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HomeMy WebLinkAbout13-0081THIS IS AN ARBITRATION MATTER ASSESSMENT OF DAMAGES HEARING NOT REQUIRED TABAS & ROSEN, P.C. BY: LEWIS C. TRAUFFER, ESQUIRE Attorney I.D. #60267 1601 Market Street, Suite 2300 Philadelphia, PA 19103 (215) 569-5050 THE MILTON S. HERSHEY MEDICAL CENTER P.O. Box 853 Hershey, PA 17033 VS BRANDON D . Z I)wIlKERMAN 312 April Drive Apt. 4 Camp Hill, PA 1701]. Attorney for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. i3- ~~ CNIL ACTION COMPLAINT -CIVIL ACTION NOTICE C ~ VI~ ~ ~/(N~ ~:~ cr N '~ ~. ~a -vim ~ ~-+~ ~ rms.-- " ~ u,r- ~ ~ .~ ~. ,~- ' 't! ~~~ ~~ 3 D ^} -~ 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 are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you.. You are warned that if you fail to do so the case may proceed without you and a judgment maybe entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief 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 OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OU'T WHERE YOU CAN GET LEGAL HELP. 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, Pennsylvania 170 ( 3 (717)249-3166 or (800)990-9108 S nJ~,. ~ g8ca~ ~~,agu 4~7 COMPLAINT - CIVIL ACTION THE MILTON S. HERSHEY MEDICAL CENTER VS BRANDON D. ZIMMERMAN 1. Plaintiff is a non-profit corporation located at the address indicated in the caption hereof. 2. Defendant is an individual who resides at the address indicated in the caption hereof. 3. As the result of a certain medical condition, defendant was treated by the plaintiff on Sept. 23, 2010 thru Sept. 27, 2010. 4. The amounts, quantities and nature of said medical care, the dates on which said medical care was rendered, and the charges therefore are set forth in Exhibit "A" which is incor- porated herein as if set forth at length. 5. Said medical care was commensurate with the condition of defendant and was necessary for the health and welfare of defendant. 6. At or about the time of defendant's treatment by plain- tiff, implied, constructive and oral contracts arose between defendant and plaintiff by the terms of. which defendant became obligated to pay plaintiff the charges for the medical care rendered by plaintiff to defendant. 7. Defendant refuses to pay the balance due although plaintiff has made demand that defendant do so. 8. As a result of the foregoing, there is due and owing from defendant to plaintiff the sum indicated in Exhibit. "A". WHEREFORE, plaintiff demands judgment against defendant for the sum of $40,497.73 plus six percent (6%) interest per annum from the date of discharge to the date of judgment, record costs and non-record costs. TABAS & ROSEN, P.C. LEWIS C. T FFER, ESQUIRE Attorney for Plaintiff MS HERSHEY MEDICAL CENTER PAGE: 1 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 12/29/11 at 11:08 AM Guarantor: ZIMMERMAN B RANDON D 100 GREASON RD CARLISLE, PA 17015-0000 Patient: ZIMMERMAN BRANDON D Visit #: 14996736 Date ~ Svc Code I Description ~ ------- Unzts( --------- -------------- --- Debits ~ Credits 09/23/10 09/23/10 10213 S SEMI PRIV MED/SURG 1 --- 1775.00 -- 09/23/10 16505 30105 ADULT LVL III TRAUMA RECOVERY ROOM STAGE I 1 09/23/10 09/23/10 46472 EMERGENCY VISIT, LEVE 168 1 4032.00 946.00 09/23/10 46620 46699 VENIPUNCTURE THERA/DIAG INJECTION 1 23.00 09/23/10 09/23/10 46727 NONINVAS PULSE OX, MU 1 1 150.00 136.00 09/23/10 46937 100031 THER IV PUSH,EA ADDL MRSA BY PCR 1 79.00 09/23/10 101003 ABO BLOOD GROUP 1 2 238.00 09/23/10 101004 ANTIBODY SCREEN 1 100.00 09/23/10 101005 RH TYPE 99'00 09/23/10 101p32 COMPAT, ELECTRONIC 4 50.00 09/23/10 104002 ALCOHOL (ETOH} BLOOD 1 360.00 09/23/10 104009 , AMYLASE, BLOOD 1 74.00 09/23/10 104156 SGPT (ALT) 63.00 09/23/10 09/23/10 104433 BASIC METABOLIC PANEL 1 22.00 61.00 09/23/10 104438 105052 RENAL FUNCTION PANEL 1 63.00 09/23/10 105059 PARTIAL THROMBOPLAS T PROTHROMBIN TIME 1 55.00 09/23/10 105656 CBC W/PLT AUTO 1 32'00 09/23/10 105657 CBC W/PLT/DIFF AUTO 1 42.00 09/23/10 09/23/10 191023 LVL4 SURGICAL PATHOLO 1 68.00 123.00 09/23/10 245208 246707 LIDOCAINE 2% IOML MPF 1 5.80 09/23/10 246836 HYDROMORPHONE 2MG/1ML FENTANYL CITRATE 2 1 3.85 09/23/10 272129 ML ROCURONIUM BROMIDE 5M 2 1 6.00 09/23/10 272199 ONDANSETRON 2MG/ML 2M 4 14.95 09/23/10 09/23/10 273532 PROPOFOL lOMG/ML 100M 1 3.00 31 20 09/23/10 274218 275298 CEFAZOLTN SODIUM BAG 2 . 14.55 09/23/10 307101 MORPHINE 5MG/ML 50 ML CHEST 1 VIEW 1 46.80 09/23/10 307220 PELVIS 1-2 VIEWS ~ 171.00 09/23/10 09/23/10 310501 CT HEAD UNENHANCED 1 226.00 1079 00 09/23/10 310516 310519 CT THORAX ENHANCED CT ABDOMEN ENHANCED 1 " 2239.00 09/23/10 09/23/10 310560 CT C-SPINE UNENHANCED 1 1 1544.00 1297 00 09/23/10 310567 310704 CT PELVIS ENHANCED OMNIPAQUE 300MG/ML 15 1 . 1756.00 09/23/10 09/23/10 391201 OR TIME EA ADD MIN >6 1 35 117.00 09/23/10 391400 398354 OR TIME EA MTN UP TO CLIP (IMPL} 60 3480.00 ------------- ------------ - 2 36.00 Continue ~~ MS HERSHEY MEDICAL CENTER PAGE: 2 500 UNIVERSITY DRIVE HERSHEY, PA 17033 Statement on: 12/29/11 at 11:08 AM Guarantoz: ZIMMERMAN BRANDON D 100 GREASON RD CARLISLE, PA 17015-0000 Patient: ZIMMERMAN BRANDON D Visit #: 14996736 Date f Svc Code ~ Description ~ Units ( Debits _---__-Creditsy 09/23/10 09/23/10 398410 SOLUTION DURA PREP _~---- ----_-~-----^--- 13 00 -y-- 09/23/10 398641 398848 PBDS MAJOR ABDOMINAL CATHETER 1 . 125.00 09/23/10 399230 FOLEY SCD SLEEVES MED 1 31.00 09/23/10 400159 SUTURE - A 1 59.00 09/23/10 400163 SUTURE _ C 2 12.00 09/23/10 460576 STAPLER 2 24.00 09/23/10 09/23/10 480017 0 CELL SAV (AUTOTRANSFU 1 23.00 1233 00 09/23/10 5 3000 503001 ANES TIME HOSP COMP ~ ANES TIME HOSP COMP 60 . 780.00 09/23/10 09/23/10 503035 > SINGLE TRANSDUCER SET 35 1 210.00 171 00 09/23/10 503123 503128 ADULT A-LINE KIT BAIR HUGGER UPPER BOD . 48.00 09/23/10 09/23/10 503136 HOT LINE TUBING 1 61.00 114 00 09/23/10 627070 670727 IV EXT SET 90 W/FLASH PCA ST INTEGRAL 1 . 15'00 09/24/10 09/24/10 10213 NOSIP S SEMI PRIV MED/BURG 1 1 55.00 1775 00 09/24/10 104438 105657 RENAL FUNCTION PANEL CBC W/PLT/DIFF AU 1 . 63.00 09/24/10 09/24/10 272199 TO ONDANSETRON 2MG/ML 2M 1 4 68 00 3 00 09/24/10 600520 621054 SPIRO INCENTIVE ADULT 1 . 15.00 09/25/10 10213 IV LACTATED RINGERS 1 S SEMI PRIV MED/BURG 3 9.00 09/25/10 105036 HEMATOCRIT 1 1775.00 09/25/10 09/25/10 105656 CBC W/PLT RUTO 1 1 25.00 42 00 09/25/10 246923 247831 PROMETHAZINE 25MG ACETAMINOPHEN 4 . 3.00 09/25/10 09/25/10 250092 325 MG OXYCODONE APAP 1TAB 6.00 © 3 09/25/10 272199 ONDANSETRON 2MG/ML 2M g 0 • 6 00 09/25/10 272589 621054 PNEUMOCOCCAL VACCINE 1 . 143.90 09/26/10 10213 TV LACTATED RINGERS 1 S SEMI PRIV MED/BURG 3 9'00 09/26/10 09/26/10 105657 CBC W/PLT/DIFF AUTO 1 1 1775.00 68 09/26/10 246124 246923 DOCUSATE-SENNA 50MG-8 1 .00 3.00 09/26/10 250092 PROMETHAZINE 25MG OXYCODONE APAP 1TR8 2 3'00 09/26/10 09/26/10 621054 IV LACTATED RINGERS 1 1 3.00 3 09/27/10 627070 56609 IV EXT SET 90 W/FLASH 1 .00 15.00 09/27/10 105656 INxTZAL EVALUATION--OT CBC W/PLT AU 1 228.00 09/27/10 09/27/10 246124 TO DOCUSATE-SENNA 50MG-8 1 42.00 3 ; _.___ 250092 OXYCODONE APAP 1TAB .00 __________ __ 12.00 -- Continue - -----' MS HERSHEY MEDICAL CENTER PAGE: 3 500 UNIVERSITY DRIVE HERSHEY, PA 1.7033 Statement on: 12/29/11 at 11:08 AM Guarantor: ZIMMERMAN BRANDON D 100 GREASON RD CARLISLE, PA 17015-0000 Patient: ZIMMERMAN BRANDON D Visit #: 14996736 Date ~ Svc-Code ( ------------ Description ~ Units- Debits ~ Credits f ------ 10/10/10 ~ 985039 ~ AUTO/WKC LATE CHG ADJ 1 - ------------- ____________________.-____ 1 - 57aa.oo- * - Not posted ----------------- Balance---~--_29213`05-~ ~} 3 STA7EIIAENT OF PHYSiCfAN SERVICES ~'ENNST~TE I'~~RSN~~' Milton ~. I-~ershey N~edica.l tenter '_ ' IF ANY QUESTi0N5, PLEASE CQNTACT: M3HM1 BRANDON D Zltl!lMERMAN 700 GREA50N RD CARLISLE PA 1701x•9469 acCOUNr # '1936640 5TATEWlENT DAFE: Q1IZ6I1 ~ LAST STATEMENT DATE: Q~~~~~~ FED TAX ID#2; „~ rai itlvr: BRAIlDON D ZYMI~RH~N ~ 1938640~~ . $ -. ~ ,,; ~- _ .,.:„ ...;~,. .~-t~, ~, r r ~> :.~.>~~:~ x~ s~ 1444b736 PERFORMED BY: HEIDI L FRJWCEL MD TRAUMA SURGERY DIY 04/23/10 3610D PLACE DF SYC: INPATIENT SPLENECTOMY TOTAL 1L16110 12/13/10 5514,OD ~"i%~P WITH PRIMARY INS REQU MICC OR AUTO PAYMENT 09/23/10 7101026 11/ PERFORMED BY: CHRISTINE M pETERSOW ND DIY DF DIAG RADIOLDG CHEST 1 YIEFI lb/10 BD.OD NON-COMP KITH PRI#1ARY INS REQU 09123/10 7217D26 PELVIS ~RPOSTER 11/16!10 HDN-CDf(P WITH PRIMARY INS REQU 77.OD 09123!10 712b02b ~ THORAX !i/CONTRAST ENH 11/lb/10 NON-CONK WITH PRIMARY INS RE@U ~S.DD 09/23110 7416D2b 11/16/10 ~ C T ABDOH~ ENHANCED 559 00 . NON-COMP i~ITH PRIMARY INS REQU 09/23/10 7219326 ~ CT PELVIS ENHANCED 11116110 NON-COEiR WITH PRIFIARY IkS RE$U 5D7.OO 09/23/10 704502b ~ ~ PERFORMED BY: TAD Ot)1'ANG MD DIY OF DIAL RADIOLOGY CT HEAD UVENHANCED 11/16/10 373.Q0 NON-COMP WITH PRIMARY INS RE@U 09/23/10 7212fi2b lIlIb1I0 CT CERVICAL SPINE UNENHAN NON-COMP WITH PRIMARY INS REQU 507.OD - PERFORMED BYs HEIDI L FRANKEL MD TRAUMk SEJR6ERY DIY -- 09/23/10 49245.57 1 PLACE OF SYCs EMERGENCY ROOM TR TEAM DIAL EYAL INT LON 1/16/1D 4524.00 NON-COMP KITH PRIMARY INS REQU PERFOIBSED BY: .IOZEF MALYSZ Mp DIY OF ANATOMIC PATHOLOGY 09/23/10 8530526 ~ PLACE OF SYC: INPATIENT TISSUE EXAM LEVEL 4 11/16/10 227, DD NON-COMP WITH PRIMARY INS REQU PERFORMED BYs STEVEN A MEADOR MD DIY DF EMER6 RODFI 09/23/ID 99285 ~ PLACE DF SYC: EMERGENCY RDDFI EMEIH;ENCY VISIT 11/16/i0 Q-98.fl0 hDN-COMP WITH PRIMARY INS REQU PERFORMED BYs STEVEN R ALLEN MD TRAUMA SURGERY biY 09/26/10 49231.24 11/ ~ PLACE DF SVC; INPATIENT DULY HOSPITAL CARE 1b/10 BAL ~ WITH PRIMARY INS REQU 120,OD ~ ~ 7 of 2 0.00 2244.32- 3269.b8 D.QO 8D.00 0.00 77.OD 0,00 543.00 O.OD 559,00 O.DO 507.00 O.DO 373,DD O.OD 507.00 0.00 4524.00 D.DO 227.ao D,00 498.00 *++s..+-r. ao L~CHECK BOX AND ENTER ANYADDRESS OR INSURANCE CORRECTIONS ON BACK PE~!(~~TATE HERSHEY ~~~®~ s.:~ershey 1Vi~izeat tenter IF AHY QUEST]OHS, PLEASE CONTACT: ACCOUNT # IAL S 7938640 COMPANY PAID CONTACT THEM DIRECTLY. FOR Ali1f OTHER QUESTIONS REBARDItJ6 YOUR BALANCE, PLEASE CONTACT OUR OFFICE. IF PAYMEM' HAS BEEN !LADE, THANK YOU AND DISREGARD THIS BILL. RNIl3 THANC YOU FOR USING MSHt4C PHYSICIANS GROUP FOR YOUR PHYSICIAN SERVICES. IF YW HAVE ANY QUESTIONS REGARDING TNIS BILL, PLEASE ~ COFlfACT US AT 717-531-5D59 OR 800-2~a4-2519, BETWEEN S:DOAM AND 5:30PM MONDAY THREriJGH NEDNESDAY OR BETI~EEN 8:00191 AHD 4t:3DPM THURSDAY AND FRIDAY. N r m STATELiEHT nAT~: Q112$/12 LASr sTATeM~Hr DATE: 03122111 FED TAX tD BALANCE SUMMARY RESPONSIBLE PARTY POLICY # GUARANTOR RESPONSIBILITY TOTAL ~ 11284,68 -----------_.___T___~°---___lMP-_4RLdL+~LsP~~s_€pErdclr.~.n~p~£1~1t8L8S2£I_26LP~RICp~-~~r_~1,~yr wrr _YOU PIfYMENT_ _ _ BF6 57A7EIt1ENT DATE: GLARANTOR RESPONSIBILITY:'^1RINIMLLh1 PAYMENT: MSHMC PHYSICIANS GROUP 01/2$112 S 11284.68 $'112$4.68 BILLING SERVICES HER HExlf PA 17035.0854 DRRR1~938b4D UP DDDDDDDUD11C84b8D3~Cb~2 Mail MSHMC PHYSICIANS GROUP Ta. MSHMC PHYSICIANS GROUP BRANDON D ZIMMERMAN PO BOX 64S3I3 100 Gt2EASON RD PITTSBURGH PA 15264-331 CARLISLE PA ].7015-g46q RFfICE USf ANLY WR CREDIT CARD pAYINEHT, PLEASE FlLI• IH IHP6RMATK)H BEtAW _ CHECK ONE _~,,,~ [II[[Illllllilill ~-_ 1938640 ^VI3A CARD NUFABER EKP DATE -'- - - - : ' DISC $ 11284.8$ ~0211$I HC: FB$O ____ CARDHOLDER NAIuIE (PRIiJF} - TYP: DMND - cREOIT CARD SIGNATURE MSHMC PHYSIICtANS GROUP ^ CHECK 80X AND ENTER ANY ADDRESS OR INSURANCJF. ~ORHEC7~ONS ON SACK 2 ,~ ~ZTMMERMAn', BRANDON ~~1938640 $29,213.05 (Hosp) 11,284.68 (Phys) VERIFICATION LINDA SCHLADER hereby states that she is the Team Manager, Customer Service of the Milton S. Hershey Medical Center and verifies that the statements made in the foregoing pleading are true and correct to the best of her knowledge, information and belief. The undersigned understands that the statements therein are made subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. LINDA SCHLADER DATE: ~a-i3-1~. SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson f�e i H` P� ij0t,i✓� ��, Sheriff �akyotr at�u+�br�.rd .,, Jody S Smith 1013 KAi R 26 Ate 3 Or " 1' v Chief Deputy Richard W Stewart CUMBERLAND COUNTY "''° `""'' a Solicitor Of FiGE OF THE SHERIFF PENNSYLVANIA The Milton S. Hershey Medical Center Case Number vs. 2013-81 Brandon D Zimmerman SHERIFF'S RETURN OF SERVICE 03/13/2013 Ronny R Anderson, Sheriff, being duly swom according to law, states he made diligent search and inquiry for the within named Defendant to wit: Brandon D Zimmerman, but was unable to locate the Defendant in his bailiwick.The Sheriff therefore returns the within requested Complaint&Notice as"Not Found"at 312 April Dr.Apt.4, Camp Hill Boro, Camp Hill, PA 17011. Residence is vacant and per the Camp Hill Postmaster mail is still delivered to the address provided. SHERIFF COST: $48.00 SO ANSWERS, 6z )�`l March 20, 2013 RON R ANDERSON, SHERIFF ;y CountySuite Sheriff.Teleosoft,Inc, FULEO-Oi FIC" F THE PF07t-laOTAR'�' 2013 MAY -8 Ali 10: 1 TABAS & ROSEN, P.C. CUMBERLA D COUNTY BY: LEWIS C. TRAUFFER, ESQUIRE PENNSYLVANIA I .D. #60267 1601 Market Street, Suite 2300 Philadelphia, PA 19103 (215) 569-5050 Attorney for Plaintiff THE MILTON S. HERSHEY MEDICAL COURT OF COMMON PLEAS CENTER CUMBERLAND COUNTY VS BRANDON D. ZIMMERMAN NO. 13-81 Civil Term P R A E C I P E TO THE PROTHONOTARY: Please reinstate the attached Complaint to be served at 1450 Cranes Gap Road, Carlisle, PA 17013 . LEWIS C. T FFER, ESQUIRE Attorney for Plaintiff 9 91W 2# agbrDH SHERIFF'S OFFICE OF CUMBERLAND COUNTY. Ronny R Anderson Sheriff Jody S Chief Dep Smith ty t i f' ( r� 13MAy 1S Pty Richard W Stewart _; Solicitor OFFiCEQFTVE CU' 'B AN P ih�S YL VA 't The Milton S. Hershey Medical Center Case Number vs. Brandon D Zimmerman 2013-81 SHERIFF'S RETURN OF SERVICE 05/13/2013 06:56 PM-Deputy Dennis Fry, being duly sworn according to law, served the requested Complaint& Notice by"personally"handing a true copy to a person representing themselves to be the Defendant,to wit: Brandon D Zimmerman at 1450 Cranes Gap Road, North Middleton, Carlisle, PA 17011 DE IS FRY, DEPLOY— SHERIFF COST: $34.78 SO ANSWERS, May 14, 2013 RbNW R ANDERSON, SHERIFF (c)CounlySuRa Shori f,Toteosoft,Inc. .TABAS&ROSEN,P.C. BY:LEWIS C.TRAUFFER,ESQUIRE ID NO.: 60267 ' 1601 Market Street,Suite 2300 PHILADELPHIA,PA 19103 215-569-5050 The Milton S. Hershey Medical Center COURT OF COMMON PLEAS P.O. Box 853 Hershey, PA 17011 CUMBERLAND COUNTY VS. NO.: 13-81 Brandon D. Zimmerman 1450 Cranes Gap Road North Middleton Carlisle, PA 17013 ORDER FOR JUDGMENT FOR WANT OF AN ANSWER AND ASSESSMENT OF DAMAGES TO THE PROTHONOTARY: Kindly enter judgment in the sum of$47,251.98 in favor of the Plaintiff(s) in the above entitled matter for failure of the Defendant(s) to file an Answer to Plaintiff(s) Complaint in n r-� -; CP Civil Action and assess Plaintiff(s) damages as follows: n -n co C_ t-11 r � Amount of Claim: $ 40,497.73 � `� ,CD �C3 'C-) Interest at 6% per C3 '; annum from date of 3_ discharge 9/27/10, 09/26/10 $ 6,754.25 Total: $ 47,251.98 Attorne or Plaintiff(s) I assess dam es as ve Pro Prothonotary I. ....... ........ . ..........°hereby certify that the I... ... ...................c 10 day letter i er R.C.P.R.237.1 was forwarded to that the above n es are correct and the Precise Residence Address of the Defendant Brandon D.Zimmerman Judgment creditor is Address 1450 Cranes Gap Road-North Middleton Address: Same Carlisle,PA 17013 1! Ct.# 94 S% Date June 17,2013 Address of 12#a R� Defendants: Same t 1e h 4 'AUOkle d The Milton S. Hershey Medical Center COURT OF COMMON PLEAS P.O. Box 853 Hershey, PA 17011 CUMBERLAND COUNTY VS. NO.: 13-81 Brandon D. Zimmerman 1450 Cranes Gap Road North Middleton Carlisle, PA 17013 AFFIDAVIT OF NON MILLITARY SERVICE COMMONWEALTH OF PA COUNTY OF CUMBERLAND LEWIS C. TRAUFFER verifies to the best of his knowledge, information and belief: (a) that the defendant(s) is/are not in the Military or Naval Service of the United States or of its allies, or otherwise within the provisions of the Soldiers' and Sailors' Civil relief action of Congress of 1940 as amended; (b) that defendant Brandon D. Zimmerman is over 21 years of age and resides at: 1450 Cranes Gap Road,North Middleton, Carlisle, PA 17013 and is employed in Private Business. (c) that defendant is over 21 years of age and resides at: and is employed in Private Business. The undersigned understands that the statements herein are made subject to the penalties of 18 Pa.C.S.Sec.4904 relating to unswom falsification to authorities. LEWIS C. T UFFER,ESQUIRE Attorney for the Plaintiff TABAS & ROSEN, P.C. BY: LEWIS C. TRAUFFER, ESQUIRE ID No. : 60267 1601 Market Street, Suite 2300 Philadelphia, PA 19103 (215)569-5050 THE MILTON S. HERSHEY MEDICAL CENTER : COURT OF COMMON PLEAS P.O. BOX 853 HERSHEY, PA 17033 : CUMBERLAND COUNTY VS. : NO.: 13-81 BRANDON D. ZIMMERMAN 1450 CRANES GAP ROAD NORTH MIDDLETON CARLISLE, PA 17013 NOTICE OF INTENTION TO TAKE DEFAULT JUDGMENT TO: BRANDON D. ZIMMERMAN 1450 CRANES GAP ROAD NORTH MIDDLETON CARLISLE, PA 17013 DATE OF NOTICE/FECHA DEL AVISO: June 17, 2013 IMPORTANT NOTICE YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGEMENT 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 Phone No.: (717)249-3166 or(800)990-9108 AVISO IMPORTANTE USTED SE ENCUENTRA EN ESTADO DE REBELDIA POR NO HABER PRESENTADO UNA COMPARECENIA ESCRITO CON ESTE TRIBUNAL SUS DEFENSAS U OBJECTIONES A LOS RECLAMOS FOR1ULADOS EN CONTRA SUYO. AL NO TOMAR LA ACCION DEBIDA DENTRO DE DIEZ DIAS DE LA FECHA DE ESTA NOTIFICATION, EL TRIBUNAL PODRA, SIN NECESIDAD DE COMPARECER USTED EN CORTE U OIR PREUBA ALGUNA, DICTAR SENTENCIA EN SU CONTRA Y USTED PODRIA PERDER BIENES U OTROS DERECHOS IMPORTANTES. USED DEBE LLEVAR ESTE AVISO A UN ABOGADO ENSEGUIDA. SI USTED NO TIENE ABOGADO, VAYA PERSONALMENTE O LLAME POR TELEFONO A LA OFICINA MENCIONADA A CONTINUACTION. ESTA OFICINA LE PUEDE PROVEER LA INFORMACION NECESARIA PARA CONTRATAR A UN ABOGADO. SI USTED CARECE DE LOS MEDIOS NECESARIOS PARA CONTRATAR A UN ABOGADO, DICHA OFICINA LE PUEDE SUMINISTRAR LA INFORMACION NECESSARIA ACERCA DE AQUELLAS AGENCIAS QUE OFRECEN SERVICIOS LEGALES A LAS PERSONAS QUE TIENEN DERECHO A RECIBIR TAL AYUDA GRATIS O A UNA CUOTA REDUCIDA. Cumberland County Bar Association 2 Liberty Avenue Carlisle,PA 17013 Phone No.: (717)249-3166 or(800)990-9108 LEWIS C. TRAUFFER, ESQUIRE ATTORNEY FOR THE PLAINTIFF THIS CORRESPONDENCE IS BEING USED TO COLLECT A DEBT AND THE INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. OFFICE OF THE PROTHONOTARY CUMBERLAND COUNTY COURT HOUSE ONE COURTHOUSE SQUARE CARLISLE, PA 17013 TO: Brandon D. Zimmerman CUMBERLAND COUNTY 1450 Cranes Gap Road North Middleton Carlisle, PA 17013 No.: 13-81 The Milton S. Hershey Medical Center P.O. Box 853 Hershey, PA 17011 VS. Brandon D. Zimmerman NOTICE Pursuant to Rule 236 of the Supreme Court of Pennsylvania, you are hereby notified that a Judgment has been entered against you in the above proceeding as indicated below. DA VID D. B UELL PROTHONOTARY X JUDGMENT BY DEFAULT MONEY JUDGMENT (^Ao` JUDGMENT IN REPLEVIN JUDGMENT FOR POSSESSION JUDGMENT ON AWARD OF ARBITRATION TRANSFER OF JUDGMENT IF YOU HAVE ANY QUESTIONS CONCERNING THIS NOTICE, PLEASE CALL: ATTORNEY_ LEWIS C. TRAUFFER ESQUIRE AT THIS TELEPHONE NUMBER: 215-569-5050