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Home My WebLink About14-7010r S C T I N !A s E C T I 0 N Supreme Coq of ° ennsylvania Cour ofeCommo` yleas Cil overs beet I County For Prothonotary Use Only: Petition Declaration of Taking )'.l tIP - Docket No: #--- 7° 1° 4/. `1 -G 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 IX Complaint 5 Writ of Summons 5 * Transfer from Another Jurisdiction ❑ Lead Plaintiff's Name: •Lead 66n Meed, Defendant's Name: PC/2n ba -- Dollar Amount Requested: I within arbitration limits Are money damages requested? ❑ Yes No (check one) 0 outside arbitration limits Is this a Class Action Suit? IR Yes 'No Is this an MDJAppeal? X Yes No fki • Name of Plaintiff/Appellant's Attorney: 12( 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) Intentional 9 Malicious Prosecution 0 Motor Vehicle El Nuisance ❑ Premises Liability 9 Product Liability (does not include mass tort) 0 Slander/Libel/ Defamation O Other: MASS TORT J Asbestos . O Tobacco O Toxic Tort - DES Toxic Tort - Implant El Toxic Waste O Other: PROFESSIONAL LIABLITY C7 Dental O Legal 0 Medical 0 Other Professional: CONTRACT (do not include Judgments) Buyer Plaintiff u Debt Collection: Credit Card El Debt Collection: Other J O Employment Dispute: Discrimination 0 Employment Dispute: Other O Other: REAL PROPERTY El Ejectment 0 Eminent Domain/Condemnation 0 Ground Rent Landlord/Tenant Dispute 0 Mortgage Foreclosure: Residential O Mortgage Foreclosure: Commercial El Partition 9 Quiet Title O Other: 5 CIVIL APPEALS Administrative Agencies Board of Assessment 0 Board of Elections ept. of Transportation Statutory Appeal: Other 5 El Zoning Board ▪ Other: MISCELLANEOUS ▪ Common Law/Statutory Arbitration 0 Declaratory Judgment Mandamus Non -Domestic Relations Restraining Order 0 Quo Warranto 0 Replevin Other: Lei 5 5 Updated 1/1/2011 (T74/1(--)474.1 your name) Vs. IN THE COURT OF COMMON PLEAS OF CUMBERLAND�COUNTY, PENNSYLVANIA No. /!( 70/0 Driver's License/Auto Registration Appeal Orr ; rnry\ Commonwealth of Pennsylvania Department of Transportation Bureau of Drivers Licensing APPEAL OF DRIVER'S LICENSE/AUTO REGISTRATION SUSPENSION AND NOW, this (enter today's date) / Z.7p S , 20 / LI , comes the Appellant, (Type your name) , by his/her attorney, `(//4 and states as follows: Av,g(�i n Gjri h/l M 1. Appel yPAoperato number or automobile registration number is: 2. PennDOT proposes, by Notice dated (insert "mailing" date here) Appellant's , 20 /Z-1 , to suspend riving privileges automobile registration for a period of (Insert length of suspension) �n pursuant to Section suspension is to be effective (Insert suspension effective date) C,)- of the Vehicle Code, which t7_/17 ,20 Z-/ ****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) Fri CD —4C:) —T- C) —77 TC)—,, HThe police lacked reasonable grounds to stop Appellant and / or request Appellant to submit to a chemical test. nAppellant did not knowingly or intelligently refuse a chemical test; nThe 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). n Other (Specify reason:) L0/1". Cas -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, ign name here) (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: City / State / Zip Code: Telephone Number: Email address: 064- !o fpoi r ) 3 Ca 11-21AAwer L -Gin -C I7)//3bu/ /'4/ 17c� i0\ MW -A (717) 973 aeq z 4 7 @ fcr hoa . corn 2 COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF TRANSPORTATION Bureau of Driver Licensing Mail Date: NOVEMBER 12, 2014 AUSTIN RUFFER GRIMM 634 MUMPER LN DILLSBURG PA 17019 Dear MR. GRIMM: WID # 143099283535427 001 PROCESSING DATE 11/05/2014 DRIVER LICENSE # 31613739 DATE OF BIRTH 12/26/1997 This is an Official Notice of the Suspension of your Driving Privilege as authorized by Section 1538E of the Pennsylvania Vehicle Code. As a result of your 11/04/2014 conviction of violating Section 3362 of the Vehicle Code, EXCEEDING MAXIMUM SPEED, on 08/26/2014: ■ Your driving privilege is SUSPENDED for a period of 90 DAY(S) effective 12/17/2014 at 12:01 a.m. Before PennDOT can restore your driving privilege, you must follow the instructions in this letter for COMPLYING WITH THIS SUSPENSION, PAYING THE RESTORATION FEE and PROVIDING PROOF OF INSURANCE. You should follow ALL instructions very carefully. Even if you have served all the time on the suspension/revocation, we cannot restore your driving privilege until all the requirements are satisfied. 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 12/17/2014. You may surrender these items before, 12/17/2014, 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 identification (e.g., birth passport, marriage certificate, your photo identification card. two (2) forms of proper certificate, valid U.S. etc.) in order to obtain You will not receive credit toward serving any suspension until we receive your license(s). Complete the following steps to acknowledge this suspension. 1 143099283535427 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 notarized 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 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 confirming the date that credit began. If you do not receive 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 products, 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 a www.dmv.state.pa.us or mailed to the address 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. 143099283535427 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". PROVIDING PROOF OF INSURANCE Within the last 30 days of your suspension/revocation, we will send you a letter asking that you provide proof of insurance at that time. This letter will list acceptable documents and what will be needed if you do not own a vehicle registered in Pennsylvania. IMPORTANT: Please make sure that PennDOT is notified if you move from your current address. You may notify PennDOT of your address change by calling any of the phone numbers listed at the end of this letter. APPEAL You have the right to appeal this action to the Court of Common Pleas (Civil Division) within 30 days of the mail date, NOVEMBER 12, 2014, 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 your appeal to be valid, you must send this time -stamped certified 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 12/17/2014. Sincerely, Kara N. Templeton, Director Bureau of Driver Licensing 143099283535427 SEND FEE/LICENSE/DL-16LC/TO: Department of Transportation Bureau of Driver Licensing P.O. Box 68693 Harrisburg, PA 17106-8693 INFORMATION (8:00 AM TO 5:00 PM) IN STATE 1-800-932-4600 OUT-OF-STATE 717-412-5300 TDD IN STATE 1-800-228-0676 TDD OUT-OF-STATE 717-412-5380 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA use te.4A;w,fi (Type your name) No.( H"" 76/ Vs. Driver's License/Auto Registration Appeal Commonwealth of Pennsylvania c= .Rµ ., Department of Transportation r0�'� -'mn Bureau of Driver Licensing Z. n 'r. (P;- 1 -.<''p -r ---.- )7- c- c:_ 7"-X- r11 ea 7 / , u 20 � I caused to be�• CERTIFICATE OF SERVICE The undersigned hereby certifies that on mailed by regular mail, postage prepaid, a copy of the Appeal, Order Scheduling Hearing, and all attachments, to: Date: 0 -e -a 7 , 20 / Office of Chief Counsel Vehicle and Traffic Law Division Riverfront Office Center, 3rd Floor 1101 South Front Street Harrisburg, PA 17104-2516 Signature: Type your Name: Address: City / State / Zip Code: Telephone: C> H 63,E ii(se?A- (7er? (7/7) X33 -0 of ** 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 r(rnf No. (Print your name) Vs. Commonwealth of Pennsylvania Department of Transportation Bureau of Driver Licensing golo ObiL Driver's License/Auto Registration Appeal ORDER SCHEDULING HEARING ON APPEAL AND NOW, this dol of t-CeYWa �JG., 20 n4a hearing is scheduled on the appeal of Petitioner for the 7-th day of /12A/ZZA , 204f at 9 :..1e/tM in Courtroom # .3 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. Cor(Ls fr2vA &LL, 14/,641,3 1.21 e 1 ev, -0E:A 0.-p (-7--,2„syck4.14,0,., d/d J/i7 Judge 3