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IN THE COURT OF COMMON PLEAS
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OF CUMBERLAND COUNTY
STATE OF _ PENNA.
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DEBRA MARIE THIPHAVONG,
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CIVIL 95
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Plaintiff
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MONH THIPHAVONG,
Defendant
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AND NOW.~",~,
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DEBRA MARIE ..... __.
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MONH THIPHAVONG
ond """",.,",.,',.,.""".""."""""""""".,.,.
ore ciivorcftd from thft honds of matrimony,
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The court rfttoins iurisdiction of the following c1nims which hove
bOftn roisp.d of record in this nction for which a final order has not yet
bp.ftn p.ntered;
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NONE
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DEBRA THlPHAVONG,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
: IN DIVORCE
. 1'3;).
: NO. 95- CIVIL TERM
v,
MONH THIPHAVONG,
Defendant
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: no fault under Section 3301(d) of the Divorce Code.
2. Date and manner of service of the complaint: February 16, 1995 by certified mail.
3. Date of execution of the required Counter-Affidavit by Section 3301(d) of the
Divorce Code: March 9, 1995.
4. Related claims pending: none.
?l~ BElLUZ
Student Attorney
Date , 5-:22-~
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THOMAS M, PLACE
ROBERT E. RAINS
LINDA E. FISHER
Supervising Attorney
THOMAS L, PEELER
FAMILY LAW CLINIC
45 North Pitt Street
Carlisle, PA 17013
717/240-5204
v,
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
: IN DIVORCE
DEBRA M. THIPHAVONG.
Plaintiff
MONH THIPHAVONG,
Defendant
: NO. 95- 13;1.,..
CIVIL TERM
COMPLAINT UNDER 23 Pa.C.S. !Ill 3301(cl and 330Hd) OF THE DIVORCE CODE
The plaintiff, Debra M. Thiphavong, by her attorneys, the Family Law Clinic, sets
forth the following cause of action:
1. Plaintiff is Debra M. Thiphavong, who currently resides at 9 South Baltimore
Street, Apt. I, Dillsburg, PA 17019,
2. Defendant is Monh Thiphavong, who currently resides at 1550 William's Grove
Rd., Lot 57, Mechanicsburg, PA 17055.
3. Defendant has been a bona fide resident of Cumberland County and the
Commonwealth for at least six months immediately previous to the filing of this Complaint.
4. The plaintiff and defendant were married on June 12, 1987 in Cumberland
County .
5. Plaintiff and defendant have lived separate and apart since February 1, 1993,
6. There have been no prior actions of divorce or for annulment between the parties.
7, The marriage is irretrievably broken.
r \:tl J L:::J ra '91)
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DEBRA M. THIPHAVONG,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
v,
: CIVIL ACTION - LAW
: IN DIVORCE
MONH THIPHA VONG,
Defendant
: NO, 95- 73../... CIVIL TERM
PETITION TO PROCEED IN FORMA PAUPERIS
Debra M. Thiphavong, plaintiff in the above titled action, respectfully requests this
Honorable Court to grant her leave pursuant to Pa,R.C,P, 1920.62 to proceed in fonna
pauperis to the extent that she be relieved of all costs attendant to this action,
Date 2 -t, - 'ls
I.
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L t k 0'[,,1 (~
THOMAS M. PLACE
ROBERT E. RAINS
LINDA E, FISHER
Supervising Attorney
THOMAS L, PEELER
Staff Attorney
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FAMILY LAW CLINIC
45 North Pitt Street
Carlisle, PA 17013
717/243-2968
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DEBRA M. THIPHA VONG,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
v.
: CIVIL ACTION - LAW
: IN
MONU THIPHA VONG,
Defendant
: NO. 95- 73..2-CIVIL TERM
ATTORNEY'S AFFIDAVIT SUPPORTING PETITION
FOR LEAVE TO PROCEED IN FORMA PAUPERIS
I, Michele L. Belluzzi, of the Family Law Clinic, attorney for the party petitioning to
proceed in fonna pauperis, certify that I believe petitioner is unable to pay the costs of instituting
this action and that I am providing free legal service to petitioner.
Plaintiffs Affidavit showing inability to pay the costs of litigation is attached hereto.
Date .2 - ~- ?s-
1Z4
Michele . Belluzzl
Student Attorney
L-tr'Y]J/l '-.) C: h~~~
THOMAS M, PLACE
ROBERT E. RAINS
UNDA E. FISHER
Supervising Attorney
THOMAS L. PEELER
Staff Attorney
FAMILY LAW CUNIC
45 North Pitt Street
Carlisle, PA 17013
717/243-2968
,-
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DEBRA M. THIPHA VONG,
Plaintiff
v.
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
: CIVIL ACTION - LAW
: IN DIVORCE
MONH THIPHA VONG,
Defendant
,
: NO, 95- '/3.z...CIVIL TERM
AFFIDAVIT SUPPORTING PETITION FOR LEAVE
TO PROCEED IN FORMA PAUPERIS
TO THE HONORABLE JUDGES OF SAID COURT:
The Petitioner, Debra Thiphavong, residing at 9 South Baltimore.Street, Apt. 1,
Dillsburg, PA 17019, York County, Pennsylvania, upon her oath deposes and says:
I. I am the named plaintiff in the above titled civil cause of action and the defendant is
Monh Thiphavong.
2. This affidavit is made to inform the court as to my status of indigency and to induce
the court to grant me leave to proceed in this cause as an indigent.
3. In making this affidavit, I am aware that perjury is a felony and that the punishment
is a fine of not more than $3,000 or imprisonment for not more than seven years or both.
4. I do not have any money on my person, at home, or elsewhere which could be used
for the expenses of this proceeding.
5. I do nol own real estate, personal property, or any other assets. I am not owed any
amounts of money by any person,
6. My husband, Monh Thiphavong, presently resides at 1550 William's Grove Rd., Lot
57, Mechanicsburg, PA 17055, He is 37 years old.
(a) I last lived with my husband Monh Thiphavong in January, 1993,
(b) My husband is employed as a dietary ai~at the Messiah Village, I do not have
,
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information or knowledge as to whether my husband owns an automobile, owns real estate, or
has any other personal property or assets,
(c) I have not brought action for child support payments because my child has been
living with him.
7. I have one child: Cassandra Thiphavong, who was born on March 23, 1988, and who
resides with Monh Thiphavong at 1550 William's Grove Rd" Lot 57, Mechanicsburg, PA
17055.
8. I work at Certified Cleaning Service as an office cleaner,
9, My social security number is 200-52-3652.
10, I have the following income: $600.00 per month from Certified Cleaning Service.
11. My monthly expenses are as follows: $325.00 for rent; $221.00 for car payments; $50
for phone and electric bills; $30.00 for food; and $50.00 for gas, for a total of $676,00,
12, I have a checking account with a current balance of $20,00,
13, I am making car payments on a 1991 Chevy Cavalier. I have 24 outstanding payments.
14. I understand that I have a continuing obligation to inform the court of improvement in
my financial circumstances which would permit me to pay the costs incurred herein.
15, I verify that the statements made in this affidavit are true and correct. I understand thai
false statements herein are made subject to the penalties of 18 Pa,C,S, ~4904, relating to
unsworn falsification to authorities.
WHEREFORE, petitioner prays that this Honorable Court grant petitioner leave to
proceed in forma pauperis in the above titled action without fee or cost to the petitioner,
Date~
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DEBRA M. THIPHA yaNG -J
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;:.. . CompI.t.ltlm. 1 ,nd/or 2 for addltlonal..rvlc... I Ilia wllh to recelvl the
, i. Complet. lterne 3. ,nd 4. . b. following "rvlce. Itor In IKt,. ,. .
~. .. p,int your name .nd Idet,... on the "V'fI' of tN. form to that w. cln 'ee): R "
EdEiiim thil card to you. '
thIa form to the front 01 1M mlllp4ec.. Of on the back If ,PIC' 1. 0 Addlel....', Addr..
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.Tto WrIt."RttumRtc.lpt Requelt.d" on thl m.ilpiK' below the.rtldenumbef 2. [3 Rlltrlcted Delivery :
1 . The Return RKelpt wlll.how to whom the ."Ie" WI' deSlv.,ed and the dl"
I d.llv.m. Conlult aelmalte, for 'e8.
'i 3. Artlcl. Addr...ed 10: 4., Artlcl. Number 1 j :,
i MONH THIPHAVONG P 734 297 023
E 1550 \'1ILLIM1SGFOVE ROAD 4b, S.rvlce Typo
8 LOT 115 7 ~ ~:~~::~.d i:,
MECH1\NICSBlIRG, PA 17055
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, aecember 1991
.u.a. GPO: 1113-3I2-714
DOMESTIC RETURN RECEIPT
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~ Certified Mail Receipt
- .x:. No Insumnce Coverago proVided
__ Do nol use lor International Mall
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'j.1'b'F.lH THIPHAVONG
r6~~H~~LLIAMSGROVE
MEenA~SBURG, PA 1705
Poslagu
$ .55
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FAMILY LAW CUNIC
46 North Pitt I"..,
C.rU,I., PA 17013
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DEBRA THIPHAVONG,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
v.
: CIVIL ACTION - LAW
: IN DlVORCE
MONU THIPHA VONG,
Defendant
: NO, 95-732 CIVIL TERM
CERTIFICATE OF SERVICE
I, Michele Belluzzi, Student Attorney, Family Law Clinic, hereby certify that I have
served .a.true and correct copy of said Divorce Complaint on Monh Thiphavong, residing at
1550 William's Grove Rd., Lot 57, Mechanicsburg, PA 17055, by depositing a copy of the
same in the United States mail, certified, restricted delivery, return receipt requested, postage
prepaid,. this 14th day of February, 1995,
IC uzzi
Student Attorney
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
IN DIVORCE
DEBRA THIPHA VONG,
Plaintiff
MONH THIPHA VONG.
Defendant
1.
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2.
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NO,95-732 CIVIL TERM
DEFENDANT'S COUNTER-AFFIDAVIT UNDER SECTION 330Hd)
OF THE DIVORCE CODE
Check either (a) or (b):
(a) I do not oppose the entry of a divorce decree,
(b) I oppose the entry of a divorce decree because (Check
(i), (ii) or both):
(i) The parties 10 this action have not lived separate and
apart for a period of at least three years.
(ii) The marriage is not irretrievably broken,
Check either (a) or (b):
(a) I do not wish to make any claims for economic relief.
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.
(b) I wish to claim economic relief which may include
alimony, division of property, lawyer's fees or
expenses or other important rights.
I verify that the statements made in iliis cOllnt~r-affidavit are true and correct. 1 understand th:1t
false statements herein are made subject to the penalties of 18 Pa.C.S. ~4904 relating to unsworn
falsification to authorities,
Date ~ - 9 ~ /q Cf (' -
,
MO,^ ~'J'~
. MONHTHI AVO~
Defendant
NOTICE: If you do not wish to oppose the entry of a divorce decree and you do not wish to
make any claim for economic relief, you need not file this counter-affidavit.
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DEBRA THIPHA VONG,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
v,
: CIVIL ACTION - LAW
: IN DIVORCE
MONH THIPHA VONG,
Defendant
'13.;1.
: NO. 95-5t2 CIVIL TERM
CERTIFICATE OF SERVICE
I, Michele Belluzzi, Student Attorney, Family Law Clinic, hereby certify that I have
served a copy of the Notice of Intention To Request Entry Of Divorce Decree and a Defendant's
Counter-Affidavit Under Section 3301(d) Of The Divorce Code on MONH THIPHA VONG, at
1550 William's grove Rd., Lot 57, Mechanicsburg, PA, 17055, by depositing the same in the
United States mail, first class, postage prepaid, this 8th day of March, 1995.
THE FAMILY LAW CLINIC
45 North Pitt Street
Carlisle, PA 17013
(717) 240-5204