HomeMy WebLinkAbout02-0767010170465368
JUDGMENT NOTE
Mechanicsburg , Pennsylvania, 1-24-2000 , $ 3,048.85
(place) (date) (amount)
FOR VALUE RECEIVED, I/we promise to pay to the order of E r i e I n s u r a n e e E x c h a n g e
thesumofThree Thousand Forty Eight and 85/100
said sum to be payable said sum to be as follows: F i f t y
dollars, ($ 50. 0 0 ) on the 2 5 t h day of F e b r u a r y
20® and
Fifty
dollars, ($ 5 o. 0 0 ) on the 2 5 t h day
of every month thereafter until the entire amount is paid in full.
UPON FAILURE to make payment as herein agreed in this note, I/we hereby authorize and
empower any attorney of any Court of Record of Pennsylvania or elsewhere, to appear for and
confess Judgment again.~t me for the sum due and payable hereon, pursuant to Pa. R.C.P. 2951
(a) (1) with or without declaration, with costs of suit, interest at the rate of 6% per annklm, an
attorney's fee, release of errors, and without stay of execution; and I/we also waive the fight
of inquisition on any real estate that may be levied upon to collect this note; and I/we do hereby
voluntarily condemn the same and authorize the Prothonotary to enter said voluntary
condemnation upon any Fieri Facias that may be issued to collect said Judgment; and I/we
further agree that said estate may be sold on a Fieri Faeias, and I/we do hereby waive and
release all relief from any and all appraisement, stay of execution, exemption or bankruptcy laws
of this or any other state now in force or hereafter to be passed.
ix
(L.S.)
This note is given executed without duress or coercion and with full and complete understanding
that upon failure to make payment as agreed, that my operating privileges may be suspended.
Further, I do hereby acknowledge that the 4amage incurred in the accident of
December 11 ,19 99 , for which this note is given resulted from my negligence and
fault, and I do hereby acknowledge and waive my fight to any hearing or trial on that issue.
DRIVER DATE OF BIRTH /0~/3- ?/~ x ~ ~__~,,~.~ (L.S.)
DRIVER OPERATOR NO.
OWNER DATE OF BIRTH
OWNER OPERATOR NO.
XX
(L.S.)
FEB 2 5 2000
010170465368 SG
(a) Where Judgment is confessed:
Erie Insurance E~ch_~nge
Doreen Chaplin
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY
CIVIL ACTION -LAW
NO. 0,~ q67 TERM 19
TO Doreen Chaplin , Defendant (s):
You are hereby notified that on ~~. /~ ..~o~ , W
/
Judgment by confession had been entered against you in the sum of $ 3,048.85
in the above captioned case.
Prothon~th~
I hereby certify that the following is the address of the Defendant (s)
stated in the Certificate of Residence: ~
54 Tory Circle
Enola, PA 17025