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DIANA L. HARREN,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 95- :);];).) CIVIL TERM
CUSTODY
v.
FREDERICK H. HARREN,
Defendant
ORDER OF COURT
AND NOW, upon consideration of the attached complaint, it is
hereby directed that the parties and their respective counsel appear
before _M 'IL"'\(" \ l r?-"'1.fj<' t""l , the conciliator, at 30.;2 5 /t;1J.,S I
lu.rrf> tI,d on the ~f\t\ day of --!'lQojf",,\Jt, , 1995, at q'a>1} .m.,
for a Pre-Hearing Custody Conference. At such conference, an effort
will be made to resolve the issues in dispute; or if this cannot be
accomplished, to define and narrow the issues to be heard by the court,
and to enter into a temporary order. Failure to appear at the
conference may provide grounds for entry of a temporary or permanent
order.
% the Court,
MU)l-ceJ L ~c.>...<#.w f ~
Custody conciliator v ~~ I
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU 00 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, 4th FLOOR
CUMBERLAND COUNTY COURTHOUSE
CARLISLE, PENNSYLVANIA 17013
TELEPHONE NUMBER: (717) 240-6200
AMERICANS WITH DISABILITIES ACT OF 1990
The Court of Common Pleas of Cumberland County is required by law
to comply with the Americans with Disabilities Acto of 1950. For
information about accessible facilities and reasonable accommodations
available to disabled individuals having business before the court,
please contact our office. All arrangements must be made at least 72
hours prior to any scheduled hearing or business before the court. You
must attend the scheduled conference or hearing.
DIANA L. HARREN, . IN THE COURT OF COMMON PLEAS OF
.
Plaintiff :
. CUMBERLAND COUNTY, PENNSYLVANIA
.
v. .
.
. NO. 95- CIVIL TERM
.
FREDERICK H. HARREN,
Defendant . CUSTODY
.
COKPLAIRT ~OR CUSTODY
1. The plaintiff is Diana L. Harren, residing at 2525
Chestnut Street, Bowmansdale, Cumberland County, Pennsylvania,
17008.
2. The defendant is Frederick H. Harren, residing at RD 2,
Box 130, Landisburg, Perry County, Pennsylvania, 17040.
3. The plaintiff seeks custody of the following child:
lID
Pre.eDt Addre..
Ala
Elizabeth Jean Harren
2525 Chestnut st.
Bowmansdale, PA
2 years old
DOB: 8/24/93
The child was born out of wedlock.
The child is presently in the custody of the plaintiff,
who resides at 2525 Chestnut street, Bowmansdale, Cumberland
County, Pennsylvania.
Since the child's birth the child has resided with the
following persons and at the following addresses:
Do Addre.. Il.Ati
Plaintiff 2525 Chestnut St. 9/1/95 -
Brent Hoffman Bowmansdale, PA present
Defendant and RD 2, Box 130 8/4/95 - 9/1/95
his girlfriend Landisburg, PA
Plaintiff RD 1, Box 425 1/95 - 8/4/95
Liverpool, PA
Plaintiff
Defendant
RD 2, Box 130
Landisburg, PA
8/24/93 - 1/95
The mother of the child is Diana L. Harren, currently
residing at 2525 Chestnut street, Bowmansdale, Cumberland County,
Pennsylvania.
She is married.
The father of the child is Frederick H. Harren, currently
residing at RD 2, Box 130, Perry county, Pennsylvania.
He is married.
4. The relationship of the plaintiff to the child is that of
mother. The plaintiff currently resides with the following
persons:
lID
Relation.hio
Elizabeth Jean Harren
Daughter
Boyfriend
Brent Hoffman
5. The relationship of the defendant to the child is that
of father. The defendant currently resides with the following
person:
lID
Relation.hio
Girlfriend
Tina (last name unknown)
6. The plaintiff has not participated as a party or
witness, or in another capacity, in other litigation concerning
the custody of the child in this or another court.
7. The plaintiff has no information of a custody
proceeding concerning the child pending in a court of this
CODllllonwealth.
8. The plaintiff does not know of a person not a party to
the proceedings who has physical custody of the child or claims
to have custody or visitation rights with respect to the child.
9. The best interest and permanent welfare of the child
will be served by granting the relief requested for reasons
including but not limited ~o the following:
a) The plaintiff has been the primary caretaker of the
child since her birth and has provided the emotional and
physical needs of the child since that time.
b) The defendant has not acted in the child's best
interest since he fraudulently removed the child from the
plaintiff, refused to return the child, refused to allow the
plaintiff to see or speak to the child for a period of
approximately three weeks, and threatened to keep the child
from the plaintiff indefinitely.
10. Each parent whose parental rights to the child have not
been terminated and the person who has physical custody of the
child have been named as parties to this action.
WHEREFORE, the plaintiff requests this Court to grant
primary physical and legal custody of the child to the plaintiff
with partial custody in the defendant at times mutually agreed
upon by the parties.
The plaintiff further requests that the defendant be ordered
not to remove the child from the state of Pennsylvania.
The plaintiff requests any other relief which is just and
proper.
Respectfully submitted,
an carey
'Attorney for Plai iff
LEGAL SERVICES, INC.
8 Irvine Row
Carlisle, PA 17013
(717) 243-9400
The above-named plaintiff, Diana L. Harren, verifies that the statements
made in the above Complaint are true and correct. The plaintiff understands that
false statements herein are made subject to the penalties of 18 Pa.C.S. g4904
relating to unsworn falsification to authorities.
Date:
J' 3 LJ - (/ S
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Diana L. Harren, Plaintiff
DT ANA I.. HARREN,
r N TIlE COIIRT OF r.OMMON PI.EAS
Pia i nl iff
v.
CIIMAERI.ANIl COllNTY, PENNSYLVANIA
r.IVIL ACTION - I.AW
NO. 'l'i-
CIVIL TERM
FREnERIr.K H. HARREN,
Dl'ferulanl
r.lISTODV
PRARCTPF. TO PROCKF.D IN FORMA I'AITP~JnS
To the Prothonotary:
Kinrlly allow Diana I.. HarTpn, to proC'ppd in forma paufJpris.
I, Joan r.ar'py, atlorney for Ihp parly proC'pl'lling in forma l'i1tlppris, ('prlify
that I helipvp Ihe 1~lrty is unahlp 10 pay Ihp l'o<;ls anrllhal I am providing frpp
Ipgal sl'rviC'ps to I hp 1~lrt y. Thp pari y' s i1ffidavi I showing i nahi IiI Y 10 pay 1 hI'
('osls of litigat ion is allill'hpd hprpl".
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I.KGAI. SKRVTCKS, TNC.
A Il'villp Row
Carl isll', PA 17011
(717) 241-Q400
DTANA L. HARREN,
IN TIiE COURT OF COMMON PLEAS OF
Plaintiff
v.
CUMBERLAND COUNTY, PENNSYLVANIA
FREDERICK H. HARREN,
Defendant
NO. 95-
CIVIL TERM
CUSTODY
AFFIDAVIT IN SUPPORT OF PEl'ITION
FOR LEAVE TO PROCEED IN FORMA PAUPERI S
1. I am the plaintiff in the above matter and because of my financial
condition I am unable to pay the fees and costs of prosecuting, defending, or
appealing the action or proceeding.
2. I am unable to obtain funds from anyone, including my family and
associates, to pay the costs of litigation.
J. I represent that the information below relating to my inability to
pay the fees and costs is true and correct.
a) Name: Diana L. Harren
Address: 2525 Chestnut Street, Banansdale, PA 17008
Social Security Number: 201-54-6810
b) If you are presently employed, state
Employer: N/A
Address:
Salary/wages per month:
Type of work:
If you are presently unemployed, state
Date of last employment: April, 1995
Salary/wages per month: $4. 75/bour
Type of work: counter sales person
c) Other income within the past twelve months
Business/profession: $350.00
Other self-employment: N/A
Interest: N/A
Dividends: N/A
Pension ROd annuities: N/A
Social Security benefits: N/A
Support payments: $78/wt x approx. 18 wks = $t,404.oo
Disability payments: N/A
Unemployment compensation and supplemental
benefits: N/A
Worker's Compensation: N/A
Public Assistance: approxi~tely $816.00
Other: N/A
d) Other contributions to household support
Wife/Husband Name: N/A
If wife/husband is employed, state
F.mployer:
Address:
Salary/wages per month:
Type of work:
Contributions from child(ren):
e) Property owned
Cash: $10.00
Checking Account: N/A
Savings Account: $25.00
Certificates of Deposit: N/A
Real Estate (including hompl: N/A
Motor vehicle: N/A
Stocks/bonds: N/A
Other: N/A
f) Debts and obligations
Mortgage: N/A
Rent: $380/.,.
Loans: N/A
Monthly expenses: $200.00
g) Persons dependent upon you for support
Wife/husband Name: N/A
Child: (name, age)
4. I understand that I have a continuing obligation to inform the
court of improveeent in my financial circumstances which would permit me to
pay the costs incurred herein.
5.
I verify that the statements made in this affidavit are true and
correct.
understand that false statements herein are made subject to the
penalties of 18 Pa.C.S. g 4904, relating to unsworn falsification to
authorities.
Date:
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D i 80a L. Harren,
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Plaintiff
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DIANA L. HARREN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
95.5227 CIVIL TERM
vs.
FREDERICK H. HARREN,
Defendant
CIVIL ACTION - CUSTODY
ORDER
AND NOW, this
I .1. .. day of December, 1995, it appearing that the defendant
is desirous of obtaining counsel to represent him. hearing on the above matter set for December
20,1995, is continued to Wednesday, January 3, 1996, at 1:30 p.m. in Courtroom Number 4,
Cumberland County Courthouse, Carlisle, PA.
BY THE COURT,
./I/i
Joan Carey, Esquire
For the Plaintiff
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Frederick H. Harren
R. D. Box 130
Landisburg, PA 17040
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DIANA L. HARREN,
Plaintiff
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
vs,
FREDERICK H. HARREN,
Defendant
CIVIL ACTION. LAW
NO. 95-5227 CIVIL TERM
CUSTODY
ORDER
AND NOW, this
'i - day of N o.,;t-- '-- ,1995, upon consideration of
the attached Custody Conciliation Report, it is ordered and directed as follows:
1. The Plaintiff, Diana L. Harren, shall have primary legal and physical
custody of Elizabeth Jean Harren, d.o.b. 24 August 1993, subject to periods
of partial custody and visitation with Defendant, Frederick H. Harren, as
agreed upon by the parties,
2. This Order is entered on a temporary basis pending a full hearing
on the case. The hearing will be held on the rxa ~ day of
UUnd'I\/ ,1995. at /:.30 o'clock r.M. in Court Room No.
L of the Cumberland County Court House, Carlisle, Pennsylvania.
Joan Carey, Esquire 1.-'
Attorney for Plaintiff ~ ~I ;
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Frederick H. Harren. pro se j~
BY THE COURT, /
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DIANA L. HARREN,
Plaintiff
vs.
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CUSTODY
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
FREDERICK H. HARREN,
Defendant
CIVIL ACTION - LAW
NO. 96.6227 CIVIL TERM
ORDER
AND NOW, this
day of
, 1995, upon consideration of
the attached Custody Conciliation Report, it is ordered and directed as follows:
1. The Plaintiff, Diana L. Harren, shall have primary legal and physical
custody of Elizabeth Jean Harren, d.o.b. 24 August 1993. subject to periods
of partial custody and visitation with Defendant, Frederick H. Harren. as
agreed upon by the parties.
2. This Order is entered on a temporary basis pending a full hearing
on the case. Tha hell ring will be held on the
day of
, 199_, at
o'clock _.M. in Court Room No.
_ of the Cumberland County Court House, Carlisle. Pennsylvania.
BY THE COURT.
J.
Joan Carey. Esquire
Attorney for Plaintiff
Frederick H. Harren, pro se
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6. The Plaintiff's position on custody is as follows: The Plaintiff has had
custody sinca the parties separated in January, 1995. She was also the primary
custodial parent during the course of the marriage. Plaintiff was concerned
becsuse Father took the child in August and refused to return the child. Eventually
he did return the child. Consequently, she needs a custody order granting her
primary custody but expressed extreme flexibility in providing Father with a regular
and consistent visitation schedule.
S, The Defendant's position on custody is as follows: Father refused to
provide a position as to what type of schedule he requested. All that he indicated
was that he wanted joint custody.
7. Need for separate counsel to represent child: Neither party requested and
the Conciliator does not believe that separate counsel is necessary for the child.
B. Need for independent psychological evaluation or counseling: Neither
party requested and the Conciliator does not believe that this is necessary.
9. A hearing in this matter is expected to take approximately one-half day.
10, Other matters and comments: The Father was completely
uncooperative during the custody conciliation. He refused to discuss the issues and
eventually walked out of the conciliation. He seems to be more concerned with
paying support than with a custody schedule. He did acknowledge, however, that
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FREDERICK H. HARREN.
Pctitioner
IN THE COURT OF COMMON PLEAS
OF THE 41 ST JUDICIAL DISTRICT.
PERRY COUNTY BRANCH
\'S.
NO. 95-5227 CIVIL TERM
DIANA L. HARREN.
Respondent
CIVIL ACTION - CUSTODY
PETITION TO MODIFY CUSTODY
To the Honorable Judges of said Court:
Petitioner. Frederick H, Harrcn. by his attorney. Jerry A. Philpott. Esquire. files this petition
and respectfully rcpresents the tllHowing:
Petitioner is Frederick H. Harren. who resides at RD 2 Box 130. Landisburg. Perry
County. Pennsylvania.
2
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Respondent is Diana L. Harren. who resides at Third Street. Apt. 8. West Fairview.
Cumberland County. Pennsylvania.
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3 The parties are married but have been separated for the past five years. There was
one child born of this marriage. Elizabeth Jean Harren. born August 24.1993.
4 On November 9. 1995. the Honorable Kevin A. Hess entcred a custody order upon
recommendation ofthc conciliator. a copy of which is attached as Exhibit A and confirmed by Order
on January 3. 1996. a copy of which is attached as Exhibit B. granting rcspondent primary lcgal and
physical custody with periods of partial custody in petitioncr at times thc partics agree.
5 Since the cntry of the Ordcrs the following substantial circumstances and facts have
changcd. giving rise to this petition:
a. Rcspondent learned thc child misscd 22 days of schoollasl year. The child
is not a sickly child.
b. The child olicn visits petitioner without a clean change of underwear.
When questioned the child says mommy doesn't like to do the laundry.
c. The child tells respondent their electric is turned ofT quite olien and they have
nothing to cat but cereal and sandwiches because the food in the refrigerator
stinks.
d. The child lives with her younger half sister and half brother, respondent,
respondent's paramour and respondent's friend in a two bedroom apartment.
e. Respondent has moved numerous times over the last five years with difTerent
companions in Juniata. Perry. and Cumberland Counties.
6 As a result ofthe foregoing conditions. the existing provisions regarding custody are
no longer in the best interest and welfare of the child.
7 The best interests and welfare of the child will be promoted by a modification of the
present visitation schedule for the above rcasons.
WHEREFORE. your petitioner respectfully prays that thi
order by vesting primary legal and physical custody to petit'
respondent.
Dated: {I- ~-9 '1
I verify that the statements made in this Petition for Modification arc true and correct. I
understand that false statements herein arc made subject to the penalties of 18 Pa.C.S. 94904.
relating to unsworn falsification to authorities.
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DIANA L. HARREN,
Plaintiff
vs.
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CUSTODY
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
FREDERICK H. HARREN,
Defendant
CIVIL ACTION - LAW
NO. 95-5227 CIVIL TERM
ORDER
AND NOW, this
1- day of N...,e-k.- ,1995, upon consideration of
the attached Custody Conciliation Report, it is ordered and directed as follows:
1. The Plaintiff, Diana L. Harren, shall have primary legal and physical
custody of Elizabeth Jean Harren, d.o.b. 24 August 1993, subject to periods
of partial custody and visitation with Defendant, Frederick H. Harren, as
agreed upon by the parties.
2. This Order is entered on a temporary basis pending a full hearing
on the case. The hearing will be held on the oM ~ day of
Un.mJ.wA/ ,1995, at /:.3 0 o'clock ~.M. in Court Room No.
L of the Cumberland County Court House, Carlisle, Pennsylvania.
Joan Carey, Esquire ~
Attorney for Plaintiff ~
. 11/1'/lfr
Frederick H, Harren, pro se u.-
BY THE COURT, I
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5. The Plaintiff's position on custody is as follows: The Plaintiff has had
custody since the parties separated in January, 1995. She was also the primary
custodial parent during the course of the marriage. Plaintiff was concerned
because Father took the child in August and refused to return the child. Eventually
he did return the child. Consequently, she needs a custody order granting her
primary custody but expressed extreme flexibility in providing Father with a regular
and consistent visitation schedule.
6. The Defendant's position on custody is as follows: Father refused to
provide a position as to what type of schedule he requested. All that he indicated
was that he wanted joint custody.
7. Need for separate counsel to represent child: Neither party requested and
the Conciliator does not believe that separate counsel is necessary for the child.
8. Need for independent psychological evaluation or counseling: Neither
party requested and the Conciliator does not believe that this is necessary.
9. A hearing in this matter is expected to take approximately one-half day.
10. Other matters and comments: The Father was completely
uncooperative during the custody conciliation. He refused to discuss the issues and
eventually walked out of the conciliation. He seems to be more concerned with
paying support than with a custody schedule. He did acknowledge, however, that
2
the Mother hes been taking care of the child. Since there is a concern by the
Mother that Father will take the child if an order isn't in place, the Conciliator
recommends that a temporary order be entered pending a full hearing. If Father
decides to contest the custody issue, he can be present at the hearing. If not, the
Conciliator recommends that the order be affirmed with custody primarily in
Mother.
Date: 7 November 1995
Michael L. Bangs
Custody Concilia r
3
DIANA L. HARREN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
V
95-5227 CIVIL TERM
FREDERICK H. HARREN,
Defendant
CIVIL ACTION - CUSTODY
1
.
.
ORDER OF COURT
AND NOW, this 3rd day of January, 1996, at 1155
p.m., this matter having been called for hearing after due
notice to all parties, and the defendant having failed to
appear, the recommended order of the conciliator is herewith
affirmed, and it is directed that the plaintiff, Diana L.
Harren, shall have primary legal and physical custody of
Elizabeth Jean Harren, born August 24, 1993, and subject to
periods of partial custody and visitation with the defendant,
Frederick H. Harren, as the parties shall agree.
By the Court,
Joan Carey, Bsquire
Legal Services, Inc.
For the Plaintiff
J.
Frederick B. Barren
R.D. 2, Box 130
Landisburg, PA 17040
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testimony. Additionally, both parties will submit their
proposal for a resolution of the matter.
BY THE COURT,
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HESS, J.
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Diana L. Harren, Esquire, pro se
Jerry A. Philpott, Esquire
Attorney for Defendant/petitioner
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DIANA L. HARREN, )
Plaintiff/Respondent)
)
vs. )
)
FREDERICK H. HARREN, )
Defendant/Petitioner)
)
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY,
PENNSYLVANIA
NO. 95-5227 CIVIL TERM
CIVIL ACTION - LAW
CUSTODY/VISITATION
JUDGE PREVIOUSLY ASSIGNED: The Honorable Kevin A. Hess
CUSTODY CONCILUTION COHI'ERBNCE StMQRY REPORT
IN ACCORDANCE WITH CUMBERLAND COUNTY RULE OF CIVIL PROCEDURE
1915.3-8(b), the undersigned Custody Conciliator submits the
following report:
1. The pertinent information concerning the child who is the
subject of this litigation is as follows:
twIf;.
BIRTHDATE
CURRENTLY IN
CUSTODY OF
Elizabeth Harren
August 24, 1993
2. A Conciliation Conference was held on February 17, 2000,
and
the
following
individuals
were
present:
the
Plaintiff/Respondent did not appear; the Defendant/Petitioner
appeared with his attorney, Jerry A. Philpott, Esquire.
3. Items resolved by agreement: See attached Order.
4. Issues yet to be resolved: See attached Order.
'J. The Plaintiff's/RespondPllt's position on custody is as
tollows: ~lother did flot attend ttil' c:','ll<'iliation. Apparently, she
knew about the conciliation and received it by regular mail. The
attorney for Father indicated that the certified mail was not
picked up. Her position is unknown since she did not attend.
6. The Defendant' s/Petitioner' s position on custody is as
follows: Father believes there should be a change in custody
because the Mother is neglecting the child. He reports that the
child missed 22 days of school last year. He also indicates that
the child has visited the Petitioner without a clean change of
underwear and that the child reports that the electric is turned
off quite often. He also :ndicates that the Mother has moved on
numerous occasions and that the child lives with her younger half-
sister and half-brother and the Mother's paramour in a two bedroom
apartment. He believes a change of custody is appropriate because
of the concerns he has for the well-being of the child.
7. Need for separate counsel to represent child: Neither
party requested.
8. Need for independent psychological evaluation or
counseling: None requested and the Conciliator does not believe
any is necessary.
9. A hearing in this matter will take one-half (1/2) day.
10. Other matters or comments: The Conciliator (Ed not have
any ability to detennine the various issues in the case because t.he
Mother did not show up. However, since the Father was asking for
~
a change in the existing custody schedule, the Conciliator did not
believe he could enter an Order changing the existing custodial
arrangement and is sending it to the Court for a full hearing.
Date: March
, 2000
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East Pennsboro Area School District
Undo J. BIRD', I).Ed.
Supainlm<<nl or SdHkJh.
P#7
RIchard W. t.ry
EltTnaulry SchtX11 Principii
February 8. 2000
Elizabeth Harren has missed
school year.
18t
days of school this
Elizabeth has been tardy two (2) times.
'Ti'Rt'Ih,'I' 'It' CI'mlt' lire frlfllfY:
West Creek IIlIIs Elementary School
400 Errord ROld, ('amp 11I11. PA 17011-1144
Phonr: (717) 732-0142 . .'11: (7171 732.8'143
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Cumberland County
Children & Youth
Services
,j>"""""tl '(,/',k'","
.j>'#Ul""'l:i",'1..1,~nltll#'U
/Iqtn:y
AdmInIsIr8IDr
Gory I. S""V. LSW
County
Commlulonera
-"'-
Earl A. K....
IWdI L"'"
Suite 200
Human Service. Building
16 West High StrHt
Carlisle, PA 17013-2961
(717) 240-6120
(717)697-0371, EJ1.612O
(717) 532.7286, Elt. 6120
Novcmbcr 2. \998
Frcd H. Harrcn
R.D. #2. Box \30
Landisburg. Pa I 7040
RE: Elizabeth Harren
Dear Mr. Harren:
Cumherland County Children and Youth Services has completed our
initial assessment. The Agency has detennined that there is a need for
continued Agency services due to the admitted cocaine use during Diana's
recent pregnancy.
If you have any questions. please contact this Agency.
Sincerely.
M ~~ Ad... _ QO_ '-
Marlene A. Fuller. LSW
Casework Supervisor
CCC&YS 1-4D 2/97
I
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PIOWfl I'HorES[;IONAl UUllQING
".1', tJ TtllflD Sf, SUITE 1!>0
I.\fHlISnUnG. PA 17110
HrPHONE (7\7; 232.9774
'1llltlG INQUlrHE$ (711) 232.2884
IF 10AMfOJrMor~lY
JONES, DALY & COLDREN ASSaf :IATES
JAMES E JONES, M 0
JAMES F OAlY, JR, MO
ROBERT L COLDREN ... D
MARIO M SANQILLO M D
SANDRA S RATlIrF. M D
H BRAD HENKEN 0 0
DANA SETZER. ... D
TAX 10. # 23,1896303
DEFENDANT'S
EXHIBIT
.)"
Amount Due ~_-1ll.~
OWl HOffm
319 THlID STREET
IPT II
WEST fllRVIEW PI l1e21
Patienl No. 21m
Dale
,
I
PLEASE REMOVE AND RETURN THIS PORTION WITH V( )un PAYMENT
Page
DATE CODES DESCRIPTION CH~RGES PAYMENTS ADJ. AMT. DUE
e9/29/91 86\88 ELIZIBETH STREPIOCOCCUS SCREEI DELETED ;, II.ee 11.00
e21eBlee 99213 EllWETH OFfICE VIIIT EIPIHOEO VISIT li.ee 18.ee
e2/18/ee 86188 ELIlIIETH STREPTOCOCCUS SCREEI DELETED 2 20.00 2Ue
e1/21/ee !Il93 ELIlA8:TH ROUTIIE C~EC(~P I TH~JU6', 11 lue lue
el/e2lee 99213 ELIlIlETH OffICE VIIIT EIPIIOEO VIIIT 11.00 18.ee
el/e2/ee 8me ElIll3E1H STREPIOCOCCUS RlTI6EI SCIEEIII 2ue 2ue
CURRENT BALANCE DUE
1Il. it
PATIENT
BALANCE ·
II Ut
CE IS OVERO~E . COI RCT uS OR 8E REFERRED 10 cellECTIOI RiEICI .
I
31,60 61.90 + OVER 91
DAYS DAYS DAYS
,Ie I I....
._____..1....__ _.__.__,,~- ..-n_.L.
T----~AVMENTsRECEIVED AFTER STA,TEME.NT, D., ATE- \
A80VE WILL APPEAR ON NEX2_STATEM-E~T ._".___
____._____.______.__...__._ . ___.-l
ii. .
MAlI.l C~ECl\S PAYABtE TO
JONES. DALY & COLDREN ASSOCIATES
LPTC,wl'll ~('~E<;S'O'-Al 8\J:,X~lt;!...
,Oi N h.'AD 51 5\.:t'l '''(.'
H4,I-IIl'<,E..;R" .''\ I"'.'
.',' l.!~ ,,','1
AMOUNT
BillED TO
INSURANCE
CURRENT
U,U
------..._-~._--
-...
- - " ". . . - '. . .... . . ~
CUAATMlHT Q' !'\ale "'U'''~I
cuweeRlAKJ COlM'Y ASSIST AN(;E OFFICE
33 Wes1mmter Drive
P.O. B"x 599
Carlisle, Pemsylvania 17013-0599
TlUI'HOHl: NUMII::'
"1OQ'211'0rn
17171 2'0.2700
LAHDLORD AFFIDAVIT
OEFENOAN1'S
E~\-\\Bn
DATE S. ..~ u ..00
clKl r,J '7 q ,17
mc ()J~-V_1Q
3
I IIRIIny STATE mAT I All C1JIJlENTLY iERTIIIG TO TBE IllDIVIDUAL(S)
LISTED IIELOIf:
IWIE: D'A~r:I U/-If( r.?,s;J I DATE lOVED III: ~I ((I _
ADDRESS: ,?/q 3t21J 0fr<€€+ .f-Ipl-flt, ~ilclJa/rl!l(l.J Pet, ('7tJJ5
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SCBOOL DISTRICT: fllS./- fPI1I15b(lrn TOI/NSBIP: ftJS( ReIln5 ~('O
I ALSO STATE THAT THE FOLLOlIING PERSON(S) ARE CURRENTLY
RESIDING AT SAME ADDRESS:
FI j?Cl hp+J-.. ~'a rrf'/I
,
kr;.sf-;f'. l(off(Y1~1)
CJa..t-~ r-Io.r/cll
PLEASE CBEa YOUR RELATIONSHIP TO REIlTER:
0("NON-RELATED RELATED
RELATIONSHIP
* * * * *
DOES TENANT PAY
TRESE UTILITIES:
_YES :LNO
~.
V~TER
GARBAGE
/SEVER
DOES TENANT PAY A
BUT UTILITY:
t/YES ~NO
TYPE:
UROSI!lfE
IO'ITLED CAS
./ELECTRIC
CAS
OIL
DOES TENANT PAY A
NON-BUT UTILITY:
i... YES _110
TYPE:
.i-ELECTRlC
DOES TENANT PAY
A COOI.lHG UTILITY:
_YES LNO
TYPE:
_GAS/I1JJT VATER
1IOm.ED GAS
DROSI!lfE
y &:X1 ~".,
IS THIS RENTAL ONDER SECTION 81 _NO ~n:s. I!" n:S. CLIENTS SBAllE:.:>v.lA.I
LAHDLORD IWIE u} r . ..)m I m
LANDLORD ADDRESS SSS I-\..-t (,,1( ~f WL5i (;JW1.,l PB9NE' 7 3J~<I(,)-
LANDLORD SIGKATUIE !,J/lu.L...... C /Jr.....u::;C I /7/i6lTE 1.P/7/cu
'/ I !
DIANA L. HARREN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
95-5227 CIVIL TERM
FREDERICK H. HARREN,
Defendant CIVIL ACTION - CUSTODY
IN RE: HEARING CONTINUED
ORDER OF COURT
AND NOW, this 28th day of April, 2000, following
a conference call with the plaintiff, pro se, and the
defendant/petitioner's counsel, hearing herein is
continued, and the parties are directed to appear for
hearing in this case on Thursday, June the 8th 2000, at
9:30 a.m.
By the Court,
Diana L. Harren, Pro Se
Third Street, Apartment 8
West Fairview, PA 17025
~~
53-00
"RKS
.
.
Jerry A. Philpott, Esquire
227 North High Street
P.O. Box 116
Duncannon, PA 17020
For the Defendant/Petitioner
:mae
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