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'" , " " ,." " " " ". ,,' " " ", " \. ~) ..':'; ~ ~ ..,1 '; " " It;. " '\ '" ~ ,(I \ ii ':I. ~ ,,~ ~ " , ,.\ , " \ "\\,, " I ) ); I.Ii " i' " {, {.II , , ,/ , J ,/ .' ,/' " ,/" Ii ,/," / ,; " I: i" j','." " I',.. " ',II ',\. I , ~! \ IV ' " I 1 !, " " 7" ..'5 ~. " " " " " if " ~ ...... I ~i \ ' c", I ~I I; ii j. "f " 'I ..::tt:f~:~::~ :1+~-:~t:_',_.'!.2' .,~._~!~~.~t~._", '_~:', ~:.}'~'L~:'_. _::~}~~ '~~~ _.::_~:'_~ _-'!+~'_,,'~!:', ~~:' ,,:~~~:_."_;'~'.~ '~,t:: .::~:I_,~':_:':.~'.:_:'~!~': :'~.~"., <~::- - ::_.:~', ':~::.,::~~'.~.',~~~:~ ~~'~~~;'l~ ~ '" , ,~ ~ '~ ~IN TH~ COURT OF COMMONPLE;AS' ~' * ~ ~ OF CUMSr::Rl-ANP COUNTY W ~ ~ w. w. ~ iI, Wt ~ " ~ ~ ~ " ," W t,~ ~ ~ ',I " ~ . } " ~ ,I'; /:t I!l ~ 11 ~ i" ffl 8 :. ~ ~ " 6TAT!:: OF I::I~NNA, ~ ~, .', ill $ ,l ~ ~ ,.0; ~~ ' .:i ~ ~ ~, ~ ~. ~ ~:) " ", ~ ,', '. ~ lOt Fl ~ (.l" ffl ~ ,. ! I ~ tl! ~ ~ ~ $ ~ tl! ~', ,;, r ,,~ ',. ~l I': ~,; ~ ~ . ~ " ' ,', . J ~ ~ II ~,', W .~ ., I ' ~ ," I'I'UlItUllllln,'y" : .,~;:- .i.; -:t.:;--:~:. ':.: . .' I,.' ~.~ ~:.:," ~.:. '.:+:; ::+t.' .it:: .~.:,' .:+:'. ,~.:. .:.:' ':+:. .t+:. .:+:' ':+:' .t.:. ':+:. ,t~:. .:+:. .rt:, .:+:. .:.:. .:+:. .:+:.' 'l'1-:1\1\11" ~lil.'.1,I':.111 II I .. N I) .~,l,I,::!i,?I,?"!)m,).',,J',E.1\~I. Ii II II 1'1nlntJI'I' \'.'1'''11''. orv]!. I\G'I'JOtl ~ ,.I\\{ ,~!MIIW P .KII,'.l,l~ll, PpfUH(lul1t ,tl IllVOl\OE DECREE IN C E + ~, \"0M .' M.;.) , ( f/" \ ' ,2,qqO", It Is ordered and .. " . D ,( V 0 R ANDNQW, ,~'" .1.1"""", '. decreed that 'l'lmnT. I., 1(111.',1'11" Illol'11111 . , , , . . " , , I . , . . . . . . . . . . . I.' . , , , , ,. . , , I . '-1 , , , , ',' , l,t I r ., " and, . -' , I , 1" , , , . , . , , . , A~~\l~~ ,I~t, ,~1~1:111~1\ I . . . , . I" . , . , I , I I ,'-. -' . j , 'I defendant, ore divorced from the bonds of matrimony, ,;, ~ ~ ~ , " I ' The court retolnslurlsdlctlol1of the following dCllll1s which have been raised of record In'thls action fo'r which 0 final order hOB, nol yet peen entered I , , :\'lll! ,111\l;l;l,l\ijl! ,~~~ ~l;~I\,lql)~ ,1~lHqql\.lqt)~ ,(.1I)~q(U\r)~, (I t ,?999, 1,11,1\1, ~1t1\1~\1, \JY, ~\1p, , , ,HI\l:~~qEl ,~Il ,hq>;qhy'\tlq(P:llq1;l\~qll ,It)~'1, ~htll ,lllvl}\,QI), 1)1)'1\'11'1 , ,\'llt, \W~, 1)\1)1'111'111, , " , ' ~, I1l1rllwl', lIw pllrtllJH IIglW 1\1 \)\111111\\1\.1 IIVltll1 SOpIll'll\ol)' lIIHIIIPllrl 1)'\1111 lito \1lhul' III Imy plllo\.l Ill' phw\.ls 1111.\1 ho \11' sho l\llly s\.lloollls 1110)' hllw h\.lMol\lr\.l 11\.11111 1I\1ll\g, N\.Ilth\.l1' pllr\y shllll " ' 111111\.1sl, hlll'IISS, 11I1I\\1Y, 1 I\hl 1'\.1 , thl'\.IIII\.I11 PI' 1111\.11'1\.11'0 with tho p\I\\l1' PIII'I>' IlllIIlY 11l1l11L'1' II' 11\\ \ SO\.lI'\.lI\ lllluh pliny 1\1I1Y OIII'l'Y 011 IIl\dl!1\!1IIB\.II\llll1y l!ll1ployl11ol\t, p\'lll\Jsslol\, h\lHhwss 01' pllwl' 1I01lvlty liS .. 11\.1 01' slwl11!1Y duoll1l1dvlslIhl\.l 1\11' his 01' Iwl' solo'lIsu 1\111\ hOllol1l, NLI\llwl' pliny shllll 111101'101'0 wllh IIl\l \lSOS, 0I1'11UI'shlp, ol\.IoYl\wl\1 or dlspos\llol\ Ill' IIl\y pl'opol'lY 1\011' IllI'l\ud '111111 1\11\ spoolllll(1 IWl'o111 111' propurlY 11CI'L1IIl\Ul' lIuqllll'od hy tllo 011101', 1\, Tho OOl\sl(IL1l'lltlol\ lilr Ihls COl\II'IIullll\d IIBI'OOI\1OI1\ Is IIw111\11\1111 IWllo1l1In ho \1htl\ll\od hy hlllh or IhL1 p!ll'llos hL'I'\.Ito IIl\d ,Iho unvonlll1ls IInd lI11roPIl1UlltH,ol' ulloh nl' Ih\l PIIl'IIus to qlu ollWl', Tlwlllloql\lIOY or \ho u0l1HldcI'II111111 Ihl' IIl1l1gruol\1Ol1lS hUl'ol1l olll1ll1lllud Is Htlpl\llIlolI, \)0111osscd. 1I11d Illh\lItI\.ld hy 11\\1 p\ll'lIuH, \\tlll Ihu plll'lluH 11\\01\1110 hologlllly houl\d horchy, lJlloh plll'ly 10 Iho Alll'ool1lOntnokll\lwlodgos IIl\d doohll'os Ihlll ho 01' sho, I'OHpo()llvcly: (I) Is 1'0pl'osol\Iod hy coul1sol of his 01' hor own ohoosll\g; .' I., (2) Is 1\ll1y IInd L10lllplololy il\lhl'l\lod or tho I\lolH I'ollllll\llto tho s\lh.l\.lot 11\111\01' or III Is Agl'L10l1wl11 IInd or tho I'lghts lint! llllhilllloH or tho p!lrllOSi m onlol's Il1to this !\lll'Ool\1Ont \'O\(II1II1I'lIy nlkl'l'cool\'lnl! tho IIdvloo or cOUI1Holl (4) hllH glvonolll'ol\lllInd 111111\11'0 IhoUlIhl to Iho mllldllg ol'lhls ^llroOI1101111 (5) hilS ellroll\">' I'olld ollch pl'ovlsloll 01' this ^l!l'ooIllOllli IIlld ((1) l\illY lII1l1 conlp\otely 11l1l1ol'slllnt!H olluh pl'ovlslon ol'lhls Al!I:ool11ont, hoth liS to tho sllh.lool ","tlOI' IIlld lO1l1l1 cHoet. , This AgroolllL'llt shllll hcoomo ol'footlvo I1ll1lwdlllloly liS ol'tho dlltc ol'cxoclIlloll, , " , , ~, IIIH 11\0 P\\IPOHO III HI 11110111 pI' IhlH 1\l\rOllll1OIlI 10 HU\\l.O Ibrowl' 1111\1 oOl1lplololy Il1u InloroHI '1l11d ohlll\lI\1.PI1!; 01'1110 plI\'lloH'1111111 pmporly Ihlll tl10Y 011'11 H\IPIIIIII'ul)', 1111\11111 pmpol'l)' \hlll, WPIIIII \Il1l1l1ly 11M 11\111'11111 PIOPOI'lY \11111\11' Il1u PU111lhylV1l1111l Pilip rOll ('o!lo, 'I'1I1\l 2J,~uOlI01I1\OI(1l), 1\1111 Ihlll IH rpl~rl'l!d 10 1Illl11H ^grc\'llwIlIIIII IMIlI'IIIlI1110plII'lY", IlS h\llll'lIullll1oIHH\lII'llIl,llwll' Iwll'lI 11\1\1 IlHHlllIlH, '1'110 plll'lloH 11l1l'1lll\lOlHplul\ Illllll'll\u Ilwlr/Vlllrlllll PlopcrlY 11111 n1l\111\1ll' 111111 llonlill'111H 10 1l.lIIHIIII1\I,I\\11' 1l111l1\llInl, wl\h l\no rolllll'lllo Ihul'lllhlll 01' ulwl1 Pllrly, 'I'hoJllvlslol1 01' o~IIIIll1g MIlI'IIIII Plopol'\Y IH 1)111 h1\Pllllu\l, hy Ihu 11111'11011 10 OOIlHIII\llo Inlll1Y W"YII Hlllu or ll~\)llIIngu 01' IIHHuIH,lIllllllwl\II'IHlol1lll \1011l11 ol'luclc\1 II'lIhl1\lllho 11111'(1(h10Il0I1 PI' o\lIHIl\u 1\1I111H 01' pllwl' , " Pl'opol'lY 1101 c0I1IlIIlIlIlIl11 Ilpllrl or 1110 111l\1'IIIII OSllllo, IIIH Iho 1\11'11101' p\ll'pnllu ol'lhlll l\llrOOI1WIlI In Ho\llll.lhrol'ul' I1l1d cOl11pluloly IIIlY oh\lglltloll \lndur Ihu PU1111Hylv1I1l11I ()ll'nlw C'n!lo I'UIIlIlI111 10 IIpl1\11I1I1 Mllppl1l'l 01' nlll11011Y, I' (1, Elluh pl\l'Iy.ruproHol1lH 1I1ll\ 1I'1I\TIlI\lH Ihlll hu or 11110 11I1H I11l1do II 1\IIIII11d f\\11' tlIHololI\\I'o 10 Iho , 0\1101' 01' 1111 01' hlH 01' hili' pl'opol'ly Inlol'uHIH of' I\I1Y 11111111'0, Illol\ldlnll IIIlY 11\01'IgIIgo, plodgo, llull, Olllll'lJO, HUOlIl'Ity Illlerosl, U110\l111\11'1\1100, 01' 1'01111'101101110 whlohllllY pl'oporly III 1I\lh.lool" Blloh plll'IY 1\lrlhor rOpl'Ollll111H Ihlll ho 01' Hho hllH I11l1do II 1\llIlIlld lilll' dlHOloHlll'O 01' 1111 duhlH 1IIlll0hllgn\lol1H or nllY 1l1l11l1'1l Ihl' II'hlll\l hu Ill' Hhulll Oln'l'Ol1lly lInhlo 01' mny hUCIllllu IInhlo. Enoh 1\11'11101' I'l,1pl'oIlOI\\H 111111 11'111'1'1111111 Ihlll ho 01' Hl\O hllH nlll Illl\llo nllY glnH (11' 11'lI\1Hl'ol'lI Ihl' 111I1<1Uljllnlll cllnHldo1'llllOI101' MlIl'lllIll'ropol'ty wllhO\\l tho pr111l'.001l1l0111 Ill' Iho olhol', IJnoh I'nny l\uklloll'lu<lguH.lhnt. tolhl,1 OX10111 <lolIll'u<I, hu Ill' IIho IHlII hnt! nUCCHS 10 111\ jolllt nll<l Hoplll'nlu Hlnle IIIllI l1u<lol'l\1 TIIX Hol1l1'll1l I1lull hy 01' 011 hohnl I' of ollhol' 01' hoth 1'111'111,111 dut'lnlJ IlH\lTllIlll', .\ ,,, " I, " (;()~lMnN"%\I:1'Il OF ",,;NN/iYlN,\NII\ . COIIN'!'Y Ill" (~lIl\IllIm I '1\1'11) I I /iHI . 1 .. . I'IQ\HON,\I,I.Y AI'l'IMHlm IIICFUHIC MIC, IhlH .~!J~.. 11(1)' 1l1',::]'J(.Ut;I:::':=:::,~ .. 2(11)(1, 1\ NIIIIII')' Pllhll~, III nl\d lill' lil;" <"011111101ll1'\Jlllth Ill' P\J11l1Hyll'lIl1ll1 IlIlll,JIlIlI1\y. Ill'. C'IIlI1IWI'IIII1II, '!'Iqml I" I\I':J,I,lql, kl1o\\'l1 III 1110 (111' HI\\IHl\wII'l'iI)' Pl'oV\lI1) 10 ho il10 11IJ1'HOI.l WllllH\J 11111110 IH HllhH~l'lhcll Illlh~ wlthlll MlIlTllIlW H\JIII~IlWl1t ^W'\JOI11Cnl, IIl1d IIpknl1ll'lvdg\JH Ihlll HllO \1~vo\lI\J(llho Hllm~ fhl' IIw plII'pOIlOH 11101'0111 COIlIlllllclI, IN WI'I'NI'iHIi WlIl'illlmF, I hll\'O 1101'0111110 Holmy hOl\lllll1d IImOlll1 HOII!, ~?8~~I~:~\~~~~~1Ii:I~~~~~:~m~~1l3 L~~/d,.,c&(. . _ fd.Ct..-. ~ 'r,__,A A _' ~_~_____: Moml'al, fl~nn'vlvanln A6ROOlIIIIOII 01 ~oln'I(16 '\; ~r'--=.r_L.f!::. ! COMI\'iONWlcJ\l)I'lI OF I'ICNNSYIN ANIA I I Slil COIJNTY (W CIJ~HHCllI.tI\NI) 1 . 1'Ji;HHONALIN AIII'I';AIUiU IIIWOIUC MN, thlH C-S~, III1Y 01' --'ri~(t:t,-_., ,2000, 0 NIlIIII'Y P\lhllc, 111 111\1\ fhl' tho C0l11l1l0l1WOlllth 01' Pltl1llHylVlIl1l11 IIl1d CmUlIy 01' , CIlIl1 hcrI II 1111 , ,'^MICS I). 1(1';I,I,ICIt, kl1owl1 (OI1W (01' HllliHlilClol'lIy pl'OI'OI1) 10 ho Iho pOI'Hll11 WhllHC 111111lO IH HuhHCl'lhcd III (ho \vlthll1 MlIl'I'llIllO Hclllol11cl1\ Al\I'CCI11011I, 11111\ 1I0K\lllWlcI\goH Ihol hc cXCCIIIOll'lho HIIIl10 Ihl' tho pmpllHoH (horolll c0I111l1I1cd,.. IN WI'I'NI';SH WIIICIUiOlr, I hllI'C.IWI'ClIl1tll Hot l11yhlllll\ 111111 nn\cllll HlllI!, ..-~~JzL.lJ~w.LJ NotOllol Oonl . Illldool Allll OorOOlon, NolOlY I'lIhllo M Olllllalo IOI(), Ollmhollnnd OOllllty y GOllllnl661()lll!xplloa JIIlln 10, aOlle III 'I'I':tIHl f"Iilq,I,IQI, 1'IIIIII\lfl' . I 11'/ Till': COli 11'1' 01" (,!l~lMnN I'I,I':,\H 01" I I PII~IIWI\I,,\I'/P rH\lNTY, l'l':NNHYloV,\NI,\ I I (:\\'11, (\FINN .I,,\W I I IJH.~~lll'I\'''' 'I'1':II~l I I II'/III1'IllWI'; 1!MIWII'E 'UUlllitltii\U:LIlliL111l11 I', 11AMI,:H P, lilq,\,I'II, 111'1'1'111111111 Tlllho 1'1'1'1\1"111'1111)01 TlillI~lIIllllilllollolil,II1IJ1llhul willi 1\1"I\1l1o\l'hlll hltill'llllllloll, 101hl' 0"11111'01 ulllly IlI'II <lII'I1IUIII\1,u'IUU\ I, Ih'I\IIIIIII\1II1II'OIUI'1 hl'l'll'lol'lI1110 IIICII~dl1\\'I1I1I1<1ul s('olll1l1 ~~()\(I\l ,11' Ihu 1111'111"" l'l1llu, ,2, Plllo 1111<111I11111I0101' HCI'I'lou Ill' OOlllplllllll: 1\ CI'i'III1I',1 "oPy 01' Iho I '111111'\lIh1l 11I\11\'11lou WII~ ~OI'I'C<lIIP!'1I Ihll Ilcl\'llIllIlll,.II1I1li'H I), Kllllol, 1111 SoplulIIl'\l1 J~, 191)11, h)' 01'111111111, IUHIIII'lo!1 !luliVCIY 11I1111, 'l,hll"~~OIIII1 hlll1ll1 1'10 ' MI, 1111'1 tvll'~, WIIIIIIII1 Kol1ol', ,12 i' W"~I l'ulllrHlluul, CIIIIIHI",Clllllholhl1\11 ('I'IIIII)', I'clIl1~yl\'I'11111 17()1~, wllh l\ull1l'1\ I\ooulpl Nl1l11lwl'('.OI~ 27'1 P'), ' 3, "'"11plul\l ulIIIUI' pl11'1I91'11ph (II) Ill' (II), (Ill 11111u "I' I'XUUIIIIIlII Ill' Ih" lIi'fidlll'lI Ill' ''''I\~uIIIIUl\lIhud h)' S""IIIIII ]301(01 Ill' illO PII'!II'''o el1dUI hy plllllllll'l'l MIIY 4, 2011111 lIy.II"l'ul\lhlllll tv\IIY~, 20111I, "', ' .. (\11(11 1)lIlu Ill' uHoolllh'" 111'.lho IIflilhll'lll'UII\I.II"d hy Soo\lol1 3~IlIlII) 11\' Ihu 1l11'0!,"u c"dr: ._--------,..._'--.-"h)(2) PIIII' Ill' 11111111 Il1i" ~tJi'\'loo Ill' Iho l.l\lIh1lln'~ lIf1llllll'll 11pl111 I.hu dulolllllll1ll .. ..__.-_.__._-~-_.._..' 4, Ilvllllu,1 Olllllll~ ilullllIlIgl I'll )NI!, ~, ('nmplolo ullllol' (11101' (II), .. I' (1\1 Dill" 1\\1l11l11\IIIWr 01' ~"1'1'\u0 o!'lhll Nolluo nl' IlIlUllllolI 10 Ii II' 1'l'IIcoll'" In Trllll~lIlll1\uuol'll, ,,' II uopy nl'\l'hluh I~ 1\IIIIuhuIII ' (hl Dlllu pll1ll1ll1'1'~ IVl\lvcr nl' 1'101100 111 Su"lh'" Dll 1("1 Dll'ol'uo WII~ I1kd willi IlIu I'l'nlhonnllll'Y: Mil)' 4, 2111111, I'l'olh'\lI\1lnl)': " ......__._--..-._----~. ~--~~ ...-.---, .' " TIClUlI I,. I\IQ,I,ICH, I""lllmf I, I IN TIIIC CO\Jlrt,' UF COMMUN I'!,!eMi OF I I (~PI\'W'C'U,i\Nn (:n\lN'I'Y I I'II;NNHYIN i\NII\ 1 I 0""" I\CI'InN . I,MV 1 I 1)"- CIVil, 'I'ImM I 1 IN nlVllIWIC VI ,Ii\MliR Il, I\ICI,I,IC\~, l)pfllllll II II 1 l'I,AINTWF'S MAHIUAOE COUNRICLIN<l AFFlllA VIT " Tlw pllllnlln; tlllln!! dnl)' IlWllI'nllOplln\ln!! Inll\w.lloPllHOH IIml HI')'HI' I, I hllYO boon II<1VIHOII 01' tho IIVlII\IIblllly 01' 111111'1'11I!!0 OO\II1Ho\ln!! l\1H11IIHlcI'HIIII1\llhlll I, " mlly 1'0qnoHI Ihlll Iho Olllll't 1'0111111'0 thlll 111Y HPO\1HO IInd I pl\\'tlolplItulll oll!lnHOIlI1!!, , " " , ~, I 1I11\lo\,HIl\n<l thl\t tho cllmt 111111111l\lnH l\ IItl! 01' 1l1l1lTln!!o cn\IIlHlltOI'H Inlho l'\'nthnl1oll\I')"H ofnco, which \lHt IH l\VlIlIllhlo In 1110 l\plln I'CIIIIOHI, J, Boll1!! Hn mlvlHo<l., 1 <Ill nnl \'OI)\loHt Ihll\ tho cnu\'l \'oq\ll\'o thll(Il1Y Hi1nllHC tln<l , pnl'llolplltqlll on\I11Hclln!! prlllt' ton <llvol'Cc tlocnlo holll!!,hl\ndlt<l dllWl1, ' , ., , ,- ,_ ,t " , 1 vOl'lly Ihlltlho illl\lolllOlllil 1l111t10 111 thlll IIf11dllVI.1 II\'O 11'\10 l\\1l1 onlTool. 11l1\1101'HIIIlld thlll , '" \)11101 ScptOll1hOI' 2/, I 199M ,_____~_&b..1~J~-._~.eJ ~ TICIUU I" KtCq,ICIt I' " 'I. r " "l {: I, N ~'j,,~!., (~IJ .~r: " ;::I.r( ~ ..; l,. h:: ,,,11 . i: ) ;,'1: " 'I I)" 'j; ?" " 1',);) " 'I' fill: . ~ I' , if " I ",')I!J " " (1:1/, :"t-. ~ r :\1" 'f I'l '1"/'/ /, V" '{IJ J~ I' , C', vl 'J ,-,"I P (., '." jl' \\ ,', ,..j I" I' (i (I " ',.' Li. p'- " " \l ..' " '. \, " ,; .'" ;1; " " I', It " " ;!l " " " .'1 " " " " I' " " ,,' " , " p .. " " ,.. 1:"1 (:,: " \11: 1:" cr.'. " " .. .,J.,\, " \:1") Co') t')I:',! " ':) "I' ," l)({ \' I , .c. '.1 1."\. (,.. \')'..\ hi ('\' ,; \,. " ,1' "':'1' itl ,,. (:If 1 r"- , ", f> \ ,Ii i.\ " '," \" '" ;... J.,'\ 'I"': \.~"p.. " , , I,,' ,Il': .,:: I', " \I, C'J '''1 " () ,: \..'1 (.::) " '.; " .. , " " ," " " " I' ;' " ," p" " " " [' " " " "i. " " .,"" 'I " " I:"~ ,l'i; I ~ i^i~.\ , ,I '., 'n', I" "l\r',i r,':. :.." I' 1"'" "j' (,,' j"" ),'\1 \1,'. " I'" ;f.J ;; !' 17" ,,...-; ,. ..;} :r~ I~\... ...., (,-,J f~-',t,_ q cl' (~) " Ii ,,' '>, I,,' ., f.'," ,...'.:('", 1,.)";0' ( . ) ;. ~r: r"l",:j , ~_, f ,,/ 1(1 . ,\ f,;'~ ~). ";..' ., \,"\(J\ (f.l..., ,-. ~ II ~ .,) '0 ',I" " "j' " " " 'f f," " , , H ''-' " ,!' ".. " Ii " ,,- " " " " " q " ," " " ,i " '. 'j, " I, " 'I, , " " " " , d , , i'l Iii " ,i " ;11 ~1 l... 't ll} 4'1 .. ~ I ).~ H ,j 'I' " II . .' ~Ij < I": " i " r':'" " '" " , .. d " (f' " 1.:'(' I". '. li"'j 'I " (/, ( ,I r.)i t. I (() iJ",l . h\.. I L It, rn! ,) t.-' In () iI!, "i. ., " " " ;', 'I. '"J-." " .' 'i' ," '" " ;!' ,. " ,'; I' II " " I" , 'I- " " " ., " " I' " I,' i, .. " I, " I',. ,I " " -,I. "'ICHnl lit I\IQ,I,ICH, l'Inlnllffll'11Illlnnlll' I INTIII': qUinT nF rOMMnN I'I,ICMHW , , (.l~J~'lI\ICnl,i\N" C(HJNTY, ,,":NNHYI,v i\NIA I I PIVII, M~TlnN . 1,/\ W I I l)".!;!;l~ CIVil, TlmM , , IN "IvnnclC v, . ,I/\MICS Il, Iml,I,ICII, \lllfllllllnn Itnll~pnnllllnl l'ICTrrUl.l'LEpjt ftl!!!;~IAkltICI,mE 'ANn. NOW, IhlH Jlrh. IIIlY Ill' Oetllhpl', 11)l)H, eomoH Iho pellllllllOl', Terri I" Kollor, hy her l\l\ornuyn, Irwin, Mul<;.nluhl & 11\I!!IIOH, IIl11lmll~uS tho IbllnWln!! Plltllloll Ihl' Spcollll HolIlll' lI!!nhIHIII19.I'IlHpOndcIII"llIlllOn p, l';'ullol'. I. Tho pollllollcl' in Ton'i 1-, 1<;'01101' whlllH Iho p\lIlnlll'r in II dlvul'OO IIcllon l1le(II1I'()!l.5SI2 Civil TO\'\l1 In c\ll11hol'h\l111 CO\lnly, PennHylvllnlll, lieI' IIddresH IH 12 1<11111'0\ Ollk Pl'ivo, Bollin!! /'1 Spl'ln!!H, POnnHY vlIlIllI 17()()7. 2, , Tho I'OHPl11111cl11 In ,1111110H D. Kollol' who IH lho dolbndllnt III Hllld dlvdl'uo lIulloll, "IIIH , IIddl'OHn In u/o MI', IlIltl MI'H, WllIll1l1l Kollul', 421 Wost POlln Sll'uot, Cl1l'lInlo, POllnHylVnnh\ 17013, 3, Tho PI1I'IIUH HOPIII'l\tcd on ^U!!\IH\ 22, I ()()H, whon thu dolbndllnt 101\ Iho ml1l'lIl1\ pl'OmlHllR IIl1d I'onlllwd hlH porHUllIIl holon!!III!!H. t, ' 2 ,,, " 11 I WI'IqUWOIW,lho Pollll1111l'l', '1'01'1'11" I~ollol', l'oNpooll\lllY JPII\IOHIH 11111\ IhiN Ilpnnmhlo CU\1l'I PIlipI' 1111 unlpl' nunh\H\ IIw 1'0HP\lIHI\!I1I"lliIlWH n, I\ullol', 1'011111 1'1 I1U hll11\11 p'!r Iho 1'01\01' Hol l\lnh nh\1\'\lln HIIII\ Pollll\l1101" i' "~I HOYll\lolflllly Hllhmllloll. :~3:)~~. ~:____ '"ll1l'IlIlH I , 1\'loI(IIll\hl. II -ICHfjlllro' "1l(Il'no~ fill' I'ctftiuncl'. 'I 1...11" 1(01101' ft(I W~IHt I'nlllfl'ot1-lII'IlU' ~lIl'lIHlo. I'onmylvllnlli 17111~.~m 71 H41).2~1i~ Rnpl'lllllll CUIII'II,1>, NUl 2M7fl 1>1I1l11 Oillnhol' (I, 11)1)H III I; " "'; " " ,f i' 5 ,~", fi ljiL ,:1., ',:(\ I'" , ~ I. 'i', l',' ;y 110 ,1/:1/;' li " I: 'J, '-}(I Ii /,1".. H CIi,'"li,'.! i,'; 1.1 CUUI~IY '. "f:NI!!JWWVI'/\. li./<(cJul ..1//1 c::l/<,;',h(,!Q) ;A4) /-,3/()() " " {';'}'" (I, \ I'..) "~I' " " . " " ,,, , " 1\' ," " , ri; "l I..,,' II , ~:' I f,:'; , H. ;;, () ~. I' f.ll, \",'-' L" i II ( " f.~-) (, ~, " .~.!. i::.; ;.:~ ~}; ( .) ; ~ .;,; ;' :J ;,;~j ".lli)., '1;..:-' !(' ".J ,'.lr.tl l'lll. ", ;'1) () " ,'0' ,...... h !' ,.1'" 11. ;('" <'I " " 1.:..\ . \11':,1 \1 " II ,," I' it " '" " .' " " " " " " fI' 'I, II H " ", " p, 1; . \'HI IN '1'111\ COI IH'I' OF cPMMON PI,IW, nF l'1 IMIII':l{1 ,^Np (~(l\IN'I'Y, PliNN~IYI,V ANIA I)H"~512 ('lVII, 'l'I\I~Hl \..I\F,I,I,lil{, Plilll\llrr ,,1^MllH p, KllI,LIiH, 1l~1~l\dlll\l CIVil, M"I'lllN " lllvnlW\i INJillLl!LA\J'ol]1E2til~I,\:J'.III.illl~UJRJ:il!m:1ALl1.EJ..Im: ulmER ANP NOW, Ihl~ ~=l(', · (III)' Ill' (Iolohol', II)!JH,lIl\ol' 1010ph\11100nl\lb1'01WO with 0(111111101,lho 1101I1'111!! ~\ll Ih\, Novcl11hol' 4, 11)1% I~ (1lll1lll\lIod !!\lIIOI'IIII)' In!!IVO (ho plll'llo~ Iho . oppn\'1I1I111)' Inlll\1loll\1IY 1'0HnlVC Iho \,olll\'l1nrollol1 llllwr'~ 1t0111~ nfpol'HOl\lIlty, Pcmlll1l! 1\11'11101' OI'\I~I', Iho PlIl'lloH lII'O ol\lnll1ol\.I\'ol11.II1O ~olllll!!,ool1\'(lyll1!!,ol' \1I~~lpllllol10rIlIlY IIH~oIH,II1\lhll,11111! pOI'~lllllll P\'ol1\lI'I)' 11111\ wllhl\rl1wl1\'Ii'nl\1 1111)' ,11111\ 1I1I1'0111'0\l1OI1II\I11I\H h1Ohlllhll\ 40 I K pliil1~, , . ", \lY TIIH COllin, , , . ..__-/( ;..J1~,!r,. , K~~rl>tII~HH' .1, ,( _ (! cd",'l '.... ,.""";,l',,t I (/1, I </ /0{ , ~ '., ,J.. ~-) , I;, MIII'O\lH ^, McKIII!!I1I, III, lIHq\lll'o Fnl' Iho 1'111111\11'1' Hllhol't X. Olll'oy, HHq\lll'o Fnl' (ho \)oI'clIl\lIl1l ll'hll " ".~ ly-; (;,.. 1-11 ~":I (,':~(\ fl"1 "I' I.(),. r]" I.f 1\, lO'\I' 1'1 I " t../ " 'I' "j II. .< .I el' C~~ " I;J, (; .J,'I' I}."... .I i)~ l;:i . ,-"(!) , ,I >,; tUb 1_"0.. ,. .\ o ',.." i;;-"; "-" I- " " .... ,f") I~h ,. ',. " u " '1 " " " " "I'" I, " " ,,' .I' " \', ,. '; I I' ;, I' " " II " ,. ,. " " " , ,1, ., ,. " " ,. " , " I, " " I' " " ,. ;, " .I' !, t., ;; " '11' 'r' I' 'fi ;, " lAW Pl'l'lOIiS IRWIN Md<NICUrr [1 HUGH/3$ /l(IIWIIIIIIIII'IS M'Wi'I/,I'I,M.!NIIII//;1II ,1.I1/(:.111/(/(IIIM 111:/11:('(',111 /1/111111:,\' ,I/.II/^' II .I('/III',INI/ "(//1(/11.1(/,.11/1.//:/1 WI'S!' I'O/rll'lIIil' IJII(JI'li/1S/0~AI, (JIIII pl~(1 110 Wlml' I'P/rWIl/,!' S1'IlL111 r , PAIILIS/.I!; I'liI</fo/8\'I.VANIA '7(1 1:1.;li!!!l! " (?I7)iNIH!:/!I:' , I'A)( (717) INIHI:I!ioI f.MAII" WIII.AWIIII(II'1'II1/1' 1 ,r.P^' " lli/HI//I.\ IIIII'I.\' (/VJl.IV J7/ 1/ 1111111>.1, IIIII'I.\', .III, (/V,IMV,H,j " 11111'1,\', 1111I'1,1',1 IIIII'I.\' (/VIO,IW,) 11/11'/.1', IIIII'IN,( ,\"^'.\'I(//l1' (/I,",IVV/I ,1II11'1.\'"II,^NIIII/I'.I/lII(//lt.l(mi, ) Mil)' 2:\1 ~(l{)O " I~, \~llhlll'IICII(.!I\IlI" II, Ulvu!'pp I\'I"HIIlI' , '1"'IlIlI,ln CnIYIlI', Offlcp Mn""l\pI' OFFICIC OF I>IVOHCIC MI\NM1NH !) NIl!'I,h ""lInVI'I' flll'PIlI CIIl'Ihlll, l'pn\l&Y"'I\lIllII7U1~ Hill 'l'IlI'I'II" I~QUIlLY' ,Iillllll& I), I~plllll' IJH.5f1\2 001\1' Uoh lIl1d '1'1'1I011 AH I hmllmlloll\od 10 YOII, tho pllrlloH hllvo HOlllod 1111 oIlIH\lIl1lliIlI.!IHH\\OH rOI.!III'llIl1g Iho Plvoroo 11111\ IIR rollllolloool1omlo IHH\1oH, I hnvo ol1oloHod II pOPY PI' lho oxoolltoll Mllrrlllgp So1l101l1On\ Agroonwnl rot' YOII\' lito, ' " '\'loIIHO VllOlIlo YO\l1' IIJ1Pllll\\l1lOl1( liS plvoroo MIIHlol' 111 ordol' Illr mo to Olllllplo(o Iho 1)lvorlJo, \1lollHo clIII mo I t' yon hllVo 11I1Y Q\1oHtllll1s, Vpry (rill)' YOllrS, MAMIIlIlI\l El1ol11Hllrll 00: Huhor\ X, Ollroy, I!sl)ulro MH. Torrl t, Kollor " ,..1 .,." " ~, IIIH tlw pllrpl1HO 111111 1l\l\11llIJI'Ihls !\lIIWIlWI11 (II Hotlllllhrol'\ll' 111111 ollllllilollll)' \lw Inllll'll111 IIlHlllhlll1ll\I\1IlH \11' Ihll plll'llllH 1111111 pl'oporly Ihlll tho)' \1WIl HOPIII'IIIIlI)" 1111111111 pl'operl)' Ihlll \\'\1\1111 111111111')' IIH 111111'11111 pl'\1POI'I)' IIllllel' Iho 1'01l1l~ylvlIllllI \'lll'lIreO Cllllo, '1'1110 2:1, ~oollpl1 'IOl{o), 1I1111 Ihlll Is I'llffll'ro\llo IlllhlH 1\l1l'ool1wnl liS "MlIl'illlll'l'llpOl'ly".IIH IwlwoOll IIW11lHOIWH, Iholl' IlPll'H 111\1\ .. I ' . . nHHltins, TllP PIlI'IIIlS hllvo I\tl1J1n11l1l11 10 \111'1\19Iholl' Mllrlllll PI'Op9r1)' 11l1l11l11111WI' Ihnl Clllll\1I:I11H Ii; 1I,111HllluII nlh' HI 111111 111'\1 , with 11110 r\lllllnl (0 (Iw I'll.!hls ol'olleliPIII'\Y, 'I'lw IIlvlHlpll\1l'oxlHIIIlI.! MlIl'llllll'l'opllrl)' IH llolll1lollllo11 by (he PIIl'I19H (0 OllllBll\\\to in IIny \1'11)' n slIlo 01' oXllhlllll.!O PI' IISHIlIs, 111111 Iho IIlvlHllllllH Iwllll.! 01'1'00\011 wll1\11111 (ho II1\roIlIlO(loll III' OII(Hlllo 1\1IlllR Ill' Il'tlwl' pl'llperl)' llllt 0\111s\l\\\tlllg \1 PIlr!ol'lho ll1l1rlllllllHlllto" It IH tho I\ll'Ihol' pllrpoHo ol'lhlH Al.!l'llUmUIJt (PHonlo Ih1'\11'01' IIl1d 01l11lpllllol)' 1I11)' ohltgllt1011 ,. \1Il111lr Iho P\lIlIlH)'II'IIIlIII PI\'ol'po ellllo l'olllllily (II HPO\IHIII HllpplJrt Ill' 1I1111lllIlY, 6. ElIoh plIl'i)' \'oPl'oHoI11HI1I111 1~I\I'l'II11(H Ihlll hool' Hho hllllulI\llo II 1\111111111.11111', dlsoloHIII'O 10 tho ' IIlhel' III' 1111 oj' his or hol' )lI'OpOl'ty IlltOI'OHIH of 1,IIlY 1111\\11'11, 1110111111111.1 lIUYllllll'll.!lIgo, plodgo, 11011, " Ilhlll'go, Hooll1'lty IlIlol'osl, 011011111hl'II11Po, 01' l'osll'lotlol\ 10 whloh III1Y propol'(Y Is H\II1,1ool. nlloh pmw , ' 1\11'(hol' I'opl'os~n\s \hllt ho Ill' Hho hllH 11ll1llo II 0111111111 lilll' dlHOlllSIIl'O 111'1111 dohts.II1111 ol1l1l.!lIt1011R or 1I1l)' 1111\\11'0 Ihl' whloh 11001' she IH CIII'I'Olltly IIl1hlo or 11111)' 110\1l1\1I1\ 11111110, Elloh 1\lrthol' reprosonls lIud W11I'l'lIntH (hili ho O\, sho hllHllllt 11111110 1I1l)' glnH PI'(l'lIllHf'OI'S fill' Inlldoli\lltlo cOIlHlllol'nlltlll Ill' Mnrltllll'rol1ol'ly Without (hepl'lnl' 00I1S01\( urlho othol', ," I~noh I'nrly nokl\oll'lodglls Ihnl. to tho OXtollt c1oHlrod, iw nl' sho hilS hllll nCOIlHS 10 nil jolnl lIud HOpll1'llto HUl(O III\Il Fodol'll! TIIX RIl(UnlS 1lI0d hy Ot' Oil hohlllf' of' olthol' 01' holh 1'1II,'\los dUl'hll.! lll1l1Th1110. , ,\ " IN WITNI':HH WlllqumF,lhlll1l1r1I~H hll!,Il\1I1In hll\,~1 HllllllOl!' 11I111(IH 1I!1I1 HIlIIIH \110 IIIIY 111111 )'Ollr I1rs\ 1I\1I1\'0 writ lUll, ....-,L::~- i$~'iICI\I,) ( Tlmnll" 1~ICI,l.lm' ~~Qro^J .. C. ,II\MICflo!l, l~l\I,I,'m . _<BICA") r" " ..,' !, ,J,' " " 1/ .' ~.~ , '\ I. " I, .,1' H " " , " ~ ~.. --..,. 0-.. (.) ," '-d ~ 0 It: ("-~ ;\1'.: ,. , " , (:L '" ..; ().. " .,', 0' ;, ~ =rl , 1 ,0 !, ~ .~ , \(;:1 (:l!. 1;.1. 'bt. , ; '" ,J If " , , I, ,. " " '" j; , , " '. " 'I, " " " , ',i' ii' " " " " l'p " " ,. ;" II, " PRP~HINQTIr.l; TP WITIII'P~P INmMI: fUR S\JI'I'PRT 'D'e/,(/kl,'!l',l) (1It'll- ~Iftlp -'!UUlnumVllllllll-ld-I!Pllll~J.\'lllllp, "II'!~'f \ ,01")// 'I (..t.~1 .. "Cn,l\,lly/Plil, p( PUMBBlll,1\NP , II, " ,. 'p Pnlllll[OrllllrlNlllln1 ,Q.lJ!09!Ol(;).,' ,::U';(.,"'ff( Cn\Jr(ICftjn Nlllnhllr (SPI) i\11r/IIIIIIIII" I(lr r.~HI ,1II111111t1r1'J ,. o (lllllllhll (lr<II'IINllllcl' (1<) Alill'II''''1111r<II'I/Nolln' o ilIIIII1I1,11c'IIHlcll/NolIll' 1'I11i'lhYWWlIl1hlllllcll" 1\"II'(,llllN NUlli]."1 'rvco Ill,llg'l'IlQ~!C!l l!nli'II'YI'llWllhh"ldlll . !,!,iil\" t1.. B 1 Ii 1 .Jl.lU.._, f:II'I'loYI'IIWIH~I"IcII'I't7iild"'" m..P.OX :\600 l~J}.\lliq !:1I 1?105-360L ) III: Klqll,I~JL_@l1!!.!L!h. I 11111'/11\'111'1(11'111101',.\'10111\1' 11,1,1, 1'11,1, Mil ) .11~U7L__ rllll'III\'I'I,I( 'hllil"'" S,ld,11 SI'IIIfI\\' NIIfIlI~'1 055110010'/ "[1111'1111"'1'/(1111111111'1 C:,,,,, hh'"I1f1"1 ' ~,11/(/1'I11/1I11/ /11/' III,111l1l1f 1I,IfIfN ,"lac {,III'(I wI/it l'MN 'III ,11I"l'/IIIII'II/) C:lflltufloll 1'01111111', N'llil" 11",(, rll,I,M\! " svv'l\IIII'I/Illm" ((If 1111111111111111/ lI,lm,'~ ,11/11 Mrtt' 1I,1hll ,11HH'I,l/flll \VUlI (',ml~ IlIIlltt,lrll//IIlllt, . ORPf:R IN/,Ofl/vll\ 'f/ONI Tilli Is i\l1 ()f(II1I'/NIlIIr.\I11l WIII1I1i1ld Il1col111J fill SWllIlrl l111illd IIpOI1 1\11 Onllll for illpporl flllm .QUMlllll\"IINP COllllly, COIIIIIIOIlWllilltl1 o( 1'lll1l1Wlvillllil; II\' lilW, \'Ili/IIIO 1II1I1flrml (0 dml1lcl tl1ll!11 ilmOlmls frol11 1I1l1llhovo-nilmllll IIIlIpIIlYIllI's/oIIIIOOI'S IlIcolIlIIlIIllll 1\1111101 IHlllcIIOVllI1l( 11111 Olclor/Nollcllli nlll IsHlllel hy YOIII SI;ltO, $ 400,00 pol' mOIlII1I11 (;\lIrul1l sllppml $ 33 , 33 POI' 111(111111 111 PiliHIII\I sl/ppml' 1IIl0ill'S 1 ~ wuulei or lIIuillln! (i) \'115 0 110 $ 0, O.ll.pm tI1\llltl1 IlItI10dlcillillppelll "$ _ 0,00 pm tI1lll1tldol !I11Il\lllcIOil. cnsts $ pili 111 (l111 11 111 oll111r (SPClc.I!I') , rm iI Illlillllf $ . 433 t 33 110r l11ullth toho rorWMlllllllollilYoO holow, YOII do 110t I1nvlllo vnry I'm" pill' cyclolO hp 111 cOlllplllll1CO wllh Iho sl/ppoll ordul',lf \,0111 PilY cyclo dllos.l1olmnicl1 1110 OrdnrOlI sI1I1porlPoYl11cll1t r.yclo, IIsull1\! rflll~Jwllllllo r111(llII11II1UIHlW 1111,,:h 10 wlll1l1oldl .. $ 100,00 pllr WOllkly PIlY pmlod, $ _ 2QO, 00 pm I1lwllllkly Pll\' purlml (1IVOI\, Iwe> wooles), $ 216, 67por S0I11I1110111111\' Pill' pl!l'lml lIwlcu iI 111011Ih), $ 433, 331101111Pl1ll1ly \lil\' pUllpel, ../{/;M/TTANc:r: INfO/I/vIATlQNI Yqlll1111s1 hooln wlIl1l1oldlnll 110 I lllOr Ihilll 1110 filII PilY pllllodllCCllrrlll!l tOil 11m work In" elOys 1If1llr tl10 elilloor Ihls Qrdur/No(lco, SllI1d PilYl11l1l11 wlIl1ll1 SUVIIII (71workll1l1 dill'S of Ihupoydowldolllof wllhl1nldll1!1, .YOII mil lln(1I11l11 (0 IIIIIIIICIO fOil to dllfrny 11111 COil of wlll1holdlll!l, 1\Uf0l' to 11111lnws Illlvornllllllhll worle Slolo or YIlIII' ol11ploypo (or 1110 1110 olltllVilhio ill1101l11l, Tl1l1lollll wlll1l1uldlll1Hllll1t, 01111 your fuv, CillIlHlI llxctllld 55"10 o( 1110 ulllployoolsl ohllulll's . llggrogolo dlsppsohlll Wllllkly lli\lllllmS, Fur Ihu pllrpusll of 1110 1lllIlIilil.oll ,011 wlll1l1qllllnll, 11111 followln!llnforl11nllollli 11110110d (SoO IIU Iln PO, 2), . " " If rlllnl(('no hy i:l'T/WI,plooSIl cillIl'onnsylvnl1li1 Slillu c:ollottllll1s l\lld DIshllrsol110111 UI1I1 (SCIJU) I:mplo\,lll ClIslomOl SllIvlc~ nl',f177.r,7("UHllO (or InsllllttlOI1S, Milko 110111111 11 11 co I'''Yilhlo \111 I'A SCPU " send check 1l1l1'11nl1sylvl1t"il seoul 1',0, PIIX 69112, Hilrl'lshurll,l'ill7'IO(I'!)112 IN Al1btrlON, I'A YMENTS MUST /Nr.WtJ/! T/1/! /l/'/'ENI)AN1'S NAM/! AN/l T/1/! PAcs/!s M/!MOER //) fs/fOW/!. ~b/lV/! ~s III/! /!"'/II/ly~~/Ob/lHrlr's c,).IIl/r/lllltlf/vr), 0/1 SOCIM seCURITY NUMO/!R./N oR/)/!R TO O/! PROCESS/!/), DO NOT S/!ND CASH oy MAIL, .' ' '. . 1l1\Ol \\.I B1v\(ldI1Y flV nil, cOUlln lie I defeiJ:11101; \, Dolll of ordon AW\I\l11; W, 2t\'1I SOlvlte TYPll M ~~~.~ ctt.l7 . , " AllPlTIPNA~ INfPll/vIATIPNTP "/vII'I.pmS ANIl PTlH'K WITlIIIPI.llfKS ,P Ifr11ll1'\((\11 y,'ill,I[I' '(1(1111111111111"111'111111\ ropy 01 1\lls (11111\ Iii Yillll l'I11I'II>Ylil" ' ' , " " l'tlOl'IIYI Wllhhqlllllll\llI\llIlt,lhls OIlIl"/Nllllcll h,,, pr!IIIIIY 01"'1 IIIIV 111111" IIll\illl"IlIlM lIi'lllll SI"II' I"l\' ,111,,111'11111' '!II,"'1I11011l" hll\l.",1 lil~ 1111'1111 III 1I1(1I\,I 1'"("11' (1111111'1 o( Ihls <111\111 h,IVO 1'r!lIll1y. I( Ihlllll ,,,"I'llcllIl,,II,,x IIIvllls 1,11'((,1( I pllJ,"I' \,(/lIlo1<llhllllltIII1J511111\ jll\,ll1rY 11,111\111111111\" ' " ~, r.OI11IIII1II1I\I'IIYl1lllllls, Villi \,,111 1IIIIII'IIIIIII'IIhhlllll ,IIlIIIIII\\S f1l1l11llll1l1llh,'" 1III1II1I11ploYI",/III,III\III'S 111(,1111111 III ,I 111111111,110\1'111111\1 " 10lhllh \11\\'1\1'1' 1111111115111111 II'lIhhollllllll, 1'01111I11\1, hOIl'\'I'III, IIJI'",,'llIly 111111\1111' 11\11 plJIllIIII IIf IhlJ ,IIIIIIII'IIYI11\,"llh,,1 Is ,,111111111\111111 111 I'Mh 1111\1'101'11\./(/\11111"(' J,'" "lllll'orthll\llIlll'"y(I"III/P\l11J or IYllhllllIlIlIlIlIYOIII\\II'1 1111'011 1I\1I1',,\'lIillll/cI,iIlJ o! wllhholdlllll I\'hlll1 'lI"dhil\lhlll'iIYIIIIII\1,'lhll , ""y(l"llI/rlnln of Wllhholrllllll h Ihll,l,'lo ol1whl('h '"1\0111'1 W!I, Wllhhold IIOl11lhll 111111'101'1'1'" ,\\,illI\I\, 1'011 1111111 rOIl'I'II' II'hh Ihlll,l\\' 01 Iho "t\llll ,Ilf Ihlll'I11I1I1'YIIII'S/"hllllol's 1'1111111',,11'1,11 II 011'"11'1111'11111111 \\'llh'loll"II 1111 1111' 1IIIIIIIIPrlllds II'IIhlll II'hlch YOlll1111S1 111I1'11IIlIlilll Ihll Wllhllllllllllllllicllll' ,111I1 (oIW!lIlllhll 11I1'1'(llll"IYIIII.'"ls, 4,' .l'l11pIIlYIII.IO\lIl/l1l1 wlil, MIIIIII'Ir. SIII'III'lllllllelll1I\!I If 111"111 Is IHllllllh,,,, '11111 Olellll/Nlllltlllll Wllhholclll1lllllll1 ((/1 Sill'poll , ri/li,hIlII11Isll",ploYI11'/1l11Il/lot ,"le1 YIlII,IIIIII/1"I*,11l hlll11l1 .111 IIIPI""1 O/elIII/Nllllrlls 11111111I1'11(1111,,1 III ~t'.IIt\ wllhlwlclllllllll1ll\!, 1'011 I/1l1s1 (olioII' 1111' IiiII' Ilf Ihl1 sl.,11I Ilf IIlllpIIlYI1I1',/llhllllol'S I'llne 11',,1 pl,1I11 Ilf IIlHpIIlYI1""'" Villi mllsl hlll11l1 ,\11 Olelllls/Nllllcl1S 10 1I11111lllilll1sl IlxllllllpCl6SIlIIIl, (SIIII no \llIlllwl 5, Tlllmlllrilllll1 N\lllflr,III\lI1' I'll II 111\1\1 pl\lI/1l'lIy I11l1l!\, Ihll HI1(IIlIlSIIIIII AII\lI1\Y 11'111111 Ihllllllll'I\lYll\I/Il\llllllll Is I1PIIll1/1111 workl"/I fm YOII, 1'lllilSII plnl'lcll'lhllll1flllmi"IIll1 Illqlll.slllcl ,mel 1IIIIIm .IIIlI'Y Ilf Ihls Ollllll/Nlllltlllolhll A/l1I1I1 I' Idlll1tiflllelI1ll1IlW, Wrn-II'IOI,DI'I\'8IP, ~31l:'J~U'lU~ . r:MPI.OVI:I:'S/Olll,IGOI\'S NAMI',KllLI,ER,' JIIMIlS p, r:MI'~OYWS CASr: IP('NTlI'II'III_--ID1l00107 PAll' 01 H1'Allt\TION' I,AS" KNOWN IIOMI:API)III:S5, NnW I'Ml'I.oVI:I\'SNAMr/APPIU:S5, - 6, 1,lIInr Slim l'ilYI1IIlIIIs: VIlIIIl1,iY 1111 II;!IIIIfllellll 1111''''' ,II,eI wllhhlllel 1IIlllllcllHI' sllm.I'"ymlll"s sll\h ,IS \l1ll111!1I!, ('(JllHIlIssl\l1l5, or ' SIIVllliillni l'ilY, If ynlllHll'1I 01111' 'I"mlll.</1s ill"'"IIII11P slim I"'Y"11'"ls, I'CI/II,II'I 1111' pI/ISIll1 III .Ililh\llll\' hllllll\', . ~, 1:111\111111" If 1'1111 (.11111I I\'lIhhold lI1wmll ,I' Ihll Orelnt/Nllilcllrlllllrll, 1'11I1 ,1I1l1l,1\l11l fill \lolh Ihll ,1\Tllmlllilll/\1 .111\11111" 1'011 shollld IHIVII 11'1111/11,111 flPm Ihll Ilml'loYIlIl/1l111l1l0I" II1('oml' .11111 Illhlll P"'HIIII1I5 Sill hI' 1'lllil1'yll','"I,1 St,IIIII,,\\', I'lIlH\sylvillllil 51illlll,IW IIIlVlIIlI' 11lI11l\i Ihllllhllllor II "mplllymlll' .1I101hllt SIiIIIl,'II' I\'hlc:h \,1\I1Ihlll"w II! 11111 51,'10,111 II'hldlhll or sh" I' "lnplol'"el /lnl'lIl1", 0,' '\I"I-t!ls('rlllllllillllllll Villi .1111 '(1\1111\1 Ill" rill" 1It'IIIll1i"",eI.II/1e1l1i'SI"III 1,'1\' till IlIsdHllilIrl/l "" IIll1plol'III1/llhll/l1l1' IIPI11 111111'101'1111,,'1, 1IIIIIsIII/lIII Ilml'loY/llt 1,lkll1/1 elhrll'llc1<HY .\I'1I1l11 ,11I"llIsl ""I' ImpIIlYI,"!"bll/lor h'H',lII'" of" '"PPIlII II'lIhholelll1/1, I'nlll1lylVillllil 51nln I,IIV 1I111'IIII1s ,,"IIISs Ihllllblllllll Is Illnploynellll ,",olhlll 51,'111, 111 which (',ISlIlh" 1,,11' IIf Ih',' Shlll,ll1 whli:h hllIII 5hllIs nl11l'llIymllllll'lltlls, " ' 0,' " Wllhhlllclll1l1l.IInIlSI 1'111/111'11' 11111 wllhholill11l1l1l 111<111 Iho hmnlllll 1).lhll <111111111I1' illloll'ml 111' Ilml'lIe1l1l,iI COI1SII1I1Il1 !:Imlll l'IOlllc:\11I1l AI'\ (15 V,S,C, fi 11.7J (11)1/01 21thn .\ll1f1lI111' "lIolI'nll hI' Ihll 51,lln 01 Ihll 1II1lI'IIIynn's.lill1l1l1l1l'S p,li,d"ill ,,1,'U'lIf III11PlflYlnlll1\' 'Thn Fnelntillllllll1.,,,,,IIIl' to Ihll .1111111111'1111 ill'llfl\"I1I11 Wllllll'ly n,'1II1I11I' ,(AI)WI'I, ADWI: I' 1IIIlllf11 Il1rolnlllll!1 il(tllt 111iII<l1111 111ill\1I,llury " 'dlldll\:lIfll1s 'I/\:h ilSI Stillll, 1'lIdllhll,hll\lllilXI'" SIlI:1111 SllI'\III1Y I,IXII!I imil Mnilll'oItn I"xn" ." 10, ' tt +NOT!:I II YIlII or YOllr ngnnl OIl! sntvml wllh n copy of Ihls llIi1m III Ihl! slnll! Ihul ISSlImllh!! mclm, YOll Ilrn 10 follow Ihl! low of t11ll sInln 11\1I11~SlImllhl& ordnr wllh mspocllO IhllSIl lIoms, Ilnl1l1osllrlR Auol1cYI II YOII oi. VIlliI' l!1l1ployno/ohligorhnve nny qllO&\10I1I, pOM~SlIC IlnA 110"15 SI'CTlQN conlnc(. WAOI: A IT ACHMllil1!Nll " 13 "I. HANOVI:1l ST~_,__ hy IlJlophono III (7171 2'1O-6~4.L or 1',0, !lOX 320 by FAX ill WI 240-(,2/10 01' WL.lli\.I: pA 17()U- hI' 1111011101 <<P 1'1I!lo 2 \If 2 I'ol'm I'N.()~lI , Worker II) $IlI'rT. SOlylc:o Typo M (IM(lH(l.:lIf,fIHIIH I \lill~lI(l" Il.-l/': I J/l t/llll 1/ ,'. I', " " " ,', " 'I' ,.' 'I Ii " I i, 'j ",' I' ,i I" ~".. 11" iI' 11.11 , 1;;'1 '..:1' " "J '!.. r :; Ii'j' I "I ~~ ;"\'>j" .<1 :~~f ',1.1 t~~ ,j}l:.. ,llli ,'In, ;'rJ.{ (;i 'j> ,. L' I, I!" " " "'I ,. r,'i " '\. 'I, ! ~L " " t';j " " , " " " ,,' " 1I ;j /' I, Ii , ~ " I I' , . " " il ", " I I , , f' .. ,. H '! " I' /, 'I, P~P~R/NOTlq TO W1TI1lt9H! INf,:oMf. fOR s\JI'I'PIIT " t:.1!( , 'IJ', 'j',;lOi (I ( (-'( ( S\flIPJ:lm\Il\!l!1wuall , l-l!\lIll\ti.v.ll'pnlfl' dk('J~ I,' ,/,,'/// (/1 t,P(,f Co.!Cl\y/P\I\, of au BI,llI,IIWO ,_'~ A,' '.l ,i 'J,'J( . PI\\lll1f O[\hlr(Nnllrll .QJW1.!WU.. {-',\" , ,? If .. CO\lrl/CI\IIl,N\ll1lhur ($(J(,I\!IIII'/lIII//11 Inr 1'Il~11 ~I///I11WI') o (lllllll",1 PI,I"IIN"II'" . o AI1I11I1'II"1 PldI'IIN"II,," @ hll\\III...II'lllllI'IIN"i1i'1' rllll'lI'VI'IIV\'lIhhtl\dlll" I'I'dll[o11 \'IN NIII1II.., PIIWN l' WIIRpllN rl1li'1"I'iltlWllhhtlllllll'. N'IIIIII , '0 1'1111' II\'IIrlWlI,h,,1I III" A,ldl1'" ,JIINI KIlliL. III1RRIBBUIIG \'l't 1'/l0~"2636 I HI".l\IH,r.I~!l~ill!11lill p, I IlIIpllll'III'/Phllll"r'II';,"I11 11,1'1,.1'11\1, Mil I illtliQ..:.~17 -- I 11\11'11'1'''''/1 IfilfIlIH" h,,,:I,11 S"'II,III' NIH"\"r I .P!.!JJ100l0'1 I IlIIpltl\'I'I'/Ohlllltlr'.C,,," 1I1I'1111I1I1r .. I (Srr Arll/f!IIIII1/1 ((1/ "/"('11((1 /I,lIm" olffllr!,lh',III'III'l'ml rill ~IIo1rII/lIl,,,tJ . I (:1"111I1I,III'oII"II\,.N'""I'll,"I,l'Irhl,MII I ,-- , $~(J I\rlllll/IIlfllII fur 111'111I/1111'/11 '''1II1l1~ tlIlll /IIrll, fI,lIll~ ,mllrl,lIfl11 11'/111 r,l.\{1., rill ,11/.11'1111I[1111, O/{Pf:{( tNrO{(~1I\nONI Thll 111111 Drrlllr/NlI\ll'llln WI\hhnhlll1l:nl11ll (nr S\lPPIlII'hllsllrl \IPUI111l11lfChlr for Illppnr\ (roll1.. oUMllllRLII\'lp Clllll1ly. Cnl1l1lHlI1Wlll\llh of 1'11l1l11y1Vill1lil, Ill' low, I'olllllll rO\llll[(lIllo 'lI(1(hl~llhIliP '01l111l111'1 frnll1lhll ullllvo,nlllnfllllllllplnl'o!I'l/ohlluor'l Incoll1ll1111111 IIlIlhol' 11011c(1 OV11l11( Iho orllnr/Nollcn II nlll 1IIIIull hI' 1'011I' SllIln, .. $ " 0,00 pur I1H1I1\h In C\1If1l111 11I111,nrl $ 0 ,00 pOl' 11llll11h In IlUIHhn1 IIIP'pnrl Arl'llurs12 WO\lks Ill' ull1illnrl Gym @ nil $ 0, 00. pili' 11l0111hll1 n1llellcul slIPporl $ ....Q,.Jl.Q.IHlI' nHllllh (nr UUllotlc: tIlsl cosll $ , PilI' 11ll1111h 111 olllur (Iporlfy) for fllolnl III $ 0 ,00 pur Il1111ilh III hp rnrwflfllpll IUI10VP(J hulllW, .Ynll110 1101 huvp (n vmy I' III I I' pilycy(:\ulolm 111 C(lmp,lh1l1~(1 wllh thll Illppml orllo!, I( 1'0111' PilI' c:\,dulloul nill n'lIl~h Ihll ()[110IOII IIIIJIlml pllynHil11 c:yclo. IIsollw (ollnwlllulllllulUIIl1lnu how 1l1l/Ch 10 wllhhohh $ 0.00 por W(I(lkly pill' porloll, $ J..&(l.flor hlwuokly pill' purim! (nVIH\' IWO WO\lks), $ 0,00 flllr.lolllllllolllhly IlilY flllrlml (IWICOllll10l1lhl, $ o. QO por !11ol1lhly IIII\' porlod, .' ({II MITT ANCI: ,IN/,O/{!vfl\ nON: YOIlI1lIlI( .hOIlII1 wllhhohlll1l1 no lillut Ihlll1 111\1 flrsl pol' porlml orcllrrll1Ulll1l (10) wmkll1l1l1l\Ys lIf1ur Ihddl\(1l ilf Ihls Orllul/Noll~o, Slllld IlilYIl1IlI1( wlIl1lll IUVlll1 (7) wmkll1l1 dl\YI uf 11111 pilydillU(lIl,to nf wllhholdll1U, YOII i\f\l0111111\l1l10 ' dodllC' II (oulo 1I0(my 'hll COil of wllllholdlnll, Itllfor tolhllll1WI uovulI1lnu i!\1l wurk Slil(U of ynllr llI\ll1lnyuo for \1111 . \1111 IIl1llWlIhln lIlllollnl, 11111101111 Wllhhold illl1ll1ll\l, ill1d 1'011[ (UU, 1:lll1nut uxcll'od 55"1" of tho oll1plnyuo'll ohllllm's . 1\>>llrolll\lo IlIlpUSllhlo WUllkly 11111'11111111, I'or 11111 fllllpOSIl of Il1ullllll\iltlon Oil wllhholrllnll, 11111 fnllowll1l1ll1(onl1\ltlol1 Ii noodod (Sou/I!) 011 110, 2), . .' . II IOll1lttlnll hI' l'n/l:IJI, pl\lillO c\llll'unnlylvlll1lil5ll1lll Cnlll1cllol1s ill1d Dllhllrslll1H!I11 UI1I1 (5CIJUi I'lllflloyor ' CIIlIIlInOr SIHvlcll ill 1-1177-(,7(,-95110 fm 111i11l\Ctll1nl, M"ka ltelnlttllnca J>"Yllhlll IllI M SCDU Sand check 101 J>cnnsylVllnlll seuu, 11,0, JlllX 69112, HMrlsburll1 I'll 17106-9112 IN AOll/TfoN,1'A I'~~NTS MUST INCWI>f. 11m fJfI'f.Nj)ANr'.~ NAMf ANI> 1Uf./'ACIlf.S MtiMHf.R /IJ (slmll'II abovll ,1,\ "ro f.lIIlllnYIlIl/ObllHllr's C,l~IlIIIO/lIl1lur) OR soc/At S~'CIJRITY NUM/lfR IN OnDtilUO HfIIROCfS,Wl, PO NOT stiNt> CASII HI' MAl/., , .. \lI\01 1~1 Slll\llcl~y III' nw COUltT! ',j 1)010 Qf Ordllll ^ul\\Ial: Ill, 20'..11 501vlco Typll M I', -f'-., l.. ,. " ~ ",. 11MI1Nrulll\I(1,lll~~ ""~,,\-.'\.~i ~!~,1""",n"""" I..'" "')11,,,, .., ;, .. '/.' .. ~'jr ~'\1 ,~",..~.I ' ..." ~ - - . . -'---" ,Jlllxm 'orml'N-020 Workor II) $IM'T I\PfllTlPNI\I. INf(lIlM"TIPN Tq ~M'II.PYI:I\~ "Nfl PTI":II WITIHIPI.P~H~ \:ll( I 1 \II c:l<tH I Villi JilII flllll1hl'II 101'1IlVlclll ,I I'IlI'Y II( 1111\ (IIml \Il YIIIII 1'lI\l'h'YIIII, 1,' l't!lIrI!YI Wl!hhohllllll 11I\lllIt Ihl\ OIlIIlI/NIlIIeIl h,11 I'IIIlII(V,!,VI.t .IIW olhlll 11111'11 1'IIlIIlli IIlIdlll 510111' IiiII' ,11I,,1e111 IIIIl \,il11l1lelllll11ll. I'llihlhll \iIX 11I\,1e11 III 1.11,11'11"'(11I1' rlll'lIlpl II( Ihll 1I1,1e" II'iVlIl'llllilIY, If Ihl1l11 ,llIlll'cllIl.dl,IX 1111'111\ III 11111111 1'1e.,I\1I 1'1l1l1'1' I Ihllllllllll'lllelll illll.t1l'Y lIilllllhlllow, ~, (:III11\1I1\lilll li.Wil\l,"lil YIlII 1',1Il I'lllllhlllll \l'lIhllllld .111111111111 flllllll\\llll' Ih,11I PIli! 1,"\pIIlYI'"/Il\lIIIlIlI'1 1111'01\\/1 lei " \11I1I11l P,IYIIIIIIII .. 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YIIIIII\II\! hllllor 0111 Drdllr\INolIl'lIh 11111\,1' 111<',11"\1' "~llllIl I'lInlh\l', (S~'" YII 1,,,11111'\ . S. Tlltll1ll1'"llolI Nollflr.1111I1I1 YlllIlI\lIll I'llIlI\pllY 1101111' III" IIlll\lI\.\II,," AIII"1<I' wl\l!" II\IllllI'I'IIIYIlIl/0111111111 I' IHlIIIIIIlIll \\'lIIklllll (or" YOII, rh'lliil I'rovl,l" 1I\1l III(Illl\",lIol\ Illl\",..lflll ,111<11<*"1\ '! (,lIpy 01 Ihl' Ollllll/NIII\I," 10 Ih" AII""e:y 1<1""11(1.1111 ""lo\\', Wlllll'IOI.PI'1\'5IPI ~lil'I'I~'I~:)1l . 1:/Y\l'I.OYI:I,,6/PIII.1(10Il'S NAMI:, K1U>I,llR, "lIMIlO P. fMI'I.OYI'I"6 CAS I' IIJI'Nlll'lrlll--OBDll0010'1 nA[f' 01' sl:I't\I\ATIONI,,..-- . I.AST KNOWN IIOMI: APlJlll:S5, NI:\V'I'Iv\l'I.OYI'H'S NAMI'/^pnlll'5SI (1, \.\11111' 51111\ 1',IVI\II11I1S1 YOIIII\,IY IHlIlll\lIlolIlIII rlll'llIl '''iii WllhlHllI1 hllll\ 1\11111' i\lI11 l',jY"H>l\h IIII'll ,IS "111\\/1111, 1'1111\1\1155\1>1\1,01 IllV\lr.1I1e:ll lillY, If YOII 1I1l"" ,IIIV qllllllllll\S ,1111111111111\1' 111111 1',IYIllIIIlII, ('(IIIIolt.lllI" P"'IIlII III ,lIl1holll\' ""loll', [I, " 7, 1,1,II1I1IlYI I( YOII ',111 III \\'IIIIIIIII<lI"(,(1I'It' ,I' III" Ol<llll/Nollrll <lllltl'l"Y"1I 0II11 IInhl" fill hlllh 11'" ,\1'1 1111\111,,111<1 ill\H1II1,1 ynll sl\lllllll hllVII 11'111\1\,,\11 (I"'" IlIll IIIIII'IOYllll/nhllllol'S IlIli,"1t> nlld 11111111 I'''"l1l1h'l \1\1 IIy 1'''"1\'yIVlIl\ln SI<lII.I<I\\" 1'''"llsylv,mlil 61,11" 11111'11\11'<111\5 \1111"15 Ihil nhllllor II ll",plny,,",111I ."'"lhlll 5101111, 11\ II'hll'h ""\Illl~" IiiII' o( IIIll 51,lh.llIlI'hlrh hll nf ,hll Is Ill\ploY"<lIl\!I'''"II, ' U. AIIII..lIsc:t1",II"II\I>1I1 Y(/II ,II" 11I111111'111I <I (Ill" 11"lllllI\llI"d I""dlll 5/'11" I,IIV for 11I,e:II,nllll\lI' 111\ 1IIIlplny",,/n!>lIllnr hll'" 11IIIplnYII\IlIlI, [11(11,51"" In IlIllplIlY; or IoIkl"" dlsl'lI'Il""'Y 01\ 110" "11011",1 ,II\Y 11Il\pIIlY"I'/llhllllllt hI1l'.111111 111,1 1111'1'011 wllhllll1cIlI'II, 1'llI\I1iylvillll.1 Slill" I,lli' 1l'11'1I111fi 11I111l!5 Ih" IIhlllllll lfi Illl\I'111YlleI hi ""l1lhl" 51,1111, I" which l'olilllhll lillY II( 1111.51,11" III wllkll "" III 11\11 Is 1l1l11,IIIYIlIIIIIIV"rt\5, , " g,' ' Wllllhn\ctll111 I.lmllll YIliI m,ly 11111 \Vllhhll1cl 11\11'" IlliIIIIIIIlI;m"r 0(: IIlh" ,111\11111\\1 ,11l1l\V1II1 hy Ihll rlldll",1 Cillli\II'1Il1 CI"e111 rlolllrtllll\ Art (15 lJ,S,C, 61[,7:\ (h)ll 01 2)th" ,m\olllll' ,11I0Wlld IIY Ihll 5101111 IIf 11111 ",,'ploYIlIl',/ohIlIlOl" prlllrlpill pl,'tll o( 1lIl1I'IlJymlll1I.' Th" 1'''11111,,1111\111 ill'pll"s IlIlhll;lIIl\II'II;lI" <1I'I;i,~"hlll 1I'Illllily i',llIlhllll!APWI:), APWI: 1\ thll ""111\10111" 111(1,1(1"1 Illilllllllll\1i1IHlilllllY Ilndllt:lllll11 IlIrl1 ilil 51011",1'11<1""11, 1,,('.11 1,IXIl" Sorl,1151l1'llJlIy 1,IX"'1 111\11 Mlldl"'"I' I,IXII', 10, _____ II 'NOll:1 If 1'~lI or YOllr pgol\lntll sl1Ivntl wllh n'c:nllY of Ihls mtlnr III Ihn tlllWlhnllssllnlllhn orlllll, YOII iIIlllo follow Iho 10IV of Ihn sl01l11hlll IlsllIIlI this nrdnr with rnsplH:llo IhuIU 1t11l1\5, ,", l\llqllnsllnll 'AllnncYI If 1'011 or YOllr umployolllohllllor hOVll ilny <llIn5l1ol\S, ObMl,STIC RI:I.ATIONS SI'CTlON r.ol1\i1r\ _,- WAOl! A1TACIIMI,NT UNIT 13N. HANOVI:It5T hI' Inhlphol1o 11\ j7171 240,(,llL or 1'.0. 1I0X 320 hI' "AX ill (7171 240,r,2.1lL or WOOl: I'A 1701 :1 _____ hy 1I1lnrno\ @ l'nlll1 2 of 2 "'Hill I:N,0211 Wl1Ikllt II) $1M"I' SlllVlcq.lYllfl t~ (lMllt,(I,:III"{Ht'.\~ 1 ',I!IJ~tfl'n Ihl,': IJ/II/nll " , , ;, IIIH (ho plll'lI11HO IIl1d 1\1(\.l111111'Ihl~AurCIlI\111llt In Hlllllo lhrpwl' IIIHlllolllpllllL,ly Ilw i\1lorllHI 111111 nllll!1l1llnnH nl'lhc PIIl'lhlH 111111111'l'oPL'I'IY 1I1111Ih(l~' own Hopllrllllll~',III\\11I1I 1'1'I111(JIW (hili WO\lld 1I1111111Y IIH 1lI1I1'ltlll Pl'ol'ol'l>' IIIHlcl' Iho I'cl1I1H)'lvlIllll1 Pll'nlw 1'0d\J, lillI' 1:1, HCCllnl1401(pl, \1\1d lhllllH rlllCITcII 101\1 (his A!!l'clll1WI\I IIH "Mllrillll PI'\Hl\ll'lyll, IIH holwool1 (1111111Hclws, IIwll' holrs 1111\1 IIHHIIlI1H, llw pllrllcH hlll'lllltll,llllP(lllllnllll'ldulhplr MIII'ItIlI Proplll'l>'11I1I11111111WI' Ihlll cnl1lhl'mH to 1I,111Hllll1dlilll' sl lI\1dlll'l I , Wilh dll!J rl,lUlll'llln thurlllh(H Ill'llllch Pllrly.' 'TI\LI dlvlHlol1 nl'llxlHtll1!l Mllrltlll Prpporly IH 11IlllnluIHlcd hY,lho pllrlloH III oonHl11\ilo In IIIlY 1\'11>'11 slllu nl'IlXchll\11Jlllll' IIHHIltS,II\1d (hc dlvlsll1nls Iwl\11.! ortt'olodwlthlllllllwlnll'l1lhlollon ol'o\1(sldu 1I1I111s 111' I1thor 11rol'01'Iy nol CI1\1sllt\1l1llu II pllrl nl'(lw 111111'11111 OHIlIlu, IlIH Iho'l\ll'lhol' I'\II'POSO Ill'lhls 1\!lrll\.lI11UIl( (n H\.lltlo tlll'OVOI' lI\1d c0l11plc(0ly III1Y ohlllllltl1ill' IIlHlol' Iho 1'0\1\1HylvIII111I1)ll'nrLIl) Code 1'011l1ll1g 111 HpOllSll1 HllppOI'1 01' 1I11111011Y, " , h, Elloh PIII'(Y rllpl'llsOI1(H I\1HI II'IIIT11Il\s Ihllt honr Hho hllH 11111<10 1I1\IIIIII1d filiI' dlsoloHlII'o 10 (he llthel' ornll 01' his 01' hOl' pl'OporlY II\(OI'OHIH 1ll'II11Y 11llllll'o, 111011ldll1l! 11I1>' 111111'11.!1I110, plollgo, \lOll, lIhllr!!U, Hoomlty hllcreH(, 011011l11hr1l1l1lO, Ill' l'oslrlollo\1 lo,whloh 11\1>' pl'Opur(y Is H\1h,lool, Blwh pilI'I>' . 1\ll'llwr rllprllHOI1(H thlll ho 01' Hho hllH 1111HluII 1\11\111111 lilll' I\IHllloHlIl'U 01' 111\ dohtH I\l1d ohllgllt!ol1H pI' nl1~' I1n(ul'O 1\11' which 11LI or sho IH 0111'1'01111>' \Inhle 01' I1my hooo\1lL\ IIlIh10, Elld1l\ll't!l01' l'~pl'oHol1ls IIl1d lI'lII'1'nl\IH Ihnt ho 01' HlwhllS Ilolllllldo nil>' glf\H 01' (l'IIllHlul'H 1\11' Il1ndoqlillto o\lI1Hldcl'ntllll1111' Mllrltnl Properly Wllholll Iho PI'IIlI' CllllHlll1t Ill'tho othlll', ElIoh Pllrl>' ncliI\owllldgoH (hll(, to lh~ oxtol11 doslnld, hu 01' shll hIlS l\luIIlL'COHH III 1111 ,1o,ll1t III\<I sCl1nl'III\) Sllllllnl1l1 Pollol'n1 TIIX Rellll'llH f\\c\1 h>' Ill' IlI1 hohnlf' Ill' either Ill' hoth PllrlloH <1111'11111 ,111 111'1'1 n1\O, ,1 I, " " It', -" TlilHIU 1." \~^ 'l13lllnll'I', 1'1 (:Iint:ll'!' IN '1'11I': COW'l' 01;' COMMON plllill\fJ OJ" r!tJfv1\lHJln,I\ND COllN'I'Y, .l'1,INNf.JYl.vI\NII\ v, POMWJ'\'TC IWI,I\'I'IONfl fJlile'I'loN CTV j I, J\(l'I'TON - O\lI'I'oWl' NO, U~-661~ CIVT~ DI~, ~9, 0'1'1 illill.l!llU2E_G..Qilli~! i\NP'NOW, tl1j.H ?-l1tll diW of' flopl:lJlI\hur, ?-OOI, \lpOn \lflM\i1fJ D, I<lUl,j,li:H, 1)llf'Ol\l\nnl'. oonoiqel:a\:IQn of' the'p(J!:It:lon I:or fJOntoll\pl: f'llael :In tho , f\bC1VO- anp!: :loneel lI\i.\t trn' ,'lnc1 p\lrpllilnt to i'Hl, i.\,p:oP\I\ej\!: retlchoQ In open oOl.n:t betweon I?lld.nt:l f I:, '1'0l:'l:1 )"" WilY))1:1911t, I'apl:ec~ontecl by Mf.\ra\\~I\, Mcl<night, 1 II, 1!lor1\llro, nnd, po t:enelfln!: fJamBfl D, I<ollor I-eprel3fJnt1nu hill\pelf, It: i13 on\01:0(1 nnrl cllreo[:mln13 /:olloW13 I' 1., 'rho Det:ondnnti hl~rBnf'tor', oh1.111 on a timl'lly bEl!,d.a p<\y the <\1i.lI\ony ordOl: o~lsl:1n9 h81:Bin, nnd ho phnll tEll~s l3l\oh I'Itepi3,ElI'I i\J:[-l, neoePPiWY . to fac.l.li tnte EI wngo Elttnohll\ent /:01' colleotion of: the onler, UntU ~Jl\oh t:lll\e tnl he aElei3 tile eHea\: of. Jl Wl\ge attl\ohmlJnt on hio pny otul)i3, he I'lhall PElY the amol\nt reql\irect, directly to the lJJ:oper n\lthod.ty, 2, '1'he Dofondnnt, IJnll\ol3 p, Kollor, ahElll OOOplill:l\te with the Pla1ritiff:, T~rrlL, Waybright, In a1gniog'nl1Y docwnel1l:i3 , neCeflfll\l:y to 1mplol\\ont tho 1I f.o i.nall):ance on hJ.i3 1 He 1:,0 be pnJcl " by the het'qin of the Plnintiff Elt ho): exponfJe, 'l'ho lIf:e infl\\l:nnoe refel:tet;\ to ahl\ll 'be for n peri.oct of. approxi.lllately 6 yeal:S, 'l'henmoUnt " lHe i.nfl\\ranCO providod f.0l: heroil1 ahElll be '$~6,OOO,OO, .3, '1'he" Plni.ntUf:/ '1'0 rd. J." Waybright, ngreea to oooperate with tho J)~)hJndnnt and. E1J.gn anY cloo\\ments necesl'lal:Y \;0 trl1naf.et the ,13ldl'lt.l11g oOl1,etory lotfl into tho flole nmne" oj: the tlefel)dl\nt, Jllmea D, Keller, <l, '1'he Plai.ptHf. in consideration of theae ' agteements ahall Waiv~ nIl her claim for logal f:oea as EI result of. " this peU\:ion. " /; I " " ,,' " Ol;. I' ". \" H " ,I' ./' t. I' " " " " I . , ' " j'i " I . i I oJ I I \ - , I , , , . , " ~ " I , , I I . ' , ". I [,!_l ( , I , I" " 1 . , ,. ) I' I. I" " .. !1 'I ,j;' " " \i' . , ' " I . .I' , ' '\i 'f'il " ." l! ,," '1- ;, d, " ,.t. " "'i " , , I if " " " I' " f' " , ",1 Ii. oHIlI:H/NnTlr.t: TO WlTlllful.P INm"'H: mil Sljl'I'flIIT fil~l~ .l,:lImnllll\wpallll..uf-~~I111lvlv"lIlil, CI1.!clly/PIsl, nf ClUMIlNl!II/\NP. . PnlllCl(Orclllr/Nllllrll 0'1110/04 Ttlhllll!ll/cj\S\! Nill11hllr ('~"III\II,II'/I!IIII" (11r ('I'~II ~flm"hln'i OIIIIUlllollllHhI/IN(!IIrI' o ,11!\1'l\lh'iII IHh'I/Nullcll CRl II'III\III,'Ic'lll/lc'I/Nuilro nTlMl'lllll,I,ll ,rlltH'I'OnIII1. 1II~IlV LCIW au NlIWlmnllV liP MIPPW1'OWl-l I'll .1 '/OU'I-311.1,U ____ ill, lilil'hlm , ,11l.!!\!,ill.J.l.,. _ \ luplul'III'/(lhlllllll" N,'IIII'II,,.,, rh'l, ^IIJ 11-" ~r I J II llJt:.q 0 ".!1i11. I) { j( I)l L r'1II11111\'I'I'/(lhIlIlUI'~ SUI I,ll SI'! tully NlIl!\h," , . ,gfiQU0010'1 _ , j IlIIplu\;iii7ohlluuI" (:,l>ll hhlllll(luI (' (-' r:: ( '($1'0 ~I"'I'I"/I"" (I" "',1111U(( IIMIII'f 1 {, J.) I(~ (! (/// ,1HIlI'I,*,'/IVIIII 1'1111'1 nIl .1//olI'IIII/II/I/J (:H"I,II,.II'\IIUI\I'~ NUI\I\lIl.,l>I, I'h." Mil 1.i\',pIIlVIIii\Vllhht'hhll" 1'11l11II\1111i~ "1I1!'I'," $1111 tIrlrll'fllllltn (11r lip/10m/II III '''1tnll~ mil/ h/rt/III,1IN ,mllrl,1tpl/ with (',1~1I~ Ill/ ,111,1('/1111111/1, ORPI'R INfORM/I nON: This I~ iHl Prrlllr/NlIlIrll III Wllhhlllrllnl'llll111 fllr SlIpporl Ih\SIIl! IIpnll illl olll('r fill sllPpoq 'from' . OuMlll1l1r~l-lp COllllly, Cnl11mllnWllilllh of f'lInllsylvilnHl, Ily lilW, Yllll .1rnl'llrIIIIiI.r111l l!nl!lIC\ tl1I1S11 "mllun!'; f[llll1lllU fthnvn'!lmnUlII!mplnyn!"s/llhllllor'~ Inclllllnllnlll (1IIlhol' nl\\lcll IIV11n If \1\11 Pnlnr(Nlltll'nl~ nlll I~~lll'll hy Y"!ll' Slntu, ' $ 0 ,00 pllr Il1llnth Inl:tllrllnt ~lIppllrl $ 0,00 pllr nlpnth In pftsHIIIIl ~IIPP(lrI ^ITOilrs 12 \\'iIllks or Ill'llillnrl 0 YII~ QQ 110 $ . 0,00 pllr 1l11l111h In nl\l(lIr:ftl slIpplll'l $ _ tl.Jl..O.pol' mOllth for llorlllllr: In~1 cn~t~ $. pllr monlh In Illhllr (~pnl'lfy) fi,1' i\ tlll~1 nl $ 0 ,00 pllr'flHlI1lh In hll (nrWOl'llllllln Imyull holnw, YOIl <In nul hnYlltu YiHY \'0111' pilY (:yrllltollllln compllnnco with thll S\lpp"rllllllllr, If yqllr PilY cyrlu c11l1!s nnl1111\lch ' . tho,IHlloroll ~lIppun rnymol11 rydn, IIslIlho (ullowlnlllo dnlnrmlnllllllw milch III wllhholdl , $ 0.00 pU\, Wllllkly pny,pllrllld, " $ 9,00 liol' hlWllBkly Pfty porlod (flyn!)' (Wll wonks), . $ 0,00 pOl' Snll1ll11llnlhly PilY porlllll lIWlrn ft I11nnlh), $ 0.,00 pili' monlhly p.w porlod, Rttvll1TANCC INI'OI~MAT/ONI ,You mllsl hnuln wllhl111llllnll nn !illnr Ihon Ihu f1rsl POI' pnrlod oCClIrrllllllon (10) wlld,lnll dnys nflur Ihu dO(ll of thlH Qrdor/Nnll(:o, Soml pnYll10nl within Sllvon (7) wOl'klnllllllY~ of 11111 poydnlu/dnln Il( wllhhllldlnll, YOII nm llntlllllrl to dodllcln (I)lllll dnfmythn ensl Ilf wllhhllldlnlll I~ufur III thnlnws Illll'urnlnl\ thll wmk stnll'"( YOllr IlrnplllYllo (Ill' tlm nllownhlo nrnlllllll, Tho (Oll1lwllhholll iHllDIIIlI, .1Ild Y"llr fllll, cnl1lllllnxclllllI 55% n( tho urnpllly"u'sl Ilhllllnr's 111111rollnld IIlsposl1lJlo wllokly nomlnlls, I'llr thll pllrpllsu Ilf thollnlllnililll on wlihhllldlnll, lho (1lllllwll1lllllfllrrnllllon Is noodnli IS[)o1110 Illl PIl,2),. . ,. If IOmlilhm hy I'rT/I!IJI, plul1so cillll'llnnsylYnlll.l Slillu Cllllectlllns illll! IJIsllllrSll1l1l11lt UI11I (SCDLJ) l:rnphlyul' ClIslolHllr Sl1lvlcu n(,1.1I77.67r..U5I1ll fill' Itlslrllcllolls, " Make Ilomlttancellllyable 101 f'A SCOU Senti check tOlllel1l1sylvanlll seou, .P,Q, 1I01( (,9112, HmlsbunJ, Pi1 1710(.,9112 ,IN AlJfJ/TION, I'A YMIJNTS MUST INCWDIJ THIJ DlJfIJNIJANT'.~ NAME AND TN/:I'AcSES MEM/iER If) Ishpwn . nbllvl.' ~$ ,/II.' flll/J/IlYI.'I.'/Obllgp/,'s C,1SI.' Irll.'lIl/(II.'/') OR $oc/At sf,CURITY NUMIIIJR IN ORDER 1'0 tllJ MOCIJSsIJD, 00 NOT SENO CAsH /lY MAIL, '.. , P"""'fO"'''''~ 2-, 2 o. ~ IIV";;;t:('folb I'otrn I:N,ll211 SIHvh:n Tyjlll M OMII N,;, Ii'''Ii Ii' Wlnknr II) $ II\'l'/j1 ,. APlmlQNM ,NfnIIMI\TIUN TO "Mltl.nYr"~ ANP nTIWII WlllII'nlPrt\S .. (J II dH'rkl'JI 1'1111 .\!I' rIll/"III'11 10 \'ll'~I\11I " \:0")' \I( Ihll (1111/'10 1'11111 111II/"IlI'IH" I( 1'1l\'t IHlI"Ie'VI.I' W(/!lI> 11111 >Iilll! Ihll\ I> I 111111111\1 IIPliIlhl' bill I Ih,1I ,SII'I 11\ > 11111'1, 11'(1111' 11111> 111'1111'1'111'1 III 1'0111 I'lIlp 111'111' 1'\'111\ I( 11111 ho~ I> IIIlI I'IIIlI ,1111, I, WI,' ""p!llI'ltllilI11\l VpIIllIlOIIY 1'01ll1'11I,III1P ,Il( 1'I.tlpl"lIy 1111'1I1111111111111I11,"'1111"1\, 1IIIIIIIIY'Il\\'IIIHlllllbIIIlIShllb, 111\11111111.11I'1111'1\1111 h'llll\lII\1I1 1111'1111'111111" 1I1\IIIVlllhllll 1,lIlhlllIhIlIIIWllhllllllllll.II"'llltlill\l'I' \l'lIh Ihl> 111111111, ' 2, /'rlllrll'YI Wllhhol<III1I1II1\1!llf Ihl\' Illh'I!Nllllnl h,1ti "11111111' 1I1'l11 11111' 11111\11 11111111 ,,'PI'I"> !lI\llell %111111111' ,llIillnsllhll >illllll hll'lIlI\I1, . r'!1 Ilf'lllli~ Ie'yl,lb III p(("1\ h,lllllll f\ll'i1lpl p( Ihll 1I1111n I\ilV\lllIlorllY, I( 11\1111' ,\lIII'IIII,llI!III'I~ h11'1,1b h, p((1I1'1 1'1/1'''1' 1I1I1I,lIllhl' 1I'!I!111b1l1l1l I'IIIIIH'Y 11111'1,1 hI11e.1I" ' , :\, C"'11hII\I1I8I"WI11\111111 YIlII 1'1'11' nllllhh\ll Wllhl\llltllll\!O!IlIII, (11l1\! 1\!1l11I 1I\ilIIIlIIIII'lIIpIIlY(lI'!Il\lIlIlIlI'> hll'llIllIlllI,l >11\11111 PllYllll1l11 III 1IIII'h ""lll1l'Y 1I'!lIIIlillllll wllhhole 11111, 1'1111 11I11sl, 11'.111'\11'1'1, SIIPIII,ll11l1' 11I1111!lfy 111\I1'11I1l1l1lllf 11111 slllllll'l'lIl'lIIll1ll !!Hllls ,1I111l'\lIilI.lilllllll1rll IlIlIpIIIYIIO!II\IIIIIIll, .. 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Is OII1I1II1\,tldll1 ,111011l1lJ SI,'lo, 111 1\'111111 1'<1'" 1110 I,I\\' of 1110 SI,iII'lo \\'l1ll'h 110 III '1111 I, IIIOplc>\,I'dIlOI'OIll" '.' , I " U,' Wllhllllllll,," ~lllIlIil YOII lI1il\' 11111 I\'lIl1hol\I'l1loll'll1l1l1l1l11lo"ol' of: I) 1110 ;lIl1!HIIIII ,\110\\'1111 11\' Iho /'1,1101,11 C;'II'"lIlIlI ell'dll 1'1'0101'11011 AI I (I!i u;s,C, ~ I C17,111I1I J IlJ 2)'ilw ,II101l1llli ,111101\'1'11 h\'II\II SllIllI'of 1110 III11ploI'01l"/01l1l1l1lf'S prlorlp,11 pl"l'l1 of i'lI1plo\,lI\lllIl, 1111' I'lItlclr,111I11111 ilppllo,10 111I1 1I1II1101lilllllll'po,,\"lci \\'I!okl\' IWOIIlIl' (/IIJW!'I, IIIlWI' I. 11111 1\111 111r<lIlIolofl ,lflol 11I"ldl1lll11i11l1ll1lol)' dodllt:lIl1l\h IoIl\'h ,lhI SlillI', ""1101,11, 11I1',III<lXII\I SIIr!jJl SO(,lIrlll' IIIXI'" ,11111 Mli'lIir,lllll.,XOI, /'0111'11",111I111111, YOIlI1II1\' 1101 11'1111110111 1'1OfI1 111,111 II III ,111\1111111' ,1111>1\'1'11 111111111' 11,101,,1\' of 11101"1111111 Hlllo, 1'11I1111>,,1 01l11'1i'1'11/' 1\'110 11I1'1'11'1' ,I '''''"l1r1lclJ, \,!HII11,')' 1101 \\'lIhllolll IIIIlfO IlIimlhll ,1111011111> ,IIIII\\'I'd 1I1111c'I 1110 I"l\' of 11'0 '1"llIll1illl'bllllll 1110 olllcll, " , Ill,I\llcllllllllillln(11I Ii ,1--' 'NOTi:! If YOll hi Yoll/' ill\1I111 Mil Slll'l'lId \I'.llh ill'llpy of Ihls onlll/' In Ihll slil(o II1i1lllllilld Ihllllldlll', ,YOli ,11'1110 (olin\\' "111 lilIl' of 1111' '\'110 1111111""11I1 (hlh IIldorwilh lI'sIIl.clllI Ihl1\O 11111111,' . 'I,S\llIlIIllIcclllYI , ..If YlIlIllr YO;"'llIl1ployo%hlll\ol' hilvo;my qllllSlIolIs, llilML~llc Im:t.\.I.JoNs sl:CTION WIII<lcl WAm ArlACHMl'NT UNIT' .l.JJW~!2\1JUiJ hI' 1010phol111 ill l? 17) 2.10-[,225 01' '!ill. lloX :120 hI' h\X ,11 (illll1U:.li.2.1JL_ Ill' CAIU.lSLI' i'A 1701:1 h\'11I101l1l11 wW\\"l'hlhlslll'polt,slilltl,Pil,Wi sllrvltn Typo M 1',11\11 2 of 2 rIllI11I:N.(iin VVI'"kl1l' II:) '21205 ., (IMlIl~UiUl"fHII'd f~:" '-1"",1 'j.. '4"1' i l,!") , I.> Ii'.' I. .~ i ,,-. I'." '-\:: , ' 1.11, I' C') '1" I ll-:l,j ii;I," " I, 1'1:: :1.. ~.\ -+ \.,') , , C.l. " " c ~ ,.,j " " /, If II, t." ,',.' " 'I I " " ,,, " '" ;j<., " 'I " i" " , , ,I' ,,' " " " '\", " "If " "', ,I' I, ..If "