HomeMy WebLinkAbout01-6820IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN MeLAUD
Plaintiff
V
CHRISTOPHER ROBERT McLAUD
Defendant
CML ACTION- LAW
NO.: d[-(~~/~'~ CMLTERM
IN DIVORCE
NOTICE TO DEFEND AND CLAIM RIGHTS
You have been sued in court, lfyou 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 n 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 the 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 at:
Office of the Prothonotary
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DMSION OF PROPERTY,
LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULLMENT 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 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
Two Liberty Avenue
Carlisle, PA 17013
717-249-3166
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
V
CHRISTOPHER ROBERT MeLAUD
Defendant
CIVIL ACTION - LAW
NO.: CIVIL TERM
IN DIVORCE
COMPLAINT IN DIVORCE
COMPLAINT UNDER SECTION 201 (c)
OF THE DIVORCE CODE
COUNT ONE
Plainfiffis Katherine Ann MeLaud, who currently resides at 208 Walnut Bottom
Road, Carlisle, Cumberland County, Pennsylvania.
Defendant is Christopher Robert McLaud, who currently resides at 660 Boas Street,
Apas-tment 612, Harrisburg, Dauphin County, Pennsylvania.
Plaintiff and defendant have been bona fide residents of the Commonwealth of
Pennsylvania for at least six months immediately previous to the filing of this
Complaint.
The plaintiff and defendant were married June 26, 1999 at Towanda, Bradford
County, Penn.~ylvania.
There have been no prior a~tions of divorce or annulment between the parties.
(1.)
o
11.
12.
The marriage is irretrievably broken.
Plaintiff has been advised that counseling is available and that plaintiff may have the
fight to request that the court require the parties to participate in coun~ling.
Plaintiff requests the court to enter a decree in divorce.
WHEREFORE, after the expiration of the statutory time period and upon the
filing of the appropriate affidavits, plaintiff petitions the Court to enter a divorce
decree dissolving the marriage between the parties.
COUNT TWO
The prior paragraphs of this Complaint are incorporated herein by reference thereto.
The public policy of the Commonwealth of Pennsylvania encourages parties to a
marital dispute to negotiate a settlemem of their differences.
While no settlement has been reached as of the date of the filing of this Complaint,
plaimiffis and has always been willing to negotiate a fair and reasonable settlement
of ail matters with defendant.
To the extent that a written settlement agreemem might be entered into between the
parties prior to the time of hearing on this Complaint, plaintiffdesires that such
written agreement be approved by the Court and incorporated in any divorce decree
which may be entered dissolving the marriage between the parties.
(2.)
WHEREFORE, if a written settlement agreement is reached between the parties
prior to the time of hearing on this Complaint, plaintiff respectfully request that,
pursn_ar~t to Sections 3104(a)(1) and (3) and 3323(b) of the Divorce Code, the Court
approve and incorporate such agreement in the final divorce decree.
Respectfully Submitted,
1722 Green Street
Harrisburg, PA 17012
(717) 238-6551
Attorney for Plaintiff
(3 .)
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
CHRISTOPHER ROBERT McLAUD
Defendant
CIVIL ACTION - LAW
NO: CIVIL TERM
IN DIVORCE
VERIFICATION TO COMPLAINT IN DIVORCE
Plaintiff verifies that the statements made in this Complaint are true and correct. Plaintiff
understand that false statements herein are made subject to the penalties of 18 Pa. C. S. Section
4904, relating to unswom falsification to authorities.
Katherine Ann McLaud
Plaintiff
Date
1N THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
V
CHRISTIPHER ROBERT McLAUD
Defendant
CIVIL ACTION - LAW
NO.:
NO.:
CERTIFICATE OF SERVICE
I hereby certify that I am this day depositing in the U. S. mail, puts-ant to Pa. R.C.P
1920.4 and 1930.4 one copy for delivery by certified mail, restricted to addressee, return
receipt requested, and one copy for delivery by regular mail, tree and correct copies of the
foregoing Complaint in Divorce upon the person indicated below.
Christopher Robert McLaud
660 Boas Street
Apartment 612
Harrisburg, PA 17102
fiate
MichaelffffMcGover~ Esquire
Suprem~"Court No. 52802
Attorney for Plaintiff
1722 Green Street
Harrisburg, PA 17102
Attorney for Plaintiff
C
-<
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
CHRISTOPHER ROBERT McLAUD
Defendant
NOTICE OF AVAIl,ABILITY
TO THE WITHIN-NAMED DEFENDANT:
CIVIL ACTION- LAW
NO.: ~l (O ~"-~ CML TERM
IN DIVORCE
OF COUNSELrN~
You have been named as the Defendant in a Complaint in a divorce proceeding
filed in the Court of Common Pleas of Cumberland County, This notice is to advise you
that in accordance with Section 3302(d) of the Divorce Code, you may request that the
court require you and your spouse ro attend marriage coun~ling prior to a divorce being
handed down by the court. A list of professional marriage counselors is available at the
Domestic Relations Office, 13 North Hanover Street, Carlisle, Penn.qylvania. You are
advised that this list is kept as a convenience to you and you are not bound to choose a
counselor fi:om this list. All necessary arrangements and the cost of counseling sessions
are to borne by you and your spouse.
If you desire to pursue counseling, YOu must make your request for counseling
within twenty days of the date on which you receive this notice. Failure to do so will
consifitute a waiver of your right to request counseling.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
CHRISTIPHER ROBERT McLAUD
Defendant
CIVIL ACTION - LAW
: NO.:
NO.:
:
.-
:
CERTIFICATE OF SERVICE
I hereby certify that I am this day depositing in the U. S. mail, pursuant to Pa. R.C.P
1920.4 and 1930.4 one copy for delivery by certified mail, restricted to addressee, return
receipt requested, and one copy for delivery by regular mail, true and correct copies of the
foregoing Notice of Availability of Counseling upon the person indicated below.
Christopher Robert McLaud
660 Boas Street
Apartment 612
Harrisburg, PA 17102
Date
~4ichae~/]. l$lcGo~m, Esquire
Suprem~ Court No. 52802
Attorney for Plaintiff
1722 Green Street
Harrisburg, PA 17102
Attorney for Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
CHRISTOPHER ROBERT McLAUD
Defendant
CIVIL ACTION - LAW
NO.: 01-6820 CIVIL TERM
IN DIVORCE
WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A
DIVORCE DECREE UNDER SEC. 3301(c) OF THE DIVORCE CODE
I consent to the entry of a final decree in divorce without notice.
2. I understand that I may lose fights concerning alimony, division of property,
lawyer's fees or expenses ifI 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 that the statements made in this affidavit are tree and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa. C.& Section 4904
relating to unswom falsification to authorities.
Date: iq ~,~ Y 2OO Z ~,~,/i~
~2h~w'16phelt l~o~ertt/~cLaud, Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
CHRISTOPHER ROBERT McLAUD
Defendant
CIVIL ACTION - LAW
NO.: 01-6820 CIVIL TERM
IN DIVORCE
WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A
DIVORCE DECREE UNDER SEC. 3301(c) OF THE DIVORCE CODE
1. I consent to the entry of a fmal decree in 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 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. Section 4904
relating to unsworn falsification to authorities.
Katherine Ann McLaud, Defendant'
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
CHRISTOPHER ROBERT McLAUD
Defendant
CIVIL ACTION - LAW
NO.: 01- 6820 CIVIL TERM
IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed
On November 30, 2001 and served on December 7, 2001.
2. The marriage of the plaintiff and defendant is irretrievably broken. Ninety days
have elapsed since the date of service of the Complaint.
3. I consent to the entry of a fmal decree in divorce and waive service of the
notice of intention to request entry of decree.
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. Section 4904
relating to unsworn falsification to authorities.
Katherine Ann McLaud
Date: f} -;t ~' ~ o 2--
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD,
Plaintiff
VS.
CHRISTOPHER ROBERT McLAUD,
Defendant
.'
: CIVIL ACTION ~ LAW
:
: NO. 01-6820
:
: IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under Section 3301 (c) of the Divorce Code
was filed on November 30, 2001.
Date:
2. The marriage of Plaintiff and Defendant is irretrievably broken and
ninety (90) days have elapsed from the date of filing of Complaint.
3. I consent to the entry of a final Decree of Divorce after service of a
Notice of Intention to Request Entry of the Decree, or the filing of a Waiver of
Notice of Intention to Request Entry of a Divorce Decree.
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. Section 4904 relating to unsworn falsificatior uthorities.
Christopher 1~ t/ert/vlcLaud, Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
CHRISTOPHER ROBERT McLAUD
Defendant
CIVIL ACTION - LAW
NO.: 01-6820 CIVIL TERM
IN DIVORCE
PRAECIPE TO TRANSMIT RECORD
Transmit the record, together with the following information, to the Court for
Entry of a divorce decree:
(1.) The grounds for the divorce is Irretrievable Breakdown under Section
3301 [c]
(2.)
(3 .)
The Complaint was served on December 12, 2001 by Certified Mail,
Return Receipt Requested
Date of execution of the Affidavits of Consent required by Section
3301[c] of the Divorce Code:
By the Plaintiff: May 29, 2002
By the Defendant: May 14, 2002
(4.) The attached written agreement is to be incorporated into the Divorce
Decree.
(5 .)
The Waivers of Notice of Intention to Request Entry of a Divorce Decree
were:
Executed by the Plaintiff: May 29, 2002
Executed by the Defendant: May 14, 2002
Filed on: May 29, 2002
(6.) All other documents required by Rule 1920.42(C) are enclosed herein.
Respectfully Submitted,
l~'i~2ha~ Je~enn ~rGe~e ~, Esquire
Harrisburg, PA 17102
(717) 238-6551
Pa. Supreme Court No. 52802
Altomey for Plaintiff
Dated:~~z~,,~
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
KATHERINE ANN McLAUD
Plaintiff
CHRISTIPHER ROBERT McLAUD
Defendant
CIVIL ACTION - LAW
NO.: 01-6820 CIVIL TERM
IN DIVORCE
CERTIFICATE OF SERVICE
I hereby certify that I have on this date served a copy of the Praecipe to Transmit Record
in the above captioned matter by first class mail, postage prepaid, addressed to:
Frank J. Niemiec, Esquire
NIEMIC, SMITH AND PELLINGER, L.L.P.
427 Main Street
Towanda, PA 18848
Counsel for Defendant Christopher Robert McLaud
Date
~ichael J/~c-Govern, Esquire
Supreme Court No. 52802
Attorney for Plaintiff
1722 Green Street
Harrisburg, PA 17102
Attorney for Plaintiff
MARITAL SETTLEMENT AGREEMENT
This Agreement is made by and between Katherine Ann McLaud of Cumberland
County, Pennsylvania, (hereinafter "Wife") and Christopher Robert McLaud of Dauphin
County, Pennsylvania, (hereinafter "Husband").
WHEREAS the parties hereto are Husband and Wife, having been married on
June 26, 1999 at Towanda, Bradford County, Pennsylvania: and
WHEREAS there are no children born of the parties marriage; and
WHEREAS certain differences exist between the parties and they have decided to
permanently live separate and apart from each other, and they intend by this Agreement
to fully and finally settle all of their respective rights and obligations as between each
other, including, but not necessarily limited to, the settling of all interests, rights, and
obligations between them or their estates arising out of their marriage and the ownership
of all assets of whatever nature during the course of their marriage.
NOW THEREFORE, in consideration of the premises and of the mutual
promises, covenants and undertakings set forth in this Agreement, and for other good and
valuable consideration, the receipt and adequacy of which is hereby acknowledged by
each of the parties, Wife and Husband, intending to be legally bound hereby, covenant
and agree as follows:
ADVICE OF COUNSEL: Wife has been represented by Michael J. McGovern,
Esquire, of Harrisburg, Dauphin County, Pennsylvania. Husband has been represented by
Frank J. Niemiec, Esquire of Towanda, Bradford County, Pennsylvania.
Page 1 of 7
ABSENCE OF AN AGREEMENT: Each party represents that she or he
understands that in the absence of an Agreement, and as a matter of law: (1) as a
surviving spouse she or he might be entitled to a greater share in the Decedent's estate
than is provided for in this Agreement; and (2) as a separated and/or divorced spouse, he
or she might be entitled to greater support, maintenance, alimony pendente lite, counsel
fees, costs, alimony, dislribution of property, or other financial benefit arising from the
marital relationship than is provided for in this Agreement.
ACKNOWI,g, DGEMNT OF VOLUNTARINESS: Not withstanding the fore-
going, the parties shall be bound by the terms of this Agreement. Each of the parties
further acknowledges and agrees that with such knowledge, and after having read this
Agreement carefully and fully, this Agreement is fair, reasonable, and equitable; that it
is being entered into freely, voluntarily, and in good faith; and that its execution is not
the result of any duress, undue influence, coercion, collusion and/or improper or illegal
agreement.
DEFINITIONS:
(1) The phrase "Divorce Code" shall be defined as Pennsylvania C.S.A., Title 23,
Section 101 et. seq, effective March 19, 1991;
(2) The phrase "Date of Execution" or "Execution Date" of this Agreement shall
be defined as the date that the last party signs this Agreement;
(3) The term "Asset" shall be defined as anything of value, including but not
limited to, real and/or personal, tangible and/or intangible property and all financial
interests however held;
Page 2 of 7
(4) The term "Effective Date of Agreement" shall be defined as the date this
Agreement shall become effective and binding upon the parties. The Effective Date of the
Agreement shall be the Date of Execution;
EFFECT OF DIVORCE DECREE: This Agreement shall merge with any final
decree in divorce which might be entered and therefore, upon entry of a decree in
divorce, this Agreement shall lose its independent status and shall become a Court Orde,.
EFFECT ON DIVORCE: Wife previously filed a Divorce Action in the Court of
Common Pleas of Cumberland County, Pennsylvania, No. 01-6820, Civil Term, seeking
a divorce pursuant to Section 201[c] of the Divorce Code. As defined in the Code, the
parties' marriage is irretrievably broken and the parties do not desire marital counseling.
RESPONSIBILITY FOR PROCEEDING WITH DIVORCE: Wife shall be
responsible for the prompt filing of the Praecipe to Transmit the Record and the related
required documents and costs necessary to obtain the divorce decree. Except as provided
in this Agreement, this Agreement shall remain in full force and effect, even if no final
decree in divorce is entered.
PERSONAL RIGHTS: Each party shall be free from any direct of indirect
interference by the other in her or his personal and business activities as of the date of the
execution of this Agreement. The parties shall not interfere with, harass, or malign each
other, or their respective families, friends, or colleagues of each other
WARRANTY OF DISCLOSURE; Wife and Husband represent and warrant that
they have disclosed to each other in full their respective assets, liabilities, and income as
Page 3 of 7
of the date of their separation and that this Agreement was negotiated and entered into on
the basis of those disclosures and their substantial accuracy. The parties acknowledge that
they are aware that, but for this Agreement, they might be entitled to additional formal
discovery, including by review of documents, inspections, interrogatories, or otherwise.
REAL ESTATE: The parties have no marital interest in any real estate.
PERSONAL PROPERTY: The parties have equitably divided their personal
property to their mutual satisfaction.
JOINT DEBTS: The parties acknowledge outstanding joint debts of one thousand
two hundred thirty one dollars and sixty two cents ($1,231.62). Wife will assume the
responsibility for these debts until such time as Husband graduates from college or for
three years from the Date of Execution of this Agreement, whichever date occurs first. At
that time Husband agrees to pay Wife six hundred fifteen dollars and eighty one cents
($615.81) Wife agrees to waive any claim to interest on the aforesaid deferred payment
on condition that the payment is made within the agreed time period.
MOTOR VEHICLES: Wife and Husband have each retained possession of her or
his personal automobile and each waives any claim to the vehicle in the others
possession.
BANK ACCOUNTS, LIFE INSURANCE POLICIES, RETIREMENT
BENEFITS AND OTHER PROPERTY: There are no bank accounts, life insurance
policies, retirement benefit plans, or other personal property to be divided between the
parties.
COUNSEL FEES: Each party shall be responsible for her or his own legal fees
Page 4 of 7
and expenses.
RESUMPTION OF MAIDEN NAME: Wife agrees that as soon as it is legally
practical to do so after the Court's granting ora Decree in Divorce she will file the
appropriate documents with the Court to resume her maiden name.
RELIGIOUS DIVORCE/ANNULMENT: If either of the parties, at any time after
the court's granting ora civil decree in divorce, desires to obtain a divorce or annul-
ment under the doctrines of their faith, the other party will reasonably cooperate in
obtaining such a divorce or annulment. The costs for obtaining such a divorce or
annulment shall be paid by the requesting party.
MUTUAL WAIVERS AND RELEASES: Except as provided for in this
Agreement, this Agreement constitutes a full and final resolution of any and all claims
which each of the parties ever had, now have, or may have in the future against the other
party and/or the estate of the other party.
WAIVER AND MODIFICATION: This is the complete Agreement between the
parties and no modification or waiver of any of the terms of this Agreement shall be
valid unless in writing and signed by both parties.
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. No
waiver of any breach or default of this Agreement shall be deemed a waiver of any
subsequent default of the same or similar nature or a waiver of strict performance of any
other obligations pursuant to the terms of this Agreement. The failure of either party to
insist upon strict performance of any of the terms of this Agreement shall in no way
Page 5 of 7
affect the right of such party to enforce those terms in the future.
BREACH: In the event of any breach of the provisions of this Agreement, the
remedies available to the non-breaching party are cumulative and include all remedies at
law and inequity, and shall not be limited to those remedies specifically referred to in
this Agreement. Unless otherwise agreed to by the parties, the Court of Common Pleas of
Cumberland County shall be the proper venue and that court shall have jurisdiction for
any action for any action arising out of this Agreement, including resolving any disputes
between the parties.
INTEGRATION: This Agreement supercedes any and all prior agreements and
negotiations between the parties, whether written or oral, expressed or implied.
SEVERABILITY: If any provision or provisions of this Agreement shall be
finally determined to be invalid, then only that provision shall be stricken from this
Agreement and in all other respects this Agreement shall be valid and shall continue in
full force and effect.
DEATH BEFORE DIVORCE: This Agreement shall remain in full force and
effect from its effective date even is one or both of the parties die prior to the entry of a
final decree in divorce.
MUTUAL COOPERATION: each party shall promptly take all reasonable steps
for the purpose of giving full force and effect to the provisions of this Agreement.
LAW: This Agreement shall be construed in accordance with the laws of the
Commonwealth of Pennsylvania which are in effect as of the Date of Execution of this
Agreement.
Page 6 of 7
HEADINGS NOT PART OF AGREEMENT: Any headings preceding the text of
any of the paragraphs or subparagraphs of this Agreement are inserted solely for
convenience of reference, shall not constitute a part of this Agreement, and shall not,
therefore, affect its interpretation.
COUNTERPARTS: This Agreement may be executed in counterparts, each of
which shall be original and together shall constitute the same Agreement.
IN W~ITJ ES: ~,H~EOF, the parties have set their hands and seals.
Chr~7~c Laud Date Katherine Ann McLaud Date
W!tx)ess '
Page 7 of 7
KATHERINE ANN McLAUD
Plaintiff
VERSUS
CHRISTOPHER ROBERT McLAUD
Defendant
IN THE COURT OF COMMON PLEAS
OFCUMBERLAND COUNTY
STATE OF ~~j. PENNA.
No. 01-6820 CIVIL TERM
DECREED THAT
AND
DECREE iN
Katherine Ann McLaud
, PLAINTIFF,
Christopher Robert McLaud
, DEFENDANT,
ARE DIVORCED FROM THE BONDS OF MATRIMONY.
THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE
BEEN RAISED Of RECORD IN THiS ACTION for WHICH A FINAL ORDER HAS NOT
YEt BEEN ENTERED;
IT IS FdRTHER ORDERED, ADJUDGED AND DECR~ED, that the terms, provisions and
conditions of a certain property settlement aqreement between the parties,
dated May 24, 2002 and attached hereto, are incorporated and merged in
this Decree and Order by reference as fully as though the s~e were set forth
herein at length.
PROTHONOTARY
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
vs.
Plaintiff :
Defendant :
File No. _~/- ~F~
IN DIVORCE
NOTICE TO RESUME PRIOR SURNAME
No~tice is hereby given that the Plaintiff/Defendant in the
above m~tter, having been granted a Final Decree in Divorce on the
/CiA 'day of ~_z'_ 3 ~d2~ , hereby elects to resume the
prior surname of //~?/~C~i~ /~ /~b~/_~ , and gives
this written notice pursuant to the provisions of 54 P.S. ~ 704.
Signature '
Sigmature of name being resumed
COMMONWEALTH OF PENNSYLVANIA:
:
COUNTY OF CUMBERLAND :
SS.
Notary Public, personally appea~e~ ~che 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.
seal.
In Witness Whereof, I have hereunto set my hand and official
u~,~ M. BIJSER, Notary
Meeh.,,i,,o~::C -. ubllc I ~ O ary~Public