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14-7324
1 t Supreme Court of'Pennsylvania Court'd Common-Pleas For Prothonotary Use Only: Cil'Cover:Shret Docket No: cuMBRLANb :' County I M. V 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: S ® Complaint M Writ of Summons [3 Petition ® Transfer from Another Jurisdiction 0 Declaration of Taking E C Lead Plaintiff's Name: Lead Defendant's Name: ,r MOHAMED MUSE LINCOLN VAN PELT Dollar Amount Requested: Owithin arbitration limits I Are money damages requested? El Yes 0 No (check one) x®outside arbitration limits O N Is this a Class Action Suit? El Yes El No Is this an MDJAppeal? 0 Yes 0 No A Name of Plaintiff/Appellant's Attorney: John B. Dougherty, Esquire ® 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) CONTRACT(do not include Judgments) CIVIL APPEALS 0 Intentional [3 Buyer Plaintiff Administrative Agencies ® Malicious Prosecution 0 Debt Collection:Credit Card © Board of Assessment ®x Motor Vehicle E3 Debt Collection:Other E3 Board of Elections Nuisance Dept.of Transportation Premises Liability Statutory Appeal:Other S ®Product Liability(does not include ❑Employment Dispute: Emass tort) Q Slander/Libel/Defamation Discrimination 0C 0 Other: Employment Dispute:Other Zoning Board T Other: I 0 Other: O MASS TORT n Asbestos N [3 Tobacco ® Toxic Tort-DES E) Toxic Tort-Implant REAL PROPERTY MISCELLANEOUS Toxic Waste 0 Other: 1:1 Ejectment � Common Law/Statutory Arbitration B El Eminent Domain/Condemnation 0 Declaratory Judgment Ground Rent Mandamus Landlord/Tenant Dispute Non-Domestic Relations 0 Mortgage Foreclosure:Residential Restraining Order PROFESSIONAL LIABLITY ®Mortgage Foreclosure:Commercial ®Quo Warranto © Dental Partition ®Replevin Legal Quiet Title [3 Other: [; Medical E3 Other: Other Professional: Updated 1/1/2011 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,PENNSYLVANIA CIVIL DIVISION Plaintiff(s) &Address(es) y Mohamed Muse : Case No. " 30 /Civil Term 645 Cumberland Point Mechanicsburg, PA 17050 Civil Action—Law VS. Defendant(s) &Address(es) Lincoln Van Pelt 1121 York Road Mechanicsburg,PA 17055 rA:; Tracy Van Pelt 4' 1121 York Road Mechanicsburg, PA 17055 Allstate Fire &Casualty Insurance Co. ,.. 2012 Market Street Camp Hill,PA 17011 PRAECIPE FOR WRIT OF SUMMONS TO THE PROTHONOTARY/CLERK OF SAID COURT: Issue summons in the above case. 3 Writ of Summons shall be issued and forwarded to Sheriff. Dated: �� �It '" 41A� Signature of Attorney Print Name: John B.Dougherty Address: 800 North Second Street Harrisburg,PA 17102 Telephone#: 717-238-1657 Supreme Court ID Number: 70680 s , WRIT OF SUMMONS r YOU ARE NOTIFIED THAT THE ABOVE-NAMED PLAINTIFFS AGAINST YOU. )HAS/HAVE CONINIENCED AN ACTION S` X � Prothonotary/Clerk, Civil Division Date: Deputy- SHERIFF'S OFFICE OF CUMBERLAND COUNTY Ronny R Anderson Sheriff THEPROTF Jody S Smith Chief Deputy Richard W Stewart Solicitor 2015 JMiI 15 PM 3: CUMBERLAND COLHTZ` PENNSYLVANIA, Mohamed Muse vs. Lincoln Van Pelt (et al.) Case Number 2014-7324 SHERIFF'S RETURN OF SERVICE 12/23/2014 05:32 PM - Deputy Shawn Harrison, being duly sworn according to law, served the requested Writ of Summons by handing a true copy to a person representing themselves to • - Theod• e Van Pelt, husband, who accepted as "Adult Person in Charge" for Tracy L Van Pelt ,, 1 Y• Road, Monroe Township, Mechanicsburg, PA 17055. SHAR"' DEPUTY 12/23/2014 05:52 PM - Deputy Shawn Harrison, being duly sworn according to law, served th- -quested Writ of Summons by "personally" handing a true copy to a person representinf; h--'sel - to be the Defendant, to wit: Lincoln Van Pelt at 331 N. Baltimore Avenue, Mt. Holly Springs, • , •6 AA 'i r1 HA' P eV ON, DEPUTY 12/31/2014 02:21 PM - Deputy Tim Black, being duly sworn according to law, served the requested Writ of Summons by handing a true copy to a person representing themselves to be Jan Vajda, Agent, who accepted as "Adult Person in Charge" for Allstate Fire & Casualty Insurance Company at 2200, Camp Hill Boro, Camp Hill, PA 17055. ACK, TIM SHERIFF COST: $125.00 SO ANSWERS, January 02, 2015 RONNY R ANDERSON, SHERIFF (c} CountySuite Sheriff, Teleosott, Inc.