HomeMy WebLinkAbout96-06037
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KENNETH A. BERKICH.
PLAINTIFF
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY. PENNSYLVANIA
v.
No. 96-6037 CIVIL TERM
CAROL S. BERKICH.
IN ANNULMENT
DEFENDANT
DEFENDANT'S ANSWER TO PLAINTIFF'S
MOTION TO COMPEl. DEPOSITIONS
I. Admitted.
2. Admitted. By way of clarificDtion. the Defendant's Motion to Take Oral Deposition
Testimony was filed on May 8. 1997.
3. Admitted.
4. Admitted.
5. Admitted on information and belief. As candor to the Court. Pennsylvania Rule of Civil
Procedure No. 1920,22 has been rescinded. effective July I, 1997.
6. Admitted on infonnation and belief.
7. Denied, The Plaintiff has not stated with any specificity as to how these depositions arc
necessary. The Defendant maintains that the depositions of John C. Drey, the Defendant's son, John C.
Drey. and Linda DeMann arc not necessary to address the issue of a common law marriage. In fact they will
unreasonably annoy, embarrass. and harass Mrs. Berkich. her former husband. John C. Drey, her son,
John C, Drey. and her friend. Linda DeMann. They will also increase the legal expenses for both parties.
FUlthennore, they will delay the annulment hearing and prolong the ultimate tennination of this marriage.
They will merely serve as an imrusion into Mrs, Berkich's life before she married the Plaintiff. However
if these testimonies are necessary. then they should be given in open court so the Judge may weight the
veracity of each witness as well as the testimony that witness offers.
,
.
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VERIFICATION
DARRELL N. VANORMER, JR.. ESQUIRE. being duly sworn according to law. disposes and
slates that he is the allorney for the Defendant; lhat he is authorized on behalf of lhe Defendanlto make
this affidavit; lhalthis affidavit is made by him and notlhe Defendant as he is more familiar with the
subject maller of the Motion; and lhatthe avennents contained in the auached Molion are lrue and correct
to best of his knowledge, infonnation, and bellef. The undersigned understands that the statements made
therein are made subject to lhe penalties of 18 Pa. C.S. g 4904 relating to unsworn falsification to
authorities.
fn.
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KENNETH A. BERK[CH.
: [N THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY. PENNSYLVAN[A
Plaintiff
vs.
NO. 96.6037 Civil Tcrm
CAROL S. BERKICII.
[N ANNULMENT
Dcfcndant
PRAF.:CIPF.: TO LIST MOTION FOR IIF.:ARING
AND NOW.lhis .;J/s(/ilay of Novcmhcr. 1997. comcs Kcnnclh A, Bcrkich. hyand
through his attorncy, Michacl D. Rcnlschlcr. Esquire, who tiles the within Praccipc of which Ihe
following is a stalement:
I. On Augusl7. 1997, a Motion to Compcl Depositions was filed on behalf of Plaintiff in
the above case.
2. On AuguSI 28. [997. Defendant Carol S. Berkich filed an answer to Plolintiffs MOlion
10 Compel Depositions.
3. Since Defendant has answered Ihe Motion ofPlainlifflo Compel Depositions. Plaintiff
hereby requests that a hearing be scheduled in order to resolve Ihe Motion to Compel Deposilions
in the above case.
WHEREFORE. it is respectfully requested that this Honorable Court schedule a hearing
on Plaintiffs Motion 10 Compel Depositions in the above case.
Respectfully submitted.
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MICHAEL D, RENTSCHLER, ESQU[RE
28 North 320d Street
CampHill.PA [7011
(717) 975-9129
Plaintiff
: IN TIlE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
KENNETH A, DERKICH.
vs.
: NO. 96-6037 Civil Term
CAROL S. DERKICII,
: IN ANNULMENT
Defendanl
CERTIFICATE OF SERVICE
I hereby certify that on this date I served the foregoing document by causing a lrue and
correct copy Ihereofto be place in the United Slales mail, lirsl class postage pre-paid. addressed
as follows:
Darrell N, VanOrmer. Jr.
344 South Market Street
Elizabethtown. P A 17022-2491
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MICHAEL D. RENTSCHLER, ESQUIRE
28 North 320d Streel
Camp Hill. PA 17011
(717) 975-9129
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KI..ITH A. BlaKICH,
PLAINTIFF
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IN THI COURT OF COMMON PLEAS
CUMBERLAND COURTY, PENNSYLVANIA
NO. 9(... (,0 '1'7- Hin. CIVIL TBRM
IN ANNULMENT
V.
CAROL S. BIRXICH,
DlrKNDANT
COMPLAINT UNDER SECTION 3304(a)(1)
FOR ANHULMINT
1. The plaintiff is Kenneth A. Berkich, who resides in
Cumberland County with a mailing address of P.O. Box 961,
Mechanicsburg, Cumberland County, pennsylvania 17055.
2. The Defendant is Carol S. Berkich, who resides at an
unknown location with a mailing address of P.O. Box 3315,
Shiremanstown, Cumberland County, pennsylvania 17011.
3. The plaintiff and Defendant have been bona fide residents
of the commonwealth of pennsylvania for at least six months
immediately prior to the filing of this Complaint.
4. The plaintiff and Defendant were married on December 31,
1990 in Tarrant County, Texas.
5. At the time of such marriage Defendant had remarried by
common law, her first husband, John C. Drey, and said marriage had
not been annulled nor had there been a divorce.
6. John c. Drey is still alive.
7. During her second marriage to John C. Drey, Defendant
held herself out to the public and signed legal documents,
including real property owned by the entireties, as "Carol S.
Drey."
. .
8. Prior to the December 31, 1990 marriage to Plaintiff,
Defendant signed an affidavit in Texas stating that she was not a
married woman.
9. Defendant used the name "Carol S. Drey" wh\!ln she applied
for employment at the River Rescue as an EMT in Harrisburg,
Pennsylvania on or about 1988.
10. Defendant purchased a house as the wife of John C. Drey.
11. While living with John C. Drey as husband and wife,
Defendant received Teamster's health and medical benefits as John
C. Drey's wife until 1990.
12. At the time of the marriage to Defendant and until after
the parties separated, Plaintiff did not know of the prior second
marriage by Defendant to John C. Drey.
13. There was a prior Divorce Action filed by Defendant,
between the parties, 2282 Civil 1992, in Cumberland County which
was dismissed by order of court on October 10, 1995. There is
currently an action filed by the Plaintiff, pending in Divorce, 294
Civil 1996, which should be stayed pending the outcome of this
Complaint in Annulment. There are no other pending actions of
divorce or annulment between the parties in this or any other
jurisdiction.
14. Bec&use the Defendant had not annulled or obtained a
Decree In Divorce in her common law marriaga to John C. Drey prior
to entering into the marriage with Plaintiff, the marriage to
Plaintiff is void.
15. The Defendant is not a member of the Armed Services of
the united States or any of its Allies.
16. The Plaintiff requests that the Court enter a decree of
Annulment.
Count II
Fraudulent MiBrepreBentation
17. Plaintiff hereby incorporates paragraphs 1-16 of its
complaint as if there are set forth in full.
18. Defendant knowingly entered into the marriage with
Plaintiff on December 31, 1990 fully aware of her common law
marriage to John C. Drey.
19. Defendant misrepresented to the plaintiff and the Court
in Texas that she was a single woman at the time of the marriage on
December 31, 1990.
20. When Defendant entered into ~he marriage with Plaintiff
on December 31, 1990 she knew of her prior common law marriage to
John C. Drey and knew that she had held herself out to the public
and signed legal documents as "Carol S. Drey."
21. Defendant's actions were intended to induce reliance by
the Plaintiff and the Court.
22. Defendant's misrepresentations induced reliance, whereby
the Plaintiff entered into a marriage on December 31, 1990
believing the marriage to be valid.
23. On December 31, 1990 the Defendant entered into a
fraudulent marriage perpetrating a fraud on the Court.
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24. Following the fraudulent 1990 marriage to Plaintiff,
Defendant received approximately $14,000.00 on the sale of the home
she purchased with her common law husband John C. Drey.
25. Upon receipt of the :funds on the sale of the home in
Paragraph 21, Defendant moved to Texas.
26. After depleting most of the $14,000.00, Defendant
telephoned the Plaintiff seeking reconciliation.
27. Plaintiff did accept the offer of reconciliation, and
allowed the Defendant to move back into his Pennsylvania home.
28. Plaintiff spent $60,000.00 for the support and care of
Defendant between December of 1990 and 1995, in the belief that she
was legally married to the Plaintiff.
29. Due to the fraudulent marriage induced by Defendant,
Plaintiff suffered damages of loss in property in the amount of
$60,000.00, causing Plaintiff to transfer interest in his home to
the Defendant, and to transfer other valuable property rights as
allowed by law to the Defendant as a proximate result of his
reliance on Defendant's claim that she was single and eligible to
marry him.
30. Due to the fraudulent actions of the Defendant, Plaintiff
seeks actual damages in the amount of $60,000.00.
31. Plaintiff. asks the Court to enter an equitable remedy
returning marital property rights titled in Defendant's name to the
Plaintiff, and make a finding that Defendant had no equitable
interest in any of the marital property.
5. Admitted in part, denied in part. Admitted that
plaintiff and Defendant are not divorced. Denied that their
December 30, 1990 marriage is not annulled. By way of further
answer, a decree in Annulment does not create a new status, but
affirms that there has been no change in status, and that plaintiff
and Defendant were never married.
6. Denied. After reasonable investigation, Plaintiff is
without knowledge or information sufficient to form a belief as to
the truth of this averment and therefore the same are denied and
proof thereof is demanded at a hearing.
7. Admitted on information and belief.
8. Denied. After reasonable investigation, plaintiff is
without knowledge or information sufficient to form a belief as to
the truth of this averment and therefore the same are denied and
proof thereof is demanded at a hearing.
9. Denied. Defendant is not entitled to support by
plaintiff because their marriage on December 30, 1990 is bigamous
and void due to Defendant's prior marriage to John C. Drey. IV WV
of further answer, if the marriage to plaintiff is not void,
Defendant left the marital residence without legal cause, with
greater income, and no debt then upon entering into the
relationship, therefore Defendant is not entitled to Support or
Alimony pendente Lite.
WHEREFORE Plaintiff Kenneth Berkich respectfully requests that
the Court deny Defendants request for Spousal Support or Alimony
Pendent Lite.
Im!f..MATTER
10. On August 20, 1996, while a Complaint in Divorce was
pending, Docket No. 294 1996, a hearing was held on the matter of
Spousal Support before Frank B. Goshorn, Conference Officer; no
Order was recommended because Defendant was not entitled to Spousal
Support.
11. Plaintiff filed a Complaint in Annulment on November 4,
1996.
12. In Paragraph 13 of DefBndant's Answer to the Annulment
Complaint, Defendant Admitted that the Divorce action should be
stayed pending the outcome of the Annulment.
13. An award of Alimony Pendente Lite is not appropriate
where Plaintiff and Defendant were never married.
14. Although Defendant has filed her Petition for Special
Relief under tho Complaint in Annulment, Docket No. 6037, 1996, she
is either attempting to obtain Alimony Pendente Lite pursuant to
the Divorce action, or is seeking Spousal Support without following
the proper procedure, including a hearing.
LAW OFFICE OF THOMAS GOULD
15. Defendant alleges in Paragraph 6 of her Petition for
Special Relief that she is without adequate funds to support
herself; under these circumstances, if Alimony Pendent Lite were
awarded, and a decree in Annulment later awarded, Plaintiff would
be without a remedy to recover the improper payment.
WHEREFORE Plaintiff Kenneth Berkich respectfully requests that
the Court enter an Order denying Defendant's Petition for Special
Relief seeking Spousal Support or Alimony Pendente Lite.
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BY;. . ':-- --
Michael S. Travis
ID # 77399
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
Attorneys for Kenneth Berkich
Dated:
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY. PENNSYLVANIA
Kenneth A. Berkich. Plaintiff
v,
Carol S. Berkich. Defendant
No. 96-6037. Civil 1996
Action in Annulment
REPLY TO PLAINTIFF'S NEW MATTER
TO THE HONORABLE. THE JUDGES OF THIS COURT:
NOW COMES Defendant. Carol S. Berkich, by and through her attorney. Darrell N.
VanOrmer. Jr.. and files Ihe within response to Plaintiff's New Matter as follows:
10. Admitted in part; denied in part. It is admitted that on 20 Augusl1996 a
Spousal Support Hearing was held before Frank B. Goshorn. Conference Officer. It is denied
that no Order was recommended because Defendant was not entitled to Spousal Support. The
action taken was the mutual signing of a Stipulation, A true and correct copy of the
Stipulation is attached hereto by requirement and marked" Exhibit A". Mr. Goshorn also
referred the issue of spousal support to the Court for it to determine the mlttter. A true and
correct copy of the Mr. Gorshorn's Conference Summary is attached hereto by requirement
and marked "Exhibit B".
II. Admitted.
12, Admitted. By way of further explanation the Divorce Action filed by the
Plaintiff. Divorce Action 294 Civil 1996. should be stayed until the Complaint in Annulment.
I
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which was subsequently filed by the Plaintiff. is determined. However this admission was not
intended to stay the request for support or alimony pendente lite.
13. Denied. An award of Alimony Pendente Lite is appropriate where the Plaintiff
and Defendant were never married, Alimony Pendente Lite is "laJn Order for temporary
support granted to a spouse during the pendency of...[anl annulment
proceeding." 23 Pa,C,S.A. ~ 3103.
14. Admitted in part; denied in parI. It is admitted that the Defendant filed her
Petition for Special Relief under the Complaint in Annulmelll. No. 96-6037. It is admitted
that she is attempting to obtain Alimony Pendente Lite through the Divorce Action or the
Complaint in Annulment or otherwise. It is also admitted that she is seeking spousal support.
It is denied that the Defendant is not following proper procedure. Special relief is an
appropriate mechanism to ohtain the relief requested. By way of further explanation, she is
attempting to obtain special relief in compliance with Pennsylvania Rules of Civil Procedure
Rule 1910.25. This Rule empowers the court, upon application. to grant special relief. There
are no provisions in the Rule establishing a set procedure. The special relief sought is to
address the tinancial obligations burdening the Defendant. The Court has the authority in
accordance with Rule 126 to correct any errors or defects in the Petition for Special Relief. as
well as ask for a hearing on spousal support if necessary to determine the issues.
15. Admitted. By way of further explanation. the Defendant is seeking special
relief to lIddress her immediate tinllncial burdens. Upon the granting of special relief. which
will have the elTeet of temporarily casing her monetary problems. the Defendant will be able
to pursue with vigor the l'etitiun fur Annulment and the Petition fur Divorce liIed against her
2
VERIFICATION
DARRELL N. VANORMER, JR., ESQUIRE, being duly sworn
according to law, deposes and states that he is the attorney for
Defendant, Carol S. Berkich; that he is authorized on behalf of
the Defendant to make this affidavit; that this affidavit is made
by him and not the Defendant as he is more familiar with the
subject matter of the Motion; and that the averments contained in
the attached Reply to New Matter are true and correct to the best
of his knowledge, information and belief. The undersigned
understands that statements made therein are made subject to the
pe~alties of Ie Pa. C.S. Section 4904 relating to unsworn
falsification to authorities.
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(he l"lIlIrs "cre 1I111tri,'lI nil Drcell1),':1' 10.1'1'11) nn" ~el'mntrd .hlll~ 2R. 1'1%.
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
Kennelh A. Berkich. Plalnliff/Respondent
v.
Carol S. Berkich. DefendantlPetilioner
No. 96-6037, Civil 1996
Action in Alimony Pendente Lire
ORDER
AND NOW. this
day of
, 199_. upon hearing.
the Rule to Show Cause herelofore granted in this case is made absolute and the Respondent.
Kennt:th A. Berkich. is directed to pay Petitioner, Carol S. Berkich. the sum of $ per
week as alimony pendente Iile and to Darrell N. VanOrmer & Associales the sum of $ as
counsel fees and expenses.
By the Courl:
-'
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
KeMCth A. Berkich, Plaintiff/Respondent
v.
Carol S. Berklch, Defendant/Petitioner
No. 96-6037, Civil 1996
Action in Alimony Pendente Lite
PETITION FOR ALIMONY PENDENTE LITE. COUNSEL FEES.
COSTS. AND EXPENSES
The Defendant/Petitioner, Carol S. Berkich, by her attorney, Darrell N. VanOrmer, Esq.,
respectfully represents as follows:
'I. The parties were married 30 December 1990.
2. Plaintiff/Respondent filed a Complaint in Divorce on 22 January 1996 and
a Complaint in Annulment on 4 November 1996.
3. Petitioner moved out of the marital home on or about 28 June 1996.
4. They are not divorced.
S. Petitioner answered Complaint in Divorce wherein she seeks, inter alia,
equitable distribution, alimony, alimony pendente lite, counsel fees, costs, and expenses.
6. Petitioner has retained counsel and will be put to considerable expense in
preparation for her case in the employment of counsel and the payment of costs.
7. Petitioner is without adequate funds to support herself and to meet the costs
and expenses of this litigation and is unable to sustain herself during the pendency of this action.
8. Petitioner is attending Harrisburg Community College majoring In nursing.
9. Petitioner has recently been hospitalized with pneumonia and has been
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unable to work as an emergency medical technician.
10. Respondent is at present employed by Quaker Oats, Co., where his salary
exceeded $48,000.00 In 1995.
11. Respondent has failed and refused to support Petitioner adequately since the
parties separated.
WHEREFORE, the Petitioner prays that this Honorable Court grant a Rule on
Respondent to show cause why an Order should not be made upon him to pay Petitioner alimony
pendente lite and to pay her counsel fees, expenses, and such further relief as may be deemed just
and proper.
Respectfully submitted
LAW OFFICES OF
DARRELL V ANORMER, JR. & ASSOCS.
Dated: t/~/?&
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY , PENNSYLVANIA
Kenneth A. Berklch, Plaintiff/Respondent
v.
Carol S. Berkich, Defendant/Petitioner
No. 96-6037, Civil 1996
Action In Special Relief
RULE TO SHOW CAUSE
AND NOW, upon consideration of the foregoing Petition for Special Relief, and on motion
of Darrell N. VanOrmer, Jr., Esq., attorney for Petitioner, Carol S. Berkich, a Rule is granted
on the Respondent, Kenneth A, Berklch, to show cause why an Order for Spousal Support or
Alimony Pendente Lite should not be entered in favor of the Petitioner.
Rule returnable on the
day of
, 199_, at
o'clock _.M., In Court Room
, Carlisle, Pennsylvania.
By the Court,
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AND NOW, this
day of
,199_, the
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
Kenneth A. Berkich, Plaintiff/Respondent
v.
Carol S. Berkich, Defendant/Petitioner
No. 96-6037, Civil 1996
Action in Special Relief
ORDER
Respondent, Kenneth A. Berkich, is directed to pay Petitioner, Carol S. Berklch, the sum of
$ per week for Spousal Support/Alimony Pendente Lite.
By the Court:
J.
9. Respondent has refused to support Petitioner adequately since the parties
separated.
WHEREFORE, the Petitioner requests this Honorable Court enter an Order for
Spousal Support or Alimony Pendente Lite in her favor and against the Respondent. In the
alternative, the Petitioner requests this Honorable Court enter a Rule to Show Cause why said
Order should not be entered.
Respectfully submitted
LAW OFFICES OF
DARRELL N. VANORMER, JR. & ASSOCS.
BY:
DA
I.D.#22 6
Attorney for Defendant/Pedtioner
Dated:
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KEII1IBTH S. BBRKICH, I IN THE COURT or COMMON PLEAS
PLAINTIFF I CUMBBRLAND COUJITY, PBII1ISYLVAHIA
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V. I NO. 96 - 6037 CIVIL TBRM
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CAROL S. BBRKICH, I IN AHWLMENT
DBFBNDANT I
ORDBR
AND now this
day of
February,
1997,
upon
consideration of the Plaintiff's Motion to Stay Alimony Pendente
Lite Hearing, it is hereby ORDERED that a Rule is issued upon the
Defendant to show cause, if any, why Plaintiff's Motion to Stay
Alimony Pendente Lite Hearing should not be granted.
Rule returnable
days from date of service.
All
proceedings in the matter are stayed pending further order of the
Court.
BY THE COURT
IJ.
.
.
CBRTIFICATB or CONCURRENCB/NON-CONCURRENCB
I hereby certify that on February 14, 1997 I contacted Darrel
N. VanOrmer, Jr., Esquire, counsel for Carol S. Berkich, and sought
concurrence in the attached motion.
[ ] Concurrence was granted.
[ ] Concurrence was not granted.
[x] Concurrence or non-concurrence could not be obtained
because opposing counsel was unavailable. Additional attempts will
be made to obtain concurrence or non-concurrence and a further
certificate will be filed with the court as soon as possible.
Opposing counsel is requested to call the undersigned upon receipt
of this rnption to advise of his/her position regarding concurrence
or non-concurrence in the attached motion.
The undersigned counsel hereby certifies that there has not
been prior judicial involvement in the above captioned action by
the Court.
Respectfully submitted,
Date:
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-By.
Michael S. Travis
ID #77399
LAW OFFICE OF THOMAS GOULD
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
Fax 761-1974
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KEIIJIB'rH S. BBRXICH, I IN THB COURT or COMMON PLEAS
PLAINTIFF I CUMBBRLAND COUNTY, PBII1ISYLVANIA
I
V. I NO. 96 - 6037 CIVIL TBRM
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CAROL S. BBRXICH, I IN ANlfULMBNT
DBPBNDAHT I
PLAINTIFF'S MOTION TO STAY
ALIMONY PBNDBNTE LITB HEARING
1. A Hearing has been scheduled for March 5, 1997 on the
issue of Alimony Pendente Lite for the Defendant in the above
captioned matter; the Hearing Order erroneously captions the matter
as "In Divorce," listing Carol S. Berkich as Plaintiff, she is the
Defendant in No. 96-6037, DR# 26-197, which is in Annulment.
2. Plaintiff has filed a Complaint in Divorce No. 96 - 294
CIVIL TERM.
3. Plaintiff has filed a Complaint under Section 3304 (a) (1) ,
No. 96 - 6037 CIVIL TERM, seeking Annulment which includes a count
of Marital Fraud.
4. The parties have agreed to Stay the action in Divorce
pending the outcome of the Annulment Complaint.
s. If the marriage is annulled Defendant would have no right
to Alimony Pendente Lite.
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6. If Alimony pandente Lite were awarded, and a decree in
Annulment later awarded, Defendant would be unjustly enriched.
7. The Annulment proceeding is in the discovery phase and it
is anticipated it will shortly be listed with a Master.
s. The issue of Alimony Pendente Lite is more properly
addressed after the outcome of the Annulment and Marital Fraud
claims are determined.
9. On February 5, 1997, Kenneth Berkich, the Defendant in
support Action No. 96 - 1996, DR - 25,003 filed a Motion to stay
the Support Hearing pending the outcome of the Annulment.
10. On February 7, 1997, the Court issued a Rule upon the
Plaintiff in the Support Action to Show Cause why the Motion to
Stay the support Hearing should not be granted, staying all
proceedings in the Support Action; and to list the matter for a
Hearing if the Rule is Answered. Copy attached as Exhibit A.
11. The Defendant's Alimony Pendente Lite claim, as with the
support claim should be stayed pending a decision on the Annulment
and Marital Fraud claim.
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WHEREFORE, the Plaintiff respectfully request this Court to
STAY the Alimony Pendente Lite Hearing pending a hearing before a
Master on the issue of Annulment.
Respectfully Submitted,
Date:
,1 /171//
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Michael S. Travis
ID #77399
Law Office of Thomas Gould
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
Fax 761-1974
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CBRTIFICATB or SBRVICB
I, MICHAEL S. TRAVIS, hereby certify that on this date I
served a copy of the foregoing Defendants' Motion to Stay Alimony
Pendente Lite Hearing by placing the same in the United States
Mail, First Class, postage prepaid, addressed to the following:
Darrell N. Vanormer, Jr.
344 S. Market Street
Elizabethtown, PA 17022
Date:
._l/i~ /.;;'
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By. _.~__:C-.::-:-- ~
. ,-cMi~hael S. Travis
ID 11 77399
Law Office of Thomas Gould
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
Fax 761-1974
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KENNETt I A, IIERK(('II.
Pluinliff
IN TilE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,PENNSYLVANIA
v.
NO. l)(j-(j(},17 CIVIL TERM
CA[{()L S. IIERKICII.
Dcfcndanl
IN ANNULMENT
CERTIFICATE OF SERVICE
AND NOW, lhis ! ~ ..rL day of fl1~
,1912,1
Michclle L. Drawbaugh. lor Ihc Law Firlll of Durrcll N. VunOnllcr. Jr., &. Associ~les, hcrcby
ccrtify thull have, this day, scrvcd a truc und corrccl copy of Ihe Answers to [ntcrrogutorics
upon ['lainliITnnd/ur his counsel hy depositing u copy ofSllllle in thc Uniled Slales Mull,first
c1uss posluge pre-paid,ul E1i7.1belhlown. Pennsylvunia, nddress liS Ihllmvs:
Michael S. Travis. Esquire
Law Office ofTholllas D. Gould
2 Enst M,1in Streel
Shirelllunstmvn. PA 170 II
BY: ..,
Michelle L. Drawbaugh
, ,
...
KBNNETH A. BERKICH, I IN THB COURT OF COMMON PLEAS
PLAINTIFF I CUMBERLAND COUNTY, PENNSYLVANIA
I
V. I NO. 96 - 6037 CIVIL TERM
I
CAROL S. BERKICH I IN ANNULMENT
DEFENDANT I
INTERROGATORIES
To: Defendant
Demand is hereby made by the Attorney for the plaintiff for
answers, under oath or certification, to the following
Interrogatories within the time and manner prescribed by the rules
of this Court, within thirty (30) days after service of this
Notice, your Answers in writing under oath to the following
Int.errogatories.
NOTE: Questions concerning marriage, children and marital
offenses are with relation to the other party to this suit, unless
otherwise indicated.
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KENNUTII A,BERKICII,
Plaintiff
IN TIlE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, I'ENNSYLV ANIA
v.
NO. 96-6037 CIVIL TERM
CAROL S. llERKICH,
Dcfcndant
IN ANNULMENT
ANSWERS TO INTERROGATORIES ATTACIIED IIERETO
I) Carol S, llcrkich, agc 51 (D/OIB 12-15.45), SSN; 202-36-4502, civilian/non-
military/ncvcr scrvcd in thc military scrviccs, Dcfcndant's phonc numbcr is unlistcd and address
is "secrct". Due to past incidents of physical abuse and harassment, Mr. llerkich will not bc
provided with my tclephone number and/or addrcss.
2)
1982 - 1989
7/89 - 11/90
6050 I locker Drivc, Chambcrshill, Ilarrisburg;
3320 Llsburn Road, Mechanicsburg, Pennsylvania
with Kcn Bcrkich
5800 Trail Lakc Drive, Arlington, Texas
3320 Lisburn Road with Kcn Bcrkich
1809 Granite Drivc, Arlington, Texas
3320 Llsburn Road with Kcn Berkich
moved to undisclosed location. Living by myself.
11/90 - 1/1/91
1/1/91 - approximately 5/92
5/92 - 10/92
10/92 . 6/96
6/96 to prcscnt
3) Dockctcd to numbcr 2282 Civil 1992 in thc Court ofCommonl'lcas of Cumberland
County, Pcnnsylvania/Civil Action in Divorce. A copy of Complaint in Divorce was filed Junc 24.
1992. Various and asundry mattcrs relativc to thc divorce procecdings look placc. Carol S. Berkich
was Plaintil1': Kcnncth A, Bcrkich \Vus Dclcndunl. Dclcndunt, Kcnncth A, llcrkich, \Vas rcprcsentcd
by Attorncy Thomus D. Gould und/or othcr mcmbers of Mr. Gould's la\V Iirm.
Thc cusc was purgcd in the norlllul coursc of procccdings duc to inuction,
4) I huv(; bccnmarried thrcc timc:
u. John Drcy,lllurricd Octohcr 12, 19611. divorccd in Duuphin County, upproxilllately
July, 1974,
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\l, Johll Whakll, lIlmTi~d Ik~~lIlh~r 12, 1976, di\or~~ ill Ikl'ks COllllly,
upproxilllatdy Jallllul'Y I'JK I,
~. K~III1~lh 1\. 1I~l'kich. lllarricd I k~~lIIh~r 30, 19l)O,
I huvc no dcpcllllcnl childrcn, lhcn:lill'c, lhcrc urc 110 cllslody iSSIlCS,
5) Frolll Jllnc 1')K3 IIl1lilapproxinlatdy JIIIIC 19K'J, I was scll~clllploycd us u hculllician,
oWllinlllllY own hcauty shop. Thosc n:cords mc ullavuil.lhk: 'oslulld/or dcstroycd ullhis tilllc, My
bCUllliciallliccnsc hus cxpircd ,11I.1 I would 1101 hc pCl"lllillCd 10 cnllugc inlhosc uClivilics utlhis timc.
JUIIC 19K9, I work cd Illr Killncy Shocs IiII' six (6) wccks Inlhc Ihclnry as uluborcr
at $5.35 an hour,
NOl'Cmhcr 19K1) through Novcmbcr I')l)(), I work cd onc (I) ycur ul Mcchullicshurg
IBM us u wurchousc workcr al $9.35 an hour,
Scplcmhcr 19K9 lhrough May I 99.j, I workcllonu pal'l-limc basis ul Lowcr Allen
Towllship us un EMT al a rulC or pay 01'$7.50 pCI' hour, Silllultancously 1 workcd as un EMT on a
parl-limc basis IiII' Lisbufll Emcrllcncy Mcdical Scrviccs al $7,()O pCI' hour,
11)1)2 10 prcscnl, I work cd on a pal'l-timc/as nccdcd lmsis as a stalc testing cvulllalur
Illr Emcrgcncy IIcahh Scrviccs Fcdcrutiollula ratc or puy or $10,00 pCI' hOllr.
Durillg thc sprillg/solllmcr or 1')1)6, Ihllll Apl'i1lhrullgh Scplcmhcr 191)6, I worked
as a pUI'I-timcd, as nccdcd hOlllc hcahh aid lilr I'llllcssillllallllllllC I kahh Scrviccs ul a rulc or pay
01'$7.11.
6) Scc ,lIlswcr 10 qllcstionS. I was sdr-cmploycd IiII' u pcriod or ycars us a hcauticiall,
Thosc I'cclll'ds arc lost alld/or dcslrllycd; lilY liccllse hus cxpircd mill I amllllahlc 10 pal'licipate in
Ihosc vcnturcs allhis timc,
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7) Scc IInswc..s to pUnlgruphs 5 IIl1d ("
III Sec IInswcrs 10 pUnlgruphs 5, 6U1lI17,
'I) Thill inlill"lllution is nnul'uiluhlc: 10slllnd/o..dcSI....ycd duc 10 pussugc ol'limc,mol'ing
I'ruml'ennsylvuniu 10 Texus, ele. A copy ol'lhe tux return IiIcd in IlJlllJ is ulluchcd. AIIIIIX rcturns
I'rom IlJlJO Ih..ough un inclusil'c lux YCll.. IlJI)4 wcrc Iilcdjoinlly wilh hushllud. Kcnncth A, llc..kich,
Kcnnclh A. \Ie..kich hils copics or Ihose ..eco..ds, TIIX ..clurns for IlJlJ5 1I1ll11lJlJ6 mc IIllllChcd,
10) The..c is no wllgc exccution or lIllllchmcnlto puy oul of my incomc IIny mnounls Ill'
moncy ullhis limc lilr uny purposc.
II) Scc unswcrs 10 questions 5 lhrough lJ.
12) IlJKIl Ford Escorl owncd in my nllmc ulonc; IlJ\)5 ('I) SulUrll owncd joinlly wilh
Kcunclh A, llc..kich, Rcul Eslulc loculcd ul 3320 Lisbu\'ll Roud, owncd jointly with Kcnnclh A.
Ilc..kich,
Any uml ull olhcr pc..sonul propc..ty lhut I huvc is eithcr Icss lhun thul, pc..sonul
propcrlY such us clothing, etc" or undclcrlllined I'uluc, Furniturc Ihull hul'c, I do nol huvc lith: 10
sincc Illoney is still owcd on it.
(3) Scc IInsll'c..lo qnestion 12,
14) Mosl or Ihose ..ccords mc unavuilahlc, eithc.. Ihrollgh pussagc of limc, losing thcm
0" dcstn>ying Ihcmdnc 10thci"lIging IImllhc I'lIctlllUl I move l'..ollll'cnnsylvlInill h. Tcxus sevcrlll
limes, Muny or thc records sincc I')')() would be in thc posscssion Ullll/O" control or I'llIinlil'l',
Kcnneth A, Ilc..kich. doring Ihc limc we cilhc..livcdlogelhc.. und/o.. wcrc murricd ulllllivcd logcthe..,
In IlJ')2 I dill ..cceivc u snlllol' upproximUlcly $14.()()(),()O in cxchangc Ii... sulc of illY
intc..esl in lhc ..csidcncc loculcd ut (,()5() Ilockc.. Drivc in Ilu....ishurg. I'cnnsylvuniu, Thlllllloncy \Vus
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plnced illlll Ill)' nccoulII whclI I wellttll Tcxas IIml wus uscd tll pay hills, uchls and lither living
cxpcnscs, Olhcr lllUn "nonnal" IIlllllies UII a weckly hasis fmlll paychecks, Illinur ineollle lax
refullds. if nil)'. ctc., Ihlll wcnt illh. illY hallk acellunls und thclI werc used lu PIlY nllnnulliving
cxpcnscs und hills, IlllIvc received nll suhslnnliul SUIllS llf mlluey,
Irclllse to gi vc my ClllTenl hank UCCUllnl und/llr inl\'l'IIllItionl\.r Ihc salllc rcusolls tlml
I prcvillusly rclllsed tll give my lIudrcss ulld tdephollc nUlllbcr us sclli.rlh in my unswer Iuqucslioll
numher I,
15) I huvc no sul~ty dcposit hox,
16) I oWllno stocks. sccurities, honus ur othcr investmcnls,
17) See IInswcr to purugruph 14 rdutivc to thc $14.000,00 I rccdveu li.r thc ll'llnsler of
my inlerest in thc 6050 Ilockcr Drivc I'csillcllec, Olhcr lllUn lllUl I Imvc nol sold, trunslel'l'cd or
olhcl'wise disposed of uny nmjur itcms which pruvideu !Iny sources or SUIllS of subslunliulmonics,
Ill) ()ucstiulI is uhjccled tUlls heing ullduly hurdeosolllc,
19) a. 3320 l.isbul'll RUlIll, Mcchllnicshurg, Pennsylvnnill. Ownedjuintly with Kenneth
Ilerkich, Stilluwned lit lhis lime.
h, 6050 I locker Drive. Ilmrisburg, See nnswers 10 questiuns rclutive tu lhc
lIucker Drive sulc.
e. 136 Iluuk Slrcet, Ilinlsboruugh, Pennsylvnniu, OWlled iljointly wilh husbund,
Juhn Whulen, Tnmslcrred to Johll WhlllclI IiII' no considcrntion us purl of Ihe
divorce in I lJll I.
20) I hclicl'C lhel'e is onc (I) policy thllllllllY still he III cxislence 10 MussuchuscllS MulU1I1
IIISUl'lInCe Cllmpllny, Thc cush vllluc is modcst, ifulIY slill exists, Prcviously clIsh vlllue wus lukell
out llr thc policy h. PIlY premiollls. Mllllics wcrc III hc pllid hllck IIlId sillce I have beellllllUhle 10 PIlY
Ihe 1ll01le)' huck, I dll not know thc elll'l'Cllt stutus llrlhc Plllicy, ClII'rellt henelicilll'Y is illY son, Juhn,
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21) NOIlC,
22) Scc ullllchcd 1l111lllhly hllllgcl/livillg CXpCIlSC CUlllpilulioll,
2211) IJIl~llowllullll illuddilioll. '1lICSlioll is ohjccled III liS heillgllllduly hllrdcusllmc uud
irrelcvllnt.
22h) Scc unswcr 10 22u,
23) Nllnc.
2-1) Scc unslVcr 10 prior wurk hislory qllcslions. I mil currcnlly 1V0rkinllonu pnrl-limc
liS nccdcd husis li.r Emcrllcncy Mcdiculllculth Scrviccs Fcdcrulion, IlIIllulsoullclldingnllrsinll
SChOll I cilhcr purl-limc ur lillI-limc sincc Il}l) I.
25) Ohjcclcd 10 us violuling rub of cOlllidcnlilllily und ulso relcvuncc.
26) 1I. Diunc und JclTWilmcr 32171.urry Drivc, II1Irrishurll, I'A 17109;
b. Sunlc DcMichel;
c. Jllhll Drcy;
d. Mikc ulld Dcb Tully, Arlinllllln, Tcxns;
c, Dianc umll hllllulll'cr. Ilockcr Drivc, Ilurri~burll;
f. Joc DcMunn;
II, Kcnnclh 1\, IIcrkich. 3J20 I.ishnrl1 Roud. Mcclnmicsburll. I'cnnsylvuniu; und
h, My son, Jllhn l', Ilrcy. 25 Kcnhridgc I.unc. Eli/llbclhlolVn. I'A.
AlIllflhcsc illllil'idllllls 1I10nc limc ur unolhcr eilhcr hcnrd mc slulc or Juhn Drcy shllc
Ilml wc wcrc CX-SpOIlSCS Iivinglogclhcr nnd thlll wc wcrc nOllllarricd, Mikc ullll Dcb Tully urc m)'
brlllhcr lInd sislcr-n-llIw, Othcr illdivi,lllllls wcrc neighbors or 1Illllllulli'iclllls, Whcn I met Kcnnclh
IIcrkich ul Rivcr Rcscllc in I'JHHII'JH9. I slulc,lto himllllhullimc Ihullwus livinllwilh lilY cx-
5
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hushUlIII huttlmll wus notllllllTkd to him,
27) Irrelcvllnt/nonc,
2K) I{cruscd ou hasis orconlidcnliality/pdvilcllC und relcvuncy.
21)) This qncstion Ims hccn prcviously answcrcd, I huvc owncd thrcc (3) picccs or
propCrlY in illY lirc, cach wilh nlY Ihrcc (3) hllshllmls, Thut inlilnllulion is conlllincd elscwhcrc in
thcsc unswcrs,
30) Scc lInswcr 10 PUntllruph 2'),
30a) Apparcntly Ihc litlc clllllpany lind/or Scrivcncr whuprcpurcd thc Dccd usslIlllcd thut
John umll wcrc husband and wili.: hccausc wc hud Ihc SlllllC luslnulllc und wc wcrc living togcther.
At no lilllc wcrc uny inslructions or dircctiuns llivcnlo unyone III prepurc thc Dccd in sueh u lilshilln.
It wus nol rculizcd unlillllicr settlclllcnt und IIlicr Ihe Deed wus rccorded,
31) Scc uuswer to purugruph 26,
32) As purt or Ihc divorcc Ihllll Mr, Whulen in Rcudinll, Berks CUllnly, Pcnnsylvuniu,
lilllowing the divorce, I reussullled illY pdor murded numc ol't'molDrey duc tothc Iilct Ilmll hud
u son mUlled John Drey, The uppropriul'; docUlllenls,10 thc hcst or my knowlcdgc, were tilcd utthe
courlhollsc hy illY uttorncy, A copy or which is uttuched,
33) Thc thrce (3) mllllCS, would have hcenund/or could huvc hccn Cuml Whulcnllnlill
reussulllcd illY prior nllllle ur emol Drey us set lill'th in illY unswcr 10 qucslion 32, Since my
nHlrriugc 10 Kcnneth A, Ilcrkich. IIHlve used thc mllllC ClIrolBcrkich,
34) John (', Drcy, K2 Rcgcllcy Soulh. Cmlislc,l'cnnsylvuniu. 17013. (717) (,1)7.627K,
35) Sce pdor unsw~rs, Thc I'JK'J rcturn is ullachcd, I'JI)O IhrUl1llh 11)1)4 is in posscssion
uml control or Kcnncth A, Bcrkich, I IJI) 5 ulld 1')1)6 urc ullachcd,
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VERIFICATION
The undersigned verifies that the Answers contained herein are
true and correct.
The undersigned understands that false
statements herein are made subject to the penalties of 18 Pa. Cons.
stat. 54904, relating to unsworn and falsification to authorities.
~1hf.. t ,f>ntlOJ
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AL.tOl"aay fOJ;
Date: ~t/?7
__...(.............ot,"" (1I.P,O,.....__7oflnllrud_1
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3 "'''IM'MIII MpllIl. "II'.. hIli _M....... ",u,", 10, ...... ... ,.. ..... "",
4 Hlld 01 hou..hold (wllh quallfr\t1l ~),l'H pi'. ? 01 1..11IICl\onI.) II lhe quallfrl"l pan"" II yolI' child bUt not
yG<Il dtpand.nl. .nl., child'. name he,.,
..II I wIdo ., wllh dt nl child " ,. diad ..9 ' Sat ? olln.I,uetlana.
Youfllll 11...,.on. (luch .. VOW pa,.nl) can claim 'OU II . dtptndtnl 011 hllOl he, \II }
'.Iurn. do nol cht<k boa ea. Bul blM.lo ChKk lhe boa 011 l1n133b 011 pap Z, .
It 0 lpou.. . . . . . . . . . , . .f . . . . . . . . . . . . , . . .
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Incomt
Pia... .IlKh
Cop, B 01 ,ou,
forma W.2, W.20,
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",lructlons
on p.,114)
AdJullld
Gross Incomt
tkpt"tmlnt.I lhe ,r."ury_lnllfnll ".".nullen'kl
U.S. IndlvldulllnCome Tlx Return
. \I 01ol8 No. 1M' 007.
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'Iperworll Rlducllon
Act Hotlcl, I"
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not....... _ w or
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d II ,OIl child dIdn" Iht Jrilh JOU but ~ cIaImad II JIll ....._,1 undor. pr..,..,.nanI. thadI hanI .. 0
o '0111 numbl, o'.umpllonocl.lmad. . , . , .
7 W..... IOwill, 111'1. .Ic. (.U..h FOIIII(.) W,2) , . , . . .
tl 'ou~1o Inl.,"lIncomo (ol'<uUICh Sc/oodull 8" - 14(0) .
. ~ '..,.._"nll'""ncomo (SH pili 10). OON" IntkIdt on "no Sa
t Divldond Incomo (./10 .UICh Schadull 8" - "'00). . , .
10 '.uble ,.'undaol.I.I. .n<llotal_ \11II. "'11)', I,om _ilI"'.1 on pap \I oIl..lrudlcn..
II A1lmon,rK."'ad. . . , . . . . . .
I Z Bu,lnolllncoml" (1OIl,)(.UICh Sc/tadult C), , . , . ,
:3 C.PUllplnor(lolI)(lnlChSc:hedultO, . . . . . . .
14 C.plll'..ln dl.lrlbullon. noI..portad 011 1111I."_ pap II)
.1 Ol"',..I....(IOIl...)(.UIChF..m41J7) , , , . . . . . . . . . , , . . .
I" 'oIlIlRAdl,I,lbullcn.. . l..1Jtj L-1...'...bl..mounl(........II)
170 'o,.lpanslonllnd.nnulllll Uza.]. '-17~T...bIo.mounl(-pap 12)
.t Rlnl.. ,0,.111.., ptrln."hlp.. ..1.111, l'UllI. a1c. (.nICh Schad"1I E)
I' farm Incom...(....)(.U..h SchadulaF) . .. . " ...'
20 Un.mplormonl componllllon (I..u,anco)!'" PIIt 13) , . . . .
210 SotlalllCu,lI,bonollll. ,12101 I 21U.ubloamounl("'pap 13)
U Olha' Intoml(II.Ilypo.nd.mounl-........ '3) ..,........................,....,..........
n AdcHhllmounll.hownlnlhlllll' I <Glumn I..llno. Jlh.ou h 22. 'hi. I. , loIllllM.... ..
Z4 You, IRA dtduellon. from .ppllcable _kahIIl on..... 14 .. .,
ZI Spou....IRA dadutllon.lrom .ppllcabla __, 011 PIt" 140' 15
2. SoIl,omplorod "".h 1nI".nca clod.."on. ........- "" pili 15
Z7 KRlh ,.II.Im.nl pl.n and IIlI,omployad UP daductlon
21 P.non, on ...Iy wlthdr.w.lol..,lop
2. Allmon, p.ld, . R.tlpl.nl,.11I1 name
.nd hoclll IICu.11y numllt.. , .
Add II.. 241h, h 29, Thl.. ... .111.1" u,'monl. '
ubt,." In. ,om IInl . This. you, utI. .,... ncom.." 'h. HrN . leu IMn
.19,J40.nd. child I/,.d wllh)'Oll ... "E.rnod ""'om. Crod"" (I/n. 58) on po,. 20 0'
thl n.tfuc'Ion.." u w,n' IRS '0 I II , ,.. ... J 60' 'he In, ud/OlI' ..., l
.
, I' .-
l
.
30
~ 'dt
. ...
T..
Compu.
t.llon
'..m 1040(19191
U
u.
Cr.dlls
IS..
nltruclloOl
on p." II,)
Other
TUII
IIncludllll
My.ne. llC
P.ymonl.)
M.dlClre
'ltmlum
P'Jm.nls
Alllch 'Ofm,
W.2, W,20.
.nd W,2P
lofronl.
Refund or
Amounl
You Ow.
Sian
H.r.
(K"r, ICOp,
of th 1,.lurn
'CM'YDU'
"cord, )
rlld
r"pl/l/',
U.. Onl,
Amounll,omll",,31(.dJU1loc1I'01lIncomo),.., . . . . . , . , . .. , . ,I
Chock II: 0 T... ...,. 65 01 old.. 0 IlInd: 0 .,..... w.. 65.. oIdll 0 Blind,
Add Ih. numbo, 01 boa.. ch.cked .nd .nl.. Ih. tol.1 hell. , . , , , . . . n.
- II """..... (Iuch II IOU' pollnl) con clolm,..,... depondent. ch.ck h.... . . In 0
· II you II. m.",ocI ""11I1 ..110111. '.Iu,n .nd 'OU, .p6u.. lI.mllO. d.d",,"on..
Of you.... du.I,','uIIU.n, II. p". Ihnd check hll', . ,
34 fn'"lh. { . Tou"I'IItI"'~d"lI.n(ltompo"I70ltheln'l,ucllon.),Oll
10,... . Y..., h.mlo'''.~u,lltn. (I,om Schtdulo A,lIn. 26)
0': " ,.., lI.mu.. .1I.ch 8chodulo A .nd 'hock h.1I . .0
U Sublloclllno.4 I,om Nn. 32. Enlll'he lI.uh hll. . . . , , ,
JI MUhlplyU.ooobylh.lol.lnumboro"..mPllonaclolmtdonlln.6., . .. . . .
11 T...~. ......... Sobl'.'llIn. 38 Itom 'W. IS, fnl.. lhe lI.ull (II '.11 Ihln 1t'0, .n'"It'o) , .
Coullon. " und., ... 14 .nd rou heVl ..OI.lIl1n $1.000 oIlnmtm.nllncomo. chock hili . 0
.nd II. ..... 17'0 II. II you heVllo UII 'OIm 881 8 10 II.u,. you, 10.,
31 fnl., III, Chock 11I,om: . MTII T.bl.. _oT.. R.I. Schtdulll. or ,0 'OIm 1615.
(lI.nylal,omForm(.)III4..nllllh.lomounlht,.., I.) ,
It Addlllon.It""(lIIpa.. II), Ch.ck II lrom: .0 'o.m4870 .0 'OIm4872 .
dU nd h 01.,
41 Clldll 101 child .nd dep.nd.nl co,. .'pon... (.ltach 'orm 144/)
42 C,odll ,.,Ih..klll'r OIlh. dl..blod (11I..h Schedu', R) "
,
41 Fo,..n I.. c'ldll (I"och 'OIm /1/6) . . . . , .
44 O.n.'.1 bu,'nell c,telll, Ch.ck II f,om:
.o'Ofm31OO 01 _0 Fo'm'(,poclly)
4S CI.dll 101 p,1or r..' minimum I.. (I"och 'orm 8801)
4. AddllnIl41Ih,olltlh4S,Enllllh.lol.l. . . . . .
47 Sublllc IIn.48Itomlln.40,fnllllhu ulllllolllllln,"o .nl.....o
4. SoIl,.mploym.nlt"(,""ChSchoclUloSE), . . . . . . .
4. A1t.IR.liv.mlnlmumIO(I""ch'OIm62SIl. . , . . . , . , . , , . . .
SO R.c.plulll.... (III pa.. II), Ch.ck If f,om: .0 'OIm 4258 _ 0 FOIm 16//
II Soclal...u,,,y 10 on lip Incom. nolllporltel 10.mploro'(llIoch 'OIm 4137)
sa To on .n IRA 01. quaNlltd IIlIlIm.nl pion (./Ioch 'OIm un) .
53 Addlln..471h,0I hS2.Enllllh.lolll .,....,...
54 Suppl.m.nl.1 Modlc.1I pllmlum (.It.ch 'OIm 'BOB). . . . , , . . . .
81 Add IIn.. 53.nd 84. Thl.,. ur 101.1 Iollnd.n.u .m.n,.1 M.dl,... .mlum
II ,.dtlllIncorn.10 wlIhhokl(lI.n, I. f,om FOfIll(.) 1099. chock. 0) .
17 1989 ..lImolod," parman...nd lmounl.pjlIltd f,orn 1981 "'urn 17
81 ftrnld Incom. c'odll(... pia' 20), . . , . , . . ., 81
It Amounl paid wllh 'OIm 4868 (OIlln,'on '1QUf.1) . . . " 8.
10 f.cell .oclal lI<urlly I.. Ind RRTA 'u wllh~.1d (III PII. 20) 10
II CltdIIfOlF.d".llolonlu".(III"hFOIm41J6), . . .1
U Rqullled In...lmanl ,.mponr Clldil (11I1.h 'ormI439)
.. Add IIn.. 861hro 82. Th....,. our lolll I monl. ,
.. II Nn. 63Ia",,,, lhan Nn. 85. Inl".mounl OVER'AID ,
II Amounl 01 IIn. 8410 ba REFUNDED TO TOU, . . . ,
II Amounlol Nn. 1410 bo A"UEO TO TOUII 1.10 IITIMATEDTAll. 8
S7 IIl1n. 851a "/If' \hon IIn. 63. .nl" AMOUNT YOU OWL AII.ch chick 01 monar ord" 101 full
.mounl par.blllo "Inlllnll R".nu. Servlc.," Writ. YOU' IOCI.I "cu,lIy numbar, d.",... phon.
numbe',.nd "J989FOIm 1040"0011. . . , . . I . . . . . . . . . . . . .
II P.n.U !"unde,. .ntoh.llmll.d", III 21,..
.
n,o
}
Unde, PtnIItIeI 01 "fluty',' Mellf. lhall hi.... .umlntd lhl, "IUfn Ind ."om..,n,!". KhtdU"'1nd ,tal.mlnl., .nd 10 thl be., of "'-.r tlnowltd.. .nd
belitl, (hlr "' but. could,.nd tom,.t.. Otd.flllon 01 pt'Plt., (othtllhln I.-PI,")" blStd on .llnfOfm.11on of ""kh ""pI,er NIIIl, "nhltda',
~ '(our '''fI.lur. 0..1. 'tour occupation
~
",
1pouM', occup'11on
\ .
PrfPI"'"
Iiplluft
flrm"Nm.(ot ~
roulllt IIlftmplo,.d)
'nd .dd,n,
0.1.
CIlt<ki' 0
MI'-Imp
II. No,
liP cod,
.U.'. "ur_1l1 ".",.". O"tetl tlll-UI',.,
SCHEDULE C
(Form 1040)
OM' No 1'4' 0014
Profit or Loss From Business
(Sole Proprletor.hlp)
p.rtner.hlpl, Joint V.nlure., Etc" Mull fll. form 10es,
A...th""nl
... AnKh 'I} hrm 1040 or '~rm 10.... II- 1..ln,t",ctlon,'or ',hHllllte ('.rm 1040). Sequenc,No 09
hdalllc'"'"r numlMt CIIHI
O~ Lj OC)..
rlne P' UI n," C .
(from P'I' 2) . I
D 1..'IopfIDo...... (Hal IIHI
I
I M.lhod(.!UlldID (I) 0 COlt (4) 0 o-noIlPr,ly(1I
valu. clol n.lnYlntory: I.pllnatlon) chlCk,dllk p IIn. 0)
, AcCDunUnam.lhod: (I) ~ Cllh (a)o Accru.1 (3)0 Oth"('plClly)~,......,........."".......,......
Q Wlllhll. .ny ch'na.ln d.lllmlnln. qu.nUUII, cD.II, Dr v.IU,UON betwHn openlna.nd cl..ln.lnv.nlllfY111I.V.... .U.ch "pIanallon,)
H Al.~oud.ducUf\l..pt:nH.'OIbulln...u'.orrou'hom., (U-VII.-II.lnlhucUanl'Olllmltatlonl.). . . . . . . , . . . .
, Old au'mlt.rl.1I rtlcl It,'loth. rltlonol this bUIln"ldu,1 19891 If 'No 11,.lnltructlons lor limitation. on IOSIIl. . . .
J II thl.lCh.dul.lnclud.. 110.., CIIdll. dlducUon.lncDml, 01 Dlhlll" benlllt IIllUna to. t.. .hlll" rtqulrad to be 1t.I.lllad. ch.ck hll.. . ~ 0
II youcheck,d thllbo., YOU MUST ,"ach 'orm 1271.
11IIII Income
i!@89
1>-51"'""'" 01 the "...""
InlllNI R,vtnut tltMcI co>>
Hamlot IMopI'''IOf
II
. \
c
I Gr...,ac.lpl. or III... . . . , . . . . I
a R.lurnund IlIow.nca. . . , . , . . . a
3 SublrlCllln. 21'Dm Iln.l. Enllllh....ull hll'
4 CD.t olaoodl .oId .nd/o, opellllonl (from IIn. 39 on pap 2)
5 Sublllcllln.4 I,om IIn. 3 .nd .nlll 'h. aroll prolll hili ,
, OlhlllncDm..lncludlna F.d...I.nd .t.I..llolln. 0' fUll I.. clldll OIlIlund (...In.lrucUon.) .
7 Addllnll5tnd6,Thl.l. our rOlllncom.. , , . . . . . , . . . , . . , . ,
IZIIII EKpln...
-
3
4
5
,~ 7 -
I
aa R.palll , . . . . . . , .
2J Suppll.. (not Includad In P.rt III) ,
a4 T..... tY:O '. I.O.-!}, . .
2S Trlvel. m.,II, .nd Int.rt.lnm.nt:
. Trl....I. . , , . . . . , ,
b M..lund
.nt.rt'llnm.n' .
cEnter 2096 ollln.
25b lubllct to
tlmllatlons (...
InstrucUon.). ,
. ~Ilflli}"n~ 2~c fro"l.'Jnt 2~ l.
21 'liMn.. ('~' lilh'fuctlclnVf r'.. .
27 W.... (1," lob. cradll). . . .
21 Olhllllpenll' (1I.llype Ind .mDunt):
IVIA(,Jf.\Z.JIU~,...,...., .:1&.,09
~::rf))(, _ ....:......, .~~,
lOcroLI:I.&F.\T, J ......:il(X),
L~Jllb((V,..,...,...... )00.,
~i.i' '~~{{;~Lt,A\Y~m~
:r~I~,.~",.,..
21
I Iodvlrll.ln.. . . . , . . .
. O.d d.bl. from III.. 01 ..!Vlell
(1I.ln.lrucUDn.). . .
10 CII.nd t,uck tlpens.. .
11 Comml..lonl . . . .
U DtpllUDn , . . , .
U Dtpllcl.Uon .nd ..cUon 179
d.ducllDn from Form 4512 (nol
Includld In P.rt III) . , . . . U
14 Employ.. ben.lll pr....m. (olh..
IhlnonU~~.. , . . .
15 FIII.hl(n"'hMlt6r~rtlll)
II In.ultncl(olhlllhlnh..llh) .
17 Inl....I:
I MDr1&I.' (p.ld to ben"', .Ic.)
bOlh.., ,. ";J...~IJ,.
II L'lsl.nd prof...lon.I\1t~lhl .
I' Olllc. tlp.nll. . , , . . .
ao Pin. Ion .nd p'DII"'hlllna pl.nl .
2 I R.nt Dr 1,""
. Mlchlnery and .qulpmlnt ,
b Olhlf buslnl" proplf!)'. .
-
10
II
U
28 Add lmountlln cotumnl for IIn.. 81hrouiih 28. Thlller. our '01.1.. nil' . . , . . . '. , ,..
30 Nit prolll or (Ian), Subtr.ct IInl 29 hom Ilnl 7.11. profit. .nllf hl,.lnd on Fo.m 1040.~llf\lI2, Ind on
Schldull SE, line 2.11 lion, YOU MUST Roan lollnl 31. (Flduclllln, ...lnllrucUonl.), . . . .
31 If you hlv' . lon, you MUST chock the boll th,tdtlcrlbtl )'Ou, InvII'mlnt In thll ICUVUt("1 Instrucllonl) ,
It you chrcked 311, .nler thlla'" on Form 1040,lIn. 12, .nd Sch.dul. SE, IIn. 2.
II YDuchackld 31b, you MUST .tt.ch Form 1111.
fur '.parwork R,du,Uon Act Notle.. 118 form 1040 InlhucUon'.
30
I 3 It 0 Allln'..*'-nq'l · .
, Ubo So..I.":~..II..o"llilk.
'ch.dul. C (Fo,m 1040) I'"
P. 2
khtdu..C (Joun IGtO) 1919
COl' 01 Goodl Sold IJ!d or 0 .rlllonl (See Instructions,
I"Vlntalr II bellnnln, 01 V'" (II dIU...nt hom I.,t VII'" clGAln,lnvlntory, .ttach ,.plln.tlon.) .
Purchll" 1," COlt 01 ittm,..lthdr.wn for perlonal UII
Co.1 01 labor, (Do nolln.lud. .al..y paid 10 you".II,)
M.terlal.and IUppUII I .,
Olhll c..l. , :
Add IIn.. 32Ih'''''8l136 .
lnvlntorv It .nd 01 WI" . ',\ .
Co., of oo,..ol,.n' or 0 ...'Ion., Sublrlcllln. 38 from IIn. 37, [nlll Ih....ult hll..nd on .1 IIn.4 3'
Prine I al Bu.lna" or Prola..lonal Acllvlt Cod.. Clullon: Cod.J h.VII be.n "./J.d, Ch.ck ur cod. CI,,'u/l
loc.l. 'hi maio' bUlln... cal.aory Ihll btlt ductlbel you, actlvltv (10' ..ampl., R.I.ll T'ld., Servlcel, ,'c.). Within thl major Clt,lOry, "Iecl thl .cUvlly
code Ihll motl clGHly 1,.nUU..lho bu.ln..' 01 p,o,."lon Ihalls lho principal'''''''. of you. "I.. or IICllpl', En,,, 'hi, ','lall co" on p... I, IIn. I,
(No'o: l/)>lOr /lI'nclpo/ .""'c. 01 'ocom." I,om I..mll1/l ,,'I,III...)Ou .hould 1110 'ch.,u', I (fo,m 10401. 101m Incom. and E.pan...,)
Con."uellon 2615 AI.nl Of bloktf lor othtfl"mt- flnaneo, In.u,.ne. R..I 7856 M'll~. reproducUon. comme,clal
Codt mora than 50" 01 1'011 Hili on Ealal., and R.lal.d ..,.Ie.. ,11. phoIDl"phJ'. .nd
commllt5on 1'lflOIllphk: Mme..
001. Optf.UW budder. .for own account) &'20 A....."t, ..,nl. 01 bu..,. 1612 Computlf p'~'.mm"".
0.'..... cen"Ht.., R.I.II Trad.-..llln. 0004.10 6'71 R..I..,.I, ptoper1J' mlnll'" "oc'''~':i d. . pllper.tlon,
Indl.ldu.l. and Houllhold. " 10 Subdlvtd.,1 and deWloptfl, .."pt and Itl.l ..me"
0014 A..WiSeR'''' buUdl:Z elmlllf!" 7922 Computlf "pelt, mllotlnanca,
OM9 NonrttldtnU.1 b.... me 3012 Stll:t doof.la door, bv ""phone 5Ua Opll.lorl ,nd ,,,IOt. Q'bu""*inp. and I,,'I~
0015 Hie"" .nd ,.,.., construction Of r.: ., p1.n,orlromrnolN" unll Iocludlnl,"Id.ntLlI 7113 (qulpm.n rlnt.I,nd ~I'I~
3819 01 r hllV1 conllrloKhon (pipe 30JI Ct.klIOfm.i6ord" 5553 Oplf.lolI.nd ItnOlI 01 olhlf 11.1 f"Clft' compullf Of .ulOln IVI)
lavtnl.1N1dp con.truetlon. lie.) 30!3 V,ndIf\1 machln. ..U"" r.oportv 1914 nVII ..lIvI ,nd P'OIKtlvI
."IIM", .,... clfttree'.,.. '111I"1 'rom Showroom, '102 naur.nel.,antl 01 bll_'" ..rvk..
"4" Other "'tuI.ncenrvktl 7880 atilt. bullnl""Mc"
lncluMn. ,.pak. StOll, 0' Olh., find Lo..llon 6064 $Hurll, Iuoll... Ind dlllt'.
0212 Plumbln.. helU", II' condltloni,.. '....lIn.r..... Inti .'UII 6010 Commodil, eontladl br.rllnd 'tflonalllnkll
Olll P,lnl"'l ,nd ~pIf hi"",.. 307!1 b'~I""(mllll or INCU) dill,.., ,nd IKu'lf, lnet 8110 ellul, lhopl (Of btlulkiln)
0213 (J,clrkal WOtk ~modil, .Ichl,.... S311 SI,bI, lhOp (01 ~rbe.)
0299 "IIOfVJ, dry .111. Itonl. UI. 3066 Cat. Itrvictl 1130 Im.Um.nt .dYllOl'l.nd Hrvlctl 8314 PhoIOll.phlc portl'" sludiot
0414 Cllpent"Q!'ncllloofl:,:\ JO!I5 OIlnlllne pl"tS (11,ohoIk 1148 Clldilln,llIuUonl.nd morta... 6532 'untlll "Me".nd cftmtlcwl..
0410 Roolint, I .... Ind .he. mllal 1210 blVI'",,) blnk". 6/14 Child dly caft
04$$ COf'I('''' work GroClf)' .IOf" (&tn"alline) 61SS TltI. Ibllllet OWCII 8130 T'lehl~ Of tutorl::\
0885 Othlf bUlkh~'d' contraclor. 0612 &Juri.. ..1Il1ll.1 r.tall $777 Olh" (tnlne. Ind 1111 "tl" 8755 Counsel tlI (.."pi talth
(.JUlvlhon, Ire. .Ic_) 1238 Other 'ood 110'" (milt. ptodUCI. C"liUontll)
Clnd"ltC.) 8771
1251 llqUOf'llOItI inil'''' and chlpllins
M.nu'.elurln., lneludln. 1217 D'ue.IOIII Tran.porlallon, 6882 Othe' ptrlONl I"Vie,.
P,lnlln.and Publl.hln. AutomoUv. ...lIltrwk. .t.Uonl Communleallon., Public Automollv. ...-kll
0638 Food ptodud..nd brttr.... 1111 NIW CIf dill.,. (II.nc:hllld) UIIIIII.., and Rolal.d .1I.le.. 68U Automotlvl IInl.1 Of ....1"1,
0651 TI.UI. m~odudl .i1hout drive'
0679 Applfll othe, tl.U5I Plod"'I. 1135 Ultd ct, dlllell 6114 ,..k.bl 8839 Pllkll1l, ..up' v.l.t
1517 Othe, .utomollv. de.lt..
0695 llllhe" '001..,., hlndbtp, .tc. (motOlC'tl'l~ '1C",UoI'\I1 6112 Bus.nd Ilmou.lne If.ntpor1.Uon 8951 Au'omotlv. ..p.lrl, ,.n.,.I
0110 lur",IuIt 1M 'i.twII "thtd.., .Ic 6361 Othe, h~hW'>>' pall'''''' .M lpec:ltll.td
0836 lumblr and other wood Pfoduc:tI 3533 ,..~ .ce."orle,i.nd partl ""'IPO .11on 8896 Olhar .u'omollv. HMe" (WI&h,
0851 Prlnl....., t:.blWIlna 3'58 OIl anell",k'I 1110", 6338 "",kin. (lI"p' b.ah cot5.dlonll1 towl"l,.IC.)
0877 Plpt..nd.1 product. G.n".1 m.rchlndt.., ,,,ar." 6195 Courle, or packll' dtllY.lY I....ie MI.CtIl.n.ou. "'11.. tletp'
1032 Slone, ell,. '":JIIU ptod!.KLI 6510 'fllh colltttion .llhout own dump comput".
1051 Prime,,. metal usI'.' an"UfnllYfI 6536 Public wlI.houIl~
1013 "bllcllod""llI...oducll 171S V"ltl,.'torll 65S1 WI'''h.n'~'llOn 9019 TV.nd ludkt equlpm.nl llpal,
1099 MlchlntlY Ind mKhlnt lhops 1711 other !.n....1 m.,chandlse Itor.. 6619 AlrlrlnspGf II..", 9015 OIhlf .Jtcllkal.qulpm.nt IIPII,
1115 [Stehle end .lectronlc equ:f:.nt 3756 Shoe I orn 6615 Tflv.I'I.nl, and lOllfOpelllOfI 90$0 R.upholll"y.nd IUlnitur.ltpalr
1881 otht'manulac:tUlI~kMlUI ,... 3112 Mln'..nd boJ" dolhinllloraa 66$0 Oth.r tl.ntport,lion Mrvic:.. 2661 OIhlf equlpl1Mnlltpair
1!111 Women', III ,.Io-w.., .torll 6616 CommuNe.llon ...... M.41ctl.nd hullh ."vie..
Mlnln. and Minora. Exlraellon 1921 Wom.n'.I<<I'IOf)'.nd lII*"tI, 6692 UIIIIII.., Includin& dumps, 9217 OlfluI Ind dlnkl a' m.dlcal
.Iorll.nd 'uffilf. tnDwplowirl,. 'Old dllnlne, 'Ic. dcKIOl'I (MO.)
1511 MlI.1 m1nlnl 3919 lend" clolhl"lllor.. , 9233 OUit...nd cllnkl 01 d.nU.II
1537 Cotlminlfll 1!IM Other 'PPI,.I.nd actlllOtV .Iorll S.,."le.. (P...on.I, P,o,...lon.I, 9258 OII.op.alhlc phWllcltnl.nd
1552 Oillndlll 1970 Furnllur'Itor.. .nd Bu.ln... Sa,."I...) ~lOn'
1719 Qui'tyl"..nd oonmtt.mc m4nint 1!196 TV, .udlO,.nd .Itclronkl 9241 .11111.
1!168 Compultt .nd IOlIw". Ilor.. Hol.11 .nd other 1odt1"1 '''ct. 9214 ChlIOP'lClolI
A.rleullural....le.., FO"'''1, 4119 HooHhc:ld ,~ptilnc:. .Iorl. 7096 Holtll, mol.ll, .nd lou,lIl horn.. 9290 Oplom.lrblt
fl,hln. 4111 Other horn. umllhlne IIortl 1211 Roomlf\l.nd tto.,dlne houllt 9415 RI<lll.d.nd pllctiul nUlIII
~.floortOVl'lfI(I,IIC.J 1231 CampI .nd campi", Plfkl 9431 Olh" hulth ~ItUtlOMII
19l1 Crop IIMctI 4311 UlIC: end 'ICord Itorn laundr, .nd dunln, If'Yk.. 9456 Medlcal.nd nl..labor.tOfI"
1951 y.,..intfylffYktl.lnc~ptll luUdln.. Nt",,"I. an. ,""n 9412 Nunlna.nd ptflol'\ll CII, f.ciliUII
1974 llvt.tocktN":l .uppIJ 7419 Coinoptllt.d Itundrltl.nddry 9666 othlf hellth "Nit..
1990 ou,,"~ " clllnlna
2111 F"m ltbcM.nd maN..""nt 44\6 Bulldl~ m.lllltll dI.I.,. 1435 Othe, l.unclrlc dry ,1t.nlRI, and Amu"m.n' .nllfle",Uonal
.oMe" 4432 p.lnl.....,.nd w.lIptptr stor.. g'ment '.IV II ..nlet'
2212 ItotUcullUl. and ItndlUpl"l 44$7 HtrdW".ItOfn 14$0 'ral "'d.::rholll.,,'IOI"'rt 6557 Ph)'I.,,1 htnt" '.ciliU..
2231 FortlllY. ..tIPt klalnI 4473 NUfIl,ltl .nd I"dln IUPP'r .10'" 1476 J,nlo""I. III.lldlll.1I 9597 Motion piClulI.nd
0816 l..... Other "t.M lIorll (buildlflC, houM..nd IJrindow _klIOPlod",Iton
2246 Commlfcltl IlIh~ 4614 Ultd mlrthandtll.nd .ntique clt.nlnl) 9668 Mohon ~clur. Ind 'apt
246!1 Hunl", and tllP IIorll (lI"pt molor "Nelt parh) IUlln... end/Of p.uonat dilllibu Ion Ind lllied 1t",lctl
'630 Gilt, novtlly..nd lOUVlnl, IhopI lI,vlclI 9611 YldtOllpt IInl.1
Whol...I. Trad.-80llln. 4655 'kulll. 1617 hili H'YlCII (Of ".".,If) 9619 MoIIOf'l p'tlUII thlll...
4611 J'W.If)'Ilorll 9610 BowIl~nt'll
Oood.lo Olh.. Bu.ln....., Ele. 1633 IntOm. 1'1 P:r:"lion 9696 Plol'lI "Iports .nd llelre,
4691 Sport"'l r.ood..nd bIe,d. "''''' 7658 Atc:ounh"l' book"HP!na
Dllllbl. 1004.. Inclu41nl 4'12 B~td"11I Indud.nl ~omot"l .nd maMi"I
nt. [~lo"'I'" ..~.. 9811 Thlllllc:a pe,fOfmtfl, mUlkllnl,
mlchlnllV, .qulpm.nt. ..... 4831 Hobby, toy, I~m. Shopl 7M2 Alt IltttlUU11 I'IVkn
met,I...le. 48\1 Carner. .nd ph 0 IUpply ItorU 7108 Sur'r.yi"ltlr,riC,.. .a.nll, p'od"'.... .nd Itlllrd
4819 Opllttl lood. 110111 ..IVk..
2618 Stlll.na 'or ,oor own .tCOlln, 1245 MIllIIi.m.nt'I.men 9631 Other .musem.nt.nd ItcrllUonl1
2634 ",.nIOf tNoklf lor olher fi,mf- 4695 ~.~. .nd IlIlhll aoodl 110'" 7260 Public rel.liool Nrvkll
mottlh.n &O1l oll'oU IIltl on 5017 I 01", .ltludl,. ntW$II.ndI 7266 Conlultl"" "",k'I
eornmtukH't $033 St.lionery Ilol'S 7116 Adva'\i\I"I, .."pl dlrKt mlit
Non4ullbl" tOOrl.. Incldlna 5OS6 ,.b,Ie.OO n..dl.work Ilor.. 1112 [mptormln' I~",,~.nd 6866 Untb'-lotll"lly
$074 Mobile IJam. dul". ~"QIInI"UPPY
load, flbll, c .mlnl.. .tc. 5090 Fu.I dlll.II (.Iupt ..lOkn.) 1199 onlumll tredlt "portl"a.nd
265!1 S.lllllllor roo' own Itcoonl 5884 Othe, "I'llllorll colleclions'lVle.. . .
.U.I.OPO: tNt-a"'t.
"
. .
SCHEDULE Sf
(Form 1040)
SocIal Security Self-Employment Tax
OMINoIS4S0014
OtpoRmenl 01.... '''....' ~ ...I..It..,.....,., _4u1. 8l (f.rm 1040).
In....... ~........ _. .0) ~ AnKh I. f.,m 1040.
Him. 01 peflOO with ..I"lmplo,mlnl Income Clllhown on IOClIl HCUflt~ CI,d) SoclllllcurU, numbl, of p.rlon
, ., _ith 1II'.tmplo,mtnl Incom....
"i!@89
Anadlmen' III
S ....nc No
Who MUlt File Schedule SE
You mustllle Schedule SE If:
e YOUI nIt ellOlnllS 110m sel'-employmlnt were $400 or more (or you hId wallIS 01 $100 or morelrom an allctlnll church or
church, controlled orllanlzatlon); AND
e YOUI wallIS (subject to social security or lallrold retlrlment tex) were less than $48,000,
Elceptlon, If your only sell.amploymenllncoma was trom uIOlnlls as I minister, mlmber oIl religious order, or Christian
Scllnca prlctltlonlr, AND you lIIed Form 4361 and recllved IRS Ipprovll not 10 bl tlxed on those ellOlngs, DO
NOT 11I1 Schedula SE.lnsleed, write 'Exlmpt-Form 4361' on Form 1040, line 48,
For more Inlormatlon about Schedule SE, see thllnstructlons,
Note: Most people can use the short Schedule SE on thIs page. But, you may have to use the/onser Schedule SE
that /s on the back.
Who MUST Ullthe Lona Schedule SE (Section B)
You must usa Secllon B II ANY olthe tollowlng applies:
e You choosl the .optlonll method. to lI11ure your eell'employment lex (sla Slctlon B, Part II);
e You are a minister, member ola religious order, or Christian Science rractlllonlr amI you received IRS approval (I rom
form 4361) not to be laxed on your earnings trom these sourclS, bu you owe slll'employment tax on other ealOlngs;
I You were an employee 01 a church or church'controlled orllanlzallon that chose by law not to pay employer social security
taxes;
I You had lip Income that Is subject to social security tax, but you did not report those lips to your employer; OR
I You were a govelOmenlemployee wllh wages subject ONLY to lhel.45'16 Medicare part 01 thl social security tax.
Slctlon A-Short Schedule SE
Read lbovelo lea II ou mUlt uHlha 10 Schedula SE on lhe back Sncllon B ,
I Nel 'Irm prolll Ot (1011) "om Schedula F (Form 1040), IIna 36, and 'Irm partnerships, Schedull K.I
(Fo,m 1065).lIna 14a , . . . . . . . . . , . , . . , . , . . . . . . , . .
a N.l plolII 0' (1011) Irom Schedule C (Form 1040). llna 30, Ind Schedule K.I (Form 1065), line 14e
(olhe, Ihln 'liminal, SH thelnllructlonl 'or othlr Incomalo report , . . . . . . , . . ,
3 Add IInlll and 2. Entlllha lolal. IIlhetolallllllsthln $400. do not malhls schedule: you do .0'
owe HIt'lmployment tax . . . . . . . . . . . . . . . . . . . . . . . . ...
7 Enler Ihe Imallar 01 line 3 or line 6
3
,
, ,
148 000 00
-::
-
-
.
II ~6
S.h.d.l. SE (F.rm t040) IU'
4 The IarSllt amount 01 combined WISII Ind 1I",employment 11101118I lubJect to soclallecullly or
ren'OldrellremenlllX(t1erl)lorI9891I. . . . . ... . . . . , . , . , . .
5 Tolllsoclllllcullly WI8"S and lips (flom FOtm(s) W,2) Ind ranroad rellremlnl compensetlon (11111)
, Subtract line 5 from line 4, Enter lhe relull. IIlha ruullllllrO or Ie.., Ilop hire; you do not owe
IIIf.employment.... . . . . . ~
. Rlleolla.. . . . . . . .
II Salf.omploymenttaL IIl1nl 7 II $48.000. Inlll $6.249,60, Otherwlll. mulllply lhl emount on IIn3 7
b the dlClmllamounl on line 8 and entar the ...u11. Alia enllllhlllmounl on Fo,m1040 IIn.48
for '.p.rwores ".duetl," Act No'k., II. form 1040 InlhuetlonL
khodulo I[ h,m 1040 1919 A"Khmonl
Hlml 01 ptllan wllh IIlhmplormlnllnconll (1Ilhown on ...111 .ocurllr card)
.
. ,
Seellon B-Lonl Schedule BE
Belorleom lell '" II ou eln Ult thllhort Schedule SE on Ihe olheralde Seellon A ,
II II you lie I mlnl'lll, mlmberoll rlllatoUl older, or Chrllllln Science pllellllonll, AND you f11ld form U'I, bul you hed $400 or
mall 0' olher IIrnlnp lub/lello III1'employmenlllX, eonllnue with Plrt Ilnd check hlle. . , . . . . . . . . . ~ 0
· II your only ellnlnp lubltello HlI'lmploymenlllX wile WIIlII ham In eleellnll chu,ch or ehureh,conlrolled o'lllnlllllon Ihllll
e..mpl 'rom emploYllsoclellleurlly lI.eund rou lie noli mlnlllll on member all relillloul ordll, Iklp IInll 1-3b. Enlll"ro on
line 3e end 0 0 line 51,
fI ure Soelll Seeurll Sen,Em 10 ment Tax
1 Net Ilrm prolll 0' (1011) Irom Schedule f (form 1040), line 36, end 111m plrtnlllhlpt, Schedule K.I
(form 1065).1101 14. . . . . . . . . . . . I . . . . . . . . . . . . . . .
a Nil prolll or (1011) Irom Schldule C (Form 1040), line 30, and Schedule K.I (form 1065), line 141
(olhll lhen lermlnlll. See Inllrucllonl '0' olher Income 10 report, (Employell 0' In eleellllll church or
church.conlrolled orlllnlullon do nol.nlll you, form W.2 wellll on Ihllllne, See theInll,ucllonl,) .
3e Enlll Ih. emounllrom line I (or, II you eleclld Ihe '"m opllone. mllhod, Irom line II below). . . .
II Enllllhllmounl"om line 2 ( or, II you eleclld Ihe nonlerm opllonll melhod, ',om line 13 below) . ,
c Add IInll31 end 3b. Enler Ihelolll. II Ihelolellllelllhln $400, do not II/e Ihlllchedule; you do not
owe IIlI,employmenl lex. (beepllon: If you "'''1 In employ.. 0' In I/Iclln, chu,ch or church.
conl,oIled "".n/zllllon .nd Ih. lot" olllnl' 3. .nd 3b IIltu Ih,n 0$400, Inl" Zlro Ind ComP/ltl Ihl
"JlofthllscheduII,) . . . . . . . . . . . . . . . . . . . . . . . . . . .
4 The lerlllll emounl 01 eomblned WIIltI Ind IIII.employment elrnlnp lubl.ctlo soclll Heu,'ly or
IIl1ro.ed IIl1l1mlnlll. (1111 l)1or 198911, , '. . . . . , , . . . . . . . . . . , ,
51 TollllOCllllleurlly WIIltI and IIpl ('rom form(l) W.2) Ind IIl1ro.ed Ill1remenl
comp.nllllon (lIer 1), Nole: Gowmmlnl Imp/oy,.. whOl' ....". "'''1
su*,I only 101M 1.4596 M.dl"" lu ,ntI ,mploy,.. of Clrt.ln church 0'
church.cont,olled or"nlulIons should nol Inc/ud, lhosl w",. on Ihl. IInl.
SI.lnstruct/olll . . . . . . . . . . . . . . . . . " .
II Unllported IIpI lub/eet to socllllleurlly tlX (ham form 4137, line 9) or to
1I11,0ed rellllmenlllX (1111 I). . . . , . , , , , , . . " 5b
c Add IInll511nd 5b. Enler Ihelolll. . . . . . . . . , . " '" , , . . .
'1 Sub'"clllne 5c Irom line 4, Enler the IIlull. IIlhe rllult 111110 or Itll, enllllero Ind Itop hell; you
donotowe..lI.employmentllX. , . . . . . . . . . . , . . . . . , . . . . ~
II Enlll your Medl,," qUllllled IlOvernmenl wellll, Seelhe Inslruellonllo ..ell you musl ulllhe worklhell In
lhollInllrucllonl10 IIllulI your 1tll'Imploymenl lax , I ISb I I I
c Enlll your fO/m W,2 weSII 01 $100 or more Irom In eleellnll church or ehureh'conl,olled
o'lllnlllllon . . . . . . , . . I t5c I I I
d Add IInll 3c and 60. Enllllhe lolal . . ~
7 Enlerlhllmallarolllne6ao,lIne6d . . , . . . . , , . , , . . . . , . , . . ,
8 Rat, oftlx. . . . . . . . . . . . . . . .,. . . . . . . . . . . . . . . K .1:502
, 'el(.employmenttu, II line 7 II $48.000, ent.r $6,249,60. Olherwlse, multiply Ihe Imounl on IIna 7
b the doclmalamounl on line 8 and enler Iheresull. Also enler thlnmount on Form 1040 line 48 . .
o Ilona' Method To FI UII Nel Earnln I See 'Who Cln Fila Schedule SE' In IhelnsllUcllonl. ,
Seelnllrucllons lor IImlllllonl. aenerally, you may uselhls part onl)' II:
II Vour .rolllerm Incoml' wes not mOil Ihln $2,400; or '
B Vour .rolllerm Income' W81 mora lhen $2.400lnd your n.t larm prollts' were lelllhan $1,600; or
C Your net nonferm proflll' wOlllolllhln $1,600 Ind Ilso 1111 Ihen lwo.lhlrdl (4\) of you, .roll nonlllm Income,-
Note: /I line 2 .bovell lwo.thlrd. (U)ar more o(your flOU non'"m Income', or If line 21. $I,600or mole. you m.y nol uJllh. option.' me/hod,
'from Schldule f (form lIMO), Ilnl 11. ond Sch.dule K.I (fo'm 1(65).llno 14b, 'from Sch.dull C (form IIMO).lIno 3D. Ind Schedull X,I (fOlm 1(65).lIn. 141,
Ifrom Schedulo f (folm lIMO), line 36, .nd Schedule K'I (fOlm 1(65). line 140, 'from Schedule C (form IIMO).lInl 7. Ind Schodull K'I fOlm 1(65).lInl I4c,
10 Mlllmumlncomeloroptlonelmllhodl , . , . , , . , . . , . . . . , . . . . . 60 0
11 ferm Optional Mathod-II you mill 1111 A or B abova, Inler Ihl omall.r 01: Iwo,lhl,do (") 01 srosl
111m Income I,om Schedu!a F (Form 1040), line 11, end larm partnershlpl. Schedula K.I (Form
1065). line 14b; or $1,600, Also enllllhlumounl on line 3l1bo.e . . . . , . . . . . . .
12 Sublraclllne 11 Iromllne 10, Enterlherllult . . . , . . , . . , . . . .. , . . . . .
13 Nonlerm Opllonll Method-It you meet 1111 C above, enler Ihe Imalt.ot 01: IvJo,ihlrdl (") olllross
nonlerm Income 110m Schedull C (Form 1040). line 7, end Schedule K.I (form 1065). line 14c; or
$1.600; or,lt you e'ecled Ihl firm opllonll melhod,lhe amount on line 12, Also enler Ihls amounl on
line 3babo.e . , . . . , . . . . , . . . . . , , . . . . . . , . . 13
Fo, Peplrwork Rlductlon Act Nolkl. .11 Form 1040 In.lluctlon.. Ouo 010 ,..._...,. . . Sch.dule Sl (Fo,m 1040)1911
utnc. No, II
Soclllllcurllr numbol 01 pI..on
wllh "",emplormenllncoml ~
, .2
,
,.,m
1040A
Label
ISH PI90 leI
U" th, ml
Iobel.
OUlerwIH.
pl.... pnnl
.,-
Check the
box for
your filing
status
ISH pie' 20,)
C~k only on.
_.
Figure
your
exemptions
ISH p'e' 22.1
l'mOlllhln
Mv,n
dlpendlntl.
Me pag. 25.
Figure your
adjusted
gross Income
Attach COPV' 8 o.
your Farm. w.a
and 1OW.R h.r..
If 'IOU dldn'l QI' .
W.2. HI pig. 21.
Sncla". but do not
.ttach, Iny p.yment.
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~
~
~
=
U1~
-
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U1~
~~
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OeptNnen' 01 lne T",aury-Intlmal R'venue SlINc,
U.S. Individual Income Tax Return
(I.l
1995
L
A
e
I
L
H
I
"
I
~s u.. Onty 00 nol WIlli OIltapl. '" 11'\11 apl".
oMe No U<"QQU
YOUI' loelal IIcurtr, numb.'
'J.62,'?(,." 4q')'~
.po.....'. lOci" 'Runty nymber
.\ 101 :40: ';l5'fU-
Hotnt...... ~ and Mtlll toY""" PO bol, HI PlOt II
~...wn Of'" *.. II"'. 11'4 ZIP '001 It rOW ha,~~Ol.IdOr''', Nt PIG' 11 r
<Oh\re.n\M ~tou:l(,\ rQ. \7011 -'~3b
Presidential Election Campaign Fund (See pegft 19.)
00 you want $3 to go to this fund? . . . . . . . . . .
If a oint return. does our spouse want $3 to 0 to this fund?
1 0 Single
2 0 Married filing joint return (even II only one had Income)
3 Oll Married filing separate return. Enler spouse's social s~curitv ,number
above and full name here. ~ \( ~(\,l\ ~~ I\- J::i'" ( 1> I( n
.. 0 Head of household (with qualifying person). (See page 21.) lithe qualifying person Is a child
but not your dependent, enter this ,child's name here. ~
Quail In wldow(er) with dependent child ( ear spouse died ~ 19
Your..lr. If your pllent (or IOmeon. ,III) can claim you 8'1 depend.nt on hll or hit tax
IItum, do not check bo... ea. But b. lur. to chick the bo... on Un. l8b on page 2.
For Prlvlcy Act Ind
Plperwork
Reducllon Act
Nollce, ... plge 11,
Note: Checking "Yes" will
not change your tax or
reduce our refund,
C.p,nd.nll
on Ie not
.nttr,d ,bOYI
.dd numb,,, [JJ
,nltr,d on
linn .bon
7 :)2.500
8a J..\
9
-:lOb
l1b
12
13b
~ 14 1. '5";)..1
. . jCWIt 'M""n. tpOl.l..', Inl NIne 11IO '"'tltI
..,,,nam,
"'pl, no
Ve. No
II
8a
b 0 S UII
C Dep,nd,nt..
(2) Depondont's soclo'
lecUlity number. II born
il11995, 0.. pogo 25,
131 Oopondont's
IIlationsnlp lO
you
141 No, of
months lived in
your home in
1995
(1) Flrsl nom,
Last name
d If your child didn't live wilh you bulls claimed as your dependent
under a pre-1985 agreement, check here . . . . . , , ~ lD
e Total number of exempllons claimed,
7 Wages, salaries, lips, etc. This should be shown In box 1 of your W-2
form(s). AlIach Form(s) W-2,
IllI Taxable Interest Income (see page 28), If over $400, allach
Schedule 1.
b Tax.exemptlnteresl. DO NOT Include on line 8a. 8b
9 Dividends, If over $400, allach Schedule 1.
10a Total IRA 10b
dlstribullons, lOa
11 a Total pensions 11 b
and annuities, 11 a
12 Unem 10 ment com ensatlon see a e 32 ,
13a Social security 13b
benefits, 13a
14
15a
our total Income,
15a
\ .
b Souse's IRA deduction see a e 35 . 15b
c Add lines 15a and 15b, These are your total adfustments, 15c
16 Subtract line 15c trom line 14. This Is your adjusted gross Income.
It less than $26,673 and a child lived with you (less than $9,230 if a child
didn't live with ou). see "Earned Income credit" on page 47, ~ 16
co.. No. 12601H 1995
). (See pa e 22,)
}
No. of bo...
ch,ck,d on
I. .nd Ob
No. of your
chlld"n on
Ic who:
, U....d with
10.
, didn't IIv.
with you dUI
to dlvorCl or
"Plratlon
I..' p.gl al)
'l. 'S d- \-
Form 1040A page 1
1&05 Form 1040-' paga 2
Figure 17 Entar the amount Irom line 16,
your
standard
deduction,
exemption
amount,
and
taxable
Income
. I
Figure
your tax,
credits,
and
payments
II you wanllhl
IRS 10 ligu"
your tax. ...
the instruction,
10' IInl 22 on
pagl41.
Figure
your
refund or
amount
you owe
~
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~
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Z-
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~
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~
~
~
17
18aD
'J..s;).\ E
18. Check {O You wa" 65 or older 0 Blind} Entar number 01
It: 0 Spouaa was 65 or older 0 Blind box.. chackld ~
b II your parent (or someone else) can claim you es a dependent,
check here, , . . . . . . , . . . . , , , , . ~ lab
o II you are married filing separately and your SPOUS8 Itemizes
deductions. see page 40 and check here.. . . . . . , ~ 18c
18 Enter the Itandard dlduotlon shown below lor your Il1Ing stetus. But
If you c:hlc:kld any box on line 18a or b, go to page 40 to IInd your
standard deduction. II you c:hlcked bOll 180, enter -0-.
. Slngl_$3,900 . Married filing 10lnUy or Qualifying wldow(er)-S6,550
. Head of household-S5,750 e Married Il1Ing eeparately-S3,275 19
Subtract line 191rom line 17. II line 191s more than line 17 enter -0-. 20
Multi I $2 ~OO b the total number 01 exem tlons claimed on line 6e. 21
Sublract line 21 Irom line 20. II line 21 Is more than line 20, enter -0-.
This Is our taxable In com.. ~ 22
23 Find the tax on the amount on line 2~. Check IIlrom:
Tax Table a es 65-70 or 0 rorm 8615 see a B 42 . 23
24. Credit lor child and dependent care expenses.
Attach Schedule 2,
b Credit lor the elderly or the disabled.
Attach Schedule 3. 24b
c Add lines 24a and 24b, These are our total credits,
25 Subtract line 24c from line 23, II line 24c Is more than line 23, enter -0-.
28 Advance earned Income credit a ments Irom Form W-2.
27 Household em 10 ment laxes. Attach Schedule H.
28 Add lines 25 26, and 27. this Is our total tax.
29. Total Federal Income lax withheld. II any Is
Irom Form s 1099 check here, ~ 0
b 19ge estimated tax paymentu and amount
a lied Irom 1994 return,
c: Earned Income credit, Allach
Schedule EIC II au have a uall
Nontaxable earned Income:
amount ~ I and type ~
d Add lines 29a, 29b, and 29c (don't Include nontaxable earned Income).
These are our total a menta. ~ 29d
30 II line 29d Is more than line 26. subtract line 28 Irom line 29d.
This Is the amount you overpaid.
Amounl 01 line 30 au want refunded to OU,
Amount of line 30 you want applied to your
1996 eeUmated tax, 32
33 II line 28 Is more than line 29d, subtract line 29d from line 28. This Is
the emount you owe, For details on how to pay. Including what to
wrila on your payment, see page 55.
34 Estimated tax penalty (see page 55).
Also. Include on line 33, 34
Si U~., peniIU.. 01 pt'jury. I declal. thai I h.~. ....mlned lhl' ,.Iurn If'Id Iccompan'tlng .c;h~ul.. and "allm,nll. and 10 Ih,
gn your bill of mV knowledgl and blll,r. IhlY Ill. lIu.. contel, ;lnll .celltal.lr hst .11 amount, and '01.1"" 01 Income I ,ecll..ld dunno
return Ihl W VIII. Oeclatil.on 01 prlPAre, 101hl' IhilOlhallJlpaY.flll buedon,ad 1I110,"11110n 01 which tha prlp..a'"n any knowlDdga.
~ YOU'llgnalut. 0.1. 01.1' occupallon j. - 'f
, - . ,,' 1 1:.1\ '::>'Tl)i) Ei\.
~ SpouH'1 Ilgnollul., II JOint r.lurn, BOTH mUll Ilgn. 0.1.
q
lil
o
20
21
22
"j .-
-
Q-
"
24a
24c
25
28
27
~ 28
29a
~4
--
29b
29c
31
32
30
31
.~~6
~ t!'-
33
Kllp . l;OPY of
this relum 10'
your 'Korda.
Paid
pre parer's
use only
SpOUI.'. occupation
P'ft,lll.,', ~
IlQNlut. ,
Film', nama 101 your,
II ..1I..mplo)'~1 .nd
add'...
Oal.
PIlP""', SSN
Checlli il
..tl'lmplo adO
EIN
ZIP cadit
1995 Fo,m 1040A page 2
~
$
~IH_recrcle4,..".,
'U.. Qo"IfMlent P'WUWlg OItlt;.I, 1"1. JIII05.
, ,. ,
, '
Household Child Household Child
Week Week Month Month
EXPENSES .\
Home . 41S,~
Mortgag~...................................... $ $ $ $
Malntena ........................................... $ $ $ $-
U\IIllIes (telephone, heeling ISO.1SfJ
eleclrlc, etc.) ........,.............................., $ $ $ $
Employment (Iraneport.lIon. DO 80.0.1
lunches) ............................................... $ .20 . $ $ $
TaxII
Raal Eatate .............................................. $ $ $ $
Perlonal Property........,....,......,.........,.... $ $ $ $
Income ..................................................... $ $ $ $
Insurance
W8.~,6"n~.6T. ..ifllf,.,...X5t:f....................... $ ,$ . :r.SO .
Automobile .............................................. $ $ $ 34\-. 00 $
Llle/AccldenIlHe.llh ,............,..,......,...... $ $ $ $
Other ........................................................ $ $ $ $
Automobile (payments, lunl,
repairs) ...................................,............. $ $ $ =to. 00 $
Medical
Doctor. Oenllst, Orthodonllst ..,............. $ $ $-- $
HOSPIl~............,................,........ $ $ $ $
Specla <<I asse braces, etc.) .....,......... $ S $ ::LC>, o. $
Educallon
Private, Parochial School ....................... $ S $ $
College ..................................................... S S $ $
Personal
Clothing ................................................... $ S S .:1.0. ISO S
Food ......................................................... $ ~O.GO $ $ 2'tO. DO $
Other (household supplies, .
barber, etc.) .......................................... $ S $ S
Credit payments and loans ..........,......... $ $ $ 2(,.0.&0 $
MlsceUaneous
Household help/child care ..................,.. $ $ $ S
Entertainment (Inc, papers,
books, vacaUon, pay TV, etc.),........... $ $ $ $
Gills/Charitable contrlbullons ..........,.., $ $ $ $
Legal Fees ............................................... $ S $ $--
Other child support/alimony .'
payments ..................,.............,............ $ $ $ $
Other (speclly) ....,.................',......,................ $ S $ $
Total E~penses ......,...............,..........,........... $ S , . $ l"l '1 I.. ,50 $
." "'.'
PROPERTY OWNED
Checking Accounle ........
Savings Accounte ...........
Credit Union ..............,....,
Slecks/Donds ..."......'""..
..................
,-r 0 LU~." ~.
e~_1 .\0....... p",-
\" II.. 1="_'21 rsc,.
Real eslale ..............,......,
......................
Other ..................,........,....
........................1.......
Tolal, Properly.....................
INSURANCE Complny
Hospital ,......,....,..,..,..,..,~' r--74\
Medical....,..,..,..,..,..,........ ~ .4-4' $c.\...... '4I.._I'-f
Health/Accident .............._
Disability Income ......'....,
Olher (dental, etc.) .........,
('H . Husband, W. Wile, J. Joint, C. Child)
, .
Ownerlhlp'
Volul H W J
S D." __ -y-_
s ___
S "..170 ___
S ___
S ---
S --_
S ___
S ___
s ltS.lmCl~) _ ~
s ___
s~ _-L-_
S ___
S ___
Polloy No.
COYlrlge'
H W C
s ~ "oolf?-. ot.
~~-
---
SUPPLEMENTAL INCOME STATEMENT
.
A, This lorm must be lI11ed out by a peraon who (check one):
_ (t) operates a buelness or practices a profession; or
_ (2) Is a member 01 a partnership Or Jolnl venlure; or
_ (3) Is a ahareholder In and Ie ealarled by . cloaed corporation Or almllar entity.
B, Allach to thle etatement I copy 01 the lollowlng documente relallng to the buslne". profeaslon, partnerehlp.
lolnt venlure, corporation or elmllar enllly,
(I) the most recent Federal Income Tax Retyr", and
(2) the most recent Prollt and Lou Stalement,
C, Name and Address 01 business:
Telephone Number
O. Name end Address (II dlllerent than C) 01 accountanl, conlroller Or other person In charge of flnenclal
records:
E. (1) Annual Income rrom business ....................................i........................................................ S
(2) How alien Is Income received? .....,...............,.....................,...."................,................,........ $
(3) Gross Income per pay periOd ..................",........,......",....,......",,,......:,.......,,,...:,,......,........, $
(4) Nellncome per pay period ,..........................................,........".."...:",..,.....................,..,...... $
(5) Specific deductions II any .........................,...................,........"""".."....."..........,.........,...... $
J 1040
Label
lat.
pog.II,1
u.. Ih. 1111
,.b.I,
OthlrWIII.
pl.... punl
Of Iyp.,
Pluldlnllll
(laGllon Clm~"8n ~
~I I. 11
I
FIling StatuI ~
~
Chock only 4
one bo..
a
a.
Exempllons
b
0
II more Ihan I'.
deplndenls.
111181hlll
inSllucllonl
10' lin. 6c,
d
Income 1
e.
AlI..h b
Copy B 0' you, 8
'o,m. W-2. 10
W-2Q, Ind
1088.11 h.... \I
II you dId nol 12
g.t . W-2. 13
... thl 14
inllNc;Uonl la.
fer line 1. 110
Encloll. but do 11
nol anach. any II
payment. AJIO.
phlasl enclose 18
Form 1040.V 20.
I... Ih. 21
M1slrucllonl
IOf lin. 621,
o.PeWn~1 QI \he "...",__-101.11I" A.'lIfN\Ue 'erv~' <1t'B\96
U,S. IndlvlduallncomB TalC R.turn 1'1 U(!!I
fQl "'. 1'. JiIIl. I-Otc 11. liM 01 olhl' I... .,..,
Yow "'el nMN M\d .....1111 h,. ntm4t
l 6' ~erkl'c.h
.1996. tf\dl"'9
"'51 u.. Crol,-Do rC;l ..U, Of ""1" .'1'''1 "It,
~ you wan' 13 10 1II0'~ .. . . . . . .-t";
II. Dill' ilium, dOli au, IP'&J.. wanl 13 to 0 10 Ihlllund1 .
Songl.
MAlllld 1~lng IDIfIIlIlum (IVtrl " only on. hid NlComl)
M~'1Id '1Iu'lca "!:.,oI'l Ilium, Enl" ~H'llOCliI uculIly no. above iI1d l~ nil1\t h.,t. ...
Hlad or hOUSllIIlQhj IWllh qulhfy.....g pll'on). IS.. Il1ltrUCllonl) If Ihl qualilv,"Q person 1$ a ctllhJ bul nol you,
cJeptndtnt. eOlu' Ihll child', naml hi". ...
QUail in wldo'o'lle,) wllh d. endln. C~l:d ly..r IpOUIt di.d II> 19 t. (See IOSI,UCUons I
(ZJ Vourell.. II your j:atenl lor lomeone 1111) can cllilm you I. a dependent on till or he, I.,.} Nil. II '11I11
fI'ulO.donolchlckbox6a.,. . . . . . . . . . . . . .. U"~ldlll
IIRn"IRIII'
· DUll. . . , . . . . . .' . . . . . . . . . . . . . .. Ho. 01 WOU,
Dlplndlnt.: I Ipll1Unl1 'OC~ IJI .p.na.nrs II. 'to ~1-trl1ll c1'lIll1l1n In linl
,,(urtl. nllffiOlf. II 0011I Ulj'IOlllh,p 10 ~\u ., .:.1 'e .Ilo:
In fll&! Nfl'II ~ll: njm. If1 1996. IIlII 011 ll~rfl' . 'j1oj
.lIwdwilhrllU
. 1111 'In Ii,. Wllh
,allllullotll,OIU
lllllplUlIlIR
UUlnllIIlUllIAII_
O.plR\llnlllll'c
1I111InllulI.blIwl_
AllllflumUfI
Inlllld 01
IInlllbow."
TOlal number of ...mellon5 claimed
Wages, .atil'.'. I,p., 110 AU.ch FOIml'l W-2
T...bl. inl.,..t, Au.cn Sch.dul. B ., OV.' $400 ,
T..-u.mpl ",III.". CO NOT 1OC1ud. on line e. eb I I
OlVld.ntj Illcom._ Ai~I:~ Schedule 8 I' OVIl $400
TlUable "funds, cre:::I:5, or 0""1' 01 IIIII and locw mcoml la.e. (511 IflSlruehcnl1
AJmony recllvld
BUMI" ancoml or ;lesS!. Allaeh Schedull C Of' C.EZ
Cipllil giin or (Iols" Illuqulred. .!tach Schodule 0
O'hlr gallll 9f (lone". AlIach Form 4197 .
TolillRA Ot'1nbulloos. . l..!!!J LJ b Tautl. imeunl ,SI'lnsll
Tolal p.nllCln.llI\d annu,".' l.1!!.1 .~ b T...illl. .mcunll'" ''''I
Renlal real 'Ilall. ro)'uu. partnl,ships. S corporallon., Irusll. lie. Altacn SChedule E
Farm Incomo or llosS!. Altach Schedule F
Unomploymllll compensallon . .
SOCial SleLUIly blnelll$ . I 20. 1 '1 b TiAible ilT.cunllu, Ins!.1
Olhtlll1coml.1I11 IYl=e ~d amounl-Illlnl'rucliool ................................
.........................................................................................
22 Add Ihl.mounl. in Ih.lat fl hi column fot lin.. 7 Uvou h 21. Thilll oUI'o,.llnc;oml ..
231 Yow IRA deduclion is.. ,n:ilruClioos) 23.
Adjusted b Spou..'.IRA d.ductocn '... ml,uctlon.) 23b
Gross 24 Mov",g ..p.n..., At,,:n Form 390,3 or 3903,' 24
Income 2S On.-hall ol..II,.m~lclm.nll... AII.ch Sch.dul. SE 25
II hnl 31 .. under 20 S.U.empIoYltj hullh ,nlufanel d.ductlon till Inll.). 28
129,495 (undor 27 K.ogh & SlIl-.mploy.. SEP plan.. II SEP. Ch.ck ~ 0 ' 2'
$9.500 I' I cMd 28 finally .;)II tatly wlthdfawal olllyings 28
tJld not Iiv. Wllh 28 AlllJ'lOf1y pl.Id. Recipient's 55."" . 29
you). ... thl
inSlruCllDnS lor 30 Add Unll 23a Uuough 2:iJ .
hne 54 31 SlIbl,acl Itne 30 Irom Illlt: 22. ThiS is our Id ult.d rOlllnc;oml ..
for Prlno)' ACil and P.p.rwark R.duCillon Ac;' Nolic;'t I" pig. 7. c.. flo 12~!.l~G
10 OMU flu 1~"~.OOU
'tCllul u,." ",wily numb.,
aaa 0'" 45url.
Ipou,,', 'CII'la""Wlty numllar
fo, h.lp IIndlng Iln.
InllfucUonl, I" pig..
a Ind 3 in 'h. boukl."
V'I No
Uol.: Ch""'lflg
.'y.,' ",JIM'
,nang. rout'," 01
Itdu"~"funcI
..L
;v;~~
9
:101
:-;-;-]
I 12
13
14
l~b
1Gb
17
, Ie
19
20b
~.~
r';'~'
21
22
:-~~1?
.,~,
~~~'S.:
~:-~'&'
.:~~:~
~~~~~~
..~'\:'
l~:~ ~
i~~.:
~~,
~.~~t
:~~~:
. ~
fUlIll 1040 11~~61
, .
fOlm 10-10 118MI
Tax
Compu-
tation
II you want
III. IRS 10
I'll'" yOUI
lax. ... th.
IIIIlruCllonl
'01 "". 37.
Credits
43
44
45
45
47
48
40
150
81
Payments 82
53
84
Other
Taxes
An.ch
FOIma W.2.
W-2G. and
1099,A on
thl 'ronl.
Relund
Amount hom 1&l\1II 3 t (idIU'I'~ Y'05l1 Income). . . . . . . . . . . .
C1..ck II: 0 You wll. 6~ or olJo'. 0 el",d: 0 8pou.. was 65 01 oldol. 0 Blond
Add lhl numb., 01 baAt. &;hlllClwlJ above and enl" lhl talil hili.. ~ 33.
II It you III m.wad I~ong IIP.llloly and yOlll lpaull Ilomlu. dlducl....a 01
you Will I dull-llllus .11110. Id' lnll,ucllonl and chick he,. . . ., ... 33b 0
1"lmiUd dlducllonl 11011I Seh.dull A. llno 28. OR
En'" Standard d.ductlon $hown below 101 YOut r~,1n g 1'.luI. But 181 thl
'hi 1OII,u,I.oolll you Chdl;kllllJ MlV 00" on tin. 33. or b Dr IUfneon"
ta'elf nn Clilm you II . '-'Ilpundonl.
~:,.,,: I S"'gl.-S~,OOO . M.wld "ling jolnlly 01 au.lllvlng w,dowlor}-S6,7G0
. Ho.J 0IhOYllllold-$5,900 I M..,lld "ling .lp..a1oly-SJ,J50
8ublrac~ lull 3'" "um hn. 32 . . . . . . . . . . . . . . . .
If bill 32.. '88.47~ Of 1.11. muluplv $2,550 by 'hi 101.1 numb" a. lxemptions clalfnllJ on
line 6d. IIIule 32 .1 Oylf saa,.us, UI me wotkahll' '" tha Inlt. IUI tIl. .moun' to Inlel
Taxabl. mcom.. 5ubt'a~llln. 36 horn hoe 3~. " 160' 36 II mall Ihan hnl 3l:a. Inle, .Q.
T.I. S,"""UUCIlOl1I, ClliCk ,llot.llncludla any I.. 110m . 0 Fo'ml.1881~
b 0 FOIm ~972 , , , , , , . , , . ; . . , , , . , .
CrtdlllOl child and d.p.nO.nl c..ro ..p.nan Mach FOIm 2H 1 39
Crodd lor Ih. Ilddlly OIlh. d,..UliO, Au.ch Sch.dull A .. 40
FOIIlgn I.. CI.d,I, Allach Fo,m 1116 41
Olh... Chick ,'hom 10 Fo,m 3800 ~ 0 F~V:: 83~' "
00 FOIm 8601 dO Fo,m ,spocllyl 42
Add linla 39 111Iough ~2 , , . . . .
Subl,act hoe 43 I,om IIn8 38. II Iird 43 II mal' than bnB 38. 8nle, .0. .
Sill-employment tall. Ana;:" S.:ndiJutlll JE. . . . . . . . .
AUemallYe mimmum la~. ~lIa:~ F.-IIn 6251 .......
SocaalllcUlIIV and MelJiCarel.h;:n lip UlCome not leporti" 10 emptoyer. Anach FJrm ':137
Tax on quallhod retlllmonl plans, Including IRA.. II requir.d, allaeh Falin 5329 .
Advancl t.m.d ,,,com. croO,1 paym,,,"hom FOImla) W.2
HouI.hoId .mploym.nll...., Allacll Sch.dul. H, . .
Add lines U lhfou h 50. ThiS 15 VOllr 101.1 '11 . . . .
Fld..aIlncoml ... Wll/1I1l1d Irorn FOlma W.2 and 1099 , 52
1996 lltunat.d IlIA ~aym."1S ."j jmaunl applied lrom 19i5111um. 53
I..m.d &n,om. 'r.dl\. "':1:1 S':"it:ulll EiC I' you h.Jye. qualll)'lOg "'~'
chold, NonllAaclo '''010 ",,,m., ""cunl ~ I I I ~
and tYPI ~ ......................,.....................,.... 54
Amounl pa~ wllh Form 4868 ,Ul4uost lor 1"lonllon}. .. 55
EKeI.. .oclal IICu/lly end RRTA Ia. wllhh.ld '''"In$I.).. &8
Olll.. p'lm.RIS, Chick ,"Icm . 0 Form 2~J9 II 0 FOIrn 4136 &7
Add lloes ~2 Uuough 51. Thau are our lQe.1 . mlnta . ."
If lint &8lSmOIQ Ihantinl 51, lublrac' line 51 'rom line 58. ThIS illllo amoynl you OVERPAID
Amounl olllnl 59 you w."1 REFUNDED TO YOU. . . , , . , . . . , . ~
~ II Aoullngnumb.. CImID=rJ c Typo: 0 Clllck"'9 0 5"1109"
aa
330
:M
:II
30
37
38
30
40
41
4i
83
50
57
50
50
150.
Ha.... II .Int
dil.clly to
yOUl bank
lecounll Stl
inltendf~in ~ d
6011. c. end d, 81
Amount
You Owe
Sign
Here
Kllp a copy
ollhis "twn
for vour
'Ico,ds,
Paid
Pre parer's
Use Only
P.l~. 2
I 3i
I
br,O
35
()..L/
38
37
-
'" N
'}:~"".
~
38
~~~ ~',,~
s,:,'i,
~~~,:-,~
~~~:
':.~~:~~
~'.."
~~,,~~
..--:.....:s.
~
~3
~~
~5
~.
H
~8
~8
50
51
ii";,
,
I
,
l,>""
~, ".,
E'.\~':'
s~ :.:
~.~~'-;~
.~ ,."
, >....,
5d
59
eo!.,
f"
~~':';:
L,..
t.~:,~~~
Accounl numb..
Amaunl.1 kn.19 au ":In! APPLIED 10 TOUR 1911 ESTlMATlD TAX ~ 51
Ii 111"," 5". mOl' IlIan I"'. 5a, .ublt,cllln. 68 "om I",. 51. ThIS ia Ihl AMOUNT YOU OWE,
FOf deladl on how IQ PlY Inu u:al:l Form 1040-Y, ... "',"ucllon.. . . . . . .'" 82
83 EllimalelJ lall penallV. Allo incluJu on Itne 62. . . . . I 83 I 1~' .~ ~f'.~I.~R~.:'.:~:.~T'~~:::.;~
Undt, pllWllIl 01 IH'IUf), I (ltc'''' In.11 flihe "'~ll\IOtd lhll ,.Iurn and Ktompan~lIl\J .'htdwII 1l\(J r 11'Ill.,nU .s"~ ~: ~". c.,llJl nly "1l0\"I"\J~u .IB.J
bt6I.l. lIl')' ..,lfu.. :OUlCI. aI'Id c:m::I.1I Oacl.Jlilion 01 pllPill" toU", U\oln lolAPilWIIII' b.UJ ;:n.1. "';flll,)I.Ct'l;:' .\r :" p.~JI.' IUS Jr,t ~f10\"hf.JJ"
7
""llHPI i -::>1LlfH.fv'-
ilM1E lFJ.,T ,"t\f\\ t:.\lI\LL'lill:lL-
St:::a.u ,;,,;;..'JI':r.
~ YOUI aovOIIUl.
~
SpUUII"If'olO.IU'I. It 'IO,nI '.....rn 6CTilmuII 11\10.
\
"
PIIP.,.,', ~
lig,l.1lu'. ,
Film', name (01 )'01.111 ~
II sllll-'lmpIOVIlJ! it'd
IdlJIIU
00111
Ch.:.. .
Sfll.....:: ;~.\j
o Punl'ci'on'ICrd.ilfMP"
I P"OJ/III,' SO':..II 'j"II:uhlj 1111
o ,:
E"
:'~ 7;;t
'U S 011..........1 P,.,"..., o",~. I'~'" -WI' '\lJI
,./I""....13"~.J6' 9.07A11
'.1 ...
FRat KE'rSTOIELAlO TRANS 717 73\ \799
,
I
.
SPECIAL WARRANTY DEED
THIS DEED, JIIoae the ~,b( day of April, in the yoar of Our
l.ora One Thousand Nine lIundred ana Ninety-Two (1992)
BETWEEN JOHN C. OREY AND CARO~ S. OREY, partie. of the fir.t
part, GRANTORS (Now Known II enol 8: Berktch)
AND
.
,
THOMAS H. GARLIC AND LISA A. GARLIC, hi. wife, parties or
the second part, GRANTEES
WITNESSETH, that tho Grantors, for and in conuidoration of
the BU. of Eighty-Thrso Thousand rive lIundrod ($83,500.00)
DoUar., lawful 1Il0ney of the United State. of AlllerJ.oa, to the
Grantor. in hand woll and truly paid by the Grantees, at or
before thB .ealing ana dulivery of these presonts, the receipt
whereat i. hereby aCknowledged, and the' Grantor. being therewith
tully .ati.tied, do by the.. pre.ents ,grant, bargain, sell and
convey unto the Grantees torever
ALL that oertain traot or parcel ot land and premises,
lJituate, lying and being in the Town.hip of SWlilalra ill the
County at Dauphin and Commonwealth of pennsylvania, more
particularly bounded and desoribed a. tollows;
BEGINNING at a point on the northern boundary line ot 1I0cker
Drive at a point located on the dividing line between Lot # 15
and Lot # 16 a. .et forth on the hereinatter referred to Plan;
thenoe, along the northern boundary line ot Uocker Drive north
eighty-three (83) degree., twenty-one (21) minut.., twenty-one
(21) s800nds, wost, ninety (90) feet to a point on dividing lina
between Lot , 14 and Lot # 15 as set forth on the hereinatter
reterred to Plan; thence along .aid divldln9 line north six (6)
degree., thirty-eight (38) minutelJ, thirty~nine (39) .econd. ."lIt
ona hunc1red nineteen and fifty-one hunc1r~~t:hlil (119.51) 1'eul; to II
point on the southern boundary line 01' Lot. now or formerly ot
West Shore Plaza, Inc. 1 thanoe along .a.1d lande now or fOJ:mor 1 y
of We.t Shore Plaza, Inc., .outh eighty-three (83) degrees.
P.2
"
t"enty-one (31) mlnute., twenty-on. (21) ..oonds eut ninety (90)
fuot to a polnt on the dlvi~ln9 11n. betv.en Lot I 15 and Lot I
lti a. .et forth on the her.lnafter .entioned Plan uf Lot., thence
a1.on9 aald dividlng llne ao"th six (I) degree., thirty-eight (38)
lIinute., thlrty-nlne (39) .econda welt one hundred ninet.en and
fitty-one hundredth. (119.51) teet to a polnt, belng the plaoe of
BEGINNING.
BEING Lot I 15 on the rlnal .\lbdivldon Plan tor Blaine C. Hocker
and pranoe. E. Hooker, hi. vife, r.vi.ed July 11, 1979 and
re~orde4 in Dauphin county Office of the ~eoorder of Deeds in
ploJ,n Book "P", Volullle 3, p.ge 57. '
,
HA'IIIIG thereon erected . Cape Cod A1uainua dwelllng known and
nunbered aa 10!l0 Hoolcer Drive, HarrhburiJ, PennsYlvania.
BBlIIG TilE SAME pralll... whlch It , MR, INC., a Penn.ylvania
oot~oration, by its deed dated Hay 28, 1982 and reoorded in the
Offioe of the Reoorder of Deeds of Dauphin County in Book a93
pagB 226 granted and oonveyed unto JOHN c. DREY AND CAROL 6.
. DREY, ,GRANTORS herein.
TOGETHER with all and singUlar the buildinga, illprovements,
vay~, woods, waters, watercours.s, rights, libertie., privilegea,
heruditaaents and appurtenances to the .a.. belonging or in
anyw1s. appertaining, and the rever. Ion and reversions, remainder
and rellaindere, rent., i..uea and profita th.r.of, and of ev.ry
part and parcel ther.ot, and al.o all the ..tate, right, title,
intel.eat, use, pos....ion, property, ola1. and demand IoIhlltlloever
ot the Grantors both in law and in .qul~y, ot, in and to the
pr..is.. h.r.in 4e.orlbed and every part and paro.l thoreOf with
the .ppurtenance.. To have and to hold all and eingular the
prelllses herein described together with the hereditaments and
appurtenanoe. unto the Grantee. and to Grantees' proper use and
benefit forever.
\'
I
\
,.r.
...l1d the .aid Granton will warrant specially the property
hereby oonveyed.
\ .
, 12..13-1996 9,~8A1t
.; , ,
FRat KE~Ta'lE l.AlD, TRANS 717 731 1799
P.<1
, ,
In all reterenoes herein to any parties, persons, entities
or oorporation., the use of any partioular gender or plural or
.ingular number is intended to inolude the appropriate gender or
number as the text of the within instrument may require.
Whsrever in this instrument any party shall b. designated or
referred to by name or general referenoe, suoh designation is
intended to and shall have the sa~ etteot a. it the word.
"heirs, executors, admini.tratore, personal or legal
representative., suooessors and aesigns" had bsen in.erted after
eaoh and every suoh designation.
IN WITNESS WHEREOF, the Grantors have hereunto set their
hands and seals the day and year first above written.
WITNESS:
YlA'hA- L t /LeL
J
a,;t ate...
~f~.~Dr~
,loClU(..l ~
aSI Carol S. Bn-kich
COMMONWEALTH OF ~~~
COUNTY OF DAUPHIN )
On this, the 8..tt,day ot April, 1992, betore ms II
Notary public. the undersigned otficer, personally appeared John
C. Dr~y, known to me (or satisfaotorily proven) to be the person
whose name is subscribed to the within in.trument, and
aoknowledged that he executed the same for the purposos therein
contained.
.eal.
IN WITNESS WHEREOF, I hereunto set my hand and offioial
,,' ,
NOTARiAl SEAL
Yll:lllE R. WElKER, NOTARY PUOUC
CAMP HILL BORO. CUMBERlAHD CO,
MY COMMISSION EXI'lRES MARCH 4 1995
YJA',lY.L / ~.JJ~
,
.
, ,
.-
..
DEFINItIONS AND INSTRUCTIONS
(A) Whenever the term "document" is used herein, it includes
(whether or not specifically called for) all printed, typ,ewritten,
handwritten, graphic or recorded matter, however produced or
reproduced and however formal or informal.
(B) Whenever you are asked to "identify" a document, the
following information should be given as to each document of which
you are aware, whether or not you have possession, custody or
control thereof:
(1) The
computer
etc.) ;
(2) Its date (or if it bears no date, the date when it was
prepared);
nature of the document (e.g., letter, memorandum,
printout, minutes,' resolution, tape recording,
(3) The name, address, employer and position of the signer
or signers (or if there is no signer, of the person who
prepared it);
(4) The name, address, employer and position of the person,
if any to whom the document was sent;
(5) If you have possession, custody or control of the
document, the location and designation of the place or file
in which it is contained, and the name, address and position
of the person having custody of the document;
(6) If you do not have possession, custody or control of
the document, the present location thereof and the name and
address of the organization having possession, custody or
control thereof; and
(7) A brief statement of the subject matter of such
document.
2
,-
.
(e) whenever you are asked to "identify" an oral
communication, the following information should be given as to each
oral communication of which you are aware, whether or not you or
others were present or participated therein:
(1) The means of communication (e.g., telephone, personal
conversation, etc.);
(2) Where it took place;
(3) Its date;
(4) The names, addresses, employers and positions
who
participated
in
(a) of all persons
communication; and
(b) of all other persons who were
who overheard that communication;
present during or
(5) The substance of who said what to whom and the order
in which it was said; and
(6) Whether that communication or any part thereof is
recorded, described or referred to in any document (however
informal) and, if so, an identification of such document in
the manner indicated above.
(D) If you can claim that the subject matter of a document or
oral communication is privileged, you need not set forth the brief
statement of the subject matter of the document, or the substance
of the oral communication called for above. You shall, however,
otherwise "identify" such document or oral communication and shall
state each ground on which you claim the such document or oral
communication is privileged.
(E) Whenever you are asked to "identify" a person, the
following information should be given:
3
the
.
, .
(1) The name, present address and present employer and
position of the person; and
(2) Whether the per~on has given testimony by way of
deposition or otherwise in any proceeding related to the
present proceeding and/or whether that person has given a
statement whether oral, written, otherwise, and if so, the
title and nature of any such proceeding, the date of the
testimony, whether you have a copy of the transcript
thereof, the name of the person to whom the statement was
given, where the statement is presently located if written
or otherwise transcribed, and the present location of such
transcript or statement if not in your possession.
(F) The term "you" shall be deemed to mean and refer to the
party to whom these interrogatories have been propounded for answer
and shall also be deemed to refer to, but shall not be limited to,
your attorneys, consultants, sureties, indemnitors, insurers,
investigators, and any other agents insofar as the material
requested herein is not privileged.
(G) The word "incident" shall be deemed to mean and refer to
the incident as alleged to have occurred and as set forth in the
Complaint.
These Interrogatories shall be deemed to be continuing
Interrogatories.
Between the time of your answers to said
Interrogatories and the time of resolution of this matter, if you
or anyone acting in your behalf learns the identity or whereabouts
of other witnesses not disclosed in your answers, or if you obtain
or learn of additional information requested herein, but not
supplied in your answers, then you shall promptly furnish a
supplemental answer under oath containing the same.
4
3. If there were any previous proceedings with reference to
this marriage or its dissolution, or support and maintenance of
either spouse and of any dependent children of this marriage or
their custody and rights of visitation, state (a) date, (b) Court,
(c) names and addresses of attorneys for each party, (d) nature of
determination or other results of each proceeding.
4. with reference to any other marriage, common law or
otherwise, by you, state (a) date and place thereof, (b) name of
your spouse, (c) names, ages and addresses and who has custody of
any dependent children thereof, (d) date, place and reason or cause
of termination or dissolution thereof.
6
5. State the names, addresses and telephone number of your
employers, for the period three years prior to December 31, 1990,
the hours and rate of payor earnings, wages, commissions and
overtime pay, any bonuees, gratuities, expense and drawing accounts
and allowances for transportation and other accommodation9 and
expenses, all pensions, stock purchase options, retirement plans,
insurance, profit-sharing or other benefit plans. If there is a
contract of employment, state the terms thereof or, if in writing,
attach a copy hereto.
7
6. If you are, or have been self-employed or conducted a
business or profession as a sole proprietor, partner or
corporation, state (a) which it is, (b) the nature thereof, (c) the
name, addrees and telephone number thereof. If a partnere;hip, list
the names and addresses of all partners and the extent of their
interest therein. If a corporation, list the names and addresses
of all directors, officers and shareholders, the extent of their
shareholdings and the relationship to you of all partners,
shareholders, directors and officers.
7. with reference to the enterprise set forth in the
proceeding question, state where the books and records thereof are
kept, the name and address of the person in whose charge they are
and the name and address of any accountants and auditors whose
services are used.
B
"
16. Itemize all eharee of stock, securities, bonds, mortgages
and other investments other than real estate in your name or in
which you have OtO had an interest, showing where and in whose name
they aru registered, the identity of each item, its market value,
the amount of dividends or other income paid by each, and the
present location and custodian of all certificates or evidence of
such investments.
17. If during the last eight years you have sold, transferred
or otherwise disposed of any items in questions 12 through 16, or
any interest therein, state which items where so sold, transferred
or otherwise disposed of, to whom, the dates of the transaction and
the consideration received for each.
13
.
18. As to all real estate which you own or owned in which you
have or had an interest, for the last twenty (20) years state (a)
location, type of property and deed references, (b) date of
purchase and price paid, (c) name and address of all co-owners and
the amount of their interest, (d) amount of mortgages thereon, the
balance due thereon, and the name and address of the mortgagee, (e)
if income property, name all tenants or occupants and annual rent
paid by each, (f) itemize operating expenses, including but not
limited to taxes, mortgage payments, insurance, heating fuel, water
and other utilities.
19. If you have sold or otherwise disposed of any real estate
or interest therein in the past eight years, state (a) location and
type of property, (b) date of sale, selling price and original cost
thereof, (c) name and address of purchaser, (d) relationship of
purchased to you, (e) disposition of the proceeds of the sale.
14
20. List all life insurance policies in which you are the
insured or beneficiary showing as to each policy (a) name of
company, face amount and policy number, (b) name of insured.
beneficiary and relationship to you, (c) annual premiuma and who
pays them, (d) present cash surrender value.
21. List any and all property of value, greater than $100.00,
which you hold in trust for anyone, showing (a) nature of the
property and its location and custodian, (b) present value and
original cost of each, (c) the name and address of the person for
whose benefit you are holding the same and that person's
relationship to you, (d) the conditions or terms of the trust, (e)
how such property was acquired and who paid the consideration.
15
22. Itemize your current average monthly living expenses in
detail, including, but not l1mited to, rent, clothing, food,
utilities, telephone, transportation and car, medical and dental,
insurance of any nature, mortgage and other loan payments, taxes
and other regular personal items of any nature.
22a. with reference to your living expenses three years before
your marriage to the plaintiff, Bet forth in detail the same
information as asked in question 122.
16
23. If you contribute to anyone's support or welfare, list
(a) the name and address of those whom you support, (b) their
relationship to you, (c) amount and frequency of support payments,
(d) whether voluntary or by Court order, (e) name and address of
Court and every attorney involved.
22b. with reference to your living expenses during your
marriage to the plaintiff, set forth in detail the same information
as asked ill qU3stion 122.
17
. ,
.
, -
. .,
CER'l'IFICATION
I hereby certify that the copies of the written reports or
complete summaries of any oral reports of t~eating physicians or
expert witnesses, annexed hereto, are exact copies of the entire
written report or reports or complete summaries of any oral report
or reports rendered by them; that the existence of other reports of
treating physicians or expert witnesses, either written or oral,
are unknown to me; and that if such reports become later known or
available, I shall serve them promptly upon the propounding party,
but in no case later than the time prescribed by the court rules.
Date:
service of the within (Interrogatories) (AnSwers) is hereby
acknowledged:
on
,19_
Attorney(s) for plaintiff
on
,19_.
Attorney(s) for Defendant
.
.. . ,
.
. .
." ..
REOUEST FOR PRODUCTION OF DOCUMENTS
If you have not already done so, produce the following:
1. Any and all copies of any documents which reference the
subject matter of this case.
2. All documents or exhibits upon which you intend to rely
at the trial of this case, including exhibits which you will
attempt to introduce.
LAW OFFICE OF THOMAS GOULD
9Y:
Michael s. Travis
2 East Main Street
Shiremanstown, PA 17011
(717) 731-1461
Fax 761-1974
ATTORNEY FOR PLAINTIFF
,
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Dated:
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KENNETH A. BERKICH.
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
vs.
: NO. 96-6037 Civil Term
CAROL S. BERKICH,
Defendant
: IN ANNULMENT
MOTION TO COMPEL DEPOSITIONS
AND NOW, this ~ day of August, 1997, comcs Kcnneth A. Berkich, by and through
his attorney, Michael n. Rentschler, Esquire, who files thc within Motion of which thc following
is a statement:
I. On November 4, 1996, the Plaintiff, Kenncth Berkich, filed a Complaint in Annulment
against Defendant Carol S. Berkich.
2. Aftcr thc Complaint was filed, Mr. Bcrkich filed a Motion to Take the Oral Dcposition
Testimony with Leave of Court. In that Motion, it was rcquested that the dcpositions of John C.
Drey, his son John C. Drey, and Linda DcMann be takcn.
3. On or about June 9, 1997, Defendant Carol Bcrkich filcd an Objection to Plaintiffs
Motion to Take Oral Deposition Testimony with Lcavc of Court.
4. The Defendant stated that it was her bcliefthat thc depositions violate the provisions
of Pennsylvania Rule of Civil Procedure No. 1920,22; that they will harass Mrs. Berkich and hcr
former husband John C. Drey, her son John C. Drcy, and her fricnd Linda DeMann. It was also
statcd that the oral dcpositions would delay thc annulmcnt hearing, prolong the tcmlination of thc
marriage; and would mcrcly scrvc as a "lishing" cxpcdition into Mrs, Berkich's Iifc bcforc shc
married thc Plaintiff, Finally,thc Dcfcndant allcgcs that Pennsylvania Rulc of Civil Proccdurc
No. 400 I. llil:Q.. does not apply to an action for annulmcnt.
5. Plaintiff believes, and therefore uvers,thut Pennsylvuniu Rule ofCivill'roccdure No.
I 920.22(a) spccifically upplies to uctions for unnuhnenl.
6. One of the central issucs pertaining to the annulmentuclion is whether Curol Drey.
now Carol Berkich. wus married to John C. Drey by common luw.
7, The depositions of John C. Drey, the Defendunt's son John C. Drey, und Lindu
DeMunn are u necessary tool to be used in order to uddrcss thc issuc of u common luw murriage.
8. Since the depositions are relatcd and ncccssury to thc issue pertaining to thc
annulment, the ora: depositions will not dclay uny annulmcnt hcaring nor prolong the ultimute
termination of the marriage becausc ifCurol Berkich, formcrly Curol Drey, was married to John
Drey ut the time she exchunged marital vows with thc Plaintiff, thc marriuge would be declared
void or voidable and the issues pcrtaining to divorce uctlon und thc accompanying support action
would be rendered mool.
9. The Plaintiff requests that u heuring bc scheduled to address the Defendant's
objections to his Motion for Oral Depositions with Lcuve of Court.
WHEREFORE, It is respectfully requestcd that this Honorable Court compel the
depositions requested in Plaintiffs Motion to Take Orul Deposition Testimony with Leuve of
Court.
Respectfully submitted,
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MICHAEL D. RENTSCHLER. ESQUIRE
Supreme Court I.D. 1/45836
28 North 32nd Street
Cump Hill, I'A 17011
(717)975-9129
Allo/"lleY.liJI' Kennelh /Jerk/ell
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KENNETlI A, IlERKICIf,
Pl.AINTIFF
IN TilE COURT OF COMMON PEAS
CUMBERl.AND COUNTY, PENNSYLVANIA
v.
No, 96-6037 CIVIL TERM
CAROL S. BERKICIf,
IN ANNULMENT
DEFENDANT
DEFENDANT'S OBJECTION TO Pl.AINTIFF'S MOTION
)"0 TAKE ORAl. nEwsmaN TESTIMONY WITH LEAVE OF COURT
Carol S. Berkich, by her undersigned counsel, objects 10 Plainliffs molion 10 toke oral
deposilionteslimony of John C. Drey, John C, Drey, and Linda DeMann on lhe grounds lhat discovery of
this nature violales the provisions of the Pa. R,C.P. No, 1920.22 (copy of the Rule is attached), These
oral deposilions will harass Mrs, Berkich, her former husband, John C. Drey, her son, John C. Drey, and
her friend, Linda DeMann. Also, these oral deposilions will delay the annulment hearing and prolong,
still further, the ultimate terminalion oflhis marriage. Finally, these oral depositions will merely serve
as a "fishing" expedition inlo Mrs. Berkieh's life before she married lhe Plaintiff.
Furthermore, Plainliff requests this leave of court "pursuant to Pa.R.C.P. 400 I, et. (sic) seq,"
These rules do not apply 10 an action for annulment. A copy of Rule 4001(a)(2) is attached.
WHEREFORE, Defendant objects to Plaintiff's Motion and respectfully request thaI This
Honorable Court deny Plaintiffs MOlion to lake oral deposition of John C. Drey, John C. Drey, and
Linda DeMann,
Respectfully snbmilted
LA W OFFICES OF
DARRELl. N, V ANORMER, JR, & ASSOCS,
Dole: &;-Cf-97
MAY 0 91997tY
KENNBTH S. BBRKICH, I IN THB COURT OF COMMON PLEAS
PLAINTIFF I CUMBBRLAND COUNTY, PENNSYLVANIA
I
V. I NO. 96 - 6037 CIVIL TBRM
I
I
CAROL S. BP:RKICH, I IN ANNULMENT
DEFBNDANT I
ORDER
AND now this 1)'+-\
of the plaintiff's Motion to
day of /'-"~} 1997, upon consideration
Take oral Yeposition Testimony with
Leave of Court, it is hereby ORDERED that a Rule is issued upon the
Defendant to show cause, if any, why Plaintiff'S Motion should not
be granted.
Rule returnable l)j days from date of service. All
proceedings in the matter are stayed pending further order of the
Court.
COURT
\ (L-y (?
. J.
..
.'
MAY 0 91997tr
KBNNBTH S. BBRKICH, I IN THB COURT or COMMON PLEAS
PLAINTIFF I CUMBBRLAND COUNTY, PBNNSYLVAHIA
I
V. I NO. 96 - 6037 CIVIL TZRM
.
I
CAROL S. BBRKIClI, I IN AHWLMENT
DBFENDANT I
ORDBR-GRANTING MOTION
AND NOW this
day of
1997,
upon
consideration of the Plaintiff's Motion to Take Oral Deposition
Testimony with Leave of court, it is hereby ORDERED that Plaintiff
is granted the right to depose John C. Drey Sr., John C. Drey Jr.
and Linda DeMann, pursuant to Pa.R.C.P. 4001 et. seq.
BY THE COURT
J.
.
,
"
KBII1IBTH S. BBRKICH, . IN THE COURT OF COMMON PLEAS
.
PLAINTIFF I CUMBERLAND COUNTY, PENNSYLVANIA
I
V. I NO. 96 - 6037 CIVIL TBRM
.
.
I
CAROL S. BERKICH, I IN ANNULMENT
DEFENDANT I
PLAINTIFF'S MOTION TO TAKB
ORAL DEPOSITION TESTIMONY WITH LEAVE OF COURT
1. On January 22, 1996, Plaintiff filed a Complaint in
Divorce No. 96 - 294 CIVIL TERM.
2. On November 4, 1996, Plaintiff filed a Complaint in
Annulment under Section 3304(a)(1), No. 96 - 6037 CIVIL TERM,
which includes a count of Marital Fraud. A copy of the Plaintiff's
Complaint in Annulment is attached hereto as Exhibit A.
3. The parties have agreed to Stay the action in Divorce
pending the outcome of the Annulment Complaint.
Defendant's Answer, attached hereto as Exhibit B.
Paragraph 13,
4. The Plaintiff alleges in his Complaint for Annulment that
the Defendant is the common law spouse of John C. Drey and could
not have entered into a valid marriage with the Plaintiff.
Plaintiff's Complaint in Annulment generally, attached hereto as
Exhibit A.
5. The Plaintiff wishes to take oral deposition testimony of
John C. Drey.
"
6.
John C. Drey was married to the Defendant between 1968
Paragraph 12, Defendant's Answer, attached hereto as
"
and 1974.
Exhibit B.
7. Plaintiff has alleged in his Complaint that Defendant re-
married John C. Drey between 1980 and 1990. plaintiff's Complaint
in Annulment, generally, attached hereto as Exhibit A.
8. The Plaintiff believes his deposition testimony will
reveal facts that John C. Drey held himself out to the public as
the spouse of the Defendant prior to the Defendant's marriage to
the Plaintiff in 1990.
9. The plaintiff wishes to take oral deposition testimony of
John C. Drey, Jr., son of the Defendant and John C. Drey.
10. The Plaintiff believes his deposition testimony will
reveal facts that John C. Drey held himself out as the spouse of
ths Defendant at all times relevant.
11. The plaintiff wishes to take oral desposition testimony
of Linda Deman.
12. Linda Demann was a neighbor of the Defendant between 1980
and 1990.
13. The plaintiff believes her deposition testimony will
reveal facts that John C. Drey ,and Defendant held themselves out to
the public as common law husband and wife between 1980 and 1990.
14. Under Pennsylvania law, the Defendant could not be
married to the plaintiff due to the prior existing common law
marriage between Defend~nt and John C. Drey.
(
(
KENNETH A. BERKICH,
PLAINTIFF
IN THE COURT 01" COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
V.
I
I
I
I
I
I
I
NO. 96 - W137
CIVIL TERM
CAROL. S. BERKICH,
DEFENDANT
IN ANNULMENT
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YOU HAVE BEEN SUED IN COURT. If you wish to defend ~a~st
the claims set forth in the following pages, you must take pr~pt
action. You are warned that if you fail to do so, the case may
proceed without you and a decree of divorce or annulment may be
entered against you by the Court. A judgment may also be entered
against you for any other claim or relief requested in these papers
by the Plaintiff. You may lose money or property or other rights
important to you, including custody or visitation of your children.
NOTICE TO DEFEND AND CLAIM RIGHTS
When the ground for is indignities or irretrievable breakdown
of the marriage, you may request marriage counseling. A list of
marriage counselors is available in the Court Administrator's
Office, Fourth floor, Cumberland County Courthouse, Hanover and
High Streets, Carlisle, Pennsylvania.
IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY,
LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED,
YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Court Administrator
Cumberland County Courthouse
Fourth Floor
Hanover and High Streets
Carlisle, PA 17013
(717) 697-0371 EAt 6200
TRUE COPY FROM RECORD
In Tesllmony whereof, 1 here unlD set my hand
and the seal 01 said COIl>> at Carlisle. Pa,
Thih~:( ~ 1)1' ~~' ,:19Qb
\. a ~; L-t'fjF
, Prothonotary
Exhibit ^
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KENNETH A. DERKICH, I IN THE COURT OF COMMON PLEAS
PLAINTIFF I CUMBERLAND COUNTY, PENNSYLVANIA
I
V. I NO. - 1996 CIVIL TERM
I
CAROL S. BEMICK, I IN ANNULMENT
DEFENDANT I
COMPLAINT UNDER SECTION 3304(a)(1)
FOR ANNI1LMENT
1. The Plaintiff is Kenneth A. Berkich, who resides in
Cumberland County with a mailing address of P.O. Box 961,
Mechanicsburg, Cumberland County, Pennsylvania 17055.
2. The Defendant is Carol S. Berkich, who resides at an
unknown location with a mailing address of P.O. Box 3315,
Shiremanstown, Cumberland County, Pennsylvania 17011.
3. The plaintiff and Defendant have been bona fide residents
of the Commonwealth of pennsylvania for at least six months
immediately prior to the filing of this Complaint.
4. The Plaintiff and Defendant were married on December 31,
1990 in Tarrant County, Texas.
5. At the time of such marriage Defendant had remarried by
common law, her first husband, John C. Drey, and said marriage had
not been annulled nor had there been a divorce.
6. John C. Drey is still alive.
7. During her second marriage to John C. Drey, Defendant
held herself out to the public and signed legal documents,
incl uding real property owned by the entireties, as "Carol S.
Drey."
"
(
(
8. Prior to the December 31, 1990 marriage to Plaintiff,
Defendant signed an affidavit in Texas stating that she was not a
married woman.
9. Defendant used the name "Carol S. Drey" when she applied
for employment at the River Rescue as an EMT in Harrisburg,
Pennsylvania on or about 1988.
10. Defendant purchased a house as the wife of John C. Drey.
11. While living with John C. Drey as husband and wife,
Defendant received Teamster's health and medical benefits as John
C. Drey's wife until 1990.
12. At the time of the marriage to Defendant and until after
the parties separated, Plaintiff did not know of the prior second
marriage by Defendant to John C. Drey.
13. There was a prior Divorce Action filed by Defendant,
between the parties, 2282 Civil 1992, in Cumberland County which
was dismissed by order of court on October 10, 1995. There is
currently an action filed by the Plaintiff, pending in Divorce, 294
Civil 1996, which shouLd be stayed pending the outcome of this
Complaint in Annulment. There are no other pending actions of
divorce or annulment between the parties in this or any other
jurisdiction.
14. Because the Defendant had not annulled or obtained a
Decree In Divorce in her common law marriage to John C. Drey prior
to entering into the marriage with Plaintiff, the marriage to
Plaintiff is void.
"
"
(
(
15. The Defendant is not a member of the Armed Services of
the United States or any of its Allies.
16. The plaintiff requests that the Court enter a decree of
Annulment.
Count II
Fraudulent Misreprosentation
17. plaintiff hereby incorporates paragraphs 1-16 of its
complaint as if there are set forth in full.
18. Defendant knowingly entered into the marriage with
plaintiff on December 31, 1990 fully aware of her common law
marriage to John C. Drey.
19. Defendant misrepresented to the plaintiff and the Court
in Texas that she was a single woman at the time of the marriage on
December 31, 1990.
20. When Defendant entered into the marriage with Plaintiff
on December 31, 1990 she knew of her prior common law marriage to
John C. Drey and knew that she had held herself out to the public
and signed legal documents as "Carol S. Drey."
21. Defendant's actions were intended to induce reliance by
the plaintiff and the Court.
22. Defendant's misrepresentations induced reliance, whereby
the plaintiff entered into a marriage on December 31, 1990
believing the marriage to be valid.
23. On December 31, 1990 the Defendant entered into a
fraudulent marriage perpetrating a fraud on the Court.
.'
'.'
(
(
.
24. Following the fraudulent 1990 marriage to Plaintiff,
Defendant received approximately $14,000.00 on the sale of the home
she purchased with her common law husband John C. Drey.
25. Upon receipt of the funds on the sale of the home in
paragraph 21, Defendant moved to Texas.
26. After depleting most of the $14,000.00, Defendant
telephoned the plaintiff seeking reconciliation.
27. plaintiff did accept the offer of reconciliation, and
allowed the Defendant to move back into his pennsylvania home.
28. plaintiff spent $60,000.00 for the support and care of
Defendant between December of 1990 and 1995, in the belief that she
was legally married to the Plaintiff.
29. Due to the fraudulent marriage induced by Defendant,
plaintiff suffered damages of loss in property in the amount of
$60,000.00, causing plaintiff to transfer interest in his home to
the Defendant, and to transfer other valuable property rights as
allowed by law to the Defendant as a proximate result of his
reliance on Defendant's claim that she was single and eligible to
marry him.
30. Due to the fraudulent actions of the Defendant, plaintiff
seeks actual damages in the amount of $60,000.00.
31. plaintiff asks the Court to enter an equitable remedy
returning marital property rights titled in Defendant's name to the
Plaintiff, and make a finding that Defendant had no equitable
interest in any of the marital property.
, ;
.
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. '(
WHEREFORE, the plaintiff respectfully
(
I
req~...st
tnis Honorable
Court to grant b.im judgement in his favor and aqainst. the Defendant
tor unliquidated damaqes plus interest, costs of suit and attorneys
tees not in exc..' of $70,000.00, plus equitable r.lIledies includinq
but not limie-d to r.turninq title to lIlaritd property to b.illl, that
tb.e Court make a tindinq that Dehndant b.ad no ine-rest in any
marital property ot the plaintitf" and any otb.er relief the Court
deellls appropriate.
~
~;el S-: Travis
Attorney for plaintiff
IO J 36508
Law Office of Thomas Gould
2 !ast Main Street
Shiremanstown, PA 17011
(717) 731-1461
Fax 761-1974
I ver.l.fy that the statements made int Ms Complaint are true
and correct. I understand that false statements b.erein are made
subject to t~e penalties of 18 pa. C.s. 54904, relating to unsworn
talsification to authorities.
Date:
/g/;' h~
,
.
"
. " .
-
.
8, Admitted,
9, Admitted,
10, Admitted in part anll denied in part, Defendant did purchase a house with
John C, Drey, She did not do so as his wife, The deed erroneously listed her as his wife. There
was never a mutual intent on the part of Mr. Drey or Defenllant to be husband and wife after her
divorce from John Whalen in 1981.
II, Denied, Proof Is demanded at trial. By way of further explanation, it was
Mr, Drey's responsibility to terminate Defendant's coverage under his Insurance, lie failed to
notify the carrier In 1975 that he and Defendant were no longer married,
12, Denied, It is denied that Defendant married John C, Drey a second time
so there was nothing for the Plaintiff to know, Furthermore Plaintiff did know that Defendant had
been married to John C. Drey from 1968 to 1975, that they were divorced, and that they were
merely living together,
13, Admitted,
14, Denied, It is denied because there was never a common law marriage
between Defendant and John C. Drey,
15, Admitted on information and belief,
16, Denied, As there was a legal marital status between the Plaintiff and
Defendant, an annulment would be inappropriate, Only an Action in Divorce would terminate
such a legal status,
WHEREFORE, the Defendant respectfully requests this Court to deny Plaintiff's
Petition for Annulment.
"
. "
. 'I. -
MSW~R.JO_CQMI'I ,A I t'LU/'mI3R..c.Q.\.IlfLlI:
I'RAULJULENT MISREPRESENTATION
17. Admitted on Information and belief,
18, Denied, It is denied that Defendant entered Into a common law marriage
with John C. Drey.
19. Denied. There was no misrepresentation of her single status hecause she
was single at the time of her marriage to Plaintiff.
20, Denied in part and admitted In part. It is denied that Defendant el1lered Inlo
a common law marriage with John C, Drey, It is admitted that she held herself out and signed
documel1ls, legal and otherwise, as "Carol S, Drey" because that was her legal name as of January
1981.
21. Denied, It is denied that Defendant intended to induce reliance on the part
of the Plaintiff or the Court.
22, Denied, It is denied that Defendant perpetrated a misrepresentation, In fact
she was legally single at the time of her marriage to Plaintiff.
23, Denied, It is denied that Defendant entered into a Fraudulent marriage on
31 December 1990. Her marriage to the Plaintiff was entered into without any impedimel1ls.
24. Denied in part and admitted in part. It is denied that her 1990 marriage to
the PlaintiFF was Fraudulent; it is also denied that John C, Drey was her commrm law hushand,
It is admitted that she received approximutely $14,000 From the sale of the property she and Mr,
Drey held as tenants in common, The ngure represents 50% of the sum realized on the sale of
the house,
25, Admitted,
,"
III " .
-
-
I' 't ..
.-,-....
26. Denied, [t is denied that Defendalll allcmpted a reconciliation with the
Plaintiff, In fact he approached her in a move for reconciliation.
27. Denied. After Plaillliff approached Defendant about reconciliation. she
accepted and moved back into their home in Pennsylvania,
28, Admilled on information and belief,
29, Denied. It is denied that Defendant induced a fraudulent marriage. Any
transfer of property rights or other interests were the results of their lawful marriage.
3D. Denied, It is denied that Defendant commilled any fraudulent actions out
of which the Plaintiff could have suffered actual damages.
31. Denied, Defendant has an equitable interest in any and all marital property
arising from her lawful marriage to the Plaintiff,
WHEREFORE, the Defendant respectfully request that the Plaintiff's request for
damages plus interest, costs of suit and allorneys' fees, and other equitahle remedies and relief
be denied,
Respectfully submilled
LAW OFFICES OF
DARRELL N, VANORMER, JR, & ASSOCS.
BY:
DAR N, Vf\NORMER,
1.0.#22046
Allorney for Defendant
344 South Market Street
E1izabethtown, PA 17022
(717) 367.6831
KENNETH A. BERKICH, I IN TKE COURT OF COMMON PLBAS
PLAINTIFF I CUMBERLAND COUNTY, PEHHSYLVANIA
I
V. . NO. 96 - 6037 CIVIL TERM
.
I
CAROL S. BBRKICH I IN ANNULMENT
DBFENDANT I
NOTICB OF SERVICE OF
FIRST SBT OF INTBRROGATORIES AND
REQUESTS FOR PRODUCTION OF DOCUMENTS
DIRECTED TO DEFENDANTS
TO THE PROTHONOTARY:
Please take notice that an original and two copies of
plaintiff's First Set of Interrogatories and Requests for
production of Documents directed to Defendants were served upon
Darrell N. VanOrmer, Jr., Esq., 344 S. Market Street,
EliZabethtown, PA 17022.
LAW OFFICE OF THOMAS GOULD
,- --'-"
'-~----~
M chael S. Travis
2 East Main str.eet
Shiremanstown, PA 17011
(717) 731-1461
Fax 761-1974
ATTORNEYS FOR PLAINTIFF
Dated:
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[N THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYL V AN[A
Kenneth A. Berkich, Plaintiff
v,
Carol S, Berkich. Defendant
No, 96-6037
[n Annulment
ORDER
AND NOW, this
day of
, [99_. upon
consideration of the motion by Defendant, Carol S, Berklch. for a protective order and Plaintiffs
answer thereto, it is hereby ordered that Plaintiffs notice of the depositions of Harris Savings Bank.
Teamster Local Union 776, and River Rescue of Harrisburg. scheduled for March 24, 1997, are
vacated, and Plaintiff is precluded from further deposition discovery on the matters specified in the
notices and from any discovery of Harris Savings Bank, Teamster Local Union 776, and River
Rescue of Harrisburg, except upon further application to and order of the Court,
By the Court:
j,
4,1996,
6, They arc not divorced and the marriage has not been annulled,
7, Defendant answered the Complaint in Divorce and filed New Motter requesting
Equitable Distribution, Alimony. Alimony Pendente Lite, Counsel Fees, Costs and Expenses on
December 24, 1996, Defendant's Answer was filed under Docket Number 96.294,
8, Defendant answered the Complaint in Annulment on December 20, 1996, In her
answer Defendant denied Plaintiffs avenncnts that at the time of her marriage to Plaintiff, or at any
time, she was the common law wife of John Drey, Plaintiffs Answer was filed under Docket
Number 96.6037.1
9, Plaintiff submitted Interrogatories to the Defendant under the Annulment Docket
Number of96.6037 on January 13, 1997,
10, Defendant answered the Interrogatories under the Annulment Docket Number of96.
6037 on March 12, 1997, Defendant answered the Interrogatories as a courtesy extended to her
husband and in a good faith attempt to bring this whole matter to 0 close.
11. Plaintiff has subpoenaed Harris Savings Bonk of Harrisburg, Pennsylvania to be
deposed on March 24, 1997 under the Annulment Docket Number of96.6037, The subject matter
of the deposition is to discover specifically any affidavits mode which show that Defendant was
married to John Drey at the time she and Mr, Drey applied for a mortgage from Harris Savings Bunk,
Such subject matter does not relate to Defendant's request for equitable distribution or alimony
mode in her Answer to Plaintiffs Complaint in Divorce filed on December 24, 1996 under Docket
Number 96-294, See Exhibit "An,
12, Plaintiff has subpoenaed Teamster Local Union 776 of Harrisburg, Pennsylvania to
2
be deposed on March 24,1997 under the Annulment Docket Number of 96-6037, The subject
matter of the deposition is to discover specifically W1Y statements which show that between 1981 and
1989 Defendant was married, Such subject matter does not relate to Defendant's request for
equitable distribution or alimony mode in her Answer to Plaintiffs Complaint in Divorce filed on
December 24, 1996 under Docket Number 96-294, See Exhibit "S",
13. Plaintiff has subpoenaed River Rescue of Harrisburg located in Harrisburg,
Pennsylvania to be deposed on March 24, 1997 under the Annulment Docket Number of96-6037.
The subject matter of the deposition is to discover specifically any statements which show that
between 1987 and 1989 Defendant was married, Such subject matter does not relate to Defendant's
request for equitable distribution or alimony mode in her Answer to Plaintiffs Complaint in Divorce
filed on December 24, 1996 under Docket Number 96-294, See Exhibit "C",
14. Under the Pennsylvania Rules of Civil Procedure 1920-22, discovery in an action of
divorce or annulment is prohibited unless (0) it is authori71:d by a special court order or (b) there is
o claim for alimony or distribution of property rights,
15, Plaintiff has not received authorization for discovery by 0 special court order,
16, Subject matter requested by Plaintiff in his depositions of Harris Savings Sank,
Teamster Local Union 776, and River Rescue of Harrisburg has no relationship to Defendant's
request for alimony or distribution of property rights,
17, Defendant's request for alimony and equitable distribution was made under an action
for divorce,
18, Plaintiffs request for depositions were made under an action for annulment in which
no claims for alimony or equitable distribution were mode,
3
19. For the foregoing reasons, Plaintiff should be precluded from taking depositions ITom
Harris Savings BIIllk, Tellffister Local Union 776, and River Rescue of Harrioburg,
20, In the IIlternative, if depositions lITe allowed, the captions for the Subpoena ll/ld the
Notice of Records Deposition for the three (3) pllTlies deposed should be lIffiended to reflect the
Complaint in Divorce and filed under Docket Number 96.294,
WHEREFORE, Defendllllt, Carol S, Berkich, respectfully requests that this Court enter an
order immediately staying the scheduled depositions of Harris Savings Bank, Tellffister Local Union
776, ll/ld River Rescue of Harrisburg, In the alternative, Defendll/lt requests that this Court require
that Plaintiff to lIffiend the captions of the Subpoena ll/ld the Notice of Records Deposition for the
three (3) pllrlies deposed to reflect the Complaint in Divorce ll/ld file under the Docket Number of
96-294,
Respectfully submitted
LAW OFFICES OF
DARRELL N, V ANORMER, JR, & ASSOCS,
Dated: tJ)u/rn..
I
BY: /4 4-~11 ~ ~ Ik
DARRELLN, VANORMER,JR, 'f/"
1.D,#22046
Attomey for Defendll/lt
4
VERI FICA TION
DARRELL N. V ANORMER, JR,. ESQUIRE, being duly sworn according to law, disposes
and states that he is the attorney for the Defendant; that he is authorized on behalf of the Defendant
to mAke this Motion; that this Motion is made by him and not the Defendant as he is more familiar
with the subject matter of the Motion; and that the avennents contained in the attached Motion are
true and correct to best of his knowledge, infonnation, and belief. The undersigned understands that
the statements made therein are made subject to the penalties of 18 Pa, C,S. ~ 4904 relating to
unsworn falsification to authorities.
OK
~
..---
~lmIT "A"; I\1lcJl 1 of 2
RECEIVED MAR 1 5 1997
&J
;
LAW OFFICE OF THOMAS D. GOULD
THOMAS D. GOULD
MICHA!L S, TRAVIS'
a EAST MAIN STREET
SHIREMANSTOWN.PA 17011
(717) 731.'411
FAX 701,1814
.AOUlnlO NlW ""IaY IAA
'March 14, 1997
Harris Savings Bank
Attention I Records Custodian
Second and Pine Streets
P.O. Box 1711
Karrisburg, PA 17105
REI Berkich v. Berkich, No. 96-6037
Dear Sir or Madaml
Our firm represents the Plaintiff, Mr. Berkich in the above-
referenced action. Part of the case involves documents completed
by Mrs. Berkich, then named Mrs. Carol S. Drey, and her then
husband John C. Drey. They obtained a mortgage through your bank
dated May 28, 1982, a copy of whicb. is enclosed. We are requesting
documentation of the mortgage application and all ancillary
documents signed at that time, specitically any affidavits that
they were married at that time. Therefore, I have enclosed with
this letter a Records Subpoena for the purpose of obtaining
complete single sided, legible copies of the document(s) described
in the Subpoena.
You may comply with the obligations of the Notice of Records
Deposition and Subpoena by mailing complete copies of the records
to my oftice, to the direct attention of myself, before March 24,
1997. This would obviate the necessity of your personal appearance
or that of a delegate at the deposition which is to be held at
these offices on March 24, 1997, at 1:00 p.m.
./
EXHlBIT "A"; Pal:l' 2 of 2
Please note that in order to be complete, the attached
Aftidavit must be properly signed and notarized. If you have any
que.tions reqarding this obligation and complying with the Notice,
please feel free to contact me at your earliest convenience. We
will be happy to arrange for reimbursement of reasonable costs of
reproduction.
Sincerely,
LAW OFFICE OF THOMAS GOULD
<=--
~-
Michael S. Travis
Attorney for Plaintiff
-
MS'l'/lmg
Inc.
pC.'.iid~~\barr.fi"N'{: vanormlr
EXHIBIT ''ll''; ~ .1 or 2
---
LAW OFFICE OF THOMAS D. GOULD
G
THOMAS D. GOULD
MICH.4IL S. TRAVIS'
2 EAST MAIN STREET
SHIREMANSTOWN.PA 11011
1111) 731,146\
fAX 76H914
',,*"10 NlW ARIIY 1M
March 14, 1997
Teamsters Local Union 776
2552 Jefterson Street
Harrisburg, PA 17110
REI Berkich v. Berkich, ~o. 96-6037
Dear Sir or Madaml
our firm represents the plaintiff, Mr. Berkich in the above-
reterenced action. Part of the case involves documents completed
by Mrs. Berkich, then named Mrs. Carol S. Drey, and her .then
husband John C. Drey. She obtained insurance through your
organization between 1981 a,nd 1989. We are requesting
docUlllentation of th.e insurance application and all ancillary
dOCUlllents signed at that time, specifically any statements that she
was married at that time. Therefore, I have enclosed with. this
letter a Records Subpoena for the purpose of Obtaining complete
single sided, legible copies of the docUlllent(s) described in the
Subpoena.
You may comply with the obligations of the Notice of Records
Deposition and Subpoena by mailing complete copies of the records
to my office, to the direct attention of myself, before March 24,
1997. This would obviate the necessity of your personal appearance
or th.at of a delegate at the deposition which is to be held at
these officas on March. 24, 1997, at 2:00 p.m.
-
'c
-
EXHIBIT "8"i, Pal!Jl 2 of 2
//
/
..-
Please note that in o~der to be complete, the attached
Affidavit must be properly signed and notarized. If you have any
questions regarding this Obligation and complying with the Notice,
plea.e feel free to contact me at your earliest convenience. We
will be happy to arrange for reimburse~ent of reasonable costs of
reproduction.
Sincerely,
LAW OFFICE OF THOMAS GOULD
c-
Michael S. Travis
Attorney for Plaintiff
I
MS'l'/lmg
Bna.
p..........lla..IDaJ:J:'.1l;.H.~,VlU10J:1ll."" .
E>>IIBIT "C"i I'lI3l 1 of 2
~
LAW OFFICE OF THOMAS D. GOULD
LtJ
THOMAS D, GOULD
M1CHAl!L S. TRAVIS'
a eAST MAIN STREeT
SHIREMANSTOWN,PA 17011
(7171 73\,14al
FAX 78\011174
,.00,,"10 HlW JIIIIIV "'"
March 14, 1997
River Rescue of Harrisburg
1119 S. Cameron Street
P.O. Box 2008
Harrisburg, PA 17105
REI Berkich v. Berkich, No. 96-6037
Dear Sir or Madaml
Our firm represents the plaintiff, Mr. Berkich in the ahove-
referenced action. Part of the case involves docUlllents completed
by Mrs. Berkich, then named Mrs. Carol S. Drey, and her then
husband John C. Drey. She made application for employment with
River Rescue between 1987 and 1989. We are requesting
docUIlIentation of the employment application and all ancillary
docUIlIonts signed at that time, specifically any statements that she
was married at that time. Therefore, I have enclosed with this
letter a Records Subpoena for th.e purpose of obtaining complete
single sided, legible copies of the docUIlIent(s) described in the
Subpoena.
You may comply with the obligations of th.e Notice of Records
Deposition and Subpoena by mailing complete copies of the records
to my office, to the direct attention of myself, before March 24,
1997. This would obviate the necessity of your personal appearance
or that of a delegate at the deposition which is to be held at
these offices on March 24, 1997, at 1130 p.m.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. I'ENNSYL VANIA
KENNETH A, BERKICH,
PlaintilT
v,
CAROL S, BERKICH.
Defendant
No, 96-6037
In Annulment
CERTIFICATE OF SERVICE
AND NOW. this :l..C>~ day of ~.......&-
,1997 I. Allen D, Moyer.
Law Clerk for the Law Firm of Darrell N, VanOnner. Jr" & Associates, hereby certify that I have.
this day, served a true and correct copy of the Motion of a Protective Order and Stay upon the
persons indicated below by depositing a copy of same in the United States Mail. first class postage
pre-paid, at Carlisle. Pennsylvania. addressed as follows:
Michael S, Travis, Esquire
2 East Main Street
Shiremantown, PA 17011
BY~"~A~
ALLEN D, MOYER