HomeMy WebLinkAbout05-1292
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IN THE COURT OF COMMON
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PLEAS
IPLA~IFF. _~~
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PENNSYLVANIA
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I DEFENDANT
NOTICE TO DEFEND AND CLAIM RIGHTS
YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND AGAINST THE
CLAIM SET FORTH IN THE FOLLOWING PAGES, YOU MUST TAKE PROMPT ACTION,
YOU ARE WARNED THAT IF YOU FAIL TO DO SO, THE CASE MAY PROCEED
WITHOUT YOU AND A DECREE OF DIVORCE OR ANNULMENT MAY BE ENTERED
AGAINST YOU BY THE COURT. A JUDGMENT MAY ALSO BE ENTERED AGAINST
YOU FOR ANY OTHER CLAIM OR RELIEF REQUESTED IN THESE PAPERS BY THE
PLAINTIFF. YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS IMPORTANT
TO YOU INCLUDING CUSTODY OR VISITATION OF YOUR CHILD(REN).
WHEN THE GROUND FOR THE DIVORCE ARE INDIGNITIES OR
IRRETRIEV ABLE BREAKDOWN OF THE MARIAGE, YOU MAY REQUEST MARRIAGE
COUNSELING. A LIST OF MARRIAGE COUNSELORS IS AVAILABLE IN THE OFFICE
Of>~~,P~OTHONOTARY ATCUIll13Ef<LAND COUNTL( ,
~SLE ,PENNSYLVANIA.
IF YOU DO NOT FILE A CLAIM FOR ALIMONY; DIVISION OF PROPERTY,
LA WYERS FEES, OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED,
YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM.
YOU SHOULD TAKE TillS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
. Hi I7b/3
For Petitioner
Address;
1 IN THE COURT OF COMMON
_l__________________________
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PLEAS ~~ .' ~
I PLAINTIFF, ,
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PENNSYLVANIA
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I DEFENDANT
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CIVIL DIVISION
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COMPLAINT IN DIVORCE
COMES,thePlaintiff,~rntJa M. ghic/d!'
,by FILING
PRO SE, who files this Complaint in Divorce a statement of which is as follow:
I. The Plaintiff is '>at/1 da M. gn/c:L d S , an adult
individual currently residing atll>3 E... Wtl i f]l.J) Sf tar lisl c 18 /7/)/3
2. The Defendant is [;CcTT A AtUTH an adult
individual currently residing at
rf3t./ &t-ek 72d 8htfman.r bole- Po. /1cq[)
3. The Plaintiff has been a bona fide resident of the Commonwealth of
Pennsylvania for at least six (6) months previous to the filing of this Complaint.
4. The Plaintiff and Respondent were married on date:
Auj 23, 2bD I the State of 'Pe.nn~/(/a.flJd
5. There have been no child(ren) born of this marriage and wife is not now
pregnant.
6. There have been no prior actions of divorce or for annulment between the
parties.
7. Neither party is a member of any branch of military.
8. The marriage is irretrievably broken.
9. Plaintiff has been advise that counseling is available and that Plaintiff may
have the right to request that the Court require the parties to participate in counseling.
10. The PlaintiffYameJa ;Ill. , 8hi eids.
, respectfully
requests that this Court grant this Divorce pursuant to Section 3301 (c), or in the
alternative, Section 3301 (d) ofthe Divorce Code and that a Decree of Divorce be
entered.
I verifY that the statements made in the Complaint are true and correct. I
understand that false statements made herein are subject to penalties of 18 Pa. C.S.A
Section 4904, relating to unsworn falsification to authorities.
Respectfully submitted,
r1:na::!o~ mLd-r~
Name:
Dated: Ait-f:Lrr.-L & / U tiS
AFFIDAVIT
COMMONWEALTH OF PENNSYL VANIA
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Before me, the subscriber; a Notary Public in and for said Commonwealth and
County, personally appeared
, who, being duly sworn
according to law, deposes and says that the facts contained within the foregoing
Complaint in Divorce are true and correct to the best of his/her knowledge, information,
and belief, and that he/she is authorized to make this Affidavit.
COUNTY COURT OF COMMON PLEAS
INTAKE
DATE:
CASE NUMBER:
PLEASE CHECK ONE:
,,/ DIVORCE FILING - NO CHILDREN:
DIVORCE FILING - W/CHILDREN UNDER 18:
CUSTODY FILING -W/CHILDREN UNDER 18:
.eJ.:.AINTIFF/PETITIONER NAME AND ADDRESS:
f-/flt,'a M, &hie{cJ~
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(U 1St e Pa- /1D/3
PHONE: 717- 24-D- 2-QW(;
D~FENDANTIRESPONDENT NAME AND ADDRESS:
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PHONE: 717- Sf32- 3/-,>/",w
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PLEAS
PLAINTIFF,
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PENNSYL VANIA
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ACCEPTANCE OF SERVICE AND ENTRY OF APPEARANCE
PLEASE take notice that I, S;CO 7T A 1111 UTH , Defendan
provided with a Copy of the Notice to Defend and Claim Rights and Complaint ~
Divorce and do accept service of same. I further enter my appearance in
action for all purposed.
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Defendant
Address:
SENDER: COMPLETE THIS SECTION
. Complete items 1, 2, and 3. Also complete
item 4 jf Restricted Delivery is desired.
. Print your name and address on the reverse
so that we can return the card to you.
. Attach this card to the back of the mailpiece.
or on the front if space permits.
1. Article Addressed to:
~ A )~L.01-f
134- Cr cd<- 'Rd
.?1JOrnJflS Wle W
/7C40
2. Article Number
(Transfer from service label)
PS Form 3811. February 2004
Telephone: (7/7 ) 5fa - &~
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A. Signatu
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o Agent
Addressee I
C. ate of Delivery
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D. Is delivery addressdlfferent from (tam 17 0 Yes
If YES. ente, delivery address below: 0 N\
3..... S,,-vice Type
ftI Certified Mail
o Registered
o Insured Mall
D ExPress Mail
o Return Receipt for Merchandise
DC,O,D,
4. Restricted Delivery? (Extra Fee) 0 Yes
7004 2510 0000 3345 4086
Domestic Return Receipt
102595-02-M-1540
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AFFIDAVIT OF CONSENT
I. A complaint in Divorce under Section 330 I ( c) of the: Divorce Code was filed on
(date:) ;tWrCk.. lit 2. ()()5
2. The marriage of the Plaintiff and Defendant is irretrie:vably broken and ninety
days have elapsed from the date of filing and Complaint.
3 I consent to the entry of a final decree of Divorce after service of notice of
intention to request entry of the decree.
WAIVER OF NOTICE OF INTENTION TO REOUEST
ENTRY OF A DIVORCE DECREE
UNDER SECTION 3301(c) OF THE DIVORCE CODE
1. I consent to the entry of a fmal decree of Divorce without notice.
2. I understand that I may lose rights concerning alimony, division of property,
lawyer's fees, or expenses if! do not claim them before a Divorce is granted.
3 I understand that I will not be divorced until a Divorce: decree is entered by the
Court and that a copy of the decree will be sent to me immediately after it is filed with the
prothonotary.
I verify that the statements made in this affidavit are true and wrrect. I understand that
false statements here-in are made subject to the penalties of III Pa C.S. Section 4904
relating to unsworn falsification to authorities.
Date: .:Ji.Jp1frz 20"6 .
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PLEAS
IPLAINr~ -- - -- - ---- -r T -- - --- ------ ------ -,
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L_______ __ ______ _j~ __~UNTYL - ----- --~
PENNSYLVANIA
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AFFIDAVIT OF CONSENT
1. A complaint in Divorce under Section 330l(c) of the Divorce Code was filed on
M tLn:-k. I 1,,2 ()efl..date:).
.
2. The marriage of the Plaintiff and Defendant is irretrievably broken and ninety
days have elapsed from the date of filing and Complaint.
3 I consent to the ently of a final decree of Divorce after service of notice of
intention to request ently of the decree.
WAIVER OF NOTICE OF INTENTION TO REOUEST
ENTRY OF A DIVORCE DECREE UNDER
SECTION 3301(c) OF THE DIVORCE CODE
1. I consent to the ently of a final decree of Divorce without notice.
2. I understand that I may lose rights concerning alimony, division of property,
lawyer's fees, or expenses if! do not claim them before a Divorce is granted.
3. I understand that I will not be divorced until a Divorce decree is entered by the
Court and that a copy of the decree will be sent to me immediately after it is filed with the
prothonotary.
I verify that the statements made in this affidavit are tme and correct. I understand
that false statements here-in are made subject to the penalties of 18 Pa C.S. Section 4904
relating to unsworn falsification to authorities.
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SEPARATION AND PROPERTY SETTLEMENT AGREEMENT
TillS agreement is entered into between /:amd9 M, &ill ~/&, whose
. Il~ ',} p~ 17013
address isl b3 f WIll tiW 6t- WrU,s'(.hereinafter "Wife" and
<" /'^~ A- Ai, ,-;-1.-, 'd' 7~CrU-k.~ h 'naft
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"Husband", Husband and Wife are sometimes referred to herein as the "Parties".
WHEREAS, the Husband and Wife are married and desire to make a mutually
acceptable settlement of their rights, liabilities, obligations and property rights arising out
of and during the course of their marital relationship. No n~conciliation is contemplated;
and
WHEREAS, Husband and Wife filed for divorce under the provisions of29 Pa.
C.A. Section 3301 (c) and each has had an opportunity to consult with an attorney of
their choice. The parties acknowledge that the marriage is irretrievably broken; and
WHEREAS, the Parties were lawfully married on Auj us, L ;:) 3 , ~ tJO I
in ':pUn; County, 'hnflS'd/ varVa
WHEREAS, there were no children born to or adopted by the Parties.
Wife is not now pregnant; and
WHEREAS, the Parties separated o~tc- 27, 20Ci.3
and from said date
up to the present, the Parties have lived separate and apart without any cohabitation for at
since the date of separation; and
WHEREAS, The parties hereto agree that the provisions of this Separation and
Property Settlement Agreement shall be incorporated into any Judgment or Decree of
Dissolution of Marriage.
NOW THEREFORE, FOR AND IN CONSIDERATION OF the mutual
benefits and advantages accruing to each party, the undersigned do hereby solemnly
covenant, agree and contract as follows:
1. CHILD CUSTODY: No children were both to this marriage, wife is not now
pregnant and no children were adopted by the parties.
2. PROPERTY SETTLEMENT: Husband and Wife are in possession of all
personal property belonging to each, and neither makes any claim to any personal
property in the possession of the other except as provided below.
(a) List of Property to be awarded to Wife. nane.-
List here
(b) List of Property to be awarded to Husband. h trn e.-
List here
3. DEBTS: Except as otherwise provided herein, Wife shall be responsible for
her individual debts and Husband shall be responsible for his individual debts. There are
no unpaid joint debts of the parties except as provided below, if any.
(c) Debts to be paid by Husband
List n t;n e.-
(d) Debts to be paid by Wife
List hen e-
4. ALIMONY: Neither Party claims entitlement to aJlimony as they are not
entitled to same and both Parties expressly waive any claim to alimony.
5. LEGAL REPRESENTATION DISCLOSURE: Each party agrees that neither
party has been represented by an attorney in this matter and that both parties have had an
opportunity to consult with any attorney of hislher choice.
6. FURTHER DOCUMENTS: Each party agrees that he or she will sign and
execute any further or additional documents as may be ne,;essary to put into effect the
intended purposes hereof.
7. ENTIRE AGREEMENT: This Agreement constitutes the entire agreement
between the parties and each party acknowledges that them are no further agreements not
expressly included herein and that this Agreement may be modified, altered, or amended
only in writing, duly signed and notarized by each in the form of this original.
8. FULLY READ AND UNDERSTAND: Each p;arty represents and
acknowledges that he or she has fully read this Agreement, consulted with each other,
carefully considered same, and have signed and executed same after such consultation,
and after consulting with their respective attorneys, that the signing of this Agreement is
free and voluntary without force or collusion by either party or any third party, and that
each party signed same with the full knowledge of said party's rights, obligations, and
responsibilities.
9. MODIFICATION: This Agreement shall estop and preclude either party from
making other or further demands and claims upon the other, not included herein, except
that such legal action may be taken by either party as is necessary to enforce or modify
the terms and provisions hereof, except that the Property Settlement provision shall not be
subject to modification.
lO. SUBSEOUENT DIVORCE: It is agreed and undeJrstood that this Separation
and prope~ttlement Agreement is entered into in connection with a Divorce action
pending in txrl ~ Pennsylvania and that this Separation and Property
Settlement Agreement shall be incorporated into the Finail Decree of Dissolution of
Marriage of the Parties. Further, that this Separation and Property Settlement Agreement
finally settles all rights of the parties and the property jointly or individually owned by the
parties, and that this Agreement, and the enforceability the:reof, is not contingent upon
either party or both parties being granted a divorce on any grounds.
1 I. CONTROLLING LAW: This Agreement shall be governed, enforced and
interpreted according to the laws of the Commonwealth of Pennsylvania.
12. EFFECTIVE DATE: This Agreement shall not be enforceable until duly
executed by both Parties.
13. HEIRS AND ASSIGNS: This Agreement shall be binding upon the heirs,
administrators, estate and assigns of the parties.
IN WITNESS WHEREOF, Wife,
has
executed this Agreement on the _ day of
, 20 , and Husband,
has executed this Agreement on the _ day of
,20_.
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('"'" Signatufl~ ofHu an~
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Print Name:
STATE OF PENNSYLVANIA
COUNTY OF
On this, the C:::U. day of lclht rJ-ntt.) , before
me, the undersigned~ally ap~ ,
known to me (or satisfactorily proven) to be the person whose name is subscribed to the
within instrument, and acknowledged that _ (he/she) e:xecuted the same for the
purposes therein contained.
In witness whereof, I hereunto set my hand and offidal seal.
~
,'/OTARIAL SEAL
PROTHONOTARY. NOTARY PUBU&
CARUSl.E CUMBERlANO COUNTY COURT HOUSE
MY COMMISSION EXPIRES JANUARY 2, 2Oll6
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Printed Name:
My Commission Expires:
STATE OF PENNSYLVANIA
COUNTY OF
On this, the day of , before
me, the undersigned officer, personally appeared ,
known to me (or satisfactorily proven) to be the person whose name is subscribed to the
within instrument, and acknowledged that _(he/she) executed the same for the
purposes therein contained.
In witness whereof, I hereunto set my hand and official seal.
Notary Public
Printed Name:
My Commission Expires:
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PENNSYLVANIA
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ACKNOWLEDGEMENT
((k )\ complaint in Divorce under Section 3301(c) ofth,~ Divorce Code was filed on
rch / r} UJO ~ . I agree that the marriage of the Plaintiff and Defendant is
irretrievably broken and ninety days have elapsed from the date of filing the Complaint.
All information contained within the attached documentation is true and correct to the
best of my knowledge, information, and belief
It is my desire to file with the ~ fa/'l.d County Court of
Common Pleas the attached Marital Property Settlement Agreement and to be bound fully
and completely by the terms and conditions as set forth within said Marital Property
Settlement Agreement documentation.
IN WITNESS WHEREOF I set my hand and seal this
,20
day of
~4~
SIGNATURE
NAME: S=rI- /'f ;M~ ~
On this ~ day of I 1t~ ' ~_~, ~fore me, a Notary
Public, the undersigned officer, rsonallyappeared X fI- jM,.JI",
known to me to be the person whose name is subscribed to the written instrument, and
acknowledged that he/she executed the same for the purposes therein contained.
IN WITNESS WHEREOF I hereunto set my hand and official seal.
'c
PROTH:O~ARIAL SEAL
CAIllSI.E CUiYiBiJ1L~E NOTARY PUBLIC
MY COM~SION '.:',~!~1Ju~jWf. ~SE
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PENNSYL VANIA
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PRAECIPE TO TRANSMIT RECORD
To the Prothonotary:
Kindly Transmit the Record, together with the following infonnation, to the Court for
entty of a divorce decree:
1. Grounds for Divorce: irretrievable breakdown under Section 3301 (c) or 3301
(d) of the Divorce Code. (Check applicable section.)
2. Date and manner of service of the Complaint: O!ll.l:lt E DATE):
Jl..hr 2.3. :LDOS via (check one) Personal Service or~lrtified Mail.
3. (Complete either paragraph (a) or (b).)
(a) Date of execution of the Affidavit of Consent/Consent Waiver required by
Section 3301 (c) of the Divorce Code: by PlaintiffL- ) by Defendant
( )..
(b) (1) Date of execution of the Plaintiff's Affidavit r~'quired by Section 3301(d) of
the Divorce Code:
(2) Date of service of the Plaintiff's Affidavit required by Section 3301(d) of the
Divorce Code:
4. Related claims pending:
5, (Complete either (a) or (b))
a) Date and manner of service of the notice of intention to file Praecipe to transmit
record, a copy of which is attached:
b) Date plaintiff's Waiver of Notice in Section 3301(c) Divorce was filed with the
Prothonotary: ~ .J.w l./ 6, 2Ot>S
Date defendant'sJaiver of Notice in Section 3301 (c) Divorce was filed with
the Prothonotary. W 4 Si z.oos
6. The following is requested:
Decree in Divorce with property settlement agreement attached.
Decree in Divorce with no other relief granted
Bifurcated Decree in divorce with the court to retain jurisdiction over
unresolved claims which shall be listed for a hearing. Stipulation or order to
bifurcate required.
Order approving ground for divorce and relerring matters for ahearing on
unresolved claims.
Decree in divorce deferred.
7. Pennsylvania vital statistics form is attached.
103 E; W L-LLo7.iJ '81-
Plaintiff
Address:
(!ofU'S!4, Pa 170/3
Phone: (7/7--.J 2 4tJ, 2. C; d:,b
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IN THE COURT OF COMMON PLEAS
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OFCUMBERLANDCOUNTY
(:JameJa M. &hier&
PENNA.
STATE OF
No.
05
1d?10{
VERSUS
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DECREE IN
DIVORCE
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~, IT IS ORDERED AND
AND NOW, j"'~ (,
DECREED THAT ?on,e I a ;i1
AND ~C/)tt A kLLLm
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, PLAINTIFF,
, DEFENDANT,
ARE DIVORCED FROM THE BONDS OF MATRIMONY,
THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE
BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT
YET BEEN ENTERED;
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