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HomeMy WebLinkAbout02-3662 NM F C E F � ' Stephanie E. Chertok, Esquire PA Supreme Court ID#: 52651 13 LT —5 Pri 2: $ 2 Adam R. Deluca, Esquire PA Supreme Court ID#: 311738 CUMBERLAND COUNTY Allied Attorneys of Central Pennsylvania, LLC PENNSYLVANIA 61 West Louther Street Carlisle, PA 17013 (717) 249-1177 (717) 249-4514 Fax JAN RENEE RUSSELL IN THE COURT OF COMMON PLEAS OF Plaintiff, CUMBERLAND COUNTY,PENNSYLVANIA V. CIVIL ACTION- LAW LESLEY DONN RUSSELL NO. 02-3662 CIVIL TERM Defendant IN CUSTODY PETITION TO MODIFY CUSTODY AND NOW, comes Plaintiff by and through her counsel, Stephanie E. Chertok, Esq., and Adam R. Deluca, Esq., and avers the following in support of her Petition; 1. The Plaintiff, Jan Renee Russell, hereinafter("Plaintiff'), is an adult individual who currently resides at 1325 White Birch Lane, Carlisle, Cumberland County, Pennsylvania 17013. 2. The Defendant, Lesley Donn Russell, hereinafter("Defendant"), is an adult individual who currently resides at 59 North Bedford Street, Carlisle, Cumberland County, Pennsylvania 17013. 3. The parties have one dependent child, namely Abigail Grace Russell, hereinafter("Child"),born April 19, 1999. The child was not born out of wedlock. " 4. The relationship of Plaintiff to the child is that of natural mother. Plaintiff currently resides at 1325 White Birch Lane, Carlisle, Cumberland County, Pennsylvania 17013. She is divorced and resides with no other persons other than child. 5. The relationship of Defendant to the child is that of natural father. Defendant currently resides as 59 North Bedford Street, Carlisle, Cumberland County, Pennsylvania 17013. He is divorced and resides with no other persons. 6. Plaintiff previously filed a Complaint in Divorce and contemporaneously in Custody at the above term and docket number on July 30, 2002 and a stipulated Order of Court was entered on March 12, 2004. Said Order is attached as Exhibit A. 7. At that time Plaintiff was represented by Susan Kay Candiello, Esq., and Defendant was represented by Hubert X. Gilroy, Esq. 8. Plaintiff seeks to maintain shared legal custody and primary physical custody but she seeks to modify Defendant's partial physical custody such that child would only be with Defendant during supervised visits, once a week on a day that is mutually agreeable each week by both parties, in public locations, for a period of two hours, until such time that child's primary care physician and counselor determine that it would not be detrimental to the child's welfare to resume the previously agreed upon visitation schedule. Further,pending Defendant seeking counseling and changing his behavior, Plaintiff seeks to have the visitation schedule in the Order of March 12, 2004 suspended. This pertains to the following child: Name Present Residence Age Abigail Grace Russell 1325 White Birch Lane 14 years Carlisle, PA 17013 (DOB 04/19/1999) 9. Plaintiff proposes the supervised visits be monitored by either Anne Clemmons, a family friend who is an adult individual residing at 1025 Hill Place, Carlisle, Cumberland County,Pennsylvania 17013, Sandy Whitcomb, a family friend who is an adult individual residing at 25 Cambridge Court, Carlisle, Cumberland County, Pennsylvania 17013, or another adult individual that is mutually agreed upon by both parties. 10. Plaintiff does not know of a person not a party to the proceeding that has physical custody of the child or claims to have physical custody or visitation rights with respect to the child. 11. The best interests and permanent welfare of the child will be served by granting the relief requested because: (a) , Defendant has put child through extreme mental abuse since Plaintiff and Defendant's divorce in March of 2004 but Plaintiff's continued occasional discussions about his behavior resulted in improvement temporarily. However, since June of 2013, Defendant's abusive behavior toward child has intensified, to the point where child's friends will not visit her while at Defendant's home. The abuse consists of constant criticism, screaming, breaking and throwing things such as computers and cell phones,threatening to dispose of child's pets,refusing to allow child to leave Defendant's home while then criticizing child for not going out of the house, and holding child captive during visits to Defendant's home. (b) Defendant's mental abuse has caused child to suffer from severe anxiety when faced with going to Defendant's home. (c) Child's severe anxiety has led to mental breakdowns, migraine headaches, dizzy spells, upset stomach, insomnia, and physical aches and pains. (d) Due to child's extreme symptoms, child's primary care physician has placed her on prescription medication, namely Prozac and Klonopin as of September 4, 2013. (e) Due to child's extreme symptoms, child has sought counseling which began September 5, 2013. (f) Defendant's actions have led to mandatory reporting to Children and Youth Services by child's primary care physician. (g) Defendant has threatened to throw objects at child, and has thrown objects, such as cell phones, in her direction. (h) Plaintiff has asked Defendant multiple times to seek counseling for his anger and Defendant refuses to do so. (i) Child does not wish to see Defendant without supervision due to fear of Defendant's anger and emotional abuse. 12. Each parent whose parental rights to the child have not been terminated and the person who has physical custody of the child have been named as parties to this action. No other persons are known to have or claim a right to custody or visitation of the child to be given notice of the pendency of this action and the right to intervene. WHEREFORE, Plaintiff respectfully requests this Honorable Court to enter an order granting her shared legal custody and primary physical custody but modifying Defendant's partial physical custody such that child would only see Defendant during supervised visits, once a week on a day that is mutually agreeable each week by both parties, in public locations, for a period of two hours, until such time that child's primary care physician and counselor determine that it would not be detrimental to the child's welfare to resume the previously agreed upon visitation schedule. Further, pending Defendant seeking counseling and changing his behavior, Plaintiff requests that the visitation schedule in the Order of March 12, 2004 be suspended. Respectfully submitted, Stephanie E. Chertok, Esquire PA Supreme Court ID #: 52651 Adam R. Deluca, Esquire PA Supreme Court ID #: 311738 Allied Attorneys of Central Pennsylvania, LLC 61 West Louther Street Carlisle, PA 17013 Counsel for the Plaintiff JAN RENEE RUSSELL, IN THE COURT OF COMMON PLEAS PLAINTIFF OF CUMBERLAND COUNTY, i PENNSYLVANIA VS. NO. 02-3662 CIVIL TERM LESLEY DONN RUSSELL, CIVIL ACTION- LAW DEFENDANT ACTION FOR DIVORCE /CUSTODY ORDER OF COURT AND NOW, this 1-2 �day of �12L�,i , 2004, upon consideration of the attached Stipulation for Agreed Order of Custody, Plaintiff, JAN RENEE RUSSELL, and Defendant, LESLEY DONN RUSSELL, shall SHARE LEGAL CUSTODY of their daughter, ABIGAIL GRACE RUSSELL, and Plaintiff, JAN RENEE RUSSELL, shall have PRIMARY PHYSICAL CUSTODY and Defendant, LESLEY DONN RUSSELL shall have PARTIAL PHYSICAL CUSTODY of their daughter, ABIGAIL GRACE RUSSELL, in accordance with the language contained in the within Stipulation. BY THE COURT, J. t{ TRUE dbN[pr @• . ,.,1.'s+aid �7:k;;,l,-4'yez+ b;,>.� l07 �eig.I '�i�','fQ4af�itpsr.'.e!72r 'k, E S r•jie>: i�F'a i jai F'nf ' ham "'A �t'Qti�b?I�s��ftl JAN RENEE RUSSELL, IN THE COURT OF COMMON PLEAS PLAINTIFF OF CUMBERLAND COUNTY, PENNSYLVANIA vs. NO. 02-3662 CIVIL TERM LESLEY DONN RUSSELL, CIVIL ACTION- LAW DEFENDANT ACTION FOR DIVORCE /CUSTODY ORDER OF COURT AND NOW, this /"Z day of , 2004, upon consideration of the attached Stipulation for Agreed Order of Custody, Plaintiff, JAN RENEE RUSSELL, and Defendant, LESLEY DONN RUSSELL, shall SHARE LEGAL CUSTODY of their daughter, ABIGAIL GRACE RUSSELL, and Plaintiff, JAN RENEE RUSSELL, shall have PRIMARY PHYSICAL CUSTODY and Defendant, LESLEY DONN RUSSELL shall have PARTIAL PHYSICAL CUSTODY of their daughter, ABIGAIL GRACE RUSSELL, in accordance with the language contained in the within Stipulation. BY THE COURT, J. A^, ryryt��,. a ,^7"ya.� p� '':r"�'- i,Y [`, '°'°';�/wiPgqg, �'Yo a L'5 kv> xc � 8 4`''54:. y,`a P�� kc,��m c0 Y .•ln..i�J<�.r d}f',::.•N.;p"e:���'�, G fi.t,P '•E*s.^ onikti t'{*e:d nd t.«.�i ALL y of Prothon.ury JAN RENEE RUSSELL, : IN THE COURT OF COMMON PLEAS PLAINTIFF : OF CUMBERLAND COUNTY, PENNSYLVANIA VS. NO. 02-3662 CIVIL TERM LESLEY DONN RUSSELL, CIVIL ACTION- LAW DEFENDANT ACTION FOR DIVORCE /CUSTODY STIPULATION FOR AGREED ORDER OF CUSTODY r-3 The Plaintiff (hereinafter sometimes referred to as "Mother") is JAX RFWEI�J' RUSSELL, who currently resides at 1001 Forge Road, Carlisle, Cumberland C�.iantyr-3 Pennsylvania, 17013. The Defendant (hereinafter sometimes referred to as "Father") is LESLEY If`(�NN RUSSELL, who currently resides at 155 East Louther Street, Carlisle, Cumberland County, Pennsylvania, 17013. ABIGAIL GRACE RUSSELL, born on April 19, 1999, (hereinafter sometimes referred to as "Abigail"), is the subject of this Stipulation for Agreed Order of Custody and is the natural child of the Plaintiff and Defendant. It is Plaintiff and Defendant's belief that it is in the best interests of their minor child to have a meaningful ongoing relationship with both her natural Mother and natural Father, provided the child is in a safe environment. WHEREFORE, Plaintiff, JAN RENEE RUSSELL, and Defendant, LESLEY DONN RUSSELL, have entered into a mutual agreement regarding the custody of their child and respectfully request this Honorable Court to enter the following Order: 1. Plaintiff and Defendant shall share Legal Custody (as defined in 23 Pa. C.S.A. Section 5302) of their minor child, ABIGAIL GRACE RUSSELL. 2. All decisions affecting Abigail's growth and development including, but not limited to: choice of camp, if any; choice of day care provider; medical and dental treatment; psychotherapy, psychoanalysis, or like treatment; decisions relating to actual or potential litigation involving their child, directly or as beneficiary, other than custody litigation; education, both secular and religious; scholastic athletic pursuits and other extracurricular activities, shall be considered major decisions and shall be made by Father and Mother,jointly, after discussion and consultation with each other and with a view towards obtaining and following a harmonious policy in the child's best interests. 3. Mother and Father agree to keep the other informed of the progress of their child's education and social adjustments. Mother and Father agree not to impair the other's right to shared legal or physical custody of the child. Mother and Father agree to give support to the other in the role as parent and to take into account the consensus of the other for the physical and emotional well-being of their child. 4. While in the presence of their child, neither Mother nor Father shall make or permit any other person to make, any remarks or do anything which could in any way be construed as derogatory or uncomplimentary to the other parent. It shall be the express duty of each parent to uphold the other parent as one whom the child should respect and love. 5. It shall be the obligation of each parent to make the child available to the other in accordance with the physical custody schedule and to encourage their child to participate in the plan hereby agreed and ordered. 6. Each parent shall have the duty to notify the other of any event or activity which could reasonably be expected to be of significant concern to the other parent. 7. With regard to any emergency decisions which must be made, the parent with whom the child is physically residing at the time shall be permitted to make the decision necessitated by the emergency without consulting the other parent in advance. However, that parent shall inform the other of the emergency and consult with him or her as soon as possible. Day-to-day decisions of a routine nature shall be the responsibility of the parent having physical custody at the time. 8. Mother and Father shall be entitled to complete and full information from any doctor, dentist, teacher or authority and have copies of apy reports given to them as a parent. Such documents include, but are not limited to, medical reports, academic and school report cards, birth certificates, etc. Both parents may and are encouraged to attend school conferences and activities. It shall be the responsibility of each parent to contact the child's school and obtain information about the child's education and major school events. 9. Mother shall have Primary Physical Custody and Father shall have Partial. Physical Custody of their minor child, Abigail. Father shall have Partial Physical Custody according to the following schedule: A. Father shall have Abigail every other weekend from Friday after school through Monday morning, when Father shall return Abigail to school; B. Following Father's weekend he shall have Abigail Thursday evening after school through Friday morning when Father shall return Abigail to school; C. Following Mother's weekend Father shall have Abigail Monday after school through Tuesday morning when Father shall return Abigail to school; D. Mother and Father shall each have the option to request one to two (1-2) consecutive weeks of visitation during the child's summer vacation from school. Mother and Father shall provide each other with a minimum of one (1) week's written request for a week of vacation time; E. The following holidays Abigail shall be with the parent whose schedule of regular visitation falls when the holiday occurs: 1)New Year's Eve and Day, (this holiday shall be determined by the year in which the New Year's Eve occurs); 2) Memorial Day; 3) Independence Day; 4) Labor Day. F. Easter: Mother and Father will agree to divide this holiday in coordination with their individual family holiday activities; G. Thanksgiving: Mother and Father shall alternate Thanksgiving with Mother having Abigail in the even years and Father having Abigail in the odd years; H. Christmas. Mother and Father shall alternate the Christmas holiday. In even years, Father shall have the child beginning Christmas Eve day at 12:00 p.m. through Christmas Day at 4:00 p.m. In odd years Father shall have the child Christmas Eve day until 8:00 p.m. when he shall return the child to Mother. Father may then have the child beginning 4:00 p.m. on Christmas Day. I. Father shall have Abigail on Father's Day and Mother shall have Abigail on Mother's Day; I Father shall have Abigail after school and return her to school on the following morning for Kristin's birthday (Abigail's half sister) September 18, and on Father's birthday, September 27; K. Mother shall have Abigail overnight for her birthday, August 7; L. Mother and Father shall share Abigail's birthday, April 19; M. All holidays, vacations, and specially designated times for visitation with the child shall supersede the regularly scheduled visitation. 10. Mother has the right to request an extended weekend to travel with the maternal grandparents and Abigail to visit Abigail's maternal uncle. Mother shall make all reasonable attempts to schedule these weekends on her weekends. If, for whatever reason, Mother is not able to schedule these weekends on her weekend, Father agrees to allow Abigail to visit with her maternal uncle on these weekends and Father may request any additional time to make up for any lost weekends or days as a result of these visits. 11. Father and Mother agree if either of them does not have to work on a day Abigail is in day care, they may take Abigail out of day care for visitation. This will not apply to school, once Abigail is in school. 12. Father agrees he will pay the first three (3) weeks of child care expenses for Abigail each month and Mother agrees she will pay the last week of child care expenses for Abigail each month. Father and Mother shall make these payments directly to the child caregiver in a timely manner. 13. When the child begins kindergarten the payments to the child caregiver will end. Father then agrees he will pay Three Hundred Dollars and No Cents ($300.00) each month as child support to Mother. These payments shall be made on or before the tenth (10th) day of each month. The child support agreement as stated, may be altered in writing by mutual agreement of the parties or if the parties are unable to reach a mutual agreement either party may file with the Domestic Relations Section of Cumberland County. 14. Mother shall have the child as an income tax deduction. 15. Mother and Father agree to share transportation, with the party who is beginning their custody period with Abigail providing the transportation for Abigail. 16. Mother and Father agree to be responsible for any ordinary everyday expenses which occur during their individual custody periods with Abigail. 17. Mother and Father shall be free to mutually agree to alter and/or change the terms of this agreement. If the alteration and/or agreement is permanent and/or a change which will occur on numerous occasions, the parties agree the alteration and/or change shall be in writing and signed by both parents. DATED: 20W A /� '� aK ZESELYY E RUSSELL DATED: j � 2003 ONN RUSSELL (This space is intentionally left blank.) , COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF CUMBERLAND On this, the e day of ��i rG�-- 20(/3/, before me, a Notary Public, the undersigned officer, personally appeared SUSAN KAY CANDIELLO, known to me (or satisfactorily proven) to be a member of the bar of the highest court of said State and a subscribing witness to the within instrument, and certified that she was personally present when JAN RENEE RUSSELL, whose name is subscribed to the within Marital Property Settlement Agreement, executed the same, and that said person acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official Seal. Not Public My %ommission Expires: COMMONWEALTH OF PENNSYLVANIA SS: COUNTY OF On this, the , �� day of ia �t�he 2003, before me, a Notary Public for the Commonwealth 6f Penns Iva undersi ned officer r y g , personally appeared LESLEY DONN RUSSELL known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Marital Property Settlement Agreement, and acknowledged that he executed the same for the purpose therein contained. IN WITNESS WHEREOF, I have set my hand and notarial seal. f i Notarial Seal Notary blic Bridget Ann Corcoran, Notary Public Carlisle Boro, Cumberland County My Commission Expires: 11dy Commission Expires June 10, 2006 Member,Pennsylvania Association of Notaries VERIFICATION I, Jan Renee Russell, verify that the statements made in this Petition are true and correct. I understand that false statements made herein are subject to the penalties under 18 Pa. C. S. §4905 relating to unsworn falsification to authorities. Date Jan Renee Russell Stephanie E. Chertok, Esquire PA Supreme Court ID#: 52651 Adam R. Deluca, Esquire PA Supreme Court ID #: 311738 Allied Attorneys of Central Pennsylvania, LLC 61 West Louther Street Carlisle, PA 17013 (717) 249-1177 (717) 249-4514 Fax JAN RENEE RUSSELL IN THE COURT OF COMMON PLEAS OF Plaintiff, CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION- LAW LESLEY DONN RUSSELL NO. 02-3662 CIVIL TERM Defendant IN CUSTODY CERTIFICATE OF SERVICE I, Adam R. Deluca, Esq., hereby certify that a copy of the Petition to Modify Custody was served upon Defendant, this � day of �An l9�, 2013, by first-class mail,postage prepaid, and certified mail, restricted delivery, return receipt requested,pursuant to Pa.R.C.P. 1930.4 (c) at the following: Lesley Donn Russell 59 North Bedford Street Carlisle, PA 17013 ?C Q.;, Adam R. Deluca, Esquire Counsel for Plaintiff JAN RENEE RUSSELL IN THE COURT OF COMMON PLEAS OF PLAINTIFF CUMBERLAND COUNTY, PENNSYLVANIA.— -O Z w .rn r� r V' 2002-3662 CIVIL ACTION LAW cnr .- -C>© CD LESLEY DONN RUSSELL © cD t t IN CUSTODY e; DEFENDANT ORDER OF COURT AND NOW, Monday,September 09,2013 , upon consideration of the attached Complaint, it is hereby directed that parties and their respective counsel appear before Dawn S. Sunday,Esq. ,the conciliator, at 39 West Main Street,Mechanicsburg,PA 17055 on Tuesday,October 08,2013 1:30 PM for a Pre-Hearing Custody Conference. At such conference, an effort will be made to resolve the issues in dispute; or if this cannot be accomplished, to define and narrow the issues to be heard by the court, and to enter into a temporary order. Failure to appear at the conference may provide grounds for entry of a temporary or permanent order. The court hereby directs the parties to furnish any and all existing Protection from Abuse orders, Special Relief orders,and Custody orders to the conciliator 48 hours prior to scheduled hearing. FOR THE COURT, By: /s/ Dawn S. Sunday, Esq._�� Custody Conciliator V The Court of Common Pleas of Cumberland County is required by law to comply with the Americans with Disabilites Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled conference or hearing. YOU SHOULD TAKE THIS PAPER TO YOUR ATTORNEY AT ONCE. IF YOU DO NOT HAVE AN ATTORNEY OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association a� Gel/ 32 South Bedford Street Carlisle, Pennsylvania 17013 Telephone (717) 249-3166 Cot?kd a ���day, �s� " ����A M f � FlLED-0 -I"E Stephanie E. Chertok, Esquire PA Supreme Court ID #: 52651 C 013 SEP 13 PM 2: 4 2 Adam R. Deluca, Esquire PA Supreme Court ID#: 311738 CUMBERLAND COUNT' Allied Attorneys of Central Pennsylvania, LLC PENNSYLVANIA 61 West Louther Street Carlisle, PA 17013 (717) 249-1177 (717) 249-4514 Fax JAN RENEE RUSSELL IN THE COURT OF COMMON PLEAS OF Plaintiff, CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION- LAW LESLEY DONN RUSSELL NO. 02-3662 CIVIL TERM Defendant IN CUSTODY AFFIDAVIT OF SERVICE The undersigned does hereby certify that on September 6, 2013, a true and correct copy of the Petition to Modify Custody filed in the above-captioned action was served upon the following individual by mailing a copy by U.S. Postal Service,postage prepaid, via first-class mail and certified mail,restricted delivery, return receipt requested. A return receipt was received from the U.S. Postal Service indicating that the defendant accepted the certified mail on September 7, 2013. A true and correct copy of the U.S. Postal Service return receipt is attached hereto. Lesley Donn Russell 59 North Bedford Street Carlisle,PA 17013 DATE: CV Stephanie E. Chertok, Esquire PA Supreme Court ID #: 52651 Adam R. Deluca, Esquire PA Supreme Court ID #: 311738 Allied Attorneys of Central Pennsylvania, LLC 61 West Louther Street Carlisle, PA 17013 (717)249-1177 (717) 249-4514 Fax J e o q \SCSI j-- O D � -7 M C o �0 �m N 3 3 iu .0 -MLUE -1 „ tb a n m �� `t �m L wya-m M �} Ln Postage $ A 2 rr S ° . o- 1) w m O w E*r 3 CL ON r .;;;r M 1 Certified Fee 0j N m 0 o �• C3 ark ° m °' m ° m ° � C3 Return Receipt Fee ere cflx 70 C N W� D (Endorsement Required) . ' IY V cC 3 C y rn M” Restricted Delivery Fee i, - n 0 �0 �' -: •*:0, 4 O (Endorsement Required) 0 13 C. =Dr C m 0 Ec 3 t Total Postage 9 .� C3 n m m e&Fees m O -�� n W m - S T�sl e 'Do,-,n IR U.ss e I I �' - -- -r...- --- - - - - -- -- - O Street,fipi moo.;-� -- � � r' or PO Box No. 5q 00,-fh ��-Ferel s� m °----°------... .............° -- ---- -° W m- Ci State,ZlP+4 __.... - -- __ v O rrF3Pr M g m m v' E-Emu LU CD Cry m FL I w n a Certified Mail Provides: o C Z ■ Amailingreceipt a `° Z t_ Q' n n � ■ A unique identifier for your mailpiece E, p ■ A record of delivery kept by the Postal Service for two years 6- 0 3 Important Reminders: W c CD ff 3 ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail& � � � 3 n ■ Certified Mail is not available for any class of international mail. a ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For 11 1113 valuables,please consider Insured or Registered Mail. m ■ For an additional fee,a Return Receipt may be requested to provide proof of $ S o a A delivery.To obtain Return Receipt service,please complete and attach a Return rp a Receipt(PS Form 3811 to the article and add applicable postage to cover the n < m -fee.Endorse mailpiece'Return Receipt Requested".-To receive a fee waiver for m a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. P For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement°Restricted Delivery" in If a postmark on the Certified Mail receipt is desired,please present the art!- cie at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 OF UNITED STATES POSTAL SERVICE NI Fee y •Sender: Please print your nvme, dri6ss, and ZIP+4 in this box• - I O l l i ed is fforil s o-F Cen'h"cc-Q t A L L C acts(`I s le., v� 1 I�:.:: y �'lll llllillll rlj�rltill.' hIII111111111r1:1I1iplEi till r r • JAN RENEE RUSSELL, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANJ-A v. : Civil Action- Law 7 _ } : L_t : No. 2002-3662 Civil r- ` LESLEY DONN RUSSELL, : r-, =y Defendant • -c-. : IN CUSTODY CRIMINAL RECORD /ABUSE HISTORY VERIFICATION I, Lesley Donn Russell, hereby swear or affirm, subject to penalties of law including 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities that: 1. Unless indicated by my checking the box next to a crime below, neither I nor any other member of my household have been convicted or pled guilty or plead no contest or was adjudicated delinquent where the record is publicly available pursuant to the Juvenile Act, 42 Pa.C.S. §6307 to any of the following crimes in Pennsylvania or a substantially equivalent crime in any other jurisdiction, including pending charges: Check Crime Self Other Date of Sentence all that household convictions apply member guilty plea, no contest plea or pending charges ❑ 18 Pa.C.S. Ch. 25 ❑ ❑ (relating to criminal homicide) ❑ 18 Pa.C.S. §2702 ❑ ❑ (relating to aggravated assault) ❑ 18 Pa.C.S. §2706 ❑ ❑ (relating to terroristic threats) ❑ 18 Pa.C.S. §2709.1 ❑ ❑ (relating to stalking) ❑ 18 Pa.C.S. §2901 ❑ ❑ (relating to kidnapping) ❑ 18 Pa.C.S. §2902 ❑ ❑ (relating to unlawful restraint) ❑ 18 Pa.C.S. §2903 ❑ ❑ (relating to false imprisonment) ❑ 18 Pa.C.S. §2910 ❑ ❑ (relating to luring a child into a motor vehicle or structure) ❑ 18 Pa.C.S. §3121 • ❑ ❑ (relating to rape) ❑ 18 Pa.C.S. §3122.1 ❑ ❑ (relating to statutory sexual assault) ❑ 18 Pa.C.S. §3123 ❑ ❑ (relating to involuntary deviate sexual intercourse) ❑ 18 Pa.C.S. §3124.1 ❑ ❑ (relating to sexual assault) ❑ 18 Pa.C.S. §3125 ❑ ❑ (relating to aggravated indecent assault) a e ❑ 18 Pa.C.S. §3126 ❑ ❑ (relating to indecent assault) ❑ 18 Pa.C.S. §3127 ❑ ❑ (relating to indecent exposure) ❑ 18 Pa.C.S. §3129 ❑ ❑ (relating to sexual intercourse with animal) ❑ 18 Pa.C.S. §3130 ❑ ❑ (relating to conduct relating to sex offenders) ❑ 18 Pa.C.S. §3301 ❑ ❑ (relating to arson and related offenses) ❑ 18 Pa.C.S. §4302 ❑ ❑ (relating to incest) ❑ 18 Pa.C.S. §4303 ❑ ❑ (relating to concealing death of child) LI 18 Pa.C.S. §4304 ❑ ❑ (relating to endangering welfare of children) ❑ 18 Pa.C.S. §4305 ❑ ❑ (relating to dealing in infant children) ❑ 18 Pa.C.S. §5902(b) ❑ ❑ (relating to prostitution and related offenses) ❑ 18 Pa.C.S. §5903(c) or ❑ ❑ _ (d) (relating to obscene and other sexual materials and performances) • ❑ 18 Pa.C.S. §6301 ❑ ❑ (relating to corruption of minors) ❑ 18 Pa.C.S. §6312 ❑ ❑ (relating to sexual abuse of children) ❑ 18 Pa.C.S. §6318 ❑ ❑ (relating to unlawful contact with minor) ❑ 18 Pa.C.S. §6320 ❑ ❑ (relating to sexual exploitation of children) ❑ 23 Pa.C.S. § 6114 ❑ ❑ (relating to contempt for violation of protection order or agreement) ❑ Driving under the ❑ ❑ influence of drugs or alcohol ❑ Manufacture, sale, ❑ ❑ delivery, holding, offering for sale or possession of any controlled substance or other drug or device 2. Unless indicated by my checking the box next to an item below, neither I nor any other member of my household have a history of violent or abusive conduct including the following: • Check Self Other Date all that household apply member ❑ A finding of abuse by a Children & Youth ❑ ❑ Agency or similar agency in Pennsylvania or similar statute in another jurisdiction ❑ Abusive conduct as defined under the ❑ ❑ Protection from Abuse Act in Pennsylvania or similar statute in another jurisdiction • ❑ Other: ❑ ❑ 3. Please list any evaluation, counseling or other treatment received following conviction or finding of abuse: 4. If any conviction above applies to a household member, not a party, state that person's name, date of birth and relationship to the child. 5. If you are aware that the other party or members of the other party's household has or have a criminal/abuse history, please explain: I verify that the information above is true and correct to the best of my knowledge, information or belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. 4gA44g' Sign tune Lesity b. Russell Printed Name JAN RENEE RUSSELL • IN THE COURT OF COMMON PLEAS OF Plaintiff • CUMBERLAND COUNTY, PENNSYLVANIA vs. • 2002-3662 CIVIL ACTION L • LESLEY DONN RUSSELL : -r Defendant IN CUSTODY • ORDER OF COURT AND NOW, this /L" day of O..1-o bw , 2013, upon consideration of the attached Custody Conciliation Report, it is ordered and directed as follows: 1. The partial physical custody schedule set forth in the prior Order of this Court dated March 12, 2004 shall be temporarily suspended by agreement between the parties pending the reconvened custody conciliation conference as further provided in this Order. 2. The Father shall obtain an alcohol evaluation by a professional or agency which has the qualifications to conduct such an evaluation as recommended in the evaluation of the Child conducted by Beacon Psychological Services. The Father shall sign any authorizations necessary to share the results of the alcohol evaluation with the Mother's counsel. 3. The Father shall also contact Beacon Psychological Services to schedule an appointment to obtain clarification on the issues related to the custodial situation as identified in their psychological evaluation of the Child. 4. After the Father's appointment at Beacon Psychological Services and completion of the alcohol evaluation, the Father's counsel may contact the conciliator to schedule a time to reconvene the custody conciliation conference. 5. No party shall be permitted to relocate the residence of the Child which significantly impairs the ability to exercise custody unless every individual who has custodial rights to the Child consents to the proposed relocation or the Court approves the proposed relocation. A person proposing to relocate MUST comply with 23 Pa. C.S. § 5337. 6. This Order is entered pursuant to an agreement of the parties at a custody conciliation conference. The parties may modify the provisions of this Order by mutual consent. In the absence of mutual consent, the terms of this Order shall control. BY THE COURT, J. cc: vg-tephanie E. Chertok Esquire and Adam R. DeLuca Esquire—Counsel for Mother Michael J. Whare Esquire—Counsel for Father (5e?/ ViL 119 10 JAN RENEE RUSSELL : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA vs. • 2002-3662 CIVIL ACTION LAW • • • LESLEY DONN RUSSELL Defendant : IN CUSTODY Prior Judge: Kevin A. Hess CUSTODY CONCILIATION SUMMARY REPORT IN ACCORDANCE WITH CUMBERLAND COUNTY RULE OF CIVIL PROCEDURE 1915.3-8, the undersigned Custody Conciliator submits the following report: 1. The pertinent information concerning the Child who is the subject of this litigation is as follows: NAME BIRTH YEAR CURRENTLY IN CUSTODY OF Abigail Russell 1999 Mother 2. A custody conciliation conference was held on October 8, 2013, with the following individuals in attendance: the Mother, Jan Renee Russell, with her counsel, Stephanie E. Chertok Esquire, and Adam R. DeLuca Esquire, and the Father, Lesley Donn Russell, with his counsel, Michael J. Whare Esquire. 3. Due to the fact that there is a recently initiated Children and Youth Services investigation in this matter and a recent psychological evaluation of the Child which contains conclusions of serious concern, the parties agreed to entry of a temporary Order in this matter suspending the partial custodial arrangements until further information and clarification of the situation is obtained. After the items in the proposed attached Order are completed, it was agreed that the custody conciliation conference will be reconvened. Oc44. Jo ,.o 13 _ .�_ • Date Dawn S. Sunday, Esquire Custody Conciliator 4. Stephanie E. Chertok, Esquire PA Supreme Court ID #: 52651 :1• pra .; •2 Adam R. Deluca, Esquire `�- I u `' I PA Supreme Court ID #: 311738 Allied Attorneys of Central Pennsylvania, LLC PENNSYLVANIA 61 West Louther Street Carlisle, PA 17013 (717) 249-1177 (717)249-4514 Fax JAN RENEE RUSSELL IN THE COURT OF COMMON PLEAS OF Plaintiff, CUMBERLAND COUNTY,PENNSYLVANIA v. CIVIL ACTION- LAW LESLEY DONN RUSSELL NO. 02-3662 CIVIL TERM Defendant IN CUSTODY CRIMINAL RECORD/ABUSE HISTORY VERIFICATION I, Jan Renee Russell, hereby swear or affirm, subject to penalties of law including 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities that: 1. Unless indicated by my checking the box next to a crime below, neither I nor any other member of my household have been convicted or pled guilty or pled no contest or was adjudicated delinquent where the record is publicly available pursuant to the Juvenile Act, 42 Pa.C.S. §6307 to any of the following crimes in Pennsylvania or a substantially equivalent crime in any other jurisdiction, including pending charges: Check all Crime Self Other Date of convictions Sentence that apply household guilty plea, no member contest plea or pending charges 18 Pa.C.S. Ch. 25 (relating to criminal homicide) 4. 18 Pa.C.S. §2702 (relating to aggravated assault) 18 Pa.C.S. §2706 (relating to terroristic threats) 18 Pa.C.S. §2709.1 n n (relating to stalking) 18 Pa.C.S. §2901 ❑ ❑ (relating to kidnapping) 18 Pa.C.S. §2902 ❑ (relating to unlawful restraint) ❑ 18 Pa.C.S. §2903 (relating to false imprisonment) 18 Pa.C.S. §2910 n (relating to luring a child into a motor vehicle or structure) 18 Pa.C.S. §3121 (relating to rape) 18 Pa.C.S. §3122.1 (relating to statutory sexual assault) ❑ 18 Pa.C.S. §3123 (relating to involuntary deviate sexual intercourse) 18 Pa.C.S. §3124.1 ❑ (relating to sexual assault) 18 Pa.C.S. §3125 (relating to aggravated indecent assault) a ❑ 18 Pa.C.S. §3126 ❑ ❑ (relating to indecent assault) 18 Pa.C.S. §3127 ❑ (relating to indecent exposure) 18 Pa.C.S. §3129 (relating to sexual intercourse with animal) 18 Pa.C.S. §3130 (relating to conduct relating to sex offenders) 18 Pa.C.S. §3301 U ❑ (relating to arson and related offenses) ❑ 18 Pa.C.S. §4302 ❑ (relating to incest) 18 Pa.C.S. §4303 ❑ (relating to concealing death of child) ❑ 18 Pa.C.S. §4304 (relating to endangering welfare of children) 18 Pa.C.S. §4305 (relating to dealing in infant children) ❑ 18 Pa.C.S. §5902(b) (relating to prostitution and related offenses) 18 Pa.C.S. §5903(c) or❑ (d) (relating to obscene and other sexual materials and performances) ❑ 18 Pa.C.S. §6301 ❑ (relating to corruption of minors) 18 Pa.C.S. §6312 ❑ (relating to sexual abuse of children) 18 Pa.C.S. §6318 (relating to unlawful contact with minor) 18 Pa.C.S. §6320 (relating to sexual exploitation of children) ❑ 23 Pa.C.S. § 6114 (relating to contempt for violation of protection order or agreement) Driving under the ❑ influence of drugs or alcohol ❑ Manufacture, sale, delivery, holding, offering for sale or possession of any controlled substance or other drug or device 2. Unless indicated by my checking the box next to an item below, neither I nor any other member of my household have a history of violent or abusive conduct including the following: Check Self Other Date all that household apply member A finding of abuse by a Children& Youth Agency or ❑ similar agency in Pennsylvania or similar statute in another jurisdiction Abusive conduct as defined under the Protection from❑ ❑ Abuse Act in Pennsylvania or similar statute in another jurisdiction Other: 3. Please list any evaluation, counseling or other treatment received following conviction or finding of abuse: 4. If any conviction above applies to a household member, not a party, state that person's name, date of birth and relationship to the child. 5. If you are aware that the other party or members of the other party's household has or have a criminal/abuse history,please explain: I verify that the statements made in the Criminal Record/Abuse History Verification are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities and can be punishable by fine or imprisonment. _ /- 6.td.eze ature 40 ,Russel Printed Name