HomeMy WebLinkAbout13-5685 ERIE INSURANCE EXCHANGE, : IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : NO. Is - ;5&' s 6'd'
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JESSICA CAVINS, MW C/)
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Defendant : CIVIL ACTION - LAW S -. 0 -
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CONFESSION OF JUDGMENT =°
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Pursuant to the authority contained in the warrant of attorney, the original or a ci*y W
which is attached to the complaint filed in this action, and Pa.R.C.P. 2955, I appear for the
Defendant and confess judgment in favor of Plaintiff and against Defendant as follows:
Principal $ 2,880.18
Thomas E. Brenner, Esquire
Attorney ID #32085
4250 Crums Mill Road, Ste. 301
P.O. Box 6991
Harrisburg, PA 17112
Attorney for Plaintiff
Ctc.�LLl ti�l�g 01
{00663033;v1}
ERIE INSURANCE EXCHANGE, : IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PENNSYLV�YIA CD
V. :NO. 13 '�� 6t/1 ::C-q
JESSICA CAVINS
Defendant : CIVIL ACTION - LAW
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COMPLAINT IN CONFESSION OF JUDGMENT
AND NOW, comes Plaintiff, Erie Insurance Exchange, by their attorneys, Goldberg
Katzman, P.C., who state:
1. Plaintiff Erie Insurance Exchange is a business entity authorized to issue policies of
insurance within the Commonwealth of Pennsylvania including automobile insurance, with a
business address of 4901 Louise Drive, Mechanicsburg, Cumberland County, Pennsylvania.
2. Defendant Jessica Cavins is an adult individual who resides at 748 Walnut Bottom Road,
Shippensburg, Cumberland County, Pennsylvania.
3. On June 4, 2010, Plaintiff and Defendant entered into a Judgment Note, where Defendant
agreed to reimburse Plaintiff $2,880.18, the amount of damages Plaintiff incurred as a result of a
motor vehicle accident caused by Defendant.
4. A true and correct copy of said Judgment Note is attached hereto as Exhibit "A ".
5. This judgment is not being entered by confession against a natural person in connection
with a consumer credit transaction.
6. Said Judgment Note cannot be assigned.
7. Said Judgment Note has not been entered in any other jurisdiction.
8. Said Judgment Note permits Plaintiff to enter judgment against Defendant, whether or
not Defendant is in default.
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WHEREFORE, Plaintiff Erie Insurance Exchange demands judgment against Defendant
Jessica Cavins in the amount of $2,880.18 as authorized by the June 4, 2010 Judgment Note.
Respectfully Submitted,
GOLDBERG KATZMAN, P.C.
'11� �J
.
Thomas E. Brenner, Esquire
Attorney ID 432085
4250 Crums Mill Road, Ste. 301
P.O. Box 6991
Harrisburg, PA 17112
717 - 234 -4161
J i
Date: � 13
Attorney for Plaintiff
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017- 010171081306 VS
JUDGMENT NOTE
Mechanicsbnrg Pennsylvania, 4123110 , $2 .18
FOR VALUE RECEIVED, Uwe promise to pay to the order of Erie Insurance
the sum of Two thousand Light hundred eighty and 181100 said sum to be payable
said sum to be as follows: F_ Ott L dollars, ($ 50.00) on the '31st day of May. 2010 and
F' dollars, 0,50.061 on the last day of every month thereafter until the entire amount is
" 4 ,
-paid in full.
Uwe hereby authorize and empower any attorney of any Court of Record of Pennsylvania
or elsewhere, to appear for and confess Judgment against 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 annum, an attorney's fee, release of errors, and without
stay of execution; and Uwe also waive the right of inquisition on any real estate that may
be levied' upon to collect this note; and Uwe do hereby voluntarily condemn the same -and
authorize the Prothonotary to enter said voluntary, condemnation upon any Teri Facias
that may be issued to collect said Judgment; and Uwe further agree that said estate may
be sold on a Fied Facias, and Uwe do hereby waive and release all relief from any and all
appraisement, stay of executio ex or b ankru ptcy l aws of this or any other state
—
------- in force or hereafter to be passed. "
_(LS)
essica Cavins
(LS)
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
niay be suspended.
Further. i do hereby acknowledge that the damage incurred in the accident of
sr
Februv 14 2010, for which this note is given resulted from my negligence and fault,
and (do hereby acknowledge and waive my right to any hearing or trial on that issue.
_ DRIVER DA OF BIRTH X (L.S.)
DRIVER O TOR NO. X 'ca C" o
OWNER D , OF It
X t 1 1 3a • 1 2 4 qq
OWNER OPERATOR NO. X ?
a EXHIBIT
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017 -010171081306 VS
DISCLOSURE FOR CONFESSION OF JUDGMENT
UWe, Jessica Cavins am executing.this._?3rd _day of _April _. 2010_. a
Judgment Note for Two thousand eight hundred.eiAt_v. and 18/100 ($2 18
DOLLARS obligating me to repay that amount.
Initials: X i
J.C.
Initials:
It has been explained to me by representative of'the Erie-Insurance Group that the Note
contains wording that may permit them or their attomeys. to dntei Judgment against the at
the Courthouse, whether or not said Note is in default, without notice to me and without
offering rile an opportunity to defend against the Entry of Judgment, an_ d that the
Judgment may be collected* by.any legal means.
- -- -- - - -- -- — - - Initials: X iL - - -- -
• J•C-
Initials:
In executing the. Note, Me am knowingly, understandingly, and voluntarily waiving any
rights to resist the Entry of Judgment. against meat the Courthouse, and am consenting to
she Confession of Judgment.
Initials: . X S�-
J.C.
Initials:
S
017 -010171081306 VS
AFFIDAVIT TO ACCOMPANY JUDGMENT NOTE
Being duly sworn according to law, the undersigned jointly and severally depose and say
that:
1. Me are over twenty -one years of age, not within the military service of the
United States and its allies nor otherwise within the civil relief provision of
the Soldiers and Sailors Civil Relief Act of 1947 as amended.
2. UWe have delivered to Erie Insurance a Judgment Note containing a
confession of judgment to secure certain payment obligations.
3. IIWe understand that a confession of�judgment allows for the entry * of a
judgment by confession against them'and that.said judgment encumbers all
real estate that they own.
4. The note is not related to a consumer credit transaction.
IN WITNESS WI MOF and intending to induce Erie Insurance to complete the
t ransaction as, provided, the und ersigned have affixed their hands and s eals o this .
- - - - -- - - - - - -- --
-- . y of —
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X� (SEAL)
/Je_s�ca Cavins
(S EAQ
.Sworn to and subscribed before me
This 4 ._ day of - -T1 .kr)f ,20-10
TAI v
NOTARIAL SEAL otary Public
DEBORAH WARREN. Nntary PtMC
Shlppei urg Tv+p., Qurt,61111M CoumY
Vq C4nwjs&tn E)V is Nov. 9.2013
1
017 -010171081306 VS
CERTIFICATE OF RESIDENCE
The parties to the transaction are X .°mot CCN , '2s
Name,'
Address
x
Address
x
Address
I certify that these are the Iast known addresses of the parties to this matter.
� a
By: X �'f _
017- 010171081306 VS
I certify my annual income (exceeds/is less than) TEN THOUSAND AND 00 /100
DOLLARS,.that the blanks in this disclosure were filled in when 1 initiated and signed it,
and that I received a copy at the time of signing.
- X �c= ��d��rs
ssica Gavin
Date: X ' -0cl o
-
-0 y -1
ACKNOWLEDGMENT
Commonwealth of Pennsylvania)
County of )
Before me, the undersigned Notary, personally appeared
Whose initials appear above, and who acknowledges under
oat that they_ execute the above Disclosure for_Confession of Judgmentsogether_with
the Confession of•Judgment Note referred to in the First Paragraph of the Disclosure on
this date.
=9MY" seat: (SEAL) - aau, nay Odit - ei ' r ` No Public x� * No; e, lets N o tary
My commission expireson the ---�—day of -e Z0
ota ova
VERIFICATION
Iier' A0�. S` IAU C f�
I, , an authorized representative of
ERIE INSURANCE EXCHANGE, hereby acknowledge that I have read the foregoing
COMPLAINT IN CONFESSION OF JUDGMENT, that the facts stated therein are true and
correct to the best of my knowledge, information and belief, and that the Judgment Note attached
as Exhibit "A" is a true and correct copy.
I understand that any false statements herein are made subject to penalties of 18 Pa. C.S.
Section 4904, relating to unsworn falsification to authorities.
ERIE INSURANCE GROUP
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Dater f
100587813;v11
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CERTIFICATE OF SERVICE
I hereby certify that I served a true and correct copy of the foregoing document upon all
parties or counsel of record by depositing a copy of same in the United States Mail at Harrisburg,
Pennsylvania, with first -class postage prepaid, addressed to the following:
Jessica Cavins
748 Walnut Bottom Road
Shippensburg, PA 17257
GOLDBERG KATZMAN, P.C.
By:
Jay s ale
Date: y /21 r2d
{00663040;v 1 }
ERIE INSURANCE EXCHANGE, : IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PP
�3 V. :NO. -
JESSICA CAVINS,
Defendant : CIVIL ACTION - LAW
NOTICE PURSUANT TO RULE 236
Notice is herby given that the attached judgment was entered against Defendant Jessica
Cavins.
Prothonotary '
Date:
{00664029;v 1 }
ERIE INSURANCE EXCHANGE, : IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : NO. 13-5685
JESSICA CAVINS,
Defendant : CIVIL ACTION - LAW zrn rn
= r- -0
-<3a -- C
x —I C
AFFIDAVIT OF JUDGMENT FROM MOTOR VEHICLE ACCIDU '
TO THE PROTHONOTARY:
hereby certify that the Judgment entered against Defendant Jessica Cavins, Judgment
Debtor on the Certification of Motor Vehicle Judgment, arose as a result of a motor vehicle
accident caused by Defendant. A copy of the referenced certification is attached hereto. I make
these statements subject to the penalties of 18 Pa. C.S.A. § 4904 relating to unsworn falsification
to authorities.
LmTra-s E. Brenner, Esquire
Attorney I.D.# 32085
Date: December 9, 2013 4250 Crums Mill Road, Ste. 301
P.O. Box 6991
Harrisburg, PA 17112
717-234-4161
SWORN TO AND SUBSCRIBED
before me, a Notary Public, this
day of ; 2013.
Notary Pubk'
COMMONWEALTH of PENNSYL.vANIA
Notarial Sea!
Helen A.aadf Notary Public (�
City of Harrisburg,Dauphin County /�,/j 2�
My(:Orr1mlSglOtr BOfeS June 28,2014 "�"�JI
{00674526;v1} Member.Penns*ania Association of Notaries
Lnsurance Exchange.
v S.
Jessica Calvins
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r
fa the Court of Common Pleas of
(,-iurnberland County, Pennsylvania
ndgrnent in favor of Plain tiff on
No. 1_375685
6/4/201
for
cvil Term, 2.013_
Entered September 3, 2013
Erie Insurance Exchange laintiff
--
in the above judgment, do appear and acknowledge that this day have nd _n-
a tc.,ceivedind
from --
;he deftndant in the above Judgment, full payment and r.aisfaction of the sarte. with interest and cold desirecriha't
-171 CD-7-1
:an
satisfaction therefore shall be entered upon the records thereof.
And further, 1 do hereby authorize and empower DAVid D. Buell
-rx.)
theProthonotary of said Court, to appear _fiar...-fae
and in inY name and stead to enter full satisfaction upon the record of said Judgment, as fully and effectually, to all
intents and purposes, as I could were personally present in person to do so. And for so doing this shall be
your sufficient .varrant of authority.
have hereunto set our hands and seals this 21st
In testimony whereof, we
day of March ,
State of Pennsylvania
County of Cumberland,
}
(Seal)
Christy Sayers isbur Claims SUmxpor
Personally appeared before me, the subscriber, chriaty_ Sivers
(Seal)
the Plaintiff in the
above Joilgnent, and in due form of law acknowledged the within and foregoing Power of Attorney to satisfy the Judg-
ment se, forth, to be an
act and deed, and desired that thc. same stall be filed of record in the office of the Prothon-
utaty of the Court of Common Pleas of said County.
tevimcny .,vhe.reof, 1 hae r...unto -;et my hand and snl
e.
ONWE F PENN., ;;?;:
NOTARIAL SEAL
ZANNE M. WILAND, Notary Publk:
ethargesburg Sorough, Cumberland County
My Commission Expires November 1,2016
(110 vC-
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