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IN 'I'm: COllin 01" COI\1MON I'U:AS OF
Clll\lIU:JU,ANU COI I NT\'
l'lnhlllrr
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CIVIL ACTION - LA W
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CIVIL n:ltM
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IN UIVOltO:
COl\tI'l.AINT IN J)Jvoltn:
COl\1t:S NOW, thc Plnilllill: S'I't:Vt:N Uit: MAXt:\', by IIl1d through his coullscl,
Sally J, Winder, t:lllnlr.., IIl1d rcprescllls as Ihllows:
I. PlllilllUl'is Sn:VEN I,U: MAXE\', who currclllly rcsidcs III 275 Meadows Road,
Ncwville, Cumbcrlnlld Coullty, PCllllsylvallia, sillce February 199.1.
2, DelClldalllls Tt:ltIU Rt:Nt:E MAXt~\', who currelllly resides 01128 Wealherwood
Cour1, Apt. II, Willsloll-Salcm, Norlh Carolllla, sillcc Jalluary 19'15.
), Plailllill' has beell a bOlla flde residclIl oflhe COllllllollwealth ofPcllllsylvallia lor at
leasl six mOtuhs immcdiately previous to Ihe llIillg of this COll1plaill'
4. The Plailllill'nlld Delclldaru wcremalliedollAprill7.I987.IIIYllIk. YllIk Coullly,
SOUlh ClllOlllln
5. There hnve bcellllo prior IIcliollS of divorcc or lill IIlIlIulmelll belweclI the pallies,
b. The mallingc is inclrievnbly brokell.
7, Plainlill'uvcls Ihlll he hils been lid vised nfthe IIvllilnbilily nfwllnscling sessiuns Ibr
holh parties upun request llfcilher pllrly III by urder UfCOllrl, and Ihllt II list uf1lulllilled
prolcssionllls whu provide such counseling service is IIvllilllble III lhe Dumestic Relations Olllce
upon requesl. By the tiling of this Complllint, Ihe Plllintill'lIcknuwledges hllvinl! heen advised by
his altmney of record oflhe aVllilllbility ofcuunseling sessions and ufn Iisl nf1lunlilied
plOlcssionals. Pluinlill'lilrlher avers Ihal he has heen advised Ihallhe choice ofa qualitied
Pllllcssional shllll be lit Ihe option of the Plaintill'nnd de/cndanl and nced nol be selected Il'oln the
list available upon requesl and, Iilllher, Ihat arrangements fill' and the paymcnl oflhe services of
Ihe lJualillcd plOlcssional shall be Ihe responsibility of the parties and will not be Included inlhe
docket costs oflhis proceeding.
8. Plllinlilr requesls the COUll to enter a decree of divorce,
SRlly J. , IlIdrr, Allornry for 1"RllltlfT
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Date: --4-2J2~
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NOTln: TO U.:....:NUANT
If you wish Iu dcny IIny oflhc sllltclllcnls scllilllh ill this nllidnvit, yuulIIusllile a cuunlcr-
IIl11davil wilh Iwcnty dllYs IIl1cr this all1davit hilS bccn scrved on you or the sIalclllcnls will be
adlllilled.
I.I,AIN....I..I'.'S AI,'I'"II)A VIT IINU.:R
St:CI'ION JJOI(II) 011 Tin: U1VORCE com:
I. The parties 10 this aclion scpllrated on Seplclllbcr 4, 1991, and hove conlinued tu live
5eparale and apal1 fill II I'eriud (If at leasllwo ycars.
2. The lIIania!!e i5 inetrievably brokcn.
J. I UndCf8land thlll IlIlay lose rights Cllnccrning alilllony, division (If plll(lerty, lawyer's fees
or cxpcllses if I do 1101 c1l1illl thcm belore a divorcc is grolltcd,
I verify thai Ihe SllIlclllcnts lIlade inlhis IIl11davit arc Irue and corrcct. I undcrstand Ihnt fldse
statements hcrcin nre IIlllde subjcct to thc pcnahics of 18 I'a, (' S scclion4lJ()4 relllting to
unsworn fltlsiflcalions to authoritics.
Dale _~ c.>'-i h~I:L~ti_
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II' holh)
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(h) I wisli tll dllillll'l'lIlIOllllr Iclicfwhkh lIlay IIldude "1iIllOIlY, divisioll
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Hay I', 19'H
HI. Terri H. Haxey
128 W~ath~rwood Cl.
Wlnllon-Sllom HC 27103
REI HAXEY V. HAXEY
Our HI. Huoy I
Thank you for your pro'"l't rulponl~ In slllninll and retorninll to me th~
Counter-Affidavit and Acceplance of Sorvice.
I am aasumll'" thot you do not ol'pole the Ulvorce ond do not wish to
mike Iny clalml for ~conomlc rell~f. Pleal. confirm to md that thil Is
lrue 10 thlt I mlY check off those it"m. on th" eountn-MfidsvH. 1
ball eve you jUlt forgot to do thlt when you lillned the Counter-Aflldlvit
and put it in the mail. If you will either call me, Iu md. or wrHe to me
and lei me know thet thll II the cale and 1 will just check tholO H"ml on
the orllllnll Affidavit, 80 ah"ad and fila it and obtain lh" Ulvurce
Decree,
SJW/haf
Very truly yuurs,
'ftIt;o,}/)J)~