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Home My WebLink About95-04228 ::) 12 "3 ~ r;e. .. , " *~--~~*~*-~-~~~****~.)-~.*-~~.**-~ :~.__., ---.---~-------,.---.----.--'" ,,--,.- ",' ----"-..---,...-..-..~---.....-----.'l: ^ l~ ~i IN THE COURT OF COMMON PLEAS '~ ~l ~ WI .,*/ W '.' , OF CUMBERLAND COUNTY ~ '.' tv.~~ ;;~: " ! ... . . ~'.~~.;...r PENNA, VI '.' STATE OF ~ w ~ w ',' .SHIRLEY POKROWKA. Plaintiff l\ (I. 95-4228 CIVIL.. TERM II) CIVIL ACTION - LAW * ~ 'i" \' I"':",ll.'~ w '.' .RICHARD POKROWKA. IN DIVORCE w '.' Defendant w ',' ~ '.' ~ '.' DECREE IN DIVORCE ANDNOW~~,...I?~., 19?~.,... it is ordered and decreed that ..,...., ~!II~!-!!Y. ?9!<!l-9!'1!<!\.., . . .. .. . .. .. . ... . ,.. .." plaintiff. and. . . . . , . , . , . , . ., . . .I~~l;~~ ,~q~l!q~. . . , . . , .' . . , , . . .' . .. . . " defendant. ore divorced from the bonds of matrimony. ~ ',' ~l ',' ~ t'~ W '.' ~ ~.' ~ ," ~ ~ '. ..:. ~ The court retains jurisdiction of the following claims which have been raised of record in this action for which a final order has not yet been entered; ~ '.' ~ 'i" ~ '.' . . , . . . .I:lql:l~.,. ..'. ,.,. ..., ...' ..,..,. . .,.,.-0......,.... ", ~ ~ ~.' ~ ,.' ........,.....,. ... ...... .... o. ... ..1.. ........ ... .... ... ~ r.' ~ .' $ ~ ',' ~ ... ~ '.' ~ *- '.' *- ',' ~ l~ .. ,', ~ ~ ~ ~ '.' $ ~ ~ ~~ ,;,. ~ ,~ ~ ... ~ 1~ ~ * I~ )'.' ~~ i' I~ I',' , , ~ ~ J. * S .* ,~ ~ . . * , . , ~ .~-~.- ". -, . :i: *---**--***-~.~*~.**~*~.~. ._.. .__r _ ._~._....._. '..._-":. __~ /~'15'~) M,{'~ ,IH:JI/~;;4 ~'-7 I,)./!) ~y '71~~ /W,...tJ/ ?/; .~ /Pf"~ SHIRLEY POKROWKA, Plaintiff v. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION- LAW NO. 95-4228 CIVIL TERM IN DIVORCE RICHARD POKROWKA, 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: irretrievable breakdown under Section 3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: August 12, 1995 by first class U.S. mail, certified, return receipt requested. 3. Date of execution of the Affidavit of Consent required by section 3301(c) of the Divorce Code: By the Plaintiff: By the Defendant: December 7, 1995 December 7, 1995 4. Related claims pending: None. 5. Indicate date and manner of the notice of intention to file Praecipe to Transmit record and attach a copy of said notice under Section 3301(d)(1)(i) of the Divorce Code: N/A. ,.. By Respectfully submitted, SODUS & VERNEY . Ii ! , . {'...1 1. I '.....d. t. / J cqueline M. Verney, Es uire 1.D. No. 23167 7 Irvine Row Carlisle, PA 17013 717/243-9190 Attorney for Plaintiff fi - G In ~ ,,- !~ _J.,- CJ,~ - U." if ~ .:-:' Co ~71;:' fl. - ;'~'{:;; 0.: - ..1.,. O:UJ t] U::;,'" ',. l:.Jt.y ~ e:, !.~ll.. ~ '"" If) ...) c-. 0 /:' -~ ,,1 ':i ~ , J I~ .......- .....jJ ~ J { , .J u fi d d ... 1L >i. ~ 1L ' 0 0 \J"Jo 0 0 () In 0 em, ,- t{) \[1 () ..5 .,. ~ 'J '. .. In- '(i + I~ ::7=' - \() 10 ~"" If") 0 r- ~ .... , ~ rj .zl' , r- = - -- ~ 'i/ 11 11. = ~ j c.> ,., :::> '""" . , ,. SODUS & VERNEY Anomc)'s.l(.law . P.O. Box 936 'Carlisle. tennsylviU1iil 11013 (717)243,9190 Facsimile (1\7) 24l,994R . . ; I ------- .--- v. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. CIVU. 11l1l!> 9S-1-j- dd C;S>C' :.,l \~,,'V\ IN DIVORCE 1..'- SHIRLEY POKROWKA, Plaintiff RICHARD POKROWKA, Defendant NOTICE TO DEFEND AND CLAIM RIGHTS You have been sued in Court. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case will proceed without you and a decree in divorce or annulment may be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary at the First Floor, Cumberland County Courthouse, South Hanover Street, Carlisle, Pennsylvania 17013. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF MARITAL PROPERTY, LAWYER'S FEES, OR EXPENSES BEFORE A DIVORCE IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Court Administrator Cumberland County Courthouse Fourth Floor Carlisle, Pennsylvania 17013 (717) 240-6200 v. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. CIVIL 1995 SHIRLEY POKROWKA, Plaintiff RICHARD POKROWKA, Defendant IN DIVORCE COMPLAINT UNDER SECTION 3301/cl OR 3301/dl OF THE DIVORCE CODE 1. Plaintiff is Shirley Pokrowka, an adult individual, currently residing at 49 North East Street, Apartment 3, Carlisle, Cumberland County, Pennsylvania, 17013. 2. Defendant is Richard Pokrowka, an adult individual, currently residing at 1918 Spring Road, Carlisle, Cumberland County, Pennsylvania, 17013, the parties having separated on July 2, 1995. 3. Plaintiff and Defendant are bona fide residents of the Commonwealth of Pennsylvania and have been so for at least six months immediately previous to the filing of this complaint. 4. Plaintiff and Defendant were married on April 10, 1993, in Carlisle, Cumberland County, Pennsylvania. 5. There have been no prior actions for divorce or annulment between the parties. 6. Neither Plaintiff nor Defendant is in the military or naval service of the United States or its allies within the provisions of the Soldiers & Sailors Civil Relief Act of 1940 and its Amendments. 7. The Plaintiff has been advised of the availability of counseling and the right to request that the Court require the parties to participate in counseling, Knowing this, the Plaintiff does not desire that the Court require the parties to participate in counseling. 8. Plaintiff and Defendant are citizens of the United states of America. 9. The parties' marriage is irretrievably broken. WHEREFORE, Plaintiff requests your Honorable Court to enter: (a) a decree in divorce, dissolving the marriage between the two parties; (b) an order equitably distributing all property, both personal and real, owned by the parties; and (c) such further relief as your Honorable Court may deem equitable and just. (L.'-1~.t If /'i9J.'- Da te I I Respectfully submitted, SODUS & VERNEY By P-f- ,,~<~ ~-~ .:J cq, line M. Verney, Esqu r.D. No. 23167 7 Irvine Row Carlisle, PA 17013 717/243-9190 Attorney for Plaintiff VERIFICATION I verify that the statements made in the foregoing divorce complaint are true and correct. I understand that false statements herein made are subject to the penalties of 16 PA.C.S. Section 4904 relating to unsworn falsification to authorities. )S / 1/ /f.f'" Date d~ okrowkjY # '., <........~'fJl~W..-... "~uly. ['" ~ Ln ~ !~ ~ ~ _J...... CJ....J, L"i :r: O~-~ 'F!: .:.: Ct;j 0 ,~ ..... c: ~.'i':'! u.. . ~. IfI,JJ Co: '.r::.i." 'II;I.j F: Lo..' f)~ W 15 .....: L",) t5 C1' ~~ al> ~i~e !il '" I III ~ .z;:l:.l U~OI>O ......1> fa< t-<u... o U c:l !;;S<~z t::> ;:IN''' S~;::! ~clu", el~ . ~ 1 I~ Ie ~ :;l ~ ell Z ;'IS t:fa< ~~ ~~ ~ ~ Ie . ~ I ~ ~ ~.~ : $ ~ i ~ ~ . ~ s ~ I ~ 1 :; s . ; '1 ~ .... ~ ... i~ i;: I >-- ,- - a ;, 2 ; aa ~> .;. i .;.~ ~;:- ;::. ... .e o. eM w :t iil -' a: c " SHIRLEY POKROWKA, PlalntlfT : IN TilE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW 95-4228 CIVIL TERM RICHARD POKROWKA, Defendant IN DIVORCE PLAINTIFF'S AFFIDAVIT OF CONSENT 1. A complaint in divorce under Sections 3301(c) and 3301(d) of the Divorce Code was filed on August 8, 1995. 2. The marriage of plaintiff and defendant is irretrievably broken and ninety days have elapsed from the date of the filing of the complaint. 3. I consent to the entry of a final decree in divorce. 4. 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; however, a Stipulation for Bifurcation has been signed by the parties preserving all economic claims in this maUer. I verifY that the statements made in this affidavit are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. ~u_ 7 . / ,/ / / ,J/ / ./ , I/,,;!.', ) , .1 ' . ~.. .' .' /1/ Iii ',. .(i, if,: '- r' ( I . SIJIRLEY POKROWKA ,1995 , , i'i; In is ;i! .:.r .;.1..~ b N ~~ r.)r~ ;.1: ():'i~ ... 1'""'\;J i~ ~-~{~ .. t- o: .),,- ...' I L~ ...... ~ l.J ';1u,1 r.:: L<' C~ c> ~; "". ~ In a '" ~~ 3> :~~e ~ Po< I 101 ,.4U ..:z:....~ ~o>o ......> ra. !jU'" Os<col:l I-< "'lI: OIl ,.4"'''' l:>~"'''' 8 i:J. u'" :~ i ~ ! E ~ t1 ~I ~ ~ lJ. t; ~ ii: ... e: ~ 1; a i ~ I ! ~ ~ ~~I~; i ~ Ii! ~ . I< .~. ~ ~ .... .... '" .. .;l ~ <I ~~ 2 tl ~ ill . I> .. ~ 1 . 01 ~~ ~ ~ ~ ffi CIl lI: !"S ~~ ~~ I:le ~ .... -- ~ '.-. . '. r-. '..""''''' . , ~a N' .~ "N "- N.. ;::;: ;::;; -. .. , . .. .... ;- RICHARD POKROWKA, Defendant IN DIVORCE SHIRLEY POKROWKA, Plain tilT : IN TilE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW 95-4228 CIVIL TERM DEFENDANT'S AFFIDAVIT OF CONSENT I. A complaint in divorce under Sections 3301(c) and 3301(d) of the Divorce Code was filed on August 8, 1995. 2. The marriage of plaintiff and defendant is irretrievably broken and ninety days have elapsed from the date of the filing ofthe complaint. 3. I consent to the entry of a final decree in divorce. 4. 1 understand thatl may lose rights concerning alimony, division of property, lawyer's fees or expenses if! do not claim them before a divorce is granted. 1 verify that the statements made in this affidavit are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities, J)o c.Jl- 6. 7 , ,1995 ~J~ rgree RICHARD KR WKA :- -- u- LO [,- ~ ../. !<' 9 ;~:'~ : ': ('~ -- t":;:_" " - ~_.- .;.: C)::~ r.'C -, . ,r--. ~. .' ~ ' ., o!~ :'!>~ <..; .,.~ .r_ f_ ' J ~.;.J F' I.LI ~ :...~ L..;.. Co> :5 III :s 0\ 0 ~~ ~I~~. i!i lloo I ..4 tJ e "Z ~ c:d U~Ot>O ........t> ro. !-IU.... o ~"'liil !-I8 "'iI: 011 ..4"'.... =~...... 8 1:,), UOI :~ ,-'d- ... ... .... ... .;l ~~ ~ tl ~ 5l ... ~ '8 . .. ~& ~ f ~ ~ lol!-l ~.... i~ '" - ~ t:el ....Iil !i:", ....!j ~8 ~ ~~ ~ ~ ! 8 ~ ~~I~~ ~~~:~~ ~ ~ i ~ ~ : ~ ~ J ~." W t; ~ ~ ! ~ ~ . a: .' . ~ u . :> -. -. :7; &li3 j:J' ,~ .... ~~ .... ;:;; -. ... -I SHIRLEY POKROWKA, PlalntllT : IN TilE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW mCHARD POKROWKA, Defendant 95-4228 CIVIL TERM IN DIVORCE PLAINTIFF'S MARRIAGE COUNSELING AFFIDA VIT The Plaintiff, being duly sworn according to law, deposes and says: I. I have been advised of the availability ofmaniage counseling and understand that I may request that the court require that my spouse and I participate in counseling. 2. I understand that the court maintains a list of marriage counselors in the Prothonotary's Office, which list is available to me upon request. J. Being so advised, I do not request that the court require that my spouse and I participate in counseling prior to a divorce decree being handed down. I verilY that the statements made in this affidavit are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. _'.1.( I /. /. ') // . /I;~ 'j',. . /'( - 0/> .i-('/'jh ////( tL. _1/..f':'l("~~c~( , './SHIRLEY POKROWKA '0.-" ,1995 .';!....>," .. ~ t; l (~ ~~ ~~z_ _ u~,: ....... ..... . c- (~~! . 'Sf" r- ..~. ~ I [,-::'. "' L'JI.U t'J ~J (1.1 G.. ~ c;.l ~ ~ ~ a ~5 ~ ~~~~ ~ roll-< ~I U t; '" :Z:;~I-< .... .. .. g ~ i !~li :; ~ r>. I c.l :! ::l::l .. z l'J' 8 .:z:::l;! .~ ~ ," . ~o=-o Ii ~ t .. ~ .... fa. BO~ ~~ .- . t:I ~ . ~ z ~~ U z ~~ o ~ 1:1 ~ . .. .. ~- o .. ~ ~ i i .. ~" 1-<c.J Nj!l ui Of ~~~9 ~ f ; II .. . :; 8 ,",1I'l I> . r a: c.JO\ ~ ~ ~ ;~ 1:18 .~ ~ l;;l -- ...... -. SHIRLEY POKROWKA, Plaintiff : IN THE COURT OF COMMON PLEAS OF v. : CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 95-4228 CIVIL TERM RICHARD POKROWKA, Defendant IN DIVORCE DEFENDANT'S MARRIAGE COUNSELING AFFIDAVIT The defendant, being duly sworn according to law, deposes and says: 1. I have been advised of the availability of marriage counseling and understand that I may request that the coun require that my spouse and I panicipate in counseling. 2. I understand that the coun maintains a list of marriage counselors in the Prothonotary's Office, which list is available to me upon request. 3. Being so advised, I do not request that the coun require that my spouse and I participate in counseling prior to a divorce decree being handed down. I verifY that the statements made in this affidavit are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. _Do.n.- ~~ 7 . w~ RI OKROWKA ,1995 r1 In f:: " UJ~ c; ~,.' 0('_; -- r::;:~ ~t!: ....:: 1._::;_' (, :.;.; (-I =: .~~1 " e:.: - U:!:IJ CJ i! ~'. I".: LJ !;;::? L-:J I' ..... ci ::, cr. (.) 'If'"" r.- ,- - -- SODUS a: VllRNEY. ~.uw . "---- P.O. loa 936 CotIIaIe, 1'ooaIyl\'lllll17013 (717):143-9190 ...........(717):143-994. 'J --. SIIlHLEY POKROWKA, Plaintiff IN THE COURT OF COMMON PLEAS CUMBEHLAND COUNTY, PENNSYLVANIA CIVIL ACTION-LAW NO. 95-4228 CIVIL TERM IN DIVORCE , , ; l,. I. , RICHARD POKROWKA, Defendant ~ERTIFICATE OF SERVICE , ,I .\ I hereby certify that I served a true and correct copy of Defendant I s within Divorce Complaint upon Richard Pokrowka, by first class mail, postage pre-paid on the 12th day of August, 1995, addressed as follows: I , / t: r-t, ~.~ , .( , \:. 1 Richard pokrowka 1918 Spring Road Carlisle, PA 17013 Respectfully submitted, SODUS & VERNEY .. ,~ I ~ By Q~< ?~ .C_, fi I . [/;.'V1LL.::v- .:(acqu!:lline M. Verney, Esqui$ t.D. No. 23167 7 Irvine Row Carlisle, PA 17013 717/243-9190 _", . Attornev for Plaintiff " .... ..jl DR: '"I . Complete hi"" 1 ,ncl/of 2 IOf IddItIonII ..Me... : I . Complete It,ntI 3. end 4, . b. . Print your name end Iddre.. on the revttH of thl. form to INt WI can ,.tum thI. card 10 you. . Ii . Attach WI form to the front 01 the maUpfKI, or on the bltk If 'piC, . do.. not permit. -I . Writ,""ttumRlce9tRequelttduonthlrMilplKlbelowthtartldtnumbe1 2. 0 Reltrlcted Delivery . . The Rltum Re<<Ipt w.1how to whom the If16dt w.. dI~ Ind the dill a deltv.,td. Consult oltmalter for fell. 3. Article Addrllled to: 41. Article Number 1 atlo wlah to recelvl the following IINic.. UOt an 8xtr. ,..I: 1. 0 Addr....... Addr... Mv. f?,.ltllan1, ib/::rvwktl- ''lIS QJrf~ ~ OOA('(~lt, I:JI /70/> j l .e. J 3 "1' i.. 4b. S.rvlc. Tvp. II: o R.glst.red 0 In.ur.d illI C.rtllled 0 COD .i . o Expr... M.II 0 R.turn R.c.lpt for !I 7. Date of Delivery I ! ?- ,01-." r il >- 8. Add,...ee', Addr... IOnly If requested .-c .nd ,.. I. p.ldl ~ , I, ~ , , r l , , . D.comber 1991 *u...""""on-=- DOMESTIC RETURN RECEIPT IN TilE COURT OF COMMON I'I.EAS OF CUl\mEltI"AND COUNTY, I'ENNSYI. VANIA --; hIf2U.", A'pOf(I(tit..J K~ . PlaintilT Vs File No. 95-4228 IN DIVORCE 12/ C/~ ~el) .j vol<' KOW I<.A . Defendanl NOTICE TO RESUME I'RIOR SURNAME ~otice is hereby given that the Plaintiff / defendant in the above matter, [select one by marking "XU] _ prior to the entry of a Final Dccree in Divorce, or X. after the entry of a Filla I I lccree 111 I hvorce dated / J - /!f. f{ 5" hereby elects to resume the prior surname ofCOP~rJ 11 fiveR.. ,and gives this written notice avowing his / hs.r intention pu a to h f 54 Date: 1/ -;yq-(YI ~~ . D. . r'" Slg e of name bemg resurneQ rW1ZI"~ COMMONWEALTH OF PI:,Nj'lj~ r'L V;O\14I;, ) COUNTYOF VOll.J~J,q) ../... I On the ~ day of No vt: IV1oIO e.'R. ,200 I.f, before me, the Prothonotary or the notary public, personally appeared Ihe above affiant known to me to be the person whose name is subscribed to the within document and acknowledged that he / she executed the foregoing for the purpose therein contained. In Witness Whereof, 1 have hereunto set my hand hereunto selmy hand and official seal. ~ \J l~Q)-~ Prothonotary or Notary Publi~ 1/)llIn1ol- . . My ~llIIOOI422 ~ ~ ~Mlrd1t2.200e ~ '.' ~ '.J .. . t'" ..... (- .. .,. ~ '" " L) I' .-::. ~ J 01 - 2r '-:-' J , . ..... lilt "\4"1(""..", I" ..-. ,1I'.''''I''~. I'. I' 'Ill ~tipultttinns J\gttinst 1fiiens -{J. r;'-- eel ,10 Mark E. De. ja and Holly K. Deja~ Owm:r H, S & A Custom Built Homes, Inc. \ CuntraL'lnr J In the Court III' ("ummnn Plcu~. ('lIunly uf Cumberland . l'cl1m,ylnania Numbor ch-_ '/J.:J? e.~vJrorm.19 WHEREAS. Mark E. Deja and Holly K. Deja of Mechanicsburg, l'onn'yl\'Uniu. S & A Custom Built Homes, Inc. i~ ahuulln execute cnntempnrancuusly herewith. U I.'unlracl. with of I'cnnsyl\'uniu. building upon a 101 of lund ,ilUalo fur the erectiun of u slnry ALL THAT CERTAIN lot or piece of land situate in East Pennsboro Township, CUmberland County, Pennsylvania, bounded and described as follows, to wit: BEING Lot 141 on the Final Subdivision Plan of Lagans Run, Phase II, recorded in Plan Book 68, Page 50. ,- e; C~J I~ 1...; i:,,: <.0 <J1 NOW'August 19 95 . at tho limo of and immodiatoll' before lhe exeeutinn of the prin- dpal eontract. and before any authorily ha, boen giS'en hy Iho ,uid Mark E. Deja and Holly K. Deja lolho ,aid S & A CUstom Built Homes, Inc. to commence work nn the suid huilding, or purchase materials fur the same in considcrDlinn of the making of the said eonlracl wilh Mark E. Deja and Holly K. Deja consideralinn of One [)ollllr. 10 S & A CUstom Built by Mark E. Deja and Holly K. Deja Homes, Inc. IInd Ihe further paid . it IS agreed Ibat nn lion ,hllll be med IIgllin'l lhe building by the cunlrueluf. or tiny suh-contractor. nor hy any of the mUh:rial men or workmen or any other Jlerson fur any labor. or materiAls purchased. nr exlra lahnr nr nmlerials purchased hn Ihe ereclinn (If !\aid huilding. Ihe righll(l tile such liens heing expressly wai\'cd. WITN F.SS. our hands and seals Ihe day and year ;"fme!\; Id. SIGNED AND SEAI.ED IN TIlE I'RESENCE 01' ~~/:' ~~ ~~,-A.~~u.J.u-j- (Q9/ ~~!:.;; / ~-/ r:.:f':~ '::! .., ~ ... .J ~ \ "....~ ) \ ~. ~ .;j .-i " III !!: 0- s:: s:: E Q (0; ... ~ ... Pit ~ 1; ... ... 0 - .... u " - ::: c u III ~ :l e l:a- " s:: ~ ... 0 u - .... ... , c tit, I:S 0 ~ U ci z "tl .!! u: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff : Vs : File No. Defendant : IN DIVORCE NOTICE TO RESUME PRIOR SURNAME Notice is hereby given that the Plaintiff/defendant in the above matter, [select one by marking "x"] __ prior to the entry.of a Final Decree in Divorce, or X_aftertheentrvofaFinall)ecreeml',lvorcedatecl ~. -./~_.. ~.~ hereby elects to resume the prior surname of ~'t~iDg:T/t,//-/tB b/~/~ , and gives this written notice avowing his/he._.,r intention pur/s~to~h~pr~~f~ "~ / '~- t" 54 )~S,t/_ 704. Date: //- o~q-~c// .-.,h~_~~ ,30~t.,h~,Jdd~ ~ Signature Si~ ofnan~e being resumed COMMONWEALTH OF t~NSYLVANIA ) COUNTY OF [/O Ct,K/g)) On the .2~'4~ay of 1~)o u £~'l,k>[ i'~ , 200 t'{, before me, the Prothonotary orthe notary public, personally appeared the above affiant known to me to be the person whose name is subscribed to the within document and acknowledged that he / she executed the foregoing for the purpose therein contained. In Witness Whereof, I have hereunto set my hand hereunto set my hand and official Prothonotmy or Notary Public # ~ c~.~