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Supreme Cou"ro%Pennsylvania
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Docket No:
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The 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.
Commencement of Action:
Petition .
Declaration of Taking
® Complaint ® Writ of Summons a
III Transfer from Another Jurisdiction fi
LPlaintiff's Name:
eali mh2g-Ly av-eit, O`
Lead Defendant's Name:
Pe v dd t
Dollar Amount Requested: i within arbitration limits
Are money damages requested? M Yes E No
(check one) fi outside arbitration limits
Is this a Class Action Suit? Yes CJ No
Is this an MDJAppeal? I Yes Et No
Name of Plaintiff/ pellant's Attorney:
Check here if you have no attorney (are a Self -Represented [Pro Se] 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 Mass Tort)
El Intentional
O Malicious Prosecution
O Motor Vehicle
O Nuisance
O Premises Liability
O Product Liability (does not include
mass tort)
El Slander/Libel/ Defamation
• Other:
MASS TORT
O Asbestos
El Tobacco
• Toxic Tort - DES
O Toxic Tort - Implant
O Toxic Waste
O Other:
PROFESSIONAL LIABLITY
10 Dental
O Legal
O Medical
El Other Professional:
CONTRACT (do not include Judgments)
0 Buyer Plaintiff
O Debt Collection: Credit Card
O Debt Collection: Other
Employment Dispute:
Discrimination
O Employment Dispute: Other
El Other:
REAL PROPERTY
0 Ejectment
O Eminent Domain/Condemnation
O Ground Rent
O Landlord/Tenant Dispute
O Mortgage Foreclosure: Residential
O Mortgage Foreclosure: Commercial
O Partition
0 Quiet Title
O Other:
CIVIL APPEALS
Administrative Agencies
• Board of Assessment
O and of Elections
aDept. of Transportation
• Statutory Appeal: Other
• Zoning Board
• Other:
MISCELLANEOUS
O Common Law/Statutory Arbitration
O Declaratory Judgment
19 Mandamus
O Non -Domestic Relations
Restraining Order
0 Quo Warranto
0 Replevin
0 Other:
Updated 1/1/2011
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTV, PENNSYLVANIA
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(Type your name) 1 --rel/79
Vs. Driver's Registration Appeal
Commonwealth of Pennsylvania
Department of Transportation
Bureau of Drivers Licensing
APPEAL OF DRIVER'S LICENSE/AUTO REGISTRATION SUSPENSION
Np NOW, this (enter today's date)
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�\ , by his/her attorney, and states as foliows:
1. Appellant's PA operator's number or automobile registration number is:
20 \'/
, comes the Appellant, (Type your name)
1 (
2. PennDOTproposes, bvNotice dated (insert "mai|ino"date here) \~��i're�'` , 20 , to suspend
driving privileges automobile registration for a period of (Insert ength of suspension)
pursuant to Section
of the Vehicle Code, which
suspension is to be effective (Insert suspension effective date) , 20
****A copy of the Notice sent by PennDOT is attached to this Appeal****
3. The suspension of Appellant's operating privileges is contrary to law in that:
(Check those which apply)
The police lacked reasonable grounds to stop Appellant and / or request Appellant to submit to a chemical
test.
Appellant did not knowingly or intelligently refuse a chemical test;
The conviction on which AppeUant's suspension is based was overturned by successfu appeal, OR is currently
under appeal. (Attach a copy of the court docket this Appeal).
Other (Specify reason;)
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CD
--(
1
-OR-
The suspension of Appellant's automobile registration is contrary to law in that:
My failure to have insurance was for a period of Iess than 31 days AND | did not
drive nor permit anyone else to drive my vehicle during the time it was without
insurance. (Attach proof of insurance to this Appeal and either a notarized
statement of PennDOT form MV -221 to document non -operation of the vehicle).
��
} ~| Other (specify . ^ �� . � td �
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VHEREFORE,Appe|brtnspectfu|lyrequests this Honorable Court to sustain the appeal from the suspen
sion
of operating privileges or automobile registration.
Respectfully submitted,
Sign name her
//
(�'�K�( L-/X�`{�_�p/</1
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�ypename here)
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VERIFICATION
The undersigned hereby states that the statements made in the attached Appeal ofSuspension or
Registration are true and correct to the best of my knowledgeinformation and belief. The undersigned understands
that the statements in the attached Appeal are made subject to the penalties of 18 Pa. C.S. Sec. 4904 relating to
unsworn falsification to authorities.
Signature:
Type Name:
Address:
City / State / Zip Code:
Telephone Number:
Email address:
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COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF TRANSPORTATION
BUREAU OF MOTOR VEHICLES
PO BOX 68674
HARRISBURG, PA 17106-8674
www.dmv.state.pa.us
KIMBERLY R CASARELLA
1481 TIMBER BROOK DR
MECHANICSBURG, PA 17050
Dear Customer:
WID* 141609999008224 001
TITLE* 64813027
PROCESSING DATE 140609
TRANSACTION CODE 00060
OFFICIAL NOTICE MAIL DATE: 06/16/14
The Department recently requested that you provide us with proof of financial responsibility (insurance) for the
following vehicle:
MAKE: TOYOTA YEAR: 2007 BODY TYPE: SEDAN
LICENSE PLATE#: GFK6330 TITLE#: 64813027 VIN#: 2T1BR30E57C855353
This information was requested because GEICO GENERAL INSURANCE COMPANY notified us that the
insurance policy covering the vehicle listed above was terminated on 04/20/14. Either no response was received
or the information you provided was not acceptable.
As a result, the registration for the vehicle listed above will be suspended for three months effective 07/21/14 at
12:01 A.M. as authorized by Section 1786(d) of the Vehicle Code.
THIS IS A FINAL ORDER OF SUSPENSION. You are required to return your current registration plate,
sticker and card to the Department immediately. Credit toward serving this suspension will not begin until the
Department receives your registration products. Additionally, you are required to pay a restoration fee in the
amount of $50 to the Department in accordance with Section 1960 of the Vehicle Code. Please make check or
money order payable to the PA Department of Transportation. Do not send cash. You can also pay by credit
card online at www.dmv.state.pa.us by selecting "Pay Your Financial Responsibility Restoration Fee". Within
30 days of your eligibility date for restoration, you will also be required to show proof of insurance for this vehicle.
We have enclosed a self-addressed envelope for your use when corresponding and a mailing label to assist with the
return of your registration plate, sticker and card. When the Department receives your registration products, we
will send you a letter within 3 weeks confirming that they were received. If, after 3 weeks of mailing your
registration plate, sticker and card to the Department you do not receive a letter stating your registration products
were received, please contact us immediately.
You have the right to appeal this suspension to the Court of Common Pleas of the county of your residence within
thirty(30) days of the mail date of this letter. If you file an appeal in the County Court, the Court will give you
a time -stamped certified copy of the appeal. In order for the appeal to be valid, you must send this time stamped
certified copy of the appeal by certified mail to:
Pennsylvania Dept of Transportation
Office of Chief Counsel
1101 S Front Street -3rd Floor
Harrisburg, PA 17104-2516
.. �
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
allo. �53/1 &It'll Z '7
(Print your name) I
Vs.
Commonwealth of Pennsylvania
Department of Transportation
Bureau of Driver Licensing
Driver's License/Auto Registration Appeal
ORDER SCHEDUUNG HEARING ON APPEAL
AND NOW, this /HA day of 20 /i a hearing is scheduled
on the appeal of Petitioner for the
day of ,2O ���
at Nd g
in Courtroom # of the Cumberland County Courthouse, One Courthouse Square, 4th
Floor, Carlisle,
PA 17013, at which time testimony will be taken and argument heard.
A copy of this Order has been served on Appellant. (t shall be Appellant's responsibility to serve
a copy of this Appeal, all pttachments, and this Order on the attorney for the Commonwealth, at the
following address:
Office of Chief Counsel
Vehicle and Traffic Law Division
Riverfront Office Center, 3rd Floor
1101 South Front Street
Harrisburg, PA 17104'2516
It shall further be Appellant's responsibility to file a Certificate of Service with the Prothonotary
stating that service was made on the Commonwealth of Pennsylvania.
n.LL
U the �
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Judge
Thomas A. Placey
Common Pleas Judge
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTYPENNSYLVANIA
r� Ceisocre,it9,rv\���� �
(Type your name) '
Vs.
Commonwealth of Pennsylvania
Department of Transportation
Bureau of Driver Licensing
No.
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Driver's License/Auto Registration Appeal
CERTIFICATE OF SERVICE
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The undersigned hereby certi�esthat on ��
\'7 \
,ZO , i caused to be
mailed by regular mail, postage prepaid, a copy of the Appeal, Order Scheduling Hearing, and
all attachments, to:
Date: \~� : it -f
Office of Chief Counsel
Vehicle and Traffic Law Division
Riue,frontOffice Center, 3rd Floor
1101 South Front Street
Harrisburg, PA 17104-3516
Signature:
Type your Name:
Address:
City / State / Zip Code:
Telephone:
��
.---_- -'.-_-__-~~ , `_` n_.~�~
(-)n)-7570 -- `
** This form must be completely filled out and filed in the Prothonotary's office
promptly after mailing the documents to PennDOT **
Kimberly Casarella
VS
Commonwealth of PA
Dept. of Transportation Bureau of Driver Licensing
In the Court of Common Pleas of
Cumberland County, Pennsylvania
No.14-5312
PRAECIPE
Civil Term
I would like to withdraw my request for a hearing. I no longer wish to appeal my
registration. I will not be in court that day. 1 do ,„..10A- vIcku.e., a r\
0.9t- (\of- vu-ckrd ayisk-efmenLtiA
C5f,r) nrEcYlwealk.-> 6 P PA
C—)
David D. Buell, Prothonotary
Oi
a-Hoff4
KIMBERLY R. CASARELLA,
Petitioner
v.
COMMONWEALTH OF PENNSYLVANIA,
DEPARTMENT OF TRANSPORTATION,
BUREAU OF MOTOR VEHICLES,
Respondent
IN THE COURT OF
COMMON PLEAS OF
CUMBERLAND COUNTY
NO. 14-5312 CIVIL TERM
VEHICLE REGISTRATION
SUSPENSION APPEAL
ORDER
AND NOW, this 18th day of December, 2014, the appeal filed in the above -
captioned matter is:
Attest:
REMANDED to the Department of Transportation for
correction of its records.
DISMISSED and the suspension which is the basis of this
appeal shall be REINSTATED.
SUSTAINED and the suspension which is the basis of this
appeal shall be RESCINDED.
WITHDRAWN and the suspension which is the basis of this
appeal shall be REINSTATED.
CONTINUED and RESCHEDULED for the day of
, 2015, at .m., in Courtroom
Room No. of the Cumberland County Courthouse,
Carlisle, Pennsylvania.
.r-
-C
✓ Kimberly R. Casarella, 1481 Timber Brook Drive, Mechanicsburg, PA 17050
Philip M. Bricknell, Esq., PennDOT, Riverfront Office Center, Office of Chief Counsel,
3rd Floor, 1101 South Front Street, Harrisburg, PA 17104-2516
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