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Home My WebLink About13-6028 Supreme Co. :r ennsylvania Courf lease CiIMBERLAN�� t t ? iocsil �. '. �/. Coun The information collected on this form is used solely for court administration purposes. This form does not supplement or replace the filing and service ofpleadings or other papers as required by law or rules of court. Commencement of Action: ❑ Complaint ® Writ of Summons ❑ Petition ❑ Transfer from Another Jurisdiction ❑ Declaration of Taking Lead Plaintiff's Name: Lead Defendant's Name: ROGER HURRELL NATIONWIDE INSURANCE COMPANY Dollar Amount Requested: [3 within arbitration limits Are money damages requested? 13 Yes ❑ No (check one) 13 outside arbitration limits Is this a Class Action Suit? ❑ Yes JP No Is this an MDJAppeal? (3 Yes ® No Name of Plaintiff/Appellant's Attorney: MARCUA A. MCRNIGHT, III ❑ Check here if you have no attorney (are aSelf- Represented [Pro Se] Litigant) rr Nature ofyth Case: Place an �`X" to.the Ieft;of the M case.catsgory that MdStYaPPurately! describes your. a P'R111f�4'RT,F AiS`E., "Iftyou are making more than one type. of claim;' check,the.one that Jk you coh dei most important. TORT (do not include Mass Tort) CONTRACT (do not include Judgments) CIVIL APPEALS ❑ Intentional [3 Buyer Plaintiff Administrative Agencies S' ❑ Malicious Prosecution ❑ Debt Collection: Credit Card ❑ Board of Assessment ' Motor Vehicle ❑ ® ❑Debt Collection: Other Board of Elections ❑ Nuisance ❑ Dept. of Transportation t ❑ Premises Liability ❑ Statutory Appeal: Other ? ❑ Product Liability (does not include ❑ Employment Dispute: mass tort) [3 Slander/Libel/ Defamation Discrimination E3 Other: E] Employment Dispute: Other [3 Zoning Board ❑ Other: 4w ❑ Other: MASS TORT ❑ Asbestos ❑ Tobacco ❑ Toxic Tort - DES ❑ Toxic Tort - Implant REAL PROPERTY MISCELLANEOUS ❑ Toxic Waste [3 Other: [3 Ejectment ❑ Common Law /Statutory Arbitration ❑ Eminent Domain/Condemnation ❑ Declaratory Judgment ❑ Ground Rent ❑ Mandamus ❑ Landlord/Tenant Dispute p [3 Non-Domestic Relations ❑ Mortgage Foreclosure: Residential Restraining Order PROFESSIONAL LIABLITY ❑ Mortgage Foreclosure: Commercial ❑ Quo Warranto ❑ Dental ❑ Partition ❑ Replevin t ❑ Legal ❑ Quiet Title ® Other: Medical ❑ ® Other: �7 ❑ Other Professional: Updated 1/1/2011 ROGER HURRELL, IN THE COURT OF COMMON PLEAS OF PLAINTIFF CUMERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW V . NO. 2013 - 61)�8 CIVIL TERM NATIONWIDE INSURANCE COMPANY DEFENDANTS JURY TRIAL DEMANDED PRAECIPE FOR ISSUANCE OF A WRIT OF SUMMONS TO PROTHONOTARY: Please issue a Writ of Summons against the defendants, Nationwide Insurance Company, and enter my appearance on behalf of the plaintiff, Roger Hurrell. Please direct the Sheriff to serve the defendants as follows: Nationwide Insurance Company One Nationwide Gateway Des Moines, IA 50391 Respectfully submitted, co - IRWIN & IGHT, — By: Marcus A Pro Knight, II, Esq e 60 West m t Street, Carlisle, PA 13 j (717) 249 -2353 e Court I.D. N 25476 October 15, 2013 To: NATIONWIDE INSURANCE COMPANY You are hereby notified Roger Hurrell, plaintiff, have commenced an action against you which you are required to defend or a default judgment may be entered against you. PROTHONOTARY B DEPUTY Date: I �,S 920 4 /1- U 6��/ SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson = Sheriff Jody S Smith 2( °r Chief Deputy ° , f" 1 Richard W Stewart Solicitor Roger Hurrell Case Number vs. Nationwide Insurance Company 2013-6028 SHERIFF'S RETURN OF SERVICE 10/16/2013 Ronny R Anderson, Sheriff,who being duly sworn according to law, states that he served the within Writ of Summons upon the within named defendant, Nationwide Insurance Company, in the following manner: On October 16,2013 the Sheriff mailed by certified mail, return receipt requested a true and correct copy of the within Writ of Summons to the defendant's last known address of One Nationwide Gateway, Des Moines, IA 50391. The certified mail return receipt card was received by the Cumberland County Sheriff's Office signed by Signature Incomplete(initials only)on October 20, 2013. SHERIFF COST: $34.57 SO ANSWERS, October 25, 2013 ROMJY R ANDERSON, SHERIFF Postal CERTIFIED RECEIPT Q' (Domestic Mail Only, • Insurance Coverage Provided) (� For delivery information 0 0 MI __kGPM3. USE ra ru Postage $ ru Certified Fee M Postmark C3 Return Receipt Fee Here p (Endorsement Required) M Restricted Delivery Fee Q (Endorsement Required) r- Total Postage&Fees M r- m ° Nationwide insurance Company ............ ° '9f46Ant:1G One Nationwide Company C3 or PO Box M cnj state,2 Des Moines, iA 50391 - - PS Form :tr August 2006 See Prevetse fat Instructions all i • Complete Items 1,2,and 3.Also complete A. Sign0b" Item 4 If Restricted D81"Is desired. X ❑Agent • Print your name and address on the reverse 0 Addressee so that we can return the card to you. B. Received by(Printed Name) 0. Date of Dellvery • Attach this card to the hack of the mallpiece, or on the front If space permits. D. Is delivery address dHFsrecrtirom Kam 1? ❑Yea 1. Ardcle Addressed to: if YES,MAW delivery address below: 0 No Nationwide Insurance Company One Nationwide Company Des Moines, IA 50391 3 TAW o cemw Mall G1 Fie m* 0 Registered D Return Receipt for Merchandise 0 Insured Mali O C.O.D. 4. Resttrfcted Daliverj/t Pit Fee) 0 Yes 2. Article NumtW ?00? 0 710 0003 2 210 3 719 (idpts* ".*0*W PS Form 391 1,Fetxuary 2004 lion es8c Return Ra0e0 11021%5 41-1&115010