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HomeMy WebLinkAbout14-6186S E C T I 0 N A S E C T 1 0 N Supreme Court of Pennsylvania. Court -'of -Common Pleas C:ivil2Covei Slieet 64-4t\-":./&-:;, &V.'. County For Prothonotary Use Only: f>;/./ . S/ : Docket No: 6(.? -(P Ci ki' I The information collected on this form is used solely for Court administration pu poses. 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 0 -- Transfer from Another Jurisdiction Lead Plaintiff's Name: C o t.ff S tpie JIR Lead Defendant's Name: 'Ve_nn DO Dollar Amount Requested: withinOarbitration limits Are money damages requested? Yes []'No (check one) outside arbitration limits Is this a Class Action Suit? Yes No Is this an MDJAppeal? Yes EYNo Name of Plaintiff/: ppellant's Attorney: E 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) O Intentional O Malicious Prosecution O Motor Vehicle 0 Nuisance O Premises Liability O Product Liability (does not include mass tort) O Slander/Libel/ Defamation O Other: MASS TORT • Asbestos O Tobacco • Toxic Tort - DES O Toxic Tort - Implant O Toxic Waste O Other: PROFESSIONAL LIABL1TY O Dental 0 Legal O Medical O Other Professional: CONTRACT (do not include Judgments) O Buyer Plaintiff O Debt Collection: Credit Card O Debt Collection: Other O Employment Dispute: Discrimination O Employment Dispute: Other O Other: REAL PROPERTY O Ejectment O Eminent Domain/Condemnation O Ground Rent O Landlord/Tenant Dispute O Mortgage Foreclosure: Residential O Mortgage Foreclosure: Commercial O Partition O Quiet Title O Other: CIVIL APPEALS Administrative Agencies O Board of Assessment O Board of Elections Lept. of Transportation • Statutory Appeal: Other O Zoning Board . O Other: MISCELLANEOUS O Common Law/Statutory Arbitration • Declaratory Judgment O Mandamus 0 Non -Domestic Relations Restraining Order 0 Quo Warranto 0 Replevin 0 Other: Updated 1/1/2011 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA C�0-cL \.e (Type your na e) Vs. Commonwealth of Pennsylvania Department of Transportation Bureau of Drivers Licensing No. 1g Cj -p3 ma) r*7 Driver's License/Auto Registration AppeE ,r .<o =cD APPEAL OF DRIVER'S LICENSE/AUTO REGISTRATION SUSPENSION AND NOW, this (enter today's date) C)al ,1U �\. � \12- , by his/her attorney, grt/t 7s 20 , comes the Appellant, (Type your name) ik16 and states as follows: X00`^ 1. AM41344rator's number or automobile registration number is: 2. PennDOT proposes, by Notice dated (insert "mailing" date here) 1% , 20 Appellant's []driving privileges y,to suspend +automobile registration for a period of (Insert length of suspension) \2 OM( pursuant to Section n ctv) La) of the Vehicle Code, which suspension is to be effective (Insert suspension effective date) ©C\-- 9)? , 20 ki4 ****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) gy7>f 30_3-03 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 Appellant's suspension is based was overturned by successful appeal, OR is currently under appeal. (Attach a copy of the court docket this Appeal). 1-91.'. l Other (Specify reason:) umec -From pe,rd oc\ aloe 1 Sia.-iik3 r L afiian would he Sopenck'd.ctue ft) no Lneurclrnee. kiGa CI:n(2LnCia.(, proVems a.nd CLi&* dare Car from 810514- Q!6$1 i /. QlleJ ft nndofi o , A101:) st/ &nfCar . d#e tri Loft needed )b (Acid aiocerl4icks ; CAribenef &it Re -Q ,Kid 4o cwt 13ic-Friend wl tfUA 901X431(11 (Aryier M 1.42_0 0ox) G-CY% -110 iler NNE `clod veil Sept- 54), 20i4 @ rntd n'I - Q.nd mc -C) a C,op6 o{ - r iris. On Q 10 1 lU, gui- a-naWiar )e reciop �Oar Wort, Pscixe, g.(1 -Frena acct ve Q4Al2. cvatta t'D he Ise acthe On 41-10 tPS MO. We, did 406 We 0( a11i;i►' 6at,r►cj MnoL4 d►d� \f‘° N ca\\ed, 41°) Spode 11) �0, Cvmerl. sa.06 god �eP� 1 `z s uAanciz. Cacd`. \Pc CDP1/46 , unGuyinc o . CCw - , Ak J4\e c-hv e c3 c cam- 1Rz6 e yed Le. S nJ A\-\sL 'u sacmcQ. 3 GaN- cpd '0\c_ \-ko V.,\A AN ela Jam. a Coe cenk Cu-/, rrlsv‘, Sic i crz l d 0° 4,1(\a_/- 412 1 S v-vaicvs. Cover Ac Eit4ec-H ve Qs r ,fie(- " V11- VA064 Cow CLS C�1 Sec* 8 k 2_04 14- Qem ckcA v\d. ve l d us cinSf2ADV g, 11-4 WC1,5 C lAkpicikaLasevim ����isoNc -OR - The suspension of Appellant's automobile registration is contrary to law in that: My failure to have insurance was for a period of Jess than 31 days AND 1 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 reason:) � ~�-��`c p WHEREFORE, Appellant respectfully requests this Honorable Court to sustain the appeal from the suspension of operating privileges or automobile registration. Respectfully submitted, (Sign name ere) ��/� �- (Type rY'ame here) VERIFICATION The undersigned hereby states that the statements made in the attached Appeal of Suspension or Registration are true andcorrect to the bestof my kriowledge, information and belief. The undersigned understands that the statementin 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: 2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF TRANSPORTATION BUREAU OF MOTOR VEHICLES PO BOX 68674 HARRISBURG, PA 17106-8674 www.dmv.state.pa.us GARY L SEIPLE 512 BRIDGE ST APT 3 NEW CUMBERLND, PA 17070 WID* 142549956000224 001 TITLE$ 57231956 PROCESSING DATE 140911 TRANSACTION CODE 48900 OFFICIAL NOTICE MAIL DATE: 09/18/14 Dear Customer: The Department recently requested that you provide us with proof of financial responsibility (insurance) for the following vehicle: MAKE: HYUNDAI YEAR: 2002 BODY TYPE: SEDAN LICENSE PLATE#: HRL4948 TITLE#: 57231956 VIN#: KMHWF35H82A603120 This information was requested because GEICO CASULTY CO notified us that the insurance policy covering the vehicle listed above was terminated on 08/06/14. 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 10/23/14 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 du 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 If you believe your insurance coverage was terminated in error or you did not receive proper notice of your insurance termination, you should file a complaint with the Pennsylvania Insurance Department, Bureau of Consumer Services. Complaints can be filed via the website at www.insurance.pa.gov or mailed to the Pennsylvania Insurance Department, Bureau of Consumer Services 1209 Strawberry Square, Harrisburg, PA 17120. Please include your insurance company name and policy number with your complaint. By Order of 044 -G414-c-4140.— Director Bureau of Motor Vehicles Department of Transportation Information (8:00 Pennsylvania Out of State TDD Pennsylvania TDD Out of State AM to 5:00 PM) 800-932-4600 717-412-5300 800-228-0676 717-412-5380 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA C* " \e 3Q (Type yak name) Vs. Commonwealth of Pennsylvania Department of Transportation Bureau of Driver Licensing No. /L—(�O 641 I Driver's License/Auto Registration Appeal CERTIFICATE OF SERVICE The undersigned hereby certifies that on ) 01 c9 9, , 20 1`1, I caused to be mailed by regular mail, postage prepaid, a copy of the Appeal, Order Scheduling Hearing, and w- 1 gib. all attachments, to: Date: i b'aa , 20 ILI Office of Chief Counsel Vehicle and Traffic Law Division K Riverfront CS�fice Center, 3rd Floor 1101 South Front Street Harrisburg, PA 17104-2516 Signature: Type your Name: Address: City / State / Zip Code: Telephone: 1:1) 512 3rridotSt- 41- lAtuD Cum,.1c7 ek_l a:tro _ `Qcx. no -ib -l1'1 31a -25 ** This form must be completely filled out and filed in the Prothonotary's office promptly after mailing the documents to PennDOT ** IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA �xe No. (Print your name) Vs. Driver's License/Auto Registration Appeal Commonwealth of Pennsylvania Department of Transportation Bureau of Driver Licensing ORDER SCHEDULING HEARING ON APPEAL AND NOW, this day of ( _, 20_1,4t., a hearing is scheduled on the appeal of Petitioner for the day of at -!�—:d6—AM 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. It shall be Appellant's responsibility to serve a copy of this Appeal, all attachments, 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. By the Court, .. Judge rig ' A �n Z:CD