HomeMy WebLinkAbout04-4460IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUN'FY, PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff,
VS.
CIVIL DIVISION
ARBITRATION DIVISION
COMPLAINT IN CIVIL ACTION
DONALD L. SOLONINKA,
Defendant.
Filed on behalf of Unifund CCR
Partners, Plaintiff
Counsel for Unifund CCR Partnem:
Jonathan S. McAnney, Esquire
Pa. I.D. #50041
TUCKER ARENSBERG, P.C.
Firm #287
1500 One PPG Place
Pittsburgh, PA 15222
(412) 566-1212
LIT:310716-1 014636-113960
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff,
vs. No.
DONALD L. SOLONINKA,
Defendant.
NOTICE TO DEFEND
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 ara served, by entering a
wdtten appearance personally or by attorney and filing in writing with the Court your defenses or objections to
the claims set forth against you. You ara 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 ralief requested by the Plaintiff. 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 REDUCED FEE OR NO FEE.
CUMBERLAND COUNTY BAR ASSOCIATION
2 LIBERTY AVENUE
CARLISLE, PA 17013
(800) 990-9108
USTED DEBE LLEVAR ESTE PAPEL A SU ABOGADO ENSEGUIDA. SI USTED NO TIENE UN
ABOGADO, VAYA O LLAME POR TELEFONEIFI: LA OFIClNA FIJADA AQU[ ABA JO. ESTA OFIClNA
PUEDE PROVEER~ CON INFORMAClON DE COMO CONSEGUIR UN ABOGADO.
SI USTED NO PUEDE PAGARLE A UN ABOGADO, ESTA OFICINA PUEDE PROVEER~
INFORMAClON ACERA AGENClAS. QUE PUEDAN OFRECER SERVICIOS LEGAL A PERSONAS
ELIGIBLE AQ UN HONORARIO REDUClDO O GRATIS.
CUMBERLAND COUNTY BAR ASSOCIATION
2 LIBERTY AVENUE
CARLISLE, PA 17013
(800) 990-9108
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff,
VS.
DONALD L. SOLONINKA,
Defendant.
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)
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)
)
)
)
)
)
)
COMPLAINT IN CIVIL ACTION
AND NOW, comes the Plaintiff, UNIFUND CCR PARTNERS, by its
counsel, Tucker Arensberg, P.C. and files this Complaint stating as follows:
1. The Plaintiff is Unifund CCR Partners, a Delaware partnership, with
offices located at 10625 Techwoods Circle, Cincinnati, Ohio 45242.
2. The Defendant, Donald L. Soloninka is an individual and resident of
819 Bridge Street, Cumberland, PA 17070.
3. On or about December 14, 1998, the Defendant applied for and was
approved to receive a Providian National Bank Credit Card (hereinafter "Account"). Such
Account was issued at Account Number 4465610301230435.
and owing.
The Defendant utilized such Account and incurred a balance due
5. As of July 7, 2003, the Defendant owed $4,138.67 in principal, and
$401.06 in interest. The total amount owed is $4,539.73. See the Affidavit of
Indebtedness attached hereto as Exhibit "A" and incorporated by reference as if fully set
forth at length herein.
6. Despite written and oral demands for payment, the Defendant has
failed and refused to pay the amount due and owing.
7. Reasonable attorneys' fees in the amount of 20% of the principal
balance are due and owing.
Defendant:
The following amounts are currently due and owing from the
Principal and Interest
Reasonable Attorney's Fees (20%)
TOTAL:
$4,539.73
$ 907.95
$5,447.68
9. The Account has been assigned by Providian National Bank to the
Plaintiff including all rights to collect the amount due from the Defendant.
WHEREFORE, the Plaintiff, Unifund CCR Partners demands that judgment
be entered in its behalf and against the Defendant, Donald L. Soloninka, in the sum of
$5,447.68 plus costs and interest.
TUCKER ARENSBERG, P.C.
By
Jona ney, Esquire
Couns~ for Unifund CCR Partners:
TUCKER ARENSBERG, P.C.
1500 One PPG Place
Pittsburgh, PA 15222
Attorneys for Plaintiff
VERIFICATION
The undersigned verifies that the statements made in the foregoing
Complaint are true and correct to the best of her knowledge, information and belief and
understands the statements therein made are made subject to the penalties of 18
Pa.C.S. §4904 relating to unswom falsification to authorities.
Unifund CCR Partners
AFFIDAVIT OF INDEBTEDNESS
State of Ohio )
County Of Hamilton ss.
Jessica Bergholz, being sworn, deposes and says that she is Media Supervisor of Unifund CCR Partners herein called
assignor, which is doing business at 10625 Techwoods Circle, Cincinnati, Ohio 45242 and that she is authorized to
make the statements and representations herein.
The defendant is not in any branch of the military.
There is due and payable from DONALD L SOLONINKA, Account Number 4465610301230435,the amount of
$4539.73 (principal balance in the amount of $4136.67 plus interest up through 07/07/2003 in the amount of
$401.06). By the terms of the agreement between the defendant and the original creditor, interest is accruing
from the aforesaid date at the rate of 6.00 percent per annum.
This account was originated with Providian National Bank. Unifund CCR Partners purchased this account from
Providian National Bank. Said account has been assigned, transferred and set over unto, Tucker Arensberg with
full power and authority to do and perform all acts necessary for the collection, settlement, adjustment,
compromise or satisfaction of said claim.
Client# 215
DATED 07 July 2003
Title
10625 Techwoods Circle Cincinnati, OH 45242
Address
Subscribed and sworn tob~
· ~...-.
day of July
SHERIFF'S RETURN ~ REGULAR
CASE NO: 2004-04460 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CIIMBERL/kND
UNIFUND CCR PARTNERS
VS
SOLONINKA DONALD L
SPIANNON SHERTZER ,
Cumberland County, Pennsylvania,
says, the within COMPLAINT & NOTICE
SOLONINKA DONALD L
DEFENDANT at 1315:00 HOURS, on
at 819 BRIDGE STREET
NEW CUMBERLAND, PA 17070
BONNIE SOLONIKA
a true and attested copy of COMPLAINT & NOTICE
Sheriff or Deputy Sheriff of
who being duly sworn according to law,
was served upon
the
the 10th day of September, 2004
by handing to
together with
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs:
Docketing 18.00
Service 12.58
Affidavit .00
Surcharge 10.00
.00
40.58
Sworn and Subscribed to before
me this /L ~ day of
So Answers:
R. h o~s Kline
09/13/2004
TUCKER ARENSBERG
$ puty eri
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff,
VS.
DONALD L. SOLONINKA,
Defendant.
CIVIL DIVISION
ARBITRATION DIVISION
No. 04-4460 Civil Term
PRAECIPE FOR ENTRY OF DEFAULT
JUDGMENT
LIT:339116-'J 014636-113960
Filed on behalf of Unifund CCR
Partners, Plaintiff
Counsel for Unifund CCR Partnem:
Jonathan S. McAnney, Esquire
Pa. I.D. #50041
TUCKER ARENSBERG, P.C.
Firm ~Y287
1500 One PPG Place
Pittsburgh, PA 15222
(412) 566-1212
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUN'rY, PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff,
VS.
DONALD L. SOLONINKA,
Defendant.
No. 04-4460 Civil Term
PRAECIPE FOR ENTRY OF DEFAULT JUDGMENT
To Prothonotary:
Please enter Judgment by Default in the above-captioned case for the
Plaintiff and against Defendant, in the amount of $5,447.68 plus costs and interest, for
failure to answer or otherwise respond to the Complaint.
I hereby certify that the attached written Notice of Intention to take a
Default Judgment was mailed to the Defendant ten days prior to the filing of the
Praecipe for Entry of Default Judgment.
Date: October 15, 2004
Jonathan S'"//McAnney, Esquire
~(~;j~ sD~l~f r~500~nlifu nd CC R pa rtn ers:
TUCKER ARENSBERG, P.C.
Firm ~Y287
1500 One PPG Place
Pittsburgh, PA 15222
412-566-1212
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff,
VS.
DONALD L. SOLONINKA,
Defendant.
CIVIL DIVISION
ARBITRATION DIVISION
No. 04-4460 Civil Term
TEN DAY NOTICE
Filed on behalf of Unifund CCR
Partners, Plaintiff
Counsel for Unifund CCR Partners:
Jonathan S. McAnney, Esquire
Pa. I.D. #50041
TUCKER ARENSBERG, P.C.
Firm #287
1500 One PPG Place
Pittsburgh, PA 15222
(412) 566-1212
LIT:337563-1 014636-113960
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff,
vs.
DONALD L. SOLONINKA,
Defendant,
CIVIL DIVISION
ARBITRATION DIVISION
No. 04-4460 Civil Term
TO:
Donald L. Soloninka
819 Bridge St
Cumberland, PA 17070
DATE OF NOTICE: October 1, 2004
IMPORTANT NOTICE
YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN
APPEARANCE PERSONALLY OR BY AN A'I-FORNEY 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.
CUMBERLAND COUNTY BAR ASSOCIATION
2 LIBERTY AVENUE
CARLISLE, PA 17013
(800) 990-9108
Jonatha neyEsquire
Pa. I.D. #,~0,~1
Counsel ~br F/laintiff
TUCKEI~/~ENSBERG, P.C.
1500 On,PPG Place
Pittsburgh, PA 15222
CERTIFICATE OF SERVICE
I hereby certify that a true and correct copy of the within Ten Day Notice
was served on the following by first class mail, postage pre-paid on October 1, 2004:
Donald L. Soloninka
819 Bridge St
Cumberland, PA 17070
Jonathan ire
Pa. I.D. #5~)041
TUCKER ~,F~ENSBERG, P.C.
1500 On~ P/PG Place
Pittsburgh,./PA 15222
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY.
COMMONWEALTH OF PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff
vs.
DONALD L. SOLONINKA,
511 r «i Defendant
: CIVIL-LAW
: DOCKET NO. 2004-04460 CIVIL TERM
METRO BANK,
US P:'?)n\(N6 Garnishee
0_?Ll \J PRAECIPE FOR WRIT OF EXECUTION
(MONEY JUDGMENT)
To the Prothonotary:
Issue a Writ of Execution in the above matter,
(1) directed to the Sheriff of Cumberland County, Pennsylvania
(2) against Donald L. Soloninka, defendant; and
(3) Against Metro Bank, Garnishee;
(4,I and index this Writ in the judgment index and
(a) against Donald L. Soloninka, defendant(s), and
(b) against Metro Bank, as garnishee,
as a lis pendens against real property of the defendant in name of garnishee(s) as follows:
N/A
(5) Amount Due:
Interest from 10/18/2004
Credits
Costs to be added:
Clerks Fee:
Sheriff:
Total:
1
SS . So "
o? <<
Ot
a,Sbu?'
?a ak\
$ 5,447.68
$ 2,628.32
$ 0.00
/n ' k
DatAthis day of NOV , 2012
Angela L. Mattis, PA ID #309229
Attorney for Plaintiff
36 West Main Street
Bloomsburg, PA 17815
Phone: (570) 387-1873
Fax: (570) 387-6474
S S
o LL
cf? S)d
V? (kC( iK
,-r
?cd
WRIT OF EXECUTION and/or ATTACHMENT
COMMONWEALTH OF PENNSYLVANIA)
COUNTY OF CUMBERLAND)
NO 04-4460 Civil
CIVIL ACTION - LAW
TO THE SHERIFF OF CUMBERLAND COUNTY:
To satisfy the debt, interest and costs due UNIFUND CCR PARTNERS Plaintiff (s)
From DONALD L. SOLONINKA, 819 BRIDGE STREET, NEW CUMBERLAND, PA 17070
(1) You are directed to levy upon the property of the defendant (s)and to sell
(2) You are also directed to attach the property of the defendant(s) not levied upon in the possession
of
GARNISHEE(S) as follows:
METRO BANK, 65 ASHLAND AVENUE, CARLISLE, PA 17013
and to notify the garnishee(s) that: (a) an attachment has been issued; (b) the garnishee(s) is enjoined from
paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant
(s) or otherwise disposing thereof;
(3) If property of the defendant(s) not levied upon an subject to attachment is found in the possession
of anyone other than a named garnishee, you are directed to notify him/her that he/she has been added as a
garnishee and is enjoined as above stated.
Amount Due $5,447.68
L. L. $.50
Interest FROM 10/18/2004 - $2,628.32
Atty's Comm %
Atty Paid $136.58
Plaintiff Paid
Due Prothy $2.25
Other Costs
Date: 11/712
(Seal)
Lic;PULY
REQUESTING PARTY:
Name : ANGELA L. MATTIS, ESQUIRE
Address: 36 WEST MAIN STREET
BLOOMSBURG, PA 17815
Attorney for: PLAINTIFF
Telephone: 570-387-1873
Supreme Court ID No. 309229
SHERIFF'S OFFICE OF CUMBERLAND COUNTY
Ronny R Anderson ~ ~ `-~;+
Sheriff . ~,,~
~,~it9? C'i:'~U7p~1PPl~i {r~~CJ.7 ,.;, ..,~
~ ~-r3
Jody S Smith ~~ ~rn
~~ o E'''i--
c
Chief Deputy ;~ ~ - ~
~, ~
C J
Richard W Stewart ~~ '~ ~~
Solicitor ~r~ ~ ~ ~ ' =~'~~ ~ ~ 3
~ ~~
Unifund CCR Partners ~~``
Case Number
vs.
Donald Soloninka
2004-4460
SHERIFF'S RETURN OF SERVICE
11/09/2012 03:25 PM -Dennis Fry, Deputy Sheriff, who being duly sworn according to law, states that on November 9,
2012 at 1525 hours, attached as herein commanded all goods, chattels, rights, debts, credits, and monies
of the within named defendant, to wit: Donald L. Soloninka, in the hands, possession, or control of the
within named garnishee, Metro Bank, 65 Ashland Avenue, Carlisle, Cumberland County, Pennsylvania, by
handing to Deneen Raudabaugh, Assistant Head Teller, personally three copies of interrogatories together
with three true and attested copies of the writ of execution and made the contents there of known to her.
The writ of execution and notice to defendant was mailed on November 13, 2012 to Donald L. Soloninka at
819 Bridge Street, New Cumberland, PA 17070.
November 13, 2012
DEN FRY, DEPU
SO ANSWERS,
~..,. ~-
RON R ANDERSON, SHERIFF
ou'?wS+.aite She'iff. 7ri~ecnft. I^r.
~-~ ~~
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY ~ ~~
COMMONWEALTH OF PENNSYLVANIA .,.•.. ~. ~~ ~ `J'` ~--
UNIFUND CCR PARTNERS,
Plaintiff
vs.
DONALD L. SOLONINKA,
Defendant
vs.
METRO BANK,
~~~5 ~ 4
y t ..,, J~ ',".
F~ c"',
CNIL-LAW mac' c.~ .!P'
--' G
~ ~ ti
DOCKET NO. ?004-04460 CNIL TERM ...
Garnishee
C~~~~°~
INTERROGATORIES TO GARNISHEE
TO: Metro Bank
65 Ashland Avenue
Carlisle, PA 17013
You are required to file answers to the following interrogatories within twenty (20) days
after service upon you. Failure to do so may result in judgment against you. If you need
additional information such as a social security number, contact the attorney listed at the
end of this document.
1. At the time you were served or at any subsequent time did you owe the
defendant any money or were you liable to the defendant on any negotiable or other
written instrument, or did the defendant claim that you owed the defendant any money or
were liable to the defendant for any reason?
Defendant receives direct deposit SSI
2. At the time you were served or at any subsequent time was there in your
possession, custody or control or in the joint possession, custody or control of yourself
and one or more other persons any property of any nature owned solely or in part by the
defendant?
3. At the time you were served or at any subsequent time did you hold legal
title to any property of any nature owned solely or in part by the defendant or in which
defendant held or claimed any interest?
4. At the time you were served or at any subsequent time did you hold as
fiduciary any property in which the defendant had an interest?
5. At any time before or after you were served did the defendant transfer or
deliver any property to you or to any person or place pursuant to your direction or
consent and if so what was the consideration thereof?
6. At any time after you were served did you pay, transfer or deliver any
money or property to the defendant or to any person or place pursuant to the defendant's
direction or otherwise discharge any claim of the defendant against you?
7. If you are a bank or other institution, at the time you were served or at any
subsequent time did the defendant have funds on deposit in an account in which funds are
deposited electronically on a recurring basis and which are identified as being funds that
upon deposit are exempt from execution, levy or attachment under Pennsylvania or
federal law? If so, identify each account and state the reason for exemption, the amount
being withheld under each exemption and the entity electronically depositing those funds
on a recurring basis.
8. If you are a bank or other institution, at the time you were served or at any
subsequent time did the defendant have funds on deposit in an account in which the funds
on deposit, not including any otherwise exempt funds, did not exceed the amount of the
general monetary exemption under 42 Pa.C.S. § 8123? If so, identify each account.
9. If your answer to any of the above is in the affirmative, state the amount
on deposit or owed or describe the property in detail and provide any other particulars of
the transaction as maybe relevant to this attachment.
COMPLETED BY:
Signature
Title
Interrogatories submitted to garnishee by:
Angela L. Mattis, PA ID #309229
Attorney for Plaintiff
36 West Main Street
Bloomsburg, PA 17815
Telephone: 570-3 87-1873
Fax: 570-387-6474
Name (print)
VERIFICATION
The undersigned does hereby verify subject to the penalties of 18 PA. C.S. § 4904 relating
to unsworn falsifications to authorities, that he/she is Jennifer Hilbish
(Name)
Levy Specialist of Metro Bank, garnishee herein,
(Title) (Company)
that he/she duly authorized to make this verification, and that the facts set forth in the foregoing
Answers to Interrogatories are true and correct to the best of his/her knowledge, information and
belief.
l
J
(SIG ATURE)
UNIFUND CCR PARTNERS,
Plantiff
v.
DONALD L. SOLONINKA,
Defendant
v.
METRO BANK,
Garnishee
y D~
~~,
IN THE COURT OF COMMON PLEAS
OF THE NINTH JUDICIAL DISTRICT
2004-04460 CIVIL TERM
IN RE: CLAIM FOR EXEMPTION
ORDER OF COURT
AND NOW, this 29th day of November 2012, upon consideration of Defendant's
request for a prompt court hear~g to determine the Claim For Exemption, the a
HEARING will be held on a December 2012, at 1:30 p.m. in Courtroom No. 6,
Cumberland County Courthouse, Carlisle, Pennsylvania.
Thomas A. Placey C.P.J.
Distribution List:
~ngela L. Mattis, Esq.
2 Mill Street
Danville, PA 17821
~natd L. Soloninka c ~~ "r;
819 Bridge Street m~ ~
~,_ .~
~'
New Cumberland, PA 17070 ~~., „c ..~~---
n
~ r ~7
~~d- ~~J~ i
Cumberland County Sheriff Department ' ~~ ° °c:
`
~ ~'~ ~r~
Court Administration - ~~~a 'C~ ~~' ~ ~-_~~;:~;
:
>
~:~ cJ,, ~
-
///3d f t ~
~~u^
I'f
RONNY R. ANDERSON
Sheriff
JODY S. SMITH
Chief Deputy
~°~`'~t~
OFFICE OF THE SHERIFF
One Courthouse Square, Room 303
Carlisle, Pennsylvania 17013
Cumberland County Court Administration
1 Courthouse Square
Carlisle, PA 17013
of ~un~~Prt~
~d
November 28, 2012
RICHARD W. STEWART
Solicitor
Enclosed please find a Claim for Exemption, pertaining to Civil Case Number 04-4460,
filed by Donald Soloninka, which was received in the Cumberland County Sheriff's Office on
November 28, 2012, via facsimile.
Please forward a copy of the Notice of Hearing to my attention in the Sheriff's office,
however it is the Court's responsibility to notify all parties involved. Thank you for your
consideration to this matter.
Sharon R. Lantz
Staff Assistant
Involved Parties:
Angela L. Mattis, Attorney for plaintiff
Donald L. Soloninka, Claimant
819 Bridge Street, New Cumberland, PA 17070
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY
COMMONWEALTH OF PENNSYLVANIA
UNIFUND CCR PARTNERS,
Plaintiff
vs.
DONALD L. SOLONINKA,
Defendant
CNIL-LAW
DOCKET NO. 2004-04460 CNIL TERM
vs.
METRO BANK,
Garnishee
CLAIM FOR EXEMPTION
To the Sheriff:
I, the above-named Respondent(s), claim exemption of property from levy or
attachment:
(1) From my personal property in my possession which has been levied upon,
(a) desire that my $300 statutory exemption be
_ (i) set aside in kind (specify property to be set aside in kind):
_ (ii) paid in cash following the sale of the property levied upon;
or
(b) I claim the following exemption (specify property and basis of
exemption):
(2) Form my property which is in the possession of a third party, I claim the
following exemptions:
r
(a) my $300 statutory exemption: in cash; _ in kind (specify property):
(b) Social Security benefits on deposit in the amount of $~ ~~
(c) other (specify amount and basis of exemption) ~~Q • ~ ~
I request a prompt Court Hearing to determine the exemption. Notice of the
Hearing should be given to me at ~ 9 ~ ~ ~ G ~
~~ w~ eR ~,~ ~~ 77~~7 D
(Address)
659-87~~~8~a7
(Telephone Number)
I verify that the statements made in this Claim for Exemption are true and correct.
I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.
Section 4904 relating to unsworn falsification to authorities.
J/~
DATE: ~~ ~~ ~ / 1
Respondent
SHERIFF OF CUMBERLAND COUNTY
CUMBERLAND COUNTY COURTHOUSE
1 Court House Sq.
3rd Floor
Carlisle, PA 17013
'll~t~Z~~' ~v3q~