The URL can be used to link to this page

Home My WebLink About01-0880IN TIlE COURT OF COMMON PL~&S O1~ cv~e~_~o CIVIL DIVISION FEB 1 4 20 S COUNTY, PENNSYLVANIA Plainti~ VS. Defendant. COMPLAINT IN DHtORCE PURSUANT TO 23 PA.C.$.A. ~ 3301 1. ThePlaintJffis L, Sr~c~o,D ~.. 'boaox_s~r~: , who currently resides at Camp ~ S~te P~m~ P.O. Box 200, C~p ~, PA 17001-02~. 2. The Def~d~t is 7~ ~. ~ ,who~flyr~desat 3. ~e PI~ does not ~ow ~e late~ ~dre~ of ~e D~t. ~e ~e ~d ~ess of ~e Defmd~t's n~e~ rela~ve ~or o~er p~son who wo~d ~ ~ely to ~ow ~e wh~o~s of the Defendant are: 4. The Plaintiff and Defendant were married on 'i~.CEmta, Ef{_ "~1~ ! 9~:'t at ~5~'TN~Z Arqf C/<~£CC/4 /Ct &r~ ~n 5. The Plaintiffkas resided within this Commonwealth for at least six months immediately prior to the commencement of this divorce action. Y~ 6. The Defendant has resided within this Commonwealth for at least six months immediately prior to the commencement o£this divorce action. 7. The Plaintiff seeks a divorce based upon the following groun~ [CIRCLE LETTER(S) WHICH ARE THE GROUNDS YOU ARE SEEKING THE DIVORCE ON] action of divorce flied either in this Commonwealth or any other state:rac~ 9. The Plaintiff does have knowledge of a pending divorce action filed in County, , Case Caption Number ~ W'fllful and malicious desertion, and absence fi.om the habitation of the injured and innocent spouse, without reasonable justification or any cause for a period from c. The Del~ndan~ knowingly enterM imo unlawthl bigamous marriaff,,, while the former mmiag0 is s611 subsisting. d. Cruel and barbarous treatmmt that endangered the life o£the Plaintiff or the health of the injured m nt ff. e. The Plaintiff or the Defendant has been convicted and sentenced in a court of law to a term of imprisonment of more than two years. f. The Defendant offered such indignities to the innocont and injured spouse, so as to render the spouse's condition intolerable and life burdensome. To the best of the Plainti~s knowledge, information and belief, there has not been any previous Case 10. The Plaintiffhas been advised of the aveil~'flity of counseling and that either party has the right to request that the Court require the parties to partidpate in counseling. Wi~R~I~ORE, tho Plaintiffrequest that the court enter a decre~ of divorce. Dated: (5 ~) / Plainti~ Pro Se Instituiion Number a7 ?z/c?~ P.O. Box 200 Camp Hill, PA 170014)200 COURT OF COMMON PLEAS OF C_U~ ~0~ ~ COUNTY, PENNSYLVANIA ~.~ ~n~, PLAINTIFF : CIVIL ACTION : : VS. : : : ~u~a~_~ , DEFENDAnt : NO. PETITION TO PROCEED IN FORMA PAUPERIS TO THE HONORABLE, THE JUDGES OF THE SAID COURT: Petitioner respectfully represents that: 1. Petitioner, i,~zac~3 ~ ~3~t~cczs captioned action or divorce. , is the plaintiff in the above- 2. Petitioner's social secur/ty number is: 3, Petitioner's address is: The State Correctional Institution at Camp Hill, P.O. Box 200, Camp Hill, PA 17001-0200. 4. Petitioner's income infoimafion is fully and accurately set forth on the attached IN FORMA PAUPERIS STATEMENT. 5. In addition to the petitioner, the follow/ng are dependant on such income: (a) Child(ren) of this marriage: c a~-r~*azt~, ~bBc~/'re~ ~ (b) Others: Petitioner and Respondent). (relationship to 6. Respondent,-r,¢a~-A k. 0t)5~a:5 captioned action for divorce. is the defendant in the above- 7. Respondent's social security number~s.' · 8. Respondent's address is: 5LZ ~, tb7~ .~-r. /~Oc~, PA 1716~ 9. Responderii's income and source are believed to be: .~ ~ 10. (If unemployed, state when and where respondent was last employed.) 1 11. A support compla/nt was flied against respondent on or about the day of .20 (a} The Domestic Relations number is: (b) Petitioner receives support from respondent week/month. per (c) Petitioner (has}(has not} assigned support rights to the Department of Public Assistance. 12. After talldug with an attorney, Petitioner is of the opinion that he has a good and just cause aga/nst the above named respondent on the grounds of: 13. Petitioner is unable to pay any of the necessary costs, or giver security for the fees, costs and expenses, necessary to prosecute s~/d action without substantially impairing h/s ability to provide the necessities of life for himself and his child(ten). 14. WHEREFORE, Petitioner respectfully requests your Honorable Court to enter an Order Granting Petitioner leave on file the Complaint in Divorce as an indigent party and to proceed W termination thereof without the necessity of paying an costs therefore. Respectfully subm/tted, Petitioner 2 IN ~ COURT OF COMMON PLEAS OF Cot~fO.~0 COUNTY, PENNSYLVANIA ~- ~0/~C~7.% , PLAINTIFF : CIVIL ACTION : VS. : : : ~ IN FORMA PAUERIS STATEMENT I, h~-Lc4~ t~. t3o8c57~~ , states under penalties provided by 23 Pa. C.S.A. 6106 relafing to unsworn falsification to authorities that: 1. I am the plaintiff in the above action and because of my financial condition I am unable to pay the court costs or fees to file the Complaint of Divorce. 2. My responses to the questions below relating to ability to pay the fees and cost are true and you presently employed? (A) Are NO (1) If the answer is "yes," state the amount of your salary or wages per month, and give the na~e and address of~vour employer. (List both gross and net salary) ~ (2) If the answer is "no," state the date ofhst employment and the amount of the salary and wages per month which you received. (B) I-hv~ you r~:~ived within tl~ past twetv~ montl~ my money from sad of th~ following sources? (1) Business, profession or other form of seif-~maploym~t? YES NO (2) Rent payments, interest or dividends? YES NO (3) Pensions, annuities or life insurance payments? (4) Gifts or inheritances? (5) Any other sources? YES NO YES NO If the answer to any of the above is "yes," describe each source of money and state the amount rec~ived fi-om each during the past twelve months. CRCr-Cla~t2~ ~ba-F' r~. ~k~/ 1 -uo polnoox~ PAGE 1 M-B-1003 INMATE NAME NUMBER LAST EJ7493 DUBOIS BATCH DATE $ MO DY YEAR 8364 12-29-2000 32 7386 01-08-2001 10 7386 01-08-2001 50 8012 01-12-2001 32 INMATE ACCOUNTS SYSTEM MONTHLY ACCOUNT STATEMENT 01-29-2001 2614C FIRST MI OLD BALANCE WILLARD 24.04 TRANSACTION DESCRIPTION TI~ANSACTION BALANCE AFTER AMOUNT TlqANSACTION CAM COMMISSARY · oa 12/29/2000 -23.7o .34 MAINTENANCE PAYROLL GROUP i 12-01-00 TO 12-31-00 26.80 28.94 ACT 84 TRANSACTION * 2980/99 01/08/01 -5.32 21.62 CAM COMMI ~SARY FOR 1/12/2001 -21.44 .1S NEW BALANCE AS OF THIS STATEmeNT ................... > .18 WILLARD L. DUBOIS, III : V. : TERESA A. DUBOIS : IN THE COURT OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 01-0880 CIVIL TERM IN RE: IN FOP. MA PAUPERIS ORDER OF COURT AND NOW, this 1~T~ day of FEBRUARY, 2001, based on the attached petition to proceed In forma pauperis, the request is granted and petitioner may proceed without payment of the costs. WILLARD L. DUBOIS, III #EJ7493 SCI - CAMP HILL P.O. BOX 200 CAMP HILL, PENNSYLVANIA :sld By th~ Edward E. Guido, J. 17001-0200 Month Day Year My Name (~st name, fi~t name. middle) ~ Complete 3treet Address or ~ Box or Rural Rou[e ~d ~R Box ~A ~t./Suite ~ CiW or Post O~ce S~te ZIP or ZIP + 4 Code CONIMONWEALTH OF PENNSYLVANIA IN THE COURT OF CO~24ON PLEAS OF CUMBERLAND COUI~T¥, CIVIL DIVISION PENNSYLVANIA PRAECIPE TO TRANSMIT RECORD To the Prothonotary: Transmit the record, together with the following information, to the court for entry of a divorce decree; 7. Ground for divorce: irretrievable breakdown under section (201 (c)) (207 (d) (1) of the divorce code. 2. Date and manner of service of the complaint: 3. (A) Date of execution of the affidavit of consent required by section 201 (c) of the divorce code: by plaintiff U~D &~D~0z~: by defendant I~/~5~ ~. O0foat~ 2. Date of service of the plaintiffs affidavit upon the defendant: