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HomeMy WebLinkAbout12-3437IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY I ?- cN I (?; THOMAS E. LEWIS NO.: - 7 cc VJ. C7 Commonwealth of Pennsylvania : -- Department of Transportation : - ; , Bureau of Drivers Licensing PETITION TO PROCEED IN FORMA PAUPERIS Petitioner, <MV5 f-,tv 15 , requests the Court to allow him/her to proceed' without payment of the costs in this matter and in support of such request, has completed the attached Affidavit of Financial Status. Date t0 R Petitioner 4 - ?: . W IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY THOMAS E. LEWIS vs. Commonwealth of Pennsylvania : Department of Transportation Bureau'of Drivers Licensing NO.: _ 1 -3y37cV 1 FINANCIAL AFFIDAVIT "r'?7 s'c j -?c GJ a L I am the Petitioner in the above matter and because of my financial condition am unable to pay the fees and costs of prosecution. 2. I am unable to obtain funds from anyone, including my family and associates, to pay the costs of litigation. 3. I represent that the information below relating to my ability to pay the fees and costs is true and correct: Name: c7Vre8 " iS Address: a`?3 '--Je Aro zoo (hcCy?cn?csbcS Q ? 70 SD J ai Social Security No.: l e i r- y q - g-6 30 A. Employment If you are presently employed, state: Employer: '15-dktr ( ? 0 6 J?&- V\3 a?o) Address: ?6 -J?%Y Sx--2RO cvr S `Ovrc P f , \lW ?'??It !J , 6 S r ?,?) Salary or wages per month: $ V60 04A Type of work: tJ eo C k j A B. Other income within the past twelve months: Business or professional: N (A A Other self-employment: `0 ; ? ZInterest: At Dividends: lv(.A Pensions and annuities: Al / A Social Security benefits: Support Payments: /U' Disability Payments: M A Unemployment Compensation and Supplemental Benefits: l1l` Worker's Compensation: Public Assistance: ft 1 Other: N /A C. Other contributions to household support: (Wife) (Husband) Name: Employer: _ Salary or wages per month: Type of work: Contributions from children: Contributions from parents: Other contributions: D. Property Owned: Cash: -# a It l? i. i` l1 Checking account: N Savings account: ? Certificates of deposit: Real Estate (including home): Motor vehicle: Make: leg J ?P? GF-?d Year: 1 ?Ct Cost: 9!? Amount owed: Stock/Bonds: Al Other: E. Debts and Obligations: Mortgage: Rent: -71? &j Loans: Other: F. Persons dependant upon you for support: (Wife)(Husband) Name: Children, if any: r. Names/Ages: Other persons: Name: Relationship: Name: Relationship: Name: Relationship: G. Expenses: Rent/Mortgage: Taxes: Electric: Gas: Heating Oil: _ Water: Sewer: t? tL c? C C?. NA AJ ?A NIA Nil Trash: Property Insurance: Al Telephone: Car Loan: tA Car Insurance: Gasoline/Oil/Repairs: Niel Medical/Dental: N` 0) Life/Health Insurance: N I Food (food stamps for $) plus additional: _ Household Supplies/Laundry: '! (A Child Care: Clothing: Loans: ,v I A Charge Accounts: Miscellaneous: Other: CL TOTAL Monthly Expenses: 'A'T <?% Z 4. 1 understand that I have a continuing obligation to inform the Court of improvement in my financial circumstances, which would permit me to pay the costs incurred herein. 5. 1 verify that the statements 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, which upon conviction provides for a fine not to exceed $2,500.00 or for imprisonment for a term not to exceed one year. Petitioner: X Date: 3o poi IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Thomas E Lewis No ?ot 37 3 (Type your name) Vs Commonwealth! of Pennsylvania Department of transportation Bureau of Drivers Licensing ?rTf Driver's License/Auto Registration Appeal C., APPEAL OF DRIVER'S LICENSE/AUTO REGISTRATION SUSPENSION Y'J C7 rJ -V _ D AND NOW, this (enter today's date) May 30 2012 , comes the Appellant, (Type your name) Thomas E Lewis , by his/her attorney, pro se and states as follows: 1. Appellant's RA operator's number or automobile registration number is: 2. PennDOT proposes, by Notice dated (insert "mailing" date here) May 1 2012 to suspend Appellant's driving privileges ?? automobile registration for a period of (Insert length of suspension) 3 (three) months pursuant to Section 1786(d) of the Vehicle Code, which suspension is to be effective (Insert suspension effective date) June 5 2012 ****A copy of the Notice sent by PennDOT is attached to this Appeal**** 3. The suspension of Appellant's operating privileges is contrary to law in that: (Check those which apply) The police lacked reasonable grounds to stop Appellant and / or request Appellant to submit to a chemical test. Appellant did not knowingly or intelligently refuse a chemical test; The conviction on which Appellant's suspension is based was overturned by successful appeal, OR is currently under appeal. (Attach a copy of the court docket this Appeal). ? Other (Specify reason:) 1 -OR- The suspension of Appellant's automobile registration is contrary to law in that: W1 My failure to have insurance was for a period of less than 31 days AND I did not drive nor permit anyone else to drive my vehicle during the time it was without insurance. (Attach proof of insurance to this Appeal and either a notarized statement of PennDOT form MV-221 to document non-operation of the vehicle). ?? Other (specify reason:) PA Dot did not process the information that it requested, was informed that no legitimate reason existed for a suspension, and the insurance lapse occurred beginning on May 6, 2012, 6 (six) days after PA Dot had already issued it's notice. It is the policy and practice of the insurer to issue "cancelation notices" each and every month regardless of whether the policy was actually canceled or not. WHEREFORE, Appellant respectfully requests this Honorable Court to sustain the appeal from the suspension of operating privileges or automobile registration. Respectfully submitted, (Si ame here Thomas E Lewis (Type name here) VERIFICATION The undersigned hereby states that the statements made in the attached Appeal of Suspension or Registration are true and correct to the best of my knowledge, information and belief. The undersigned understands that the statements in the attached Appeal are made subject to the penalties of 18 Pa. C.S. Sec. 4904 relating to unsworn falsification to authorities. Signature: Type Name: Thomas E Lew Address: 263 Texaco Road City / State / Zip Code: Mechanicsburg, PA Telephone Number: 717-691-7213 Email address: @ 2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF TRANSPORTATION BUREAU OF MOTOR VEHICLES PO BOX 68674 HARRISBURG, PA 17106-8674 www.dmv.state.pa.us WID* 121159999020430 001 TITLE* 63307181 PROCESSING DATE 120424 TRANSACTION CODE 00060 THOMAS E LEWIS 263 TEXACO OD MECHANICSBURG, PA 17050 OFFICIAL NOTICE Dear Customer: MAIL DATE. 05/01/12 The Department recently requested that you provide us with proof of financial responsibility (insurance) for the following vehicle: MAKE: JEEP YEAR: 1995 BODY TYPE: STATION WAGON LICENSE PLATE: IIJA2292 TITLE: 63307181 VIN#: 1J4FX78SOSC753608 This information Was requested because PERMANENT GENERAL ASSURANCE COMPANY notified us that the insurance 'policy covering the vehicle listed above was terminated on 03/08/12. Either no response was received or the inf rmation you provided was not acceptable. As a result, the registration for the vehicle listed above will be suspended for three months effective 06/05/12 at 12:01 A.M. as authorized by Section 1786(d) of the Vehicle Code. THIS IS A FINAL ORDER OF SUSPENSION. You are required to return your current registration plate, sticker and card to the Department immediately. Credit toward serving this suspension will not begin until the Department receives your registration products. Additionally, you are required to pay a restoration fee in the amount of $50 to the Department in accordance with Section 1960 of the Vehicle Code. Please make check or money order payable to the PA Department of Transportation. DO NOT SEND CASH. Within 30 days of your eligibility date for restoration, you will also be required to show proof of insurance for this vehicle. We have enclosed A self-addressed envelope for your use when corresponding and a mailing label to assist with the return of your retration plate, sticker and card. When the Department receives your registration products, we will send you a let er within 3 weeks confirming that they were received. If, after 3 weeks of mailing your registration plate, ticker and card to the Department you do not-reeeive a-letter statiMyour registration products were received, please contact us immediately. You have the right to appeal this suspension to the Court of Common Pleas of the county of your residence within thirty(30) days of the mail date of this letter. If you file an appeal in the County Court, the Court will give you a time-stamped certified copy of the appeal. In order for the appeal to be valid, you must send this time stamped certified copy of the appeal by certified mail to: Pennsylvania Dept of Transportation Office of Chief Counsel 1101 S Front Street-3rd Floor Harrisburg, PA 171042516 Statement of Non-Operation of Vehicle NOTE: THIS STATEMENT IS UNACCEPTABLE IF INSURANCE LAPSE IS GRI;ATI;R THAN 30 DAYS. ALL INFORMATION MUST BE COMPLETED BY THE VEHICLE OWNER ONLY. hereby state that I did not operate or permit operation of the following motor vehicle between// J Z to 2 due to lapse of insurance. IN 1J4FX78SOSC753608 TITLE 63307181 LICENSE PLATE NO. IIJA2292 ,,,,I ??:4? " ..3a1 a©t2 ShAture in ' Dater IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Thomas I} Lewis No. 1 ,- 3 ' ? C lY 1 (Type your name) Vs. Driver's License/Auto Registration Appeal Commonwealth of Pennsylvania Department of Transportation Bureau of Driver Licensing CERTIFICATE OF SERVICE The undersigned hereby certifies that on May 30 , 2012 , 1 caused to be mailed by regular mail, postage prepaid, a copy of the Appeal, Order Scheduling Hearing, and all attachments, to: Office of Chief Counsel Vehicle and Traffic Law Division Riverfront Office Center, 3'd Floor 1101 South Front Street Harrisburg, PA 17104-2516 Date: May 30 2012 Signature Type your Name: Thomas E Lewis Address: 263 Texaco Road City / State / Zip Code: Mechanicsburg, PA Telephone: 717-691-7213 ** This form must be completely filled out and filed in the Prothonotary's office promptly after mailing the documents to PennDOT ** IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY THOMAS E. LEWIS vs. Commonwealth of Pennsylvania : Department of Transportation : Bureau of Drivers Licensing NO.: ) ?- -3Y3 7 c--j-l ORDER AND NOW, TO WIT, this ?4 day of 2QJ , it is hereby Ordered that the petitioner's request has been (granted) {? permission to file a Motor Vehicle Registration Suspension Appeal In Forma Pauperis. C a e sent to the a o 0 0 BY THE COURT, Judge v/ 77"M tl?oy 04a, e-1 ,P,rGG G?? IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA (Print your name) Vs. Commonwealth of Pennsylvania Department of Transportation Bureau of Driver Licensing No. 1 ?-- 1 31 Driver's License/Auto Registration Appeal ORDER SCHEDULING HEARING ON APPEAL AND NOW, this day of ?rJi 20jj-, a hearing is scheduled on the appeal of Petitioner for the yI/._day of Ljj! a U 20/-4 at :-j_ tjq?M in Courtroom # of the Cumberland County Courthouse, One Courthouse Square, 4th Floor, Carlisle, PA 17013, at which time testimony will be taken and argument heard. A copy of this Order has been served on Appellant. It shall be Appellant's responsibility to serve a copy of this Appeal, all attachments, and this Order on the attorney for the Commonwealth, at the following address: Office of Chief Counsel Vehicle and Traffic Law Division Riverfront Office Center, 3`d Floor 1101 South Front Street Harrisburg, PA 17104-2516 It shall further be Appellant's responsibility to file a Certificate of Service with the Prothonotary stating that service was made on the Commonwealth of Pennsylvania. By the Court, Judge ran j-? ?- ? C?E? ?C P 04: CBctn e?/ -4 r_1 , ?L L THOMAS E. LEWIS, Petitioner v. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY COMMONWEALTH OF PENNSYLVANIA, NO. 12-3437 CIVIL TERM DEPARTMENT OF TRANSPORTATION, BUREAU OF MOTOR VEHICLES, APPEAL OF VEHICLE Respondent REGISTRATION SUSPENSION ORDER AND NOW, this 24th day of October, 2012, the appeal filed in the above- captioned matter is: - REMANDED to the Department of Transportation for correction of its records. DISMISSED and the suspension which is the basis of this appeal shall be REINSTATED. SUSTAINED and the suspension which is the basis of this appeal shall be RESCINDED. WITHDRAWN and the suspension which is the basis of th is appeal shall be REINSTATED. CONTINUED and RESCHEDULED for the day of 20 , at _.m., in Co~t~ior~ .~; r-ry cz7 Room No. of the Cumberland County Courte,~ r ';~' Carlisle, Pennsylvania. ~ r `~' _-. ~. ~ x-1'1 r __.., __ BY THE COURT: ~`=' ~ ; . ~ ~; ~ r ~~ "_ ~ 1 _ ... t_ .,l .. Attest: /Thomas E'. Lewis, 263 Texaco Road, Mechanicsburg, PA 17050 /Philip M. Bricknell, Esq., PennDOT, Riverfront Office Center, Office of Chief Counsel, 3~d Floor, 1101 South Front Street, Harrisburg, PA 17104-2516 ~,p~~~ w~.a.'f,e~ J0~3~ ~r ~ IZt~