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HomeMy WebLinkAbout98-00951 {. I '" l~ ,~ l~ l I I ~ I I I..... 1 ~ II)." " \l l-.Q I~ r : ~ ~ :-- . ,:I ~ ...... ~ t ~ ~, ~ ~l1t 13. AV~Ost IN THE COURT OF COMMON PLEAS Vc' 0, CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION '5~ K 8"'b~~j- NO. '7€!.1- 'tS l 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 93301 (c) 3301 (d)(l) of the Divorce Code. (Strike out Inapplicable section), 2. Date and manner of service of the complaint: -~~m"".:.. ..j:'l,.e-L...)j~:~o&.t. ~ (---,- o~ ~...),(.t ~-~~~-----------------____m___ _ 3. Complete either paragraph (a) or (b), (a) Date of execution of the affidavit of consent required by 93301 (c) of the Divorce Code: by plaintiff _11- S@ ~'be.,..;'m~; by defendant _L~ ~\,../ z.ooO (b) (1) Date of execution of the affidavit required by 93301 (d) of the Divorce Code: -&;/-1l--______._____ (2) Date of filing and service of the plaintiff's affidavit upon the respondent: -----tY/EI-- _ ~__m.__._________ 4. Related claims pending: ~!'1g,-,--t:t~~1J1_iJ"~ I. f"'~~''l~ u.)\~ ~ -4'-L~-'--------__ 5. Complete either (a) or (b), (a) Date and manner of servloe of the notice of intention to file praecipe to transmit record, a copy of whioh is attaohed: _________._______________, (b) Date of plaintiff's Waiver of Notice in 93301 (c) Divorce was filed with tile Prothonotary: m_~~_~__ .l.o\:'\,J Date defendant's Waiver of Notice in 93301 (c) Divorce was flied with the Prothonotary: ---__ ~~--~P_~e'__._~v~-_. '-wI , I i ( I , I \: II " (1- Lr, E; - I':' .. '5....: ,!' ~:~ " ~,--' !~~~I :.::.' , "_,.1 :a~ " i:);:] I () - ;;..,. -~c (') r:\J ';,: ce. "/:' ~- dll., III .!:-!(J,. (,1 .",-~. L) ~., 0 (J " JANE B. ARBEGAST, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA vs. CIVIL ACTION - LAW NO. 98- 'I" / CIVIL TERM SCOTT K. ARBEGAST, Defendant IN DIVORCE .Q.QMPLAINT IN DIVORC.E AND NOW comes the above-named Plaintiff, JANE B. ARBEGAST, by her attorney, Samuel L. Andes, and makes the following Complaint in Divorce: 1. The Plaintiff is JANE B. ARBEGAST, an adult individual who currently resides at 808 Wellington Drive, Carlisle, Cumberland County, Pennsylvania. 2. The Defendant is SCOTT K. ARBEGAST, an adult Individual who currently resides at204 Richland Road, Carlisle, Cumberland County, Pennsylvania. 3. Both the Plaintiff and Defendant have been bona fide residents of the Common- wealth of Pennsylvania for at least six months immediately previous to the filing of this Complaint. 4. The Plaintiff and Defendant were married on 3 April 1982 in Carlisle, Pennsylvania. 5. There have been no prior actions of divorce or annulment between the parties. 6. This marriage is irretrievably broken. 7. Plaintiff has been advised of the availability of marriage counseling and the Plaintiff may have the right to request that the Court require the parties to participate in counseling. c.o.u.NIJ 8. The Plaintiff requests this Court to enter a Decree of Divorce. WHEREFORE, Plaintiff requests this Court to enter a decree in divorce pursuant to the Divorce Code of Pennsylvania. J CQU..NLIl- EaUITAa~ISTRIBUTION 9. During the course of the marriage, the parties have acquired numerous items of property, both real and personal, which are held in joint names and in the individual names of each of the parties hereto. WHEREFORE, Plaintiff prays this Honorable Court, after requiring full disclosure by the Defendant, to equitably divide the property. both real and personal, owned by the parties hereto as maritAl property. COJJ.NI III - AIJ.MQN.Y 10. Plaintiff lacks sufficient property to provide for her reasonable needs in accordance with the standard of living of the parties established during the marriage. 11. Plaintiff is unable to support herself in accordance with the standard of living of the parties established during the marriage through appropriate employment. 12. The Defendant is employed and enjoys a substantial income from which he is able to contribute to the support and maintenance of Plaintiff and to pay her alimony in accordance with the Divorce Code of Pennsylvania. WHEREFORE, Plaintiff prays this Honorable Court to enter an Order awarding Plaintiff from Defendant permanent alimony in such sums as are reasonable and adequate to support and maintain Plaintiff in the station of life to which she has become accustomed during the marriage. C-OUNT IV - ALIMONY HN.QENTE I.IIf 13. Plaintiff is without sufficient income to support and maintain herself during the pendency of this action. 14. Defendant enjoys a substantial income and is well able to contribute to the support and maintenance of Plaintiff during the course of this action. WHEREFORE, Plaintiff prays this Honorable Court to order Defendant to pay her reasonable alimony pendente lite during the pendency of this action. ..f Ii i ii 'I II I JANE B, ARBEGAST, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA vs, CIVIL ACTION - LAW SCOTT K, ARBEGAST, Defendant NO, 98-951 CIVIL TERM IN DIVORCE AEflDAVIT OE..C...QNS..ENI 1, A Complaint in Divorce under Section 3301 (c) of the Divorce Code was filed on 19 February 1998 and was served upon the Defendant on or about February 26, 1998, 2, The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing of the complaint and the date of service of the complaint on the Defendant, 3. I conStJnt to the entry of a final decree in divorce either after service of a Notice of Intention to Request Entry of the Decree or upon filing of my Waiver of the Notice of Intention to Request Entry of the Decree. 4, I have been advised of the availability of marriage counseling and understand that the Court maintains a list of marriage counselors and that I may request the Court to require my spouse and I to participate in counseling and, being so advised, do not request that the Court require that my Spouse and I participate in counseling prior to the divorce becom:ng final. I verify that the statements made in this Affidavit are true and correct and I understand that false statements herein are made subject to .he penalties of 18 Pa, C.S, Section 4904 relating to unsworn falsification to authorities. , - I DAif./ 2::{)~_____ Jatt:1~Ei:T------- - ~~I iir JANE B. ARBEGAST, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA vs. CIVIL ACTION - LAW NO. 98-951 CIVIL TERM SCOTT K. ARBEGAST, Defendant IN DIVORCE AFFIDA VILQE_CONSENI 1. A Complaint in Divorce under Section 330'llc) of the Divorce Code was filed on 19 February 1998 and was served upon the Defendant on or about February 26, 1998. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) I days have elapsed from the date of filing of the complaint and the date of service of the ! complaint on the Defendant. 3. I consent to the entry of a final decme in divorce either after service of a Notice of Intention to Request Entry of the Decree or upon filing of my Waiver 0'1 the Notice of Intention to Request Entry of the Decree. 4. I have been advised of the availability of m3friage counseling and understand that 1 the Court maintains a list of marriage counselors and that I may request the Court to require my spouse and I to participate in counseling and, being so advised, do not request that the I Court require that my spouse and I participate in counseling prior to the divorce becoming final. I I I verify that the statements made in this Affidavit are true and correct and I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. _ CJ,,/t..-oO . DATE I I , , ~/ /I(~-~--- ~T K. A~T '- ~'<J r-: ~:(; 'C:: ";,. ~; :: ., :':3 C'oJ ;":~~~l '-. c'_ r,')';, ':~ :~ ,;-.,) ;.t'~Q (....i iJ i';; r:\", "J(D LLI '(In.. c./J :~~ , , C~.l :;) c , (,';; () ,,- \'<') r,:: i:C C"" ..., I. .. :~';~1 "'"' " , , , :r.: I': C-\.. ) :;J ",.. '" l..l/l r..; .1 >~. "1:;;5 Co< 'It I LJ.: 'IH1. V. -, ,.., ~l ) ,~ ("", () . ",.. ,~,.j %: ',~ ~= ~?~. \, ; ('~ :~l~: , " ,.,." ,.\;.. 11.-' 'l~~j (. " ,.. >.1 ' ~n C--..J .-,'}.; ...cf' C'" c.}J(O \.l..l J~1 (1.. (j; (? :'3 c-, 0 . ...". .-~ .. . JANE B. ARBEGAST, ) IN THE COURT OF COMMON Plaintiff ) PLEAS OF CUMBERLAND ) COUNTY, PENNSYLVANIA ) vs. ) CIVIL ACTION - LAW ) SCOTT K. ARBEGAST 1 ) NO. 98-951 CIVIL TERM Defendant ) ) IN DIVORCE ACCEPTANCE OF SERVICE I hereby enter my appearance on behalf of the DefendF.lnt, Scott K. Arbegast, and , accept service of the Complaint in divorce on his behalf and acknowledge receipt of a copy of the same. DATE: ~ ~&, 11ft;;. ~aw{/:~ Wayn F. Shade, Esquire >-< l..,O ,- .. (',~: (."'~! " '.. . , , " " ~,' " , I fJ' : I i , ( I -., c\ I ('..1 1" I -, if: I r I ".... I t,.. U <..<' ;i Ci <;.0-- .J .., . JANE B. ARBEGAST, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA vs. CIVIL ACTION - LAW SCOTT K. ARBEGAST, Defendant NO. 98- 7 \- / CIVIL TERM IN DIVORCE COMPLAINTJN.D/VORCE AND NOW comes the above-named Plaintiff, JANE B. ARBEGAST, by her attorney, Samuel L. Andes, and makes the following Complaint in Divorce: 1. The Plaintiff is JANE B. ARBEGAST, an adult individual who currently resides at 808 Wellington Drive, Carlisle, Cumberland County, Pennsylvania. 2. The Defendant is SCOTT K. ARBEGAST, an adult individual who currently resides at204 Richland Road, Carlisle, Cumberland County, Pennsylvania. 3. Both the Plaintiff and Defendant have been bona fide residents of the Common- wealth of Pennsylvania for at least six months immediately previous to the filing of this Complaint. 4. The Plaintiff and Defendant were married on 3 April 1982 in Carlisle, Pennsylvania. 5. There have been no prior actions of divorce or annulment between the parties. 6. This marriage is irretrievably broken. 7. Plaintiff has been advised of the availability of marriage counseling and the Plaintiff may have the right to request that the Court require the parties to participate in counseling. CIDlNIJ 8. The Plaintiff requests this Court to enter a Decree of Divorce. WHEREFORE, Plaintiff requests this Court to enter a decree in divorce pursuant to the Divorce Code of Pennsylvania. J CO,UHIJI . EaUITABLE DISTRIBUIlQN 9. During the course of the marriage, the parties have acquired numerous items of property, both real and personal, which are held In joint names and in the individual names of each of the parties hereto. WHEREFORE, Plaintiff prays this Honorable Court, after requiring full disclosure by the Defendant, to equitably divide the property, both real and personal, owned by the parties hereto as marital property. CQUNT III . ALIMONY 10. Plainti ff lacks sufficient property to provide for her reasonable needs in accordance with the standard of living of the parties established during the marriage. 11. Plaintiff is unable to support herself in accordance with the standard of livirlg of the parties established during the marriage through appropriate employmer,t. 12. The Defendant is employed and enjoys a substantial income from which he is able to contribute to the support and maintenance of Plaintiff and to pay her alimony in accordance with the Divorce Code of Pennsylvania, WHEREFORE, Plaintiff prays this Honorable Court to enter an Order awarding Plaintiff from Defendant permanent alimony in such sums as are reasonable and adequate to support and maintain Plaintiff in the station of life to which she has become accustomed during the marriage. COUNT IV..:AI.IMONllEN.OENTE 1JIE '13. Plaintiff is without sufficient income to support and maintain herself during the pendency of this action. 14. Defendant enjoys a substantial income and is well able to contribute to the support and maintenance of Plaintiff during the course of this setion, I WHEREFORE, Plaintiff prays this Honorable Court to order Defendant to pay her reasonable alimony pendente lite during the pendency of this action. 4 '41 ",. (<) E:r; ," t:-: .. (', (,Y; UJ.; ~"? ! .~"'. ,I f:l'.-;;.' t:J... , ':"'1 '1'< (".:1 ) C~~ ' C-') I U.H- "';+:!'-'-' C" ci:1e:~ [1_ ::f' ".\ " :C "FC- U~ 0:1 :~) 0 en () , r 0'"",-... 3. ,l:)...~,,<.t- Illlht, COlli'! of COIIl/llon PICllS of Clllnbcl'Inod County, Pcnosylvania vs, No, 3B.:"~:t-?::c__ Civil, ~~ 8c.~-H-- k A...I,,(j<!oo'..:J: ---~...__._~.~-~...~.- 1:4" - ___.____.____ Ple-~..... .._-'---._~---..__.,--------------- v,)-'-~-dY-s..L t'id,,'IJ\JR_~\~h_~_~-U,J ~J,(e n~ '_ - -j~)~ck..i-4" ~1-f-,u~cLu.Q;) lG - LB~__~__ . ._-. ._-----. '-'----. -..---....----.-.--......--.----.--- '--..---..-. .. --_......_------_._--~----------~-_.----. -_.~---..~--.-._._- ...__.-.._,.._----_._,...._-._-~.--.-- ------~.~_._._-----_...._----,.._..__._._----_..._-~---~-- -~--~.,---..._-~.;-_._._---- ._..~~---~-_.._-----~._._---~-----._---~ -------...--..-----.---------.-- To .-.---...-.--.-.... -. !}f{ltll()1l0Illry 2.5 ~f~~-~W) ". -.-----.. AUofllcy for Plllinliff , .r', , fi ;"}.,J f , 'V -'~ \.- I. ." .' ,~. ". ~ I, ;i, \'114~ , 1~..._; ~ J ,~<\t. '., :,!;,,' '" ., ,. 'fl' ,. jd .' \ g, ;!) '" .... ~ ~ Q.. .... U ~ tool .t, et:: Q.. ~-'. -.' ,-, ~ ii',121111 'I'ITY CUfi:lL.,i r r.1__~:-')i'j't.,r- PtNN8'(LVl\HV\ ~ '"P ,::1 U; w. .. ~~ ' '''-..\,..' \ I! t, '! 1'1 I I ) / '-, l ,\I ~ '\, i.~' - \;,i,~'_ g\,'t'1- :;. -- ,iq--' 'V. -,-'f' ( I t \~. f" I, ~ 1 " \) 'I , , I SCOTTK. ARBEGAST PACSES M~rnber Number: 3526100027 4, If there are in your employment one or more additional employees whose incomes are subject to the Order of the Court of Common Pleas of CUMBERLANP County for attachment of support, you may combine the attachment payments into a single payment to the Domestic Relations Section and separately identify the portion attributable to each obligor. 5. You must notify the Domestic Relations Section when the defendant obligor terminates employment and provide the Section with the employee's last known address and the name and address of the new employer, if known, 6. The maximum amount of the attachment shall not exceed 50 % of the employee's net income which is wiUlin the limits set in the Consumer Credit Protection Act, 15 V,S.C. ~1673. 7. The term "income" as defined by law includes compensation for services, including, but not limited to, wages, salaries, fees, compensation in kind, commissions and similar items; income derived from business; gains derived from dealings in property; interest; rents; royalties, dividends, annuities; income from life insurance and endowment contracts; all forms of retirement; pensions; income from discharge of indebtedness; distributive share of partnership gross income; income in respect of a decedent; income from an interest in an estate or trust; military retirement benefits; railroad employment retirement benefits, social security benefits; temporary and permanent disability benefits; worker's compensation and unemployment compensation. Servlc~ Type M PRg~ 3 of 4 POrtn EN -028 Worker ID $IATT SCOTT K. ARB~GAST PACSES Memhcr Nllmher: 3526100027 GENERAL INSTRUCTIONS. 1. Employers may elect to deduct up to 2 % of the attachment amount for their costs. This amount must not be deducted from the attachment. It must be paid from the employee's net earnings after the income attachment deduction has been made. 2. Dates monies were withheld from the employees' pay must be provided on the payment transmittal foml to the Domestic Relations Office. 3. If you choose to make payments via an electronic funds transfer, instructions may be requested from the Domestic Relations Office. BY THE COURT: Date of Order: March 25. 1998. JUDGE OROI R.J. Shadday eel defendant Service Type M P~se 4 of 4 Ponn EN.028 Worker ID $ IATT 6, Defendant desired the separation of Il1e parties and so he promised to Plaintiff that Plaintiff and the parties children Inove to the rental property on Redwood Drive and that the residence on Richland Road 1.>1: sold, 7. Plaintiff accepted Defendant's prr)i'v~;.iI alld, in reliance upon the agreement reached by the parties, moved herself and her 11Iillur children from the marital residence on Richland Road and into the rental property Oil R',dwood Drive, 8, Thereafter, Plaintiff and Defendallt 11!;lr,c1 the Richland Road property for sale with a local realtor, 9. The property on Richland Road h."; 111>1, as yet, been sold and Plaintiff believes that the property has not been sold bcciluse the Defendant. who remains in possession of the property, has sabotaged efforts to sell the property so that he can retain it for his own purposes and possession, 10. Defendant has recently made 8rr<illg.'llIents to move his paramour and her two young children move into the Richland RozlrI home, 11, Plaintiff desires the sale of the RichL\llcl Road property so that the proceeds of the sale can be used to payoff and satisfy (Iell,s owed by the parties, She does not want the Defendant's paramour and her family to live in the house because that experience will be upsetting to the Plaintiff's <:1'lllIren who will have lost their home to their father's paramour and her children, 12. Defendant has breached the agroollll'llt he made with Plaintiff for the sale of the Richland Road residence and has injured 1~lz\l11tiff by that breach, SAMUEL L. ANDW'l A'C'rOHNEY AT 1,AW ~\Jf') NOUTll 'I'WI~I.I''I'lI !iTUI';Io:T 1',0, }lOX 1011 I.I;;MOYNl1;, PIr.NN9YLVANIA 170{~a 1'f.I,tlJ'1l0NF. (1l11101'Mfl\ ,^X {11711UI.14(1~ ,15 July 1998 The Honorable J. Wesley Oler Judge of the Court of Common Pleas Cumberland County Courthouse 1 Courthouse Square Carlisle, PA 17013 RE: Jane B. Arbegast vs. Scott K. Arbegast 98-951 Civil Term In Divorce Dear Judge Oler: You have scheduled a hearing at 3:30 p.m. on 3 August 1998 on my Petition for Emergency Relief in the above matter. I originally filed that Petition because we believe Mr. Arbegast was not cooperating to list and sell the house. Since the Petition was filed, the parties have entered into an agreement to sell the property and settlement is scheduled for late July. I write to request that you postpone the hearing scheduled for 3 August 1998 generally, Once we know whether the sale is concluded in late July or early August, I will either withdraw the Petition for Emergency Relief, by Praecipe, or request that you reschedule the hearing if further action is required. Thank you for your attention to this matter, .-'{.. " S, am' /,1,~ir cc: Donald T. Kissinger, Esquire Jane B. Arbegast '.;'.' I I II III I JANE B. ARBEGAST, Plaintiff vs. ) ) ) ) ) ) ) ) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL.VANIA CIVIL ACTION - LAW NO. 98-951 CIVIL TERM IN DIVORCE SCOTT K. ARBEGAST, Defendant PETITION FOR SPE.tIAL RELIEF AND NOW, comes the above-named Plaintiff, by her attorney, Samuel L. Andes, and petitions the Court for special relief In this matter based upon the following: 1. The Petitioner herein is the Plaintiff, Jane B. Arbegast. 2. The Respondent herein Is the Defendant, Scott K. Arbegast. 3. The parties In this matter are also parties to an action for child and spousal support In an action titled JANE B. ARBEGAST, Plaintiff vs. SCOTT K. ARBEGAST, Defendant, and docketed to number 72 S 98 (PACSES Case No. 349100020). 4. In the support action between the parties, at the time an Order for support I was entered by agreement, the parties agreed that the arrears owed on the Order at that time, which stood In the amount of $1,226.00, would be paid to Petitioner from the proceeds of the sale of the parties' residence In Carlisle and that the payment of those arrears would later be charged against the Defendant's share of the equity distribution of marital property. 5. The parties have concluded the sale of their home and have received proceeds In the amount of $16,284.62, which were Issued to them In a joint check, a copy of which Is attached hereto and marked as Exhibit A. 6. Defendant has failed and refused to endorse the check representing the proceeds of the sale of the residence so that the check can be negotiated and the arrears paid to Petitioner as agreed and so that the balance of those funds can be :1 held In an Interest bearing account until the parties make final distribution of the proceeds. 7. Defendant, by failing to keep the agreement between the parties and by failing to endorse the check 50 the proceeds of the sale of the residence can be deposited on Interest, has Injured and continues to Injure Petitioner. WHEREFORE, Petitioner prays this Court to order and direct Defendant to endorse the check, to direct that the arrearages due under the support order bl:: paid from the proceeds of the sale of the residence, and that the Defendant's ultimate distribution of marital property be charged with the arrearages paid. [J~~ ~I L. Andes Attorney for Petitioner Supreme Court ID # 17225 525 N. 12th Street Lemoyne, PA 17043 (717) 761-5361 .i~oUu '" '" ..-l d~ iii '" 'ii ~ 00 "'u Cl\;; C\l O'le 15 reo C\l (C .-l g' :f. .~ < (J) ,... [i . I I II> J! ~ ,~! M !IO ~ ~~ o.~ ~~! h~ ~ ~g~~~ g i ~ ~'-:r: i h~i~ IJl ~ F- e !l M I .'11" ~.~ QijUIl\"1 III oJ <:> t;;: ~ Q ~ 1 o ~ ~ ICCd'd9<JIlOIII TW? ~ ::> o U ~ ~ ~ ~ ~ ~ 0: i ai Q) c: "' .., '0 fa ." '" <1l"" 1il1"'&~ '0 c:< <1lll. :2 . ~.!.l.91 s::a:~ R'<t "' ii'i~u "'ff] )-,~Cl ~g~~ ttOUO! IQIi'lWI " , ,. ., '" ;\ '! '" " " ,,, " 'L '. cr L, n.I :;,' rn I:: O. .... ", ...... ~!, CC' ./ 0" ... .. . - " LD t" rM ;' 0:: U1 ,i ... \'~ ", r1'I .... :) ,.." :,: 0': .. I" - :1: , , " 'L :' ..... ~~ CC i~ ,. r\J iL, MJ ; ... ., 0:, 'L 1:' " .., I., I '" JANE B. ARBEGAST, ) IN THE COURT OF COMMON Plaintiff ) PLEAS OF CUMBERLAND ) COUNTY, PENNSYLVANIA ) vs. ) CIVIL ACTION - LAW ) SCOTT K. ARBEGAST, ) NO. 98-951 CIVIL TERM Defendant ) IN DIVORCE ORDER AND NOW, this --2.f1 r~ day of 0 t' -tk.4 1998, It being reported to the Court by Plaintiff's counsel that the matters raised in the Plaintiff's Petition for Special Relief have been resolved at this time, we hereby cancel the hearing scheduled for 9:30 a,m. on Thursday, November 5, 199d. The matter will be scheduled for another hearing at the request of either party, If further hearings on the Petition become necessary. BY THE COURT, . VII~'iY)J0'\.'I.nd A./I~'("""'''' ;';; .'. :' ,," -,. ..",,1'0' - . --, ,"'fl'''' f,.,\1 ~ ~, 'I :(' I' ,I ,I ~";I 1-:1 I (l( {,.o \.(, J,,'JlJ '.::) )'" '1 -_~ J I ~.i,. 'i" . 'i. _.1 - 0,; "" -.. ~ , , '1 ~ ~ r SCOTT K. ARBEGAST PACSES Mcmhcr Numhor: 3526100027 PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. This order of attachment for support is binding upon you until further notice and shall have priority over any attachment, execution. garnishment or wage attachment under state or local law except one relating to a prior support order. You must commcm:e the attachment of the defendant obligor's income as soon as possible but no later than fourteen days from the date of the issuance of this Order of Attachmcnt. You are notificd further that pursuant to law: I. The defendant obligor has been notified that an order of attachment for support would be issued. 2. Willful failure to comply with this order may result in (i) your being adjudged in contempt of court and committed to jailor fined by the court; (il) your being held liable for any amount not withheld or withheld but not forwarded to the Domestic Relations Section; and (ili) attachment of your funds or property. 3. The attachment of income or the possibility thereof as a basis, in whole or in part, for the dlscharge of an employec or any disciplinary action against or demotion of an employee is prohihiled. Violation may result in (i) your being adjudged in contempt and committed to jailor fined by the court and (ii) an action against you by the employee for damages. 4. If there are in your employment one or more additional employees whose incomes are s\lbject to an attachment of support, you may combine the attachment payments into a single payment to the Pa SCDU and separately identify the portion attributable to each obligor. 5. You must notify the Domestic Relations Section or the Pa SCDU when the defendant obligor terminates employment and provide the Section with the employee's last known address and the name and address of the new employer, it' known. PRgo 2 of :1 Form EN-02a Worker]O $ IAT~' Sorvlce Type M SCOTT 1<. ARBEGAST PACSES Momh.r Numher: 3526100027 6. The maximum amount of the attachment shall not exceed 50 % of the employee's net income which is within the limits set in the Consumer Credit Protection Act, 15 V,S.C. ~1673. 7. The term "income" as defined by law iucludes cOlllp(>nsation for services, including, but not limited to, wages, salaries, fee!;, compensation in kind, commissions and similar items; income derived from business; gains derived from dealings in property; interest; rents; royalties; dividends; annuities; income from life insurance and endowment contracts; all forms of retirement; pensions; income from discharge of indebtedness; distributive share of partnership gross income; income in respect of a decedent; income from an interest in an estate or trust; military retirement benefits; railroad employment retirement benefits; social security benefits; temporary and permanent disability benefits; worker's compensation; unemployment compensation; other entitlements to money or lump sum awards, without regard to source, including lottery winnings; income tax refunds; insurance compensation or settlements; awards or verdicts; and any form of payment due to and collectable by an individual regardless of the source. GENERAL INSTRUCTIONS 1. Employers may elect to deduct up to 2 % of the attachment amount for their costs. This amount must not be deducted from the attachment. It must be paid from the employee's net earnings after the income attachment deduction has been made. 2, If you choose to make payments via an electronic funds transfer, contact the Pa SCDU Employer Customer Service at 1-877-676-9580. Date of Order: October IS, 1999 DRO: R.J Shadd,-.y xc: defendant Sorvlce Type M Form EN-028 Wmker lD $ IATT '.. (f) ',. rr, Ir:, r.. '. .. , .,r {'I"; ; , ';~,I ..'J ::;" (..\ '! ~,i ',' , .~f_~ ('-J ! '." .j j ,:;J {' , 11 (./... 4... .,-, r:J 1~') C) 0 '~~""hr -~ ..' t..,o,r.\ 1" \---,-, " In the Court of Common Pleas of CIJI\IBERLAND Connty, Pennsylvania DOMESTIC ImLATlONS SECTION Defendant Name: SCO'I'T K, ARllEGAS1' Member lD Number: 3526100027 l'h'lt.lil'lIul!!: AlIl'tlrrl'SI)(JIldl'IICC IIItlflllllll'ludc till' ~kUlhcr II> Numl!lJr. THE MCNAUGHTON COMPANY STE 201 4400 DEER PATH RD HARRISBURG PA 17110-3908-51 ORDER OF ATTACHMENT OF INCOME PllIlnllffNamc JANE B. ARB~GAST JANa a, ARBa~T I!I!anclal Break Down of Mlllthlle Cases on Atl"chment PACSES I>,lckl.ll . Ca~l' Numhcr Numhllr ) ') 1'1 349100020 00012 8 1998 .;! '1.:s '/5 915100046 951 CIVIL 98 i ~ i $ Attachment Al1Iountll:rcuuellcv 119,'6/WEEK 10 ,42 ~1!II2K / ~ i / / TOTAl. A'n^CH\IE~T MIOVNT, $ 250,38 To: THE MCNAUGHTON COMPANY Pursuant to the laws of the Commonwealth of Pennsylvania the income of SCOTT K, ARBEGAST . defendant obligor, SSN 200-52-6054 of: 5221 WINDING WAY, HARRISBURG, PA. 17109-6343 -21 is hereby attached to the l(Jllowing extent. You are directed to pay to the Pa State Collection and Disbursement Unit the sum of $ 250.38 from the income due the defendant obligor, The per WEEK attachment payment must be sent to the Pa State Collection and Disbursement Unit within seven business days of the date the defendant obligor is paid. CHECKS SHOULD BE MADE PAYABLE TO: PA SCDU AND SENT TO: Pennsylvania SCDU P.O. Box 69112 Harrisburg, Pa 17106-9112 So,vi"c Typc M Form EN-028 Wo,ko,lD $IATT - SCOTT K. ARBEGAST PACSES Memher Numher: 3526100027 PAYMENTS MUST INCLUDE TilE DEFENDANT'S NAME AND TilE PACSES MEMBER ID OR SOCIAL SECURITY NUMBER IN ORDER TO 1m PROCESSED. DO NOT SEND CASH BY MAIL. This order of attachment for support is binding upon you until further notice and shall have priority ovcr any attachment, execution, garnishment or wage attachmcnt under state or local law cxcept one relating to a prior support order. You must commence the attachment of the defcndant obligor's income as soon as possible but no later than fourteen days from the date of the issuance of this Order of Attachment. You are notified further that pursuant to law: I. The defendant obligor has been notified that an order of attachment for support would be issued, 2, Willful failure to comply with this order may nJsult in (i) your being adjudged in contempt of court fmd committed to jail or fined by the court; (ii) your being held liable for any amoullt not withheld or withheld but not forwarded to the Domestic Relations Section: and (Hi) attachment of your funds or property. 3. The attachment of income or the possibility thereof as a basis. ill whole or in part. for the discharge of an employee or any disciplinary action against or demotion of an employee is prohibited. Violation may result in (i) your being adjudged in contempt and committed to jail or fined by the court and (il) an action against you by the employee for damages. 4, If there arc in your employment one or more additional employees whose incomes are subject to an attachment of support, you may combine the attachment payments into a single payment to the Pa SCDU and separately identify the portion attributable to each obligor. 5. You must notify the Domestic Relations Section or the Pa SCDlJ when the defendant obligor terminates employment and provide the Section with the employee's last known address and the name and address of the new employer. if known. Page 2 of J Form EN-02a Worker ID $IATT Servke Type M "",,=,,-~~ SCOTT K. ARBEGAST PACSES Momhor Numhor: 3526100027 6. The maximum amount of the attachment shall not exceed 50 % of the employee' s net income which is within the limits set in the Consumer Credit Protection Act, 15 V.S.C. *1673. 7. The tenn "income" as defined by law includes compensation for services, including, but not limited to, wages, salaries. fees. compensation in kind, commissions and similar items; income derived from business; gains derived from dealings in property; interest; rents; royalties; dividends; annuities; income from life insurance and endowment contracts; all forms of retirement: pensions; income from discharge of indebtedness; distributive share of partnership gross income; income in respect of a decedent; income from an interest in an estate or trust; military retirement benefits; railroad employment retirement benefits; social security benefits; temporary (Uld permanent disability benefits; worker's compensation; unemployment compensation; other entitlements to money or lump sum awards, without regard to source. including lottery winnings; income tax refunds; insurance compensation or settlements: awards or verdicts: and any form of payment due to and collectable by an individual regardless of the source. GENERAL INSTRUCTIONS 1, Employers may elect to deduct up to 2 % of the attachment amount for their costs, This amount must not be deducted from the attachment. It must be paid from the employee's net earnings after the income attachment deduction has been made. 2. If you choose to make payments via an electronic funds transfer, contact the Pa SCDU Employer Customer Service at 1-877-676-9580. Date of Order: 'hrch DRO: RJ Shadday )(c: defendant Servioe Typo M 22, 2000 Puge 3 ~."".. , ',', " -'I , ' )' )11 (,C )~,' ) JUDGE Form EN-028 Work.r ID $ IATT ":---~ (') l< eT; \r.. ;/ r:~ ('.~ ,,; ~ I.'; , (") () '-'.' .'!.., <" I ,. u.. ~? , ( ::\ <. , -,. ,i'l f>~ (>oj L' ;'i<' '" 'I (0 :~:~ U;l n.. ..- ,:'.:1: ,. !;;) -;J \': <.:i Cl C"} ..,.. , State Commonwealth of Pennsyl~aniil. Co./Cily/Dist. of CUMBERLAND Date of Order/Notice 11/01/00 Court/Case Number (Sp(.Acid(.,iiiUm for ms(' sommary) ORDER/NOTICE TO WITHHOlD INCOME FOR SUPPORT )1./ ;-'}:': ,'/ I',h) ;)" ;' (, }'I"-f, ( ,',/'1' 't'. .' I' " / , '( , .- ( . ,"t J"I~ /'/~'/l1 ~J/I. ,-' (0 1\,II1('f1(I('d c.lrd(,r/N(,!i(.t, , Jkl' 'h'Jj>;"I ('lilt. ;Y ) , . 'J" . ,/1 0 Jt'flllirMII' (),dN/Noliu' //1("';/(, ' ,/t'//{_'(-c-.I'/l...,' I)", ,-) I) -; 'I \ I RI: lI_RBb~GAST, SCOTT K. f:mployt'p/(Jllligclr'.; N,lnw (LI~I, Fir~l, Mil o (IriWIl,11 ()rdl'r/NlItiu' Empl(lYt'rlWilhh(JI11('r'~ ft'l!r't<ll fiN Nun~t;;----'- KEYSTONE STAFFING SERVICES INC Eml,loYNlWllhholdt:r's N.lmp' 360 MARKET ST F.mploYI'rlWllhhold{lr'S Addrt'ss 200-52-6054 [11lJ.'IOYI'\'/Ohli~~or\ ~(]{I,d \il'cwily Numllt'f LEMOYNE PA 17043-1632 3526100027 l rnploYI'''/( )1)llgor'.; C:,IS!' Idl'nlilh'r (.f)(lt-' Addf'lldum lor pldi"Uff ndm(lS duodif/('d with CdS(l$ on dttifchmenO Clh!odi<ll PMI'nt". Naml' (Ll<;t, Fir''', l\llJ See Addendum for dependenl names and birth d.l/('S a.uodaled IV;III cases on allachmenl. ORDER /NFORMA 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 ernployee's/obligor's income unlil further nolice (,ven if the Order/Nolice is not issued by your State. $ 1 ,082.00 per mooth io current support $ 0.00 per monlh io past-due support Arrears '12 we.eks or greater/ 0 yes @ no $ ___Q.,j'Qper month io medical support $ o....Q..Q.per month ior genelic test costs $ per month in other (specify) for a total of S _~82 . ~ per month to he forwarded to payee below. You do not have to vary your pay cycle 10 be in compliance with the support order, II your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 249 ...2iper weekly pay period. $ 499,38 per biweekly pay period (every two w(,eks!. $ 541,00 per semimonthly pay period (twice a month!. $ 1.082.00 per monthly pay period. REM/HANCE INFORMATION: You must begin withholding no laler than the first pay period occurring teo (101 working davs alter the dilte of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost 01 withholding. Refer to the li,WS gO'leroing the work stale of your employee for the the allowable amount. The total withheld amount, and your fee, cannot exceed 55% olthe employee's/ obligor's aggregate disposable weekly earnings, For the purpose of the limitation on withholding. the following information is needed (See #9 on pg. 21. If remilling by EFl/EDI, please call Penosylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructioos. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106.9112 IN ADDITfON, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER fD (shown above as Ihe Employee/Oblisor's Case fdentifier) OR SOCIAL SECURfTY NUMBER IN ORDER TO BE PROCESSED, DO NOT SEND CASH BY MAIL. ~"".. '''''li'I'..zn: 1.-' .'. .1. 9'. '.bU..:' 1/ {t ,(' (, I,') Date of Order: _!kNembeI' 2. 2000 DRO: RJ Sha:lJuy xc: ,:t.:>fenJunt BY THE COURT: Service Type M (),\\II'.,., I'ph.llj"n(!,!(,' IllllilH] .nJ1X;F, 'orm E N-028 Worker 10 $IA'fT ADDITIONAL INFORMATION TO EMPI,OY[RS AND OTlUR WITHHOlDERS o If rlw(.kpd YIlll <1ft' rt>qllirt.d 'fl pflJ\'idt' d ((IllY III Ihi, i(lfIlI If! yrlllr ('Jllpl1IYt'f' 1. Priority: \Vilhholding undl'f thi, Ordt.r/Nntin' h"" priorilY OWf dl\~' (lth,'r It'H.11 pr{llt''l'~ ul\dt~r S,.llt' I,l\\' <lH,lill<;1 Ihl' <;t1IlH' il1rrH1lf~ fflder"lldx ItNit!'i illld(t~rl bf!foft! rf.ndpl of lid, Urdf!f hd'll' prilJrily. If 111m!! .lft' Il'df'f,1I1tlx It'vit!'i ill ,dff'('l pll'cl'W ('(Itll.l( I tll!' rmllll!'iting .1J\,!1H y li'ih!d hdo...v 2, Comhining P.lynullll..: Vou ('till ((In\birw wilhhf'ld ,IIlHJUllh frOtllllHHf: thilll (JIlt' 'lfllploYf!t!!(Jhljgor'~ IIlCOIllt' ill <1 single pdyrlHml to f!Jcl\ .1gt'!IH'Y n~qut~'iting withholding. You Illll'il, howt'Vt'r, 'itlp.Htlttdy idl!lllify llw portion ofth!, 'iillglfl fl<lYIlHHlllhdl is dltrihut.lhle to e,lrh f!mpl()Yt!ehlbliWlr. ],' R~portinRth~P"yd"I~ID"I~ of Wilhholdi"R: VOll mml ,ep'>rllhe p<lydaleld<lle of wilhhnldi"R whe" ,e"dinR the "aym.,,!. The paydatf'!/daM' of withholdinR j" th~ datt'> rm whkh ilmollnt Wil4 withht-Id from thf": f'!mploypf"'4 WilK,",4. VOU lllur,1 comply with tlw 1.lw of tht~ st,lle of the mnpl()Yt~e's/ohlig(Jr'r, prlllcip.l1 piMP of f~lllpl(JynwIlI with ff!r,pt!d to Ihe tllnt'! w!rioclr, within whlth you 1ll11'itlmplfHllfmt tlH~ withh(lldillH ordp.r .llld forwdrd tlw r,upprHI p.IYfll!-!rUCj. 4.. ElllploYf!t40hligor with Multiplf~ Support H(lldillH';: If rIUHf! Ie; mort~ lhdll Olll! Ordtlr/~~otjn! to Wilhh()ld Inwnw for Support dg.linsl this emplnyet!/ohlig(H .1Ild YOll MP. 1I1ldhl1' to honor <III supp(Jfl Ordl!r/Nolin~s dllA to fmlt~rtll or St.lt~ withholding limits, youlllust follow the lilW of Ilw r,tJ.ltl of t~lllploYt!p.'r,/(JhliHor\ principii I pldcl-! of !'rnployrnp.llt Vou must honor .III Orderr,/r~{)lin!s to tlw grf!dtp.sI exl",,1 possihle, (See #9 h"lowl 5. Tmmilliltion Nolific<\tion: VOll nlll'if promptly Ilotify thf~ Rf!qUf.r,tillg Aw~n{"y Whf!11 tlw mnplcIY~f!/ohlJg(lr ir, nolongm wmking for you, Pleilse provide the infornldtioll rp.qlH~"lt~d tllld mtllm 01 (Opy of llli" Ordnr/N(lti('f~ 10 !he AWmcy idf!lltifind 11f'low. WITHHOI.DER'S ID: 2329113480 EMPI.OVEE'SIOBl.IGOR'S NAME: ARBEGA.!IT.JCOTT K. EMPI.OVEE'S CASE IDENTIFIER: 3526100027 DATI OF SEPARATION: lAST KNOWN I-IOME ADDRfSS: NEW EMPlOVER'S NAME/ADDRESS: 6, Lump Slim Pdymentr,: You molY he required to report dlld withhold from lump ~llln pdynwIlt'i <;uch <I'i hOllllSAS, commissions, or 5f!VefdllCe pay, If YOll have <my qlwslio!H <\hoUllulllp Slllll p,lympnrs, Ulllldrtlhe pt'H501l or aUlhority hf!low. 7, LiJ.hility: If you f,lil to withhold inCOIWl cl<;the Ordm/Nolkf! dimrls. you <Iff! litlhlp for both the dC rUnllllilted dlllOllllt you should have withheld from the f!lllploym40hligor's iIlCOlll!! <lIld otlw( pt]lhlltit~~ set hy Ptmnr,ylvdlli<l St<ltp IdW. Pt-mn5yf'..'clnia Stdte law Hovp.rn" unless the obligor is p.ll1ployed ill another Stiltf~, in which CilSr. lilt! law of thr. SI.llp in which lw or slw is f-~nlployed AoverJl'i. 8. Allti-discrimilldtlon: VOlI iHP. suhject to il flm'! delermlrlfKllIndm SIdle 1,Iw for di5ch<Hging iJll f-~mployee/ohliKor from employment, refusinR to employ, or l,lkillg di'idplilllHY <H:tiOI) dg"inst IIllY f~mploY'~f~/ohligor heCdLlSf! of d support withholding. Pennsylvanill Statf! IJW goVt'!rns unlf!~~ thf'! ohligor lr, employed inllnotlwr Stdt~, in which r<lo;p' 11m Idw of the StJ.lf! in which he or she is ernployp.d govern~. 9.. Withholding Limits: You nldY not withhold morellldl1 thf! Ip.o;o;m of: 1) thf! dmlllllltr, allmVl'~d hy the Ff!derJI Consumer (Iedit Protection Act {1S U,S.c. ~, 673 (b)1, or 2) the dlllrlUnls dUowf!d by the St,lltHd the p.ll1ployee's/obligor's prin('ipdl pldn~ of f!mploYIllr.llt. The federal limit applies 10 thl-'! aggreg<lte dispmJhlt! weekly P,iHningr, (A own, ADvVE is the nfll incollle lP.ft ,Ifter Illaking m<H,d,uory deductions such dS: Statfl, Fp.dmaL IClC\ll tdxer,i Sod,ll Sf'rurity tdxeo;; dtld Mt1dirarp t<lXPS. 10, 'NOT[: If you or YOllr agent are served with iI copy of Ihis order in the stale that issued Ihe order, YOll are to follow the law of the state that issued this order wilh respect 10 these items. Requesting Agency: DOMESTIC RElATIONS SECTION ~aOX 320 Q,RlISlE PA 17013 Ii YOll or your employee/obligor have any questions, conlact WAGE ATTACHMENT UNIT by telephone al ( 71 71 240-6225 or by FAX al lZl~ or hylmM"m @ Page 2 oi 2 Form EN-028 Worker ID $IATT Service Type M (",\1\ ',i.. 11'1', III ',~ l'I'II.lIi'OI,II.III':IJ'llillll '\"'"""' ~~11M ~~.D__M!.i\fhro~~ oeleodaol/OI>I\V,Ofl J>.RBEOI\S't, SCOT'! ~. , ,,' ~ ,."".."j.,pif> r~",,,.,,./.>"I' ~ .,..". - "" ". ~"""" """. ~,"'" ",,'" ~ """'" ,'",",,,'" ""'" " "'"", .. , ,,, ' "" "".,, . "" \ "" , .. "'" ",;.,,,,"," ",."",. C\lII<I\leo)" N.OW\'\: 03/15/85 T" ~1.P\l E. "RIlEO"B1' 10 / ~ 8/9 2 T~99 ", "RBEOAOT 008 \' \\ ',:, , , ~ I Oil ,he,l<e<l, vol! ",e 1,,<\<llllId 10 "01011 Ihll r\llld\I"") ideolllied .hoV" I" .nv \I".llh \I~"".'"'''' roVel.\\" ,wail-,ble 1\lIOll\\\I I\le e"Wlovee';/ooll\\,'1 ,,,,"WloV,,,.OI, 011 rI,"cl<"d, Vlll' "", 1",q<lII,,<I 10 ""roll II'" ehlldlle"11 01. Ideolllie<l above io aoV he.ll\I I"""ao"" ,oV",I<I\\e aW a. ' 10;0<1\\1; In" eo,plove""f,,\I\i\\OI'; e",ploVo,"o\. ^"'('t.c.('i:\%t'~ ~ ~ ^"arn,,'e'~ ~o.oo C\lil<lll"o)'; N,,,,,e(,\', 008 ~~c r~~ ~ocl<el 61~~ ~ \ 0,00 Ollld\I""'" Nanl.I'): OOB 011 e\le,(I<",d, VO(l .Ie leq(llled 10 eOloll \\le ,blld\IA") ideolllle<l above 10 alW \lealll' 11~,,"a'''''' ,ovela\\e, avall.ble ""o<l\\b I\le e",plo~ee"/ol,II\\OI ,eoWlo~,,'e"\. o It c\lecl<Ad, VOl! ale ,,,,<\(li,,,,d 10 "\'11011 Ihe chlldlle.l\) ble Ide"lllIed above I" .oV heal!\I I~""a"ce (Ov.,a\\e avalla In,o(l\\" I"A AmploVee';/obl,\\OI' AmploV"'""\. P^C<<.' C.~ ~ Oorl<AI . ,Who,en0!Jl!!\llll ~ ~ 0.00 Cn;ld\leo)" N",,,el'\', OOB ~~I~C t\~l'J;\!.'J!;l ~ ",,,'h--,el'l "rOQ1Ull ~oo C"I\d\leo'" N,,",,,I;): OOB 011 rherl<"d, VlI\\ ,II" ,,,<\(lII,,d 10 ",0,011 I\le chlldllAO) Id"olllie<l .boV" 10 ,"W \le.II\lIt~,,"al"'" rov","\\" av"ll.bl" 11",,(1\\\1 II,", ",,,ploVlI"';/ooll\\OI ; eoWloV\".o" Oil ('".cl<ed, Vl)ll.,e ,.q(ll,.d 10."'0111\1. ('hlldll"o), ' 'd ,,1\11.<1 aOov. i" ,,'W ""alllt ,,"<lI.oe. l'OVel.\\e aV"\I,,ol" 1"~O(l\\h Ih" e",plnvee',/OhIl\\OI'; e"Wlnvo"'o" fOI") (N-028 'Wo,\<.ellO $1J>.'t't i\dde"el"'" ('1~,\\Sll.:liI11(\.\I\:'" \ "'\l\I~\h\1o I,AIl'; \1! \ \/\1\1 sel'llce Wpe t>I '- 01 >- r,: h":' 1-'" ~, ,. , , ~,.". , , (,~ ")<1' '_'0) ~i:} ~'r; 1" -)E., ..~ ..,- , 0., :l :.:) , , '<l ) la , , , :~-; , :,1 , I u) ;J (.1.. ..,~. , . I ".. , , t,;' ,-~J " LJ U State Commonwealth ll1..fJ:nmlli'anlit Co'/City/Disl. of gUMBERL,AND Date of Order/Notice 06/15/01 Court/Cilse I,umber (Si'eAddendiim for ras!' summ<lfY) ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT YI'I/I(( ",( /J. 1'\ \ \ J /;/,\ o {lri~\irMI {lrdN/f\lolill' o AIl1l'ndt'd (lrJlpr/Nolicl' @ '{'rmin,lh' ()rr!I'r/Notill' EmpIO~'tlr/Withh(lldN\ h'dt'r.!1 [IN NumlK'r KEYSTONE STAFFING SERVICES INC Empl{)YI'r^.yithh{lld('r'~ N,lflll' I Rl ARBEGAST, SCOTT K. ) [mplclYt'I'!Ohlillor\ N,1I1ll' (l,<I~t, r:lr'il, ,...,\1) I' 200-52-6054 [lllpl(\YI'I'/Ohli~or', Soh,11 S,'curily Nurnl){.r I ,'j', I ( ( (' III" ~1CJI C\J _ q~ 360 MARKET ST Empluy{'rlWililholdpr', A(lcln'.... LEMOYNE PA 17043-1632 3526100027 [lllployt'l'!Ohligor\ eN' Idl'nlilil'r (5('(' Add(llldum for pldintiff hdmrs dHOddll.'d with Yd5('j on dUitchmf'ntJ Clhlor!i,ll PMl'nt'.; N,lflW O,<l~t, rir..l, 1\111 II " Ie' Ii '-, \ ....2..:.:.1...:-. See Addendum for dependent names and birth dates assodatl!d with CMes on attachment, ORDER INFORMATION: This is an Order/Notice 10 Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania, By law, you are required to deduclthese amuunts from the above-named employee's/obligor's income IInlil further nolice even if the Order/Notice is not issued by your Slale, $ 0.00 per monlh in current support $ 0.00 per monlh in pasl-due support Arrears 12 weeks or greater? 0 yes ~ no $ 0.00 per month in medical support $ o. Q.Q.per month for genelic test costs $ per month in olher (specify) (or a total of $ 0 . 00 per monlh 10 he forwarded 10 payee below, You do not have 10 vary your pay cycle to be in compliance with the support order, If your pay cycle does not match the ordered support paymenl cycle, ule the following \0 determine how much 10 withhold: $ __Q..Q.Q per weekly pay period. $ 0 . 00 per biweekly pay period levery Iwo weeks), $ 0.00 per semimonthly pay period (Iwice a month), $ 0.00 per monthly pay period. REMITTANCE INFORMA TlON: You must begin withholding no later than the first pay period occurring ten (1 Q) working days afler the date of this Order/Notice. Send payment within seven (7) working days of Ihe paydale/date of withholding. You are entitled to deduct a fee to defray the Cosl of withholding. Refer to the laws governing the work state of your employee for the the allowable amount. The total withheld amount, and your fee, cannol exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limilalion on withholding, the following information is needed (See #9 on pg. 2), If remitting by EFTlEDI, please call Pennsylvania State Collections and Disbursemenl UnillSCDUI Employer Customer Service at 1-877-676-1)580 for instructions. Make Remittance Payable to: PA SCOU Send check to: Pennsylvania seou, P.O. Box 69112, Harrisburg, Pa 17'106.9'112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obl/sor'.1 Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: Date of Order: June 18, 2001 DRO R. J. Shadday xc: defendant Service Type ~J (L\\!I ",u,: (H;'II,nl',,1 I ~l'il,ll"HI I L.t". 11/ \ I (1111 /J Form IN-028 Worker ID $IATT >," ADDITIONAL INfORMATION lO [MPlOVERS AND OHlER WIlHHOlDERS o If """k,.d you .H" ,e,qui",d 10 p"lVld" " "'py of Ihi; lorm 10 your "n'ploy"" 1. prio,ity: Withlloldil'IIU"''''' thi, Ord,'r/Noli'" II,>, pi iorilY IIV"r ,II\Y otl",r I"gdl pro' ,," uod," 51,,1" 1,1'1'1 "gdill,'II", I,U"" io,o'"'' l'"d"",II,1X I,'viel io "If", I ndoo, II"',,ipl of IlIil 0"\'" h"", priorily, If II".", ,H" h.d,,,,,1 I,IX I"vi,., in df"1 I pbl'" wol," I II", r"q",,,,il1f\ .lW'Il<'yllc,INI\w!ow. 2, Combioing P"yo"1Il11 Y,'", ,Ill ,oolbi,,,, witllll"ld ,""0111'" f,ol11 111'"'' Ih,II1 '"'" ,'n,ploy,,,,/obligor'I in('()lm' io ",iog'" p"yn""ol \0 ,,01,11 ,lg"'"Y ,,,quellil1gwilllholdiog You n,u,', lIowev"', ,,,p.H,,I,,ly id"olify th" porlio" oi II". lingl" IhlYI11"ot tll,,1 i; altribllldblf', to fh\ch ~~lllpl(Jyt~e/oblig()r. ),' R~p<)rtlng th~ P"ydllt~/Dllt~ of Wilhholdio~: You IllU,t r~p()[t III. paydat./daIP "f wilhholdinl\ when ,,,ndlng the p"yn,.nt Th. payda~,/dalt> ofwllhholding i, th~ dale on which amount '1'101' withh.ld from the emploY.." '1'1"1\'''' You 1111i\1 , oll\ply wilh IIIf' 1,1'1'1 of IIIf' ".11" 01 tl", "mploy"e',/ohligor'I priorip,,1 pi,\l" 01 "mployo"",1 wilh II"p"rl 10 Ih" lio'" pt"iodl wilhio which you mu',1 il11pl"o"'OI IIIf' withholding or(h~r .lncl forw.Hd t\w ~lIpp(Jrl P,\YIW~IlI". 4.' Employ"e/Obligor wilb Mullipl" Supporl Holdiog" If 11""" i, ,"0'" Ib"o 00" Ordt,,/No'i[l, 10 Wilbbold IO'OI1It' for Support "gaio't tbi, "mploy",'/ohligo, ,11\,1 YOU.H" uo"bl" 10 b,",or ,,1\ IUpport Ord,,,/Noli"" du" 10 1',,,1,,,,,1 or Sh'l" wilhboldiog Iimil', you o"ISI follow Ihe 1,1'1'1 01 tl", 11,,1e 01 "mploye,Nobligor" prin' ip,,1 1'1,,,,, of "",ployll1t'OI. You mu,l hooor ,,\1 Ord"rs/Noti"" 10 II", gr",'''''' ~~x:!t'.nl pO"5ihh~. tSP.t'~ #9 bplow) 5, Terminaliol1 NOlifi,"lioo: You 11,,"1 promptly oolily II", Requ"<ling Agen,y '1'11"'0 Ih" '"l1ploy",,/ohliW" i, 00 IOl1g"r working for Ple,,,e provide II", inforr,,,,lion ""IIII"I,.d ,11',1 ",IWIl ,\ ropy of Ihi, Order/Noli,e to II", Agell' V idelllif",d helow, WITHHOLDER'S ID: 2329173460 EMPLOYE['S/OBI.ICOR'S NAME: ARB!!GAST-,_R.Q91'T K. EMPLOYEE'S CASE IDENTifiER: 3526_100021 Di\TE OF SEPARATION: LAST KNOWN I-IOME ADDRESS: -- ,--- NEW EMPLOYER'S NAME/ADDRESS: -- --------- yOl!. - 6, Lump SUll' p"y"","t\; You,,,,,y be ",quired 10 r"porl ,lIld wilhl1<lid Irol11 lump ""11 p"ym"nl' ,uch d' nOllu;e;, com",!"ion;, or severance p,'y, If V"l, 11<1V" dOY quo'liolll "houl Itlmp \\1111 I",ymell\'o, ,onl,\llll", po"on 'If ",ulhorily belllw, ~---- 7, Li"hilily: IIyou f"iI to wilhhold in'o"''' ,1\ II", Order/Nolire dire,\I, V"ll.He Ii"hl" for both tbe ,\lTlImul,,'ed ,lO")tlllt you ,hould have withheld from Ihe employee/obligor'; il\COIl'" dlld oll",r pe'1<lltle' ",, ny Penn,ylv,1I1i,' Sh'''' Idw, Peno;ylv,lIli" SI"te I,\W gove,n; Ullle" the obiigor i, employed in another Slale, in whi,h """ tilt, law of Ill!' St,'le in which Ill! 0' ;h" i, employed govero;, 6, Anli_dimi""in"tion: YoU.He ;uhie, 110" fin" d"""l1Iil,,,d under Sh,lr 1,,'1'1 fo' di"h,lfging ,m e",ployee/obligor frol1l e",ployn","t, refuling \(, employ, or I"king di;,iplin,HY ,,,linn "gaill'l any el11ployee/ohligor b",,'"\\' of" support wilhholding, Pellnlylv"n;a SI"le I,IW governl Ulllell Ihe ohligor i, "'11ploy"d in ,111011"" Shlle, in which '''''' the 1.,'1'1 oi Ihe St,,'e ill which he or ;he i, emp!oyNI wlVt!rn~. 9.' Wilhholdillg Limit;; You "",y nOI withhold l110re 111<111 th" I,,"ef 01: 1) Ihe 0111""1111' dllowed hy Ihe feder,,1 Con',ul11er Credil Prolerti"n Art (15 U,S,c. 9167'J (h)1: 0(2) II", ,11",,,1\11; dlllllyed by Ih" Stale of Ihe, employee's/obligor'I prineip,,1 pl",e of el11ploy",ellt. The feder"llil11il "pplie; to Ih" "gg",gale di'po;,lble wl'"kly ",'Tllinll' (ADWU, ADWE il II," nel inwl11" left ailer ",aking malldalory deduclion; ;uch as: Stdte, f"defa!' loc,,1 t,IX";: So, i,,1 S",wilY 1"X1": ,,,,,I M"rli',If" I""." 10, ._~---- 'NOH: If YOll or your agent are served with a COpy of this order in Ihe ,tate thai issllcd Ihe order, YOll are 10 follow Ihe law of the slaW that issued Ihis order wilh respect 10 tl""e itenls, Requesting Agency: QOMf.5lIC R[I.AlION5 S[ClION E.Q. BOX nQ ---- eMUSI.E PA 17013 --- If you or your employee/obligor have any queslions, conlacl WACI AfTACI-IMINT UNIT by lelephone al tV 7) 240-622 5 or by lAX <II l717l 240-(,]411 or by Inlernet (jJ; -'- Form EN-021l Worker 10 $IATT P<lge 2 of 2 Service Type M ( 1\\1\ ~i".: II'I) il!l I ,\1 lopl1411011 !M!'" \1!\lIIH) - ..... " T '- lO r~ U; v- I, , .. . ,f ,. ) J -:-.S ) r , C i ," r ("7;1 ('. , .. ,; OJ '.. .::_:i u~ , <-} U . - ~ ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT r)W ?x!j I'i '/ & State CommonWllaLlb. of Pennsylvalllit ,}Je s., S , ''1'l/tJtJ(J.).O Co'/City/DISI, of CUMBERLAND / ().<: ;,i-'?,:!. '"7'1 Date of Order/Notice 01/24/02 Z)lt, 19'1f" ~~-; (! ItllL Court/Case Number (See Addlmdum lor case sUl/llnary) I!f/('r;{~ qI7'J~/N.'fj(IG> i)IL ,;).'73'/1, ) R[:ARBEGAST, SCOTT K, ) [lTlpl(JY{,l'/Ohll!l(jr'~ N"OH' iLISI, Flr.;I, Mil ) ) ) o Ofiginal Orck.r1Nolln' o Arm'mll.d ()rd..rlN(lli(:(' o Ti!rminalt' Onh'r/NoUu. Eml~l()yerfWlthh(Jldt!r''i fNler.ll fiN Nurnl)(!r TRIANQ~E PRESS_INC Employer/wlthholdnr's N<lml' 200-52-6054 EmploYl't'/Obli~(Jr\ Sod'll Sl'curity NumhPr 6720 A~LENTOWN BLoYD Employt'1/Wilhholdnr's Addrt'ss HARRISBURG PA 17112-3309 3526100027 Empl()y(,p/OI~'I~or's C,ISi! Ich!nUile( (.I.. Add.ndum (or pl.lnliff n.m.. mod.,.d wll~ ,..... on .f/iChm.nV C:u~l(JdjJI Pun'nl', N.lnH' (ldSI, First, NIl) See Addel/dum for dependellt "ames allli 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 CUMBERIJ\ND Counly, Commonweallh oi Pennsylvania, By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State, $ 1 ,082.00 per month in current support $ 0.00 per month in pasl-due support Arrears 12 weeks or greater? Oyes <Xl no $ 0.09. per month in medical support $ 0.00 per month for genetic tpsl costs $ per month in other (specify) for a total of $ 1. 082 .00 per month to be forwarded to payee below, YOII 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 Ihe !ollowing to determine how much !o withhold: $ 249.69 per weekly pay period. $ 499.38 per biweekly pay period (every two weeks). $ 541.00 per semimonthly pay period (twice a monlh). $ 1.082 ..ll.Q.per monthly pay period, REMITTANCE INFORMA TlON: 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 thl~ paydale/9ate of withholding, You are entitled to deduct a fee to defray the cost oi withholding. Refer to the laws governing the work state of your employee for the the allowable amount. The total withheld 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 #9 on pg. 2), If remitting by EFl/EDI. please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Cllstomer SelVice at '-877-676-9500 for instructions. Make Remittance Payable 10: PA SCDU Send check to: pennsylvania SeDU, P.O. Box 69112, Harrisburg, Pa 17106.9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER 10 (shown above as the Employee/Obligor's Case Idelltifil'f) OR SOCtAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY HIE COURT: SelVice Type M ~\"fI:.r.lf' .' I' . ~ \11 Nn 1)1)70 UIH I ~"-l. ~ 1~1l1(~tI"III)~te 1JIIII(lO !kfkJ /, / ~ k ' ~'t t 'f Cr {, 1'[/ ' Jl 2xt'G Form EN-026 Worker ID $IATT Date of Oreler: .IAN 2 5 200Z .. " ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOlDERS o If checked you am rt1qulrf~c1 to providt' ,J wry (jf this r(;fm to your {lll1rl(JYI~t~, 1, Priority: Withholding uncler this Or(h~r/N()tiu~ hdS priority {JVf!r ,my other It-'H<11 pIOCP'iS undm Sl<lft~ l.lW againsllhA S,lfnp. lnrome, FedfuallC\x Itwlfl'i in t!fff!cl bdorf~ mCfllpl of Ihis (Jrrh:( Il.IVf! priority. If lhe"~ <Iff! FfJdi~rdl t.IX Ifwim ill tJff('ct ple.l'if! COlltdCllhp. requesting ilgency li'ted below, 2, Combining PJymento;.: Vou <:.111 r()mhillf~ with/wid .1nlOllllts from mure th<lll OfW t~mpJ()ym~/obljgor's income In a single payment to each <lgency rflque<otlng withholding. You must, howevt:HI St~p.lr.lIFdy identify tile portion of the !lingle p;lymf!l\t thaI is attributable to flitch flmployefl/obliRor. j,' ~~Reporting-lheP.ydat~/Date 01 Withholdi'lg: You mu<l r.port thepaydate/dill. ofwithhoidingwh~n '~nding the'payment: -Th.- paydateldam--of-witnnoldinKi, tht'!"d<ltf"on whirh,'tmollnt WM-withheld fromtnf'! ~mploYf'!e'"! Wl'~t!~: You mllst comply with the law of the slale of the employee's/(Jbli~or's principal pl<lu! of employment with w'ipect 10 llwlime periods within which YOll mllst implement the wllhholdlng order and forw.ucl tlw support pdynwnt'i, 4.. Employee/Obligor with Multiple Support t-!(Jlclings: If thme IS nlor~~ Ih<ll\ DlW Orclp.r/Notice to Withhold Income (or Support agaJnst this employee/obligor ,1ncl you <Ire unahlfl to honor ,Ill support Order/Notic~!s due to Feder.1I or Slate withholding limits, you mllst follow the law of the stale of f!mploYf!f"s/obligor's princip.ll pldn~ of t'HllfJloynHmt. Vou mLlS! honor <Ill Orders/Notices to the greatest exlent possible, ISee #9 b.low) 5. Terminalion Notificcltion: YOll must promptly notify Ilw Requesting Agenry wilen the ernploYf!f!/obligor Is no longer working for YOll. Please provide the information mqllmtnd and rNurn d copy of lhi~ Order/NotiCtJ In Ihe Agency identified below. WITHHOLDER'S 10: 2317268420 EMPLOYEE'S/OBLlGOR'S NAME: ARBEGASL-. SCOTT K. EMPLOYEE'S CASE IDENTIFltR: __ 3526100<227 DATE or SEPARATION: LAST KNOWN HOME ADDRESS: _____ NEW EMPLOYER'S NAME/ADDRESS: 6. lump Sum Paymp.nls: You mclY be required to feport Jnd withhold from lump sum payments such as bOnLlSe5, commissions, or severance pay. If YOll have any qumtions .lbollt lump slIrn paynH-mls, contcKt the person or authority below. 7, Liability: If you filii to withhold inmme <IS Ihe Order/Notice directs, you dre liable for hoth Ihe accumuiated ilmount you ,hould have withheld from the employee/obligor's incollw Jnd other pefldlties set hy Pf!fltlsylvania Stare law. Pennsylvania Slate law governs unless the obligor is emploYfJd in .lnother Stille, ill which ('ase thf! I.rw of the Stdle in which he or stw is employed governs. B. Anli-discrimination: YOll <Ire suhjftct to .1 fine determined under Sldte Idw for discharging dn employee/obligor from employment, refusing to employ, or tclking disciplirldry o1{"llon clgaiml any emploY~f!/obljgor beGluse of a support withholding. Pennsylvania Slilte law governs unless the obligor is fllllployed in anolher State, jn ,"vhich case the law of the State in which he or she is employed pvern" 9,' Withholding limits: You nlilY nOI withhold more th,Hllhe lesser of: 1) Ihe alllounts allowed hy the rederal Con,umer Credit Protection Act 115 U,S,C, 91 &73 Ih11, or 2) the amounts allowed by Ihe Slate (lIthe employee',lobligor', principii I place 01 employment. The Federilllim;t applies to Ihe ilggregolte disposilhle weekly earnings (ADWE), ADWE is the net income leh ilh.r making mandatory deductions such as: Stelle! Federclll local taxes; So('i<ll Security t..nwsi ilnd Meclk,ue taxes. 10, 'NOTE: If you or YOllr agent are served with a copy of this order in the stale that issued the order, YOll are to follow the law of the state thai issued this order with respect 10 these items, REquesting Agency: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST e..Q. BOX 320- CARLISLE PA 17013 II YOll or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at 1717) 240-6225 or by FAX at l.Z.l7l 240-624R ,or by Inlernet @ Page 2 of 2 Form EN-02B Worker ID $IATT Service Type M (J,\lII~'h:Ol}J().l)l.H hfJlr4tlon[l.lll!: 1<1.11100 .~ If) '- h_~ IJ: (. " , .. ".'::; , , ("i "-1' f-' ~-',? " , _T; L) ::i. ! 0_ ... ~.. -\ :-,'.1 "" (f'"') ) ~a '\ (Lj . n 0... ; ~: "d :,:l C.:J U ,,' ORDER/NOTICE TO WlTmlOlD INCOME FOR SUPPORT ,1/ /'/ I I -.<;~) State -'wnmonwealllt,of Pfnns,iliani.a. , : t, , ,'" ' / ,.', ' ( @Original Ord,'IINnlln, Co.lCitylDisl. o( ~_mAND_____ "Jrl,,' , ,;' II III f'(' ) 0 Anwnd",1 Ord",INulI'" Date of Order/Noticc 02/12/0. ,\oi,' .;/ )'/11 {I ,;J ., n',..",'",'" ()"Io'rINoll,,, " --'-- fWt.... r5/ /11m IQCO' J ! -'III Court/Casf: Number (See Addfmdum/or f,1Sl' .wmmary) , \ ) L'" L.- .,7,' ~ 1)1' '.., ;; /" (' (/ 1/, I ( (( / 'I (" . I RLARBEGlIS'r, SCOTT K. Elllployt~r^VilhholdN'" Flldl;-;~Y8N NUIllIM\~----~' ) EmploY('t'fObliWlr\ N,.nH' (List, fir,>l, MI) J H BRAND'r & ASSOCIATES INC I 200-52-6054 EmploYf!rlWilhholdi'r'~ ~4J"1O -Employpp!Obligor's SodJI Sm:lIrily Nwntlt1r 657 FORGE RD EmploYtlrlWilhholder', Acldn'ss CARLISLE p~ 17013-4367 3526100027 Emlll{lyt'f.'/()bljlJor'~ Cil.,l' Idt1rllili('f (s('(' Adrkndllm ~or plainliff nelm!!s d!iSoci..t{ld w;!h Cd$('S on rftldchmenfJ Cu~IOfli,11 PMI'nl's Nam(! (List, firs!, Mil See Addendum/or dependent names alld birth dates associated with cases on attachment, ORDER INrORMA TlON: This is an Order/Notice to Withhold Income for SUPllort based upon an order (or support from CUMBERLAND County, Commonwealth of pennsylvanio. By law, you are required 10 deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State, $ 1 ,082.00 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? 0 yes (Xl no $ p ~Q.Q per month in medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1,082.00 per month to be forwarded to payee below. '\,;;:;-;" J You do not have to vary your pay cycle to be in compliance With the support order. If your pal' . cle does rFo .fOatch the ordered support payment cycle, use the following to determinc how much to withhold: ' $ 249.69 per weekly pay period. $ 49,2...J.e.per biweekly pay period (cvery two weeks), $ 541.00 per semimonthly pay period (twice " month!. $ 1.082.00 per monthly pay period, REMITTANCE INFORMATION: c::5 You must begin withholding no later Ihan the first pay period occurring ten (101 working (lays, ter tile date df1l1is Order/Noticc. Send payment within seven (7) working days of Ihc paydate/date of withholding. You are entitled to dedud a fee to de(ray the cost of withholding. Refer to the laws govcrning the work Slate of your employee for the the allowable amount. The total withheld amounl, and your fee, cannol 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 pg. 21. If remitting by EFT/EDI, please call Penns\'lvania Slate Collections and Disbursementllnit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA seDU Send check to: Pennsylvania SeDU, P.O. Box 69112, Harrisburg, Pa 17106.9112 tN ADDITION, PA YMENTS MUST INCWDE THE DfFENDANl'S NAME AND THE PACSES MEMBER ID (shown above as the EmployeefObllgor's CaSl' Identllier) OR SOCIAL SECURtTY NUMBER IN ORDER TO BE PROCESSfD, DO NOT SEND CASH BY MAIL. BY THE COURT: Date o( Order: FED j ~ ,Og~ // ! l ,( ~. //j ;/ i/ Service Type M '.,'..-l'......,II":'.lL~D ,/ ',,' . t Jir.:..' I.', --'". . f.__:"w~') (l\\n',",:O'I'!I.()I~,.1 ,'L1:1 ( , IWlloIti!'FlI!,IlI': \1/1Iilll\ ,-~,,-- -------- -r. ~ ,."( ,', ". , ; i:.,'\r'l Form EN-028 Worker ID $IATT ADDITIONALINI'ORMATION TO EMPLOYERS AND OHlER WnHHOLDERS [J If (lmckml YOl! .Hf' ft!quirmj to prflvlth' ,\ copy {If Ill).; ((Jrm 10 your f'f1IployP!! 1, Priority: Withholding ul1(lt~r ,hi" Ordl!r/N()IICt' 1M'! pr!< Ifity (Jvm "'1Y (JtIH~r lug,,1 prrJCI!'ic, ul\dt~r St,llp. I.\w dg,liml lhtl 'i,lI1W illcome, Fflderdlldx lf~vlt~s In ('f(lKI before wCfdpllJ( lhi.. (lrd!'f IMV!' priority. Iflht'H: .HI' h~dl'r.III,lx fllvim ill {~(flHl plf!tl'ie nmtdct tlHl rf~qlle'itlf'H .IW!IlCY Ilslmll1elow. 2. Comhllling P,IYI1l(!Ilt'i: You rlifl llllllhitll' wilJdlt'ld <lllltJ(tnl'; !rolll mop' th,\tl (JIll' "lllpl[)Yt!t!/ohligor's illuJ/lw ill':l sinHlf! fJ<iyrmHll to each a/-lnney mque'illng withholding. YOll Iml'il, hOWf!VI'f, 'il!ptlr,iIl'ly ldplllify tll!! portion of IIII! 'iinHlt~ IMynwnlllh11 i.. ,lllribuldblf! 10 flitch employm!/ohJ Igor, 3.' , ., Reportinn the f'i1ydllte/D"'e 01 Withholdi"!:, Yo" mu<t "'p<>rlthe p,'yd"te/dill" of withholdiog when <ending the p,'yment. The paydare-/dateof wtthh(,lldln~ i~.-tht'! d",f"! on which amount W,-l'l wifhht>lcl from ,h~ l"!mploY/:'I'" \N<tg'~'i. YOllmust comply with ,h~ l<lw (Jf IIw 'itate of the elllploYfln',/ohligor's principal pl,ln! of employnwllt with n~'ip{~(tt(lllw tlnw pf!rjods wilhin whirh you nlllsl implement the withholdIng ordflr ~lIld forward the support ,MynlfHlt,. 4, a f:mployp.e/ObIlWH with Multiplt~ Support Holdings: If tlWrf' I' IlHHf~ lhall orH' Ord~~r/N(Jfkf~ to Withhold Inc(Jm~ for Support .1IJainst this elllploym!/ohlignr and you Mf! lIn,lhl!' to honor "II support Ordt!r/N()tiCf~'i dUt-! to Fl'der<l1 or Stilte withholding limits, YOll mllst follow the law of Iht! st,llt! of p.rnr!oYAf~'S/()bljH{Jr's priuripdl rldcr! of employment, You Illust hOllOI' dll Ordms/Notkt!s to Ihl:~ grf~atest exlen, pOlSible. IS"" #9 b"low) 5. Termination Notification: YOll must promptly notify the R~lqLJt!Stjng AW~flCY wlwn Ihr. elllploym~/ohligor is no longer working for you. Ple,lse provide the inforlTldlion reqllf!stmi ,md r~~lurn tl copy of this Order!N()tiu~ 10 the Agency idmltified below, WITHHOLDER'S ID: 2518244320 EMPLOYEE'S/OBlIGOR'S NAME: ARBEGAST , SCOTT K. EMPLOYEE'S CASE IDENTIfiER: 3526100027 DATE Of SEPARATION: LAST KNOWN I-IOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum P(lyments; VOll nhiY be rp.quirP.d 10 report and withhold from lump slim pdynlents sLlch as honllses, commissions, or severance pay. If YOll havt:~ <my qumtioflS d~)()Ullump sum r<IYlm~nt<j, mntaCl the person or Juthority below. 7. Liahility: If YOll f.lll to withhold Inn)nh~ d'i dw OrciN/Notice dirtHt'i, you are li,lhlR for hoth the accumulated dmollnt YOll should hilve withheld from the employee/obligor\ income dnd other pelhlllies set by Pennsylvania SIdle law. PennsylvJnia Stdte law governs unless the obllgor is employed in <wother StdtE'l, in which case the law (Iffhf~ Stdte in which he or !the is emplored govE!rns, 6, Anti-discrimination: You are subjf!(t to J fine delenninecl under Slale law for disrhMging an r.mployee/obligor from employment, refusing to employ, or taking di!tciplinMY action d~pinst.HlY employee/obligor ne<:<luse of i.l support withholding. Pennsylvania State law governs unles!t the obliHor is employed in another St.ltr~, in which (<lite the 1.1W of thl'! Sl~lte in which he or she is employed governs. 9. III Withholding Limits: You indY not withhold rnorP. than the lesser of: 1) thf~ amounts ,dlowed by the rf!derdl Consumer Credit Protection Act (15 U,S,C, \ 1673 (b)l; or 2) ,he amollnts illlow",' by the Stil'e of the employ",,'s/obligor's principii I plil"" of employment. The FedcralUmit applies to the aggregat~l dispos,lble weekly earnillhs (AD\rVn. AOWE is the net income left ,lfter Illaking mandatory deductiom such as; Stelte, federall local taxes; Sorial Sf!curity tilXf'Sj and Medic.1fe taxes. 10, 'NOTE: If YUlt or your agent are served with a copy of this order in the state thai isslled the order, YOlt are to follow the law of the state that Issued this order wilh respecl to these ilems. Requesting Agency: DOMESTIC RELATIONS SECTION LJ~NOVER ST ~. BOX 320 QJllISI.E PA 17013 If you or YOllr employee/obligor have any questions, conlact WAGE AHACHMENT UNIT by telephone al (717) 240-6225 or by FAX at lZlZl.l1O,6248 or by Internel ~ Page 2 of 2 Form EN-028 Worker tD $I1\T'f Service Type M ()\\il ..." : O'J~O-Il 1.l4 l"pil,lli"n(III,,=I;'\I,'On f nV.' '.00;" 'r";;' 'i ORDER/NOnel TO WllIiHOlD INCOME FOR SUPPORT !'i/ yx - 1"; () /1'/( State Commonwealth of PenrlSY.I.\oanlil, Co,/City/Disl. of ~UMBERLAND ( ) 1(<:- ( ( ; )fi / I (tYI, Date of Order/Notice 02/07/02 I)/! ) (,Yj<, Court/Case Number (See Addendum for case summary) o ()rlginJI ()rdl'r/Nolkl' o Anlt'nrh.d (lrl!t'r/N(llicp o TI'fl1lirhlh'(Jrl!l'r/NI1liro EmploYN/Wilhho!dl'r'>i Ft.dN,11 EIN Numhl'r TRIANGLE PRESS INC El1lflloyt'rlWilhholrler'!> Ntlnll' 6720 ALLENTOWN BLVD EmploytlrlWilhholdl'r'<; Addn'~" HARRISBURG PA 17112-3309 I RI, ARBEQ~ST , SC01'T K. ) [nlpl()y('('/()hli~~or'" N,IIl\l' iLI\1. Fir.;l, 1....111 200-52-6054 -Fmplo,'l'I'/Ublif:nr'.; S(lfi,ll ~(l("u(Hy Nwnlll'f 3526100027 EfllIJloYl'I,/(lIJligrlr'\ (:,l"t' hlt'nliii(l( (Sf'(l AddMdum (or pldintlff nam(lS associdt(ld with CdSlI,i on "ttachmMt) C:uo;,ludi,11 PMt'n''.; Ndnll' (1..1,1. Fir..l, ,'vIII See Addendum for dependent names and birtl, dates associated witll cases on attacllment. ORDER INFORMA TlON: This is an Order/Notice to Wilhholdlncome iOI Support based upon ,1'1 order ior support from CUMBERLAND County, Commonwealth of Pennsylvania, 0\' law, you are required to deduct these amounts from the above-pamed employee's/obligor's income until iUrlher notice even ii the Order/Notice is not issued by your State. $ 0.00 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? Oyes @ no $ ~__...Q..,.Q.Q.per month in medicai support $ O...Q.Q.per month for genetic test costs $ per month in other (speciiyl ior a total of $ __0 .00 per month to be forwarded to payee below. You do not have to vary your pal' cycle to be in compliance with the support order. If your pay cycle does not match the ordered sllpport payment cycle, use the following to determine how much to withhold: $ 0.00 per weekly pay period. $ ~..Q.Q.per biweekly pay period (everv two weeks!. $ O...J2.QJler semimonthly pay period (twice a month!. $ 0.00 per monthly pay period. REMITTANCE INFORMA TION: You must begin withholding no iater than the iirst pay pel'iod occHrring ten (10) working days afler the date of this Order/Notice. Send payment within seven (71 working days of the paydate/date of withholding, You are enlitled to deduct a iee to defray the cost oi withholding. Refer to the iaws governing the work state of your employee for the the allowable amount. The total withheld amount, and your fee, c"nnot exceed 55% of the empioyee's/ obligor's aggregate disposable weekly earnings. For the purpose oi the limitation on wilhholding, Ihe following information is needed (See #9 on pg. 21, If remilting by EFT/EDI, plea;e call Pennsylvania State Collections and Disbursement Unit (SeOUl Employer Customer Service at 1-877-676-9580 ior instructions, Make Remittance Payable to: PA seDU Send check to: Pennsylvania SeDU, P.O. Box 69112, Harrisburg, Pa 17106.9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THf PACSES MEMBfR 10 (sllown above as the Employee/Obl/sor's Case tdf'ntifier) OR SOCIA L SfCURITY NUMBER IN ORDfR TO BE PROCfSSED. DO NOT SEND CASH BY MAIL, Date of Order: FEB BY THE COURT: 8'.. -,.I/!~~d/- kWd , : c.; !":~ THil' ~'V1"'i\ F"7 Form EN-028 (::l-...:jkAt~~l,.\II"".:IJ'i71I(1I'" Worker ID $IATT _.....-) I (l./'fJ 1.'Il'i..ltinl>I 1,11r>. IFJI'illl Service Type M ADDITIONAl. INFORMATION TO EMPI.OYERS AND OTHER WITHHOl.DER~ o If dwckncl you <Hl' n~qllirt!(llt) provid~~ tl ((lPY (If tlli~ form III yuur f'fIlpl(I~'f'f1. 1. Priorhy: \Vithholding llllclf'r lhh Ord!'rlr"'oti(f~ I)'I~ pri(Jrily ()Vf'r .lIlY (111wI h:g.ll prOf f"i'i lll\d~~r Sldtro lilW dg<limt llw ,all1P inronw, ftlderrll tdX lp.vim in effect im((Hf! wndpt of lhi~ orell'! h.l\'f~ priority. If thl'ft' .1ft' f"dpf.ll t.lX li'vif''i itlldff~( t ph.',m' {"ont.KI t/w rmlUp.<;ting ilW~IH'Y Ilslf!d belm\'. 2, Combining P.lynHmt'i: YOl! (".Ill ((JlllhilH' \vitl1lHdd ,11l\OUIlf'; fWIll mort! tlltil\ nllt' 1~lllpIOYf~p/(jhliWJ('.; incolllt-, in d single p.I~'1llp.1l1 10 e.]ch <lgf'flCY requesting withholding, YIlU nlmL hlJ\Vf'VI'I, 'i!'1l.Hdtl'l~' idt~tHify ,IIf' portion of tlw ,>inglf' p<iynlt~IH Illdl is .lttrihlltdhlf: 10 each t~ll1pl()ynf'.!l,hljWlr. J.. Rl'!ptlrtin~ th~ P<tyd':ltt!fD':ltP. ()fWlthholdif)~: You Il1l1'11 r~port th~ p"yd.:llf'/dal~ 0; wilhholdirl~ wh~n'lendif)g thr:-payment. The p.,ydate/da~ of withholdinRi'lthe!datt'! on whirh amount W,l'! wi!hlHdd from llw p.mployp.f.',! wa~wo;. Yolt must (;ul11ply with th~ ldw of the sIdle of the emplI)Yf!~!'s/()hligor's principClI piau. (If f'nlploynwnl with rfl'ip~(II() tlw tinw periods within which YOlllllllst il11plermmt thH Wilhholdin)l, order dlld forward the support PdYI)H~IlI". 4.. EmploYf!p./Obligor with Multiple. Support t-loldillg,,: I; tlwre is more thdll OIW Ordpr/Notiu. to Withhold InuJIlle for Support .1gdillSt this p.mployee/obliHor and you Mf~ L1lhlhlf' to honor <Ill support Orc!fH/Noticps c111f-~ to h!(h~rdl or Stdte withholding limits, you lIlust follow the l,lw of thf~ st<lte of ~lllployp.p.'s/()bljg(Jr's princiPdl pf<Ht~ of fllllpfoYI1lf-'nt. You must honor .111 Ordf~rs/N()tin!s to t1w greatest flxh~nt possible. (5fJp. #9 h{~low) 5, Termin<ltion Notification: You mu..t promptly notify tfw Rf~qlW..tiflg A~Wt)cy when the empk)Yefdobligor is no longer working (or you. Ple,l'ie provide the informdtio!l n~qLlesttld dncl relurn d copy of this Ordt~r/N(Jtin: 10 lht~ Agt~IKY idf~ntifiP.d below. WITHHOLDER'S ID: 2317268420 EMPLOYEE'S/OBLlGOR'S NAME: ARBEGAST , SCOTT K. EMPI.OYEE'S CASE IDENTIFIER: 3526100027 DATE Of SEPARATION: _____ lAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump 5wn Pilyments: You nldY be required to report <IIKI withhold from lump SLlIll p<lynlents such as hDl1LlSeS, commissions/ or sever,lIlce P,lY. lfyoll h':lVe i1ny questions <lbollllump SLlIll 'Mynwllts, rOllfdcf tlw pp.rSOl1 or <lllthority hf~l()w. 7. Liabillly: If YOll fJil to v\'ilhhold inconw dS the Ordp.r/NoljCf~ directs, you .;ue li,lblt' (or both Ihe dCClIllluldled illllount you should have withheld from the employee/obligor's illconw Jlld otlwr pfmdllif~s set by Pp.nnsylvanid Stdlt~ IdW, p(~'Hlsylvaniil State law governs unless the obligor is employed in .:mother St<lle, in which ("d'if~ tlw law of llw Sl,lte in which he or she is employp.d gOVt~rns. 8. Anti-disnimini.ltion: You di'P. sLlbjecllo .J fine d('~termined under St,lte IJ\v for di..chJrging iln emploYf~e/obligor from employment, refusing to employ, or t.lking disciplinary .lelinn again"t .lny p.mployee/obligor becdLlse of cl support withholding. Pennsylvania Stdte lilW governs llllless the ohligor is t!mpl()y~~d in <lI)other Stdtt-~, in which C<lse thp. law of the 5tatt~ in which he or she is employed Rovp.rns. 9.. Withholding Limits: YOll may not withhold morp. th,lIltlw 1p."sN of; 1) the dll101lnts dll(lwecl by rhe federal Consumer Credit Proteclion Acl (15 U.S.c. 91673 (b)l, or .2) IllI' allloLlnts "lIow"d by lilt' 51ale of Ih" "l11ployee's/ohligo,'s principal place of employment, The Feder.lllirnit dpplies to flu'! aggreg.lte disposilhh: weekly eiHnings (ADWE). A.DvVE is the Iwl Income left .lfter making mandatory dedllCtions sLlch dS: Stale, Federal, loedl taXf!S; Soci"d St~("urily taxe,,; ,lIld i\-'\~die,lrf~ t<lX[~'i. 10, 'NOTE: If you or your agent are selVed with a copy of Ihis orcler in the Slate thaI issued the order, you are 10 follow the law of the stale that issued this order with respect 10 these ilems. Requesting Agency: DOMESTIC REI.ATIONS SECTION 13 N. HANOVER ST [,..Q,JKlX 320 CARL.lSI.E PA 17013 Ii you or your employee/obligor have ~ny queslions, contilcl WAGE ATTACHMENT UNIT by lelephone al E.l 7) 240-6225 or by lAX at (717) 240-62.4!L- or by Internet @ Page 2 01 2 form EN-028 Worker ID $IATT Service Type M (l\\Il'.".:II'/;'(J,I>I,.' fwil,jlior,!I,tll': IJ/1j'iI<J ORI>ER/NOTlCl 10 WITHHOLD INCOME FOR SUPPORT / /..1 o Original urdor/Notia1 o !\nH'r1(I(~(1 Ord()r/No!icl:! o r prmln,II(1 Ordor/Notkc St.lte CommollW.llll1tb..l1i.rlllll1Syll:.uJi.a. i', J.' II i { } I C ,(" II)' I r ('UMUFRLANU 0.. ,i1y ".Il ---,-_...._,..,-,--- / "/" 11/ (i11.1t D,llE' Ilr ardl.r/Noti, e 02/2 I I 0 J ()/ ',.. c. Trlblll",I/C."I' NumbN(See Adc/i.ndum for case summary) 1\1(. ," 'I /', ! I'"'' 'f{- TR1ANGL~ PRESS INC 6720 At,LENTOWN BLVD HARRISBURG PA 17112,3309 KI:~A/;TI, 8Co'rT K. imployrc/Ohligor\ Ndm(' (l.a~t, !-ir:>l. Mil 200-52-6054 IlllploYf'f'iOhli~or'''S~ci<li \f!curlfY Number 3526100027 Fmploypc/Obligor'<; Casp Idmltifier (See Addendum for plaintiff lIam~s as,HKJa'ec/ with ('",S(I$ on ",t.c:hmMt) (~lISI()(ljil! Parent's Nilmfl (1.<151. rir~L Mil rnlployrrl\Nilhholdc;'s '('<lordl [IN Numbt.r See Addendum for depeno'ent names and birth dates .1Ssodated with c.1ses on attachment. (IRDER INI'URMA TfON: This Is an OrderlNotice 10 Withhold Income for Support based upon an order for support from CUMBlmLAND County, Commonwealth of Pennsylvanlil. By Idw, you dll' required to deduct these amounts from the above-named employee's/obligor's income until furthl'l notice even if till! Greim/Notice is not issued by your State. $ , 1. ,082.00 per month in current support $ 0.00 per month in pdst-due support Arrears 12 wet'ks or gnWerl Oyes (g) no $ .. ---'0:00 per month in medical support $ =-:--=-- 0-:00 pel month for genetic test CCJsts $ per month In other (spl'cify) for a total of $ ____1, 082.00 per month to be forwarded to payee below. You do not have to Vilty your PdY cycle to be in compliance with the support order. If your pay cycle does not match the ordered support pdyment cycle, use the following to determine how much to withhold: '$ '____ ~.,tiper weekly PdY period, ~ ___'1..2ll..llper biweekly pay period (every two weeks). $ _ 541.00 per semimnnthly pay period (twice a month), $ -----1,.Jl..l!.L.Q.Q..pel monthly PdY period, lW'vfITTANU: /\/lnRIvIA TfON' You mllst 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 pdydate/date of withholding. You are entitled to deduct d fel' to defray the cost of withholding. Refer to the 1.1WS gOVf'rning the work stdte of your employee for the allowable ,lmount. The total withheld amount. and your fee, cannot exceed 55% of the employee's! obligor's aggregate disposable weekly earnings. For the pllrpose of the limitation on withholding, the following informdtion is nel'ded (See II lOon pg, 2). If remitting by [FTlED!, please cali Pennsylvania State Coilections and Disbllrsement Unit (SCDU) Employer Customer Selvlce at 1-117/-676-9560 for instructions, Make Remittance Payable to: PA seou Send check to: Pennsylvania seou, P.O. Box 69112, Harrisburg, Pa 17106.9112 IN ADDtTION, PA VMENTS MUST tNCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown IIbove a.~ the Employee/Obligor's Cue Identifier) OR SOClAt. SECURITY NUMBER tN ORDER TO BF. PROCESSED, DO NOT SEND CASH BY MAtL, D.lte of Orde,,_ "-~4-l-4-2uu-.?:. ~_~~li{", ': qA~(, d ,[' ~I().3 BY. fHE co.. l.JRT: '~}'~.2.;f.' "{ / ///1.1 /,.' ~ /' , ,^L"" ;-:;,,/;;., '<,,~ pi- "mn FN.026 lJMIl N,,_ (I'))ll-Oli.t Workt'!r 10 $IAT1' Service I yp" M ADDITIONAlINFORMA'JION TO EMPI.OVERS AND OHlER WITHHOlDERS o Ii rlH'cked you Me required to 'H(JVi~lf' (11:(JP~! 01 thi;; forlllln your I'rIl/lloye(', If YO~Jr ('rnployep,worko; ill I_I 'ilcllt' thill is di"(l(t'nllrcHlllht' '!lale IIldl j""lwd tiltS (}f( N," copy fllll~iIIH' provid(!( 10 your t'fllployt't' ('VOrl 111"(' 110)( I... not dll!('~(~d, 1, W{l appredillt' lilt' vohmttlrY (ofllplil\rlCe of Fed('(cllly t'('cogni/ed IndillfllriluH" tritJdlly.(Jwrll'd !JU<,llll'S<'(''', ilnrl IlldidrH)WrH'd busiJwsses located on ,1 reservation thdt dlOOSt' to withhold in ,HTorddlH'(, with thl" Ilotice, 2. Priority: Withholding under thi,; Order/Nolin' hils IIriority ow!r .my oltH'r IOgill process und{l( Sldlp law tlJ~.liflSlltw ~ilnw income, Fnd(l((ll 1,1X levies in pffcct hefore rewipl of thi... orciN have priority, If thN(l <ire Fpdprdl tdX levit's In (lH(~Cl plpilse conldct the requf!sting .gency \lsled he low, 3. Combining Payments: You (',m cornhinp withheld amollnts from morl' thiln orw (~rnpl(Jye(l/obli~(Jr's in(olTH' in i1 single paymonllo each ilRnncy ((~questing withholding. You must, however, separately identify the portion of the singl!' paymont that IS attributablo to (lach employe('/ohligor, 4.' Reporting'lhe Paydate/Date of Withholding: YOII mll,t rt'port IhepaydalelOate of wilhholding when ,ending the payment. The- paydate/date nf wlthholdingl'the date on whlrh amollnl w^, withh.'IcHrom Ihe employee', wIlge', You musl rornply wilh Ihe I.w of the state of the omploy(!p's/ohligor's principal place of ('mp)oymf'nl with W!ipcrl to the tinw periods within which you mu~l implement the withholding order and forward the support paymonts. 5.' Employee/Obligor with Multiple SlIpport Holding" Illhere is more Ih.n om' Order/Nolice 10 Withhold Income Inr Support .g.lnsl this employoe/ohllgor ilnd you are unable to honor "II support Order/Notices due 10 FedNill or Stale withholding limits, 'lOll mllst follow the law of the state of employeo"J/obligor's principal plilee of f'mploymenl. You must honor all Orders/Notices to the greatest extent possible. (See #10 1",loWI 6. Termlnallon Notification: You must promptly 1l0lify Ihe Requesting Agency when Ihe employee/obligor is no longer working lor you, Please provide ttw information requested and retum a copy of this Order/Notice to the Agency identiiied below. WITHHOLDER'SID, 2317268~20 EMPLDYEE'S/OBLtGOR'S NAME,__.. ARBEGlI_1IT.... SCOT'f K. _____,_, EMPI.OYEE'S CASE IDENTIfiER: 3526100027 DATE Of SEPARATION: LAST KNOWN HOME ADDRESS, __ NEW EMPLOYER'S NAME/ADDRESS: 7. Lump Sum Payments: YOll may he reqLlimd to report and withhold from lump surn payments such as bonuses, commissions, or severance pay. If YOLl have any qu()stion.. about lurnp sum payments, contact the person or authority below. B, !.lability: II \'ou fail 10 wllhhold income.s the Ordm/Nolice directs, you ,He liahle for bolh the .ccumulaled .mollnt you should h,,, " withheld from the employee/obligor's income <md other penalties set by Penn::.ylvania State law. Pennsylvania Slale law governs unles') the obligor is nmployed Ifl another Slale, in which case lhe law of the Statp in whkh hf' or she is employed Boverm. 9. Anll-dl.crhnlnation: YOU,He subject 10. fine delermined under SI.lc j.w for dlscharglng.n employee/obligor lrom employmenl, refu,ing to employ, or taking disciplinary action tlgainst any mnployce/obligor because of a 'iupporl withholding. Pennsylvania State law governs unl(!ss thr obligor is employed In another Stalo, in which case the law of Ihe State in which he or she is employed governs. 10,' Withholding LImit" You m.y not withhold more Ih.n th,' lesser of: 1) the .mollnts .llowed by the l'eder.1 COllsumer Credit Protection Act (15 [J,S.c. 91673 (bll; or 2) the .mounls allowed by the SI.le of the employee's/obligor's principdl pl.ce 01 employment, The federallirnit applies to the i1ggrogate disposilhlo weekly f'nrning.. (ADWE). ADINE is the net Incomp left after making mandatory dedllctlom such as; Stale, FedNilC localtaxcSi Social Security taxes; i:lI)d Medicare lax(l~. 1" Additional Info: .._ 'NOTE: If you or your ,'gent ,He served with a copy of this order in the sl.le that issued Ihe order, you Me 10 follow the law of the slate that issued this order with rospect to these ilems, Submitted By: QQ.MJJTIC REIA'IIONS SECTlON__ 13 N. IIANQ.'dR.S.L__,__,__ 1'.0. BOX 320 Ql!llCilLf'.t.UZQJ 3 If you or your omplo\,oe/oblignr have any queslions, conlilCl WAGE ATlACHMENT UNIT hy 'el('phone <II LZl?l.Z40-6225 or hy I'AX at lZlZL2.1Q-624B or by inlt'rnel www.childsup.I)(.rl.st.lte.pd.us I'age 2 of 2 form EN-02A Worlwr ID $IAT1' Service Type M lIM!! No 0'}70.(11~.1 .' ORD[R/NOTln TO WITfIHOI.D INCOMl H>R SUI'PORT SI.lle _CmullUlmte.<lllh of PelJtm'.ll'illlid. Co./Cily/f)isl. of ClJliBJo:RLcAND __~_~ Dill" of Ord"I'/Noli('" OH/22/0:l JrihlJllill/c.lSt' Nurnl,,'r-(Sel' Addl'ridum for c.l,II' ,wmm,1ryi (0(lrigintlltlrdI'T/N{)li{!' () t\tl1l'1ldl'd (IrdN/NcJlin' o !lHmin,I!I'{Jrdl'r/Noli('{' R & R PtJ\STER AND DRy\qAL,t, 325 EAS'rERN DR HARRISBlJRG PA 17111-3394 M:/. ?~ s l'I~f ;'!It$f C; .sfl~ IC>O{);U) bu 199 r ~ 95"1 t!(/lIL ~~lS 97S'IO(.)OYt, f{1 : .ARlH~OAStr, HeO'IUl' K. I rnplnVi'I'/Ohligor'.; N,w1f' {l ,I~L Ijr~L Mil 200-52-6054 IllIjllo}'f'f'!()bligm's Soci,,1 Sl'curily NurnhPr 3526100027 ~)Yl'{'/()\)liAnr\ (-,IS/' IdpntiiiE'r (5(11' Adcl(llJ(lum lor"ld/llllff n,lmps Il.HOd,lt(lc/ with C,U(l.i on iJlt,u'hml'nt) '(~I()diJl~;;-~s Naill(' (lilS!, first, MO rmp!oYNlWilhholdl"" f f'dflfdlllN NUIllI)('r See Addendum for dependent n,lIIle" and birth d.tfes associated with ca"e,' on att,lchment. ORDER INEOf!.MA TI( W; This is an Ol'dt'r/Nolin' to Wilhhold In('Orn" for Supporl hils"d upon an ord"r for supporl from CUMBERLAND ('ounly, Cornrnonwpalih of P<!nnsylv,lIlia. By law, you "''' "'quir"d 10 d<!ducllhrse arnounls from 1111' ahovf'-l1am<!d emploYf',,'s/ohliAor's incornp unlil furllwr nOlic" "w'n if Ihf' Order/Nolice is nol issupd by your Slale, $ 1 ,082.00 per monlh in currenl supporl $ 0.00 ppr monlh in pasl-dup supporl Arrears 12 wet'ks or greilterl Oyes @ no $ 0 . 00 per monlh in rn"dical supporl $ 0 . 00 p"r monlh for gellPlic If'sl cosls $ - P"I' monlh in olhf'r (sp"cify) for a total of $ ~.!l92. 00 pcr monlh 10 be forwarded 10 payee below, You do not have 10 vary your pay cyele 10 Ilf' in compliann' wilh the supporl order. If your pay cyel" does not match Ih" orcl,,,ed supporl paymenl ('yelf', use Ihe following 10 dpl('(min<! how much 10 withhold: $ 2'19.69 per w<!ekly PdY period, $ 499~.l!l.P('l' biweekly P,IY period (f'very two wepks), $ ____1>!U_...9.Qper semimonlhly IMY Ill'riod (Iwicf' ,llllonlh), $ 1, Q.!.I.Z_...QQpf'r monlhly pay period, RElvlfn ANeE fNFORMA ncw: You must begin wilhholdinA no 1,llpr than Ihf' first pay period occurrinA Ipn (10) workinA days afler Ihe d,lle of this Order/Noliee, Send paynll'nt within spven (71 wnrking days of II", paydalp/dalc' of withholding, You are enlitled to deducl a ff'e 10 d"fray Ihe ('osl of withholding, Rpfel' 10 Ihe 101101'" govf'rning 111(' work slille of your employef' for Ihe i:lllow,lblp (HllOllnt. Thp lotal withllPld amount, ~lnd your I(IP, Cdflnol pxc{>pd 55(1!~) of the pmploypp's! ohligor's aggregal" disposable wl'ekly earnings, For 1111' purpose of Ih" Iimitalion on wilhholding, Ih" following informalion is n""ded (See 1/ I 0 on pg. 2), If remilling by En/ED!, pl"ase call Pc'nnsylv,1I1id Stalf' Colle('lions and Dishursr-~menl Unil (SCOU) Employer Cuslomel' Servicf' al 1-877-676-95110 for inslruclions, Make Remittance Payable 10: PA SeDU Send check 10: Pennsylvania seou, 11,0. 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 ColSe Iderltifleri OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Dale of Order: AUt, ?, 5 2003 "i',-I f' r~;(R' DY THE COURT: /7 x~ ,'" Form EN-0211 Work..,. ID $IATT S"rviCl' Type M (1\\11 No (l'I'IHII',.j AI>I>IlIONAlINFOKMAlION TO IMPLOYI'RS AND 01 Hill WllIlIlOWIRS o If r!l('cKP!1 you Mi' rl'quiH'd 10 pr\,vidf..I {(IPY 01 thi., (01111 10 VlIlIf j'IIl/,lo\'('I', Ii YO\rf l'fllplo\,i'l'.work., ill d '11.11(' II "'t i., dHtprl'nl lrom till' '~(<11(' IIl.!1 !<.C,Ul'( thi" ort!"f, d lOI'~' Illu"t hi' providE" III ~'(J\lf !'!IIp llVl'f' 1'1,'('11 it 11](' bo\ j... 1101 (IH'rkNL I. WI' .IPl'rl'ri,111' 1111' volul1ldl'Y rOllll'lidfl("(l oj ["('tlpr.,lly H'("(JI-\ni/l'd Indidll trihl",. Irillilllv-o\VIH,d !Ju..irll''>',p", dmllrulidlHlwl1l'd hu!'.iru',;,<;(''> IO("clll,d on ,\ rt'<,flrv,l!iolllh"t (hoo<;{' to wilhl10ld ill tin ord.ll\(,(' willI tl1i" !lolin', 2. Prloritv: Withholding uncl!'r thi<:. (>rdflr/Nolit'(' h,I<' priorily 01,'(" .lilY othl" Il'g,III'f(HI'..... ulldl'r f.lt,I!P 1,)'1',' dg.,ill'illlw '1II11H' im:ol1l(!, h~dNtlllll,( ll'vip<; in I'ltt'c1 hl'lort' (('({'ipt of till" ordl'r 11,1\'1' priorilv. Ii tIU'Fl' M(' Il'dl'rdl t,l\ Il'vil''i ill ('ill'cl pl{'<l'i(1 <lHlltlrt 1111' r('(llw.,till!~ il~(lfl("Y lhtpd hl'low. \. (utnblnlnK Pilynwnt'\: Yuu (.111 (omhiIH' \v!thlll'ld dIlIOllll\'i (rolll II1ml' tll,HI OIl(' {,[1lploy{'{'/ohligor\ illconH' in <l 'iinglp IMyrnl'nt to Pilrh ,\I.Wlley H'qUl''itillg wilhh(l!dill'~, You fllll'iL !lO\VI'Vl'r, 'iPp<lrdtl'ly idl'nlify tlH' porlion olIIH' 'iingh' PdYflH'fll Ih"t j<; ,11lrilJul,lhlf' to (',wl1 (llllllloY('('/(ltJlig<lr. 4.. R('portil1g the Pctydal('![},l\(' of VVilhholdillg: YO\llTlu<;1 mport tfl(' p,lydlltl'liblt. of withholding wh{,11 "flnding It)!' payment. Tht' puyd<'lleld;llt. of withh()ldin!~ b tlH' d<lh' on which ,IIW1\1I11 'N,l'> wilhlwld from Ill(' {'mploY(,I"'i Wilgl'S. You must comply with H]{~ lilW oj It1€' state oj tlH' ('lTlploYf'c's!obligor\ prillei"dl pl.H'i' lit ('ll1ploynll'llt with r{'~pl'(1 to tIlt", timl' pNiod'i within which you mU'i1 irnpl('nwnl Ilw withholding orciN ,Hid ;om"'dfd III(' -.upporl PdYIllPfll'l. S,. Empl()yee/Oblh~()r with Multiple SUPllOrl Holding'!: Ii tllNP i., morp thdn (lnp ()rd{'(!Nolin' 10 VVithlHlld lncol1H' ior Support agdin"t this f'lTlpl(lYI'(l!{Jhli~or d/HI you ,]II' lIn,lhl€' to honor ,III 'iupport ()rdf'r!No!icp'i dLH' to f t'dl'r,ll or Sld!t. wilhholding lirnil'i, you lllu~1 follow the IdW 0; Ilw st,llp oj pmpluy('{'\!obligor\ prillcll'dll'ld("!' oJ €'llIploYIlH'nt. You nlll',t honor <Ill OrdN'i!Nolire-. 10 tlH' ~rl',lt{,'it extpnt pm"ihlr, (SI'l' 1110 bt.low) 6, Termination NotHkatlnn: Y{lLJ JOll'itl'((Hlllllly notily IIH' RNlupsting t\gt'ncy WIH'11 tIll' l'llIploYPI'!(lblignr i., no I(HlgN worklng;or 'lOll. PI(~<l'ie provide tIll' in;Orllldlioll (I'qw,..,\pd ,HId r('lurn 11 copy oi thi,> Ordpr/Notin' to the Ag('IKY idpnlitil'd bplow, WIlHHOLlJER'S 10: 212?3'18S00 EMPLOYEE'S/OBI.IGOR'S NAME:_--"BBE:qJlST.L_ SC01"!' K. EMPLOYEE'S CASE IDENTIfIER: 3526100027_ DAH OF SEPARATION: LAST KNOWN HOME AODRESS: NEW EMPLOYER'S NAME/ADDRESS: __ 7. Lump Sum J'ayments: Vou m,IY 1)(' n.quin'd to rl'lltJrt ,Inri withhold irollllllIHI' <;urn pdVrlH'nl'i -.ul'h <1'> imnu<;e", commissions, or S{lVerdnn' !l,lY. Ii 'lOll thlV<' ,my qUI''ilion'i "buullurnp 'i\lm pdyml'nl'>, cont,lrt ttll' \lPr<;on or <lllthority bplow. 8. Uabillly: Ii YOLl fdillo withhold ilKonH' .1-' IfH' ()rd('r/Nolirp dirl'd", you tl((. JJ,1hlp lor bolh tilt' ,HTurnulated ,lOlOunt you should h,lVf' wilhtll'ld from II\(' I'lTlplny{'('/ohligor's inconw ilnd otlH'r PI'I1<1lli('" <;('\ hy PI'IH1<;ylv,U1i,l SI,ll(' 1,1\1,'. Ppnn-.ylv,lni,1 Slille law govt'rm, unless the obligor is (llllploypd in ,1I1otht'r SI"II', in which (",l'>t' Itl(' 1,lw olllw SI,II(' in which tw or 'illp h pnlploypd govern". q, Antl-dlscrimlni\tlnn: You ,UP slIhjl'c1lo a lilH' d{'IPrmilH'd lIndpr Stall' I,l\\, ;or di,>ch{l(gin~ an f'/llployel'!obligor irolll elllplnynwnL refusing 10 employ, or l,lklng dis{"i!llin<HY ,'lctillll 'Igllillst dflY l'rnploye('!olJli~or IH'C,IlI'1P of ,I 'illllporl withh(ll<llng. pf'nnsylvani,l Sldlf' law governs unless thp obligor hi prnplc)'\o'l'd in dllotlwr SICllf', in which CiI'>f' Ill{' ldw 0; till' Sti.ltl' in which tHo or <,Iw i'i employed gOv<'rrlS. 10, >I"- Withholding Limils: Vou I1MY not withhold mOrt' th,ln Ill(' II'<;SN 01: llltH' dlllClunt.;, ,dlowpd by Ill!\ f"pd(l(,ll ('OIlSUIllN Crrdil Prolpction Art (1:' U.S.c. ~ I (\7:\ (Ill 1; or 2) ttlp ilI1l0Llnts ,\llowl'd by tlH' Stah' 01 Ihp (,Illploy('('\/ohligor'<; princilhll place of rmplnynH'nt. Thl' fedemllllllil i.1ppliI1<; 10 thr i\ggrf'gdlr di'ip~)'i,llJle w('pkly PMning'> (t\[)\'VE). I\DVVE is till' IIPt il1col11<' lplt .Ifll'r making nlilllrtillory dedurliom such il": St,ll<', h,(li~r,lL IOC,llltlx{,,,; Suei"l SpcurHy Id\(''>; ,lIld M('dic,j((' IIIX!'';', II. Addltion.llnfo: 'NOTI: If you or your agpnl""" ,"rVl'd with" ('(lpy of Ihi, ordpr in 111(' ,1.,1" tl1<\1 i",,,,,llh,, ord"r, you am 10 follow Ihe I,\w of tlw st,lf(' thdt jssul'd Ihi, ordl'r with I't'sppcllo tIW"if' ilt'Il)", Suhmillcd By: DOMISIIC Rl [AlIQNS S[ C110N LLt'UJi1bJ.f2Y!JL'!L---- ------' 1'.0. BOX ]20________..______ C6BJISIJ I'AlZ.!!1L_,__________ If you or your "mploy",,/ohligor hav" .my qup,lion" ((",Iacl ___WACI AI1ACI-IMINT UNIT hy '''\''pl"",,' at !l.!11 24011125 01' hy I AX .\1 lZ.lZll1J2:6HlL_ or hy inl"rn,,1 ~ww,_<J!i!rbuppml.>;La""IM,U' ,----~-"._---- I\\gl' 2 of 1. lormlN-lJ2n WorkPr Ii) $ lilT'!' SNvicpl Yl''' M ! )\111 ~j" (1'/'11 PI "I "'", ('I ;:: 1-r ~..C, _'I ("-' \-: .. "'\,,1':: 1;, ~<<'I,,;I L-I.l (", l.}~} () , .~... ]'",1 ~ .~ ,n... \' (.,. "l? c-) , \ l'~) ',':\ {~@. r" I ;j ('2:': O. ~_\ \.IJ '-", :i.~ (,)..; <./) 1'::' \.I.. ('f) :) C! c:) (,) " In the Court of COll1mon I'lt'lIs 01' ('ouuty, 1'('nns)'lvllnlll ('II~lIIERI ,ANIl 1l0MESTIC KEI.oI'I'I0NS SECTION 13 N. II,INOVER ST, 1'.0. !lOX .120, CARI,ISU':, ",I. 170lJ I'hone: (717) 240.6225 FilS: (717) 240-62411 Defendant Name: sco'r'f K. AR8EGAST Member ID Numher: 30,26100027 1)lcllse noll': All cllrn's)>ondenN' 11111~t Includl.' Iht"l\Icmher 10 Numh('f. ORDER TO VACATE ATTACHMENT OF UNEMPLOYMENT BENEFITS .'llIlIlIclal Urcal( HO\\'II of Multllllc ClISLOS all Attachmellt Plaintiff Nllme JAnE B, ARBEGAST P^CSES CaSl' Numhcl 975100046 $ i ~ i $ ill!!!.chlllt.llll AIl1(\tlntlflrIlCluoncv 300,00 /MONTH i / / ) I / / Dode! Numher 9S 1 CIVIL 9A TOTAL AnACIIMENT AMOllNT, $ 782.0J The prior Order of this Court directing the Department of Lahor and Industry. Bureau of Unemployment Compensation Benefits and Allowances (BUCBA). to attach $180.46 or 50 % per week of the llnemployment Compensation benefits (\f' SCOTT K. ARBEGAST . Social Security Numher 200 - 52 - 6054 . Member ID N umher 3526100027 is herehy vacated. This Order to Vacate shall he effective upon receipt of the notice of the Order hy the Depal1ment and shall remain in effect until a further Order of the Coul1 is filed. BY THE COURT Dllte of Order: ~l;.IJ 3 u 2003 JUI>GE Service Type M Forlll EN-OJ; Worker ID $ IATT