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DEFENDANT
DECREE IN
DIVORCE
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AND NOW, . . . . . . . . . . . , . .11(f14. . .(~. .. " 11). ~~~~., it is ordered and
decreed that............. .~~~~~. .~:. ~1'!1?J!:~.~ql)T..............., plaintiff,
and. . . . . . . . . . . . . . . . . . . . . . . ~~.~f!t:l. ~... .~~~.~~~?~. . .. . . . . . . . . . " defendant,
are divorced from the bonds of matrimony.
The court retains jurisdiction of the following claims which have
been raised of record in this action for which a final order has not yet
been entered;
. . . . . . . . . . . . .~J;.L.. ~I,~+~.S. .S1;J~,J:E;C'r. .T.Q. 'rtIE .~~RL'l'Jl.L. .s.E'l''l'J:..E!1EN:I'. .AGREEMJ;:NT
DATED MAY 31, 2001 AND INCORPORATED WITH THIS DECREE
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SEPARATION AND PROPERTY SETTLEMENT AGREEMENT OF
BRUCE M. ANDERSON AND ELLEN M. ANDERSON
TillS AGREEMENT, made this 31st day of May, 2001, by and between BRUCE
M. ANDERSON, hereinafter referred to as "Husband", and ELLEN M. ANDERSON,
hereinafter referred to as "Wife".
WITNESSETH:
WHEREAS, Husband and Wife were lawfully married on June 14, 1997; and
WHEREAS, certain differences have arisen between the parties as a result of which they have
separated and now live separate and apart from one another, and are desirous, therefore, of entering into
an agreement which will provide for support, distribute their marital property, and will provide for their
mutual responsibilities and rights growing out of the marriage relationship; and
WHEREAS, the parties hereto, after being properly advised, Husband by his counsel, Lee E.
Oesterling, Esquire and Wife by Henry Van Eck, Esquire or having chosen not to seek the, have come to
the following agreement.
NOW, THEREFORE, in consideration of the above recitals and the following covenants and
promises mutually made and mutually to be kept, the parties heretofore, intending to be legally bound and
to legally bind their heirs successors and assigns thereby, covenant, promise and agree as follows:
1. SEPARATION:
It shall be lawful for each party at all times hereafter to live separate and apart from the other at
such place or places as he or she may from time to time choose or deem fit.
2. INTERFERENCE:
Each party shall be free from interference, authority and contact by the other as fully as if he or she
were single and unmarried, except as may be necessary to carry out the provisions of this Agreement.
Neither party shall molest the other nor attempt to endeavor to molest the other, nor compel the other to
cohabit with the other, nor in any way harass or malign the other, nor in any way interfere with the
peaceful existence, separate and apart from the other in all respects as if he or she were single and
unmarried
3. WIFE'S DEBTS:
Wife represents and warrants to Husband that since their separation on or about September 28,
2000, she has not, and in the future she will not, contract or incur any debt or liability for which Husband
or his estate might be responsible and shall indenmify and save Husband harmless from any and all claims
and demands made against him by reasons of debts or obligations incurred by her.
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4. HUSBAND'S DEBTS:
Husband represents and warrants to Wife that since their separation on or about September 28,
2000, he has not, and in the future he will not, contract or incur any debt or liability for which Wife or
her estate might be responsible and shall indemnify and save Wife harmless from any and all claims and
demands made against her by reasons of debts or obligations incurred by him.
5. OUTSTANDING JOINT DEBTS:
Husband and Wife agree that they have no outstanding debts and obligations of the Husband and
Wife incurred prior to the signing of this Agreement that are not otherwise specifically addressed by
provision of this Agreement. In the event that either party contracted or incurred any debts since the date
of separation on or about September 28, 2000, the party who incurred said debt shall be responsible for
the payment thereof regardless of the name in which the account may have been charged.
6. MUTUAL RELEASE:
Subject to the provisions of this Agreement, each party waives his or her right to alimony and any
further distribution of property inasmuch as the parties hereto agree that this Agreement provides for an
equitable distribution of their marital property in accordance with the Divorce Code of 1980, as amended.
Subject to the provisions of this Agreement, each party has released and discharged, and by this
Agreement does for himself or herself, and his or her heirs, legal representatives, executors,
administrators and assigns, release and discharge the other of and from all causes of action, claims, rights
or demands whatsoever in law or equity, which either of the parties ever had or now has against the other,
except any or all cause or causes of action for divorce and except in any or all causes of action for breach
of any provisions of this Agreement. Each party also waives his or her right to request marital counseling
pursuant to Section 202 of the Divorce Code.
7. EOUITABLE DISTRIBUTION OF MARITAL PROPERTY:
The parties have attempted to distribute their marital property in a manner which conforms to the
criteria set forth in Section 401 of the Pennsylvania Divorce Code, and taking into account the following
considerations: the length of the marriage; the age, health , station, amount and sources of income,
vocational skills, employability, estate, liabilities and needs of each of the parties; the contribution of each
party to the education, training or increased earning power of the other party; the opportunity of each
party for future acquisitions of capital assets and income; the sources of income of both parties' including
but not limited to medical, retirement, insurance or other benefits; the contribution or dissipation of each
party in the acquisition, preservation, depreciation or appreciation of the marital property, including the
contribution of each spouse as a homemaker; the value of the property set apart to each party; the
standard of living of the parties established during the marriage; and the economic circumstances of each
party at the time the division of property is to become effective.
The division of existing marital property is not intended by the parties to constitute in any way a
sale or exchange of assets, funds or other property not constituting marital property. The division of
property under this Agreement shall be in full satisfaction of all marital rights of the parties.
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A. DISTRIBUTION OF PERSONAL PROPERTY
The parties hereto mutually agree that they have effected a satisfactory division of the furniture,
household furnishings, appliances, and other household personal property between them, and they
mutually agree that each party shall from and after the date hereof be the sole and separate owner of all
such tangible personal property presently in his or her possession.
Except as otherwise provided by the terms of this Agreement, the parties hereto have divided
between themselves, to their mutual satisfaction, all items of tangible and intangible marital property.
Neither party shall make any claim to any such items of marital property of either party, which are now in
the possession and! or under the control of the other. Should it become necessary, the parties each agree
to sign, upon request, any titles or documents necessary to give effect to this paragraph. Property shall be
deemed to be in the possession or under the control of either party if, in the case of tangible personal
property, the item is physically in the possession or control of the party at the time of the signing of this
Agreement and, in the case of intangible personal property, if any physical or written evidence of joint
ownership, such as passbook, checkbook, policy or certificate of insurance or other similar writing is in
the possession or control of the party. Husband and Wife shall each be deemed to be in the possession
and control of his or her own individual pension or other employee benefit plans or retirement benefits of
any nature with the exception of Social Security benefits to which either party may have vested or
contingent right or interest at the time of the signing of this Agreement, and neither will make any claim
against the other for any interest is such benefits.
From and after the date of the signing of this Agreement, both parties shall have complete freedom
of disposition as to his/her separate property and any property which is in their possession or control
pursuant to this Agreement and may mortgage, sell, grant, convey, or otherwise encumber or dispose of
such property, whether real of personal, whether such property was acquired before, during or after the
marriage, and neither Husband nor Wife need join in, consent to, or acknowledge any deed, mortgage, or
other instrument of the other pertaining to such disposition of property.
8. REAL PROPERTY
Husband shall own in fee simple absolute, the real property more commonly known as 904
Lancelot Avenue, Mechanicsburg, PA 17055. Payment from Husband of the sum of ten thousand
dollars ($10,000.00) dollars shall serve as full satisfaction and settlement of Wife's equitable
claim in the aforementioned real property. In consideration thereof, Wife shall relinquish and release all
right, title and interest in both law and equity to said real property and shall execute a quitclaim deed in
Husband's favor no later than 30 days from the date of the signing of this Agreement said deed to be held
in escrow pending Husband's refinance or assumption of the mortgage. Additionally, Husband shall
agree to assume the mortgage in his name solely. It is understood by the parties that the assumption of
said mortgage is contingent upon the divorce being finalized and therefore, husband will have six months
(180 days) from the date the divorce becomes final to complete the assumption of the mortgage or
refinance of the property. In the event of nonassumption or refinance of the mortgage within the ISO day
period, wife's interest in the property will be reconvened in wife , including transfer tax paid and the
property will be listed for sale.
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9. SUPPORT, ALIMONY AND ALIMONY PENDENTE LITE:
Both parties waive the right to collect spousal support, alimony or alimony pendente lite
from the other. Furthermore, in accordance with the other terms of this Agreement, Wife agrees that as
of the effective date of this Agreement she will within 10 days withdrawal and relinquish her claim for
alimony pendente lite and or spousal support by filing the appropriate written request with the Domestic
Relations Section of the Cumberland County Court of Common Pleas. Said request will be docketed to
DR #30495/ PACSES #686103124 and 00-7176 Civil Term and shall be retroactive to the effective date
of this Agreement.
10. PENSION PLAN:
The parties release any interest in the opposite spouse's Pension accumulated during the marriage.
II. COUNSEL FEES AND EXPENSES:
Husband and Wife Acknowledge and agree that the provisions of this Agreement providing for the
equitable distribution of marital property of the parties are fair, adequate and satisfactory to them. Both
parties agree to accept the provisions set forth in this Agreement in lieu of and in full and fInal settlement
and satisfaction of all claims and demands that either may now or hereafter have against the other for
alimony pendente lite, counsel fees or expenses or any other provisions for their support and maintenance
before, during and after the commencement of any proceedings for divorce or annulment between the
parties.
12. WAIVERS OF CLAIMS AGAINST ESTATES:
Except as herein otherwise provided, each party may dispose of his or her property in any way,
and each party hereby waives and relinquishes any and all rights he or she may now have or hereafter
acquire, under the present or future laws of any jurisdiction, to share in the property or estate of the other
as a result of the marital relationship, including without limitation, dower, curtesy, statutory allowance,
widow's allowance, intestate share, right to take against the will of the other, and right to act as
administrator or executor of the others estate. Each will, at the request of the other, execute,
acknowledge and deliver any and all instruments which may be necessary or advisable to carry into effect
this mutual waiver and relinquishment of all such interests, rights and claims.
13. SUBSEOUENT DIVORCE:
Husband intends to fIle a no-fault complaint in divorce against Wife. Husband and Wife each agree
to jurisdiction of the Court of Common Pleas of Cumberland County and further agree to sign an affidavit
of consent to be filed in said divorce action. In the event such divorce action is concluded, the parties
shall be bound by all the terms of this Agreement which may be incorporated by reference into the
Divorce Decree, shall not be merged into the Divorce Decree, and shall not be modifIed, but shall in all
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respects survive the same and be further binding and conclusive upon the parties. It is the intention of the
parties that the Agreement shall survive any action for divorce which may be instituted and prosecuted by
either party and no order, judgment or decree of divorce, temporary, final or permanent shall affect or
modify the financial terms of this Agreement. This Agreement may be incorporated in but shall not
merge into any such judgment or decree of fmal divorce, but shall be incorporated for the purposes of
enforcement only.
14. BREACH AND ENFORCEMENT:
If either party breaches any provision of this Agreement, the other party shall have the right, at his
or her election, to sue for damages for such breach, or seek other such remedies or relief as may be
available to him or her, and the party breaching this Agreement shall be responsible for payment of legal
fees and costs incurred by the other in enforcing his or her rights under this Agreement.
A. It is expressly understood and agreed by and between the parties hereto that this Agreement
may be specifically enforced by either Husband or Wife in Equity, and the parties hereto agree that if an
action to enforce this Agreement is brought in Equity by either party, the other party will make no
objection on the alleged ground of lack of jurisdiction of said Court on the ground that there is an
adequate remedy at law. the parties to not intend or purport hereby to improperly confer jurisdiction on a
Court in Equity by this Agreement, but they agree as provided herein for the forum of Equity in mutual
recognition of the present state of the law, and in recognition of the general jurisdiction of Courts in
Equity over agreements such as this one.
B. Notwithstanding anything to the contrary herein, Husband and Wife may also proceed with an
action at law for redress of his or her rights under the terms of this Agreement, and in such event it is
specifically understood and agreed that for and in specific consideration of the other provisions and
covenants of this Agreement, each shall waive any right to a jury trial so as to expedite the hearing and
disposition of such case and so as to avoid delay.
C. Each party further hereby agrees to pay and to save and hold harmless the other party from any
and all attorney's fees and costs of litigation that either may sustain, or incur or become liable for, in any
way whatsoever, or shall pay upon, or in consequence of any default or breach by the other of any of the
terms or provisions of this agreement by reason of which either party shall be obliged to retain or engage
counsel to initiate or maintain or defend proceedings against the other at law or equity or both in any way
whatsoever; provided that the party seeks to recover such attorney's fees, and costs of litigation must first
be successful in whole or in part, before there would be any liability for attorney's fees and costs of
litigation. It is the specific agreement and intent of the parties that a breaching or wrongdoing party shall
bear the burden and obligation of any and all costs and expenses and counsel fees incurred by himself or
herself as well as the other party in endeavoring to protect or enforce his or her rights under this
Agreement.
15. ADDITIONAL INSTRUMENTS:
Each of the parties shall from time to time, at the request of the other, execute, acknowledge and
deliver to the other party any and all further instruments that may be reasonably required to give full force
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and effect to the provisions of this Agreement.
16. VOLUNTARY EXECUTION:
The provisions of this Agreement and their legal effect have been completely reviewed by the
parties, and each party acknowledges that the Agreement is fair and equitable, that it is being entered into
voluntarily, with full knowledge of the assets of both parties, and that it is not the result of any duress or
undue influence. The parties acknowledge that they have been furnished with all information relating to
the [mancial affairs of the other which has been requested by each of them.
17. ENTIRE AGREEMENT:
This Agreement contains the entire understanding of the parties and there are no representations,
warranties, covenants or undertakings other than those expressly set forth herein. Husband and Wife
acknowledge and agree that the provisions of this Agreement with respect to the division and distribution
of marital and separate property are fair, equitable and satisfactory to them based on the length of their
marriage and other relevant factors which have been taken into consideration by the parties. Both parties
hereby accept the provisions of this Agreement with respect to the division' of property in lieu of and in
full and final settlement and satisfaction of all claims and demands that they may now have or hereafter
have against the other for equitable distribution of their property by any court of competent jurisdiction
pursuant to Section 401(d) of the Divorce Code or any other laws. Husband and Wife voluntarily and
intelligently waive and relinquish any right to seek a court ordered determination and distribution of
marital property, but nothing herein contained shall constitute a waiver by either party of any rights to
seek the relief of any court for the purpose of enforcing any provision of this Agreement.
18. DISCLOSURE:
Husband and Wife each represent and warrant to the other that he or she has made a full and
complete disclosure to the other party of all assets of any nature whatsoever in which such party has an
interest, the sources and amount of the income of such party or every type whatsoever and of all other
facts relating to the subject matter of this Agreement.
19. MODIFICATION AND WAIVER:
A modification and waiver of any of the provisions of this Agreement shall be effective only if
made in writing and executed with the same formality as this Agreement. The failure of either party to
insist upon strict performance of any of the provisions of this Agreement shall not be construed as a
waiver of any subsequent default of the same or similar nature.
20. PRIOR AGREEMENT:
It is understood and agreed that any and all property settlement agreements which mayor have been
executed prior to the date and time of this Agreement are null and void and of no effect.
21. DESCRIPTIVE HEADINGS:
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The descriptive headings used herein are for convenience only. They shall have no effect
whatsoever in determining the rights or obligations of the parties.
22. INDEPENDENT SEPARATE COVENANTS:
It is specifically understood and agreed by and between the parties hereto that each paragraph
hereof shall be deemed to be a separate and independent covenant and agreement.
23. APPLICABLE LAW:
This Agreement shall be construed under the laws of the Commonwealth of Pennsylvania.
24. VOID CLAUSES:
If any terms, conditions, clause or provision of this Agreement shall be determined or declared to
be void or invalid in law or otherwise, then only that term, condition, clause or provision shall be stricken
from this Agreement and in all other respects this Agreement shall be valid and continue in full force,
effect and operation.
25. AGREEMENT BINDING ON HEIRS:
This Agreement shall be binding and shall inure to the benefit of the parties hereto and their
respective heirs, executors, administrators, successors and assigns.
the parties hereto have set their hand and seals the day and year first
(SEAL)
Address:
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IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
BRUCE M. ANDERSON
Plaintiff,
No. 00-7176 Civil Term
v.
Civil Action - Divorce
ELLEN M. ANDERSON
Defendant
PRAECIPE TO TRANSMIT THE RECORD
To The Prothonotary:
Transmit the record, together with the following information, to the Court for entry of a
divorce decree:
1. Ground for divorce: irretrievable breakdown under Section (x) 3301(c) () 3301(d)(I) of the
Divorce Code. (Check applicable section).
2. Date and manner of service of the complaint: Service on October 26, 2000 via Certified Mail
signed by defendant.
3. (Complete either paragraph (a) or (b).
(a) Date of execution of the affidavit of consent required by Section 3301 (c) of the Divorce Code: by
plaintiffm; by defendant N/A .
(b) (1) Date of execution of the plaintiffs affidavit required by Section 330 I (d) of the Divorce Code:
May 31. 2001; (2) date of service of the Plaintiffs affidavit upon the Defendant: N/A
4. Complete the appropriate paragraph(s).
(a) Related claims pending: None
(b) Claims withdrawn: None
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(c) Claims settled by agreement of the parties: There are no outstanding claims, all claims settled
by agreement of the parties.
(d) State whether any agreement is to be incorporated into the Decree. Agreement attached hereto
and to be incorporated into decree. If so, attach a true and correct copy of the fully executed agreement:
(e) Has a request for counseling been made by either party? : No. If so, has the counseling been
completed?:
5. I certify that the notice required by Rule 1920.42(e) was mailed on: Waived by parties on May 31,
2001 and waivers are enclosed and a copy thereof is attached.
Lee E. Oesterling, Esquire
Attorney LD. #71320
Attorney for Plaintiff
20 South Market Street
Mechanicsburg, P A 17055
(717) 790-0490
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Law Offices of Hazlett & Oesterling
20 South Market Street
Mechanicsburg, P A 17055
(717)-790-0490
IN THE COURT OF COMMON PLEAS OF THE 9th JUDICIAL DISTRICT
CUMBERLAND COUNTY, PENNSYLVANIA
BRUCE M. ANDERSON
Plaintiff,
No.(j6-7/7~ C{\J\',
v.
Civil Action - Divorce
ELLEN M. ANDERSON
Defendant
NOTICE TO DEFEND AND CLAIM OF RIGHTS
YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the
following pages, you must take prompt action. You are warned that if you fail to do so, the case may
proceed without you and a decree of divorce or annulment may be entered against you by the Court. A
judgment may also be entered against you for any other claim or relief requested in these papers by the
Plaintiff. You may lose money or property or other rights important to you, including custody or visitation
of your children.
IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DMSION OF PROPERTY, LAWYER'S FEES
OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE TIlE
RIGHT TO CLAIM ANY OF TIlEM,
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A
LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE TIlE OFFICE SET FORTH BELOW
TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, P A 17013
(717) 249-3166
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NOTICE OF AVAILABILITY OF COUNSELING
TIlE DIVORCE CODE OF PENNSYLVANIA REQUIRES THAT YOU BE NOTIFIED OF TIlE
AVAILABILITY OF COUNSELING WHERE A DIVORCE IS SOUGHT UNDER ANY OF TIlE
FOLLOWING GROUNDS:
23 Pa.C.S, ~ 3301(a)(6)
23 Pa.C.S. ~ 3301(c)
23 Pa.C.S. ~ 3301(d)
- Indignities
- Irretrievable Breakdown; Mutual Consent
- Irretrievable Breakdown; Two year separation where the court
determines that there is a reasonable prospect of reconciliation
A list of marriage counselors is available in the Office of the Prothonotary, Cumberland County
Courthouse, 1 Courthouse Square, Carlisle, Pennsylvania 17013. Telephone: (717) 240-6194.
HAZLETT & OESTERLING
Lee E. Oes . # 71 20
Attorney for Plaintiff
20 South Market Street
Mechanicsburg, P A 17055
(717)790-0490
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Law Offices of Hazlett & Oesterling
20 South Market Street
Mechanicsburg, P A 17055
(717)-790-0490
IN THE COURT OF COMMON PLEAS OF THE 9th JUDICIAL DISTRICT
CUMBERLAND COUNTY, PENNSYLVANIA
BRUCE M. ANDERSON
Plaintiff,
No. (}o- ?/?t. ~:;:;j_/~
v.
Civil Action - Divorce
ELLEN M. ANDERSON
Defendant
COMPLAINT UNDER SECTION
3301(C) OR 3301 (D) OF THE DIVORCE CODE
I. Plaintiff is Bruce M. Anderson, an adult individual, sui juris, who currently resides at 904
Lancelot Avenue, City of Mechanics burg, County of Cumberland, Commonwealth of Pennsylvania 17055.
2. Defendant is Ellen M. Anderson, an adult individual, sui juris who currently resides at 904
Lancelot Avenue, City of Mechanics burg, County of Cumberland, Commonwealth of Pennsylvania 17055.
3. Plaintiff has been a bona fide resident of the Commonwealth of Pennsylvania for a
period of more than six (6) months immediately preceding the filing of this complaint.
4. The parties were married on the 14th day ofJune, 1997, County of Cumberland,
Commonwealth of Pennsylvania.
5. Neither Plaintiff nor Defendant is in the military or naval service of the United States or
its allies within the provisions of the Soldiers' and Sailors' Civil Relief Act of the Congress of 1940 and its
amendments.
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6. There have been no prior actions for divorce or annulment instituted by either of the
parties in this or any other jurisdiction.
7. For purposes of ~ 330l(d) of the Divorce Code, the parties have been living separate and
apart since on or about September 28, 2000.
8. The marriage is irretrievably broken.
9. Plaintiff has been advised that counseling is available and that Plaintiff may have the
right to request that the court require the parties to participate in counseling.
10. Plaintiff intends to file an affidavit of consent after 90 days have elapsed from the date of
service of the Complaint on the defendant and believes that defendant will also file such an affidavit.
COUNT I
REQUEST FOR A NO-FAULT DIVORCE UNDER S 3301 (c) OF THE DIVORCE CODE
11. The prior paragraphs of this Complaint are incorporated herein by reference thereto.
12. The marriage of the parties is irretrievably broken.
WHEREFORE, Plaintiff respectfully requests the Court to enter a decree of divorce pursuant to ~
330l(c) of the Divorce Code.
HAZLETT & OESTERLING
Lee E. Oestef' " . # 71320
Attorney for Plaintiff
20 South Market Street
Mechanicsburg, P A 17055
(717)790-0490
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VERIFICATION
I verify that upon personal knowledge or information and belief that the statements made in the
foregoing Complaint are true and correct. I understand that false statements herein are made subject to the
penalties of 18 Pa.C.S. S 4904, relating to unsworn falsification to authorities.
~~
,
Bruce M. Anderson
Date: f~/.F/,fv
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'tI .Complete items 1 andlor 2 for additional services.
Cii _Complete items 3, 4a, and 4b.
CD -Print your name and, address on the reverse of this form so that we can return this
! card to you.
~ -Attach this form to the front of the mailplece, or on the back if space does not
! permit.
GJ -Write-Return Receipt Requested- on the mailplece below the article number.
.s::. _The Retum Receipt will show to whom the article was delivered and the dale
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1. d Addressee's Address
2. 0 Restricted Delivery
Consult postmaster for fee.
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! ELLEN M. ANDERSON
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IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL
DISTRICT, CUMBERLAND COUNTY, PENNSYL VANIA
No. 00-7l76CivilTerm
Divorce-Certificate of Service
BRUCE M. AND~RSON
Plaintiff
v.
ELLEN M. ANDERSON
Defendant
CERTIFICATE OF SERVICE
I hereby certify that on the 26th day of October ,20....QQ..., a true and correct copy of the
Complaint in Divorce, Notice of Availability of Counseling and Notice to Defend in the above-
captioned matter, was served upon the persons and in the manner listed below:
Service by Certified Mail, Return Receipt # P405056884, and,
Service by First Class. Mail Postage Prepaid addressed to the following:
Ellen M. Anderson
904 Lancelot Avenue
Mechanicsburg, P A 17055
The original Return Receipt and copy of first class mailing is attached hereto, marked as Exhibit
"A", and incorporated by reference.
Lee E. Oester g, J.D. # 71320
Attorney for Plaintiff
20 South Market Street
Mechanicsburg, PA 17055
(717)790-0490
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IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTRICT
CUMBERLAND COUNTY, PENNSYLVANIA
BRUCE M. ANDERSON
Plaintiff,
No. 00-7176 Civil Term
v.
Civil Action - Divorce
ELLEN M. ANDERSON
Defendant
AFFIDAVIT OF CONSENT
I. A complaint in divorce under Section 3301 (c) of the Divorce Code was filed
on October 17. 2000
2. The marriage of plaintiff and defendant is irretrievably broken, and ninety (90) days have
elapsed from the date of filing and service of the Complaint.
3. I consent to the entry of a final decree of divorce after service of notice of intention to request
entry of the decree.
I verify that the statements made in this affidavit are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S. ~4904 relating to unsworn falsification to
authorities.
Date:
3' JIll>> I
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BRU M. ANDERSON, Plamtiff
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IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTRICT
CUMBERLAND COUNTY, PENNSYL VANIA
BRUCE M. ANDERSON
Plaintiff,
No. 00-7176 Civil Term
v.
Civil Action - Divorce
ELLEN M. ANDERSON
Defendant
WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A
DIVORCE DECREE UNDER ~ 3301(c) OF THE DIVORCE CODE
1. I consent to the entry of a fmal decree of divorce without notice.
2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or
expenses if 1 do not claim them before a divorce is granted.
3. I understand that I will not be divorced until a divorce decree is entered by the Court and that
a copy of the decree will be sent to me immediately after it is filed with the prothonotary.
I verify that the statements made in this affidavit are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn
falsification to authorities.
Date:
flr'/PI
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BRUCE M. ANDERSON, Plaintiff
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IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTlRICT
CUMBERLAND COUNTY, PENNSYLVANIA
BRUCE M. ANDERSON
Plaintiff,
No. 00-7176 Civil Term
v.
Civil Action - Divorce
ELLEN M. ANDERSON
Defendant
AFFIDAVIT OF CONSENT
1. A complaint in divorce under Section 3301 (c) of the Divorce Code was fIled
on October 17. 2000
2. The marriage of plaintiff and defendant is irretrievably broken, and ninety (90) days have
elapsed from the date of fIling and service of the Complaint.
3. 1 consent to the entry of a final decree of divorce after service of notice of intention to request
entry of the decree.
I verify that the statements made in this affidavit are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S. ~4904 relating to unsworn falsification to
authorities.
Date:
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IN THE COURT OF COMMON PLEAS OF THE NINTH JUDICIAL DISTRICT
CUMBERLAND COUNTY, PENNSYLVANIA
BRUCE M. ANDERSON
Plaintiff,
No. 00-7176 Civil Term
v.
Civil Action - Divorce
ELLEN M. ANDERSON
Defendant
WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A
DIVORCE DECREE UNDER ~ 3301(c) OF THE DIVORCE CODE
I. I consent to the entry of a [mal decree of divorce without notice.
2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or
expenses if I do not claim them before a divorce is granted.
3. I understand that I will not be divorced until a divorce decree is entered by the Court and that
a copy of the decree will be sent to me immediately after it is filed with the prothonotary.
I verify that the statements made in this affidavit are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn
falsification to authorities.
Date: ,'S\~ \\ t'l\
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BRUCE M. ANDERSON,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
NO. 00 - 7176 CIVIL
ELLEN M. ANDERSON,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
TO: Plaintiff
,.-",-
DEFENDANT
ANSWER TO COMPLAINT UNDER ECTION 3301101
OR 33011dl OF THE DIVORCE CODE
TOGETHER WITH COUNTERCLAIM
AND NOW, comes your Defendant, Ellen M. Anderson, by and
through her counsel, Cunningham & Chernicoff, P.C., who files
this Answer and Counterclaim and in support thereof, avers the
following:
1. Admitted.
2. The averments of paragraph 2 are partially admitted
and partially denied.
The identity of the Defendant is
admitted. To the contrary, however, the Defendant, Ellen M.
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Anderson, currently resides at 904 South Market Street,
Mechanicsburg, Cumberland County, Pennsylvania.
3. Admitted.
4. Admitted.
5. Admitted.
6. Admitted.
7. Admitted.
8. Admitted.
9. The averments of paragraph 9 are denied. To the
contrary, Defendant is without knowledge or information
sufficient to form a belief as to the truth of the averment
and strict proof thereof, if relevant, is demanded at the time
of trial.
10. The averment of Paragraph 10 represents a conclusion
of law to which a response is not required. If it is later
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judicially determined that a response should have been filed,
the averment is specifically denied.
COUNT I
REQUEST FOR A NO-FAULT DIVORCE UNDER
~3301(c} OF THE DIVORCE CODE
11. The averments of Paragraphs 1 through 10 of the
Answer to the Complaint are incorporated herein by reference
as if more fully set forth herein.
12. Admitted.
COUNTERCLAIM
COUNT II - EOUITABLE DISTRIBUTION
13. The averments in paragraphs 1 through 12, inclusive,
are incorporated herein by reference thereto.
14. During the course of the marriage, the parties
acquired marital property.
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WHEREFORE, the Defendant requests the Court to equitably
determine, divide, distribute and assign the marital property
of the parties pursuant to Section 3501 of the Divorce Code.
COUNT III - COUNSEL FEES, EXPENSES,
ALIMONY PENDENTE LITE AND ALIMONY
15. paragraphs 1 through 14 , inclusive, are incorporated
herein by reference thereto.
16. Defendant lacks sufficient property to provide and
pay for expenses of this action, including her reasonable
counsel fees, nor to provide for her maintenance.
WHEREFORE, Defendant requests the Court to enter an Order
granting Defendant reasonable counsel fees and expenses,
alimony pendente lite, and alimony.
Date:
z.11--z-.!/}\
, I
P.C.
By:
n D. Esquire
#23 4
320 North Second Street
P. O. Box 60457
Harrisburg, PA 17106-0457
Telephone: (717) 238-6570
(Attorneys for Defendant)
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VERIFICATION
I, ELLEN M. ANDERSON, verify that the statements made in
the foregoing ANSWER TO COMPLAINT UNDER SECTION 3301 (e) OR
3301 (d) OF THE DIVORCE CODE TOGETHER WITH COUNTERCLAIM are
true and correct to the best of my knowledge, information and
belief. I understand that false statements herein are made
subject to the penalties of 18 Pa. C.S.A. ~4904, relating to
unsworn falsification to authorities.
Date:
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BRUCE M. ANDERSON,
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
v.
NO. 00 - 7176 CIVIL
ELLEN M. ANDERSON,
Defendant
CIVIL ACTION - LAW
IN DIVORCE
CERTIFICATE OF SERVICE
I do hereby state that I served a true and correct copy
of the ANSWER TO COMPLAINT UNDER SECTION 3301 (e) OR 3301 (d) OF
THE DIVORCE CODE TOGETHER WITH COUNTERCLAIM in the above
captioned matter, by placing the same in the U.S. mail, first-
class, postage prepaid, on February 22, 2001, addressed to:
Lee E. Oesterling, Esquire
Hazlett & Oesterling
20 South Market Street
Mechanicsburg, PA 17055
(Attorneys for Plaintiff)
Respectfully submitted,
Date:
"J.17..z.-1ol
P.C.
an D.
. #231 4
320 North Second Street
P. O. Box 60457
Harrisburg, PA 17106-0457
Telephone: (717) 238-6570
(Attorneys for Defendant)
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ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT
);tL OO-IJF7& (! / tI; L
State .Co~monwealth of Pennsvlvania P;:;ct:f> / )?ltJ/u3/,;}1/
Co./C1ty/Dlst. of CUMBERLAND U7 r
Date of Order/Notice 03/07/01 JR. .,,;i'of./f5"
Court/Case Number (See Addendum for case summary)
@Original Order/Notice
o Amended Order/Notice
o Terminate Order/Notice
) RE:ANDERSON, BRUCE M.
) Employee/Obligor's Name (Last, First, MI)
)
)
)
)
)
)
)
171-52-8195
Employee/Obligor's Social Security Number
0341100690
Employee/Obligor's Case Identifier
(See Addendum for pJaintiH names assoaated with cases on attachment)
Custodial Parent's Name (Last, First, MI)
EmployerlWithholder's Federal EiN Number
CONSOLIDATED FREIGHTWAYS
EmployerlWithholder's Name
C/O PAYROLL
Employer/Withholder's Address
1 CAROLINA WAY
CARLISLE PA 17013-8813
See Addendum for dependent names and birth dates associated with cases on attachment.
ORDER lNFORMA TlON: This is an Order/Notice to Withhold Income for Support based upon an order for support
from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these
amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not
issued by your State.
$ 743. 95per month in current support
$ o. ooper month in past-due support Arrears 12 weeks or greater? o yes @ no
$ 0.00 per month in medical support
$ 0.00 per month for genetic test costs
$ per month in other (specify)
for a total of $ 743 .95 per month to be forwarded to payee below.
You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match
the ordered support payment cycle, use the following to determine how much to withhold:
$ 171. 68 per weekly pay period.
$ 343.36 per biweekly pay period (every two weeks).
$ 371.98 per semimonthly pay period (twice a month).
$ 743.95 per monthly pay period.
REMITTANCE INFORMATION:
You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this
Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to
deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the
the allowable amount. The total withheld amount, and your fee, cannot exceed 55% 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 EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer
Customer Service at 1-877-676-95BO for instructions.
Make Remittance Payable to: PA SCDU
Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112
IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown
above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED.
DO NOT SEND CASH BY MAIL.
DRO: RJ Shadday
xc: defendant
MAILED
<9 -/d--o~
March 8. 2001
BY THE COURT:
Service Type M
OMB No,: 097Q.1I1~4
Expiration Date: 12131!OO
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Kevin A. . JUJX;E
Form EN-028
Worker 10 $IATT
Date of Order:
-- ~
- '~-~.
-
ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS
o If checked you are required to provide a copy of this form to your employee.
1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income.
Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting
agency listed below.
2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment
to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to
each employee/obligor.
3.* Repoltil,g tile.. Pc!..yJQteJDate of'Nill,l,oldil,g. '/Otllll"-l;;>t lepolttl,e pdydatJJatt of vvitlllloldillo vvLeh selldil,g HI\... t-'Qyltlellt. Tllc
payddlJJQtt of vvitl,l,vIJ;I,o;;;> tLe date. Oil vvl,id, alllOtlht VVQ;;> vv;U,I,eld nOlI! tile.. clltplvyce's vvages. You must comply with the law of the
state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the
withholding order and forward the support payments.
4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support
against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must
follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest
extent possible. (See #9 below)
5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for
you. Please provide the;inlormation requested and return a copy of this Order/Notice to the Agency identified below.
WITHHOLDER'S ID: 4367000048
EMPLOYEE'S/OBLlGOR'S NAME: ANDERSON, BRUCE M.
EMPLOYEE'S CASE IDENTIFIER: 0341100690 DATE OF SEPARATION:
LAST KNOWN HOME ADDRESS:
NEW EMPLOYER'S NAME/ADDRESS:
6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or
severance pay. If you have any questions about lump sum payments, contact the person or authority below.
7. Liability: Ilyou fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should
have withheld Irom the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs
unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs.
8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from
employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding.
Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is
employed governs.
9. * Withholding Limits: You may not withhold more than the lesser 01: 1) the amounts allowed by the Federal Consumer Credit
Protection Act (15 U.s.e. 91673 (b)1; or 2) the amounts allowed by the State 01 the employee's/obligor's principal place 01 employment.
The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory
deductions such as: State, Federal, local taxes; Social Security taxesi and Medicare taxes.
10.
"NOTE: If you or your agent are served with a copy 01 this order in the state that issued the order, you are to lollow the
law 01 the state that issued this order with respect to these items.
Requesting Agency:
DOMESTIC RELATIONS SECTION
PO. BOX 320
CARLISLE PA 17013
II you or your employee/obligor have any questions,
contact WAGE ATTACHMENT UNIT
by telephone at (71 7) 240-6225 or
by FAX at (717) 240-6248 or
by Internet @
Page 2 01 2
Form EN-028
Worker ID $IATT
Service Type M
OMB No.: 0970-0154
Expilation Date: 12/31/00
:U--,;j,';\'>_,
ADDENDUM
Summary of Cases on Attachment
Defendant/Obligor: ANDERSON, BRUCE M.
PACSES Case Number 686103124 0D19E: PACSES Case Number
Plaintiff Name /' ~ Plaintiff Name
ELLEN M. ANDERSON
Docket Attachment Amount
00=7176 crVIL$ 743.95
Child(ren)'s Name(s):
DOB
EJI;'~'~:~~:~:;~.~~;~;~~~i;~~;::~;~';;;~:.~~;I~;;~~;.................(......
identified above in any health insurance ~overage available
through the employee's/obligor's employment.
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ 0.00
Child(ren)'s Name(s):
DOB
If checked, you are required to enroll the child(ren)
in any health insurance coverage available
employee's/obligor's employment.
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ 0.00
Child(ren)'s Name(s):
DOB
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PACSES Case Number
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Plaintiff Name
Docket Attachment Amount
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Addendum
Form EN-028
Worker ID $IATT
OMBNo.:0970-0154
Expiration Date: 11/31/00
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DR 30495
PACSES In 686103124
BRUCE M. ANDERSON,
Plaintiff/Respondent
vs.
: IN THE COURT OF COMMON PLEAS
: CUMBERLAND COUNfY, PENNSYLVANIA
: DOMESTIC RELATIONS SECTION
: CIVIL ACTION - LAW
ELLEN M. ANDERSON
Defendant/Petitioner
: NO. 00-7176 CIVIL TERM
ORDER OF COURT
AND NOW, this 8th day of March, 2001, based upon the Court's determination that
Petitioner's monthly net income/earning capacity is $1,208.13 per month and Respondent's monthly
net income/earning capacity is $3,068.00 per month, it is hereby Ordered that the Respondent pay to
the Pennsylvania State Collection and Disbursernent Unit, $743.95 per month payable weekly as
follows; $171.68 per week for alimony pendente lite and $0.00 on arrears. First payment due with
Respondent's next pay date. Arrears set at$I,487.90 as of March 7, 2001. The effective date of the
order is January 22, 2001.
Parties agree that the effective date is the filing date of the spousal support complaint date of
January 22, 2001 under Docket No. 73 S 2001, PACSES Case No. 390103006.
Husband is to report to the Domestic Relations Section within five days upon receipt of this
order for a payment plan to liquidate the retroactive arrearages.
Failure to make each payment on time and in full will cause all arrears to become subject to
immediate collection by all ofthe means as provided by 23 Pa.C.S.~ 3703. Further, if the Court
finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare
the Respondent in civil contempt of Court and its discretion make an appropriate Order, including,
but not limited to, commitment of the Respondent to prison for a period not to exceed six months.
Said money to be turned over by the P A SCDU to: Ellen M. Anderson. Payments must be
made by check or money order. All checks and rnoney orders must be made payable to P A SCDU
and mailed to:
PA SCDU
P.O. Box 69110
Harrisburg, PA 17106-9110
Payments must include the defendant's P ACSES Member Number or Social SecUrity Number in
order to be processed. Do not send cash by mail.
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Unreimbursed medical expenses that exceed $250.00 annually are to be paid 70% by the
Respondent and 30% by Petitioner. The Petitioner is responsible to pay the first $250.00 annually in
unreimbursed medical expenses. Respondent to provide medical insurance coverage. Within thirty
(30) days after the entry of this order, the Respondent shall submit written proof that medical
insurance coverage has been obtained or that application for coverage has been made. Proof of
coverage shall consist, at a minimum, of: 1) the name of the health care coverage provider(s); 2) any
applicable identification numbers; 3) any cards evidencing coverage; 4) the address to which claims
should be made; 5) a description of any restrictions on usage, such as prior approval for hospital
admissions, and the manner of obtaining approval; 6) a copy of the benefit booklet or coverage
contract; 7) a description of all deductibles and co-payments; and 8) five copies of any claim forms.
This Order shall become final ten days after the mailing of the notice of the entry of the Order
to the parties unless either party files a written demand with the Prothonotary for a hearing de novo
before the Court.
DRO: R. 1. Shadday
Mailed copies on
\3 -ICJ.() I to: <
et'
BY THE COURT,
Petitioner
Respondent
Jordan Cunningham, Esquire
Lee Oesterling, Esquire
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In the Court of Common Pleas of CUMBERLAND County, Pennsylvania
DOMESTIC RELATIONS SECTION
ELLEN M. ANDERSON ) Docket Number 00-7176 CIVIL
Plaintiff )
VS. ) PACSES Case Number 686103124
BRUCE M. ANDERSON )
Defendant ) Other State In Number !:>.30~5
ORDER
AND NOW, to wit, on this
20TH DAY OF JUNE, 2001
IT IS HEREBY
ORDERED that the support order in this case be 0 Vacated or o Suspended or
GY Terminated without prejudice or 0 Terminated and Vacated,
effective
MAY 31, 2001
, due to:
THE PARTIES' SEPARATION AND PROPERTY SETTLEMENT AGREEMENT. THERE IS A
BALANCE OF $583.35 OWED TO PLAINTIFF AND WILL BE PAID BY THE EFFECTIVE WAGE
ATTACHMENT.
BY THE COURT:
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Kevin A. Hes JUDGE
DRO: R.J. Shadday
xc: plaintiff ;m:l defend;mt
Service Type M
Form OE-504
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ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT
~t<:i, 00-717& (!IPlL
State Commonwealth of Pennsvlvania jJJ!/-t!S'd 5' t- pc, lo3/;lif
Co./City/Dist. of CUMBERLAND >- r
Date of Order/Notice OS/01/01 .tJ.K.- 3oY9c:;-
Court/Case Number (See Addendum for case summary)
o Original Order/Notice
o Amended Order/Notice
(8) Terminate Order/Notice
) RE:ANDERSON, BRUCE M.
) Employee/Obligor's Name (Last, First, Mil
)
)
)
)
)
)
)
171-52-8195
Employee/Obligor's Social Security Number
0341100690
Employee/Obligor's Case Identifier
(See Addendum for plaintiff names assodated with cases on attachmenV
Custodial Parent's Name (Last, First, MI)
EmployerlVVithholder's Federal E1N Number
CONSOLIDATED FREIGHTWAYS
EmployerlVVithholder's Name
PO BOX 50S4
Employer/Withholder's Address
PORTLAND OR 9720S-50S4
See Addendum for dependent names and birth dates associated with cases on attachment.
ORDER INFORMA TION: This is an Order/Notice to Withhold Income for Support based upon an order for support
from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these
amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not
issued by your State.
$ 0.00 per month in current support
$ O. 00 per month in past-due support Arrears 12 weeks or greater? Qyes <Xl no
$ 0.00 per month in medical support
$ 0.00 per month for genetic test costs
$ per month in other (specify)
for a total of $ 0.00 per month to be forwarded to payee below.
You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match
the ordered support payment cycle, use the following to determine how much to withhold:
$ 0.00 per weekly pay period.
$ 0.00 per biweekly pay period (every two weeks).
$ 0.00 per semimonthly pay period (twice a month).
$ 0.00 per monthly pay period.
REMITTANCE INFORMATION:
You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this
Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to
deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the
the allowable amount. The total withheld amount, and your fee, cannot exceed 55% 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 EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer
Customer Service at 1-877-676-9580 for instructions.
Make Remittance Payable to: PA SCDU
Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112
IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown
above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED.
DO NOT SEND CASH BY MAIL.
BY THE COURT:
Date of Order: AUG
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LAf',rationDate: 12/31/00
Form EN-028
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ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS
o If checked you are required to provide a copy of this form to your employee.
1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income.
Federal tax levies in effect before receipt of this order have priority. lfthere are Federal tax levies in effect please COntact the requesting
agency listed below.
2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment
to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to
each employee/obligor.
3. * Rej..tvltihg tLe ["ardale/Dare of Vv'itl,lloIJ:"5' Vvu IIIUst lepolt tIle pardare/date of vv itl,l,oIJil'5 nlle" sel,dillg tIle pClrJlleht. Tile
"ardate/dare of vvitLLoldillg i~ tile Jgu.. VII nLic:L Qlllvtlllt naS nitLLeld "0111 tLe elllploree'~ ndge~. You must comply with the law of the
state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the
withholding order and forward the support payments.
4.' Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support
against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must
follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest
extent possible. (See 119 below) .
5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for
you. Please provide the ,information requested and return a copy of this Order/Notice to the Agency identified below.
WITHHOLDER'S ID: 9414447980
EMPLOYEE'S/OBLIGOR'S NAME: ANDERSON, BRUCE M.
EMPLOYEE'S CASE IDENTIFIER: 0341100690 DATE OF SEPARATION:
LAST KNOWN HOME ADDRESS:
NEW EMPLOYER'S NAME/ADDRESS:
6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or
severance pay. If you have any questions about lump sum payments, contact the person or authority below.
7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should
have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs
unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs.
8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from
employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding.
Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is
employed governs.
9.' Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit
Protection Act (15 U.S.c. 91673 (b)l; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment.
The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory
deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes.
10.
'NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the
law of the state that issued this order with respect to these items.
Requesting Agency: If you or your employee/obligor have any questions,
DOMESTIC RElATIONS SECTION contact WAGE ATTACHMENT UNIT
13 N. HANOVER ST by telephone at (7171 240-6225 or
P.O, BOX 320 by FAX at (7171 240-6248 or
CARLISLE PA 17013 by Internet @
Page 2 of 2
Form EN-028
Worker ID $IATT
Service Type M
OMB No.: 0970-0154
Expiration Date: 12/31/00
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ADDENDUM
Summary of Cases on Attachment
Defendant/Obligor: ANDERSON,
PACSES Case Number 686103124 & D~9s
Plaintiff Name ('--
ELLEN M. ANDERSON
Docket At1achment Amount
OO=7i76CIVIL$ 0.00
Child(ren)'s Name(s): DaB
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dlf~h~ck~d,;~~~rere~~i;ed;~~~;~llth~c~il~(r~n;.".' ..' .
identified above in any health insurance coverage available
through the employee's/obligor's employment.
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ 0.00
Child(ren)'s Name(s):
DaB
D If checked, you are required to enroll the child(ren)
identified above in any health insurance coverage available
through the employee's/obligor's employment.
PACSES Case Number
Plaintiff Name
Docket At1achment Amount
$ 0.00
Child(ren)'s Name(s):
DaB
D If checked, you are required to enroll the child(ren)
identified above in any health insurance coverage available
through the employee's/obligor's employment.
Service Type M
BRUCE M.
PACSES Case Number
Plaintiff Name
Docket At1achment Amount
$ 0.00
Child(ren)'s Name(s):
DaB
o IfC~~Ck~~,;~~~re ;~qUiredt~enr~11 th~~hild(re~). .,' .......
identified above in any health insurance coverage available
through the employee's/obligor's employment.
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ 0.00
Child(ren)'s Name(s):
DaB
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identified above in any health insurance coverage available
through the employee's/obligor's employment.
PACSES Case Number
Plaintiff Name
Docket At1achment Amount
$ 0.00
Child(ren)'s Name(s):
DaB
D If checked, you are required to enroll the child(ren)
identified above in any health insurance coverage available
through the employee's/obligor's employment.
Addendum
Form EN-028
Worker ID $IATT
OMB No.: 0970-0154
Expiration Date: 12/31/00
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