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Home My WebLink About98-00433 ..... .' GREGORY CHESTER . IN THE COURT OF COMMON PLEAS OF . plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA . . . v. . CIVIL ACTION - LAW . . IN DIVORCE . . . IDA MARSH : Defendant : NO. 98-433 STIPULATED COURT ORDER AND NOW, this day of Ili/'()_ , 1998, the the marital settlement n7 Ii.. Court hereby enters an order based on agreement of the parties and the stipulation of the parties: (1) Gregory Chester shall pay to Ida Marsh the sum of $125 per week for a period of seven years, until 11/20/2005, and shall pay an additional sum of $5 per week on support arrearages, which currently stand at $1015. (2) These weekly payments shall be treated as spousal support until the divorce decree is entered and thereafter they shall be treated as alimony. (3) The payment of support arrearages and alimony shall commence the week after this agreement is signed. (4) The alimony obligation shall terminate upon the death of either Gregory Chester or Ida Marsh, but the Ida Marsh's estate may recover any arrearages due at the time of her death. .' ..... (5) This order shall be enforceable by the power of this court for contempt and shall be treated also as an order of court pursuant to the support case filed as 335 S 96 and PACSES# 257000061 for purposes of any necessary wage attachment. By the Court, /I-Ii Hess Approved by: ~(~-" C.,h~tA'- Thomas M. Place Katherine C. Pearson SUPERVISING ATTORNEY Donald Marritz STAFF ATTORNEY ~ 0 l--- Shawn Bozarth, Esq. Attorney for Gregory Chester 120 South Street HarriSburg, PA 17101 (717) 232-4227 7jJ.~ /vJ(v 7f/. /J 1M b/i/.J.) Certified Legal Intern Attorney for Ida Marsh FAMILY LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 (717) 243-2968 Fax: (717) 243-3639 _ ~,,...,..~d, S/.2.'i/?.f, ....J,~ ~ .LI r- "'....h... /Y>o.a.~e<.e 5/~'1/1S-' '5.h,,"-'''' DO 2,.. II ",.., ... ~<l. - '-'(J~''- t> <r ..o,~. , GREGORY CHESTER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - IN DIVORCE v. IDA A. MARSH, Defendant NO. 98-433 CIVIL TERM PRAECIPE TO TRANSMIT RECORD To the Prothonotary: Transmit the record, together with the following information to the court for entry of a divorce decree: I. Ground for divorce: irretrievable breakdown under 3301 (d) of the Divorce Code. 2. Date and manner of service of the complaint: January 3, 1998 by certified mail 3. (1) Date of execution of the affidavit required by ~3301(d) of the Divorce Code: January 3, 1998 (2) Date of filing and service of the plaintift~s affidavit upon the respondent: January 29, 1998 4. Related claims pending: none. 5. Date and manner of service of the notice of intention to file praecipe to transmit record, a copy of which is attached: October 29, 1998 by first class mail, addressed to Shawn Bozarth, Esq., 120 South Street, Harrisburg, PA, 17101, attorney for the Plaintiff. / /.UP\t.-"lt. /771, UJu t::rU./L Niehole M. Walters itied Leg lInt m for Defendant ThomasM. PIa e Robert E. Rains SUPERVISING ATIORNEY Donald Marritz STAFF A TIORNEY Date: Novmeber 3D, 1998 FAMILY LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 (717) 243-2968 Fax: (717) 243-3639 GREGORY CHESTER, Plaintiff IN TIlE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY , PENNSYLVANIA v. CIVIL ACTION - LAW IN DIVORCE IDA MARSH Defendant a:... NO. 98-433 CIVIL '.. Certificate or Service I, Nicho1e M. Walters, Certified Legal Intern, Family Law Clinic, hereby certify ~f . &+1 I am serving a copy of the notice of intention to transmit the record on Shawn A.' Boz3r:th, attorney for plaintiff Gregory Chester, maintaining an office at 120 South Street, Hapisburg, PA 17101, by depositing a copy of the document in the United States mail, postage prepaid on this 29th day of October, 1998. '71' - '1 .,rl:""": Ir" . furl,"it: L NICh01e M. Walters Certified Student Intern FAMILY LAW CLINIC 4S North Pitt Street Carlisle, PA 17013 (717) 243-2968 . ~I 01';' n >- ~ rr; -" ..,,:1. .<. 1-- N ~..~... ILlS) ':-J ;~: 0" C)::!. VU .- J: :I~ c>- (.;~ ~-~ C:)~~-, 8" c:' s:;~~ ::10_ M i~:f.= Ii:.'" ...',. \tIUJ CJ cqu- r.:: :J:: .... Ii u. rn ::J 0 0" U . :0 .,. ~ >- q; ~':.;.: w("J c.J~~ -\.") H:;! 9,c, 0" 1.1.IL.L ~!1'1 L::;..V r.. 1.1_ o 1 ~ '.. ~ L;... ~~1 ~;S '....i ~~': ':::1 ~:~ .:'(n t;~ ~~ 11t.U ~ :.! t.l. "5 ~) c .,- ..r': '-'" '" ..:..: -, m Q' j <It " 1-' ,I- , , '''-', .,.. v-~ r0 .'" t.r,B f" ........ N ~ ;;:J 00 .......... \ P ~ ~. 0.::, -.s N "'" "<'> W l!- I;) """ -- ~~ ~~ : i';' .... 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I ,. ;:qr.,:;f,P:, , . ~ :; I,. , I':ferr ..ri:'.....i::r!.;;i1 ;,i": \, " .. ; , '. I .' . , c' " , , i , , : : -:(';1., 'j '0':' '-. ~. ,I '::'1: . '.., ~:: 'i' .{ r' " " ,:} "I ....-. -l J:;;~ '/j',v' ,t;, 'J f), ;'. ., fll. '. -' ':; , ;J i I.," ,. '_I'. J/ . ' .i;' v. : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW : IN DIVORCE GREGORY CHESTER, Plaintiff IDA MARSH, Defendan tI Counterclaimant : NO. 98-433 CIVIL TERM AFFIDAVIT SUPPORTING PRAECIPE FOR LEAVE TO PROCEED IN FORMA PAUPERIS I. I am the defendantlcountercIaimant in the above matter and because of my financial condition am unable to pay the fees and costs of prosecuting or defending the action or proceeding. 2. I am unable to obtain funds from anyone, including my family and associates, to pay the costs of litigation. 3. I represent that the information below relating to my ability to pay the fees and costs is true and correct. (a) Name: Ida Marsh Address: 32 R. East North Street, Carlisle, PA 17013 Social Security No.: 186-306510 (b) Employment If you are presently employed, state Employer: -- Address: -- Salary or wages per month: -- Type of work: -- If you are presently unemployed, state Date of last employment: October 3, 1997 Salary or wages per month: $640 Type of work: van driver (c) Other income within the past twelve months Business or profession: -- Other self-employment: -- Interest: -- Children, if any: u Name: Age: Other persons: -- Name: -- Relationship: -- 4. I understand that I have a continuing obligation to inform the court of improvement in my financial circumstances which would permit me to pay the costs incurred herein. 5. 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. ~4904. relating to unsworn falsification to authorities. .2 Date~'7 q J" .\l rP tl ./1- m(f/I,~.l Petitioner Ida Marsh r , IDA MARSH Defendant/counterclaimant NO: c . I P, -1.j.3.3 C,v,' I i i '\1 I' , Ii' ii-, ~' . ; , , I ' 1'1, . I ~ II t{, I I , v. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW IN DIVORCE GREGORY CHESTER plaintiff ABBWER AHD COUNTERCLAIM IN BQUITABLB DIBTRIBUTIOH AHD ALIKOHY Defendant/counterclaimant, Ida Marsh, by the Family Law Clinic sets forth her Answer to complaint for Divorce and counterclaim as .., .- follows: ANSWER TO 1. Admitted. 2 . Admitted. 3. Admitted. 4. Admitted. 5 . Admitted. .\ . I 6. Admitted. 7. Admitted. 8. Admitted. j , COUNTERCLAIM 9. Pursuant to Pa.R.C.P. 1920.15, defendant hereby asserts a counterclaim for equitable distribution and alimony. Count 1: Eauitable Distribution 10. Defendant does wish to make a claim for equitable ( distribution, including but not limited to pension benefits. 11. plaintiff and defendant have been unable to agree to said distribution of property. r, ~ c- ~ 'c ,.- n LJ.I.;._. (~~(1 [1: '1' ~f.,. c.., c. U,L. G~L: .L I.... lJ. o 'J' t,-,o: '- [:.; ;j ,,0- '....:'.,;..:; I~ ~l ,n: ,~ ~::! ,.~;? .' --- :~ir '.'_i (') I C:' '" :r.: (1':: C). .. " v. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW IN DIVORCE GREGORY CHESTER Plaintiff IDA MARSH Defendant NO. 98-433 ANSWER TO PRAECIPE TO TRANSMIT RECORD To the prothonotary: 1. On March 3, 1998, defendant received plaintiff's praecipe to transmit the record. 2. The praecipe to transmit the record falsely indicated that there were no related claims pending and that the divorce could therefore be entered. 3. On February 17, 1998, when defendant attempted to file her answer and counterclaim, she discovered that she needed to pay a $30 filing fee. At that time, defendant put the plaintiff on notice of her intention to file economic claims, by mailing a copy of her answer and counterclaim to defendant's attorney. 4. On March 3, 1998, defendant filed her answer and counterclaim, which included provisions for alimony and equitable distribution, along with her in forma pauperis praecipe. On the ,. f:~ ..:J' '>. ..:J ~;: .. :':-l ,-... (".! ~0 UJ:.' , , c..''''.. '. -,'" <.) .p~. " ~I I:;:;' f.;~. :.:j C) ,., , " \f.) .,., C I .:, Lt.; L._' I ..~! _J II? r . '>(j iT- iJ.: ~~:; ::JL\_ ... I n., ::'::1 <5 <f' U ., ." ',. (VI . if; ~" (~ .. I': " " ,..... ~!i =,' . . , " i-:: S .. :J <.;.',1:, \ ' ,-. r.i.... (~. L::;L ) ;::~ [}~: C.: ,.J_ , I IJ ."... '".. i .. .. 13::- ::) C) 0' U GREGORY CHESTER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACfION - IN DIVORCE v. IDA A. MARSH, Defendant NO. 98-433 CIVIL TERM PRAECIPE TO 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 3301 (d) of the Divorce Code. 2. Date and manner of service of the complaint: January 3, 1998 by certified mail 3. (I) Date of execution of the affidavit required by ~3301(d) of the Divorce Code: January 3, 1998 (2) Date of filing and service of the plaintiffs affidavit upon the respondent: January 29, 1998 4. Related claims pending: none. 5. Date and manner of service of the notice of intention to file praecipe to transmit record, a copy of which is attached: October 29, 1998 by regular first class mail, addressed to Shawn Bozarth, Esq., 120 South Street, Harrisburg, PA, 17101. Date: Nichole M. Walters Certified Legallntem for Defendant Thomas M. Place Robert E. Rains SUPERVISING ATIORNEY Donald Marritz STAFF ATTORNEY FAMILY LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 (717) 243-2968 Fax: (717) 243-3639 i; 0" N 1-' (,,1 Cl 0.:> 0' E: ,- -'} --- (.:>~ ():i.. Cl~ -..~ :-~. tn ",--:;.. ;;i-:.y !!ji:il GFJ.. :s (.) <:'J ii: ~ ,- Ll.,r,l u..,- r;'O r;-:C 9~: el'.- ~". r..lU u"": F ". o .::, - - ..:.: " . ' . GREGORY L. CHESTER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 98-433 CIVIL TERM v. IDA A. MARSH, Defendant J'RAECIPE TO DISCONTINUE DEFENDANT'S EOUlTABLE DlSTRmUTION CLAIM To the prothonatory: Please discontinue the Defendant's, Ida A. Marsh's, claim for equitable distribution that was filed on March 3, 1998 in the Defendant's answer and counterclaim. Date: \0' 2(\;~ ~IJ~ Thomas M. Place SUPERVISING ATIORNEY Donald Marritz STAFF A TIORNEY FAMILY LAW CLINIC 4S North Pitt Street Carlisle, PA 17013 (71 7)243-2968 Fax (717)243-3639 ~ C"l ~ .'='- ~ 9 ::)..... IIC) t':>t.~ b::~ - l'=-)~i~ ItC' -' (~~ "- iF. 0::: ~_. ~:':~3 c 0" LL c-: j,~ :;::;. .!.\IJ. t- ludJ EtU, w :1.10.. F- e ," lI_ co :5 Cl U' (.) " , .' GREGORY CHESTER, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW IN DIVORCE .' / KrJ711. N' hole M, Walters Certified Student Intern IDA MARSH Defendant NO. 98-433 CIVIL Certlncnte of Service: I, Nichole M. Walters, Certified Legal Intern, Family Law Clinic, hereby certify that I am serving a copy of the notice of intention to transmit the record on Shawn A. Bozarth, attorney for plaintiff Gregory Chester, maintaining an office at 120 South Street, Harrisburg, PA 17101, by depositing a copy of the document in the United States mail, postage prepaid on this 29th day of October, 1998, I I FAMILY LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 (717) 243-2968 I "lj'- " , tr. C') (; 4 - ,!: t- o ::>a;t uJ~! - ()~.;: qCl :r::. ()~t \Ere ~ c;!:? qc::., <1' ::"::0 oc'- ,'oJ ...1~ .... 5!lIJ (S;7;' t; 1.lltU .?-: 0 ~~O- 1I.. ca ::.> 0 a' rJ . ,I ~ ORDER/NOTICE TO WITHHQlD INCOME FOR SUPPORT IXl. ,~l!l-if?3 (lll/It..... Stale Commonwealth of Penn5vlvanla /)j-J(! 5,'[1:; O{~F?CldC:)Cc't:J Co.lCily/DI51. of CUMBERLAND ^t> ,r;L?~- Date of Order/Notice oal10101 v,,,- ..,~j. - .J Court/Case Number (See Addendum (or Cdse summ.lry) 00 (JrlttlnJI Onlt'r/NIIUn' o ^"ll'ndl'l' Onfl"/Nulln' o Tl'rmln.lh' Onll'r/Nnlict' EmploY(lrM'lIhh(Jlcl(~r's Fl'dl'rJI EIN NUll1ht,t GUARDSMARK INC EmployerlWllhholdN's Ndmt' STE 1000 Employt!rlWilhholder's Allcln!ss 437 CHESTNUT ST PHILADELPHIA PA 19106-2414 ) RE: CHESTER , GREGORY L, I [m"lllyt.l./Ohllttur.... NolinI' (l,I~I, f1r~l, Mil I 205-46-6571 ) EltlllluYI11,/()I,llttc1r\ Suri.II "IIemUy Nurnl)!', ) 5235000032 ) Emplnyt'I'/Ohlittnr', c'lW hlt'nllfil'r I (S.. Add.ndum for pl.lnliff n.m., mod.,.d with c...' on .It.rhmMt) ) Cu<.IUlU.II P.IO'"'.... N.lIl1l' (l.J~I, Flr..l, Mil I See Addendum (or dependent names and birth dates associated with cases on attachment. ORDER INFORMA T/ON: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonweailh of Pennsylvania, By law, you are required to deduct Ihese amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice Is not i5sued by your Slate. $ 541.67 per monlh in current support $ loa. 33 per month in past-due support Arrears 12 week5 or greater1 Oyes (Xl no $ 0.00 per month in medical supporl $ 0.00 per month for genetic test costs $ per month in olher (specify) for a lolal of $ 650.00 per monlh 10 be forwarded 10 payee below. You do not have to vary your pay cycle to be in compliance with the 5upport order, If your pay cycle doe5 not match the ordered 5Upport payment cycle, use the following to determine how much to withhold: c-' $ 150.00 per weekly pay period, ,.., $ 300.00 per biweekly pay period (every two week5). $ 325.00 per semimonthly pay period (twice a month). $ 650.00 per monthly pay period. REMITTANCE INFORMA TION: You must begin wilhholding no later Ihan the fir5t pay period occurring ten (10) working days after the date of thi5 Order/Notice. Send payment within seven (7) working daY5 of the paydale/date of withholding. You are entitled 10 dedud a fee to defray the cost of withholding, Refer to the laws governing the work slate of your employee for,the the allowable amount. The total withheld amount, and your fee, can'lot exceed 55% of the employee's/ obligor'5 aggregate disposable weekly earning5, For the purpose of the limitation on withholding, the following information is needed (See #9 on pg, 2). If remilling by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDUl Employer CU5tomer Service at '-677-676-9560 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106.9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identi(ier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: /' Date of Order: AlJO 1 3 2GOl Service Type M C o/I.JI/.eb E ~"'" ,,"I t o.\\R 1'.;0,: O~Jl0.01$~ r,t-/3 fslllr.t1ollllollr:12/Jlloo ~ ...:J7./Ll6"G' Form EN-026 Worker 10 $IATT .. ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLD~RS o If dH!c:kp.d you .m~ ff~qulrp.d 10 providl~.1 ropy of this formllJ your l!IllploYI!f!. " Priority: WllhholdlnH under lhi" Ordm/Notke hll" priority (lVI!r ,my nlhm It!g.11 proff!lilj under Sidle I.IW tlHdin!it the Sdl11P. Income. Federill tllK levies In l!ffm:1 herml! mn!ipl of this order h,IVI! priority. If IhNf~ .Ut! Ff!dm.11 I.IX h~vielj in f!f(ert ple.He conf.lct lhe requesting .sency 1I.led beluw, 2. Cornhlnll1H PdYllumlli: You r.1I1 c:omhhu! wilhl\f!ld .lInounts (rn1111110m IIMIl olle employee/obligor's income In d sinnle pdyment to each ilgency requl!slil1M withholding. You I11lJCil, howevm, liep.IrIIII!ly ichmlify tIlt! portion of t1H~ singh! pdYI11p.nt 111.11 is durihutdhle In e.ch employeeJuhllsor, 3,' -Repn"ing,the~Paydo"'JD.le of Wilhholding~-You m",t report the poydale/doteofwithholding when,ending'lhe-poymentc-The- payda",Jdate-of wlthholding'j"the dole on which umount wo, wilhheld'fmm the'employee', wages; You mU'1 comply wilh Ihe low of Ihe .tole of the employee's/ohligor'. principal plan, of employmenl wilh re.penlo Ihe lime period. within which you mU'1 implemenl the withhold inK order and forward Ihe .uppo" poymenl., 4.' Employee/Ohliw" wilh Multiple Supporl HoldinH" If Ihere i. nlOre Ihon one Order/Notice 10 Withhold Income for Support againsllhi. employee/obligor and you ore unable 10 honor "II .upporl Order/Nolice. due to Feder,,1 or Slole Wilhholding limil., you mU.1 (ollow the IJW o(the stille of el11ployee's/ohligor's principJI pl;Jn~ of p.ll1pIOYI11P.I1I. YC)U must honor oJll Orders/Notices to the greiJtest exlenl possible, (See #9 below) 5. Termination Nolification: You musl promptly notify Ihe RequestinH Agency when the employee/ohliHor i. no 10nHer working for you, Plea.e provide Ihe informalion reque'led and relurn a copy of Ihi. Order/Notice 10 the AHency idel1lified below, WITHHOLDER'S 10: 6210439700 EMPLOYEE'S/OBLlGOR's NAME: EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER, GREGORY L. 5235000032 DATE OF SEPARATION: 6. Lump Sum Payments: You may he required to report ilnd withhold (rom lump sum pJymellts such clS bonuses, commissions, or severance pay. If you have any questions about lump sum payments, conldct the person or authority helow. 7, liability: If you fail to wilhhold income a. Ihe Order/Nolice directs, you ore liable for holh Ihe occumulaled amount you should hove withheld from the employee/obligor'. income and other penoltie. .el by Penn.ylvania Slate law. Penn.ylvania Slole law govern. unless the obligor i. employed in onolher Slole, in which co.e Ihe low of Ihe Slole in which he or .he i. employed govern., B, Anli-discrimination: You ore .ubjecllo a fine delermined under Slale law for di.charging an employee/obligor from employment, refu.ing 10 employ, or taking di.ciplinary aclion again'lony employee/ohligor hecau.e of a ,uppo" withholding, Pennsylvania State law governs unless the obligor is employed in another Stale, in which case the law of the Stelle in which he or she is employed govern., 9,' Wilhholding limits: You may nol wilhhold more Ihon Ihe lesser of: 1) Ihe O"">llllt. ollnwed hy the Federal Con.umer Credit Proleclion Acl (1 5 U,S,C, 91673 (b)l, or 2) the amounts allowed by Ihe Slale of Ihe employee'./obligor'. principal place of employmen!. The Federal limit applie. to Ihe oggreHale di.po.ohle weekly earning. (ADWE), ADWE i. Ihe nel income left after making mandatory deductions such as: State, Federal, local Iclxes; Soci<ll Security taxes; and Medicare tllxes. 10, ONOTE: If you or your agenl are served with a copy of Ihis order in Ihe Slate that issued the order, you are to follow the law of the state thaI issued Ihis order with respecllo Ihese ilems, Requesting Agency: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O, BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by lelephone al (717) 240-6225 or by FAX at (7171 240-6248 or by Inlernet @ Page 2 of 2 Form EN-028 Worker ID $IATT Service Type M O.\'Bl'\u.:O'j70.0154 1'l1h.lklllO.t..; 12/JIII10 ~ r-' ~ ~ .? ~ ,... .. ~~~ ,r, C'1 ("):;.;.,. \J ...- :)~ ( 'J ~ '. (\- :~~ I'~ ., '- , , .ff) , r' ) -... .~:~:\ ': \ ' t::::: ~, ~;:: .HU . tJ~C1.. -' ~ , :::l , ' C) CJ '.' \ .. >- C:l ~ 0:; ...:J ~~ .<:: "-' ::::> -1: l t.! ~~~ (': C) =7 (':1-:-:' :c: f_1*.t L:'~~ ' .. n~ C.lS:! /'i;--:" " , r-' -'.,,, ~:~ ': ",:lZ L'~ " ,I ~ ,.leD '.J. ::Q0_ "'" .-::. 1_1_ :;:) .. I .::::- (.) - ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT -oJi..r ,JJ)' S / ht. Slale Commonwl'allh of Pennsylvania ~ Co.lClty/Dlst, of CUMBERLAND A/r'("S '>J--,>-I!t.'(.i"l1/r ( Date of Order/Notice 01/0a/03 bid. 1r/7f:-tI3~ C-ltlL Tribunal/Case Number (See Addendum for case summary) ? RE: CHESTER, GREGORY L. Employee/Obligor'S Name (lasl, flr,I, Mil 205-46-6571 Employee/Obligor'S Social Security Number 5235000032 Employee/Obligor's Caw ldenlifier (5.. Addendum (0< pia/nt/II nam.. assocJared with cases on attachment) Cuslodiall'arenl's Name (last, First. MU " o Original Order/Nolice o Amended Order/Notice <E) Terminate Order/Notice EmployerlWllhholder's Federal EIN Number GUARDSMARK INC STE 1000 437 CHESTNUT ST PHILADELPHIA PA 19106-2414 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA T10N: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania, By law, you are required to deduct these amounts from the above-named employee's!obligor'S income until further notice even if the Order/Notice is not issued by your State, $ 0.00 per month in current support $ 0.00 per month in past-due support $ 0.00 per month in medical support $ 0 , 00 per month for genetic test costs $ per month in other (specify) for a tolal of $ 0.00 per monlh to be forwarded 10 payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0.00 per weekly pay period, $ 0.00 per biweekly pay period (every two weeks). $ 0.00 per semimonthly pay period (twice a month). $ 0.00 per monthly pay period, REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after"th date'of this Order/Notice. Send payment within seven (7) working days of the paydateldate of withholding, Yo are entitled to deduct a fee to defray the cost of withholding, Refer to the laws governing the work state of your e. ployeecfor the allowable amount, The total withheld amount, and your fee, cannot exceed SS% of the employee'sf obligri?s aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See 1110 on pg. 2), If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDUl Employer Customer Service atl-B77-676-9SBO for instructions. Arrears 12 weeks or greaterl 0 yes <ID no ~. "~"'U ...., r.: . . '~ Make Remittance Payable to: PA SCOU Send check to: Pennsylvania SCOU, P.O. Box 69112, Harrisburg, Pa 17106-9112 INADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor'S Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Date of Order: Jt'&-,,,, Form EN-02B Worker 10 $IATT Service Type M CJ!. {G- ..' .. ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o II !;heckl'll you are required to l"r~lde a ~opy or Ihl. (orm 10 your em/,Ioyee, II your employe'i work. 10 a .tate thai I. dirIment from the stille IIMt Issu('( III Is orller. it ropy must he provldl'( to your (~l11plnyee even (the box Is not checked. 1. We ap",eclale the voluotary compliance o( Feder,dly r!'cognlll,llndl,Ul trlh!'., IrllJ.1l1y-ownt,1 hu.h,!'ss!'., and Indlan.owned businesses locilted on i1 rescrv.ltlOI1 lhilt d\Ons(~ to wllhhold In ilrcnnl,tn[n wllh this nnlln!. 2, Priority: Wlthholellng under Ihl. Onler/Nollc!' ,,," ",iorlly ove'r any other Ie'R,d process under St.'I!' 1,1W aR.lln.1 the .ame Income. Federal lax levies In e((ect he(ore receipl o( Ihls onl,'r h.we priority, If Ihere are Feder;,1 t;IX levl!'s In e((ecllll!'a.e conlacllhe requesllng agency IIs1ed helow, 3, Combining Payments: You can comhlne wllhheld amounls (rom more Ihan one employee/ohllgor's Income In a single payment to each agency r"'luesllng withholding, You mu.I, however, .eIJar,'lely identl(y Ihe portion of Ihe single paymenllhat Is atlrihutahle 10 each employee/obligor, 4. '-R~lng-the-paydalelElale-ofWllhholdlng:-You musl'report Ihe pnydale/dale o( wilhholding when sending Ihe pnymenlc-The- paydllleldllle-of-wllhholding-l.,thednleon which'amounl wa.withheld (rom Ihe employee" wage.,' You must comply with Ihe law of Ihe slate o( the employee's/obllgor's principal place of emllloymenl with respecllo Ihe lime periods within which you musllmplemenl the withholding order and (orward Ihe support payment., 5,' Employee/Obligor with Multiple Support Holdings: I( Ihere i. more than one Order/Notice 10 Wllhhold Income (or Support against this employee/obligor and you are unable 10 honor all support Onler/Nollces due 10 Federal or Slale wllhholdlng limits, you must (allow the law o( the slate o( employee's/obllgor's principal place o( employment. You musl honor all Orders/Nollces to the grealesl exlent possible. (See # 1 0 below) 6. Termination NotlOcatlon: You must promplly notify Ihe Requesting Agency when the employee/obligor is no longer working (or you, Please provide the in(onnatlon requesled and relum a copy o( Ihls Order/Nollce 10 Ihe Agency Idenllfied below. WITHHOLDER'S 10: 6210439700 EMPLOYEE'S/OBLlGOR'S NAME: EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER. GREGORY L. 5235000032 DATE OF SEPARATION: 7. Lump Sum Payments: You may be required 10 report and wilhhold (rom lump sum payments such as bonuses, commissions, or severance pay, I( you have any question. aboullump sum paymenls, contacllhe person or aUlhorlly below, 8, L1ablllty: I( you (all to wllhhold income as Ihe Order/Notice directs, you are liable (or both Ihe accumulaled amount you should have withheld (rom the employee/obligor's income and 01 her penalties set by Pennsylvania Slate law, Pennsylvania Stall' law governs unless Ihe obligor Is employed In another Stall', in which case the law o( Ihe State in which he or she Is employed governs, 9. Anlkllscrimlnalion: You are subject 10 a fine delermined under Stale law (or discharging an employee/obligor (rom employment, refusing 10 employ, or laking disciplinary action against any employee/ohllgor because o( a support withholding, Pennsylvania State law governs unless Ihe obligor Is employed In another Slate, in which case the law o( the Slale in which he or she is employed govems, 10,' Wilhholding Limits: You may not withhold more than Ihe lesser 0(: 1) the amounlS allowed by the Federal Consumer Credit Protection Act (1S U,S,C. ~ 1673 (b)1; or 2) the amounts allowed by Ihe State o( Ihe employee'slobligor's principal place o( employment. The Federallimil applies to Ihe aggregate disposable weekly earnings (ADWE), ADWE Is Ihe net Income lefi after making malldatory deductions such as: Stale, Federal, local taxes; Social Securily taxes: and Medicare taxes, 11. Addltlonalln(a: ONOTE: If you or your agent are served with a copy of this order in the slate that issued Ihe order, you are to follow the law of Ihe slate thai issued this order with respect 10 these items. Submitted 8y: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telephone al (717) 240-6225 or P,O, BOX 320 by FAX al 17171 240-6248 or CARLISLE PA 17013 by Inlernet www.chlldsupport.state.pa.us Page 2 o( 2 Form EN-028 Worker ID $IATT Service Type N n"B No.: lI'I1fl-OI'J4 :>- ~I a: ?: ...-:~ I'~~ -'. .'- '. ;".; U,1:"::.: ..::; ~t{::? .-. ,-):'1; -- ~~~ (;l;:.: 0... ~, ...,-:--, '7':l~ Q.(~:: .,.., ;,'(175 I .~... [['/:-.; =z: to::; j.:- v.,; "IUla ''- --: ~~!I:L (.) ,.., :'5 0 u l,t -..,... .' .- ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT '^~L . - (I ire/ U~-f- ,-,..1) -. i'" '~ State Commonwealth of Pennsylvania Co.lClly/Dlst. of CUMBERLAND 1}J."~'i'~ "("''1 tt.."..(1(;.; Date of Order/Notice 01/0B/0~ QIt.-I.!'i'l'/(''1?-,:; ('IFle Tribunal/Case Number (See Addendum (or case summary) . HI: CHESTER, GREGORY L. I:mploy('e/ObligOl's NJm~ (lasl. first. Mil (!) Oll8in.1I Order/Notice o ^m~nd('d Order/Notice o lcrmln.lle Order/Notice EmployerM'ilhholdcr's redmJI [IN NumlH'1 C&S WHOLESALE GROCERS INC 340 EMIG RD EMIGSVILLE PA 1731B 205-46-6571 lmployec/Obligor's Social Security Number 5235000032 lmll!oyrc-/ObllgOf's Case Identifier (5.. MdMdum (or pl.lnllff n.m.. e1ssoc/~'rd wllh ('.Ufl on afl.mmrnlJ Cuslexli.lIIJ.ucnl's Name (l.ut. First. MU See Addendum (or dependent names and birth dates associated with cases on attachment. ORDER INFORMA TlON: This Is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania, By law, you are required to deduct these amounts from the above-named employee'sfobligor's Income until further notice even if the Order/Notice is not Issued by your State, $ 541. 67 per month in current support $ lOB. 33 per month in past-due support Arrears 12 weeks or greaterl Oyes (Xl no $ 0.00 per month in medical support $ 0.00 per month (or genetic test costs $ per month in other (specify) for a total of $ 650.00 per month to be forwarded to payee below. ~'\7 You do not have to vary your pay cycle to be in compliance with the support order. If your'pay;cycle do'~s not match the ordered support payment cycle. use the following to determine how much' ' hhold: ' :: $ 150.00 per weekly pay period. $ 300.00 per biweekly pay period (every two weeks), $ 325,00 per semimonthly pay period (Iwlce a month), $ 650.00 per monthly pay period. REMITTANCE INFORMATION: " You must begin withholding no later than the first pay period occurring ten (10) working days ter the date'of this Order/Notice. Send payment within seven (7) working days of the paydateldate of withholding, You are entitled to deduct a fee to defray the cost of withholding, Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee. cannot exceed 55% of the employee'sf obligor's aggregate disposable weekly earnings, For the purpose of the limitation on withholding. the following information is needed (See #10 on pg, 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service atl-B77-676-9580 (or Instructions, Make Remittance Payable to: PA SCOU Send check to: pennsylvania SCOU, P.O. Box 69112, Harrisburg, Pa 17106.9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Service Type M \.~ :.-: ~~". r r~ _. "~~~ ~r " .~ cJ~f(~'-'.o9' 20'03.. OM",n,ll'llll-U'" BY THE COU~:r'------'') ...,~__~_d:... ...c,........~ .._,...~c-~ ,...-"1" " (,oiUo/ oCt) r I.II/)~;'--'{ Jl. '/.Jt'd' Form EN-028 Worker ID $IATT Date of Order: JAN - 9 2003 ot(t. ..... ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOI.DERS o I( theckl11 you are re<lulred to prr~I\le il copy u( thl, (ormlu yuur "ml'luye,', I( YUl" ,'mplu""'! work, In il 'tale Ihatl, dllfercnllrom the stale Ihilt ISSUl!< 1115 orciN, 11 (OI)Y must he provld{'{ 10 your l'lI1l1 ovee ev~n (tile hox Is not checked. 1. We appreclale the volunlary compll"nce u( Federally ,ecognl,,,'lndlan I,ih.." tril..,lIy.owm~1 hu,lm'"e" ,lnd Indlan-own"j businesses located on i1 u!servatlon thill choose to withhold In ,1CCOnl,H1r11 wllh this noll((~. 2, Prlorlly: Wilhholdlng under Ihl, Onler/Null", h... prlorily over ;my olher l..g.lI proc.." und..r Sial" 1.11'1 as,lln'lll... ,.1m" Income. Froeral tax levie, In ef(ect ue(ore recelpl of Ihl, onl,'r h.we p,iorlll', I( there ,,,e F"h'r.lII.\X levie, In d(eclllle...e conlact Ihe ,e<lue,lIng agency "'Il~' helow, ), Combining Payments: You can combine wilhheld amounl, (rom more Ih.m one employee/obligor', Income In a single paymenllo each agency re'luesllng withholding, You mu,t, however, sep;lt.,lely Idenlify Ihe portion of II,.. ,Ingle payment Ihalls allrlbulaule to each employel'loullgor, 4. "Reportinglh,,'PnydaleJDal,,'o(Wllhholdlng:-You'muslreport Ihe paydall'ldale of wilhholding when sendinglh"'payment;-The- paydaleJdatl!'ofwilhholding'ts'lh" dal" on'which amounl WllS withheld (romlhe employoe'swagl!SC You must comply with Ihe law o( the slate o( 11m employee's1oullgo,'s p,lnclpal place o( employment wllh ,e'pecllo Ihe lime pmlods wllhin which you musllmplemenllhe wilhholdlng orde, and (orward 11m ,upport paymenls, 5,' Employee/Obligor wllh Multiple Support Holdings: I( Ihere is more than one Onler/Nolice 10 Wilhhold Income (or Support against thl, employel'loullgo, and you a,e unaule 10 honor all support Order/Nollces due 10 Fromal or Slate wllhholdlng limlls, you mu,t (01101'1 the law o( the slale of employee's1obligo,'s principal place of employment, You muS! honor all Orders/Nolices to the g,eatest extent possible. (See #10 uelowl 6. Term'natlon Notification: You mu,t p,omplly nolify Ihe Re<luesting Agency when Ihe employel'louligor i, no longe, working (0' you, Please provide the In(ormalion ,equest"" and ,etum a copy o( this Onle,/Notice to Ihe Agency idenlifi"" uelow, WITHHOLDER'S 10: 5666100167 EMPLOYEE'S/OBLlGOR'S NAME: EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER, GREGORY L. 5235000032 DATE OF SEPARATION: 7. Lump Sum Payments: You may be re<lul,"" to report and wilhhold (,om lump sum payments such as uonu,es, commissions, 0' severance pay. I( you have any queslions auoullump sum paymenls, contact Ihe person 0' aUlho,ily uelow, 8, Liability: I( you (ail to withhold income as Ihe Orde,/Nolice directs, you are liable (0' uOlh Ihe accumulal"" amounl you should have wilhheld (rom the employee/obligor's Income and olhm penallies setuy Pennsylvania Slate law. Penn,ylvania State law govems unless Ihe obligo, is employed in anolhe, Stale, in which case the law o( the Slale in which he 0' she is employ"" governs, 9. Antkllscrlminatlon: You a'e subject to a fine dete,min"" unde, Slale law (or discharging an employel'louligor (rom employmenl, ,e(using to employ, or taking disciplinary acllon against any employel'louligo, becau,e of a support withholding, Pennsylvania Slate law governs unless the obligo, is employ"" in anolhe, State, In which case Ihe law of the Slate in which he or she is employed governs, 10,' Withholding Limits: You may not wilhhold more Ihan Ihe lessm 0(: 1 I the amounts allow"" uy the F""e,al Consume, C,""it Protection Act (15 U.S.C, ~ 1673 (bll: 0' 21 Ihe amounls allow"" by the State of Ihe employee's1ouligo,'s p,incipal place o( employmenl, The Federal limit applies to the aggregate disposable weekly eamings (ADWE), ADWE is Ihe net income left afte, making mandalory deductions such as: State, Federal, locallaxe" Social SecurilY ta,e" and M""icare taxes, 11, Additlonalln(o: 'NOTE: If you or your agent a'e served with a copy of Ihis order in Ihe stale thai issued the order, you are to follow the law of the state that issued this order with 'especlto Ihese items, Submitted By: If you or your employee/obligor have any queslions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N, HANOVER ST by telephone at (717) 240-6225 or P.O, BOX 320 by FAX al (717) 240-6248 or CARLISLE PA 17013 by internet www.childsupport.slate.pa.us Page 2 of 2 Service Type M o..mNu,:lIWO-01S.\ Form EN-028 Worker ID $IATT , -- ADDENDUM Summary of Cases Oil AlIachmenl Defendant/Obligor: CHESTER, GREGORY L. pACSES Case Numher 257000061 Plaintiff Name IDA A, MARSH ~ Attachment Amnunt 335 S 96 S 650,00 Chlldlren)'s Namels): PACSES Case Numher Plaintiff Name Docket Attacl,ml'nt Amount S 0.00 Chlldlrcn)'s Name(s): DOB DOB o If checked, you are required to enroll the chlldlren) Identified above In any heallh Insurance coverage available through the employee's/obligor's employment. o If checked, you are required to enroll the chlldlren) Identified above in any heallh Insurance coverage available through Ihe employee's/obligor's employment, PACSES Case Number Plaintiff Name Docket Attachment Amount S 0.00 Child(ren)'s Name(s): PACSES Case Numher Plaintiff Name DOB Docket Attachment Amount S 0.00 Child(ren)'s Namels): DOB o If checked, you are required to enroll the childlren) identified above In any health insurance coverage available through the employee's/obligor's employment. o If checked, you are required to enroll the child(ren) . identified ahove In any heallh Insurance coverage available through the employee's/obligor's employment, PACSES Case Number Plaintiff Name Docket Attachment Amount S 0.00 Child(len)'s Namels): PACSES Case Number Plaintiff Name DOB Dockel Attachment Amounl $ 0.00 Child!ren)'s Name!s): DOB o If checked, you are required to enroll the child(ren) identified above in any heallh Insurance coverage availahle through the employee's/obllgor's employment. o If checked, you are required to enroll the childlren) identified ahove In any heallh insurance coverage available through the employee's/ohligor's employment. Addendum Form EN-028 Worker ID $IATT Service Type M OMS No.: 097().()154 \ ~ . ORDER/NOTICE TO WITHHOLD INCOME FOR SUPI'ORT Slale Commonwealth of Pcnnsvlvanla Co.JClly/Dlst. of CUMBERLAND Dilte of Order/Notice 07/07/03 Trlbun,ll/Cilse Numh!!r (See Addendum (or Colse sumnlolry) o Orillin.lI Order/Notice G) Al1lel1lll'cl Ordt!r/Nollc(! o ft'lI1lln.lle Oulrr/Nnli{(' C & S WHOLESALE GROCERS 100 QUALITY CIR HARRISBURG PA 17112-9496 )/(/, 1991- (33 ftt({. 11/C!,!;{S d/j7{:oC'{Jfr./ ~I: CIIES'I'EIl , GREGORY I" I mllloyr,{'/OhIlRor'" N.lInl~ (t..l~t. flrsl. MU 205-46-6571 1,l11ploy('~/OhliKor's Soci.ll Security Number 5235000032 [mploye(l/ObllgOf's Case IclenUfier (5.. MrJ.nrJum (0' pl.lnUI( nom.. auoc/al('d with ('.:Isrs on all.mm('ntJ Cu~l()dIJIIJ.1renl's N.lmc (lasl, nrsl. MI) lmploycrJ\Vilhholcl{'f'S rcder.lI UN Numhl" See Addendum (or dependenl names and birlh dales associ,lled with cases on allachmenl. ORDER INFORMA TION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonweallh of Pennsylvania, By law, you are required to deduct these amounts from the above-named employee'slobligor's income until further notice even if the Order/Notice is not Issued by your Stale. S 541.67 per month In current support So. 00 per month in past.due support Arrears 12 weeks or greater? Oyes (ji) no So. 00 per monlh in medical support S 0.00 per monlh for genetic test costs S per month in other (specify) for a total of $ 541. 67 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: S 125.00 per weekly pay period. S 250.00 per biweekly pay period (every two weeks), S 270.83 per semimonthly pay period (twice a month). S 541.67 per monthly pay period, REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice, Send payment wilhin seven (7l working days of the paydateldate of withholding, You are entitled to deduct a fee to defray the cost of withholding, Refer 10 the laws governing the work state of your employee for the allowable amount. The total wilhheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings, For the purpose of the limitation on wilhholding, Ihe following information is needed (See #10 on pg, 2), If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDUl Employer Customer Service at 1-877-676-9580 for instructions, Make Remittance Payable to: PA SCOU Send check to: Pennsylvania SCOU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as Ihe Employee/Obligor't.<;.~if':ff!in'1l'iJJ2'i:lfIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. '1-:To _---_ . .(J'l BYTHECOU~ .,). Date of Order: .lUL 0 8 2003 ~..::.~ l ~otJ"IJ::';.l L uVILJD;\ -, Service Type M OMB No,: O'J71)'{115.1 Form EN.028 Worker 1D $IATT ... ADDITIONAL INFORMATION TO EMI'LOYERS AND OTHER WITHHOLDERS o It t{l1t!ckl'il you iHlJ rellUlrt.!I If.' IJfI'~I\'t' it l'OIIY of Ihl.. (mill 10 your (11111/110\,(11', U \lOll' l'I11III(JYlJ(I' WOlk.. ill II ';t,th11t1Mll!i 1 ( Ilferr.n' lrom lh(' ..t,lll~ tlMt l!i!illl't 111 OJ on (If, .1 C Ol)\' mll"lt hp proYle 1'( to your "fliP OY.'(I (1'1(111 , 1111' ho't( I... nol f wcket: , 1. W(! apllrccliltl' till' volunl.uy rOf11I)IIIUlCt~ of f'I'tIl'r.ll1y flIfOHIII/C'1llmlli!fl trill.I" trUMlly.oWlll'lI hll"iII1lI!t!il'l.ot .ulll hllll.m.owI1I'd businesses 10C.lll'tl on .1 tI'!iI'rv.ltlnn Ilhlt dlllow 10 \\'lIhholtlln ,uTord.lI11-11 Wilh lhl... nollrt', 2. Priority: Wllhholdlnn ulHh~r 1111... Onllll/Nolln' l"'Ii IIrlority OVI" .my ollwI II'H.IIII1OU'\"I lIndt'! SI.III' tiny .In.IIl,...llllI' 1j,1I11l' lnrunw. F~rCr.11 1.1)( lev I (IS In c(fcft In1fml' fI~n~lpl of Ihi!! nnll., h.1\'11 priority. If IIll'rl' IUl' h'fh1rllll.l'-' lI'vil's In l'ffl'rt ph'II'JC' ('onll1(1 Ihl! U!(llIl!stlnn ~gency lI,tl~1 below, 3. ComhlnfnR Payment,,: You Cllf1 cornhirll' wilhlwld IUl10unls (rnI11I1101t' Ihlm 0Ill' 1'l11lllnYlll'/ohllnor'!i Income In .1 ShlKll! p'lYl11cnllo each agcnlY f'CIIUcsUng withhold In>>. YOUl11usl, hm,\'I!Vl'r, SI!IMr.tlely idl'nlify tlw IHution of Ihl! !tiI1KIt' IMyrnent Ilhllls itUrlhutabll! 10 c,lch employro'obllgor, 4. "Repo~ing,the Paydate'Dnte of Wllhholding:'-You mu,t It'pO~ Ihe payd~I"/d~le of withholding when ,ending Ihe pnyment;- The- pnydntl'ldnteof withholding i. Ihe dale on whichl1mounl Wi" withheld from Ihe emploYl"'" w~ge" Yr.UIl""t comply wllh Ihe I~w of Ihe st~le o( Ihe employee's/obligor's prlllcillal pl~cc of emploYIl,"1l1 wllh re'pecllo 11ll' lime 1""lod, wlthlll which you mU'llmplemenllhe withholding onler ~nd forw~rd the ,uppo~ p~ymenl', 5.' Employee/Obligor wllh Mulllple Support Holdings: If Ihere Is more Ihall olle Onler/Nolice 10 Wilhhold Incol11e for Suppo~ against Ihls employee/obligor and you are unable to honor all ,uppo~ Onler/Nolice, due to Feder,llor Stalc wlthhnldlng limits, youl11ust (ollow Ihe law of Ihe 'Iale o( el11ployee's/obligor's principal place of emplnyment. You mu,t hnnor all Onlers/Nolices 10 Ihe glt'ale'l exlellt possible. 15"" # 10 below) 6. Termlnallon Nollficallon: You musl promptly nOlify Ihe Re'luesling Agency when Ihe el11ployee/obligor Is nn longer working for you. Please provide Ihe Informalion requested and relum a copy of Ihis Onler/Nolice to the Agency Idenllfil~1 below, WITHHOLDER'S 10: 7665100199 EMPLOYEE'S/OBLlGOR'S NAME: EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER, GREGORY L. 5235000032 DATE OF SEPARATION: 7. Lump Sum Paymenls: Youl11ay be required 10 repo~ and withhold from lump SUI11 paym"nts ,uch as bonuses, commissions, or severance pay, If you have any 'Iue,lion, aboullump sum paymenls, colllacllh" per",n or ~ulhorlty below, 8, Liablllly: If you fall 10 withhold income as Ihe Order/Nolice dlrecls, you are liable fur bolh Ihe accumulated amount you should have withheld from Ihe employee/obligor's Income and olher pen~ltles sel by Pennsylvania State l,lW, Pennsylvania Slate law govems un Ie" Ihe obligor i, employed In anolher State, In which ca,e Ihe law of Ii," Slate in which he or ,he I, employed govern" 9, Anll-dlscrlminallon: You are ,ubject 10 a fine delermlned under Stale law for dl5Charglng an employee/obligor from employment, refu,ing to employ, or taking dl,ciplinary aClion again't any employee/obligor beca",e of a ,uppon withholding, Penn'ylvanla State law govern, unless the obligor Is employed In anolher Slate, In which case Ihe law of Ihe Slale in which he or ,he Is employed governs. 10,' Wllhholdlng Limils: You may nol wilhhold more Ihan the lesser of: 1) Ihe amounts allnwed by Ihe Federal Consumer Credit Proteclion Act (15 U,S,c. ~ 1673 (bl1; or 2) Ihe amounts allowed by Ihe Slate of Ihe employee's/obligor's ",Incipal place of employment. The Federal limit applies 10 Ihe aggregale disposable weekly earnings IADWE). ADWE Is Ihe net Income lefl after making mandalory dedudions such as: Slale, Federal, local taxes; Social Security taxeSi and Medicare taxes. 11, Additional Info: . NOTE: If you or your agent are served with a copy of Ihis order in Ihe state that issued Ihe order, you are to follow the law of the slate Ihallssued this order wllh respect to Ihese lIems, Submitted By: If you or ynur employee/obligor have any queslions, DOMESTIC RELATIONS SECTION mntact WAGE ATTACHMENT UNIT 13 N. HANOVER ST hy I"'ephone al (717) 240-6225 or P,O. 80X 320 hy fAX at /717\ 240-6248 or CARLISLE PA 17013 hy inll'roet www.chlldsupport.state.pa.us , : , ! , Page 2 nf 2 Service Type M o.\\1J Nil,: It'IlIHIIH Form EN-028 Worker ID $IATT , , In the Court of Common l'lens of Counl~'. I'ennsylvllnln CUl\lImRI.ANIl Ilom~..nc IIEI.ATIONS SEenON 1.\ N. IIANIII'EII ~,., 1',0. nox .\lO, CAllUS"':, 1',\. 1701.1 l'I1one: (717) 240.6225 t'nx: (717) 240.6248 Ocl'cndanl Namc: GREGORY L. CIIESTER Mcmbcr ID Numbcr: 5235000032 I'rnsc nole: All ('orr~l)(md(,l)('e 1111L'" Indude Ihl' !\Irmher If) Numher. MODIFIED ORDER OF ATIACHMENT OF UNEMPLOYMENT BENEFITS f!!l'liff Name IDA A. HARSH Financial Break Down of Multlole Cases on Attachment I'ACSES Dodel Case Numher Numher 257000061 98.433 CIVIL $ ~ $ $ ~ $ AlI:lchmenl Arnount/Freuuencv s41.67I.MONTn ~ / i ~ / / TOTAL A1TACIIMENT AMOUNT: $ 541.67 Now. by Order of Ihis Court, the Department of Labor and Induslry, Bureau of Unemployment Compensation Benefits and Allowances (BUCBA), is hereby directed to auach the lesser of $125.00 per week, or 50.0 %, of the Unemployment Compensalion benefits olherwise payable to the Defendant, GREGORY L. CHESTER Social Securily Number 205-46-6571 , Member ID Number 5235000032 . BUCBA is ordered to remilthe amount auached to the Departmenl of Public Welfare (DPW). DPW shall forward Ihe amounl received from BUCBA 10 the Domestic Relations Section of this Coun for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Couns for support and/or support arrearage, DPW may reduce the amount attached under this Order so that the 10lal amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U,S,C. ~ 1673(b)(2) and 23 Pa. C.S. ~ 4348(g), This Order shall be effective upon receipt of the notice of the Order by the BUCBA and shall remain in effect until the Defendant's entillement to Unemployment Compensation benefits, under the Application for Benefits dated MAY 27. 2001 is exhausted. expired or deferred, BUCBA shall comply wilh this Order. unless it is amended or vacated by subsequent Order of this Court. All questions. challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Coun, BY THE COURT Date or Order: JUL 0 8 2003 ~ C u.U/r)'() JUDGE t:f.>unU,/> Service Type M FornI EN.034 Worker ID $IATT ;, >- ... ~ 0:; - N 1;:: .. ;:: t':JQ ..:1 ::J:< ,-) -~ (. r~ .:'"-\2" G:."," c: '- ~;: '_1. ~._ '.l::>: 9(." cr.) ,_..,.~ 01:: j~ U.II.J. I .,; u!lll :::i 'f{' .~ U LO f-. =1 ;y, a.. '5 u. M - 0 ::J Cl (.) Sc:a n.l')E.' d " ~I.: CHESTER, GREGORY L, 1,1I1ploYI'('/OhllKOf'S N.lIne ll.ast. nrst, Mil 205-46-6571 '-mploYf'I!/OhIiKnr's Sodll Security Number 5235000032 [mplnv~{'/Ohligm's else IdentifjN IS.. Arld.ndum (or pl.ln/lf( n.me. dssoc/.,...d wlfh CdSpS on attachmrnt) Custodial P.lrcnl's NJme (lasl. fIrst. Mil I , ORDER/NOTICE TO WITHHOlD INCOME FOR SUI'I'ORT Slale Commonwealth of Pennsvlvanla Co.lClty/Dlst, Ilf CUMBERLllND Date of Order/Notice 07/10/03 Tribunal/Cas!! Numher (See Addendum for C,15e sumnlo1ry) [mf1loyerlWllhholder's red(~r.11 [IN Numbl" C & S WHOLESALE GROCERS OLD FERRY RD PO BOX 821 BRATTLEBORO VT 05302-0821 tJ/. 119f-1YHYIM.. ()It~'i) ;J5W)(){j~fr.1 <9 OllRIIl.ll (hcll.,/Nnli( l' o Al11l'nclf'11 Oull'r/Nflllce o I1'IIll111011l' Orlll'r/Nullte See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA TlON: This Is an Order/Notice to Withhold Income (or Support based upon an order for support from CUMBERLAND County. Commonweallh of Pennsylvania, By law. you are required 10 deduct these amounts from the above-named employee'sfobllgor's Income until further notice even If the Order/Notice is not issued by your State. $ 541.67 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater1 Qyes @ no $ 0.00 per month in medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 541. 67 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 125.00 per weekly pay period. $ 250.00 per biweekly pay period (every two weeks), $ 270.83 per semimonthly pay period (twice a monlh). $ 541 .67 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice, Send payment within seven (7) working days of the paydateJdate of withholding, You are entitled to deduct a fee to defray the cost of withholding, Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of Ihe employee'sf obligor's aggregate disposable weekly earnings. For the purpose of Ihe limitation on withholding, the following Information is needed (See #10 on pg. 2), If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDUI Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCOU Send check to: Pennsylvania SCOU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's.p~./ee!JCWW ~9EIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. ~ '7 -/1-0 ~ BY THE COU : Date of Order: JUll 1 - C Ot<.J I~KtJ Service Type M OMB No,: 11"70.01 'i~ ;JVlJ~ Form EN-028 Worker ID $IATT , ... ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o II d1Ockl'j1 you mo n"lulr..llo prfl~lllo "j'oPY of Ihl, (mill III your "IIlI'loy",', If YOI" "lIlpIOl"'" wmk, In.. ,1,'10 Ihat I, dlffcrcnllrorn t1w liMit! lI1.1llsSlU~ 1l1!i on (lr, ,I fOpy II1ml ht. provicl(lt 10 your (Imp OY(1(' (lVlllllf 11\1' hox is nol chccked. 1. We i1flpr~c111tc the volunlmy ClIllllJlli1l1n! or Ffld(I,.ll1y w('oJV11/11c! Indl.1I1 trlhllS, lrih.lIly.owrwd hushwlj'i(!s, iHld Indlill1.owrwd businesses located on i1 n~S(!rvi,lInn Ih.lI rhoosl11o wllhlHllcf In iHTorcl,lI11'C' wllh lhl", Ilolln., 2, PrlorllYI Withhold log und", Ihl, Onl,'r/Nollfl' h.IS prlmity ov"r ,lilY 1l111l'r 10g.,II""fl'" lJIull'r 51,\1" I.,w ,'g"Ir"I 1110 ,,111l0 In como, Federall.l)( levies In effect heron.! u!Cl!lpt of Ihls onfl'r h.lVPIJ,inrily, If lIWfP iUl' fl'tler.,1 t,l:< h~vlt's In (1(((lclfJlLwil! (Onl.lCllhc rcctucsllng agoncy Iisled below, 3, Combining Payments: You can colllhlrll' withheld ilJllllllnl' (rom lIlon' Ih,lll 0Ill' "Illploy,','/ohllgm's InCOllll' In a ,Ingll' p,1ymenllo each agency requesllng withholding, YOUIllIl,I, howl'wr, 'l'p,",IIl'ly Idl'nll(y Ih,' portion 01 1Ill' ,lrlgh, p,\YIlll'nllllolll, ..ltrlhul,1hle 10 each employel'lohllgor. 4, '-ReportingthePaydall'lDale ofWlthholdlng:-You mll,t "'port the paydate/dale of withholding when',endlng the payment;-The- pnydateldateofwithholding'j, the date onwhich amount wa, withheld from the employee', wagesl' You mllsl comply wllh Ihe law of the stale of the employee'slobllgor's princllJal place o( employmenl wllh respecllo Ihe IIl11e periods wllhln which you must Implemenl the withholding order and (OIwanllhe support paymeols. 5,' Employee/Obligor wllh Multiple Support Holdings: If Ihere Is more Ihan one Ordl'l/Nollce 10 Wllhhold Income for Support againsl this employee/obligor and you are unable 10 honor all support Order/Nollces due to Federal or 51 ale wlthholdlog IImll', you musl (ollow the law of the stale o( employee'slobllgor's principal place of employment. You l11ust honor..1I Onlers/Notlces to the greatesl exlent possible, (See #10 below) 6. Termination Notification: You must promplly nollfy the Reque'llng Agency whenlhe l'mployee/obllgor Is no longer working for you, Please provide the Informallon requested and return a copy o( Ihls Onll'l/Nollce 10 Ihe Agency Idenllfied "elow, WITHHOLDER'S 10: 0411409500 EMPLOYEE'S/OBLlGOR'S NAME: EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER, GREGORY L. 5235000032 DATE OF SEPARATION: 7. Lump Sum Payments: You may be required 10 report and wllhhold from IUl11p sum paymenls such as bonu,es, commissions, or severance pay. If you have any queslloos aboullump sum paymenls, contacl the person or aUlhorlty below, a, Liability: II you fall 10 withhold Income as Ihe Order/Notice dlrecls, you are liable (or hoth Ihe accumulaled amounl you should have wllhheld from Ihe employel'lobllgor's Income and olher penallles set hy Pennsylvania Slale law. Pennsylvania Stale law governs unless Ihe obligor Is employed 10 anolher Stale, In which case the law of the Slale In which he or she Is employed governs. 9, Antl-discrimlnalion: You are subject to a fine detl'lmlned under State law for discharging an employee/obligor (rom employment, refusing to employ, or laking disciplinary acllon against any employel'lohllgor because o( a support wllhholding. Pennsylvania Slale law govem, unless the obligor is employed in another Slale, In which ca'e Ihe law o( the State In which he or she Is employed governs, 10." Withholding Limits: You may not withhold more Ihan the le"er of: 1) Ihe amounls allowed by Ihe Federal Consumer Credit Prolection Act (1 5 U,S,c. ~ 1673 (b)1; or 2) Ihe amounls allowed by Ihe Slale of the employee'slobligor's principal place of employmenl, The Federal limit applies 10 Ihe aggregale disposable weekly earning' (ADWE). ADWE Is Ihe net income le(t a(ler making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. 11. Additionalln(o: "NOTE: If you or your agenl are served with a copy of this order in the slate Ihat issued the order, you are to follow the law of the slale thai issued this order with respect to these items, Submilled By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N, HANOVER ST by telephone at (717) 24().622S or P.O, BOX 320 by FAX al (717) 24()'624R or CARLISLE PA 17013 by inlernet www.chlldsupport.state.pa.us Page 2 of 2 Form EN-02a Worker ID $IATT Service Type M OM8 Nu,: U'J70-1II'i4 , i '\' I, , I: ' It,t , ' , '. I ~ !{ , i ! I I :, i I 1 , I ., I j , , \ if ! I I .( I~ it 1,/'.. I": \',: I' , L', . J':{,: . ',,~' k;'~ , I \ I \ I 1 I I I I I , I i I ....,,:..l p',,:)U U''='.::IS -- C') ,- b; c,' 1::: .-:'- ~ :-J:..:: I.. M C' :~3fi uj.,': <...,.....; :-::: _~.l . ;.~l~ ~~- . c..- 1.I_ft- 0,':, - .;-:ij; G?\-~: '~l/- I'..J~ '~- -' -' :"jl(Q U:~r-l :::> :no.. r:.: ...., ~. ,< U.. C") -.:> 0 0 D ',' ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania CoJClly/Dlst. of CUMBERLAND Dale of Order/Nolin' 00/13/03 Tribunal/Case Numher (See Addendum (or (',1se summary) R[: CHESTER. o Orlgh1.l1 Olllcr/Noller. o Amended Onler/Nolke @ hmnln.lle Order/N()li((~ C & S WHOLESALE GROCERS OLD FERRY RD PO BOX 821 BRATTLEBORO VT 05302-0821 ;I)! /9Jf - ~~ ('/1//(. /Jde<;g ,;z~760 CJ 0& I GREGORY L, I.mployeetObUKor'. N,lmell.,.I, I.Irs\, Mil 205-46-6571 [mplovc('/ObIlKor's Soci.11 S('curlty Numher 5235000032 [mployeI'/ObIIRor'!i CdSt~ Identifier (5.. Add.ndom (or pl./nllf( n.m.. aSJocldlpd with C.Utt. on .U.chmMIJ CU!.lodlJl f'.lrenl's Name (li151, First. Mil EmployerlWilhhohh!I'S l'ecll'l.lI [IN NUl1lln', See Addendum (or dependenl names and birth dales associaled with cases on allachment, ORDER /NFORMA TlON: This is ,1n Order/Notice 10 Wilhhold Income for Support based upon an order for support from CUMBERLAND Counly, Commonweallh of Pennsylvania, By law, you are required 10 deduct these amounls from the above-named employee's!obligor's income until further nolice even if Ihe Order/Nolice Is not Issued by your State, $ 0,00 per monlh in currenl support $ 0,00 per monlh in pasl-due support Arrears 12 weeks or greaterl Qyes <&:l no $ 0 ,00 per month In medical support $ 0 . 00 per month for genetic lest costs $ per monlh In other (specify) for a total of $ 0.00 per month to be forwarded to payee below. You do not have to vary your pay cycle 10 be in compliance with the support order, If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to wilhhold: $ 0,00 per weekly pay period, $ 0.00 per biweekly pay period (every two weeks), $ 0.00 per semimonthly pay period (twice a month), $ 0.00 per monthly pay period, REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring len (10) working days after Ihe dale of this Order/Notice, Send payment within seven (7) working days of the paydateldale of wilhholding, You are entitled to deduct a fee 10 defray Ihe cost of withholding, Refer to the laws governing the work slate of your employee for the allowable amount, The tolal wilhheld amounl, and your fee, cannot exceed 55% of the employee's! obligor's aggregate disposable weekly earnings, For the purpose of the limilation on withholding, the following information is needed (See #10 on pg, 2), If remilling by EFl/EDI, please call Pennsylvania Slate Coli eel ions and Disbursement Unil (SCDU) Employer Customer Service at 1-877-676-9580 for inslructions, Make Remittance Payable to: PA SCOU Send check to: Pennsylvania SCOU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Idenlifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. ~":'l' ' r.~n r1' .1. ! ~I,iAl~y THE COURn-::-- _/ .tJ~ ~ 4',;.,...., --- '~~. Dale of Order: '" I~ 1 3 . t=/J''''H-KI.) Co Service Type M O"lBNlI.:II'J7lHII.l.1 Form EN-028 Worker 10 $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o I{ dwckc/I vou ~rc re'lulred to l"I'~I\le ~ ropv of Ihls (orm 10 vour ~ml'loV"l" I( VO\" ('mplove~ works In ~ st.lle Ih~t Is (Ilfml.'nt rom Ihe stall.' IIM1 Issue( IIlls ortler, il copy must hl! provldl'( 10 your emp aycc CV(!1l If llll.' box Is not c11(~ckll{1. 1, We ~Ilprecl,'le Ihe volunt~ry rnmllllanc!! o( F"ler"llv "'coRllll<~IIf1{II.lI1lrlhes, trllJ.llIv.owncd husln!!sses, ~nd Indl~n.owned businesses locilled on a rcserviltlnn lhitl chnO!>I~ 10 withhold In ,If((Jrtl.II1((~ wllh this nolln!. 2. Prlorlly, Withholding uOlI<'l this Onler/Nolin' h~~ prloritV ov!!r .mv olher leg~lllro(ess und!!r St~1c 1.1W ~g~inst the s~me income, Fcderallax levies in e((ccl bl.'(or(~ WCl~lpt of this melt!r l1itve priorlly. If llH'rl.' .U(! r(~dl.'r,lIlil)( levies in effect please conlaCI the requesting ~gencv IIstl~1 helow, 3. Combining Paymenls: You (an mmhlne wlthl1l'ld amounts (rom more lI",n OOl' cmploye,'/ohllgor's Inenme In a single p~ymenllo each agency re'luesling withholding, You must, howeVl'r, Scp.1r.llely Idenlify the portion o( Ilw slngl!! paymenllh,'lls allribulable 10 each employee/obligor, 4, '-Reporting Ihe'Paydalc/Dale of Wilhholdlng:"Youmusl "'port the payd~le/d~le o( wilhholdingwhensendinglhe'paymenl;-The-- paydaleldaleof wilhholding'is the dale on which amount waswlthhehHmm Ihe employee's wages; You musl comply with the law of Ihe stale of the employee's1obllgor's prlnclpallll~ce o( employmenl wilh respeclto Ihe lime periods within which you must Implement Ihe withholding onler and forward the support payments, 5,' Employee/Obligor wllh Multiple Support Holdings: If Ihere is more than one Onler/Nolice to Wilhhold Income for Support against Ihls employee/obligor and you arc unable to honor all support Order/Nolices due to Federal or State wilhholdlng limits, you must follow the law of Ihe stale of employee's/obllgor's principal place of employment. You must honor all Orders/Nolices 10 the grealesl extenl possible, (See #10 below) 6. Termination Notification: You must prompliy nolifV the Requesling Agency when Ihe employee/obligor is no longer working for you, Please provide the Infoonatlon requested and relurn a copy of Ihls Ooler/Notice 10 the Agency idenlified below. WITHHOLDER'S 10: 0411409500 EMPLOYEE'S/OBLlGOR'S NAME, EMPLOYEE'S CASE IDENTIFIER, LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER. GREGORY L. 5235000032 DATE OF SEPARATION, 7, Lump Sum PaymenlSl You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum paymenls, contact the person or aulhorily below, 8, Liability, If you (all to wilhhold Income as Ihe Order/Nolice directs, you are liable for both the accumulated amounl you should have wilhheld from the employee/obligor's income and other penalties set by Pennsylv.lnla SlalC law. Pennsylvania State law governs unless Ihe obligor is employed In another State, In which case the law of the Stale In which he or she Is employed governs, 9, Anll-dlscrlmination: You are subject to a fine determined under Slate law (or discharging an employee/obligor from employmenl, refusing to employ, or taking disciplinary aClion agalnsl any employee/obligor because of a support wilhholding. Pennsylvania State law governs unless Ihe obligor Is employed in another State, In which case the law of the Slate In which he or she is employed govems, 10,' Wilhholding L1mitSl You may nol wllhhold more Ihan Ihe lesser of: 1) the amounts allowed by Ihe Federal ConsumerCredil Prolection Acl (15 U,S,c. ~1673 tb)l; or 2) Ihe amounlS allowed by Ihe State o( the employee's/obligor's principal place of employmen!. The Federallimil applies to the aggregale disposable weekly earnings (ADWE), ADWE is Ihe nel income lefi afier making mandalory dcduclions such as: State, Federal. local taxes; Social Security taxes; and Medicare taxes. 11, AdditionallnfOl 'NOTE: If you or your agent are served with a copy of this order in Ihe state that issued the order, you are to follow the law of the state that issued this order with respect to these items, Submitted By, If you or your employee/obligor have any quesllons, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N, HANOVER ST by telephone al (717) 240-6225 or P,O, BOX 320 by FAX al (717) 240.6248 or CARl.ISLE PA 17013 by inlernet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Worker 10 $IATT Service Type M {)~\IINu.:1I')7I1-OI.'i" .. '. ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT o 01l81n.,1 Ordor/Nnllro o Am('ndcd Of(II~r/Nollce o T('rmlnille Ordrr/Nollc(' Stale Commonwealth of Pennsvlvanla Co.lClly/Dlsl. of CUMBERLAND D.111! o( Order/Notlc:e 08/13/03 Trihunal/C.ISI! Nurnht'r (See Addendum (or case summ.1rY) HI: CHESTER , GREGORY L. [llljJloYl'('/OhIIRor's N.mll~ (I.a~l, rlrsl. Mil I.mploy"rNv'ilhh()lcl('r'~ I (.tlN.111IN NUl1lhN DFAS CLEVELAND CENTER' C/O DFAS CODE L GARNISHMENT OPS PO BOX 998002 CLEVELAND 011 44199-8002 205-46-6571 [",ployce/Obllgor's Social Security Number 5235000032 lmploycc/Obllgor's Cue Idcnllfjer (5.. Add.ndum (or plalnllff nam.. dssoc/illed with CdStlS on attachment) Cuslexlial Parent's Name llast, First, MI) W. /99'i -(33 tit'lL. /l'kf~~ ~ :,('5"7 {J()O{;fr I See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA TION: This Is an Order/Notice 10 Wilhhold Income (or Support based upon an order (or support from CUMBERLAND County, Commonwealth of Pennsylvania, By law, you are required to deduclthese amounls from the above-named employee's!obligor's income until further notice even if Ihe Order/Notice is nol issued by your Slale, $ 541.67 per month in currenl support $ 0.00 per monlh in past-due support Arrears 12 weeks or grealer? 0 yes <ID no $ 0.00 per monlh in medical support $ 0.00 per monlh for genetic lesl cosls $ per monlh in olher (specify) for a lolal of $ 541. 67 per monlh 10 be forwarded 10 payee below. You do not have 10 vary your pay cycle to be in compliance wilh the support order, If your pay cycle does not match the ordered support paymenl cycle, use the following to delermine how much 10 withhold: $ 125.00 per weekly pay period, $ 250.00 per biweekly pay period (every two weeks). $ 270.83 per semimonlhly pay period (twice a month), $ 541.67 per monthly pay period, REMITTANCE INFORMATION: You must begin wilhholding no later Ihan the (irsl pay period occurring ten (10) working days after the date of this Order/Notice, Send payment wilhin seven (7) working days of Ihe paydaleldale of wilhholding, You are entilled to deduct a fee to de (ray Ihe cosl of wilhholding. Refer to the laws governing the work Slale of your employee for Ihe allowable amount. The total wilhheld amounl, and your fee, cannot exceed 55% of the employee's! obligor's aggregate disposable weekly earnings, For the purpose of the limitation on withholding, the following information is needed (See #10 on pg, 2), If remitting by EFT/EDI, please call Pennsylvania Stale Collections and Disbursement Unit (SCDU) Employer Cuslomer Service aI1-877-676-9580 for instructions, Make Remittance Payable to: PA SCOU Send check to: Pennsylvania SCOU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Dale of Order: AUS 1 3 2DIl3 ,..~THECOU . -7;1/.{J3 , E.<J{ ul4.,cf.) c: JV ~t=: Form EN-028 Worker 10 $IATT Service Type M OMB No.: O'Jl(){)154 , I~,.~ n "~I ,\ pi::tULJE'OS; >;: ." ~ -, s? u:. :;-: 1.-. (.~ :'1..1': II I~' -: ")~ <-y. '- Z .PC"": - '~';z,: r',:-i' -. "Ji. ;'''l~ '- ( . ,'5- 2~ ~:' ... ",'4 );;- LU' ',:-;;, ;E~L;~. t:. .1J1.0 j-:': ;::J r,nn.. ..... .... ~!: II. ,:--') :-.> .0 0 (.) ~ 'r .. .. ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o If ~hecked you ,1tI' rellulrell to Ilrl'~I\h'.. fOpy of this (ormlo your ~ml'loy"e. If YOI" emplove~ works 10 a st.lle Ih..t Is lfill~'C'nt lronl 1Ill! sliltl! lhill Issucc I" S onll'I, it COI)Y must he provldl1( to yuur ern I' ayec ev~n j( tile box Is nul dlC(k~I. I. We allllred..te the volunt.uy compliance o( Feder,llIy recognlll'1I Inlllan trllll's, Irlllollly.()woell hush1l'sses, ..oil lolllan-ownell businesses IOCill~1 on i1 n~servi1tlon Ihill (hoo~c 10 withhold In i1((Ord,lnCl~ with tills notice. 2, Priority: Wllhhollllng under Ihls Order/Nollce h.1S priority over ,my other leg,lll,ron,ss uoder SI.lle I,lli' ag,llnsllhe s.lme Income, Federal lax levies In e(fcct br.(ore receipt of Ihls ordN hiWC prlorily. If them lire F(ltlerill f,IX levies In e(((lcl ph~il5P contact the rc(!uestlrlR agency IIsled below. 3, Combining Payments: You c.ln combl",' wilhheld amounls from more liMn one emploYl','/ohllgor's Income In ,1 single p..ymenlto each agency requesllng wllhhollling, You musl, however, sep,,,..tely id,'nli(y 1111' ponlon of the shlsle p,'ymeollh,,'ls allribul,lble 10 each employee/obligor, 4, "Reponing,the Paydnle/Dale o( Wlthholdlng:-You mu,t "'pon the ,>nyll,,'e/llnle o( wilhholding when ,ending thepnymenl;-The- paydateldateofwlthholdlng'i, the dnle onwhlchnmounl wn,wlthheld(rom the employee" wng"', YOUl1lust comply wllh the law o( Ihe stale o( the employee'slobllgor's principal place o( employment with respecllo Ihe lime perlolls within which you mustlmplemenlthe withholding order and (orw..ollhe suppon payments, 5,' Employee/Obligor with Multiple Support Holdings: I( there is more tlMn one Order/Nollce to Wilhhold Income (or Support against Ihis employee/obligor and you a'" unable to honor all suppon Ooler/Notlces lIue 10 Federal or Stall' wllhholdlng 11m lis, you must (olioII' Ihe law oi Ihe slate o( employee's/oblillor's principal place of employmenl. You must honor all Omers/Notlccs to Ihe g",..teslextenl possible. ISee # 1 0 below) 6, Termlnallon Nolllicatlon: You musl promptly notl(y the Requesllng Agency when the employee/obligor is no looger worklog (or you. Please provide Ihe In (ormation requesled and relurn a copy o( this Order/Notice to the Agency Ideotlfled helow. WITHHOLDER'S 10: 2491016300 EMPLOYEE'S/OBLlGOR'S NAME: EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER, GREGORY L. 5235000032 DATE OF SEPARATION: 7, Lump Sum Payments: You may be ,equlred 10 repon and wilhhold (rom lump sum paymenls such as bonuses, commissions, or severance pay, I(you h..ve any questions ..boullump sum payments, conlaCllhe person or aulhorlly below. 8, Liability: If you (ail to withhold income as the Ooler/Nolice dlrecls, you are Ii..ble (or holh the ..ccumulated amount you should have wilhheld (rom Ihe employee/obligor's income and other penallies sel hy Pennsylvania Slate 1..11'. Pennsylvania State law govems unless Ihe obligor is employed In another St..te, in which case Ihe ,..11' of Ihe Slate In which he or she is employed governs, 9. Antkllscrimination: You are subjecI to a fine delermlned under St..te law (or dlscharglng..o employee/obligor (rom employment, refusing 10 employ, or laking disciplinary ..ctlon ..gainst any employee/obligor because o( a suppon withholding, peonsylvania Slate law governs unlesslhe obligor is employed in ..nother St,,'e, In which case Ihe law o(the 51..11' In which he or she is employed govems, 10,' Withholding Limits: You may not wllhholcl more Ihan the lesser 0(: 1) Ihe amounts allowed by the Fede",1 Consumer Credll Protection Act (15 U,S,c. ~ 1673 Ib)1: or 21the ..mounls allowed by Ihe Slate o( Ihe employee's/obligor's princip..' place of employmenl. The Federallimil applies to Ihe aggreg"le dispos..ble weekly earnings IADWE), ADWE is Ihe nellncome le(1 afler making mandatory deductions such ilS: State, Federal, local taxes; Social Security taxcs; and Medicare tilXCS. 11. Additionalln(n: 'NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are 10 follow the law o( the slate Ihat issued Ihis order with respect 10 these items, Submitted By: DOMESTIC RELATIONS SECTION 13 N, HANOVER ST P,O. BOX 320 CARLISLE PA 17013 I( you or your employee/obligor have any questions, contacl WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX al (717) 240.6248 or hy inlernel www.childsupport.slate.pa.us p,'ge 2 o( 2 Form EN.028 Worker ID $IATT Service Type M ()"-HS No.: lI'I70(lI"~ .... j ~\ peuuE'OS >- ..:/. ~ r.r; U~ j:S Z uJr7~ c.- :.?-::!: 0<'" Uz [1=.... I:..... I,J~ f)~.:. :-,~ j ., ~ 0>- C"'f' ..::' ..-./f/) -'-,' .:~l/": (t.." ._J r' .-, \.1. , c..!:; i..:1{O , ...., jOH ." n71cl.. ~ Ll. ~'''J :::1 0 .::;> 0 ',. \ \ \ \ '<. ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 0011&in,'101lIer/NllliC(, <S) A"U'lUhltl OItIt'f/Nnti((~ o 1cllnln.,lt10IfII'f/No\lcr State sommonweallh 01 Peno..lvanla. Co.lClty/Oist. of CUMBERL/lND Date of Order/Notice 09/02/03 Tribunal/Case Number (See Addendum (or case summary) RI: CHESTER GREGORY L, [",ployc~/Ohll"CJI'!J N.lIn~ I\.J~t, rlr5t, flr\ll lmploycrNvithhohler'!j, relleri" [IN Numlnll 205_46-6571 (InployeeJOullgor'!t Socii'll Sllcurity Numher 5235000032 Employee/Obligor's Case Itlentlfier (5.. Add.ndum lor plalnllll nam.' assodared wifh can's on auachmrnf) Custodial Piuent's Name lla'!lt, nlst. MU DFAS CLEVEL/lND CENTER. C/O DFAS CODE L GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 iJk/. 99-';~~ edlL ,lJI'1CSE.5 ~? () 0 OO~ / See Addendum (or dependent names and birth dates associated with cases on aUachment. ORDER INFORMATION' ThI' ,. " O",,"N,""" W""",1d W~, 'M "pp'"' b",d 'P"" " ,",.. 'm ~"''"' '<0. C"'"""""" ","'W, C~_WM;;" of ,,,",y'""'" By ,'w, VO" "c ,,",,'.d 00 dol'" Ib" "'"",, '<0. ,", """",.,d .,p,,,,,'''';;'' ",'. ,,,.,, ,,," 'oO"" ,.'re~" ""<0 O,d,'N"'" ,. '" issued by your State. $ 541.67 per month in current support . ,PO ." p" .",;;;, pol."' ~"," ^'''" " w"" ,,,,..,,,, 0"" (j) PO $ 0.00 per month in medical support $ O. oQ.per month lor genetic test costs $ per month in other (specify) lor a total 01 $ 650.00 per month to be forwarded to payee below. y" d, "" ;;,"' " PO" ,00' p', """ " ", '" oompli"re w'lb Ib, '",P" ,",... "VO"' p," "d' "'" "" .,." the ordered support payment cycle, use the lollowing to determine how much to withhold: $ 150.00 per weekly pay period. $ 300. OQ.per biweekly pay period (every twO weeks), $ 325. OQ.per semimonthly pay period (twice a month), $ 650. OQ.per monthly pay period. REMITTANCE INFORMATION: '" ."" """ w""",Id'" "' ''"'' "'00 "'" Ii" !"y ""'00 ,",PI,,", ''" "m .,"'", dOV' ".. ,he dol' " Ib" O..,,",,'re. ,,,d p",,",PI w"hI' """ m ~"'"' d,y' " Ib, ,."...." of w,,"oo'''"', '" ore ,",,,'01 " dodod , ,~ " do"," Ib, d", ol w'lboold'"' R,'m" ,,,, "~WI ,_.,", ,,.. .,~ "," of ,",".P''''' 'M lb. allowable amount. The total withheld amount, and your lee, cannot exceed 55% 01 the employee's! obligor's _" dI_" _k. ,,,",,,,, 'M <hc poop'" ,',", Ii.,m"'" '" .,,"oo'dI". ,,.. """,", ,,",..,,'" " needed (See #10 on pg. 2). If remitting by EFT/EOI, please call Pennsylvania State Collections and Disbursement Unit (SCOUl Employer customer Service at 1_877.676-9580 lor instructions. Make Remittance Payable to: PA seOU Send check to: Pennsylvania seOU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown .,_" ", ..p"~,,,,,,;,,,,, c." ",",m..' OR .0e,A< .<CU"" NUMR" 'N ORD" TO Rf PROe"'<O, DO NOT SEND CASH BY MAlL." "'f .-' .,..."" ..... ' 0",,'0"'" SEJ> 3 roo;"'" ... '"' . ':::R:~ Form EN-028 Service Type M """N,,,lI'I1IllH" Worker 10 $IATT .' ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOlDERS o II dll'ckl'll you .m' rl'qulll'd 10Ilfl)~I\h' "l'oPY O( Ihls form 10 your ~"'I'loy('I'. I( yn\" l'mploVl'I' wlllks 10., SI.ll1' 1I101tls dll((~renllrnl11ll1P ~litl('1l1ol1IsS11l,( tillS 1m (If, " ropy JIlust he prnvhh!t 10 your (llllp oy(~e (~vcn If the hox is nol checked. 1. We ilPl>reclill(! thl! volunlilry COf1lI,llilI1Cl' of F('(lllf.llly fl'cognlll'(lllHllill1lrlhest Iril).1lly-ownl'd huslnessl!S, .1mllndl.ll1'()Wned businesses IOC.l11'cI on II fl'servilllon Ihlll choose to withhold in ,1ccordillKc wilh this n()li((~. ..... 2, Prlorlly: Wlihhnlding under this Ooler/Nollce h~s priorilY nver ~ny otlwr Il'g~lllrocess under 51,111' law ag.linsllhe s~me Inconl<'. Fl'tlcml tllX levies in {'(feel before fl'CCipl of this order hilV(! priority. If there ilfC FL'(lcr.ll t.1X levies in effect please (Onl.1(1111(' requesting agency IIsled belnw. 3. Combining Payments: You can combine withheld amounls Irommore Ih,lll (JIll' employee/obligor's Incnme In a single paymenlln each ~gency requesting wlihholding. You musl, however, sl'par.llely Idenlify Ihe po~ion o( Ihe single paymenllh~lls allribulable 10 each employecJobllgor. 4. "Repo~lng-the-P~ydatcJD~leofWithholding:-Ynu-mu'lrepn~ Ihe pavdall'/d~le 01 withholding when ,endinglhe payment-The- pavdale/dale-ofwithholding-i, Ihedale on whlchamnunlwa,wilhheldfrom the I'mployee',w~gcs.- Ynu musl comply wllh Ihe law o( Ihe slale o( Ihl' employee's/obligor's principal IliacI' or employ men I wllh rl'specllo Ihe time perlnds wilhin which ynu musllmplemenllhe wilhholdlng ooler and Imwaollhe SllppO~ paymenls. 5,' Employee/Obligor wllh Multiple Suppnrt Holdings: illhere is more than one Ooler/Nolice 10 Withhold Income for Suppo~ against Ihl, employee/obligor and you ~re unable In honnr all suppo~ Order/Notices dU['ln Federal or Slale withholding limits, you musllollow Ihe I~w o( Ihe slale o( emllloyee's/obllgor's principal IliacI' nf emplnyment Ynu musl honor all OlllerslNollces 10 Ihe grealesl exlenl possible. (See # 10 bl'lnw) 6. Termination Notification: You musl promplly nollly Ihe Requesting Agency when Ihe employecJobllgor is no longer working for you. Please provide Ihe In(ormatinn requested and relum a copy of Ihls Ooler/Nollce 10 Ihl' Agency idenlified below. WITHHOLDER'S ID: 2491016300 EMPLOYEE'S/OBLlGOR'S NAME: EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER. GREGORY L. 5235000032 DATE OF SEPARATION: 7. Lump Sum Payments: You may be required 10 repo~ and wllhhold Iromlump sum paymenls such as bonuses, commlsslnns, or severance pay. If you have any qUl'sllons aboullump sum paymenls, conlacllhe person or aUlhorily below. 6. L1abillly: ilyou fail 10 withhold income as Ihe Order/Notice direcls, you are liable lor bolh Ihe accumulated amount you should have wilhheld (romlhe employee/obligor's income and olhl'r penalties sel by Pennsylvania 51.111' law. Pennsylvania Slalelaw governs unless Ihe obligor Is employed In anolher Slale, In which c~se Ihe law of Ihe Slale In which he or she Is employed governs. 9. Anti-dlscrimination: You are subjecllo a fine delermlned under Slale law for discharging an employee/obligor (rom employmenl, refusing 10 employ, or laking disciplinary action againsl any employee/obligor because of a suppo~ withholding. Pennsylvania Slale law governs unless Ihe obligor is employed in anolher Slall', In which case Ihe I~w of Ihe Slale in which he or she is employed gnverns, 10.' Withholding Limits: You may nol wllhhnld more Ihan Ihe lesser of: 111heamounls allowed by Ihe Federal Consumer Credit Prolection Acl (15 U.S.c. ~1673 (b)1; or 2) Ihe amounls allowed by Ihe Slale of Ihe employee'slobllgor's principal place of employment The Federalllmll applies In Ihe agglegale disposable weekly earnings (ADWE). ADWE is Ihe nl'llocome lell afll'r making mandalOI)' deductions such as: State, Federal. local taxes; Social Security taxes; and Medicare taxes. 11. Addltionallnlo: 'NOTE: If you or your agent are served with a copy of this order in the stale th~t issued the order, you are to follow the law of the stale that issued this order wilh respeclto these ilems. Submilled By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by lelephone al (717) 24().622S or P.O. BOX 320 by FAX at (717\ 24()'624R or CARLISLE PA 17013 by internet www.chlldsupport.stale.pa.us Page 2 of 2 Form EN-028 Worker 10 $IATT Service Type M (lWJNu,:Il'IlOOli.1 ..... .rJi..=iUUA:? ::J'::'; ~ c:. ~ -1- ,,- ., ::>.,,-: C - LU-oj rl~ -,:7. C).I~. -.- ,-,~ _I' 0:: '~ u... , ~b ' 1 ,-, .;1' ~:.t if) 1.1- I ,.12 U\". c-.. la~ ::::'Ul C\... '.1Jw IJ-"C lJ.-' ~Qo... .F' <r. ~- tI- C'> ::;J 0 c:> (.) '" ..... P :""1 ell.). .::' ~3 .'::, ;.., -- ~ r.t; c:: -" \.- :.:: :.? -;: uJ8 '~IZ ~~.. ...- ,.)4: t:\ 0:: ~i-'.. :".':::::; .;.. 5:: Co .:1' ._~ if) (.:.,. 1 ~'_JZ ::!- lC;Z n:.tV 0.- lJ.JW u..' IDa.. r" cr. :z l1- C'> [5 0 0 ~ pOOlUUI!.'::lS '"' r- ~ iT, .::r ~ ,,- M 5",- ~9: 0-'" :l:: ..-.,:;.:.: fE~ Co. '- ::!; ::-:;1;;: ~~ r- .~:~!~ I -l :~j(6 u:hY :::> F -, [1:10.. --:; t5 _or :5 = = 0 .... ... ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth nl Pennsylvania Co.lCily/Olst, of CUMBERLJl.ND D.llt! of Ordm/Nutlce 07/02/04 TrlhuniIIlCils(! Numhm fSee Addendum (or Colse .wmm.try) RI': CHESTER, o Orlnin.lI ()rd~r/N(lIIc(l G) Aml'fll!C!d Ordt!r/Nollc(l o h,,,nin,II(~ Ordrr/Nnllce DFAS CLEVELAND CENTER" C/o DFAS CODE L GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 oil. /19{, 133 {'(tilt. /t/cc,t[ S ,;l!iWytJtl(,..1 GREGORY L, [mploYl'c/Obllgor's Nilmc ('-ast. nrsl. MI) 205-46-6571 [mployee/Obllgor's Social Security Numl>cr 5235000032 lmploy..IObllgor', Ca,eld.nllfler (S.. Addendum for plain/III nam.' associated with caSfS on attachment) Custodial Parent's Name (last. First. Mil lmploYl:'rlWlIhhohler's rrc!erJI UN Numhm See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA TlON: This Is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania, By law, you are required to deduclthese amounts from the above-named employee's!obligor's income until further notice even if the Order/Notice is not issued by your State, $ 541. 67 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? ayes <Xl no $ 0 ,00 per month in medical support $ 0.00 per month (or genetic test costs $ per month in other (specify) for a total of $ 541 . 67 per month to be (orwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much 10 withhold: $ 125.00 per weekly pay period. $ 250.00 per biweekly pay period (every two weeks), $ 270.83 per semimonthly pay period (twice a month), $ 541.67 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydateldate of withholding. You are entitled to deduct a fee to defray the cost of withholding, Refer to the laws governing the work state of your employee for the allowable amount, The total withheld amount, and your fee, cannot exceed 55% of the employee's! obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #10 on pg. 2). If remitting by EFT/EOI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106.9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case fdenti(ier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. ,."1"' DO NOT SEND CASH BY MAfL. " '.; ~1 tl' '~'1')~ JUL _ 6 200" l...".. ~" ,0 THE COU~. : Date of Order:' .::::::;; FJ)tO{/l2tJ [. (/.{..) ~C' Service Type M OMB No.: O'17tI.0I $4 7V.!J&c:.. Form EN.028 Worker 10 $IATT " ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o II ~heck"ll ynu are re'lulred In prl)~I(I" a (npy nf Ihls fnrnlln ynlll, "rn/'lny.'," If y,O\" ,'rnplnv,," works In " SI,111'lh.11Is dUrNellt from the slate th,11IS5U1'( lilts orller, .1 copy rnLJ~II)ll prOVnll'( 10 your PI 'I) nyl'c t!v(~n If !Ill! hm: Is nol dll'cked. 1. WI! .1PIJrcclale the volunlc'ry compll,mell of Fl'dcr.llly rt!(oAnlll'iIII1III.Ul trillcs, triIMlly,owl1(l{1 huslnpss(!s, .11H1lndllll1-oWlll'd buslness(!s loctllcd on il rcscrvilllon Ih.lI rhome tn wllhholtlln ilfforcl,lI1rn with Ihilt nOllrt!, 2. PriorUy: Withholding under lhis OrciN/Nolin! h.15 priority over .my nllwr h'n.,1 pron'!is umlN Slille I.l\\' "R.limlllw SiU11l' Inronw. Federill til)( I(~vlcs In c'fccl !Jc(ou! recell}t of this order l1&1v(' priorily. If then! .lre f{lfIt1,.11 t.l)( h!vll's in (!f((lcl pletlse fonl.lelllw rcque~lInR agency IIsl"d helnw, 3, Combining Paymenls: You can cnrnhlne wilhheld ,1mounls lrom rnore Ihan nne employee/ohligor', Income In a single paymenlln each agency requesting wllhholdlng. You rnusl, hnwever, 'eparalely Identify till' po~inn nf Ihe single p,'yrn"nllhalls al1rihulahle 10 each ernployee/ohllgor. 4, '-Reporting th"PaydalelDale-oIWilhholding:-Youmu'lrepnrt the pilydateldill" 01 wilhholding when ,ending Ihe payment--The- paydaleldaleol'wilhholding-i'-th" dill" on which-amount wa,wilhheld 110m Ihe employee's wage,; You rnusl comply with the law of Ihe slale of Ihe emplnyee'slobllgor's principal place 01 employmenl wilh respeclln Ihe Ilrne periods wllhin which you musl implemenllhe wllhholding ooler and forward Ihe suppo~ payrnenls, 5,' Employee/Obligor wllh Mulllple Support Holdings: If Ihere Is more Ihan one Ooler/Nolice In Wllhhold Incnrne for Suppo~ agalnsl Ihls employee/obligor and you are unahle 10 honor all suppo~ Order/Nolices due 10 Federal or 51ale wilhholdlng Iimlls, you musl follow the law olthe slale 01 employee'slohllgor's principal place 01 employment You rnusl hnnor all OolerslNotlces In Ihe greatesl exlent possible, (See #10 helow) 6. Termination Notification: You rnusl promptly notify the Requesting Agency whenlhe employee/ohllgor Is no longer working for you, Please provide Ihe Informalion requested and relurn a copy ollhls Order/Nolice 10 Ihe Agency Idenllfied helow. WITHHOLDER'S 10: 2491016300 EMPLOYEE'S/OBLlGOR'S NAME: EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: CHESTER, GREGORY L. 5235000032 DATE OF SEPARATION: 7, Lump Sum Payments: You may he required 10 repo~ and wllhhnld frorn lump surn Ilayrnenls such as honuses, commissions, or severance pay, If you have any questions aboullurnp sum Ilaymenls, contacllhe person or aulhorily belnw. a, LIability: If you fall 10 wilhhold incorne as Ihe Order/Nolice directs, you are liable lor both Ihe accumulaled amounl you should have wilhheld lrom Ihe employee/obligor's Incorne and other penallles sel by Pennsylvania Slale law. Pennsylvania Slale law governs unless Ihe obligor Is employed in anolher Slale, in which case Ihe law of the Slale In which he or she is employed governs. 9. Anll-dlscrimlnallon: You are subjecI to a fine delermined under Slale law for discharging an employee/obligor lrom employmenl, refusing 10 employ, or taking disciplinary action agalnsl any employee/obligor because of a suppo~ wilhholdlng. Pennsylvania Slale law governs unless Ihe obligor is employed In anolher Slale, in which case Ihe law ollhe Slale In which he or she Is employed govems. 10.' Withholding LImits: You may nol wilhhold more Ihan Ihe lesser nf: 1) Ihe arnounls allowed by Ihe Federal Consurner Credil Prolection Acl (15 U.S.c. ~ 1673 (b)l; or 2) Ihe arnounls allowed by the Stale nllhe employee'slobligor's principal place of employment. The Federallimil applies 10 Ihe aggregale disposable weekly earnings (ADWE). ADWE Is Ihe net income lefl after making mandalory deductions such as: Slale. Federal, locallaxes; Social Securlly laxes; and Medicare laxes. 11. Addlllon.llnlo: 'NOTE: If you or your agent are served with a copy of this order in the slale Ihat issued the order, you are to (ollow Ihe law of the state thai issued Ihis order wilh respecllo these items. Submilled By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION conlacl WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX al (717) 240-6248 or CARLISLE PA 17013 by internel www.childsupport.state.pa.us Page 2 of 2 Form EN.02a Worker ID $IATT Service Type M 0.0.18 Nu.: ll'JlU.Ol.~-1 ... p8UU t?~li:: >- r- f; ct; ..:J" ~ M S.,.... tJ.J~ Or" c,-=; L"~- :_)::f. [till E: C~~ ~- .:':Ui 0 r- 8: I '1._. .),::~"; - UJ -. I .. _~_ ti:jf. ::> ':.ll.-U ... l:.\(J.. \5 -... ~5 c=> = L) '" ., . .. ORDERlNOTICE TO WITHHOlD INCOME FOR SUPPORT State Commonweallh nl Pennsylvania Co.lCity/Dlst, of CUMBERLAND Date of Ordcr/Notlcc 11/21/05 Case Numbcr fSee Addendum for case summary) EmployerlWllhholder'. Federa' EIN Number DFAS CLEVELAND CENTER> C/O DFAS CODE L GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 257000061 98-433 CIVIL o Orlflln.l1 Oult!I/Nntlct' o Aml'nllpd Oulcr/Nnllc(' (8) tr.rmIl1JII! Order/Notlcr. RE: CHESTER , GREGORY L. Ernpluyee/Obllgor'. Name (la.I, FII.I, Mil 205-46-6571 Employee/Obligor" Socia' Securlly Number 5235000032 Employee/Obligor', Case Identifier (See Md.ndum lor plain/III name' assoc/,'ed with c.,e' on a".chm.nll Custodial Parent's Name (last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA TION: This Is an Ordcr/Notice to Withhold Income for Support bascd upon an ordcr for support from CUMBERLl\ND County, Commonwealth of Pennsylvania, By law, you are requlrcd to deduct these amounts from thc above-named employcc's!obligor's incomc until further notice even If the Order/Notice Is not issued by your State, $ 0.00 pcr month in currcnt support $ 0.00 pcr month in past-due support Arrears 12 weeks or grcater? Qyes <Xl no $ 0.00 per month In current and past-due medical support $ 0 . 00 per month for genetic test costs $ per month In other (specify) for a total 01 !Ii 0.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0 . 00 per weekly pay period. $ 0 . 00 per biweekly pay period (every two weeks). $ 0.00 per semimonthly pay period (twice a month), $ 0 . 00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydateldate of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's! obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following Information Is needed (See #9 on page 2). If remllling by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obfigor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Date of Order: NOV 2 2 2005 DRO: R. J. Shadday Service Type M BY THE COU Jtrlge Form EN-028 Worker 10 $IATT Edward E. OMB No.: 0970-0154 ...... .. .. ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o If thockCjI you are rOllulr",\ to "'pvllle a cony o( this (orm tn your ~nlJJloyee, I( your emlllnye. works In a st,1te Ihalls dlllenml from the stille tlMI 5511l'f Ill!i ortlc(, il copy mw.t he! provlclcd 10 your crllploycc eyen II tile hox Is not ( lcckl'Cl. " Priority: Withholding under this Order/Nollce has priority nver 'lilY nlher legalllrocess under Stato law against the same Income, Federal tax levies In effect be(nre recelllt nf this nnler h,we 1"lnrlty. I( there are F",lerallax levies In offect ploase cnnlact tho rO(lUesllng agency IIst",l below. 2. Comblnlog Payments: You can combine withhold amounts from more Ihan one employeolobllgor's Incomo In a single paymont to each agoncy requesting withholding. You must, howevor, sOllaratoly Idonllly Iho portion oltho single paymonlIhitlIs altrlbulablo 10 each employoolobllgor. 3, '-Reportlng-the-PaydatelOate-otWithholdlng:-Voltmust'rt!portth!!"paydateJdate-ofwlthhoIdlnS'when~endlng the-payment;-The- paydateldate-ofwithholdlng-I.-thedate'Orrwhlch'amountwa.wlthheld'lrom-th!!"employee's-wages; You must comply with the law of tho state oltho omployoo's1obllgor's principal placo nl omploymont with respocllo the limo periods within which you must Implomontlho withholding ordor and 10IWard Iho support paymonls. 4,' Employee/Obligor with Multiple Support Holdings: IIlhoro Is moro than one Order/Nollco to Withhold Incomo for Support agalnsl Ihls employeolobllgor and you are unable 10 honor all support Order/Notices due to Federal or Stale withholding limits, you mustlollow Ihe law 01 the stale 01 employoo's1obllgor's principal place o( employmont. You must honor all ardors/Notices to the groatest extonl possible, (See #9 below) 5, Termination Notification: You must promptly notify Ihe Requesting Agency whon the employee/obligor Is no longer working (or you. Please provide the Inlonnatlon requesled and retum a copy ollhis Order/Notice to the Agency Idenllfied below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLlGOR'S NAME: CHESTER , GREGORY L. EMPLOYEE'S CASE IDENTIFIER: 5235000032 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required 10 report and withhold Irom lump sum payments such as bonuses, commissions, or severance pay, Ilyou have any questions aboullump sum payments, contact the person or authority below. 7. liability: II you lailto withhold Income as the Order/Notice directs, you are liable for both lhe accumulated amounl you should have withheld Irom the employee/obligor's Income and other penalties set by Pennsylvania State law. Pennsylvania Stale law govems unless the obligor is employed In anolher Slate, In which case Ihe law 01 the Slate in which he or she is employed govems. 8, Antl-dlscrimlnatlon: You are subject to a fine delennlned under State law lor discharging an employee/obligor from employment, reluslng to employ, or taking disciplinary action against any employee/obligor bocause of a support withholding, Pennsylvania Slate law govems unless the obligor Is employed In anolher Stale, In which case lhe law 01 the State in which he or she Is employed govems. 9,' Withholding limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U,S.c. ~ 1673 (b)l; or 2) the amounts allowed by the Stale of the employee's1obligor's principal place 01 employmont. The Federal limit applies to the aggregate disposable weekly eamlngs (AOWE), AOWE Is the net income lelt after making mandalory deductions such as: Stale, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law 01 the issuing tribe. For tribal omployers who receive a stale order, you may not withhold more than the amounls allowed under the law 01 the stale that issued the order. 10, Addltlonallnlo: 'NOTE: If you or your agent are served with a copy of this order In the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. II.Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telephone at (717) 24lJ..6225 or P.O. BOX 320 by FAX at (717) 24lJ..6248 or CARLISLE PA 17013 by internet www.childsupport.state.pa.us Service Type M Page 2 of 2 Form EN-028 Worker 10 $IATT OMB No.: O'J7()"()IS4 l , O'1(/l C (~"'9 '7/~ >. 0'. j:J: <uP (,)~:-: p:r.;; ..t,&._ ;(<:) ~[E It<l/ iE "'" o _1" ...or >-. /"0; .~i _ "0ff .i!? i;f'"'.:' (., c:? :.r:: Cl... ~ "'" Cl ::r: "" eo" c-... '.... ... >- ~ ~ ~ ..:l" UJ~ c;, .:~)~ C.)c5 :I:: C);:::~ G:~ "- -)~? 'I. J~2~ O. 60 N n: N ~(J_ >- i'::,,: (CLIJ J.:~~ r- 0 -~ ~- u.. u-, ..::: = ;.:J 0 = 0 <'-I . , , {....,...~.\ " . <~ 'f .