Loading...
HomeMy WebLinkAbout11-2162JAY D. and ANNA MAE CRUM, IN THE COURT OF COMMON PLEAS Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA SAIDIS SULLIVAN LAW 26 West High Street Carlisle, PA Defendant CIVIL TERM ,1' ? ?.r.t l rlr.? > w NOTICE; You have been sued in court. If you wish to defend against the c1diMs t f tth 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. V. CIVIL ACTION - LAW NO. ROBERT H. BLACK, I/ -C?- / & 1Z YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO N HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFI 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,.:QFFER ,-EGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. r Piz; -A Cumberland County Bar Association 32 South Bedford St. r-` ~w Carlisle, Pennsylvania Telephone number (717) 249-3166 - -' D tea' &4 D ?A" 0- ?y d-'? 3e?* ku-If I,SS 6 J-?f 1 JAY D. and ANNA MAE CRUM, IN THE COURT OF COMMON PLEAS Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW NO. ROBERT H. BLACK, (a Defendant CIVIL TERM COMPLAINT AND NOW, come the Plaintiffs, Jay D. Crum and Anna Mae Crum, by and through undersigned attorneys, Saidis Sullivan & Rogers, and represents as follows: 1. Plaintiffs are Jay D. Crum and Anna Mae Crum, husband and wife, ad individuals who reside at 1790 North Meadow Drive, Mechanicsburg, PA 17055 (herein "Plaintiffs"). 2. Defendant is Robert H. Black, who currently resides at 1272 Oakridge Road McDonald, Washington County, Pennsylvania 15057 (hereinafter "Defendant"). 3. Plaintiffs and Defendant entered into a residential lease dated October 1, 201 (hereinafter "Lease"). A true and accurate copy of the Lease is attached hereto as Exhibit "A and incorporated into this Complaint by reference. 4. Plaintiffs' cause of action arises out of Defendant's breach of the afore SAIDIS SULLIVAN LAW 26 West High Street Carlisle, PA residential lease. 5. The Lease covered the property located at 1788 North Meadow D Mechanicsburg, Pennsylvania 17055, which Defendant agreed to pay monthly rent and oth costs. 6. The Lease term was from October 1, 2010 through September 30, 2011. ( Lease ¶ (4)). 2 7. There is no security deposit being held in escrow. (See Lease ¶ (7)). 8. Pursuant to the Lease, rent was due in arrears on or before the last day of each month. (See Lease ¶ (6)(A)). 9. Pursuant to the Lease, Defendant is obligated to pay monthly rent in the of $1,000.00, plus an additional sum of $500.00, which would be used, in part, for the of real estate taxes and insurance, for a total monthly payment of $1,500.00. (See Lease 16, 14). 10. Defendant failed to make a payment on or before December 31, 2010. 11. Because of Defendant's failure to make a payment on or before December 31, 2010, Defendant is in breach of the Lease. 12. It is believed and therefore averred that Defendant has abandoned the in violation of the lease. 13. Paragraph 23, "Landlord Remedies if Tenant Breaches Lease" provides for th following that Plaintiffs (Landlord) may file a lawsuit against Defendant (Tenant) for damages, and unpaid charges, and for rents and charges for the rest of the lease term. ( Lease ¶ 23(A)(2)). 14. Pursuant to the terms of the Lease and by reason of his breach of the Lease SAIDIS SULLIVAN LAW 26 West High Street Carlisle, PA Defendant is responsible for the remaining ten (10) months of the lease term in the amount $15,000.00. 15. The amount in controversy is within the Cumberland County Arbitration limits. 3 WHEREFORE, Plaintiffs demand judgment against Defendant in the amount $15,000.00 plus interest, costs, attorneys' fees, and other relief as your Honorable Court shat deem appropriate or necessary. Date: ILI SAIDIS SULLIVAN LAW 26 West High Street Carlisle, PA Respectfully Submitted, SAIDIS ULLIVAN & ROGERS P?' son E. Kelso, Esquire Attorney ID No. 209107 26 West High Street Carlisle, PA 17013 (717) 243-6222 Attorneys for Plaintiffs 4 RESIDENTIAL LEASE LR This form recommended and approved for, but not restricted to use by the members of the Pennsylvania Association of REALTORSO (PAR). LANDLORD'S BUSINESS RELATIONSHIP WITH PA LICENSED BROKER BROKER (Company) NONE PHONE ADDRESS FAX LICENSEE(S) Designated Agent? ? Yes ? No BROKER IS THE AGENT FOR LANDLORD. OR (if checked below): Broker is NOT the Agent for Landlord and is a/an: ? AGENT FOR TENANT ? TRANSACTION LICENSEE TENANT'S BUSINESS RELATIONSHIP WITH PA LICENSED BROKER BROKER (Company) NONE PHONE ADDRESS FAX LICENSEE(S) Designated Agent? ? Yes ? No BROKER IS THE AGENT FOR TENANT. OR (if checked below): Broker is NOT the Agent for Tenant and is a/an: ? AGENT FOR LANDLORD ? SUBAGENT FOR LANDLORD ?TRANSACTION LICENSEE When the same broker is Broker for Landlord and Broker for Tenant, Broker is a Dual Agent. All of Broker's licensees are also Dual Agents UNLESS there are separate Designated Agents for Landlord and Tenant. If the same Licensee is designated for Landlord and Tenant, the Licensee is a Dual Agent. Broker(s) may perform services to assist unrepresented parties in complying with the terms of this Lease. PARTIES 1 1. This LEASE, dated October 1, 2010 is between LANDLORD(S) Jay D. Crum 2 Anna Mae Crum 3 called "Landlord," and TENANT(S) Robert H. Black 4 Pamela R. Black 5 called "Tenant," for the Property located at 6 .1788 North Meadow Drive, Mechanicsburg, Upper Allen Township, PA 17055 7 called "Property" 8 Each Tenant is individually responsible for all obligations of this Lease, including rent, late fees, damages and other costs. 9 2. CO-SIGNERS 10 Co-signers: 11 None 12 Each Co-signer is individually responsible for all obligations of this Lease, including rent, late fees, damages and other costs. Co-signers do 13 not have the right to occupy the Property as a Tenant without the Landlord's prior written permission. 14 3. LANDLORD CONTACT INFORMATION 15 Rental Payments: Maintenance Requests: 16 Payable to: Mr. and Mrs. Jay D . Crum Contact: N/A 17 Address: 1790 North Meadow Drive Address: 18 Mechanicsburg, PA 17055 19 Phone: 717-691-7986 Phone: 20 Fax: Fax: RENTAL TERM 21 4. START AND END DATES OF LEASE (also called "Term") 22 (A) StartDate: October 01, 2010 at 12: 01 a.m./d1 23 (B) End Date: September 30, 2011 at 12:00 a\&Vp.m. 24 5. RENEWAL TERM (check one) 25 ® This Lease will AUTOMATICALLY RENEW for a term of ninety (90) days (also called the 26 "Renewal Term") at the End Date of this Lease or at the end of any Renewal Term unless: 27 1. Tenant gives Landlord at least 60 days written notice before End Date or before the end of any Renewal Term, OR PREPARED BY: Robert C. Saidis, LR, Residential Lease, 03/07. Pennsylvania Association of REALTORSO COPYRIGHT PENNSYLVANIA ASSOCIATION OF REALTORSO 2007 ReaIFA$T® Software, 02010, Version 6.16. Software Registered to: Robert C. Saidis, Saidis, Flower & Lindsay Tenant(s) 09/02110 15:59:54 Page 1 of 7 Landlord(s) _ 28 2. Landlord gives Tenant at least 60 days written notice before End Date or before the end of any Renewal Term. 29 ' This Lease will TERMINATE on the End Date unless extended in writing. RENT AND DEPOSIT 30 6. RENT arrears 31 (A) Rent is due in ?&)akLe? \ btht\deki"X, on or before the last day of each month. 32 (B) The total Rent due each month is: ....................................................................................... I ............... $ 1,000.00 33 (C) The total amount of Rent due during the Term is: ............................................................................ $ 12,000.00 34 (D) If Rent is more than 5 days late, Tenant pays a Late Charge of .......................................$ 50.00 35 (E) All other payments due from Tenant to Landlord, including Late Charges or utility charges, are considered to be Additional 36 Rent. Failure to pay this Additional Rent is a breach of the Lease in the same way as failing to pay the regular Rent. 37 (F) Tenant agrees that all payments will be applied against outstanding Additional Rent that is due before they will be applied 38 against the current Rent due. 39 (G) Tenant will pay a feeof$ 25.00 for any payment that is returned by any financial insti tuti on for any reason. Any Late 40 Charges will continue to apply until a valid payment is received. 41 (H) Landlord will acce tthe following methods of payment: ® Cash ® Money^Order ® Personal Check 42 El Credit Cards Other: Other: 43 7. PAYMENT SCHEDULE Due Date Paid Due 44 (A) Security Deposit, held in escrow by: $ 0.00 $ 0.00 45 Held at (financial institution): 46 (B) First month's rent 0.00 $ $ 0.00 47 (C) Other $ 0.00 $ 0.00 48 (D) Other $ 0.00 $ 0.00 49 Total Rent and security deposit received to date: .......................................................................... $ 0.00 50 Total amount due ......................................................................................................».................................................... $ 0.00 51 8. RETURN OF SECURITY DEPOSITS (see Information Regarding Security Deposits on back) 52 (A) When Tenant moves from the Property, Tenant will return all keys and give Landlord written notice of Tenant's new mailing 53 address where Landlord can return the Security Deposit. 54 (B) Within 30 days after Tenant moves from the Property, Landlord will give Tenant a written list of any damage to the Property that 55 Landlord claims Tenant is responsible for. 56 (C) Landlord may deduct repair costs and any unpaid rents from Tenant's Security Deposit. Any remaining Security Deposit will be 57 returned to Tenant within 30 days after Tenant moves from the Property. 58 CARE AND USE OF PROPERTY 59 9. USE OF PROPERTY AND AUTHORIZED OCCUPANTS 60 (A) Tenant will use Property as a residence ONLY. 61 (B) Not more than four (4) people will live on Property. List all other occupants who are not listed as Tenants in paragraph l: 62 63 10. POSSESSION 64 (A) Tenant may move in (take possession of the Property) on the Start Date of this Lease. 65 (B) If Tenant cannot move in within days after Start Date because the previous tenant is still there or because of property 66 damage, Tenant's exclusive rights are to: 67 1. Change the starting date of the Lease to the day when Property is available. Tenant will not owe rent until Property 68 isavailable; OR 69 2. End the Lease and have all money already paid as rent or security deposit retumed, with no further liability on the part of 70 Landlord or Tenant. 71 11. LANDLORD'S RIGHT TO ENTER 72 (A) Tenant agrees that Landlord or Landlord's representatives may enter the Property at reasonable hours to inspect, repair, 73 or show the Property. Tenant does not have to allow possible tenants to enter unless they are with the Landlord or Landlord's 74 representative, or they have written permission from the Landlord. 75 (B) When possible, Landlord will give Tenant 12 hours notice of the date, time. and reason for the visit. 76 (C) In emergencies, Landlord may enter Property without notice. If Tenant is not present, Landlord will tell Tenant who was there and 77 why within 24 hours of the visit. 78 (D) Landlord may put up For Sale or For Rent signs on or near Property. 79 12. CONDITION OF PROPERTY AT MOVE IN 80 Tenant has inspected the Property and agrees to accept the Property "as-is," except for the following 81 None 82 13. 83 84 85 86 APPLIANCES INCLUDED ® Stove ® Refrigerator ® Dishwasher ® Washer ® Dryer ® Garbage Disposal ® Air Conditioning EJOther LJOther _ Landlord is responsible for repairs to appliances listed above unless otherwise stated here: PREPARED BY: Robert C. Saidis, LR, Residential Lease, 03/07. Pennsylvania Association of REALTORS@ COPYRIGHT PENNSYLVANIA ASSOCIATION OF REALTORS® 2007 RealFA$T® Sbftware, 02010, Version 6.16. Software Registered to: Robert C. Saidis, Saidis, Flower & Lindsay Tenant(s) 09/02110 15:59:54 ® Microwave Page 2 of 7 Landlord(s) Tenant is responsible for all repairs and maintenance, whether ordinary or extraordinary. 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 14. UTILITIES AND SERVICES Landlord and Tenant agree to pay for the charges for utilities and services provided for the Property as marked below. If a service is not marked as being paid by the Landlord, it is the responsibility of Tenant to pay for that service. Landlord is not responsible for loss of service if interrupted by circumstances beyond the Landlord's control. Landlord Tenant ?ys ?ys Cooking Gas ? ® Electricity ? ® Heat ? ® Hot Water ? ® Cold Water ? ® Trash Removal ? ® Sewage Fees ? ® Sewer Maintenance ? ® Lawn and Shrubbery Care ? ® Heater Maintenance Contract Landlord Tenant 5 YS pays Air Conditioning ? ® Cable Television ? ? Condominium Fee ? ? Parking Fee ? ? Maintenance of Common Areas ? ® Pest/Rodent Control ? ® Snow/Ice Removal ? ® Telephone Service ® ? Real Estate Taxes ? ? Comments: Tenant shall also pay Landlord, as part of Tenant's rent, the additional sum of $500.00, which shall be used, in part, for the payment of Real Estate Taxes and insurance. Tenant is responsible for all maintenance and repair costs, both ordinary and extraordinary. Tenant shall receive credit for the cost of any repairs or improvements made by Tenant in the event Tenant subsequently purchases the Property. 105 15. TENANT'S CARE OF PROPERTY 106 (A) Tenant will: 107 1. Keep the Property clean and safe. 108 2. Dispose of all trash, garbage and any other waste materials as required by Landlord and the law. 109 3. Use care when using any of the electrical, plumbing, heating, ventilation or other facilities or appliances on the Property, 110 including any elevators. H] 4. Tell Landlord immediately of any repairs needed and of any potentially harmful health or environmental conditions. 112 5. Obeyall laws. 1 13 (B) Tenant will not: 114 1. Keep anyflammable, hazardous and/or explosive materials on the Property. 115 2. Destroy, damage or deface any part of the Property or common areas. 116 3. Disturb the peace and quiet of other tenants or neighbors. 117 4. Make changes to the property, such as painting or remodeling, without the written permission of Landlord. Tenant agrees that 118 any changes or improvements made will belong to the Landlord. 119 5. Perform any maintenance or repairs on the Property unless otherwise stated in the Rules and Regulations, if any. 120 (C) Tenant is solely responsible to pay the costs for repairing any damage lliAMBe\flaUt bfi3ai?dr?l?eh?at?t's`fi$}?dr\g?tt??t? \ 121 16. SUBLEASING AND TRANSFER 122 (A) Landlord may transfer this Lease to another landlord. Tenant agrees that this Lease remains the same with the new landlord. 123 (B) Tenant may not transfer this Lease or sublease (rent to another person) the Property or any part of the Property without 124 Landlord's written permission. 125 17. PETS 126 Tenant will not keep or allow any pets on any part of the Property, unless checked below. 127 ® Tenant may keep pets with Landlord's written permission according to the terms of the attached Rules and Regulations. 128 18. RULES AND REGULATIONS 129 (A) Rules and Regulations for use of the Property and common areas are attached. ? Yes K No 130 (B) Any violation of the Rules and Regulations is a breach of this Lease. 131 (C) Landlord may change the Rules and Regulations if the change benefits the Tenant or improves the health, safety, or welfare of 132 others. Landlord agrees to provide all changes to Tenant in writing. 133 (D) Tenant is responsible for Tenant's family and guests obeying the Rules and Regulations and all laws. 134 19. SMOKE DETECTORS AND FIRE PROTECTION SYSTEMS 135 (A) Landlord has installed smoke detectors in the Property. Tenant will maintain and regularly test smoke detectors to be sure 136 they are in working order, and will replace smoke detector batteries as needed. 137 (B) Tenant will immediately notify Landlord or Landlord's agent of any broken or malfunctioning smoke detectors. 138 (C) Failure to properly maintain smoke detectors, replace smoke detector batteries or notify Landlord or Landlord's agent of any broken or 139 malfunctioning smoke detectors is a breach of this Lease. 140 (D) Landlord may provide additional fire protection systems for the benefit of Tenant. Responsibility for maintaining these systems is 141 stated in the Rules and Regulations, if any. 142 (E) Tenant will pay for damage to the Property if Tenant fails to maintain smoke detectors or other fire protection systems. 143 20. LEAD-BASED PAINT HAZARD DISCLOSURES FOR PROPERTY BUILT BEFORE 1978 144 ® Property was built in or after 1978. This paragraph does not apply. PREPARED BY: Robert C. Saidis, LR, Residential Lease, 03107. Pennsylvania Association of REALTORS@ COPYRIGHT PENNSYLVANIA ASSOCIATION OF REALTORS@ 2007 RealFA$T® Software, 032010, Version 6.16. Software Registered to: Robert C. Saidis, Saidis, Flower & Lindsay Tenant(s) 09/02/10 16:09:28 3 of 7 Landlord(s) Page 145 146- 147 148 149 150 151 152 153 154 155 156 157 158 159 160 21. 161 162 163 164 165 166 167 168 169 170 171 22. 172 173 174 175 176 177 178 179 180 181 23 182 183 184 185 186 187 188 189 190 191 192 193 24. 194 195 196 197 198 199 200 25. 201 202 203 204 205 206 26. 207 208 ?. Property was built before 1978. Landlord and Tenant must provide information in this paragraph. (A)- Landlord does not know of any lead-based paint or lead-based paint hazards on the Property unless stated below: Landlord knows that there is lead-based paint, or that there are lead-based paint hazards on the Property. Landlord must explain what Landlord knows about the lead-based paint and hazards, including how Landlord learned that it is there, where it is, and the condition of painted walls, trim and other surfaces. Landlord must give Tenant any other information Landlord has about the lead-based paint and lead-based paint hazards. (B) Landlord has no reports or records about lead-based paint or lead-based paint hazards on the Property unless stated below: Landlord has given Tenant all available records and reports about lead-based paint or lead-based paint hazards on the property. List records and reports: (C) Tenant initial all that are true: Tenant has received the pamphlet Protect Your Family From Lead in Your Home. Tenant has read the information given by Landlord in paragraph 20 (A) and (B) above. Tenant has received all records and reports that Landlord listed in paragraph 20 (13) above. (D) Landlord and Tenant certify, by signing this Lease, that the information given is true to the best of their knowledge. DESTRUCTION OF PROPERTY (A) Tenant will notify Landlord or Landlord's agent immediately if the Property is severely damaged or destroyed by fire or by any other cause. Tenant will immediately notify Landlord or Landlord's agent of any condition in the Property that could severely damage or destroy the Property. (B) If the Property is severely damaged or destroyed for any reason: 1. Tenant may continue to live on the livable part of the Property and pay a reduced rent as agreed to by Tenant and Landlord until the damages are repaired, OR 2. If the law does not allow Tenant to live on the Property, this lease is ended. (C) If Lease is ended, Lan dlord will return any unused security deposit or advanced rent to Tenant. (D) If Tenant, Tenant's family, or Tenant's guests cause damage by fire or by other means, this Lease will remain in effect and Tenant will continue to payrent, even if Tenant cannot occupythe Property. INSURANCE AND RELEASE f A) Tenant understands that Landlord's insurance does not cover Tenant, Tenant's property, or Tenants guests. Tenant is advised to obtain property and liability insurance to protect Tenant, Tenant's property and Tenant's guests who may be injured while on the Property. IFCHECKED, Tenant must have insurance policies providing at least S property insurance and S liability insurance to protect Tenant, Tenant's property and Tenant's guests who may be injured while on the Property. Tenant must maintain this insurance through the entire Term and any Renewal Term. Tenant will provide proof of insurance upon request, (B) Landlord is not legally responsible for any injury or damage to Tenant or Tenant's guests that occurs on the Property. (C) Tenant is responsible for any loss to Landlord caused by Tenant, Tenant's family or Tenant's guests, including attorney's fees. ENDING LEASE LANDLORD REMEDIES IF TENANT BREACHES LEASE (A) If Tenant breaches Lease for any reason, Landlord's remedies may include any or all of the following: 1. Taking possession of the Property by going to court to evict Tenant. Tenant agrees to pay Landlord's legal fees and reasonable costs, including the cost for Landlord or Landlord's agent to attend court hearings. 2. Filing a lawsuit against Tenant for rents, damages and unpaid charges, and for rents and charges for the rest of the Lease term. If Landlord wins (gets a money judgment against Tenant), Landlord may use the court process to garnish Tenant's wages and take Tenant's personal goods, furniture, motor vehicles and money, in banks. 3. Keeping Tenant's Security Deposit to be applied against unpaid rent or damages, or both. (B) If Tenant breaches Lease for any reason, Landlord can begin eviction proceedings without written notice. TENANT WAIVES OR GIVES UP TENANT'S RIGHT TO A NOTICE TO MOVE OUT UNLESS A DIFFERENT NOTICE PERIOD IS STATED HERE: TENANT ENDING LEASE EARLY _ Tenant may end this Lease and move out of the Property before the End Date of the Lease or any Renewal Term only with written permission of Landlord, and only if (A) Tenant gives Landlord at least days written notice, AND (B) Tenant pays Landlord a Termination fee of , AND (C) Tenant continues to pay all rent until the End Date of the Lease, or any Renewal Term, or until a new tenant is approved by Landlord and a new lease takes effect, whichever happens first. ABANDONMENT (A) If Tenant abandons Property while Rent is due and unpaid, Landlord has the right to take possession of the Property immediately and to rent the Property to another tenant. (B) Any of Tenant's personal property or possessions remaining on the Property after Tenant moves out will be considered to be abandoned property. Landlord will have the right to remove and dispose of any abandoned property in any manner determined by Landlord. Tenant will pay for the cost of removal and disposal of abandoned property. SALE OF PROPERTY (A) If Property is sold, Landlord will give Tenant in writing: 1 . Noti cc that the Security Deposit has been given to the new landlord, who will be responsible for it. PREPARED BY: Robert C. Saidis, LR, Residential Lease, 03/07. Pennsylvania Association of REALTORS@ COPYRIGHT PENNSYLVANIA ASSOCIATION OF REALTORS® 2007 RealFA$T® Software, 02010, Version 6.16. Software Registered to: Robert C. Saidis, Saidis, Flower & Lindsay Tenant(s) 09/02/10 15:59:54 Page 4 of 7 Landlord(s) 209 . 2. The name. address and phone number of the new landlord and where rent is to be paid, if known. 210 (B) Tenant agrees that Landlord may transfer Tenant's Security Deposit and advanced rent to the new landlord. 211 (C) Landlord's responsibilities to Tenant under this Lease end after the Property has been sold and the Lease transferred to anew landlord. 212 (D) If Landlord sells the Property during the Lease or any Renewal Term, Landlord has the right to terminate this Lease if 213 Landlord gives at least days written notice to Tenant. Tenant is not entitled to any payment of damages. 214 27. IF GOVERNMENT TAKES PROPERTY 215 (A) The government or other public authority can take private property for public use. The taking is called condemnation. 216 (B) If any part of the Property is taken by the government, Landlord will reduce Tenant's rent proportionately. If all the Property is 217 taken or is no longer usable, this Lease will end and Tenant will move out. Landlord will return to Tenant any unused Security 218 Deposit or advanced rent. 219 (C) No money paid to Landlord for the condemnation of the Property wi11 belong to Tenant. ADDITIONAL TERMS 220 28. TENANT HAS FEWER RIGHTS THAN MORTGAGE LENDER Landlord may have a mortgage on the Property. The rights 221 of the mortgage lender come before the rights of the Tenant. (Example: If Landlord fails to make mortgage payments, the mortgage lender 222 could take the Property and end this Lease.) 223 TENANT MAY BE WAIVING OR GIVING UP TENANT'S RIGHTS. TENANT UNDERSTANDS THAT IF THERE 224 IS A FORECLOSURE, THE NEW OWNER WILL HAVE THE RIGHT TO END THIS LEASE. 225 29. CAPTIONS The headings in this Lease are meant only to make it easierto find the paragraphs. 226 30. ENTIRE AGREEMENT This Lease is the entire agreement between Landlord and Tenant. No spoken or written agreements made 227 before are a part of this Lease unless they are included in this Lease in writing. No waivers or modifications of this Lease during the 228 Term of this Lease are valid unless in writing signed by both Landlord and Tenant. 229 NOTICE BEFORE SIGNING: If Tenant has legal questions, Tenant is advised to consult an attorney. 230 If Landlord or Tenant are represented by a licensed real estate broker, Tenant and/or Landlord acknowledge receipt of the 231 Consumer Notice as adopted by the State Real Estate Commission at 49 Pa. Code c35.336 and/or §35.337. 232 By signing below, Landlord and Tenant acknowledge that they have read and understand the notices and explanatory information 233 set forth in this Lease. f r WITNESS < TENANT DATE Robert H. Black WITNESS AC- TENANT DATE Pamela R. Black WITNESS WITNESS CO-SIGNER DATE WITNESS CO-SIGNER DATE CO-SIGNER WITNESS LANDLORD DATE Jay D. . Crum WITNESS `} / ?-z? y _ LANDLORD - &r' b rV D Anna Mae Crum 234 Brokers'/Licensees'Certifications By signing here, Brokers and Licensees involved in this transaction certify that: (1) The information 235 given is true to the best of their knowledge; AND (2) They have told Landlord of Landlord's responsibilities under the Residential 236 Lead-Based Paint Hazard Reduction Act (42 U.S.C. §4852d), described in the Lead Hazard Disclosure Requirements (see Lead-Based 237 Paint Hazards Notice). Brokers and Licensees must make sure that Landlord gives Tenant the information required by the Act. 238 BROKER FOR LANDLORD (Company Name) 239 ACCEPTED BY 240 BROKER FOR TENANT (Company Name) _ 241 ACCEPTED BY DATE PREPARED BY: Robert C. Saidis, LR, Residential Lease, 03107. Pennsylvania Association of REALTORS@ COPYRIGHT PENNSYLVANIA ASSOCIATION OF REALTORS@ 2007 RealFA$T® Software, ©2010, Version 6.16. Software Registered to: Robert C. Saidis, Saidis, Flower & Lindsay 09102/10 15:59:54 DATE Page 5 of 7 LANDLORD TRANSFERS LEASE TO A NEW LANDLORD 242 As part of payment received by Landlord, (current Landlord) now transfers to 243 (new landlord) his heirs and estate, this Lease and the right to receive the rents and other benefits. WITNESS WITNESS LANDLORD Jay D. Crum LANDLORD Anna Mae Crum NOTICES AND INFORMATION PENNSYLVANIA PLAIN LANGUAGE CONSUMER CONTRACT ACT DATE DATE The Office of Attorney General has not pre-approved any special conditions or additional terms added by any parties. Any special conditions or additional terms must comply with the Pennsylvania Plain Language Consumer Contract Act. INFORMATION REGARDING SECURITY DEPOSITS Taking Security Deposits During the first year of a Lease, a Landlord may not require a security deposit of more than two months' rent. After the first year of a Lease, this amount cannot exceed one month's rent, and any security deposit of more than one month's rent must be returned to the Tenant. If rent is increased during the first five years a Tenant is in a Property, Landlord may require that the amount of the security deposit be increased as well. After five years, the security deposit cannot be increased even if the rent goes up. Holding Security Deposits If a Security Deposit is more than $100, the Landlord must keep the Security Deposit in a special bank account called an escrow account. Landlord is required to tell Tenant the name and address of the bank where the escrow account is located, as well as the amount of the deposit in the escrow account. After the second year of a lease the Security Deposit must be in an escrow account that earns interest. Interest that is earned on Security Deposits belongs to the Tenant, but each year Landlord has the right to keep some or all of that interest up to an amount equal to I% of the Security Deposit to cover certain administrative expenses. [For example, if a Security Deposit of $500 is held in an escrow account that eams $10 of interest in a year, Landlord has the option to retain up to 1% of the Security Deposit amount ($5) out of that interest.] If the interest carried is less than I % of the Security Deposit amount, Landlord may keep all the interest, but Landlord can never take any money out of the original Security Deposit for administrative expenses. After the second year of a lease, any interest belonging to Tenant must be returned to Tenant once a year on the anniversary of the first day of the original lease term. Returning Security Deposits When a lease is ended, Landlord has 30 days to give Tenant a written list of any damage to the Property that Landlord claims Tenant is responsible for. If the cost to repair this damage is less than the amount of the Security Deposit being held, Landlord must return the amount of the deposit not being held back to fix those damages when the list is provided, along with any additional interest that has not yet been paid to Tenant. If damages are more than the amount of the Security Deposit plus interest, Landlord may keep the entire Security Deposit. Landlord may not keep any of the Security Deposit to cover damages if a fist ofdamages is not given to Tenant within that 30 day period If Landlord doesn't return Tenant's Security Deposit within 30 days of the end of the Lease, Tenant may sue and Landlord maybe required to pay Tenant up to twice the amount of the portion of the Security Deposit that should have been returned. It is the responsibility of Tenant to give Landlord his/her new address after the Lease is ended. If Tenant does not provide a new address to Landlord, Landlord is not liable for damages for failing to return: Security Deposit monies within 30 days. LEAD-BASED PAINT HAZARDS Lead Hazards Disclosure Requirements The Residential Lead-Based Paint Hazard Reduction Act says that any Landlord of property built before 1978 must give the Tenant an EPA pamphlet titled Protect Your Family From Lead in Your Home. The Landlord also must tell the Tenant and the Broker for Landlord what the Landlord knows about lead-based paint and lead-based paint hazards that are in or on the property being rented. Landlord must tell the Tenant how the Landlord knows that lead-based paint and lead-based paint hazards are on the property, where the lead-based paint and lead-based paint hazards are, and the condition of the painted surfaces. Any Landlord of a pre-1978 structure must also give the Tenant any records and reports that the Landlord has or can get about lead-based paint or lead-based paint hazards in or around the propertybeing rented, the common areas, or other dwellings in multi-family housing. It is also required that the EPA pamphlet be given to tenants before the Landlord starts any major renovations on a pre-1978 structure. The Act does not applyto housing built in 1978 or later. PREPARED BY: Robert C. Saidis, LR, Residential Lease, 03/07. Pennsylvania Association of REALTORS@ COPYRIGHT PENNSYLVANIA ASSOCIATION OF REALTORS@ 2007 ReaIFA$T® Software, 02010, Version 6.16. Software Registered to: Robert C. Saidis, Saidis, Flower & Lindsay Tenant(s) 09/02/10 15:59:54 Page 6 of 7 Lead:Warning Statement Housing built before 1978 may contain lead-based paint. Lead from paint, paint chips, and dust can pose health hazards if not taken care of properly. Lead exposure is especially harmful to young children and pregnant women. Before renting pre-1978 housing, Landlords must disclose the presence of known lead-based paint and lead-based paint hazards in the dwelling. Tenants must also receive a federally approved pamphlet on lead poisoning prevention. INFORMATION REGARDING MEDIATION Mediation is a way of resolving problems. A mediator may help the disputing parties reach an agreeable solution without having to involve the courts. Landlord and Tenant may agree to take any disputes arising from this Lease to a mediation program offered by the local association of REALTORS& or to another mediator. Landlord and Tenant can agree to mediation as part of this Lease (by signing a mediation form to attach to this Lease), or they can sign an agreement to mediate after a dispute arises. INFORMATION REGARDING TENANTS' RIGHTS Landlord cannot increase rents, decrease services, or threaten to go to court to evict Tenant because Tenant: (1) complains to a government agency or to Landlord about a building or housing code violation; (2) organizes or joins a Tenant's organization; or (3) uses Tenant's legal rights in a lawful manner. INFORMATION REGARDING MOLD AND INDOOR AIR QUALITY Indoor mold contamination and the inhalation of bioaerosols (bacteria, mold spores, pollen, and viruses) have been associated with allergic responses including upper respiratory congestion, cough, mucous membrane irritation, fever, chills, muscle ache or other transient inflammation or allergy. Claims have been made that exposure to mold contamination and bioaerosols has led to serious infection, immunosuppression and illnesses of neuro or systemic toxicity. Sampling of indoor air quality and other methods exist to determine thepresence and scope of any indoor contamination. Because individuals may be affected differently, ornot affected at all, by mold contamination, the surest approach to determine the presence of contamination is to engage the services of a qualified professional to undertake an assessment and/or sampling. Assessments and samplings for the presence of mold contamination can be performed by qualified industrial hygienists, engineers, laboratories and home inspection companies that offer these services. Information pertaining to indoor air quality is available through the United States Environmental Protection Agency and maybe obtained by contacting IAQ INFO, P.O. Box 37133, Washington, D.C. 20013-7133, 1-8004384318. Tenants should immediately notify Landlord if there is any condition in the Property that may lead to the growth of mold or if the Tenant believes that mold growth is present in the Property. NOTICE REGARDING CONVICTED SEX OFFENDERS (MEGAN'S LAW) The Pennsylvania General Assembly has passed legislation (often referred to as "Megan's Law," 42 Pa. C.S. § 9791 et. seq.) providing for community notification of the presence of certain convicted sex offenders. Tenants with concerns on this issue are encouraged to contact the municipal police department or the Pennsylvania State Police for information relating to the presence of sex offenders near a particular property, or to check the information on the Pennsylvania State Police Web site at www.pameganslaw.state.paus. PREPARED BY: Robert C. Saidis, LR, Residential Lease, 03/07. Pennsylvania Association of REALTORS@ COPYRIGHT PENNSYLVANIA ASSOCIATION OF REALTORS@ 2007 ReaIFA$T0 Software, 02010, Version 6.16. Software Registered to: Robert C. Saidis, Saidis, Flower & Lindsay Tenant(s) 09/02/10 15:59:54 Page 7 of 7 Landlord(s) VERIFICATION I, Jay D. Crum, verify that the statements made in the foregoing Complaint are true SAIDIS SULLIVAN LAW 26 West High Street Carlisle, PA correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S § 4904, relating to unswom falsification to authorities. Dated: f - O-n Jay D. u 5 SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Stewart Solicitor i ! L:7 T1 Jay D. Crum (et al.) vs. Robert H Black Case Number 2011-2162 SHERIFF'S RETURN OF SERVICE 03/01/2011 Ronny R. Anderson, Sheriff who being duly sworn according to law states that he made a diligent search and inquiry for the within named defendant, to wit: Robert H. Black, but was unable to locate him in his bailiwick. He therefore deputized the Sheriff of Washington County, Pennsylvania to serve the within Complaint and Notice according to law. 03/08/2011 Washington County Return: And now, March 8, 2011 I, Samuel Romano, Sheriff of Washington County, Pennsylvania, do hereby certify and return, that I made diligent search and inquiry for Robert H. Black the defendant named in the within Complaint and Notice and that I am unable to find him in the County of Washington and therefore return same NOT FOUND. Request for service at 1272 Oakridge Road, McDonald, Pennsylvania 15057 is located in Allegheny County. SHERIFF COST: $37.44 March 11, 2011 SO ANSWERS, t RON R ANDERSON, SHERIFF ;c; COu',,ySA0 Shen'. TElec, oft. Ire s WASHINGTON COUNTY, PENNSYLVANIA OFFICE OF THE SHERIFF SAMUEL F. ROMANO SHERIFF JAMES B. DALESSANDRO CHIEF DEPUTY Court Docket #: 2011-2162 County of Washington, Commonwealth of Pennsylvania JAY D. CRUM & ANNA MAE CRUM vs. ROBERT H. BLACK COURTHOUSE SQUARE SUITE 303 100 WEST BEAU STREET WASHINGTON, PA 15301 724-228-6840 FAx 724-223-4719 Sheriff File Number - 11000982 Affidavit of Service COMPLAINT I hereby CERTIFY and RETURN that service was NEVER attempted with the due diligence and inquiry for ROBERT H. BLACK. Service was unable to be made for the following reasons: THIS ADDRESS IS IN ALLEGHENY COUNTY. Fees Received from Attorney: FIRST DEFENDANT BASE COST ($24.50) POSTAGE ($1.00) Total: $25.50 Attorney Name: SAIDIS SULLIVAN LAW, 26 WEST HIGH STREET CARLISLE, PA 17013 Affirmed & Subscribed to before Me 3/8/2011 (74) A30TARIA SEAL Notary Public ,- D ANIFI S. ? 4o ary Public VNaC?E ,+s,ar, lotastingtor, County, PA My commission expires: My Coinm„sion Expires February 24, 2014 a,- ? 7 vtrs a of Washington County WASHINGTON COUNTYr PENNSYLVANIA OFFICE OF THE SHERIFF SAMUEL F. ROMANO SHERIFF JAMES B. DALESSANDRO CHIEF DEPUTY Court Docket #: 2011-2162 County of Washington, Commonwealth of Pennsylvania JAY D. CRUM & ANNA MAE CRUM vs ROBERT H. BLACK COURTHOUSE SQUARE SUITE 303 100 WEST BEAU STREET WASHINGTON, PA 15301 724-228-6840 FAx 724-223-4719 Sheriff File Number - 11000982 Affidavit of Service COMPLAINT I hereby CERTIFY and RETURN that service was NEVER attempted with the due diligence and inquiry for ROBERT H. BLACK. Service was unable to be made for the following reasons: THIS ADDRESS IS IN ALLEGHENY COUNTY. Fees Received from Attorney: FIRST DEFENDANT BASE COST ($24.50) POSTAGE ($1.00) Total: $25.50 Attorney Name: SAIDIS SULLIVAN LAW, 26 WEST HIGH STREET CARLISLE, PA 17013 Affirmed & Subscribed to before Me 3/8/2011 C? Notary Publi N? PAuLE'T_pANIELS,NctaryPublic Vkashin?.4ton, Washington Couv'4y, PA OYi>I?w, D My commission expir jbly co"',n,ig ion Expires February 24, 2014 Sheriff of Washington County CRUM, JAY D. and ANNA MAE, IN THE COURT OF COMMON PLEAS Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW NO. 11-2162 BLACK, ROBERT H., Defendant CIVIL TERM PRAECIPE TO REINSTATE COMPLAINT .ma vl3 TO THE PROTHONOTARY: .. Kindly reinstate the attached Complaint originally filed in the above captione"casgn February 23, 2011. Date: J fw /(/ Respectfully submitted, rs?F rrAA ? V1 SAIDIS, S LLIVAN & ROGERS J n E. Kelso, Esq. ttorney ID # 209107 26 West High Street Carlisle, PA 17013 (717) 243-6222 Counsel for Plaintiff #ro.oo Po A77Y e*.3/o14 Q# Z50 8C8 JAY D. and ANNA MAE CRUM, IN THE COURT OF COMMON PLEAS Plaintiffs CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW r` NO. 11-2162 ROBERT H. BLACK, ' R Defendant n xr -vim CIVIL TERM c? ?, -fl ea ?n To: Robert H. Black 1 C-C-) m CD 1272 Oakridge Road " i McDonald, PA 15057 Date of Notice: May 4, 2011 IMPORTANT TEN DAY 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 (10) 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 CAN NOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGBILE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 South Bedford St. Carlisle, Pennsylvania Telephone number (717) 249-3166 Respectfully submitted, SAIDIS ? ?V 4G By: son E. Kelso, Esquire Attorney ID No. 209107 Saidis Sullivan & Rogers Attorneys for Plaintiffs 26 West High Street Carlisle, PA 17013 (717) 243-6222 1 JAY D. and ANNA MAE CRUM, Plaintiffs V. ROBERT H. BLACK, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 11-2162 CIVIL TERM CERTIFICATE OF SERVICE On this 4th day of May, 2011, I, Jason E. Kelso, Esq., do hereby certify that I have served a true and correct copy of the foregoing Ten Day Notice of Intention upon the persons indicated below b y United States first class mail, postage paid, and addressed as indicated below. SAIDIS SULLIVAN & ROGERS RECIPIENT: Robert H. Black 1272 Oakridge Road McDonald, PA 15057 J . Kelso, Esquire MA6mey ID No. 209107 Saidis Sullivan & Rogers 26 West High Street Carlisle, PA 17013 (717) 243-6222 2 3 i7r? t,lnr ft- r'U ;I i tur1JU 13 PM 3:?; CUMBERLANO PENNSYLVANIA JAY D. and ANNA MAE CRUM, IN THE COURT OF COMMON PLEAS Plaintiffs, CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW NO. 11-2162 ROBERT H. BLACK, Defendant : CIVIL TERM Praecine for Notice of Intent to Attach Wales To the Prothonotary: Issue a Notice of Intent to Attach Wages in the above matter (1) against Robert H. Black , Defendant (2) against American Income Life Insurance / Simon Arias A ency, Employer of the Defendant. Dated:_ June 13, 2011 ay eopQ . ? ?Gz-?3i37G 4?" 2, (' '0 !Y6 6 Jas Kelso, Esquire rney for Judgment Creditor-Landlord or ,94 Judgment Creditor-Landlord if unrepresented Attorney ID No. 209107 26 West High Street Address Carlisle, PA 17013 Address (717) 243-6222 Telephone Number Certification by Judgment Creditor - Landlord I certify that Jay D. and Anna Mae Crum 1. The Plaintiff judgment-creditor is Name 1790 North Meadow Drive Address Mechanicsburg, PA 17055 Address Robert H. Black 2. The Defendant judgment-debtor is Name 1272 Oakridge Road Address McDonald, PA 15057 Address American Income Life Insurance / Simon Arias Agency 3. The Employer Garnishee is Name 12330 Perry Highway, Suite # 100 Address Wexford, PA 15090 Address 4. The judgment arises out of a residential lease for the premises at 1788 North Meadow Drive Mechanicsburg PA 17055 (address). 5. (a) The amount of the judgment is $15,000.00 (b) A security deposit in the amount of $ 0.00 is being held by the judgment creditor-landlord. This security deposit X has been applied has not been applied to payment of rent due on the same premises for which the judgment has been entered. (Any security deposit that has not already been applied to rent will be deducted by the Prothonotary from the amount of the judgment in determining the amount to be attached.) (c) The amount of $ 0.00 has been paid toward satisfaction of the judgment. (Do not include the security deposit.) This Praecipe is filed within five years of the date of the original judgment upon which Execution is sought. The judgment was entered (check one): X in a civil action commenced in the Court of Common Pleas in an action brought before a Magisterial District Judge in an action commenced in the Philadelphia Municipal Court. 8. Check the appropriate paragraph and attach the required documents: (a) If the ju?gmert was ent.:reci in a civic, action (Pa. R:C.P.M.D.J. 3i?1 et seq.) before a Magisterial District Judge, a copy of the Complaint filed with the Magisterial District Judge is attached to this Notice, showing that the action arose from a residential lease. (b) If the judgment was entered in an action for the recovery of possession of real property (Pa. R.C.P.M.D.J. 501 et seq.) before a Magisterial District Judge, copies of the appropriate Magisterial District Judge records are attached showing that the action arose from a residential lease and that the Defendant appeared or filed papers in that action or that the Complaint was served by handing a copy to the Defendant. (e) If the judgment was entered in an action in the Philadelphia Municipal Court in which the Defendant was served pursuant to Phila.M.C.R.Civ.P. No. I I I (A) or (C), a copy of the Complaint filed with the Philadelphia Municipal Court is attached to this Notice, showing that the action arose from a residential lease. __(d) If the judgment was entered in an action in the Philadelphia Municpal Court in which the Defendant was served pursuant to Phila.M.C.R.Civ.P. No. 1 I I(B), copies of the appropriate Philadelphia Municipal Court records are attached showing that the Defendant appeared or filed papers in the action. I certify that the statements made in this Certification 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 t uthorities. Date: t_ _ bf X06! - - --- - iud 7 11 i d editor - i2i;ClIL'ru SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff Jody S Smith Chief Deputy FILED-OFFICE CIF THE PROTHONOTARY Richard W Stewart Solicitor 2011 JUL 13 AM 8: 02 CUMBERLAND COUNTY PENNSYLVANIA Jay D. Crum (et al.) vs. Robert H Black (et al.) Case Number 2011-2162 SHERIFF'S RETURN OF SERVICE 06/15/2011 Ronny R. Anderson, Sheriff who being duly sworn according to law states that he made a diligent search and inquiry for the within named defendant, to wit: Robert H. Black, but was unable to locate him in his bailiwick. He therefore deputized the Sheriff of Allegheny County, Pennsylvania to serve the within Notice of Intent to Attach Wages according to law. 06/15/2011 Ronny R. Anderson, Sheriff who being duly sworn according to law states that he made a diligent search and inquiry for the within named defendant, to wit: American Income Life/ Arias Agency, but was unable to locate them in his bailiwick. He therefore deputized the Sheriff of Allegheny County, Pennsylvania to serve the within Notice of Intent to Attach Wages according to law. 07/0112011 10:55 AM - Allegheny County Return: And now July 1, 2011 at 1055 hours I, William Mullen, Sheriff of Allegheny County, Pennsylvania, do hereby certify and return that I served a true copy of the within Notice of Intent to Attach Wages, upon the within named defendant, to wit: American Income Life/ Arias Agency by making known unto an adult in charge named Natalie, Manager for American Income Life/ Arias Agency at 12330 Perry Highway, Suite 100, Wexford, Pennsylvania 15090 its contents and at the same time handing to her personally the said true and correct copy of the same. 07/05/2011 12:05 PM - Allegheny County Return: And now July 5, 2011 at 1205 hours I, William Mullen, Sheriff of Allegheny County, Pennsylvania, do hereby certify and return that I served a true copy of the within Notice of Intent to Attach Wages, upon the within named defendant, to wit: Robert H. Black by making known unto Joyce Wood, Sister of Defendant at 1272 Oakridge Road, McDonald, Pennsylvania 15057 its contents and at the same time handing to her personally the said true and correct copy of the same. SHERIFF COST: $53.44 July 11, 2011 SO ANSWERS, RON R ANDERSON, SHERIFF icj i-ountvSuite Sherrtt. Telecaoft. Inc, . JAY D. and ANNA MAE CRUM, IN THE COURT OF COMMON PLEAS Plaintiffs, CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW NO. 11-2162 ROBERT H. BLACK, Defendant CIVIL TERM CLAIM FOR EXEMPTION FROM WAGE ATTACHMENT Notice This Claim for Exemption must be filed with the Prothonotary of the Court within 30 days of service upon you of the Notice of Intent to Attach Wages. To the Prothonotary: I, the above-named defendant, claim exemption of my wages, salary or commissions from attachment on the following ground: ? My net monthly income is below the poverty income guidelines as provided by the Federal Department of Health and Human Services. OR The amount of wages to be attached would place my net income below the poverty income guidelines as provided annually by the Federal Department of Health and Human Services. I have _ Q dependents. My net monthly income is $ '3d (Net monthly income is your total monthly wages less (1) any support payments made to the court, (2) federal, state and local income taxes, (3) F.I.C.A. payments and nonvoluntary retirement payments, (4) union dues and (5) health insurance premiums.) I certify that the statements made in this Claim for Exemption are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unworn falsification to authorities. Date: 71,411 // Robert If Black, Defendant 7/ `7- 4,c?--3& c- -r :r-71 This claim shall be delivered or mailed to: rC- M- Office of the Prothonotary rn Court of Common Pleas r-- O Cumberland County One C oui thouse Square C 3 Carlisle, PA i 7013 > C:: ? 1V C rTt 717-240-6195 i q ? -< rv JAY D. and ANNA MAE CRUM, Plaintiffs, V. ROBERT H. BLACK, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 1.1-2162 CIVIL TERM NOTICE OF INTENT TO ATTACH WAGES. SALARY OR COMMISSIONS Date of service of this Notice: (Date to be inserted by the Sheriff) A judgment has been entered against You in court. ii,r notipayincrit of rent fee, or dwnagL to, residential rruper y that you . ?::7biiii i0 atiisCll lJ;u of vpul net wages, S&iJt'V Or c;ul1ln11SS1o11S for each pay period until the judgment is satisfied. The following exception will prevent your wages from being attached: Poverty Guidelines--Your wages may not be attached if your net income is below the poverty income guidelines as provided annually by the Federal Department of Health and Human Services or if the amount of the attachment would cause your net income to fall below the poverty income guidelines. !i copy of the guidelines is attached to this notice. If this exemption is applicable to you, you must return the claim for exemption of wages which is attached to the prothonotary within 30 days of the date of service of this notice upon you. The date of service of this notice is set forth above. If you return the form claiming this exemption within 30 days, your wages will not be attached without subsequent court prozeedings. There inay be other legal grounds for opposing the wage attachment that you may be able to raise by filing a motion with the court. For example, your wages may not be attached if you are an abused person or victim as set forth in Section 8127(f) of the Judicial Code when the attachment is to satisfy a judgment for physical damages to the leased premises. 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 CA"iv'Q01' AFFORD TO MIRE A LAI Y.I'_1:, 1111S OFFICE MAY BE ABLE TO 1'l :)?J1DC YOU WITH INFORMATION ABOUT AGENCIES 1HAT A-I_.Y OFFt f< f_EGAi- SERV_ C i=5 iLhi-II3I_E .--ERSC?INB AT A. REDUCED FEE OR NO FL E13. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 (717) 149-3166 or 800-990-9108 TRUE COPY FROM RECORD In Testanwny whereof, I here unto set my rid and the seal of sold urt at Cadisie, This J.:?.day of. 1I-. 20 11 Fr,_)",-- ;pry r JAY D. and ANNA MAE CRUM, IN THE COURT OF COMMON PLEAS Plaintiffs, CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW NO. 11-2162 ROBERT H. BLACK, Defendant CIVIL TERM NOTICE OF CLAIM OF EXEMPT tON OF WAGES FROM ATTACHMENT To the above named Plaintiff: The Defendant in the above-captioned matter has filed a claim for exemption from attachment of his or her wages, salary or commissions. A copy of the claim is attached. If you wish to challenge the claim for exemption, you should file with the Court a motion setting forth facts which show that the Defendant's net income is not below the Federal Department of Health and Human Services poverty income guidelines or that the attachment will not cause the Defendant's net income to fall below those poverty income guidelines. Date: / _ Prothonotary r