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HomeMy WebLinkAbout14-6780S E C T I 0 N A S E C T I 0 N Supreme Court of Pennsylvania Court:of Comm• on Pleas Civil, CoveSheet Gv Mf- eYZLAk•-i,b,(County For Prothonotary Use Only: !/ 1/ , t/ , ,,,, Docket No: /y- 607 g) cu'til 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: ❑ Complaint ❑ Writ of Summons ER Petition Transfer from Another Jurisdiction ❑ Declaration of Taking Lead Plaintiff's Name: S Ara AN i- F (-3A'RN 11`2*- Lead Defendant's Name: Pex\ h� a T Are money damages requested? ❑ Yes ❑ No Dollar Amount Requested: ❑within arbitration limits (check one) ) ❑outside arbitration limits Is this a Class Action Suit? ❑ Yes - ❑ No Is this an MDJAppeal? Yes - No Name of Plaintiff/Appellant's Attorney: g Check here if you have no attorney (are a Self -Represented I Pro Sed 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) ❑ Intentional ❑ Malicious Prosecution ❑ Motor Vehicle ❑ Nuisance O Premises Liability O Product Liability (does not include MOSS toil) ❑ Slander/Libel/ Defamation O Other: MASS TORT O Asbestos ❑ Tobacco ❑ Toxic Tort - DES • Toxic Tort - Implant ❑ Toxic Waste ❑ Other: PROFESSIONAL LIABL1TY ❑ Dental ❑ Legal ❑ Medical O Other Professional: CONTRACT (do not include Judgments) O Buyer Plaintiff ❑ Debt Collection: Credit Card O Debt Collection: Other O Employment Dispute: Discrimination O Employment Dispute: Other O Other: REAL PROPERTY O Ejectment ▪ Eminent Domain/Condemnation O Ground Rent ❑ Landlord/Tenant Dispute ❑ Mortgage Foreclosure: Residential ❑ Mortgage Foreclosure: Commercial • Partition ❑ Quiet Title O Other: CIVIL APPEALS Administrative Agencies O Board of Assessment ❑ Board of Elections pg Dept. of Transportation Statutory Appeal: Other ❑ Zoning Board O Other: MISCELLANEOUS O Common Law/Statutory Arbitration ❑ Declaratory Judgment O 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 COUNTY, PENNSYLVANIA SARd BAF' N H -A R-1- No. lL% - �o -1 ��% c , t �ec`" r. -w, --0 3 .- rrt vs. Driver's License/Auto Registration Appeal cn N ^C, 'Z7 3? f727. \si (Type your name) Commonwealth of Pennsylvania Department of Transportation Bureau of Drivers Licensing APPEAL OF DRIVER'S LICENSE/AUTO REGISTRATION SUSPENSION rn —4 C) AND NOW, this (enter today's date) NOV , 2019 , comes the Appellant, (Type your name) SA1ZAL1- 1311.1a -N , by his/her attorney, and states as follows: 1. Appellant's PA operator's number or automobile registration number is: Z6 875" 86' 2. PennDOT proposes, by Notice dated (insert "mailing" date here) OG+ ZZ , 20 14 , to suspend Appellant's driving privileges automobile registration for a period of (Insert length of suspension) pursuant to Section 15 Lk 1 B11 of the Vehicle Code, which suspension is to be effective (Insert suspension effective date) PEC 3 , 20 O y ****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 Appellant's suspension is based was overturned by successful appeal, OR is currently under appeal. (Attach a copy of the court docket this Appeal). Other (Specify reason:) 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 less than 31 days AND I 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:) WHEREFORE, Appellant respectfully requests this Honorable Court to sustain the appeal from the suspension of operating privileges or automobile registration. Respectfully submitted, (Sign name here) SACZ-AH 16A1Z-N (Type name here) VERIFICATION The undersigned hereby states that the statements made in the attached Appeal of Suspension or Registration are true and correct to the best of my knowledge, information 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: 300 N. P,2 -CH - City / State / ,2C City/State/ Zip Code: MZCHANICSS3UI QA 170S5- Telephone 70SSTelephone Number: 111 6 t d.322 Email address: MISSSAR A\-1Z,tifi--4 @ M A 1 L. Co M SARAkI \-3ARNNA9.. - 2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF TRANSPORTATION Bureau of Driver Licensing Mail Date: OCTOBER 29, 2014 SARAH RUTH BARNHART 300 N ARCH ST MECHANICSBURG PA 17055 Dear MS. BARNHART: WID * 142956180735564 001 PROCESSING DATE 10/22/2014 DRIVER LICENSE * 26875864 DATE OF BIRTH 04/25/1982 This is an Official Notice of the Suspension of your Driving Privilege as authorized by Section 1547B1I of the Pennsylvania Vehicle Code. As a result of your violation of Section 1547 of the Vehicle Code, CHEMICAL TEST REFUSAL, on 10/18/2014: Your driving privilege is SUSPENDED for a period of 1 YEAR(S) effective 12/03/2014 at 12:01 a.m. COMPLYING WITH THIS SUSPENSION You must return all current Pennsylvania driver's licenses, learner's permits, temporary driver's licenses (camera cards) in your possession on or before 12/03/2014. You may surrender these items before, 12/03/2014, for earlier credit; however, you may not drive after these items are surrendered. YOU MAY NOT RETAIN YOUR DRIVER'S LICENSE FOR IDENTIFICATION PURPOSES. However, you may apply for and obtain a photo identification card at any Driver License Center for a cost of $27.50. You must present two (2) forms of proper iden- tification (e.g., birth certificate, valid U.S. passport, marriage certificate, etc.) in order to obtain your photo identification card. You will not receive credit toward serving any suspension until we receive your licensets). Complete the following steps to acknowledge this suspension. 1. Return all current Pennsylvania driver's licenses, learner's permits and/or camera cards to PennDOT. If you do not have any of these items, send a sworn nota- rized letter stating you are aware of the suspension of your driving privilege. You must specify in your letter why you are unable to return your driver's license. Remember: You may not retain your driver's license for identification purposes. Please send these items to: Pennsylvania Department of Transportation 142956180735564 Bureau of Driver Licensing P.O. Box 68693 Harrisburg, PA 17106-8693 2. Upon receipt, review and acceptance of your Pennsylvania driver's license(s), learner's permit(s), and/or a sworn notarized letter, PennDOT will send you a receipt con- firming the date that credit began. If you do not re- ceive a receipt from us within three (3) weeks, please contact our office. Otherwise, you will not be given credit toward serving this suspension. PennDOT phone numbers are listed at the end of this letter. 3. If you do not return all current driver license pro- ducts, we must refer this matter to the Pennsylvania State Police for prosecution under SECTION 1571(a)(4) of the Pennsylvania Vehicle Code. PAYING THE RESTORATION FEE You must pay a restoration fee to PennDOT to be restored from a suspension/revocation of your driving privilege. To pay the applicable restoration fee, payment can be made at anytime online @ www.dmv.state.pa.us or mailed to the ad- dress listed below. Please include your driver number on your check, money order or correspondence. Pennsylvania Department of Transportation Bureau of Driver Licensing P.O. Box 68693 Harrisburg, PA 17106-8693 The Restoration Fee is based on the Consumer Price Index and subject to change. For the current restoration fee amount due, please visit PennDOT's website at www.dmv.state.pa.us to obtain a copy of your restoration requirements letter. If you do not have internet access, please call PennDOT's Customer Care Center at 1-800-932-4600 to request a copy of your restoration requirements letter. Please note: Paying the restoration fee DOES NOT satisfy the requirement to acknowledge your suspension/revocation. If you have not acknowledged your suspension/revocation, please follow the instructions listed under "Complying with this Suspension/Revocation". 142956180735564 APPEAL You have the right to appeal this action to the Court of Common Pleas (Civil Division) within 30 days of the mail date, OCTOBER 29, 2014, of this letter. If you file an ap- peal in the County Court, the Court will give you a time - stamped certified copy of the appeal. In order for your appeal to be valid, you must send this time -stamped certi- fied copy of the appeal by certified mail to: Pennsylvania Department of Transportation Office of Chief Counsel 1101 South Front Street Third Floor, Riverfront Office Center Harrisburg, PA 17104-2516 Remember, this is an OFFICIAL NOTICE OF SUSPENSION. You must return all current Pennsylvania driver license products to PennDOT by 12/03/2014. Sincerely, Kara N. Templeton, Director Bureau of Driver Licensing INFORMATION 8:00 a.m. to 5:00 p.m. IN STATE 1-800-932-4600 TDD IN STATE OUT-OF-STATE 717-412-5300 TDD OUT-OF-STATE WEB SITE ADDRESS www.dmv.state.pa.us 1-800-228-0676 717-412-5380 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA S4w-AV, RA. No. (Type your name) Vs. Commonwealth of Pennsylvania Department of Transportation Bureau of Driver Licensing t7 leo Driver's License/Auto Registration Appeal CERTIFICATE OF SERVICE The undersigned hereby certifies that on Nov 21 , 201y , I mailed by regular mail, postage prepaid, a copy of the Appeal, Order Schedu all attachments, to: Date: IV oV Z l , 20 1%1 Office of Chief Counsel Vehicle and Traffic Law Division Riverfront Office Center, 3`d Floor 1101 South Front Street Harrisburg, PA 17104-2516 Signature: Type your Name: Address: caused to be ling Hearing, and C") t ) o ri co m c r ro f""" D C' G7 SAQA1# ZPrC2N HA R.+ SotS-'l- City / State / Zip Code: P^ FcAAANkCSDAJR..el PA \7©55' Telephone: • 1 l -z G161 O37...1-- ** This form must be completely filled out and filed in the Prothonotary's office promptly after mailing the documents to PennDOT ** ru N ri U.S. Postal Service. —CERTIFIED MAILTM RECEIPT (Domestic Mail Only; No Insurance Coverage Provided) For delivery information visit our website at www.usps.com® Postage Certified Fee 0 Return Receipt Fee CI (Endorsement Required) CI Restricted Delivery Fee ci (Endorsement Required) u7 H Total Postage & Fees 0 C3 N Sent To 0013 $3.30 $13.41) $4.49 16 Postmark Here 11/21/2014 gtreet, Apt, No.; or PO Box No. City, State, ZIP+4 .1 PS Form 3800, August 2006 See Reverse for Instructions . r 1 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA SARA (Print your name) No. y — (o c)v--(4e(xl- Vs. Driver's License/Auto Registration Appeal Commonwealth of Pennsylvania Department of Transportation Bureau of Driver Licensing ORDER�DEQSCHEDULING HEARING ON APPEAL AND NOW, this a7 6' day of___24ze, 20/x% , a hearing is scheduled on the appeal of Petitioner for the aO day of 64-14 4,4M , 2045- at / : 3c) i° M in Courtroom # V 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. -P/ 7;2.5_ --Sae-ah 81, -Ake--/ 6p„`es Ata./.0.4/ lt4a4//y y --t; By the Court,