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Home My WebLink About14-4583 Supreme Court:of Pennsylvania Cou- Com Pleas • Y P et For Prothonotary Use nly: J Docket No: illy ST I C ,rd - County 11, 77ie information collected on this form is used solely.for court administration purposes. This form does not supplement or replace the filing and service of pleadings or other papers as required by law or rules of court. I Commencement of Action: S El Complaint ❑Q Writ of Summons El Petition El Notice of Appeal ❑ Transfer from Another Jurisdiction ❑ Declaration of Taking E C Lead Plaintifrs Name: _ _ _ _ Lead Defendant's Name: _ Z. Jaquay Williams - ; 6 NSC Equity Holdings, LLC i I ❑ Check here if you are a Self-.Represented (.Pro Se)Litigant O Name of Plaintiff/Appellant's Attorney:Stephen G. Held__ _ – _ N Dollar Amount Requested: ❑ 'within arbitration limits Are money damages requested?: ❑X Yes ❑ No (Check one) outside arbitration limits A Is this a Class Action Suit? ❑ Yes No Er-- 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. i TORT(do not include Mass Tort) CONTRACT(do not include Judgments) CIVIL APPEALS ❑ Intentional ❑ Buyer Plaintiff Administrative Agencies ❑ Malicious Prosecution ❑ Debt Collection:Credit Card ❑ Board of Assessment ❑ Motor Vehicle ❑ Debt Collection:Other _ ❑ Board of Elections ❑ Nuisance —__ ❑ Dept.of Transportation ❑ Premises Liability ❑ Zoning Board S ❑ Product Liability(does not include ❑ Statutory Appeal:Other E mass tort) El Employment Dispute: ❑ Slander/Libel/Defamation Discrimination C ❑ Other: ❑ Employment Dispute:Other -- - – � T Judicial Appeals 1 ❑ MDJ-Landlord/Tenant I El Other: ElMDJ-Money Judgment O MASS TORT - `T -A - ❑ Other: __ ❑ Asbestos I N ❑ Tobacco ❑ Toxic Tort-DES ❑ Toxic Tort-Implant REAL PROPERTY MISCELLANEOUS ❑ Toxic Waste ❑ Ejectment F1 Other: ❑ Common Law/Statutory Arbitration B ❑ Eminent Domain/Condemnation ❑ Declaratory Judgment -- ❑ Ground Rent ❑ Mandamus ❑ Landlord/Tenant Dispute ❑ Non-Domestic Relations ❑ Mortgage Foreclosure Restraining Order PROFESSIONAL LIABLITY ❑ Partition ❑ Quo Warranto ❑ Dental ❑ Quiet Title ❑ Replevin ❑ Legal k ❑ Medical ❑ Other: ❑ Other: _ _ - ❑ Other Professional: E Nursing home negligence I ? I Pa.R.C.P.205.5 2/2010 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Vic.(_ No. 2014 Civil Action-( ) Law ( ) Equity JAQUAY WILLIAMS GGNSC EQUITY HOLDINGS,LLC 2149 Penn Street 7160 Dallas Parkway Harrisburg, PA 17110 Suite 400 Plano,TX 75024 SYKWE WILLIAMS 1709 Fulton Street . GGNSC CAMP HILL, III,GP, LLC Harrisburg, PA 17102 46 Erford Road C-) Camp Hill, PA 17011 —+ SYHEEB WILLIAMS r7i cam..' 2149 Penn Street GGNSC CAMP HILL, 111, LP d/b/a GOLDEN �:0 c-) 73 _ Harrisburg, PA 17110 LIVING CENTER-CAMP HILL <> CD 46 Erford Road C) UAHNTAE WILLIAMS Camp Hill, PA 17011 551 Woodbine Street Harrisburg, PA 17110 GOLDEN GATE NATIONAL SENIOR CARE,LLC N) 7160 Dallas Parkway Individually and on behalf of the Suite 400 ESTATE OF MYRA ELIZABETH Plano,TX 75024 WILLIAMS,dec. GGNSC ADMINISTRATIVE SERVICES, LLC 7160 Dallas Parkway Suite 400 Plano,TX 75024 GGNSC CLINICAL SERVICES, LLC 7160 Dallas Parkway Suite 400 Plano,TX 75024 GGNSC HOLDINGS, LLC 7160 Dallas Parkway Suite 400 Plano,TX 75024 versus S Plaintiff(s)& Defendant(s)& Addresses Addresses " PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY OF SAID COURT: Please issue a Writ of Summons in the above captioned action. Writ of Summons shall be issued and forw rded to (xx) attorney Stephen G. Held, Esquire 1300 Linglestown Road -Suite 2 Signature of Attorney Harrisburg, PA 17110 Supreme Court ID#72663 (717)238-2000 Date: WRIT OF SUMMONS TO THE ABOVE NAMED DEFENDANT(S): YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFF(S) HAS/HAVE COMMENCED AN ACTION AGAINST YOU. Prot notary Deputy Date: Ronny R Anderson Sheriff Jody S Smith Chief Deputy Richard W Stewart Solicitor SHERIFF'S OFFICE OF CUMBERLAND COUNT'1(i,_ ot 2014 AUG 13 PM 3: 19 CUMBEPLAN) COUNTY PENNSYLVANIA u OFFICE OF THE SHERIFF Jaquay Williams (et al.) vs. GGNSC Equity Holdings, LLC (et al.) Case Number 2014-4583 SHERIFF'S RETURN OF SERVICE 08/06/2014 01:10 PM - Deputy Jamie DiMartle, being duly sworn according to law, served the requested Writ of Summons by handing a true copy to a person representing themselves to be Nicole Carr, Admissions Director, who accepted as "Adult Person in Charge" for GGNSC Camp Hill III LP d/b/a Golden Living Center - Camp Hill at 46 Erford Road, East Pennsboro, Camp Hill, PA 17011. kUj Q Vf1-156C J I\AIE DIMARTLE, DEPUTY 09/06/2014 01:10 PM - Deputy Jamie DiMartle, being duly sworn according to law, served the requested Writ of Summons by handing a true copy to a person representing themselves to be Nicole Carr, Admissions Director, who accepted as "Adult Person in Charge" for GGNSC Camp Hill III GP LLC at 46 Erford Road, East Pennsboro, Camp Hill, PA 17011. SHERIFF COST: $60.95 August 07, 2014 ' untySUite Sheriff,'ielaosofl.. Inc. wai) cJ x JF4M�E DIMARTLE, DEPUTY SO ANSWERS, RONNY R ANDERSON, SHERIFF