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Home My WebLink About04-5652 FRANCIS B. SMITH, Petitioner v. : IN THE COURT OF COMMON PLEAS : CUMBERlAND COUNTY, PENNSYLVANIA 0'1- .5 (, ~.2., t!..wJ / ~ : NO. COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING UCENSE RECALL APPEAL pennON AND NOW, this 9th day of November, 2004, comes Francis B. Smith, through his attorneys, Mancke, Wagner & Spreha, who respectfuUy represent 1. Your Petitioner, Francis B. Smith, is an adutt individual residing at 1781 N. Meadow Drive, Mechanicsburg, Cumber1and County, Pennsylvania. 2. Your Petitioner received a license recall notice, a copy of which is attached hereto and made a part hereof as Exhibit A. 3. Your Petitioner believes said license recall is iHegal, unjust, and improper for reasons which include, but are not limited to, the following: (a) Your Petitioner does not have a condition that would make him unable to safely operate a motor vehicle; (b) Your Petitioner's right to privacy was violated under both Federal and State Constitutions and statutes and regulations; (c) Your Petitioner's right to privacy was violated under Federal and State regulations including, but not limited to HIPM regulations, 45 C.F.R. 160.102 etseq., 50 Pa.C.S. ~7111, 71 Pa.C.S. ~1690.108, 42 Pa.C,S. ~944, 28 Pa.Code fi115.27, 42C.F.R. ~2.1, 42USCS~29Odd-2and 28 PaCode ~5.53 and/or any other related statutes or regutations relating to confidentiality accorded to the Petitioner pursuant to Federal and .. State Constitutions, regulations and/or statutory provisions regarding confidentiality; (d) there is no medical basis for declaration that Your Petitioner is unable to safely operate a motor vehicle; and (e) the action by the Department of Transportation violates Federal and State constitutional provisions relating to due process. WHEREFORE, Your Petitioner prays Your Honorable Courtto hold a hearing to detennine the validity of the suspension outlined in Exhibit A. Respectfully subnitted, Jo:~B 2'<ESQ., 10 No. 07212 Manc4,;~ 1& Spreha 2233 ~. Front Street Harrisburg, PA 17110 717-234-7051, Attorney for Petitioner Dated: November 9, 2004 LAW OFFICES MANCKE. WAGNER 8: SPREHA 2233 NORTH FRONT STREET JOHN B. MANCKE P. RICHARD WAGNER EDWARD F. SPREHA. JR. HARRISBURG. PA 17110 PHONE (717) 234-7051 FAX (717) 234-7080 VERIFICATION I hereby verify that the statements made in this document 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. !\lov 8 ;LDO'l-\-' ) Date 1- ~--R~ revalllls COi\IJ\IONWEALTII OF PENNSYLVANIA DEl'ARTMENT OF TRANSPOlrL\TION Bureau ul' Drivel' Liccnsin1-! J\laiIDate: Od()I)(~I' II. .!HH4 FRANCIS SMITH 'U - i L.\ ~ 0 ~ 17'd I NORTH MEADOW DR MECHANICSBURG PA 17055 Dear Mr. FRANCIS SMITH: We have recei veu meuical informalion inuicating that you have a Neuropsychiatric cOl1uition which prevents YOll from safely operating a motor vehicle. As of 11/1512004. YOllll1ay no longer drive. Your driving privilege is hereby recalled inJefinilcly as mandated by Section 1519(c) oCthe Vehicle Cuue. This decision has been maue by comparing your medical cUlldition with Ihe slandards recommended by our Medical Advisory Board and auopted by this Department. This action will remain in effect until we receive meuical information Ihat your condition has improved anu YOll are able to safely operate a motor vehicle. In order to comply with this action, you must return all current Pennsylvania driver's licenses. learner\ permits. temporary driver's licenses (camera cards) in your possession on or before the effective date listed above. If you cannot comply with the requirements stated above. a sworn affidavit stating that you are aware of the sanction against your driving privilege must be submitted. When the Department receives your license or affidavit. we will send you a receipt YOU lVIA Y NOT RETAIN YOUR DRIVER'S LICENSE FOR IDENTIFICATION PURPOSES. However. you may apply for ano obtain a photo identification card at any Driver License Center. You have the right to appeal to the Court of COlllmon Pleas (Civil Division) within thirty (30) days of the mail uate of this notice. 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 your appeal to be valid, you must send this time-stamped copy of the appeal by certified mail to: Pennsylvania Depai1Inent of Transportation Office of Chief Counsel Third Floor. Riverfront Office Center Harrisburg. P A 17104 ~ EXHIBIT " ~ <:l ~ f+ w !;t I" ~ ~ , ~ \A --OU; \0 Y(lU c-liIlIl1Uc-t s~lld ill yuur lic~llsc bdnrc lhe dTecli\'l~ dale Ill' recall unless YIlU appear in persoll hdOle a judge ;\Ild 1'C\.:eive an order permilling YOlllo l'()fltillllc driving, ~) l' If yuu havl' any questiolJs or lJe~d further information. please conlact lhe Medical Ullil. P.O. Box 6~6l)2. Harrisburg. PA 171()6-86l-Q oreall (717) 787-1.)662 belwccnthe hours (,f ~:()O a.Ill. ,1llU -1-:30 p.m. Sincerely. ~~.~ Rebecca L Bickley. Director Bureau of Driver Licensing Driver License #: 06072275 ~ ~ -- V'l ~ ~ ~ v'\ ~ "t- o VI ~ c ~~ ~ ~ ~ ~ ::;l ,... ~ o f;~ ;:,~ ~ :'; : \, (1 c-' :3 " G /"--.) ~:~~ ...,(;.- o '1 ::;:1 iY'j'Il r''':' ::gFq () ;r' :~j ;~ ('1m .i~~ :JJ -< =t.... c; ...;;; I \.0 2 -....110 ~-? (,..> v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO: 04-5652 FRANCIS B. SMITH, Petitioner COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING f PETI110N FOR SUPERSEDEAS AND NOW, this I cr day of November, 2004, comes Francis B. Smith. through his attorneys, Mancke, Wagner & Spreha, who respectfully represent 1. Your Petitioner is an adult individual residing at 1781 N. Meadow Drive, Mechanicsburg, Cumber1and County, Pennsylvania. 2. Your Petitioner received a recall notice from the Deparbnent of Transportation, a copy of which is attached hereto and made a part hereof as Exhibit A 3. Your Petitioner has filed an appeal fromUle recall with the Cumberland County Prothonotary's office on November 9, 2004, a copy of said Petitioner is attached hereto and made a part hereof as Exhibit B. 4. Your Petitioner has received an evaluation and a driving test administered under the direction of Dr. Ravi Dukkipati, a neurotogist and as a result of said evaluation, Dr. Dukkipali has indicated that Your Petitioner is able to safely operate a motor vehicle (see Exhibit C attached). 5. Your Petitioner will be irreparably harmed if his driving privileges are recalled pending the appeal in the underlying recall appeal. subIllItted. When tIle uepanmem receIves YUUl Ul;t;I1;)t; Vi ,.llUUc.lvn, ....'"' ....... "''''"'' J"'" ~ '---'1--' YOU MAY NOT RETAIN YOUR DRIVER'S LICENSE FOR IDENTIFICATION . PURPOSES, However, you may apply for and obtain a photo identification card at any Dnver License Center. You have the right to appeal to the Court of Common Pleas (Civil Division) within thirty .(30~ days of the mail date of this notice. If you file an appeal in the County Com1, the ~ourt WIll gIve you a time-stamped ceItified copy of the appeal. In order for your appeal to be valId, you must send this time-stamped copy of the appeal by celtified mail to: Pennsylvania Depm1ment of Transportation Office of Chief Counsel Third Floor, Riverfront Office Center Harrisburg, P A 17 104 , \A ...OlA; \0 .. .. . , Y uu stilllllust send in your license before the effective dale of recall unless you appear in person before a judge and receive an order permilling you to continue driving. " " l"p \1 I, ~, If you have any questions or need further information. please contact the Medical Unit. P.O. Box 68682. Harrisburg. P A 17106-8682 or call (17) 787 -9662 between the hours of 8:00 a.l11. and 4:30 p.m. Sincerely. ~~.~ Rebecca L. Bickley. Director Bureau of Driver Licensing Dri ver License #: 06072275 FRANCIS B. SMITH, Petitioner v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. OLL--.... 5-6.9- COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING ORDER AND NOW, this_dayof ,2004, upon consideration of the within Petition, it is hereby ordered and decreed that a hearing be held on the _ day of . 200--, at _ o'clock in Courtroom _. Cumberland County Courthouse, Carlisle, Pennsylvania. Notice of said hearing shall be sent by certified mail to the Deparbnent ofT ransportation by Petitioner's attorney at least sixty days prior to the date of the hearing. By the Court, J. Distribution: Prothonotary's Office John B. Mancke, Esq., 2233 N. Front Street, Harrisburg, PA 17110 PA Dept. of Transportation, Office of Chief Counsel. 1101 S. Front Street, Harrisburg, PA 17104 ~ EXHIBIT " C1 ~ ~ B ~ ..:. ~ , FRANCIS B. SMITH, Petitioner v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING C) "-.) c~ c:::, ." (:.~ () ~:-,' ,',,'.- ~:- -1'1 , ..^."". (:') .:,:! -.., F;l"Z! I /-. \.Q ~-;7 ;q () r UCENSE RECALL APPEAl PE1I110N ;l~ ~! ,:1;2 AND NOW, this 9th day of November, 2004, comes Francis B. Smith, through his attorfieYs, ~nck_~~~ ..,::.: c: I " ---I. Wagner & Spreha, who respectfully represent: 1. Your Petitioner, Francis B. Smith, is an adult individual residing at 1781 N. Meadow Drive, Mechanicsburg, Cumber1and County, Pennsylvania. 2. Your Petitioner received a license recall notice, a copy of which is attached hereto and made apart hereof as Exhibit A. 3. Your Petitioner believes said license recall is illegal, unjust, and improper for reasons which include, but are not limited to, the following: (a) Your Petitioner does not have a condition that would make him unable to safely operate a motor vehicle; (b) Your Petitioner's right to privacy was violated under both Federal and State Constitutions and statutes and regulations; (c) Your Petitioner's right to privacy was violated under Federal and State regulations including, but not limited to HIPM regulations, 45 C.F.R. 160.102 et seq., 50 PaC.S. 97111, 71 Pa.C.S. 91690.108, 42 Pa.C.S. S4944, 28 PaCode S115.27, 42 C.F.R. s2.1, 42 USCS S290dd-2 and 28 PaCode 95.53 and/or any other related statutes or regulations relating to confidentiality accorded to the Petitioner pursuant to Federal and t'RUE COPY t:fi"'P'~ ~t:"f"",r..,.n... i-r~~~l~;, J')\,..._ ,"*'!'1U tn T......4'F~'U">n\i ""\Oo:>(Oc1 i 1""1 "~':il <::(t~ my Ot:\i1.J o;)Ull~V 7 YiI'lV \.;- . ~ ~ I.~_~- '..... ~ ~'.~ .. and the ~I of said Coo ! Cariislc. Pa. rlli~ 9~ Ifl Ii. o?(IJ V ~,9 '1 PrM\'v)nn'f'1'Y State Constitutions, regulations and/or statutory provisions regarding confidentiality; (d) there is no medical basis for declaration that Your Petitioner is unable to safely operate a motor vehicle; and (e) the action by the Deparbnent of Transportation violates Federal and State constitutional provisions relating to due process. WHEREFORE, Your Petitioner prays Your Honorable Court to hold a hearing to determine the validity of the suspension outlined in Exhibit A. Respectfully submitted, JO:~\Ba4:ESq.,ID No. 07212 Manc 4,1~~~er & Spreha 2233 ~. Front Street, Harrisburg, PA 17110 717-234-7051, Attorney for Petitioner Dated: November 9,2004 LAW OFFICES MANCKE, WAGNER Be SPREHA JOHN B. MANCKE P. RICHARD WAGNER EDWARD F. SPREHA. JR. 2:233 NORTH FRONT STREET HARRISBURG. PA 17110 PHONE (717) 234-7051 FAX (717) 234-7080 VERIFICATION I hereby verify that the statements made in this document 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. !\lov 8 2..DQ'+ ) Date ~... ,/ . ? ,~. ~~#'~ '13 4' ,JM~ / .// ICGdlns CO!\I!\IONWEALTJI OF PENNSYLVANIA DEPARTMENT OF TRANSPORTATION Bureau of Drin'l' LkcllSill~ i\hlil Date: Odohcr II. 2004 FRANCIS SMITH 'U - i 1..\ - 0 y. ! 7'61 NORTH MEADOW DR lvlECI-IANICSBURG PA 17055 Dear .lvlr. FRANCIS SMITH: We have receivet.!medical information indicating: that YOll have a Neuropsychiatric condition which prevents you from safely operating: a motor vehicle. As of 11115/2004. you may no longer drive. Your driving privilege is hereby recalled int.!efinitely as mandated by Section 1519(c) of the Vehicle Code. This uecisioll has been maue by comparing your medical condition with the standards recommended by our Medical Advisory Board and adopted hy this Department. This action will remain in effect until we receive medical information that your condition has improved anu you are able to safely operate a motor vehicle. In order to comply with this action, you must return all current Pennsylvania driver"s licenses. learner"s permits, temporary driver's licenses (camera carus) in your possession on or before the effecti ve date listed above. If you canHot comply with the requirements statet.! above. a sworn affidavit stating that you are aware of the sanction against your driving privilege must be submitted. When the Department receives your license or affidavit, we will send you a receipt. YOU MA Y NOT RETAIN YOUR DRIVER'S LICENSE FOR IDENTIFICATION PURPOSES. However, you may apply for ant.! obtain a photo it.!entirication card at any Driver License Center. You have the right to appeal to the Court of Common Pleas (Civil Division) within thirty (30) days of the mail date of this notice. If you file an appeal in the County Court, the Court will give you a time-stamped certif.ied copy of the appeal. In order for your appeal to be valid. you must send this time-stampeJ copy of the appeal by certified mail to: Pennsylvania Depal1ment of Transportation Office of Chief Counsel Third Floor. Riverfront Office Center Harrisburg. P A 17104 ,!, EXHIBIT " <l: <:J w --' f+ ~ I-' Ul .:, --' '-<l: , ~ \ '\ ..-oU; \0 Y pu stilllllllst Si:IHJ in yuur lici:llsC bdorc the' dTeclive lble ur recafllllllcss you appear ill pers\lll berme ajudge and receive an (lI'lkr permitting you tu continuc driving. , P \' If you have any ljuestions or need rurther inrormatiol1. please cul1tacttlic rVledical Ullit. P.O. 13ux 68682. Harrisburg. PA 171()6-86~2 or call (717) 787-l)()62 between the hours ur X:{)O a.l11. and -+:J() p.m. Sincerely. ~~,~ Rebecca L. Bickley. Director Bureau of Driver Licensing: Driver License #: 06072275 FROi'1 : NEUROLOGY CENTER PC FA>< NO. : 7179750670 Nov. 09 2004 05:18PM P3 DL-13 (10-01) DEPARTMENT OF TRANSPORTATION · BUREAU OF DRIVER LICENSING INITIAL REPORTING FORM (Print or T)'pe Requested Information) FOR BUREAU USE ONLY Date Received Driver # Reference DEAR PROVIDER: Although the Department seeks your Judgement about your patlent.s medical rIlness to safely operate a motor vehicle, the decisioh about your patIent's driver's license is a responsibility of the Department's Bureau of Driver Licensing which must also lake Into account other considerations. Please complete Sections A, 8, C, and D. (,M ~\~ JR. ETe FIRST NAME ft2A~( \~ HEIGHT SEX Eve COLOA feet I INCHes STREET ^1~5 \ N . SOCIAL SECURITY NUMBER DATE OF BfATH \ 11 '~Ir~ 1.--[ 1.IB Dl \ I ~ I ~ Mff"l,~ I is ~trJ Q{ I CITY {'N(ct..' f \\ to( \ of TELEPHONE NUMBER rll7 &H rrD l' I SJJ-.TE I ZIP CODE r (.\ . I, 4")) DATE OF EXAMINATION: SECTION B DIAGNOSIS OF DISORDER OR DISABILITV: Please Check (fII) Appropriate Items o Loss or Impairment of a Foot, Leg, Finger, Thumb, or Hand. Condition: a Unslable Diabetes o Cerebral Vascular Disease o Cardiovascular Disease o Loss of ConsclolJsness ~ Cause: a Neurological Disorder .. )JMental DeficIency M( 'I CO ~:J.,j, a Mer.tal Disorder (J -. -, .... .... r.J Alcohol Abuse Q Drug or Controlled Substance Abuse Q Vision Deficiency Q Other Medical Condition which would Interfere with the patient's ability to drive. Explain: . l '-i"4A.("~ a Comments: Do these c~tlons affect the patient's ability, from a medical standpoint only, to safely operate a motor vehicle? Cl YES )'J NO . ,... . Seizure Disorder: Q YES ~o Date of Last Seizure: Does the patient meet any of thtfDepartment's waiver requirements? If yes, please explain: !. EXHIBIT <t aVES aNa ~ w ..J (5 ~ ~ ~ ,- I1iIIud1I ALL INFORMAnON IS CONFIDENTIAL AS PROVID D IN PROVIDEFI'SNAME(P~~. ~rlnr) t"'l /J SIGNATUR .. r~ ( V,^\,LtM. { Prn ~ CLASSIFICATION-OR SPECIALTY: rJ(\} V~~) PHYSICIAN STATE LICENSE NUMBER: OFFIce PHONE: ~o cu'l roQ;. L- -, \l q,~ 1 ~ '( 'S Return this form to: BUREAU OF DRIVER UCENSlNG · DRIVER QUAUFlCAnONS SECnON · PO BOX ea. . HARAI88URG.PA 17106-1682 ", F4Y Inm7\ ~,~ L VEHICLE CODE, SECTION 1618(d) ER' Neurology, Center, P.C. 897 Poplar ChufG" ROclJ Camp Hili, PA 17011 v NOV 1 0 2UU4 j- FRANCIS B. SMITH, Petitioner v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. OL( - 5G52 () vii COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING ORDER AND NOW, this 17 f). day of "i~~ , 2004, upon consideration of the within Petition, ~ is hereby ordered and decreed1hal a hearing be held on the ~ day of 1 ~ . 200~ at 1JQ. o'clock in Courtroom ~ Cumberland County Courthouse, Carlisle, Pennsylvania. Notice of said hearing shall be sent by certified mail to the Department ofT ransportation by Petitioner's J. attorney at least sixty days prior to the date of the hearing. /' By the 9Ourt, (/ Distribution: Prothonotary's Office ~n B. Mancke, Esq., 2233 N. Front Street Harrisburg, PA 17110 \ .%l5ept of Transportation, Office of Chief Counsel, 1101 S. Front Street Harrisburg, PA 17104 -Ii ;"-~., :-{~.::.....} I . \... L CF It c ,:>~~~ C:"'.'Jrl.'~',' L . ..1 '" I f:"ij: .," 1'.,"'.1." ~__ ^CD'd~.~;~' i _ '-'0 C':': . ~ .....-J., ~_ ___ I:::; ..... t... " '~"'. I J __i_"'~ r'JTt \: !\ '-. FRANCIS B. SMITH, Petitioner : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA v. : NO: 04-5652 COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING ~1'~:""",-... J<' PETI110N FOR SUPERSEDEAS AND NOW, this lo+h day of November, 2004, comes Francis B. Smith, through his attorneys, Mancke, Wagner & Spreha, who respectfully represent 1. Your Petitioner is an adutt individual residing at 1781 N. Meadow Drive, Mechanicsburg, Cumber1and County, Pennsylvania. 2. Your Petitioner received a recall notice from the Department of Transportation, a copy of which is attached hereto and made a part hereof as Exhibit A. 3. Your Petitioner has filed an appeal from the recall with the Cumberland County Prothonotary's office on November 9, 2004, a copy of said Petitioner is attached hereto and made a part hereof as Exhibit B. 4. Your Petitioner has received an evaluation and a driving test administered under the direction of Dr. Ravi Dukkipati, a neurologist and as a result of said evaluation, Dr. Dukkipali has indicated that Your Petitioner is able to safely operate a motor vehicle (see Exhibit C attached). 5. Your Petitioner will be irreparably harmed if his driving privileges are recalled pending the appeal in the underlying recall appeal. WHEREFORE, Your Petitioner prays Your Honorable Courtto hold a hearing and enter a Supersedeas Order reinstating and/or continuing Your Petitioners ability to operate a motor vehicle pending the resolution of the under1ying recall appeal petition. Respectfully submitted, John; ~q..ID No. 07212 Mancke. Wagner & Spreha 2233 N. Front Street Harrisburg, PA 17110 717-234-7051, Attorney for Petitioner Dated: November 10, 2004 LAW OFFICES JOHN B. MANCKE P. RICHARD WAGNER EDWARD F. SPREHA. JR. MANCKE. WAGNER 8: SPREHA 2233 NORTH FRONT STREET HARRISBURG, PA 17110 PHONE (717) 234-7051 FAX (717) 234-7080 VERIFICA liON I hereby verify that the statements made in this document 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. /J-q-o~ Date ~ ~k-~~-B. ~1- / recallns COMMONWEALTII OF PENNSYLVANIA DEPARTMENT OF TRANSPORTATION lllll'cau of Drivel' Liccnsing Mail Datc: Octobcr 11, 2UU4 FRANCIS SMlTH 'D - i L..\ . 0 ~ 1781 NORTH MEADOW DR MECHANICSBURG PA 17055 Dear Ml'. FRANCIS SMITH: We have received medical information indicating that YOlI have a Neuropsychiatric condition which prevents you from safely operating a motor vehicle. As of 11/15/2004, you may no longer drive. Your driving privilege is hereby recalled indefinitely as mandated by Section IS19(c) of the Vehicle Code. This decision has been made by comparing your medical condition with the standards recommended by our Medical Advisory Board and adopted by this Department. This action will remain in effect until we receive medical information that your condition has improved and you are able to safely operate a motor vehicle. In order to comply with this action, you must return aU current Pennsylvania driver's licenses, learner's permits, temporary driver's licenses (camera cards) in your possession on or before the effective date listed above. If you cannot comply with the requirements stated above, a sworn affidavit stating that you are aware of the sanction against your driving privilege must be submitted. When the Department receives your license or affidavit, we will send you a receipt. YOU MAY NOT RETAIN YOUR DRIVER'S LICENSE FOR IDENTIFICATION PURPOSES, However, you may apply for and obtain a photo identification card at any Driver License Center. You have the right to appeal to the Court of Common Pleas (Civil Division) within thirty (30) days of the mail date of this notice. If you file an appeal in the County COUl1, the Court will give you a time-stamped certified copy of the appeal. In order for your appeal to be valid, you must send this time-stamped copy of the appeal by certified mail to: Pennsylvania Depat1ment of Transpol1ation Office of Chief Counsel Third Floor, Riverti'ont Office Center Harrisburg. P A 17104 ~ EXHIBIT " Cl ~ 4 ~ I" l/l ...:. ....I I <( , \A ...OlA; \0 .. .. . , You still must send in your license before the effective dale or rccallunlcss you appear in person before a judge and receive an order permitting you to continue driving. .' " I P \, \ '. if you have any <..juestions or need further information. please contact the Medical Unit. P.O. Box 68682. Harrisburg. P A 17106-8682 or call (17) 787 -9662 bet ween the hours of 8:00 a.lll. and 4:30 p.m. Sincerely. ~~,~ Rebecca L. Bickley. Director Bureau of Driver Licensing Driver License #: 06072275 FRANCIS B. SMITH, Petitioner v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. OLL"-,, 5-69- COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING ORDER AND NOW, this_dayof , 2004, upon consideration ofthe within Petition, it is hereby ordered and decreed that a hearing be held on the _ day of . 200--, at _ o'clock in Courtroom _, Cumberland County Courthouse, Carlisle, Pennsylvania. Notice of said hearing shall be sent by certified mail to the Department ofT ransportation by Petitioner's attorney at least sixty days prior to the date of the hearing. By the Court, J. Distribution: Prothonotary's Office John B. Mancke, Esq., 2233 N. Front Street, Harrisburg, PA 17110 PA Dept. of Transportation, Office of Chief Counsel, 1101 S. Front Street, Harrisburg, PA 17104 !. EXHIBIT , ~ ~ ~ B I" en .:.. ..J J <( FRANCIS B. SMITH, Petitioner v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING Cj "'-.) ~:~ C.':.) .... c:;:, () r--:;.~ :", ~- ":::rl f~5 ,:;:1 ~:.:.= r;"11s ~ :-~"i r:q c ) ,L- -,"r. ]! i.~J(:~: ... (~) (' .,; 11'1 AND NOW, this 9th day of November, 2004, comes Francis B. Smith, through his attorFie:Ys, Minck~~i __ -A,,) "':;;.,' Wagner & Spreha, who respectfully represent (- ," ~ ~._~..' (~. LICENSE RECALL APPEAL PETITION 1. Your Petitioner, Francis B. Smith, is an adult individual residing at 1781 N. Meadow Drive, Mechanicsburg, Cumber1and County, Pennsylvania. 2. Your Petitioner received a license recall notice, a copy of which is attached hereto and made a part hereof as Exhibit A. 3. Your Petitioner believes said license recall is illegal, unjust, and improper for reasons which include, but are not limited to, the following: (a) Your Petitioner does not have a condition that would make him unable to safely operate a motor vehicle; (b) Your Petitioner's right to privacy was violated under both Federal and State Constitutions and statutes and regulations; (c) Your Petitioner's right to privacy was violated under Federal and State regulations including, but not limited to HIPAA regulations, 45 C.F.R. 160.102etseq., 50 Pa.C.S. ~7111, 71 Pa.C.S. ~1690.108, 42 Pa.C.S. ~4944, 28Pa.Code ~115.27,42C.F.R. ~2.1, 42USCS~29Odd-2and 28 Pa.Code ~5.53 and/or any other related statutes or regulations relating to confidentiality accorded to the Petitioner pursuant to Federal and t-nUE COPY ert"'.',ll ~r,f't'n... n j....r'i.~\l't.~~ Jl)~_~_",-,!""'I~ fn Testknony WY'i6(ccf. I }:>~:;, U~':;<) SC~ my t\Zfi-o and the ~I 01 said Coor} p1 Cariisle. PI. Tm.\ 9fJ/JA flay ol. ~~'I ~;r1. --, ~." Prm\'HJ~1'f?rv State Constitutions, regulations and/or statutory provisions regarding confidentiality; (d) there is no medical basis for declaration that Your Petitioner is unable to safely operate a motor vehicle; and (e) the action by the Department of Transportation violates Federal and State constitutional provisions relating to due process. WHEREFORE, Your Petitioner prays Your Honorable Court to hold a hearing to determine the validity of the suspension outlined in Exhibit A Respectfully submitted, I...~ "\ ~ John\B ck~ Esq., 10 No. 07212 Manc . , Wagner & Spreha 2233 ~. Front Street, Harrisburg, PA 17110 717-234-7051, Attorney for Petitioner Dated: November 9, 2004 LAW OFFICES MANCKE, WAGNER & SPREHA JOHN B. MANCKE P. RICHARD WAGNER EDWARD F. SPREHA. JR. 2233 NORTH FRONT STREET HARRISBURG, PA 17110 PHONE (717) 234-7051 FAX (717) 2.34-7080 VERIFICATION I hereby verify that the statements made in this document 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. 1\10\1 8 2..DQ* ) Date (; . -z ....../2) ," ~--v;~F'~ p.,. /h<~ /' ,~// n:c;dlns COl\lJ\IONWEALTJl ()F PENNSYLVANIA IJEPARTMENT OF TRANSPORTATION BlII'eauof IJrivcr LiccnsiIlI-! !\Jail Datl': Octohcr 1 J. 2()()4 FRANCIS SJvIITH 'D- i L\ -0 ~ 17'61 NORTH MEADOW DR MECHANICSBURG PA 17055 Dear Mr. FRANCIS SMITH: We have recei veo meoical information inoicating: that you have a Neuropsychiatric condition which prevents you from safely operating a motor vehicle. As of L IIL5/2()()4, you may no longer drive. Your driving privilege is hereby recalled indefinitely as mandated by Section IS19(c) or the Vehicle Code. This liccision has been maue by comparing your medical condition with the standards recommended by our Medical Advisory Board and adopted by this Department. This action will remain in effect until we receive medical information that your condition has improveu and you are able to safely operate a motor vehicle. In order to comply with this action. YOlll11Ust return all current Pennsylvania driver's licenses. learner's permits, temporary driver's licenses (camera canis) in your possession on or before the effecti ve date listeu above. If you cannot comply with the requirements sIal eo above, a sworn affidavit staling that you are aware of the sanction against your oriving IJrivilege must be '- '- l..,.. '-' submitted. When the Department receives your license or affidavit, we will send you a receipt. YOU MAY NOT RETAIN YOUR DRIVER'S LICENSE FOR IDENTIFICATION PURPOSES, However, you may apply for unu obtain a photo identifkation card at any Driver License Center. Yau have tbe right to appeal to the Court of Common Pleas I Civil Division) within thirty (0) days of the mail date of this notice. If YOll file all appeal in the County Court. the COLIn will give you a time-stamped certified copy of the appeal. In order for your appeal to be valid, you must send this time-stamped copy of the appeal by certifieo mail to: Pennsylvania Department of Transportation OtTice of Chief Counsel Third Floor. Riverfront Office Center Harrisburg, PA 17104 I''!.J EXHIBIT " <t 1.:1 w ..J f+ ~ tl .:. ..J ,<t wi ~ \'\ ....olA; \0 \'llll still 111 1I \1 send in YUlIr liccll:--e before thc dlccli\'c dalc of rccallulllcss you appear in pcrsoll hcrorc ajudge and rccei\'c all order pcrlllilling you 10 contillue driving. ,'p \, Ie you have allY questiolls or need further information. please cOlltaclthe rVlcdical Unil. P.O, 131>.'\ 68682. Harrisburg, P A 17 106-8682 or call (717) 787 -Lj()62 bel\veclJ the hours or X:()O a.lll. ,1Ild -+:J() p.m. Sincerely. ~~.~ Rebecca L. Bickley. Director Bureau of Driver Licensing Dri vel' License #: 06072275 FRml : NEUROLOGY CENTER PC FAX NO. :7179750670 Nov. 09 2004 05:18PM P3 DL-13 (10-01) DEPARTMENT OF TRANSPORTATION. BUREAU OF DRIVER L.ICENSING INITIAL REPORTING FORM (Print or l)'pe Requested Information) FOR BUREAU USE ONLY Date Received Driver It Reference DEAR PROVIDER: Although the Department seeks your Judgement about your patIent's medical fitness to safely operate a motor vehicle, the decisioh about your patient's driver's license is a responsibility of the Department's Bureau of Driver . Licensing which must also lake Into accounl other consideratIons. Please complete Sections A, S, C, and D. CM \\~ JR. ETC FIAST NAME ft2A~( \\ HEIGHT SEX EVE COLOR fEeT I INCMfB STREET AI~5 \ ~ . SOCIAL SECURITY NUMBER DATE OF BIRTH \ 111 ~ 1t4 tf . oj \ I ~ I ~ Mff"1 ,~y I is ~~ Q, fClTY tw?.r.t. - f \\ I" \ of DATE OF EXAMINATION: -- DIAGNOSIS OF DISORDER OR DISABILITY: Please Check (tI) Appropriate Items o Loss or Impairment of a Foot. Leg. Finger, Thumb, or Hand - Condition: Q Unstable Diabetes Q Cerebral Vascular Disease o Cardiovascular Disease o Loss of Consciousness - Cause: o Neurological Disorder ... )JMental Deficiency r\,\t ,; ():) 1I..:J,j. l \lW74A.r~ o Mer.lal Disorder ~ .... -1 JP ..... Q r.:i Alcohol Abuse a Drug or Controlled Substance Abuse Q VIsion DeficIency Q Other Medical Condition which would Interfere with the patient's ability to drive. Explain: a Comments: TELEPHONE NUMBER t117 ~n Sjo f I S~TE I. ZIP CODE r ~ I, d ')} Do these ~tlona affect the patient's ability, from a medical standpoint only, to safely operate a motor vehicle? QYES /-J NO . L. VEHICLE CODE, SECTION 1618(d) ER' - ~ ALL INFORMATION IS CONFIDENTIAL AS PROVID D IN PFlOVIDEI'l'SNAME(P~~e ~rlnf) t""l . IJ SIGNATUR .... (<.oN ( v'^ ~l.tA ( Prn f\.M:> CLASSIFICATION-OR SPECIALTY: tJ''(\J V ~ \.c ) PHYSICIAN STATE LICENSE NUMBER: OFFICE PHONE: ~o (U tl.l'o~ I..- J C7 q,~ t ~ ~ 'S Return this form to: BUREAU OF DRIVER UCENSlNG · DRIVER QUALIFICAnONS SECnON . PO BOX 88&82 . HARRI88URG. PA 17106-8682 .. FlaY 1ft tnn ~'!i SECTION C Seizure Disorder: Q YES ~:' Date of Last Seizure: Does the patient meet any of th.fDepartment'Q waiver requirements? If yes, please explain: aVES aND !. ~ ~ ~ ~ .:. ..J c( .--' EXHIBIT (5 Neurology. Center, P.C. e97 Poplar Chureh Road Camp Hili. PA 17011 . . I" . '..' sy 5:3 (i r--.;) (-:-; ~".:-J ..... ( .. ::'.~ l:'~; _~:. 'i , .._~.. C) '11 .-1 . ,- 11; ~J I ~ 1 '.." C) C) -") , ~ [ ) "--~-~ , \-11 C) ':-:J W .< "" \J ,0/ NOV 1 7 2004 ~ v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO: 04-5652 FRANCIS B. SMITH, Petitioner COMMONWEALTH OF PENNSYL V~IA, DEPARTMENT OF TRANSPORTATIO~; BUREAU OF DRIVER LICENSING ORDER (x.(>>.. . A~ ~.. t ~ AND NOW, this ~ day of ~ ~\O ~ ,2004, upon consideration of the within Petition, it is hereby ordered a hearing be held on the ~ day of ~ ~ , 2004, at \ \'. O\) o'clock, in Courtroom -.1::...... of the Cumberland County Courthouse, Carlisle, Pennsylvania. Notice of said hearing shall be inrnediately forwarded to the Deparb11ent of Transportation, Office of Chief Counsel. r J. l Distribution: Prothonotary's Office ~n B. Mancke, Esq., 2233 N. Front Street Harrisburg, PA 17110 ~Depl of Transportation, Office of Chief Counsel, 1101 S. Front Street Harrisburg, PA 17104 ~~~ /f'- ~c\ \\\0\ q~ 1 '. .:1 },,If< "r,"'-''t. I\..J so ...., .'j l!d PI Q f.C'f~ ~1JOl }jj\l:..C;~"\"::>-:-,-C'CC ;~l ;:y ~j;J-(J;ll:j -~r) -..\-......., FRANCIS B. SMITH, PETITIONER IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING, RESPONDENT 04-5652 CIVIL TERM ORDER OF COURT AND NOW, this ~ _ day of December, 2004:, following a hearing on petitioner's request for the entry of a supersedeas pending a hearing on the merits of his license suspension to be conducted on February 7,2005, IT IS ORDERED that a supersedeas, IS GRANTED. John B. Mancke, Esquire For Petitioner ) v<'3eorge Kabusk, Esquire For the Department of Transportation ~ :sal .... C1'\ ("'") !.."'-~ ('f') () "''''- t>~ ""'- ",'j" 0- '-~J (-.~ ... f r::.'1 I: r: C0 " I.LJU- I ._.1 c..._) '1: t~J . ::C Ll-l : /-- C) i t tL _:T' "..-:. 0 c...." :.:) c::::> <"-' U ... v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 04-5652 FRANCIS B. SMITH, Petitioner COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING AND NOW, this ~aYOf ~DER , 2005, and upon agreement of John B. Mancke, Esq., attorney for Petitioner, and George Kabusk, Esq., attorney for Dep,artment oft ransporlation, it is hereby ordered and decreed that the hearing scheduled in the above-captioned matter for February 7, 2005 at 1 :30 pm is continued and the hearing in the above-captioned matter is hereby scheduled for April 4, 2005 at 2:00 pm in Courtroom 2, Cumberland County Courthouse, Carlisle, Pennsylvania. By the Co~~/ /' I' .... // ~l l .~ '/ ...-? .----- Judge Edgar . a\'ley~ Distribution: Prothonotary's Office ~hn B. Mancke, Esq., 2233 N. Front Street Harrisburg, PA 17110 .;George Kabusk, Esq., PA Depl ofTransportation, Office of Chief Coun.sel, 1101 S. Front Street Harrisburg, PA 17104 0-' ~.1~ (,'~) l~\ ;~~~', ~~I~; i,~~~ (\,f(:; '-"("- i_-jC_ ::~l~p \".....:1-. .... LL- o N ..::s <.:..t "':: ,'::1- N I ct:l '..<-l l<- ~,r::J g ,.... ~ v. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 04-5652 FRANCIS B. SMITH, Petitioner COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING PRAECIPE TO WITHDRAW To the Prothonotary: Please withdraw the above-captioned license recall appeal. hn B. Maneke, Esq., 10 No. 07212 neke, Wagner & Spreha 2 3 N. Front Street Harrisburg, PA 17110 717-234-7051, Attorney for Petitioner Dated: Mareh 10, 2005 .. FRANCIS B. SMITH, PETITIONER : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA V. COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING, RESPONDENT 04-5652 CIVIL TERM ORDER OF COURT AND NOW, this l1 day of March, 2005, petitioner having withdrawn his appeal from a license suspension, the hearing scheduled for April 4, 2005, IS CANCELLED. ( By th;,coCi rt~ , Edgar B. Bayley, J. '. ~n B. Mancke, Esquire For Petitioner > Op~~ ~orge Kabusk, Esquire ,~ 03- 17 -oS :sal " r' -----~-- .I .' FRANCIS B. SMITH, Petitioner : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY. PENNSYLVANIA v. : NO. 04-5652 COMMONWEALTH OF PENNSYLVANIA. DEPARTMENT OF TRANSPORTATION, BUREAU OF DRIVER LICENSING PRAECIPE TO WITHDRAW To the Prothonotary: "i Please withdraw the above-captioned license recall appeal. <.J; r,. C) ,;11 C': hn B. Mancke, ESQ., 10 No. 07212 ncke, Wagner & Spreha 2 3 N. Front Street Harrisburg, PA 17110 717-234-7051, Attorney for Petitioner Dated: March 10, 2005