HomeMy WebLinkAbout09-2404ROBERT D. KODAK, ESQUIRE
KODAK & IMBLUM, P.C.
407 N FRONT STREET, PO BOX 11848
HARRISBURG, PA 17108-1848
(717) 238-7159
Attorney for Plaintiff
CRAIG LAHAR, DMD
v
BRUCE A. LINDSLEY
IN THE COURT OF COMMON PLEAS OF
Cumberland COUNTY, PENNSYLVANIA
NO. CR - A04 aiyL'ITP-r*t
CIVIL ACTION - LAW
NOTICE
YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claim 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 an
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
TWO LIBERTY AVENUE
CARLISLE PA 17013
717-249-3166
Plaintiff
Defendant(s)
AVISo
USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de las
demandas que se presentan mas adelante en las siguientes paginas, debe tomar accion
dentro de los proximos veinte (20) dias despues de la notificacion de esta Demanda y
Aviso radicando personalmente o por medio de un abogado una comparencencia escrita
y radicando en la Corte por escrito sus defensas de, y objecciones a, las demandas
presentadas aqui en contra suya. Se le advierte de que si usted falla de tomar accion
como se describe anteriormente, el caso puede proceder sin usted y un fallo por cualquier
suma de dinero reclamada en la demanda o cualquier otra reclamacion o remedio
solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas aviso
adicional. Usted puede perder dinero o propiedad u otros derechos importantes para
usted.
USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO
INMEDIATAMENTE. SI LISTED NO TIENE UN ABOGADO, LLAME 0 VAYA A LA
SIGUIENTE OFICINA. ESTA OFICINA PUEDE PROVEERLE INFORMACION A CERCA
DE COMO CONSEGUIR UN ABOGADO.
SI USTED NO PUEDE PAGAR POR LOS SERVICIOS DE UN ABOGADO, ES
POSIBLE QUE ESTA OFICINA LE PUEDA PROVEER INFORMACION SOBRE
AGENCIAS QUE OFREZCAN,SERVICIOS LEGALES SIN CARGO 0 BAJO COSTO A
PERSONAS QUE CUALIFICAN.
CUMBERLAND COUNTY BAR ASSOCIATION
TWO LIBERTY AVENUE
CARLISLE PA 17013
717-249-3166
CRAIG LAHAR, DMD `•. IN THE COURT OF COMMON PLEAS OF
Plaintiff Cumberland COUNTY, PENNSYLVANIA
NO. o 9- ao? Tom.
BRUCE A. LINDSLEY
Defendant(s) CIVIL ACTION - LAW
COMPLAINT
The Plaintiff, CRAIG LAHAR, DMD, by its attorneys, KODAK & IMBLUM, P.C.,
brings this action of Assumpsit against the Defendant to recover the sum of FIVE
THOUSAND NINE HUNDRED SEVENTY DOLLARS AND SEVENTY-FOUR CENTS
($5,970.74), along with interest thereon at the statutory rate from July 25, 2008, upon a
cause of action of which the following is a statement:
1. The Plaintiff, CRAIG E LAHAR, DMD, is a registered, licensed dentist duly
registered with the Commonwealth of Pennsylvania, with an office and place of
business at 200 Cumberland Parkway, Mechanicsburg, Cumberland County, PA
17055.
2. The Defendant, BRUCE A. LINDSLEY, is an adult individual residing at 921 Park
Place, Mechanicsburg, Cumberland County, Pennsylvania 17055.
3. On or about March 2, 2006, Defendant submitted a Patient Information Sheet to
F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\LAHAR DMD 35021.%Td 2
Plaintiff, a true and correct copy of which is attached hereto, marked Exhibit "A"
and made a part hereof.
4. Thereafter, on or about March 3, 2006, Plaintiff and Defendant entered into a
Financial Policy agreement regarding the services to be rendered by Plaintiff at
Defendant's request, a true and correct copy of which is attached hereto, marked
Exhibit "B" and made a part hereof.
5. On the dates, in the amounts, and for the prices set forth in a true and correct copy
of the Plaintiffs Statement of Account hereto attached, marked Exhibit "C" and
made a part hereof, Plaintiff, at the special instance request of the Defendant,
performed labor and provided services of the kind and description set forth on said
Exhibit to the total amount of Four Thousand Five Hundred Ninety-Two Dollars and
Eighty-Eight Cents ($4,592.88). r
6. The prices charged for said labor performed and services provided were just and
reasonable, were the legal and market prices therefor and were the prices which the
Defendant promised and agreed to pay to Plaintiff.
7. Due to the default of Defendant, and pursuant to the terms and conditions of the
Financial Policy and Agreement executed by Defendant hereto attached as Exhibit
"B", attorney's fees in the total amount of One Thousand Three Hundred Seventy-
F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\LAHAR DMD 35021.wpd 3
Seven Dollars and Eighty-Six Cents ($1,377.86) have been added to said account.
8. The balance due and owing by Defendant to Plaintiff is the sum of FIVE
THOUSAND NINE HUNDRED SEVENTY DOLLARS AND SEVENTY-FOUR
CENTS ($5,970.74), as appears by Exhibit "C" hereto.
9. Plaintiffs Invoices are not attached to this pleading due to the voluminous nature
of same and have previously been provided to Defendant.
10. Plaintiff frequently demanded payment from Defendant of said amount due and
owing as aforesaid, but Defendant refused and neglected and still refuses and
neglects to pay said amount or any part thereof.
WHEREFORE, Plaintiff brings this suit to recover from Defendant the sum of FIVE
THOUSAND NINE HUNDRED SEVENTY DOLLARS AND SEVENTY-FOUR CENTS
($5,970.74), together with interest as set forth herein.
Respectfully submitted,
KODAK & IMBJ", P.C.
Robert D. Kodak, Esquire
407 North Front Street
Post Office Box #11848
Harrisburg, PA 17108-1848
(717) 238-7159
Attorney ID No. 18041
Attorney for Plaintiff
CUMBERLAND SURGERY CENTER
CIWG LAIIAR, D.M.D.
ORAL & MAXILLOFACIAL SURGERY. P. C.
PATIENT INFORMATION SHEET
Date -t% d
Title First Name Lin a6 M.I. Last Name
Nickname_ Date of Birth - Age, f2 Soc. Sec. # -4? 6-
Address , I WF//ice CityAo&edvuLVtfr State ? .? Zip / 7,o C -i --
Home Phone (7l7) Cell or 2"d # e aired (7/ 7>~-?-ice Race An
General Dentist s J1aiA . ? liCie Refened By?r ShOt?1lk'ti-
Physician Gr2Up "ji I?Zm Phone _ Address
Ckc , ?t2,Cft'ce?-lll Q3?? 9_`
Emergency Contact /.'d(? y, C //?/t A Phone. S vt'..&ddress
Name, address & phone # of nearest relative not living with you: SAmi s ?cT?R_
RESPONSIBLE PARTY INFORMATION (If other than Patient)
Name &OK Relationship to Patient
Address Phone ( )
Social Security # Employer
Employer Address Phone ( )
MEDICAL & DENTAL INFORMATION MUST BE COMPLETED FOR US
TO FILE CLAIMS ON YOUR BEHALF!
Insurance Company A?y
Group #
Employer
Name of Policy Holder
Policy Holder Date of Birth
Policy Holder ID #
Policy Holder Soc. Sec. #
Relationship to Patient
SECONDARY DENTAL INSURANCE
Insurance Co
Group #
Employer
Name of Policy Holder
Policy Holder Date of Birth
Policy Holder ID #
Policy Holder Soc. Sec. #
Relationship to Patient
Rev. March 05
Insurance Company QA
Group #
Employer
Name of Policy Holder
Policy Holder Date of Birth
Policy Holder ID #
Policy Holder Soc. Sec. #
Relationship to Patient
SECONDARY MEDICAL INSURANCE
Insurance Co
Group #
Employer
Name of Policy Holder
Policy Holder Date of Birth
Policy Holder ID #
Policy Holder Soc. Sec. #
Relationship to Patient
EXHIBIT -Ai
CUMBERLAND SURGERY CENTER
CRAIG LAHAR, D.M.D.
FINANCIAL POLICY
We are committed to providing you with the best possible care and would be happy to discuss our
professional fees with you at any time. Your clear understanding of our financial policy is important to our
professional relationship. Please ask if you have any questions about our fees, financial policy, or your
financial responsibility. I have been advised that Dr. Craig Lahar owns this facility and I am free to choose
another facility to provide surgical treatment.
INSURANCE
If you have insurance, we will be happy to submit your claim for you. Your insurance company claim can
ONLY be submitted if we are supplied with the proper insurance information from you (i.e.: insurance company
address and phone number, subscriber's identification number and group number.) It is your responsibility
to make sure your policy is active on your date of service. Otherwise, you are responsible for payment in full at
time of service.
Insurance coverage is an agreement between you and your insurance company. We verify insurance
benefits and file insurance claims as a courtesy to you, our patient. There is no implied or written guarantee of
insurance coverage for our office. We do not become involved in disputes between you and your insurance
company regarding deductibles, co-payments, covered charges, secondary insurances, "usual and customary"
charges, etc., other than to supply necessary factual information. Deductibles and/or co-payments required at the
time of service are an estimated amount based upon information we receive from your insurance company. This is
subject to change once the claim if filed and processed. If you are covered by a non-participating insurance, it is
our policy to collect 30% of the charges at the time of service unless your insurance company has informed us
otherwise. You are responsible for the prompt payment of your account. If payment is not received from your
insurance company within 90 days, the balance on the account becomes your responsibility. All services not
covered by insurance are due in full on the day of service. Forty eight (48) hours notice is required for an
cancellation of services requiring general anesthesia. Failure to do so will result in a $250 cancellation fee.
If you do not have insurance we expect payment in full for all treatment at the time of service unless other
arrangements have been made We accept cash check Visa and MasterCard
YOUR AGREEMENT
Uwe have read and agree to the above policy and understand that I am financially responsible for all
charges whether or not paid by my insurance. I understand that a finance charge of 1.5% may be added to my
account if not paid within 30 days. A $5.00 rebill fee will be added to all additional statements sent after 30 days.
understand and agree that my account may be turned over to the collection agency or attorney for collections after
45 days with a collections fee of 30% being added to the total bill. I understand that any additional attorney fees,
collection fees or court costs necessary in the recovery of this account will become my responsibility. There is a
$30 fee for any check returned by the bank.
Responsible party
Accompanying Parent/Guardian signature Date
(if different than above) ??!!
Office Personnel signature( ,a_ _,,,6 Date 643
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11 - Rev. 12/05
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VERIFICATION
I, Craig E Lahar DMD Owner
(name) (title)
verify that the statements made in the aforegoing document 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.
Dated: I - 2{j ,v 1
Craig E. Lahar DMV,,?c
By: 61
Title: Owner
35021
Lindsley
2009 1 6 P 2: C 3
419.5o M AT'H
ct* qqo(
?t"?aa383?,
Sheriffs Office of Cumberland County
R Thomas Kline t, of `ifirlbrEdward L Schorpp
Sheriff Solicitor
Ronny R Anderson Jody S Smith
Chief Deputy FiCE of THE SSE-R'FF Civil Process Sergeant
SHERIFF'S RETURN OF SERVICE
04/20/2009 05:34 PM - Gerald Worthington, Deputy Sheriff, who being duly sworn according to law, states that on
April 20, 2009 at 1734 hours, he served a true copy of the within Complaint and Notice, upon the within
named defendant, to wit: Bruce Lindsley, by making known unto Bruce Lindsley personally, at 921 Park
Place, Mechanicsburg, Cumberland County, Pennsylvania, 17055, its contents and at the same time
handing to him personally the said true and correct copy of the same.
SHERIFF COST: $37.42
April 21, 2009
SO ANSWERS,
R THOMAS KLINE, SHERIFF
Deputy Sheriff
Docket NO. 2009-2404
Craig Lahar, DMD v Bruce Lindsley
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C1
CRAIG LAHAR, DMD IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. NO. 09-2404 CIVIL TERM
BRUCE A. LINDSLEY CIVIL ACTION - LAW
Defendant :
TO: PROTHONOTARY, COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
PRAECIPE FOR DEFAULT JUDGMENT
Please enter judgment in favor of Plaintiff and against above-named Defendant(s)
BRUCE A. LINDSLEY, named for failure to file within the required time an Answer to the
Complaint in the above-captioned case and assess the Plaintiff's darnages as follows:
Amount claimed in Plaintiff's Complaint $5,970.74
Interest at the statutory rate of 6% per annum from July 25, 2008 320.92
Total = $6,291.66
I hereby certify that a written Important Notice of the intent to file this Praecipe was mailed
or delivered to the Defendant(s) and/or his/her Attorney of Record, if any, after the
default occurred and at least ten (10) days prior to the date of the filing of this Praecipe and
a copy of the notice(s) is/ are attached.
KODAK & IMB /C.
B ..
Y
Robert D. Kodak, Attorney for Plaintiff
DATED: 43/09 Judgment entered and damages assessed as above.
/S - _62?_
rothonotary AKB
LAW OFFICES OF
KODAK & IMBLUM, P.C.
CAMERON MANSION
Robert D. Kodak 407 NORTH FRONT STREET
Gary J. Imblum POST OFFICE BOX 11848
HARRISBURG, PA 17108-1848
www.kodak-imblum.com
May 15, 2009
BRUCE A LINDSLEY C 1 ?I
921 PARK PLACE FILE MECHANICSBURG PA 17055
RE: Craig Lahar, DMD
VS: Bruce A. Lindsley
Our File No. 35021
No. 09-2404 Court of Common Pleas
Cumberland County, Pennsylvania
Dear Mr. Lindsley
Telephone
717.238.7152
Facsimile
717.238.7158
In accordance with Pennsylvania Rules of Civil Procedure 237.1, we are enclosing herewith a
Notice of a Praecipe for Entry of Default Judgment. According to the records as they are found in the
Office of the Prothonotary of Cumberland County, you have not filed responsive pleadings to the
Complaint filed against you to the above term and number, nor has any attorney entered an appearance
on your behalf.
Accordingly, we are forwarding to you the enclosed Notice which indicates that if you do not take
action as set forth in this Notice, we, at the expiration of time indicated therein, will request the Office
of the Prothonotary of Cumberland County, Pennsylvania, to enter judgment against you in the amount
as set forth in said Complaint.
Very truly yours,
RDK/bjh
enclosure
KODAK & IMBLUM, P.C.
Robert D. Kodak
robert.kodak@kodak-imblum.com
THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINED WILL
BE USED FOR THAT PURPOSE. THIS COMMUNICATION IS FROM A DEBT COLLECTOR.
cc CARL SUCCA PRES
COMMERCIAL ACCEPTANCE CO
PO BOX 3268
SHIREMANSTOWN PA 17011
449054
FILE COPY
CRAIG LAHAR, DMD
Plaintiff
V.
BRUCE A. LINDSLEY
Defendant
TO: BRUCE A. LINDSLEY, Defendant(s)
DATE OF NOTICE: MU 15, 2009
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY., PENNSYLVANIA
: NO. 09-2404 CIVIL TERM
CIVIL ACTION -LAW
IMPORTANT NOTICE
YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE
PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR
OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS
FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A
HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS.
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 LEGAI, SERVICES TO ELIGIBLE
PERSONS AT A REDUCED FEE OR NO FEE.
CUMBERLAND COUNTY BAR ASSOCIATION
TWO LIBERTY AVENUE
CARLISLE PA 17013
717-249-3166
J ?? I l l ? 4
( ILL:
OF TFIIE F' ,, r ,.,• I .', a'?Y
20 P9 vii N 23 2: 1, 0
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CRAIG LAHAR, DMD
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
V. NO. 09-2404 CIVIL TERM
BRUCE A. LINDSLEY CIVIL ACTION -LAW
Defendant :
TO: BRUCE A. LINDSLEY, Defendant(s)
You are hereby notified that on \, ? u ne 42, _, 20P'the following
(Judgment) has been entered against you in the above-captioned case.
,judgment entered in the amount of $6,291.66
DATE: 0.3 09
0," P \
Prothonotary
I hereby certify that the name and address of the proper person(s) to receive this notice is:
BRUCE A LINDSLEY
921 PARK PLACE
MECHANICSBURG PA 17055