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HomeMy WebLinkAbout02-0248MICHELLE CHAVIS, Plaintiff VS. ALTON D. CHAVIS, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. (_.)~ - ,~q~C~ ~(,(~-,~t : CIVIL ACTION - LAW : : DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the court. A judgment may also he entered against you for any other claim or relief requested in these papers by the plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the office of the Prothonotary, Room 101, Dauphin County Courthouse, Front and Market Streets, Harrisburg, PA 17101. IF YOU DO NOT WISH TO FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET HELP. DAUPHIN COUNTY LAWYER REFERRAL SERVICE 213 NORTH FRONT STREET HARRISBURG, PA 17101 (717) 232-7536 MICHELLE CHAVIS, Plaintiff VS. ALTON D. CHAVIS, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA .' : NO. ~-~t./~ : CIVIL ACTION - LAW : : DIVORCE COMPLAINT IN DIVORCE UNDER SECTION 3301(c) OF THE DIVORCE CODE AND NOW COMES the above-named Plaintiff, by Melanie L. Erb, Esquire and the law firm of SERRATELLI, SCHIFFMAN, BROWN & CALHOON, P.C., and seeks to obtain a Decree in Divorce from the above-named Defendant, upon the grounds hereinafter more fully set forth: COUNT I DIVORCE 1. Plaintiff is Michelle Chavis, who currently resides at 309 Cherokee Drive, Mechanicsburg, Cumberland County, Pennsylvania 17050 since November 2001. Plaintiff's Social Security Number is 196-52-3536. 2. Defendant is Alton D. Chavis, who currently resides at 229 Boas Street, Harrisburg, Dauphin County, Pennsylvania, 17102 since April 2000. Defendant's Social Security Number is 225-25-7261. 3. Plaintiffhas been a bona fide resident in the Commonwealth for at least six months immediately previous to the filing of this Complaint. 4. The Plaintiff and Defendant were married on November 11, 2000, in Cumberland County, Pennsylvania. 5. The Plaintiff has been advised of the availability of counseling and that she may have the right to request that the Court require the parties to participate in counseling. 6. There have been no prior actions of divorce or for annulment between the parties. 7. The marriage is irretrievably broken. 8. The Defendant is not a member of the Armed Services of the United States or any of its allies. 9. The Plaintiff and Defendant are both citizens of the United States. 10. Plaintiff avers that there are no children of the marriage. WHEREFORE, the Plaintiff prays your Honorable Court to enter a Decree in Divorce from the bonds of matrimony. COUNT II EQUITABLE DISTRIBUTION 11. Paragraphs one through ten are hereby incorporated by reference herein. 12. Plaintiff states that Plaintiff and Defendant possess various items of both real and personal marital property which is subject to equitable distribution by the court. 13. Plaintiff requests that this court grant equitable distribution. WHEREFORE, Plaintiff prays that Your Honorable Court: (a) Equitably distribute all property, personal and real owned by the parties; (b) Grant such further relief as the Court may deem equitable and just. Respectfully submitted, Melanie L. Erb, Esquire SERRATELLI, SCHIFFMAN, BROWN & CALHOON, P.C. 2080 Linglestown Road Suite 201 Harrisburg, PA 17110 (717) 540-9170 ATTORNEY FOR PLAINTIFF VERIFICATION I verify that the statements made in the foregoing Complaint in Divorce are tree and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. Date:./--/3 -Or M/'chelle Chavis SERRATELLI, SCHIFFMAN, BROWN & CALHOON, P.C. S UITI-: 201 H^~aS~UR¢;, PA 17110.,9670 VITAL RECORDS RECORD OF -- I DIVORCE OR ANNULMENT COU.TV -- I [~] [cH£CKON~} [] cumberland MICHELLE CIa. AVIS, Plaintiff VS. ALTON D. CHAVIS, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. 02-248 : CIVIL ACTION - LAW : : DIVORCE PRAECIPE TO REINSTATE COMPLAINT TO THE PROTHONOTARY: Please reinstate the Complaint in the above-captioned matter. Respectfully submitted, Dated: Melame L. Erb, Esquire SERRATELLI, SCHIFFMAN, BROWN & CALHOON, P.C. 2080 Linglestown Road Suite 201 Harrisburg, PA 17110 (717) 540-9170 ATTORNEY FOR PLAINTIFF MATRIMONIAL SETTLEMENT AGREEMENT THIS AGREEMENT, made thisf/Jo.., of r'/,4~Z~f 2004, between, Michelle Chavis, hereinafter called "Wife" and Alton D. Chavis, hereinafter called "Husband". WITNESSETH: The parties hereto, being Husband and Wife were lawfully married on November 11, 2000 in Cumberland County, Pennsylvania; There were no children bom of the parties. Diverse and unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of HUSBAND and WIFE to live separate and apart for the rest of their natural lives, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other including, without limitation by specification: the settling of all matters between them relating to the ownership and equitable distribution of real and personal property; the settling of all matters between them relating to the past, present and future support, alimony and/or maintenance of each other; and in general, the settling of any and all claims and possible claims by one against the other or against their respective estate. NOW THEREFORE, in consideration of the premises and mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of Page - 1- which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby, covenant and agree as follows: 1. INCORPORATION OF PREAMBLE The recitals set forth in the Preamble of this Agreement are incorporated herein and made a part hereof as if fully set forth in the body of the Agreement. 2. AGREEMENT NOT A BAR TO DiVORCE PROCEEDINGS This Agreement shall not be considered to affect or bar the right of HUSBAND and WIFE to an absolute divorce on lawful grounds if such grounds now exist or shall hereafter exist or to such defense as may be available to either party. This Agreement is not intended to condone and shall not be deemed to be condonation on the part of either party hereto of any act or acts on the part of the other party which have occasioned the disputes or unhappy differences which have occurred or may occur subsequent to the date hereof. The parties acknowledge that their marriage is irretrievably broken and that they shall secure a mutual consent no-fault divorce pursuant to the terms of Section 3301 (c) of the Divorce Code in Wife's Cumberland County divorce action docketed to number 02-248. Simultaneously with the execution of this Agreement, the parties shall execute and file all documents and papers, including affidavits of consent, necessary to finalize said divorce. 3. EFFECT OF DIVORCE DECREE The parties agree that unless otherwise specifically provided herein, this Agreement shall Page -2- continue in full fome and effect after such time as a final Decree in Divorce may be entered with respect to the parties. 4. AGREEMENT TO BE INCORPORATED 1N DIVORCE DECREE The parties agree that the terms of this Agreement shall be incorporated into any Divorce Decree which may be entered with respect to them. 5. NON-MERGER It is the parties' intent that this Agreement does not merge with the Divorce Decree, but rather shall continue to have independent contractual significance. Each party maintains his or her contractual remedies as well as court ordered remedies as the result of the aforesaid incorporation or as otherwise provided by law or statute. Those remedies shall include, but not be limited to, damages, resulting from breach of this Agreement, specific enforcement of this Agreement and remedies pertaining to failure to comply with an order of court or agreement pertaining to equitable distribution, alimony, alimony pendente lite, counsel fees and costs as set forth in the Pennsylvania Divorce Code or other similar statutes now in effect and as amended or hereafter enacted. 6. DATE OF EXECUTION The "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. Page -3- 7. DISTRIBUTION DATE The transfer of property, funds and/or documents provided herein shall only take place on the "distribution date" which shall be defined as the date of execution of this Agreement unless otherwise specified herein. 8. FINANCIAL DISCLOSURE The parties confirm that each has relied on the substantial accuracy of the financial disclosure of the other, as an inducement to the execution of this Agreement. 9. SEPARATION Husband and Wife shall at all times hereafter have the right to live separate and apart from each other and to reside from time to time at such place or places as they shall respectively deem fit, free from any control, restraint, or interferences whatsoever by the other. Neither party shall molest the other or endeavor to compel the other to cohabit or dwell with him or her by any legal or other proceedings. The foregoing provision shall not be taken to be an admission on the part of either Husband or Wife of the lawfulness or unlawfulness of the causes leading to their living apart. 10. PERSONAL PROPERTY The parties hereto mutually agree that they have divided all furniture, household furnishings, appliances and other household personal property between them, and they mutually agree that each party shall from and after the date thereof be the sole and separate owner of all Page -4- tangible personal property present in his or her possession. 11. REAL PROPERTY The parties acknowledge that Husband was the owner of real estate known as 229 Boas Street, Harrisburg, Dauphin County, Pennsylvania. Husband and Wife acknowledge that this property, formerly the marital home, has been sold. Wife agrees to waive all her right, title and interest in any proceeds from the sale of the marital residence. ! 3. AUTOMOBILES With respect to the motor vehicles owned by one or both of the parties, they agree as follows: (a) The 1997 Chrysler Sebring Convertible is the sole and exclusive property of Wife. (b) The 1999 Nissan Pathfinder shall become the sole and exclusive property of Husband, subject to a loan held by Mellon Bank. The titles or assignment of any lease agreements to said vehicles shall be executed by the parties, if appropriate, for effectuating transfer as herein provided on the date of execution of this Agreement and said executed titles/assignments shall be delivered to the proper party on the distribution date. For the purposes of this Paragraph the term "title" shall be deemed to include "power of attorney" if the title or lease agreement to the vehicle is unavailable due to financing arrangements or otherwise. In the event any vehicle is subject to a lien, encumbrance, lease or other indebtedness the party receiving said vehicle as his or her property shall take it subject to said lien, encumbrance, lease or other indebtedness and shall be solely responsible therefore and Page-5- said party further agrees to indemnify, protect and save the other party harmless from said lien, encumbrance, lease or other indebtedness. Husband agrees to refinance any outstanding loan with regard to the 1999 Nissan Pathfinder and remove Wife's name from the loan and title within thirty (30) days of the date of this Agreement. Each of the parties hereto does specifically waive, release, renounce and forever abandon whatever right, title and interest he or she may have in the vehicle(s) that shall become the sole and separate property of the other pursuant to the terms of this Paragraph. 14. DEBTS The parties acknowledge and hereto mutually agree that they have previously divided all joint debts to their mutual satisfaction and shall indemnify and hold each other harmless from any future liability with regard to said debts. Husband shall be responsible for all household expenses including, but not limited to, gas, electric, cable, telephone and cell phone from November 1,200I on, and shalI indemnify and hold Wife harmless. A liability not disclosed in this Agreement will be the sole responsibility of the party who has incurred or may hereafter incur it, and each agrees to pay it as the same shall become due, and to indemnify and hold the other party and his or her property harmless for any and ail such debts, obligations and liabilities. From the date of the execution of this Agreement, each party shall use only those credit cards and accounts for which that party is individually liable and the parties agree to cooperate in closing any remaining accounts which provide for joint liability. 15. EMPLOYEE BENEFIT PLANS Page -6- Except as may otherwise be provided herein, each of the parties does specifically waive, release, renounce and forever abandon all of his or her right, title, interest or claim, whatever it may be in any Pension Plan, Retirement Plan, Profit Sharing Plan, 40IK Plan, Keogh Plan, Stock Plan, Tax Deferred Savings Plan and/or any employee benefit plan of the other party, including but not limited to Wife's 401 (k) Plan and hereafter said Pension Plan, Retirement Plan, Savings Plan, Tax Deferred Savings Plan and/or any employee benefit plan shall become the sole and separate property in whose name or through whose employment said plan is carried. 16. DIVISION OF BANK ACCOUNTS/STOCK/LIFE INSURANCE. The parties acknowledge and agree that they have previously divided to their mutual satisfaction all of their bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value and hereafter WIFE agrees that all said bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value in the possession of HUSBAND shall become the sole and separate property of HUSBAND; and HUSBAND agrees that all said bank accounts, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value in the possession of WIFE shall become the sole and separate property of WIFE. Each of the parties does specifically waive, release, renounce and forever abandon whatever right, title, interest or claim, he or she may have in any bank account, certificates of deposit, IRA accounts, bonds, shares of stock, investment plans and life insurance cash value that is to become the sole and separate property of the other pursuant to the terms hereof. 17. LEGAL FEES Page -7- Both parties shall be responsible for the payment of the fees owed to their own attorney. Husband and Wife do hereby waive, release and give up any rights which they may respectively have against the other for payment of counsel fees. 18. OTHER WRITINGS Each of the parties hereto agree to execute any and all documents, deeds, bills of sale or other writings necessary to carry out the intent of this Agreement. 19. DISCLOSURE AND WAIVER OF PROCEDURAL RIGHTS Each party understands that he or she has the right to obtain from the other party a complete inventory or list of all of the property that either or both parties own at this time or owned as of the date of separation, and that each party had the right to have all such property valued by means of appraisals or otherwise. Both parties understand that they have the right to have a court hold hearings and make decisions on the matters covered by this Agreement. Both parties understand that a court decision concerning the parties' respective rights and obligations might be different from the provisions of this Agreement. Each party hereby acknowledges that this Agreement is fair and equitable, that it adequately provides for his or her needs and is in his or her best interests, and that the Agreement is not the result of any fraud, duress, or undue influence exercised by either party upon the other or by any other person or persons upon either party. Both parties hereby waive the following procedural rights: a. The right to obtain an inventory and appraisement of all marital and non- Page -8- marital property as defined by the Pennsylvania Divorce Code. The right to obtain an income and expense statement of the other party as provided by the Pennsylvania Divorce Code. The right to have property identified and appraised. The right to discovery as provided by the Pennsylvania Rules of Civil Procedure. The right to have the court determine which property is marital and which is non-marital, and equitably distribute between the parties that property which the court determines to be marital, and to set aside to a party that property which the court determines to be that parties' non-marital property. The right to have the court decide any other rights, remedies, privileges, obligations covered by this Agreement and/or arising out of the marital relationship, including but not limited to possible claims for divorce, child or spousal support, alimony, alimony pendente lite (temporary alimony), equitable distribution, custody, visitation, and counsel fees, costs and expenses. 20. FURTHER DEBT Wife shall not contract or incur any debt or liability for which Husband or his property or estate might be responsible and shall indemnify and save harmless Husband from any and all claims or demands made against Husband by reason of debts or obligations incurred by Wife. Page -9- 21. FURTHER DEBT Husband shall not contract or incur any debt or liability for which Wife or her property or estate might be responsible and shall indemnify and save harmless Wife from any and all claims or demands made against Wife by reason of debts or obligations incurred by Husband. 22. MUTUAL RELEASE Except as otherwise provided herein and so long as this Agreement is not modified or canceled by subsequent agreement, the parties hereby release and discharge absolutely and forever each other from any and all rights, claims and demands, past, present and future specifically from the following: spousal support from the other, alimony, alimony pendente lite, division of property, claims or rights of dower and right to live in the marital home, right to act as executor or administrator in the other's estate, rights as devisee or legatee in the Last Will and Testament of the other, any claim or right as beneficiary in any life insurance policy of the other, any claim or right in the distributive share or intestate share of the other parties' estate. 23. iNCOME TAX PRIOR RETURNS The parties have heretofore filed joint federal and state returns. Both parties agree that in the event any deficiency in federal, state or local income tax is proposed, or any assessment of any such tax is made against either or them, each will indemnify and hold harmless the other from and against any loss or liability for any such tax deficiency or assessment therewith. Such tax, interest, penalty or expense shall be paid solely and entirely by the individual who is finally Page - 1 O- determined to be the cause of the misrepresentations or failures to disclose the nature and extent of his or her separate income on the aforesaid joint returns. 24. FiNAL EQUITABLE DISTRIBUTION OF PROPERTY The parties agree that the division of all property set forth in this Agreement is equitable and in the event an action in divorce is commenced, both parties relinquish the right to divide said property in any manner not consistent with the terms set forth herein. It is further the intent, understanding and agreement of the parties that this Agreement is a full, final, complete and equitable property division. 25. ENTIRE AGREEMENT This Agreement constitutes the entire understanding between the parties, and there are no covenants, conditions, representations or agreements, oral or written, of any nature whatsoever, other than those herein contained. 26. LEGALLY BINDING It is the intent of the parties hereto to be legally bound hereby and this Agreement shall bind the parties hereto and their respective heirs, executors, administrators and assigns. 27. FULL DISCLOSURE Each party asserts that she or he has made a full and complete disclosure of all the real and personal property of whatsoever nature and wheresoever located belonging in any way to Page-11- each of them, of all debts and encumbrances incurred in any manner whatsoever by each of them, of all sources and amounts of income received or receivable by each party, and of every other fact relating in any way to the subject matter of this Agreement. These disclosures are part of the consideration made by each party for entering into this Agreement. 28. COSTS TO ENFORCE in the event that either party defaults in the performance of any duties or obligations required by the terms of this Agreement and both extra-judicial and judicial proceedings are commenced to enforce such duty or obligations, the party found to be in default shall be liable for all expenses, including reasonable attorneys fees, incurred as a result of such proceedings. 29. AGREEMENT VOLUNTARILY AND CLEARLY UNDERSTOOD Each party to this Agreement acknowledges and declares that he or she respectively: (1) Is fully and completely informed as to the facts relating to the subject matter and their Agreement as the rights and liabilities of both parties; (2) Enters into this Agreement voluntarily after receiving the advice of independent counsel; (3) Has given careful and mature thought to the making of this Agreement; (4) Has carefully read each provision of this Agreement; (5) Fully and completely understands each provision of this Agreement, both as to the subject matter and legal effect. Page-I2- 30. AMENDMENT OR MODiFICATION This Agreement may be amended or modified only by a written instrument signed by both parties. 31. SEVERABILITY If any term, condition, clause or provision of this Agreement shall be determined or declared to be void or invalid in law or otherwise, then only that term, condition, clause or provision shall be stricken from this Agreement and in all other respects this Agreement shall be valid and continue in full force, effect and operation. Likewise, the failure of any party to meet his or her obligations under any one or more of the paragraphs herein, with the exception of the satisfaction of the conditions precedent, shall in no way avoid or alter the remaining obligations of the parties. 32. LAW APPLICABLE This Agreement shall be governed, construed and enforced under the statute and case law of the Commonwealth of Pennsylvania. 33. HEADINGS NOT PART OF AGREEMENT Any headings preceding the text of the paragraphs and subparagraphs herein are inserted solely for convenience of reference and shall not constitute a part of this Agreement nor shall they affect its meaning, construction or effect. Page - 13 - BY SIGNING THIS AGREEMENT, EACH PARTY ACKNOWLEDGES HAVING READ AND UNDERSTOOD THE ENTIRE AGREEMENT, AND EACH PARTY ACKNOWLEDGES THAT THE PROVISIONS OF THIS AGREEMENT SHALL BE AS BINDING UPON THE PARTIES AS IF THEY WERE ORDERED BY THE COURT AFTER A FULL HEARING. IN WITNESS WHEREOF, the parties hereto have executed this Agreement the day and year first written above. WITNESS: 7.. 07.. oq M'ICHELLE CHAVES ALTON D. CHAVIS Page-14- PROOF OF SERVICE (Requesting Agent) . SERRATELLI, SCBIFFMAN, BROWN & CALHOON, MELANIE L. ERB, ESQUIRE 2080 LINGLESTOWN ROAD SUITE 201 HARRISBURG, PA 17110 (Plaintiff) MICHELLE CHAVI S (Type of Document) DIVORCE COMPLAINT (Witness Fee) (CaseNo.&Jurisdi~ion) CUMBERLAND COUNTY COURT COMMON PLEA; NOi 02-2~8 (Defendant) ALTON D. CHAVIS (To Be Served On) (Accepted By) ALTON D. CHAVIS 229 BOAS STREET HARRISBURG, PA I I i I (Date Served) I (Time) I - '7: (Process Server's Report)' -~hscription: ale xl,]White Skin ~. [ ]Black Hair [ ]Female [ ]Black Skin ~[,.]Bmwn Hair [ ]Brown Skin [ ]Blonde Hair [ ]Yellow Skin [ ]Gray Hair ~ , . [lRedSkirL , []RedHair according ~6 law, deposes an(~ says thru h~she is process server herein named; and that the fact herein set forth above are true and correct to the I~ of their know[~dge, j.ntbwtfa~on ~nd bgi~t~ /'" Pro,,ssS,rvcr~ ]White Hair ]Balding ]Moustache ]Beard ]Glasses .~14-20yrs [ ]Under 5' [ ]clndar 100lbs 21-35yrs [ ]5'0"-5'3" [ ]100-1301bs [13.6-50yrs "~i5'4"-5'8" ""rlql31-1601bs ]51-65yrs [ ]5'9"-6'0" [ ] 161-200lbs ]Over 65yrs [ ]Over 6' [ ]Over 200lbs Sworn tp aI¥t subscrib~ed before me ~is ~ ~ayof ~a&~ O Commission Exp. MICHELLE CHAVIS, Plaintiff VS. ALTON D. CHAVIS, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 02-248 : CIVIL ACTION - LAW : : DIVORCE AFFIDAVIT OF CONSENT AND WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(C) OF THE DIVORCE CODE A Complaint in Divorce under 3301(c) of the Divorce Code was filed on January 17, 2002 and reinstated on February 15, 2002. (2) The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. (3) I consent to the entry of a final decree of divorce, without formal notice of the intention to request entry of divorce decree. (4) I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses, ifI do not claim them before a divorce is granted. (5) I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the Decree will be sent to me immediately afler it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Sec. 4904 relating to unsworn falsification to authorities. DATED ~Vl%helle Chavis MICHELLE CHAVIS, Plaintiff VS. ALTON D. CHAVIS, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 02-248 CIVIL ACTION - LAW DIVORCE AFFIDAVIT OF CONSENT AND WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(C) OF THE DIVORCE CODE (l) A Complaint in Divorce under 3301 (c) of the Divorce Code was filed on January 17, 2002 and reinstated on February 15, 2002. (2) The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. (3) I consent to the entry of a final decree of divorce, without formal notice of the intention to request entry of divorce decree. (4) I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses, ifI do not claim them before a divome is granted. (5) I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Sec. 4904 relating to unsworn falsification to authorities. DATED Alton D. Chavis MICHELLE CHAVIS, Plaintiff VS. ALTON D. CHAVIS, Defendant : 1N THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : : NO. 02-248 : CIVIL ACTION - LAW : : DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry of a Divorce Decree: 1. Ground for divorce: 3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: Process Server on February 25, 2002. Proof of Service attached. 3. Date of execution of the Affidavit of Consent required by Section 3301(c) of the Divorce Code: by Plaintiff February 6, 2004; by Defendant February 2, 2004. 4. Related claims pending: None 5. Date Plaintiff's Waiver of Notice in 3301(c) Divorce was flied with the Prothonotary: Date Defendant's Waiver of Notice in 3301(c) Divorce was filed with the Prothonotary: Dated: BROWN & CALHOON, P.C. 2080 Linglestown Road, Suite 201 Harrisburg, PA 17110 (717) 540-9170 Attorney for Plaintiff MIC~r~C~AViS Plaintiff VERSUS ALTOND. C~AVIS D~f~n~qt INTHE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY STATE Of ~~ PENNA. NO. 02-248 DECREE IN AND NOW,_ DIVORCE , IT IS ORDERED AND DECREED THat Michelle C~avis PLAINTIFF, AND Alton D. Chavis , DEFENDANT, ARE DIVORCED FROM THE BONDS OF MATRIMONy. THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH hAVE BEEN RAISED OF RECORD IN TH~S ACTION FOR WHICH A FINAL ORDER HAS NOT YET BEEN ENTERED; ATTEST: PROTHONOTARY IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintilt : Vs : File No. Oo,0 ~'o,'0 ~/~ : IN DIVORCE : : : Defendant NOTICE TO RESUME PRIOR SURNAME Notice is hereby given that the Plaintiff/defendant in the above matter, [select one by marking ] prior to the entry of a Final Decree in Divorce, or ~//after the entry of a Final Decree in Divorce datedfr'e-Jo* uarj/q/~iY. O0 ~ hereby elects to resume the prior surname of ,'~'c~t~l I~.. ~ t)c~ NC , and gives this written notice avowing his / her intention pursuant to the provisions of 54 P.S,. 704. Date:t93-0~7~2C~ ~ ~~ Signature Signature of naffl'e being resumea COMMONWEA~LTH OF PENNS~YLVANIA ) COUNTY OF d On the~-day of~, 200_~, before me, the Prothonotary or the notary public, personally appeared the above affiant known to me to be the person whose name is subscribed to the within document and acknowledged that he / she executed the foregoing for the purpose therein contained. In Witness Whereof, I have hereunto set my hand hereunto set my hand and official seal. NOTARIAL SEAL CLAUDIA A. BREWBAKER, NOTARY PUBLIC Carlisle Boro, Cumberland County My Commission Expires April 4, 2005 Notary Public