HomeMy WebLinkAbout97-00035
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IN
THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
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STATE OF
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ELIZABETH K. POTTER,
Plaintiff
;'\(1.97-0035 CIVIL TERM II)
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SCOTT A. POTTER,
Defendant
DECREE IN
DIVORCE
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ANDNOW......jV~.k......... 19~,., it is ordered and
decreed that ...
. . .ELI~A~ETJ:I~. pOTrER
, plaintiff,
defendant,
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and. . . . . .. . . . . . . . . . . . . SCOTT .A.. .PO'l'rER. . . .
are divorced from the bonds of matrimony.
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The court retains jurisdiction of the following claims which have
been raised of record in this action for wh ich a final order has not yet
been entered;
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No. issues. are outstanding " .All. issues. have. been .resolved .and. Bettled. by, the
PHties'. .MilHi<ilge.SettlementA\lfeementllated.Jl1tll': ~,.l~~~,. Ulep. of.. .reco.r.d. and ~
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incorporated but not merged into this Decree.
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financial and property rights and obligations as between each other
including, without limitation by specification: the settling of all
mat ters between them relat ing to the ownership and equi table
distribution of real and personal property; the settling of all
matters between them relating to the past, present and future
support, alimony and/or maintenance of Wife by Husband or of
Husband by Wife; and in general, the settling of any and all claims
and possible claims by one against the other or against their
:,
respective estates,
NOW, THEREFORE, in consideration of the premises and mutual
promises, covenants and undertakings hereinafter set forth and for
other good and valuable consideration, receipt of which is hereby
acknowledged by each of the parties hereto, Wife and Husband, each
intending to be legally bound hereby, covenant and agree as
follows:
1 . INCORPOR.A'l'IOlLOF.J>REAMBLEl
The recitals set forth in the Preamble of this Agreement
are incorporated herein and made a part hereof as if fully set
forth in the body of the Agreement.
2. AGRE~AR TO DIVORCE PROCEEDINGS,
This Agreement shall not be considered to affect or bar
the right of Husband and Wife to an absolute divorce on lawful
grounds if such grounds now exist or shall hereafter exist or
to such defense as may be available to either party.
This
Agreement is not intended to condone and shall not be deemed
to be condonation on the part of either party hereto of any
act or acts on the part of the other party which have
DIANE G. RAIl('I.IFF
].148 TRINIlI.E R()'\1l
CAMP 1111.1.. PI\ 1701 I
PIIONE: (7171 7.\7-11100
F/\X: 0171975 (lun
Page 2 of 22
occasioned the disputes or unhappy differences which have
occurred or may occur subsequent to the date hereof,
3. DIVORCE DECREE.
The parties acknowledge that
their marriage
is
irretrievably broken and that Wife will secure a two year
separation non-consent no-fault divorce decree in the above
captioned divorce action, without any contest from Husband,
If Husband's in any way contests the entry of the divorce
decree or otherwise takes any action to prevent Wife from
securing the entry of that decree on June 11, 1999 or in the
event Wife fails or refuses to finalize said divorce, said
failure or refusal shall be considered a material breach of
..
this Agreement and shall entitle the other party at his or her
option to terminate this Agreement.
4. EFFECT OF DIVORCE DECREE:
Unless otherwise specifically provided herein, this
Agreement shall continue in full force and effect after such
time as a final Decree in Divorce may be entered with respect
to the parties.
5. AGREEMENT TO BE INCORPORATED IN DIVORCE DECREE.
The terms of this Agreement shall be incorporated into
any Divorce Decree which may be entered with respect to them.
6. ~RGERt
This Agreement shall not merge with the Divorce Decree,
but rather, it shall continue to have independent contractual
significance and each party shall maintain their contractual
remedies as well as court remedies as the result of the
DIANE G. R,\IlCI.IIT
3448 TRINIlI.I. RO,\1l
CAM!' I ilL!.. !'A 17011
!'1I0NE: (7J7J 7.17011M)
FAX; 17171 t)7~(}(ltJ7
Page 3 of 22
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10. nNANCIAL-DISCLOSUREL
,
The parties confirm that each has relied on the
substantial accuracy of the financial disclosure of the other,
as an inducement to the execution of this Agreement and each
party acknowledges that there has been a full and fair
disclosure of the parties' marital assets and debts and the
parties' respective incomes, which has been provided to each
party.
11. DISCLOS
OCE.lll1RAILlUGHTS...:.
Each party understands that he or she has the right to
obtain from the other party a complete inventory or list of
all of the property that either or both parties own at this
time or owned as of the date of separation, and that each
party has the right to have all such property valued by means
of appraisals or otherwise. Both parties understand that they
have the right to have a court hold hearings and make
decisions on the matters covered by this Agreement.
Both
parties understand that a court decision concerning the
parties' respective rights and obligations might be different
from the provisions of this Agreement.
Each party hereby acknowledges that this Agreement is
fair and equitable, that it adequately provides for his or her
needs and is in his or her best interests, and that the
Agreement is not the result of any fraud, duress, or undue
influence exercised by either party upon the other or by any
other person or persons upon either party.
Given said understanding and acknowledgment, both parties
hereby waive the following procedural rights:
DIANE O. H.,\I>CI.IFF
J~IRml~I>I.I'R()"I>
r"~.fI' 11l1.L. 1'/\ 17ull
PHONE: 171717.\70100
1:,\:\: (717JI}7~lIm7
Page 5 of 22
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a. The right to obta in <In i nvelllol y dlld dpI"d Ill' 'III' 'III ," d I I
marital and sepilrate prop"I'ty dll d,'1 tll"d I,y I h"
Pennsylvania Divorce Code,
b.
The right to obtain an illcom" ,1Ild "XI"'lll,e III "I I'm"1I1 ",
the other party as provided by I: he l't'"IHY 1 V,1I1 I d IJ I VI HI',.
Code, except in instances where lIuch "" IIII'I,m,' "lid
expense statement is het-eafte;r l'equIl'l'd I(J bl' 111,.d III
any child support ilction or allY (JI hl'l' I'r,)I'",'d i II'JIl
pursuant to an order of court,
The right to have any dincovelY ;\11 m,IY I", l"'llId t.I "d by
the Rules of Civil Pt-ocedure, except dIIlCOV"IY ,lIillln'l
out of a breach of thi s Agre;e;melll, Ollt 01 dllY r'll I I d
support action, or out of any Otllt'l' ploe",'dlll'lll III which
discovery is specifically ol-den,d by till' CIlllrt ,
The right to hilve the court d"tenninl' whir'll PUJI"'lty III
marital and which is non-ln"I'it.I1, ,1Ild "ljllildbly
distribute between the partie:! lh"l I'1"1"'II:y which th"
court determines to be marital,
c.
d.
e. The right to have the COllrl: (Ji.'cirlf,' "llY uth"I' t'19htll,
remedies, privileges, or obI I 'FIt 101m cov"l-ed by this
Agreement, including, but not 1 imiu'd to, pOlllllble claims
for divorce, spousill support, alimony, <lljmony pendente
lite (temporary illimony), counllel I ""II, COHlI! and
expenses.
12.
BANKRI1l'ICY :
The parties hereby agt'ee that the pnJVilliOlHl of this
Agreement shall not be diflchan1""ble in b.l/lknlptcy and
expressly agree to reaffirm any and ,11 lobI iCJdl: iOllfJ contilined
herein,
In the event a party f i l,'n nuch bankruptcy and
pursuant thereto obta inB a d i ncha I'<Je of .1IlY obI igat ions
assumed hereunder, the otllt'r pdny Hha 11 hdve; the right and
option to declilre thin Agn",m('nt to be nllll and void and to
terminate this Agreeme;nt ill which "vt'nt I:he division of the
parties' marital assetn and all otlWl' rights determined by
this Agreement shall be; nubject 1:0 court determination the
same as if this Agreement had nevet- been entered into.
DIANE G, RADCLIFF
3448 TRINDl.E ROAD
Cr\~fIlIIlLL. I'A 1701 J
PHONE, <7171 737,1111"
FAX; OI711J75.0{1l)7
Pdqe (j of
22
13. SQ.CIAL-BEC11RI'rLBENEFlTSl
,
The parties agree that subject to the rules and
regulations of the Social Security Administration, each of the
parties shall continue to be eligible for Social Security
benefits to which he or she would ordinarily be qualified as
a party to a divorce after a marriage of ten (10) years or
more in duration, if the parties' marriage is determined to be
of ten (10) or more years in duration.
14. INCOME TAX MATTERSi
The parties have heretofore filed joint federal and state
returns, Both parties agree that in the event any deficiency
in federal, state or local income tax is proposed, or any
assessment of any such tax is made against either of them,
each will indemnify and hold harmless the other from and
against any loss or liability for any such tax deficiency or
assessment therewith. Such tax, interest, penalty or expense
shall be paid solely and entirely by the individual who is
finally determined to be the cause of the misrepresentations
or failure to disclose the nature and extent of his or her
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separate income on the aforesaid joint returns.
15. PERSONALJUGH1'.S...t
Husband and Wife may and shall, at all times hereafter,
live separate and apart. They shall be free from any control,
restraint, interference or authority, direct or indirect, by
the other in all respects as fully as if they were unmarried.
They may reside at such place or places as they may select.
Each may, for his or her separate use or benefit, conduct,
carryon and engage in any business, occupation, profession or
DIANE G, RADCLI!'!'
3448 TRINDlE ROAD
CAMP lUll, PA 17011
PIIONE, (7171 737,lI1lMI
FAX: 017,1)75-0(,97
Page 7 of 22
DIANE G, RADCUFI'
3448 TRINDlE RO,\))
CAMP IlIll, I'A 171111
PHONE: (7171737,111("
FAX: (717) 975-ll6l)1
employment which to him or her IlhlY :]e"1II ddv I lldbl ("
lIusband
and Wife shall not molest, h<l I'dllll , dilltl1rb or lIIalign each
other or the respective falllil ien of ",1('h othl'l- nOl' compel or
at tempt to compel the ot lH'r to coh,\b i t 01' dwe II by any means
or in any manner whatnoevel- with hilll 01- Ilt,r.
16. MUTUAL RELEASESI
Husband and Wife ",ll'h do h"l eby IIIlltl1,tlly remise, release,
quitclaim and [oreve'I' di'lC'hdl'l" ) h., olllt!J' ,Ind the estate of
such other, fot- ,11 1 ) 111I" ) 0 ,""Il", dnd for all purposes
whatsoever, of and f 1011I dllY dnd 01 I 1 1 l'Iht
tit Ie, interest
and/or claims in or d'ldlnlll III" ,d h"l pdl'ty, the property
(including income and '101111 11""II"')I"'rty IlPreafter accruing)
of the other or CI'Jainlll I h,' 1'111011" ,,r III1<.'h other, of whatever
nature and whereno"v,'1' 1111110111', which h., 01' she now has or at
any time hereaftel- IIIdY bdv" 01'10111111) lIl1ch other party, the
estate of such oth..1' 1'011'1 y or ) h" pl'operty of the other party
or any part thereof, wh,,) Ite 1 ,'I'i II i n'J out of any former acts,
contracts, engagement II 01 I I ,lili 1 it jell o[ such other or by way
of dower or Cl1rtlley, 01 ,'}'limll in the nature of dower or
curtsey or widow'lI 01 wldllw"I"1I I'iqhts, family exemption or
similar allowancl', III 11I1't.,1' lilt, illtestate laws, or the right
to take a'Ja i 11II1 t h,' "1'01111'" II wi II; or the right to treat a
lifetime conv"Ydn"" by I h., othel' an testamentary, or all other
right" 01 01 1l\llvivill'l IIpOlllle to participate in a deceased
npouIII"1I 1'111011.', wh"lh"I' dl'iuing under the laws of (a) the
COllllllonw"dlth "I 1"'llllllylvdnia,
(b) State, Commonwealth or
Tl'ITiIOl'y,,1 Ih" llnil.l.d States, or (c) any other country; or
Clny l'iqhtll which eitlwr party may have or at any time
P'lqe B of 22
OII\NE (j. RADCI.1H:
JHR TRISD!.E IlOAD
CAMP IIILl.. PA 111111
PIIO:"'E: 017) 7.H.lllOll
I:AX: \717lln~'U(11J7
hereafter have for past, present or future support or
maintenance, alimony, alimony pendente lite, counsel fees,
equitable distribution, costs or expenses, whether arising as
a result of the marital relation or otherwise, except, and
only except, all rights and agreements and obl igat ions of
whatsoever nature arising or which may arise under this
Agreement or for the breach of any provision thereof. It is
the intention of Husband and Wife to give to each other by the
execution of this Agreement a full, complete and general
release with respect to any and all property of any kind or
nature, real, personal or mixed, which the other now owns or
may hereafter acquire, except and only except, all rights and
agreements and obligations of whatsoever nature arising or
which may arise under this Agreement or for the breach of any
provisions thereof.
17. WAIVER OR MODIFICATION TO BE IN WRITING:
No modification or waiver of any of the terms hereof
shall be valid unless in writing and signed by both parties
and no waiver of any breach hereof or default hereunder shall
be deemed a waiver of any subsequent default of the same or
similar nature.
18. Mll'l'l1~lU
Each party shall, at any time and from time to time
hereafter, take any and all steps and execute, acknowledge and
deliver to the other party, any and all further instruments
and/or document that the other party may reasonably require
for the purpose of giving full force and effect to the
provisions of this Agreement.
Page 9 of 22
19 . AGREEMENT BINDING ON HEIRS 1
This Agreement slldll be binding and shall inure to the
benefit of the parties hereto and their respective heinl,
executors, administrators, successors and assigns.
20. INTEGRATIONl
This Agreement constitutes the entire understanding of
the parties and supersedes any and all prior agreements and
negotiations between them. There are no representations or
warranties other than those expressly set forth herein.
21 . OTHER_JLOCUMENTATION:.
Wife and Husband covenant and agree that they wi 11
forthwith (and within at least twenty (20) days after demand
therefor) ,
execute any and all
written instruments,
assignments, releases, satisfactions, deeds, notes, stock
certificates, or such other writings as may be necessary or
desirable for the proper effectuation of this Agreement,
and/or as their respective counsel shall mutually agree,
should be so executed in order to carry out fully and
effectively the terms of this Agreement.
22. lliLWAIYEILOF---DEFA~
This Agreement shall remain in full force and effect
unless and until terminated under and pursuant to the terms of
this Agreement. The failure of either party to insist upon
strict performance of any of the provisions of this Agreement
shall in no way affect the right of such party hereafter to
enforce the same, nor shall the waiver of any subsequent
default of the same or similar nature, nor shall it be
DIA:\E 0. RADeI.IFF
34'S TRISIlI.I' ROAIl
C^~tI'lIIl.1., 1''' 17011
PilOSE: 0171 7.\7 llllMl
FAX: OJ7} 1J7~n(llJ7
Page 10 of 22
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construed as a waiver of strict performance of any other
obligations herein,
23. BREACH!.
If for any reason either Husband or Wife fails to perform
his or her obligations owed to or for the benefit of the other
party and/or otherwise breaches the terms of this Agreement,
then the other party shall have the following rights and
remedies, all of which shall be deemed to be cumulative and
not in the alternative, unless said cumulative effect would
have an inconsistent result or would result in a windfall of
the other party:
a. The right to specific performance of the terms of this
Agreement, in which event the non-breaching party shall
be reimbursed for all reasonable attorney's fees and
costs incurred as the resul t of said breach and in
bringing the action for specific performance.
b. The right to damages arising out of breach of the terms
of this Agreement, which damages shall include
reimbursement of all attorney's fees and costs incurred
as the result of the breach and in bringing the damage
action.
b. The right to all remedies set forth in Section 3502(e) of
the Pennsylvania Divorce Code, 23 Pa. C.S.A. 3502(e), and
any additional rights and remedies that may hereafter be
enacted by virtue of the amendment of said statute or
replacement thereof by any other similar laws.
c. Any other remedies provided for in law or in equity.
24. LAl'LJ)F PENNSYL.VANI~I.CABLE...t
This Agreement shall be construed in accordance with the
laws of the Commonwealth of Pennsylvania.
25 . SKV-ERABILITY:
If any term, condition, clause or provision of this
Agreement shall be determined or declared to be void or
invalid in law or otherwise, then only that term, condition
DIANE l), RA()('I.II+
3+181 RI~I>I.E R(),\1l
CAMI' 1111.1.. I)A 17011
PIIO:SE: (717) 7.\711100
FAX: 171711J7~Ohll7
Page 11 of 22
clause or provision shall be stricken from this Agreement and
in all other respp.cts this Agreement shall remain valid and
continue in full force, effect and operation. Likewise, the
failure of either party to meet his or her obligations under
this Agreement under anyone or more of the paragraphs
hereunder, with the exception of the satisfaction of a
condi tion precedent, shall in no way avoid or al ter the
remaining obligations of the parties.
26. F.IHAlLEQlllTABLELDIS'l'RIBUTIOLOF P!\OEERl'Y..t
The parties agree that the division of all property and
debts set forth in this Agreement is equitable and in the
event an action in divorce has been or is hereafter commenced,
both parties waive and relinquish the right to divide and
distribute their assets and debts in any manner not consistent
with the terms set forth herein and further waive and
relinquish the right to have the court equitably divide and
distribute their marital assets and debts. It is further the
intent, understanding and agreement of the parties that this
Agreement is a full, final, complete and equitable property
division,
27. WJUVER OF INHE!\I'l'ANCEJ..
Each of the parties hereto does specifically waive,
release, renounce and forever abandon any right. title,
interest and claim, if any, either party may have in and to
any inheritance of any kind or nature whatsoever previously,
or in the future, received by the other party.
DlM,a: G, 1{,\IlCI.1FI:
H4K TllIN1>1.1. IIOAI>
C/'~IIIII1I.L. 1'1\ 17011
PIIO~E: 017,7]7.0100
FAX: (17) c)7~ O(I!}?
Page 12 of 22
28 . PERBONAL_ PROPERTY I
Husband and Wife do hereby acknowledge that they have
previously divided their tangible personal property including,
but without limitation, to the following: jewelry, clothes,
furniture, furnishings, rugs, carpets, household equipment and
appliances, tools, pictures, books, works of art and other
personal property ("the Personal Property"). Hereafter Wife
agrees that all of the Personal Property in the possession of
Husband shall be the sole and separate property of Husband;
and Husband agrees that all of the Personal Property in the
possession of Wife shall be the sole and separate property of
Wife,
The parties do hereby specifically waive, release,
renounce and forever abandon whatever claims, if any, he or
she may have with respect to the Personal Property which shall
become the sole and separate property of the other.
29. AFTER-ACQULRED PROPERTY,
Each of the parties shall hereafter own and enj oy,
independently of any claim or right of the other, all
property, tangible or intangible, real, personal or mixe~,
acquired by him or her, since November 25, 1996, the date of
the parties' marital separation, with full power in him or her
to dispose of the same as fully and effectively, in all
respect s and for all purposes, as though he or she were
unmarried and each party hereby waives, releases, renounces
and forever abandons any right, title, interest and claim in
and to said after acquired property of the other party
pursuant to the terms of this Paragraph.
DIANE G, R,IIJCI.IIT
H48 TRINIJI.E ROAD
CAMP 1111.1,. Pr\ 171111
PIIONE, (71717.\7,111'"
FAX; (717) 1J75.11f,1J7
Page 13 of 22
30. VEHICLES.BOATSANDTHJLLlKEI
With respect to the vehicles, boats, snowmobiles,
motorcycles and the like owned by one or both of the parties,
or the trade in value thereof ("the Vehicles") if the Vehicles
have been sold or traded in prior to the date of this
Agreement, the parties agree as follows:
a. 1987 Pontiac Grand Am shall be the sole and separate
property of Wife.
b. 1991 Toyota pick up truck and the 1978 Chevrolet Corvette
shall be the sole and separate property of Husband,
b, Identification of a Vehicle herein shall include not only
the Vehicle, but also the sale or trade-in value thereof
if it had been sold or traded in prior to the date of
this Agreement,
c. The titles to the Vehicles shall be executed by the
parties, if appropriate, for effectuating transfer as
herein provided on the date of execution of this
Agreement and said executed titles shall be delivered to
the proper party on the distribution date.
d. For purposes of this Paragraph the term "title" shall be
deemed to include "power of attorney" if the title to the
Vehicle is unavailable due to financing arrangements or
otherwise.
e. In the event any Vehicle is subj ect to a lien or
encumbrance the party receiving the Vehicle as his or her
property shall take it subject to said lien and/or
encumbrance and shall be solely res~onsible therefor and
said party further agrees to indemn1fy, protect and save
the other party harmless from said 11en or encumbrance,
f. Each of the parties hereto does specifically waive,
release, renounce and forever abandon whatever right,
title and interest they may have in the Vehicles that
shall become the sole and separate property of the other
party pursuant to the terms of this Paragraph.
31. R.EAILESTATK.t
The parties are the owners of a certain tract of improved
real estate known and numbered as 931 South 318t Street Camp
Hill, PA 17011 ("the Real Estate") having an approximate value
DIANE (I. R,\I)CI.lH:
),HB TRINDLE ROAD
CAMI) IIII.L. ))A 171111
PI laNE: (717) 7.H.1I11MI
FAX: (17) 975-11(,'J7
Page 14 of 22
DIANE C;, RADCI.IFF
344H HINDLE ROAD
CA~fJlIIII.L.I't\ 17011
PIIONE, (717173711""
FAX: (717) 1J75-HfJlJ7
of $95,000,00 and which is encumbered with a mort.gage owed to
Homeside Lending, Inc" having an approximate balance of
$70,683,00 ("the Mortgage"), The Real Estate is currently
under contract for sale ("the Contract") with a tentative
settlement date to occur on or before June 15, 1999, With
respect to the Real Estate, the Mortgage and the Contract the
parties agree as follows:
a, The parties shall perform all actions and execute any and
all documents necessary to complete the sale and
settlement as required by the terms of the Contract.
b. In the event the Real Estate is not sold and settled
pursuant to the terms of the Contract, the parties shall
continue to list the Real Estate for sale with a
qualified mutually agreeable realtor and shall market the
property so as to sell it at the best price obtainable,
the parties further agreeing to follow all reasonable
advise provided to them by their realtor as to listing
and sales price and terms. Further the parties shall be
required to accept any reasonable offer to purchase the
Real Estate as may be hereafter suggested by the realtor,
absent mutual agreement of the parties to the contrary.
c. Pending the sale and set tlement of the Real Estate,
Husband shall be solely responsible for the payment of
the Mortgage ands any and all expenses associated with
the Real Estate.
d. At settlement on said sale of the Real Estate the net
proceeds derived after payment of all normal and
reasonable settlement costs and payment of all existing
liens, mortgages and encumbrances, shall be divided and
distributed between the parties as follows:
1. Payment to Husband of sixty (60%) percent of the
net proceeds;
2, Payment to Wife of forty (40%) percent of the net
proceeds.
e. With respect to tax reporting requirements and payment of
taxes resulting from the sale of the Real Estate it is
acknowledged and agreed as follows:
1, Under the current IRS rules and regulations no
taxes should be reportable or due and owing as the
result of the sale,
Page 15 of 22
DIANE G, RAI>CI.IH
J.I~R THINIlI.I' IWAIl
CAMP IIILI..I'1\ 171111
PIIONE, (717) 7.\7 OIlM)
FAX: (7(71 l)7~O(IIJ7
2. In the event that such reporting is required after
the sale of the real estate, the parties shall each
be required to timely and prompt report their
prorata share of any and all gains and taxes,
including capital gains and capital gains taxes, or
the equivalent, arising out of the sale of the real
estate, if any and if requi red, and shall pay any
and all taxes resulting from said reporting on his
or her appl icable income tax returns and shall
indemnify, protect and hold the other party
harmless therefrom,
3. For purposes of this paragraph Husband's prorata
share shall be based on sixty (60%) percent of the
gain and Wife's prorata share shall be based on
forty (40%) percent of the gain.
4. In the event it would be more beneficial for the
entire gain to be reported on the tax return of one
of the parties, the entire gain shall be reported
on that party's applicable tax returns and shall
provide the other party with a copy of that tax
return, so that on or before the date the tax
return is due to be filed the other party shall pay
to the reporting party his or her prorata share of
the tax owed.
32. RETIREMENT 1\.ND PENSIQH-ELANBi
Each of the parties does specifically waive, release,
renounce and forever abandon all of their right, title,
interest or claim, whatever it may be, in any Pension Plan,
Retirement Plan, IRA Account, Profit Sharing Plan, 401-K Plan,
Keogh Plan, Stock Plan, Tax Deferred Savings Plan, any
employee benefit plan and/or other retirement type plans of
the other party, whether acquired through said party's
employment or otherwise, ("the Retirement Plans"). Hereafter
the Retirement Plans shall become the sole and separate
property of the party in whose name or through whose
employment said plan or account is held or carried.
Page 16 of 22
~
33 . BANlLACCOUNTSLSl'OCK/LIFE _INSURANCE 1
The parties acknowledge and agree that they have
previously divided to their mutual satisfaction all of their
bank accounts, certificates of deposit, bonds, shares of
stock, investment plans and I ife insurance cash value, ("the
Accounts"), Hereafter Wife agrees that all the Accounts held
in the name of Husband shall become the sole and separate
property of Husband; and Husband agrees that all the Accounts
held in the name of Wife shall become the sole and separate
property of Wife.
Each of the parties does specifically
waive, release, renounce and forever abandon whatever right,
title, interest or claim, he or she may have in the Accounts
that are to become the sole and separate property of the other
pursuant to the terms hereof,
34. OWNERSHIP OF DOG:
Ownership of the dog, Hershey, shall be and is hereby
transferred to Husband, Hereafter Hershey shall be the sole
and separate property of Husband free and clear of all right,
title, interest and claim of Wife.
The provisions of the
prior court order entered in this case pertaining to custody
of Hershey shall be deemed to be terminated. If requested by
either party, each party will execute any and all documents
necessary to transfer ownership or terminate the custody order
so as to effectuate the terms of this paragraph.
35. WIFE'S DEliTSl
Wife represents and warrants to Husband that since the
parties' marital separation she has not contracted or incurred
DIANE G. RAIJCLlH:
J.l48 TRINDLE HOAD
CAMP 1IIL1.. JlA 17011
PilON!:: (17) 7.\7-011.I0
FAX: (1711)7~06tJ7
Page 17 of 22
any debt or liability for which Husband or his estate might be
responsible, Wi fe further- represents and warrants to Husband
that she will not contract or incur any debt or liability
after the execution of this Agreement for which Husband or his
estate might be responsible, Wife shall indemnify and save
Husband harmless from any and all claims or demands made
against him by reason of debts or obligations incurred by her,
36. HUSBAND'S DEBTS.
Husband represents and warrants to Wife that since the
parties' marital separation he has not contracted or incurred
any debt or liability for which Wife or her estate might be
responsible. Husband further represents and warrants to Wife
that he will not contract or incur any debt or liability after
the execution of this Agreement for which Wife or her estate
might be responsible. Husband shall indemnify and save Wife
harmless from any and all claims or demands made against her
by reason of debts or obligations incurred by him.
37. MARITAL DEBT:
During the course of the marriage, Husband and Wife have
incurred certain bills and obligations and have amassed a
variety of debts, and it is hereby agreed, without
ascertaining for what purpose and to whose use each of the
bills were incurred, the parties agree as follows:
a, Wife shall be solely responsible for the following bills
and debts:
1. Visa Account U 4121-4499-9880-1802;
2. Any vehicle loan for Wife's Vehicles as required
and set forth in Paragraph 30 herein.
DIANE G. RADCLIFF
.l.t.IR TRINDI.E ROAIl
CAMP IIILI.. I'A 171111
PIIONE: 01717.H.1I10U
J:AX: (71711J7~OfllJ7
Page 18 of 22
,
(
3. Her 40% share of any taxes resulting from the sale
of the Real Estate as set forth in and required by
paragraph 31 herein.
4. Any and all taxes resulting from her withdrawal of
funds from her Retirement Plans set forth in
Paragraph 32 herein;
5. Any and all other debts, liabilities, obligations,
loans, credit card accounts, and the like incurred
in Wife's sole name, and not otherwise provided for
herein,
b. Husband shall be solely responsible for the following
bills and debts:
1. Member's 1"' PSL loan having a balance at separation
of $4,585.25, and utilized to purchase the
Chevrolet Corvette (previously paid in part from
the proceeds received from the sale of the
Corvette) ;
2. Member's 1'[ PSL loan having a balance on October 8,
1998 of $1,783,00 and utilized to purchase the
Toyota pick up truck,
3, Any vehicle loan for Husband's Vehicles as required
and set forth in Paragraph 30 herein.
4, The Mortgage as required and set forth in Paragraph
31 herein;
5, His 60% share of any taxes resulting from the sale
of the Real Estate as set forth in and required by
paragraph 31 herein,
6. Any and all taxes resulting from his withdrawal of
funds from his Retirement Plans set forth in
Paragraph 32 herein;
7, Any and all other debts, liabilities, obligations,
loans, credit card accounts, and the like incurred
in Husband's sole name and not otherwise provided
for herein.
c. Each party agrees to hold the other harmless from any and
all liability which may arise from the aforesaid bills
which pursuant to the terms herein are not the
responslbility of the other party.
d, Any joint debt shall be canceled so that neither party
can make any further charges thereunder, and if said
charges are made in violation of this Agreement, then the
party incurring said charge shall immediately repay the
same,
DIANE G, KA/l('I.II'"
l4-l8 TKI~/lI.E KDA/l
(AMI' 1111./.. /,,\ 17111/
PIIDNE: 17171 7.171111"
flAX: (71711J7~U(IIJ7
Page 19 of 22
llIANE (; RAIJCI.II'F
J44B HINIJLE HOAIJ
CAMP 1111.1.. PI\ 171111
JlIIONE: 017) 7J7111lJO
F/\X: 1717IlJ7~I){lln
e, Husband shall refinance or solely assume the two (2)
Member's 1'" PSL loans set forth in subparagraphs b.l,
and b, 2. above within sixty days of the date of this
A~reement so as to release Wife from any and all further
llability thereunder.
f, If a party is assuming any other joint debt pursuant to
the terms of this Paragraph not otherwise speci f ied
herein, within sixty (60) days of the date of this
Agreement that party shall be required to refinance or
solely assume that obligation so as to relieve the other
party from any and all further liability thereunder,
g. Any liability not disclosed in this Agreement shall be
the sole responsibility of the party who has incurred or
may hereafter incur it, and the party incurring or having
incurred said debt shall pay it as it becomes due and
payable,
h. From the date of this Agreement, each party shall only
use those credit card accounts or incur such further
obligations for which that party is individually and
solely liable and the parties shall cooperate in closing
any remaining accounts which provide for joint liability,
3B.INDE~IEICATIQN:
Any party assuming an obligation pursuant to the terms of
this Agreement shall indemnify, protect and hold the other
party harmless from and against all any and all liability
thereunder, including, but not limited to, any attorney's fees
and costs incurred by the other party as the result of
defending against the obligation and/or enforcing the
provisions of this indemnification.
39. WAIYE1LOF-ALIMONY. SPOUS~~
The parties hereto agree and do hereby waive any right
and/or claim they may have, both now and in the future,
against the other for alimony, alimony pendente lite, spousal
support, maintenance, counsel fees, costs and expenses.
Page 20 of 22
IN TilE ("lllI<T UF CUI~r-1,llI l'1,EM:
CUMHEHLMJIl COUIJ'J"!, l'1-:IItJ,;YLVMlIA
ELIZABETII K, POTTEH,
Plaintiff
No. Sn~003S
v,
CIVIL ACTION - I,AW
SCOTT A, POTTER,
DIVORCE/PROTECTION FROM ABUSE
Defendant
PRAECIPE OF TRANSMIT RECORD
To the prothonotary:
Transmit the record, together with the following information, to the
court for entry of a divorce decree:
1. Ground for divorce:
Irretrievable breakdown under Section 3301(d) of the Divorce Code,
2. Date of filing and manner of service of the complaint:
a. Date: January 3, 1997
b. Manner: Personal service by process server
3.
Date
3301
a.
b,
of execution of the affidavit
(c) of the Divorce Code:
Plaintif f: N/ A
Defendant: N/A
of consent required by Section
OR
Date of execution of the Plaintiff's affidavit required by Section
330l(d) of the Divorce Code and date of service of the Plaintiff's
3301 (d) affidavit upon the Defendant:
a. Date of execution: January 1, 1999
b. Date of filing: January 15, 1999
c. Date of service: January 19, 1999
4. Related claims pending: There are no issues outstanding. all issues
have been resolved by a Marriage Settlement Agreement dated June 4,
1999 filed of record and to be incorporated but not merged into the
divorce decree.
5. Date and manner of service of the Notice of Intention to file
praecipe to Transmit Record, a copy of which is attached, if the
decree is to be entered under Section 330l(d) (1) (i) of the Divorce
Code:
a, Date of Service: May 21, 1999
b. Manner of Service: U.S. Mail upon Defendant's Attorney
OR
Date Waiver of Notice in section 330l(c) Divorce was filed with the
Prothonotary:
a. Plaintiff's Waiver: N/A
b. Defendant's Waiver: N/A
/
,ESQUIRE (
ale Road \
C.m, Hi", P^ "0"
Supreme Court ID n 32112
Phone: (717) 737-0100
Fax: (717) 975-0697
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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY
No. 9'1- 0 "3S' Cev,L ~,~.,. v
ELIZABETH K. POTTER,
Plaintiff
SCOTT A. POTTER,
Defendant
CIVIL ACTION - LAW IN
DIVORCE
NOTICE
YOU HAVE BEEN SUED IN COURT. If you wish to defend against
the claims set forth in the following pages, you must take
prompt 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.
When the ground for divorce is indignities or irretrievable
breakdown of the marriage, you may request marriage counseling.
A list of marriage counselors is available in the Office of the
Prothonotary at the Cumberland County Courthouse, Carlisle,
pennsylvania.
IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF
PROPERTY, COUNSEL FEES OR EXPENSES BEFORE THE FINAL DECREE OF
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.
COURT ADMINISTRATOR
1 COURTHOUSE SQUARE
CARLISLE, PA 17011
(717) 240-2600
,
COUNT II: EOUITABLE DISTRIBUTION
9. paragraphs 1 through 8 are incorporated by reference
hereto as fully as though the same were set forth at length.
10. Plaintiff and Defendant have legally acquired
property, both real and personal, during their marriage from
June 20, 1987 until the date of separation, all of which is
"marital property".
11. Plaintiff and Defendant have acquired, prior to the
marriage or subsequent thereto, "non-marital property" which has
increased in value since the date of marriage and/or subsequent
to its acquisition during the marriage, which increase in value
is "marital property".
12. Plaintiff and Defendant have been unable to agree as
to an equitable division of said property the date of the filing
of this Complaint.
WHEREFORE, Plaintiff requests this Honorable Court to
equitably divide all marital property of the parties.
Respectfully submitted,
~ f
.-
IlIANE c;, RAllcun'
ArI'()RNI:\'.AT.I.AW
'H" TRI~nu ROAn
CA'''' 1111.1., I'A 171111
l
f
VERTIFICATION
ELIZABETH K. POTTER vertifies that the statements made in
this Complaint are true and correct.
ELIZABETH K. POTTER
understand that false statements herein are made subject to the
penalties of 18 Pa C.S. Section 4904, relating to unsworn
falsification to authorities.
~\:.It~~ ~. Qo\lrlV\.
ELIZA TH G. POTTER
DIANE G, RADCLlt'F
A1TORNF.Y-AT.I,AW
'44" TRI~IJU, ROAn
CAMP 11I1.1_, PA 17011
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
SCOTT A. POTTER,
Defendant
AFFIDAVIT OF SERVICE
I, Richard Kreitzer, being duly sworn or affirmed according to
law, deposes and says:
1. I am over 18 years of age.
2. I am not related to either party to this action.
3. I served a true and correct copy of the Petition for
Protection from Abuse and Complaint in Divorce upon the
Defendant, Scott A. Potter, by personally handing the
same to the Defendant on the 3'; day of January, 1997 at
his place of employment, Dauphin Deposit Training Center,
Derry Street, Harrisburg, Pennsylvania.
~'~;jA~"ER
Associated Services
Sworn to and subscribed before me
a Notary Public in and for
Cumberland County, Pennsylvania
this ~ day oftyYLt( , 1991....
mJ)fJJt) r! L1A1--t7J~(
NOTARY PUBLI
My commission expires:
DIANE Q, RADCLIFF
3448 TRINDLE ROAD
CAMP H!LL, PA 17011
17171737,0100
NOhll1~1 ~il<Il
JMimill. l IJllnlllV Not..v "lIbll"
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
SCOTT A. POTTER,
Defendant
AFFIDAVIT_OF_SERV~CE
I, Diane G, Radcliff, Esquire, being duly affirmed according
to law, deposes and says:
A true and correct copy of Plaintiff's Notice of Intention to
Request Entry of Divorce Decree together with the proposed Praecipe
to Transmi twas
served upon the Defendant's legal counsel of
record, Max J. Smith, Jr., Esquire, on May 21, 1999 by mailing same
by first class mail, postage prepaid, addressed as follows:
Max J. Smith, Jr., Esquire
134 Sipe Avenue
Humme1etown, PA 17036
Copies of the Notice of Intention, Praecipe to Transmit and
the cover letter dated May 21, 1999 addressed to the above attorney
ate attached to this Affidavit.
, ESQUIRE
Road
, A 17011
phone: (717) 737-0100
Fax: (717) 975-0695
Supreme Court ID # 32112
Sworn to and subscribed before me
a Notary Public in and for cu~erland
Count fit Pennsylvania this,)./ day
of ~ O.'f ' 1991-, ,
~) vf' AJ.'oJl!
NOTARY PUBLIC
NOlanill Seal
., l'or;H' l Oonloy. Normy Public
"',' ,'.j,',,:,~jorO, Cumberland County
..,1~l.n.~rplrns Supl. 23.1999
'.(){l.tlJUI1 of NordflC~
My commission expires:
i
THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K, POTTER,
Plaintiff
NO. 97-0035
V.
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
SCOTT A, POTTER,
Defendant
NOTICE OF INTENTION TO REOUEST
ENTRY OF DIVORCE DECREE
"
i
,
I
!
I,
i
TO: Max J, Smith, Jr., Esquire
134 Sipe Avenue
Hummelstown, PA 17036
Attorney for Defendant, Scott A. Potter
DIANE G. RADCLIFF, ESQUI~E, attorney for the Plaintiff,
intends to file with the court the attached Praecipe to Transmit
Record on or after June 10, 1999 requesting that a final decree in
divorce be entered,
Respectfully submitted,
RAn ESQUIRE
indle Road
Camp Hill, PA 17011
Supreme Court ID # 32112
Phone: (717) 737 -0100
Fax: (717) 975-0697
Attorney for Plaintiff
,I
Date: May ~ 1. 1999
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
No. 97-0035
v.
CIVIL ACTION - LAW
SCOTT A. POTTER,
DIVORCE/PROTECTION FROM ABUSE
Defendant
PRAECIPE OF TRANSMIT RECORD
To the Prothonotary:
Transmit the record, together with the following information, to the
court for entry of a divorce decree:
1. Ground tor divorce:
Irretrievable breakdown under Section 3301(d) of the Divorce Code.
2. Date ot tiling and manner ot s~rvice ot the complaint:
a. Date: January 3, 1997
b. Manner: Personal service by process server
3. Date ot execution of the affidavit of consent required by Section
3301 (c) of the Divorce Code:
a. Plaintiff: N/A
b. Defendant: N/A
QR
Date of execution of the Plaintiff's affidavit required by Section
3301(d) of the Divorce Code and date of service of the Plaintiff's
3301 (d) affidavit upon the Defendant:
a. Date of execution: January 1, 1999
b. Date of filing: January 15, 1999
c. Date of service: January 19, 1999
4. Related claims pending:
5. Date and manner of service of the Notice of Intention to file
Praecipe to Transmit Record, a copy of which is attached, if the
decree is to be entered under Section 330l(d) (1) (i) of the Divorce
Code:
a. Date of Service: May 21, 1999
b. Manner of Service: U.S. Mail
QR
Date Waiver of Notice in Section 3301(c) Divorce was filed with the
Prothonotary:
a. Plaintiff's Waiver: N/A
b. Defendant's Waiver: N/A
\
/
, E;SQUIRE
Road
Ca , PA 17011
Supreme Court 10 # 32112
Phone: (717) 737-0100
Fax: (717) 975-0697
DIANE G. RADCLIFF
3448 Trinulc Roau
Camp Hill. Pcnnsylvania 17011
----~----------~
Tclcphonc (717) 737-0100
Voicc Mail (717) 558-5518
Fax (717) 975-0697
May 21, 1999
Max J, Smith, Jr., Esquire
134 Sipe Avenue
Hummelstown, PA 17036
Re: Potter v. Potter
Dear Max:
I am enclosing with this letter my Notice of Intent to Request
Entry of Divorce Decree on or after June 10, 1999 and accompanying
Praecipe to Transmit.
Very truly yours,
DIANE G, RADCLIFF, ESQUIRE
DGR/dr
Enclosure:
5/21/99 Notice of Intent
cc: Liz Potter
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Adult family .ember with whom .aid Defendantts) reside(s).
Relationship is
Adult in charqe ot Detendant'. re.idence who refused to
qive name or relationship.
"anaqer/Clerk ot place of lodqing in which Delendant(.)
resideCs).
Aqerot cr perGO~ in ~ha~o o~ Daf~r.dant'c c~ftco or u:ual
place Of busines..
Defendant's company.
-i- other _....pI/l.fo.--4U1 StlL.U. D .to
a rue and correct copy of
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an officer 01 said
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Return to:
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Tn^C[,11.. Tlior.~r,;ull, Ilol,lry Public
C.ll1," 11.:1, CillIll"II.:r,d Countx
r.1y Ccn'I1""lrn hl;i1cs Feh, lG, .001
ELIZABETH K. POTTER,
Plaintiff
IN THE COURT aF COMMON PLEAS OF
CUMBERLAND COIUNTY, PENNSYLVANIA
v. 97-0035 CIVIL TERM
SCOTT A. POTTER, CIVIL ACTION - LAW
Defendant IN DIVORCE
RE: Pre-Hearing Conference Memorandum
DATE: Friday, January 15, 1999
Present for the Plaintiff, Elizabeth K.
Potter, is attorney Diane G. Radcliff, and present for the
Defendant, Scott A. Potter, is attorney Max J. Smith, Jr.
A divorce complaint was filed on January 3,
1997, raising grounds for divorce of irretrievable breakdown
of the marriage and indignities. Counsel have indicated
that the parties have been separated for a period in excess
of two years, and that wife intends to file an affidavit
under Section 3301(d) of the Domestic Relations Code
averring the two-year separation. Husband has indicated he
will not sign an affidavit of consent. The complaint also
raised the economic claim of equitable distribution. No
other economic claims have been raised in the action.
The parties were married on June 20, 1986
and separated on November 25, 1996. There were no children
born of the marriage.
Wife is 35 years of age and resides at 126
North Front Street, second floor, Wormleysburg, Pennsylvania
where she lives alone. She is a high school graduate, and
has had some training in airline travel. She currently
works doing data work with Keystone Health Plan Central.
Her title is clinical care specialist. Her net monthly
income is $1,904.41. Wife has not raised any health issues.
She does have health insurance coverage through her
employment.
Husband is 37 years of age and resides at
931 South 31st Street, Camp Hill, Pennsylvania, where he
lives alone. He is a high school graduate, and has had some
computer school training. Currently he works as a computer
analyst for Dauphin Deposit Bank. His biweekly net income
is $977.35. He has not raised any health issues. Husband
has health insurance coverage through his employer.
Husband resides in the marital residence at
931 South 31st Street, Camp Hill, Pennsylvania. He is
uncertain at this point as to whether he wants to retain the
house. The Master, however, has advised his counsel if
husband wishes to have wife share in the costs of sale, he
should list the house within the next two weeks. otherwise,
the house will be awarded to husband at the market value
established in the case, and he will be responsible for any
subsequent costs of sale if he decides later to leave the
residence.
Wife's counsel has advised that she will
stipulate to husband's value of the real estate at
$95,000.00. However, if the house is sold, the marketplace
will determine the value. The home is subject to a mortgage
in favor of Homeside Lending Mortgage Company with the
payoff of around $71,000.00. Husband has been making the
mortgage payments of $774.98 monthly, which include taxes
and insurance. The real estate is not subject to any other
liens.
The parties have three vehicles, a 1987
Pontiac Grand Am, a 1991 Toyota pickup truck, and a 1978
Chevrolet Corvette. Parties have not been able to agree to
the values of the Pontiac and Toyota. The Corvette is
listed for sale and was purchased in 1993 for $7,000.00. If
the Corvette is sold, the sale price will be the best
indicator of the value of that vehicle. With respect to the
Toyota, there is a Members First Loan which was used toward
the purchase of that vehicle. As of October 8, 1998, the
balance on that loan was $1,783.00. The Corvette was also
purchased with a personal loan, and the balance on that loan
at separation was $4,584.24. Ms. Radcliff has indicated
that the personal loan with Members First that was used to
purchase the Corvette has increased since date of separation
because husband has been borrowing money on that account.
Husband has a pension with Woolworth Kinney,
and according to Mr. Smith the value is $3,267.90. Wife has
a VIP plan and a pension plan with Keystone Health. The VIP
plan is as noted on the pre-trial statement as having a
value of $8,407.86, and the Keystone Health Plan a value of
$9,695.12.
Mr. smith noted that there appears to be a
different methodology used in the valuation of wife's plans
as opposed to husband's plan. He is going to contact
pension appraisors to discuss with them why perhaps a
different approach was used in corning up with the values for
wife as opposed to husband. Once the values, however, have
been established, perhaps counsel will be able to stipulate
to the values of the three plans.
Wife has provided husband a list of
household tangible personal property, which she would like
to have, and apparently husband has agreed to allow wife to
have the items on the list. However, we need to have a
value for the tangible personal property remaining with
husband, and the property going to wife. Ms. Radcliff is
going to suggest an appraisor within the next two weeks so
that an appraisal can be accomplished. Counsel have
indicated that they will agree to split the cost of the
appraisal.
The parties own a brown labrador dog which
has been the subject of litigation between the parties in
this case. Apparently each party would like to have the
dog, and they will have to make a decision about how that
will be resolved since currently the parties share custody.
There was also a question as to whether any value needs to
be placed on the dog, if we are going to have the dog
included as a marital asset in the distribution of the other
assets.
Aside from the loans used to pUrChn(li!
vehicles and the mortgage the only marital debt remaining is
a Visa card loan which has a balance of $1,942.46.
A friend of the parties owed the parties
$200.00, which has been paid to wife. Husband would be
entitled to receiving a portion of that payment when the
final distribution computation is completed, depending on
the percentage of distribution used in this case.
Counsel have indicated that they will
stipulate that the marital assets can be distributed 50/50,
and that any marital debt can be allocated on a 50/50 basis.
A hearing is scheduled for Tuesday, July 20,
1999, at 9:00 a.m. Notices will be sent to counsel and the
parties.
E. Robert Elicker, II
Divorce Master
ELIZABETH K. POTTEH,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 97 - 0035
VB.
SCOTT A. POTTEH,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
ORDER AND NOTICE SETTING HEARING
TO: Elizabeth K. Potter Plaintiff
,
Diane G. Hadcliff , Counsel for Plaintiff
Scott A. Potter Defendant
,
Max J. Sm it h , Jr. Counsel for Defendant
,
You are directed to appear for a hearing to take
testimony on the outstanding issues in the above captioned
divorce proceedings at the Office of the Divorce Master, 9 North
Hanover Street, Carlisle, Pennsylvania on the 20th day
of July , 1999, at 9:00 a.m., at which
place and time you will be given the opportunity to present
witnesses and exhibits in support of your case.
President Judge
Date of Order and
Notice: 1/19/99
By:
Divorce Master
J F YOU DO NOT HAVE A LAWYEIl OH CANNOT AFFOIW ONE, GO TO OH
TELEPHONE THE OFFICE SET FORTII BELOW TO FIND OUT WHEHE YOU CAN
GET LEGAL HELP.
CUMBEHLANIJ ('()lINTY BAil ASSOCIAT10N
) I.IBI-:HTY AVENUE
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Fehruary 2, 1999
Office of Divorce Master
Attn: E. Robert Elicker, II, Esquire
9 North Hanover Street
Carlisle, I' A 17013
In re: Potter v, Potter
No, 97-0035
In Divorce
Dear Bob:
In reference to your Pre-Ilearing Conference Memo dated January IS, 1999, please be
advised that I have reviewed same with Mr, Potter, He has decided to sell the marital home, and
will agree to sign a listing agreement to that effect immediately.
In the meantime, I received a letter from Attorney Radcliff dated Fehruary 2, 1999, a
copy of which is enclosed, As you can see, Ms, RadclitT and her client have taken the position
that the time for listing the house has expired, and that the house should be distributed to my
client as part of his equitable division of assets.
While your Memo is dated January IS. 1999, I did not receive it until January 22, 1999,
at which time I immediatcly forwarded a copy to my client. Mr, Potter did not re:eive it until
early during the wcek of January 25, 1999, Thus, our po~ition is that Mr. Potter has actcd
properly within a two week time framc. In any event, we fail to sce how Mrs, Pottcr is
prejudiced in any way by our notification on February 2, 1999 that Mr. Potter intends to scll thc
house.
Any guidance you arc willing to lend in resolving this matter shall bc most appreciated,
In the meantimc, Mr. Potter shall take the steps nccessary to have the house listed for sale,
DIANE G. RADCUH'
31048 Tdndle Road
Camp Hill, Pennsylvunia 17011
Telephone (717) 737-0100
VOice :\lall (711) 55~.5518
l'ilX (7 17) 97 5 -069 7
February 2, 1999
Max J, Smith, Jr., E8q~ire
134 Sipe Avenue
Hummelstown, PA 17035
RE: POTTER V, P07TER
Dear MaXI
I believe the per10d for llst:r.g the marlcal home has expired
with no action by lo~r cllent. :t 1S therefore our position in
accordance with the Divorce ~aster'9 instructions that the marItal
home will be distrib~ted to Mr, Potter ae part of his equitable
distrib~tlon share ''';lth no credit to b~ g:.ven fer any ever.tua1
sales COscs that he may lncur,
DGR/dr
transmission by fax only
cc: Liz Potcer
(
:f I am incorrect in chis I.:nderstanding, p:ease contact me
immediately,
Very truly yours,
i;;; a. b.
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
,
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
CIVIL ACTION - LAW
IN DIVORCE
SCOTT A. POTTER,
Defendant
MOTION FOR APPOINTMENT OF MASTER
ELIZABETH K. POTTER, Plaintiff, moves the Court to appoint a Master
with respect to the following claims:
[Xl Divorce
[ 1 Annulment
[ 1 Al imony
[ 1 Alimony Pendente Lite
[Xl Equitable Distribution
[ 1 Support
[ ] Counsel Fees
[ 1 Costs and Expenses
and in support of the Motion states:
1. Discovery is complete with respect to the claims for which the
appointment of the Master is requested.
2, The Defendant [xl has [ 1 has not appeared in the action
[ 1 personally [xl or by his attorney, Max J. Smith, Jr.,
Esquire.
3, The statutory ground for the divorce is irretrievable break
down under Section 3301 (d).
4, Check the applicable paragraphs:
[l The action is not contested,
[J An agreement has been reached with respect to the
following claims:
[xl The action is contested with respect to the following
claims: Equitable Distribution.
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I, the undersigned, do hereby verify that the statements made in the foregoing
Petition and correct to the best of my knowledge, information and belief. I understand
that statements herein are made subject to the penalties of 18 Pa C. S, ~4904 relating to
unsworn falsification to authorities
Date 6"" /3::'>h'7
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4. The Defendant, Scott A. Potter, shall provide
Plaintiff, Elizabeth K. Potter, through her counsel, with a key
to the marital residence.
S, This Order shall remain in effect for a
period of one year.
6. The Lower Allen Township Police Department
shall be provided by Plaintiff's counsel with a copy of this
Order, as shall any other police department or law enforcement
office which she deems appropriate, and may enforce this Order
by arrest for indirect criminal contempt without warrant upon
probable cause that this Order has been violated whether or not
the violation is committed in the presence of the police or law
enforcement officer. In the event that an arrest is made under
this Order, the Defendant shall be taken without unnecessary
delay before the Court that issued the Order. When that Court
is unavailable, the Defendant shall be taken before the
appropriate district justice.
7. The Defendant is charged with the surcharge
for this proceeding provided by law.
8. The Defendant was present in Court for the
dictation of this Order, and a copy of the Order shall be mailed
to Defendant by Plaintiff's attorney by ordinary mail to the
address provided by Defendant at the hearing.
By the Court,
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17. WASHER AND DRYER
18. TABLE WITH 2 CHAIRS LAUNDRY ROOM (SCOTT'S FAMILY)
19. COFFEE TABLE (SCOTT'S PREMARITAL)
20. 4 PIECE WICKER SET
21. GAS GRILL
22. 2 LAWN MOWERS ( 1 SCOTT'S FAMILY)
23. SNOW BLOWER
24. SHOP VAC
25. ALL LAWN EQUIPMENT
26. 2 REFRIGERATORS ( 1 SCOTT'S FAMILY)
27. VACUUM
28. KITCHENWARE: GLASSES, PLATES BOWLS, MICROWAVE CART ETC.
29. CD PLAYER AND RECEIVER
30. SPEAKERS (SCOTT'S PREMARITAL)
31. VCR TAPES AND DRAWERS
32. NORTH CAROLINA CLOCK AND CHAIR
33. MAGAZINE RACK
34. PHONE WITH CLOCK RADIO
35. 10 COMPACT DISCS
36. 9 MAGAZINE COVER SPORTS PLAQUES
37. LAWN TRAILER (SOLD BY SCOTT POST SEPARATION)
38. ALL BED LINENS (MARITAL)
39. ALL BATH LINENS (MARITAL)
40, IRONING BOARD & IRON
41. COMPUTER (MARITAL)
42. CRYSTAL VASES, CRYSTAL CANDLE STICK HOLDERS
43. ANTIQUE RADIO (SCOTT'S FAMILY)
44. SILVERWARE (MARITAL)
:,
DIANE G, MDCLlFF
3448 TRINDlE ROAD
CAMP Hill. PA 17011
(117) 737-11100
45. TOASTER (MARITAL)
46. PLANTS
47. BOWLS AND PLATTERS
48. SET OF BRASS
49. SET OF CRYSTAL
50. STEEL SHELVES IN LAUNDRY ROOM
51. 2 CLOCKS
52. 3 HOME INTERIOR SHELVES & MIRROR (MARITAL)
53. TABLE CLOTH LINENS
54. SKILLET, WOK, BLENDER
55. DAD'S CAMERA
1>6. RECLINER (LIZ'S FAMILY)"*
57. TV, DOWNS'rAIRS *u
58. VCR, DOWNSTAIRS ...
Sg; BLUE CHAIR, DOWNSTAIRS ...
60. COUCH AND CHAIR, DOWNSTAIRS (LIZ' S FAMILY) u*
6L 2 END TABLES, DOWNSTAIRS (LIZ'S FAMILY)"*
62. ~HONB,DOWNSTAIRS (LIZ'S FAMILY)..*
63~ CHIN~ SET (MARITAL-WEDDING PRESENT FROM LIZ'S MOM).**
(jot. FILING CABINET (LIZ'S PREMARITAL)"*
pS. VANI'rY SET u*
66. DRESSER (LIZ'S PREMARITAL)".
67. 4 LAMPS (LIZ'S FAMILY)**.
68. CLOCK RADIO (LIZ'S PREMARITAL) ***
69; COFFEE POT.**
10; FtotJR.; SlIGAR, COFFgEAND' 'l'EA CONT1\.IllERS*n
71. SET OF CORNING WARE...
72. REVEREWARE".
73. MIXER*"
74. SALlO BOWL SET
75. TUPP!R1fARE
76. UTBNSILS FROM MOM...
77. RECIPES"-
78. FOOD PROCESSOR
7~' BOWLS".
80. POTS***
81. CROCK POTU*
$2. BUNDT PAN AND CAKE PAN*"
83. COORIE SHEET AND MUFFIN PANS*-*
84. TEAPOT" *
85. PICTURE OF LIZ THAT KURT DREW (LIZ GIFT)
86. CLOCK JANA BROUGHT LIZ FROM EUROPE (LIZ GIFT)
87. STATUTE FROM DONNA (LIZ GIFT)
88. 2 LAB PUPPY FIGURINES
89. SEAGULLS FROM HOME INTERIORS
90. WEDDING DRESS (LIZ PREMARITAL)
91. BOOKS (LIZ PREMARITAL)
92. DAI>'S DESR ANTLERS (LIZ GIFT)
93. DAD'S BINOCULARS (LIZ GIFT)
~4. CHRISTMAS EXCHANGE PLATES
95. CHRISTMAS SLEIGH, HOME INTERIORS
96. CHRISTMAS PICTURE, HOME INTERIORS
97. NUTCRACKERS AND MUSICAL NUTCRACKER
98. CERAMIC CHRISTMAS TREE
99. CHRISTMAS COLLECTIBLES PURCHASED AT BOSCOVS
100. ORNAMENTS
DIANE G, RADCLIFF
3448 TRINDlE ROAD
CAMP Hill, PA 17011
(717) 737.0100
101. CHRISTMAS FIGURINE AND CHURCH SET FROM HOME INTERIORS
~O~. PICNIC,8ASKET SET
,103. ORANGB AND PURPLE BLANKET SHERRY MADE (LIZ GIFT)
10'. VARIOUS VCR TAPES
105. .. 'rV TRAYS
106. MICROWAVE.**
107. GL.l\,SSES***
DIANE Q, RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
17171 737.()100
DIANE G, RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
1717) 737.0100
17. WASHER AND DRYER
18. TABLE WITH 2 CHAIRS LAUNDRY ROOM (SCOTT'S FAMILY)
19. COFFEE TABLE (SCOTT'S PREMARITAL)
20. 4 PIECE WICKER SET
21. GAS GRILL
22. 2 LAWN MOWERS ( 1 SCOTT'S FAMILY)
23. SNOW BLOWER
24. SHOP VAC
25. ALL LAWN EQUIPMENT
26. 2 REFRIGERATORS ( 1 SCOTT'S FAMILY)
27. VACUUM
28. KITCHENWARE: GLASSES, PLATES BOWLS, MICROWAVE CART ETC.
29. CD PLAYER AND RECEIVER
30. SPEAKERS (SCOTT'S PREMARITAL)
31. VCR TAPES AND DRAWERS
32. NORTH CAROLINA CLOCK AND CHAIR
33. MAGAZINE RACK
34. PHONE WITH CLOCK RADIO
35. 10 COMPACT DISCS
36. 9 MAGAZINE COVER SPORTS PLAQUES
37. LAWN TRAILER (SOLD BY SCOTT POST SEPARATION)
38. ALL BED LINENS (MARITAL)
39. ALL BATH LINENS (MARITAL)
40. IRONING BOARD & IRON
41. COMPUTER (MARITAL)
42. CRYSTAL VASES, CRYSTAL CANDLE STICK HOLDERS
43. ANTIQUE RADIO (SCOTT'S FAMILY)
44. SILVERWARE (MARITAL)
73. HIDR."
74. SALAD BOWL SIT
7 5 . 'l'l)pP!RWARe:
76. UTENSILS FROM MOM"."
77. RlCIPBS""
78. FOOD PROCESSOR
79. BOWLS....
80. POrs."
$1. CROCK POT" **
~t. SUNDT PAN AND CAKE PAN."
!J3. COOKIE SHEET AND MUFFIN PANS""
84. 'l'BAP0'l'.'"
85. PIC'l'UREOF LIZ THAT KURT DREW (LIZ GIFT)
1J6. CLOCK JANA BROUGHT LIZ FROM EUROPE (LIZ GIFT)
$1. STATUTE FROM DONNA (LIZ GIFT)
!J8.2 LAB puppy FIGURINES
69; SEAGutLS FROM HOME INTERIORS
~(). JqEDbINGDRESS, (LIZ PREMARITAL)
?].; BQQKS(LIZ PREMARITAL)
~2Y PAl>'SbEE~ ANTLERS (LIZ GIFT)
~}; DAJ)'SBINOCULARS (LIZ GIFT)
~4;CH~IS'l'AASEXCHANGE PLATES
95., CHR.IS'1'MJl,S SLEIGH, HOME INTERIORS
9.6; CHRISTMAS, PICTURE, HOME INTERIORS
91; NUTCRACKERS AND MUSICAL NUTCRACKER
ga:' CERAMtCCHRISTMAS TREE
99. CHRISTMAS COLLECTIBLES PURCHASED AT BOSCOVS
100. ORNAMENTS
I
DIANE G, RADCLIFF
3448 TR!NDlE ROAD
CAMP Hill, PA 17011
(717) 737-0100
101. CHRISTMAS FIGURINE AND CHURCH SET FROM HOME INTERIORS
102. PICNIC BASKET SET
103. ORANGE AND PURPLE BLANKET SHERRY MADE (LIZ GIF'!')
,104. VARIOUS VCR TAPES
105. .. TV TRAYS
lQ~. MICROWAVE***
.107. GLASSES***
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boxes fhllll storage room,
beach towels.
wedding book,
high school year books,
two needle point framed pictures,
medicine for t he dog,
all of the parties' pictures,
$500 00 cash; and
the family bible
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7, Since the date of separation, Respondent has removed and concealed the
aforementioned items of personalty to the exclusion of Petitioner,
WHEREFORE, Petitioner requests equitable relief as follows:
8, By concealing and removing said items of personalty, Respondent has
wrongfully, intentionally and maliciously prevented Petitioner from exercising his right in
ownership interest in said items of personalty in order to defeat claims for equitable
distribution of property
9, The conduct of Respondent as heretofore stated has been a continuous
misappropriation and Respondent refuses, after demand to refrain from said conduct.
10, Immediate and irreparable harm is being caused by Respondent's conduct,
which is defeating Petitioner's claims of equitable distribution,
a, That an injunction be issued preliminarily until hearing and finally
thereafter, enjoining the Respondent from disposing, transferring, encumbering,
concealing, selling, removing or dlienating any personalty:
b, That Your Honorable Court issue an Order requiring an accounting of all
items of personalty, and that judgment be given to Petitioner against Respondent for
monies or property due Petitioner as showed by said accounting and that no further
disposition. transfer, encumbering, concealing, selling, removing or alienating take place
without further Order of this Court;
c, That Your Honorable Court attach said items of personalty;
d, That all property belonging to and being the sole property of Petitioner be
delivered to Petitioner;
e, Such other relief as Your Honorable Court may deem appropriate;
f. That Your Honorable Court enter an Order awarding exclusive occupancy
of the marital residence to the Petitioner and denying Respondent access to the home; and
g. Award attorney's fees, costs and expenses
Respectfully submitted,
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Keith B DeArmond, Esq'
Attorney for Petitioner
DeArmond & DeArmond
2800 Market Street
Camp Hill, PA 17011
717-730-9394
Supreme Ct, I,D, No, 58878
ELIZABETH K. POTTER,
Plaintiff/Respondent
IN TilE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
V
CIVIL ACTION - LAW
97-0035 CIVIL TERM
SCOTT A. POTTER,
Defendant/Petitioner
IN DIVORCE
IN REI PETITION FOR SPECIAL RELIEF
QRPILQ1_~QllRI
AND NOW. thie 23rd day of July, 1997, pending
further order, the partiee hereto are enjoined from disposing
of, transferring, encumbering, concealing, selling, removing or
alienating any pereonal property of the parties.
The partiee hereto shall share possession of
their dog Herehey ae eet forth in our order of March 3, 1997.
Otherwiee, the pending petition and
cross-petition for special relief are dismissed.
By the Court,
./lIL
Hess, J.
Diane C. Radoliff. Eequire
Attorney for Elizabeth K. Potter
Keith B. DeArmond, Esquire
Attorney for Scott A. Potter
",II.. (ho~,( '1/2'119'1.
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entered on January 14, 1997.
4. Admitted. It is admitted that the parties are the owners of
certain personalty.
5. Admitted. It is admitted that the parties are the owners of
real estate situate at 931 South 31' Street, Camp Hill,
Pennsylvania.
6.
Admitted.
It is admitted that the Plaintiff removed the
various items of personalty from the marital residence as
alleged by the Defendant with the exception of the cash and
family bible of which the Plaintiff has no knowledge. It is
further averred, however, that these items removed by the
Plaintiff were her personal items, effects and collections,
and not items in which the Defendant had an interest or
claimed a right, and that the Plaintiff only removed them at
that time to prevent their loss or destruction by the
Defendant which she reasonably feared would occur due to the
Defendant's erratic and irrational behavior and his selling of
another marital asset and his hiding of her clothing in the
attic of the home.
7. Denied. It is denied that the Plaintiff concealed the items
removed by her. On the contrary the Defendant was always
fully aware that she had possession of the items.
8.
Denied.
It is denied that the Plaintiff has wrongfully
DIANE G. RADCLIFF
3448 TRINDlE ROAD
CAMP Hill, PA 17011
1717) 737.0100
- 2..
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
1717) 737.0100
prevented the Defendant from exercising any ownership rights
to the personalty removed by her in order to defeat a claim
for equitable distribution. On the contrary the Defendant has
no ownership interest in the property removed by the Plaintiff
and his equitable distribution rights therein, if any, remain
in tact. Further the Plaintiff remains ready willing an able
to proceed with equitable distribution of marital property and
the Defendant has refused to agree to the same.
9. Denied. It is denied that the Plaintiff misappropriated the
items removed by her. On the contrary the items removed by
the Plaintiff were her personal effects and collections and
were owned by her and not by the Defendant or the parties
jointly and therefore the removal thereof cannot amount to
misappropriation.
10. Denied.
It is denied that the Defendant has suffered
immediate and irreparable harm. On the contrary his rights of
equitable distribution to the personalty removed by the
Plaintiff remains in tact and that it is the Defendant who has
refused to consent to the divorce and to proceed with
equitable distribution as requested by the Plaintiff.
WHEREFORE, the Plaintiff respectfully requests this Honorable Court
to enter an Order denying and dismissing the Defendant's request
for Special Relief in the form of an injunction.
- 3 -
CHOSS CLAIM ",OH SPECIAL HELIEF
11. The Plainti ff incorporates by reference the Answers set forth
in Paragraphs ] through IIJ above, the same as if set forth
fully herein at length.
l2. At the time of the parties separation, the Plaintiff was only
able to remove limited clothing and no items of personalty,
given the perceived dangerous situation created by the abuse
of the Defendant.
13. Additionally due to the abuse of the Plaintiff by the
Defendant the Plaintiff had to find immediate temporary living
arrangements.
14. The Plaintiff needs to and has found a more permanent
residence for her self and requires certain of the parties
personalty in order to furnish that residence.
15. The Plaintiff has set forth on ExhibitNAN, attached hereto and
made a part hereof, a listing of the parties' personalty and
has marked thereon the items she needs, and desires to have.
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
1717) 737.0100
16. It would be fair and equitable for the Plaintiff to be
permitted to have possession of some of the parties personalty
in as there is sufficient personalty for each party to have a
fair share without having to go to the expense of replacing
the items and said temporary sharing would not defeat either
- 4-
PiHty':3 r l'lht:3 t" l!qllitable distribution of that personalty.
1"1. The Plaint! ff is prepared to iml1ledidtely move forwilrd with her
clilim for equitable distribution, but the Defendant has
refused to agree to the same.
18. The Defendilnt will not consent to the divorce, which
effectively prevents the Plaintiff from achieving an equitable
distribution of the parties marital assets.
WHEREFORE, the Plaintiff respectfully requests this Honorable Court
to enter an order permitting the Plaintiff to take temporary
possession of the personalty desired by her set forth on Exhibit A
attached hereto and made a part hereof.
Respectfully submitted,
\
.
3448 TRIND
c;AMYnlli..,
f'rFl-l-7-3"1 100
SUPREME COURT ID 32112
ATTORNEY FOR PLAINTIFF
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL. PA 17011
17171737.0100
- 5 -
VERIFICATION
ELIZABETH K, POTTER verifies that the statements made in this
ANSWER AND CROSS CLAIM are true and correct. SHE understands that
false statements herein are made subject to the penalties of 18
Pa.C.S. Section 4904, relating to unsworn falsification to
authorities.
~'l(.,qo\f1'
(7!r;r, > J;E'r. ' -~ \
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
17171737.0100
- 6 -
17.
18.
19.
20.
21.
22.
23.
24.
25,
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
DIANE G. RADCLIFF
3o\4ll TRINDLE ROAD
CAMP HILL, PA 17011
1717) 737.0100
WASHER AND DRYER
TABLE WITH 2 CHAIRS LAUNDRY ROOM (SCOTT'S FAMILY)
COFFEE TABLE (SCOTT'S PREMARITAL)
4 PIECE WICKER SET
GAS GRILL
2 LAWN MOWERS ( 1 SCOTT'S FAMILY)
SNOW BLOWER
SHOP VAC
ALL LAWN EQUIPMENT
2 REFRIGERATORS ( 1 SCOTT'S FAMILY)
VACUUM
KITCHENWARE: GLASSES, PLATES BOWLS, MICROWAVE CART ETC.
CD PLAYER AND RECEIVER
SPEAKERS (SCOTT'S PREMARITAL)
VCR TAPES AND DRAWERS
NORTH CAROLINA CLOCK AND CHAIR
MAGAZINE RACK
PHONE WITH CLOCK RADIO
10 COMPACT DISCS
9 MAGAZINE COVER SPORTS PLAQUES
LAWN TRAILER (SOLD BY SCOTT POST SEPARATION)
ALL BED LINENS (MARITAL)
ALL BATH LINENS (MARITAL)
IRONING BOARD & IRON
COMPUTER (MARITAL)
CRYSTAL VASES, CRYSTAL CANDLE STICK HOLDERS
ANTIQUE RADIO (SCOTT'S FAMILY)
SILVERWARE (MARITAL)
i
~
>
45. TOASTER (MARITAL)
46. PLANTS
47. BOWLS AND PLATTERS
48. SET OF BRASS
49. SET OF CRYSTAL
50. STEEL SHELVES IN LAUNDRY ROOM
51. 2 CLOCKS
52. 3 HOME INTERIOR SHELVES & MIRROR (MARITAL)
53. TABLE CLOTH LINENS
54. SKILLET, WOK, BLENDER
55. DAD'S CAMERA
56. RECLINE~ (LIZ'S FAMILY).**
57. TV, DOWNSTAIRS * U
~8. VCR, DOWNSTAIRS u*
59. BLUE CHAIR, DOWNSTAIRS ...
60. COUCH ANO CHAIR, DOWNSTAIRS (LIZ'S FAMILY)***
61. 2 END TABLES, DOWNSTAIRS (LIZ'S FAMILY)***
62. PHONE, DOWNGTAIRS (LIZ'S FAMILY)*"'*
63. CHINA SET (MARITAL-WEDDING PRESENT FROM LIZ'S MOM)...
64. FILING CABINET (LIZ'S PREMARITAL)"*
~5, VANITY SET ***
66. DRESSER (LIZ'S PREMARITAL)..*
67. 4 LAMPS (LIZ'S FAMILY)"*
68. CLOCK RADIO (LIZ'S PREMARITAL)***
69. COFFEE POT***
'to. Io'tOUR, SUGAR, COFFEE AND TEA CONTAINERSitn
71. SET OF CORNING WARE.*.
72, REVEREWARE.*.
101. CHRISTMAS FIGURINE AND CHURCH SET FROM HOME INTERIORS
10~. PICHIC BASKET SET
103. ORANG! AND PURPLE BLANKET SHERRY MADE (LIZ GIFT)
10'. VARIOUS VCR TAPES
105. .. 'N TRAYS
106. MICROWAVE...
107, GLASSES...
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL. PA 17011
(717) 737.ijl00
ELIZABETH K. POTTER,
Plaintiff
v.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
No.Ql- OO~S" C\~~
SCOTT A. POTTER,
Defendant
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
ORDER
AND NOW, this
~~d.
day of January 1997, upon
consideration of the within petition and upon motion of DIANE
G. RADCLIFF. ESQUIRE, attorney for Plaintiff, ELIZABETH K.
POTTER, IT IS HEREBY ORDERED that a hearing is to be held on
the within Petition on the /-;'1/ day of /In "'IOX,'_,,
''/'11 ,,'J
ro/1f5, at (Ff{ o'clock /) .M. in Courtroom No. ,)-
It is further ORDERED that in the interim time between
Cumberland County Courthouse, Carlisle. Pennsylvania. The
Defendant. SCOTT A. POTTER, shall appear on that date at that
time and place and preferably with counsel representing him.
now and the time set for the above - mentioned hear ing, the
Defendant, SCOTT A. POTTER, is directed:
(a) to refrain from abusing the Plaintiff, Eli zabeth
K. Potter as that term is defined by the
Protection from Abuse Act;
(b) to have no contact with the Plaintiff;
(c) to refrain from entering the Plaintiff I s place of
employment or residence;
DIANE G, RAIlCI.JFf
ATTllRNI:\"-AT_I.AW
Hilt TRISIIJ.l ROAn
C:AMP 11I1.1., PA 17011
(d) to refrain from stalking or harassing the
Plaintiff.
THE DEFENDANT IS HEREBY ADVISED OF illS RIGHT TO BE
REPRESENTED BY AN ATTORNEY OF HIS OWN CHOOSING. IF THE
DEFENDANT DOES NOT HAVE A LAWYER OR CANNOT AFFORD ONE HE
SHOULD GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND
OUT WHERE HE CAN GET LEGAL HELP.
Court Administrator
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
(717) 240-6200
AMERICANS WITH DISABILITIES
ACT OF 1990
The Court of Common Pleas of Cumberland County,
Pennsylvania, is required by law to comply with the Americans
with Disabilities Act of 1990. For information about
accessible facilities and reasonable accommodations available
to disabled individuals having business before the court,
please contact our office. All arrangements must be made at
least 72 hours prior to any hearing or business before the
court.
DIANI: G. RAIlCI.IFI'
ATTORNH.AT.l.AW
:H4" TRINnn KnAJI
CAMP 1111.1., PA 171111
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ELIZABETH K. POTTER,
PIa inti f f
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
No.
SCOTT A. POTTER,
Defendant
CIVIL ACTION . LAW
PROTECTION FROM ABUSE
PETITION UNDER PROTECTION FROM
ABUSE ACT 23 Pa.C.S.A. 6101 et sea.
AND NOW, this ~ ~ day of ~, 199Tj':
comes the Plaintiff, ELIZABETH K. POTTER, by her attorney,
DIANE G. RADCLIFF, ESQUIRE, who petitions the Court under the
above-captioned Act as follows:
1. The plaintiff, ELIZABETH K. POTTER, is an adult
individual residing at 128 Forest Drive, Camp Hill, Lower
Allen Township, Cumberland County, Pennsylvania 17011.
2. The Defendant, SCOTT A. POTTER, is an adult
individual residing at 931 South 31st Street, camp Hill,
Cumberland County, Pennsylvania 17011, the parties' jointly
owned marital residence.
3. The plaintiff is employed at Pennsylvania Blue
Shield located at 300 Corporate Center Drive, Camp Hill, East
pennsboro Township, Cumberland County, Pennsylvania.
4. The aforesaid residence of the plaintiff is owned
by the Plaintiff's sister and brother-in-law and the
Defendant has no legal right to access thereto.
9. The aforesaid abuse perpetrated by the Defendant
consisted of the following:
(a) In January 1996, during one of the snow storms,
the Plaintiff returned to the marital residence
from her sister's home to find the Defendant in
the basement holding a rope that was tied to the
kitchen door at the top of the basement stairs,
thereby seeking to prevent the Plaintiff from
entering the basement. When the Plaintiff cut the
rope, walked down the stairs, and approached the
Defendant about this situation, the Defendant
became angry and agitated and forcibly threw the
Plaintiff up the stairs in an attempt to get her
out of the basement. The Plaintiff then called 911
but was prevented from completing her call because
the Defendant ripped the phone cord out of the
wall. The policy responded nonetheless and the
Plaintiff left the marital residence and stayed
overnight at her sister's for her safety.
(b) In 1996, probably in the spring, the Defendant
during an argument with the Plaintiff told the
Plaintiff in a threatening manner that she had to
leave the marital residence before he killed her.
(c) On or about November 16, 1996, the date of the
DIANE G. RAIlCJ.lH
An'IlRN!:\,.AT.I.AW
~H" TRINIH.r ROAII
C~MI' Itln. PA 17011
parties' separation, the Defendant, as he was
leaving the marital residence, told the Plaintiff
I
,
r
(c) restraining the Defendant from entering the
Plaintiff's place of employment and/or her
residence and from harassing the Plaintiff or her
relatives;
(d) directing the Defendant
to pay reasonable
DIANE G. RADCUH
ATroRNEY.AT.I.AW
!HII TRINIIU: ROAn
CAMP 1111.1.. 1'.40 11011
attorney's fees and costs incurred in this action;
(e) directing the Defendant to refrain from stalking
or harassing the Plaintiff;
(f) directing the Defendant to provide the Plaintiff
with a key to the marital residence;
(g) directing the Defendant to cooperate with all acts
necessary to seCure the proper registration of
Plaintiff's vehicle;
(h) such further relief as is equitable.
Respectfully Submitted,
\
, ESQUIRE-
e Road
PA 17011
,
3
i
VERIFICATION
ELIZABETH K. POTTER verifies that the statemep.ts made in
this Petition
are true and correct. ELIZABETH K. POTTER
understands that false statements herein are made subject to
the penalties of 18 Pa.C.S. Section 4904, relating to unsworn
falsification to authorities.
I
~~'ao\~ \( ~~
ELIZ TH K. OTTER
IIIANE G. RAIlCLlH
ArroRNI:\'.AT.I.AW
:'HII nU~III.l. ROAIl
U.~II'III1,t..I'" 17011
C~"TIVICATION OF PFA'S
Casc Numbcr q~ tJJ..ft.~ 1u-nv
Namc ~-.a. -f!.&vv
q 3/7. 3/-U.-:Ji:ud
~ 1V.dL, fA /7011
Victim's Namc:
~dk. ~
Prothonotary Office
Pcrson Certifying Information {'~~. )Y"~ Date
III~ /97 _
- f ,
ELI ZABETII K. POTTER,
PlLlintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNfjyLVANIA
v.
No. 97 .OO.lr; CIVIL TERM
SCOTT A. POTTER,
Defendant
CIVIL ACTION. LAW
DIVORCE/PROTECTION FROM ABUSE
ORDER
AND NOW this
j~
, 1997 in
vo. ~ IC. c:..tt
day of
consideration of the within Petition, it is hereby ordered
and decreed that:
"':/1 _Co Jc..4c. oI.I.J V",.,.
.i c: c:,...hArhll pd fnr the
fJU,.,.,.... -1 ~",tJ..l-.
ddrof
(1) A hearing
- ,--i-<j"l'l--ttt-------O',_luck "':==-:~-ln courL~ '
Cumberland_ COllnty Court House--nt which time-anrr-~e the
.--- -
~pondent shall appear, preferably with legal counsel
presenting_~~Jru:L----Sha.5 show cause why
requested in thec-petiti~-f;-~h6U1d r-;-~ti5" ~Lartteth"
the
relief
(2) Pending the hearing aforesaid the Respondent is
hereby enjoined from selling
transferring, conveying,
giving away or otherwise disposing of the dog, Hershey.
-- r'}
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1lJAl'-a: G. RAIICUH
AT! OR~f.\".AT-1.AW
.'WI-J RI~IJU ROr\1I
C\~II' 1111.1..1':\ 171111
l
t
~:
(J) pendinrJ the hl!,u in'.! ,1foresaid the piHties shall
ShcUI? Hershey on an alternatinq week basis, th.! exchange time
to occur edeh Saturday before 12:00 Noon, commencing with the
petitioner for the week of March 1, 19'J7.
BY THE COURT
--1Y-. AIL
/ J.
/
ELIZABETH K. POTTER,
Pl.lintiff
IN THE COURT Of' COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
No. <l7-0IJjr,CIVILTERM
SCOTT A. POTTER,
Deflmd,Hlt
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
PETITION FOR SPECIAL RELIEF
AND NOW this ~ day o( k b~ 1997 comes the
Plaintiff. ELIZABETH K. POTTER by her Attorney, DIANE G.
RADCLIFF, ESQUIRE and files this petition for Special Relief
and represents that:
1. Your petitioner is Elizabeth K. Potter, an adult
individual residing at 128 Forest Drive, Camp Hill.
Pennsylvania 17011 and is the plaintiff in the above action.
2. Your Respondent is Scott A. Potter, an adult
individual normally residing at 931 South 31st Street, Camp
Hill, Pennsylvania 17011, but temporarily residing at 8164
Antetim Drive, Lewisberry, Pennsylvania
17339 and is the
Defendant in the above action.
3. The parties are husband and wife, having been
married on June 20, 1987.
4. Dur ing the cour se of the marr iage the par ties
acquired a female Chocolate Labrador Retriever named
"Hershey", which is currently AKC registered in the name of
n1A:-;E G, RAIlCI.IH
ATI'()RS[\,.AT-I.AW
~IIM TKI~nn ROAII
(:,\.\11' 1111.1., 1''\ 171111
the Respondent.
5.
During the course of their marriage the parties
~LIZABETH K. POTTEIl,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBEHLAND COUNTY, PENNSYLVANIA
DIANf: G. RAIlCI.IH
ATroRNI:\'.AT.I.AW
.1UH TKI:'IiIH... RfJr\1I
CBIPIIIU., I'" 171111
v.
No. 'J"! '0035 CIVIL TERM
'COTT A. POTTER,
Defendant
CIVIL ACTION . LAW
DIVOHCE/PROTECTION FROM ABUSE
ORDER
AND NOW this
day of
, 1997, IT IS
iEREBY ORDERED AND DECREED AS FOLLOWS pertaining to the
arties' Labrador Retriever, Hershey (hereafter, "HERSHEY"):
1. The parties shall share custody of HERSHEY on an
alternating week basis with the exchanges between them to
occur each Saturday by 12:00 p.m.
2. The parties shall cooperate with each other to
provide necessary veterinary care for HERSHEY and shall
keep each other informed of all appointments made for that
care. The parties shall equally share in the veterinary
care costs.
3. If either party moves from the general Lewisberry,
Pennsylvania area hereby making the above arrangements no
longer feasible or should other circumstances occur
warranting such a change, the parties shall attempt to
reach a mutual agreement as to necessary modifications and
in absence thereof. either party shall be entitled to
petition the emu t for a chanue In said arrangements and
after a hl~ar inu therl~()n the court shall make appropriate
chanues, the cOllrt retaining jurisdiction over this
matter.
BY THE COURT
J.
OIA:'>E G. RADeLl...-
ATroR~':\'.AT.I.AW
"tlIl HlI~nu Ro....n
(:,\MPIIIU., I'" 17UII
VERIFICATION
ELIZABETH K. POTTER verifies that the statements made in
this petition dre true and correct.
ELIZABETH K. POTTER
understands that false statements herein are made subject to
the penalties of 1H Pa.C.S. Section 4904, relating to unsworn
falsification to authorities.
~'D..tR-\" ~. -'<o~~
ELIZABETH K. POTTER
D1A:'\t: G. RAIlCUt'F
ATrORN[Y-AT.I.AW
!HlI TRISIJU: ROAU
UI~t1'IIII.J..I'r\ 170))
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I. .. T~UI ....D COIlIItCT _ 01'
TIll OIlIGINAI. I'ILm (If' _Do
DlANI ... UDCLI".
LAW orrlCE
DIANlt G. RADCUFF
AT1'Omfn AT LAw
ml TrIDdIe aood
Camp Hill. PA 17011
..
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER, ("") .n n
F.. -J "
P laintif f NO. 97-0035 ,--
"". I
r:': (-: , , ,.~
,--
V. CIVIL ACTION - LAW ,
".l 'r;
IN DIVORCE I.,
SCOTT A. POTTER,
Defendant
":1')
;... ,I
, i
., ,
~l ';'111
'-,
PLAINTIFF'S ANSWER TO DEFENDANT'S PETITION FOR SPEC~ 8iLI~ IN
TijE FORM OF AN INJUNCTION PREVENTING REMOVAL, DISPOSITION,
ENCuMBERING OR ALIENATION OF PROPERTY AND THE PLAINTIFF'S CROSS
CLAIM FOR SPECIAL RELIEF
. \ -<, cl
AND NOW, th~s (-y, ) -
r .:
Elizabeth K. Potter and
Day of July, 1997, comes the Plaintiff,
files the above referenced pleading whereof
the following is a statement:
ANSWER TO DEFENDANT'S PETITION
1. Admitted. It is admitted that the Defendant resides at 931
South 31" Street, camp Hill, Pennsylvania.
:1. Admitted. It is admitted that the Plaintiff resides at 128
Forest Drive, Camp Hill, Pennsylvania. It is further averred,
however, that this residence was to be temporary only as a
haven for the Plaintiff due to the abuse perpetrated upon her
by the Defendant, and that the Plaintiff has secured
alternative living accommodations which she desires to move
into in the near future.
3.
Admitted.
It is admitted that the parties were married on
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
(717) 737.0100
June 20, 19B7, that the Plaintiff filed a complaint in divorce
on January 3, 1997 and that a Protection from Abuse Order was
entered on January 14, 1997.
4. Admitted. It is admitted that the parties are the owners of
certain personalty.
5. Admitted. It is admitted that the parties are the owners of
real estate situate at 931 South 31" Street, Camp Hill,
Pennsylvania.
6.
Admitted.
It is admitted that the Plaintiff removed the
various items of personalty from the marital residence as
alleged by the Defendant with the exception of the cash and
family bible of which the Plaintiff has no knowledge. It is
further averred, however, that these items removed by the
Plaintiff were her personal items, effects and collections,
and not items in which the Defendant had an interest or
claimed a right, and that the Plaintiff only removed them at
that time to prevent their loss or destruction by the
Defendant which she reasonably feared would occur due to the
Defendant's erratic and irrational behavior and his selling of
another marital asset and his hiding of her clothing in the
attic of the home.
7. Denied. It is denied that the Plaintiff concealed the items
removed by her. On the contrary the Defendant was always
fully aware that she had possession of the items.
8.
Denied.
It is denied that the Plaintiff has wrongfully
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
(717) 737.0100
- 2 -
prevented the Defendant from exercising any ownership rights
to the personalty removed by her in order to defeat a claim
for equitable distribution. On the contrary the Defendant has
no ownership interest in the property removed by the Plaintiff
and his equitable distribution rights therein, if any, remain
in tact. Further the Plaintiff remains ready willing an able
to proceed with equitable distribution of marital property and
the Defendant has refused to agree to the same.
,
9. Denied. It is denied that the Plaintiff misappropriated the
items removed by her. On the contrary the items removed by
the Plaintiff were her personal effects and collections and
were owned by her and not by the Defendant or the parties
jointly and therefore the removal thereof cannot amount to
misappropriation.
10. Denied.
It is denied that the Defendant has suffered
,immediate and irreparable harm. On the contrary his rights of
equitable distribution to the personalty removed by the
Plaintiff remains in tact and that it is the Defendant who has
refused to consent to the divorce and to proceed with
equitable distribution as requested by the Plaintiff.
WHEREFORE, the Plaintiff respectfully requests this Honorable Court
to enter an Order denying and dismissing the Defendant's request
for Special Relief in the form of an injunction.
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
(717) 737.0100
- 3 -
, '.
- . .
. '.-
- , '
...
EXHIBIT "A"
: O.IlADCUFF
'lUNOlE ROAD
HILl.'A 17011
37.0100
DIANE G. RADCLIFF
3448TRINDLE ROAD
CAMP HILL. PA 17011
(717) 737-0100
17. WASHER AND DRYER
18. TABLE WITH 2 CHAIRS LAUNDRY ROOM (SCOTT'S FAMILY)
19. COFFEE TABLE (SCOTT'S PREMARITAL)
20. 4 PIECE WICKER SET
21. GAS GRILL
22. 2 LAWN MOWERS ( 1 SCOTT'S FAMILY)
23. SNOW BLOWER
24. SHOP VAC
25. ALL LAWN EQUIPMENT
26. 2 REFRIGERATORS ( 1 SCOTT'S FAMILY)
27. VACUUM
28. KITCHENWARE: GLASSES, PLATES BOWLS, MICROWAVE CART ETC.
29. CD PLAYER AND RECEIVER
30, SPEAKERS (SCOTT'S PREMARITAL)
31. VCR TAPES AND DRAWERS
32. NORTH CAROLINA CLOCK AND CHAIR
33. MAGAZINE RACK
34. PHONE WITH CLOCK RADIO
35. 10 COMPACT DISCS
36. 9 MAGAZINE COVER SPORTS PLAQUES
37. LAWN TRAILER (SOLD BY SCOTT POST SEPARATION)
38. ALL BED LINENS (MARITAL)
39. ALL BATH LINENS (MARITAL)
40. IRONING BOARD & IRON
41. COMPUTER (MARITAL)
42. CRYSTAL VASES, CRYSTAL CANDLE STICK HOLDERS
43. ANTIQUE RADIO (SCOTT'S FAMILY)
44. SILVERWARE (MARITAL)
45. TOASTER (MARITAL)
46. PLANTS
47, BOWLS AND PLATTERS
48. SET OF BRASS
49. SET OF CRYSTAL
50. STEEL SHELVES IN LAUNDRY ROOM
51. 2 CLOCKS
52. 3 HOME INTERIOR SHELVES & MIRROR (MARITAL)
53. TABLE CLOTH LINENS
54. SKILLET, WOK, BLENDER
55. DAD'S CAMERA
$6. RECL!NER (LIZ'S FAMILY)".
51. TV, POWNSTAIRS ...
58, VCR, DOWNSTAIRS ...
$9; BLUE CKAIR, DOWNSTAIRS ...
~O. COUCH ANO CKAIR, DOWNSTAIRS (LIZ'S FAMILY)...
61. 2 END TABLES, DOWNSTAIRS (LIZ'S FAMILY)...
~2: PHONE, DOWNSTAIRS (LIZ'S FAMILY)."
63; CHINA SET (MARITAL-WEDDING PRESENT FROM LIZ'S MOM)'"
64, FILING CAnINET (LIZ'S PREMARITAL)...
.65, l/ANI',l'Y SET ...
66. DRESSER (LIZ'S PREMARITAL)...
67.: 4 LAMPS (LIZ'S FAMILY)".
68. CLOCK RADIO (LIZ'S PREMARITAL)."
69. COFFEE POT...
'10. FLoUR,SUGAR, COFFEE AND TEA COtlTAINERS***
71. SET OF CORNING WARE.'.
72. REVEREWARE".
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DIANE G, RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
(717) 737-0100
DIANE G, RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
(717) 737.0100
73. HIl!l\h.
']4. S~ SOWL"SBT
75.. 'l'!JPPBRWARIl:
'6. UTENSILS FROM MOMt**
'1.7.. RlCIPBS.*.
'1.$. ,FOOD PROCESSOR
'19. BOWLS."
~O. POTS.....
,81, CROCl( POT.*.
iJt.BUNDT1>1INANO CAKE PAN***
~3; COOIUESHEETANDMUFFIN" PANs."
~4; TEAPOT".
~5. PICTURE OF LIZ THAT KURT DREW (LIZ GIFT)
~(j. CLOC1:{JANA BROUGHT LIZ FROM EUROPE (LIZGlli''f)
87. STATU'l'EFROMDONNA (LIZ GIFT)
8e.2 LAB PUPP-y FIGURINES
1J9;SEAGutX.SF'ROlfHOME INTERIORS
P,Q; ~DDtNGP1{ESS(Ltz PREMARIT1\L)
~J,? ~OOK~(I,IZl>IlEMARITAL)
112. t>A!);SJ)E~lrANTLERS (LIZGIli''I')
93. l)A!)'S.BI~OCT]tAR.S (LIZGIF,!,)
94;ClI1tIS'rMASSXCHANGE PLATES
PS; CHllISTJGl,S.SLEIGH" HOME 'INTgRI()R~
~(j} CHRISXM.lI.SJ'lCTURE, HOME INTERIORS
97; tlU'I'Cf!A.CKSllS ,AND MUSICAL N"l1TCRACKEll
~a::c.eRAktCCHlttSTMASTltEJIJ
99; Cll:ltrS'I'MAS COLLECTIBLES PlJRC!tASSOA'l'(SQ$(:Q,V$
;lOo; ORNAMENTS
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Diane Radcliff. Esquire
For the Plail1liff
rn~It.{,.t
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Keilh II. DeArmond. Esquire
For the Dcfendal1l
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
SCOTT A. POTTER,
Defendant
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
TEMPORARY PROTECTION ORDER AND NOTICE OF SCHEDULING OF HEARING
AND NOW, this ~ Day of March, 1998, upon consideration of
the within Petition and upon motion of Diane G. Radcliff, Esquire,
Attorney for the Petitioner/Plaintiff, Elizabeth K. Potter, IT IS
HEREBY ORDERED THAT a hearing is scheduled on the within Petition
for the .; t, day of March, 1998 at ~ t, S 0 O'clock, L.m. in
Courtroom
I
of the Cumberland County Courthouse, Carlisle,
Pennsylvania. The parties are directed to appear at that date time
and place, preferably with legal counsel representing them and give
testimony on the issues raised in the attached Petition.
IT IS FURTHER ORDERED that between now and the time of the
hearing, the Respondent/Defendant, Scott A. Potter, is temporarily:
a. directed to refrain from abusing the Plaintiff.
b. prohibited from having any contact with the Plaintiff.
c. enjoined from entering Plaintiff's place of business,
Plaintiff's residence and from harassing the Plaintiff or
Plaintiff's relatives.
d. enjoined from stalking or harassing the Plaintiff.
NOTICE Is hereby given to the Defendant that a violation of
this Temporary Protection Order will subject the Defendant to
DIANE G. RADCLIFF
344B TRINDLE ROAD
CAMP HILL, PA 17011
17171737.0100
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
SCOTT A. POTTER,
Defendant
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
PETITION FOR RENEWAL OR EXTENSION OF PROTECTION FROM ABUSE ORDER
PURSUANT TO 23 Pa C.S.A. 6101 ET. SEC.
And now, this
&.d
day of March 1998, comes the
Petitioner/Plaintiff, Elizabeth K. Potter, by her attorney, Diane
G. Radcliff, Esquire, and files the above referenced Petition and
represents that:
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL. PA 17011
(717) 737.0100
1. Your Petitioner/Plaintiff is Elizabeth K. Potter an adult
individual residing at 126 North Front Street, 2nJ Floor,
Wormleysburg, Pennsylvania 17043.
2. Your Respondent/Defendant is Scott A. Potter an adult
individual residing at 931 South 31';t Street, Camp Hill,
Pennsylvania 17011.
3. The parties are husband and wife having been married on June
20, 1987 and separated on November 25, 1996.
4. After a hearing held on a Protection from Abuse Petition
previously filed by the Petitioner/Plaintiff in this case, the
Honorable J. Wesley Oler, Jr., JUdge of the Court of Common
Pleas of Cumberland County entered a Protection Order dated
January 13, 1997 generally enjoining the Respondent/Defendant
- 3 -
from abusing the petitioner/Plaintiff, harassing, stalking or
contactinq her at her residence or place of employment. A
true and correct copy of the January 13, 1997 Order is
attached hereto, marked Exhibit "AN and made a part hereof.
5.
Since the entry of the Januilry 13,
1997 Order, the
Respondent/Defendant has engaged in a course of conduct,
pattern or practice which indicates continued risk of harm to
the petitioner/Plaintiff and which
which causes the
petitioner/Plaintiff to have a reasonable fear for her safety.
The following are examples of that conduct, pattern or
practice:
a. On or about september 9, 1997, the Respondent/Defendant
telephoned the petitioner/Plaintiff at her place of
employment and threatened her or left a threatening
message for her on her voice mail. As the result of
conduct, the petitioner/Plaintiff contacted the police
and the district attorney's office and caused a letter
dated September 24,
Respondent/Defendant
1997 to
be
sent
to
the
pertaining
to
this threatening
action. A true and correct copy of the september 24,
1997 letter is attached hereto, marked Exhibit "BN and
made a part hereof.
b. On or about December 26, 1997, the Respondent/Defendant
had phone contact with the petitioner/Plaintiff and
advised her that she better watch out since her PFA Order
was about to run out. The petitioner/Plaintiff believed
this to be a threat to her physical well being. As the
result of this conduct the petitioner/Plaintiff caused
DIANE G. RADCLIFF
3MB TRINDLE ROAD
CAMP HILL, PA 17011
{7171737.0100
- 4 -
;1
r
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
(7171737.0Ioo
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letters dated December ?9, 1997 to be sent to the
Respondent/Defendant and his leqal counsel, Max A. Smith,
Jr., Esquire, di rectin() the Hespondent/Defendant to
process all communication bet.ween leqal counsel and not
to contact the Petitioner/Plaintiff in person or by
phone. True and correct copies of the two (2) December
29, 1997 letters are attached hereto, collectively marked
Exhibit "CN and made a part hereof.
c. On or about February 25, 1998, the day after the
Petitioner/Plaintlff had spent the night at her sister's
home, the Respondent/Defendant telephoned her at her
employment and in a threatening manner questioned where
she had slept the night before, informing her that she
was driving him over the edge.
This conversation
indicated
Petitioner/Plaintiff
the
that
to
the
Respondent/Defendant had been stalking her and that he
was unstable causing her fear for her physical safety.
d.
Sa turday,
February 28,
the
1998,
On or
about
Petitioner/Plaintiff went to the Respondent/Defendant's
residence (the previous marital residence) to effectuate
a custodial exchange of the parties dog, Hershey, in
accordance with the Order dated March 3, 1997 as
reaffirmed by the Order dated July 23, 1997 entered by
the Honorable Kevin A. Hess, Judge of the Court of Common
Pleas of Cumberland County Pennsylvania.
A true and
correct copy of which is attached hereto, marked Exhibit
"DN and made a part hereof. A true and correct copy of
the Order dated July 23, 1997 is attached hereto, marked
- 5 -
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Exhibit"!-:" dnd mad" d ['drt hereof.
When the
Petitioner/Plaint.il j arr ive she found the marital home
locked and that ilcceS0 to the dog was being denied her by
the Respondent/Defendant. The Hespondent/Defendant then
exited the home and Cilme onto the porch and informed the
Petitioner/Plaintiff that if he would not give her the
dog unless she showed hi lli respect and that if he ever
caught her with another man he would kill her. The
Petitioner/Plaintiff managed to get the dog into her car
and the Respondent/Defendant came after her and tried to
drag the dog out of her car. As the Petitioner/Plaintiff
attempted to leave, the Respondent/Defendant told her
that he was going to slit her throat while at the same
time he made a slicing motion across the front of his
neck.
As
the
result
of
this
conduct
Petitioner/Plaintiff
immediately
left
the
the
Respondent/Defendant's residence and contacted the police
to report the incident.
6. As the result of the aforesaid continuing action, pattern or
practice, the Petitioner/Plaintiff has a reasonable fear for
her continued safety and requires the entry of a protection
fro abuse order.
7. The Petitioner/Plaintiff believes that if contact between the
Petitioner/Plaintiff and the Respondent/Defendant is lessened
the threat to the safety of the Petitioner/Plaintiff will also
be lessened. As the result thereof, the Petitioner/Plaintiff
believes that she should be granted temporary sole custody of
the parties' dog, Hershey, so that she need not have any
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
17171737.0100
- 6.
contact with the Respondent/Defendant or in the alternative
that the Orders of Court attached as Exhibit "D" and "En
i
f
should be modified to alternate the custodial periods on a
biweekly basis and to have the custodial exchanges for the dog
occur at a public location.
8. The Respondent is currently represented by Max A. Smith, Jr.,
Esquire, although said attorney has not officially entered his
appearance in the within action nor has he responded to the
Petitioner/Plaintiff's legal counsels inquiries pertaining to
settlement of the economic issues.
9. The following Judges were previously assigned to this case:
a. JUDGE J. WESLEY OLER, JR.: January 1997 Protection from
Abuse proceedings;
b. JUDGE KEVIN A. HESS: March 1997 and July 1997 Special
Relief proceedings regarding injunctive relief pertaining
to personalty and custody of the parties' dog, Hershey.
WHEREFORE, your Petitioner/Plaintiff respectfully requests this
Honorable Court to enter an Order:
a.
Di recting
the
Respondent/Defendant
from
abusing
the
Plaintiff/Petitioner/Plaintiff;
b. Prohibiting the Respondent/Defendant from stalking, harassing
or having any contact whatsoever with the Petitioner/Plaintiff
whether at her residence, place of employment or any where in
the commonwealth, whether in person or by phone;
c. Enjoining the Respondent/Defendant from entering or phoning
the Petitioner/Plaintiff at her residence or place of
employmen t;
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL. PA 17011
1717) 737.0100
- 7 -
EXHIBIT "An
JANUARY 13, 1997 PROTECTION ORDER ENTERED BY JUDGE OLER
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
1717)737.0100
- 10-
4. The Defendant, Scott A. potter, shall provide
I
plaintiff, Elizabeth K. potter, through her counsel, with a key
to the marital residence.
5. This Order shall remain in effect for a
period of one year.
6. The Lower Allen Township police Department
shall be provided by Plaintiff's counsel with a copy of this
Order, as shall any other police department or law enforcement
office which she deems appropriate, and may enforce this Order
by arrest for indirect criminal contempt without warrant upon
probable cause that this Order has been violated whether or not
the violation is committed in the presence of the police or law
enforcement officer, In the event that an arrest is made under
this Order, the Defendant shall be taken without unnecessary
delay before the Court that issued the Order. When that Court
is unavailable, the Defendant shall be taken before the
appropriate district justice.
7. The Defendant is charged with the surcharge
for this proceeding provided by law,
8. The Defendant was present in Court for the
dictation of this Order, and a copy of the Order shall be mailed
to Defendant by plaintiff's attorney by ordinary mail to the
address provided by Defendant at the hearing.
By the Court,
T",.., r"'ov F!>I"'~J p!:CORD
I- .' t. ,.~'l"" ....
Ie, ~ ", . ,," ~;, I \., r~ L~,IC ~;1 my hand
a.~llll'; :':~, (J; ~J;t: ~1,;'J.1 at Carlisle, Pa.
ib;s J'ftk- day ofQ~!l.o.,.., 19..1..7
~ J.-.;?-
....C.l.....V....u -, , l
........,..,.... .. j)n-' Prolhonot~
J
SEPTEMBER
EXHIBIT "B"
24, 1997 LETTER TO SCOTT A. POTTER
FROM DISTRICT ATTORNEY
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
17171737.0100
- II -
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,
OFFICE OF THE DISTRICT ATTORNEY
CUMSERLAND COUNTY
ONE COURTHOUSE SQUARE
CARLISLE, PENNSYLVANIA 17013
..
M L. e;BERT, JR.
DISTRICT ATTORNEY
(7171 Z4Q-6Z10
(717) 697-037', En tJ210
(717) !53Z-72815, En 6210
FAX: (717) 240-15164
September 24. 1997
Mr. Scott A, Potter
931 South 31 M Street
Camp Hili, PA 17011
Dear Mr. F'Jtter:
On January 13, 1997. Protection From Abuse Order No. 97-0035 was signed by the Honorable J. Wesley Oler.
Jr., Judge and placed Into effect for a period of one year. Protection From Abuse Order No. 97-0035 lists Elizabeth K.
Potter as the plaintiff and you, Scott A. Potter, as the defendant.
The Office of the District Attorney. Criminal Investigation Division Is currently in receipt of a criminal complaint filed
by the Esat Pennsboro Police Department. Patrolman Rynard alleges that on September 9, 1997 at approximately 1400
hours and 2250 hours, you, Scott A. Potter did directly violate Protection Order No. 97-0035 by telephoning the plaintiff at
her place of employment and personally threatening her and/or leaving threatening telephone messages on her voice mail.
Mr, Potter, paragraph 3 of Protection From Abuse Order No. 97-0035 states. "The Defendant. Scott A. Potter. is
prohibited from contacting the Plaintiff, Elizabeth K. Potter, at work and is prohibited from harassing the Plaintiff,. Penalties
for violating the provisions of Protection From Abuse Order No. 97-0035 are a possible conviction of indirect criminal
contempt under 23 Pa,C,S. 96114, punishable by imprisonment up to six months and a fine of $100.00 - #1,000.00.
Mr, Potter. at this time, the Office of the District Attorney, Criminal Investigation Division does not intend to file a
petition of Indirect Criminal Contempt on the alleged incident of September 9. 1997, Although, please be advised, Mr.
Potter, any further allegations of Indirect Criminal Contempt received by this office can result In a petition being filed on
both the allegation of September 9, 1997 and any new allegations.
Should you have any questions or concerns regarding this correspondence or Protection Order No. 97-0035,
please do not hesitate to contact this office at, (717) 240-7806.
;"~ (: nlTl
=-.J-U-~
Letitia . Woodford
County Detective
Office of the District Attomey
cc: Elizabeth K. Potter
Diane G. Radcliff, Esquire
Patrolman Rynard. East Pennsboro Township Potice
DIANE G. RADCLIFF
3448 Trindle !Wad
Camp Hill. Pennsylvania 170 II
Telephone (717) 737-0100
Voice Mail (717) 558-5518
Fax (717) 975-0697
December 29, 1997
Max J. Smith, Jr., Esquire
134 Sipe Avenue
Hummelstown, PA 17036
Re: potter v. potter
Dar Max;
I received a telephone call from Liz potter today informing me
of certain difficulties that she has experienced with her husband,
Scott potter. She informed me that on Friday, December 26, 1997,
upon receipt of a copy of my December 24, 1997 letter to you, she
contacted Scott to confirm with him the time of the Saturday
custodial exchange for Hershey. In that conversation Scott
apparently again expressed the fact that he felt he was entitled to
substantial additional time due to the fact that he did not have
custody of Hershey basically since the time of the last hearing.
When Liz responded that this matter had been dealt with before and
that she thought they had an agreement for him to .have this one
week period, he responded that she was not to bother bring Hershey
over to his house and that he would see her in court.
In spite of this communication, Liz went to scott's house on
Saturday to deliver Hershey as we agreed. When Scott answered the
door, they apparently had a repeat of their above referenced
telephone conversation ending again with the statement by Scott
that she was not to bother leaving Hershey with him and that he
would see her in court.
I do not want to continue to have Liz experience this kind of
harassment. As indicated to Scott in my prior correspondence, we
are willing to give Scott his future custodial rights with Hershey.
We are not willing to give him make up rights since Hershey was
always available to him and he voluntarily chose not to exercise
his rights with her. If he disputes this, he should file the
appropriate petition rather than continue to play these games. You
DIANE G. RADCLIFF
HI8 Trindlc Road
Camp Hill, Pennsylvania 170 II
Telephone (717) 737-0 LOll
Voice Mail (717) 558-n L8
Fax (717) 975-0697'
December 29, 1997
Scott A. Potter
931 South 31ft Street
Camp Hill, PA 170~1
Re: Elizabeth Potter
Dar Mr. Potter:
Your Wife, Elizabeth Potter, has requested that I contact you
pertaining to future communication between the two of you. She has
requested that I advise you that all such communication, whether in person
or by phone or letter is to take place between the attorneys and not
directly between you and Liz.
I am, therefore, instructing you that you are not permitted to contact
Liz in person, either at her residence or place of employment. Nor are you
permitted to have any oral or written communication with her. A violation
of these instructions will result in the processing of criminal charges
against you under the Harassment by Communications and/or Criminal Trespass
criminal statutes. If any communication is necessary, it should take place
between each of your respective legal counsel.
1 have forwarded a copy of this letter to your attorney, Max J. Smith,
Jr. Esquire so that he may advise you of its legal ramifications. I have
also provided a copy to the local police department having jurisdiction
over this matter so that they are apprized of this situation should their
intervention become necessary.
DGR/dr
\
(
cc: Liz Potter
Max J. Smith, Jr., Esquire
Wormleysburg Police Department
Transmission by: Certified and Regular Mail
v.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
No. 97.0035 CIVIL TERM
i
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,
ELIZABETH K. POTTER,
plaint if f
AND NOW this
..3 il<L
day of
-r>-1 (l.\.(" ...""
.
, 1997 in
SCOTT A. POTTER,
Defendant
CIVIL ACTION . LAW
DIVORCE/PROTECTION FROM ABUSE
ORDER
consideration of the within petition, it is hereby ordered
and decreed that: I ' '
-<..;.ct .r........ .~k....Uct -"".F"h> rJU-t.t~ "6 J:;J/r~.la.~""'t .
(1) A hearing Hl :Jd,,,Jul,,d ror the - --------dayof
- ;--r99"7at- 0' duc;k . M. TIlCour t RO~
R~nCl.ent shall
~nrp<:p~t-iJ;l3 hLII,
appear, prefprAhly
tlme and 1-'laee-the,
,-.I; t-n 111'J<l' ("'nl~
&mbAT 1 ~nrl CQ"ntj
CO.He Iluu::." dL whIch
and snall ::.l,uVl cau:Jc \:h~' Hip TP] ief
",p'l"fiEtee in LIlt" E'"dtt-on should not be grauted.
(2) Pendir:, cr,;; 1,e:~J;;"":; afor-::said the Respondent is
hereby enjoined from selling
transferring, conveying,
giving away or otherwise disposing of the dog, Hershey.
\NE G. RADCLIFF
[TORNEY.AT.LAW
HS TRINDLE ROAD
,\~IP IIILL. PA 17011
EXHIBIT "En
JULY 23, 1997 SPECIAL RELIEF ORDER ENTERED BY JUDGE HESS
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
17171737.0100
- 14-
,
.
ELIZABETH K. POTTER,
Plaintiff/Respondent
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
V
CIVIL ACTION - LAW
SCOTT A. POTTER,
Defendant/Petitioner
97-0035 CIVIL TERM
IN DIVORCE
IN REI PETITION FOR SPECIAL RELIEF
ORDER OF COURT .
AND NOW, this 23rd day of July, 1997, pending
further order, the parties hereto are enjoined from disposing
of, transferring, encumbering, concealing, selling, removing or
alienating any personal property of the parties.
The parties hereto shall share possession of
their dog Hershey as set forth in our order of March 3, 1997.
Otherwise, the pending petition and
cross-petition for special relief are dismissed.
By the Court,
'/7IL
Diane C. Radcliff, Esquire
Attorney for Elizabeth K, Potter
Keith B, DeArmond, Esquire
Attorney for Scott A. Potter
Hess, J.
Ibg
TRUE C<iPY FROM RECORD
In Tas"r.1~"V " Ii r .,f, ! ;, . 'I~'O ,Jt my hand
and the s"JI 0; said Cou:: at Cirli!le, Pa.
Thisi?!-f;t!", day Of_~...,19..9.,:1.
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ELIZABETH K. POTTER,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
t
v.
NO. 97-0035
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
SCOTT A. POTTER,
Plaintiff
ORDER OF COURT
AND NOW, this '(It day of March, 1998 upon relation of Max
J. Smith, Esquire, on behalf of Defendant that he and Plaintiff's
counsel, Diane G. Radcliff, Esquire, are in agreement that the
hearing in this matter scheduled for March 5, 1998 at 8:30 a.m, be
rescheduled to a later date, the hearing is rescheduled for April
2l, 1998 at 8:30 a.m.
PENDING THE HEARING, the temporary order under the Protection
from Abuse Act dated March 3, 1998 shall remain in full force and
effect,
BY THE COURT,
Diane G, Radcliff, Esquire
3448 Trind1e Road
Camp Hill, PA 17011
Attorney for Plaintiff
Max J. Smith, Jr" Esquire
P.O. Box 650
Hershey, PA 17033
Attorney for Defendant
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A
DIANE G, RADCLIFF
3448 TAINDLE ROAD
CAMP HILL, PA 17011
17171737-0100
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
SCOTT A. POTTER,
Defendant
ORDER
AND NOW, this -L!} tl day of --Rr~( 1998, upon
consideration of the within Stipulation of the parties, IT IS
HEREBY ORDERED that:
1. The Defendant is prohibited from abusing the Plaintiff.
2. The Defendant is prohibited from entering Plaintiff's
place of business or Plaintiff's residence and from
harassing the Plaintiff or Plaintiff's relatives.
3. The Defendant is directed to refrain from stalking the
Plaintiff.
4. The Defendant is prohibited from having any contact with
the Plaintiff. The foregoing further shall not prevent
the Defendant from having one telephone call per week
with the Plaintiff at her place of employment during
normal working hours limited to discussions on matters
relating to the parties' dog, Hershey, and financial
matters relating to the divorce. The foregoing further
shall not prevent the Defendant from having incidental
and limited contact with the Plaintiff for purposes of
exchanging the custody of the parties' dog, Hershey, in
accordance with the following set forth terms and
conditions.
5. Pending further Order of Court, the parties shall
DIANE G, RADCLIFF
3448 TRINDlE ROAD
CAMP HILL, PA 17011
17171737.0100
continue to share custody of their dog, Hershey, on an
alternating week basis. Any other Order of this Court
notwithstanding, the custodial exchanges shall be made on
Saturdays at 12:00 p.m. at the parking lot of the Country
Ki tchen restaurant in Camp Hill, Pennsylvania. The
parties or their agreed upon designees shall arrive
promptly for these exchanges so that their custodial
exchanges can be made with minimal inconvenience to or
contact between the parties.
6. Notice is hereby given to the Defendant that a violation
of this Order will subject the Defendant to arrest under
Section 6113 (relative to arrest for violation of Order)
or contempt of court under Section 6114 (relative to
contempt for violation of order or agreement) and may
result in imprisonment of up to six (6) months and/or a
fine of not less than $100.00 nor more than $1,000.00.
7. This Order shall remain in effect for a period of one
year from the date of this Order.
8. This Order is entered without admission on the part of
the Defendant as to the allegations in the Plaintiff's
Petition, and therefore the entry of this order is
without prejudice to the Defendant and cannot be used
against the Defendant as an admission in any other
proceedings between the parties.
9. Two copies of this Order shall be distributed to each of
the counsel for the parties: Diane G. Radcliff, Esquire
for Plaintiff and Max J. Smith, Jr., Esquire for
Defendant. Additionally, a copy of this Order shall be
served by the Plaintiff's legal counsel upon the
- 2 -
apprOpr'd!" l>lll i,'" d"pdrtlllent having jurisdiction over
tl1.. 1'1.01111 ill':; r..:iid"lIce iJnd place of employment.
BY THE COURT:
IJi:;lrll,llllon of this order is to be made to:
illdll.. (;. Hddcliff, Esquire
q~H Trilldle HOild
Calllp IlIII, PA 17011
Allorlll'Y lor the Plaintiff
Mdx .1. :;n1lth, .Jr., Esquire
I I~ :, i P(' Avenue
IlIIlllllll'I:;tuwn, PA 17036
AUorlll'Y for the Defendant
-
~>-
rn,,';...L,l 4/~llqg,
.g. of .
DIANE G llAOCLIIf
3448 TIlINOLE nOAD
CAMP HIU, I'A 17011
1717) 7370100
- 3 -
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
(717) 737-0100
IN THE COURT
ELIZABETH K.
OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
POTTER,
Plaintiff
NO. 97-0035
V.
SCOTT A. POTTER,
Defendant
CIVIL ACTION - LAW
DIVORCE/PROTECTION FROM ABUSE
STIPULATION
AND NOW, this ~ day of --J3~(l. 1998, the parties
El i zabeth K. Pot ter, Plainti ff, and Scott A. Potter, Defendant,
together with their respective legal counsel, Diane G. Radcliff,
Esquire for the Plaintiff and Max J. Smith, Esquire for the
Defendant, do hereby stipulate and agree as follows:
1. The Defendant shall be prohibited from abUsing the
Plaintiff.
2. The Defendant shall be prohibited from entering
Plaintiff's place of business or Plaintiff's residence
and from harassing the Plaintiff or Plaintiff's
relatives.
3. The Defendant shall be directed to refrain from stalking
the Plaintiff.
4. The Defendant shall be prohibited from having any contact
with the Plaintiff. The foregoing shall not prevent the
Defendant from having one telephone call per week with
the Plaintiff at her place of employment during normal
working hours limited to discussions on matters relating
to the parties' dog, Hershey, and financial matters
relating to the divorce. The foregoing further shall not
prevent the Defendant from having incidental and limited
- 4-
~
~.
!
contact with the Plaintiff for purposes of exchanging the
custody of the parties' dog, Hershey, in accordance with
the following set forth terms and conditions.
5. Pending further order of Court, the parties shall
continue to share custody of their dog, Hershey, on an
alternating week basis. Any other Order of this Court
notwithstanding, the custodial exchanges shall be made on
Saturdays at 12:00 p.m. at the parking lot of the Country
Kitchen restaurant in Camp Hill, Pennsylvania. The
parties or their agreed upon designees shall arrive
promptly for these exchanges so that their custodial
exchanges can be made with minimal inconvenience to or
contact between the parties.
6. The Defendant is aware and has been give notice that a
violation of this Order will subject the Defendant to
arrest under Section 6113 (relative to arrest for
violation of Order) or contempt of court under Section
6114 (relative to contempt for violation of order or
agreement) and may result in imprisonment of up to six
(6) months and/or a fine of not less than $100.00 nor
more than $1,000.00.
7. The Order to be entered pursuant to the terms of this
Stipulation shall remain in effect for a period of one
year from the date of the Order.
8. This Stipulation and the Order to be entered pursuant to
the terms of this Stipulation is entered without
admission on the part of the Defendant as to the
allegations in the Plaintiff's Petition, the Defendant
expressly denying said allegations, and therefore the
DIANE G, RADCLIFF
3448 TRINOLE ROAD
CAMP HILL, PA 17011
17171737.0100
- 5 -
entry of this Stipulation and any order to be entered
pursuant to this Stipulation is and shall be without
prejudice to the Defendant and cannot be used against the
Defendant as an admission in any other proceedings
between the parties.
9. The parties expressly authorize the court in the above matter
to enter an order in accordance with the terms of this
Stipulation.
IN WITNESS WHEREOF, the parties and their legal counsel have set
their hands and seals the day and year below written.
~~AB~~-\~. ~OTS~~P.,\
DATED: , 1\::? I \ -q 't
3~psr
~; fry 91;t: (, )
LIIH hl
E
..:.: 'Jfr7i/l Il~~
SCOTT A. POTTER
f/.9/7~P
DATED:
DATED:
DIANE G, RADCLIFF
3448 TRINDLE ROAD
CAMP HILL, PA 17011
17171737-0100
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EL/ZABETI/ K. PonER,
Plainliff
IN TIlE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNS YL VANIA
vs,
97-0035 CIVIL
scan A. PonER,
Dcfendant
CIVIL ACTION - LA W
ORDER OF COIJR"(
AND NOW. this
II.
/..
day of April. 1998. upon considcration of the
attached letter from plaintill's counsel. Diane G. Radcliff, Esquire, the hearing scheduled for
April 21. 1998, is cancclled.
BY THE COURT,
Diane G. Radcliff, Esquire
3448 Trindle Road
Camp Hill. PA 17011
Attorney for Plaintiff
I, 'I'
I " ,
I/c., ( r:{ _
J.iWesley Oler,/r., ]; ('1
/
Max J. Smith, Jr., Esquirc
P. O. Box 650
Hershey. PA 17033
Attorney for Dcfendant
:r1m
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G~
DIANE G. RADCLIFF
344H Trindle RllJll
Calllp Hill. Pennsylvania 17011
Telephone (717) 737 -0100
Voice Mail (717) 55H-551H
Fax (717) 975-0697
April 15, 1998
The Honorable J. Wesley Oler, Jr.
Cumberland County Courthouse
One Courthouse Square
Carlisle, PA 17013
Re: Potter v. Potter
Dear Judge Oler:
This letter is to advise you that the parties have reached an
agreement pertaining to the PFA Petition which is scheduled for
hearing on April 21, 1998. A stipulation has been executed by them
which is being transmitted to me in the next day or so. I hope to
have that Stipulation and Proposed Order to you in this matter by
Friday. In the interim, you may feel free to remove this hearing
from your calendar.
DGR/dr
cc: Liz Potter
Attorney Max Smith
I
, ESQUIRE
~
t
.'
1'I.II.AIIEIII K. 1'01 II 'It
Plaintiff
IN lllH'OliR r or CO\I\ION PI.I'AS
l'l1\II1LRI.AND COliN IY. PI'NNSYl.V ANI,\
\'S.
NO. '17.1I11l5
SCOTl A, POTll:lt
Iklcl1llant
('(VII. .K liON. I.A W
IN DIVORCL
PRAITIPI': 10 WITIIDRA W APPEARANCI:
nl'lllI: I'IWTllllMITARY:
Please withdraw the appearance of Keith II. DeMmond. Esquire as eounsellilr Scott i\.
Potter. Delcndant in the ahove-captioned matter.
Date: .-i ~q_'i!'___. I <)9H _~~'~"-l-~'/
y-' Keith II. DeMmond. Esquire
DeMmond & IkArmond
2HOO Market Strect
Camp lIill. PA 17111 I
PRAECIPE TO ENTER APPEARANCE
TO TilE PROTIIONOTARY:
Please enter the appearance of ~Iax J. Smith. Jr.. Esquire. as counselliJr Scott A. Potter.
Iklenoalll in the ahove-capltoncd matter.
Date: ~!i' 1-
.199H
qJ1c.~Cl!
----;----;---.-:-~.-'ii~----- ---
MAX J. SMIIII. JR.. !:sqUIre
JAMES. SMITII. DlIRKIN & CONNEI.I.Y III'
P,O. lIox 6511
Ilcrshey.PA 1703-'
(717) 5-,-,--,2HO
DIANE G. RADCLIFF
3448 Trindlc Road
Camp Hill. Pcnnsylvania 17011
-~~-
Telephonc(717) 737-0100
Voicc Mail (717) 558-5518
Fax (717) 975-0(,c)7
September 9, 1998
E. Robert Elicker, Esq.
Office of Divorce Master
Cumberland County Court
9 North Hanover Street
Carlisle, PA 17013
Re: Potter v. Potter
No. 97-0035
Dear Mr. Elicker:
Pursuant to your preliminary Order entered in this case, I am
enclosing herewith the Plaintiff's Pre-Trial Statement which was
due to be filed no later than September 18, 1998.
I
DGR/cea
Enclosure: Plaintiff's Pre-Trial Statement
cc: Elizabeth Potter (w/enclosure)
Max J. Smith, Esquire (w/enclosure)
q/~~Yf,
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
SCOTT A. POTTER,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
AND NOW, this
ERE=..TRIAL-S.TATEMEN'l'
day of
, 1998,
comes the Plaintiff, Elizabeth K. Potter, and files the following
set forth Pre-Trial Statement:
TABLE OF CONTENTS
1. Background information.
2. Listing of warital assets and debts.
3. Pensions.
4. Income and expenses.
5. Counsel fees and costs.
6. Experts.
7. Other witnesses.
8. Listing of proposed exhibits.
9. Proposed resolution.
Respectfully Submitted,
DATED:
q -l \-9~
,"
\ ~
,_.._..... L_
DIANE-G-- , ESQUIR
3~Trind e Road
C PA 17011
Supreme Court ID # 32112
phone: (717) 737-0100
Fax: (717) 975-0697
Attorney for Plaintiff
1J11\NEli ItAI}{'l.IH
J44K 1 HINllI L I{()AIl
CAMPIIII.I..I'A 17011
1'1I0NLt71717J7.01ll0
FAX 1717IlJ7~.uhln
fl) tI .l~II:!
I.
(
I. BACKGROUND. INFORMATION
A. PARTIES:
HUSBAND
NAME SCOTT ALLEN POTTER
ADDRESS 931 SOUTH 31'" STREET
CAMP HILL, PA 17011
DATE OF BIRTH 4/4/61
PLACE OF BIRTH HARRISBURG, PA
SOCIAL SECURITY NUMBER 168-48-3519
HEALTH GOOD
EMPLOYER DAUPHIN DEPOSIT BANK
OCCUPATION COMPUTER ANALYST
LENGTH OF RESIDENCY IN PA ENTIRE LIFE
EDUCATIONAL BACKGROUND HIGH SCHOOL GRADUATE
COMPUTER SCHOOL
DATE OF BIRTH
PLACE OF BIRTH
SOCIAL SECURITY NUMBER
HEALTH
EMPLOYER
OCCUPATION
LENGTH OF RESIDENCY IN PA
EDUCATIONAL BACKGROUND
WIFE
ELIZABETH KATHERINE POTTER
126 NORTH FRONT STREET, SECOND FLR.
WORMLEYSBURG, PA 17043
7/24/63
JOHNSTOI'IN, PA
210-58-6414
GOOD
KEYSTONE HEALTH PLAN
CLINICAL HEALTH CARE SPECIALIST
ENTIRE LIFE
HIGH SCHOOL GRADUATE
4 MONTHS COURSE IN AIRLINE TRAVEL
NAME
ADDRESS
DIANE G, RADCLIFF
3448 TRINDLE ROAD
CAMP H'lL, PA 17011
PHONE 1717) 737.0100
FAX 17171 975.0697
ID#32112
Page 2
B. CHILDREN OF THIS MARRIAGE:
NAMES
NONE
AGES
N/A
DATE OF BIRTH EMANCIPATION
N/A N/A
I COMMENTS: I N/ A
C. MARRIAGE INFORMATION:
DATE OF MARRIAGE
PLACE OF MARRIAGE
DATE OF SEPARATION
CIRCUMSTANCES OF SEPARATION
6/20/87
HARRISBURG, PA
11/25/96
WIFE LEFT DUE TO HUSBAND'S
THREATENED ABUSE
C. PRIOR MARRIAGES:
I WIFE
HUSBAND
D. CHILDREN OF OTHER
I WIFE
HUSBAND
E. PROCEEDINGS INFORMATION:
I NONE
NONE
RELATIONSHIPS/MARRIAGES:
I NONE
NONE
DATE ACTION COMMENCED
DATE OF SERVICE OF COMPLAINT
MANNER OF SERVICE OF COMPLAINT
ISSUES RAISED IN DIVORCE DIVORCE AND EQUITABLE
COMPLAINT DISTRIBUTION
JANUARY 3, 1997
DATE OF FILING OF ANSWER N/A
AND/OR COUNTERCLAIM
ISSUES RAISED IN COUNTERCLAIM N/A
BIFURCATION NONE
PREVIOUSLY RESOLVED ISSUES NONE
DIANE G, RADCLIFF
3448 TRINDlE ROAD
CAMP Hill, PA 17011
PHONE 17171 737.0100
FAX (717) 975.0697
10 # 32112 Page 3
II. MARITAL .ASSETS AND DEBTS 1
NO. DESCRI PTION VALUE POSSESSOR
1. 931 S. 31 sr ST. CAMP HILI, $100,000.00 HUSBAND
PA
2. 1987 PONTIAC GRAND AM $1500.00 WIFE AND
CURRENTLY; HUSBAND
$3,000.00 AT
SEPARATION
3. 1991 TOYOTA PICK UP TRUCK UNKNOWN HUSBAND
AND WIFE
4 . 1978 CHEVROLET CORVETTE 7,000.00 HUSBAND
AND WIFE
5. US SAVINGS BONDS UNKNOWN HUSBAND
6. WIFE'S VIP PLAN (9/30/96) 8,407.86 WIFE
7. WIFE'S KHP PENSION PLAN 9,695.12 WIFE
(7/30/98 VALUATION)
8. HUSBAND'S TO BE APPRAISED HUSBAND
WOOLWORTH/KINNEY PENSION
PLAN
9. HUSBAND'S HOUSEHOLD GOODS 12,165.00 HUSBAND
(SEE EXHIBITS ATTACHED
FOR LISTING)
10. WIFE'S HOUSEHOLD GOODS 325.00 WIFE
(SEE EXHIBITS ATTACHED
FOR LISTING)
11. HERSHEY (CHOCOLATE NONE WIFE AND
LABRADOR DOG) HUSBAND
11. HOMESIDE LENDING MORTGAGE (71,029.72) HUSBAND
TO BE UPDATED AND WIFE
12. PSECU CORVETTE PSL (4,585.25) HUSBAND
(11/15/96) TO BE UPDATED AND WIFE
13. PSECU TOYOTA PSL (6,228.94) HUSBAND
(11/15/96) TO BE UPDATED AND WIFE
14 VISA ACCOUNT 4121-4499- (1, 942.46)
9880-1802
TOTALS UNKNOWN AT THIS
TIME
DIANE G. RADCLIFF
3448 TRINDLE ROAD
CAMP HILL. PA 17011
PHONE 17171737.0100
FAX 17171975.0697
ID # 32112 Page 4
.
~
{
III. NON-MARITALASSETS_AND_DEBTS
NO.
DESCRI PTION
BASIS FOR
EXCLUSION
SEE EXHIBIT FOR HUSBAND OR
EXCLUSION BASIS WIFE
OWNER
25
HOUSEHOLD GOODS AND
FURNISHINGS
IV. PENSIONS
THE FOLLOWING IS A LISTING OF THE PENSIONS OF THE PARTIES:
PARTY DESCRIPTION
HUSBAND: WOOLWORTH'S/KINNEY'S PENSION: $207.48 PER MONTH AS
OF 4/1/26
WIFE: KHP PENSION: MONTHLY BENEFIT $314.73 PER MONTH AS OF
7/24/28; PRESENT VALUE $9695.12. SEE EXHIBITS FOR
APPRAISAL.
V. IHCOloIE AND EXPEtLSES
THE FOLLOWING IS A LISTING OF THE INCOME AND EXPENSES OF THE
PARTIES:
PARTY
HUSBAND
DESCRIPTION
GROSS MONTHLY INCOME
NET MONTHLY INCOME
MONTHLY EXPENSES
AMOUNT
UNKNOWN
UNKNOWN
UNKNOWN
WIFE
GROSS MONTHLY INCOME
NET MONTHLY INCOME
MONTHLY EXPENSES
2667.42
1904.41
2029.15
DIANE G. RADClIFF
3448 TRINDlE ROAD
CAMP Hill. PA 17011
PHONE (717)737.0100
FAX 17171975.0697
ID # 32112
Page 5
--'\
VI. COUNSEL. FEES
THE FOLLOWING IS A LISTING OF THE COUNSEL FEES AND EXPENSES
INCURRED BY THE PARTIES:
PARTY DESCRI PTION DATES AMOUNT
HUSBAND COUNSEL FEES N/A N/A
COSTS N/A N/A
ANTICIPATED FEES N/A N/A
AND COSTS
WIFE COUNSEL FEES N/A N/A
COSTS N/A N/A
ANTICIPATED FEES N/A N/A
AND COSTS
VII. EXP.ERT...JUTNESSES
THE FOLLOWING IS A LISTING OF THE ANTICIPATED EXPERTS WHO WILL
BE CALLED TO TESTIFY IN THIS CASE:
NAME
NONE KNOWN AT THIS TIME
SUBJECT OF TESTIMONY
N/A
ADDITIONAL EXPERTS WHO MAY BE CALLED TO TESTIFY ARE NOT KNOWN
AT THIS TIME. IF SUCH ADDITIONAL EXPERTS ARE RETAINED, THE WIFE
RESERVES THE RIGHT TO CALL THEM AS WITNESSES UPON PROPER
NOTIFICATION TO THE HUSBAND.
VIII. OTHER WITNESS.ES
THE FOLLOWING IS A LISTING OF THE ANTICIPATED WITNESSES OTHER
THAN EXPERTS WHO WILL BE CALLED TO TESTIFY IN THIS CASE:
NAME
ELIZABETH K. POTTER
SUBJECT OF TESTIMONY
HISTORY OF MARRIAGE AND EVIDENCE
PERTAINING TO THE RELEVANT FACTORS TO
BE CONSIDERED IN EQUITABLE
DISTRIBUTION.
ADDITIONAL WITNESSES WHO MAY BE CALLED TO TESTIFY ARE NOT
KNOWN AT THIS TIME. IF SUCH ADDITIONAL WITNESSES ARE IDENTIFIED,
THE WIFE RESERVES THE RIGHT TO CALL THEM AS WITNESSES UPON PROPER
NOTIFICATION TO THE WIFE.
DIANE G. RADCLIFF
3448 TRlNDlE ROAD
CAMP HILL. PA 17011
PHONE (717)737.0100
FAX 17171975.0697
ID # 32112
Page 6
DIANE G. RADCLIFF
3448 TRINDlE ROAD
CAMP Hill. PA 17011
PHONE (717)737.0100
FAX 17171 975.0697
ID#32112
IX. EXHIBITS
THE FOLLOWING IS A LISTING OF EXHIBITS WHICH ARE ANTICIPATED
TO BE SUBMITTED AT THE HEARING IN THIS CASE:
NO. DESCRIPTION
1. WIFE'S INCOME AND EXPENSE STATEMENT
2. APPRAISAL OR COMPARATIVE MARKET ANALYSIS OF MARITAL HOME
3. APPRAISAL OF 1987 PONTIAC GRAND AM (ATTACHED)
4. APPRAISAL OF 1991 TOYOTA PICK UP TRUCK
5. APPRAISAL OF 1978 CHEVROLET CORVETTE
6. DOCUMENTS PERTAINING TO HUSBAND'S US SAVINGS BONDS
7. WIFE'S VIP PLAN STATEMENT AS OF SEPARATION (ATTACHED)
8. WIFE'S KHP PENSION APPRAISAL (ATTACHED)
9. HUSBAND'S WOOLWORTH/KINNEY PENSION APPRAISAL
10. LISTING AND VALUATION OF HOUSEHOLD GOODS (ATTACHED)
11. HOMESIDE LENDING MORTGAGE STATEMENT AS OF DATE OF
HEARING
12. CORVETTE PSL STATEMENTS FROM SEPARATION AND HEARING DATE
13. TOYOTA PSL STATEMENTS FROM SEPARATION TO HEARING DATE
14. VISA ACCOUNT STATEMENTS AT SEPARATION AND HEARING DATE.
(SEPARATION DATE STATEMENT ATTACHED)
IF ADDITIONAL EXHIBITS ARE IDENTIFIED, WIFE RESERVES THE RIGHT
TO SUBMIT ADDITIONAL EXHIBITS UPON PROPER NOTIFICATION TO WIFE.
X. P~OEOSEDLRESOLUTION
A. EQUITABLE DISTRIBlJTIQN:
THE PARTIES MARITAL ASSETS AND DEBTS SHALL BE DIVIDED
EQUALLY. EACH PARTY TO RETAIN HIS OR HER RETIREMENT PLANS
WITH OFFSETTING CREDITS AGAINST OTHER ASSETS OR CASH PAYMENT
REQUIRED IF PENSIONS AND RETIREMENT PLANS ARE OF DIFFERING
VALUES. IF HUSBAND IS TO BUY OUT THE MARITAL HOME, HE IS TO
PAY WIFE 50% OF THE NET EQUITY VALUE. HE IS ALSO TO REFINANCE
THE MORTGAGE ON THE MARITAL RESIDENCE SO AS TO RELIEVE WIFE
FROM FURTHER LIABILITY THEREUNDER.
B. DIVORC~:.
A NON-FAULT DIVORCE DECREE EITHER UNDER SECTION 3301 C OR
3301 D SHALL BE ENTERED.
Page 7
EXHIBIT 1.
WIFE'S INCOME AND EXPENSE STATEMENT
DIANE G. RADCLIFF
3448 TRlNDlE ROAD
CAMP HILL. PA 17011
PHONE (717) 737.0100
FAX 1717)975-0697
ID # 32112
Page 8
B. OTHBR INCOME.
DBSCRIPTION
INTEREST
DIVIDENDS
PENSIONS
ANNUITIES
SOCIAL SECUR lTY
RENTS
ROYALTIES
EXPENSE ACCOUNT
GIFTS
UNEMPLOYMENT COMPENSATION
WORKMAJ1'S COMPENSATION
INCOME TAX REFUNDS
SUPPORT OR ALIMONY
COMMISSIONS
TIPS
OTHER ISPECIFY)
TOTAL OTHER INCOME
MONTHLY
5.74
YEARLY
69.53
5.74
69.53
PART II
EXPENSES
DESCRIPTION
HOME BXPENSES I
RENT
FIRST MORTGAGE
SECOND MORTGAGE OR HOME EQUITY LOAN
MAINTENANCE AND REPAIRS
ELECTRIC
GAS
OIL
WATER
SEWER
OTHER UTILITIES
TRASH
AMOUNT
525
30
DESCRIPTION AMOUNT
TELEPHONE 60
CABLE TV 25
REAL ESTATE TAXES
HOMEOWNERS INSURANCE/REtITERS
GROCERIES AND HOUSEHOLD SUPPLIES 200
TAXBS.
INCOME TAXES NOT WITHHELD 16.15
PER CAPITA/OCCUPATION TAXES 20
OTHER TAXES 1
AUTOMOTIVE AND TRANSPORTATION EXPENSES,
PAYMENTS
FUEL 85
MAINTENANCE AND REPAIR 75
LICEilSE AND REGISTRATION 3
PUBLIC TRANSPORTATION
INSURANCB,
AUTOMOBILE INSURAN:E 39
LIFE INSURANCE INOT DEDUCTED FROM PAY)
ACCIDENT INSURANCE
HEALTH INSURANCE INOT DEDUCTED FROM PAY)
OTHER INSURANCE
MEDICAL EXPENSES NOT RBIMBURSED BY INS. ,
MEDICAL/DOCTORS 4
DENTAL
OPTICAL 2
ORTHODONTIC
HOSPITAL
MEDICINE 4
SPECIAL NEEDS/THERAPY
EDUCATIONAL EXPBNSES,
PRIVATE/PAROCHIAL SCHOOL TUITION
COLLEGE/VOCATIONAL TUITIOn
ROOM AlID BOARD
DBSCRIPTION AMOUNT
FEES AND SUPPLIES
BOOKS
RELIGIOUS TRAINING
CRBDIT CARDS AND LOANS,
l. MEMBER'S 1" VISA BALAllCE 404.00 200
2. BON TOri BALAlJCE 0
3. SEARS BALANCE 0
4.
PBRSONAL BXPENSBS ,
CLOTHING 108
LAUNDRY AND DRY CLEAlJ ING 40
BARBER AND HAIR DRESSER 75
LUNCHES 60
MISCBLLANBOUS BXPENSBS.
HOUSEHOLD HELP
CHILD CARE
MEMBERSHIPS
NEWSPAPERS/MAGAZINES/BOOKS 18
ENTERTAINMENT 80
VACATIONS 100
GIFTS AND TOYS 90
CHARITABLE CONTRIBUTIOrlS 200
LEGAL FEES
OTHER CHILD SUPPORT
OTHER SPOUSAL SUPPORT/ALIMONY
OTHER MISC. EXPENSES VETRNIARY BILLS 32
EMPLOYMENT EXPENSES NOT DEDUCTED FROM PAY
UNIFORMS
OTHER EXPENSES-SPECIFY
TOTAL EXPENSES 2092.15
,
~
,
PROPBRTY OWNllD
OWNllRSHIP
TYPE
DESCR I PTION
H
W JT
VALUE
CHECKING
MEMBERS 1 'T
840
x
SAVINGS
MEMBERS 1 ST
x
1841
CREDIT UNION
STOCKS/BONDS
REAL ESTATE
931 S. 31 'T STREET, CAMP HILL
x
100,000
OTHER
CHRISTMAS CLUB ACCOmJT
344
x
INSURANCB COVERAGB
TYPE COMPANY POLICY NO. H W C
HOSPITAL/BLUE HIGHMARK BC/BS 210-58-6414 X
CROSS
MEDICAL/BLUE HIGHMARK BC/BS 210-58-6414 X
SHIELD
HEALTH ACCIDENT HIGHMARK BC/BS 210-58-6414 X
DISABILITY HIGHMARK BC/BS 210-58-6414 X
INCOME
DENTAL HIGHMARK BC/BS 210-58-6414 X
VISION HIGHMARK BC/BS 210-58-6414 X
OTHER-SPECIFY
*H~Husband: W=Wifei ,1=Joint; C=Child
1
,
SUPPLEMENTAL INCOME STATEMENT
[X] CHECK HERE IF NOT APPLICABLE
lal This form is to be fi lled out by a person:
(1) Who operates a business or practices a profession, or
(2) Who is a member of a partnership or joint venture, or
(J) Who is a shareholder in and is salaried by a closed
corporation or similar entity.
(b) Attach to this statement a copy of the following documents relating to
the partnership, joint venture, business, profession, corporation or
similar entity Icheck block to indicate the document is attached),
(11 The most recent Federal Income Tax Return. attached
(2) The most recent Profit and Loss Statement. attached
(c) Name of Business:
Business Address:
Business Telephone,
(d) Nature of Business (check onel
]
1
[ 1
[ J
l. Sole Proprietorship
2. Partnership
J. Joint Venture
4. Professional
5. Corporation
6. Other
[ J
(e) Name of accountant, controller or
other person in charge of financial
records:
If) Business Income,
1. Annual income from business:
2. How often is income received:
J. Gross income per pay period
4. Net income per pay period
5. specify deductions, if any'
,-'
I, ELIZABETH K. POTTER, verify that the facts set forth in the
foregoing Income and Expenses Form, including all attachments
thereto, are true and correct to the best of my knowledge,
information and belief. I understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. 4904 relating to
unsworn falsification to authorities.
DATE :<::t \'0 \ <\ "l
.
~'C'o.. 'u9~~. 1(\ Ro::A\,~~
ELIZABETH K. POTTER
"~r~x.~!9~
1'.)'1;'1111'
'>'Y 8ftin (hla:
"a t'ndlhle:
Il.ltP ',,",,11
Ii I.'"
01/11#1"'"
EJl"r~t f
OK" 000006654
C<< Ie: 01/16/"'"
:1
Pathr ,fllu&l.,,, ht".r lr"
ll' N frlmt It lnd flaor
~ar.l.v.bur, 'A 11a~1
t:mpllly"Ul:
Co,te.nllr:
I.onllon'
Job title:
P. hIE
GDnH
Vt III.-tlan """II,.."t kllPC
(HSOO
Cllnlc.1 C.r. S~.cl.II.t
.SO '31,00 Annuli
fAXIJ^U,
:\hrIlIiSlalu.:
Allow.At.,.:
Add!. ref.:
Add). Inl:
"."lftl
",rrlld
I
Sill,
Ilnlle
~
'is....' llO-\t.'~I.
:.. 'Nil. UN'N'" r oU<L'l
...Cu'''",... "0\,11)."
IlnctI"lun M.II lIoun hmln.. 1I0lln t:unlnil' n.lerlDtlnn CU"ltftt VTn
Iletul.r Pu l,17'.U U1.Z5 Z,061.11 FED O'SDI/D1.~ 7!.U US.Z5
Vacation '.00 lI.n n. . S1 FED FICA "-die. U.t6 n."
FED Wlthhal_lnt lZt.S' zu.n
.A Wlthholdln, SZ.7S n.o
Pi W,.tub,.., 11.7' U.S6
p. E PW'In'_ , 0.10 11.01
1 17'.U ISD.Oo l.S56.Z. 25' . SS 5ZJ.U
. .
""ctllllon Co....., VTD D",""I.. Currenl VTn "esftIB,loII C....... VTn
....lth J.U '.U HJghllark Club 0.15 0.50 lI,. . 0.6. I.ZZ
$hrt Tr. Oll(al 5.54 5.54 United Way Fund l.aD 4.00 U.I S.... n.76
0.,,\81 O.ot s.Ja Suppl...,,'ll II I.SI 1.16
4111 70." 1"1.51
OapencMnt L U. 0.00 D."
long hr. Ohab 0,110 t.U
Tot.l: '.14 11.01 Total: 74.52 152.0:1 'YQaltl.
Carr.nl: l,ll'.ll 1,.".59 25'.51 '3.66 . U7.91
YTO, Z 55'.24 Z n..sa UJ.U 171.11 1 "2.n
511ft B,rance 11.25 Sllft aallftcc 0.00 Start a.IIIICe: 0.00 ADVICE . t
+ Earned: 112.50 .. Eam"': 4S.DD + [lined: 22.50 ",... I.
Taken: 0.01 . Takl.: 0.00 . Taken: O.DD Tol.l:
+ I. Adlustments: 0.00 + ,- Adlanm.nls: , " Sold: 0.01
End B.lance US.75 End B.lance: 45.00 +/- AdlunmenlS: 0.00 Docuftl"'tl; 000000004012
End Ballncc 2l.S1
,
~ESS^CE,
.~~~
1""","I.1!t Liun,," 0' lite Ill"" Cro.. IN 81"" 'hl,lll A...(I~I'"
'Rt,"t'''ll Milk, " 1M 81ve Ctnl 1M 8llltl Sh'lllll "'"OCIItI,n.
'''''IIOCI''IO"oflM.,.II4,",III",CtOt..l'llIIlIlwl''I.I~PI'fI.
DEPOSIT NOTICE ONLY.. NON-NEGOTIABLE
DATE
01/16/1996
NO.
000008654
DEPOSIT AMOUNT .
637.91
Potter.Eliz.beth K.therine
126 N Front st 2nd Floor
Wormley.burg PA 17043
CIIod<I".
161"U'"
.
117.91
BAG' 0103
LOCATION CH300
OEPT 0759
Talal:
.
'37.'
DEPOSIT NOTICE ONLY - NON.NEGOTlABLE
"~~,~
I'~.. I j,,,up
1,..,III'lIllnD..li'
I'n Ind 1),111'
,(liP ~.t.L E.."p\ f {hl'l~ If 000009099
01110/\....
ol1l5/1QQe I hrtk 111(' Ql/50/1..46
pothr,Ellub.th ".'h.rln. rn,plnH..IU. 00lH1 1\' U'" , I N11.,~1 .,"alt'
1':" N Front 51 Ind Floor <<u\1 ('I'nh'" Ulllll.tlon ".nlg.~."' IItlPC \I"UIIOII "'.IIUI ".trled Sln"l.
WOfftl.ylburg PA 110_5 I,\lullnn: CH500 ,\IIOI".Inl\'" I
,..hlllll' Cllnic.l C.u. 'ip.c181 hi \ddl I'll.
"i'" ZlOwIj6.""'lft l'~" KJlr; 50,b5\.OG Anl''l\j!l1 \ddl 'nil
pot H' ,'Il i:-\P;~"(;S ' \\1'
""('UUI'R'o" ""llluO
Ih...tlllllllln Ibtr 111lur\ h'AIn..' IllIun [HRI;;';:' l)~l'flnlll1n ('''flt'nl ,,,,
"e\lulu Pey 1,178.12 Zolt.a S.Z39.n FED nASD1/Ol,.b 'Z.n 211.1"
v..c.Uon 0.00 ,1.1S zq",55 FED FtCA H.diu lit.." 50..5
FED WithhOld In, U;!.5. ~ol.11
.l Withhold I", S2.1S 11I.10
PI Wrfllh,brel 11.7' H.H
PI E Plnn,b T 0.00 10.00
," I 111. lZ US.oo S.!J!a4.!att -..~- Z5&.54 nq.q",
" - . .
l)l"~I'r1n'lrtn fU"l'n1 "0 llMul..'llfn funrn' ' III llIlUu..'lun ('urn'nl '.Ill
Hnlth S.&O ll.I' H1QMlrk Club 0,Z,5 0.15 l.lh . 0.&1 1.n
Shrt Trfll 01.1.1 5.54 11.0' unltad Way Fund Z.OO ".00 "I 31." 1111.114
O.ntal 0.00 S.JO 5upph..anhl II 1.51 4.74
'01 70.&'J HZ.07
llaplndant Uf. 0.00 O.b'
lane hr_ Dlllb 0.00 Z.30
fnl"" CJ.l' 17.22 Tuul: 74.52 Ilb.55 -h'uhll'
III .. "J' '" "'fiiTiI .. ~ " ...
Cunrn1: 1,171.12 1,11.,.5' Z5&.54 n..' . as7.'1
, 1l1, '5H.n ' 508..7 77'1.'1" 151.17 2 SOO.6S
\ , rp.r.1I , ~-I
Sul1 nabnce: 11.25 SI..f1 nll.."tC 0.00 5101I1 R..bn[t': 0.00 IDVICE "
+ r:un<<l: 11Z.50 + f.2.rnt'd: 45.00 + .:2.1"": Zl.50 CHI'ClC. "
hJ..tn: 0.00 hl.rn: 0.00 lll;.en: 0.00 Tn1:l1:
+ t. \dlu~lmllnl\: 0.00 + f. .\diu\tmtnU' 0.00 Sold: 0.00
rnd'hl.lnn~ In.75 .:nd nlllnre: 45.00 + /. Adlu"menU: 0.00 Ilncumt'"I M: 000000004019
[nd nlbnrC': 22.S0
\U:SS\la:;
DEPOSIT ~OTlCE Ol"L Y -. :\O:\_:\EGOTIAnI.E
~~1'fv
I..U"..It.l!tl'U...." 01'''. SI...Crontl'4 Sill' ,,,,.IIt....Oel_llOn
'Iht,,'.n4 "lUll 0'."" 81... Cro.. ...It SIu' \1'1.,14 ....oe'-'.O"
~II A..oe,_I'OIl ol,,.It.,.I'I4,tlt 8'u' CrOll '114 .111' SI'Il'" PI~II'
\HIF. 01/30/1998
:0.0.
000009099
OI:rOSIT .~'IOl:o.T $
"
\n""nll\ ..
Check in,
,\ccnunl 'un tlcr
i.l"UDOD
potter,Elizabeth Katherine
126 N Front St 2nd Floor
Wormleysburg PA 17043
II";. 0103
10UII'" CH300
.
llI:rT 0759
Inul:
DEPOSIT :-;OTICE O:-;L'i -. :\O:-;.:\EGOTI,\RLE
837.92
)l" n It \mllu",
n7.n
117.,t
a~~~
I'JY GIIlUP:
Ply n~jn Ihle
I'n End nal~
tlHP (."tr.! b_.,a' f fhlt1.k;: 000009541
011l./\n,
GNU'"'' rht'i hIe: ollts/nll'
ss~: llO-U....l"
[mplll)" Ill:
en" Cenler.
("Iullnn:
Jubfllla:
Pa hlr.
QOIH1
UtllluUon ".nag...nt lotPe
CHlOll
Cllntcll C.r. SPlelell,t
$0 '11.00 AnnUli
IX\: DAf^l
'hrllal Sla,ul:
Allu..anla:
Add!. "1:1.:
dl I.:
h-dt"f:&1
Hurlad
Sill.
Slngl.
Pott.r.[II,lbath ..tharln.
12' N 'ront St 2nd Floor
War.lay,burg PI 110"5
1In1'.~ '~II ,- ..~IN"< H":~
...Cun.n'... ."YT!)".
lJt'urilllion Mall! II1Iun funin'. Ilnun f:atnln t Ill!1nlllllun Cun!'h1 vm
Rltut.,. PlY I,ll'.ll 211.25 ","lI.n flD OASDI/DI..b 12.5l nO.zl
V.c.tion a.OD 11.15 2'ft,53 fED fiCA "edlc. ..... .,...
fED Wlthholdlng 12Z.5' ....0.1.7
.A Wlthholdln. SZ.1S 1]O.'S
PA Wrehabr,1 11.7. It7 .12
Pi E PaMlb T I,U la.oO
. 171.1Z 500.00 " lU.". , IU.SS 1 OS6.'"
n_rrl",ln" Cune'" VTn nf1ul"tio" runtn1 VTO nl!1crlllllnn Cur~r..t VTD
H..lth 5.60 16."" Hhthll.rk Club O.IS 1.00 Llf. . 0.61 2.ft"
5~rt lr. 011(_1 5.5" 1'.62 Unl t.d V.v fund 2.00 1.00 001 11." 155.52
OMhl 0.00 5.n Suppl...nt.l l1 1.5. 6.51
001 70." 21Z.7'
O.p.nd.nt llh 0.00 0."
Lonl hr. Olsab 0.00 2.lO
Tnnl: 9.1" 36.36 Tolll: 7".52 301.07 . Taxable
. .
Currenl: 1,171.12 1,1".59 256.55 as.66 . 157.91
vm, " 71Z.'" " 67..5' I 036.'" H7.45 1 HI.56
Slart Balancc 11.25 5'''1 Balance: 0.00 Start Salute: 0.00 ADVICE "
+ [uned: 112.50 + [a,nrd: "5.00 + Earned: 22.50 CurCIC "
. Taken: 0.00 . Taken: 0.00 . Takrft: 0.00 TfUal:
+f.AdluSlmeftls: 0.00 +J.AdluS1mrnts: o GO . Sold: 0.00
End O..bnce: 123.75 F.ftd Balance: U.OO +/.AdluS1menU: 0.00 Documenl 11: 000000004024
Eftd DJI~ftte: 22.50
~ESSAGE,
..~~~
InlS,p'M'"' Liu"".. of th. BIll. Cro.. .M Br~ II'II.hl '-'.0(1111011
'R',I'I''''d lAlit, 0"11. Bill' Cro...1\4 8hM 51'11"d .....octltlon.
.11 '-'''OCIII'Oll 0' IM'."I'IO',"I S," Crull "Ill SltH SIIlIld PI.'"
DEPOSIT NOTICE ONLY -. NON-NEGOTIABLE
OAn:
02113/1998
NO.
000009541
DEPOSIT AMOUNT .
837.91
Potter. Elizabeth Katherine
126 N Front St 2nd Floor
Worm1eysburg PA 17043
ttOU I .
Ch.cklnl
. h
161U31100
r . I nunl
an.91
RAG. 0103
I.OCATlON CH300
DEPT 0759
Total:
.
157.'1
DEPOSIT NOTICE ONLY.. NON-NEGOTIABLE
.~f!9~
P~y GIIIU,
I',,. Btll" Dalr.
I'n End Ihle:
.HP .", ,....t, Ih~", 000009987
OU01lU9,
o1ll0/1"" nll't hie' 01127/1".'
Pot hr tEl !lab.th lIathar 1"- t:mplo)"HIO: 00.,51 lAX IMfA: ftodcral Sill.
IZ' N Ftc,"t st lnd Flour [,,\I C.nlH: Utll1..tlon "anag...nt . Impc :\h,i1al SlaIUI: Hatriad 5lngl.
Wor.l...bur, PA 110'~ l.ucallun: CHIOO AlIlI".nces: I
.JollTlllr. Cllnlc.l C.t. Spacl.llst Addl. Pc1.:
SS't, 1I0-SI-'U' PI~ hlr- 50,'11,00 Annual 'ddl. 'm"
1I(l".' .~, 'G' U'[<
"'('un~nl'" ."\'11)'" I Il.,nlallon
Ill",,:rjlllllln Mal. lIuun hl"ln, IllIun .:arnln, Cun.nl V'"
Ragul.r P.W I,UI.ll u..n 5,5".11 FED OASD1/DI.~ 72.51 SU.7t
lIacatlon 0.00 11.15 n..ss FED FICA ".diu 16." 14.1S
FED Wlthholdln, HZ.S" '1l.1S
PO Mlthholdlnl U.7S In.''
PA Nr.hlbrg' 11.7. 51."
PI. [ PeMlb r 0.00 10.00
,o"r I 171.lZ 57S.0Q s.no", ,,' lSft.5C1 I l'U.OS
.
1')e1C.I",lo" r;;..;o;;- VTn n~cflll,lo" Currrnl VTD Or1Cfl"lion Cur.e'" VTD
H..lth 5." lO.n Hlgh11.,.k Club O.ZS 1.25 Llf. . 0..1 5.05
$hd fn Dhf.l 5.S" ZZ.16 United Yew Fund l.OO 10.00 401 31." 194.40
Denhl O.DO 5.30 SupphHnhl LI 1.51 1.90
.01 10." US.4S
Dependant life O.GO 0."
Lont fer. DhM O.GO 2.30
Tolll: '.14 45.50 Total: 74.52 575.59 . Taxabl.
C1men': 1.111.12 1.169.59 2U.54 IS." . 111.92
no, 5191.61 544'.15 1 Z!S.OJ 4Z1.09 " 116.4'
Slart Balance: 11.Z$ Start BalanCE 0.00 Start Oalance 0.00 AnvlCE '1
+ Earn": 112.50 + E.fnn: ",5.00 + ["ned: ZZ.SD c....e... II
Tabn: a.aa . Taken: O.OD Taken: 0.00 Total:
+,. AdlullmentJ: 0.00 +'- AdjullmenlS: . .. . Solei: 0.00
F.nel Oalance: 1ZS.7S EIId Balance 4$.00 +/- Adluflmtntr: D.Da Document to 000000004050
End 8alallee:: Z2.S0
~l[SSAG[,
.~~~
IM.,.NI.", liu".... 0' tfle Blue Crall 1M Blue SlIl.I, .....oclltlon
'R""~,,, '.hrtt of ,'" 811M CI"QII .114 81M Sht.llI ....Met.tlon,
I" ""O(IItIOII 0' IM.,.M.'" 8lUII Cra" ,11III 81... Shl.llI PI'''.
DEPOSIT NOTICE ONL V -- NON-NEGOTIABLE
02127/1998
NO.
000009987
DATE
DEPOSIT AMOUNT .
837.92
Potter,Elizsbeth Kstherine
126 N Front St 2nd Floor
Wormleysburg PA 17043
"". ,
CheckS".
1S7.9Z
. .
111413001
BAG j 0103
I.OCATlON CH300
OEPT 0759
.
IS .'2
Total:
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
"~~1!2~
f)~y emu,:
I'a)' Rt'1lin Uale:
I)~ t:n.lhlr.
ltiP C.,,,r.l h.",,' F thlKa;' 000010431
Ollll/U"
0110"'''' r- "" hrllt 0l/11/)'9"
Pothr .Ellz.tllth It.tI,.r In"
ll' N Front St tnd floor
Wor.J.~.bur. PA 170.1
t:mplny"lIJ:
<:u,tCenllr.
I..oCJI:jnn;
Jill! Tille
Pa hlr.
OGnu
Ut lllntlon ""'.IJ..."I - UiIlC
[tt)OO
Clinteel C.r. Splel_tl,t
~I "1,00 Annuli
'\X 1),\ ,\,
\1&1llal SI.luI:
"lIu'''"c''':
A4.1,I'et:
I
"'...;uul
"err I.d
I
St,,,
Untt.
SS"i. 110-1j'-,,,u
III ~fl . "~'NC.' un.
".("u".I\I". "."lU."
lJMcrlltlnn R.I. luun r"nl" , IInl," .:.,"1"1' n"rrIDllo" Curr',,' >Tn
..",l.t PlY 1,171.11 a!l.ts 6,77'.1' fED QASDI/Dlub 7Z.1l 4n.l0
....e.tlon '.00 11.75 194.n 'fD 'ICA "edlu 16... 111.11
'ED Wlthhold'n, Ill.56 l55.n
.A Wlthholdln, :n.n 1".3'
Pi W,.h.br.' 11.1. 10."
Pi E PeMlb T D.OO 10.00
1 17'.1l ltSD,DD ., 0".12 25'.5. I 549,51
. .
I n.,:crilt,lnll C""~I VTO O"crlDllnn Current VTO I ".,:c,IIt,IOR CurreR' VlO
H..lth S... 21.U HIghaerk Club o.n 1.50 Llf. . 0.'1 3."
Shrt Tr. DII(el 5.5. Z7.70 United Wey Fund l.oO IZ.IO <01 n." US.l'
Denhl D.DO 1.lI Suppl...,.t.l LI 1.5. ,..,
'01 70." U..I.
D.pendent L I f. 0.00 0."
Lone hr. Dllab 0.00 2.10
Tol.l: '.n 5.... Tnl.l: 7'.52 UD.ll . Tuabl.
, ..
Curr.nt: I,HI.1l 1,1".59 25'.5. IS." I In.!Z
vm, 7 0".72 7 017.74 I 54'.57 50..75 5 014.40
Sl.rt Balll~ H.ts Slart Balance 0.00 SI1f1 Balun:: 0.00 ADVICE '1
+ Eamed: llZ.50 + Eamed: .5.00 + Eafned: U.50 CHECK ,.
. Tabn: 0.00 Take,,: 0.00 . Tab,,: 0.00 Tol.l:
+1-AdluSlMenll: 0.00 +/~ AdlustMeftlt: a.DO Said: 0.00
End Bal.nce lZS.75 End Balantc 45.aa +/. AdluSlMfftlr: a.oo IlOCuMtnl fI: 000000004074
End Dilute: 22.50
~lESS'\GE,
a~1!2~
Incl.p.nd.", LJUM'" 01111. 81.,. C~" 'M llue Shl.hl .....ocIItIO"
"R',lmt." M,rka 01 lhe Btll. CIO" .M II.,. Shl.llI .....OCIItlOIl,
." ...."CIIUOIlOIIIlll.'.IllI.nt IlIue Cre.. .I'lIIlBlue '''1.111 Pl..,.
DEPOSIT NOTICE ONLY -- :\'ON-:\'EGOTIABLE
DATE
03/13/1998
NO.
000010431
DEPOSIT AMOUNT $
837.92
Pottar,E1izabath Katharine
126 N Front St 2nd Floor
Wormleysburg PA 17043
ccnll' .
Checldn,
crounl ~umb
161.,3000
r odt mounl
117.'2
BAG' 0103
LOCATION CH300
DEPT 0759
Tnlal:
I
837..2
DEPOSIT NOnCE ONLY -- :"ION-NEGOTIABLE
.J~~~
1'1)' (;'IIUp
1'1~ 1I~ln Ihle:
I'n rnd Illll"
IOU Hel hUflt F Chnla,: 000010869
0$/011".'
O~nll/l'i'1 f"h II. hlr: IUIl7/1'J'"
Poll.r .Ellnb.lh ..th.rln.
IZ' N Front It lnd Floor
Wor.h'lllbur. PA 110..1
.:mplnt"IlJ'
['''I t,nler.
turaliun:
Jublill,:
PI MOIlr
Donu
Utlllntlon H""liI,..nt ICUflC
[HSOO
Clinical Clr. SPlel,ll,t
JO,':Sl.OO 'nnUII
1.\'( OAt-\:
'h,llal SWill:
AlIn".n'et
Addl.I'ct.;
dd I
"rdtnl
",rrl.d
I
SI,..
!lilngl'
ss~. 110.la....l_
I , ~'.~l~r.' un,
o"("UIf."I'" "'VII)'"
ntHrt lln" N.1I' IIIIU" b,nt" , Ilnlln ':.unl~~ l)f1rri-llrln ('uruM VTn
"-lt1Jlar Pu '.'.sa "91,n 7.71.... fED QUDl/Ohn It.U S07.1l
Flu I).. 0" 7,50 117.'1 7.!II 117.'1 HD fiCA "edlu a.n 11'.16
V.utlon , .51 111.11 l6.ZS 'it.l. fED Withhold In, 1l1.S. 157.95
.A WithhOlding n.n 129.11
Pi lI"lubrlll 11.11 n.'"
Pi E P'Nub T 1.00 11."
U.DI I UI.1Z Sn.DD . 2,....,. 25'.5" I 1".11
..
')"C-j_,lo- ;..::.~;.. VTn "...crl-Uo- C;;;;nt VlIJ In_crj..,lnll ru"'r'" VTI)
H..lth 1.61 Z1.2' HI....rk Club '.25 1.15 LIf. . '.'1 ".21
Shrt Jr. Dtleel 5.5' n.z, United Way fund 2.ao U.oa "1 sa." 212.1'
Dent.1 D.DD 1.31 S.".,h_ant.1 II 1.5. 11."
"I 10." U4.n
D.panclant L I', 0.00 0."
Lon, r.r. Dhab 0.00 l.sa
Tllul: '.1' n.7' Tn'al: 7".52 sz..n . Tl.ubl,
. ..
Currrnt: 1,171.12 1,1".59 256.54 n." . In.9Z
YTIl, I 141'.14 . 1I7.S1 I IU.ll S".U 5 ISl.Sl
V
Sian Balance IlolS Sian BII.llee 0.00 Stan aallllt<< D.DO IDVIC! .,
... ""alla~lc lIZ,S' + Eam": 45.00 + Eamed: It.50 C....C. .,
- Takta: IlolS . Taba: D.DO - Tall.rn: 7.50 TllU!:
""-Adjul'mrnl.: 0.00 +/-Adlu,'mrnr.: a." . 50/4: 0.00
[nil nlllace: nl.SO [n4 Balance: 4IS.OO +1- Ad!unmcrns: D.OD OncurunllJ: 000000004102
En. B.lance 15.00
'IESSAr.E,
..~~~
I"""IIC.", Llc,,,,,,, of 11'1. Bille CIon I'" Bille Sh,.., A"oelllIO"
'".,.tt'f'. Milk. oflh. BlIleC'o".... BIlle Sh..,. ""OellllO".
........OCIr!IO"0' IM.,.IIlI.", BIlle CtOn.... 11\11 SIll'.' PI.",
DEPOSIT NOTICE ONLY.. NON-NEGOTIADLE
DATE
03/27/1998
:'10.
000010869
DEPOSIT "'\lOUNT .
837. 92
Pott.r,E1izab.th Kath.rin.
126 N Front St 2nd Floor
Worml.ysburg PA 17043
CtflU .
CMekl",
emuftl Sumht
16141SDOO
h Il,U mnu r
In.''
DAG' 0103
LOCATIO:'l CH300
DEPT 0759
Tolal:
.
In.''
DEPOSIT NOTICE ONLY -- :'iON-:'iEGOTIADLE
a~~~2~
PI~ GflIU,:
Pay IJf1.InlhlC
Pa .:"4Ihll:
1ll*,1I' '.r.l [.IlI.t f
DJ/U'l'"
04/01/1'"
0"", 000011309
h~ 1<< 0'"0./1'''
Pott,r,Ell..-.th _.th"lnl
1" H front It lno floor
Wor.llnburl Pi 17041
t:m,ln~.. 10:
Cltll C'A'''':
l.ucatluft:
Ju~ TIlle:
r. Rale:
00ln7
Utili,.ti." Han.,...nt . .>>PC
CHJOO
Cllnlc.l C.r. 1,1.lll1,t
SO 'JI.00 AnnUli
lAX OAT
:\I,rll.1 St,luI:
AlIow.nca:
Addl. Pel,:
d,
f"",1
".rrl..
1
Stll'
SIngl1
S!lN: 1I0.".'.1"
11m:.' ,. ......
"'Curr.nt'" o"vrn'"
DncrillJon Malt lIou" f:atnln, 1I0un t::unlnn ()rJcrlltt\un CUf"n' "..,
lie",!., PI' 1,17'.U S".U '.''''.11 fED aUDI/Oh'" n.u 5ID.:n
flu n.. Off 0.00 7.11 117.11 fED 'ICI "I.flu .,... 155.12
VltClUon O.DD n.li 41Z.34 FED Wlthholcl)ng UZ.16 "O,il
.. Wlthhalcllnl 12.n 261.11
PA W,.lntlr.' 11.71 ".n
PA E Plm." , 0.00 10.00
1 11'.IZ 600.00 , 4n." 256.54 I DU.n
. ,
n_cn..,lo" ("U"tft' VT1l I n..(PlnHo.. '("Uffeft' VTT1 nes"r1"f1o" .-("~"tnl vm
H..1th 3.60 30.'4 HIgtw.rk CluIII O.U 2.00 L1t1 . 0.61 ....
Shrt Jr. DiI(.1 5.54 31.7' Unit... V'V Fund 2.n 16.00 "I 31.11 311.0.
Dint.. a.GO 5.50 Suppl.Mnt.1 LI 1.51 11." .
'01 70." 565.5Z
D.pMd."t LIt. 0.00 0."
lone hr. DI.... 0.00 2.10
,
TOfll: '.14 72.92 TOfll: 74.52 5".15 . Taubl.
Cun",t: 1,171.12 1,1".59 156 . 54 IS." I 157.'2
VTIl, , "U." , 356.92 Z 062.n '72.07 6."0.Z"
Slut Blluce 11.25 Stan Blllftee 0.00 Start Ballllcc 0.00 ADVICE II
+ AnUablc 112.50 + Eamlll: 4S.0a + Eamed: Z2.50 c-ex I,
. TakeD: 11.15 . Yaktlll: G.GO . TakeD: 7,50 Toul:
+ I. Adjustments: 0.00 +1- Adjustmenls: 0.00 . Solll: 0.00
En. O.lance llZ.50 En' Balance 45.00 +/.A.Justmtftfs: 0.00 Document #: 000000004118
Ead BaluC'C 15.01
MESSAGE:
.~~~
IM'''.w."c Ut'"I", .f tM ar.,. C,....1I4 811.. 'hil14 ....NCIIti."
"R,tllte'" Mln. or tM 1I1~ Cmll .t14 III.,. ''''1114 .....ocinJo".
.11 AIIOClltlo" If 1n4',1I14."c 8111I Croll 1114I 11111I Shil14 PII,..
DEPOSIT NOTICE ONLY.. NON.NEGOTIABLE
DATE
04/09/1998
NO.
000011309
DEPOSIT AMOUNT .
837.92
Patter,Elizebeth Katherine
126 N Frant St 2nd Flaar
Warmley.burg PA 17043
.
CheckIng
.
161..3111
.,
157.'Z
BAG' 0103
LOCATION CH300
OEPT 0759
Tolll:
.
'17.92
DEPOSIT NOTICE ONLY.. NON-NEGOTIABLE
.~S~X~IQ~
l'nt;/IIup:
P~y n"WIn U.ll~
1'1 t:ndlhll'"
WP '."tr"t I..,"pt' llh'll... 000011754
010: q".
010/1./1"''11 (hrlk )jll' OIoIZ/o/I'f"1
~
PQtt.r.[llleb.t~ _.th.rln. I:mplut..-m. Gonn I\.'I(IJ.\TA: ,"....tlnl SII'e
lZ6 N front 51 lnd floor Clut [","lct: Utilization "~.9...nt - lltlPC \1.fll;aI"ilillul: Harr lad 'iln"l.
Waf.hWlburg PA UGH 1.1Iulllln CH50a ,\lIllwtnu": ,
.Iublllltl: Clln1cal C.r. SPlel.ll,t Add!. I'd..
SS'"": ZIO-S8-Ullli f':IV Malt": 5O,fa\1.00 Annual ,'''1 '\ml:
Ilot "MS.\:'\U L' ,~N;;I\rs "....,s
...('urn'"'... ..., In-e.
1l1"u,lnlifln N31e! Ilulln .~nnl"ll. Ilull" FJlnlnll\ !J('urlal!un ('un,"' ""
A.guhr Pay i,HI.ll 6/ol.lS 10,012."5 fED OASDI/Dlub 12.5Z 65Z.1\
Flu fl.. 0" o.oa 1.50 111.11 FED fleA Hedlu 16.'" ISl.'"
Vacation 0.00 ZIl.Z5 HZ,S6 fED Withholding 117.l6 l,nt."
'A WlthhLldlne 5Z.ts 2'4.5'
PA Wr.lubr,' 1l.1I 1U.OZ
PA E Pennlb f 0.00 11.10
, , 171.1l 615.00 10,60$.0' . 251.25 1 SU.'ID
.. . .. , .
I IJt"IcrjDlinfl Curr,n' VTn t',crlallln C:Uffrnt VTIl In.'lC,j"'t.n" ('Uf'.", VII>
H..lt" 1.60 34."4 HlgtwI.rk Club 0.25 l.25 LIf. . 0.61 5.'"
Shrt fr. Dill.l 5.1i4 44.52 Unlt.d W.y Fund 2.00 11.00 .., 17.61 321.71
"I 55.34 35.14 Suppl...nt81 L 1 1.51 1".Zl "I 21.20 2l.2a
D.nh1 0.00 3.30 '01 35.3" 600.16
D.p.nd.n t L1f. 0.00 0."
Long f.r. OIIG 0.00 l.30
Toul: 44.4' 117."0 Tnlal: 39.17 631. SZ . Tuahl.
.. .
CUfnnl: 1,171.1Z 1,134.25 251.25 lS.n . 143.2i!
YTIl' 10 601.08 10 .'1.17 2 111.to 755.72 7 511.46
Stan Dalanee 11.25 Slln Oalant<< 0.00 Slart Dllance: 0.00 ADVICE 'I
+ Auilahle: 112.50 + Elfn": 45.00 + ElfnN: ZZ.50 C~"I( ,.
Tallen: n.n Tallen: 0.00 - Taken: 7.50 Tol.l:
+/- Adhlllmenll: 0.00 +/.,\djulfmenll: 0.00 Sold: 0.00
End b.lanee: lIZ.50 End n.lance: 45.00 +/.AdlulfMentl: 0.00 DOCUMent,.. 000000004108
E"dD.lance: 15.00
MF.SSAC[,
.~~~
l"'d.'."'d.frtL.ul'l....ol'h.OlIHlCto...1'I4 011Hl 5/11.14 ""D(11110"
'R',I".r.d M.,h 01 11'1, 81101II Croll .1'14 Oh". 51'111111 "nO(lIIlO"
I" "110(11110" ollncl.p.nd.nt BIIoIII Cro.. 'lit! Bille Shl.lt! Pl'",'
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
04/24/1998
NO.
000011754
DATE
DEPOSIT AMOUNT .
843.22
Potter,Elizabeth Katherine
lZ6 N Front st Znd Floor
Wormleysburg PA 17043
.
Check 1"1
"" .
16unuo
.
.
IU.Z1
nAC, 0103
I.OCATION CH300
IlI:PT 0759
.
145.
Tn.al:
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
8~S~!~~
I' ~y I;rnup
l'ayll~I"lhlt:;
1'1.... Fnd Dale.:
IIlP ." ,....., th".. 000013062
0')/111. .1"
O,)Il~/l'f'fll (hl'<k ),Il': 0./0\/19'"
Pot hr ,E Ill.bath KaU,., In'
ll. " front St 2nd floor
War.Iay,burl p, 110~S
EmpluYNIJ):
ellU Cenler.
l.(IcaUun:
Jub TIlle:
P. R.alr.
oonH
UlllillUon Nanau...nt . Ilt1PC
clnoo
CIJnlcat C.r. Splel_ll,t
~Z 00'.00 Annual
L\X IJ,.\T A:
'hfilIISIIIIII:
Allu.ances:
Addl.I'ct.:
AddL ml:
Ft-de-n.!
"'rrlad
I
Sllll
Un,h
ss~. 210-U-64U
" -.-.n ,. T,
"-run.nt'" ,u\'TU'"
Uf1CI!Dllnn Rail Ilnun t:arnlnv1 I lilli'S tarnln' Il",crlnllon Cllrrlnl VTn
RIlJ\ll., Pn 151. " 15'.25 u,na." FED onD 110 hab n.51 .n,n
Flu flM Off 15.11 "'.n n.n 5'''. or. FED FICA ".dIu ".Z6 Z06.U
P.r,on.1 p.ld r 7.10 125.11 1.51 lU.ll FED Nlthttoldlng .1IIa,U 1,41t.Sl
",uhr hrnln. 106. or 0.00 lD6.DZ p, Withholding n.I' n..1O
lJacaUon 7.51 lU.ll n.n U5.lt!i PA ~nhtbrlll is.57 1~1.4I
PA E hnntb T 0.00 10.00
SD.DD 1351.1. '00.00 1.,3.9.te' Z9l.S. , lZl."
- -
I)~crlllllon rur;c-~r -~n rn:1crllltloft Curr,n' VTn nesc.j"'lo. Cu"," VTI)
H..ltt1 S.6O ..s.l4 Hlgha.rk Club o.n S.Oo Ll'. . 0.71 7.6ft
St1rt Tn Dhl.1 5.79 '1.44 UnU.d ".y Fund l.OO Z4.00 '01 la.06 3'''.91
'01 "0.11 141.72 $uppl..."t.1 LI ..61 I'." "I Z~.07 ".65
Dant81 0.00 1.30 .01 "0.1l 711.Z4
D.,end.nt L I'. 0.00 a."
Lon, hr. ahab 0.00 Z.10
Totti: 49.50 n1.7I Tolll: "".o~ 16%.19 IIT"'ttll.
Current: 1,117.1' I,Z....l zn.s' '1.5ft . 951.06
YTO, 14 1.'.'" Hi 099.40 , lZl." I OZO." to 206.71
StlrtO.I,ncc 11.15 S'1110.1artec '.00 511rt Bllute 0.00 ADVICE .,
+ Avalllble IlZ.S0 + [am. 45.00 + Earned: ZZ.50 """CK II
. T.k.n: 1'.15 . Take: 7.50 . Tabn: ZZ.50 TOIII:
+1- Adlu"m,n,r: 0.00 +1. Adlultmlllu: 0." . Sol.: 0.00
End Olllnce IDS.OD En. Dalute n.50 +/.Adlullmtnll: 0.00 Oocum.nl I: 000000004091
Ed O,llnc<< 0.00
MESSAGE,
.~!!2~
'"dll,"~'1l1 LIun".. 01 tll, Bholl ero.. 1114 BIIM 'IIi'" AI,OClltlO"
'R',lll,r,d M.rk, olUt' 8111I ero" .M 81101II 11'11,14 .....0(11'110",
I"AuocittlOft oflnd,pln4lnt BII#II erG" 1114 Blut 1/1/114 PI.",
DEPOSIT NOTICE ONLY -. NON.NEGOTIABLE
DATE
06/05/1996
NO.
000013082
DEPOSIT AMOUNT .
951.06
Potter, Elizabeth Katherine
126 N Front St 2nd Floor
Wormleysburg PA 17043
[COu I .
Ch.cklng
"" u h
1'1"'000
. 0 I nu I
nl.06
BAG' 0103
LOCATION CH300
DEPT 0759
Tolal:
,
.51.06
DEPOSIT NOTICE ONLY.. NON.NEGOTIABLE
.~SfLS]?,~
".. ., ''''pl F (h,," 000013518
1I'!1/50/I<!'UI
IJh/I."II'Iql Ch,..kll..,. Oh/l'UI'I".
l' ~t 1;/lIup
1',1) 1I1'l;m D"'l':
Pn ~ lid 1I~11'
,
~
I1nthr,[llznhath II'lIlharl".
Ii'b Ii frunt 'it lml flollr
WIH.I'~'bllrw PA 110"'3
,\\ I) \ I ,\'
\IJrIl<11 S'.IIU1:
,\III1"":ln(('\:
,\ddl I'd:
.\rldl"nll"
rrllplu~I.t! III
('ml (fnll"-
1,lIlJlIlIn:
Juh IlIle:
1':1\ 'bit,.
It'ltt'f11
H"rrl.d
""... 1IO-r,A-""h
Ooa'Hl
Utlllullon Hnnn\l...nt 100PC
(IBaa
CllnlclIl C4r. 'Spld,.lllt
';>,00'100 '&"'m",1
"\IJIl'
5111\11,
i
110l'Mo; "" . \H'I";S 1\\1.S
.. '('Ilrrrnt~'. ''''"P''
Ih'\lrifl1i,," N.lh' llull" Llfnin" Iltlun l-"Jlnlnl" IJl'uriDtinn ('utrl'nl \ III
AI\luhr Pny U5.S6 an.,s U.156....0 FED DUOI/DI..b IS." '5'.31
P.r'o",1 Pnld r 51.50 615,56 itS.DO 751.61 FED fiCA Hedice 11.15 ZZIt.l4
Flu H... Off 0.110 lZ.So 36".Dft FED Wlthholdlna lZ_.?3 1.bDS.lS
A'guhr EarninQl 0.00 0.00 10&.02 Pi Wlthh,l1dlnll ~4. 21 4U.'Jl
VIICIUon 0.00 B,15 535.~S Pi Wr..lnbrgl ll..u 155,7'
Pi f Pannlb r 0.00 10.00
,,' 37.50 1.251.12 "'5.00 15.580.511 " 2'4.'J1 3.3117,fJ5
.. , ,
f)Mrripl;lIn rurrenl VII> f)Mninljn" r"rrrM VlIl n..nIDllfln Currenl \'In
Ilulth 5.60 ,.II.U HlghaUk Club 0.25 3.25 Ufl II O.n a."1
Shrt Tnl DIIIIl 5.79 61.l3 Unlt.d Wav Fund 2.00 26,00 "I 111.47 40],311
.., 36.'3 1114.65 Supph...ntal LJ 1.68 2a.14 "I ZZ.I' 110.79
Dlnhl 0.00 3.30 "I 3b." 750.17
D.plnd.nt LI fa 0.00 0.69
long Tar. Dhab 0.00 2.30
rn131: 46.32 .$04.02 Tn131: 40.16 In.l5 . hubla
I' .. )'!'i N' .
Currenl: l.lS!.IZ 1,115.57 264.97 '7.11 . 171.97
VTIl: 15 SID.SI 152114.91 , 3117.63 1 107. Z7 11 0115.61
V" , " , , , ./ '"
Slut Ih.l;lnee: 11.25 Slart nalance: 0.00 SIart Dal;J,nce: 0.00 ADViCE '1
+ Av;J,ih.h1e: 11l.50 + Earned: 45.00 + ~:arnt1l: 22.50 CHF:CX .,
, T3kcn: la.75 - Taktn: 45.00 Taken: 22.50 Tolal:
+f. ,\djuumrnl': 0.00 +f- '\dlu~lmrnl': 0.00 Suld: 0.00
End "alaneI'; 105,00 t:nd lIalanu!: 0.00 +/- I\dluslmrnlS: 0.00 Documeal it. 000000004095
F.nd nalance: 0.00
.\It:SS,\GE:
.~~~
IIIcI.,.ncl.nlllun".. olt~. a'II' Ctall ,nd Bill' Shl.1I1AIIOtllllon
'R.,,,,,,.c1 PAMill 0' 1~' 8h.. C,otl 4nd Blul SllI,'d Anoellllon,
,n Anoel'llon 01Ind"lrld'1l1 BIIII CtOtl .nd BIIII Shl.ld PI,n.
DEPOSIT NO'nCE ONLY -- NON-NEGOTlADI.E
06/19/1998
IlATE
NO.
000013518
IlEPOSIT AMOUNT .
878.97
Potter,E1izabeth Katherine
126 N Front St 2nd Floor
Wormleysburg PA 17043
,\l'COunt .
Chlck!ng
uu f
'".97
ceo.
16141]100
nAG N 0103
1.0C,\II0'; CH30D
Ill:l'r 0759
rolal:
'71.71
.
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
.JS!0'1!2~
)'1) (;IIIUp
1'lyHf1Il1l (hIt:
1'1 End Ilalr.
_IWf ',lbuptf <-h~k. 000013961
G"1. '.
06/16/1'" ('hl"("k (hIe: 01l0l/I'''.
Pott,r,EIII'b.th a.tharlne
IZ6 N Front 5t Znd 'loor
WOf.l,Y.b~r, Pi l'a~J
.:m,lfl)Nm:
(1111 C.n!lr:
I.tlcalllln:
JlI. Till.:
Pa Rate:
f.,X llA lA,
'h,Ual Statu,:
^lIl1"'n~n:
Addl. f'l.1"
,ddl ml:
!-Jlalll
Slnllle
rcod.nl
",r,ted
1
l.it;.... ZIO-~1-6illl"
001957
lltllluUon ",nall"'l'It - ltlPC
(HU'
Clinical Car. SPlel,III'
'1 009.00 Annud
IIfl"'" ",~I) FA""",,, fAXL'
."Cun""l'" "'\'ru'"
n....{rlllllun M.lI llllu" .:;",,,lnl lIoun Earnlnn nnerlDIllln rurnnl VTIl
R'lIuhr Pay 1,Ul.ll ".'.15 15,061.51 FED CASDI/Ohab 7S.11 I,OS5.1l
Flu Tl_I Off 0.00 n.50 "".1" fED F leA "ad In 17.72 UZ.OI
Perlon.a Paid' 0.00 "5.00 nl." fED Withholding lZ4.n 1,150.1'
R.~,d.r Earnln. 0.00 0,00 106.02 ., W ithhold I", H.ll '67.11
V.c::aUon a.ao n.n SU.'S PI Wr_h'br,' 1l.n 1".10
PI E Pann,b T 0.00 11.00
" . Ul.U 1,050.00 1'.'1l.70 Z".'f1 S,Ul,'O
, - , " .,lIn ..
f)f'utillllon Cuttrfll VTn I)IPSrrlllllnn Curr~"1 VTIl OIPSctlDlinn CUrtfn' VTIl
H..lth 1." 5Z.U HI....rk Club 0.l5 1.50 llh. 0.71 ',I'
$hrt Tr. Dlslal 5.79 n.oz Unlted W.y Fund l.OO 28.00 ". 11.47 IUl.1S
". S6.91 ZZ1.51 Suppl..antal 11 1.61 ll.n ". ZZ.16 Ul.'5
D_ntal 0.00 S.3D .11 36.91 "7.10
D.pendent llf_ 0.00 0.69
Lon, hr. D!sab 0.00 l.30
Tofal: ".32 350.3" Tolll: 40.86 .....11 . Tlnhl.
Curr~nl: I,Ul.12 1,115.57 264.97 '7.1' . '7'.97
vm, 16 '11.70 16 470.54 , 65l.60 . "4.4S 11 96ft.65
V
Sllrt 8111nce:: 11.25 Slart Oalance: 0.00 Start Oalanea: 0.00 IDYIU '1
+ Aullable: lll.50 + E:unN: 45.00 + Earned: ZZ.50 CHECI( .
. Taken: 11.75 . Taktn: 45.00 Taken: zz.sa Tolal:
+1. Adluitmfnli: 0.00 + /. AdJuitmtnll: . GO . Sol': O.DO
.:nd Balance: 105.00 End O.lana:: 0.00 +1. AdJul1mrnu: O.DO Docum.nt t: 000000004104
[nd Balance 0.00
\lr.SSAGr.,
"~S!2~
IlId.'......nt Llcll'.... 01 'hoe 8111II Cro.. 'M 8111II Shl.1I1 ""'.ClttlOfl
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."'.....oCI..lonof Ind.,.nd.nt 8111a Cro.. Ind 81111 5hll14 PI.n,'
DEPOSIT NOTICE ONLY -- ;liON-NEGOTIABLE
NO.
000013961
0710211998
DATE
DEPOSIT AMOUNT .
878.97
Potter,E1izabeth Katherine
126 N Front St 2nd Floor
Worm1eysburg PA 17043
<to" I
CheckSn,
cC'l'tunl u b
161483100
r 0 I mount
.7..97
BAG' 0103
I.OCATlO" CH300
OF.PT 0759
Tolal:
.
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DEPOSIT :-lOTICE ONLY.. ;liON-NEGOTIABLE
\
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0111 ,.
07l1t., l'''' IhNlt hll!: 01/1111'.'
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ray U~ln Ih.flt:
"a t:n41hll!:
t:nlpll/~M IU: OOlU1 T^~ IMT,\: fC'denl Shill
PQtt.r,El1~.b.th Klth.rlll'
lU N front 51 llld floor CUI' C.nllf: Ut 111nt Ion "an.uuant 0 UUJC "lolital Stalus: "url,d Sln,h
WOf.ley,bur, Pi 110~~ I,ocallllft: CHIOl Alln"lnc;es: I
Jub flIIE Clinlc.l e.r. Specl,ll.t A4dl.l'I.1.:
SS", 210-51'6414 PnRlole: 12 00'.00 Annuli .'ddr \"'"
1I(I"R!\ ,.;;" ....NINr,< 'HI<
"o('u"'"'o,, ."Y.ru".
Uf'urllllllln Rail Iluuf'l t::u"I"II, Ilnun t:arnin", O~Cflnllnn Current VTn
Regular PlY .,Z51.12 l,OZS.1S ",nl.n FED OASDI/Dlub 15.19 1.110."
Flu TI.. off 0.11 ZZ.5D 'Sn.n fED FICA M,dlcl 17.75 1St.1l
Per.one. P,ld , 0.00 45.00 151.67 FED Wlthholdln. lZ4.n 1,nS.11
hguhr hlnlng 0.00 0.00 106.02 .. Wlthholdlnll 34.11 501.n
IJ.c.tlon '.00 n.lS 535.'-5 PA Wnh.brgl n.n 110.41
PA ! P~lb , 0.00 U.C11
. Z3L1Z . US.OO 11 OU.IZ , 264.97 3,917.57
.. 0 .
UMcr1b111l Currenl 'TO ne5~..h.tn. Cur-e'" VTn ~c't"lln" Currenl "VTII
H..lth 3.60 56.04 HI."..rk Club a.n 3.75 Lt,. . 0.77 9.95
Shrt Tr. 0111" 5.7' 71.1. Unl t.d W'Y f\WI 2.00 30.00 4" .'.47 4"0.32
4" 36.'3 2S'.S1 SUPP...",t.. L 1 1.61 Z".ZO 4" ZZ..6 155.11
D.nhl a.GO s.n ... 36.n 124.OS
O.pllnd.nt LU. O.DO a."
Long hr. DI..b a.oo 2.n
fnlal: "'.n 596.66 Tnl.l: "0." 184.97 . Taxable
N' ,
Current: I,Z31.1Z 1,.'5.57 Z64.97 11.11 . 171.97
'TIl, 11 '4Z.12 11 656.11 S 911.57 . 211.6:5 12 US.62
Slut O,I,nce: 11.Z5 Staft Oalance D.'I Slaft Oalance a.DD ADVICE to
+ Available: 112.5D + Eamed: 45.00 + Eamt4: 2Z.SD CHECK .
. Talltn: .'.75 T,km: "5.GO - Taken: 22.SD Tolll:
+(.,\dlullmenll' D.OO + J- Adjustments: D.OO . Sold: D.DO
End Bllance: 105.00 End Ballnce: 0.00 + /- Adlus1mtnll: 0.00 Document I#; 000000004104
End OllaDce O.DO
t
,
MESSAGE,
.~~~
lnd.p.lld.m lieu.... "the BI~ C,.1t .M Bh,. $hl.If .....O(ltlIOll
'A"IIt.r.d JA.rh of tll. BIIII Cro.. .114 BI.... Shl,l' "..oelatlo".
'" .....OClltttO" or IM,p,"'ellt BI~ ero.. .M BIUI SIII.I, PI.",
DEPOSIT NOTICE ONLY -- NON-NEGOTIADLE
07/17/1998
NO.
000014396
DAn;
DEPOSIT AMOUNT ~
878.97
Potter,Elizabeth Katherine
126 N Front St 2nd Floor
Wormleysburg PA 17043
Call1nt t
Chlcldnll
Accounl Numb"
161USDOD
Oe oll,\mnunl
118.97
RAG ~ 0103
LOCATION CH300
DEPT 0759
Tnlal:
.
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DEPOSIT NOTICE O:'llL Y .. :'IIO:-':-NEGOTIADLE
..~~~~
(h,," 000014832
1',\C;fllUP
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Pllthr,Elll"b.th k.th.rln..
126 H front St 2nd flaor
Wor~l.y,burg PA 110_5
t:mplu)..lIJ
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I)r'lflllttnn Mol" llllun t::unln, fI...." hrnir;-;, Ur-nl"'lnn Cum'ftt V III
R'\Juhr PlY l,l69.U l,On.OD 11."".lD fED OASDJ/DI..b 15.10 1..16.71
V.c.tlnn 3.1S '1.5' n,SI 591.01 fED FICA H'dle. 17.n l71.54
flu TI.. Off 0.00 22.50 SU.D4 fED Withholding U4.'S 1,"0.04
p.rtDnal Paid T 0.00 "'s.ao 751.61 .A Withholding 5....ll 535.5...
Reguhr Eunlng 0.00 0.00 106. DZ PA Wr.h.brgl ll..n 191.71
PA [ P.nn.b T 0.00 10.00
u,~I: 3.75 I ZJ1.11 . ZOO.OO 1'.Z73.'''' ..r Z64.9' 4.IIZ.55
- . .
Ul"rrl"llnn Cunrn' VTO Unrrlnllnn ("tirr~n' VTIl OncrlDtlnll Currrnl \'11)
Hulth 3.'1 59.6" HlghJI.rk Club D.n 4.00 Ll,. . 0.77 10.71
Shrt 1'r. DIs(.1 5.7' .....60 Unl t.d W.v fund Z.OO !l.00 '01 18.'" "51.79
401 36.93 Z'5..... Sypph..nhl Ll 1..1 Z5.88 '01 1Z.16 177.11
D.nhl 0.00 3.30 ... 36.'3 160.96
D.pWld.nt llf. 0.00 0.69
Long hr. DI..b 0.011 1.30
Inlll: "6.n "U.9I Tnlal: "0.16 lJZ5.n *huhle
.. .
Cunrnl: 1,131.11 1,115.57 Z6....'. 87.11 . 87..'6
vm 19 Z73.'" 10 ."1.60 " 18Z.55 I 3....1 l3 nt.51
. .
Sian Ihllnre II.Z5 Start Rllance: 0.00 SI.lrt nalance: 0.00 .DVICE "
+ A\'::alllblr. lIZ.50 + [arnl'd: it5.DO + [arned: ZZ.50 CHECK "
T:tkrn: 21.50 - Taken: 45.00 Taken: Zl.50 TOIal:
+/.,\djuitmrnlt: 0.00 +/. Adlu'lm~nll: 0.00 Snld: 0.00
F:nd nallnl:1P: 101.15 r.nd nalance: 0.00 +/. AdJustmrnts: 0.00 IJII('umrnl It: 000000004126
F.nd n.!lnel!: 0.00
~1f:SSAC;.:;
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1I\<.'.nllll'l\l UCln"" a' I.... 81",. e,.u ...d !Iw. S"'..lll ....10(1.,1011
'R.~,'tor.~ M.u" of ,.... 81u. Cron .n4 Blu. S"'l'" ""O(I"IOn,
In ""OeIIUlIn o"nd,p.ndlnt 81",. Cron.ncf 81",. Shi,'d PI.",
DEPOSIT ;\/OTlCE ONLY -- NON-NEGOTIAllt[
07/31/1998
;';0.
000014832
DAn:
Dr.rOSIT A~IOUNT $
876.96
Potter,Elizabeth Katherine
126 N Front St 2nd Floor
Worm1eysburg PA 17043
(;l'fJlln' T e
Ch.cklnG
11(' lUll Amnu"'
.7..96
\C('IIU f:o,rumh('f
161..uoaG
nAG N 0103
'.lJelTllJ;'; CH300
Ilr.rr 0759
Tnlal:
.
'711."6
DEPOSIT ;\/OTlCE ONLY.. :"O;\/.;\/EGOTI,\III.[
,.'"'
1040EZ
Use
the
IRS
label
here
-
Pre.ldeotlal
EI..tloD
CampallD
(S.. page 7,)
Income
Allocb
Copy B of
Formll'
W.2 bere.
Enclole but
do not attach
any payment
with your
return.
Note: You }
mull cheok
Yes or No.
Payments
and tax
Refund
Have it
directly ~
.deJX',ited! See
page 13 Ind ~
fill in !lb,
!lc. and !ld.
Amount
you owe
D"pMtllll!/I1 (lll/ll" Trruury-llI(,.rnal f1rvrnUl! :;rl"'\'I<"
Income Tax Return for Single and
Joint Fliers With No Dependents iPI 1997
1J~18:-1o 1!i~~.l)tj7~
Your fllst naml .nd mltlal L.~l naml
-
h'ZA6Ln/ K
II . JOlnl '"u,", 100ull" h,Sf nama and .nll'al
P.J -((tie.
lut nama
HOtTlf I(Wln H~umc:.. 1/113 Slrttllll VOu IIhl .. P 0 bC_, '" r;IQI 1 .ApI. no
I~~o:/\ ~ dl OffCt:~:~/\! lIP c~. ~ ~o:'/\r. I fC~'9~I:n(~~'~IQ' 7
WO'(iMl..~YJ6lJl/.r" hI /7IJ'I)
Notel Chtele,,,, '"Yu. WIll not chanll' your tax or rtdUCI your ,,(und.
Do you want $3 to go to thia fund? ~
If a joint return, does your spouse want $3 to go to this fun~
1 Total wages, salaries. and tips. This
should be shown in bo. 1 of your
W.2 formls). Attach your W.2 formlsl. I
2 TOlCable interest income. If the total is over $400. you
cannot use Form I040EZ. 2
3 Unemployment compensation (see page 9). 3
4 Add lines I, 2, and 3. This is your acijusted il"OlI
Income. If under $9,770, see p.ge 9 to find out if you con
claim the earned income credit on line 8a. 4
II Can your p....nta (or someone elsel claim you on their ...turn?
Ye.. Enter smount No. If slnil.. enter 6,800,00.
from worksheet "If married, eoter 12.200,00.
00 b.ck. ,... See b.ck for expl.n.tion. 5
8 Subtract line 5 from line 4. If line 5 is larger than
line 4. enter O. This is your taxable Income.
~ 6
7 Enter your Federal income tax withheld from bo. 2 of
your W.2 formls). 7
8a Earned Income credit Isee page 91.
b NontOlC.ble earned income: enter type and amount below.
Typo · 80
9 Add lines 7 and 8a. These are your total paymentl. 9
10 Tax. Use the amount on line 6 to find your tOlC in the
t.. table on pages 20-24 of the booklet, Then, enter the
t.. from the table on this line. 10
U. If line 9 is larger than Iin. 10, subtract line 10 from
line 9. This is your reluod.
b Routing number
c Type:
Chedtinl
l1a
Savin,..
d Account
number
l.
12 If line 10 is larger than line 9, subtract line 9 from line
10. This is the amount you owe. See page 13 for details
on how to pay. 12
I b.... "ad thlJ "tun. Uader pea.IU.. ot perjury,l dtclan thll to Ib, bllt ot my bo.ltd,_ and bell". lb.
"Iun 1.1"". cornet, aad .ccutalll)' lI.lIaU amouat. aad lOUJ'ttl of laeom.1 nnlnd durin, lb. tu J.ar.
Your timature Spou,e's sliT\ature I( jOlJlt return
SIgn ~
here ,.
Keep copy for
your recorda.
Oat. Your occupaUon 08te
\ \, ~\''''c.....\ ~
'2> :30 \0\ s..~'...,.\,s.-I,.
For Privacy Act and Paperwork Reduction. Act Notice, lee pale 18.
Spous.s occupation
Clt. No. t2elea
Your socIal ...curity number
~
.
.J I 0
58
b '( I
spou..... IOClal .ecurlty numb,
,
3 1
31
;).tf
J
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r
r For
I OIl'CI.1
I Uso
I Ooly
L
x
~
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b 9
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o 0
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I 3
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If 1 7
.l. 0
I{ 7 ?
)., 0
C:, 7 I
c "
I 9 J
3 0
1997 form 1040EZ
,
EXHIBIT 3.
APPRAISAL OF PONTIAC GRAND AM
DIANE G. RADCLIFF
3448 TRINDlE ROAD
CAMP Hill. PA 17011
PHONE (7171737.0100
FAX 17171975.0697
1D#32112
Page <)
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Pay Orvin Uale
I'a End Dale:
"Y' (."t,.1 [.upt F Ch<<k M: 000006208
1 In"
12u6lUt1 ChK laIr. 01101lU9I
Pott.r,Ell.abath Katharine Employ.. 10: 00ln1 TAX !lATA: "'"onl Stilt
la H Front St 2nd Floor Cost Cenler. Utlll..tlon "_".g...nt - IOIPC :\Oh,lIaISlaUas: ".rrlld Singh
Wor.laY'bUr. Pi 110<<1) LacaUon: CIUOO Allu..nces: 1
Jub Tlllk Clinical C.r. SPlel.ll.t A4.1. Pet.:
SSN: llD~51~64U P,"JUte:: 30 U1.00 Annual 'd", AmI,'
HY<.
...Cuntft'... ...YTO...
Deserl.llnn R>to Itoun Earnl,," IllUm .:unln Uescrt"llon CUffenl VTn
".",I.r PlY lIS. 51 S6.ZS IIs.n FED O&SOI/OI.ab 1Z.n 12.15
V.ution 11.75 294.51 11.15 nCl,.n fED FICA Mad lea 17.01 17.01
FED Withhold!", nz." 12Z.Sf
.. Wlthholdlng n.'" 12.'"
Pi [ PMIl," T 11.110 10.00
Pi Wr.1ylbr., 11.7' .1.,.
11.75 I 17'.1l 75.oa 1 171.1l Z".15 2".15
- .
-n~--;;tl.llon ., VTn I n-c..l"fl... CUrTent ~ I n""..,ro. Curr."I VTn
H..lth 5.64 .... Shield Club 0.25 0.25 Llf. . 0.'1 0.61
Dental J.JO J.5O United W.y Fund 2.00 2.00 UIK 31." 31."
hpendent L &f. 0." a."
Supp1....,tel L I 1.5a 1.5a
Lang hr. D h_ 2.3D 2.30
40Ue 70." 70."
Total: I.'" .... Tolal: 17.51 77.51 . Taxable
Canan: 1,171.U 1,1".7' 2".15 ".45 , 124.12
YTD: 1171.12 1 1".7' 2".15 16.45 1Z4.'l
Sran Salaac:c 15. DO Sr.rt Salalce 0.00 S'an Balance 0.00 ADVICE .,
+ Eamei: 127.50 + Eamed: IS.DO + Earned: 0.00 CHECI[ "
. TakeD: 151.25 . Taka: 15.00 . Taken: 0.00 TOfal:
+/. Adlus1menfr. 0.00 + /. A.lunftlfttr: . DO - Sold: D.DO
[.11 Balance 11.Z5 [nil Balance 0.00 + /. Adlustmtnu: 0.00 Doaament I: 000000004070
End B.lanc:c 0.00
MESSAGE:
.~S!2~
11'ICI.'.Ild.... Un"".. .f tN 8h,. C,... 'M 811,. Ihl.11II N,ocl,hlt
'''''lfttttlll Meru of tN B'~ CNt.. .1Id 8111e !~,IIll"'''oc'lllo".
'" AsHCllllo" of 11IlI.,.neI.nt 8111t Crn. ,lid BIlle Shl,11II PI,,,,
DEPOSIT NOTICE ONLY n NON-NEGOTIABLE
DAn:
01/02/1998
NO.
000008208
DEPOSIT AMOUNT $
824.82
Potter,E1izabeth Katherine
126 N Front St 2nd Floor
Warm1eysburg PA 17043
crounl T .
Ch.cklng
crou 1 Numb
161411000
D~ 0111 oun'
U4.1Z
BAG' 0103
LOCATION CH300
DEPT 0759
Total:
.
IZ4.12
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
1\ .
PENSION APPRAISERS INC.
,....
-.
1'.0. Box 4:196. Allrnlown, PA 18105-4396
1800-447-<1084. Fa, 610770-9342
E-MAil,: I'rnRpp(ojlJ1rll~lonarrril j'rn;.('orn
WWW: hlCr:I/IVIVIV.rrn~iIlIlHpl'rlli~rr....nrl\
July 30, 1998
Diane G. Radcliff, Fsq.
3446 Trlndle Hoad
Camp HIli, Pennsylvania 17011
RE: Present Value of Elizabeth K. Potter's Defined Pension Benefit
File No. 07.26.98.258.1962A
Dear Al10mey Radcliff:
We havo detennined tho present value of Ellzaboth K. Poller's defined pension bennfjl by tho
Life Expectancy Melhod as of July 30, 1998 to he $9,695.12. This calculallon was dcrivp,cJ
from the following infonna!ion and facls:
BIRTH DATE: July 24,1963
VALUATION DATE: July 30,1998
MARRIAGE DATE: June 20.1981
SEX: Female
PENSION PLAN: Keystono Health Plan CentraVHighmark Rellremenl Plan
ASSUMED DATE EMPLOYMENT STARTED: June 17, 1985
(Assumed date pension holder began participation in the plan)
DATE BENEFITS STOPPED ACCRUING: October 18,1996
(Assumed date pension holder ended participation in the plan)
ASSUMED DATE MARRIAGE ENDED: November 25,1996
AGE WHEN I3ENEFITS COMMENCE: 62 Years
LIFE EXPECTANCY TABLES: Based on 1963 Group Annuity Mortality Table
LIFE EXPECTANCY AS OF DATE MARRIAGE ENDED: 84.62 Years
LIFE EXPECTANCY PAST BENEFIT COMMENCEMENT
DATE AS OF DATE MARRIAGE ENDED: 22.82 Years
TIME LEFT UNTIl. BENEFITS COMMENCE
AS OF VALUATION DA TE:
26.98 Years
"Valuators of Defined Pension Benefits for Equitable Distribution"
10 d
;I'~I) "__ 01'/ 111
ill Sf 13:11186 .Sl-~iW
~
t
.
July 30, 199A
EII7abolh K. Poher - File It O'l.28'!l8-2!i8-19fi?A
Page 2
LifA Expectancy Appraisal Method
INTEReST RATF. ASSUMPTION; 5.16 %
Sourcn: Now York Times, .July 27, 1998 edition. This rate is
an index of yiolds lor long term A.rated general obligation
municipal bonds compiled weekly by THE ROND lIUYCR.
ASSUMED MONl HL Y lIENEFIT: $314.73
Monthly pension benelit the pension holder would receive ilt
retirement age with a lully vested pension based upon
compensation and plan provisions as 01 October to, 1996.
REDUCTION FOR MORTALITY AND DISABILITY: 0.9409
Represents a reduclion lor the probability the pension holder will
not survive from the Date 01 Valuation to the Date Benelits
Commence.
REDUCTION FOR NON-VESTING: 1.0000
Represents a reduction for the probability of service to 100 parcent
vesting as equal to the portion already completed,
REDUCTION FOR MARITAL COVERTURE FRACTION: 0.8230
Represents lhat portion 01 the value of the benefits attributable to
the marriage. The numerator 01 the fraction represents the total
poriod of time the pension holder participated in the plan during
the marriage and the denominator is the total period the pension
holder participated in Iho benefits program.
PRESENT VALUE BEFORE REDUCTIONS:
Reductions for Mortality and Disability:
$ 12,520.16
x 0.9409
x 1.0000
x 0.8230
$ 9,695.12
Reduction for Non-Vesting;
Reduction for Marilal Coverture:
VALUATION Fon EQUiTABLE DISTRIBUTION:
SOd
\I'~;, "._ 1J1'i 131
6iSI 111118b,Si.~n~
EXHIBIT 10.
LISTING OF HOUSEHOLD GOODS AND CONTENTS
DIANE G. RADCLIFF
3448 TAINDlE ROAD
CAMP Hill. PA 17011
PHONE (717) 737,0100
FAX 17171975.0697
ID#32112
Page 12
l
t
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
o
NO. 97-0035
V.
CIVIL ACTION - LAW
IN DIVORCE
SCOTT A. POTTER,
Defendant
LISTl:NCLOF~HOt1SEHOLD_GOODS_AND__ CONTENTS
1. MARITAL....I.TEMS....nLTHE...P_OSSESSI ON....OF.....Ht1SBAND I
ROOM
DESCR I PTI ON
ESTIMATED VALUE
t
f
:.
LIVING ROOM
3 PIECE FURNITURE
SET
$800.00
1 GLASS AND BRASS
COFFEE TABLE AND 2
GLASS AND BRASS END
TABLES
$350.00
2 LAMPS
$80.00
$40.00
$50.00
$50.00
$30.00
$100.00
MAGAZINE RACK
TV
VCR
CLOCK
3 HOME INTERIOR
SHELVES; 1 HOME
INTERIOR MIRROR; 1
HOME INTERIOR
SEAGULLS
BLOWN UP PICTURE
FROM HONEYMOON
$50.00
2 LAB PUPPY
FIGURINES
$10.00
ROOM DESCRIPTION ESTIMATED VALUE
16X20 WEDDING $75.00
PICTURE
BEDROOM 1
QUEEN SIZE BED $650.00
TV $50.00
TV STAND $30.00
ROUND END TABLE $5.00
CLOCK PHONE RADIO $25.00
BEDROOM 2
ROUND END TABLE $5.00
CLOCK RADIO $15.00
3 PICTURES $10.00
KITCHEN
KITCHEN TABLE WITH 4 $20.00
CHAIRS
MICROWAVE $50.00
REFRIGERATOR $1,200.00
8 PICE CORELLE $100.00
DINNERWEAR AND
SILVERWEAR SET
MICROWAVE CART $20.00
MISCELLANEOUS $700.00
COOKWEAR:
APPLIANCES, COFFEE
POT; WOK; UTENSILS;
CROCK POT; TOASTER;
BLENDER; MIXER ETC.
DOWNSTAIRS
COMPUTER $50.00
DESK AND BRO\1N CHAIR $0.00
CLOCK $10.00
ROOM OEseR I PT ION ESTIMATED VALUE
TV TRAYS $30.00
16 X 20 WEDDING $75.00
PICTURE
VARIOUS PICTURES, $200.00
FRMAES, CANDLES,
BASKETS, NIC NACKS
REC ROOM
BLUE CHAIR $25.00
TV $500.00
VCR $200.00
ENTERTAINMENT CENTER $25.00
CD PLAYER $350.00
VCR TAPES AND CDS $700.00
NORTH CAROLINA CHAIR $100.00
NORTH CAROLINA CLOCK $25.00
DAD'S PLAQUE DEER $25.00
HORNS
PHONE MACHINE $20.00
HERSHEY'S DOG BASKET $100.00
TOYS Cor,LARS ETC.
SPORTS PLAQUES $60.00
LAUNDRY ROOM
WASHER AND DRYER $600.00
4 STEEL SHELVES $40.00
DIRT DEVIL $20.00
WIFE'S BOOKS $100.00
TABLE LINENS, VASES, $75.00
CANDLES AND COOLER
DAD'S BINOCULARS AND $100.00
CAMERA
.,
ROOM DESCR I PT ION ESTIMATED VALUE
STORAGE ROOM
ALL CHRISTMAS ITEMS $500.00
WEDDING PRESENTS: $500.00
CRYSTAL BOWLS,
PLATTERS, VASES,
CANDLE HOLDERS,
CRYSTAL GLASSES ETC.
PICNIC BASKET $30.00
OTHER HOLIDAY ITEMS $200.00
2 BEACH CHAIRS $10.00
SHED
GAS GRILL $200.00
SNOW BLOWER $250.00
LAWN MOWER $400.00
SHOP VAC $40.00
ALL OTHER LAWN $400.00
EQUIPMENT: WEED
WACKER, EDGER ETC.
TOOLS $200.00
MISCELLANEOUS
WICKER FURNITURE: 3 $125.00
PIECE SET WITH
COFFEE TABLE AND
CUSHIONS
VACUUM CLEANER $25.00
LAWN TRAILER (SOLD) $900.00
BED LINENS, BLANKETS $400.00
AND TOWELS
IRONING BOARD AND $15.00
IRON
LUGGAGE $25.00
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
V.
SCOTT A. POTTER,
Defendant
NO. 97-0035
CIVIL ACTION - LAW
IN DIVORCE
2 . MARITAL-J:TEMS.....IN_THE...1'OSS~SIOH-OF_WU'Et
ROOM DESCRI PTION VALUE
BEDROOM 1
2 LAMPS
BEDROOM 3
2 LAMPS
VANITY SET
DOWNSTAIRS
CHINA SET
FILING CABINET
REC ROOM
PHONE
TOTAL
$20.00
$20.00
$50.00
$200.00
$25.00
$10.00
$325.00
IN TilE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
CIVIL ACTION - LAW
IN DIVORCE
SCOTT A. POTTER,
Defendant
3 . N.ON=MARI'rAL_PROl'ERT~l.
DESCRIPTION VALUE POSSESSOR BASIS FOR
EXCLUSION
WIFE'S NON-MARITAL PROPERTY
CLOCK FROM $50.00 HUSBAND GIFT FROM
EUROPE SISTER BEFORE
MARRIAGE
DRESSER $20.00 WIFE PRE-MARITAL
CLOCK RADIO $10.00 WIFE PRE-MARITAL
PICTURE OF $0.00 HUSBAND PRE-MARITAL
WIFE DRAWN BY
HER BROTHER
RECLINER $200.00 \-11 FE GIFT FROM
WIFE'S FAMILY
COUCH $100.00 WIFE GIFT FROM
WIFE'S FAMILY
WING CHAIR $75.00 WIFE GIFT FROM
WIFE'S FAMILY
2 END TABLES $25.00 WIFE GIFT FROM
WIFE'S FAMILY
COLLECTION OF $400.00 HUSBAND PRE-MARITAL
RECORD ALBUMS
TOOLS $200.00 HUSBAND GIFT FROM
WIFE'S FATHER
HUSBAND'S NON-MARITAL PROPERTY
DOUBLE BED HUSBAND GI FT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
2 DRESSERS HUSBAND GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
SINGLE BED HUSBAND GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
DRESSER HUSBAND GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
DINING ROOM HUSBAND GIFT OR
TABLE WITH 4 INHERITANCE
CHAIRS FROM HUSBAND'S
FAMILY
ANTIQUE HUTCH HUSBAND GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
ANTIQUE RADIO HUSBAND GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
COFFEE TABLE HUSBAND PRE-MARITAL
SPEAKERS HUSBAND PRE-MARITAL
SMALL ANTIQUE HUSBAND GIFT OR
TABLE INHERITANCE
FROM HUSBAND'S
FAMILY
2 LAMPS HUSBAND GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
.
REFRIGERATOR
HUSl3AND
GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
TABLE WITH 2
CHAIRS
HUSBAND
GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
LAWN MOWER
HUSBAND
GIFT OR
INHERITANCE
FROM HUSBAND'S
FAMILY
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$IGN^ Tunt
EXHIBIT 13.
HUSBAND'S TOYOTA PSL STATEMENT AS OF
SEPARATION
DIANE G, RADCLIFF
3448 TRINDlE ROAD
CAMP Hill, PA 17011
PHONE (717) 737.0100
FAX 17171 975,0697
ID # 32112
Page 14
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$IGNMURt
EXHIBIT 14
JOINT VISA ACCOUNT STATEMENT AS OF
SEPARATION
DIANE G. RADCLIFF
3448 TRINDlE ROAD
CAMP Hill. PA 17011
PHONE 1717) 737.0100
FAX 17171 975,0697
ID#32112
Page 15
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ASSETa.AND-LIABILUIES_OF_.PARTIES
plaintiff marks on the list below those items applicable to
the case at bar and itemizes the assets on the following pages:
(X) 1.
(X) 2.
(X) 3.
( ) 4 .
(X) 5.
(X) 6.
( ) 7.
( ) 8.
( ) 9.
( 10.
( 11.
( 12.
( 13.
( 14.
( 15.
( 16.
( ) 17.
(X) 18.
( 19.
( 20.
( 21.
( 22.
( 23.
( ) 24.
(X) 25.
(X) 26.
(x) 27.
(x) 28.
(x) 29.
( ) 30.
DIANE G, RADCLIFF
3448 TRINDLE ROAD
CAMP HILL. PA 17011
17171737-0100
Real property
Motor vehicles
Stocks, bonds, securities and options
Certificates of Deposit
Checking accounts, cash
Savings accounts, money market and savings certificates
Contents of safe deposit boxes
Trusts
Life Insurance policies (indicate face value, cash
surrender value and current beneficiaries)
Annuities
Gifts
Inheritances
Patents, copyrights, inventions, royalties
Personal property outside the home
Business (list all owners, including percentage of
ownership, and officer/director positions held by a party
with company)
Employment termination benefits - severance pay, worker's
compensation claim/award
Profit sharing plans
Pension Plans (indicate employee contribution and date
plan vests)
Retirement plans, Individual Retirement Accounts
Disability payments
Litigation claims (matured and un-matured)
Military/V.A. benefits
Education benefits
Debts due, including loans, mortgages held
Household furnishings and personalty (include as a total
category and attach itemized list if distribution of such
asset is in dispute)
Other
Mortgages
Vehicle loans
Credit card debts
Other loans and obligations
- 2 -
MARI.TAL_RROPER'U
Plaint if f lists all marital property in which either or both
spouses have a legal or equitable interest individually or with any
other person as of the date this action was commenced:
ITEM NO. DESCRIPTION OF PROPERTY NAloIES OF ALL OWNERS
1 931 south 31" Street, Camp Scott A. and
Hill, PA 17011 Elizabeth K. potter
2 1987 Pontiac Grand AM Scott A. and
Elizabeth K. Potter
2 1991 Toyota Pick Up Truck Scott A. and
Elizabeth K. potter
2 1978 Chevrolet Corvette Scott A. and
Elizabeth K. potter
3 US Savings Bonds Scott A. potter
5 PNC Checking Account Scott A. and
Elizabeth K. potter
5 PNC Checking Account Scott A. potter
6 PNC Savings Account Scott A. and
Elizabeth K. potter
18 Wife's VIP Plan (9/30/96) Elizabeth K. potter
18 Wife's KHP Pension Plan Elizabeth K. potter
($314.73/mo as of 7/24/28)
18 Husband's Woolworth Pension Scott A. Potter
plan ($207.48/mo as of 4/1/26)
25 Household goods and furnishings Scott A. potter and
Elizabeth K. potter
- 3 -
!JIANI:(j RAIX'l.IH
.144K IIUNlll.l' HOAIl
C^~lIll1\1l..l'^ 17011
(71717H.O\Il()
i
t
>
PROPERTY TRANSFERREILWI.~E (31 YEAR5_
OF THE DATE.....OF THE CQMMENCEMEN'LOF-THE-ACTION
ITEM DESCRIPTION OF
NO. PROPERTY
26 Equipment Trailer
DATE OF CONSIDERATION NAME OF
TRANSFER TRANSFEREE
unknown unknown unknown
DIANE G, RADCLIFF
3448 TRINDlE ROAD
CAMP Hill, PA 17011
17171737.0100
- 5 -
LIABILITIES
ITEM DII:SCRIPTION OF NAMES OF CREDITORS NAMES OF DEBTORS
NO. LIABILITY
2'1 Melt t \Ide!'. I!tllllf'uide Lending Scott and
Elizabeth Potter
20 VI'Jlir'],' J.odll Mo.'mll!.' I' , B First PSL Scott Potter
(t '01 VI'I I 1')
211 V,'hi,'J,. 11(),lll Member's 1" PSL Scott Potter
(Toy"loI)
~? 9 ('Iedll ("inl ViflCl Acct. 4121- Scott and
1'19<) - 9860 -1802 Elizabeth Potter
IH^NI Ii fl^llCllIl
1.1411 III1NIrII II"^, I
CAMP !till. P^ I/o I'
tllIl III 0100
-6-
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
ELIZABETH K. POTTER,
Plaintiff
NO. 97-0035
V.
CIVIL ACTION - LAW
IN DIVORCE
SCOTT A. POTTER,
Defendant
INCOME AND BXPENSE STATEMENT OF ELIZABETH K. POTTER
DATED. August 5, 1998
PART I Income
A. EMPLOYMBNT INFORMATION.
EMPLOYER,
KEYSTONE HEALTH PLAN CENTRAL
ADDRESS,
300 CORPORATE CENTER DRIVE. CAMP HILL, PA 17011
TYPE OF WORK:
CLINICAL CARE SPECIALIST
PAYROLL NUMBER:
008937
PAY PERIOD:
BI-WEEKLY
B. EMPLOYMENT INCOME.
GROSS PAY PER PAY PERIOD 1231.12
ITEMIZED DEDUCTIONS
FICA (6.2%) 75.80
MEDICARE (1.45%) 17.73
FEDERAL TAX 124.93
STATE TAX (2.8 %) 34.21
LOCAL TAX (1%) 12.31
MANDATORY RETIREMENT
VOLUNTARY RETIREMENT 73.86
UC/SUI
MEDICAL INSURANCE 3.6
MISCELLANEOUS INSURANCE 7.47
MISCELLANEOUS DEDUCTIONS-UNITED WAY;HIGHMARK CLUB 2.25
TOTAL DEDUCTIONS 352.16 -352.16
NET PAY PER PAY PERIOD 878.96
NET PAY PER MONTH 1904.41
DESCRIPTION AMOUNT
TELEPHONE 60
CABLE TV 25
REAL ESTATE TAXES
HOMEOWNERS H:SURANCE/RENTERS
GROCERIES AND HOUSEHOLD SUPPLIES 200
TAXBS.
INCOME TAXES NOT WITHHELD 16.15
PER CAPITA/OCCUPATION TAXES 20
OTHER TAXES 1
AUTOMOTIVB AND TRANSPORTATION EXPENSES,
PAYHENTS
FUEL 85
MAINTENANCE AND REPAIR 75
LICENSE AND REGISTRATION 3
PUBLIC TRANSPORTATION
INSURANCB,
AUTOMOBILE INSURANCE 39
LIFE INSURANCE (NOT DEDUCTED FROM PAY)
ACCIDENT INSURANCE
HEALTH INSURANCE (NOT DEDUCTED FROM PAY)
OTHER INSURANCE
HBDICAL EXPBNSES NOT RBIKBURSED BY INS.,
MEDICAL/DOCTORS 4
DENTAL
OPTICAL 2
ORTHODONTIC
HOSPITAL
MEDICINE 4
SPECIAL NEEDS/THERAPY
EDUCATIONAL EXPENSES:
PRIVATE/PAROCHIAL SCHOOL TUITION
COLLEGE/VOCATIONAL TUITION
ROOM AND BOARD
DESCRIPTION AMOUNT
FEES AND SUPPLIES
BOOKS
RELIGIOUS TRAINING
CREDIT CARDS AND LOANS:
1. MEMBER'S l"T VISA BALANCE .104.00 200
2, BON TON BALANCE 0
3. SEARS BALANCE 0
4.
PERSONAL EXPENSES,
CLOTHING 108
LAUNDRY AND DRY CLEAlHNG 40
BARBER AND HAIR DRESSER 75
LUNCHES 60
MISCELLANBOOS EXPENSBS.
HOUSEHOLD HELP
CHILD CARE
MEMBERSHIPS
NEWSPAPERS/MAGAZINES/BOOKS 18
ENTERTAINMENT 80
VACATIONS 100
GIFTS AND TOYS 90
CHARITABLE CONTR IBUTIONS 200
LEGAL FEES
OTHER CHILD SUPPORT
OTHER SPOUSAL SUPPORT/ALIMONY
OTHER MISC. EXPENSES VETRNIARY BILLS 32
EMPLOYMENT EXPENSES NOT DEDUCTED FROM PAY
UNIFORMS
OTHER EXPENSES-SPECIFY
TOTAL EXPENSES 2092.15
PROPERTY OWNllD OWNllRSHIP
TYPE DESCRIPTION VALUE H W JT
CHECKING MEMBERS 1 :,T 840 X
SAVINGS MEMBERS 1 :jT 1841 X
CREDIT UNION
STOCKS/BONDS
REAL ESTATE 931 S. 31 'T STREET, CAMP HILL 100,000 X
OTHER CHRISTMAS CLUB ACCOUNT 344 X
INSURANCB COVBRAGB
TYPE COMPANY POLICY NO. H W C
HOSPITAL/BLUE HIGHMARK BC/BS 210-5B-6414 X
CROSS
MEDICAL/BLUE HIGHMARK BC/BS 210-58-6414 X
SHIELD
HEALTH ACCIDENT HIGHMARK BC/BS 210-58,6414 X
DISABILITY HIGHMARK BC/BS 210-5B-€414 X
INCOME
DENTAL HIGHMARK BC/BS 210-58-6414 X
VISION HIGHMARK BC/BS 210-58-6414 X
OTHER-SPECIFY
*H=Huobandi W=Wi fe j J=Joint; C=Child
SUPPLEMENTAL INCOME STATEMENT
[X] CHECK HERE IF NOT APPLICABLE
la) This form is to be filled out by a person:
(1) Who operates a buoinesB or practices a profession, or
(2) Who is a member of a partnership or joint venture, or
(3) Who is a shareholder in and is salaried by a closed
corporation or similar entity.
(b) Attach to this statement a copy of the following documents relating to
the partnership, joint venture, business, profession, corporation or
similar entity Icheck block to indicate the document is attached) ,
(1) The most recent Federal Income Tax Return.
(2) The most recent Profit and Loss Statement.
attached
attached
(c) Name of Business,
Business Address,
Business Telephone,
(d)
Nature of BusinesD (check onel
[ 1. Sole Proprietorship
[ 2. Partnership
[ 3. Joint Venture
[ J 4. Professional
5. Corporation
6. Other
(e) Name of accountant, controller or
other person in charge of financial
recorda:
If) Business Income:
1. Annual income from business:
2. How often in income received:
3. GrOBS income per pay period
4. Net income per pay period
5. Specify deductions, if any:
J
~
I, ELIZABETH K. POTTER, verify that the facts set forth in the
foregoing Income and Expenses Form, including all attachments
thereto, are true and correct to the best of my knowledge,
information and belief. I understand that false statements herein
are made subject to the penalties of 18 Pa. C.S. 4904 relating to
unsworn falsification to authorities.
DATE:~\~\Q,.~
.
~-o- W<-.\-'l 1(\ ~r~,e~
ELIZABETH K. POTTER
.~S!8'~~
I'ay Group:
Ploy Hi'll" U.lt:
P.. rn4l>ale:
,... Con'''' "..p' F lh,d', 000008208
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ll' " front It lnd floor COlt eenler. Utilization "W1.IJ..~t - tl.liPC '1a,U.ISI,"n: ".rrild Slnlll
Wor.llrlbur. Pi 110~1 I.oClllon: CHUD Allu"ances: I
Jut! TIII<< Clinlnl C.r. Spuhlht Add!. Pct.:
SS~; lU-Sl"UU P.v Rate: 10 ')1.00 AnnUli Add!, Am."
TAll_'
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nlultallllft Mal. Iloun t:ltft'rur1 Iloun .:111\1,,1' I)esctllltlllft CuU....1 VTn
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V.c.tlon 11.15 29".51 11.15 2'''.51 FED FICA "din 11.11 11.01
FED Wlthholdlnl llZ.59 ilZ.59
PA Withholding n.'" n.7'
Pi E PIII'II'I.b , 11.00 10.01
Pi Wr.hlbr., 11.11 11.7.
11.75 I 11'.ll 75.01 1 17'.ll T.hr. 2'''.15 2'''.15
. .
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H..lth 5.'. 5.U Shl.ld Club 0.25 0.25 llf. . 0.'1 0.'1
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Carnnl: 1,171.12 1,1".1' 266.15 ".45 , IU.IZ
YTll, 1 HI.ll 1 "'.19 2".15 I'.U 12".12
Start Saluc:c 15." Slart Balaace 0.00 511rt Oalance O.DD ADVICE ..
+ [arn": 1Z1.5I + [am": 15.00 + [am.: 0.00 C""CK ,.
- Tako: U1.Z5 - Talltal 15.00 . Taken: 0.00 Talal:
+J- AdJullm.nl.: 0.00 +/-Adjat1l1lml.: . DO . Sold: O.DD
[dOalance: 11.25 End B.lance: O.DD + ,- A4Jut1mtfttl: 0.00 Document II: 000000004070
End B,lance 0.00
MESSAGr,
.~~~
1~I"M.1It Uu"'...., I"" BIlle C,o.. 1M IllIe Ihll'~ A..ocl~.n.
.""iltl,..~ "'Irq "111. .'1Ie Cro.. IrIlI 11l1e 11I1.1~ AI'K'~"n.,
.n AI'CK1~1.n. " Intl'PIMllIt BIIM c,.tt 'M II... 'hl.l~ Pili'll
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
DATE
01102/1998
NO.
000008208
llEPOSIT AMOUNT .
824.82
Potter,Elizebeth Ketherine
126 N Front St 2nd Floor
Wormleyeburg PA 17043
.n .
Checklna
cC'Ou 1 u h
161"'''00
J)r alII Amoun'
12".12
BAG' 0103
LOCATION CH300
DEPT 0759
Toral:
,
124.82
DEPOSIT NOTICE ONLY -- NON.l'a:GOTlAIlLE
.~S!2'n12r1~
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1'.yflf1,lnlJlllt:
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Wor.lev'bur, PI. 110~S
t:mplnYNfI)'
('u,' ("enler:
l.nUllon
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lAX IlA T
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Allow.nen:
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1
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SS"': llD-\1'6U4
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Shrt Yr. Oishi 5.54 5.54 Unl tad W.y Fund Z.OO 4.00 .oIl 51." 17.16
Dent.1 0.01 1.50 S~ph...nhl LI 1.51 s.a
4011 70." 141.S'
D.p.nd~t II fa 0.01 0."
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Total: '.14 11.0' Total: 74.52 I5Z.U . T...~I.
Carrenl: 1,l7'.ll 1,1".59 Z56.51 IS." . 1S7.n
VTD: Z 55'.Z4 Z 559.51 US.40 170.11 1 "iLlS
Start ealance 11.25 Start Balance: 0.01 Slaft Ollnce: 0.00 ADVICE II
+ Elfnlll: 11Z.50 + E.m": 45.DD + [lrnN: ZZ.5D c...." ..
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En' B.l.nce:: 125.15 En' Blllnee: 45.00 + /. A'jurtmtnu: 0.00 Document ~ 00000000401Z
En' Oalance:: 22.S.
~ESSAG[:
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In'.p.n..1lt Liu".... Ollh. 811111 Croll .nf BI... 'hl.14 AII,ciltl'"
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DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
01/1611998
NO.
000008654
DATE
DEPOSIT AMOUNT .
837.91
Potter,Elizebeth Ketherine
lZ6 N Front st Znd Floor
Wormley.burg PA 17043
Checkl,..
1'14'sa..
out
'57.91
BAC, 0103
LOCATION CH300
DEPT 0759
Tot.l:
.
.57..1
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
.L~S~Y~,2~~
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p,,\ Ilq:'R II,llt.
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ADVICE '1
CHEeI! '1
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000000004019
f:nd 1I..I~nu,: ZZ.50
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1~1,u"o1'..' l>(,..uu or ,.... at,.. Clln. 'I" at,., ''''.Ill! jIIuO('lIl'OIl
'11'1'1",,4 ~.u~, or l~. at,.. C'~II ~". at,., '/1,,14 "110(""011
~" ""0"~1'0" 0' t"d"'~'''1 Slu. C,on .". Slu. '/1111' PI.".
m:ros.... :\'O'/'ICE O:\'I.Y -. :\'O:\'-:\'EGOTlMII.E
U\I':
01/30/1998
,'0,
000009099
llI:rOSIT ,l'llll'T .
837.92
"
Potter,Elizabeth Katherine
lZ6 N Front St Znd Floor
Wormlaysburg PA 17043
\nuu I .
Check In,
H'flunl'u hI'
l'lU3DDQ
h' n II mnu t
137.9l
""," 0103
IIlIIIIl" CH300
IIU'f 0759
IHIII:
an.'IZ
nEPOSI'/' ~OTlCE O~I."'.. :\'O~-:\'EGOTl'\nLE
.~~1!2~
I',,)'(;,""P;
.'.)'IIl'V,lnlJ.,v.
"n-End (hit"
.tlP Canlral hl""t f (h~'lkli' 000009541
II I Ilftl U9I
Ol106ll'nl Chl'l )"'t'" OllB/1991
,
I
k
I
Putt.t ,flll.blth K.th., In. t:mpllJ)""III: OOl'H L\\ 1IA1 A, hdl.ul -;1111.'
IZ6 H fro..,t St 2nd flour ('fl'fCenl~ Utlll,.tlon "~.g...nt IlHPC 'lam,1 SUIUI: "_"rl.d Slnllle
~ur.l.y.bur. PI 1/O_~ 1.IIl.tllln: CIUOO Allmunl": ,
Jut! 11111; Cllnlcll C.r. SPlel.lllt Addl.IJI.1;
!-is'' llO-""-'''U I'lY HaIr. \0 Ul.OO AnnUli Addl Amt.:
1I1l1'RS A~III:A""~c:s fAnS
".("UHl'ntu. ."\'lIl".
I)r\t,lpllon M..le IllIun .:.,nln, fllIun .:unlnll' I)Mulpllnn [unt'nl VII>
"-,uhr PI" I,H'.1l lll.Z5 lII,"II.1S fED aUDI/Dlub 12.U 190,l'
Vlcatlon D.IO 1'.75 29".5S nD FICA ".dle. Ii." .,...
FED Withholding IZZ.U 4U.11
.A Withhold in, n.1S 15o.n
PA 1I,..tv.brlll 11.1. "'.1Z
PI E P8Mlb , 0.00 Ia.oo
I I 111.ll 500.00 . 11l." u l56.55 I 056.'"
, . . ..
I fJru:!l1njon Currenl nil n~tflDtlnn runl'M VIII n~ulDllnn Cur,rnl YTII
H..lth S." 1'." HlghIt.rk Club 0.l5 1.00 Uf. " 0.6. l.ftft
Shrt fr. DII(.1 5.54 1'.61 Unl t.d 'ley fund l.OO 1.00 .., 31." 155.52
Dent.l 0.00 S.SO Suppl....,tel U 1.51 6.52
..1 70." 21l.7'
Dependent Uf. 0.00 0."
Lonl hr. DhH 0.00 l.30
Tntal: '.a 36.36 Tolll: 74.5Z 301.07 -Tulhle
. . ..
Curren!: 1,17'.ll 1,.".59 256.55 1S.66 . 8n.'1
VTIl, . 712.48 " 678.56 1 056.'9 H7.4S ] HI.S6
, .
Slart Balance: 11.25 SliM Balance: 0.00 Slart Balance: 0.00 ADVICE II
+ t:arnN: 112.50 + .:a,n": 45.00 + F.amtd: 22.50 CHECI( I,
Taktn: 0.00 Talten: o.ao Talttft: 0.00 Tolal:
+/. Adjustmrnls: 0.00 +/. Adjustments: o GO Sold: 0.00
tn' Dalance: IZS.75 En' Balance: 45.00 +/.A'Juslmtllfl: 0.00 Ooeumen'M: 000000004024
End Bal1nCf': ZZ.50
\lI:SSAGF.,
.~S!2~
IM.p.n.."'1 Lite"'.... of thl BIIlI Croll 1M Blve Shl.14 Auoellltlo,.
'R.gllt.,.. Mlrk' " lilt 8111, Croll .l'I4 Blue Shl,'d AeIOClalioll,
'" .....ocltrlono',Il4.'.Itd.nt8Iut Croll 'nd BJII8 Shl"; PJ'"I
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
llATE
02113/1998
NO.
000009541
llEPOSIT AMOUNT $
837.91
Pott.~,Eliz.b.th K.th.~in.
126 N F~ont St 2nd Floo~
Wo~ml.ysbu~g PA 17043
cm. .
Check Inl
<<0\1 N\I bt
lialSODl
r ~ t 0\1 I
117.9.
nAG' 0103
I.OCAIION CH300
11F.PT 0759
Total:
I
157.91
DEI'OSIT NOTICE ONLY -. NON-NEGOTIABLE
"~S!2'~I9~
UIP tlntr.l lJC.apt f t hl't" 11 000009967
OliO 11 l'f'fl
01/Z0/1""1 I ht'I" 1.1~ Olll1l1'tU
IJ~1 C;ruup
fl.)IIt'1l,ln Ihl~:
I'~ rnd Ih.,.
I'nlhr,flllnblth IlIH...rh..' l:nlplu)rellJ" 001'157 lAX I>AI A' h-dl'ul ~116'l!
I?t. N front St Znd Floor ('lull'"'!'t: Utlll,.tlon "IUII.."..nt IItWC \hrllaISI.IU': H,rrl.d 51(1'.11.
Wo,.I.~,burg P1 1/O~S 1.llu1Inn: (.H500 AIIII",.n[": 1
.Inbll1l.: Clinical Can SPlchlls' Addl. I'd,;
~S'i' llO-S,I.."I' II.\, kalr. 501:151,00 'nnuII "ddl AmI.:
""".. AMI .. ..'.
..'('Ufff'n'o" '"''10'''
1)C'1ulhtlun Ihl. I I 11Im t:unlnv, Ilulln t:arnlnll' n.,crlDllun ('uru'"1 ",..
fhlguhr PIV l.ll..ll n6.l5 5.SU,a1 fED OISD1/D1..b Il.n Ul.7'
Vacation 0.00 11.15 2""S5 FED FICA "edlel a.'. 1ft ,IS
FED Withholding lH.S' 61l.n
P' Wlthholdln8 n.n lU."
PI. Wr.h'brlll IL7' 51.'0
Pi E: P.nnlb , D.OD 11.00
1111.11 sn.DO 5 nD.ftO 2S6.5" \ nS.n
.. . . ..
I)r,crl-llnn Cu"r'" vrn I nrsc.I't1o" Curre'" Vn) I nCl1C.,,,,lo" roo..,.. Vf1)
H..tth s... 20.U Hlet*.rk Club D.U 1.Z5 Llf, . 0.61 S.OS
Shrt Yr. Dhf,l 5.5" 2Z.16 unlt,d ,,'V Fund Z.ao 10.0' ..\ U... 19"."0
D,nt,l '.DO S.n Supph.,ntal LI 1.5' 1."
... 10.69 nS.45
D,p.ndent Llf. 0.00 0.69
long '.r. Dhab 0.00 2.10
lnlll: '.U "5.50 Tolal: '''.52 US.S' . Taxabl,
..
Currrnl: 1,111.12 1,1".S' Z56.S" IS." , 1S1.'Z
VTIl, 5 1'90.60 5 8"'.15 I US.as "ZI.n " 116.41
Stlrt nallnce: 11.25 Start B.lance:: 0.00 Start B.lance: D.OD ADVICE II
+ r.arn": 112.50 + F.arnrd: "5.00 + t:arned: n.so ._rv "
r.ken: a.ao . Takt'1\: O.OD rakln: 0.00 Total:
+ /- Adlustments: 0.00 +1. Adlustments: .,.. . Sold: O.DO
End Oalance: tU.7S t:nd Balance:: "5.00 + /- Adjustments: D.DO Ooc.mtn1 It: 000000004050
.:nd Oalance: 2Z.50
\1F.SSAGE,
.~~~
1I'Id",n4'", LIC'Il"" of Ih, 81u.C,on ,lit 811M '\hl,l. o\IlotlltlOI\
oR"iIW'" M.rll, or Ih, BIIM C'on 1M Blue SI\t,'4 Anotllllot'l,
.t'I Ano'"tloll or 11td",rt4.t'l1 BIIM Cron 1M Blue SI\lll. Plitt'
DEPOSIT NOTICE ONLY -. NON-NEGOTIABLE
02/27/1998
NO.
000009987
DATE
DEPOSIT AMOUNT .
837.92
Potter,Eliz8beth Ketherine
126 N Front St 2nd F1Dor
Wormleysburg PA 11043
Chock I...
16U'S'"
U1.'Z
HAGN 0103
I.OCATlO~ CH300
OI:rT 0159
ofal:
. ..
DEPOSIT NOTICE ONLY.. NON.NEGOTIABLE
.~~~
I'a)' (;rlJUp:
I'IY HeKln U.,.:
I', Endlhl.:
".. Cant"II.....' f thftU 000010431
OllZI/.,n
03/06./1'91 (hrc. hit': nilS/I""
t:m,IU)HII): OOltS1 lAX IJATA, "'C'd'1'.1 SI.,.
PDtt.r,EII~ab.th K.th.rln.
lU H front St lnd floor Clnt Clnrn. utllll,tlon Hanai,..nt ~ 'HPe MlrU,15111111: "arr lad $Ingle
Wor.l.y.b~,. PI 170_3 l..uUlllln: CHUD "\110'''"[": 1
.lnllll1lc Ctlnled C.r. Splchlht Add!. I'ct.;
ss~ llO-U-'.U II." R.ler. U '3\.1I Annu.1 A..r Am"
IInt'lt' AM' fU""C IAn"
""('u".I\'... ...."TO...
()I'U",llIlllIn R." flnu" .:arnlnt Ilnu" .:.,"1"1 O"crllllol\ Currenl \'TU
hlJYla,. PIV 1,11'.U "u.n ',71il1..' HD OUOl/Dlub 'l,St OS.SO
Vlcatlon '.00 l'.n 294.n fED fiCA "edln ..... lOl..l
fED tUthholdJn, Ill.S' U5.n
PI Wlthholdlnl ll.n '''.n
PI Wt.habtg' 11.71 70."
PA E Plnnlb T 0.00 10.01
I 17..U .sO.OD 1 0".72 2S6.SilI 1 5.9.51
.. . ..
IlHcr11lrto" ("Uneftl VTn ~I_;I~ Cunt'ft' "Tn Oeu.1ftlon Cu",,,' nn
Hu}th S... n... HJgtwI.rk Chb D.a 1.5D ll'. . '.61 3."
Shrt Fr. Dhf.. 5.S. 11.10 lIn!t.d W.w Fund l.ao n.ao "1 S.... lSS.I.
Dent.} D.ID 3.30 SUPP...."t.} II 1.51 ,...
'al 10." .,4...
D.p~d....t llf. O.ID 0."
long 1'.r. Dluta 0.01 Z.SO
flll.l: '.a 54." Tol.l: ".52 .50.11 . Ta.--hl.
.. ..
l"uffenl: 1,17..12 1,1".59 ZS6.54 IS." . n1.n
YTIl, 1 a6l.1Z 1 017.1' 1 5".51 504.75 5 01.....
Sllft Balllee: 11.Z5 SI.rt aal.nte '.ID S'llt aalance 0.00 ADVICE '1
+ [.mM: 112.51 + E.raM: '5.00 + E.mM: U.5t e...," ..
. r.b,,: D.DO . rab,,: I.DD . T.km: I.ID ToI.1:
+1. Adluumt'ftls: D.DO +/. AdJustmen,s: . .. . Sol": 1.00
f:nd n.l.nce: IU.1S End O.I.nce: 45.00 +/. ""Iustmtntr: 1.00 OOClIlDtftl1ll: 000000004074
End O.I.nce: n.so
:\n:SSAGf::
.~~~
I"'dl,.nd.nt Llu"".. of lh. Itue C,o.. 1M llue Ihl.14 ""0(1.,101'1
'A.,i"".4 1.11," 01 the 81ue Cro.. 1f14 11~ Ihi." AI.Hi.,1.".
." .....O(I.,lon of rfl4.,.II4I.nt 81", Cro...1\IIII 81", 1"1,14 pr'M!
DEPOSIT NOTICE ONL V eo NON.NEGOTIABLE
DATE
03/13/1998
NO.
000010431
DEPOSIT AMOUNT .
837.92
Pottsr.Elizsbsth Ksthsrins
126 N Front St 2nd Floor
Wormlsy.burg PA 17043
Check lnt
161415...
,
151.92
nAC' 0103
I.OCATION CH300
IlI:PT 0759
Tol.l:
.
'51."
DEPOSIT NOllCE ONLY -- NON.NEGOTIABLE
.J~~~
P;I) (;IlIUP:
I'a)' OrvIn Ihle:
II~ .:nd Ihll.":
_liP C.ntr.t EultfJt F
05/0111""
05120/1'"
(h,,' _, 000010669
fhn Ir: 05l17/!'tlJI
Pott.r,fll,.b.th Kath.rln.
Ii' H Front it lnd Floor
War.ley.burl PI 110'1
.:mplll)'Hm:
Cn\ll'enlu:
I.ncalJlln:
JlIbfllle:
I'. Male:
oonn
Utillutlan "fIn.u..nt 1(tIPC
CHSOO
(linle.. C.r. Splel_tl,t
50 .11.00 Annual
I.IX "^I
'hllla! SfIIUS:
AIIII""Rl:e1:
Adel.I'd.:
idl "
Irdl'fill
Hurl.d
1
St.,...
Slngl.
ss~: 110-U-'ClICl
(lI;.' '''1 .'..",c.. lAX!:,
."('utl"n'''. "'\'IU'"
IJru-"tllu!t Nallt 'Inun L:unlnlll IllIun .:.rninl 1)('\crIDtlnn Currl'nl "'In
R.gular PIV 'U.s.a ""1.25 Pill.... fED OASDI/Dhn Il.U ~Ol.U
flu II.. Off I.U 111.'1 1.$0 111.'. FED FICA H.dlca 1'.9\ 11'.1'
V.c.tlon 1.51 117.'1 16.ZS 'HZ.'" fED Withholding Ill.56 nl.'~
.& Withhold In, Sl.1S zn.1l
PI Wr.tv'brlll 11.11 Il.U
PA E P.nn.b T 0.00 ID.DD
r, 15.00 1 11'.1Z 525.00 . lU.I\ 2!i..!i~ I 10'.11
" . . ,"'
I)~crllltlflll CurfC'1l1 VTIl )efcrlollflll Current VlI) I)ncrla,lflll ('u"tn' V III
H..1th S.6D 27.Z' HIghII.rk Club 0.25 1.15 L1'. . 0.'1 '.21
Shrt Jr. DIsC.1 !i.5~ JS.2~ Unlhd W.y Fund 2.00 10\.00 ..1 sa." 212..'
Dent.1 0.00 1.SD Supp...ent.1 L I 1.51 11.06
... 70." 49~ .IS
D.p.ndant LI.. G.GG D."
lon, r.r. Dlub G.GO Z.U
Tlltal: '.14 61.1' Tntll: 1~.5Z 52~.n . TUlbl.
'"
Current: 1,17I.ll l,a'.59 25' . S~ IS... . 111.9Z
nil, . Z~'.'" . tlf.!.! 1 106.11 511.'\1 5 '51.SZ
51111 nalance: 11.25 Stlrt nalance: 0.00 51al1 nalance: '.01 ADVICE II
+ Aulla~le: 112.51 + Elrn.: U.OO + Earned: 22.So ,...... .
- TakC'n: 11.n . Taken: 0.00 . Tak,n: 1.51 TOlll:
+/- Adjustment.: D.DD +/.A4jullm,nU: 0.00 . Sold: D.U
r.nd n.l.nce H2.5o End nalance U.DO + I. Ad!ustmlnu: O.Do Document t. 000000004102
En. n.lance: 15.00
MI:SS^GE;
.~~~
III..p.rM.rIllIUIl.... 01 Ih. BIUII Cro.. .1Ilt BIIoII Shill' Anotll1loll
'R'Iltl.,.. I,hr'" at 1M BIUII Cron ,NI BIIoII Shll14 AUHll1.lDll.
'" AtlOCll11011 01 Illdl,tndtrll Bille Cra.. ,114 Blwa Sill'" PI,,,,
DEPOSIT NOTICE ONLY -. NON-NEGOTIABLE
DATE
03/27/1998
NO.
000010869
DEPOSIT AMOUNT .
637.92
Pott.r,E1izab.th Kath.rin.
126 H Front St 2nd Floor
Worml.ysburg PA 17043
Ch.dllnt
16141StIl
1S7. tz
n^G. 0103
I.OC^T10N CH300
IlEPT 0759
Totll:
.
111.92
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
.~~~~~
""yGruu,:
ra)'U~ln Ihlc:
"" t:ndlhlr.
UtP Cent,.1 hi.' f lh~'l.1t.1I 000011309
OS/Zl/l'"
04/0S/a.. (tux hI u/o"".,
Pott.r.fll....th ..th.rln. t:m,luy..m: Gonn I X DAf', "l"dou Stile
IU H front It lnd FJoor Cu.. C.nt.r: Utlll..tlon "Inlv...n\ - ICHPC :\-hrilll Stalin: ",,.,Ied lingle
Wor.I'Ylb~r. PA 1114J l.ucallun; CHSlll Allowances: ,
Joll Tille Cllnl~.1 C.r. 1,lel.ll.t "..1. Pd.:
5SN: rlO-U-'." .......tate: 51 611.00 AnNJII "", 'N','
,,,,,,.. .N'.....NINGS "
"'Curr...'''. ."\,,'In'"
lJ"ul-Ufln M.l. llnun t:unl"., Ilnu" t:unln, U"crl"llo" Cuntllt ..n
"-gul., PIW 1,11'.ll 5U.n 1,"..'1 fED OAlDI/D..... n.n uI.n
fl.. lI.. Off 0.00 1.50 111.'1 fED fiCA "Idle. 16.96 lU.1Z
V'Clltlon 0.00 ".n "Il.s.. FED WUhholdlng IU.S' "I.U
P' WlthholcUn, n.n lit.1i
Pi Wr.tvsbrl' 11.71 '''.Zoll
Pi E P""".. , 0." 11.00
1 11'.1Z '00.00 . Ittu." n..s. l 06Z.'~
.
I n"",.,r.. r......,,,. vrn In. ",I.Uo. "runtftl VTn nn....I.II". Cur".' vl')
....1th S... 50.'4 HlthII.rk Club o.n 2.00 Llf. . 0.61 ".11
Shrt Yr. Ohe.1 S.5", 5'.7' Un1 bd W.,. Fund Z.OO 16.01 ..1 SI." 511.04
Oenhl 0.01 5.50 Sup,l..ent.l LI 1.\1 n.'" ,
<01 70." sn.u
O.pendent L1f. O.DD 0."
long hn 0..... 0.01 I.SO
"
Tolll: '.14 n." ToIII: 14.5l S".1S 'Tau".
Cln"'l: 1,17l.n 1,1".5' ZS'.54 IS." . 157."
VTD: . 414." . S5'.92 l DU.n 67Z.17 . "a.2"
SlIrt B,lue<< ll.n Sian Blbne<< O.OD Sian Bllaru:e:: O.OD ADVICE II
+ Anlllblc 112.50 + Eam.: 45.OD + Elm.: 22.50 'ow,. ,
. Tlhe: 1I.n . Tlk",: a.DO . takel: 7.50 10111:
+/.AdJurtmtftll: G.OD + /. i.i~nm..": ,.. Sol': 0.10
Ed Bllane<< 112.50 En' B.lance: U.Dt + ,. A'Jurtmtnll: 0.00 DOCUllltn11: 000000004118
En' B.llle<< 15.01
I
t
MESSAGE:
.~~~
1II4I,,.II4.11t UClM... ,f tN 1111I CtI.. ,114 811M 1...,14 A..eclttl."
''''IINrH M.tU .f ttle 811M Cm. .114 111M ,...,14 Alloel"I'''.
." ".."IItI." ,f 11I4I,,.IItI,1It 811M Cm. .NlIIIM 11'11,14 PI.1lI
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
04/09/1998
NO.
000011309
DATE
DEPOSIT AMOUNT .
837.92
Pott.r,Eliz.b.th K.th.rin.
126 N Front St 2nd Floor
Worm1.y.burg PA 17043
Chock .""
ISl."
l'14'S"1
BAG' 0103
LOCATION CH300
DEPT 0759
otal:
.
1S7"
DEPOSIT NOTICE ONLY.. NON.NEGOTIABLE
.~il~Y1l~~
I'n 1,'''lIp
1'.1) IIq(1Il 1J.lll'
l'~ rnd 1111.,
~!!Il l..nllll I..HII,I' Illlll.. 000011754
OI,/o"/l"qa
O"/)1I1I1Q8 I hl'tk lblt' 0,,1<'../1"'18
PlIt I.r ,E 111,,11.1" ~"th.r jlla
1.'6 N frun' 51 1m!' 10uI
WOI.I_ysburg PA I'O"~
I mpllltl't'lIJ
C n\t (.'1111"
I.UIJIIIII'l
11Ih 11th',
1';1 N~I('
1\\ 11.\ 1-\:
"'ILIII!
51"111.
h..ll',,,1
""rrl.d
oon:l1
Ul Ill.uI Ion """a.,.".,,1 ,,,WC
UIUO
(1Inl<:.' (lit. 'i11.cl.I"1
lO 11\1.00 AnnUllt
\Imlill ""OIlu'
,\1111"'''1'1,1'\:
Mdl.I'lt.
Mdl.nll"
!-is'' 110....8...,.14
1I0l 'M",,\'\I} r .\M...."C:S '.'~':S
"'(11111'1'11'" .", IU'u
11i"lllnlllln ".11(' 111111" r:"nlnl/' Ilnlln J.llnlnll\ 1l1.\tltDIllln I'urnnl ,...
R.guhr Pfty 1.111.1l ..U.l!i lD.a7l.'S fED OASDI/Dlub 12....' 6!il.I'"
Flu '111I. Off 0.00 1....0 111.11 rED rlU H.dle. 1..,. l'i2."
Vacation a.DO let,a Hl.S~ fED iii Ilhholdlng 117.l6 1,0"'.11
., WUhhLldlng JZ.7J noll.51
PA ",.ar,brl_ 11.11 106.DZ
PA [ Penn,b T 0.00 10,00
I 17. .Il 61S.00 10,bn.0' , l51.25 2 JU.'to
... , , '.
()('~uiDlll1n ('lIrt('n' nil l)c1(".",III" Cum'nt VI') J)~c'i"lln" rUf',nl VIII
Hutth J.U Sit.44 Hlgh.ark Club o.n Z.Z5 Llf. II 0.61 5.ft"
Shrt Tr. Dhtel 5.54 4*;.SZ UnU.d Way Fund 2.00 1'.00 ." 17.61 H' .11
." S5.)4 SS.H Suppl...enhl Ll 1.5. 14.22 ." Zl.20 21.7.0
D.ntal 0.00 S.SO ." 55.54 600.16
Dep.ndent LI f. 0.00 o.n
long hr.. Dlub 0.00 2.10
Inial: 44..... 117.40 rn'31: J".ll .31.32 -Tauhl.
.. - .. ,
{'un,nl: 1,17I.ll l,IH.25 251.Z5 n.6S . 84).22
nil, 10605.08 10 "'91.17 , 'n.'o 155.72 1555.4'
, ..
Start R:alancf:: 11.25 St:art nalance: 0.00 Start Ihlance 0.00 ADVICE I,
+ Avallahle: lll.50 + t:arned: 45.00 + t:unr4: 22.50 CHECK I,
lalltn: l1.l5 tall.n: 0.00 hkrn: 7.50 Tnlal:
+f-Adlu\lmrnls: 0.00 +f-,\dluslmt'nls: 0,00 Snld: 0.00
t:ndlhlance: 112.50 t:nd Oal.nce: 45.00 +f- ,\dlu\lmrnls: 0.00 l)ucUmtnl/l: 000000004108
t:nd R.al.ance: 15.00
.\1t:SSAG[:
.ID2'~~
I",d.p.",d.m.llu",.... of Ih. Blu. Croll ,,,,d Blue Shllld A..oclol1lo"
'R.,IIt.r.d M,,~. Of ,"'. Blu. C'OIl ,,.,... Blue SlIllld AnocIIllo".
,,,, ""OCII110" oll",d'p.",d.1It Blue C'OIl.n4 Blue Stu.ld PI,,,,,
J>El'OSIT ~(rnCE O~LY -- NON.~EGOTIAIII.E
04/24/1998
~O,
000011754
IlAII:
O[POSIT A.\tOUNT .
843.22
"
Potter,Elizabeth Katherine
126 N Front St 2nd Floor
Wormleysburg PA 17043
,\eenunt e
Ch.c:klng
cmunl~umht
16unooo
()t ntlt mount
Io\J.ZZ
RAG' 0103
I.OCATIO~ CH300
1ll:I'r 0759
Tnlal:
t
143.Z2
DEPOSIT ~OTICE ONLY -- NON.~EGOTI"IlLE
.JSI~X~~~~
I'~y (;rllup
I'~)' 1If1ln Ihlr.
I'a rod Ihlf':
utP C.ntral tu"pl f lht'1.k 1# 000013082
OS/I'I1"".
0\11'/19'. {kN hll" O'/O~/I'"
Putt., ,E J I,.b,th ..th,r In.
11. N front 5' 2nd floor
War.lay.bur. PA l'O~J
t:mplll)NIU:
(-11\' ("rnh'r.
"unllnn:
.Jublllle:
.1, Rale:
Don"
Uti 1 iut Ion ".fulf,..nt . lowe
CH500
Cllnln! C.r. Spnt.lht
51 00'.00 AnnUli
'^X II I ^,
h-deul
Harr I,d
I
SIll"
Unlla
~S'l llO-\l-nU
.'hrllll SlaluI:
Allcnnnc...:
Addl.I'c:t.:
dd
",,"'.' AN ,. uv...
."(queM-" '''VIII''.
De-nll-tllln Kall lIuun hlnln. IllIun rarnl;;t" "nul-linn C"r"n' \'In
RIlf\lI,r PlY I!I." IU.U U.UO.U rn OASDIIDhllb u.n an.ss
f1.. '1_ Off 11." "'.n l'.SO S6'.U fED fiCA Medlu 1'.26 ZU.U
P.,.,on,l P,ld , ,,SO IZS.ll I.S0 IlS.1l fED Wlthholdln, 140.56 1,Ua.JZ
.....l.r E.rnlnl .".n '.00 106.02 Pi Wlthholdln, 17.11 19'.71
Vaeat Ion 7.50 US.11 :n.n U5."5 PI. Wr_hsbr,' U.J7 IU.U
PI. E P.mlb T '.01 10.00
SO." I )S1.1" "'.00 1-. SU.... l".54 , Ill."
,
rI)"~ -=;.- vm l'l~ cur'en' nn hn-I-Io- rUffenl VTIl
H..lth S.U 4S.l4 Hlpark Club 0.25 J.OO ll'. . 0.17 7.'"
Shrt Yr_ Dhl.1 5.19 '1.44 Unl t.d W.)' Fund 2.00 2".01 "I ZO... Sl4.'1
'" 40.11 IU.7Z Suppl......t.l II 1... 1'.1' "I 24.01 lII.n
Dint_I 0.00 S.30 4" 40.11 71J.Z4
D.pendent L I f. 0.00 0."
Lone Ten DI..b 0.00 l.1O
Tolll: 49.50 257.7' Tolal: 44." 762.St . TUlbl,
Currfllt: I,Sn.14 l,Z'I.41 29Z.54 ').54 . '51..'
VTIl, 14 !4t.'" 14 .".40 , lZZ." I OlD." I. lG6.71
S'a" Oalant<< II.n 511" Oalant<< 1.00 Slart Ralanet: 0.01 ADVICE If
+ A".II.hle: I1Z.50 + Elfned: 4S.oa + E.rned: l2.50 C"-". I,
- T,llen: 11.75 . Takeft: 7.50 . T.ken: lZ.50 Total:
+ I. Adluf1menlr: 0.00 + I. A.jurtmHlts: 0.00 . Sol.: 0.00
EdO,lance: 105.00 End B.I,nce n.50 + 1- Adlustments: 0.00 Documenl I: 000000004091
[n.O,lance: 0.00
~t1:SSAGE,
.~~~
tPl.."M'nt Linn.... of Ihl BII,. Croll .114 BIINI Ihll14 "..oe."""
'R",,,,~, Mil.' of tn. HIlMI Cro.. .114 81lM1 Shi.14 ""oeII(IO".
"' "..ocllllo" ollndlPIIl4.nt BIlMI Cro.. .114 BIIII Shi." Pl.",
DEPOSIT NOTICE ONLY -- NON-l'OEGOTIABLE
IlATE
06/05/1998
NO.
000013082
DEPOSIT AMOUNT .
951.06
Potter,E1izebeth Ketherine
126 N Front St 2nd Floor
Wormleysburg PA 17043
ct'Ount I
Chlcklng
croun' u he
161U3000
Ih rnll nlOu I
9S1.06
BAG' 0103
!.OCATION CH300
DEPT 0759
Tntal:
.
'51.0'
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
tilJS[~1'~!2~
I'~) l;',,"p
I'..) 1I1"j,~ln lI~h'
I'H tnd Ihlt'
_lIP el'll".1 f~l"pt r (h,'d.. 000013518
Q!l/}O/I"',a
On 11."11 '1'1' { hI"" II ~l,' 0" II '111'1""
Sh'gl_
~
t
;
l'llttllf ,[lll.,(,..111 ICntlllH Inti
Ii'h N " nnt~' ""I f luur
Wut"hvtburg f1A 1104.5
l.nlplll~I'I' III
Iml (ifill',
I..utilln
Jllhllllt'"
I';n H;.h'
oOIlHI
UIII lor", Ion Phllllll"".n! . 101l'e
(lUOO
Cllnltnl Car. Splclnll,t
'l,OOq.Oo A"nunl
1\\ IJ \I ,\"
'IJnl..1 "Jlu..
'\1I,,'unll.'\
.\ddll'lt
.\lIdl \n,l-
I {~ln.11
",,'rled
......It'
....., 71/),11,,,,"..'01'0
flIH'M"'l ,\'lJ-I~-\H.'I'{;S 1.l.\I.S
"'IUIU'"I... ".'111'"
1).,,,,I"rl..n H..III' IllIllF\ LUllln'\ 111I1u.. Lnn.n., 1JI."olrlnllllfl '"ulft'nl ,,,.
".yvIM P., 6IS.!.6 In./S U..U....o fED OASDl/Dlub 7S.1'1 'J!.9.U
Jllt'lInlt Pnld r 11.S0 615.56 ~5. 00 l3a.61 rED fiCA H,dIu 11.1J lZIt.Sft
Flu II.. Off 0.00 U.SO 3".0_ fED wi thholdlng 12".'13 1,60S.l\
Il.guhr Eernlng 0.00 0.00 lO!l.U P' Withholding 3".21 H2.'1
Vlleetllln O.DO H.1S S.U.lt5 Pol Wrlllh,brlll 12.51 155.19
Pol E Penn,b , 0.00 to .DO
", H.SO , HI.12 'lIS. 00 IS,SIIO.r,lI " 2f,"." 3.1lI1."
" ,- , . "
1J{,\I,;j:!llln f'",u'nt "". .JMuHllIn ('urll'nl I'll Ih"lrrlfttllln ('urn'nt \Ill
Ilnlth 3.60 I'tlI.IilI Hlghlllerk Club 0.25 3.25 L If. . 0.11 I.U
Shrt Tr. Dillal 5.1' .,.Z! Unltd WIlY Fund 2.00 26.00 '" 1I.ftl 1t03.33
'" 36.'1 lalt.65 Supple..nt.l LI 1.68 20.1_ ,.. 2Z.16 110.1'
Dental 0.00 3.10 '" 36.'3 150.11
Dependent Llf. 0.00 0..'
Long hrll Dlub 0.00 Z.3O
1'111:11: 46.52 JD4.02 Tnt:ll: ftO.a6 103.25 . h'ClbI.
.. .. 'I' . .. . " .
('urnnl: I,Z51.12 1,1I5.S1 264.91 17.18 . a1a.'J]
VIn: 15 5aO.SI IS 2/14.91 , 311.61 , 107.27 11 08'i.b8
\'1", " " , , , 'r " ,
Slnllhl..nce: 11.2S Sllrt nal.:ance!: O.DO Slart nalance': 0.00 ADVICE to
+ Mailable: 1I0!.SO + t:arncd: It5.DO + t:.:arnrd; 22.50 (IIECIC to
hkrn: la.75 - hktn: 45.DO T...krn: 22.50 Tnt.1l:
+/. ,\diu\lmrnh' 0.00 + ,. ^djLl\tm~nl\: 0.00 Snld: 0.00
End Ihlance: 105.00 t:ndll:al..nll!: 0.00 +/. AdIU\lmrnls: 0.00 Um:umenlll: 000000004095
t:nd na1ancr: 0.00
.\1.:SS,\G.::
a~S]2~
'nd.p.nd'M L'e.n.... o"k. Blu. CrOll 'nd Blu. Sk,.ld .....0['''''0"
'R'g,",r.d ,,",uk. 0' lk. Blu, Croll .1Id Blu. Sk,.ld Allocllt,O".
,".AtUc,.llo" c"nd'p.nd.nl Bll" Croll '"01 Blu. ",..101 PI,",
DEPOSIT NOTICE ONI.Y -- NON-NEGOTIi\IIJ.E
IlAlI:
06/19/1998
:-;n.
000013518
nEl'oslT A.IIOlJ:'<T $
878.97
"
Potter,E1izabeth Katherine
126 N Front 5t 2nd Floor
Wormleysburg PA 17043
,\c'cnuntT .,
Ch.cklng
^Cl'Ounl ~umh('
161~a3000
IJr ,,~h ,\mullnl
171.91
IIAGM 0103
I.OC.\II()~ CH300
11I:1'[ 0759
filial:
.
818.91
J>EPOSIT NOTICE O;\;I.Y.- ;\;ON.j\;EGOTJ.\III.E
.J~~~
I' ~~ f;,,,Up
I'..~ II1'Kln H..le;
"ntndlhlc'
JlIP (.nhilll.."pt r (hl"''''' 000013961
Oll/lStl'J'"
06116/t,QI (hi" !;ahY ')1/0111'"
'''i'l 1I0'!.i"~I"
t:mpIU)HlIJ
('m' (-~nttr:
tuulllln:
Jilt. fllle
l'a Ralr
oonu
ut Ill,., Ion "an.g...nt IlIWC
e!Uoo
Cllnl~.1 C.r. Spaci.ll,t
$I 00..00 Annual
lAX 1),'1,'
'hllhl Statu,
"UII",nut:
Addl I'd.
dd ml'
I'l'lh.,..1
"err lad
I
""al('
'jlngh
Pot hr.E llz.bath Il.th.r In.
IZ' H front St lnd floor
Wor.law.bur, PA 170'S
..,.. '.~ .", "..,"'" "":'
."('UHf'".'" '"\111'''
I)M(fllllllln Malt' IIl1\n' t:unlnll' Ilnun r.fnln , nnnintilln ("uu.'" ""
hguhr r.., l,Ul.U 'U.1S U,OU.51 fED DASDI/Dlull 'S... l,on.U
f 1.11 'I.. Off 0.00 n.so 5U.0, fED riCA "adle. U.1Z ZU.OI
P.r.ona' P.ld f .... U.OO 7U." rED withhold In, at,." l,nO.U
hguhr E.rnlng .... '.00 l06.az .. Wlthholdlnl !"U '''.Il
V.c.tlDn 0,11 n.1S sn,u PA ",.lylb'lIl Il.Sl 161.10
Pi E P.Mlb , O.DO 10.00
, I lSl.1Z I OSO.OO l' ..1.70 Z".91 S 65Z.6O
.. . . . ,,,
IlrufiDliun CUtrC'"" vTn l)escrlDlinn ('utrel'\l W') nt5C~I"lln" CUI't'1I1 I III
1l..lth S.U 52." Hhth...tk Club a.ts S.SO lIf. .. 0.71 9.11
Shrt Tr.. 0111.1 S." 75.0l Unlt.d W.v fund l.1I 21.00 '" 11.'" iflll.IS
.., Si.n ZZI.SI Suppl..ent.1 II 1.61 2l.Sl ... ll.I' 1SZ."
O,nt.1 0.00 S.lO ... S6.9S 717.10
Depend.n t lit. 0.00 a."
long hr. Oh. 0.00 r.sa
ToIII: ".n SSO.S' Tnlll: U.16 1_'.11 a TlUllbl.
.
Cutrenl: 1.2U.1Z 1,115.51 ZIt'.n '7.11 0 111.97
VTIl, 16 111.70 16 '10.5' S 652.60 I I". ItS II 96lt.65
.
SIII1 Balance: 11.l5 51111 B.lance: 0.00 5tll1 nllance: a.OD ADVrcE o.
t Anllable: 112.50 + t:arnn: 1t5.0I + E..nf'lll: ZZ.SO C~Ctl 0
. Tahn: 11.15 . T.ken: '5.00 . Tlbn: n.so Tnlll:
+1. Ad!latmrnl.: O.OD + I. Adlutmenls: . GO . Sold: 0.00
t:nd Habnce: 105.00 t:dOllance: 0.00 + ,. Adjuslmenls: 0.00 (}ocumenl t. 000000004104
[nd Oallnce: 0.00
,n:SSAGt::
..~~~
1,..hp.nd.M llullu" of the Blue e,o" .'14 Blue SI\I.hl A1to(1111011
'R'91."r., "hrh of 11'1. Bill' CtOU aM Blue Shill; "'''0(1111011.
'" .aUO(I.t!IOII 01 Ind",";,,,, Blue eron 1M Blue Shl.l; PI,",
DEI'OSIT NOTICE O:'liL Y .. :'IiO:'li-!,;EGOTlAIILE
DATE
07102/1998
NO.
000013961
or.roslT A.'IOUNT .
878.97
Potter,Elizabeth Katherine
126 N Front st 2nd Floor
Wormleysburg PA 17043
"OU t
Ch.cklng
cenunl u he
.'IU5oo0
)r ii' I mount
118.91
RAG' 0103
I.OCATIO' CH300
llr.rT 0759
Tolal:
o
B1B.91
DEI'OSIT NOTICE O:'liL'i -- NON-NEGOTlAIlI.E
.~~!'2~
.r",,", 000014396
I
t
_UP (l"tr.1 1.'.1'1 t
OVI1l1'"
01110/1""
I' J~ l;/IIUP
1'1)' IItVln Illll'
I'a t:n4Ihl'-:
<<hI"" hit' o"l1ln"
PoI'.r,[II,.b,th _.th.rln.
llto H front 5t lnd floor
Wor.ley,bur, PA 11o~J
fnl,I")N 11):
{'ml (:('"1..,;
1.IIUllun'
.lull 1111..;
I', R..lr.
r^' HAl ,\:
1l1PC \Iullal SlaIU"
AII.....nln:
.\4d1.I'l1.:
.dd
I'I'(h'ul Stolle
Hllrr hd Ungle
Dun'
Utilization "~.v...nt
nun
(llnlnl C.n Splclal ht
JI 00'.00 Annuli
S!-l~ lao-IjI,."I"
('l:DS "'II "'''ft:''ol .,r=r;. ""S
".('Ulff'n'." .","U".
Ih"uriD'lun kale llnun .:arnlnlt' !lnlln funln'" IIp\ul''tlllft ('uurnl ""
"agul.r Pn 1,2U,U I,an.,s I'."'." FED DASDI/DIt_ lS.79 1.110.'1
flu TI.. 0" 0.11 n.so "_.0. fED fiCA ",die. 17.11 n'.11
Parlon.1 Paid' .... n." n'.67 fED Wlthholdln, Il~.n I,ISS.II
.I;uhr hrnlnll 0." '.11 106.02 .. Wlthholdln, 5_.Z1 5tl.n
V.catlon 1.11 n.n 5SS.U PA Wr.hlbrg' lZ.Jl 111._1
PA E Pamlb , '.11 lO."
I ULIZ I 12S.00 II 0",1.11 '''.91 5 911.57
.. . . . ..
1)("'Il"tl"t1u" Cut"r.' VTIl nt'~H..I"llo. Cuue". V,,) l)"crl.,lon C-='tftl vTI)
H..lth S." S6.U HIghII.rk Club '.ZS S.7\ Llfa . 1.77 9.95
Shrt Yr. DIII.I !i.79 71.11 Unl hd W.V fund Z.OI 10.11 <.. I..U ",.0.31
.., 16.95 15'.51 Suppla.ent.. L I 1.61 1".ZI ... n.I' 155.11
Dlnt.1 .... s.n <.. 56.9S 1Z",.n
Dapltl\dant lU. O.at 0."
long hr. DI..1b 0.11 t.SO
rnlll: U.U sn." Tnlll: 4.... 1"'.97 .TIII:a..l,
.. .
Curren!: 1,ISl.1Z 1,115.57 Z"'.91 '7.11 , 171.97
YTtl: II O"1.IZ 17 is'. II S '17.57 I ULU IZ IU.n
Start Oalanct': II.n Sllrt Balance: 0.01 Slart Balance .... ADVICE 'I
+ A",i1I~It': 111.51 + Elm": 45." + Elm": n.n C~CK ,.
T.ktn: 11.75 . Takm: 45.00 . rabn: 21.S0 Toltl:
+1. Adlu,t,..rnls' 0.10 + I. Adjustments: 0.01 . Sold: ....
.:n4 Dalanct': 115.00 [nd Ollanct': 0.00 + 1- AdJuumenls: 0.00 Documenll; 000000004104
End B1IIll,cc '.00
,
:\1F.SSAGf::
..~~~
Ind.p.rd.'" lInll.... ollh. Sht' Cro" Ind Blul Shl,II ....teclltlall
'A.."II,.d Ioh,h olll\tl BI~ Cra" 1M BIIII Shill' .....OClltloll.
.'" .....aclltlo'" or IIId.p.MI'" Blue Cro" 1M Blve Shllld PI.fltI
DEPOSIT NOTICE ONLY.. NON.NEGOTIABLE
0711711998
NO.
000014396
DATE
DEPOSIT AMOUNT .
878.97
Potter. Elizabeth Katherine
126 N Front st 2nd Floor
Worml.ysburg PA 17043
ttOU
CMd&lnt
161415...
171.97
RAG' 0103
LOCATION CH300
DErT 0759
01.1:
,
.71 "
DEPOSIT NOTICE ONLY - NON.NEGOTIABLE
.J~~!2~
l'~~ (;tllllP
I'ay 1I1'~'n Oall!:
1'1 "nd OUr:
UtP (.ntt'" [....,,, I I hd..,. 000012645
OS/Olll'f'U
OVU/I'J'" C l\t~ hit' o\nUI"'"
Polhr,Ellub.th !leth.tln. J:mpln,"W. 00.911 I,HII.\I,\; rl'Mnl '\11111'
Ilb H fronl SI 2nd floor flnt (l'nlff U' III,. t I un "'1m.,..." t IlIlPC \hril.ll!'ll;alu\ Hflft I.d SllIyh
Wur.l.vlb~r8 PA 110_5 1.11I11111": (IUDO Allu..ann...: I
.luhlilll': Cllnlnl C.r. Specl.lht Addl"t!.:
S~.... llO-lil-bUIlI 1'1" Ihtr H 00..00 Antill" I 'ddl .'mt,
,It" .~ ~ >>':'"~""< ,^n~
."CUffrA"" "'\'111'"
IJ..\nllllllln Ih'" Ilnun .:.unln'" ll..un hUlIn' U..urlnllnn ("un."1 \,11)
R_",I., P.~ 'IUI.U nl.ZS ll,Ul.U FED OUDI/Daub IS,1a IDLU
Flu r1.. Off 0.01 I.U UI.I' FfD PICA "edlce ".15 111,51
Vlle.tlon 0.01 n,n "U.U fED Wlthholdln, IH.U l,S","
PA Wlthholdln, ''',Zl UI.SZ
PA Wr.hlbr,1 1l.Sl nO.lI
PA [ P.Mlb I a.ao 10.10
, I U1.1Z .n.DO 11 DIZ.n l6"." l I~O.il
.. . , . . .'
Inru.I",lnn Cutrrftl VTn I "f1t.j"t1o" Cuttrftl vn) IJt1C-:'-I~'llIn Cur'rnl vrll
H..1th 1.60 "1.6. Hlgh..rk Club D.n 2.15 LU. ., 0.11 6..'
Shrt Jr. 0111.1 5.n n.65 United W.y Fund 2.00 n.DO <Dl 11.41 !6o\.aS
'01 36.93 101.61 Supp1..Mt.1 LI 1.61 17.U '01 l2.16 60\.56
a.nhl 0.00 5.50 '01 S6.n 6n.n
D.pMd.nt Uf. 0.00 0.69
Lon. I.r. Dh.b 0.00 2.3D
Tolal: "6.12 201.20 Tntal: "0.86 111.55 . Tauhl.
.. .. .
Cunrnl: I,ZSI.1Z 1,115.57 261\.91 .7.11 . 111.96
vm, U Ill.52 12 IlD." Z aSO.1Z 926.55 9 255.65
.
Start Halance: 11.25 Sian H.lance: 0.00 Slart Hal.nee: 0.00 ADVICE '1
+ Autlahle: 112.50 + F.arned: "S.DD + t:arnN: ZZ.50 C....C. ..
r.krn: 11.25 . Takrn: O.OD . raktrl: 1.50 Tolal:
+/. Adjustmrn,s: 0.00 + /. Adluslmrnls: 0.00 Sold: 0.00
t:nd Balance: 112.50 [nd nal.nte: "5.00 +/.Atllus.m,nls: 0.00 J)ocum,nll#: 000000004099
t:nd O.lanc<< 15.00
.
~
:\tF.SS^GF.:
.~~~
1"'lt","d'!It Un """ of 1~ 81.,. C,on ,Nt Br~ Shl,hl A"OClllion
.RIQllltr,d M'tk, o'lh, BI", Cron .nd 8tll' Shl." Allocll1iOn,
,nAllocilllanollnd.p.nd.nt BIIII CrO"11I4 Blue Shl,ld Pl'tll
DEPOSIT NOTICE ONLY.. NON-NEGOTlAlILE
OS/22/1998
NO,
000012645
DATE
DEPOSIT AMOUNT .
878.96
Potter. Elizabeth Katherine
126 N Front st 2nd Floor
Wormleysburg PA 17043
em. I
CMekl",
em ,
161US'"
)ffn ou I
'71."
RAG' 0103
1.0CATION CH300
OEPT 0759
ToI.I:
.
.,,."
DEPOSIT NOTICE ONLY.. NON-NEGO'nAlILE
.L!~8'1!2~
II i~ (,tuliP
II.~ Ht'~ln n,le:
I', "nd IJUr
~HP Clnt,.l [lIupt f (h~'llt._ 000012204
0,.111119"
Oli/Ol/"'II (hl'\ hlr Q'i/QI/I'''.
l'lIthr,lll'Db,th _.th.rln. t:mplll)"IU: oOln, lAX IJAJ..\: If'dt'fa\ St.I"
Ill. t4 f runt St lnd f lullr {U\t(',nler: Utlll..tlon "anlg...nt - It"" \htllll ShllOl' "Irr hd Slnth
Wa,.I.y.~uf' PA 110_~ l,lIUllnn: CHUD ,\Hu".nln: I
Jub Illle; Clinic.' C.r. SPlelelltt Addl.I'\1.:
'" i'Il".-'''I'' I'ay Malr. ~o 6Jl.DD Annuli "d' ._"
p;;-.< ."l....'''c.' ~
"O('urrrn'o" "."IU'"
Ilrurl.IllIn Male Ilnun .:lrnln-~-' IInun brnln' (hurl-linn Cu,nnl V III
fllgYhr Pit 1.11'.11 716.n Il,nt.os HO OAUI/DI..b 72." In.16
'Iu II... Off 0.00 ',n 117.'1 fED fiCA "edlu ..." ..".-
V.catlon '.01 ,..n 'U." fED withhold I", 111.U I,lli.n
.A WIthholdlnl n.n u"n
PA Wt.h.br,. 11.71 117."
PA [ PWW'l.b f '.01 10.01
I 171.12 151. DO 11 11l.l0 ZSl.l" l ~U.U;
. ..
1I)'1[oh'l.u" ('"..,... VTn I)""r.tlo. Cu..-t VTn In_C....II.... Cunl"l VT)
Hulth S.U n.1it HI....rk Club o.n 2.50 LI,. . '.'1 '.10
Shrt Yr. Dht.1 5.54 ,..... Unlhd W... fund Z.OI ZO.OI "I 17.67 sU.n
." 15.14 10.61 Suppl...nt.l Ll l.SI 15.10 "I n.lO U.U
D.n'-l O.DD S.Ja ..1 n.n 'S6.ZI
D.p.ndent lU. G.OG 0."
Long t.t. OhM '.00 Z.3D
Tola1: 44.41 161.11 Tolal: 1'.17 '77.'" . Tuatll.
Current: 1,17'.ll l,n4.n l51.U n.65 , 141.n
VTIl, 11 7.1.10 11 'n.u Z 5'5.14 IS'. S1 . S1'."
Slaft Daluce: 11.25 Slaft Balance G.DD Slar18.1ance: ..n A~~~~ II
+ Available: Ill.50 + t:"nt4: "5.00 .. ["ne4: u.sa c ,.
- Tab,,: II.n Taken: G.OD . Tabn: 7.S0 Tolal:
+/- Adlulmnls: G.OD + ,- AdJustmenlf: . " . Sold: '.00
t:nd Hala"e<<: Ill.sa ["d Balance: 45.GO +,- Adjuftmtftll: G.GO Docull'lnt II: 000000004117
End Oalance 15.GO
\1I:SSACt:,
.~~~
1"~'p,"4,n1l1UII"" or ,"- B'II' Croll .114 Blue Shl,l' Aa'O(I'tIOl1
.R..,.It"1Il M.,h 01 lh. Btue Croll 'M Blve 51'11.1' AnKllt""
.nAuo(,1I1101l ollnlll.p.IId.n1 BlvtCro...1Id Bille 1111." PI''''''
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
05/08/1998
NO.
000012204
DATE
DEPOSIT AMOUNT .
843.23
Potter,Elizebeth Ketherine
126 N Front St 2nd Floor
Wormley.burg PA 17043
ChIck Ing
CUI , .
1614.S011
,u.n
HAC. 0103
!.OCATlO' CH300
OEPT 0759
Total:
,
MS. J
DEPOSIT NOTICE ONLY -- NON-NEGOTIABLE
.~S~X~!''Q~
I';r,~ I; Itlllp
I'n nrl:ln Ihll',
I.... "ndlhlt'
I(IlP Clntrlt hl",..t f (hl'lk" 000014832
01111/19')1
01lllt/llJ'Ia ( hl'l k 11l11' 011\111'1"11
IIntl.r .Elllflh.lh I("thlr I""
116 H ~rClnt St lnd rlDDr
Wur~l.w,b~lg PA 1'0_1
t:mplu)rtllJ:
(-u'ICrnl..r:
I.IIU1111'"
""hltlll!:
II.. Rllt':
IH 1"1,\,
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"llu_anen:
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5lnlll.
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I
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utilization "1'lI1all.,..nt - tclIPC
cusoa
Clinical e.t. SPlellll,t
:u 009.00 Annull
1l00MS ,\'0 L>"'U'I;;':'-(~- IU>:S
".(uII('n'o.. ...\ III".
IJr\lrlnllnn ";ill' Ilnun .:arnln., Ilmm ratnt;;:;; tJt'UllnUu" CUffr1l1 '"'
Allluhr PlY 1.ln.s. 1,095.00 17,461,2a fU DASDI/Dl..b 11.10 1,116.71
Vlle.Unn J.75 61.S. )7.50 597.01 fED FICA ",dice 17.n Zn.5'
flu flJllI Off 0.00 U,SO S6lt.a4 FED Withholding li_.'J .,'10,04
P.r,onlll Paid T 0.00 1tS.00 158.61 P' Wlthholdln, 54.ll Sn,S4
At,uhr Earning 0.00 0.00 106.n PA Wrlll!y'Dt.' ll,n nl.ll
PA ( p.nn.b , 0.00 10.00
~ S.'S I lH.ll .-=ZOO.OO 1'--;-115.94 fnlll: lM,911 ft.IIIZ,~~
" ""\'tI. .
r-.)rull-t1nn ('uur"t VIII IIMn!"llon ("Ilurnl "II IIMulllllnfl (:um'nt \III
Hulth 3.60 59.6" Hlghlllatk Club 0.25 4,00 lll. . 0.11 10.12
Shrt Jr. DhCal 5.79 11".60 Unlt.d Wa., fund 2.00 52.00 ." II,'" 458.19
." S6.9! 195.4" Suppl...nt.. 1I 1.611 25.11I ." 2'2.16 171.2'1
D.nlal 0.00 3.30 .., 36.'] 1160.96
D.pend.nt Llf. 0.00 0.69
long '.r. Dhab 0.00 2.30
Inial: 46.32 441.911 ru121: ftO,86 92'5.83 .lnaMf
" '. .
('unrnl: 1,2!1.1l ',115.51 lU.91 11.11 . 1171."
VHl, '9 213.'4 II "'1.61 . 112.55 I 361.'1 13 722.5'
.
SI:u1Ihl,nct': 11.25 Start n_lance: 0.00 Slart naluce: 0.00 ADVICE I,
+ M:allaMf: lll.50 + f:ar"f'II: "5.00 + f:""t4: 22.50 CU[(I! I,
. 1211.1'fl: 2l.50 . IlkI'll: 45.00 . Tab,,: 2l.50 Tlllal:
+1. ,\dluilmrnt': 0.00 +1. Adju,.mfnll: o 00 Snld: 0.00
Fnd Ihlancl': 101.25 .:"d n,lanct: 0.00 +/. Adlullmrnh: 0.00 IJncumrnlll: 000000004126
f:nd n.Janct': 0.00
,n:SSAfa::
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In<:l.p.n<:l...l lit....... 0111'1. 81u. CrOll I"; 81.,. Shl.ld AIIOtlall011
"R"l,""d M,r'.oflh. Bill' CrOll 'I\d Bill' Shl.l; .....otlallclli,
,n AIIOtllllon al In;.p.ncl.m Bill' Crotl 11\; 81u. Shl.l; PI.nt
I)EPOSIT 1IiOTlCE ONI.Y .. NON-NEGOTI.\IlI.E
07/31/1998
NO.
000014832
!lATE
llI:roslT AMOlINT $
878.96
Potter,Elizabeth Katherine
126 N Front St 2nd Floor
Wormleysburg PA 17043
l'l'1,unt T e
Chack tno
Or ,,~Il nlllll",
8711.96
rmllntNumhr
1614uooa
"M;, 0103
1,1ll'.\1IlIN CH300
nt:rT 0759
Inial:
111',"6
nEPOSIT 1IiOTlCE ONI.V -- :-;01li-1IiEC;OTl.\IlI.E
"
.
Il,'p,lftnlt'lll (Jf tIll' Tp';\'ury -Intt'rllal H,'\I'IlUt'''i''n H"
".rm Income Tax Return for Single and
1040EZ Joint Flier. With No Dependent. IPI 1997 "'II"" r'ol', "Ii'"
Use
tho
IRS
label
horo
-
PrelldeDtlal
Elec!loD
CampallD
ISeo paga 7,1
Income
Allach
Copy B or
Formll)
W.3 he.....
Entlole but
do not attach
any payment
with your
return.
Notel You }
mud check
Yes or No.
Payment.
and tax
Refund
Have it
directly ~
depr.ited! See
pille 13 and ~
fill in lib,
lie, and lid,
'fOul "IS' nama and 'nlllal
-
last "3111'
hlIA6Ln/ K
II. Jomt '.turn, 1POulf', III" nlm, Ind 'Mt81
p" (rt,(
lasl "11m,
Home ,jor,,, lr1um~ .nd $If"') II ~Ou "hi' P 0 t~l. '" C'~, 1 ApI no
~~o~n ~ ~t OH'c[~~~nr ZIP c~.~~otU'''['IIO:'~~,:n~H~'~'~' 7
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Nole. ChtcAlnll. u. ((,.ll nfJt ch(JnJlt }'lJur t(lX or rtuurll )fJur rt'funcJ.
Do you want $3 to go to this fund? ~
If 0 joint return, doea your .pou.e wont $3 to go to this fund? ~
1 Totol wage., .alarie.. and tip.. Thia
.hould be .hown in box I of your
W.2 forml.), Allaeh your W.2 forml.I, I
2 Taxable interest income. If the total i. over $400, you
cannot u.e Form I040EZ. 2
3 Unemployment compensation C.ee page 9). 3
4 Add linea I, 2, and 3, Thi. i. your adJuated il'ou
Incom.. If under $9,770, .ee page 9 to find out if you can
claim the earned income "edit on line 8a. I
a Can your parenti (or someone else) claim you on their return?
V... Enter amount No. If .Ingle, enter 6.800,00.
from worksheet " If married, enter 12,200,00,
on back. ,... See back for explanation. 5
8 Subtract line 5 from line 4. If line 5 i. larger than
line 4, enter O. Thi. i. your taxable Income.
~6
7 Enter your Federal income tax withheld from box 2 of
your W.2 formlsl, 7
8a Earned Income credltl.ee page 9),
b Nontaxable earned income: enter type and amount below.
Typo . 8a
9 Add line. 7 and 8a. These are your total payment.. 9
10 Tax. Use the amount on line 8 to find your tax in the
tax table on page. 20-24 of the booklet. Then, enter the
tax from the table on thia line. 10
Ua If line 9 is larger than line 10, subtract line 10 from
line 9, This i. your refund.
b Routing number
c Type:
ChKkin,
I1a
Savini'
d Account
number
L.
12 If line 10 is larger than line 9. .ubtract line 9 from line
10. Thi. ia the amount you owo. See page 13 for detail.
on how to pay. ' 12
III... "ad 'bl. "tura. UDder peulU.. 01 perjury, I declan that to tb. b..t of my Iulowladc' aad bell,I, lb.
"harD I. ''''', cornet. ud aceunt.l)' lI.tl all amollnts and IOUrc.. of Incom,1 recIIVld durin, the lU ,.ar.
Your Jim_lUre Spoll.e', 'iif\8ture ir jOint return
Amount
you owe
SI&n ~
here r
'.
spou.... occupation
eal. No. 12151eo
Vour aoclal ...eurlty number
J I 0
spou.... ooclal lecurlty number
58
(" tf I i
3 I
31
)1/
.
r
I I'or
I Oll,cral
I Use
I Ooly
L
x
r-
Keep copy ror D,ta Your occupation Oat.
yourrecordl. \. \. ~\:'(\,c:.o.\ ~
'2>,\~o \0\ S~,.".\.~-l,.
For Privacy Act and Paperwork Reduction Act Notice, lee pale 18.
).
(, 0
'-/
(, 9
" 3
.). '8 'I
J J
"
a 0 0
o 0
If g ~
I 3
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'I 7 7
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3
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0/ 7 ?
J
o "
C:, 7 I
I 9 J
3 0
1997 Form 1040EZ
j')')/ V')ffll irJ.:i,~:1 p,\rJ'~ ')
Use this
form If
Filling In
your return
FlIr liP" 1111 hi!',\'
III .1\'1I1d I'llllllllOl1
lllJ.l.lkl'~. "1'1'
II II'" .1
Worksheet
for
dependents
who
checked
"Ves" on
line 5
Mailing
your
return
Paid
preparer's
use only
"'1'1'i'.I,:I.11
. I "J I' :i I;;,' .! ,I II~ .' llll']" 1'1'
:n.III'"j Iii,!., ,''1li'l\
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. Y'HII" , I\.\hl" 11I1'llllll' ,IIIII' 'i I... II....... 11,,111 "",-,llllll'!
. Y1llI ,J1I 11111 I l.111I1 .111\ dt!Wlldl Jd"
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lllll 11\'1'1' .-;';.Il/q Bul d "1111 1'.Ir1wd lip". 11l1'llldlllg .dlol';tft'd lip,';, Ihat .Ifl' IIlJt 111\ Illlll'd III IHJX .-,
,tlld hnx 7 of \0111' "t.:!, .\1111 III.I\" 11111 hi' ;Iltl.. III n,,,,,, Form 1l).lf)EZ. :--;,... pil~I' ~
. Yoq did 11,11 ('l'I'''I\'I' ;lll\' .ld\';Illt'I' 1'.ll'llt..! i,U'OIHt. I'n'dll J1;1~'IIl"llt:-l.
If \1111 Ill' fpd "''1n' .dllflJl \Ollr lihllg .;1.1111';. ~"t' lJal~I' 'i 11.\"1I11 11.1\'1' ljlJl'~lllJll...; ,1"Hllt dl'jH'IHlt-nh. lJ~"
Tl'i,.T.IX lllPll' ;i"lll,~j'" Jl"~I' IHf 11.\011 ..'unnol UNt" thlM rlJrmllJ~I' TI.!t.Tax t"pil' ;1.~1:! 1...,,1' P;IL:I' I,"'il
1\1'(";111.... lhi.. lilrm I... n."d bv I Illilrhi'll'. JlII.a....I. print .\'11111' nllmtll'r~ 1Il:-l11It. till' boxI'''; ilkI' Ihl,~
'1876543210
no nollY(lt' your flumlll'r!4. Ilu nol 11_';1' dol!.t!' ....l,:n...
If you rl'l'l'i\'I.t1 iI ...q'holilr~hiJl or li'lI11w:-;hip granl or taX-t'Xl'lIlpt intpfl'st inconH'. .;Udl ;1. 011
1Il1lllil'iJlill hlllllb. ..j'I' I hl' bookll'l I,,'forf' Iillillg' in the form. "1..0, ~f'r.- till' hook)"t if y'/'II n.n.ivl'd ;l
Fnrm l11!I!I-I:\T ..;hllwin..:: F,.tlpral illl'OI1H' tax withlll'ld or if F"dpral illl'OUU" tax wa.. wllhllt.ld
frolll .\'11I11' 1I1l1'lIIp)lIYI1il'llt ('llIllPl'n..atilll1 or .-\Ia:-oka I'l'rmarll'nl Fund di\'idl'nd:,.
Il"'mt'mhl.'r. y'OU IIII1:-,l l'I'I'Ol't all '\'.11-:1':'\, :oiillilrlt':'t. and tip" ('\'I'n if .VOl! do nol gt.t it \\'.'1 fOl'llllrolll
ynllr "IlIJlln.\'t'r. YOII mli~l al:'lJ rl'purt all .,,'our tilxahlt> intl'n'sl inronw. inr!llfling mtl'rl',..;t from h.lllk~.
:,a\'in~:o: and III;ln:o:. l'rt'lht lInion~. ('te,. l'\'l'n if you do not get a Form IOB9.I:--;T.
L'st' lhi.'! \\'ork:.;ht't't to fig-un' tht' amounl to pnh'r on line 5 iffiomf'onp can claim Yllll10r \'Illlr
SpOIlSt' if marrii'd' it:-' II dt'pf'ndpllt. 1'\'1'11 if lhat ppr~on rhoosf's nol to do !H). Tn fir;" out ii'
..;oll\!'lInl' l'all cJ.lim ~'()U as a dPPI'Tul('nt, ww TeleTax lopic :J!)4 (SNI pnge I H \.
A. Entl'r till' amount fromlinl' 1 on thl' front. A. ____,
n. ~Iinimum standard dl'duction. n.
C. Enlt'r lhl' I.A!lC;EH of line A or line n here. C. '__un'.
n. ~Iaximum standard deduction. If single, enter
.1.1:;0,00; if marril'd. '>nll>r ti.nOQ,QO,
E. Enter thl' S~IAI.I.EH of linl' C or linl' D herl'. This
is your ~tandard dl"duction.
F. Ext'mptiofl amounl.
. If sing"'. ent,'r O.
. If married and-
-both you and your spouse can be claimed as
dl'pl'ndt'nts. I'nter O.
-only onl' of you can bl' claimed as a dependent,
..nter 2,1ifiO.00,
G. Add linl's E and F. Entl'r Ihe total here and on
Iin(' :'j on t}w fronl.
fi"IOllll
D. _________
E. _,_.
F.
G.
If you checked uNo" on line:) ht'C:IU:-ip no onl' ran claim you lor your SPOWH' if lll.llt lId, .1.": .I
depl'ndent. I'ntl'r on linl' ;; 11ll' amount shown 1",low that applil's to yuu.
. Single. enter 6.800,00. This is the total of your standard deduction 14.150.00r and Y'''rr
exemption r 2.6:;0,00 I.
. ~Iarril'd. t'nll'r 1~.~()()(JO. This is till' total flf your standard deduction r6.!JOO,OIlI. \""Ir
t'xpmption t:!.(j;,)O.OOI, and yuur ~pow':l"., l'xl'mplion 12.6:10.001.
~Iall your rt'tul'n hy April 15, 109H. t.~.. tilt' fm\'rll)pt' that came wilh your hOllk)t., II '. 'II do 11111
ha\'t' thall'n\'I'lll(H'. .';1'1' pa.LW:!x for tilt' atldrt'~s 10 11:'('.
",;d"f ,,,,n Illl', ,.1 1,"f)'II\ I ,I,., I ".. Ill.It I 111\" ""Inlln...1 ,hi' f,'IlIrn. ,In" III IIII' t....II,( nt\" kllfl""!""":l' 1ll,II.dl'" I'
It, 111.,,,,1\ I,,!, III 11'10.'1111- !r"J .",.r, ..~ ,,11111 "JIll. ""-"11"01 Ihlllll~ Ih,' 1.1' \,';If TllI~ d,.\ I.Inll"n.~ I, .", oI',n ,.lIlnl , I
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'"
ELIZABETH K. POTTER,
PIa lnt i [(
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANJA
v.
NO. 97, 003 5
SCOTT A. POTTER,
Defendant
CIVIL ACTION ' LAW
IN DIVORCE
DEFENDANT'S PRE-TRIAL STATEMENT
I. ASSETS
A. Marital
Asset
Date of
Valuation
Liens 01'
Encumbrances
Non-Marital
Portion
Value
See Inventory and Appraisement attached hereto as Exhibit "A".
B. Non-Marital
Asset
Date of
Valuation
Liens or
Encumbrances
Value
None
II. EXPERT WITNESSES
A real estate appraiser may need to testify as to value of
marital home if parties are unable to agree upon the same.
No other expert witnesses are expected.
III. NON-EXPERT WITNESSES
Defendant is the only non-expert witness anticipated at this
time.
IV. EXHIBITS
1. 1997 Income Tax Return
2. Wage statements
3. Pension documents
4. Real estate app~aisal
5. Mortgage payoff statement
6. NADA values of vehicles
V. INCOME
See Income and Expense Statement attached hereto as Exhibit
liB" .
VI. EXPENSES
See Income and Expense Statement attached hereto as Exhibit
"BIl,
VII. PROPOSED RESOLUTION
A.
Divorce.
divorce,
cile and
Defendant will not consent to a 3301(c)
as he believes that the parties should recon-
preserve the marriage.
B. Eauitable Distribution. In the event a 3301(d) divorce
is granted, Defendant will accept an equal division of
marital assets. He is not certain whether he intends
to seek sole ownership of the marital residence, or
whether he will agree that same shall be sold.
Date: September 18, 1998
'~'C'fUll: ,ubmi",d,
SMITH, ., Esquire
James, Smith, Durkin & Connelly LLP
P.O. Box 650
Hershey, PA 17033
(717) 533-3280
ASSETS OF PA/fl' , ES
Defendant mar'kfl on the lint b.>!ow t hone iLenw
applicable to the case at bar and it"mi~'''J the assets on the
fOllowing pages. If an item han be"1l dppraised, a copy of
the appraisal report is attached.
(X) 1.
(X) 2.
(X) 3.
( ) 4.
(X) 5.
( ) 6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
( ) 17 .
(X) 18.
) 19.
) 20.
) 21.
) 22.
( ) 23.
(X) 24.
(X) 25.
(X) 26.
Real property
Motor vehicles
Stocks, bonds, securities and options
Certificates of deposit
Checking accounts, cash
Savings accounts, money market and savings
certificates
Contents of safe deposit boxes
Trusts
Life insurance policies (indicated face value,
cash surrender value and current beneficiaries)
Annuities
Gifts
Inheritance
Patents, copyrights, inventions, royalties
Personal property outside the home
Businesses (list all owners, inClUding percentage
of ownership, and Officer/director positions held
by a party with company)
Employment termination benefits - severance pay,
workman's compensation claim/award
Profit sharing plans
Pension plans (indicate employee contribution and
date plan vests)
Retirement plans, Individual Retirement Accounts
Disability payments
Litigation claims (matured and unmatured)
Military/V.A. benefits
Education benefits
Debts due, including loans, mortgages held
Household furniShings and personalty (include as a
total category and attach itemized list if
distribution of such assets is in dispute)
Other
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UNSECURED
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( ) 6. Purchases
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Ot he l' Income:
Week Month Year
(Pill in Appropriate Column)
Interest
Dividends
Pension
Annuity
Social Security
Rents
Royalties
Expense Account
Gifts
Unemployment Compo
Workmen's Compo
Support
Other
Total
$
$
$
EXPENSES
Week Month Year
(Fill in Appropriate Column)
HOME
Mortgage/Rent
Maintenance
Utilities
Electric
Gas
oil
Telephone
Water
Sewer
EMPLOYMENT
Public Transportation
Lunch
TAXES
Real Estate
Personal Property
Income
INSURANCE
Homeowners
Automobile
Life
Accident
Health
Other Renters
774.98
30.00
78.18
72.00
90.00
23.65
22.00
60.00
65.66
AUTOMOBILE
Payments
Fuel
Repairs
MEDICAL
Doctor
Dentist
Orthodontist
Hospital
Medicine
Special needs (glasses,
braces, orthopedic
devices)
EDUCATION
Private School
Parochial School
College
Re lig ious
PERSONAL
Clothing
Food
Barber/Hairdresser
Credit Payments
Credit Card
Charge Account
Memberships
LOANS
Credit Union
225.00
100.00
75.00
20.00
5.00
8.33
40.00
50.00
20.00
40.00
40.00
225.00
MISCELLANEOUS
Household Help
Child Care
Papers/Books/Magazines
Entertainment
Pay TV
Vacation
Gifts
Legal Fees
Charitable Gifts
Other Support
Alimony Payments
OTHER
Vet bills
80.00
25.00
100.00
32.00
TOTAL EXPENSES
$
$ 2.293.49$
1
{
PROPERTY OWNED:
Description
Value
Ownership*
H
W
J
Checking Accounts
savings Accounts
Credit Union
Stocks/Bonds
Real Estate
Other
Members First
Members Firflt
6.54
62.48
-L
-L
Savinas Bonds
931 S. 31st St.
$
$
;;
;; 250.00
$95.000.00
$
-L
-L
TOTAL
$95.319.02
INSURANCE
Company
Policy No.
Ownership*
H
W
C
Hospital
Blue Cross
Other
Medical
Blue Shield
Other
Health/Accident
Disability Income
Dental
Other (Vision)
Aetna U.S. Healthcare 168-48-3519 -L
Same
Same
-L
Same
Same
Same
Same
Same
Same
-L
-L
-L
* H=Husband; W=Wife; J=Joint; C=Child
FIRST "RRYLRND BRNCDRP
PAYROLL STATE"ENT
BEGIN DATE: 08/29/1998
END DATE: 09/11/1998
187992
09/11/199B
D13589
168-q8-3519
DDB DEPT: 2125 CO"PUTEA OPERATIDNS PAY PERIOD
900-01-02 D61q2
POTTER.SCOTT A X ADVICE/CHECK NO:
931 S. 31ST STREET PAY DATE:
CA"P HILL, PA 17011 E"PLOYEE M
_ _ SOCIAL SECURITY M
TAX STATUS: FEDERAL SINGLE 0 EXE"PTIONS
TAX STATUS: STATE PA SINGLE 0 EXE"PTIONS
TOTAL NET PAY
.977 .36
HOURS DESCAIPTION
6q.00 REGULAA
DT 1.5
FLEX CAED
EI9
16.00 PTD
TOTAL EARNINGS
TOTAL FED TAXABLE
CURAENT
1,12q.q6
30.00
2Bl.11
1.Q35.57
1,377 .57
EARNINGS
TD DATEIHOURS
2Q,273.56
Q75.18
570.00
94B.89
1.133.35
27,400.99
26.29B.98
DESCRIPTION
CURRENT
TO DATE
TAXES AND DEDUCTIONS
DESCRIPTION CUARENT TO DATE IDESCRIPTION CURRENT TO DATE IDESCRIPTION CURRENT TD DATE
FED WITHHOLD 235.93 4.517.67 TOTAL DEDUCTIONS 63.96 1,213.34
PA WITHHOLD 38.57 736.35
LOC WITHHOLD 14.36 274.08
OASDIIDIS B5.41 1.630.54
FICA - "HI 19.98 381.34
OCC PRIV 10.00
TOTAL TAXES 394.25 7,549.98
DENTAL 3.23 61.37
LTD 0.93 15.77
"EDICAL Q7.00 893.DO
PTO BUY 5.04 95.76
UNITED WAY 5.D3 95.57
VISION 2.73 51.87
ESmATED YTD ACCR. PTO YTD PTO EST. PTO EIB EIB EIB
ANNUAL PTO 144.64. CAARYOVEA 112.16 USED 66.00 RE"AIN. 7B.64 AVAIL. 56.00 USED 56.00 RE"AIN. 0.00
FIRST "ARYLAND FA"ILY DAY AT THE BALTI"ORE ZOO: SAT.. OCT. 3.19981 11:00 A" TO 3:00 P". BRING A PICNIC
LUNCH AND HAVE A FUN DAY! WE'LL SUPPLY THE SODA. POPCORN AND COTTON CANDY. ENTER "AIN GATE 8 GO TO WATERFOWL
LAKE HILL AREA. YOUR E"PLOYEE ID CAAD IS YOUR AD"ISSION TICKET FOR YOU AND "E"BEPS OF YDUR I""EDIATE FA"ILY.
FOR "DRE INFOR"ATION CALL 109-6942.
1998 "ARYLAND RENAISSANCE FESTIVAL: SATURDAYS, SUNDAYS AND LABOR OAY "ONDAY, AUGUST 29 - OCTOBER 25. 1998
FRO" 10:30 A" _ 7:00 P" LOCATED IN CROWNSVILLE. "ARYLAND. DISCOUNT TICKETS - $9.50 ADULTS (16 AND OLDER),
$Q.OO CHILDREN (7 - 15). SENO TICKET REQUEST AND CHECK PAYABLE TO EAC, TO PAT PIFER 109-803.
ELIZABETH K. PQ'I"I'EH,
Plaint.iff
IN THE COUHT OF CoMMON PLEAS
CUMBEHLAND COUNTY, PENNSYLVANIA
NO. ') 7 ~ 003 'i
v.
SCOTT A. POTTEH,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
CERTIFICATE OF SERVICE
AND NOW, this L- day of September, 1998, I, MAX J, SMITH,
JR., Esquire, Attorney for Defendant, hereby certify that I have
this day sent a copy of Defendant's Pre-Trial Statement by depos-
iting a copy of same in the united States mail, postage prepaid,
at Hershey, Pennsylvania, addressed to:
Diane G. Radcliff, Esquire
3448 Trindle Road
Camp Hill, PA 17011
(lJn.y~
MAX J. SMITH, J ., Esquire
JAMES, SMITH, DURKIN & CONNELLY LLP
P.O. Box 650
Hershey, PA 17033
(717) 533-3280
EI.IZABETII K, POTTER.
Plaintiff
IN TilE COlllU OF CO\l/.IO;-.J PLEAS
Cl 1/.IIlI;RI.A:-.JD COlINTY. PENNSYL V At'\IA
\'S,
NO, 'J7-0()J5
SCOTT A, POTTER.
Dclcndant
('IVII. ACTIOi'< . LA \V
IN DIVORCE
PRAECIPE TO \VITf fl)RA W APPEARANCI'
ru Tlli: PROTIlUNOTARY,
Pleasc withdraw thc appcarancc of Kcith II, DcArmond, Esquirc as counsel for Scoll A,
POllcr, Dcfcndant in thc abovc-captioncd mallcr,
Datc: .J:I:.::J. 'i(
I
. I
<~,.) /
- - '4---...L
Keith B, DcA mond, Esquirc
DeArmond & DeArmond
2800 Market Strcct
Camp Hill. PA /7011
,1998
PRAECIPE TO ENTER APPEARANCE
TO THE PROTHONOT AR Y:
Plcase cntcr thc appcarancc of Max J, Smith, Jr" Esquire, as counsel for Scoll A. POllcr.
lJclcllllant in thc above-captioned matter,
M~!~:'~";re
JAMES, SMITH, DURKIN & CONNELL Y I.I.P
1'.0, Box 650
Hershey, PA 17033
(717) 53J-3280
Date: 'S<n 1-
,1998
i
;
I
"
(jAil\' I J,,~t1 s
MAX J SMllIl,lIt
KAKIN Il"JlKI~
JOliN J UINSll.I,\" lit
~ll1t'RI'J MMiDIJlE
I KANK I' l'I AKK
SI'SAN I 1.I1llKlK
Sil VII' A STINJ:
JIll IN J MCNAI.I.\',1I1
CiIlUiOR\' K KI<'IIMIlS
scon A IlIlTITllICK
IARAIl W IIANIlELMAN
1.AW OITllTS
JI/I/lI.',\. SII/;t", VIIThill & ('O/llll!l(I' /I P
P,O, BOX 650
IIERSIIEY,PENNSYLVANIA 17033
SUcci addu:,,,
1.l-lSII'FAVLf\t11
IIIJMSIITSHlWN,I'INNSYI.VASIA 17016
[-mail addlc"". inti) lIj"dkgal C{11lI
~
~
1717) Ill.]lKII
"AX (717) 1).1.27'11
Ihrrhbura Office:
IOK.112 Walnut SUc:c:1
lIarrishurg, ItA 11101
(717) llH-l77b
"
February 11. 1999
Diane G, Radcliff, Esquire
3448 Trindle Road
Camp Hill,PA 17011
In re: Potter v. Potter
No. 97-0035
In Divorce
Dear Diane:
Despite Mr. Elicker's letter dated February 3, 1999, my client advises that his wife has
refused his reqllest that the real estate be listed for sale. Please instruct her to cooperate with
Scott by arranging the premises to be sold as soon as such may be accomplished, Otherwise, we
shall ask Mr. Elicker to award the home to her, as referenced in his letter,
Thank you for your attention and anticipated cooperation.
Very truly yours,
JAM:AE~SMITH. DURKIN & CONNELLY 1.I.P
! ~"
J / .";
Max J. Smith, Jr.
MJS,Jr.:amk
cc: E. Robert Elicker, II, Esquire
Scott A. Potter w/enc
H4I TrIII4IIo ILood
Camp Hill. PA 17011
......... _ _rr
....
IN TilE COUHT OF CO~1~10N PLJ-:A~; OF CllMHJ-:HLANlJ COllNTY, PENNSYLVANIA
ELI ZABETIl K. POTTEI"
Plclintl If
'-
NO, ~n-003,)
V,
CIVIL ACTION - LA~I
DIVOHCE/PROTECTION FROM ABUSE
SCOTT A. POTTER,
Defendant
If you wish to deny any of the statements set forth in this
Affidavit, you must file a counter'-affidavit within twenty day:.;
after this Affidavit has been uerved on you or the statements will
be admitted.
AFFIDAVIT UNDER SECTION 3301(d)
OF TilE DIVORCE CODE
1. The parties to this action separated on November 25, 1996 and
have continued to live separate and apart for a period of at
least two years.
2. The marriage is irretrievably broken.
3. I understand that I may lose rights concerning alimony,
division of property, lawyer's fees or expenses if I do not
claim them before a divorce is granted.
I verify that the statements made in this affidavit are true
and correct.
I understand that false statements herein are made
subject to the penalties of 18 Pa.C.S. Section 4904 relating to
unsworn falsifications to authorities.
Date: \\\\ \ G..C\
.
[52A;~ ~ -\ \\ l(<. J< o-\\.~
Ellzabet K. Potter
1I1ASI-ti HAon III
.1.I";K IIU\1l1 1- Itlnll
(,A~lI' 11111,1''\ 17tlll
t717J 717.UIIl1J
.
,
,
~
financial and proper:y rights and etllgations as tetween each ether
c
including, w~thout lim:tatiGn cy s~ecification: the set:li~g or a:l
matters between
them relacir:g
"~
-~
the
owr.ership
and equitabl"
distnbutlon of real and perser.al ~'tcperty; the settling of all
matters between them relat:.ng to :he past, preser.t and futur"
support, alimony and/or mainter.ar-.ce of Wife by Husband or of
Husband ty Wife; and :.n ger.eral, the settling of any and all claims
and poss:.ole cla:.ms by cr.e aga:.r.st the other or against the:.r
respective estates.
:t
NOW, THEREFORE, ::! ccr.s:cera::an af the premises ar.d mutual
premises, ccvenar:.':3 ar.d u!"'.ie::-:a:":::-.gs hereinafter set for:h ar:d f::::
other gcod and valuable ccr.s:dera::on, receipt of which is hereby
acknowledged ty each af :~e par::es ~ereto, Wife and Husband, each
.:.ntending t~ be legal:: cCl;:'.d l-'.ereby I covenant and agree as
follows:
1. INCORPORATION OF PREAMBLE:
7he recitals set :::r:~ :r: ~he Preamble of this Agreeme~t
are :r:.c~rpora:ed ter~:~ a~d ~ade a part hereof as if fully se~
forth \~ the body of :~e Agreement.
2. AGREEMENT NOT A BAR TO DIVORCE PROCEEDINGS:
~his Agreemer:c s~a:l ~ct be co~sidered to affect or bar
the r:gh: of Husbar.d ar.d 'tl::e :0 a:1 absolute divorce on lawful
grour.ds :.: such graur.ds r.cw ex:st ar shall hereafter exist cr
to such defense as :nay be available to either party.
This
Agreement is net :nter.ded :0 condone and shall not be deemed
:0 be candonat:~r. or. the part of either party hereto of ar.y
."
act cr acts or. the par: of the other party which have
DIANE Cj, RADCLIFF
J.I.'H T1U~DLE ROAD
CIMP HILL. Pol nil I
PHONE 171i'i 7J';'.l}lllO
I:..\X 17171 'J75.0Ijl)7
?age 2 of
.,.,
~~
employment which t:J h~:n or her mal se"m ad'risable,
Huscar:d
and W~fe shall r:ot moles:, r.arass, dlst'.lrb or mal:gn e~c:-.
other or the respect~ve f~:n~l~es :Jf each other nor compel or
attempt to compel the ctr.er t~chabit or dwell by an, means
, "
or in ar:y manner whatsoever w~th hlm or her,
16. MUTUAL RELEASES,
Husband and Wife each do hereby mutually remise, release,
quitclaim and forever discr.arge the other and the estate of
suer. other,
for a"
....; ......Po
- -:1"-
for all
ar.d
.~
-~
pur---::0ses
ccme,
'tJhat5cever, of a:1d f:-=m a:"1 ~r.d all rlght, title, lntereSt
and/or claims ~n or aga::-.st the other party, the prcpe:::y
(includ~ng income and 9a~r: frcm property hereafter accr~ing)
of tr.e other or aga~nst tr.e estate of such other, of whatever
nature and wheresoever s~:~ate, which he or she now has cr at
any t ~me hereaf':er ma:: r.a':e against such other party, t::e
estate of such other cartv cr the property of the other parcy
or any ~art thereof, ~~e:~er arising out of any former ac~s,
contracts, engagements or l:acilities of such other or by waf
of dower or curtse" or ola:ms in the nature of dower or
curtsey or widow's cr w~dcwer's rights, family exemption or
similar allowance, or under the intestate laws, or the right
to taKe aga~nst the spouse's will; or the right to treat ~
I ifet~me con'reyance by t:-.e :other as testamentary, or all ot!:er
rights of a sur'r:vir:g spc'.:se to participate in a deceased
spOL:.se's estate,
h' "
0" .e'::"'.er :=.rls:..ng
the
under the laws of
(a)
Comrr:cn',oJeal:h of Pe:1r:si': ./a.::ia I
(b) State, Commonwealth or
Terr~':cry of the Uni,:ed St~tes, or (c) any other country; or
any rights which e:::1er party mal have or at any time
D1A:"E G. RADCLIFF
)....8 TRJNDLE ROAD
CAMP HILL, PA 17011
PHONE: 1117) 7)7.11100
FAX: 1717\ 'J7S-iwn
?age - of 22
hereafter have fer pas':, pr~sent or future su~port cr
maintenance, all:TlCny, 011 :-:-,cr./ pendente 1 i te, counsel f,",,,,s,
equltable distr:buticn, C~3t3 ~r expenses, whether arising 18
a result cf the mar:.:al :--=13t'"~f.9n or otherwise, except, 3.~d
only except, 0311 rl"hts 'lnd 039reement3 ar.d obligations ~_
whatsoe'/er nature ar:.si::~ cr 'IJhic:h may arise under ::'.:'5
Agreement or fcr the breath of any provislon thereof,
1-: :3
the intention of Husband a~d W:fe to give to each other by t~e
execution of
th~ S "I_"""pco.....=,,...,r
.~... t'\'::;:__ ~.._.....
1
f'J.ll,
complete
and ge:lenl
release with respect :0 a~y an~ all property of any kind :r
nature, real, person~: or ~:xed, which the other now owns 2r
may hereafter acguire. ex:ept and only except, all rights a~d
agre~ments and c~liga:io~3 :~ whatsoever nature arising =r
which may arlse under :n13 Agreement or for the breach of a~y
prov:s::r.s therecf,
17. WAIVER OR MODIFICATION TO BE IN WRITING:
Nc mcdificat10n or '"",i-/er of any of the terms hereof
shall be valid unless in ~ri:ing and signed by both partles
and no 'lIaiver of 1ny ::reac:: :-.el:'eof or default hereunder shall
be deemed a .....alver cf an:.: subsequent default of the same or
simila.:- :1ature.
18. MUTUAL COOPERATION:
Each party shall, a: any time and from time to ti:ne
hereafter, take any and all steps and execute, acknowledge and
dell'/er to the cther par::', any and all further instruments
and/or document that the :tner party may reasonably require
for the pt.:.rpcse or
:;ivi::.a
~ ~
full
force
and effect
to the
prcv:.s:or.s of this Agreement.
DIA~E G. R.\DCLIFF
loWS TRI~DLE RO,ID
C.I~IP HILL. P,I 1~1I11
PHONE: (717) 737-iIlOO
1:..\:\.1717) 'J75.r}IJl)7
?age 9 of 22
19. AGREEMENT BINDING ON HEIRS:
Th:s Agreement shall =e binding and shall inure to the
bene:l: or the parties heretc and their respectl'/e he:rs,
exec'...:tor-s, admlnistr3:=rs, St~~ssors and ass:.gns.
20. INl'EGRATION:
This Agreement ~8r.st::~tes the entire understanding cf
the parties and supersedes any and all prior agreements and
negotiations between them, 7here are no representations :r
warrantles other than th~se expressly set forth herein.
21. OTHER DOCUMENTATION:
Wi': e a::d Husbar.d cc'/e::ant and
agree that they ',oJ:::
fort~wi:h (a~d withir. at :east twenty
(20) days after demand
the1:~:o:'-: ,
a:;d
all
',...,ritten
exec'..:.te
instrument:s,
:1:'.:;
ass:~r.me::ts, re:eases, sa::s:acticns, deeds, notes, stock
certifi=ates, or such other writings as may be necessary :r
des:~able fer the p::-cper e: feet uat ion of this Agreemer:: I
and/or as t:1e:r respec:t:';e c:cunsel shall mutually agree,
should ce so executed
order to carry out fully and
effe'=ti'/ely the terms c: ::-.':'5 Agreement.
22. NO WAIVER OF DEFAULT:
Th:s Agreement
. , 1
sr:a_...
:-emain in full
force and effec:
unless and until ter~:nated ~nder and pursuant to the terms o~
this Agreement. 7he :a::~re of either party to insist upon
str:.=: I=erf:Jr:nar.ce of any,:: :he provisions of this Agreeme:::
shal: i~ ~o way affe~: the ri3ht of such party hereafter to
en::r:e the sarr.e, ncr sha:: the waiver of any subsequent
defii:.::t of the same or s::nllar nature, nor shall it be
DIA:'-i[; fl RADCLIfF
3.4M TRI~DLE IIOAD
CA~IP HILL. p,\ 1'''11
PIIO~E, (7171 7)7.11100
FAX. 1717) 1)7~.OhlJ7
?iige :0 of 22
~
f
,
~,
I
I
i
I
construed as a .tJaiver c: st::ict pe::fcrmance of any othe::
obligations hereln,
23. BRF.ACa..:.
If for any ::eason elc::e:: ~band or Wife fails to per:J::m
his or her obligacions owed co or for the benefit of the othe::
party and/or otherwise breaches the terms of this Ag::eemenc,
then the other party shal 1 have the following rights and
remedies, all of which shall be deemed to be cumulative and
not in the alternative, .tnless said cumulative effect would
have an inconsistent res~lc or would result in a windfall cf
the othe:: party:
a. The right to spec:::c ~erformance of the terms of thls
Ag::eement, In .tJh:cr. e':enc the non-breaching party shall
be reimbursed for all ::easonable attorney's fees and
costs incu::::ed as cr.e ::esult of said breach and in
bringing the action Eo:: specific performance.
b. The right tc damages a::ising out of breach of the terms
of thls Ag::eemenc, which damages shall include
reimbursemenc of all actorney's fees and costs incurred
as the resulc 0: the breach and in bringing the damage
actlon.
b. The right to all ::emed:es set forth in Section 3502(e) of
the Pennsyl'tania Divc::oe Code, 23 Pa. C.S.A. 3502(e), a:-.d
any additional :::9hts and remedies that may hereafter be
enacted by v:rtue 0: che amendment of said statute cr
replacement the::eof ty any other similar laws.
c. Any other remedies pro'tided for in law or in equity.
24. LAW OF PENNSYLVANIA APPLICABLE:
This Agreement shall te const::ued in accordance with the
laws of che Commonwealch ~_ Pennsylvania.
25. SEVERABILITY:
""
c::r.a.l::.::n,
clause or provision of
this
ar.y ter~,
Agreement shall be dete:::nined or declared to be void or
in'talid In law 0:: othe::.tJ:se, then only that term, condition
DIA:-lE (j, R.\DCLlFF
J....H TRI:-<DLE ItoAD
C..\~IP HILL. PA 17011
PHONE: 1717\ 737.11100
FAX. !717, '175.ll697
Page .. of 22
,1-
f.
t
f
clause or provislcn sr.all ce stricken from this Agreement and
in all other respects thls Agreement shall remain valld and
continue in full force, e::ec: and operation. Likewise, the
failure of either party to me~, hlS or her obligations under
this Agreement under anyone or more of the paragraphs
hereunder, with the exception of the satisfaction 0: a
condition precedent, sha~~ in no way avoid or alter the
remaining obligations of the parties.
26. FINAL EOUITABLE DISTRIButION OF PROPERTY:
The parties agree that the division of all property and
debts set forth in t:--.is .;:;r-eement is equitable and in the
event an action i:1 di'lcrce ~.as teen or is hereafter commenced,
botr. parties .....aive a::d rel:r.q'.lish the right to divide and
discribute their assets a::d debts 1n any manner not consisce::t
with the terms set :cr::: herein and further waive and
reli:1quish the right to ha'le the court equitably divide a::d
discribute their marital assets and debts. It is further the
intent, understanding a:1c agreement of the parties thac chis
Agreemer.c is a full, _.ooa., complete and equitable property
division.
27. WAIVER OF INHERITANCE:
E:ach 0:
the
oa:-::es
he::-~to
does
specifically
, -
'Na:?e,
release,
re:10ur.ce
--~
a......
::re'ler abandon any right,
...,-:.::0
,-,,-I.,. _ _,
interest and cla:m, .- a~y, ei:her party may have in and to
any ~~heri:a~ce of a~y k~~d or nature whatsoever previously,
or ~~ the future, re~e~.,ed by the ocher party.
DI,\:'IE G, R.\DCLlH
J4.l8 TRI:'IDLE ROAD
C\MP lULL. I'A lillll
PIIONE: (i\1l iJ7.11l01l
FAX. 17l,) 1J75..{)tW"i
?age :2 of 22
28. PERSONAL PROPERTY,
Husband and W:f~ de he~eby acknowledge that chey have
previously dlvlded the:~ tang:b~e personal property lnelud:ng,
but w:theuc Ilm:tatlon,
tc th~followina:
. '. ~
Jewelry, clothes,
furn:t~~e, fu~n:sh:ngs, ~~gs, oarpets, household equipment and
appliances, teols, p:.ot~~es, beoks, .....orks of arc and eche~
personal propercy ("che ?e~scnal Propercy.)
Hereafter Wife
agrees chac all of the ?e~scnal Property in the possession of
Husband shall be the se~~ and separace propercy of Husband;
and Husband agrees that
.' -
a__ 0:
the Personal Propercy in the
possession of Wife shall be the sole and separate propercy of
Wife.
The pa~ties do he~eby speolflcally waive, release,
reneunce and fore'le~ aba:-.den ',~hate'le~ claims, if any, he o~
she may have .....:ch res~eot tc the Personal Property .....hich shall
beceme the sole and se~a~ace ;~operty of the other.
29. AFTER-ACOUIRED PROPERTV:
Each cf che pa~tie5 shall hereafter own and enjoy,
independencly of any cla:.m or right of the other,
.,
a..
prcpe~ty, tangible c~ intang:ble, real, personal or mixed,
acq~::'ed by him or he::-, s:::ce November 25, 1996, the date of
the Fa~:ies' mar::al sepa~~::c~, with full power in him or her-
to d:s~ese of ti".e same as f'.1lly and effectively, in all
~espects and fo~ all pt.:~peses, as though he or she were
unma::-~ied a~d e~c~ ~a:':f ~e=eby waives, releases, renounces
and fo~eve~ abandons any ~:ght, ticle, interest and claim in
ar.d
-~
"~
said a.::-:r acqt;:::-ed property of
the other party
pursuant to che te~ms ef th:s Paragraph.
DIA;'-:E rj, RADCLIFF
3~S TRJ;-..'OLE ROAD
CA~IP IIIlL. PA [:011
PIIOKE, (717) 7J7.0100
FAX. 0171 '17S-lwn
Page 13 of 22
,
,
30. VEHICLES. BOATS AND THE LIKE:
e.
f.
With respecc ce ehe ,eh1cles, boats,
snowmobil~3,
motorcycles and the llKe owned by one or both of the parties,
or the trade ln value thereof l:4n:he Vehicles") if the Vehicles
, "
have been sold or traded 1:1 prior to the date of thlS
Agreeme:1t, the parties agree as follows:
a.
1987 Pontiac Grand Am shall be the sole and separaee
property of Wife.
1991 Tovota o:ck un tr~ck and the 1978 Chevrolet Co~/etee
shall be the sole.a~d separate property of Husband,
Identificacion of a Veh1cle herein shall include not onl'/
the Vehicle, but also ehe sale or trade-in value thereor
if it had been sold or traded in prior to the date ot
this Agreement.
The titles to the '/eh.:.::les shall be executed by the
pareies, if approprlate, for effectuating transfer as
herei:1 orov.:.ded on the date of executlon of th.:.s
Aoreemenc and sale executed titles shall be delivered to
the proper party en the discribution date.
b.
b.
c.
d.
For ourDoses of ch:,s ?a.:-aoraoh the term Iltitlell shall i:e
deemed co include "power of attorney" if the title to the
Veh:cle is ~~ava::a=le due to financing arra~gemencs cr
otherwise.
In the event a~! Veh:cle is subject to a lien ~r
encumbrance the party receiv.:.ng the Vehicle as his or her
propercy shall taKe .:.t subject to said Len and/er
encumbrance and shall ce solely responsible therefor and
sa.:.d par:y f~rcher agrees to indemni fy, protect ar:d sa're
the other party harmless from said lien or encumbrance.
Each of the par::.es hereto does specifically wai.,~
r'" 1 "'ase ~"'~ou~c'" a~c' ':J~""/e~ abandon ...hat"'./e,..- .....i ""'n' _ -
7--- I -~... .... - .., - _... _ ,~,('I.;-. -: __':::,._'
tl:le and :nteres: :~ev may have In tne Ve~:c~es t~a:
shall become the sole and separate property of the ocher
pare, pursuant to the terms ot this Paragraph.
31. REAL ESTATE:
real estate Known and nU~ered as 931 South 31" Street Camp
The ::ar-:.:.es are :::e (;',oJ::e=3 0: a certa::1 t=act of lmr:ro'/ed
Hill, PA 1701: {"the Rea: ~3:ate~} having an approximate va:~e
DIANE 1" RADCLIFF
loWS TRI~DI.E ROAD
c.\,\I!' IIlll,!'..\ I;()II
PHONE: (717) ;J7..l)100
FAX. 1717\ 'J7~.OfJl)7
P3.ge :'-1 0: :2
of $ 95,000,00 ar.d whi,:~ :a -=r::umbered wi th a mortgage owed t~
Homeside Lend:r.g, Ir:c" ha.,:r.g an approximate balance of
$70,683.00 ("the Mortgage"', :'he Real Estate is currentl,
undQr contra'-t -'.r sa ~ ',' '\~"']~.'"Contract:")
. ~ - ~. - l,= _ ...... __
''''ith a tentatl',e
settlement date :0 ee::u::: ::r. or before June 15, 1999. With
respect to the Real Eatate, ::-:e Mortgage ar.d the Contract the
parties agree as follows:
a. The pa:::ties shall pe:::::rm all actions and execute any ar.d
all documents r:eceaaa:::j to complete the sale ar.d
settlement as requifed by the terms of the Contract.
b. In the e'lent the Real E3tate is not sold and settled
pu:::suant to t~e te:::ms c: the Contract, the parties shall
contlnue to 1:3t :he Real Estate for sale with a
qualified mutuall, ag:::eeable :::ealtor and shall market t:-:e
prope:::tj so as t: sell :t at the best price obtainable,
the parties :urthe::: ag:::ee:r.g to follow all reasonable
ad.,ise provided to t:-:em by their realtor as to listing
and sales prlce ar:d :e:::ms, Further the parties shall be
:::equ:red to accept ar:y :::easor.able offer to pu:::chase t~e
Real Estate as maj be he:::eafter suggested by the realtor,
absent mutual ag:::eemen: :f the pa:::ties to the contra:::j,
c. Pendina the sale and settlement of the Real Estate,
Husband shall be sclel', resoonsible for the oayment 'Of
t~e Mo:::;-sage ands anj and a~l expenses assocIated with
tne Rea.l. Estate.
d. At settlement er. sa:i sale of the Real Estate the r.et
oraceeds de:::i'led a::e::: oayment of all normal ar.d
reasonable settlement costs and payment of all exiatir.g
liens, mortgages and er.cumbrances, shall be divided ar.d
distributed between t:-:e parties as follows:
1. paymer.t to Husband ef sixty (60%) percent of th~
net proceeds;
2.
Payment to
proceeds,
:'l:.f~
~F
'".
~orty
(40%) percent of the
net
e. With resr:ect to tax :::epe:::tino requirements and payment of
taxes result:na ::::om the sa1e of the Real Estate it is
ackncwledged and agreed as fellows:
Ur.der the ::u::::::er:t IRS rules and regulat ions no
taxes sh~uld be ~eportable or due and owing as tne
result 0: :~e sa_~.
DI".~E G R.-IDClIFF
J....8 TRJ~DLE ROAD
elMi' I!lLL. i'A l~OII
PHOSE: 1717) 7]7..0100
FAX. (717)l)7S-IWJ1
Page - of 22
DI,\~E G, RADCLIFF
H4S TRINDLE ROAD
CAMP fIILL. P,\ 171111
PHONE: 17\7) 7)7.1)100
FAX. 1717) 1)75.0h97
33. BANK ACCOtrnTS/STOCK/LIFE INSURANCE:
The partles
'. . rl
aCKnow_e_ge
and
that
they ha'le
agree
pre'l::.:>usly d::"llded to the:r mUVtlal satisfaction all of the:r
bank accounts, cert::.fica:es of deposit, bonds, shares of
stock! investment pla~s a~d l:fe insurance cash value, ("~he
Accounts"). Hereafter W::.fe agrees that all the Accounts held
in the name of Husband shall become the sole and separate
property of Husband; and ~usband agrees that all the Accounts
held in the name of Wife sha:l become the sole and separa:e
property or fl"lire.
Sach ::: the parties does specif::.cally
waive, release, reno~~ce a~c :orever abandon whatever righ~1
title, interest or cla::.m, he or she may have in the Accounts
that are to become the scle and separate proper~y of the other
purs~a~t to the terms heres:.
34. OWNERSHIP OF DOG:
Cwnersh::.p of ~he dcg, Hershey, shall be and is hereby
transferred to Husband. Hereafter Hershey shall be the scle
and separate proper~y of Husband free and clear of all r::.gh:,
title, interest and cla.:..:n of ftlife.
The provisions of t:-.e
prier court order entered :~ :his case pertaining to custccy
of Hershey sha:: ce deemed :0 te terminated. If requested tY-
either par~y, each party ~:ll execute any and all documents
necessar: :c tr~nsfer ~w~ershi~ cr terminate the custcdy or=er
so as t~ e:fec:~ate t~e :e~~s cf this paragraph.
35. WIFE'S DEBTS:
Ni:e ~ep~ese~ts ~~d ~arr3nts to Husband that s~nce t~e
~art:esl mar:ta: separ~t:=~ she has not contracted or incurred
?age _ i C f :2:;
D1A:<E G, !lAIlCLlfF
3448 TRI:<DlE ROAD
CAMP Hill, PA 17011
PHONE: 1717) 737.llll)l)
FAX: 17tif 97S.I)f)I)7
e.
Husbar.d shall re:::-.a::ce or solely assume the tINe (2)
Member's 1" PSL lo:a::s set forth 1n subparagraphs b. 1.
and b.2. above 'N1t::::1 s:;-:ty days of the date of Ch1S
Agreement so as to: ~e:ease W:fe from any and all further
liab11:ty thereunde~,
f.
~l,:
If a party is assum:::g a:1Y other Joint debt pursuancto
the terms of tr.1S ~aragraph not otherwise spec 1: led
herei:1, within s:x::; (.,,)) days of the date of this
Agreement that part:; shall be required to refinance or
solely assume that cbl:gation so as to relieve the other
party from any and all further liability thereunder.
g.
Any liability not d:sclcsed in this Agreement shall be
the sole respons:bil:t:; cf the party who has incurred or
may hereafter inct:r:\J.:, a:;d the party incurring or having
:ncurred said debt shall pay it as it becomes due and
payable.
From the date 0: t:::s Agreement, each party shall only
use thcse credit card accounts or incur such furcher
obligations for 'Nh:e:-. chat parcy is individually and
solely liable and the parties shall cooperate in closi::g
any remaini::g accct::::s 'Nh:ch provide for joint liabil1ty.
h.
38.INDEMNIFICATION:
~~y pa~:y assumi~g a~ cbl:gation pursuant to the te~ms of
this Agreement shall :::demnlfy, protect and hold the other
par:y harmless from a::d agai:1st all any and all liability
thereunder, :nclt:ding, bu: ::ot limited to, any attorney's fees
and costs :ncurred by :::e other party as the resul t of
defe::di::g against the o:bligation and/or enforcing the
prev:sicns of this indemr::::cation.
39. WAIVER OF ALIMONY. SPOUSAL SUPPORT AND COSTS:
The parties here:o agree and do hereby waive any right
and/cr cla:m they may ::a'fe, both now and in the future,
aga:::st the ether for a::~er:y, alimony pendente lite, spousal
suppcr:, ma:nter:ance, eo:t:r:sel fees, costs and expenses.
Page 20 of 22
DIANE G, RADCLIFF
J4-l8 TRlNDLE ROAD
CAMP HILL, PA 17011
PHONE, ,717) 7J7,I)JIHI
F.-\.'<; 1717) l)7S~)61)7
l
,
~
40. HEAnINGS NOT PART OF AGREEMENT,
Ar.y l:ead:ngs precedi::g t~e text of the several paragraphs
and sUbparagraphs hereof, ~re lnserted solely for convenience
of reference and shall not ~or.~.~tute a part of this Agreement
nor shall they affect its ~eaning, construction or effect.
EY SIGNING THIS AGREEMENT, EACH PARTY
ACKNOWLEDGES HAVING READ AND UNDERSTOOD
THE ENTIRE AGREEMENT, AND EACH PARTY
.N
ACKNOWLEDGES THAT THE PROVISIONS OF THIS
AGREEMENT SHALL EE AS EINDING UPON THE
PARTIES AS IF THEY WERE ORDERED EY THE
COURT AFTER A FULL HEARING.
(,
,
IN WITNESS WHEREOF, t~e p,rties hereto have set their hands
and seals the day and year celc~ ~ritten.
WITNESS:
/~/~M c?
.
!ie<--;'I If,,,,
/j
i/
~~~\o:...-\\1 ~,~~
~~IZABETH K. POTTER
:ate: ~ - '" - o\:~
(SEA~)
/f(U(,ej ".A. ,~ ,/!!Hr./v...;
//
v
S~. jlW.
SCOTT A. POTTER
~/"'/99
,
(SEA~)
:ate:
Page 4_ of 22
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'CompIII.It~ 1 ~or 2 for tddttloNf MMce..
lCompIec, It.,.,. 3. "', and 4b.
.PAnt ~ narM and .ddret. on the ~YWH of lhi, form 10 th,l WI can filum thl,
catd ,. yoU,
'Attach 1hI.lonn to IhI front of lhe mailplect, or on lhe badllf 'PIce doN not
'~R<<vm RlQipl R<<1lJflt<<r on IhI mdp'ect l*o. th, artide nunftf.
'The R..um Aec.lpt ~. Ihow to whom the enid, "'1. dellv'red Ind the data
dellvlred.
5, Ror.e/ved By: (Print Nsme)
!l
~
.!I
DIANE G, RADCLIFF
3448 TRINDLE ROAD
CAMP HilL, PA 17011
(717) 737.0100
EXHIBIT "A"
I aloo wtoh to receive the
following Hrvle.. (for 811
eldra fee):
~r8..ee'e Addre.. ~
yc:rReSfrlcled Oellvery .i
COnsull POSlmasfer tor fes, !
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4b, Service Type ~
o Registered
o Express Moll ~::fi f
o Relum ROC04>f for Molthend.. 0 COO
7, Osle 01 Oel/very \...\q ... q q j
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8, Addressee's Addre.. (Only" reque'llld
Bnd fe. to paid)
IN TilE COURT Of' COMMON PI.EAS O~' CUMIlEllI.AND COUNTY, PENNSYI.vANIA
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CIVIL ACTION - LAW
t:. \'~2.""D(.J-\.!L~_S 0-\\ r"
Plaintiff
:
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f'ile No. '1\\ .- 00':?.5
:
vs.
IN DIVORCE
:
Sco\\ ~
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Defendant
NOTICE TO RESUME PRIOR SURNAME
Notice is hereby given that the Plaintiff/Defendant in the
above matter, having been granted a Final Decree in Divorce on the
d-_?J day of --:S-\.\qE: , 19 _r'\:L, hereby elects to resume the
prior surname of ~ "2'-o..'oI2.-\.'<I X(, 0" 1)... '\J Il <.. L. ,and gives
this written notice pursuant to the provisions of 54 p.S. S 704.
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DATE: -S-\J \"1 \;2 \ \.o..~,
_~.~~>~~ ~!L -K ' ~("..1 \\~
Signature
_ ~~" l(<.. 0A1)...~€C.
stgrrarure of name being resumed
COMMONWEALTH OF PENNSYLVANIA:
SS.
COUNTY OF CUMBERLAND
On the l.2.. ~_ daY~f _ __~ ____, 19_QJ_, before me, a
Notary Public, personally ared above affiant known to me to
be the person whose name i subscri ed to the within document and
acknowledged that he/she executed the foregoing for the purpose
therein contained.
In Witness Whereof,
seal.
my hand and official
-r
NOTARIAL SEAL
~NIOR~ I NEff NOIARY PUBLI
CAHLI'iL[ OORll, CUMnER~NO COUNTY
MY COMMISSION EXPIRES Nil'IfMBER 1~. 1'"
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