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HomeMy WebLinkAbout95-02241 1l~111 ,If till IIllt,,,,.1( (H WAYNE F. SIIADE ArrORNH AT LAW 5J WPH l'oMIHH SIHHt C>\HUSIT.I'I'NN!ol'd">\NI" 1701J ... 'U' 'li\It;2" ....'Ir. .'n ...,.".,."" ", 1"_"'..,,1 -1'1":' . .l', ~ 'I I. ,. I" ' "rf< :~,' OJ' ,.101, 'I II,! ; PETITIONER'S I EXHIBIT .6) 1(,0"<) ~.( $5,73. [I(\l:".',,'1"11( . "'1"'" ""~'(ED .'" ,t.\U.. \ ".-" , REI~.""nrG"I-r:D \ .... t L l ~ a;;. 'Y' \.~\ ~'\. 1'-) RES'-n r,t.' .';1'\ I Ldn,J a r..u DEU\fERY ..- -. "\ . " .>':' ,,", >t" -. ..... ....., ....' ! 1.~~ " IN RE: JEFFREY MERRILL WARME IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 95;)JYI CIVIL TERM ORDER OF COURT AND NOW, this 2 ~ ~day of April, 1995, upon consideration of the Petition For Change of Name, it is ORDERED that a hearing on Petitioners' request be held on Tuesday, May 30, 1995, at 3:00 p.m., in Courtroom No.5, Cumberland County Courthouso, Carlisle, Pennsylvania. IT IS FURTHER ORDERED that the notice of the filing of said Petition and the aforesaid date, time and place of the hearing be published once in the Cumberland Law Journal and a newspaper of general circulation in the County at least 10 days prior to the hearing; in addition, Petitioner shall comply with all other requirements of C.C.R.P. 5, and the Act of December 16, 1982, P.L. 1309, S6, and 54 Pa, C.S. SS701 et seq. (1994 Supp.). Notice to the natural father shall be by personal service or by certified mail, return receipt requested, restricted delivery. Notice by certified mail shall not be considered adequate unless the natural father has personally signed the receipt card. BY TIlE COURT, J J. Aayne F. Shade, Esq. 53 West Pomfret Street Carlisle, Pa 17013 Attorney for Petitioners :rc TRUE COpy FAOM RECORD In i.)".tlil1(l:lY '.lIhf1(~nt, I hllfu \lilt,) ~~I my hand ,.plIIIW ~;",Illf ~JiU Cuurl ill [.<\rllblft, Pa, ) I ~1\_)Ld3Y oLi~/!-L~ 19 h )..., (, hl,((._ ,u,''1' I PrOlhon01ary I s I .. ! I ! i I I <C !ci i ~- . all I 8-r I a:! I ' i i CIl I ffi I lJ ! E = ~i <!) ~ i I I ~j I . I (D I ~~~~I ~: ! ,0 C'oI = ~ I I ~~I n. .... 0> ffi ~ .., .~... ~l LL ~ i 0 ;, '.- ~I - R CIl 13 u (!) .'. I~ c ~ 0: ~ ~ i .... :;1 i u I ~ Ql' :E g C'~ I o w == 0 ~ ~ w , a. s:: 0 ; ~ ~ Jl I ~I . - ! .....- -', \ o l:! ~ c B. & 6 <l> g Q E .~ ~ ~ -g ~E '" 2 5- il~ E f b ~ r: \l.l -; g C l]J \j iii ;~ 1) u I I I I I ! I I l""'l:l , Ii... I g ~ ,I 11 ~ ~ tli E ~ 5 ~il, g c g} ~ ~~I:-'~ R .~ Itt~! vi, "1 .-. 0' {', ~ ~ ~~J ~ , , i r f I I I I U' " Ul ti: i~ ,..... 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To: The parents of Jeff Jones From: STAN MARSHALL, Date: Sept. 29, 1992 It is a pleasure to have Jeff In my ComptJter Literacy class. He Is a model for her peers In both behavior and academic effort. It is having students like Jeff that makes teaching a worthwhile profession. You have every right to be proud of him. Thank you for sharing him with me one class period each day. Sincerely, Stan Ma,rshall . ",., , " . 3':. '. ,<\i~~';\. ':}~'~ .' 1;;;;1. '-'!;.J-.~~_-.t '., <C."'.""."..' .-,\- . ,li'l;- ~'r ,tU \(~, '. .,:/- ". ',..tr;.'-~ "." " >l,,\., ' .'rs~-"'~-I . '\ ~ ..f ;,,-:" ., ..... ,- -'1' ." . (Must Be Presented to INFORMATION Building Entry ".flame .J;> Transact i on ,,-J: (( U C- It. Student w Last Name STUDENT Bldg. No. J'l.t. Address '.J'J:' a.1.:L!u: h....l Sex (MIFl -L. Bus No. Birthdate (YYMMDD) >'\'.,/tl) Bus Time (HHMM) ~ Stop No. Immunization Required Immun i za t ion Camp I e ted r ,.' ,.( '-. - Previous School Gik j, u;.r/oSalia: 1lJ.:j' '!l( Principal When Carlisle Area School District School Admission Permit Child Enters School) Residence Code Previously in CASD (Y/N) Date Issued J.'l..;;";'~l t.. First Name k.i '"''r City/State lllrhJ*. Grade Level Middle Name Home Phone Atd Rpt Code "' I I. ~.-i I I Zip Code 1i\11.' Home Room ,'~M. Townshi p' ~t il\ . Race Code ~ ~~~~~~curity Number ~ of Bi~h Pre-School Immunization Active (Type Needed) (Y/N) ---- = = = a ~ = = a = a = = = = = = a = = = = = = = = = = = = = = = = = = = = = = = = = = = = = PARENT/GUARDIAN INFORMATION Last Name L 1. {' .1.t~ ,.- Place of Employment 1\L1lt1 Last Name J.....'t Place of Employment tU,UlIIN!r Mother's Maiden Name ..'.l;c,.....u:l;w First Name 1\ 11*1j J First Name SU, OTHERS LIVING AT ADDRESS Las t Name Fi rst Name Additional Information: J.:t:i.JIl M. I. Sex Birthdate Social Security (M/F) (YYMMDD) Number M rl tt~III'J" ~l~'J_ny.ltnU Occupation (Title) Work Phone .:uw'l/.1.. M. I. Sex Birthdate Social Security (M/F) (YYMMDD) Number ,\ r UVI fJ/<JJ .i~M.~_(~"1 Occupation (Title) Work Phone Residential Status (House. Mobile Ho~e. Apartment) - Rent - - Own - 'II lJIIL M. I. Sex (M/F) Gr. ,\0" Birthdate Soc. Sec. No. ( YYMMDD) Student Att. Student Inf' - Student A, - Census I , I II I I I f I I I i i i i MAil" mIl' 10" GUAI'ltJ ~t':'~I~~~~' I'll'. ~ 1. tlAMI U"If.I'f11,M'J~'I.J P1e"J~ rud Privacy Act St,.HrlJll'tlt .Ila Agency lJisclOSUt' Notil'e on r~lj('fSl' ",ior fo com"Ieting rh{s form, APPLICATION FOn UNIFORMED SERVICES IDENTIFICATION CARD DEERS ENROLLMENT lormApll'u~"j OMI! Nil 0'0400:0 ('lHr" Au'l JI, '''J , I" UI U"liICl z ",9 Z 0>- g ~" z~ 0", "'''0 ~ ~... ~ Z = ffiS ~ 04 6 ffi~ ",lhfj! .. Oli U~I t:(lIld <!O al;,. 6 .... <t:( ~ > 5 S,. - =>.. bi!l '" III z ... o !: -;; tJ b '" ~ '" It p"" I,M{lI I '''oMit.. II CU""WI HI\IIlUlel AlllllIl\\ .. CHY 1I OAn Of 81"111 (nrrMMMOOJ " W~\IIM(,,,.." O"'TI JO rl'MM vaJ ,,', II 'MMI U,",I'f1f,Mtdlll,} " IA\T UPOAH f~YrrM.'.f.MOOJ " (lfy .. Mil " t 'll'II)1 IAII(lI\\tJl() " '.:~ ) J4 COLUK IIAI" MS \1' J nt, (o'SH) 4. \TAlUS 10 III NO 11. IA\l UI'LJATI lyrrrMMMVU) II VII 14 \urrLlMWI^l AOUIII\\ IWOIIMA1l0N II, COUrwl.Y 10. 1I0Ml IlltPlioriE NO. ,'''dud' AI'" Cod.J .. ,. 1\ Itllt.iIH 11. MA""AL \TAlUS 16 W(IGIU I",.'" C T EL EU J4 \Ill n IIHAIlON\ltlP , ,II ~ _ 1\ I CUMUlI "l\iO(fiCl AlJUII[\\ ,I; Wi 41. OAt[ Of 111I1Il fY'r"rr~MMDD' 1 ": n, MARITAL \TATUS DAfE (yryrMMMDD) 60. [NO ELlG REASON MS C ., T, bl_Ull 6J IIIlATlON\'"P , ,~' ,,, _, II" 'I 66, LA" UPOAll (YryrMMMOD) ; " ~ " ..: 10 City 61, (U"RENI 1Il\IDlNCE AVDIIU\ " \ ~,' " " MS !: U:li 1", ':;-'1" EU Y EL' "0 :';,. ", ',' 19. SUPPLlMENTAL AOO"E\$ INfORMATION ',,1.'(;',". '" 1$, CAll Of "IITH (YrYYMMMDO) II. WEI(jHT .... MARITAL UAIUS DAII fYYrYMMMODJ ':.": '" .. [NO [L1(j R[ASON C T ' EU' EL AND SIAL I hive rlld Ind understlnd the .Condition. Applicable to Sponlor or Applicant. printed in Section VIII on reverse, I "rtify the Informltlon plOvided in connection with the eliglb,lity requirements of thl\ form i. truI Ind lceurate to the belt of my knowlldge, (If nor,1 ntd in rhe re,ence of the veri in official. rhe JI n.rure mUff b. not.r/lfd.' '0, SIGNATU (.' I 'fPIO 9J tlAY G~Ol , ":.- 'is 'IIL[ 'H DUll' "'IONt NO 1.:1 , "1"'1 It I' I , (rryrMMMDO) ~'4, i ,', : I I', ,'1,'01 ",I. I" 101. PAY GIlAOl 10J urjlflCOMMArlO NAME . ' I' ,', 101. "PIO NAMI .-./jlll,MI , .j ,: .' ""'1/ .; 104 TIIll 10S Ute 106 DUf'! PHONI NO. , ' ~ . " 'J ~ I RECEIPT OF NEW CARD IS ACKNOWLEDGED " 110 \1(jNAIUIU "I" I , I , (yyrrMMMoOJ ""-!, DO Form 1 172. 5EP 90 f.,,. ,. UWI/COMMAND NAM ;' .- I. I (, t't:!,i : 'II 91 UflITICOMMAtllJ ADORU\ (W.", Clry, Sru"llpCodrJ ,I " 'II".:' 1-1' I I I ',I. . ", I' ',; 101 UPlIrlCOMMANO "COIUU fJlf1",clry,JI.rr,llpCodrJ III OAf( \IC,,,O (rYrrMMM'DOJ Prt'\'IDU! t'd,tH:mJ ,"e oblOlere 102012'01 IN REI JEFFREY MERRILL WARME . . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 95-2241 CIVIL TERM : . . ORDER OF COURT AND NOW, this '?,O;(day of May, 1995, upon relation of Wayne F. Shade, Esq., attornsy for Petitioners, that service has not been effected upon the natural father, the hearing previously scheduled for May 30, 1995, is RESCHEDULED to Thursday, June B, 1995, at 3130 p.m., in Courtroom No.5, Cumberland County Courthouse, Carlisle, Pennsylvania. IT IS FURTHER ORDERED that the notice of the filing of said Petition and the aforesaid date, time and place of the hearing be published once in the Cumberland Law Journal and a newspaper of general circulation in the County at least 10 days prior to the hearing; in addition, Petitioner shall comply with all other requirements of C.C.R.P. 5, and the Act of December 16, 19B2, P.L. 1309, 56, and 54 Pa. C.S. 55701 at seq. (1994 Supp.). Notice to the natural father shall be by personal service or by certified mail, return receipt requested, restricted delivery. Notice by certified mail shall not be considered adequate unless the natural father has personally signed the receipt card. BY THE COURT, Wayne F. Shade, Esq. 53 West Pomfret Street Carlisle, Pa 17013 Attorney for Petitioners Irc IN REI JEFFREY MERRILL WARME IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 95- ..',} '" CIVIL TERM ORDER OF COURT AND NOW, this Z ~ tl,day of April, 1995, upon consideration of the Petition ~'or Change of Name, it is ORDERED that a hearing on Petitioners' request be held on Tuesday, May 30, 1995, at 3100 p.m., in Courtroom No.5, Cumberland County Courthouse, Carlisle, Pennsylvania. IT IS FURTHER ORDERED that the notice of the filing of said Petition and the aforesaid date, time and place of the hearing be published once in the Cumberland Law Journal and a newspaper of general circulation in the County at least 10 days prior to the hearing; in addition, Petitioner shall comply with all other requirements of C.C.R.P. 5, and the Act of December 16, 1982, P.L. 1309, 56, and 54 Pa. C.S. 55701 et seq. (1994 Supp.). Notice to the natural father shall be by personal service or by certified mail, return receipt requested, restricted delivery. Notice by certified mail shall not be considered adequate unless the natural father has personally signed the receipt card. BY THE COURT, ". " :1; r, , --'; Cl.> J ,_,.... J. '-'= Wayne F. Shade, Esq. ,","''''', ,'- ..~/'., t. ,,' 53 West Pomfret Street Carlisle, Pa 17013 Attorney for petitioners , . ,} ') " ). .. U'J U1 :rc ~ ~ :Sl 'il ~ ~" . lI" ., '" " r ;, t ~ r...c il ~ l'l r.. - ~I m 0 ! j j i I fil I.~~ t!l ~ : ~ ~ ~ r..~:S~ ! ~ ~ ~ o I U! :j gj !8~ z i r.. ~ ~! ; ~~ {j ~ H U .cl E-< ~ ~~tJ .. H r:! &1 ~O III Z . ,. , " , ;;0/ r '-t -7'; '.' . ~ ~ ':1-~ ..')~ ...)'J ~ r~,