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Home My WebLink About12-6589- ~`63.~~n,~~, "tf T IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA (~s(ti L.~G~I j ~ Na. 0~-`(0 1 . -r Type your name) ~.~ ",'~ -. ~- ~../ 1f Vs. Driver's License/Auto Registration Apq~~ .~, Z~ -y -p ~' C~nmonwealth of Pennsylvania ` ~ vim, ' t>tepartmertit of Trar~portation i r~ -r «,.. i~reau of Drivers Lkensing m ~ APPEAL Of DRIVER'S LICENSE/AUTO REGI5TRATION SUSPENSION ~ ~- ~; ~~~ ~ qq AND N W, thi enter today's date) _,_~ , 20 ~~U ~ ~ ,comes the Appellant, (Type your na ~ me) ss~/ , by his/her attorney, and states as follows: 1. Appellant's PA operator's number or automobile registration number is: 2. PennDOT proposes, by Notice dated (insert "mailing" date here) Appellant's driving privileges ~ automobile registration ,20 ,to suspend for a period of (Insert length of suspension) ~.~f/ pursuant to Section ~(./ of the Vehicle Code, which suspension is to be effective (Insert suspension effective date} , 20 ****A copy of the Notice sent by PennDOT is attached to this Appeal**** 3. The suspension of Appe{IanYs operating privileges is contrary to law in that: (Check those which apply) The police lacked reasonable grounds to stop Appellant and j or request Appellant to submit to a chemical test. Appellant did not knowingly ar intelligently refuse a chemical test; The conviction on which AppeAant'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:) GUaa ~/.~tat~i~u E2a,1 Cc~ cfa~rGU~aac/ Uri C~~lceer~l, r ~haug~f ~ .~iRa' ~nac~ t`ia ~a rfuu~r~ bud 2r~.~r~ w-uc~ G~/zou9/~, D~ll:~ ~ ~cd •2 d ./1.~~/fta~ /l~ ~~1su~a r~ ~ h~~ ~~an~ ~i~ a ~~od ~ y ~ Ui~ ~/~a~ ~r,~urud, -OR- The suspension of Appellant's automobile registration is contrary to law in that: My failure to have insurance was for a period of less than ?'.1 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 (specity reason: WHEREFORE, Appellant respectfully requests this Honorable Court to sustain the appeal from the suspension of operating privileges or automobile registration. Respectfully submitted, i ~; ~r t ~ ~` (Sig name here) t ,_ , ~~/;~ ,, (Type name here) VERIFICATION The undersigned hereby states that the statements made in the attached AppE:~al 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: ~ ~ 1;(: ~ ' ~S~ ~. ~~ Type Name: ,~-C11'., ~1~.~'' ---- Address: ~7l ~r ~t,~'~'~j~~ ~ ~ ~, l~~ ----- City /State /Zip Code: % ~~ f ~ ~' ~~~ _ _. Telephone Number: li 1 " ~~ ~? t-~ " i~~u ~j EmaiB address: ~~ ' -@~ ' __ 2 cO~i~iO~wh;~rl.-ri OF PI~;'V'VSti'i.~~,~~I.r DI~;I'AR'1'~11~;V7~ OF 'IRA~SPOR'I -r7'iO'V 13URh;:r1J OF fit)"fON Vl~;lit('I.I~:S YO 13O)i 68674 HARRIS13l)RG, P,r 171116-8674 rvwrv.dnn•.st ate.pa.us WID# 1226[]9999015252 001 TITLE# 59624209 PROCESSING DATE 120916 TRANSACTION (:ODE 00060 DENI M CASSEL 500 GENEVA DRIVE H-6 MECHANICSBURG. PA 17055 OFFICI rl_ yO"hIC1~, ~1~rlt. 1),r l I'.: Ily/23/12 llear l.usu~nier he Ucpa~lment iccently requested that yuu provide us with pr~xrf ofiinancial responsibility Iinsa_ir,ucce) l'ur the firllutvint~ vehicle: \IAKI~;: ~11:R(-I ' IZ l' YG.aR: 21103 ROllY 'I-YPh:: S 1 n~l'IOv ~r~ ~1.u ;U'~f I_i('I~;VSI~: PL:r'1~1~:#: l IrVV 195 •1-I•I'LI?#: S~)f,242O9 VIII#: ~~iZ/.iJKnrV43U.11~1~1~i~ "t l-his inlin~matiun ~~as requested because G1~.1CO C,~1Sl!i••I ~ CO nu~tilied us that the insur~urrc j~~ailn:w~ covering the vehnae listed ahnvc was terminated on U?; 2R, 12. I~;ither nu response was received ur the inli~rmat~un yuu provided wa• nut acceptable. _ ;rs a resi.dt, the iezistratiun Irn- the vehicle listed ahoee rr•ill he suspended for three months effective I11; 28/12 at 12:1)1 -r.~1. pis authurii.ed by Section 17K6(d) of the Vehicle Cude. THIS iS :r FI\.V. ORDF,R Ol~ S11SY1?'VSIO11. You are required to return your current registration plate, sticker and card to the Uepartment immediately. Credit toward serving this suspension will not begin until the Ueparhnent receives your registration products. ~ldditionall}•, you are required to pa}' a resturatir7n 1~°~~ in the amount ui `h~O t~~ the Uepartment in accordance with Section l~a(,II of the Vehicle Cude. Please snake check ur nu~ney order pay able to the P~1 Uepartment of I~ransportatinn. Uu not send cash. You can also pa.' by credit card online at w~,vw.dm~~.stah:. a.us b~• selecting "1'a}~ Your I~inancia) Responsibility Restoration l~ee'_ Within 3f1 days of ~~~ur el~~ihilit}~ date fnr restoration, ~°ou will also he required to show proof of insurance i~7r this vehicle. ~Ve hart cn~lused a self-addressed en~~elope l~ur }•uur use when a~rrespondmg and a mailing label t., assist with the return of v~~ur reg~strUiun plate, sticker and card. When the Uepartment receives your registr,ttiun products, we .'.Iii ?l`.i~d '~('•li ..i miter .pit}u1: _~ P:C:;I~`; ;';)Sa1rmII2~ that they; A~'CI't' reCe1~.'eil. if. :SftfS Z w'eekti of t11alhn~? r'OUr registration plate, sticker and card to the Dcpartrnent you do not receive a letter stating your registration products rr-ere received, phase contact us immediately. You have the right to appeal this suspension to the Court of Cnmmon fleas of the county ufyuu:~ residence within thirty(311- days of the mail date of this letter. If you file an appeal in the County Court. the (curt will ~.ive yuu a time-starnpe~.i certified cup~~ of the appeal. In order lirr the appeal to he valid, ~~nu must send than inne stamped certified cope of the appeal by certified mail to: Pennsylvania Dept of 7 ransportation Office of ("hief Counsel 1 I(11 S Front Street-3rd Floor ilarrisburg, P,r 171114-2516 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNI"Y, PENNSYLVANIA ~,, ~, i r ~. ~ ~ ~~;/ z ~, {~ (Type your name) Vs. Driver's License/Auto Registration Appeal Commonwealth of Pennsylvania Department of Transportation Bureau oi~ Driver Licensing CERTIFICATE OF SERVICE The undersigned hereby certifies that on ~~,~(`1 ;~' ~ , 20~ ~~~ , I caused to be mailed by regular mail, postage prepaid, a copy of the Appeal, Ordeir 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 1710~t-2516 Date: ~ ~~' ~ "i , 20 /fir ~- j ~. ~ ' / ~~ Signature: 1 r~ ';, , (T------- ~~ Type your Name: {` ~! ~'./C! ~L% ~?,' '. Address: ~~~~ ~~~ i (~` ~~. '.if. ~ , ~; City /State /Zip Code: ~~~'f~- 1~; ~~~~~~ ' i ~ ~~ Telephone: ~ ~ 1 ~..~ ~ .~ ** This form must be completely filled out and filed in the Prothonotary''s office promptly after mailing the documents to PennDOT ** ~~~ tN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. (Print your name) . Vs. Driver's License/Auto Registration Appeal Commonwealth of Pennsylvania Department of Transportation Bureau of Driver Licensing ORDER SCHEDULING HEARING ON APPEAL AND NOW, this /..0_'~ day of f'l~l , 20 /~_, a hearing is scheduled on the appeal of Petitioner for the /~~ day of rte, 20~ at ~:~~- 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. a-- ct. ~ cv r d t~c .. .'. ~ ~~ .~ ,c r~.~ ,".~ C3 'd d J `~. ~ ''G Y ' O ~ J~ ~--~ ~Z.,i ~t1 ti"- 13~ ~ N ~ ~ ,"~ ~o I ~s m By the Court, Judge • l,-cZSS'~~ ~ f t~ !~/`~~ ~V t-~