4. Each parent shall be entitled to have custody of the Child for two (2) uninterrupted weeks
each year for vacation time. The weeks under this provision shall not be scheduled consecutively
unless agreed between the parties. Neither party shall remove the Child from school for vacation
without the advance consent of the other parent and school approval. The parties shall provide each
other with at least thirty (30) days advance notice of vacation dates under this provision and the parent
providing notice first shall be entitled to preference on his or her selection of vacation dates. The
parties shall cooperate in arranging any summer camps for the Child and shall coordinate camps and
activities with vacation dates.
5. Except as otherwise provided in this Order or agreed between the parties, the parent
receiving custody of the Child shall be responsible to provide transportation for the exchange of
custody.
6. The custodial parent shall be responsible to ensure that the Child attends all regularly
scheduled activities during his or her periods of custody.
7. The non-custodial parent shall be entitled to have reasonable liberal telephone contact with
the Child.
8. Neither party shall do or say anything which may estrange the Child from the other parent,
injure the opinion of the Child as to the other parent, or hamper the free and natural development of the
Child's love and respect for the other parent. Both parties shall ensure that third parties having contact
with the Child comply with this provision.
9. This Order is entered pursuant to an agreement of the parties at a custody conciliation
conference. The parties may modify the provisions of this Order by mutual consent. In the absence of
mutual consent, the terms of this Order shall control.
cc: Xndsay Gingrich Maclay, Esquire - Counsel for Mother
,,Ames L. Walsh, Esquire - Counsel for Father
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KRISTINE SERAFIN
Plaintiff
vs.
CHRISTOPHER SERAFIN
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
09-712 CIVIL ACTION LAW
IN CUSTODY
CUSTODY CONCILIATION SUMMARY REPORT
IN ACCORDANCE WITH CUMBERLAND COUNTY RULE OF CIVIL
PROCEDURE 1915.3-8, the undersigned Custody Conciliator submits the following report:
1. The pertinent information concerning the Child who is the subject of this litigation is as
follows:
NAME DATE OF BIRTH CURRENTLY IN CUSTODY OF
Nathan Patrick Serafin January 16, 2003 Mother/Father
2. A custody conciliation conference was held on March 18, 2009, with the following
individuals in attendance: the Mother, Kristine Serafin, with her counsel, Lindsay Gingrich Maclay,
Esquire, and the Father, Christopher Serafin, with his counsel, James L. Walsh, Esquire.
3. The parties agreed to entry of an Order in the form as attached.
na-4 E % ?" boa 9 L"?' d=??
Date Dawn S. Sunday, Esquire
Custody Conciliator
Lindsay Gingrich Maclay, Esquire
DALEY ZUCKER MEILTON MINER & GINGRICH, LLC
635 North 12`h Street, Suite 101
Lemoyne, Pennsylvania 17043
lmaclavCa,dzmm¢law.com
IN THE COURT OF COMMON PLEAS OF = = CZ
CUMBERLAND COUNTY, PENNSYLVANIA U,r-
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KRISTINE M. SERAFIN '?
Plaintiff No. 2009-712 ="- P
CIVIL ACTION - LAW -7 F7
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CHRISTOPHER J. SERAFIN,
Defendant (In Custody)
NOTICE
YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the
following pages, you must take action within twenty (20) days after this Petition and Notice are served,
by entering a written appearance personally or by attorney and filing in writing with the Court your
defenses or 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 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 INFORMATION 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, Pennsylvania 17013
(717) 249-3166
Respectfully submitted,
DALEY ZUCKER MEILTON
MINER & GINGRICH, LLC
Date: By:
dsy Gingi M lay, Esquire
Ji
orney y I.D. 954
635 North 12th Street, Suite 101
Lemoyne, Pennsylvania 17043
(717) 724-9821
Lindsay Gingrich Maclay, Esquire
DALEY ZUCKER MEILTON MINER & GINGRICH, LLC
635 North 12`h Street, Suite 101
Lemoyne, Pennsylvania 17043
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KRISTINE M. SERAFIN,
Plaintiff
CHRISTOPHER J. SERAFIN,
Defendant
No. 2009-712
CIVIL ACTION - LAW
(In Custody)
PETITION FOR MODIFICATION OF CUSTODY
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AND NOW, this day of &A" , 2011, comes Plaintiff,
Kristine M. Serafin, by and through her attorneys, Daley Zucker Meilton Miner & Gingrich, LLC,
and files the following Petition for Modification of Custody, and in support thereof avers as
follows:
1. Plaintiff, Kristine M. Serafin, is an adult individual who currently resides at 422A
Duke Street, Enola, Cumberland County, Pennsylvania (hereinafter referred to as "Mother").
2. Defendant, Christopher J. Serafin, is an adult individual who currently resides at 2
Pine Ridge Circle, Enola, Cumberland County, Pennsylvania (hereinafter referred to as "Father")
3. Plaintiff and Defendant are the natural parents of Nathan Patrick Serafin, who was
born in wedlock and whose date of birth is January 16, 2003.
4. Mother filed for Divorce on February 9, 2009 and the parties have negotiated a
global resolution of the division of their marital property and anticipate executing a Marital
Settlement Agreement (MSA) simultaneously with the execution of a Custody Stipulation.
5. The parties seek to affirm, update and memorialize the parties' custody agreement.
As such, the parties request that an Order be issued in the form attached hereto, memorializing
and cementing the parties' Stipulation and Agreement for Custody, as set forth in Paragraph 10,
herein.
6. Mother's and Father's current addresses are above. Since separation, Mother has
had primary physical custody of the child and Father has had liberal periods of partial custody
pursuant to the schedule as set forth herein.
7. Mother has no information of any other custody proceeding concerning the child
pending in any court of this Commonwealth.
8. Mother does not know of a person, not a party to this proceeding, who has physical
custody of the child or claims to have physical custody rights with respect to the child.
9. The best interest and permanent welfare of the children will be served by granting
the relief requested because:
a. Plaintiff is the natural mother of the child;
b. Defendant is the natural father of the child;
C. Both Mother and Father have a warm, loving relationship with the child;
d. Both Mother and Father have, in the past, and will continue to provide a
stable, loving home environment for the child;
e. Both parties and the child will benefit from updating their March 26, 2009
Order and from having their updated Agreement entered as a Court Order.
10. Both Father and Mother request that the following Custody Stipulation and
Agreement be entered as a Court Order:
The parties shall have joint legal custody of their minor child, Nathan Patrick Serafin.
Joint legal custody means the right of both parents to control and to share in making decisions of
importance in the lives of their child, including educational, medical, and religious decisions.
Each parent shall have an equal right, to be exercised jointly with the other parent, to make all
major non-emergency decisions affecting the child's general well-being, including, but not limited
to, all decisions regarding his health, education and religion. The custodial parent shall inform the
non-custodial parent immediately of all medical and dental appointments and problems pertaining
to the child. If the child is sick and is unable to attend school or extracurricular activities the
custodial parent will notify the non-custodial parent as soon as practicably possible. Each parent
shall provide names, addresses, and telephone numbers for all the child's medical, dental and
other healthcare providers, school contact information as well as the school's website and any
website's relating to the child's activities. In the event that either parent cannot obtain
information or schedules directly, the other parent shall provide the documentation upon request.
The custodial parent shall notify the other parent of any medical, dental, optical, counseling and
other appointments of the child with health care providers, sufficiently in advance thereof so that
the other party can attend, if he or she so chooses.
Pursuant to the terms of Pa.C.S. §5309, each parent shall be entitled to equal access to all
records and information pertaining to the child, including, but not limited to, the child's school,
medical, dental, religious and other important records, the residence address of the child and the
other parent. As soon as practical after the receipt by a party, copies of the child's school
schedule, special events notifications, report cards, and similar items shall be provided to the other
party. To the extent one (1) parent has possession of any such records or information, that parent
shall be required to share same, or copies thereof, with the other parent within such reasonable
time as to make the records or information of reasonable use to the other parent. The custodial
parent shall provide copies of the child's report cards and other reasonable papers affecting the
child's education, medical condition or welfare.
Notwithstanding that both parents shall share legal custody, non-major decisions involving
the child's day-to-day living shall be made by the parent then having custody, consistent with the
other provisions of this Stipulation and Order.
Primary Physical custody of the child, as that term is defined in the Custody Act, shall
be with Mother, subject to Father's periods of partial custody pursuant to the following
schedule:
A. The parties shall alternate having custody of the child on weekends from
Friday after work through Sunday at 7:30 p.m. The weekend rotation shall
continue in regular rotation pursuant to the parties prior Order of March 26,
2009, as entered by the Honorable Edgar B. Bayley.
B. Father shall have custody of the child every week on Tuesday and
Thursday from after work until 7:30 p.m. During the summer school
break, the Father's Tuesday and Thursday evening periods of custody shall
be extended overnight until the following morning when Father shall
transport the child to the babysitter or to camp. The parties shall make
adjustments to the weekday evening periods of custody to ensure that the
parties are equally sharing the child's non-activity evening time.
C. Mother shall have custody of the child at all times not otherwise specified
for the Father.
Transportation for custody purposes shall be divided by the parties as equally as
possible. Unless otherwise agreed, the parent receiving custody shall transport the child from the
home of the other parent. At all times, the child shall be secured in appropriate passenger
restraints. No person transporting the child shall consume alcoholic beverages prior to
transporting the child. No person transporting the child shall be under the influence of any
alcoholic beverages while transporting the child.
The parties shall share or alternate custody of the child during the holidays as follows:
A. Christmas: The Christmas holiday shall be divided into Segment A, which
shall run from Christmas Even at 12:00 noon or after work until 9:00 p.m.,
Segment B, which shall run from Christmas Eve at 9:00 p.m. through
Christmas Day at 5:00 p.m., Segment C, which shall run from Christmas
Day at 5:00 p.m. through the halfway point of the remainder of the child's
holiday school break at 5:00 p.m., and Segment D, which shall run from
the halfway point of the remaining school break at 5:00 p.m. through the
last day of the holiday break before school resumes at 7:30 p.m. In odd-
numbered years, Father shall have custody of the child during Segments A
and C and Mother shall have custody during Segments B and D. In even-
numbered years, Mother shall have custody of the child during segments A
and C and Father shall have custody of the Child during Segments B and
D. In the event that there are an odd number of days in the child's
remaining Christmas vacation, the party having Segments A and C in that
year shall have the extra day of vacation. In the event that either party
must work and is unavailable to provide care to the child during his or her
period of holiday custody, the parent shall offer the other parent the
opportunity to provide care for the child during the custodial parent's
period of non-availability. This provision is not intended to limit the
ability of either party to make arrangements for the child to spend time
with grandparents for up to one (1) day during the holiday. However, the
custodial parent shall make every effort to arrange a time with grandparents
when the other parent is also working.
B. Thanksgiving: The Thanksgiving holiday period of custody shall
run from after school on the Wednesday before Thanksgiving through
Monday morning after Thanksgiving. Father shall have custody of the
child for Thanksgiving in odd-numbered years and Mother shall have
custody of the child in even-numbered years.
C. Easter: The Easter holiday shall be divided into Segment A, which
shall run from 7:30 a.m. until 2:00 p.m. on Easter Sunday and Segment B,
which shall run from 2:00 p.m. until 7:30 p.m. on Easter Sunday. In odd-
numbered years, Father shall have custody of the child during Segment A
and Mother shall have custody of the child during Segment B. In even-
numbered years, Mother shall have custody of the child during Segment A
and Father shall have custody of the child during Segment B.
D. Mother's Day/Father's Day: In every year, Mother shall have custody of
the child on Mother's Day and Father shall have custody of the Child on
Father's Day, with the specific times to be arranged by agreement of the
parties.
E. Memorial Day/4th of July/Labor Day: The parties shall alternate
having custody of the child on the Memorial Day, 4th of July and Labor
Day holidays equally as arranged by agreement of the parties.
F. The holiday custody schedule shall supersede and take precedence over
the regular and vacation custody schedules.
Each parent shall be entitled to have custody of the child for two (2) uninterrupted weeks
each year for vacation time. A week shall be defined as seven (7) days and shall include the
custodial parents' weekend of custody. The weeks under this provision shall not be scheduled
consecutively unless agreed upon by the parties. Neither party shall remove the child from school
for vacation without the advance consent of the other parent and school approval. The parties
shall provide each other with at least thirty (30) days advance notice of vacation dates under this
provisions and the parent first providing notice shall be entitled to preference on his or her
selected vacation dates. The parents shall cooperate in arranging any summer camps for the child
and shall coordinate camps and activities with vacation dates.
The parties shall provide the child with any and all prescribed medications and/or
medications recommended by the child's physician, during their period of custody and the parents
shall cooperate to make sure that prescriptions and medications are transferred back and forth,
when necessary and that medication logs are provided to the other parent if the child is going
between households when sick or on a medication regimen.
The parties shall provide each other with a written schedule or website address to ascertain
a schedule for the child's school, sporting, and extracurricular activities. Both parties shall
agree to honor and participate in the activities in which the child wishes to engage. During the
times that each parent has custody of the child, each parent will make certain that the child attends
any previously-scheduled extracurricular activities. The parties are directed to be supportive of
the child's activities and will transport each child to and from such activities and the preparations
and practice for the activities that are scheduled, in such time so that the child is able to participate
in those events.
Neither parent, however, shall commit the child to any activity unless that child definitely
desires to attend that activity. Participation in activities which take place during the school year is
contingent upon the child maintaining passing grades in school.
The parties shall discuss, prior to the child's enrollment in a particular activity that
encompasses both parents' periods of custody, whether the child shall be enrolled in said activity.
If no agreement can be reached, the Court will decide if the child shall be enrolled in said activity.
In the event that the custodial parent is unable to deliver the child to an agreed upon
activity, the non-custodial parent shall be permitted to transport the child to the agreed upon
activity. The custodial parent shall make certain that the child is transported to appropriate
custody exchange location in a time sufficient to enable the child to timely attend the activity.
The custodial parent shall ensure that the child completes any and all school assignments,
homework and/or projects during their period of custody.
In the event that the child is unable to attend school due to illness, it is the responsibility
of the parent then having custody to arrange alternate care for that day and to notify the non-
custodial parent of the child's illness.
In the event that either party is planning to take either child away from home for an
overnight trip, they shall provide the non-custodial parent with reasonable notice and contact
information where the child will be staying.
Both parties are expected to use common sense in scheduling telephone calls to talk to the
child. Reasonable telephone contact is not only permitted, but expected. Both parties and/or their
spouses/significant others are hereby directed to refrain from preventing the parent who may be
calling from talking to the child, or preventing the child from calling the other parent, provided
that the phone calls are not excessively frequent nor too long in duration that they disrupt the
child's schedule, or interfere with the custodial parent's period of custody.
Each of the parties and any third party in the presence of the child shall take all measures
deemed advisable to foster a feeling of affection between the child and the other party. Neither
party shall do nor shall either parent permit any third person to do or say anything which may
estrange the child from the other parent, their spouse or relatives, or injure the child's opinion of
the other party or which may hamper the free and natural development of the child's love,
affection and respect for the other parent.
The parties shall not use either child to convey verbal messages to the other parent about
the custody situation or changes in the custody schedule.
Each party shall confer with the other on all matters of importance relating to the child's
health, maintenance, and education with a view towards obtaining and following a harmonious
policy in the child's education and social adjustments. Each parry agrees to keep the other
informed of his or her residence and telephone number to facilitate communication concerning the
welfare of the child and the custody situation. Each party shall supply the name, address and
phone numbers of any persons in whose care the child will be in for a period in excess of seventy-
two (72) hours, and for each person or entity which may provide daycare for the child, excluding
current daycare providers, relatives, or public school institutions.
Emergency decisions regarding the child shall be made by the parent then having
custody. However, in the event of any emergency or serious illness of the child at any time, the
parent then having custody of the child shall immediately communicate with the other party by
telephone or any other means practical, informing the other party of the nature of the illness or
emergency, so the other parent can become involved in the decision-making process as soon as
practical.
The term "serious illness" as used herein shall mean any disability which confines either
child to bed for a period in excess of seventy-two (72) hours and which places either child under
the direction of a licensed physician.
The welfare and convenience of the child shall be the prime consideration of the parties
in any application of the provisions of this Stipulation and Agreement. Both parents are directed
to listen carefully and consider the wishes of the child in addressing the custodial schedule, any
changes to the schedule, and any other parenting issues.
Neither party shall drink to the point of intoxication when the child is in their custody.
The parties agree to cooperate with one another in an effort to foster a loving, meaningful
relationship between the child and each parent.
Relocation: It is the intention of the parties to have the child remain in the East Pennsboro
School District until the child graduates from High School. As such, both parties intend to make
every effort to stay in the East Pennsboro School District until the child's graduation from high
school. Neither parent shall move with the child if such relocation will significantly impair the
ability of the non-relocating parent to exercise his or her custodial rights unless (a) every person
who has custodial rights to the child consents to the proposed relocation, or (b) the court approves
the proposed relocation. The party seeking relocation must follow the procedures required by 23
Pa.C.S. §5337 as set forth in Exhibit "A" attached to this Stipulation, Agreement and Order.
Any modifications of this Stipulation and Agreement need to be in writing, and agreed to
by both parties. Minor, short-term changes can be made orally, if agreed upon by both parties. In
the event that either party is not in agreement with a proposed change, this Stipulation and
Agreement will control the custodial arrangement until such time as the parties are able to agree.
This Stipulation, Agreement and Order supersedes all previous custody Agreements
and/or Orders, specifically including the March 26, 2009 Order issued by the Honorable Edgar B.
Bayley.
Respectfully Submitted,
DALEY ZUCKER WILTON MINER & GINGRICH, LLC
By:
635 North 12th Street, Suite 101
Lemoyne, Pennsylvania 17043
(717) 724-9821
Attorneys for Plaintiff
VERIFICATION AND CONFIRMATION OF STIPULATION/AGREEMENT
We, Kristine M. Serafm and Christopher I Serafin, hereby verify that the facts set
forth in this Petition for Modification and Stipulation and Agreement are true and correct to the
best of our respective knowledge, information and belief. We understand that false statements
herein are made subject to the penalties of 18 Pa.C.S.A. § 4904, relating to unsworn falsification
to authorities. Furthermore, by the voluntary execution of this Confirmation, we do each
unequivocally express our mutual consent that the terms as outlined in the Custody Stipulation
and Agreement, above, are being entered into freely and voluntarily and we therefore request that
the amicable custody arrangement, as set forth in said Stipulation, be entered as an Order of Court
in the form attached hereto, without the necessity of a Custody Conciliation, Hearing or other
formal proceeding.
Date: o ?2,4,4 2?11J?
/
Afjzt? -0 M -
tine V. Serafin, Plaintiff
Date: g xo t k
Christopher J. Serafin, efendant
COMMONWEALTH OF PENNSYLVANIA:
: SS:
COUNTY OF ?)M?J(\CAAA
On this, the ?61' day of 2011, before me, the undersigned
officer, personally appeared Kristine M. Serafin, known to me (or satisfactorily proven) to be the
person whose name is subscribed to the within instrument and acknowledged that she executed
same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
COMMONWEALTH OF Pt 00MVANIA
NOTARIAL SEAL
AMY EWING, Notary Pubic
Borough of Lemoyne, Cumberland Couny?
Cwmbsion 11, 2M4
COMMONWEALTH OF PENNSYLVANIA:
SS:
T"" (Seal)
Notary P blic
C"' COUNTY OF 1
On this, the day of 2011, before me, the undersigned
officer, personally appeared Christopher J. Serafin, known to me (or satisfactorily proven) to be
the person whose name is subscribed to the within instrument and acknowledged that she
executed same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
COMMONWEALTH OF PENNSYLVANIA
NOTARIAL SEAL
AMY EWING, Notary Pubic
Borough ofnftmLamoyrie, CumberlanM Caft
rjir?u Qz (Seal) 2014 1
Notary P lic
IC
,a
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KRISTINE M. SERAFIN, :
Plaintiff
CHRISTOPHER J. SERAFIN
Defendant
No. 2009-712
CIVIL ACTION - LAW
(In Custody)
S
." -1, 1
cz,
rn fn-
77-
PQ
ORDER OF COURT
AND NOW, this day of 2011, upon presentation and
consideration of the within Petition for Modification of Custody and the Stipulation and
Agreement incorporated therein, and upon agreement of the parties, it is hereby ORDERED and
DECREED as follows:
1) The parties shall have joint legal custody of their minor child, Nathan Patrick
Serafin. Joint legal custody means the right of both parents to control and to share in making
decisions of importance in the lives of their child, including educational, medical, and religious
decisions. Each parent shall have an equal right, to be exercised jointly with the other parent, to
make all major non-emergency decisions affecting the child's general well-being, including, but
not limited to, all decisions regarding his health, education and religion. The custodial parent
shall inform the non-custodial parent immediately of all medical and dental appointments and
problems pertaining to the child. If the child is sick and is unable to attend school or
extracurricular activities the custodial parent will notify the non-custodial parent as soon as
practicably possible. Each parent shall provide names, addresses, and telephone numbers for all
the child's medical, dental and other healthcare providers, school contact information as well as
the school's website and any website's relating to the child's activities. In the event that either
parent cannot obtain information or schedules directly, the other parent shall provide the
documentation upon request. The custodial parent shall notify the other parent of any medical,
dental, optical, counseling and other appointments of the child with health care providers,
sufficiently in advance thereof so that the other party can attend, if he or she so chooses.
Pursuant to the terms of Pa.C.S. §5309, each parent shall be entitled to equal access to all
records and information pertaining to the child, including, but not limited to, the child's school,
medical, dental, religious and other important records, the residence address of the child and the
other parent. As soon as practical after the receipt by a party, copies of the child's school
schedule, special events notifications, report cards, and similar items shall be provided to the other
party. To the extent one (1) parent has possession of any such records or information, that parent
shall be required to share same, or copies thereof, with the other parent within such reasonable
time as to make the records or information of reasonable use to the other parent. The custodial
parent shall provide copies of the child's report cards and other reasonable papers affecting the
child's education, medical condition or welfare.
Notwithstanding that both parents shall share legal custody, non-major decisions involving
the child's day-to-day living shall be made by the parent then having custody, consistent with the
other provisions of this Stipulation and Order.
2) Primary Physical custody of the child, as that term is defined in the Custody Act,
shall be with Mother, subject to Father's periods of partial custody pursuant to the following
schedule:
A. The parties shall alternate having custody of the child on weekends from
Friday after work through Sunday at 7:30 p.m. The weekend rotation shall
continue in regular rotation pursuant to the parties prior Order of March 26,
2009, as entered by the Honorable Edgar B. Bayley.
B. Father shall have custody of the child every week on Tuesday and
Thursday from after work until 7:30 p.m. During the summer school
break, the Father's Tuesday and Thursday evening periods of custody shall
be extended overnight until the following morning when Father shall
transport the child to the babysitter or to camp. The parties shall make
adjustments to the weekday evening periods of custody to ensure that the
parties are equally sharing the child's non-activity evening time.
C. Mother shall have custody of the child at all times not otherwise specified
for the Father.
3) Transportation for custody purposes shall be divided by the parties as equally as
possible. Unless otherwise agreed, the parent receiving custody shall transport the child from the
home of the other parent. At all times, the child shall be secured in appropriate passenger
restraints. No person transporting the child shall consume alcoholic beverages prior to
transporting the child. No person transporting the child shall be under the influence of any
alcoholic beverages while transporting the child.
4) The parties shall share or alternate custody of the child during the holidays as
follows:
A. Christmas: The Christmas holiday shall be divided into Segment A, which
shall run from Christmas Even at 12:00 noon or after work until 9:00 p.m.,
Segment B, which shall run from Christmas Eve at 9:00 p.m. through
Christmas Day at 5:00 p.m., Segment C, which shall run from Christmas
Day at 5:00 p.m. through the halfway point of the remainder of the child's
holiday school break at 5:00 p.m., and Segment D, which shall run from
the halfway point of the remaining school break at 5:00 p.m. through the
last day of the holiday break before school resumes at 7:30 p.m. In odd-
numbered years, Father shall have custody of the child during Segments A
and C and Mother shall have custody during Segments B and D. In even-
numbered years, Mother shall have custody of the child during segments A
and C and Father shall have custody of the Child during Segments B and
D. In the event that there are an odd number of days in the child's
remaining Christmas vacation, the party having Segments A and C in that
year shall have the extra day of vacation. In the event that either party
must work and is unavailable to provide care to the child during his or her
period of holiday custody, the parent shall offer the other parent the
Opportunity to provide care for the child during the custodial parent's
period of non-availability. This provision is not intended to limit the
ability of either party to make arrangements for the child to spend time
with grandparents for up to one (1) day during the holiday. However, the
custodial parent shall make every effort to arrange a time with grandparents
when the other parent is also working.
B. Thanksgiving: The Thanksgiving holiday period of custody shall
run from after school on the Wednesday before Thanksgiving through
Monday morning after Thanksgiving. Father shall have custody of the
child for Thanksgiving in odd-numbered years and Mother shall have
custody of the child in even-numbered years.
C. Easter: The Easter holiday shall be divided into Segment A, which
shall run from 7:30 a.m. until 2:00 p.m. on Easter Sunday and Segment B,
which shall run from 2:00 p.m. until 7:30 p.m. on Easter Sunday. In odd-
numbered years, Father shall have custody of the child during Segment A
and Mother shall have custody of the child during Segment B. In even-
numbered years, Mother shall have custody of the child during Segment A
and Father shall have custody of the child during Segment B.
D. Mother's Day/Father's Day: In every year, Mother shall have custody of
the child on Mother's Day and Father shall have custody of the Child on
Father's Day, with the specific times to be arranged by agreement of the
parties.
E. Memorial Day/4th of July/Labor Day: The parties shall alternate
having custody of the child on the Memorial Day, 4th of July and Labor
Day holidays equally as arranged by agreement of the parties.
F. The holiday custody schedule shall supersede and take precedence over
the regular and vacation custody schedules.
5) Each parent shall be entitled to have custody of the child for two (2) uninterrupted
weeks each year for vacation time. A week shall be defined as seven (7) days and shall include
the custodial parents' weekend of custody. The weeks under this provision shall not be scheduled
consecutively unless agreed upon by the parties. Neither party shall remove the child from school
for vacation without the advance consent of the other parent and school approval. The parties
shall provide each other with at least thirty (30) days advance notice of vacation dates under this
provisions and the parent first providing notice shall be entitled to preference on his or her
selected vacation dates. The parents shall cooperate in arranging any summer camps for the child
and shall coordinate camps and activities with vacation dates.
6) The parties shall provide the child with any and all prescribed medications and/or
medications recommended by the child's physician, during their period of custody and the parents
shall cooperate to make sure that prescriptions and medications are transferred back and forth,
when necessary and that medication logs are provided to the other parent if the child is going
between households when sick or on a medication regimen.
7) The parties shall provide each other with a written schedule or website address to
ascertain a schedule for the child's school, sporting, and extracurricular activities. Both parties
shall agree to honor and participate in the activities in which the child wishes to engage. During
the times that each parent has custody of the child, each parent will make certain that the child
attends any previously-scheduled extracurricular activities. The parties are directed to be
supportive of the child's activities and will transport each child to and from such activities and the
preparations and practice for the activities that are scheduled, in such time so that the child is able
to participate in those events.
Neither parent, however, shall commit the child to any activity unless that child definitely
desires to attend that activity. Participation in activities which take place during the school year is
contingent upon the child maintaining passing grades in school.
The parties shall discuss, prior to the child's enrollment in a particular activity that
encompasses both parents' periods of custody, whether the child shall be enrolled in said activity.
If no agreement can be reached, the Court will decide if the child shall be enrolled in said activity.
In the event that the custodial parent is unable to deliver the child to an agreed upon
activity, the non-custodial parent shall be permitted to transport the child to the agreed upon
activity. The custodial parent shall make certain that the child is transported to appropriate
custody exchange location in a time sufficient to enable the child to timely attend the activity.
8) The custodial parent shall ensure that the child completes any and all school
assignments, homework and/or projects during their period of custody.
9) In the event that the child is unable to attend school due to illness, it is the
responsibility of the parent then having custody to arrange alternate care for that day and to notify
the non-custodial parent of the child's illness.
10) In the event that either party is planning to take either child away from home for
an overnight trip, they shall provide the non-custodial parent with reasonable notice and contact
information where the child will be staying.
11) Both parties are expected to use common sense in scheduling telephone calls to
talk to the child. Reasonable telephone contact is not only permitted, but expected. Both parties
and/or their spouses/significant others are hereby directed to refrain from preventing the parent
who may be calling from talking to the child, or preventing the child from calling the other parent,
provided that the phone calls are not excessively frequent nor too long in duration that they
disrupt the child's schedule, or interfere with the custodial parent's period of custody.
12) Each of the parties and any third party in the presence of the child shall take all
measures deemed advisable to foster a feeling of affection between the child and the other party.
Neither parry shall do nor shall either parent permit any third person to do or say anything which
may estrange the child from the other parent, their spouse or relatives, or injure the child's
opinion of the other parry or which may hamper the free and natural development of the child's
love, affection and respect for the other parent.
The parties shall not use either child to convey verbal messages to the other parent about
the custody situation or changes in the custody schedule.
13) Each party shall confer with the other on all matters of importance relating to the
child's health, maintenance, and education with a view towards obtaining and following a
harmonious policy in the child's education and social adjustments. Each party agrees to keep the
other informed of his or her residence and telephone number to facilitate communication
concerning the welfare of the child and the custody situation. Each party shall supply the name,
address and phone numbers of any persons in whose care the child will be in for a period in
excess of seventy-two (72) hours, and for each person or entity which may provide daycare for the
child, excluding current daycare providers, relatives, or public school institutions.
14) Emergency decisions regarding the child shall be made by the parent then having
custody. However, in the event of any emergency or serious illness of the child at any time, the
parent then having custody of the child shall immediately communicate with the other party by
telephone or any other means practical, informing the other party of the nature of the illness or
emergency, so the other parent can become involved in the decision-making process as soon as
practical.
The term "serious illness" as used herein shall mean any disability which confines either
child to bed for a period in excess of seventy-two (72) hours and which places either child under
the direction of a licensed physician.
15) The welfare and convenience of the child shall be the prime consideration of the
parties in any application of the provisions of this Stipulation and Agreement. Both parents are
directed to listen carefully and consider the wishes of the child in addressing the custodial
schedule, any changes to the schedule, and any other parenting issues.
16) Neither party shall drink to the point of intoxication when the child is in their
custody.
17) The parties agree to cooperate with one another in an effort to foster a loving,
meaningful relationship between the child and each parent.
18) Relocation: It is the intention of the parties to have the child remain in the East
Pennsboro School District until the child graduates from High School. As such, both parties
intend to make every effort to stay in the East Pennsboro School District until the child's
graduation from high school. Neither parent shall move with the child if such relocation will
significantly impair the ability of the non-relocating parent to exercise his or her custodial rights
unless (a) every person who has custodial rights to the child consents to the proposed relocation,
or (b) the court approves the proposed relocation. The party seeking relocation must follow the
procedures required by 23 Pa.C.S. §5337 as set forth in Exhibit "A" attached to this Stipulation,
Agreement and Order.
19) Any modifications of this Stipulation and Agreement need to be in writing, and
agreed to by both parties. Minor, short-term changes can be made orally, if agreed upon by both
parties. In the event that either party is not in agreement with a proposed change, this Stipulation
and Agreement will control the custodial arrangement until such time as the parties are able to
agree.
20) This Stipulation, Agreement and Order supersedes all previous custody
Agreements and/or Orders, specifically including the March 26, 2009 Order issued by the
Honorable Edgar B. Bayley.
BY THE COURT,
J.
Distribution: ? Lindsay Gingrich Maclay, Esquire, DALEY ZUCKER MEILTON MINER & GINGRICH, LLC, 635 N.
12th Street, Lemoyne, PA 17043 - Attorney for Plainti/Mother
James L. Walsh, Esquire, Northwood Office Center,2215 Forest Hills Drive, Suite 37, Harrisburg,
PA 17112 - Attorney for Defendant/Father _ •1i
jd
(
0"Ad-s"'? f/ if
U0
EXHIBIT A
REQUIREMENTS REGARDING RELOCATION OF RESIDENCE
A relocation is a move or change of residence that will significantly impair the ability of the non-
relocating party to easily exercise periods of custody. You cannot relocate with the child(ren)
without following these procedures. If you are contemplating such a move, you are sfron41
y
urged to seek the advice of an attorney to make sure that you are following the procedures.
You are not permitted to relocate your residence without either:
The consent of every individual who has custody rights to the child(ren) to the proposed
relocation
OR
• the court approves the proposed relocation.
NOTICE
1. The party proposing the relocation must notify every other party who has custody rights
to the child(ren) of the proposed move by certified mail, return receipt requested. You
should complete the attached "Notice of Proposed Relocation to Be Completed by Party
Intending To Relocate" and send the notice to all other parties by certified mail, return
receipt requested.
2. Notice must be given 60 days before the date of the proposed relocation OR 10 days
after the date that the party knows about the relocation only if the individual did not know
and could not have reasonably known about the relocation in time to comply with the 60
days notice or it is not reasonably possible to delay the date of relocation to comply with
the 60 day notice.
You must include with this mailing the attached "Counter-Affidavit Regarding
Relocation". The other parties must complete this form to indicate their position with
regard to the proposed move.
WHAT DO(ES) THE OTHER PARTWIES) DO WHEN THEY RECEIVE THE NOTICE AND
COUNTER-AFFIDAVIT?
1. If you receive a notice and a counter-affidavit, you must complete the counter-affidavit
and file with the Prothonotary's Office this completed counter-affidavit within 30 days
from the day you receive the notice and counter-affidavit. If you fail to file this counter-
affidavit within the 30 days, you will be foreclosed from objecting to the relocation.
2. If the counter-affidavit is timely filed and the party objects to the proposed relocation or
objects to the proposed modification of the custody order, a hearing will be held.
3. You must serve the other party with the Counter-Affidavit by certified mail, return receipt
requested.
4. If notice of the proposed relocation has been properly given and no objection to the
proposed relocation has been filed with the Prothontoary, then it will be presumed that
the nonrelocating party has consented to the proposed relocation.
If a party who has been given proper notice does not file with the court an objection to
the relocation within 30 days after receipt of the notice but later petitions the court for
review of the custodial arrangements, the court shall not accept testimony challenging
the relocation.
WHAT DO I DO IF NO OBJECTION TO THE PROPOSED RELOCATION 1S FILED?
The party proposing relocation shall file the following with the Prothonotary prior to relocation:
1. An affidavit stating that the party provided notice to every individual entitled to notice, the
time to file an objection to the proposed relocation has passed and no Individual entitled
to receive notice has filed an objection to the proposed relocation.
2. Proof that proper notice was given in the form of a return receipt with the signature of the
addressee and a copy of the full notice that was sent to the addressee.
3. A petition to confirm the relocation and modify any existing custody order, and
4. A proposed order containing the information in the notice.
WHAT DO I DO IF A COUNTER-AFFIDAVIT IF FILED WITH THE PROTHONOTARY THAT
INDICATES THERE IS NO OBJECTION TO THE PROPOSED RELOCATION AND NO
OBJECTION TO THE MODIFICATION OF THE CUSTODY ORDER CONSISTENT WITH THE
PROPOSAL FOR A REVISED CUSTODY SCHEDULE?
• The court may modify the existing custody order by approving the proposal for a revised
custody schedule submitted with the Notice. You should submit a proposed order with
distribution and attach a copy of the notice and the courter-affidavit.
WHAT DO I DO IF A COUNTER-AFFIDAVIT IS FILED WITH THE PROTHONOTARY WHICH
INDICATES THAT THE NONRELOCATING PARTY OBJECTS EITHER TO THE PROPOSED
RELOCATION OR TO THE MODIFICATION OF THE CUSTODY ORDER?
You should file a motion for a hearing with the Prothonotary's Office. The matter will be
assigned to a judge for the scheduling of a hearing and disposition.
IN THE COURT OF COMMON PLEAS OF
Plaintiff DAUPHIN COUNTY, PENNSYLVANIA
v NO. CV CU
: CIVIL ACTION
Defendant
: IN CUSTODY
NOTICE OF PROPOSED RELOCATION TO BE COMPLETED BY PARTY INTENDING TO
RELOCATE
I, , parent of
move on
follows.
intend to
and answer the following questions as
1. What is the address of the intended new residence?
2. What is the mailing address of the intended new residence?
3. What are the name(s) and age(s) of all individual(s) who will be living at this new
residence?
4. What Is the home telephone number of the Intended new residence?
5. What is the name of the new school and the new school district?
6. What is the date of the proposed relocation?
7. What are the reasons for the proposed relocation?
8. How do you proposed to change the custody schedule that is currently in effect?
9. Is there any other Information that is relevant to the proposed relocation?
10. I have included a counter-affidavit that you can use to object to the proposed
relocation.
WARNING TO NON-RELOCATING PARTY
IF YOU WANT TO OBJECT TO THE PROPOSED RELOCATION, YOU MUST
FILE THIS COUNTER-AFFIDAVIT WITH THE PROTHONOTARY'S OFFICE
WITHIN THIRTY (30) DAYS AFTER RECEIPT OF THIS NOTICE OR YOU WILL
BE FORECLOSED FROM OBJECTING TO THE RELOCATION.
I verify that the statements made in this counter-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
Signature
Print Name
Address
Telephone Number
I I 1
IN THE COURT OF COMMON PLEAS OF
Plaintiff : DAUPHIN COUNTY, PENNSYLVANIA
V. NO. CV CU
: CIVIL ACTION
Defendant
IN CUSTODY
COUNTER-AFFIDAVIT REGARDING RELOCATION
The party objecting to the Notice of Relocation must file this document with the Prothonotary's Office
within thirty (30) days of receipt of the Notice of Proposed Relocation.
I, file this counter-affidavit regarding the proposed relocation. I
received the Notice of Proposed Relocation on
1. What are the names and ages of the child(ren) affected by the proposed relocation?
2. Where do this/these child(ren) currently reside?
Check one of the following boxes:
? I do not object to the relocation and I do not object to the modification of the custody order
consistent with the proposal for revised custody schedule as attached to this notice.
? l do not object to the relocation, but I do object to modification of the custody order and I
request that a hearing be scheduled.
I request that a hearing be scheduled
? a. Prior to allowing the chi Id(ren) to relocate.
? b. After the child(ren) relocate.
? 1 do object to the relocation and I do object to the modification of the custody order, and I
request that a hearing be held on both matters prior to the relocation taking place.
1 understand that 1 must file this counter-affidavit with the Prothonotary's Office and that I must mail
a copy to the other party by certified mail, return receipt requested. I understand that if I fail to file
this counter-affidavit and mail a copy to the other party within thirty (30) days of receipt of the
proposed relocation notice, I shall be prevented from objecting to the relocation.
I verify that the statements made In this counter-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
Signature
Print Name