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HomeMy WebLinkAbout05-5387 )Zb 0 5' - :> 3 n Cw.-f -r;:, JUDGEMENT NOTE Mechanicsburl! , Pennsylvania, 01.06.2005 , $7846.02 FOR VALUE RECEIVED, I/we promise to pay to the order of Erie Insurance Group the sum of Seven Thousand Eil!ht Hundred Forty-six and 02/100 said sum to be payable said sum to be as follows: Fifty dollars, ($50.00) on the ~day of Februarv 2005 and Fifty dollars, ($50.00) on the 1st day of every month thereafter until the entire amount is paid in full, Iiwe hereby authorize and empower any attorney of any Court of Record of Pennsylvania or elsewhere, to appear for and confess Judgment against me for the sum due and payable hereon, pursuant to PA. RC.P. 2951 (a) (1) with or without declaration, with costs of suit, interest at the rate of6% per annum, an attorney's fee, release of errors, and without stay of execution; and I/we also waive the right of inquisition on any real estate that may be levied upon to collect this note; and I/we do hereby voluntarily condemn the same and authorize the Prothonotary to enter said voluntary condemnation upon any Fieri Facias that may be issued to collect said Judgment; and I/we furthpr agree that said estate may be sold on a Fieri Facias, and I/we do hereby waive and release all relief from any and all appraisement, stay of execution, exemption or bankruptcy laws of this or any other state now in force or hereafter to be passed, (L.S,) (L.S.) This note is given executed without duress or coercion and with full and complete HAR 0 7 ?aos understanding that upon failure to make payment as agreed, that my operating privileges may be suspended, Further, I do hereby acknowiedge that the damage incurred in the accident of 10,09,2004, for which this note is given resulted from my negligence and fault, and I do hereby acknowledge and waive my right to any hearing or trial on that issue. DRIVERDATEOFBIRTHX 1-;2S&X ~ DRIVER OPERATOR NO. X .1<;513,'317 '7 ~~/ (L.S.) OWNER DATE OF BIRTH l',J-.S -f:5 OWNER OPERATOR NO. S"',..r/r_ (L.S,) '-< r..>C\ :\) ;.. l"- f ~ f r ;), ~ \ ~f-r ~ f ~ () ~ c f ~ fr i c) "'-' ~ ~~~ \::J "") C:':";I ~-1 en C) :::J Q ,...... V. - ~ ,",- -l no; ~,-, ~ -' :r;-" <>0 _.J" -..:, c:> r en .r- (. 0 .... ("'- ~ ..() ~ '-' 'Q V\ \-- - \ '" .' ,'>\J "" "\ ~ ~ IJ'!, ,,", () 1" t Erie Insurance Group In The Court of Common Pleas Cumberland County, Pennsylvania vs, 0, NO, 05- S3.7 ~ lu-. CIVIL ACTION - Brandon Rogers To Brandon Rogers, Defendant (s) You are hereby notified that on acT';"_, l'l ,200.;' , the following (Order) (Decree) (Judgment) has been entered against you in the above-captioned case. Date: (!Ja,/,w /1 ;2005,' ~~7 I hereby certify that the name and address of The proper person (s) to receive this notice under Pa.. R. Civ. p, 235 is: Brandon Rogers 922l Hasting Dr Apt 204 Manassas VA 20110 r-.' 0 C? ,;:.;:, --1"1 <;;..r~ C3 C) ,-. -: ?? -';'" '-' '2 ::l (J1 ... ~t)M '-/<tCi j~~ ,) ~~,J'" II ~ ERIE, KERRY J, RITCHEY, CPCU, AIC Claims Manager ERIE INSURANCE GROUP Branch Office. 4901 Louise Dr. . Rossmoyne Business Center. P.O. Box 2013 .. Mechanicsburg. PA 17055 0710 (717) 795-8200' Toll Free 1-800-382-1304' Fax (717) 795-2315' wwwerieinsurance,com December 20, 2005 Cumberland County Prothonotary Cumberland County Courthouse I Courthouse Square Carlisle, Pa. l7013 Erie Claim No.: Ol0170774990 Erie Insured: John Gleim D/Accident: 10-9-04 Defendant: Brandon Rogers No. & Term: 05-5387 Civil Term Dear Prothonotary: I certify that the above-captioned judgment is as a result of a motor vehicle accident. Sincerely, ~~~ Louella Sanders, A.LC. Subrogation Specialist II cc: file The ERIE Is Above Allin SERViCE"", . Since 1925 ~~ - ?-'0 (::;;, "- - -:C\ c > r-;:...~ --.J ....::, ~ \' ~ _. (N ~" -+ ~ .:.1 '6 C> ~ L--\ 'y 9, T -;- _::I f-- ,. ~. ~, ~~ ----~ ,~- .---:--.) 57 " ;6-' " "