HomeMy WebLinkAbout97-00328
Rix months and a flnc of $100.00-$1,000.00; and iv) civil
contempt undcr 23 Pa.C.S. ft6114,1. RCRumption of co-reRidcnce on
the part of the plaintiff and dcfcndant shall not nullify the
provisions of the court order.
This Order shall remain in effect until modified or
terminated by the Court and can be extended bcyond its original
expiration date if the Court finds that the defendant haR
committed another act of ahuse or has engaged in a pattern or
practice that indicates continued risk of harm to the plaintiff.
A hearing shall be held on this mat ter on the J.9--th day of
j,}jjIl/UltILY , 1991-' at JJ:O~ /t.m., in Courtroom No.
~, Cumberland County Courthouse, Carlisle, Pennsylvania.
The plaintiff may proceed without pre-payment of fees
pending a further order after the hearing.
The Cumberland County Sheriff's Department shall attempt to
make service at the plaintiff's request and without pre-payment
of fees, but service may be accomplished under any applicable
rule of civil Procedure.
This Order shall be docketed in the office of the
Prothonotary and forwarded to the Sheriff for service. The
Prothonotary shall not send a copy of this Order to the defendant
by mai I.
The West Fairview Police Department wi)) he provided with a
certified copy of this Order by the plaintiff's attorney. This
Order shall be enforced by any law enforcement agency where a
violation occurs by arrest for indirect criminal contempt without
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warrant upon probable cause that this Order has been violated,
whether or not the violation is committed in the presence of the
police officer, In the event that an arrest is made under this
section, the defendant shal I be taken without unnecessary delay
before the court that issued the order, When that court is
unavailable, the defendant shal I be taken before the appropriate
district justice. (23 Pa,C.S. 6 6113).
By the Court,
~JG.V-
~ Judge
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Tamara R. Crist,
Plaint iff
IN THE COURT OF COMMON PLEAS OF
v,
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 97- IJ? CIVIL TERM
Scott M, Crist. Sr..
Defendant
PROTECTION FROM ABUSE
PETITION FOR PROTECTION ORDER
RELIEF UNDER THE PROTECTION FROM ABUSE
ACT, 23 Pa.C.S. 9 6101 et seq.
A. ABUSE.
1. The plaint iff. Tamara R. Crist, is an adul t individual
residing at 319 Third Street, Apartment 1, West Fairview,
Cumberland County, Pennsylvania 17025.
2. The defendant, Scott M. Crist, Sr., (SSN: 210-52-4982)
(Date of Birth: 10/20/74), is an adult individuai residing at 319
Third Street, Apartment I, West Fairview, Cumberland County,
Pennsylvania, 17025.
3. The defendant is the plaintiff's husband.
4, Since approximately February 1996, the defendant has
attempted to cause and has intentionally, knowingly, or
recklessly caused bodily injury to the plaintiff, has placed the
plaintiff in reasonable fear of imminent serious bodily injury,
and has knowingly engaged in a course of conduct or repeatedly
committed acts toward the plaintiff under circumstances which
have placed the plaintiff in reasonable fear of bodily injury.
This has included. but is not limited to, the following specific'
instances of abuse:
a.
On or about December 19. ]QQ6, the defendant
punched the plaintiff in the stomach, pushed her into a
wal I, grabbed her by the arms, forcefully shoved her
into a closet door. and kicked her in the side causing
several bruises and soreness in her side and back.
b. In or about September 1996, when the defendant
pulled back his fist to punch the plaintiff, she moved
to avoid getting hit but the defendant backhanded her
on the side of her face causing pain and redness.
c. In or about August 1996, the defendant punched the
plaintiff on her leg causing a bruise,
d, In or about the Winter of 1995, when the defendant
was riding in the car with the plaintiff driving, he
became angry, recklessly slammed the car into neutral,
and backhanded her in the face causing a bruise.
e. On several different occasions since February
1996, the defendant has punched the plaintiff, shoved
her, thrownher into walls, slapped her, and kicked her.
5. The plaintiff believes and therefore avers that she is
in immediate and present danger of abuse from the defendant and
that she is in need of protection from such abuse.
6. The plaintiff desires that the defendant be enjoined
from harassing and stalking the plaintiff, and from harassing the
plaintiff's relatives.
7. The plaintiff desires that the defendant be enjoined
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from rcmoving, damaging, dcstroying or sel ling any propcrty owncd
jointly by the partics or owned solely by the plaintiff,
II. RlllMnURSEMENT FOR COST OF CASIl
8. The plaintiff asks that the defendant be ordered to pay
$250.00 to reimbursc one of Legal Services, Inc, 's funding
sources for the cost of litigating this case.
WHEREFORE, pursuant to the provisions of the "Protection
from Abuse Act" of October 7, 1976, 23 Pa.C.S. g 6101 tl ~., as
amended, the plaintiff prays this Honorable Court to grant the
following rei ief:
A. Grant a Temporary Order pursuant to the
"Protection from Abuse Act:"
1, Ordering the defendant to refrain from
abusing the plaintiff or placing her in fear of
abuse.
2. Ordering the defendant to refrain from
harassing and stalking the plaintiff and from
harassing the plaintiff's relatives.
3. Prohibiting the defendant from removing,
damaging, destroying or selling property jointly
owned by the parties or owned solely by the
plaint iff.
B. Schedule a hearing in accordance with the provisions of
the "Protection from Abuse Act," and, after such hearing, enter
an order to be in effect for a period of one year:
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I. Ordering the defendant to refrain from
abusing the plaintiff or placing her in fear of
abuse,
2, Ordering the defendant to refrain from
harassing and stalking the plaintiff and from
harassing the plaintiff's relatives,
3. Prohibiting the defendant from removing,
damaging, destroying or selling property jointly
owned by the parties or owned solely by the
plaintiff.
The plaintiff further asks that this Petition be filed and
served without payment of fees and costs by the plaintiff,
pending a further order at the hearing, and that a certified copy
of this Petition and Order be delivered to the West Pennsboro
Police Departments which has jurisdiction to enforce this Order.
The plaintiff prays for such other relief as may be just and
proper.
Respectfully submitted,
for Plaintiff
LEGAL SERVICES, INC.
a Irvine Row
Carlisle. PA 17013
(717) 243-9400
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The above-named plaintiff, Tamara R. Crist, verifies that
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the atatomenta made in the above Petition are true and correct.
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The plaintiff under~tanda that false statements herein are made
subject to the penalties of 18 Pa,C.S. ~ 4904 relating to unsworn
falsification to authoritieR.
Date: /-/7- '/7
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;Tamara
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R, Crls ,Plaintiff
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INSTRUCTIONS TO THE DEFENDANT
As you know, the plaintiff has rued a legal action against you under the protectlcn
From Abuse Act and has obtained a Temporary Protection Order. The plaintiff is prepared
to have a hearing held in order to obtain a final protection Order effective for one (1) year.
M an alternative, you may consent to the entry at tho final Protection order to be In
effect for one year. If you are wlllIng to consent you should call LoP! Services. Ine. In
CarliBle at 243-9400. 766-8475 from the WeISt Shore or 530-5866 fram Sbippensburg, and ask
to speak to the staff person handUng the case about a COnsent Aa.....ment.
The Consent Agreement should be prepared before the time scheduled for the hearing
so the Court will know ahead at time that the case will not be contested. In some cases.
regardless of whether a settlement by Consent Al1'8ement has been reached. the parties
must appear In court at the time scheduled for hearing. If the case is uncontested, the
court appearance will be brief. The judge will make sure the parties understand the
Consent Agreement and final protection Order.
If you do not agree to the entry of the final protection order, a contested hearlna will
take place at the scheduled time. When a final protection order is entered. it wi11 be sent or
given to you, the plaintiff. and the appropriate police departments. If you faU to abide by
the terms of the final protection Order you will be subject to immediate arrest. and a fine of
$100.00 to $1,000,00 and/or a jail sentence of up to six l1IOnths and other re11ef'.
fEES AND rosTS
If the case goes to hearing and the judge grants a protection Order. a surcharae or
$25.00 will be assessed against you. You IlIAY also be required to pay attorney fees toL!,aal
services. Inc. for their representation of' the plaintiff.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO Na,1'~VE I.,
LAWYER OR cANNOT AFFORD ONE. GO TO OR TELEPHONE THE omcs SET
FIND OUT WHERE YOU CAN GET LEGAL HELP.
COURT ADMINISTRATOR. 4th FLOOR
CUMBERLAND 'COUNTY coURTHOUSE
CARLISLE. PENNSYLVANIA 17013
TELEPHONE NUMBER: {7171 240-6200
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Tamara R. Crist.
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PENNSYLVANIA
NO, 97- 3afl> CIVIL TERM
PROTECTION FROM ABUSE
v.
Scott M. Crist, Sr.,
Defendant
AND NOW. t his
TEMPORARY PROTECTION ORDER
';)/~aY of January, 1997, upon
presentation and consideration of the within Petition. and upon
finding that the plaintiff, Tamara R. Crist. now residing at 319
Third Street, Apartment I. West Fairview, Cumberland County,
Pennsylvania, is in immediate and present danger of abuse from
the defendant. Scott M. Crist, Sr" the following Temporary Order
is entered.
The defendant. Scott M. Crist, Sr" (55N: 210-52-4982 and
date of birth: 10/20/74) now residing at 319 Third Street,
Apartment I, West Fairview. Cumberland County, Pennsylvania. is
hereby enjoined from physically abusing the plaintiff, Tamara R.
Crist, or placing her in fear of abuse.
The defendant is enjoined from harassing and stalking the
plaintiff and from harassing the plaintiff's relatives.
The defendant is enjoined from removing, damaging,
destroying or selling any property owned jointly by the parties
or owned solely by the plaintiff.
A violation of this Order may subject the defendant to:
arrest under 23 Pa.C.S. g61\3; ii) a private criminal campi
under 23 Pa.C.S. g6tI3.1; iii) a charge of indirect criminal
contempt under 23 Pa.C.S. g6114, punishable by imprisonment up to
six months and a fine of $100.00-$1,000.00; and iv) civil
contempt under 23 Pa.C.S. 16114.1. Resumption of co-re~idence on
the part of the plaintiff and defendant shall not nullify the
provisions of the court order.
This Order shall remain in effect until modified or
terminated by the Court and can be extended beyond its original
expiration date if the Court finds that the defendant has
committed another act of abuse or has engaged in a pattern or
practice that indicates continued risk of harm to the plaintiff.
A hearing shall be held on this matter on the ;Jtltl, day of
~.lA7 ,199.1.... at //:(H) o:..m.. in Courtroom ~o.
1--, Cumberland County Courthouse. Carlisle. Pennsylvania.
The plaintiff may proceed without pre-payment of fees
pending a further order after the hearing.
The Cumberland County Sheriff's Department shall attempt to
make service at the plaintiff's request and without pre-payment
of fees, but service may be accomplished under any applicable
rule of Civil Procedure.
This Order shall be docketed in the office of the
Prothonotary and forwarded to the Sheriff for service. The
Prothonotary shall not send a copy of this Order to the - ,,-.'-'
by mai I.
The West Fairview police Department will be provided
certified copy of this Order by the plaintiff's attorney.
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Order shall be enforced by any law enforcement agency where a<-'_i'~c '
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violation occurs by arrest for indirect criminal contempt without .
Tamara R, Crist.
Plaint iff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
v.
NO. 97-
CIVIL TERM
Scott M. Crist, Sr"
Defendant
PROTECTION FROM ABUSE
NOTICE
You have been sued in court. If you wish to defend against the
claims set forth in the fOllowing pages, you must take action promptly
after this Petition, Order and Notice are served. by appearing
personallY or by attorney at the hearing scheduled by the Court and
presenting to the Court your defenses or objections to the claims set
forth against you. You are warned that if you fail to do so the Court
may proceed without you, and a judgment may be entered against you by
the Court without further notice for any money claimed in the Petition
or for any other claim or relief requested by the plaintiff, You may
lose money or property or other rights important to you.
FEES AND COSTS
If the case goes to hearing and the judge grants a Protection
Order, a surcharge of $25,00 will be assessed against you. You may
also be required to pay attorney fees to Legal Services, Inc. for
their representation of the plaintiff.
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. 4th FLOOR
CUMBERLAND COUNTY COURTHOUSE
CARLISLE, PENNSYLVANIA 17013
TELEPHONE NUMBER: (717) 240-6200
AMERICANS WlTH DISABIJ.ITIES ACT OF 1990
The Court of Common Pleas of Cumberland County is required by law
to comply with the Americans with Disabilities Act of 1990. For
information about accessible facilities and reasonable accommodations
available to disabled individuals having business before the court.
please contact our office. All arrangements must be made at least 72
hours prior to any hearing or busines~ before the court. You must
attend the scheduled conference or hearing.
Tumurn R. crist.
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY. PENNSYLVANIA
v,
NO. 97-
CIVIL TERM
Scott M, Crist, Sr"
Defendant
PROTECTION FROM ABUSE
PETITION FOR PROTECTION ORDER
RELIEF UNDER THE PROTECTION FROM ABUSE
ACT, 23 Pa.C.S. ft 6101 et seq.
A. ABUSE.
I. The pia I nt if (, Tamara R. Cris t, is an adul t ind I vidua I
residing at )19 Third Street, Apartment 1, West Fairview,
Cumberland County, Pennsylvania 17025,
2, The defendant, Scott M. Crist, Sr., (SSN: 210-52-49821
(Data of Birth: 10/20/14), is an adult individual residing at 319
Third Street, Apartment 1, West Fairview, cumberland County,
Pennsy I van I a, 17025.
), The defendant is the plaintiff's husband.
4. Since approximately February 1996, the defendant has
attempted to cause and has intentionally, knowingly, or
recklessly caused bodily injury to the plaintiff, has placed the
plnlntlff In reasonable fear of imminent serious bodily injury..
and has knowinglY engag~d in a course of conduct or repeatedlY
committed acts toward the plaintiff under circumstances which
have placed the plaintiff in reasonable fear of bodily injury.
This has Included, but is not limited to, the followins sped
instances of abuse:
a. On or about December 19, 1996, the defendant
punched the plaintiff in the stomach, pushed her into a
wall, grabbed her by the arms. forcefully shoved her
into a closet door, and kicked her in the side causing
several bruises and soreness in her side and back.
b. In or about September 1996, when the defendant
pulled back his fist to punch the plaintiff, she moved
to avoid getting hit but the defendant backhanded her
on the side of her face causing pain and redness.
c. In or about August 1996, the defendant punched the
plaintiff on her leg causing a bruise.
d. In or about the Winter of 1995, when the defendant
was riding in the car with the plaintiff driving, he
became angry, recklessly slammed the car into neutral,
and backhanded her in the face causing a bruise.
e. On several different occasions since February
1996, the defendant has punched the plaintiff, shoved
her, thrcwnher into walls. slapped her. and kicked her,
S. The plaintiff believes and therefore avers that she is
in immediate and present danger of abuse from the defendant and
that she is in need of protection from such abuse.
6. The plaintiff desires that the defendant be enjoined
from harassing and stalking the plaintiff, and from harassing the
plaintiff's relatives.
'. The plaintiff desires that the defendant be enjoined
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from removing. damaging, destroying or selling any property owned
jointlY by the parties or owned solely by the plaintiff.
B. REIMBURSEMENT FOR COST OF CASE
8, The plaintiff asks that the defendant be ordered to pay
5250.00 to reimburse one of Legal Services, Inc, 's funding
sources for the cost of litigating this case.
WHEREFORE, pursuant to the provisions of the "Protection
from Abuse Act" of October " 1976, 23 Pa.C.S, g 6101 II ~., as
amended, the plaintiff prays this Honorable Court to grant the
following relief:
A. Grant a Temporary Order pursuant to the
"Protection from Abuse Act:"
1. Ordering the defendant to refrain from
abusing the plaintiff or placing her in fear of
abuse,
2. Ordering the defendant to refrain from
harassing and stalking the plaintiff and from
harassing the plaintiff's relatives.
), Prohibiting the defendant from removing.
damaging, destroying or selling property jointly
'owned by the parties or owned solely by the
plaint iff.
B. Schedule a hearing in accordance with the provisions of
the "Protection from Abuse Act," and. after such hearing, enter
an order to be in effect for a period of one year:
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I. Ordering the defendant to refrain from
abusing the plaintiff or placing her in fear of
abuse.
2. Ordering the defendant to refrain from
harassing and stalking the plaintiff and from
harassing the plaintiff's relatives,
3. Prohibiting the defendant from removing,
damaging, destroying or selling property jointlY
owned by the parties or owned solely by the
plaintiff,
The plaintiff further asks that this Petition be filed and
served without payment of fees and costs by the plaintiff,
pending a further order at the hearing, and that a certified copy
of this Petition and Order be delivered to the West pennsboro
police Departments which has jurisdiction to enforce this Order.
The plaintiff prays for such other relief as may be just and
proper,
RespectfullY submitted,
for Plaintiff
LEGAL SERVICES, INC.
8 Irvine RoW
Carlisle, PA 17013
{7171 243-9400
4
ifROTECTION ORDER
? ' , 1
AND NOW, this' )(. day of January, 1997, upon consideration
of the Consent Agreement of the parties, the following Order is
entered:
1, The defendant, Scott M. Crist, Sr., is enjoined from
physically abusing the plaintiff, Tamara R. Crist, or from
placing her in fear of abuse.
2, The defendant is ordered to refrain from harassing and
stalking the plaintiff and from harassing the plaintiff's
relatives.
3, The defendant is prohibited from removing, damaging,
destroying or selling any property owned by the plaintiff or
jointly owned by the parties.
4. This Order shall remain in effect for a period of one
year or until modified or terminated by the Court. The Order can
be extended beyond its original expiration date if the Court
finds that the defendant has committed another act of abuse or
has engaged in a pattern or practice that indicates continued
risk of harm to the plaintiff.
5. This Order may subject the defendant to: i) arrest
under 23 Pa.C.S, g6113; ii) a private criminal complaint under 23
Pa.C,S. g6113,lj iii) a charge of indirect criminal contempt
under 23 Pa,C,S. g6114, punishable by imprisonment up to six
months and a fine of $100.00-$1,000,00; and Iv) civil contempt
under 23 Pa.C.S, g6114.1. Resumption of co-residence on the part
of the plaintiff and defendant shall not nullify the provisions
of the court order,
6, The Carlisle Police Department shall be provided with a
certified copy of this Order by the plaintiff's attorney 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 a police officer. In the event that an arrest is
made under this section, 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, (23 Pa.C,S. g 6113).
B~' the Court,
U l <.,f IY{, ~is./tnf
Harold E. Sheely, Judge
Joan Carey. t!L~1 (}tft<VJ ,~,,,. , /1/
Attorney for Plai'htiff '1<,/l'f..J'/Vl{::
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Scott M, Crist, Sr. '/. - /!
Pro Se . 'If'~t:'' A1"'~~
risk of harm to the plaintiff. The defendant understands that
this Order will be enforceable in the same manner as the Court's
prior Temporary Protection Order entered in this case.
6. Violation of the Protection Order may subject the
defendant to: i) arrest under 23 Pa.C,S. ~6113; ii) a private
criminal complaint under 23 Pa.C,S, ~6113.1: iii) a charge of
indirect criminal contempt under 23 Pa,C.S, ~6114, punishable by
imprisonment up to six months and a fine of $100.00-$1,000.00;
and iv) civil contempt under 23 Pa.C.S. ~6114,1.
WHEREFORE, the parties request that a Protection Order be
entered to reflect the above terms.
'?:VM-CVZ-tI- -/ ~wi
Tamara R, Cris ; Pla1nt1ff
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Scott H. Crist, Sr., Defendant
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Attorney for Plaintiff
LEGAL SERVICES, INC.
a Irvine Row
Carlisle, PA 17013
(717) 243-9400
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ORDER/NOTICE TO WITHjlOlD INCOME FOR SUPPORT
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St t C Ith f P I. /"J('f/'( (,/'( ,{,(,{(,(/} OO"K,nJIO"I..,/NulIU'
a e _ommonwP3.._ o~ _enn~v_vaMla, >( '\ ;, I . . ,'- Ir
Co.lCitylDist. of CUMBERLAND jy':' 2(,_11;,). \r/11-/,/WU/1 0 A""'nd,,,lOnl",/Nulln'
Dale of Order/Notice 02/15/01 ) Jll(j~ f}f/C ,(((to T.,minJldlnl",/N,,",..
Courl/Case Number (See Addendum for rase summary) / 'fIg/( lff' t/?~ J
I RE, NORRIS, PATRICK W.
Emplo~'t'r/Wilhhllldt'r'" ft'dt'roll EIN Numbt>r ) Eml~Il~'t'I.Jnhli)tIlr'~ NJml' (lJ\I, Fil'\l. MI)
RASKAS CHEESE PRODUCTS OF I 182-56-0078
Eml'lnYl'rl\\lilhh()ldl'r'~ NJmt' ) Empln}'I...lOhli)tur''I ~t)( iJI ~t'( urily Numb,"
208 E DYKEMAN RD ) 2888000026
Em"lnYt"^"ilhhul,Il'r'!1 ^ddn'\~ ) Emplu}'I'I'/()lllilolllr'" Cd\(, lilt'Olin",
SHI PPENSBURO PA 17257 _ 8 700 ) IS.. Mdtndum for pI.lntiff n.m.uuod.trd with c.... on .'lil:llm.nll
) CU~II)(IiJI PJn'nl\ NoImt' (L.nl, Fir!ll, Mll
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See Addendum for dependent names and birth dates assodated with rases on allachment.
ORDER INFORMA TION: This is an Order/Notice to Wilhhold Income for Support based upon an order (or support
from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these
amounts from the above-named employee'sfobligor's income until further notice even if the Order/Notice is not
issued by your State.
$ 485.33 per month in current support
$ 0 . 00 per month in past-due support Arrears 12 weeks or greaterl (X) yes 0 no
$ 65.00 per month in medical support
$ 0.00 per month for genetic test costs
$ per month in other (specify)
for a total of $ 550.33 per month to be forwarded to payee below.
You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does nOI match
Ihe ordered support payment cycle, use the following to determine how much 10 withhold:
$ 127,00 per weekly pay period.
$ 254.00 per biweekly pay period (every two weeks).
$ 275,17 per semimonlhly pay period (twice a month).
$ 550.33 per monthly pay period.
REMITTANCE INFORMA TION:
You must begin withholding no later than the firsl pay period occurring ten (10) working days after Ihe dale of this
Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding, You are entitled to
deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the
the allowable amount. The total withheld amount, and your fee, cannot exceed 55'10 of the employee'sf obligor's
aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the (ollowing Information Is
needed (See #9 on pg. 2).
If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unil (SCDU) Employer
Customer SelVice at 1-677-676-9560 (or instructions.
Make Remittance Payable to: PA SCDU
Send check to: Pennsylvania SCDU, P.Q, Box 69112, Harrisburg, Pa 17106-9112
IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown
above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURtTY NUMBER IN ORDER TO BE PROCESSED.
DO NOT SEND CASH BY MAIL,
DRO: R.J Sh.,H.1Y ~ BYTH~fi7'J
xc: ,lefenl.1nt )11,(. / ~V' \f \(0..1
Date of Order: Febru.1ry 16, 2001 ....17 V' ~~
&1gl1l: B, Bayley .l1lOOB
Form EN-D28 ,
Worker 10 $IATT<
SelVice Type M
(l\\a"'o,:n~1()..lllU
hpir;H"f1j)~l": I1IJllOo
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ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS
o If (hpI k....d you .He rt'quired to provide oJ ropy of lhili tormlo your ,'mploy,.,>,
1. Priorily: \Vithholdil\K undt'r this Order/Nutirt' h.1\ priority owr JIIY ollwr It'HJI prO( t'Ii'i undt'r StJIt~ IJW JHdinst the SJI11P. incollw.
FedefJI tJX levies in 1'((..11 ht'fore rereipt of this order hdVt' priority. If tllt'I'" 0.1,,' f...dpfJIIJX It~vipli in ..ffeet plt'.Jst' rontJc:llhe requesting
J};t'nry Iistt'd ht>low.
2. Comhining PJynwllIs: Vou fdO rombine wilhlwld JI110111ll\ from mot" 111.111 (JIlt' "l11ployp..Johliwu'\ inrnnw in.. single pJyment
to t'Jrh Jgt'nry rt'quf'\linK withholding. You must, howt'\w. \1'pJr,lh'ly idt'1l1ify tht. portion of tilt' sing I.... pJynwnt Ihdt is JttrihurJble to
Poll h t'l1lpl()yt't'Ic)hliWl'.
J.' 'RoportinR Iho Payda",lDa'" ofWithlmldinR' Vall mil" "'port Iho p.IydJto/dJ'" nf withhnldinR whon ,ondinR the pJymont.- The
paydalo/dJ'" nf withhnldinRi, tho do'" on whim amollnt wa. withhold f01m Iho omplnl""'" W"!;"'. YOII 01",1 rlllllply wilh Ih. IJW of Ih.
st.Jlp of lh~ Pll1ployt>t~'vClhIiHor'S prinrip.1I pldce of t'mplnynumt with ft'\pt'( Ilolhf' limp. pt'riods within whit h you must implement the
withholding order ,.md forw,.ud the support PJymp.nls,
4.' EmployeelOhligor wilh Multiple Support Holding\: If Ih.re i, mOle IhJn on. Ord.r/Nolire In Wilhhold III",me for Support
JRain,t Ihi, employee/nhligor and you are unable In honor JII '"pport Order/Notic e, due to FederJI or StJte withhnlding Iimil', YOII 0111'1
follllw the IJW of the \lJte of employee'<lobligor', princ:ipJI plJr. Ilf emplllym.nt. Villi 01"'1 hnnor JII Ord.r<lNlltir., In Ihe greale'l
eXlenl po..ihle. (See '9 helllw)
5. Termin.nion NOlifirJlion: You must promptly notify IIw Requp.\tiIlH ^genry wlum tlw employp.pJobligor is no IOllger working (or
you, Ph~.Jse provide the information requested and return d ropy of Ihi\ Ordpr/Notire 10 the Agenry idenlifip.d ~Iow.
WITHHOLDER'S ID: 4314735100
EMPLOYEE'S/OBLlGOR'S NAME: NORRIS. PATRICK W.
EMPLOYEE'S CASE IDENTIFIER: 2888000026 DATE OF SEPARATION:
LAST KNOWN HOME ADDRESS:
NEW EMPLOYER'S NAME/ADDRESS:
6. Lump Som PJymen": YOII may he required In report Jnd withhold from lump ,"m p.Iyment' ,"c:h J' bonu,e" commi..ions, or
severance pay. If you have ,,my questions aooullump sum J>dymenls, rnnlJrl the person or .lutherity below.
7. LiJbility: If ynll fJilln withhold incollle J' Ihe Ord.,lNolire dir.cl', YOII JreliJhle for halh the JcrulllulJled alllount YOII ,hollld
h.IVe withheld from the employee/obligor's inl'ome IlIld other penJlries liet hy ppnn'iylv..lIliol Stolle 1.1\\1. Pennsylvdnid Stille law governs
unlelis the obligor is employed in another Sldte, in which r.llie the IJW of t11f~ Stdle in whkh he or she is employed governs.
B. Anli-disrriminalion: You ,,Ire subject to d fine determined under Stolte IJW for discharging an employee/obligor (rom
elllploYlllenl, refu,ing 10 employ, or LIking di,ciplinary Jction JgJiml Jny elllployeeJobligor her Ju'e of J ,upport withholding.
Penn'ylvJniJ SIJle IJW Rovern, IInle.. Ihe obligor i, employed in anolher Stale, in which r a,e Ihe law of Ihe Slate in whirh he or ,he i,
employed governs.
9.' Wilhholding Limi,,: You may not withhold more IhJn the le..er nf: 1) Ihe amnunt' allowed by Ihe Federal Con,umer Credil
Proleclinn Act (15 U.S.c. S 1673 (b)l; or 2) Ihe amolln" Jllowed by Ihe Slale orlhe employee',/obligor', principal place of employment.
The FederJllilllil Jpplie, In Ihe all!lregJle di'po,ahle weekly earning' (ADWE). ADWE i, Ihe net income leh aher making mandalory
deductions surh as: Stolte, Federd!, local tJxeSj Social Security lilXeSj dnd Medir.up. tJxes.
10.
'NOTE: If you or your agent are served wilh a copy of Ihis order in the state Ihat issued Ihe order, you are to follow the
law of Ihe stale Ihal issued this order with resped 10 Ihese ilems.
Requesting Agency:
DOMESTIC RELATIONS SECTION
P.O. BOX 320
CARLISLE PA 17013
If you or your employee/obligor have any questions,
contad WAGE ATTACHMENT UNIT
by lelephone at (717) 240-6225 or
by FAX at 17171 240-6248 or
by Inlernet @
Page 2 of 2
Form EN'()28
Worker ID $IATT
Service Type M
O\\B "".: O'l~o.al 14
hllir~lionIl41.-: Il'Jl.~I()