HomeMy WebLinkAbout06-0831
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JUDGMENT NOTE
MechanicsburQ
(place)
, Pennsylvania, Januarv 13. 2005
(date)
, $ 2.858.40
(amount)
FOR VALUE RECEIVED, I/we promise to pay to the order of F:ri~ InsnrAn~~ GrOllj)
the sum of Two thousand eight hundred fi ftv-~i ght and 40/100
said sum to be payable said sum to be as follows:
Two hundred
dollars, ($ 200.00
)onthe l"t
day of Fphn'Ary
20 0')
and
Onp- hllndred
dollars, ($ 100.00
) on the
lRt
day
of every month thereafter until the entire amount is paid in full.
I/we 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, R.C.P, 2951 (a) (1) with or without declaration, with costs of suit, interest at
the rate of 6% per annum, an attorney's fee, release of errors, and without stay of execution;
and I/we also waive tbe 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 further 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
OC_b~;'o/;:hmfu=OC_fuOO~ ~.S.)
(L.S.)
This note is given executed without duress or coercion and with full and complete understanding
that upon failure to make payment as agreed, that my operating privileges may be suspended,
Further, I do hereby acknowledge that the damage incurred in the accident of
, 19 ,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.
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DRIVER DATE OF BIRTH
DRIVER OPERATOR NO.
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(L,S,)
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OWNER DATE OF BIRTH
OWNER OPERATOR NO.
(L.S,)
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010170783874 SG
CERTIFICATE OF RESIDENCE
I hereby request the Prothonotary to enter the within Judgment against:
Kyle Spriggle
20 East Coover Street
Apartment B
Mechanicsburg, PAl 7055
Defendant
Defendant within names, the last named address of the Defendant or Defendants being as
shown above, and I hereby certify that the precise address of the Judgment Creditor is:
Brenda Becker
c/o Erie Insurance Group
P.O. Box 2013
Mechanicsburg, PA 17055
Plaintiff
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Sandra Goodling
Subrogation Specialist
,?
DISCLOSURE FOR CONFESSION OF JUDGMENT
If We , Erie Insurance Group
,T;:mul'lry
, 20..ns., a Judgment Note for
, am executing this 13 th day of
Two thousand eight hundred
fifty-pient ~nn 40/100
($ 2,858.40) DOLLARS, obligating me to repay that amount.
INITIALS: \,,-'1'1-<;'
INITIALS:
Ie
It has been explained to me by representative of the Erie Insurance Group that the
Note contains wording that may permit them or their attorneys to enter Judgment against me
at the Courthouse, whether or not said Note is in default, without notice to me and without
offering me an offering me an opportunity to defend against the Entry of Judgment, and that
the Judgment may be collected by any legal means.
INITIALS: ,'{~- )(
INITIALS :
In executing the Note, If We am knowingly, understandingly, and voluntarily waiving
any rights to resist the Entry of Judgment against me at the Courthouse, and am coknting
to the Confession of Judgment.
INITIALS: 1<'1+ 5 IC
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INITIALS :
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
MaIy J. Goofier, Notary Public
Silver Spong Twp.. Cumberland Coonty
My Commission Expires Nov. 17. 2007
Member, PennsylvaniA Association Of Notaries
0ArJUl\Rj 3 ~ dOO;--
- ,
AFFlDA VIT TO ACCOMPANY JUDGMENT NOTE
Being duly sworn according to law, the undersigned jointly and severally depose and say
that:
1. I/We are over twenty-one years of age, not within the military service of the United
States and its allies nor otherwise within the civil relief provision of the Soldiers and
Sailors Civil Relief Act of 1947 as amended.
2, I/We have delivered to Erie Insurance a Judgment Note containing a confession of
judgment to secure certain payment obligations.
3. I/We understand that a confession of judgment allows for the entry of a judgment by
confession against them and that said judgment encumbers all real estate that they
own.
4. The note is not related to a consumer credit transaction.
IN WITNESS WHEREOF and intending to induce Erie Insurance to complete the transaction
~rovided, the undersigned have affixed their hands and seals on this "3 I <;;1:. day of
. \~NJ~ ,200S-
G -
/~ I/? /0 ~ (Seal)
Sworn to and subscribed before me
this 31 ~ day Of'5ArJJAci-
~
, 200'::
,
Gf.),QPu~ ~
COMMONWEALTH OF PENNSYLVANIA
Notarial Seal
Mal)' J. Gouffer, Notaty Public
Silver Spong Twp., Cumbe~and Coonty
My Commission Expires Nov. 17,2007
Member, Pennsylv~nia Association Of Notanes
I certify that my annual incom((exceedstiS less than) TEN THOUSAND and OO/IOO
DOLLARS, that the blanks in this disclosure were filled in when I initialed and signed it,
and that I received a copy at the time of signing.
;?J(1f7
Date: 1/3)/O~-
I f
ACKNOWLEDGMENT
Commonwealth of Pennsylvania )
County of r.uN\&'tR-~ ~
ss:
Before me, the undersigned Notary, personally appeared ~ '? I r ~. S pl?~~ I E-
o"'! SA,vJ~3~do''- , whose initials appear above, and who acknowledges nder oath that
they execu e above Disclosure for ConfessIOn of Judgment together With the ConfessIOn
of Judgment Note referred to in the First Paragraph of the Disclosure on this date.
(SEAL)
COMMONWEALTH OF PENNSYLVANIA
NoIaria! Seal
Mary J, Gouffer. Notary Public
Silver Spring Twp.. CUmberland County
My commisS\OO expires Nov, 17. 2007
Membef. Peflo&vlvania A.soc!slion Of Notaries
~~.J'A/&J
No Pu 1
My commission expires on the V)~ day of ,,)ovfn<l3cA
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,.,/ J" f
In the Court of Common 'Pleas of
Cumberland County, Pennsylvania
VS.
____l5y.!_e.n~P_r::LgR1!'_____ __ n____n _unn_nm
Judgment in favor of Plaintiff on _l=l3::f_QQ.l2__nn
for
$2+8.5.8 . 40
------------------------------------------~Zf~------
No, _0.6.=-..831
Term, 192.0115
Entered ___ _ _ ________..____________________ 19______
.- - ---- --- - - - - -- - - - - --- - - - - - - - - - - - - - - - - - - - - - - -- - -- -- - - - - - -- ---- -- - - -- - - - ----- _. - -- -- --___ __ _ _ __ ____ _ Plaintiff
in the :lboyc Judgm~nt, do appc.:n and acknov".ledge that
on
this day have had and received and
from _ nnn n __ n nn _ _n nISy_t<:', nS_I1_r_izz_l ?n_ n _ _ n_ _n n n uu ____ __nm_nn_n__n___n_n_n_h___
the def~ndant in the above Judgm~r!t, full payment and ~aisfaction of t~c S:J.r.le, with interest and costs, :.nd desired that
satisfaction therefore shall be entered upon the records thereof.
And further,
I
do hereby authorize and empower -____ku.x.t.ia._R.__L.o,oZ.__PLD_ta.Qn.QJ:_<!_rShn_
theProthonotary of said Court, to appear ____j~.Q_(_Jn.e____.______________u_____________
and in
my
n3.me and stead to enter full satisfaction upon the record of said Judgment, as fully and effectually, to all
intents and purposes, as
I. could were
I personally present in person to do so. And for so doing this shall be
your sufficient warrant of authority.
In testimony whereof, we have hereunto set our hands and seals this ______2_Ild_____n___n____h_________
day of ______~p~____,_________________,__,__,___,___, A.~~, D_~h
nL..Jf(,~!l (Seal)
Christ. rs, Claims SupervisQr
--'-----------'---------------,-------__,_____ (~eal)
Harrisburg Branch
State of Pennsylvania
County of Cumberland,
}
- --- -- -- - ---- --- ------- ----------- -- - - -- ---- ---
(Seal)
Personally appeared before me, the subscriber, _______Gh.r.is.J:..y__SJD.y..eLs___.~_____________________________
----------------------------------------------------------------------------..--
.- ------ -- - - - - --- --- - - ---- -- ----- --- --- - - - - - - - -- - -- - -- - - - -- -- -- - ----- - --- ---- .--- - - - - - -- --
-------------------------------------------------------------------------------
the Plaintiff in the
above Judgment, and in due form of law acknowledged the within and foregoing Power of Attorney to satisfy the Judg-
ment se~ forth, to be
act and deed, and desired that th.:: sam~ sh::tll be filed of record in the office of the Prothon-
otaty of the Court of Common Pleas of said County.
In testimony whereof, I have hereunto set myhand and
day of --'JiAA.r-4.h___h,________________ n_'_m__
NOtNllAL IlEAL
IlBIOIWlL I.IllllEIHl.1ER 511ll1.
nl j , ........ "lfIlItl lINI
IIIr llIMiIIII-Elil*II Dill Ih. 22.
seal this _____~!!~_.______________________________
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(Seal)
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POWER OF ATTORNEY AUTHORIZING SATISFACTION OF JUDGMENT
IN THE COURT OF COMMON PLEAS
Cnmbprl "n~ COUNTY, PENNSYLVANIA
Rrpnoa Becker
: No,
06 831
Term 19 700')
C/o E r i e Ins u ran C e G r 0 uP: Debt
$ 2.858.40
vs.
Entered
1 -1 3-0')
Kyle Spriggle
Having received from
Kyle Spriggle
the full amount of the debt, interest and costs of the above judgment T
do hereby authorize, empower and direct the Prothonotary of
Cumberland
County to enter satisfaction of the same on the records,
Witness
hand and seal this
A.D.I9
------
x
Attest
Claims Supervisor, AlC
State of Pennsylvania SS:
County of f1,.., b~ to lAnd....
Before me an Ii. ~ en t duly commissioned and sworn, personally
came the above named (i ), t'/$ f'f 0rY">Ue I-S being the identical person, or
authorized Officer of Company or Corporation named as Plaintiff in the above case, who in due form of
law acknowledged the above Power of Attorney to be
the same might be recorded as such.
act and deed, and to the end that
Witness my hand and seal this .2 ~day of l1AtoC ),
NOTARIAL IlEAL
DEIIOIIlMl L l.IIl8Rl.lER. NalIIy NIIc
....lk I 11_. Cwl_1Ind C8uIf:y
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