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HomeMy WebLinkAbout95-02615 .--d - .~ ~ ~ (/ ~ J ! I i , I , l{') - 3 : ('j I I " , I. ;1, I' ., , ,. II ., " .1 'i " 1\ ,i " , '. it , , " I' , <" 1.\; , , , 56/ II' l"~ ? ,'1 I VII " < I _...~ .-- '.. .__._.'t"~ -.... NICOL Y. DAY, Plaintiff : IN TIlE COllin OF COMMON I'I.EAS OF : CUMBl!ltLANI> COUNTY, PENNSYLVANIA v, , , : CIVIL ACTION. LAW IN I CUSTODY BOWARD L, RIDDICK, Defendant : NO, 9.5. CIVil, TEltM Af',IDA vir SUI'I'ORTING IIETI'I'ION IIOK u:m 10 PRo~E1m INF'ORMA I).MII'ERIS 1, I om Ihe pluimiff Inlhc IIhove nHlllcr und h~clluNC of my I1nuncllll condition 11m UMble to pay th~ fecs und cOSls of pruseculinl! or defcndin!! Ihe uctlllJl or procecdlnl!. 2. I om unuhl~ loohluln funds from 11Ilyon~, Including my fllmily lInd lISS0cllll.t:S. 10 pay Ihe cosls of IIllgallon. 3. I represcnl lhul Ih~ Informullon below relullnl! 10 my lIhllllY 10 pllY Ihe feeS and costs Is troe and correct. (0) Nome: Nicol y, Duy Address: 1.55 W. North Slreel, Curllsle, PA 17013 Social Security No,: 160..54.2018 (b) Employm~m If you ure pr~senlly employcd, stule Employer: unemployed Address: nla Salary or wages per munth: n/u Type of work: n/u If you are presenlly unemployed, slUle Dole of lasl employmenl: Fehruury. 199.5 SuI or)' or wages p~r mUl\lh: $375,00 Type of work: HAP. Inc.; humun services (c) Olher Income wllhllllhe pusltwelve mOlllhs Business or profession: n/u Other self-employment: n/u Inlerest: nla Dividends: nllI ,'1 Pension and annullles: n/a Social securilY brneflts: nla Support PUYItl~ltls: $23.40/wcck for 2 chlhJrc/I Disability puymc/lls: /l/u Urn:mpluYlIlcllI cultlpc/lslIllun unL! supplelll~llIuJ be/lel1ls: /l/a Worklllull's coltlpCnsulltlll: /1/11 Public Asslslullce: nlll Olh~r: fuod SllllllpS: $2I)O.OO/lllunlh (II) Olher cultlrlbullu/lS III huus~holL! SUppo/'l Numc: /1/11 ElIlpluyer: /I/u Salury or wugcs pel' mOlllh: II/U Type: of work: II/u CUllIrlbmlons frolll chlldrclI: n/II Contrlbullons 1'1'0111 purems: ELI11h DIlY (Itlolhcr) gives money for support of chlldre/l OIh~r cU/llrlbullo/ls: ELIwllrd L. Riddick gives vurled alllOUlIls of mO/ley for supporl ut' Zaylr A. RIL!dlck (/lUI cuurl uUlhorlzed) (e) Property uwncd Cosh: nlll Chccklng uccou/ll: /lIB Savings IlCCOunl: II/u Certlflcales of depusll: n/u Real eSlllle <Including home): n/II MOlor vehicle: Muke , Yeur: L1ues nol ownllulollloblle Cost, Alllounl Owed $ SlockJl; bonds: II/U Other: nlu TOlallncom~: $293.60/mulllh <plus IlIcome she receives from parellls and Edward L. Riddick) (t) Debls anL! obllgullOlls Mortgage: nlu Rent: $SOO/mol1lh Lollns: n/u Olher: utillli~s: 011 $65.00 eleclrlc $62,00 phol\e $30,00 cuble $60,00 chlldr~II's expellscs $300.00 TOlal expenses: $1017/1110nth (8) PersoJ1,~ dependent upon you for sUPllort Name: Children. If 811Y: Name: Zyulr~ A, Riddick Age: 11 months Turen R, Duy Age: 9 years Tres J. Day Age: 7 years Other persons: nla Nome: nla I .:) r u ~' 1-..1 J;'-. b; ,i ;l .... r) .. ~ , .~. t1l ........ " ~J b,.... .., .'11' ,