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COMMONWEALTH OF PENNSYlVANIA
COURT OF COMMON PLEAS
CUMBERLAND
JUOICIAL OISTRICT
NOTICE OF APPEAL
FROM
DISTRICT JUSTICE JUDGMENT
COMMON PLEAS No. 1995-3362 Civil '!'em
NOTICE OF APPEAL
Notice is Yl\nfU that lhe appellant has filed In Che alJovc Court of Common PIt'~1S an ollllJCal from the judgmcnl rendered by the District JU\tICC
on the dale and In the caslt mentioned helow,
...lIIa 0.. ....-.1......,
..... Oil'. ..-0--:-0..--....... a" D.',
JOHN PIKULIN, D.C.
Charles A. Clement, Jr. 09-1-01
........0.. ..".....1....,
en.
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I'" co..
221 Bridge'Street
New CUn'berland
PA
17070
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5/23/95
GENERAL ACCIDENT INSURANCE ..
.,....."",.. 0," .....
JOHN PIKULIN, D.C.
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CV 19 CV-OOOOll4-95
LT 19
nllS block Will be signed ONLY when this notation
R.C.P.J.P. No. 1008B.
ThiS Notice of Appeal, when recclved by the District JUSlice, will operate as
a SUPERSEDEAS 10 the juugmenl for IJOnCSSlon in thiS case.
!It
Mark D. raclshaw - 71 -237-6033
is required under Pa.
If aplJellanr was Claimallr (see Pa. R.C.P.J.P.
No, 100/161 ill acrioll before Districr Justice, he
MUST FILE A COMPLAINT wirhill lWl!IIly (201
daysalrer lilillg hi. NOTICE 01 APPEAL,
S,gn,nut., 01 Prorhonot.,v Of D~PUfV
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
(Thi. seclioll of lor", ro be userf ONL Y whell appellallr was DEFENDANT (see Pa. R.C.P,J.P, No, 1001171 ill acrioll before Districr Ju.rice,
IF NOT USED, derach from copy olllOrice 01 appealro be served UPOII appelleel.
PRAECIPE: To Prothonotary
Enter rule upon GENERAL ACCIDENT INSURANCE
N.,mtl of .pp.lI~fI(sJ
. a complaint in this appeal
(Common Plea. No, 1995-3362 Civil '!'em I wilhin twenty (201 day. after .ervie
Slgn.,UffI 01 ~., MIl or hil."om... or .gent
RULE: To
r.:1O'N1O'D.ft.r AfV'TnJ:V11 n.1C::IID.ft.M('~
N.m. 01 ~pflllftl(d
. ap""lIeelsl
111 You are nOlified that. rule i. hereby enlered ul>on you to file a complaint in Ihi. appeal within twenty (201 day. alter the dale of
service of this rule upon you by personal service or by certified or registered mail.
121 If you do not file a complaint within thi.lime. a JUDGMENT OF NON PROS WI LL BE ENTERED AGAINST YOU.
131 The dale of .ervice of this rule if .ervice wa. by mail i. the dale of mailing,
Olle:
.111"" 22, . 19~
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"OPe 312.90
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COMPLAINT
(T"iS ()foof of S('rL'/(l! MUST fir FfL FO WITHIN r!\:r r.t)} /Jiir'S ...iF' { II' /d;fI~i till' nlJ{iU' (If ,ml'!,',)!. ClWlk ,"jfJ/ll!c.IIJ/t,'/JCI".'M
COMMON\VEAlTti or PENNSYLVANIA
COUNTY OF..__~____^_,_
;u
AFFIDAVIT:
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J Ulp'( of 111\' NOllC!: ul i\I'I"',II, CUll'mlltl Pit',I',
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No. .~---:_______, upun tl:I'
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O,:>,;'",! JUq,Ct' dl''i.t.lll,ilj,tJ thCII~d' on
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..od fill fth~ltl"" I' ',F<rVI'd flU! Hull'
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!1I l ,I.! .. COl\lpi'idq <tru,lllp,tlly:ntj lh.~ cf"O\(.~ N01;f:~ of Appf-'cil 111)011 Ihl' appcll~f'I..1 to
__, HI "1 lIy I1t'/',OI1,II- 'il'll.'ir;fl! hy ((t,"dl(HJt (Il~ql'"r,~rl~(ll
In,l.!, sorUIN"'S rerf1'ljJl'JllitChl'd hf'lt'tu
SIVOfiN IAI f IBMfDl AND SUB5Cfll!lED UEfOlIE Ml
THIS_ _ [MV or. 19... _.
S'!JIl.lftIW "~I fI"'l ',I" 1)(,'0'" ., "1~11" .JI"IJ.I~" ..\'<1, o'.-/!'
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NOTICE OF APPEAL
COMMONWEAL TH OF PENNSYLVANIA
COURT OF COMMON PLEAS
ClJolBnu.1IND
JUDICIAL DISTRICT
-
,
FIlOM
DISTRICT JUSTICE JUDGMENT
COMMON PLEAS No 1995-3362 Civil TeDn
NOTICE OF APPEAL
NOllce l!o glVl..'I1 thai Ilw dppell.tl1t hin fdl'd 111 the ahovL' COUlt of Commun Pleas an dllpeal f,ul111hu judYIIU!nI rcrull!rcd hy the DisHict JustlCL'
on the dalL' dud In the Cine nwntioned helm-v.
iii'ii'i""iji-.'..UA,.,
"...01". "0-, Co" "'".... 0'" D.'.
JaIN PIKULIN, D.C.
Olarles A. Clement, Jr. 09-1-01
.00.... 0'" "...~......,
elf'l'
.,..,.
... coo.
221 Bridge Street
New ClMberllU1c1
PA
17070
DA'. O. 'UD.".'"
If' ..... c.... 0" '" ,.' "
"..._,....'
5/23/95
GENmlAL ACCIDfHr INSURANCE
JottI PIKULIN, D.C.
c....,... NO.
CV 19 CV-OOOOl14-95
LT 19 Hark D.
ThiS hlock will he signed ONLY when thiS notation is required under Pa.
R.C.P.J.P. No. 1008B.
ThiS Notice of Appeal, when leceivud hy the District Justice, Will opt.Hale as
a SUPERSEDEAS to the judgment for POSSC!5oSIon in IhlS case.
If appellallt was Claimant (see Pa. R,C.P.J.P.
No. 1001(6) in ilCtiofJ before Disrrict Justice, he
MUST FILE A COMPLAINT wirhin twenty 120}
day. alter filing Iri. NOTiCE of APPEAL,
S,,,n,Jrur~ 01 ProlhonOlary or Dt!pulY
PRAECIPE TO ENTER RULE TO FILE COMPLAINT AND RULE TO FILE
IThis section of for", to be useel ONL Y when appellant was DEFENDANT (see Pa, R,C.P,J,P, No. 100l/') in action before District Justice.
IF NOT USED. detach from copy of notice of appeal to be served upon appellee},
PRAECIPE: To Prothonotary
Enter rule upon GENERAL ACCIDENT IN5UIlANCE
NoJmr 01 JpprllH(sl
. a complaint in this appeal
ICommon Pleal No. 1995-3362 Civil '1\3mI ) within twenty (201 days aher lervi
RULE: To
r.~"l. "O"TT"""" Ib1S1lRa.MCF
N.me Df J/J".IIee(rI
. appelleelsl
(1) You ale notified that d ,ule is heleby enteled upon you to file a complaint in this appeal within twenty (20) days after the date of
service of this ,ule upon you by personal selvice 01 by certified or registeled mail.
121 II you do not Ii Ie a complaint within thil time, a JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOU.
(3) The date of selvice of this'rule if service was by mail is the date of mailing.
.,
Date: .1I1n.. ", . 19...Ma
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.I .r a.pury
AOPC 312.90
eQURl FILE
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PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT
(Thl!) p'Oof of S('fL'/!'t' MUST fil FlLfO tv/nON F/\/f {51 Vi\ )'S ,4FTf '" !,flllf,' til,' nt)t.'If.' of .1'11"'11 L'lIl'{ k ;1!'J1J't"bh~ /JO~IJ.'SJ
COMMONWEAL TH or f'ENNSVlVANIA
COUNTY 0.___ . ___~E:RLAN_J:?_____._.___ ,"
AFFIDAVIT:
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Cd ",,,'J- GENERAL ACCIDENT INSURANCE . . _ . .' ..._.... ""
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ISee Re~ersel
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Postmark Of Dale
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COMMONWEALTH OF PENNSYLVANIA
COUNlY OF: CUMBERLAND
'15" - j jt,,, ~iJ 7L.--
COMMON PLEAS NOTIFICATION
PLAINTIFF REQ~~~~RM
~ENERAL ACCIDENT INS.
P.O. BOX 8851
CAMP HILL, PA 17011
L
.... Dot No
09-1-01
-,
OJ NMtt Hon.
CHARLES A. CLEMENT,
1106 CARLISLE ROAD
CAMP HILL, PA
T_ (717) 761-4940 17011
JR.
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DEFENDANT:
NAME and AOOAES9
rpIRULIN, D.C., JOHN
221 BRIDGE STREET
NEW CUMBERLAND, PA 17070
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CHARLES A. CLEMENT, JR.
1106 CARLISLE ROAD
CAMP HILL, PA 17011
Docket No,: CV-0000154-95
Date Filed: 4/17/95
Pl.... be advlHd that an appeal hu be.n flied In the above captioned c.... KJndty us. thle form to indicate the ,..uttl
In thll a..., and rolurn to th"l!"ulng .uthorlty (1IIt.d .-.).
RESULT OF APPEAL
SUMMARY APPEAL
APPEAL STRICKEN" .pp..1 hll b..n dil.llow.d.
APPEAL DISCONTINUED. .pp..1 h.. be.n dl,ontlnu.d by .ppell.nt
DISTRICT JUSTICE DECISION UPHELD" court h.. re..h.d I.m. deellion .. orlgln.1 dl,trlc:lju,Ue. d..I,lon,
_ district justice office II to collect remaining tinea/coata.
APPEAL SUCCESSFUL. court h.. re..h.d d..lllan flvor.bl. to def.ndant
full refund 10 be IlIu.d by dlltrlc:l ju'tle. ollie..
plll1a1 refund 10 be IlIu.d by dl,trlc:l ju,U.. alii..,
REVISED DISTRIBUTION OF FINES AND COSTS
II dlltrlc:l Jullle. ollie. IlIa IlIu. . p.rtlaI refund. pl....lndlc.t. any new dl,tributian In tho amount(l)
ot fin.. and COI" 81 . ,eault of the court', decision.
FINE
COUNTY CRT COST
STATE CRT COST
STATE CST!
HEARING COST
EMS
CAT
JCP
rNC
CNC
CCD
OTHER(pl.... Ip.eify)
CIVIL APPEAL
APPEAL STRICKEN. .ppell h.. been dllo1low.d,
APPEAL DISCONTINUED. Ipp..1 h.1 b..n dlleantlnu.d by Ippell.nt
DISTRICT JUSTICE DECISION UPHELD, court h.. releh.d tho I.m. d.elllon .. tho dlltrlc:ljuIU..judgm.nt
DISTRICT JUSTICE DECISION DISMISSED" .ourt h.' re.eh.d . deel,lon thol do., not con.ur whh tho dl,trlct lu,Ue.judgm.nt
WRrr OF CERTIORARI
WRIT STRICKEN. Ippe.1 h.. be.n dl,.lIow.d.
WRIT DISCONTINUED. writ h., b..n dl,eonllnu.d by .pp.lllnt
DISTRICT JUSTICE DECISION SET ASIDE. tho e.,o will bo r.h..rd duo to irregularity. lack of JUri'dlction. or Improper vonuo.
WRIT DISMISSED. dl,trlct Ju,tleo doel,lon w., not found to be f1.wod, I.eklng jurl,dlctlon. or h.vlng Improper vonu..
STATEMENT OF OBJECTION (Pl.... glv.. g.n.'.laummary ollha ,eaulll)
OBJECTION DISCONTINUED. obJoetlon h., beon dl,eontlnu.d by tho app.lI.nt
OBJECTION DENIED. objoellon h., boon donl.d by tho Court of Common Pl...,
OBJECTION UPHELD. .ppoll.nt', obJoctlon h., boon uph.ld by tho Court of Cammon Pl....
AOPC 729-94
FORM PRINTED:
6/29/95
8:40:33