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Home My WebLink About11-3568' CF:\FILES\Clients\3050 Donegal\Current\612\3050.612. complaint] Revised: 3/14/11 11 58AM George B. Faller, Jr., Esquire Cl) ..a MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER a: ° n MARTSON LAW OFFICES rnco MW _-n I.D. 49813 X; ° r- 10 East High Street n rn Carlisle, PA 17013 r= (717) 243-3341 3*C cam-,., Attorneys for Plaintiff ' y ic; _ r,; ATLANTIC STATES INSURANCE IN THE COURT OF COMMON PL S bT :5 COMPANY, as Subrogee of CUMBERLAND COUNTY, PENNSYLVAN IA KENNETH WITT, Plaintiff V. NO. CIVIL ACTION - LAW JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants JURY TRIAL DEMANDED NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so, the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiffs. 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 REDUCE FEE OR NO FEE: Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 (717) 249-3166 e*?*33 ni- P-'O-d 5-77 Y J George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff DONEGAL MUTUAL INSUR COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. ??- 3s CIVIL ACTION - LAW : JURY TRIAL DEMANDED COMPLAINT 1. The Plaintiff, Donegal Mutual Insurance Company, is an insurance company licensed to business in Pennsylvania with an address of 1195 River Road, Marietta, Pennsylvania 17547- 0302. 2. The Defendant Amanda M. Fawbush is and adult individual residing at 711 Grahamswood Road, Newville, Pennsylvania 17241. 3. The Defendant Jeremy Chestnut is an adult individual residing at 711 Grahamswood Road, Newville, Pennsylvania 17241. 4. On or about June 29, 2009, Kenneth G. Witt was operating his 2006 Buick, heading east on West High Street in Carlisle, Pennsylvania. 5. As he approached the intersection with West Street, a 1999 Ford owned by Defendant Jeremy Chestnut and operated by Defendant Amanda Fawbush, failed to stop at a red traffic signal at the intersection of West Street and West High Street and collided with the right front side of Kenneth G. Witt's vehicle. 6. As a direct and proximate result of the collision, Witt's vehicle sustained property damage in the amount of $7,021.04. A copy of the repair estimate in that amount is hereby attached as Exhibit "A." 7. As a direct and proximate result of the collision, rental expenses in the amount of $900.00 were incurred. A copy of the rental invoice is hereby attached as Exhibit "B." 8. As a direct and proximate result of the collision, Kenneth Witt sustained personal injuries, including, but not limited to, an injury to his left shoulder requiring surgery in the form of an acromioplasty and repair of his left rotator cuff. 9. On or about June 29, 2009, Plaintiff Atlantic States Insurance Company insured Kenneth Witt for property damage, rental expense, and uninsured motorist coverage. 10. At the time of the collision, the vehicle owned by Defendant Jeremy Chestnut and operated by Defendant Amanda Fawbush, was not insured. 11. As a direct and proximate result of the collision, Atlantic States Insurance Company paid Kenneth Witt $30,901.99 in uninsured motorist benefits and Kenneth Witt assigned any right to collection to Atlantic States Insurance Company. 12. Atlantic States Insurance Company is subrogated to all the rights of Kenneth Witt as a result of the accident on June 29, 2009. 13. The accident was caused solely as a result of the negligence, recklessness, and carelessness of the Defendants in that Amanda Fawbush failed to stop at a red traffic signal and failed to yield the right of way to Kenneth Witt. 14. The accident was caused as a result of the negligence, recklessness and carelessness of Jeremy Chestnut in that he negligently entrusted his vehicle to Amanda Fawbush and allowed her to drive the vehicle when it did not have the proper liability insurance in Pennsylvania. WHEREFORE, Plaintiff demands judgment against the Defendant in the amount of $38,823.03. MARTSON LAW OFFICES By Geor'g,CB. FAer, Jr., Esquire I. D. Number 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Date: ////%// Attorneys for Plaintiff C? aE,r??Aa,? ?? z?<"Bir ?' DONEGAL INSURANCE GROUP 1195 RIVER ROAD P.O. BOX 302 MARIETTA, PA 17547-0302 (717) 426-1931 FAX: (717) 426-7023 "' ESTIMATE "` 07/06/200912:56 PM ..:...:................................................................................................................. Owner Owner: KENNETH & MARY WITT Address: 1013 NORTHFIELD DR Cell: (717)576-0558 City State Zip: CARLISLE, PA 17013 FAX: Control information ....................................................................................................................................................................................................... ........................ E Claim # : PAA-PA-01-09-0086590 Loss Date/Time: 06/29/2009.08:00 AM Deductible: $250.00 File # : Insured Policy # : PAA-0569150 Loss Type: Collision Accounting # : 0004313 Ins. Company: Donegal Insurance Group Agent: Kristi Steech Address: Email: krististeech@donegalgroup.com Insured: KENNETH & MARY WITT Address: Claim Rep: Kristi Steech Address: Email: krististeechCc6donegalgroup.com Loss Payee: MEMBERS 1ST FCU Work/Day: (800)877-0600x7460 Cell: (717)576-0558 Work/Day: (800)877-0600x7460 ....................................................................................................................................................................................................... ................. Inspection ....................................................................................................................................................................................................... ......................... Inspection Date: 07/06/2009 Inspection Location: Clarks Auto Body Inc Address: 1308 Pine Road City State Zip: Carlisle, PA 17015 Primary Impact: Front Driveable: No Inspection Type: Field Contact: Work/Day: (717)486-4151 Secondary Impact: Rental Assisted: Assigned DatelTime: First Contact DateMme: Appraiser Name: JACK CHIARA Address: P.O. BOX 567 City State Zip: NEW CUMBERLAND, PA 17070 Received Date/Time: 06/3012009 01:57 PM Appointment Date/7lme: 07/0612009 08:00 AM e Appraiser License # : 416512 Work/Day: (717)737-5757 FAX: (717)737-7501 . ..................................................................................................................................................................................................... ........ Repairer Repairer: CLARKS AUTO BODY Contact: Address: 1308 PINE ROAD Work/Day: (717)486-4151 City State Zip: CARLISLE, PA 17013 FAX: License # : 571224778 Regulation ID: 571224778 Target Complete Date/Time: Days To Repair: 8 Remarks .,....,-...,,.-,,,..,..,,,....,.»-.,..,..,..,,........,...,.,...........,,,,.,.?„N,....,.,.,.....u.m.,...,-.,.a,...,v......,?...,..,-..?,,,.,.,,.,,,,.,,....,....,.,........,....,.,,,,......,k ....-.,...,,....,,.,,.,. ....................................................................................................................................................................................................... .......................... i ALL SUPPLEMENTAL DAMAGE MUST BE APPROVED BY THE APPRAISER ....................................................................................................................................................................................................... .......................... Vehicle ....................................................................................................................................................................................................... ........................: 07/08/2009 01:28 PM Exhibit "A" Page 1°'s 2006 Buick Lucerne CXL V6 4 DR Sedan 07/06/200912:56 PM Claim Jf : PAA-PA-01-09.0086590 2006 Buick Lucerne CXL V6 4 DR Sedan 6cyl Gasoline 3.8 4 Speed Automatic LIc.Plate: PD-1831C Lic Expire: Prod Date: Veh Insp# : Condftlon: Good Ext. Color: DARK MING BLUE Ext. Refinish: Two-Stage Ext. Paint Code: 722J Options Lic State: PA VIN: 1 G4HD57296U187506 Mileage: 25,864 Mileage Type: Actual Code: S4353B Int. Color: Int. Refinish: Int. Trim Code: AM/FM CD Player Aluminum/Alloy Wheels Automatic Dimming Mirror Cruise Control Floor Mats Heated Power Mirrors Leather Seats MP3 Player Power Door Locks Power Windows Rem Trunk-L/Gate Release Tachometer Tinted Glass Wood Interior Trim Air Conditioning Anti-lock Brakes Bucket Seats Dual Airbags Garage Door Opener Intermittent Wipers Leather Steering Wheel OnStar System Power Drivers Seat Rain-Sensing W/S Wipers Side Airbags Theft Deterrent System Traction Control System Alarm System Auto Load Leveling Center Console Dual Zone Auto A/C Head Airbags Keyless Entry System Lighted Entry System Power Brakes Power Steering Rear Window Defroster Strg Wheel Radio Control Tilt Steering Wheel Trip Computer Damages ............................................................................................................................................................................................... ............... Line Op Guide MC Description MFR.Part No. Price ADJ% B% Hours R 1 E 5 Bumper,Front 15808579 GM Part $186.68 1.9 SM 2 N 27 Fri Bumper Cvr Overhaul Additional Labor INC SM 3 UC 6 Eover,Front Bumper Replace Reconditioned $449.00' 0.8 SM >> PARTS LOCATED AT LKQ 250 1-877-391-2727 EXT 4, QT#2503454 4 L 6 13 Cover,Front Bumper Refinish 3.7 RF 5 E 35 Defl,Front Bumper 25761497 GM Part $122.98 INC SM 6 E 29 Defl,Front Bumper Lwr 15808717 GM Part $147.65 INC SM 7 E 7 Absorber,Front Bumper 15800949 GM Part $167.00 INC SM 8 E 37 01 Grille Assembly 25768116 GM Part $204.48 INC SM 9 E 38 Insert,Grille 10366367 GM Part $153.27 INC SM 10 E 41 Headlamp Assy,Halogen LT 25754861 GM Part $283.16 0.3 SM 11 ELI 42 Headlamp Assy,Halogen FIT LIKE KIND & QUAL.PRT $175.00' +25.00 0.3 SM >> PARTS LOCATED AT LKQ 2501-877-391-2727 EXT 4, QT#2503454 12 N 973 Headlamps Aim Additional Labor 0.4 SM 13 E 44 Brkt,Headlamp Mig LT 15252146 GM Part $32.52 INC SM 14 E 45 Brkt,Headlamp Mtg FIT 15252155 GM Part $32.52 INC SM 15 E 83 Panel,Hood 25759918 GM Part $874.31 1.1 SM 16 L 83 Panel,Hood Refinish 5.2 RF 17 E 90 Mldg,Hood Front 25807076 GM Part $85.74 0.2 SM 18 1 88 Supt, Hood Lock Vert Repair 0.5' SM 19 E 52 Hinge,Hood Panel LT 10393262 GM Part $80.17 0.4 SM 20 L 52 Hinge,Hood Panel LT Refinish 0.2 RF 21 E 53 Hinge,Hood Panel FIT 10393261 GM Part $80.17 INC SM 22 L 53 Hinge,Hood Panel FIT Refinish 0.2 RF 23 E 84 Hinge,Hood Panel LT 25759896 GM Part $12.36 1.8 SM 24 L 84 Hinge,Hood Panel LT Refinish 0.2 RF 25 E 85 Hinge,Hood Panel FIT 25759895 GM Part $14.00 1.8 SM 26 L 85 Hinge,Hood Panel FIT Refinish 0.2 RF 27 E 30 01 Label,Hood 19180225 GM Part $23.83 0.1 SM 28 RI 86 Pad,lnsulator Hood R & I Assembly INC SM 29 E 89 Crsmbr,Rad Panel Upr 25765115 GM Part $124.09 0.9 SM 30 RI 71 Cover,Rad Supt Panel R & I Assembly INC SM 31 1 Radiator Support Repair 2.0' SM' 32 N 977 A/C Evacuate & Recharg Additional Labor INC ME 33 N 980 A/C Evac Rechrg & Rcvr Additional Labor 1.8 ME 34 EC 731 Condenser,A/C Replace Economy $185.00' 1.4 ME 07/08/2009 01:28 PM Page 2 of 6 2008 Buick Lucerne CXL V8 4 DR Sedan Claim #: PAA-PA-01-08-0088590 07/0612009 12:58 PM >> PARTS LOCATED AT LKQ 250 1-877-391-2727 EXT 4, QT#2503454 35 EU 599 Cradle,Engine LIKE KIND & QUAL.PRT $450.00` +25.00 4.9 ME >> PARTS LOCATED AT LKQ 250 1 -877-391-2727 EXT 4, QT#2503454 36 1 103 Fender, Front LT Repair 2.0` SM 37 L 103 Fender,Fronl LT Refinish 1.8 RF >> BLEND WITHIN PANEL 38 1 104 Fender, Front FIT Repair 3.0' SM 39 L 104 Fender, Front FIT Refinish 1.8 RF 40 RI 97 Ornament,Fender LT R & I Assembly 0.2 SM 41 RI 98 Omament,Fender FIT R & I Assembly 0.2 SM 42 RI 537 Emblem,Front Fender LT R & I Assembly 0.2 SM 43 RI 538 Emblem,Front Fender FIT R & I Assembly 0.2 SM 44 BR 210 Pnl,Front Door Outer FIT Blend Refinish 1.2 RF 45 RI 232 Pnl,lnner Door Trim FIT R & I Assembly INC SM 46 RI 300 Applique,Frt Door Fram FIT R & I Assembly 0.2 SM 47 RI 269 Mldg,Front Door Side PIT R & I Assembly 0.4 SM 48 RI 230 Mirror,Outer RIC FIT R & I Assembly 0.3 SM 49 RI 228 Handle, Front Door Otr FIT R & I Assembly 0.5 SM 50 RI 258 Deflector,Front Door FIT R & I Assembly 0.2 SM 51 1 SET UP AND MEASURE Repair 2.0' SM 52 EC CAR COVER Replace Economy $5.00` SM 53 EC FLEX Replace Economy $8.00' SM 54 EC CORROSION PROTECTION Replace Economy $8.00' SM 55 SB HAZARDOUS WASTE Sublet Repair $3.00' SM 56 EC CAULK/SEAM SEALER Replace Economy $10.00' SM 57 1 CLEAN AND RETAPE MOLDINGS Repair 0.3' SM 58 1 COLLISION PULL Repair 2.0` FR` 58 Items MC Message 01 CALL DEALER FOR EXACT PART # / PRICE 13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE Estimate Total & Entries ....................................................................................................................................................................................................... .......................: Gross Parts $2,624.93 Other Parts $1,290.00 Paint Materials $304.50 Line Item Markup $156.25 Parts & Material Total $4,375.68 Tax on Parts & Material @ 6.000% $262.54 Labor Rate Replace Hrs Repair Hrs Total Hire Sheet Metal (SM) $44.00 12.0 10.2 22.2 $976.80 Mech/Elec (ME) $45.00 6.3 1.8 8.1 $364.50 Frame (FR) $48.00 2.0 2.0 $96.00 Refinish (RF) $44.00 14.5 14.5 $638.00 Paint Materials $21.00 Labor Total 46.8 Hours $2,075.30 Tax on Labor @ 6.000% $124.52 Sublet Repairs $3.00 Towing $180.00 Gross Total $7,021.04 Less: Deductible $250.00- Net Total $6,771.04 Alternate Parts Y/00/00/00/00/00 CUM 00100100100/00 Zip Code: 17547 Default Audatex Estimating 6.0.025 ES 07/0612009 01:28 PM REL 6.0.025 DT 06/01/2009 DS 07/0112009 Copyright (C) 2008 Audatex North America, Inc. 2.7 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEX'S TWO-STAGE REFINISH FORMULA. 07106/2009 01:28 PM Pape 3 018 RECVaro vArEz NFCYCUBtt • ARMS® - Automated Rental Management System Page 1 of 1 I Rental Company: ENTERPRISE RENT-A-CAR ® 41" Donegal Invoice: D726880-5710 Insurance Bill To: DONEGAL INSURANCE ATTN: KRISTI STEECH P. O. BOX 302, ROUTE 441 MARIETTA, PA 17547 RENTER INFORMATION: Renter: WITT, KENNETH RENTAL INFORMATION: Rental Branch Location: ENTERPRISE RENT-A-CAR (5710) 800 NORTH HANOVER ST CARLISLE, PA 170131538 (717) 258-4495 ADDITIONAL CLAIM INFORMATION: Claim Number :PAAPA01090086590 Claim Type: Insured Vehicle Condition: Non-Driveable Date Of Loss: 6/29/09 Insured Name: Owner's Vehicle: 2006 BUICK LUCERNE Additional Driver: WITT* MARY* Repair Facility: CLARK'S AUTOBODY CARLISLE, PA 17013 (717) 486-4151 VEHICLES RENTED: Billing Detail: Rental Period: 6/29/09 to 8/5/09 (38 days) Billed Period: 6/29109 to 7/28/09 (30 days) Description Rate: Amount: 38 DAYS @ $28.24 $1,073.12 38 PTA TAX $2.00 $76.00 1 VRT %2.00 $21.46 1 SALES TAX %6.00 $64.39 TOTAL CHARGES: $1,234.97 Less Amount Received: $334.97 AMOUNT DUE.......... $900.00 Effective Date Year Make Model VIN Starting Ending Mileage and Time Mileage Mileage 6/29/09 4:37 PM 2009 CHEV IMPA 2G1WB57N791264653 22672 23528 856 Rental Invoice Please Return This Portion with Remittance Make Payment To: ENTERPRISE RENT-A-CAR COMPANY (5799) 2625 MARKET PLACE HARRISBURG,, PA 17110 Federal I D:26-4526440 Exhibit "B" Total Charges: $1,234.97 Less Amount Received: $334.97 Total Amount Due .................... $900.00 Please include on your check: Invoice: D726880-5710 https://www.enterprise.com/armsweb/payinvoice 8/10/2009 i. Y VERIFICATION I, Christine E. Richards, Subrogation Claims Specialist of Atlantic States Insurance Company, acknowledge I have the authority to execute this Verification on behalf of Atlantic States Insurance Company and certify the foregoing Complaint is based upon information which has been gathered by my counsel in the preparation of the lawsuit. The language of this Complaint is that of counsel and not my own. I have read the document and to the extent the Complaint is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent the content of the Complaint is that of counsel, I have relied upon counsel in making this Verification. _ This statement and Verification are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unworn falsification to authorities, which provides that if I knowingly make false averments, I may be subject to criminal penalties. ATLANTIC STATES INSURANCE COMPANY Christine E. Richards FAFtLES\aientsb030 DonegslTurreml612UOS0.612.compldotl 04101/2011 10:00 AM F294922721 CF.\FILES\Clients\3050 Donegal\Current\612\3050.612.complaint I Revised: 4/12/11 9: 57 AM George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff FILED-OFFICE CF THE PROTHONOTARY 2011 APR 12 PM 1: 5 5 CUMBERLAND COUNTY PENNSYLVANIA ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW : JURY TRIAL DEMANDED NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so, the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiffs. 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 REDUCE FEE OR NO FEE: Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 (717) 249-3166 George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW : JURY TRIAL DEMANDED AMENDED COMPLAINT 1. The Plaintiff, Atlantic States Insurance Company, is an insurance company licensed to business in Pennsylvania with an address of 1195 River Road, Marietta, Pennsylvania 17547- 0302. 2. The Defendant Amanda M. Fawbush is and adult individual residing at 711 Grahamswood Road, Newville, Pennsylvania 17241. 3. The Defendant Jeremy Chestnut is an adult individual residing at 711 Grahamswood Road, Newville, Pennsylvania 17241. 4. On or about June 29, 2009, Kenneth G. Witt was operating his 2006 Buick, heading east on West High Street in Carlisle, Pennsylvania. 5. As he approached the intersection with West Street, a 1999 Ford owned by Defendant Jeremy Chestnut and operated by Defendant Amanda Fawbush, failed to stop at a red traffic signal at the intersection of West Street and West High Street and collided with the right front side of Kenneth G. Witt's vehicle. 6. As a direct and proximate result of the collision, Witt's vehicle sustained property damage in the amount of $7,021.04. A copy of the repair estimate in that amount is hereby attached as Exhibit "A." 7. As a direct and proximate result of the collision, rental expenses in the amount of $900.00 were incurred. A copy of the rental invoice is hereby attached as Exhibit "B." 8. As a direct and proximate result of the collision, Kenneth Witt sustained personal injuries, including, but not limited to, an injury to his left shoulder requiring surgery in the form of an acromioplasty and repair of his left rotator cuff. 9. On or about June 29, 2009, Plaintiff Atlantic States Insurance Company insured Kenneth Witt for property damage, rental expense, and uninsured motorist coverage. 10. At the time of the collision, the vehicle owned by Defendant Jeremy Chestnut and operated by Defendant Amanda Fawbush, was not insured. 11. As a direct and proximate result of the collision, Atlantic States Insurance Company paid Kenneth Witt $30,901.99 in uninsured motorist benefits and Kenneth Witt assigned any right to collection to Atlantic States Insurance Company. 12. Atlantic States Insurance Company is subrogated to all the rights of Kenneth Witt as a result of the accident on June 29, 2009. 13. The accident was caused solely as a result of the negligence, recklessness, and carelessness of the Defendants in that Amanda Fawbush failed to stop at a red traffic signal and failed to yield the right of way to Kenneth Witt. 14. The accident was caused as a result of the negligence, recklessness and carelessness of Jeremy Chestnut in that he negligently entrusted his vehicle to Amanda Fawbush and allowed her to drive the vehicle when it did not have the proper liability insurance in Pennsylvania. WHEREFORE, Plaintiff demands judgment against the Defendant in the amount of $38,823.03. MARTSON LAW By George B. aller, Jr., Esquire I. D. Number 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Date; 4/12/11 Attorneys for Plaintiff ?a R,?,??Aw„ ,k DONEGAL INSURANCE GROUP 1195 RIVER ROAD P.O. BOX 302 MARIETTA, PA 17547-0302 (717) 428-1931 FAX: (717) 428-7023 "' ESTIMATE *" 07/081200912:58 PM Owner ................................................................................................................................................................................................................., -------------------- Owner: KENNETH & MARY WITT Address: 1013 NORTHF-IELD DR City Stele Zip: CARLISLE, PA 17013 Call: (717)578-0558 FAX: - ---------------- Control Inlornnstion ......_, c Claim i : PAA-PA-01-09-0088590 Loss DMITime: 080112009.08:00 AM Deductible: $250.00 Fits p : Insured Polley #f : PAA-0589150 Loss Type: Collision Accounting P : 0004313 Ins. Company: Donegal Insurance Group Agent: ON Stesch Address: Email: kristialsech0donegaigroup.com Work/Day: (80077-0800x7480 Insured: KENNETH & MARY WITT Address: Claim Rep: Kral Steech Address: Email: kristisleschWonegalgroup.com Cell: (717)578-0558 WorklDay: (8W)877-0800x7480 Loss Payse: MEMBERS 1ST FCU .i ............................................................... ............................. -------------- --- Inspection Date: 07/08/2008 Inspection Location: Clarks Auto Body Inc Address: 1308 Plne Road City Stag Zip: Carlisle, PA 17015 Primary Impact: Front Drlveable: No Inspection Type: Field Contact: Work/Day: (717)488.4151 Secondary Impact: Rendgl Assisted: Assigned Detaffime: First Contact DeWnme: Appraiser Name: JACK CHIARA Address: P.O. BOX 587 City State Zip: NEW CUMBERLAND, PA 17070 Recelved Date/Tlme: OGW2009 01:57 PM Appointment DoWnme: 07/08//2009 08:00 AM Appraiser License 8 : 418512 Work/Day: (717)737-5757 FAX: (717)737-7501 gwtulnr .................................................................................................................................................................................................. CLARKS AUTO BODY Contact• Address: 1308 PINE ROAD Work/Day: (717)488-4151 City State Zip: CARLISLE, PA 17013 FAX: Licensed : 571224778 Regulation ID: 571224778 Target Complete DateMme: Days To Repair: 8 1 Remarks ............................................................................................................................................................................... i ALL SUPPLEMENTAL DAMAGE MUST BE APPROVED BY THE APPRAISER i ......................................................................................................................... ........................................................................................................ . Vehicle .............................................................................................................................................................. Exhibit "A" Pape 1 of 8 2006 Buick Lucerne CXL V8 4 DR Shan 0710800e 12:58 PM Claim #: PM-PM01-090088680 2006 Buick Lucerne CXL V6 4 DR Sedan 6cyi Gasoline 3.8 4 Speed Automatic LIC.PIM: PD-1831C Llo State: PA Lie Expire: VIN: 1G4HD57298U187506 Prod Data: Mileage: 25,884 Veh ingW : Mllsage Type: Actual Condition: Good Code: S43538 Ext. Color. DARK MING BLUE IM. Color: Ext. RefAdsh: Two-Stage Int. Refinish: Ext. Point Code: 722J Int. Trim Code: Optima AMIFM CD Player AluminumlAlloy Wheels Automatic Dimming Mirror Cruise Control Floor Mats Hosted Power Minors Leather Seats MP3 Player Power Door Locks Power Windows Rem Trunk-UGate Release Tachometer Tinted Glass Wood Interior Trim Air Conditioning And-lock Brakes Bucket Seats Dual Airbags Garage Door Opener Intermittent Wipers Leather Steering Wheel OnSlar System Power Drivers Sea! Rain-Sensing W/S Wipers Side Airbags Then Deterrent System Traction Control System Alarm System Auto Load Leveling Center Console Dual Zone Auto A/C Head Airbags Keyless Entry System Lighted Entry System Power Brakes Power Steering Rear Window Defroster Strg Wheel Radio Control Tit Steering Wheel Trip Computer Line Op Guide MC Descrlpgon MFR.Psrt No. Prig ADJ% 1111% Hours 1 E 5 Bumper,Front 15808579 GM Part $188.68 1 9 SM 2 N 27 Fri Bumper Cvr Overhau Additional Labor . INC SM 3 UC 6 Eover,Front Bumper Replace Reconditioned $449.00' 0 8 SM » PARTS LOCATED AT LKO 2501-877-391-2727 EXT 4, OT#2503454 . 4 L 6 13 Cover,Frord Bumper Refinish 3 7 RF 5 E 35 Defi,Front Bumper 25761497 GM Part $122.98 . INC SM 6 E 29 Defl,Frorrt Bumper Lwr 15808717 GM Part $147.65 INC SM 7 E 7 Absorber,Front Bumper 15800949 GM Part $187.00 INC SM 8 E 37 01 Grille Assembly 25786116 GM Part $204.48 INC SM 9 10 E E 38 41 InsertAride Headlamp Aasy,Halogen LT 10388387 GM Part 25754881 GM Part $153.27 $283 18 INC SM 11 EU 42 Headlamp Assy,Halogen RT LIKE KIND & QUAL.PRT . $175.00` +25.00 0.3 0 3 SM SM >> PARTS LOCATED AT LKO 2501-877-391-2727 EXT 4, QT&2503454 . 12 N 973 HeadNimps Aim Additional Labor 0 4 SM 13 E 44 &W.Headlamp Mtg LT 15252148 GM Part $32.52 . INC SM 14 E 45 Brid,Hesdlarnp Mg RT 15252155 GM Part $3252 INC SM 15 E 83 Panel,Hood 25759918 GM Part $874.31 1 1 SM 16 L 83 Panel,Hood Refinish . 5 2 RF 17 E 90 MIdg,Hood From 25807078 GM Part $85.74 . 0 2 SM 18 I 88 Supt, Food Lock Vert Repair . 0 5' SM 19 E 52 ",Hood Panel LT 10393262 GM Part $80.17 . 0 4 SM 20 L 52 Hinge,Hood Panel LT Refinish . 0 2 RF 21 E 53 Hinge,Hood Panel RT 10393281 GM Part $80.17 . INC SM 22 L 53 Hinge,Hood Panel RT Refinish 0 2 RF 23 E 84 Hinga,Hood Panel LT 25759898 GM Part $12.38 . 1 8 SM 24 L 84 Hinge,Hood Panel LT Refinish . 0 2 RF 25 E 85 Hinge,Hood Panel RT 25759895 GM Part $14.00 . 1 8 SM 26 L 85 Hinge,Hood Panel RT Refinish . 0 2 RF 27 E 30 01 Label,Hood 19180225 GM Part $23.83 . 0 1 SM 28 RI 86 Pad,lnsutdor Hood R & I Assembly . INC SM 29 E 89 Crsmbr,Rad Panel Upr 25785115 GM Part $124.09 0 9 SM 30 RI 71 Cover,Rad Supt Panel R & I Assembly . INC SM 31 32 1 N 977 Radiator Support A/C Evacuate & Recharg Repair Additional Labor 2.0' SM• 33 N 980 A/C Evac Rechrg & Rcvr Additional Labor INC 1 8 ME ME 34 EC 731 Condenser,A/C Replace Economy $185.00' . 1.4 ME 071081408 01:25 PM Paps 2 of 6 2006 Buidt Luwns CXL V8 4 DR Sedan Claim l : PM-PM01-084088690 07/08f2p09 12:56 PM >> PARTS LOCATED AT LKQ 2501-877-391-2727 EXT 4, QT#12503454 35 EU 599 Cradle,Engine LIKE KIND & QUAL.PRT $450.00' +25.00 4.9 ME >> PARTS LOCATED AT LKQ 2501-877-391-2727 EXT4, QT#12503454 36 1 103 Fonder, Front LT Repair 2.0' SM 37 L 103 Fender, Front LT Refinish 1.8 RF » BLEND WITHIN PANEL 38 1 104 Fender, Front FIT Repair 3.0' SM 39 L 104 Fender,Front FIT Refinish 1.8 RF 40 RI 97 Ornement,Fender LT R & I Assembly 0.2 SM 41 RI 98 Ornement,FerMer FIT R & I Assembly 0.2 SM 42 RI 537 Emblem,Front Fender LT R & I Assembly 0.2 SM 43 RI 538 Emblem,Front Fender FIT R & I Assembly 0.2 SM 44 BR 210 Pn1,Front Door Outer RT Blend Refinish 1.2 RF 45 RI 232 Pnl,lrww Door Trim RT R & I Assembly INC SM 48 RI 300 Applique,Frt Door Frain FIT R & I Assembly 0.2 SM 47 RI 289 MI ftFront Door Skis FIT R & I Assembly 0.4 SM 48 RI 230 Mirror,Outer RIC FIT R & I Assembly 0.3 SM 49 RI 228 Harldle,Fmnt Door Olr FIT R & I Assembly 0.5 SM 50 RI 258 Deflector,Fnxrt Door FIT R & 1 Assembly 0.2 SM 51 1 SET UP AND MEASURE Repair 2.0' SM 52 EC CAR COVER Replace Economy $5.006 SM 53 EC FLEX Replace Economy $8.000 SM 54 EC CORROSION PROTECTION Replace Economy $8.00• SM 55 S8 HAZARDOUS WASTE Sublet Repair $3,00' SM 56 EC CAUUQSEAM SEALER Replace Economy $10.00• SM 57 1 CLEAN AND RETAPE MOLDINGS Repair 0.3' SM 58 1 COLLISION PULL Repair 2.0' FR' 58 Items MC Message 01 CALL DEALER FOR EXACT PART #I / PRICE 13 INCLUDES 0.6 HOURS FIRST PANEL TWO-STAGE ALLOWANCE ..Estlm? Total & EnMsa.........'.......' ..............M..........?......,,......,,?............,?,....,,.,,.,..,.,.........,..,,,.,,.,..,,,,,,,,,,.,,,..,....,,....,,,.,,.,...,..,,,.,,,.,.,,,,.,,,,,,..,,,...,,,,,,.,,; . .........................................................................................................: Gross Parts $2,824.93 Other Para $1,290.00 Paint Materials $304.50 Una hem Markup $158.25 Parts & Matsrai Total Tax on Parts & Msterlel 6.00096 Labor Rats Repay Mrs Repair Hrs Total Hire Sheet Mral (SM) $44.00 12.0 10.2 22.2 $976.80 MscWEac (ME) $45.00 6.3 1.8 8.1 $384.50 Frame (FR) $48.00 2.0 2.0 $98.00 Refinish (RF) $44.00 14.5 14.5 $838.00 Paint Materials $21.00 Labor Total 46.8 Hours Tax on Labor ® 8.000% Sublet Repairs Towing Gross Total Lou: Deductible Not Total Alternate Parts Y/00/00100AWOO CUM 00100/00100100 Zip Code: 17547 Default Audatex Estimating 6.0.025 ES 07/06/2009 01:8 PM REL 8.0.025 DT 064112009 DB 07/01/2009 Copyright (C) 2006 Audatex North America, Inc. $4,375.88 $262.54 $2,075.30 $124.52 $3.00 $180.00 $7,021.04 $250.00- $6,m.04 2.7 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEWS TWO-STAGE REFINISH FORMULA. 07/0&2D09 01:28 PM Paw 3 d8 i? Rf(VUAR RARIR tI ???3iT ARMS® - Automated Rental Management System ® J" Donegal Insurance Page 1 of 1 Rental Company:ENTERPRISE RENT-A-CAR Invoice: D726880-5710 Bill To: DONEGAL INSURANCE ATTN: KRISTI STEECH P. O. BOX 302, ROUTE 441 MARIETTA, PA 17547 RENTER INFORMATION: Renter: NTT, KENNETH RENTAL INFORMATION: Rental Branch Location: ENTERPRISE RENT-A-CAR (5710) 800 NORTH HANOVER ST CARLISLE, PA 170131538 (717) 258-4495 ADDITIONAL CLAIM INFORMATION: Claim Number :PAAPA01090086590 Claim Type: Insured Vehicle Condition: Non-Driveable Date Of Loss: 6729709 Insured Name: Owners Vehicle: 2006 BUICK LUCERNE Additional Driver. WITT* MARY* Repair Facility: CLARK'S AUTOBODY CARLISLE, PA 17013 (717) 488-4151 VEHICLES RENTED: Billing Detail: Rental Period: 6129/09 to 8/5709 (38 days) Billed Period: 6/29/09 to 7/28/09 (30 days) Description Rate: Amount: 38DAYS 0 $28.24 $1,073.12 38 PTA TAX $2.00 $78.00 1 VRT %2.00 $21.46 1 SALES TAX %8.00 $84.39 TOTAL CHARGES: $1,234.97 Less Amount Received: $334.97 AMOUNT DUE.......... $900.00 Effective Date Year Make Model VIN Starting Ending Mileage and Time Mileage Mileage 6129709 4:37 PM 2009 CHEV IMPA 2G1WB57N791264653 22e72 23528 856 Rental Invoice Please Retum This Pordon with Remittance Make Payment To: ENTERPRISE RENT-A-CAR COMPANY (5789) 2625 MARKET PLACE HARRISBURG,, PA 17110 Federal I D:28-4526440 Total Charges: $1,234.97 Less Amount Received: $334.97 Total Amount Due .................... $900.00 Please include on your chedc: Invoice: D72MM5710 Exhibit "B" https://www.enterprise.com/amsweb/payinvoice 8/10/2009 e_ VERIFICATION I, Christine E. Richards, Subrogation Claims Specialist of Atlantic States Insurance Company, acknowledge I have the authority to execute this Verification on behalf of Atlantic States Insurance Company and certify the foregoing Complaint is based upon information which has been gathered by my counsel in the preparation of the lawsuit. The language of this Complaint is that of counsel and not my own. I have read the document and to the extent the Complaint is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent the content of the Complaint is that of counsel, I have relied upon counsel in making this Verification. This statement and Verification are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unworn falsification to authorities, which provides that if I knowingly make false averments, I may be subject to criminal penalties. ATLANTIC STATES INSURANCE COMPANY Christine E, Richards 0410112011 10:00 AM F2949_22721 SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Solicitor OFF,CE tF -->"tiRIFF FILED-OFFICE l;l? THE PR97HOHOTAR 2011 APR 21 AM 10' 13 CUMBERLAH0 COUri "r ?ENNSYlwVIM141 Atlantic States Insurance Company vs. Jeremy Chestnu? (et all.) Case Number 2011-3568 SHERIFF'S RETURN OF SERVICE 04/15/2011 05:10 PM'- Stephen Bender, Deputy Sheriff, who being duly sworn according to law, states that on April 15, 011 at 1710 hours, he served a true copy of the within Amended Complaint and Notice, upon the within narked defendant, to wit: Jeremy Chestnut, by making known unto himself personally, at 713 Grahams Woods Road, Newville, Cumberland County, Pennsylvania 17241 its contents and at the same time handling to him personally the said true and correct copy of the same. STEPHEN BE DER, DEPUTY 04/15/2011 05:1 PML- Stephen Bender, Deputy Sheriff, who being duly sworn according to law, states that on April 15, 011 at 1710 hours, he served a true copy of the within Amended Complaint and Notice, upon the with n named defendant, to wit: Amanda Fawbush, by making known unto Jeremy Chestnut, adult in char a at 1713 Grahams Woods Road, Newville, Cumberland County, Pennsylvania 17241 its contents and t the same time handing to him personally the said true and correct copy of he same. STEPHEN BE ER, DEPUTY SHERIFF COST: April 18, 2011 44 SO ANSWERS, RON R ANDERSON, SHERIFF !C Cou,m;Suite Shenff, i"eleosoft. inc. FAF1$LS\Clients\3050 Donegal\Current\612\3050.612.pra2 3 0 -rry r George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES --- 4C) I.D. 49813 _ C -? -Y7 10 East High Street n Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE IN THE COURT OF COMMON PLEAS OF COMPANY, as Subrogee of CUMBERLAND COUNTY, PENNSYL VAN IA KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants TO THE PROTHONOTARY: NO. 11-3568 CIVIL ACTION - LAW JURY TRIAL DEMANDED PRAECIPE Enter default judgment in the above-captioned action in favor of Plaintiffs and against Defendant Amanda Fawbush in the amount of $38,823.03, plus interest and costs of suit as prayed for in the Complaint, for failure to file an Answer to Plaintiffs' Complaint. I do hereby certify that a written notice of intention to file this Praecipe, in the form attached hereto, was mailed to the Defendant at the address indicated thereon, on July 14, 2011, which date was subsequent to the date default occurred and at least ten (10) days prior to the date of the Praecipe. Dated: 8/3/11 MARTS A MEsquire By George B. FalleI.D. No. 49813 Ten East High Street Carlisle, PA 17013 (717) 243-3341 41q,oo PVA7»y C aN.3al Attorneys for Plaintiffs F'AF%ES\Clients\3050 Donegal\Currend612\3050.612.tendaynotatl George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants TO: AMANDA FAWBUSH DATE OF NOTICE: 7/14/11 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION-LAW : JURY TRIAL DEMANDED 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 (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 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. DAMAGES WILL BE ASSESSED AGAINST YOU IN THE AMOUNT OF THE REPAIR ESTIMATE UNLESS YOU FILE A WRITTEN PRAECIPE WITHIN TEN (10) DAYS REQUESTING A TRIAL ON DAMAGES. Cumberland County Lawyer Referral Service Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 Telephone:(717) 249-3166 MARTSO AW Off F By J? - George B. Fal , Jr., Esquire I. D. Number 90916 Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff F:\MS\C1iaab\3050 DonepKurrent\61213050.612-sM Revised: 5124111 3: 57PM George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE : IN THE COURT OF COMMON PLEAS OF COMPANY, as Subrogee of : CUMBERLAND COUNTY, PENNSYLVANIA KENNETH WITT, Plaintiff V. NO. 11-3568 CIVIL ACTION - LAW JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants JURY TRIAL DEMANDED AFFIDAVIT OF APPRAISER I do depose and state that I am a licensed appraiser; that the appraisal of $7,021.04 attached hereto is true and correct and accurately sets forth the damages to the value of the 2006 Buick Lucerne owned by Kenneth Witt and; that I have been engaged in the appraisal business for 10 years and am qualified and capable to evaluate the appraisal as attached; and the repairs were necessary and the value indicated thereon was the amount by which the damages to this automobile would fairly and reasonably have been evaluated. This statement and appraisal are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. Signatur Print N e George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW : JURY TRIAL DEMANDED AFFIDAVIT AS TO MILITARY SERVICE COMMONWEALTH OF PENNSYLVANIA ) :SS. COUNTY OF CUMBERLAND George B. Faller, Jr., Esquire, being duly sworn according to law, deposes and says that he has authority to make this affidavit on behalf of his client, and to the best of his knowledge, information and belief, the Defendant above named is not in the military service of the United States of America, that he has knowledge that the said Defendant is now living at: 713 Grahams Wood Road, Newville, Pennsylvania 17241. Said Sworn to and subscribed before me this ,3_0?j day of Qfjnjj?L , 2011. N is unknown. George B. Faller, Jr., COMMONWEALTH OF PBOMWANIA Naww sell Margaret Ann Nash, Notary Public Caftm Sam, CaMnberW County mcam"i"Was- f4jpqNW4 ]MMN 29 3015 NUTARffi t George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW JURY TRIAL DEMANDED AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) : SS COUNTY OF CUMBERLAND George B. Faller, Jr., Esquire, being duly sworn according to law, deposes and says that he is an employee of MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER, attorneys for the Plaintiffs in the above captioned matter and that pursuant to the provisions of the Pennsylvania Rules of Civil Procedure, a notice of intention to enter default judgment against the Defendant was given to him by mail on or about July 14, 1 . George B. Faller, Jr., Esqui Swo to and subscribed before me this 1 day of , 2011. COMMONWULTtt OF PE MYMIL4 Not" sow Margaret Ann Nash Notary PW* Carole Born, C rnbeltmd County ota P Ii Cm vnWm Am P IOls CERTIFICATE OF SERVICE I, Nichole L. Myers, an authorized agent of MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER, hereby certify that a copy of the foregoing Praecipe was served this date by depositing same in the Post Office at Carlisle, PA, first class mail, postage prepaid, addressed as follows: Mr. Jeremy Chestnut 713 Grahams Wood Road Newville, PA 17241 Ms. Amanda Fawbush 713 Grahams Wood Road Newville, PA 17241 MARTSON LAW OFFICES i Nichole L. Myers Ten East High Street Carlisle, PA 17013 (717) 243-3341 Dated: 8/3/11 George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants TO: AMANDA FAWBUSH, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW : JURY TRIAL DEMANDED NOTICE OF ENTRY OF DEFAULT JUDGMENT You are hereby notified that on the .34 day of , 2011, the following Judgment was entered against you in the above-captioned action: judgment in the amount of $3 8,823.03, plus interest and costs of suit as prayed for in the Complaint for failure to file an Answer to Plaintiffs' Complaint. Date: .a Prothonotary I hereby certify that the name and address of the proper person to receive this notice under Pa. R. Civ. P. 236 is: Ms. Amanda Fawbush 713 Grahams Wood Road Newville, PA 17241 F. TILES\Clients\3050 Donegal\Cuuent\612\3050.612.pral George B. Faller, Jr., Esquire -` MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER ? MARTSON LAW OFFICES I.D. 49813 -•`= ? 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE IN THE COURT OF COMMON PLEAS OF COMPANY, as Subrogee of CUMBERLAND COUNTY, PENNSYLVANI A KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants TO THE PROTHONOTARY: NO. 11-3568 CIVIL ACTION - LAW JURY TRIAL DEMANDED PRAECIPE Enter default judgment in the above-captioned action in favor of Plaintiffs and against Defendant Jeremy Chestnut in the amount of $3 8,823.03, plus interest and costs of suit as prayed for in the Complaint, for failure to file an Answer to Plaintiffs' Complaint. I do hereby certify that a written notice of intention to file this Praecipe, in the form attached hereto, was mailed to the Defendant at the address indicated thereon, on July 14, 2011, which date was subsequent to the date default occurred and at least ten (10) days prior to the date of the Praecipe. MARTS LAW By George B. Fal r, Jr., Esquire I.D. No. 49813 Ten East High Street Carlisle, PA 17013 (717) 243-3341 414 co pp A7mY ??av?aa Dated: 8/3/11 Attorneys for Plaintiffs C dloa75S I FAMES\Clients\3050 Donegal\Current\612\7050.612.tendaynotjcl ,r George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants TO: JEREMY CHESTNUT DATE OF NOTICE: 7/14/11 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION-LAW : JURY TRIAL DEMANDED 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 (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 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. DAMAGES WILL BE ASSESSED AGAINST YOU IN THE AMOUNT OF THE REPAIR ESTIMATE UNLESS YOU FILE A WRITTEN PRAECIPE WITHIN TEN (10) DAYS REQUESTING A TRIAL ON DAMAGES. Cumberland County Lawyer Referral Service Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 Telephone:(717) 249-3166 MARTSON W OFF By. -4 ?4 ? George . Faller, r., Esquire I. D. Number 90916 Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff FARLESTIimb\3050 Dcne0\Cunent\61213050.612.sff1 Revised: 5/24/11 3: 57PM George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW : JURY TRIAL DEMANDED AFFIDAVIT OF APPRAISE I do depose and state that I am a licensed appraiser; that the appraisal of $7,021.04 attached hereto is true and correct and accurately sets forth the damages to the value of the 2006 Buick Lucerne owned by Kenneth Witt and; that I have been engaged in the appraisal business for 10 years and am qualified and capable to evaluate the appraisal as attached; and the repairs were necessary and the value indicated thereon was the amount by which the damages to this automobile would fairly and reasonably have been evaluated. This statement and appraisal are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. Signatur -7 Z?/ Print N e George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants JURY TRIAL DEMANDED AFFIDAVIT AS TO MILITARY SERVICE COMMONWEALTH OF PENNSYLVANIA ) :SS. COUNTY OF CUMBERLAND George B. Faller, Jr., Esquire, being duly sworn according to law, deposes and says that he has authority to make this affidavit on behalf of his client, and to the best of his knowledge, information and belief, the Defendant above named is not in the military service of the United States of America, that he has knowledge that the said Defendant is now living at: 713 Grahams Wood Road, Newville, Pennsylvania 17241. Said Defendant's place of employment is unknown. George B. Faller, Jr., Esquire Sworn to and subscribed befor e this day of , 2011. fX, r. d Nota ub IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW COMMONWEALTH OF PENNSMN" Not" so Margaret Ann Nash, Notary Publk CvNale Bono, Cumbv*id County My Corn million P; W 14Mne 29, 2015 M04BM PlNNMANU AsoaATMN OF MOrAREES George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW JURY TRIAL DEMANDED AFFIDAVIT COMMONWEALTH OF PENNSYLVANIA ) SS COUNTY OF CUMBERLAND ) George B. Faller, Jr., Esquire, being duly sworn according to law, deposes and says that he is an employee of MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER, attorneys for the Plaintiffs in the above captioned matter and that pursuant to the provisions of the Pennsylvania Rules of Civil Procedure, a notice of intention to enter default judgment against the Defendant was given to him by mail on or about July 14, 20 Sworn to and subscribed before me this OrA day of 11 QA , 2011. k) Gak Notary li Faller, Jr., Esquire COMMONWEALTH OF PEW&WLVANIA Noterlel Seel Margaret Ann Nash, Notary Rk k CRUS Bm, O nb&Wod County My Carry dow t V am ]Iris 29,2M5 NAM AWMAMM OF NOTARIES CERTIFICATE OF SERVICE I, Nichole L. Myers, an authorized agent of MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER, hereby certify that a copy of the foregoing Praecipe was served this date by depositing same in the Post Office at Carlisle, PA, first class mail, postage prepaid, addressed as follows: Mr. Jeremy Chestnut 713 Grahams Wood Road Newville, PA 17241 Ms. Amanda Fawbush 713 Grahams Wood Road Newville, PA 17241 MARTSON LAW OFFICES By Nichole L. Myers Ten East High Street Carlisle, PA 17013 (717) 243-3341 Dated: 8/3/11 George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff V. JEREMY CHESTNUT and AMANDA FAWBUSH, Defendants IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 11-3568 CIVIL ACTION - LAW JURY TRIAL DEMANDED TO: JEREMY CHESTNUT, Defendant NOTICE OF ENTRY OF DEFAULT JUDGMENT You are hereby notified that on the Y" day of , 2011, the following Judgment was entered against you in the above-captioned action: judgment in the amount of $3 8,823.03, plus interest and costs of suit as prayed for in the Complaint for failure to file an Answer to Plaintiffs' Complaint. Date: Prothonotary I hereby certify that the name and address of the proper person to receive this notice under Pa. R. Civ. P. 236 is: Mr. Jeremy Chestnut 713 Grahams Wood Road Newville, PA 17241 F:\MES\Clients\3050 Donegal\3050.Current\612\3050.612.mvjaffjc1 Revised: 12/29/11 9:41 AM George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 49813 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE COMPANY, as Subrogee of KENNETH WITT, Plaintiff FILED-OFFICE Cr THE PROTHONOTAR`x 201I DEC 29 AM 10: 09 CUMBERLAND COUNTY i'EMNSYLVANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 11-3568 JEREMY CHESTNUT and CIVIL ACTION-LAW AMANDA FAWBUSH, Defendants JURY TRIAL DEMANDED AFFIDAVIT OF MOTOR VEHICLE ACCIDENT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF ) On August 8, 2011, a Praecipe to enter default judgment in the above captioned action was entered in favor of Plaintiffs and against Defendants in the amount of $38,823.03, plus interest, attorney's fees and costs of suit and said judgment is the result of a motor vehicle accident which occurred on June 29, 2009. I make these statements pursuant to 18 Pa. Cons. Stat. §4904 relating to unsworn falsification to authorities and understand that false statements may stjb?egt me to crirrjig4 penalties under that statute. Sw;is to and subscribed before me 2.ai day of X , 2011. George B. Faller, Jr., 6@MM@NW9Al b aP- BENNBVUfANIA Notarial Seal Shelly Brooks, Notary Public Carlisle Boro, Cumberland County My Commission Expires Aug. 5, 2013 Member, Pennsylvania Association of Notaries t a5•°a F4 J dr-4 9q9 39 e(4 ?D teq 19 r) F:\FILES\C1ients\3050 Donega19050.Current\6129050.612 mvjaffafl Revised. 12/29/11 943 AM THE PRO?NdNOTAR`t George B. Faller, Jr., Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FAI*fitEC 29 An 14' { I MARTSON LAW OFFICES I.D. 49813 UMSERLANO CA ?,?,? 10 East High Street PENNSYLVANi Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff ATLANTIC STATES INSURANCE IN THE COURT OF COMMON PLEAS OF COMPANY, as Subrogee of CUMBERLAND COUNTY, PENNSYLVANIA KENNETH WITT, Plaintiff V. NO. 11-3568 JEREMY CHESTNUT and CIVIL ACTION-LAW AMANDA FAWBUSH, Defendants JURY TRIAL DEMANDED AFFIDAVIT OF MOTOR VEHICLE ACCIDENT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF ) On August 8, 2011, a Praecipe to enter default judgment in the above captioned action was entered in favor of Plaintiffs and against Defendants in the amount of $38,823.03, plus interest, attorney's fees and costs of suit and said judgment is the result of a motor vehicle accident which occurred on June 29, 2009. I make these statements pursuant to 18 Pa. Cons. Stat. §4904 relating to unsworn falsification to authorities and understand that false statements may sum--fit me to criminal penalties under that statute. / 4 George B. Fa-Me-r, Jr., Esquire Sworn to and subscribed before me 9is d of(L , 2011. L/ C; 1Vi,yftirNV4EAL f ri ?e PENNSYLVANIA L Notarial Seal Public Shetly Brooks, Notary Cariisle 3oro, Cumberiand `5,2013 Ug. MembeCPm a mis SS sclat on of Notaries QNk?`J $7 60 f4 4J ?? oath g 19-1