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HomeMy WebLinkAbout04-4433 CHARLES C. CAROTHERS, IV, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. ; No. 2004- L/ "13.3 CIVIL TERM TRACI M. CAROTHERS, Defendant : CIV1L ACTION- LAW : IN DIVORCE & CUSTODY 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 be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or 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 grounds 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 at the Cumberland County Court House, Carlisle, Pennsylvania. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, MARITAL PROPERTY, COUNSELlNG FEES OR EXPENSES BEFORE THE FlNAL DECREE OF DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR A TTORNEY AT ONCE. IF YOU DO NOT HAVE AN ATTORNEY OR CANNOT AFFORD, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FlND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 TELEPHONE NUMBER-717-249-3166 The Court of Common Pleas of Cumberland County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the Court, please contact our office. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled conference or hearing. CHARLES C. CAROTHERS, IV, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYL VANIA v. : No.2004- 1/,,/33 CIVIL TERM TRACI M. CAROTHERS, Defendant CIVIL ACTION- LAW IN DIVORCE & CUSTODY COMPLAlNT UNDER SECTIONS 3301 (c) AND 3301 (d) OF THE DIVORCE CODE I. Plaintiff is Charles C. Carothers, IV, an adult individual who currently resides at I Dandelion Drive, Boiling Springs, Cumberland County, Pennsylvania 17007. 2. Defendant is Traci M. Carothers, an adult individual who currently resides at 1008 Louisa Lane, Mechanicsburg, Cumberland County, Pennsylvania 17050. 3. Plaintiff and Defendant have been bona fide residents in the Commonwealth of Pennsylvania for at least six months immediately previous to the filing of this Complaint. 4. The Plaintiff and Defendant were married on April 21, 200 I in Cumberland County, Pennsylvania. COUNT 1- DIVORCE UNDER SECTIONS 3301 (c) AND 3301 (d) 5. Plaintiff hereby incorporates by reference paragraphs I through 4 above. 6. There have been no prior actions of divorce or annulment between the parties as to their current marriage. 7. Neither Plaintiff nor Defendant is in the Armed Forces of the United States. 8. Plaintiff avers that the marriage between the parties is irretrievably broken. 9. Plaintiff avers that the parties have been living separate and apart since March 12, 2004. 10. The Plaintiff has been advised of the availability of counseling and that he may have the right to request that the court require the parties to participate in counseling. WHEREFORE, Plaintiff respectfully requests this Honorable Court to enter a decree in divorce. COUNT 11- CUSTODY 11. The Plaintiff is Charles C. Carothers, IV, an adult individual who currently resides at 1 Dandelion Drive, Boiling Springs, Cumberland County, Pennsylvania 17007. 12. Defendant is Traci M. Carothers, an adult individual who currently resides at 1008 Louisa Lane, Mechanicsburg, Cumberland County, Pennsylvania 17050. 13. Plaintiff seeks partial physical and legal custody of Mackenzie A. Carothers, born January 24,2003. The child was not born out of wedlock The child is currently in the custody of Defendant at, 1008 Louisa Lane, Mechanicsburg, Cumberland County, Pennsylvania 17050 Pennsylvania. During the last five years, the child has resided with the following persons at the following addresses: Persons Residences Dates Traci M. Carothers 1008 Louisa Lane, Mechanicsburg, P A 17050 August 2004 to present Traci M. Carothers 1 Dandelion Drive Boiling Springs, P A January 2003 to August 2004 Charles C. Carothers, IV Traci M. Carothers 1 Dandelion Drive Boiling Springs, P A January 2003 to March 12,2004 The natural father of the child is Charles C. Carothers, IV, currently residing at I Dandelion Drive, Boiling Springs, Cumberland County, Pennsylvania. He is married to the Defendant. The natural mother of the child is Traci M. Carothers, currently residing at 1008 Louisa Lane, Mechanicsburg, Cumberland County, Pennsylvania 17050. She is married to the Plaintiff. 14. The relationship of the Plaintiff to the child is that of natural father. The plaintiff currently resides with the following person: Name Relationshil' Not Applicable Not Applicable 15. The relationship of the Defendant to the children is that of natural mother. The defendant currently resides with the following person: Name Relationship Mackenzie A. Carothers daughter 16. Plaintiff has not participated as a party or witness, or in any other capacity in other litigation, concerning the custody of the child in this or in any other Court. Plaintiff has no information of a custody proceeding concerning the child pending in a court of this Commonwealth. Plaintiff does not know of a person not a party to the proceedings who has physical custody of the child or claims to have custody or visitation rights with respect to the child. 17. Each parent whose parental rights to the child have not been terminated and the person who has physical custody of the child have been named as parties to this action. All other persons, named below, who are known to have or claim a right to custody or visitation ofthe child will be given notice of the pendency of this action and the right to intervene. WHEREFORE, Plaintiff requests your Honorable Court to grant him partial physical custody and partial legal custody ofthe child. Respectfully Submitted, DATE: ql,(o~ ~I~~ Attorney for Plaintiff Supreme Court I.D. # 90810 340 First Street Boiling Springs, P A 17007 (717)-226-1514 VERFICATlON I verify that the statements made in the foregoing Complaint for Divorce and Custody are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. ~4904, relating to unsworn falsification to authorities. cJl~c~ ~" Charles C. Carothers, IV. DATED: .,j, /0 "i CHARLES C. CAROTHERS, IV, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : No. 2004- CIVIL TERM TRACI M. CAROTHERS, Defendant : CIVIL ACTION- LAW : IN DIVORCE & CUSTODY CERTIFICATE OF SERVICE I, Derek R. Clepper, Esquire, Attorney for Plaintiff, Charles C. Carothers, hereby certify that I have served a true and correct copy of this COMPLAlNT FOR DIVORCE UNDER SECTIONS 3301 (c) and 3301 (d) OF THE DIVORCE CODE upon the Defendant, Traci M. Carothers, by depositing the same in the U.S. Mail, First Class, Postage Prepaid, Restricted Delivery, Return Receipt Requested, to the following address: Mrs. Traci M. Carothers 1008 Louisa Lane Mechanicsburg, P A 17050 DATED: f~/ov ~ erek R. Clepper, Esquire 340 First Street Boiling Springs, P A 17007 (717)-226-1514 Supreme Court J.D. 90810 Attorney for Plaintiff "~ r:- -. ~ ~ ~ -- d ~ E;"'., ('> '-> .,.... rSJ J ~ '-" ~~ C' ('~ r-j c.:') c,::: -c- <..0 1"1 -'0 I "'-. _c ~ '3? -"''''I o -n .-< f:,.t~ ~,' '.r C)\C) -~::--; ~.~.~ . ~:~~~ . , -~~1 ",-, ~L- Q'i CHARLES C. CAROTHERS, IV, Plaintiff v. : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : f//1.(1{ 3 J CIVIL TERM TRACI M. CAROTHERS, Defendant : CIVIL ACTlON- LAW : IN CUSTODY CUSTODY STIPULATION AND AGREEMENT THIS AGREEMENT AND STIPULATION entered into the day and year hereinafter set forth, by and between Charles C. Carothers, IV (hereinafter referred to as "Father") and Traci M. Carothers (hereinafter referred to as "Mother"). WHEREAS the parties are the natural parents of Mackenzie A. Carothers, born January 24, 2003, (hereinafter referred to as "child"); and, WHEREAS, the parties are presently separated and living in separate residences; and, WHEREAS, the parties wish to enter into an agreement relative to the custody and partial custody of the child. NOW, THEREFORE, in consideration of the mutual covenants, promises and agreements as hereinafter set forth, and intending to be legally bound hereby, the parties agree as follows: 1. The parties shall have joint legal custody of the child. 2. Mother shall have partial physical custody of the child, subject to the Father's periods of partial physical custody. "_ 'U'_h_'__'."__._n____", .__"_.>"." 3. Father shall have partial physical custody at the following times: a. Commencing Saturday September 11, 2004, from Saturday afternoon to the following Monday morning, on a biweekly schedule; b. On the alternate weekends, from Sunday afternoon until the following Monday morning, on a biweekly schedule; c. Every Wednesday, from the conclusion offather's work day, until the following Thursday morning. d. Every Thursday, from the conclusion of father's work day, until the following Friday morning. 4. Father shall provide transportation to child's day care at Cumberland County Learning center on Monday, Thursday and Friday mornings during his period of partial custody. Father shall pick-up the child on Wednesday and Thursday evenings at the Cumberland County Learning Center. At all other times the parties shall decide transportation and custodial exchanges with a purpose of acting in the child's best interest. 5. The parties shall have an extended period of physical custody during their vacation period. Each party shall provide the other with reasonable notice prior to periods of vacation. ,.--------__~.,,_..._.__.~__ m 6. Father shall have partial physical custody of the child on Father's Day. Mother shall have partial physical custody of the child on Mother's Day. 7. The parties shall share partial physical custody of the child on her birthday. 8. The parties shall alternate physical custody of the child during their Holiday periods. For the purpose of this paragraph, the following Holidays shall be considered major Holidays and subject to the terms of this paragraph: New Year's Day, Martin Luther King Day, President's Day, Good Friday, Memorial Day, Labor Day, Veteran's Day, Thanksgiving Day. Holiday Schedule shall commence on Labor Day of 2004 with Father having physical custody of the child on Labor Day and the parties alternating holidays thereafter. 9. Mother shall have physical custody of the child on lndependence Day. 10. The parties shall alternate physical custody during the Christmas Holiday Period by the terms of the following schedule set forth in this paragraph. For purposes of this paragraph Christmas Holiday Period shall be defined as: Christmas Eve Day, Christmas Day, New Year's Eve Day and New Year's Day: a. On even numbered years (2004 and thereafter), Mother shall have physical custody of the child from Christmas Eve Day after 8:00 p.m. to Christmas Day at 3:00 p.m. Father shall have physical custody of the child on Christmas Eve Day until 8:00 p.m. and on Christmas Day from 3:00 p.m. until the following morning. b. On odd numbered years (2005 and thereafter), Father shall have physical custody of the child from Christmas Eve Day after 8:00 p.m. to Christmas Day at 3:00 p.m. Mother shall have physical custody of the child on Christmas Eve Day until 8:00 p.m. and on Christmas Day from 3 :00 p.m. until the following morning. c. The parties agree that they will share physical custody of the child on New Year's Eve Day and New Year's Day. Mother shall have physical custody of the child on New Year's Eve Day after 8:00 p.m. to New Year's Day at 3:00 p.m. commencing in 2004 and continuing thereafter during the even numbered years. Father shall have physical custody of the child on New Year's Eve Day after 8:00 p.m. to New Years Day at 3:00 p.m. commencing in 2005 and continuing thereafter during the odd numbered years. 11. In the event that the Holiday schedule conflicts with the regular custody schedule, the Holiday schedule shall supersede the regular custody schedule. ]2. Father shall also have partial custody of the child at such times as the parties may from time to time agree. -~------>-..~--~ 13. The parties will keep each other advised immediately relative to any emergencies concerning the child and shall further take any necessary steps to ensure that the health and well being of the child is protected. 14. Neither parent shall do anything which may estrange the child from the other party, or injure the opinion of child as to the other party or which may hamper the free and development of the child's love or affection for the other party. 15. The parties agree to use appropriate language and conduct when in the presence of the minor child. 16. The parties shall be able to modifY this agreement from time to time with a view towards the child's best interest. In the event that the parties do not agree to a change in times of partial custody the terms of this Stipulation and Agreement shall control. 17. The parties desire that this Stipulation and Agreement be made an Order of Court to the Court of Common Pleas of Cumberland County, and further acknowledge that the Court of Common Pleas of Cumberland County does, in fact, have jurisdiction over the issue of custody and the parties' minor child and shall retain jurisdiction should circumstances change and either party desire or require modification of said Order. 18. The parties agree that in making this Agreement, that there has been no fraud, concealment, overreaching, coercion or other unfair dealing on the part of the other. 19. The parties acknowledge that they have read and understand the provisions of this Agreement. 20. Each party acknowledges that the Agreement is fair and equitable and that it is not the result of any duress or undue influence. 21. Each party has been advised of his or her right to consult with counsel prior to signing this Agreement. IN WITNESS WHEREOF, the parties hereto intending to be legally bound by the terms hereof set their hands and seal the day and year written below: WITNESS: --....., """~ 4ryP ,--- Name ofwitness:T 0'1)'1) t\.. (Y\ouL e1Lc:(~ ,~ DATE: <113.\0'1 (SEAL) CHARLES C. CAROTHERS, IV DATE: .,J~JQ~ ---------_._~~- -=:::::.~ d-n,1P ----N f' - .me 0 wItness: I 0.,">). A. (YlOUL rrfacimw~ TRACIM.CAROTHERS (SEAL) DATE: '? Is I D'-l DATE: Q/~/o+ COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND PERSONALLY APPEARED BEFORE ME, this 3~ay or,/~ ' 2004, a Notary Public, in and for the Commonwealth of Pennsylvania and County of Cumberland, CHARLES C. CAROTHERS, IV., known to me (satisfactory proven) to be the person whose name is subscribed to the within Custody Stipulation and Agreement, and acknowledges that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. :;o~{~ 1-' /I~ NOTARIAL SEAL Pat~icia 1. Hc<rner. NJt;:rry Pr~}~i~ Corh::;!e Bora., Cl~p~l'''.''l:<'n'l ~-'",...,~" ". ..v...._... '; '-.-",L-'.HJ My commissioil C\;:,ii\-'S _'ime ):'), 2:003 ---~"._-.~<._~-"-~....~,,~..._- COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND PERSONALLY APPEARED BEFORE ME, this 3~ day of ~~0. ./ 2004, a Notary Public, in and for the Commonwealth of Pennsylvania and County of Cumberland, TRACI M. CAROTHERS, known to me (satisfactory proven) to be the person whose name is subscribed to the within Custody Stipulation and Agreement, and acknowledges that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. )~tf;C~~/V /' #~ NOTARJAL SEAL Patricia 1. Homer. Notary Public Carlisle 801"0., Cumberland County My commission expires June 26, 2008 CHARLES C. CAROTHERS, IV, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : No. 2004- 4433 CIVIL TERM TRACI M. CAROTHERS, Defendant : CIVIL ACTION- LAW : IN DIVORCE & CUSTODY PROOF OF SERVICE I, Derek R. Clepper, Esquire, Attorney for Plaintiff, Charles C. Carothers, IV, hereby certify that I have served a true and correct copy ofthis COMPLAlNT FOR DIVORCE UNDER SECTIONS 3301 (c) and 3301 (d) OF THE DIVORCE CODE upon the Defendant, Traci M. Carothers, by depositing the same in the U.S. Mail, First Class, Postage Prepaid, Restricted Delivery, Return Receipt Requested, and that service was complete on September 7, 2004, verified by the signed return receipt attached below. 12t c&/Are 340 First Street Boiling Springs, P A 17007 (717)-226-1514 Supreme Court LD. 90810 Attorney for Plaintiff DATED: 9('i(ot.-( Agent ~ '-~~ 1I[1tC:l:. frI. CAflufn&U: ~,\~r - 1.1008 Lw~St#r l./tNiC;t ~ SEP-72004)m .:'1 JtEUrh<;;l;;6- p,q.1'!~:. ~~~..: 2. .A1tJoIo N...- \ (TloJ18fer . -. -;-: Xv.. from~1sb6I) 7003 3110 0004 5768 4313 ~"rrn 3811. February 2~ · ComPlete iteins Item 4 ff ~ 2. and 3. AIao """'PIeie · :'~nameando::./s~ . Altachthls ~ ,:,m the C8ld to YllU. or on the front ~ the beck of the mal/piece . . . " "PaCe permits. ' 1.. A1tJoIo~to: . Domestic Retum Receipt 102595-02'~1540 ~~ ~~,', ....::~ (/) :,,-'! , '..;..~ C) r......:: J CHARLES C. CAROTHERS, IV, Plaintiff v. TRACI M. CAROTHERS, Defendant Sf? 1 () 2004 W : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : No.2004- 4433 CIVIL TERM : CIVIL ACTION- LAW : IN CUSTODY ORDER OF COURT AND NOW, this , Jr- day of ~, 2004, the attached Stipulation and Agreement is hereby made an Order of Court and all prior Orders on this matter are hereby vacated .t&erek R. Clepper, Esquire 340 First Street Boiling Springs, P A 17007 ) v'fraci M. Carothers ] 008 Louisa Lane Mechanicsburg, P A ] 7050 BY THE COURT, ~ :/' J. ....,." ... ...\ '.,'.. ',..J -) 1',.-1 (' ~ ~- ;=; ~lOGZ \.' i ( CHARLES C. CAROTHERS, IV, Plaintiff v IN THE COURT OF COMMON PLEAS OF CUMBERJLAND COUNTY, PENNSYL VANIA TRACI M. CAROTHERS, Defendant CIVIL ACTION - LAW NO. 2004.. 4433 IN CUSTOJi)Y COURT ORDER AND NOW, this ~ day of advised that jurisdiction. BY THE COURT, Oti iO_./2-// Hubert X. Gilroy Custody Conciliato , <~;,... ... .0 I ! ~ lrir\-' {\_l.-'\"""" 20:\ I' ! _ \ C',n Ij"0Z 1_ ~."..J \.l... .u ., CHARLES C. CAROTHERS, IV, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. No. 2004- 4433 CIV1L TERM TRACI M. CAROTHERS, Defendant CIVIL ACTION- LAW IN DIVORCE & CUSTODY DEFENDANT'S AFFIDAVIT OF CONSENT, ACCEPTANCE OF SERVICE AND WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF DIVORCE DECREE UNDER SECTION 3301 (C) OF THE DIVORCE CODE I. A Complaint in divorce under section 330] (c) ofthe Divorce Code was filed on September 1,2004. 2. The Defendant acknowledges receipt and accepted service of the Complaint on September 7,2004. 3. The marriage of the Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the date of filing of the Complaint 4. I consent to the entry of a final decree in divorce without notice. 5. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if! do not claim them before a divorce is granted. 6. 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. 7. I have been advised ofthe availability of marriage counseling and understand that I may request that the court require counseling. I do not request that the court require counseling. 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 P A. C.S. Section 4904 relating to unsworn falsification to authorities. Date: ]~OIID+ j{CUtJ'NflfnftVA<: Traci M. Carothers -- . ') ~ L CHARLES C. CAROTHERS, lV, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : No. 2004- 4433 CIVIL TERM TRACI M. CAROTHERS, Defendant : CIVIL ACTION- LAW : IN DIVORCE & CUSTODY CERTIFICATE OF SERVICE I, Derek R. Clepper, Esquire, Attorney for the Plaintiff in the above captioned divorce action, do hereby certify that I served a certified copy ofthe Complaint in Divorce to the Defendant, as per the Proof of Service, a copy of which attached hereto, filed with the Prothonotary on September 9, 2004. Date: II ;'2'((0'( B@llfJr 340 First Street Boiling Springs, P A 17007 (717)-226-1514 Supreme Court l.D. 908]0 Attorney for Plaintiff ~ CHARLES C. CAROTHERS, IV, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA v. No. 2004- 4433 CIVIL TERM TRACI M. CAROTHERS, Defendant CIVIL ACTION- LAW IN DIVORCE & CUSTODY r0 .-:) (J :,::J _;, C0 r"': h:! PROOF OF SERVICE , \,;:'1 :- :-1.~_'1'1 ,-- '-11_-r.~ . .~;~; ---I, :1' ('1 -rf1 1, Derek R. Clepper, Esquire, Attorney for Plaintiff, Charles C. Carothers, 1\1, hereby. certify that I have served a true and correct copy of this COMPLAlNT FOR DIVOR<:JI; U~.9ER-! w SECTIONS 3301 (c) and 3301 (d) OF THE DIVORCE CODE upon the Defendant, Traci M. Carothers, by depositing the same in the U.S. Mail, First Class, Postage Prepaid, Restricted Delivery, Return Receipt Requested, and that service was complete on September 7,2004, verified by the signed return receipt attached below. DATED: q(i (0 "( ./i)L k) [~, 1:'>erek R. Clepper, Esquire 340 First Street Boiling Springs, P A 17007 (7]7)-226-1514 Supreme Court 1.0. 90810 Attorney for Plaintiff . Complete items 1, 2. and 3. Also complete item 4if Restricted Delivery is desired. . Print your name and address on the reverse so that we can return the card to you. . Attach this card to the back of the mailpiece. or on the front jf space permits. 1. Article Addressed to: )!fA c-:r:.. M. CAf!.Jiln61..5 IO{)$ Lw1:'>!+- LtVv~ frtl../1i'rtl:u f2...1& fA /}J,-t: .~ SE?-7 "" ./~ 3. K"'C:i;~~pressMai\ o Registered 0 Return Receipt for Merchandise o Insured Mail 0 C.o.D. 4. Res1ricted Delivery? (Extra Fee) ,)( Yes 2. Article Number (f ransfer from seriiice label) PS Form 3811, February 2004 7003 3110 0004 5768 4313 Domestic Return Receipt 102595-02-M-1540 ~ CHARLES C. CAROTHERS, IV, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. No. 2004- 4433 CIVIL TERM TRACI M. CAROTHERS, Defendant CIVIL ACTION- LAW IN DIVORCE & CUSTODY PLAINTIFF'S AFF ADA VIT OF CONSENT AND WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF DIVORCE DECREE UNDER SECTION 3301 (C) OF THE DIVORCE CODE 1. A complaint in divorce under 2330] (c) and 3301 (d) of the Divorce Code was filed on September 1, 2004. 2. The marriage of the Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the filing ofthe Complaint. 3. I consent to the entry of a Final Decree in Divorce without notice. 4. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if! 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 after it if filed with the Prothonotary. 6. I have been advised of the availability of marriage counseling and understand that I may request that the court require counseling. I do not request that the court require counseling. ] 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. Section 4904 relating to unsworn falsification to authorities. Date: 1a-I.Jo'-j C- 1. D C i'E.' \v /'LD ~--.._-_.--- ~ - Charles C. Carothers, IV . CHARLES C. CAROTHERS, IV, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. No. 2004- 4433 CIVIL TERM TRACI M. CAROTHERS, Defendant CIVIL ACTION- LAW IN DIVORCE & CUSTODY 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: irretrievable breakdown under Section 3301(c) of the divorce code. 2. Date and manner of service ofthe complaint: Service upon the Defendant via certified mail, restricted delivery on September 7, 2004. 3. (Complete either paragraph (a) or (b).) (a) Date of execution of the affidavit of consent required under Section of the divorce code: by plaintiff December 1. 2004 by the defendant December 1. 2004 (b) (I) Date of execution of the plaintiff's affidavit required by Section 3301 (d) ofthe divorce code NI A (2) Date of service of the plaintiffs affidavit upon the defendant N/A 4. Related claims pending NONE 5. Complete either (a) or (b) (a) Date and manner of service of the notice of intention to file praecipe to transmit the record, a copy of which is attached: (b) Date plaintiffs waiver of notice in Section 330] (c) divorce was filed with the Prothonotary: December 3.2004 Date defendant's waiver of notice in Section 3301 (c) divorce was filed with the Prothonotray: December 3, 2004 ~'!r~ Attorney for Plaintiff, Charles C. Carothers - - ATTEST ~~ J. ~,",A~ ~P"OC"~'OT^"' , JI!p ~ /f7~ "'?:?~ .Au Yr -e' I~ ~9 ~_ ~-7W~,l. /'9 /4 Cc ({'I " ~. '. ...