HomeMy WebLinkAbout05-6222
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
Docket No. (")S'-/.,,J).:1 Ciu~L I~
,
Samantha Cammack,
Plaintiff
Scott D. Cammack,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
NOTICE TO DEFEND AND CLAIM RIGHTS
You have been sued in court. If you wish to defend against the claims set forth in the
following pages, you must take prompt action. You are warned that if you fail to do so, the case
may proceed without you and a decree of divorce or annulment may be entered against you by
the court. A judgment may also be entered against you for any other claim or reliefrequested in
these papers by the plaintiff. You may lose money or property or other rights important to you,
including custody or visitation of your children.
When the ground for divorce is indignities or irretrievable breakdown of the marriage,
you may request marriage counseling. A list of marriage counselors is available in the Office of
the Prothonotary at the Dauphin County Courthouse, Front & Market Streets, Harrisburg, P A
17101.
IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY,
LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED,
YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW.
THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER.
IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFICE MAY BE ABLE TO
PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL
SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE.
Dauphin County Bar Association
Lawyer Referral Service
213 North Front Street
Harrisburg, PA 17101
(717) 232-7536
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Samantha Cammack,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
Docket No. 05, (,";;;.2,
Scott D. Cammack,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
COMPLAINT IN DIVORCE UNDER SECTION
3301(d) OF THE DIVORCE CODE
AND NOW, comes Plaintiff, Samantha Cammack, by and through her attorney, Stephen
O. Fugett, Esquire, who files this Complaint in Divorce under Sections 3301(c) ofthe Divorce
Code, and who, in support thereof, avers as follows:
1. Plaintiff is Samantha Cammack, who currently resides at 835 Erford Road, Camp
Hill, Cumberland County, Pennsylvania, ] 70 II, since 2000.
2. Defendant is Scott D. Cammack, who currently resides at 210 Senate A venue,
Apartment 425, Camp Hill, Cumberland County, Pennsylvania, 1 70] I, since
October, 2003.
3. Plaintiff and Defendant have been bona fide residents in the Commonwealth of
Pennsylvania for at least six months immediately previous to the filing of this
Complaint.
4. The Plaintiff and Defendant were married on September 14, 2002 in Camp Hill,
Cumberland County, Pennsylvania.
5. The parties separated in October, 2003 and have been living separate and apart
since then.
6. There have been no prior actions of divorce or annulment between the parties.
7. The marriage is irretrievably broken.
8. Plaintiff has been advised that counseling is available and that Plaintiff may have
the right to request that the Court require the parties to participate in counseling.
9. Neither the Plaintiff nor the Defendant is in the military or naval service or in any
branch of the armed forces of the United States of America or its allies or is
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otherwise within the provisions of the Soldiers' and Sailors' Civil Relief Act of
Congress of 1940 and its amendments.
10. Plaintiff requests the court to enter a decree of divorce.
I verify that 1 have read the foregoing Complaint in Divorce and verify that the
statements made therein are true and correct to the best of my knowledge, information and belief.
I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. S 4904
relating to unsworn falsification to authorities.
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Samantha Cammack, Plaintiff
Respectfully submitted,
Ste en O. Fugett, sq e
P A Supreme Court ID No. 85643
240 South 18th Street
Camp Hill, PA 17011
Telephone: (717) 737-2390
Facsimile; (717)763-4958
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Samantha Cammack,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
Docket No. 05-6222 Civil Term
Scott D. Cammack,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
ACCEPTANCE OF SERVICE
I hereby accept service of the Complaint In Divorce under 23 Pa.C.S. 9330I(d). I certify
that I am authorized to accept service on behalf of the defendant.
/!j-/;;Zr05
Date
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~ott D. Cammack, Defendant
Samantha Cammack,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
Docket No. 05-6222 Civil Term
Scott D. Cammack,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
NOTICE
If you with to deny any of the statements set forth in this affidavit, you must file a
counter-affidavit within twenty days after this affidavit has been served on you or the statements
will be admitted.
PLAINTIFF'S AFFIDAVIT UNDER SECTION 3301(d) OF THE DIVORCE CODE
I. The parties to this action separated on October 1, 2003 and have continued to live
separate and apart for a period of at least two years.
2. The marriage is irretrievably broken.
3. I understand that I may lose rights concerning alimony, division of property,
lawyer's fees or expenses if I do not claim them before a divorce is granted.
I verity that the statements made in this affidavit are tme and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. 94904 relating to unsworn
falsification to authorities.
Date: 1,~- /-;; -!)S
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Samantha Cammack, Plaintiff
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Samantha Cammack,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
Docket No. 05-6222 Civil Term
Scott D. Cammack,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
PLAINTIFF'S WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A
DIVORCE DECREE UNDER SECTION 3301(d) OF THE DIVORCE CODE
I. I consent to the entry of a final decree of divorce without notice.
2. I understand that I may lose rights concerning alimony" division of property,
attorney's fees and expenses in do not claim them beti)re a divorce is granted.
3. I understand that I will not be divorced until a divorce decree is entered by the Court
and that a copy of the decree will be sent to me immediately after it is filed with the
Prothonotary.
I verify that the statements made in this affidavit are true aad correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. S 4904 relating to unsworn
falsification to authorities.
Date: Id" IJ 05
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Samantha Cammack,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYL VANIA
v.
Docket No. 05-6222 Civil Term
Scott D. Cammack,
Defendant
CNIL ACTION - LAW
IN DIVORCE
DEFENDANT'S WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A
DIVORCE DECREE UNDER SECTION 3301(d) OF THE DIVORCE CODE
I. I consent to the entry of a final decree of divorce without notice.
2. I understand that I may lose rights concerning alimony, division of property,
attorney's fees and expenses if! do not claim them before a divorce is granted.
3. I understand that I will not be divorced until a divorce decree is entered by the Court
and that a copy of the decree will be sent to me immediately after it is filed with the
Prothonotary.
I verify that the statements made in this affidavit are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S. S 4904 relating to unsworn
falsification to authorities.
Date: /). -/cl-' {};-
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VScott D. Cammack, Defendant
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Samantha Cammack,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
Docket No. 05-6222 Civil Term
Scott D. Cammack,
Defendant
CNIL ACTION - LAW
IN DNORCE
Certificate of Service
I hereby certify that I did, on December 12, 2005, serve a true and correct copy of
Plaintiffs Affidavit Under S 3301(d) ofthe Divorce code upon the persons listed in the manner
indicated:
SERVICE BY HAND DELIVERY:
Scott D. Cammack, Defendant
s~ n O. FUgett~ Es
Attomey for Plaintiff
Date: r/VIOG
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THIS AGREEMENT made this I) i) day of 'J:::e CN;4/j,Ju( 200 s:- by and OOPY
between Samantha Cammack, of 835 Erford Road, Camp Hill, Cumberland County,
Commonwealth of Pennsylvania, 17011, hereinafter referred to as "Wife," and, Scott D.
Cammack, of210 Senate Avenue, Apartment 425, Camp Hill, Cumberland County,
Commonwealth of Pennsylvania, 17011, hereinafter referred to as "Husband."
WIT NE S SETH:
WHEREAS, the parties hereto were duly married to each other on September 14,
2002 in Camp Hill, Cumberland County, Commonwealth of Pennsylvania.
WHEREAS, it is the intention of the parties to enter into an Agreement under
which their respective financial and property rights, and an other respective rights,
remedies, privileges and obligations to each other arising out ofthe marriage relation, or
otherwise, including those rights over which the Court retained jurisdiction, will be fully
prescribed and bounded thereby; and
WHEREAS, the parties hereto have been fully, separately, and independently
apprised and advised of their legal rights, remedies, privileges, and obligations arising out
of the marriage relationship, or otherwise, by counsel of their own choice and selection,
to the extent each has deemed necessary and appropriate.
WHEREAS, both parties have made independent inquiry and investigation with
respect to their respective legal rights, remedies, privileges and obligations, arising out of
the marriage, or otherwise, and each has been fully informed of the other's assets,
property, holdings, income and prospects; and
I
. .
WHEREAS, the parties hereto each warrant and represent to the other that they
each fully understand all the terms, covenants, conditions, provisions, and obligations
incumbent upon each of them by virtue ofthis Agreement to be performed or
contemplated by each of them hereunder, and each believes the same to be fair, just,
reasonable and to the respective individual best interest of each, and not the result of any
fraud, duress, or undue influence exercised by either party upon the other or by any other
person or persons upon either;
WHEREAS, the parties hereto both agree that this agreement shall remain in full
force and effect even upon the Parties' reconciliation unless a written change is made.
NOW THEREFORE, the recitals set forth hereinabove, being incorporated by
reference herein, and deemed an essential part hereof, and further consideration of the
promises contained within this Agreement, the parties hereto intending to be legally
bound, mutually agree as follows:
1. PERSONAL RIGHTS: Wife and Husband may and will, at all times
hereafter, live separate and apart. Each will be free from all control, restraint,
interference or authority, direct or indirect, by the other in all respects as fully as if she or
he were unmarried. Each may reside at such place or places as she or he may select.
Each may, for her or his separate use or benefit, conduct, carryon and engage in any
business, occupation, profession or employment which to her or him may seem advisable.
This provision will not be taken, however, to be an admission on the part of either Wife
or Husband ofthe lawfulness ofthe causes which led to, or resulted in the continuation
2
of, their living apart, Wife and Husband will not molest, harass, disturb, or malign each
other or their respective families of each other, nor compel or attempt to compel the other
to cohabit or dwell by any means or in any manner whatsoever with her or him.
2. FULL DISCLOSURE; The parties hereby acknowledge and agree that each
of them has made to the other a true, full, complete disclosure of all property and interests
which either or both of them have in all marital and separate property as defined by the
Pennsylvania Divorce Code and they do hereby waive an inventory of said property.
The parties further acknowledge and agree that they have each had an opportunity
to value or have appraised any and all marital property, and they do hereby waive a
formal appraisal of same, and no statement or representation by either party as to value
will be deemed a misstatement or misrepresentation to the other or be deemed fraudulent.
Both the legal and practical effect of this Agreement in each and every respect
and the financial status of the parties has been fully explained to both parties by their
respective counsel, and they both acknowledge that this Agreement is reasonable and that
it is not the result of any fraud, duress, or undue influence exercised by either party upon
the other or by any other person or persons upon either.
3. MUTUAL RELEASE: Wife and Husband each do hereby mutually remise,
release, quit claim and forever discharge the other and the estate of each other, for all
time to come, and for all purposes whatsoever, of and from any and all rights, titles, and
interests, or claims in or against the property (including income and gain from property
3
hereafter accruing) of the other or against the estate of each other, of whatsoever nature
and wheresoever situate, which she or he now has or at any time hereafter may have
against each other, the estate of each other or any part thereof, whether arising out of any
former acts, contracts, engagements or liabilities of each other or by way of dower or
curtesy, or claims in the nature of dower or curtesy of widow's or widower's rights,
family exemption or similar allowance, or under the intestate laws, or the right to take
against the other's will; or the right to treat a lifetime conveyance by the other as
testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's
estate, whether arising under the laws of (a) Pennsylvania (b) any State, Commonwealth
or Temtory ofthe United States, or (c) any other country, or the right which both parties
may have or at any time hereafter have for past, present, or future spousal support or
maintenance, alimony, alimony pendente lite, costs or expenses, whether arising as a
result of the marital relation, or otherwise, except, and only except, all rights and
agreements and obligations of whatsoever nature arising or which may arise under this
Agreement or for the breach of any part thereof. It is the intention of Wife and Husband
to give to each other by the execution of the Agreement a full, complete and general
release with respect to any and all property of any kind or nature, real, personal or mixed,
which the other now owns or may hereafter acquire, except and only except all rights and
agreements and obligations of whatsoever nature arising or which may arise under this
Agreement or for the breach of any part thereof, subject, however, to the implementation
and satisfaction of the conditions precedent as set forth herein.
4. DEBTS: Both parties represent and warrant to the other party that they have
not incurred any debts to which the other, or the estate of the other may be held liable
4
since the date of separation or the date of filing of the Divorce Complaint except as
provided herein, and that except only for the rights arising out oftrns Agreement, neither
party will hereafter incur any liability whatsoever for which the other party nor the estate
of the other party will be liable.
Husband and Wife agree that should any debt or liability be incurred by one party,
that party acknowledges that such debt is the sole responsibility of the person who
incurred that debt and any and all claims made against the other on account of such debt
may be deducted from the share to which the person incurring the debt is entitled as the
result of this Agreement.
The parties acknowledge and warrant that no marital debt exists.
5. PERSONAL PROPERTY: Husband and Wife each will continue to own and
enjoy, free of any claim or right of the other, all of his or her personal effects, such as
clothing, jewelry, and the like, wherever located.
The parties have mutually agreed on the division of their household goods,
furnishings and furniture. Husband agrees that all property in the possession of Wife will
be the sole and separate property of Wife. Wife agrees that all property in the possession
of Husband will be the sole and separate property of Husband. The parties hereby
relinquish any and all right or claim to such articles chosen by the other.
Henceforth, each of them will own, have and enjoy independently of any claim or
right of the other, all items of personal property of every kind, now and hereafter owned,
5
or held by him or her, with full power to dispose of same as fully and effectively in all
respects and for all purposes as ifhe or she were unmarried.
6. REAL ESTATE: The parties hereby acknowledge that no real property was by
them purchased, either individually or jointly or as tenants by the entireties.
7. APPLICABILITY OF TAX LAW TO PROPERTY TRANSFERS: The
parties hereby agree and express their intent that any transfers of property pursuant to this
Agreement will be within the scope and applicability of the Deficit Reduction Act of
1984 (herein the "Act"), as amended, specifically, the provisions of said Act pertaining to
transfers of property between spouses or former spouses. The parties agree to sign and
cause to be filed any elections or other documents required by the Internal Revenue
Service to render the act applicable to the transfers set forth in this Agreement, without
recognition of gain on such transfers and subject to the carry-over basis provisions of said
Act.
8. FINANCIAL ACCOUNTS/AUTOMOBILES: Husband and Wife have
already divided all, if any, bank checking and savings accounts, life insurance policies,
financial instruments and accounts, certificates of deposit, cash, stocks, bonds, and
accounts to the parties' satisfactions. Each party will retain sole ownership of all
financial instruments and accounts currently in their possessions.
Each party will pay and assume any loans on any vehicle(s) currently in his/her
possessIOn.
6
9. TAXES: The parties agree and acknowledge that prior to the last full calendar
year, the parties jointly filed Returns for Federal and State income tax purposes. The
parties agree that they will file separate future Tax Returns for all tax obligations, and any
tax obligation will be the responsibility of the individual party.
Husband and Wife warrant that they have heretofore paid aJl taxes on such prior
Returns including the calendar year ending December 31, 200_; that they do not owe any
interest or penalties thereon; and that no tax deficiency proceeding or audit is pending or
notice thereof received.
Husband will give Wife notice of any deficiency assessment. Wife will give
Husband notice of any deficiency assessment of which they individuaJly or coJlectively
become aware. The parties agree that should it ultimately be determined that any
deficiency and/or penalty exist with respect to the jointly filed returns, the party
responsible for the erroneous preparation and/or improper or nondisclosure of
information which has resulted in the deficiency and/or penalty, wiJl be solely
responsible for the payment of the amount ultimately determined to be due, together with
interest, as well as expenses that may be incurred to contest the assessment.
Should said surns become due as a result of individually filed returns, the party
which filed said return will be solely responsible for all sums due, and will indemnify and
hold harmless the other party for any payment thereon.
10. CHILD CUSTODY: No children were born of the relationship between Wife
and Husband
7
11. PENSIONS, RETIREMENT. AND PROFIT SHARING PLANS: The
parties will retain as their sole property any interest and each spouse waives any interest
in all of each others Pensions, Retirement, and Profit Sharing Plans, or the like, which the
parties now own or may own in the future. Both parties will promptly sign all required
papers to release any interest they may have acquired.
12. WAIVER OF RIGHTS: The parties waive all other past, present and future
rights provided in the 1980 Divorce Code, as amended, or any future laws and
amendments including their right to alimony, spouse support, equitable distribution,
alimony pendente lite, costs and expenses, and attorney's fees, except as otherwise
provided herein.
13. EOUITABLE DISTRIBUTION - GENERAL CONSIDERATIONS: The
parties have attempted to distribute their marital property in a manner which conforms to
the criteria set forth in Section 3502(a) of the Pennsylvania Divorce Code, and taking into
account the following consideration: the length ofthe marriage; the age, health, station,
amount and sources of income; contribution of each party; the opportunity of each party
for future acquisitions of capital assets and income; the sources of income of both parties,
including but not limited to medical, retirement, insurance or other benefits; the
contribution or dissipation of each property, including the contribution of each spouse as
a homemaker; the value of the property set apart to each party; the standard of living of
the parties established during the marriage; and the economic circumstances of each party
at the time the division of property is to become effective.
8
14. SUCCESSORS' RIGHTS AND LIABILITIES: This Agreement will,
except as otherwise provided herein, be binding upon and inure to the benefit ofthe
parties hereto, their respective heirs, executors, administrators, successors or assigns.
15. ENTIRE AGREEMENT: Wife and Husband do hereby covenant and
warrant that this Agreement contains all of the representations, promises, and agreements
made by either of them to the other for the purposes set forth in the preamble
hereinabove; that there are no claims, promises, or representations not herein contained,
either oral or written, which will or may be charged or enforced or enforceable unless
reduced to writing and signed by both ofthe parties hereto; and the waiver of any term,
condition, clause or provision of this Agreement will in no way be deemed to be
considered a waiver of any other terms, conditions, clauses or provisions of this
Agreement.
16. ADDITIONAL INSTRUMENTS: The Husband and Wife will, at any and
all times, upon request by the other party of his or her legal representatives, make,
execute, and deliver any and all such other and further instruments, Deeds, notes,
releases, car titles, tax forms, insurance forms, or such other writings as may be necessary
or desirable for the purpose of giving full force and effect to the provisions of this
Agreement and as their respective counsel will mutually agree should be executed in
order to fulfill promptly the terms of this Agreement.
17. GOVERNING LAW: All matters affecting the interpretations of this
Agreement and the rights ofthe parties hereto will be governed by the laws of the
Commonwealth of Pennsylvania.
9
18. INDEMNIFICATION UPON BREACH: If for any reason either the
Husband or the Wife fails to perform his or her obligations hereunder to the other spouse,
and the other spouse incurs any expense thereby (including but not limited to legal fees)
in enforcing his or her rights, the spouse who failed to perform the obligations agrees to
reimburse and indemnify the other spouse and hold him or her harmless for any and all
such expenses.
Each party hereby agrees to pay all attorney's fees and costs of litigation that the
other spouse may sustain or incur in any way whatsoever as a consequence of any default
or breach by the other spouse of any of the terms or provisions of this Agreement;
provided that the party who seeks to recover such attorney's fees, and costs of litigation
must first be successful in whole or in part, before such liability may be imposed. It is
the specific agreement and intent of the parties that the breaching or wrongdoing party
will bear the burden and obligation of any and all costs and expenses and counsel fees
incurred by him or herself as well as the other party in endeavoring to protect and enforce
his or her rights under this Agreement.
19. INDEPENDENT COVENANTS: Each of the respective rights and
obligations of the parties hereunder will be deemed independent and may be enforced
independently irrespective of any ofthe other rights, and obligations set forth herein.
In case any provision ofthis Agreement should be held to be contrary to, or
invalid under, the law of any country, state or other jurisdiction that is applicable to this
Agreement, such illegality or invalidity will not affect in any way other provisions hereto,
10
all of which will continue, nevertheless, in full force and effect under the law of the
country, state, or other jurisdiction that is applicable to this Agreement.
20. NO MERGER IN DIVORCE DECREE: In the event that either of the
parties shall recover a final judgment or decree of absolute divorce against the other in a
court of competent jurisdiction, the provisions of the Agreement may be incorporated by
reference or in substance but will not be deemed merged into such judgment or decree of
absolute divorce and will be entirely independent thereof.
21. SUBSEQUENT DIVORCE: There is pending between the parties and action
for divorce instituted in the Court of Common Pleas of Cumberland County,
Pennsylvania. The Husband and Wife agree that their marriage is irretrievably broken
and that the same will be dissolved pursuant to Section 3301(d)(I) of the Divorce Code
of Pennsylvania. The parties therefore agree as follows, TO WIT:
A. Wife will file with said court an Affidavit Under Section 3301(d)(1) of the
Divorce Code within seven (7) days of the signing of this Agreement;
B. Unless either party will have requested counseling prior to the filing of said
Affidavit of Consent, the right to request such counseling will be deemed waived;
C. The Court of Conunon Pleas of Cumberland County, Pennsylvania will retain
jurisdiction over the parties and causes of action resolved herein.
11
IN WITNESS WHEREOF, I have hereunto willingly and voluntarily set my
hand and seal to this AGREEMENT, this ~ day of 0 r(!f)?JtY'fl, 2005.
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(SEAL)
IN WITNESS WHEREOF, I have hereunto willingly and voluntarily set my
hand and seal to this AGREEMENT, this tJ-b~day of~<JJ0~-< ,2005.
" ~~"'~~C!\t:
Samantha Cammack (Wife)
(SEAL)
Signed, sealed and executed by Scott D. Cammack and Samantha Cammack,
above-named Husband and Wife, respectively, in the presence of us, who, at their request
an in eir presence and at the same time, have hereunto subscribed our names as
w' es es.
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ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
I, Scott D. Cammack, hereinbefore named Husband, having been duly qualified
according to law, do hereby acknowledge that I signed and executed the foregoing
AGREEMENT and that I signed it freely, willi Iy and ~ary.
-~~
oU . Cammack (Husband)
On this, the I f2.. day of P reE /#"?r rr:::[8005, before me, the
undersigned officer, personally appeared " <)u-i-/ b, (l tLrnff'''- ct-. , known to me
(or satisfactorily proven) to be the person whose name is subscribed to the within
instrument, and acknowledged that he executed same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official ea. No.TARIAL SEAL
PATRICIA D HESSON
Notory Public
(SIOIn:bf CAMP HILL
N t P bl ,__-._CUMBERlANDCOUNTY
o ary u ic My Commission Expires feb 26, 2008
ACKNOWLEDGEMENT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
I, Samantha Cammack, hereinbefore named Wife, having been duly qualified
according to law, do hereby acknowledge that I signed and executed the foregoing
AGREEMENT and that I signed it freely, willingly and voluntary.
~'clw<P.o..~~\;?
Samantha Cammack (Wife)
On this, the 1'y-1 day of ~~ , 2005, before me, the
undersigned officer, personally appeared 0IJJY\()-""-h4-- UfY".-rNl.. c I:...J ,known to me
(or satisfactorily proven) to be the person whose name is subscribed to the within
instrument, and acknowledged that he executed same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
~')~ J!J . ~ (SEAL)
Notary Public
13
ARIAl
PATRICIA 0 HESSON
Notary Public
CITY OF CAMP Hill
", CUMBERlAND COUNTY
My Commission EXpires Feb 26. 2008
..
AFFIDAVIT
COMMONWEALTH OF PENNSYLVANIA
SS.
COUNTY OF CUMBERLAND
fY'L 0 p..fYldL
We,
and
-J-e>-4n ~/ mL~ elm ~ ~he witnesses whose names are signed to the
attached or foregoing instrument, being duly qualified according to law, do depose and
say: that we were present and saw the parties sign and execute the foregoing
AGREEMENT; that they both signed willingly and executed the AGREEMENT as their
free and voluntary act for the purposes therein expressed; that each subscribing witness in
the hearing and sight of the parties signed the AGREEMENT as a witness; and that, to
the best of our knowledge, the parties were each at that time 18 or more years of age, of
so
'O'C" 000""",,,,", ~'"O 'nnurnoo
s sE;nc~ '
,'-----'
~
Sworn to or affirmed and subscribed to before me by
hie. 0, PtL-n-;lK
, and .JoN) tf. jA~d~ RL , witnesses,
this 1<2~ dayof '--w.ttnl b;...r
,2005
\jJ~ ~ . J1/.lM>0
Notary Public
TARtAL AL
PATRICIA D HESSON
Notary Public
CItY OF CAMP HILL
CUMBERlAND COUNtY
COlTll'l\llllOO Expkes Feb 26. 2008
14
~-------
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Samantha Cammack,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
Docket No. 05-6222 Civil Term
Scott D. Cammack,
Defendant
CNIL ACTION - LAW
IN DIVORCE
PRAECIPE TO TRANSMIT RECORD
To the Prothonotary:
Please transmit the record, together with the following information, to the Court for the
entry of a divorce decree:
I. Grounds for divorce: irretrievable breakdown under ~3301(d)(l) ofthe Divorce
Code.
2. Date and manner of service ofthe complaint: December 12,2005, in person.
3. Date of execution of the affidavit required by ~ 3301(d) of the Divorce Code:
December 12, 2005, Date of filing and service of the plaintiffs affidavit upon the
respondent: December 12, 2005.
4. Related claims pending: None.
5. Date Plaintiffs Waiver of Notice ofIntention to Request Entry of Divorce Decree
was filed with the prothonotary: December 21,2005. Date Defendant's Waiver of
Notice of Intention to Request Entry of Divorce Decree was filed with the
prothonotary: December 21, 2005.
,;>
Date:
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IN THE COURT OF COMMON
PLEAS
OFCUMBERLANDCOUNTY
STATE OF
PENNA.
SAMANTHA CAMMACK,
Plaintiff
No.
05-6222
VERSUS
SCOTT D. CAMMACK,
Defendant
DECREE IN
DIVORCE
AND NOW,
1o..V\vll.'l''i
1.."\
, ).()()fo, tT IS ORDERED AND
DECREED THAT
Samantha Cammack
, PLAINTIFF,
AND
Scott D. Cammack
, DEFENDANT,
ARE DIVORCED FROM THE BONDS OF MATRIMONY.
THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE
BEEN RAISED OF RECORD tN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT
YET BEEN ENTERED;
It is further ORDERED and DECREED that the AGREEMENT executed
by and between the parties, dated December 12, 2005,
is incorporated by reference into this Decree for the purpose
of enforcement, but shall not be deemed to have been merged
with this Decree.
~~.$-~"''''
By THE COURT:
ATIm!!. . ~
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~ ~ PROTHONOTARY
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( /~rifO~ -:rrt;J 7~ /~ ~J)
'~;7 .;z r~~ r~o/t, '7(7.It'LI
~ .~, /lF~: ~<?r? --;0' he '/
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
,--CSQvY\Q.Vy-\-hR CommG(il-<
Plaintiff
Vs
Sco+t D. Comma<!\<,
Defendant
FileNo.
ro.6 - G, d;;)~
IN DIVORCE
(") ~ 0
c: <.-::;:) -n
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~Jli~ ::n: -----4
[PL(l ~ ffl:n
Z;'S =Be:;
~;: t.' en ":2 (~
.,:;:::- > :;:::",.
c: :J: S2B
_ prior to the, entry of a Final Decree in Divorce, ;; [~; '!? ,c:?, en
or 'L after the entry ofaFinal Decree in Divorce dated,-=so.nuo ,.~ ~ ~1)D~
hereby elects to resume the prior surname of ~ \1' n ~ ' and gives this
written notice avowing his / her intention pursuant to the provisions of 54 P.S. 704.
Date: 3//1o/()~ \. ~nlW~ CDF)V..,v~Q\e
, Signature
NOTICE TO RESUME PRIOR SURNAME
Notice is hereby given that the Plaintiff / defendant in the above matter,
[select one by marking "x"]
~ 'h\)>c~~ ~ t ~~
Signature of name being res e
COMMONWEALTH OF PENNSYLVANIA )
COUNTYOF C<>.",J,-<r/a.d )
On the J fo11> day of )r) ~ , 200 J:, before me, the Prothonotary or fhe
notary public, personally appeared the above affiant lmown to me to be the person whose
name is subscribed to the within document and acknowledged that he / she executed the
foregoing for the purpose therein contained.
In Witness Whereof, I have hereunto set my hand hereunto set my hand and official
seal.
~~ c~:ru'
rothonotary or Notary lie
tlDlAAIAI. SiAL
c.... _~ WTAIIYPIlIUll
""~ l:OllN1Y c:otJImtDtJsr
MY COMMI88lON fIflRaqARY Ill~o