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NOTICE OF APPEAL
COMMONWIALlHO!_,,,~NIY~VA~~~L .. J
coun d. COMMON"UA
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JUDICIAL DIIUICT ,
DISTRICT JUSTICE JUDGMENT
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COMMON ,UAI No.
'Jr,-73411 cl viI 'I'erm
NOTICE OF APPEAL
Nark. II gl_ lhal rhe appellanl hm filed in lhe above Co..1 01 Common Pleol on appeal Iral11 Ihe judgmenl ..nd"ed by lhe Di.lricl )ullk. on lhe
dole and In lhe co.. menlioned below.
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Thil block will be signed ONLY when lhil nololiooII ,oqulred Undll p" d,;l'.'No /I a;f;t/iJI1t was CLAIMANT (sea Pa. RC.P.J.P, No.
10088.
TlMI Nalk. of Appeal, when rec.ived by lhe O'llri<l )ulll(l, will "P"olo a. 0 '001 (6) in action be/ore Distric/ Justice, he MUST
SUPERSEDEAS 10 the judgment fOl ponenioo in Ihil cOla FILE A COMPLAINT wlt/lln twenty (20) days a/ler
/iling 1115 NOTICE 01 APPEAL.
S'lJf1.ihNO of rrilt;i()iuJi,lry .(~ 'Dt.of.u;y'
--PRAE(iP'E'rO'E'tliTER RULE TO FILE COMPLAINT AND RULE TOFli.i
(Tltls section 0/ loml to be used ONI.Y willY) 'ijllClIJIII W"^ DULNDANT IM!I! 1\1 IICI'JI' N"
IF NOT USED, dolBclt /rom e<:yJY of lIof,eo o/IlH"'.11 '" /JI! served III"" ",.,,,/I,,~' J
PRAECIPE. To Prol,:",lory. ..' /
Enter rule upon :::1WLJ.l/'JtcJ.----,-,.. m__'
N.1f11tJ ul,V'.If'/l'(J("
95-7348 civil
'00' (7 J III lIelIOII /JO/OIU Dls~lel Juslleo.
____..__.. ,appell"(I), 10 1110 0 comploint In lhil appeal
RULE. To
'III J) (J iVf~~ I
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'Ibm __,_, __,) wllhin twenly (20) doyl ofter l'lfvice of rule OIIUffll enlry of judgmenl 01 non pro_
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- ~ . ,h/1.1f~fJ 01 8I,Jekll (II' his 8/IooHy (Y IQOOf
(Convnon Plea. No
,m_ , appell.e(.),
(I) You ore nolir..d Ihat 0 rul. II hereby enl..ed upon you 10 m. 0 complainl in Ihl. appeal wilhin lwenly (201 day. after lhe dol. of
servk. of lhil rule l4'llI1 you by p'l\onollllvk. 01 by c"lilied 01 regilllled moll
(2)11 you do nol lile a clll11ploinl within thlllll11l, 0 JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOU,
(3) The dol. of servk. of thll rule il lervlce WOI by moil II II.. dol. of moiling.
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COURI filE TO [IE 111.1:0 WIlIt PflOltlotl01AflY
PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT
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COMMONWEAL TIt OF PENNSYLVANIA
COllNTY OF
~ ; II
AFFIDAVIT: 1I1I'Ieby sweAl or 011"," thRll served
11 ill, (lPY ()llhp NollCfl 01 Apfl('al Common PlUtlli No .__ , upnlllh~ OlslflCI .JUtHi('9 dO$!OrlaWd ttlPIPill on
IllliftJ 01 !i1"~I\IIJ -"...._.._.__.......___.,19__.___., Llllt 11lI1Ii,0l1fll &{!n'lfO 0 hy (C~llllled, (wgltitofed) mOil, ~enlhH s
Illce1llt Oll1lChfld hpu\tn, nnet upon Ih~ Appp11t'il (l1amM._ "..___._,__,~__ ."'__,_._~.~~;~ _.,~"^",._ _ ._"" .-'.. .-.-._., UIl
___. ___.._..._...__. , HL.. ___. LJ l)) IWI!-,UIl.11 fot!"I,"t t! [J V" (ft"llflPd) (U!\JISll)lr.d) mail, !.eIHj(lf~ ICLtHpt atttH:hl'lt hrrf'to
[J ;lnLlllll!tll'l Ih,lll !>IJfH!!l IIlll null~ lu f d\:' il CU'Jipl,t!f\1 m:cornpJ'liif1Y H1U abovo No'tn!{;1 f\pp0f11 upon tho appollcij(,) to V.hUI11
lhl' null' 'hilS iHhtm!\!i{ld Oil _ _ ___H~_" HL.., n_. [1 h) Pl!f~Oh8IlHHvKI! 0 hy (C(lr1lfIPill (fPglfllt"Prl)
mittl, sl!nder's rectJipl attached ht~rolo
SWOIlN IAFf IIlM[[J1 AND SUUSCIlIBED BEFORE ME
THIS
lJA V OF ,
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My tutnrniS&lufl IUPUUI un ______ HL__.
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BUBAN K, DAV
DISTRICT JUSTICE
COOK! lOWNlltI'
PICklNION lOWNIHIP
MIPPLIIIK lOWNlltI'
Ml,lIPLLY I'~IHGI 'O~OUOH
10UIII MIPPlllON lOWH.HIP
DlBTRlCT 01-3-03
omc.
11I-11I.
,n MilL IIklll,' 0.10' '"
MOUNIIIOILY "kINOI,'A 11011I
December I, 1995
II11SERVEIl .IUIlGHENT IlETI\IUHNA"ION
Plllintlffl Trlnu Neul
Defendant I I.Isa IInppert
ComplaJ nt No.1 CV-292-95
illite nf lIearlnlll Nnvembur 2801995
I hereby rend.r ,I1Il1llmant In the plnlntlff In th. amount uf $160.00
tUllether with cnata uf $39.00. Tuttll judllment $199.00.
COMMENT I The above reflucta the IImutlnt owed tn Ihe plall1tlff fur
babysittJng aervlrea and ctlndy orderad hy the defendant.
AI.I. I'AIITlIlS AliI! NaTHI Ell TIIAT TIIEV IIAVII TIIlIl'J'V (0) IlAVS FIIOM TilE
AnOVE DATE WITII WIIICII TO APPEAL '1'1118 .JUIlGHllNT TO Tlllt m'I'Ic:JI OF TIIII
I'ROTIIONOTAIlV. CUHIlEIlI.AND COUNTY COlIllT 01' COHHON 1'1,IIAS, COUIlT 1I0UIlll,
CARLISLE, PA 17013. (.
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TRINA NEAL,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
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NO. 95-7348 CIVIL TERM
LISA RUPPERT,
Defendant
ORDER OF COURT
AND NOW, this 2.,'tt,day of December, 1995, upon consideration
of Defendant's petition to proceed in forma pauperis, Defendant is
granted leave to proceed with her appeal from the judgment of the
District Justice, without payment of the usual filing fee. No
other fees, costs or obligations are waived.
BY THE COURT,
..~R..~d
J.
Trina Neal
32 Center Street, *35
Mount Holly springs, PA
Plaintiff
('''d''l Ih"''''''\.l~,(
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17065
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Lisa Ruppert
7 pine Road
Apt. 304
Mount Holly Springs,
Defendant
_ ~ ~"l '/~/H,
- 0 ~' J. f.
PA 17065
District Justice Susan K. Day
229 Mill Street
P.O. Box 167
Mount Holly Springs, PA l7065
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No.
In tha Court at Common Pl.as at
Cumberland County, Pennsylvania
Civil
Va.
PRAECIPE TO PROCEED IN FORMA PAUPERIS
To the Prothonotary I
l1Ddly allow
(plaintiff) (Defendant), to procsed in forma psuperis.
I, ,attorney for tha party
proceeding in forma pauperis, csrtify that I ,elieve the p~rty proceeding
11 unable to pay the costs and that I am providing free legal sarvice to
the party. The party's affidavit showing inability to pay the costs of
litigation ia attachad hereto.
Attorney for
1
[N THE COURT OF COMMON PLEAS
OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION--LAW
NO. CIVIL
1. I am the (plaintiff) (defendant) in the above matter and becaule of my
financial condition am unable to pey the feee Ind coeta of prosecuting or defending.
the action or proceedinl.
2. I am unable to obtain funds {rom anyone, including my family and associatel,
to pay the cOlta ot litilltion.
,3. I reprelent that the information below felating to my ability to pay the
f.e. .nd co~t. ia F~~ and ~o~ect:
(a) NlIIIIelli,~.il.. J. ({ L,.j!fJti.J.
Addml: '? PH J/~ Il <J fJ,J/' )jj!) fJ1 T t1 0 II J
Social Sec\lrity NWDberl /1t( J' ~ 3/i' ?R
(b) EmploY1llent
If you are preeently employed, etate
Employer I ;/ I ~
Sal.ry or wag.. per month:
Type of work I
If you are prasently unemployed, state
Date of last employment I
Salary or wagee per month:
Type of Work:
(c) Other income within the
(h /7()1P5
Busineee or profeeeionl
Other eelf-employment:
[nterllt I
Dividendi:
Pen.ion and annuitiell
Social lecurity benefitll
Support paymentll
palt twelve months
J'v //\
I
2
, .
.
Di.abllity paymant..
Unamploym.nt compln.ation and
.upplezental blnlfit..
Workman'. complnsation.
Public a..btancI. 11111 ITII1olh/y
Other
(d) Othar contributions to houalhold IU ort
(Wifl) (Husband) Naml.
If your (wifl) (hUB and) is emploYld, statl
EmJIloYlrl
Salary or wa.11 plr monthl
Typl of work:
Contributione from Cbildran
Contributions from parantsl
Othlr contributionl'
(I)
ProPlrty owned
Cash I /viii
,
Chlckin. account 1
Savin.1 account I
Clrtificatll of dlposit.
Rial Istatl (including homl) I
Motor vahielll Makl
COlt
StOCUI bonds.
Other:
(l)
Dlbt. and obliaations^!/j
Mort.alll r 1
I
Rent I
Loanel
Other I
3
, Year
. Amount aw.d $
~, .
(II) Perlon. dependent upon YOU for support
CWife) (Hulblnd) Nlmel
CbildrlD, if any I ~tl2. T
N......uJ:uJ (, , Aiel I'lL
Other penon..
Name 1_
Relationahip I
4. I underltand that I heve a continuins oblisation to inform the
court of improvement in my financial circumatancee which would permit me
to pay the coati incurrld herein.
5. I verify thet thl Itatementa made 1n thia affidavit are true and
corrlct. I underatand thet falae atat.menta herein are made subject to
to the panaltile of 18 Pa. C.S. , 4904, relatins to unaworn falaification
to authoritiea.
Jd}/fA C tll~C~ j-
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Da~el>>r ") '7 I <N!)
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, COMMOHWIAUH D' PlHHIYLVAHIA
COUll Of COMMIjH'UAI-~
~
JUDICIAL Dlllllel
NOTICE OF APPEAL
fROM
DISTRICT JUSTICE JUDGMENT
CDMMDHPLlAIN.. 95-7348 cIvil 'J'enn
__n.____ _~____ ._______.___._~.___ ________._ .------~_.-"_..----.-..--.,.. .- .__._--~.__.
NOTICE OF APPEAL
Notice II u1- that tho awellanl hot filed In lhe obov. Courl of Common Plea. on "",,"01 from lho judgnwnt rend<<.d by Ih. Dillritl JUllie. on lho
date and In tho co.. mtntlantd btlow
, PIlI{'
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----,..-~----....---..--..' rlolllii~1i.lllllir::'
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199:J 'Trill,) N(,..: V\ 1../',,1 (,,/Vtfl7
CV 19 ~ ,);}..it 5 -- .. ,_n, 'J~g,?--~7;,-~ " -
lT 19 . ,.._____ ~~~{.~_(, I./t!.,~_.
ThIt bIoc~ wil be t9wd ONlY when lhi. nolotion il required und<< p~jp, No /I appollant was CLAIMANT (see Pa, HC P,J.P, No,
lOOn . .
Th/. Nolict of Appeal, when received by Ih. Dillricl JUlliu, will opernl. a. 0 lOOl(6) In acllon belore District Jusllce, he MUST
SUPfaSEDEAS 10 tho judgment for po....tion In Ihi. (ala FILE A COMPLAINT within twenlv (20) days slier
_, _"n~'_~~ filing his NOTICE 01 APPEAL.
Slgnahlre OT1lOii...~niy '" o.,.,'r'
'IAECIPE TO U.iTiRRULETO FfLE COMPLAINT AND RULE TO FilE
(ThIs section 0110011 to bo used ONLY wlJon 1Iff~,lIaJlI was D[ffNDANT (soo Po nCPJp No '00'(7) Inaction boloro District Jus/leo,
IF NOT USED, dolllclJ lrom clllY 0/ no/lea olll/,JOal /u bo scrvod I~J()fl 11/')0/100).
'IAICIPI, To Pro",:,""Iory _ /
Enltr rule upon' I ( III J N (() ----..- - ,,----.'-
NilINt I~ ..,.,IIl.'tJt I J
(Common Plea. No 95-7348 Cl vil 'UI1'1 .'m'..~_) within I_nty (20) day. oft" ."vie. of rule or ,.uff" entry of Juc9nent of non pro.
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1-)1 ...-, ,,{ ( /.';, , '
./ ~lnol...~ahd"lOmeyo~
, oppt/le.{.), 10 file 0 c<Jn1llalnl In lhi. appeal
lUll. To II' /frO N6) L__
NIrhe ri ~II
., -----, oppelIH(.).
(II Ytjy en no~fItd lhol 0 rule I. htrtby enlered upon roo 10 file 0 (Of1l'!oint in lhi. appeal within I-"Iy (20) doYI oft" lho dolt of
",vie. of "'" rule upon roo by "".onal ."vie. or by c"Iified III regi.tered moll
m If roo do nol file 0 c<Jn1llaint within lhil ~mt, 0 JUOOMfNT OF NON PROS Will BE ENTERED AGAINST YOU,
(3) The, datt of ",vie. of lhil rule K ..nie. WD. by moili. lho dolt of moiling.
Date: /)(( ) '/ ,'9q0.~"..'L. ~ )~2,.!~~
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AOPC 31' It
COURT FILE
_~___-_-----__""~4""""--'--
PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT
(TlI" 1"00/ 0/ ,orv,ce MlIS rill I III () \VIIIII/{ , I /{ I 10, PAt:, AI , /111';'"11"''' "",,,. "I 81'/"'''' c;I"ck "l'p"C81,/I, /10'0'/
COMMONWEAL TH OF PENN8nVANIA
COUNTY OF .f.u..\\-lbL\ \',,), , d....
AFFIDAVIT: I he,.by 'WIW or allll", \h811 ,,,,ved
~, "'PI 01 \Ill' 'j"t,," "I Aj'I"'"' C"m,I''''' PI.". No .y6. '/348' "I"'" 1111' (l,.,,,rl,IIl.I'CDI10,lgllaled Iho,,"" Oil
I I/o It, ,,1.'''1\''") J .:-::-..':l. ...,.... ,1\1 9.5. \l!':Y.';-""J:ill Sl'''''{~ l J hy lU!lllfUiH1) (fl'U's1.l"edl rna.lI, sonder I;
lerl"pl "\lAd'Al1tll'wl" "lid 1'1'''1\ \I\(' opp,'II!'" (",,1011 I -II:, "I~ Nea . ." . - . . .. on
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[) it ,1<\ ""\1"" '''.11 ""'., ., 1!<t.Ih.'" /.. f I,." t . "'I'!.'"'' '" , ""'1"'''\'''') II", ,lh"" rJu\W" "I ApI'''''' "POl' "'" appelloo!') 10 "'Win
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THIS 5th DAvm . ~"19&
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