HomeMy WebLinkAbout12-3466C?
Zfplaintiff
v.
01
Defendant
IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
NO. CIVIL TERM -_
PETITION TO PROCEED IN FORMA PAUPERIS'P' r}
The Petitioner, fC , in the above-captioned matter respectfully
petitions this Court for permission to proceed in forma pauperis. Asset forth in the attached Affidavit,
which is incorporated herein by reference, Petitioner is unable to pay the fees and costs necessary to
commence these proceedings.
WHEREFORE, Petitioner requests that this Court enter an order permitting her to proceed in
forma pauperis.
.4, 0/'Z_
Date
0 ? -53 a 5?5?
I?r
I
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
z : CUMBERLAND COUNTY, PENNSYLVANIA
y3ev Mj n
: NO. CIVIL TERM
Defendants
AFFIDAVIT IN SUPPORT OF PETITION
TO PROCEED IN FORMA PAUPERIS
1. I am the Defendant in the above matter and because of my financial condition am unable to
pay the fees and costs of prosecuting, defending, or appealing the action or proceeding.
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.
? II
(a) Name:
(b) Address: I Z t'"I? J ?? /r l
If you are presently employed, state I I"
Employer: 4 (gall
Address:
Salary or wages per month: 9 S?6)
Type of work:
If you are presently unemployed, state
Date of last employment:.
Salary or wages per month:
Type of work:
(c) Other income within the past twelve months
Business or profession:
Other self-employment:
Interest:
Dividends:
Pension and annuities:
Social Security benefits:
Support payments:
((? _ a
Disability payments:
Unemployment compensation and
supplemental benefits:
Workman's compensation:
Public Assistance:
Other:
(d) Other contributions to household support
(Wife)(Husband) Name:
If your (husband) (wife) is employed, state
Employer:
Salary or wages per month:
Type of work:
Contributions from children:
(e) Property owned
Cash:
Checking Account: 6:5A ^B %
Savings Account: /J L
Certificates of Deposit: Affil
Real;Estate (including home):
Motor vehicle: Make Year Cost Amount owed
Stocks; bonds:
Other:
(f) Debts and obligations
(g) Persons dependent upon you for support >
(Wife) (Husband) Name:
Children, if any:
Name: Age:
COMMONWEALTH OF PENNSYLVANIA
COURT OF COMMON PLEAS
Judicial District, CoNnty Of
NOTICE OF APPEAL
FROM
DISTRICT JUSTICE JUDGMENT
COMMON PLEAS No. /a- jtt/(p?p (.,iyi / T?°/fl9
NOTICE OF APPEAL
Notice is given that the appellant has filed in the above Court of Common Pleas an appeal from the judgment rendered by the District Justice on
the date and in the case referenced below.
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4
49,
KJ - og3u I'CV,001MO &Z- as i
This block will be signed ONLY when this notation is required under Pa.
R.C.P.D.J. No. 1008B.
This Notice of Appeal, when received by the District Justice, will operate as a
SUPERSEDEAS to the judgment for possession in this case.
ve
was Claiftfeht PSe Pa. R.C.P.D.J. No. 1001(6) in
before a District Justice,"A COMPLAINT MUST BE FILED within twenty
(20) days after filing the NOTICE of APPEAL.
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(This section of form to be used ONLY when appellant was DEFENDANT (see Pa.R.C.P.D.J. No. 1001(7) in action before District Justice. IF
NOT USED, detach from copy of notice of appeal to be served upon appellee.
PRAECIPE: To Prothonotary
Enter rule upon
Name of appellees)
appellee(s), to file a complaint in this appeal
(Common Pleas No. ) within twenty (20) days after service of rule or suffer entry of judgment of non pros.
Signature of appalent or aHomey or agent
RULE: To , appellee(s)
Name of appe#WS)
(1) You are notified that a rule is hereby entered upon you to file a complaint in this appeal within twenty (20) days after the date of service
of this rule upon you by personal service or by certified or registered mail.
(2) if you do not file a complaint within this time, a JUDGMENT OF NON PROS MAY BE ENTERED AGAINST YOU.
(3) The date of service of this rule if service was by mail is the date of the mailing.
Date:
30-ft- d PYor --y -Do"
,20
Signature of Prothonotary or Deputy
YOU MUST INCLUDE A COPY OF THE NOTICE OF JUDGMENT/TRANSCRIPT FORM WITH THIS NOTICE OF APPEAL.
AOPC 312-02
WHITE - COURT FILE TO BE FILED WITH PROTHONOTARY GREEN - COURT FILE YELLOW - APPELLANTS COPY
PINK -COPY TO BE SERVED ON APPELLEE GOLD -COPY TO BE SERVED ON DISTRICT JUSTICE
DJ BENDER 09-3-01
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
FAX No. 7178323308
P. 001
Notice of Judgment/Transcript Civil
Case
Meg, Dist. NO; MDJ-09.3-01
MDJ Name: Honorable H, Anthony Adams
Address: 35 West Orange Stro®t
Shippensburg, PA 17267
Telephone: 717-532-7676
Richard Allan Lynch
V.
John Baum Jr.
File Copy Docket No: MJ-=I-CV 0000062-2012
Case Filed: 3/2W2012
Disposition 3ommairy
MJ-MOI-CV-0000002-2012 Richard Allan Lynch John Baum Jr, Judgment for DeWdent 011!03/x012
ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUDGMENT BY FILING A NOTICE OR APPEAL WITH
THE PROTHONOTAR RK OF COURT OF COMMON PLEAS, CIVIL DIVISION. YOU MUST INCLUDE A COPY OF PHIS NOTICE OF
JUDGME:NTITRANSCR WITH YOUR NO'I'ICL OF APPEAL,
EXCEPT AS OTH RWISE? PROVIDED IN THE RULES OF CIVIL PROCEDURE FOR MAGISTERIAL DISTRICT JUDGES, IF THE JUDGMENT
HOLDER ELECTS TO 'ENTER THE JUDGMENT IN THE COURT OF COMMON PLEAS, ALL FURTHER PROCESS MUST COME FROM THE
COURT OF COMMON PLEAS AND NO FURTHER PROCESS MAY BE ISSUED BY THE MAGISTERIAL DISTRICT JUDOS
UNLESS THE JUDGMENT I$ ENTERED IN THE COURT OF COMMON PLEAS, ANYONE INTERESTED IN THE JUDGMENT MAY RILE A
REQUEST FOR ENTRY OF SATISFACTION WITH THE MAGISTERIAL DISTRICT JUDGE IF THE: JUDGMENT DEBTOR PAYS IN FULL, SE?1YLE$,
OR OTHERWISE COMPLIES WITH THE JUDGMENT.
Date Magisterial District Judge H. Anthony Adams
certify a is a tnm and oorre copy of the recd e p ngs judgment.
Date Magisterial District Judge
MPJS 315 Page 1 of 2 Printed: 05M20121&48:42AM
Richard Lynch
v,
John Baum
Private(s)
DJ BENDER 09-3-0' FAX No. 5323308 P•004
Docket No.; MJ-09301-CV-0000100-2012
Participant List
Stacy Barker Waif, Esq.
Wolf & Wolf
10 W NI®h St
Carfiiele, PA 17013-2922
Plaintiff(s)
Richard Lynch
112 Water Street
Walnut Bottom, PA 17M
Defendant(s)
John Baum
114 Water Street
Walnut Bottom, PA 17266
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laintiff
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v.
hl\ Defendants
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
:NO. CIVIL TERM
/a3.3Hlolp Ni Term
ORDER OF COURT
AND NOW this. day of 2012, upon consideration of the
attached Petition and Affidavit, the petitioner is allow94o proceed in forma pauperis.
BY THE COURT,
?.,C%?- -cam -? -?,?C
Judge
Distribution
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I ? Address
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Defendant:
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Name
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Address
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