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HomeMy WebLinkAbout13-2352 / M David a Buell Z) knee X Simpson Prothonotary v ' `‘ 'a rte' (Deputy Prothonotary 4.1 xyr&S. Sofionage, ESQ — Irene E. !Morrow Solicitor 2nd(Deputy Prothonotary Office of the Prothonotary Cum6er(and County, Pennsylvania Mr. David F. Kelly Bey April 29, 2013 Dear Mr. Bey; According to PA Rules of Civil Procedure Rule 205.5, a Civil Cover Sheet is required for you to file along with your Praecipe for Writ of Summons and Complaint. Since we did not receive a Civil Cover Sheet from you, we have enclosed one for you to fill out and return to our office. Sincerely, David D. Buell PROTHONOTARY One Courthouse Square• Suite 100•Coracle, TA 17013 • (717)240-6195• 'Fa.,,(717)240-6573 SN THE COURT 0 F CuMM PICAS 01- eUM6CP )unc! ¢ uvt> Y ?ENNs\ILVMJiA Zcav;c1 I<cl1.I c C v 114c-TI4>J "}Pk,tn-hPr N0 13--,255a . 1 I S4pp1►ee.] 4`I Cler k Vs. \(V q - M u r Scope r e fl 3c r Ju r Ti.•l DeAiondec/ (fie-Crnclurl rrl -r7 3 w Z • 'Ls 17,1 (j) N) mac; Pc TIT1ul1/4/ rok A 1="FrDV J(r <o -� c >c--) c Tv TI-IE 10A.va2ABI c Cato T` - RM AND NOLL) !'� 1 s; ' e r,io,n1t PY' 0444s c1 ,`• i� t t�� # *1 hr t).-c,'S 1(41.4 Q.esko c+ (1.41tki N~uve S fhiS hianov ,,f c Uu( 4 (' ererf ,. +ht A retY)en4,00 4r4. art U)UulcA Aver4 4 he Ailuw"nJ , D v; e1 F , here. b,1 5)Akk s under- 4_ he Penct X 4-7 v � 1 u i r J i v 'j 2u vsuG n + to ISM PANGS. § eitog rc l u o u 1' 05u aw n Pc41 ; ti c tt 4, )4, A q+-hu ( 14.0 e ;# 1 . 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KELLY BEY, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION—LAW WAL-MART SUPER CENTER, : Defendant : NO. 13-2352 CIVIL TERM PETITION FOR AFFIDAVIT OF IN FORMA PAUPERIS ORDER OF COURT AND NOW, this 3rd day of May, 2013, upon consideration of Plaintiff's Petition for Affidavit of In Forma Pauperis, the Plaintiff is authorized to proceed in the above- captioned action without payment of the filing fee. BY THE COURT, c -03 cz� /) rn m r,S-,-' re,ex_jj // Coy f ca 7 Christ ee L. Peck, J. -n z t David F. Kelly Bey 1.4.: -,,T.`D Cumberland County Prison Plaintiff, pro Se 'ed C°p 61.691 D� A .. \eceAv e //L /t3 Supreme CouxfPennsylvania Court of COrnniob Pleas For Prothonotary Use Only: °Cover Ch ?il ,S +het Docket No: l',, , County 13--a35a z The information collected on this form is used solely for court administration purposes. This form does not supplement or replace the filing and service of pleadings or other papers as required by law or rules of court. Commencement of Action: s Complaint 0 Writ of Summons 0 Petition 0 Transfer from Another Jurisdiction 0 Declaration of Taking E C, Lead Plaintiff's Name: Lead Defendant's Name: T 1 ,v .c1 F Kell,/ Be,/ wt-1- Mari Sup r 0 emit r Dollar Amount Requested: 0 within arbitration limits I Are money damages requested? $Yes 0 No ou (check one) 0 tside arbitration limits 0'; N Is this a Class Action Suit? 0 Yes 0 No Is this an MDJAppeal? 0 Yes e No A Name of Plaintiff/Appellant's Attorney: Check here if you have no attorney(are a Self-Represented [Pro SeJ Litigant) Nature of the Case: Place an"X"to the left of the ONE case category that most accurately describes your PRIMARY CASE. If you are making more than one type of claim,check the one that you consider most important. TORT (do not include Mass Tort) CONTRACT (do not include Judgments) CIVIL APPEALS O Intentional 0 Buyer Plaintiff Administrative Agencies O Malicious Prosecution 0 Debt Collection: Credit Card 0 Board of Assessment O Motor Vehicle 0 Debt Collection: Other 0 Board of Elections O Nuisance 0 Dept.of Transportation 0 Premises Liability 0 Statutory Appeal:Other S 0 Product Liability(does not include mass tort) 0 Employment Dispute: E Slander/Libel/Defamation Discrimination C Other: 0 Employment Dispute: Other 0 Zoning Board T 0 Other: I 1 0 Other: U MASS TORT O Asbestos N 0 Tobacco O Toxic Tort-DES O Toxic Tort-Implant REAL PROPERTY MISCELLANEOUS O Toxic Waste • Other: 0 Ejectment 0 Common Law/Statutory Arbitration B 0 Eminent Domain/Condemnation 0 Declaratory Judgment O Ground Rent 0 Mandamus O Landlord/Tenant Dispute 0 Non-Domestic Relations O Mortgage Foreclosure:Residential Restraining Order PROFESSIONAL LIABLITY 0 Mortgage Foreclosure:Commercial 0 Quo Warranto O Dental 0 Partition 0 Replevin O Legal 0 Quiet Title 0 Other: O Medical 0 Other: O Other Professional: Updated 1/1/2011 lar .qt0.0t,, c� (. 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