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HomeMy WebLinkAbout02-5040KAREN A. LOWRY, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW ROBERT LOWRY, NO. W- 5;'i4CIVIL TERM Defendant IN DIVORCE COMPLAINT UNDER SECTION 3301(c) OF THE DIVORCE CODE 1. Plaintiff is Karen A. Lowry, who currently resides in Cumberland County with a mailing address of 1820 Ridgeview Drive, Carlisle, Pennsylvania, since approximately August 25, 2002. 2. Defendant is Robert Lowry, whose current mailing address is at 120 S. Pitt Street, Cumberland County, Pennsylvania. 3. Plaintiff and Defendant have both been bona fide residents in the Commonwealth for at least six months immediately previous to filing of this Complaint. 4. Plaintiff and Defendant were married on May 5, 1997, in Carlisle, Pennsylvania. 5. There have been no prior actions of divorce or for annulment between the parties hereto in this or any other jurisdiction. 6. The marriage is irretrievably broken. 7. Plaintiff has been advised that counseling is available, and that Plaintiff may have the right to request that the Court require the parties to participate in counseling. 8. Plaintiff requests the Court to enter a Decree in Divorce. WHEREFORE, Plaintiff respectfully requests this Honorable Court to enter a Decree in Divorce and such other Orders as may be just and appropriate. II. CUSTODY 9. Previous paragraphs are incorporated by reference. 10. The plaintiff is Karen A. Lowry, residing in Cumberland County with a mailing address of 1820 Ridgeview Drive, Carlisle, Pennsylvania. IL The defendant is Robert Lowry, whose current mailing address is 120 S. Pitt Street, Cumberland County, Carlisle, Pennsylvania. 12. Plaintiff seeks custody of the following child: Name Present Residence DOB Christian N. Lo Age wry Confidential 3/31/00 2 years (Mailing address: 1820 Ridgeview Drive, Carlisle, PA) The child was not born out of wedlock The child is presently in the custody of Karen A. Lowry who resides in Cumberland County with a mailing address of 1820 Ridgeview Drive, Pennsylvania. During the past five years, the child has resided with the following persons and at the following addresses: List All Persons Karen Lowry List All Addresses Confidential (Mailing Address: 1820 Ridgeview Drive, Carlisle, PA) Dates August 2002-Present Robert and Karen Lowry 520 Boxwood Lane Carlisle, PA 17013 Birth-August 2002 The mother of the child is Karen A. Lowry, whose mailing address is 1820 Ridgeview Drive, Carlisle, PA 17013 . She is married. The father of the child is Robert Lowry, currently residing at 120 S. Pitt Street, Carlisle, PA 17013. He is married. 13. The relationship of plaintiff to the child is that of mother. The plaintiff currently resides with the following persons. Name Relationship Christian Lowry Son 14. The relationship of defendant to the child is that of father. The defendant currently resides with the following persons. Name Relationship Shirley Black Mother 15. 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. Plaintiff has no information of a custody proceeding concerning the children pending in a court of this Commonwealth. Plaintiff does not know of a person not a party to the proceedings who has physical custody of the child and claims to have custody or visitation rights with respect to the child. 16. The best interest and permanent welfare of the child will be served by granting the relief request because: Plaintiff has undertaken and performed the primary parental responsibilities for the child . Plaintiff is best able to provide the care and nurture which the child needs for healthy development. 17. 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 below, who are known to have or claim a right to custody or visitation of the child will be given notice of the pendency of this action and the right to intervene: Name Address N/A Basis of Claim WHEREFORE, Plaintiff requests this Court grant Plaintiff primary physical custody in the Mother with visitation in the Father as agreed upon by the parties. COUNT III. ALIMONYDENTE LITE 18. Previous paragraphs are incorporated by reference. 19. The parties hereto are husband and wife having been joined in marriage on May 5, 1997. 20. Plaintiff, Karen Lowry currently has inadequate funds to put her on equal grounds regarding divorce litigation. 21. There will be litigation concerning marital property issues. WHEREFORE, Plaintiff prays this Honorable Court to Order Alimony Pendente Lite in an amount equal to the Pennsylvania State Support Guidelines. Respectfully submitted, Date: 10 - t-7 _,0-T. Mark F. Bayley, Esquire 155 South Hanover Street Carlisle, PA 17013 (717) 241-6070 Supreme Court ID # 87663 Attorney for Plaintiff VERIFICATION I verify that I am the petitioner and that the statements made in the foregoing Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C. S. § 4904, relating to unswom falsification to authorities. Date: cc* q 10 2 Karen Lowry a W O A Q? k O Q ROBERT LOWRY IN THE COURT OF COMMON PLEAS OF PLAINTIFF CUMBERLAND COUNTY, PENNSYLVANIA V. 02488 CIVIL gCTION LAW oa-SbN KAREN LOWRY DEFENDANT CUSTODY ORDER OF COURT AND NOW, Wednesday, October 23, 2002 , upon consideration of the attached Complaint, it is hereby directed that parties and their respective counsel appear before Melissa P. Greev , Es- the conciliator, at 301 Market Street, Lemoyne, PA 17043 on Tuesday, November 12, 2002 at 12:30 PM 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. All children age five or older may also be present at the conference. Failure to appear at the conference may provide grounds for entry of a temporary or permanent order. The court hereby directs the parties to furnish any and all existing Protection from Abuse orders, Special Relief orders, and Custody orders to the conciliator 48 hours prior to scheduled hearing. FOR THE COURT, By: /s/ e ' r v s . Custody Conciliator The Court of Common Pleas of Cumberland County is required by law to comply with the Americans with Disabilites Act of 1990. 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 hearing or business before the court. You must attend the scheduled conference or hearing. YOU SHOULD TAKE THIS PAPER TO YOUR ATTORNEY AT ONCE. IF YOU DO NOT HAVE AN ATTORNEY OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 2 Liberty Avenue Carlisle, Pennsylvania 17013 Telephone (717) 249-3166 4?,? -irv f, /.Or, 4?v VNIXIASWd ?i Z'? I ?r, a -Z ? 6? ©/ NOV 1 8 2007 KAREN LOWRY, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff NO. 02-5040 CIVIL TERM V. ROBERT LOWRY, CIVIL ACTION -LAW IN DIVORCE Defendant ORDER OF COURT AND NOW, this day of -, y , 2002, the parties having --A 1-n u r reached an agreement for custody in Conciliation, and an Order having been entered docketed to the Father's Custody Complaint at 02-4884, the Court hereby dismisses Mother's Custody Count in this Divorce Complaint, without prejudice. Orders related to the custody of the minor child, Christian Nathaniel Lowry, date of birth March 31, 2000, shall be located at Docket No. 02-4884. Dist: ! Michael A. Pykosh, Esquire, 3805 Market Street, Camp Hill, PA 17011 Mark F. Bayley, Esquire, 155 South Hanover Street, Carlisle, PA 17013 :165127 z y II _ao Qvl? BY THE C0l1RT- i - - nin . ?._ ? .. ? ?' l', i? ?? ?- i;'{ ,_ KAREN A. LOWRY, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 2002-5040 CIVIL TERM ROBERT LOWRY, IN DIVORCE Defendant/Respondent DR# 32177 Pacses# 248104975 ORDER OF COURT AND NOW, this 24th day of October, 2002, upon consideration of the attached Petition for Alimony Pendente Lite and/or counsel fees, it is hereby directed that the parties and their respective counsel appear before R.J. Shaddav on December 6. 2002 at 10:30 A ay for a conference, at 13 N. Hanover St., Carlisle, PA 17013, after which the conference officer may recommend that an Order for Alimony Pendente Lite be entered. Note. This petition wiU be heard with the complaint filed under Docket 826 S 2002 YOU are further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W-2's as filed (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by Rule 1910.11® (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you IF you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. BY THE COURT, George E. Hoffer, President Judge Mail copies on Petitioner 10-24-02 to: < Respondent Mark Bayley, Esquire Date of Order: October 24, 2002 R . Shad y, Conference Officer r? YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. 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 MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 MNVAlASNN3d ,liNnoo GWlH- EMO i t .1 lid I Z AUN ZD A?idiC)Cdt?? iiU si {i Jo KAREN A. LOWRY, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION -LAW ROBERT LOWRY, : NO.c>?_,5rwyaCIVIL TERM Defendant . IN DIVORCE MOTION FOR ALIMONY PENDEIdTE LITE AND NOW, comes Karen A. Lowry, by and through her privately retained counsel, Mark F. Bayley, Esquire and in support of her Motion for Alimony Pendente Lite avers as follows: The parties hereto are husband and wife, having been joined in marriage on May 5, 1997 in Cumberland County. 2. Your Petitioner, Karen Lowry currently has inadequate funds to put her on equal grounds regarding divorce litigation. 3. There will be litigation concerning martial property issues. WHEREFORE, your petitioner prays this Honorable Court to Order Alimony Pendente Lite in amount equal to the Pennsylvania State Support Guidelines. Date: C 17 -or,, Respectfully submitted, ROMINGE.R & BAYLEY Mark F. Bayley, Esquire 155 South Hanover Street Carlisle, PA 17013 (717) 241-60'70 Supreme Court ID # 87663 Attorney for Plaintiff KAREN A. LOWRY, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION -LAW ROBERT LOWRY, NO. CIVIL TERM Defendant IN DIVORCE CERTIFICATE OF SERVICE I, Mark F. Bayley, Esquire, attorney for Plaintiff, do hereby certify that I this day served a copy of the Motion for Alimony Pendente Lite upon the following by depositing same in the United States Mail, first class postage prepaid, at Carlisle, Pennsylvania, addressed as follows: Robert Lowry 120 S. Pitt Street Carlisle, PA 17013 Dated: 10 ? 1-7_ 6-Z, Mark F. Bayley, Esquire Attorney for Plaintiff C) C.7 „ ,. J :. j ry ) e ? i I In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Defendant Name: ROBERT S. LOWRY Member ID Number: 5402100251 Please note: Au correspondence must include the Member ED Number. ORDER OF ATTACHMENT OF UNEMPLOYMENT COMPENSATION BENEFITS Financial Break Down of Multiple Cases on Attachment Plaintiff Name 3,10&a A Docket Number Attachment Amount/Frequency a s ? / s ? i TOTAL ATTACHMENT AMOUNT: $ 1,515.60 Now, by Order of this Court, the Department of Labor and Industry, Bureau of Unemployment Compensation Benefits and Allowances (BUCBA), is hereby directed to attach the lesser of $ 349.75 per week, or 55 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, ROBERT S. LOWRY Social Security Number 162-48-0922 , Member ID Number 5402100251 . BUCBA is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from BUCBA to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearages, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673 (b)(2) and 23 Pa. C.S.A. § 4348 (g). This Order shall be effective upon receipt of the notice of the Order by the BUCBA and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated JUNE 28, 1998 is exhausted, expired or deferred. BUCBA shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: Service Type M QL-C 9 2002 n,el- Form EN-530 Worker ID $ IATT C) C i ' ^.? - `,L rrl E O 7 it .. ? -- rv ac z _; ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania /['SFS `/f75Original Order/Notice Co./City/Dist. of CUMBERLAND 6-C 3 1/ 77 O Amended Order/Notice Date of Order/Notice 12/06/02 Y4 Terminate Order/Notice Tribunal/Case Number (See Addendum for case summary) r,)4e,SF5 7 3,WVk3y RE: LOWRY, ROBERT S. Employer/Withholder's Federal FIN Number Employee/Obligor's Name (Last, First, MI) THE SYGMA NETWORK OF OHIO INC PO BOX 7327 DUBLIN OH 43017-0709 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 500.00 per month in current support $ 15.60 per month in past-due support Arrears 12 weeks or greater? Oyes Q no $ 0.00 per month in medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 515.60 per month to be forwarded to payee below„ You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 349.75 per weekly pay period. $ 699.51 per biweekly pay period (every two weeks). $ 757. e0 per semimonthly pay period (twice a month). $ 1.515.60 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed) 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information i needed (See #10 on pg. 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Date of Order: DEC 9 2002 Service Type m i2 BY TH7COU'R: / V i F Sf may' /?, .J,e -7' I Form EN-028 OMB No.: 0970-0154 Worker ID $IATT C 1A ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? if4heckefl you are required to provide a copy of this form to your employee. If yotrr employee works in a state that is d i erent rrom the state that issued this order, a copy must be provi edd to your employee even if the box is not checked 1. We appreciate the voluntary compliance of Federally recognized Indian tribes, tribally-owned businesses, and Indian-owned businesses located on a reservation that choose to withhold in accordance with this notice. 2. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 3. Combining Payments: You can combine withheld amounts from more than one employeelobligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 4.* e`s wager. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. S.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must horor all Orders/Notices to the greatest extent possible. (See #10 below) 6. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. WITHHOLDER'S ID: 7602546080 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 7. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 8. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9. Anti-discrimination: You are subject to a fine determined under State law for discharging an employeelobligor from employment, refusing to employ, or taking disciplinary action against any empioyeelobligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 10.* Withholding Limits: You may not withhold more than the lesser of- 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. 11. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M by telephone at (717) 240-6225 or by FAX at 717 240-6248 or by internet wwww.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment; Defendant/Obligor: LOWRY, ROBERT S. PACKS Case Number 248104975/379/77 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 555.60 Child(ren)'s Name(s): DOB PACSES Case Number 733104854/3&?,R Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 960.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the ernployee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above m any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No.: 0970-0154 C) c_ C71 ro C , ., _ I?Jl r ^ S rv sl ` , ! In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (717) 240-6225 Fax: (717) 240-6248 Defendant Name: ROBERT S. LOWRY Member ID Number: 5402100251 Please note: All correspondence must include the Member ID Number. MODIFIED ORDER OF ATTACHMENT OF UNENvIPLOYMENT BENEFITS Financial Break Down of Multiple Cases on Attachment Docket Number Attachment Amount/Frequency $ r r r r s r TOTAL ATTACHMENT AMOUNT: $ 1,543.33 Now, by Order of this Court, the Department of Labor and Industry, Bureau of Unemployment Compensation Benefits and Allowances (BUCBA), is hereby directed to attach the lesser of $ 356.15 per week, or 55.0 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, ROBERT S. LOWRY Social Security Number 162-48-0922 , Member ID Number 5402100251 . BUCBA is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from BUCBA to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearage, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673(b)(2) and 23 Pa. C.S. § 4348(g). This Order shall be effective upon receipt of the notice of the Order by the BUCBA and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated JUNE 28 , 1998 is exhausted, expired or deferred. BUCBA shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT DEC 10 2002 Date of Order: ?, GS?EY o JUDGE Form EN-034 Service Type M Worker ID $IATT Obi/ C,o ca ORDER/NOTICE TO.WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania .1 FS aZ %7S' OOriginal order/Notice Co./City/Dist. of CUMBERLAND 3.2/77 () O Amended Order/Notice Date of Order/Notice 12/09/02 ?? (JoZlo a?'YVO.? O Terminate Order/Notice Tribunal/Case Number (See Addendum for case summary) Prue SAS 73 3P'G V?Sy j/_ 3?o6? RE: LOWRY, ROBERT S. Employer/withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) THE SYGMA NETWORK OF OHIO INC PO BOX 7327 DUBLIN OH 43017-0709 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 500. 00 per month in current support $ 43`.33 per month in past-due support Arrears 12 weeks or greater? (R) Yes Q no $ 0.00 per month in medical support $ 0 . 00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 543.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not maich the ordered support payment cycle, use the following to determine how much to withhold: $ 356. 15 per weekly pay period. $ 712.31 per biweekly pay period (every two weeks). $ 771.67 per semimonthly pay period (twice a month). $ 1.543.33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information i needed (See #10 on pg. 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: Date of Order. DEC 1 U ZUUZ I /, /,/. S'LEYbGcae, Tn6 6 C Form EN-028 Service Type m _ ", 6- ?MBNO.;0970-0154 Worker ID $IATT /Co V7t 'VAIAS TPd ??( ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecked you are required to provide a opy of this form to your em loyee. If yo r employee works in a state tha is di4erent from the state that issued this order, a copy must be provideto your employee even if the box is not cheCKed 1. We appreciate the voluntary compliance of Federally recognized Indian tribes, tribally-owned businesses, and Indian-owned businesses located on a reservation that choose to withhold in accordance with this notice. 2. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 3. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 4.* Reporting the Paydate/Date of Withholding. You must report the paydate/date of wit +01ding when send.... U., Voay ........ ..e es wages: You must comply with the law of the paydate/d te of vvithholdin Eg i -at' re date on which amount was state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 5.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #10 below) 6. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. WITHHOLDER'S ID: 7602546080 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 7. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 8. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 10.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is, the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. 11. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at 71 240-6248 or by internet wwNv.childsupport.state.pa.us Service Type M Page 2 of 2 OMB No.' 0970-0154 Form EN-028 Worker ID $1ATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975r! Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 555.60 Child(ren)'s Name(s): DOB PACSES Case Number 733104854/ Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 987.73 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the ernployee's/obligor's employment. ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the ernployee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB Noe 0970-0754 INCOMLjgl;; SUPPORT ORDERINOTICE TO WITHHOLD OOriginal order/Notice L? p?G yCj' 75, O Amended order/Notice 7 Terminate Order/Notice f??Sf s 0 alth f Pe n vlv ma 0? j3 j 7 ??? Q State Co./Ciord.of Cj?12/ $RLAND 09/02 S i3316? Date of Order/Notice 3,3?Y? 3 Tribunal/Case Number (See Addendum for case summary) V/9 C j? R61 ERT S . RE: LOEmployee/obligor's Name (Last, First, MI) 162-48-0922 Number igor's Social Security Employe.00thholder's Federal EIN Number EmployeelObl 5402100251 MGMT Employee/Obligor's Case Identifier VALENTI -MID ATI,ANgIC (See Addendum for plaintiff names C/O WENDY' S associated with cases on attachment) STE 195 Custodial Parent's Name (Last, First, MI) 3450 BUSCHWOOD PARR DR TAMPA FL 33618-4465 endent names and birth dates associated with cases on attachment. See Addendum for dep ort based upon an order for support red to deduct these This is an Order/Notice to Withhold IncometnoaSuB P lam you are requi ORDER INFORMATION: County, Commonwealth of Pennsylv, from above-named employee's/obligor's income until further notice even if the order/Notice is no amounts from the issued by your State. reater? Oyes ® no $ -0 , pp_ per month in current support Arrears 12 weeks or g oo per month in past-due support $ o . -00 per month in medical support $ ?? per month for genetic test costs $ 0 -0-0 P per month in other (specify) below. $- 0.00 per month to be forwarded to payee ort order. If your pay cycle does not mach for a tOa compliance with the support cle, use the following to determine how much to withhold: you do not have to vary Your ay cycle to comp the ordered supportt payment cy eriod. o. o o per weekly pay P two weeks). $ -- p per biweekly pay period (every $per semimonthly pay period (twice a month). $- 0. 00 per monthly pay period* pay period occurring ten (10) working days after the date of this REMITTANCE INFORMATION: date/date of withholding. You are entitled to You must begin withholding no later than the first king days of the pay to employee for the Order/Notice. Send payment within seven (7) Refer to the laws governing the work state of your e! obi ee f gor's our fee, cannot exceed 55% of the eh Y e information is deduct a fee to defray the cost of withholding. the e following ur ose of the limitation on withholding, allowable amount.- The total withheld amount, an your aggregate disposable weekly earnings. For the pp needed (See #10 on pg. 2)• b EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer If remitting by Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Pa 17106-9112 Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, ER ID (shown N PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES CAL SECURITY NUMBER IN ORDER 7066E PROCESSED. above IN ADDITION as the Employee/Obligor's Case Identifier) OR SO DO NOT SEND CASH BY MAIL. BY 1fHE COURT- / / DEC 1 20? _ Date of Order:__ T- VIUM Z111 B NO.: 0970-0154 Service Type m ,2 -/ 3 OD ? r Form EN-028 Worker ID $IATT M1(12 HI i Y_.:: y ? ?m4» ONN3,d z,1 :7 E.?d r l ??? ?? ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If, kheckeo you are required to provide a copy of this form to your employee. If your employee works in a state that is di ,rent ftrom the state that issued this order, a copy must be provided to your employee even if the box is not checked. 1. We appreciate the voluntary compliance of Federally recognized Indian tribes, tribally-owned businesses, and Indian-owned businesses located on a reservation that choose to withhold in accordance with this notice. 2. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 3. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employeelobligor. 4. "" .03 W1 `s ovage - You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 5.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #10 below) 6. Termination Notification: You must promptly notify the Requesting Agency when the employee%obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. WITHHOLDER'S ID: 5220315800 EMPLOYEE'S/OBLIGOR'S NAME:_ LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 7. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 8. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 10.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. 11. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER T P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at 717) 240-6225 or by FAX at (717) 24 or by internet www.chiildsupport.state.pa.us Page 2 of 2 OMB NO.'. 0970-0154 Form EN-028 Worker ID $IATT KAREN A. LOWRY, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 2002-5040 CIVIL TERM ROBERT S. LOWRY, IN DIVORCE Defendant/Respondent : Pacses# 248104975 ORDER OF COURT AND NOW, this 6`i' day of December, 2002, based upon the Court's determination that Petitioner's monthly net income/earning capacity is $1,399.83 and Respondent's monthly net income/earning capacity is $4,392.89, it is hereby Ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit, $555.60 per month payable monthly as follows; $540.00 for alimony pendente lite and $15.60 on arrears. First payment due next pay date at a rate of $128.22 per week. Arrears set at $1,620.00 as of December 6, 2002. The effective date of the order is October 1, 2002. The amount of support is based upon an agreement of the parties. Respondent shall pay directly to Petitioner 16% of any and all new bonus (es) with verification of said bonus within fieve days upon receipt of the bonus. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C. S. § 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and its discretion make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the PA SCDU to: Karen A. Lowy. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the defendant's PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. '.)061 ?? S?Iii,l ? 1 i? ? l P .1,`µ't i I'?-i ' •H?1f;rah h1' G t; ??' td ?. 1 ;?.?? ?f? ?` ,-,? .?; This Order shall become final ten days after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary for a hearing de novo before the Court. DRO: R. I Shadday Mailed copies on Petitioner to: < Respondent Mark Bayley, Esquire Michael Pykosh, Esquire BY THE COURT, `Oler, I I 05-05-'04 12:52 FROM-Salzmann, Hughes 7172497334 T-293 P02/03 U-851 AlA?Ifi-02 13:46 FROM-Cumbsrland County Domestic Relations 7ITZ406246 T-647 P,00UM P-165 ©a MAY 05?w 1 ERLAND COUNTY DOMESTIC RELATIONS 1 Date of Application: 5 5 ibE Request for Support Record Search Name: lbw OLast Address: Social SeaUrityrNumber: ? Domestic Relations Case Number i,1'IC? Party Requesting Information: ,pct _o 1z. hom Num ) -3 (Fax Number) (tom A Twenty Dollar (520.00) Fee is Due per Social Security Number Make check or money order payable to: DRS/Lien Search f INITIAL REQUEST 176 \ Has no Record in Domestic Relations as of. ) l Support Arrears as of End of Month Prior to Date of Application: S ? . Monthly Total Support Obligation: S %- 0,00 v ' 4 21.73. xA-e-A `s C4 ?33 /0V ,!W yo.cv d- 1.r .6e sgane,aLj C-9-7y'ldy -2S- The Amount shown above is reflected in the Domestic Balations Rectio affioe of Cumberland County, Pennsylvania. a YFId Y 7 -) X1 5 yo l oo z S( Domestic Relations Case Number: 7 33 l 0 Y 8?Y° S-oS-o y Signed: 04= Search Cwriliho r) ) BRING-DOWN REQUEST Support Arrays: $ Signed: (Lien Coordinator) As Of (Dam) (Daft) j * * * Lisa SatisfisfactionReceipt Available Upon Request*** Fri cn t' L7 - C:= W Q? In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (717) 240-6225 Defendant Name: ROBERT S. LOWRY Member ID Number: 5402100251 Fax: (717) 240-6248 Please note: AB correspondence most include the Member ID Number. MODIFIED ORDER OF ATTACHMENT OF UNEIMrPLOYMENT BENEFITS Financial Break Down of Multiple Cases on Attachment Plaintiff Name KAREN A. LOWRY KAREN A. LOWRY PACSES Docket Case Number Number 248104975 02-5040 CIVIL 733104854 00826 S 2002 TOTAL ATTACHMENT AMOUNT: Attachment Amount/Freauencv $ 555.60 /MONTH $ 960.00 MONTH / / 1,515.60 Now, by Order of this Court, the Department of Labor and Industry, Bureau of Unemployment Compensation Benefits and Allowances (BUCBA), is hereby directed to attach the lesser of $ 349.75 per week, or 50.0 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, ROBERT S. LOWRY Social Security Number 162-48-0922 , Member ID Number 5402100251 . BUCBA is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from BUCBA to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearage, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673(b)(2) and 23 Pa. C.S. § 4348(g). This Order shall be effective upon receipt of the notice of the Order by the BUCBA and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated JUNE 28 , 1998 is exhausted, expired or deferred. BUCBA shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: MAY 1 1 2004 JUDGE Form EN-034 Service Type M Worker ID $IATT c" J N v ? -n y T -n 7a° C» rn O ? W L7 , -r. ft r { < ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 0Original Order/Notice Co./City/Dist. of CUMBERLAND 0 Amended Order/Notice Date of Order/Notice 05/10/04 O Terminate Order/Notice Tribunal/Case Number (See Addendum for case summary) RE: LOWRY, ROBERT S. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number THE SYGMA NETWORK OF OHIO INC 5402100251 PO BOX 7327 /,/ Employee/Obligor's Case Identifier DUBLIN OH 43017-0709 (See Addendum for plaintiff names associated with cases on attachmenO Custodial Parent's Name (Last, First, MI) L4 73 316 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 500. oo per month in current support $ 15.6o per month in past-due support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 515.60 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how Much to withhold: $ 349.75 per weekly pay period. $ 699.51 per biweekly pay period (every two weeks). $ 757. so per semimonthly pay period (twice a month). $ 1.515.60 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #10 on pg. 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL - rk Y THE CO Rlf: Date of Order: MAY 1 1 ZQQ{ Pr?S?s ? Form EN-028 Service Type M OMB NO.: 0970"0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecke? you are required to pr vide a copy of this form to your,gmclloyee. If your employee vtorks in a state thais di0ferent from the state that issue this order, a copy must be prove a to your employee even if t e box is not chec ed. 1. We appreciate the voluntary compliance of Federally recognized Indian tribes, tribally-owned businesses, and Indian-owned businesses located on a reservation that choose to withhold in accordance with this notice. 2. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 3. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. aydat&-ate 0, withhol ing. You must report the P.YOMMM 0 1 ....... 101ding when sending the payment. The 4.* Reporting the ee'sw .. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 5.* Employee/obligor with Multiple Support Holdings: If there is more than one OrderiNotice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #10 below) 6. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. WITHHOLDER'S ID: 7602546080 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 7. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 8. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employeelobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 10.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes.. 11. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Service Type M OMB No.: 097o-o154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 555.60 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 960.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03,/31/00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No. 0910-0154 (? N c:a _ y - --1 ? . r -n l[[[-T???l r?? W ?? ?;_ ,... <-, u. Sri I J W r'' ?G ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsy vania Q Original Order/Notice Co./City/Dist. of CUMBERLAND Q Amended Order/Notice Date of Order/Notice 01/06/05 Q Terminate Order/Notice Case Number (See Addendum for case summary) RE: LOWRY, R013ERT S. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number THE SYGMA NETWORK OF OHIO INC 6wa 5402100251 C/O CORPORATE OFFICE e? Employee/Obligor's Case Identifier S TE 300 6 WI b 0n:7 (See Addendum for plaintiff names 5550 BLAZER PKWY associated with cases on attachment) DUBLIN OH 43017-3478 S ?.I ?Q?Ja Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ o . op per month in current support $ o. oo per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ 0.00 per month in current and past-due medical support $ o . 00 per month for genetic test costs $ per month in other (specify) for a total of $ 0.00 per month to be forwarded to payee below,. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ o . o 0 per weekly pay period. $ o . o 0 per biweekly pay period (every two weeks). $ o. oo per semimonthly pay period (twice a month). $ o. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. - BY THE COURT: os- Date of Order: ,IAN 'z _J. Service Type M OMB No.: 0970-0154 Form EN-028 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecked you are required to provide a opy of this form to your m loyee. If yo r employee works in a state that is diferent from the state that issued this order, a copy must be providedpto your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one em,ployee%obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* paydate/date of withholding is the date os, which aniount was withheld front the ernplo Reporting wages- You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 7602546080 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. § 1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. I I. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact 'WAGE ATTACHMENT UNIT by telephone at X717) 240-6225 or by FAX at (717) 2,W-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Worker ID $IATT .? r,"; ra r _- ?-- :_? ? ? ? - ? - - r _.., ? y r _ tea _3'??, cr; ..as? :ice P--? ?>,?' In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (717) 240-6225 Fax: (717) 240-6245 Defendant Name: ROBERT S. LOWRY Member ID Number: 5402100251 Please note: AB correspondence must include the Member ID Number. MODIFIED ORDER OF ATTACHMENT OF UNEMPLOYMENT BENEFITS Financial Break Down of Multip le Cases on Attachment PACSES Docket Plaintiff Name Case Number Number Attachment Amount/Freauencv KAREN A. LOWRY 248104975 02-5040 CIVIL $ 555.60 /MONTH KAREN A. LOWRY 733104854 00826 S 2002 $ 987.73 MONTH TOTAL ATTACHMENT AMOUNT: $ 1,543.33 Now, by Order of this Court, the Department of Labor and Industry, Bureau of Unemployment Compensation Benefits and Allowances (BUCBA), is hereby directed to attach the lesser of $ 356.15 per week, or 55.0 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, ROBERT S. LOWRY Social Security Number 162-48-0922 , Member ID Number 5402100251 . BUCBA is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from BUCBA to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearage, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673(b)(2) and 23 Pa. C.S. § 4348(g). This Order shall be effective upon receipt of the notice of the Order by the BUCBA and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated JUNE 28, 1998 is exhausted, expired or deferred. BUCBA shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: 9( o JUDGE Form EN-034 Service Type M Worker ID $ IATT ? e=sseE ? f" _' n? ' ? ?i? _ _ C.;i i: ? r nr crr -. ?-, ,? ., ORDERINOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 0Original Order/Notice Co./City/Dirt. of CUMBERLAND O Amended Order/Notice Date of Order/Notice 02/08/05 O Terminate Order/Notice Case Number (See Addendum for case summary) RE: LOWRY, ROBERT S. Employer/Vdithholder's Federal FIN Number Employee/Obligor's Name (Last, First, MU 162-48-0922 Employee/Obligor's Social Security Number JFC TEMPS INC 5402100251 C/O JFC STAFFING ASSOCIATES Employee/Obligor's Case identifier 1520 MARKET ST (See Addendum forplaintiffnames CAMP HILL PA 17011-4815 associated with cases on attachment) [hgaF-fs Custodial Parent's Name (Last, First, MI) /r7c-? pia ?y ?s See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 500.00 per month in current support $ 43.33 per month in past-due support Arrears 12 weeks or greater? ®yes Q no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 543.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 356.15 per weekly pay period. $ 712.31 per biweekly pay period (every two weeks). $ 771.67 per semimonthly pay period (twice a month). $ 1.543 .33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydateJdate of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: Date of Order: FEB - 9 2005 cEy p C) P_ !sue Form EN-028 Service Type M OMB No.:09J0-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? ifkhecke di l you are required to provide a jopy of this form to your Bmployee. If your employee works in a state that is Brent rom the state that issue tl this o er, a copy must be provided to your emp oyee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one em ployee%obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Repo,ting the Paydate/Date-of-Withl-olding You most repoit the vdyddt&ddte thholding when sending tire payinent. The You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2322201350 EMPLOYEE'S/OBLIGOR'S NAME: LOPTRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/6bligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. I 1.Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee%bligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717,1240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Service Type M Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Oefendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104875 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 555.60 Child(ren)'s Name(s): DOB ?lf checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. [] If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ?lf checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No.: 0970-0154 1 l ?r 1 iJ' ..: it ?' ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 02/25/05 Case Number (See Addendum for case summary) Employer/withholder's Federal FIN Number TRIPLE K INC C/O ATTN - LOGAN WHITE 3019 HEMPLAND RD O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) 162-48-0922 16 el U`L Employee/Obligor's Social Security Number 'W'? -66 Y 5402100251 Employee/Obligor's Case Identifier b (See Addendum for plaintiff names LANCASTER PA 17601-1309 associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 500.00 per month in current support $ 43 .33 per month in past-due support Arrears 12 weeks or greater? ®yes Q no $ 0.00 per month in current and past-due medical support $ o. 00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 543.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 356. 15 per weekly pay period. $ 712.31 per biweekly pay period (every two weeks). $ 771.67 per semimonthly pay period (twice a month). $ 1.543 .33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BYMAIL 3 (D S BY THE COURT: Date of Order -L S ?Dog V? J, -SLAY 7Z ?Z Form EN-028 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If heckl you are required to provide a copy of this form to youremAloyee. If yo r employee works in a state this dif erent from the state that issued this order, a copy must be provi detl to your employee even if the box is not check ed. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* e-payrnent. The- You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2322555780 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupportstate.pa.us Page 2 of 2 OMB No. 0970-0154 Form EN-028 Worker ID $ZATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 555.60 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 987.73 Child(reN's Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? h checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type P4 ID $IATT OMB Na.: 097"154 Worker r? 'n I . ?.-.. [':? _, ^) ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dirt. of CUMBERLAND Date of Order/Notice 03/08/05 Case Number (See Addendum for case summary) Employer/withholder's Federal EIN Number TRIPLE K INC C/O ATTN - LOGAN WHITE 3019 HEMPLAND RD LANCASTER PA 17601-1309 O Original Orcler/Notice O Amended Order/Notice OX Terminate Order/Notice RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) 82(a r d0De1 tQA£5 7j31Wf6V1 ,oil-CS?s ds?io5?y7s 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 0.00 per month in current support $ o . o0 per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ o. oo per month in current and past-due medical support $ o . o o per month for genetic test costs $ per month in other (specify) for a total of $ 0.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order, If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ o. oo per weekly pay period. $ o. oo per biweekly pay period (every two weeks). $ 0.00 per semimonthly pay period (twice a month). $ o . o o per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COU Date of Order: Service Type M OMB No.: 0970 01 au(6C- Form EN-028 WorkerlD $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If checked you are required to provide a opy of this form to your mployee. If yo r employee works in a state that is different from the state that issued this or?er, a copy must be provi ?ed to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* wni nluma ig wuoI ??IIU II 16 U- VN ylI., paydateMate of wager. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2322555780 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. _ EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Service Type M Page 2 of 2 OMB No, 0970-0154 Form EN-028 Worker ID $IATT ., , ,? :? .. .; e§ P"S P?1 F1 4..1 r ? ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dirt. of CUMBERLAND Date of Order/Notice 05/03/05 Case Number (See Addendum for case summary) Employer/Withholder's Federal FIN Number JFC TEMPS INC C/O JFC STAFFING ASSOCIATES 1520 MARKET ST CAMP HILL PA 17011-4815 O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) )/ t1, di Wz -5 4) ?/o eP, )046E5 a2 ,?T12YIP 7 -5 Y xv, s -*oz P1465f-5 73310yss'% 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ o .0o per month in current support $ o. oo per month in past-due support Arrears 12 weeks or greater? Ayes ® no $ o. oo per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ o, oo per month to be forwarded to payee below. You dp not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ o. oo per weekly pay period. $ o . o o per biweekly pay period (every two weeks). $ o. go per semimonthly pay period (twice a month). $ o. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAMEAND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY Date of Order: MR( - 3 2005 6--6-06- Service Type M OMB No Form EN-028 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If?hecked you are required to provide a copy of this form to your employee. If yo r employee works in a state that is di erent from the state that issued this order, a copy must be provided to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Repoiting tire Pay date/Ddte of Wit! iholding. YOU Must report the paydateid ate of withholding Mien seiidinr tire paynmnt. The You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Emplgyee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. tSee #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2322201350 EMPLOYEE'S/ORLIGOR'SNAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee-/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employeelobligor from employment, refusing tdemploy, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. I I. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. POX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Worker ID $IATT (-? r.? ? "T1 --t - _ ' ~'r= ? _ _ ?. __ C: i ;? =? n `n Cv Y?1 Ci` ..{ ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 05/11/05 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) MOHAWK INDUSTRIES /, -6Z#0 (// 11JL PO BOX 12069 MACS a lR,/D11g7S CALHOUN GA 30703-7002 Mar-& r33iot/?sY 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 500. oo per month in current support $ 43 .33 per month in past-due support Arrears 12 weeks or greater? ®yes Q no $ o . 00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 543.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 356.15 per weekly pay period. $ 712.31 per biweekly pay period (every two weeks). $ 771.67 per semimonthly pay period (twice a month). $ 1.543 .33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. S./S BY THE COURT: Date of Order: MAY 1 2 2005 Form EN-028 Service Type M OMBNO.:OWV-1154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hhecked you are required to provide asopy of this form to your3mployee. If yo r employee works in a state that is di Brent ffrom the state that issued this or er, a copy must be provi edd to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* ding- theTrayment.--The- pagdate/date You must comply with the law of the the miphoyee's wages. state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 5815159940 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No. 0970-0154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 555.60 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 987.73 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enrol I the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No.: 0970-0154 l? (' T C, ; ^_ 1 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KAREN A. LOWRY ) Docket Number 02-5040 CIVIL Plaintiff ) vs. ) PACSES Case Number 248104975 ROBERT S. LOWRY ) Defendant ) Other State ID Number PETITION FOR MODIFICATION OF AN EXISTING SUPPORT ORDER 1. The petition of ROBERT SCOTT LOWRY respectfully represents that on DECEMBER 6, 2002 , an Order of Court was entered for the support of KAREN ANN LOWRY A true and correct copy of the order is attached to this petition. Service Type M Form OM-501 Worker ID 21502 LOWRY V. LOWRY 0/decrease PACSES Case Number: 248104975 2. Petitioner is entitled to O increase 0 termination 0 reinstatement O other of this Order because of the following material and substantial change(s) in circumstance: -/o1) ' 60ee/C w.;.s 07??s z,? e ?/czcree wo Pc AQ/ - WHEREFORE, Petitioner requests that the Court modify the existing order for support. A?? A10,44 Petitioner Attorney for Petitioner I verify that the statements made in this complaint are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unworn falsification to authorities. Petitioner 4AS, Z&05- Date Service Type m Page 2 of 2 Form OM-501 Worker ID 21502 i.: f?J .. ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania X@Original Order/Notice Co./City/Dist. of CUMBERLAND O Amended Order/Notice Date of Order/Notice 06/22/05 O Terminate Order/Notice Case Number (See Addendum for case summary) RE: LOWRY, ROBERT S. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number JFC TEMPS INC ?Znoa-??? e v 5402100251 C/O JFC STAFFING ASSOCIATES ?B(C [+ ,g Employee/Obligor's Case identifier 1520 MARKET ST 77.? (See Addendum for plaintiff names CAMP HILL PA 17011-4815 ) associated with cases anaffaclimen0 Custodial Parent's Name (Last, First, MI) y?,gcsFS ?33/D S?&'r;/ See Addendum for dependent names and birth dates associates/ with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee'stobligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 500.00 per month in current support $ 43.33 per month in past-due support Arrears 12 weeks or greater; ®yes Q no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 543.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 356.15 per weekly pay period. $ 712.31 per biweekly pay period (every two weeks). $ 771.67 per semimonthly pay period (twice a month). $ 1.543.33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BYMAIL. ?? R= BY THE Date of Order: JUN 2 3 // - Form EN-028 Service Type M OMBNo.:0970-0150 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? I , hecke you are required. to pr idea opy of this form to your m loyee. If yo r employee orks in a state that is if?ferent from the state that issuerpthis order, a copy must be provi ?e?to your employee even if tie box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3. pay datetd2te 0 vvit! 1! jold Pig 5 the date on which amount was withheld hon, the e`swages.. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2322201350 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employeelobligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act 0 5 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employeelobligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at 1717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Worker ID $ZATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT s. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 555.60 Child(ren)'s Name(s): DOB ?if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ?if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the erployee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren's Name(s): DOB ? If checked, you are required to enroll the child(ren) ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. N (?1 r..? __ `:, _ - C._ :? ` .?,._ N ! -? ?`J 7 C? f?Cl) h mil ._7C? - din ? ?:? ? :'? j ? ,D '? ra ROBERT LOWRY, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : CIVIL ACTION - LAW KAREN LOWRY, : NO. 02-5040 Defendant : IN DIVORCE PLAINTIFF ROBERT LOWRY'S MOTION FOR APPOINTMENT OF MASTER The Plaintiff, Robert Lowry, moves this Honorable Court to appoint a Master with respect to Distribution of Property, Alimony, Alimony Pendente Lite, Counsel Fees, and Expenses. 2. Discovery is complete as to the claims for which the appointment of a Master is requested. 3. The Defendant has appeared in this action by her attorney, Mark F. Bayley, Esquire. 4. The statutory grounds for divorce are 3301(c) and 3301(4). 5. The action is contested with respect to the claims for Distribution of Property, Alimony, Alimony Pendente Lite, Counsel Fees, and Expenses. 6. The action does not involve complex issues of law or fact. The hearing is expected to take ''/z day. WHEREFORE, the Plaintiff requests this Honorable Court to appoint a Master. Date: ?? 0 J ".?.L k Michael J. Pykosh, Esq ire Attorney Id. No.: 58851 2132 Market Street Camp Hill, PA 17011 (717) 975-9446 `? c= ? ? o -n ? ?' r'. f ' '. ? ? ?- t"' ? y -pn?'; ?7 r _ i ?? ?? ? -? ? ?? c-y .?C?- '"' ??? -:. -t .o N ?.! xi -? ROBERT LOWRY, : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff V. KAREN LOWRY, : CIVIL ACTION -LAW : NO.02-5040' Defendant : IN DIVORCE ORDER , / - AND NOW, this day of 2005,'??c/%?? , Esquire is appointed Master with respect o the claims in the attached Motion. BY THE /P J. Y f 0 c N ?. ui C ?Ci 1 c ?? e cn < N _7 CD ?? KAREN A. LOWRY, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 2002-5040 CIVIL TERM ROBERT S. LOWRY, IN DIVORCE Defendant/Respondent PACSES# 248104975 ORDER OF COURT AND NOW, this 5`h day of July, 2005, based upon the Court's determination that Petitioner's monthly net income/earning capacity is $2,810.52 and Respondent's monthly net income/earning capacity is $1,462.50, it is hereby Ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit, $180.60 per month payable monthly as follows; $165.00 for alimony pendente lite and $15.60 on arrears. First payment due next modified wage attached payment. Arrears set at $4,068.14 as of July 5, 2005. The effective date of the order is may 25, 2005. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C.S.§ 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and its discretion make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the PA SCDU to: Karen A. Lowry. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the defendant's PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. Unreimbursed medical expenses that exceed $250.00 annually are to be paid as follows: 0% by Respondent and 100% by Petitioner. The Petitioner is responsible to pay the first $250.00 annually in unreimbursed medical expenses. Neither party to provide medical insurance coverage. This Order shall become final ten days after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary for a hearing de novo before the Court. DRO: R. J. Shadday Mailed copies on Petitioner 7D>= TsI-M < Respondent Mark Bayley, Esquire Michael Pykosh, Esquire BY THE COURT, ? o ? c_? Gr ' ? - ,, c= n ? r u? ' ?., , ? v v =s ="'?? ?, ?- ?jC r ? ? i/ ? G `J i S ; ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 07/05/05 Case Number (See Addendum for case summary) Employer/Withholder' s Federal [IN Number RE: O Original Order/Notice 0 Amended Order/Notice O Terminate Order/Notice ROBERT S. Employee/Obligor's Name (Last, First, MI) MOHAWK INDUSTRIES PO BOX 12069 CALHOUN GA 30703-7002 ,'/ oAw,vA)-?40 L*f&VL AW5/ £S 97S 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, Mn See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 963 . oo per month in current support $ 43 .33 per month in past-due support Arrears 12 weeks or greater? ®yes Q no $ 0.00 per month in current and past-due medical support $ o . oo per month for genetic test costs $ per month in other (specify) for a total of $ 1, 006.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 232.23 per weekly pay period. $ 464.46 per biweekly pay period (every two weeks). $ 503 .17 per semimonthly pay period (twice a month). $ 1. 006. 33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information i needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. r v J a :¢ HE COU Date of Order: JUL ?J 2005 7 -? - // Service Type M OMB No. 0970-0154 $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If checkefi you are required to provide a copy of this form to yourgoloyee. If your employee works in a state that is different ftrom the state that issued this order, a copy must be provi edd to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting-the-Paydate/Date of-Withholding--You must report the paydatehfate-of-withbole ingwhen-sendingthe-payments -The paydate/date of withholding is the date on which -amountwaswithheld-from thee mploy -e's wager. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 5815169940 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. it. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at 71 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 ONION., : D970 0154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 180.60 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 825.73 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the ernployee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(reru's Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the ernployee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Ms No., 0970 0154 Worker ID $IATT ? o ? c, s ' ? ?Q l ??? ?Y 11 ? ?_. ( ? (..? ?r In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER Sr, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (717) 240-6225 Fax: (717) 240-6248 Defendant Name: ROBERT S. LOWRY Member ID Number: 5402100251 Please note: Ali correspondence must include the Member ID Number. MODIFIED ORDER OF ATTACHMENT OF UNENIPLOYMENT BENEFITS Financial Break Down of Multip le Cases on Attachment PACSES Docket Plaintiff Name Case e Number Attachment Amount/Frequency Number KAREN A. LOWRY 248104975 02-5040 CIVIL $ 180.60 /MONTH KAREN A. LOWRY 733104854 00826 S 2002 $ 825.73 MONTH TOTAL ATTACHMENT AMOUNT: $ 1,006.33 Now, by Order of this Court, the Department of Labor and Industry, Bureau of Unemployment Compensation Benefits and Allowances (BUCBA), is hereby directed to attach the lesser of $ 232.23 per week, or 55. o %, of the Unemployment Compensation benefits otherwise payable to the Defendant, ROBERT S. LOWRY Social Security Number 162-48-0922 , Member ID Number 5402100251 . BUCBA is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from BUCBA to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearage, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673(b)(2) and 23 Pa. C.S. § 4348(g). This Order shall be effective upon receipt of the notice of the Order by the BUCBA and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated JUNE 28 , 1998 is exhausted, expired or deferred. BUCBA shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: JUL - 6 2005 ? ?i55CES/ OLE??Tit/? JUDGE Form EN-034 Service Type m Worker ID $IATT ? ?, n f? ?` ? ?? C. T_ C.- ? r -77 3 l r J ? r ° ? fJ,' ? S-, - i - '[ _ ; , S" L- N ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 07/06/05 Case Number (See Addendum for case summary) O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice Employer/Withholder's Federal FIN Number RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number JFC TEMPS INC 5402100251 C/O JFC STAFFING ASSOCIATES Employee/Obligor's Case Identifier 1520 MARKET ST (See Addendum for plaintiff names CAMP HILL PA 17011-4815 0. 02zX-6-vV0w associated with cases on attachment) Piques o1W16K911-s Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 0.00 per month in current support $ o. oo per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ o. 00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 0.00 per month to be forwarded to payee below.. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ o. oo per weekly pay period. $ o . o o per biweekly pay period (every two weeks). $ o. Do per semimonthly pay period (twice a month). $ 0. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information i needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAMEAND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: 4 ",07 1- . It Date of Order: WL - 7 2001F Form EN-028 Service Type M OMBNo.:0970-o15a Worker lD $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If checked you are required to provide a copy of this form to your 3m If yo r employee works in a state that is different from the state that issued this order, a copy must be provi?ed to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Repo. ing-the-PagdatefDate-of-Withholding.-Yovmnst-report the pagdate/dateof -wiNihokfing-when-serdingthe payment:-The pagdateldateofwit awr.rcnamavM rocas - - hholding-isth de ate vvi hhefdfron the-employ(-e`s-wager. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2322201350 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. I ].Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Service Type M Page 2 of 2 OMB No. 09700154 Form EN-028 Worker ID $IATT P J Gx KAREN A. LOWRY, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : CIVIL ACTION - LAW NO. 02-5040 ROBERT LOWRY : IN DIVORCE Defendant PRAECIPE TO ENTER COUNT IV TO THE PROTHONOTARY: Please add the attached Count IV to the Divorce Complaint filed in the above captioned docket. 63? Date: ?04, ?F8 Mark F. Bayley, Esq ire Rominger, Bayley & Whare 155 S. Hanover Street Carlisle, PA 170'13 (717) 241-6070 Supreme Court I.D. # 87663 Attorney for Plaintiff N C` d 'T1 _ : IV T t J rn rn C.? t W KAREN A. LOWRY, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : CIVIL ACTION - LAW NO. 02-5040 ROBERT LOWRY : IN DIVORCE Defendant COUNT IV - EQUITABLE DISTRIBUTION A Divorce action was filed by the Plaintiff on October 17, 2002. 2. Plaintiff seeks economic relief. 3. There are economic issues between the parties which have not been resolved. WHEREFORE, Plaintiff requests this Honorable Court resolve the economic issues. Date: 7 4 ?ZAI / Mark F. Bayley, Esquire Rominger, Bayley & Whare 155 S. Hanover Street Carlisle, PA 17013 (717) 241-6070 Supreme Court I.D. # 87663 Attorney for Plaintiff c, r- ti CO G N? KAREN A. LOWRY, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : CIVIL ACTION - LAW NO. 02-5040 ROBERT LOWRY : IN DIVORCE Defendant CERTIFICATE OF SERVICE I, Mark F. Bayley, Esquire, attorney for Plaintiff do hereby certify that I this day served a copy of the within Praecipe upon the following by depositing same in the United States mail, postage prepaid, at Carlisle, Pennsylvania, addressed as follows: Michael J. Pykosh, Esquire Law Offices of Darrell C. Dethlefs 3805 Market Street Camp Hill, Pa 17011 Dated: 1?10-i ? .&IfFg Mark F. Bayley, Esquire Attorney for Plaintiff n n u u `?cr ;5 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KAREN A. LOWRY ) Docket Number 02-5040 CIVIL Plaintiff ) VS. ) PACSES Case Number 248104975 ROBERT S. LOWRY ) Defendant ) Other State ID Number PETITION FOR CONTEMPT - DEFENDANT TO THE HONORABLE, THE JUDGES OF SAID COURT: 1. Petitioner is CUMBERLAND County Domestic Relations Section. 2. Defendant is ROBERT S. LOWRY who resides at 330 LIBERTY CT, MECHANICSBURG, PA. 17050-1840-30 3. On JULY 5, 2005 an order of support was entered by the Honorable Court directing Defendant to pay the sum of $18o.6o per month for the support of his/her dependent(s). 4. Defendant has failed to comply with the order as entered by the Court by failing to: ® pay as ordered. ® provide information which was ordered. ? appear as ordered. El other: Failure to maintain employment, last payment from employment was on 7/18/05. 5. The arrearages under the Order amount to $ 4,190.08 as of SEPTEMBER 12, 2005 WHEREFORE, Petitioner prays that the Court issue an order directing the attendance of Defendant at a hearing of said Petition and hereafter to make an adjudication of contempt. I verify that the statements made in this Petition are true and correct to the best of my knowledge. I understand that false statements herein are made to the penalties of 18 Pa. C.S. § 4904 relating to unworn falsification to authorities. SEPTEMBER 12, 2005 Date I R. J. SHARD Signature Form EN-007 Service Type M Worker ID 21005 (, i ?? ` i ?? ,? -?'1 ..:. T i I rti `; __ ?.? ::; s:- S" ti In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KAREN A. LOWRY ? Docket Number 02-5040 CIVIL Plaintiff ) vs. ) PACSES Case Number 248104975 ROBERT S. LOWRY Defendant ) Other State ID Number ORDER OF COURT Legal proceedings have been brought against you alleging you have wilfully disobeyed an Order of Court. 1. If you wish to defend against the claim set forth in the following pages, you may, but are not required to, file in writing with the Court your defenses or objections. 2. YOU, ROBERT S. LOWRY , Respondent, must appear in person in court on OCTOBER 28, 2005 , at 9: 00AM , in COURT ROOM 1 CUMBERLAND CO COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE, PA. 17013 IF YOU DO NOT APPEAR IN PERSON, THE COURT MAY ISSUE A WARRANT FOR YOUR ARREST AND YOU MAY BE COMMITTED TO JAIL. 3. If the Court finds that you have wilfully failed to comply with its order you may be found to be in contempt of court and committed to jail, fined, or both. Form EN-528 Service Type M Worker ID 21600 LOWRY V. LOWRY PACSES Case Number: 248104975 YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH THE INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 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 Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. BY THE COURT: Date of Order: S4 4_ 12 )CoS Page 2 of 2 Form EN-528 Service Type M Worker ID 21600 f-) ?J l7 J ?... Cii -I -„ fll ?. ? .?i _ ? ? G. . ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 248104975 State Commonwealth of Pennsylvania 02-5040 CIVIL OOriginal Order/Notice Co./City/Dist. of CUMBERLAND O Amended Order/Notice Date of Order/Notice 09/12/05 733104854 0 Terminate order/Notice Case Number (See Addendum for case summary) 826 S 2002 RE: LOWRY, ROBERT S. Employer/Withholder's Federal FIN Number Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number DFAS CLEVELAND CENTER* 5402100251 C/O DFAS CODE L Employee/Obligor's Case Identifier GARNISHMENT OPS (See Addendum for plaintiff names PO BOX 998002 associated with cases on attachment) CLEVELAND OH 44199-8002 Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 963.00 per month in current support $ 43 .33 per month in past-due support Arrears 12 weeks or greater? Oyes Q no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 006.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 232.23 per weekly pay period. $ 464 .46 per biweekly pay period (every two weeks). $ 503.17 per semimonthly pay period (twice a month). $ 1. 006.33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: r i Date of Order: J.i esley Oler, Judge DRO: R.J. Shadday Form EN-028 Service Type M OMB NO.:_9-_01- Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecked you are required to provide a opy of this form to your.employee. If yo r employee works in a state that is di erent from the state that issued this or?er, a copy must be provided to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. send ..g tF.e-payrrrerft.--The-- 3.* Reporting the Paydate/Date of With! olding. You must -thepagdateMate of-withholdingwhen paydate/date You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act 0 5 U.S.C. § 1673 01; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. I1.Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.chiIdsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 180.60 Child(reN's Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 825.73 Child(reN's Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(reN's Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(reN's Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(reN's Name(s): DOB ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M OMB No. 090 0154 Worker ID $IATT : - v1:) L =L ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 10/21/05 Case Number (See Addendum for case summary) 248104975 02-5040 CIVIL 733104854 826 S 2002 O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice Employer/withholder's Federal EIN Number EXEL LOGISTICS* 570 POLARIS PKWY WESTERVILLE OH 43082-7900 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 963 .00 per month in current support $ 43 .33 per month in past-due support Arrears 12 weeks or greater? (2) Yes Q no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 006.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 232.23 per weekly pay period. $ 464.46 per biweekly pay period (every two weeks). $ 503. 17 per semimonthly pay period (twice a month). $ 1. 006.33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COUIIT: 1-7 Date of Order: ?J Z21 I- J Wesley Olt DRO: R.J. Shadday Service Type M OMB No.: 0970-0 4 RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) Juage Form EN-028 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecked you are required to provide a copy of this form to your mployee. If your employee works in a state that is ch erent from the state that issued this order, a copy must be provi?ed to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting thhold ing. You must-reportthe -trrydate/date of-withhold Raydate/aate?o`rwirrmofdmgi5thedate or which from-the em ployee`swages.- You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0426011600 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 097"154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 180.60 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 825.73 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03./31/00 ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No.; 09JP01 $J ;, -. ;??,:? ?_ ?_: l.J In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KAREN A. LOWRY Plaintiff Docket Number ) PACSES Case Number Other State ID Number 02-5040 CIVIL Vs. ROBERT S. LOWRY Defendant AND NOW to wit, this Order 248104975 NOVEMBER 1, 2005 it is hereby Ordered that: THE ADDITIONAL SUM FOR PAYMENT ON THE ARREARS IS INCREASED TO $35.00 PER MONTH. BY THE COURT: Form OE-520 gNEefnj•MShadday Worker ID 21005 n ?? z; .?- :;.' - , ? ,,,? W ?? ? l ,..1 _.1-? i3 ?? ••.:.. '.rte' S-{I 4„ ? ? ?. ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 10/28/05 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number TRIPLE CROWN CORP INC 5351 JAYCEE AVE HARRISBURG PA 17112-2938 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum fw plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 963. oo per month in current support $ 43 .33 per month in past-due support Arrears 12 weeks or greater; ®yes O no $ o . oo per month in current and past-due medical support $ o . oo per month for genetic test costs $ per month in other (specify) for a total of $ 1, 006.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 232.23 per weekly pay period. $ 464.46 per biweekly pay period (every two weeks). $ 503. 17 per semimonthly pay period (twice a month). $ 1. 006.33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: Date of Order: ?/d i, 2 , ) crJ S J. 248104975 @ Original Order/Notice 02-5040 CIVIL O Amended Order/Notice 733104854 O Terminate Order/Notice 826 S 2002 RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) Form EN-028 Service Type M ONO No.:o97am54 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? Ifhhecked you are required to provide ajopy of this form to your Employee. If yoVr employee works in a state that is di erent from the state that issued this or er, a copy must be provided to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. paydate/dateof withhold rtg ist ithhe'd from the employee's vvdges You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employeelobligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2320477380 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11.Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No, 097MI 54 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 180.60 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 825.73 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ?if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No. 09]0-0154 N C ) n ..r -n J cFF? ORDERINOTICE TO WITHHOLD INCOME FOR SUPPORT 248104975 State Commonwealth of Pennsylvania 02-5040 CIVII, 0Original Order/Notice Co./City/Dist. of CUMBERLAND O Amended Order/Notice Date of Order/Notice 10/28/05 733104854 Q Terminate Order/Notice Case Number (See Addendum for case summary) 826 S 2002 RE: LOWRY, ROBERT S. EmployerANithholder's Federal FIN Number Employee/Obligor's Name (Last, First, Mq EXEL LOGISTICS* 570 POLARIS PKWY WESTERVILLE OH 43082-7900 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ o . oo per month in current support $ o . o o per month in past-due support Arrears 12 weeks or greater? Q yes ® no $ 0.00 per month in current and past-due medical support $ o . 0o per month for genetic test costs $ per month in other (specify) for a total of $ 0.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order, if your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ o . o o per weekly pay period. $ c. oo per biweekly pay period (every two weeks). $ o. o o per semimonthly pay period (twice a month). $ o. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. /J BY THE COURk Date of Order: Po%?,_ 2, Zoof J./Vesley Oler; Judge Form EN-028 Worker ID $IATT Service Type M OMBNo.:o9ro-0154 ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? Ipp hecked you are required to provide a copy of this form to your 2mployee. If your employee works in a state thaiis di4erent from the state that issued this order, a copy must be provided to your employee even if the box is not chec ed. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reportirrgthe PayclateiDate of Withholding. You must report the paydate/date of wit drolding wl.n. sending the Payment. the . You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0428011600 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: * NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. I I.Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No,: 0970-0154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 0.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ?if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee'sfobligor's employment. ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee'sfobligor's employment. ? If checked, you are required to enroll the child(rem identified above in any health insurance coverage available through the employee's/obligor's employment. ?if checked, you are required to enroll the child(ren) ?lf checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 WorkerlD $1ATT Service Type M OMB Nn.: 0970154 n r ?? ?. a o `i _ 1 I_.. ? ? n'- --? T n?r C? "- n? n i er ? a w .:?, ? !_= = --? _f =,. C ?:. jr:? `-j .c' -- u+ ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 10/28/05 Case Number (See Addendum for case summary) 248104975 0 Original Order/Notice 02-5040 CIVIL O Amended Order/Notice 733104854 Terminate Order/Notice 826 S 2002 EmployedWithholder's Federal EIN Number MOHAWK INDUSTRIES PO BOX 12069 CALHOUN GA 30703-7002 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ o. 00 per month in current support $ o. 00 per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ o . 00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 0. 00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ o. 0o per weekly pay period. $ o . o o per biweekly pay period (every two weeks). $ o. oo per semimonthly pay period (twice a month). $ El. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: '/ // Date of Order: A-) „ v 2 J v DS Service Type M OMB No.. RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) Jr.,- Judge Form EN-028 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? Ifhheckefl you are required to provide a copy of this form to your em loyee. If yo r employee works in a state that is di erent rom the state that issued this order, a copy must be providec?to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3. the-empfoyee's-waM- You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employeeJobligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 5815169940 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employeelobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No, 0970-0154 Form EN-028 Worker ID $ZATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACKS Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 8 2002 $ 0.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ?if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No, 09)0-0154 ?} j -? t Cy ??+ ? ? ? ? ?. 'r7 ri' ?.+? ?-? ? f _ r ?. C' ' 'f? a:-it . - "C) t 7 ?1 r _ W ?? - ?- ?D { ?- '? ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dirt. of CUMBERLAND Date of Order/Notice 10/28/05 Case Number (See Addendum for case summary) 248104975 0 Original Order/Notice 02-5040 CIVIL O Amended Order/Notice 733104854 Terminate Order/Notice 826 @ 2002 Employer/Withholder', Federal EIN Number DFAS CLEVELAND CENTER* C/O DFAS CODE L GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, M0 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 0.00 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ o . oo per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 0.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ o, o o per weekly pay period. $ o. oo per biweekly pay period (every two weeks). $ o. oo per semimonthly pay period (twice a month). $ 0, oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: Date of Order: q v J esley O1 Jr., Judge Form EN-028 Service Type m OMaNo.:O'J]0-0154 WorkerlD $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? Ifithecked you are required to provide a copy of this form to your ,employee. If your employee works in a state that is dfferent from the state that issued this order, a copy must be provided to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3» s-wager. You must comply with the law of the paydateMate of wit' holding is the clate-orr which amount wm withheld state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 01; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. I I.Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type m by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 0.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ?if checked, you are required to enroll the child(ren) ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No. 0970-0154 t ?`' -n ti Ci -?n G.3 .c- j In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (717) 240-6225 Fax: (717) 240-6248 Defendant Name: ROBERT S. LOWRY Member ID Number: 5402100251 Please note: All correspondence must include the Member ID Number. MODIFIED ORDER OF ATTACHMENT OF UNEMPLOYMENT BENEFITS Financial Break Down of Multiple Cases on Attachment PACSES Docket Plaintiff Name Case e Number Number Attachment Amount/Frequency KAREN A. LOWRY 248104975 02-5040 CIVIL $ 200.00 /MONTH KAREN A. LOWRY 733104854 00826 5 2002 $ 850.00 /MONTH TOTAL ATTACHMENT AMOUNT: $ 1.050.00 Now, by Order of this Court, the Department of Labor and Industry, Bureau of Unemployment Compensation Benefits and Allowances (BUCBA), is hereby directed to attach the lesser of $ 242.31 per week, or 55.0 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, ROBERT S. LOWRY Social Security Number 162-48-0922 , Member ID Number 5402100251 . BUCBA is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from BUCBA to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearage, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673(b)(2) and 23 Pa. C.S. § 4348(g). This Order shall be effective upon receipt of the notice of the Order by the BUCBA and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated JUNE 28, 1998 is exhausted, expired or deferred. BUCBA shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: ?l t > o+S ,4Ri,,Pfge M5hddddy J.//Wzsley Oler; Ji°.,4 ? JUDGE Form EN-034 Worker ID $IATT ? r-> _? ?n ,!? - 'n c... ?i _ _ T .1 ??,f_> 'L; -? d ;~ - C: ' ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 11/01/05 Case Number (See Addendum for case summary) Employer/Withholder's Federal FIN Number TRIPLE CROWN CORP INC 5351 JAYCEE AVE HARRISBURG PA 17112-2938 O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice Employee/Obligor's Name (Last, First, MO 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 963 .0o per month in current support $ 87.00 per month in past-due support Arrears 12 weeks or greater? (9) Yes Q no $ o 00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 050.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 242 .31 per weekly pay period. $ 484.62 per biweekly pay period (every two weeks). $ 525. oo per semimonthly pay period (twice a month). $ 1. 050.0o per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information i needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT:/ Date of Order: I? ov ?TJ??S? DRO: R.J. Shddday Service Type m 248104975 02-5040 CIVIL 733104854 826 S 2002 RE: LOWRY. ROBERT S. J. OMB No. 0970-0134 Form EN-028 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecked you are required to provide a opy of this form to your ymployee. If yo r employee works in a state that is dierent from the state that issued this order, a copy must be provided to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the You must comply with the law of the paydateldate of withholding is the -date on wh ch amount was withlield ho... the employee's wages. state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2320477380 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: If you or your employee/obligor have any questions, r)OMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type m by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No, 0970-0154 Form EN-028 Worker ID $IATT . ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 200.00 Child(rem's Name(s): DOB PACSES Case Number '733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 850.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ?if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No, 0910-0154 _, ? = c, n c ?.? ? 'c; ?. , ?. ?'d r _? _-,;?; ? ? " ' r;= ; is di , ? , Ys' ` , ?? ? ? ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania CO./City/Dist. Of CUMBERLAND Date of Order/Notice 12/12/07 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number FED EX GROUND 1000 FEDEX DR CORAOPOLIS PA 15108-9373 152-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 963 . oo per month in current support $ 87.00 per month in past-due support Arrears 12 weeks or greater? (Dyes Q no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ 0.00 per month in other (specify) for a total of $ 1, 050.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ _ 242.31-per weekly pay period. $ _ 484.62, per biweekly pay period (every two weeks). $ 525.00 per semimonthly pay period (twice a month). $ 1, 050. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: Date of Order: ,> -0 6 7 _ J. DRO: R.J. SHADDAY Service Type M OMB No.: 0970-0154 733104854 826 S 2002 248104975 02-5040 CIVIL O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) JUDGE Form EN-028 Rev. 1 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecked you are required to provide a copy of this form to your mployee. If yo r employee works in a state that is di ferent from the state that issued this order, a copy must be provi?ed to your employee even if the box is not cheCKed. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* wages. You must comply with the law of the payda ?/date of withholding 05 the date on yvhich amount vvM Withheld frorn the employees state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 3414410190 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11 - Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker ID $zATT _- - • ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S . PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 200.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. Service Type M PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 850.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. OMB No.: 0970-0154 Addendum Form EN-028 Rev. 1 Worker I D $ IATT °g -*?t to t 12 GI N d 02-5040 CIVIL ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 733104854 State Commonwealth of Pennsylvania 826 S 2002 OOriginal Order/Notice Co./City/Dist. of CUMBERLAND OAmended Order/Notice Date of Order/Notice 08/21/08 X@Terminate Order/Notice Case Number (See Addendum for case summary) (Done-Time Lump Sum/Notice RE: LOWRY, ROBERT S. Employer/withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number TRIPLE CROWN CORP INC 5402100251 5351 JAYCEE AVE Employee/Obligor's Case Identifier HARRISBURG PA 17112-2938 (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 0.00 per month in current child support $ 0.00 per month in past-due child support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current medical support $ 0.00 per month in past-due medical support $ o . oo per month in current spousal support $ o . oo per month in past-due spousal support $ 0.00 per month for genetic test costs $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ o. o o per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0.00 per weekly pay period. $ o . 00 per semimonthly pay period (twice a month) $ o . oo per biweekly pay period (every two weeks) $ o - oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. /7 BY THE COURT: DRO: R.J. SHADDAY Service Type M OMB No.: 0970.0154 WESLEY OLER, JR., Ii Form EN-028 Rev. 4 Worker I D $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS E] If gheckO you are required to provide a opy of this form to your mployee. If yorr employee orks in a state that is di erent rom the state that issued this o er, a copy must be provi?ed to your emp ogee even if thie box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employeelobligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2320477380 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 113 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employeelobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employeelobligor from employment, refusing to employ, or taking disciplinary action against any employeelobligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 IN); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker I D $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S . PACKS Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M Addendum OMB No.: 097"154 PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 0.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 Form EN-028 Rev. 4 Worker ID $IATT na 4;- ?. Fq- cv i - i') (:7) s? w .. 02-5040 CIVIL ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 733104854 OOriginal Order/Notice Co./City/Dirt. of CUMBERLAND 826 S 2002 OAmended Order/Notice Date of Order/Notice 08/25/08 OTerminate Order/Notice Case Number (See Addendum for case summary) OOne-Time Lump Sum/Notice RE: LOWRy, ROBERT S. EmployerM/ithholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number GIANT FOOD STORE LLC * 5402100251 C/O PAYROLL DEPT Employee/Obligor's Case Identifier PO BOX 249 (See Addendum for plaintiff names CARLISLE PA 17013-0249 associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 798.00 per month in current child support $ 52.00 per month in past-due child support Arrears 12 weeks or greater? 0 yes 0 no $ o. oo per month in current medical support $ 0.00 per month in past-due medical support $ 165.00 per month in current spousal support $ 35.00 per month in past-due spousal support $ 0.0o per month for genetic test costs $ o. oo per month in other (specify) $ one-time lump sum payment for a total of $ 1, o5o . oo per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 242.31 , per weekly pay period. $ 525.00 per semimonthly pay period (twice a month) $ 484.62 per biweekly pay period (every two weeks) $ 1, 050.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAMEAND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. / / A BY THE COURT: DRO: R. J. SHADDAY Service Type M OMB No.: 0970-0154 , JR. Form EN-028 Rev. 4 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS I heck you are required to pr vide a opyof this form to your m loyee. If yo r employed orks in a state that is i ferent from the state that issuff th?s order, a copy must be provic?edpto your employee even ?f tie box is not checked 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4. * Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employeelobligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2518690110 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employeelobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Service Type M OMB No.: 0970-0154 Form EN-028 Rev. 4 Worker I D $ IATT y ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S . PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Service Type M OMB No.: 0970-0154 PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Form EN-028 Rev. 4 Worker I D $ IATT o 4 ! C= S.J co W/ C__D • " t y? .4 A ii AV . .-% ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 02-5040 CIVIL State Commonwealth of Pennsylvania 733104854 OOriginal Order/Notice Co./City/Dist. of CUMBERLAND 826 S 2002 OAmended Order/Notice Date of Order/Notice 08/25/08 OX Terminate Order/Notice Case Number (See Addendum for case summary) OOne-Time Lump Sum/Notice RE:LOWRY, ROBERT S. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number FED EX GROUND 5402100251 1000 FEDEX DR Employee/Obligor's Case Identifier CORAOPOLIS PA 15108-9373 (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 0.00 per month in current child support $ 0.00 per month in past-due child support Arrears 12 weeks or greater? Oyes ® no $ 0.00 per month in current medical support $ o . oo per month in past-due medical support $ o . oo per month in current spousal support $ o . oo per month in past-due spousal support $ 0._g.0 per month for genetic test costs $ o. oo per month in other (specify) $ one-time lump sum payment for a total of $ o. oo per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0.00 Per weekly pay period. $ o. oo per semimonthly pay period (twice $ 0. oo per biweekly pay period (every two weeks) $ o . oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. /J A BY THE COURT: DRO: R.J. SHADDAY Service Type M ' OMB No.: 0970-0154 . WESLEY OLER, JUDGE Form EN-028 Rev. 4 Worker ID $IATT 400 ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS F1 If iheckesl you are required. to provide a opy of this form to your mployee. If your employee Yorks in a state that is Brent MY the state that di issued this order, a copy must be provi?ed to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee%bligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4. * Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 3414410190 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ED THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT. NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S . PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M Addendum OMB No.: 0970-0154 PACSES Case Number Plaintiff Name Docket Attachment AFnount $ 0.00 Child(ren)'s Name(s): DOB Form EN-028 Rev. 4 Worker ID $IATT ko -F Z. S ORDERINOTICE TO WITHHOLD INCOME FOR SUPPORT 02-5040 CIVIL State Commonwealth of Pennsylvania (2)Original Order/Notice Co./City/Dist. of CUMBERLAND 733104854 826 S 2002 OAmended Order/Notice Date of Order/Notice 10/17/08 OTerminate Order/Notice Case Number (See Addendum for case summary) OOne-Time Lump Sum/Notice Employer/Withholder's Federal EIN Number EXEL INC* 570 POLARIS PKWY WESTERVILLE OH 43082-8029 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 798.00 $ $ 52.00 0.00 $ 0.00 $ 165.00 $ 35.00 $ 0.00 $ 0.00 per month in current child support per month in past-due child support per month in current medical support per month in past-due medical support per month in current spousal support per month in past-due spousal support per month for genetic test costs per month in other (specify) one-time lump sum payment Arrears 12 weeks or greater? (g) yes O no for a total of $ 1,050.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered surwort payment cycle, use the following to determine how much to withhold: $ 242.31- per weekly pay period. $ 525.00 per semimonthly pay period (twice a month) $ 484.62 per biweekly pay period (every two weeks) $ 1, 050.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. i /7 BY THE COURT: DRO: R.J. SHADDAY Service Type M OMB No.: 0970-0154 RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) J. WESLEY OLER, JR., Form EN-028 Rev. 4 Worker ID $IATT W. ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS E] If checked you are required to provide a copy of this form to your mployee. If yo r employee works in a state that is different from the state that issued this order, a copy must be provi?ed to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 0428011600 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: DATE OF SEPARATION: FINAL PAYMENT AMOUNT- NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti- discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S . PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 200.00 Child(ren)'s Name(s): DOB PACKS Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 850.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker ID $IATT .°'1 N t:? ?"t ?`- ? ;:? t"'7 .,._? ? Sj ? .' "k} "{ w r`-", I "3 ?'? _ _... _ f? r? c_..7 .?. ?: -<: ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 10/27/08 Case Number (See Addendum for case summary) E m pl oyer/With holder's Federal EIN Number EXEL INC* 570 POLARIS PKWY WESTERVILLE OH 43082-8029 02-5040 CIVIL OOriginal Order/Notice OAmended Order/Notice (X Terminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 0.00 per month in current child support $ 0.00 per month in past-due child support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current medical support $ 0.00 per month in past-due medical support $ 0.00 per month in current spousal support $ o. oo per month in past-due spousal support $ 0.00 per month for genetic test costs $ 0.00 per month in other (specify) $ one-time lump sum payment for a total of $ o . 00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0.00 per weekly pay period. $ o. 00 per semimonthly pay period (twice a month) $ 0.00 per biweekly pay period (every two weeks) $ o . oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOC,A) SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. i BY THE COURT: / / N ?_ 11-11, 1W - Z/ /-- t _ Z 5?, DRO: R.J. SHADDAY Service Type M OMB No.: 0970-0154 733104854 826 S 2002 RE:LOWRY, ROBERT S. WESLEY OLER, JR., JUDGE Form EN-028 Rev. 4 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS Ei Ifgheckel you are required to provide asopy of this form to your?mployee. If your employee works in a state that is di Brent rom the state that issued this or er, a copy must be provi ed to your employee even if the box is not checked 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 0428011600 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : M THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT- NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Service Type M OMB No.: 0970-0154 Form EN-028 Rev. 4 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S . PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 0.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker ID $IATT ?., ?? .. ?: "3 r a <.. _.;,-: c7 ? r,.. ?.....? t `_.F_? -^? t.a.? "`t? _ ?a ?! ?, ^"'` In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Defendant Name: ROBERT S. LOWRY Member ID Number: 5402100251 Please note: All correspondence must include the Member ID Number. ORDER OF ATTACHMENT OF UNEMPLOYMENT COMPENSATION BENEFITS Financial Break Down of Multiple Cases on Attachment Plaintiff Name KAREN A. LOWRY KAREN A. LOWRY PACSES Docket Case Number Number 248104975 02-5040 CIVIL 733104854 00826 S 2002 Attachment Amount/Frequenc $ 200.00 /MONTH $$$ 798.00 MONTH / / / TOTAL ATTACHMENT AMOUNT: $ 998.00 Now, by Order of this Court, the Department of Labor and Industry, Office of Unemployment Compensation Benefits (OUCB), is hereby directed to attach the lesser of $ 229.68 per week, or 55 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, ROBERT S. LOWRY Social Security Number XXX-XX- 0922 Member ID Number 5402100251 . OUCB is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from OUCB to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearages, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673 (b)(2) and 23 Pa. C.S.A. § 4348 (g). This Order shall be effective upon receipt of the notice of the Order by the OUCB and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated MARCH 15, 2009 is exhausted, expired or deferred. OUCB shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: An it. ` Z JUDGE Service Type M Worker ID $ IATT Form EN-530 Rev.2 R l=r'? OF THE PPOTHONOTARY 2909 APR -2 PM 3: 10 PENNcSY f,^'t -41A ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT ? State Commonwealth of Pennsyly, CO./City/Dirt. of CUMBERLAND Date of Order/Notice 04/06/09 Case Number (See Addendum for Federal EIN Number OPTIMUM STAFFING, INC STE 301 3540 SEVEN BRIDGES DR WOODRIDGE IL 60517-122 summary) 733104854 826 S 2002 RE:LOWRY, ROBERT S. 02-5040 CIVIL @Original Order/Notice OAmended Order/Notice OTerminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 798.00 per month in current child support $ 0.00 per month in past-clue child support Arrears 12 weeks or greater? Dyes Q no $ 0.00 per month in current medical support $ o. co per month in past-clue medical support $ 165. 00 per month in c rrent spousal support $ 35.00 per month in past-clue spousal support $ o . o o per month for genetic test costs $ o. o o per month in other (specify) $ one-time lump sum payment for a total of $ 998.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 230.31 per weekly pay period. $ 499.00 per semimonthly pay period 460.62 (twice a month) $ per biweekly pay period (every two weeks) $ 998.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this O der/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to de uct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allow ble amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate isposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 00 00 Make Remittance Payable to: A SCDU Send check to: Pennsylvania S DU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Ca ;e Identifier) OR SOCIA¢ SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. i i "i BY THE COURT: DRO: R.J. Shadday V v Form EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker I D $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS loyee. If your employee works in a state that is Ifhecked you are required to povide a copy of this form to your ern di erent from the state that issue this order, a copy must be provideto your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine ithheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withhold ng: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Suppo Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to onor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's p incipal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested an return a copy of this Order/Notice to the Agency identified below. 3538095380 THE PERSON HAS NEVER WORKED FOR HIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: O EMPLOYEE'S/OBLIGOR'S NAME: LO WRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: NEW EMPLOYER'S FINAL PAYMENT AMOU 6. Lump Sum Payments: You may be requi d to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions ab ut lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income a the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary acts n against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not with Protection Act (CCPA) (15 U.S.C. 1673 (b)); employment. Disposable income is the net Security taxes, statutory pension contributio supporting another family and 60% of the d increased to 55% and that 60% limit is incn deduct a fee for administrative costs. The su Arrears greater than 12 weeks : If the Ord employer should calculate the CCPA limit u allowed under the law of the issuing Tribe. the limit set by the law of the jurisdiction in CCPA (15 U.S.C. 1673 (b)). Depending upo care premiums in determining disposable it 10. Additional info: DATE OF SEPARATION )Id more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit r 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of icome left after making mandatory deductions such as: State, Federal, local taxes, Social and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is posable income if the obligor is not supporting another family.However, that 50% limit is sed to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may )ort amount and the fee may not exceed the limit indicated in this section. Information does not indicate whether the arrears are greater than 12 weeks, then the ng the lower percentage. For Tribal orders, you may not withhold more than the amounts rr Tribal employers who receive a State order, you may not withhold more than the lesser of hich the employer is located or the maximum amount permitted under section 303(d) of the applicable State law, you may need to take into consideration the amounts paid for health Mme and applying appropriate withholding limits. *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these it ms. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Service Type M OMB No.: 0970-0154 Form EN-028 Rev. 4 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obli r: LOWRY, ROBERT S . PACSES Case Number 248104975 PAGES Case Number 733104854 Plaintiff Name Plaintiff Name KAREN A. LOWRY KAREN A. LOWRY Docket Attachment Amount Docket Attachment Amount 02-5040 CIVIL$ 200.00 00826 S 2002 $ 798.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): Service Type M DOB Addendum OMB No.: 0970-0154 PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Form EN-028 Rev. 4 Worker ID $IATT ALE("'FICE OF THE P, r r)N*TARY 2009 APP 13 Pik 3: 22 ORDERNOTICE TO WITHHOLD INCOME FOR SUPPORT 02-5040 CIVIL State Commonwealth of Pennsylvania 0Original Order/Notice Co./City/Dist. of CUMBERLAND 733104854 826 S 2002 OAmended Order/Notice Date of Order/Notice 04/08/09 X0Terminate Order/Notice Case Number (See Addendum for case summary) (Done-Time Lump Sum/Notice E m ployer/With holder's Federal EIN GIANT FOOD STORE LLC C/O PAYROLL DEPT PO BOX 249 CARLISLE PA 17013-0249 RE: LOWRY, ROBERT S. Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for names and birth dates associated with cases on attachment ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 0.00 per month in c $ o. oo per month in p $ o.oo per month in c $ 0.00 per month in p $ o. o o per month in c $ o. oo per month in p $ 0.00 per month for I $ o.oo per month in c $ one-time lump for a total of $ o . o 0 per You do not have to vary your pay cy4 the ordered support payment cycle, t $ 0.00 Per weekly pay K ent child support -due child support ent medical support -due medical support ent spousal support -due spousal support ietic test costs !r (specify) Arrears 12 weeks or greater? 0 yes ® no $ 0.00 per biweekly pay m payment to be forwarded to payee below. to be in compliance with the support order. If your pay cycle does not match the following to determine how much to withhold: od. $ o. oo per semimonthly pay period (twice a month) ?riod (every two weeks) $ 0.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this O er/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate isposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (ee #9 on page 2). If required by Pennsylvania law (23 A C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and isbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: A SCDU Send check to: Pennsylvania S DU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST I CLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Ca a Identifier) OR SO /?AL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: I ? / 1-1 /1' (__V/ ?V r r I ' . )_ a o j J. Wesley Oler, Jr., J4dge ' ' DRO: R.J. Shadday Form EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker ID $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS Ii4'e he c' you are r tate equired to Or vide a opy of this form to your m loyee. If yo r employee orks in a state that is nt from the s that issu this order, a copy must be provideedpto your employee even if tie box is not checked. 1. Priority: Withholding under this Order/ Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of is order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combin withheld amounts from more than one employeelobligor's income in a single payment to each agency requesting withholding. You ust, however, separately identify the portion of the single payment that is attributable to each employeelobl igor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on % hich amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal pl ace of employment with respect to the time periods within which you must implement the withholding order and forward the support ayments. 4.* Employee/Obligor with Multiple Suppo Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable t honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's rincipal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must pro ptly notify the Requesting Agency when the employeelobligor is no longer working for you. Please provide the information requested an return a copy of this Order/Notice to the Agency identified below. 2518690110 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: DOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: _ LAST KNOWN PHONE NUMBER: NEW EMPLOYER'S NAME/ADDRE 6. Lump Sum Payments: You may be requi severance pay. If you have any questions at 02100251 DATE OF SEPARATION: FINAL PAYMENT AMOUNT to report and withhold from lump sum payments such as bonuses, commissions, or lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income a the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employeelobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employeelobligor from employment, refusing to employ, or taking disciplinary action against any employeelobligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in an ther State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withh Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); ( employment. Disposable income is the net i Security taxes, statutory pension contribution supporting another family and 60% of the dis increased to 55% and that 60% limit is incur deduct a fee for administrative costs. The sup Arrears greater than 12 weeks : If the Orde employer should calculate the CCPA limit us allowed under the law of the issuing Tribe. Fi the limit set by the law of the jurisdiction in v CCPA (15 U.S.C. 1673 (b)). Depending upon care premiums in determining disposable inc 10. Additional info: )Id more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of come left after making mandatory deductions such as: State, Federal, local taxes, Social and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is )osable income if the obligor is not supporting another family.However, that 50% limit is >ed to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may port amount and the fee may not exceed the limit indicated in this section. Information does not indicate whether the arrears are greater than 12 weeks, then the ig the lower percentage. For Tribal orders, you may not withhold more than the amounts r Tribal employers who receive a State order, you may not withhold more than the lesser of hich the employer is located or the maximum amount permitted under section 303(d) of the applicable State law, you may need to take into consideration the amounts paid for health me and applying appropriate withholding limits. *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these ite s. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev. 4 Service Type M OMB No.: 0970.0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 0.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Form EN-028 Rev. 4 Worker I D $ IATT OF THE P' 2 0 0 9 AP 1, 4 PH v: 2 ;3 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 02-5040 CIVIL State SQ? q OOriginal Order/Notice , Co./City/Dist. of C 7 733104854 OAmended Order/Notice [?ERLAND Date of Order/Not? a 05/27/09 826 S 2002 @Terminate Order/Notice Case Number (See Addendum for case summary) ()One-Time Lump Sum/Notice RE:LOWRY, ROBERT S. EmployerNVithholder's F ederal EIN Number Employee/Obligor's Name (Last, First, MI) 162-48- 922 Employee/Obligor's Social Security Number OPTIMUM S TAFFING, INC 5402100251 STE 301 Employee/Obligor's Case Identifier 3540 SEVE 9 BRIDGES DR (See Addendrn for pfaintiff names WOODRIDGE IL 60517-1221 associated **h cases on attachment) Custodial Parent's Name (Last, First, MI) See A endum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA ION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBE] JjAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the a ve-named employee'slobligor's income until further notice even if the Order/Notice is not issued by your State . $ 0.0 3 per month in current child support $ o . o per month in past-due child support Arrears 12 weeks or greater? O yes ® no $ 0.0 3 per month in current medical support $ 0.0 ) per month in past-due medical support $ o . o per month in current spousal support $ o . o per month in past-due spousal support $ 0.0 ) per month for genetic test costs $ 0.0 ) per month in other (specify) $ one-time lump sum payment for a total of $ o. o o per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered suppo payment cycle, use the following to determine how much to withhold: $ 0. 00 per weekly pay period. $ 0.00 per semimonthly pay period ' (twice a month) $ o. 00 per biweekly pay period (every two weeks) $ 0.00 per monthly pay period. REMITTANCE INf RMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after he date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You re entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your empl yee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ o ligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following infor nation is needed (See #9 on page 2). If required by Pen ylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. P FIPS CODE 42 000 00 Make Remittan a Payable to: PA SCDU Send check to: ennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES (MEMBER ID (shown above as the Empl DO NOT SEND CA yee/Obligor's Case Identi ier) OR SOCIj ECURITY NUMBER IN ORDER TO BE PROCESSED. SH BY MAIL. I / / l /7 BY THE COURT: DRO: R. J. Service Type M I W OMB No.: 0970-0154 Oler, Jr., 60 Form EN-028 Rev. 4 Worker ID $IATT ONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS E] I hecko?ou are required to pr vide a Copy of this form to your eecm loyee. If yo r employee orks in a state that is ierent fr m the state that issuedthis order, a copy must be providFto your employee even if t?e box is not checked 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Paymen : You can combine withheld amounts from more than one employeelobligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Pay te/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withhol ling is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/ bligor's principal place of employment with respect to the time periods within which you must implement the withholding order and f rward the support payments. 4.* Employee/Obligor i this employee/obligor a the law of the state of er possible. (See #9 below 5. Termination Notifii Please provide the infc THE PERSON HAS N EMPLOYEE'S LAST KNOW LAST KNOW NEW EMPLC 6. Lump Sum Paymei severance pay. If you ith Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against d you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow ployee's/obligor's principal place of employment. You must honor all Orders/Notides to the greatest extent : You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. )n requested and return a copy of this Order/Notice to the Agency identified below. 3638095380 WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: E3 BLIGOR'S NAME: LOWRY, ROBERT S. +SE IDENTIFIER: 5402100251 DATE OF SEPARATION: HOME ADDRESS: PHONE NUMBER: FINAL PAYMENT AMOUNT- 'S NAME/ADDRESS: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or e any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail t withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the empl yeelobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. AntWiscrimination: You are subject to a fine determined under State law for discharging an employeelobligor from employment, refusing to employ, or t king disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obli r is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposabl income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory ension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another fami y and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for adminis rative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculi to the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law f the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 ( )). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in Bete ining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your gent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order wi respect to these items. 11. Send Termination Notice and other corresponds ce to: DOMESTIC REL TIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by intemet www.childsupport.statp.pa.us Page 2 of 2 Service Type M OMB No.: 0970-0154 Form EN-028 Rev. 4 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S. PACSES Case Number 248104975 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 02-5040 CIVIL$ 0.00 Child(ren)'s Name(s): DOB PACKS Case Num Plaintiff Name Docket Child(ren)'s Naml PACSES Case Num Plaintiff Name Docket Child(ren)'s Nami Service Type M DOB DOB Addendum OMB No.: 0970-0154 PACSES Case Number 733104854 Plaintiff Name KAREN A. LOWRY Docket Attachment Amount 00826 S 2002 $ 0.00 Child(ren)'s Name(s): DOB CHRISTIAN NATHANIEL LOWRY 03/31/00 PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Form EN-028 Rev. 4 Worker ID $IATT FILED ; ,,v; 2H9 Jul q? - I Pi 11 of 11 'r? r ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT' State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 07/21/09 Case Number (See Addendum for case summary) EmployerNVithholder's Federal EIN Number LEMOYNE SLEEPER CO INC* PO BOX 227 LEMOYNE PA 17043-0227 Employee/Obligor's Name (Last, First, MI) 162-48-0922 Employee/Obligor's Social Security Number 5402100251 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 798.00 per month in current child support $ o . oo per month in past-due child support Arrears 12 weeks or greater? ®yes Ono $ 0.00 per month in current medical support $ 0.00 per month in past-due medical support $ 165.00 per month in current spousal support $ 35.00 per month in past-due spousal support $ 0.00 per month for genetic test costs $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ 998.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 230.31 per weekly pay period. $ 499.00 per semimonthly pay period (twice a month) $ 460.62 per biweekly pay period (every two weeks) $ 998.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFEr, ANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Ca77 Idtified OR O L?RITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: DRO: R.J. Shadday Service Type M OMB No.: 0970-0154 733104854 826 S 2002 02-5040 CIVIL OOriginal Order/Notice OAmended Order/Notice O Terminate order/Notice OOne-Time Lump Sum/Notice RE: LOWRY, ROBERT S. Wesley Oler, Jr., Form EN-028 Rev.5 Worker ID $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS E] If hecked you are required to provide a copy of this form to your em loyee. If yo?1 r employee works in a state that is di Brent from the state that issued this order, a copy must be providedpto your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Wilhhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2316394770 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ED THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: O EMPLOYEE'S/OBLIGOR'S NAME: LOWRY, ROBERT S. EMPLOYEE'S CASE IDENTIFIER: 5402100251 LAST KNOWN HOME ADDRESS:. DATE OF SEPARATION: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : if the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-62 25 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev.5 Service Type M oMBNo.:0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: LOWRY, ROBERT S . PACKS Case Number 248104975 PACSES Case Number 733104854 Plaintiff Name Plaintiff Name KAREN A. LOWRY KAREN A. LOWRY Docket Attachment Amount Docket Attachment Amount 02-5040 CIVIL$ 200.00 00826 S 2002 $ 798.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): - CHRISTIAN NATHANIEL LOWRY PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB 03/31/00 DOB DOB Addendum Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker ID $IATT OF TH, Z06 9 JI' - 29 F" , 1 ^• " I `. t ?