Supreme Coyrt6fPennsylvania The informatioy- collected on this form is used solely for supplement or» splace the filing and service of pl ‘Commencement of Action: EE] Complaint Writof Sammons E] Transfer from nother Jurisdiction G a : z a R EF > me = ad court administration purposes. Talsrform Wes Ne | ngs or omer papers as required by law on Mes oFSbures wr BaD sy re 22 3 5] Declaration of Taking Lead Plaintiffs Na Jon Doe # ‘Lead Defendant's Name: Stephen Diamantoni & Associates Family Practice, P.C. Are money darnages requested? El Yes [1 No Cdwithin arbitration limits Poutside arbitration limits Dollae Amount Requested. (check one) Js this a Class ction Suit? Dyes EI No Isthis an MDJ Appeal? (Yes EI No ‘Name of Pla tifAppellant’s Attorney: Beniamin D. Andeozzi, Esa, / Nathaniel L, Foote, Esa. 11 Check here if you have no attorney (are a Self-Represented [Pro Se} Litigant) Nature of the Case: you consider most important. Place an “X” to the left of the ONE case category that most accurately describes your PRIMARY CASE. If you are making more then one type of claim, check the one that "TORT (ao not inde Mas Tor) CONTRACT (ao orincinds udgmort) | [CIVIL APPEALS Eh intentional 1) Buyer Plaintiff “Administrative Agencies: [] Malicious Presecution FE Debs Collection: Credit Card [Fj Board of Assessment Gi Motor Vekic! EB} Debs Collection: Other Gl Board of Elections ‘Nuisance EZ Dept. of Transportation Premises Lieilty EB stenory Appeal Other Prt interne |) py a serimination Co ae 1 Employment Dispute: Other Negigense_ Dotter, MASS TORT Gy Asbestos Di Tobacco Ey Toxic Tort - ES Ey Toxlo Tor (plant REAL PROPERTY MISCELLANEOUS Ey Toxo Waste EX Ejectment TE Common Law/Statutory Arbitration ote: El eminent DomainCondemaation |) J Declaratory Judgment EE Ground Rent Mandamus [J Landiord‘Tenamt Dispute Non-Domestic Relstions Ei Morgage Foreclosure: Residential Restaining Order PROFESSIONAL LIABLITY El Mongage Foreclosure: Commercial Quo Warranto ©) Demal D Partition Ci Replevin Di Legal Ei Quiet Title Bother: I Mecioal Otter: TH otter Profesional: Updated 11/2011IN THE COURT OF COMMON PLEAS OF LANCASTER COUNTY, PENNSYLVANIA PROTHONOTARY CIVIL COVER SHEET PLEASE LIST NAMES AND ADDRESSES OF ADDITIONAL PARTIES ON A SEPARATE SHEET. ALL PARTY INFORMATIO" IS REQUIRED INCLUDING ZIP CODES. ALL PARTY INFORMATION MUST MATCH THE PLEADING. PLEASE 09 NOT STAPLE THE CC'/ER SHEET TO THE PLEADING, IF AN EVENT NEEDS TO BE SCHEDULED, A CAO SCHEDULING COVER SHEET MUST ALSO BE A "TACHED : : ‘TYPE OF ACTION: Chil A.tion - Law PARTY INFORMATION z a 33 PLAINTIFF'S NAMI DEFENDANT'S NAME: Stephen Damantgn SS soso) the shea d oe PF pk ‘ ER 6s] unicipaury MUNICIPALITY: re TWP/BOROUGH: TWP/BOROUGH: RO? & DOB: TELEPHONE ¢: DOB: TELEPHONE #: (727) 295-7109 iamdaiornl) Tanmanonmn na RRR) FILING ATTORNEY / FILING PARTY INFORMATION FIRM/OFFICE: Andreoz & Associates, FILING ATTORNEY/PART": Benjamin Andreozzi AOPC: (attorney 10) #89272 ADDRESS: 121. Fronts cary: Horiba STATE: PA __ ZIPCODE: 47101 TELEPHONE #; (717) 528-9124 EMAIL: Den@victmsclulattorneyscom Titannannany ‘TAX LIEN INFORMATION MUNICIPALITY MAP REFERENCE: DEED BOOK: DEED PAG! DEED DATE: SALEPRICE: TAX YEAR: TAX LIEN AMOUNT! PROPERTY DESCRIPTION: PEA/SVPO/PFLINFORMATION HEARING DATE: SOCIAL SECURITY #: (Defendant ~ Last 4 digits) POLICE DEPARTMENT: previousperitions: yesC] nol] ives’, File Date: PagetJohn Doe #1 y, Stephen Diamantoni & Associates Family Practice P.C. et al. ‘Addendum {» Lancaster County Civil Cover Sheet: Defendant's ‘lame and Address: Lancaster Ge ieral Health 555 North Dike St, Lancaster, P/. 17604