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Home My WebLink About14-0607 Supreme Court of Pennsylvania Court of Common pleas ForProthonotury UseOnlil: Civil Cover Sheet Docket No: 1 CUMBERLAND County H The information collected on this form is used solely for court administration purposes. This forna does not supplement or replace the filing and service ofpleadings or other papers cis required by lary or rules of coin!. Commencement of Action: S Ex Complaint ❑ Writ of Summons El Petition ❑ Transfer from Another Jurisdiction ❑ Declaration of Taking E C Lead Plaintiff's Name: Lead Defendants Name: 7' State Farm Mutual Automobile Insurance Co. Kayla Belcher I Are money llar Amount Requested: ❑x within arbitration limits O ges requested'? ❑Q Yes ❑ No (check one) []outside arbitration limits N Is this a Class Action Suit? ❑ Yes El No Is this an MDJAppeal? El Yes El No A Name of Plaintiff /Appellant's Attorney: Paul F. D'Emilio, Esquire ❑ Check here if you have no attorney (are a Self - Represented IPro 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 ,Iduss 7ort) CONTRACT (do not include Judgments) CIVIL APPEALS ❑ Intentional ❑ Buyer Plaintiff Administrative Agencies El Malicious Prosecution El Debt Collection: Credit Card ❑Board of Assessment ❑ Motor Vehicle ❑ Debt Collection: Other ❑ Board of Elections Nuisance ❑ Dept. of Transportation ❑ Premises Liability ❑ Statutory Appeal: Other S ❑ Product Liability (does not include E n7cn•c 1011) ❑ Employment Dispute: ❑ Slander /Libel/ Defamation Discrimination C ❑ Other: ❑ Employment Dispute: Other ❑ Zoning Board T - -- ❑ Other: I n Other: O MASS TORT Breach of Contract ❑ Asbestos N ❑ Tobacco ❑ Toxic Tort - DES ❑ Toxic Tort - Implant REAL PROPERTY MISCELLANEOUS ❑ Toxic Waste El ❑ Other: Ejectment El Common Law /Statutory Arbitration B ❑ Eminent Domain /Condemnation ❑ Declaratory Judgment El Ground Rent ❑ Mandamus El Landlord /Tenant Dispute ❑ Non - Domestic Relations ❑ Mortgage Foreclosure: Residential Restraining Order PROFESSIONAL LIABILITY El Mortgage Foreclosure: Commercial ❑ Quo Wan•anto ❑ Dental ❑ Partition ❑ Replevin ❑ Legal ❑ Quiet Title ❑ Other: ❑ Medical ❑ Other: ❑ Other Professional: Updated 111120/ l PAUL F. D'EMILIO, ESQUIRE THIS IS AN ARBITRATION MATTER ATTORNEY I.D. #16654 PAUL M. SCHOFIELD, JR., ESQUIRE ATTORNEY I.D. #81894 905 W. SPROUL ROAD, SUITE 105 ATTORNEY FOR PLAINTIFF SPRINGFIELD, PA 19064 (610) 338 -0338 STATE FARM MUTUAL AUTOMOBILE COMMON PLEAS COURT OF INSURANCE COMPANY AS SUBROGEE OF : CUMBERLAND COUNTY HEIDI KRALL 112 E. WASHINGTON STREET DTB 8 • BLOOMINGTON, IL 61701 NO. VS. M KAYLA BELCHER z�? 71 FAIRVIEW STREET "� r CARLISLE PA 17015 -<> o C-D AND G SHANNON GERMER 71 FAIRVIEW STREET ` CARLISLE, PA 17015 CIVIL ACTION NOTICE AVISO YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND LE HAN DEMANDADO A LISTED EN LA CORTE. SI LISTED AGAINST THE CLAIMS SET FORTH IN THE FOLLOWING PAGES, QUIERE DEFENDERSE DE ESTAS DEMANDAS EXPUESTAS EN YOU MUST TAKE ACTION WITHIN TWENTY (20) DAYS AFTER LAS PAGINAS SIGUIENTES, LISTED TIENE (20) DIAS DE PLAZO THIS COMPLAINT AND NOTICE ARE SERVED, BY ENTERING A A PARTIR DE LA FECHA DE LA DEMANDA Y LA NOTIFICACION. WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND LISTED DEBE PRESENTAR UNA APARIENCIA ESCRITA O EN FILING IN WRITING WITH THE COURT YOUR DEFENSES OR PERSONA 0 POR ABOGADO Y ARCHIVAR EN LA CORTE SUS OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. YOU DEFENSAS 0 SUS OBJECIONES A LAS DEMANDAS ENCONTRA ARE WARNED THAT IF YOU FAIL TO DO SO THE CASE MAY DE SU PERSONA. SEA AVISADO QUE SI LISTED NO SE PROCEED WITHOUT YOU AND A JUDGMENT MAY BE ENTERED DEFIENDE, LA CORTE TOMARA MEDIDAS Y PUEDE ENTRAR AGAINST YOU BY THE COURT WITHOUT FURTHER NOTICE UNA ORDEN CONTRA LISTED SIN PREVIO AVISO 0 FOR ANY MONEY CLAIMED IN THE COMPLAINT OR FOR ANY NOTIFICACION 0 POR CUALQIER QUEJA 0 ALIVIO QUE OTHER CLAIM OR RELIEF REQUESTED BY THE PLAINTIFF. ESPEDIDO EN LA PETICION DE DEMANDA. LISTED PUEDE YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS PERDER DINERO, SUS PROPIEDADES 0 OTROS DERECHOS IMPORTANT TO YOU. IMPORTANTES PARA USTED, YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. LLEVE ESTA DEMANDA A UN ABOGADO INMEDIATAMENTE. SI IF YOU DO NOT HAVE A LAWYER„ GO TO OR TELEPHONE THE NO TIENE ABOGADO 0 SI NO TIENE EL DINERO SUFICIENTE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU PARA PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME POR WITH INFORMATION ABOUT HIRING A LAWYER. TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE USTED PUEDE IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE CONSEGUIR ASISTENCIA LEGAL. MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS ATA REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 S. Bedford Street Cumberland County Bar Association Carlisle, PA 17013 32 S. Bedford Street (717) 249 -3166 Carlisle, PA 17013 (800) 990 -9108 (717) 249 -3166 (800) 990 -9108 S ?)bloC) s PAUL F. D EMILIO, ESQUIRE THIS IS AN ARBITRATION MATTER ATTORNEY I.D. #16654 PAUL M. SCHOFIELD, JR., ESQUIRE ATTORNEY I.D. #81894 905 W. SPROUL ROAD, SUITE 105 ATTORNEY FOR PLAINTIFF SPRINGFIELD, PA 19064 (610) 338 -0338 STATE FARM MUTUAL AUTOMOBILE COMMON PLEAS COURT OF INSURANCE COMPANY AS SUBROGEE OF : CUMBERLAND COUNTY HEIDI KRALL 112 E. WASHINGTON STREET DTB 8 BLOOMINGTON, IL 61701 NO. VS. KAYLA BELCHER 71 FAIRVIEW STREET CARLISLE, PA 17015 AND SHANNON GERMER 71 FAIRVIEW STREET CARLISLE, PA 17015 CIVIL ACTION NOTICE UNDER THE FAIR DEBT COLLECTION PRACTICES ACT, 15 U.S.C. §1601 (AS AMENDED) THE PENNSYLVANIA UNFAIR TRADE PRACTICES ACT AND CONSUMER PROTECTION LAW, 73 PA.CON.STAT.ANN. §201, ET. SEQ. ( "THE ACTS ") IN AS MUCH AS THE ACTS MAY APPLY, PLEASE BE ADVISED THAT THIS COMMUNICATION IS FROM A DEBT COLLECTOR. THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. COMPLAINT The Plaintiff, State Farm Mutual Automobile Insurance Company, by its attorney Paul F. D'Emilio, Esquire, bring this action upon a cause whereof the following is a statement: 1. The Plaintiff, State Farm Mutual Automobile Insurance Company, ( "Plaintiff') is a Corporation authorized to do business in the Commonwealth of Pennsylvania, with a address of 112 E. Washington Street, DTB 8, Bloomington, IL 61701. Plaintiff brings this action as subrogee of Heidi Krall, herein the ( "Insured ") under 1 a policy of insurance issued by Plaintiff. 2. Defendant, Kayla Belcher is an individual residing at 71 Fairview Street, Carlisle, PA 17015. 3. Defendant, Shannon Germer is an individual residing at 71 Fairview Street, Carlisle, PA 17015. 4. On April 26, 2011, Defendants Kayla Belcher and Shannon Germer made, executed and delivered unto State Farm Mutual Automobile Insurance Company a Promissory Note in the principal sum of Eleven Thousand and 00/100 ($9,337.78) Dollars. A true and correct copy of said Promissory Note is attached hereto, made a part hereof and marked EXHIBIT "A." 5. The aforesaid Defendants Kayla Belcher and Shannon Germer defaulted on the terms and conditions of the aforesaid Promissory Note by failing to pay the principal when due and payable and is in default by reason of their failure to pay monthly payments whereby the entire principal of balance has become due and payable. 6. The following is a statement of the amount now due: a. Balance of Principal Actual Amount $9,337.78 b. Attorney fees $500.00 C. Court Cost $203.75 d. Payments made $(900.00 TOTAL $9,141.53 7. Although frequent demands have been made, Defendants Kayla Belcher and Shannon Germer have failed, refused and neglected and continues to fail, refuse and neglect to pay the balance due and owing. 8. The Note has not been assigned. 2 WHEREFORE, Plaintiff demands judgment against the Defendant upon each count in an amount not in excess of Fifty Thousand and 00/100 ($50,0 00) dollars together with costs of suit. Date: Paul F. D' io,AMXe Identific io No.:1 654 e -mail d&ess: pauld @demiliolaw.com Paul Schofield, Jr., Esquire Identification No.: 81894 e -mail address: pauls @demiliolaw.com 905 W. Sproul Road, Suite 105 Springfield, PA 19064 Telephone No.: 610 - 338 -0338 Fax No.: 610 - 338 -0303 3 au =I .Lo Law Office VERIFICATION VAUtb &ile ��Subrogation Representative with State Farm Mutual In sur a Company in the above captioned matter verifies that the facts contained in the foregoing Complaint are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsifiLtion DATE: to authorities. I Subrogation Represe tative Rr.110980017;i EXHIBIT "A" PROMISSORY NOTE For value received, the undersigned promise(s) to pay to the order of State Farm Insurance Company, (hereinafter called `the Company ") the sum of $9,337.78 Dollars, payable in installments of not less $50.00 in any one payment, with the first payment being in the amount of $50.00 to be made on May 1, 2011 and all future payments being in the sum of $50.00 to be made bi- weekly thereafter, until the whole sum, principal and zero interest has been paid. If this note is placed in the hands of any attorney collection, I /we promise and agree to pay holder's attorney's fee of at least $500.00 and collection costs. If any suit brought or judgment entered upon this note, there shall be added, to cover the Company's attorney fees, the maximum amount of recovery permitted for attorney's fees in that jurisdiction. The undersigned acknowledge receipt of a copy of this note before signing same. This note is conclusive evidence of the amount which the undersigned is legally obligated to pay because of occurrence described below, and which, by subrogation or otherwise, the Company is legally entitled to collect from the undersigned, aiid is not given or accepted in substitution for or in satisfaction of such obligation of undersigned, which arose out of the following occurrence: This note is the result of an automobile accident which required the Company to pay or pay on behalf of, its insured a claim under a collision, uninsured or underinsured motorist policy. The rights and remedies hereby given shall not affect any other rights and remedies which the Company may be against the undersigned, nor shall the Company's acceptance hereof, or of any payment or payments herein affect such other rights or remedies. Each endorser, co -maker or guarantor hereof hereby waives presentment, protest, notice of dishonor and of protest. If default shall be made in payment of this Note or any installment thereof or interest thereon, when due, or undersigned, or any endorser or guarantor of this note, shall make a general assignments for the benefit creditors or if a petition in bankruptcy shall be filed by or against any of them or if Receiver shall be appointed the property or assess if any of them, then this note and each and every installment thereof, at the option Company, shall immediately become due and payable with interest at a rate of 6% per annum. without any further noted or demand whatsoever. By execution and acceptance of this agreement the party undersigned agrees that if a default occurs in the payment of any installments due under this agreement, the driving and registration privileges of the undersigned may be suspended until the balance of the amount due the Company is paid. SWORN TO AND SUBSCRIBED 0ayl her Driver's License No. BEFORE ,YE THIS �P DAY . OF r' 2011. Shannon Germer Driver's License No. NOTARY BLIC � "t T �u 6 NOTARIAL SEAL l CAMELA J. MANGES, Notary Public Boro of Carlisle, Cumberland County ' My Commission E xpir es June 21, 2014 SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson ti 1 Sheriff t . PRO, 1-I`?i4;1 Jody Smith �t at atdn(k .� y 2014 FEB 19 PM 3: I Q Chief Deputy Richard W Stewart CUMBERLAND COUNTY Solicitor `' = PENNSYLVANIA State Farm Mutual Automobile Insurance Company as subrogee of Heidi Kr Case Number vs. Kayla Belcher(et al.) 2014-607 SHERIFF'S RETURN OF SERVICE 02/05/2014 03:30 PM - Deputy Ronald Hoover, being duly sworn according to law, served the requested Complaint& Notice by"personally" handing a true copy to a person representing themselves to be the Defendant, to wit: Shannon Belcher N/K/A SHANNON DIXON at 71 Fairview Street, South Middleton, Carlisle, PA 17015. RONALD HOOVER, DEPUTY 02/05/2014 03:56 PM- Deputy Ronald Hoover, being duly sworn according to law, served the requested Complaint& Notice by"personally" handing a true copy to a person representing themselves to be the Defendant, to wit: Kayla Belcher at 1000 CLAREMONT RD, South Middleton, Carlisle, PA 17015. -20 RONALD HOOVER, DEPUTY SHERIFF COST: $57.56 SO ANSWERS, February 11, 2014 RONNY R ANDERSON, SHERIFF PAUL F. D'EMILIO, ESQUIRE THIS IS AN ARBITRATION MATTER ATTORNEY I.D. #16654 PAUL M. SCHOFIELD, JR., ESQUIRE ATTORNEY I.D. #81894 905 W. SPROUL ROAD, SUITE 105 ATTORNEY FOR PLAINTIFF SPRINGFIELD, PA 19064 (610) 338-0338 STATE FARM MUTUAL AUTOMOBILE COMMON PLEAS COURT OF INSURANCE COMPANY AS SUBROGEE OF : CUMBERLAND COUNTY HEIDI KRALL 112 E. WASHINGTON STREET DTB 8 BLOOMINGTON, IL 61701 NO. 14-607 civil VS. KAYLA BELCHER 71 FAIRVIEW STREET CARLISLE, PA 17015 AND SHANNON GERMER 71 FAIRVIEW STREET CARLISLE, PA 17015 CIVIL ACTION STIPULATION TO DISCONTINUE IN LIEU OF DEFAULT Plaintiff, State Farm Mutual Automobile Insurance Company ASO of Heidi Krall and Defendant, Kayla Belcher; hereby agree and mutually file this instant Stipulation to mark the above captioned matter "discontinued in lieu of default" upon the following conditions: 1. Defendant admits that she is indebted to the Plaintiff in the amount of Eight Thousand Three Hundred Thirty Seven and 78/100 ($8,337.78) Dollars. 2. - The parties agree the Defendant will pay the Plaintiff the amount of Eight Thousand Three Hundred Thirty Seven and 78/100 ($8,337.78) Dollars in monthly installments, the first in the amount of Five Hundred ($500.00) Dollars is due upon signing and the remainder in monthly installments of Fifty ($50.00) Dollars beginning on or about the last business day of March, 2014 and continuing monthly thereafter. 3. In the event of a default of the above listed monthly payment terms the entire sum described in paragraph 1 less any credits is immediately due and payable. 4. Defendant shall have the right to cure a default of any of the terms for ten days. 5. In conjunction with this Stipulation to Discontinue in Lieu of Default there appears attached a Consent Order for Judgment which will be held in escrow to ensure compliance with the terms of this instant Stipulation to Discontinue in Lieu of Default. 6. After 10 days of uncured default Plaintiff shall cause the attached Consent Order for Judgment to be entered with the Court without further notice. 7. All parties agree that this settlement is final and binding on the parties and their heirs, representatives, agents and assigns and proceed with the knowledge that all parties will be barred from appealing or opening any judgment which may or may not be entered in accordance with the terms of this instant stipulation and agreement. 8. Payments shall be made payable to the Law Office of Paul F. D'Emilio and sent to 905 West Sproul Road, Suite 105, Springfield, PA 19064. B WE HEREBY STIPULATE AND AGREE TO THE ABOVE CONDITIONS OF SETTLEMENT rPaul S hofield, Jr., Esquire A torney for Plaintiff Date: yla Belcher Date: 3-1S-11-1