HomeMy WebLinkAbout06-7098
Dawne M. Blomstrom, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION - LAW
IN DIVORCE
David M. Blomstrom,
Defendant :NO. 06- 1098 CIVIL TERM
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 relief requested 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 the 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, Cumberland County Courthouse, Carlisle, Pennsylvania.
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 OFFICE 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.
Cumberland County Bar Association
32 South Bedford Street
Carlisle, Pennsylvania 17013
(717) 249-3166
AMERICANS WITH DISABILITIES ACT OF 1990
The Court of Common Pleas of Cumberland County is required by law to comply with
the Americans with Disabilities Act of 1990. For information about accessible facilities and
reasonable accommodations available to disabled individuals having business before the court,
please contact our office. All arrangements must be made at least 72 hours prior to any hearing
or business before the court. You must attend the scheduled conference or hearing.
DAWNE BLOMSTROM, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION - LAW
IN DIVORCE
DAVID BLOMSTROM,
Defendant : NO. 06 - 9 109 P CIVIL TERM
DIVORCE COMPLAINT
The plaintiff, Dawne M. Blomstrom, by her attorneys, the Family Law Clinic, sets forth
the following cause of action in divorce:
DIVORCE UNDER 23 Pa.C.S. $43301(c) AND 3301(d) OF THE DIVORCE CODE
1. Plaintiff is Dawne M. Blomstrom , who currently resides at 1512 A Mountain Road
2. Newburg, Cumberland County, PA 17240 since approximately September 2006. Prior to
that, she resided at 26 Oak Bend Road Newburg, Cumberland County, PA 17240 since
approximately June 2006.
3. Defendant is David M. Blomstrom, who currently resides in Michigan and is believed to
receive mail at Post Office Box 33, Chatham, Alger County, MI 49816 since
approximately June 11, 2005.
4. Plaintiff has been a bona fide resident in the Commonwealth for at least six months
immediately previous to the filing of this complaint.
5. Plaintiff and Defendant were married on January 18, 2003 at Exmore, Northampton
County, Virginia.
6. Plaintiff and Defendant have lived separate and apart since June 11, 2005.
7. There have been no prior actions for divorce or for annulment between the parties.
8. The marriage is irretrievably broken.
9. Plaintiff has been advised that counseling is available and that Plaintiff may have the
WHEREFORE, Plaintiff requests the court to enter a decree of divorce.
Samara Gomez
Certified Legal Intern
ROB INS
THOMAS M. PLACE
ANNE MACDONALD-FOX
LUCY JOHNSTON-WALSH
MEGAN RIESMEYER
Supervising Attorney
FAMILY LAW CLINIC
45 North Pitt Street
Carlisle, PA 17013
(717) 243-2968
Fax: (717) 243-3639
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VERIFICATION
I verify that the statements made in the foregoing complaint are true and correct, to the
best of my knowledge, information and belief. I understand making any false statement
would subject me to the penalties of 18 Pa.C.S. §4904, relating to unsworn falsification to
authorities.
Date k?,-G -Ofo Plaintiff
Dawne A Blomstrom
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Dawne M. Blomstrom, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION - LAW
IN DIVORCE
David M. Blomstrom,
Defendant : NO. 06- %99 99 CIVIL TERM
PRAECIPE TO PROCEED IN FORMA PAUPERIS
TO THE PROTHONOTARY:
Kindly allow Dawne Blomstrom, Plaintiff, to proceed in forma pauperis.
The Family Law Clinic, attorneys for the party proceeding in forma pauperis, certifies
that we believe the party is unable to pay the costs and that we are providing free legal service to
the party.
Date / 13 06
Respectfully submitted,
Samara Gomez
Certified Legal Intern
Ad ?jm. AA, hU
ROE INS
THOMAS M. PLACE
ANNE MACDONALD-FOX
LUCY JOHNSTON-WALSH
MEGAN RIESMEYER
Supervising Attorneys
FAMILY LAW CLINIC
45 North Pitt Street
Carlisle, PA 17013
717-243-2968
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Dawne M. Blomstrom,
Plaintiff
V.
David M. Blomstrom,
Defendant
To The Prothonotary:
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
IN DIVORCE
: NO. 06 - 7098 CIVIL TERM
PRAECIPE TO REINSTATE COMPLAINT
Please reinstate the Divorce Complaint in the above-captioned docket.
Samara Gomez
Certified Legal Intern
Abo?w 1_w,_4_w,4Jv4
Megan iesmeyer
Supervising Attorney
Date: a 1 Aq /077
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Dawne M. Blomstrom, : IN THE-COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. CIVIL ACTION - LAW
IN DIVORCE
David M. Blomstrom,
Defendant : N0.06 - 7098 CIVIL TERM
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. Y au 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 relief requested in
these papers by the plaintiff. You may lose mone or property or other rights important to you,
including custody or visitation of your children.
When the ground for the divorce is indig
you may request marriage counseling. A list of
the Prothonotary, Cumberland County Courthol
ties or irretrievable breakdown of the marriage,
arriage counselors is available in the Office of
Carlisle, Pennsylvania.
IF YOU DO NOT FILE A CLAIM FOR
LAWYER'S FEES OR EXPENSES BEFORE A
YOU MAY LOSE THE RIGHT TO CLAIM AN
YOU SHOULD TAKE THIS PAPER
?IMONY, DIVISION OF PROPERTY,
IVORCE OR ANNULMENT IS GRANTED,
OF THEM.
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 LAWYER, THIS OFFICE MAY BE ABLE
TO PROVIDE YOU WITH INFORMATION A OUT AGENCIES THAT MAY OFFER
LEGAL SERVICES TO ELIGIBLE PERSONS iT A REDUCED FEE OR NO FEE.
Cumberland Co
32 South
Carlisle, Pe
(717)
Bar Association
Ford Street
lvania 17013
3166
AMERICANS WITH D
The Court of Common Pleas of Cum
the Americans with Disabilities Act of 1990. Foi
reasonable accommodations available to disabled
please contact our office. All arrangements must
or business before the court. You must attend the
ACT OF 1990
id County is required by law to comply with
information about accessible facilities and
individuals having business before the court,
be made at least 72 hours prior to any hearing
scheduled conference or hearing.
DAWNE BLOMSTROM,
Plaintiff
V.
DAVID BLOMSTROM,
Defendant
CIVIL TERM
:,IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL ACTION - LAW
IN DIVORCE
NO. 06 - 7098
MPLAINT
The plaintiff, Dawne M. Blomstrom, by her attorneys, the Family Law Clinic, sets
forth the following cause of action in divorce:
DIVORCE
1. Plaintiff is Dawne M. Blomstrom, wh currently resides at 26 Oak Bend Road
Newburg, Cumberland County, PA 1 240 since approximately February 2007.
2. Defendant is David M. Blomstrom, w o currently resides at 1608 Lakeshore
Drive, Gladstone, Delta County, MI 49837. Mr. Blomstrom has resided in
Michigan since approximately June 11, 2005.
3. Plaintiff has been a bona fide resident in the Commonwealth for at least six
months immediately previous to the filing of this complaint.
4. Plaintiff and Defendant were married on January 18, 2003 at Exmore,
Northampton County, Virginia.
5. Plaintiff and Defendant have lived separate and apart since June 11, 2005.
6. There have been no prior actions for divorce or for 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.
WHEREFORE, Plaintiff requests the court to enter a decree of divorce.
Awnd'64 A7//
Samara Gomez
Certified Legal Intern
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Amm
ROB T E. THOMAS M. PLACE
ANNE MACDONALD-FOX
LUCY JOHNSTON-WALSH
MEGAN RIESMEYER
Supervising Attorney
FAMILY LAW CLINIC
45 North Pitt Street
Carlisle, PA 17013
(717) 243-2968
Fax: (717) 243-3639
I verify that the statements made in the fore
best of my knowledge, information and be]
would subject me to the penalties of 18 Pa.
authorities.
Date . 5-)?' 41 n-7
ng complaint are true and correct, to the
I understand making any false statement
§4904, relating to unsworn falsification to
Plaintiff_a l.4w in
Dawne M. Blomstrom.
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Dawne M. Blomstrom,
IN THE COURT OF COMMON PLEAS OF
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Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA
V. CIVIL ACTION-LAW
DIVORCE
David M. Blomstrom,
Defendant NO. 06-7098 I CIVIL TERM
CERTIFICATE OF SERVICE
I, Holly 0. Vaughn, Certified Legal Intern, Family Law Clinic, hereby certify that I
served a true and correct copy of the divorce complaint on David M. Blomstrom, residing at
W 6151 Elmwood, Menominee, Michigan, 49858, by depositing a copy of the same in the
United States mail, certified, restricted delivery, return receipt requested, postage prepaid.
Service was complete upon receipt by David M. Blomstrom on the 8 h day of August, 2007 as
evidenced by the attached green card.
S&(
Holly O.' Vaughn '
Certified) Legal Intern
s'-U& -
Anne c onald-Fox
Supervising Attorney
FAMILY LAW CLINIC
45 Northj Pitt Street
Carlisle, PA 17013
(717) 24 2968
Fax: (711) 243-3639
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Dawne M. Blomstrom, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION - LAW
IN DIVORCE
David M. Blomstrom,
Defendant : NO. 06-7098 CIVIL TERM
NOTICE TO DEFENDANT
If you wish to deny any of the allegations set forth in this affidavit, you must file a
counteraffidavit 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
1. The parties to this action separated in approximately June 2006, and have continued to
live separate and apart for a period of at least 2 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 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. §4904, relating to unworn
falsification to authorities.
Date \ \-VW1 OA
a15awne M. Blomstrom
Plaintiff
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Dawne M. Blomstrom, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION - LAW
IN DIVORCE
David M. Blomstrom,
Defendant : NO. 06-7098 CIVIL TERM
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under §§ 3301(c) of the Divorce Code was filed on
December 13, 2006. 'A Praecipe to Reinstate Complaint and a reinstated complaint were filed on
March 29, 2007. An Amended Divorce Complaint was filed on May 29, 2007.
2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days
have elapsed from the date of filing and service of the Complaint.
3. I consent to the entry of a final decree of divorce after service of notice of intention to
request entry of the decree.
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. §4904, relating to unsworn
falsification to authorities.
Date aO O )u'
Dawne M. Blomstrom, Plaintiff
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Dawne M. Blomstrom,
Plaintiff
v.
David M. Blomstrom,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
IN DIVORCE
: NO. 06-7098 CIVIL TERM
WAIVER OF NOTICE OF INTENTION TO REQUEST
ENTRY OF A DIVORCE DECREE UNDER
43301(c) OF THE DIVORCE CODE
1. 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, lawyer's
fees or expenses if I 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. §4904 relating to unsworn
falsification to authorities.
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Date LDawne
M. Blomstrom, Plaintiff
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Dawne M. Blomstrom, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION - LAW
IN DIVORCE
David M. Blomstrom,
Defendant : NO. 06-7098 CIVIL TERM
NOTICE TO DEFENDANT
If you wish to deny any of the allegations 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.
AMENDED PLAINTIFF'S AFFIDAVIT UNDER SECTION 3301(d) OF THE DIVORCE
CODE
1. The parties to this action separated in approximately June 2005, and have continued to
live separate and apart for a period of at least 2 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 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. §4904, relating to unsworn
falsification to authorities.
Date I I' Imp
awne M. Blomstr
Plaintiff
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Cumberland County Bar Association
32 South Bedford Street
Carlisle, PA 17013
(717) 249-3166
AMERICANS WITH DISABILITIES ACT OF 1990
The Court of Cumberland County is required by law to comply with the Americans with
Disabilities Act of 1990. For information about accessible facilities and reasonable
accommodations available to disabled individuals having business before the court, please
contact our office. All arrangements must be made at least 72 hours prior to any hearing or
business before the court. You must attend the scheduled conference or hearing.
Dawne M. Blomstrom,
Plaintiff
V.
David M. Blomstrom,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
IN DIVORCE
: NO. 06-7098 CIVIL TERM
NOTICE OF INTENTION TO REQUEST ENTRY OF § 3301(d) DIVORCE DECREE
TO: DEFENDANT
You have been sued in an action for divorce. You have failed to answer the complaint or
file a counter-affidavit to the § 3301(d) affidavit. Therefore, on or after April 17, 2008, the other
party can request the court to enter a final decree in divorce.
If you do not file with the prothonotary of the court an answer with your signature
notarized or verified or a counter-affidavit by the above date, the court can enter a final decree in
divorce. A counter-affidavit which you may file with the prothonotary of the court is attached to
this notice.
Unless you have already filed with the court a written claim for economic relief, you
must do so by the above date or the court may grant the divorce and you will lose forever the
right to ask for economic relief. The filing of the form counter-affidavit alone does not protect
your economic claims.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU
DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE
THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL
HELP.
IF YOU CANNOT AFFORD A LAWYER, THIS OFFICE 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.
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Dawne M. Blomstrom, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : CIVIL ACTION - LAW IN DIVORCE
David M. Blomstrom,
Defendant : NO. 06-7098 CIVIL TERM
PRAECIPE TO TRANSMIT RECORD
To the Prothonotary:
Transmit the record, together with the following information, to the court for
entry of a divorce decree:
1. Ground for divorce: irretrievable breakdown and separation for two years
under § 3301(d) of the Divorce Code.
2. Date and manner of service of the complaint: Certified mail, restricted
delivery, return receipt requested. Service was complete upon acceptance of service by
Defendant on August 8, 2007.
3. Date of execution of the affidavit required by § 3301(d) of the Divorce Code:
February 26, 2008; Date of filing and service of Plaintiff's Affidavit upon Defendant:
Filed February 29, 2008 and served March 4, 2008.
4. Related claims pending: None.
5. Date and manner of service of the notice of intention to file praecipe a copy of
which is attached: First Class United States Mail on March 25, 2008.
Date
Angel Bradley
Certified Legal Intern
At4xt &??
Meg esmeyer
Supervising Attorney
FAMILY LAW CLINIC
45 North Pitt Street
Carlisle, PA 17013
(717) 243-2968
Fax: (717) 243-3639
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
%rA
STATE OF PENNA.
Dawne M. Blomstrom,
Plaintiff
VERSUS
David M. Blomstrom,
Defendant
NO. 06-7098 Civil Term
DECREE IN
DIVORCE
AND NOW, Aar- 1 IT IS ORDERED AND
DECREED THAT
Dawne M. Blomstrom , PLAINTIFF,
AND David M. Blomstrom DEFENDANT,
ARE DIVORCED FROM THE BONDS OF MATRIMONY.
THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE
BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT
YET BEEN ENTERED;
NONE
BY THE C
ATTEST:
PROTHONOTARY
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Dawne M. Blomstrom,
Plaintiff
V.
David M. Blomstrom,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
IN DIVORCE
: NO. 06 - 7098 CIVIL TERM
NOTICE OF ELECTION TO RETAKE FORMER NAME
Notice is hereby given that the Plaintiff in the above matter, having been granted
a Final Decree in divorce from the bonds of matrimony on April 24, 2008, hereby elects
to retake and hereafter use her previous name of Dawne Marie Wert, and gives this
written notice avowing her intention in accordance with the provisions of 54 Pa.C.S. §
704.
Wishes To Be Known As:
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
r
Dawne M. Blomstrom
?]?/p WeX7
awne M. Wert
SS.
On the 19`h day of June, 2008, before me, a Notary Public, personally appeared
Dawne Marie Blomstrom, known to me to be the person whose name is subscribed to the
within document, and acknowledged that she executed the foregoing for the purpose
therein contained.
IN WITNESS THEREOF, I have hereunto set my hand and Notarial Seal.
NOTAR PUB
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UNDA QTARY?PUBLIC
CARLIS!£ BtNZD?}?ABfRIAlID COUNTY
MY COMMISSION W4 DEC. 22 2010
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