HomeMy WebLinkAbout12-6709IN THE CAOURTrOF COMMON PLEAS OF CUMBERLAND COUNT/Y~PENNSYLVANIA ~~
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(Type your name) `•-- ~ ~~'
Vs. Driver's License/Auto Registration Appea~~ +'S m--'
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Commonwealth of Pennsylvania ~-~ 2 ~ `~ ~~
Department of Transportation `>' eJ n. yK~
Bureau of Drivers Licensing ~`'_= ~ '~ ~~-~
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APPEAL OF DRIVER'S LICENSE/AUTO REGISTRATION SUSPENSION ._t' ~ _:
AND NOW, this ter today's date)Z i~t'-~~+~, 20 ~""~ ___, comes the Appellant, (Type your name) _
C~+~t ~. ~ • ~1 t, by his/her attorney, .C tN C-~ r ~~and states as follows:
1. Appellant's PA operator's number or autc+mobile registration number is:
__~ °_ _Z ~~ ~,Z,~----
2. PennDOT proposes, by Notice dated (insert "mailing' date here- C' C 1"Vl~~° '~' , 20~~~ to suspend
Appellant's driving privileges ~ automobile registration for a period of (Insert length of suspension)
~.f '~l~t~ _ pursuant to Section ~ _of the Vehicle Code, which
suspension is t-oTbe-effective (Insert suspension effective date) 1 1 ~ 20 ~ ~==V
****A copy of the Notice sent by PennDOT is attached to this Appeal****
3. The suspension of Appeliant'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:
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 (specrty reasona
WHEREFORE, Appellant respectfully requests this Honorable Court to sustain the appeal from the suspension
of operating privileges or automobile registration.
Respectfully submitted,
S
(Sign na her)
,/""~
~Q~G~ t~ - Ic~~~~.
(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: f~
Type Name: ~~ ~/ tt ,~.~" - ~ ~ t `1
~4ddress: Z ~~~ I "~ ~ ~i ~%p ~ `~
City /State /Zip Code: ~--1,t~-~t r ~ 10 VC I uw ~'~'t~ld Ct ! ~O~c'f
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Telephone Number: ~~ ~ • ~~~ ~ ~~
Email address: T5~` @ r~ au: ~ . (f'la.~
2
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
(Type y~~ur 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 Z- ~~'~+a~20 (a ; l 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: ~~ Ncv~, , 20 (~""_
~~ . ~Y C~ 1A.b'
Signature:
~~
Type your Name: .~ c GN ' _+~~'t r ~~
Address: ~" l'~'~I `^~~ ~~CG ~'~'r~
Gty /State /Zip Code: ~~t°C ~K S C; 5 ~%I,t ~~' ~ ~''~~`(~ V~'~''~`~
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Telephone: ~{ ~, ~~~; S ~ ~~'
** This form must be completely filled out and filed in the Prothonotary's office
promptly after mailing the documents to PennDOT **
In Forma Pauperis Form
~~ ~ t ~ ~ ~ ' '` - ` ~` ~ ~ ~ IN THE COURT OF COMMON PLEAS OF
Plaintiff CUMBERLAND COUNTY PENNSYLVANI.~~
l . N0. 2012- ~?Oq CIVIL TERM
Defendant ~ ,~''~"~ IN
C" ~ o/ctc~,4~ ~~~'~
PR ECIPE TO PROCEED IN FORMA :PAUPERIS
To t ie Prothonotary:
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Kindly allow, ~a~1.1 ~ ~ Plaintif efendant, to proceed in forma ~auperis.
[, `(~T_~' 1~'U'l~,~torney for the party proceeding in forma au eris, certify that I
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belie re the party is unable to pay the costs and that I am providing free legal services to the party.
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Attorney for laintiff efendant r ,
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City> State Zip (,~~~-~lt.x~ ~ e~C"~ ~/ 1~uI,.. ~k4=~lcu.~.t,~
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
Q v~~ °~ ~ 1~tlt ~ No. /d - (0'1 ~ / v~ l ~L°ritr.+
(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 ~ day of~!/) , 203, a hearing is scheduled
on the appeal of Petitioner for the day of ~ 20~ at g : 3G ~ M
in Courtroom # '~ of the Cumberland County Courthouse, One Courthouse Square, 4`" 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 responsibilityto 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.
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By the Court_
DANIEL J. MALLOY, IN THE COURT OF COMMON
Petitioner PLEAS OF CUMBERLAND
CUMBERLAND COUNTY
V.
COMMONWEALTH OF PENNSYLVANIA, : NO. 12-6709 CIVIL TERM
DEPARTMENT OF TRANSPORTATION,
BUREAU OF DRIVER LICENSING, LICENSE SUSPENSION
Respondent APPEAL
ORDER
AND NOW, this 15th day of March, 2013, the appeal filed in the above-
captioned matter is REMANDED to the Department of Transportation for correction of
its records.
BY TH T:
J.
Attest:
✓ Gregory H. Knight, Esq., 2 Northfield Way, Mechanicsburg, PA 17050
✓ Philip M. Bricknell, Esq., Pennsylvania Department of Transportation, Office of Chief
Counsel, Riverfront Office Center, 3`d Floor, 1101 South Front Street, Harrisburg,
PA 17104-2516
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