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HomeMy WebLinkAbout03-3503PENNY I. BOONE, Plaintiff V. MICHAEL W. BOONE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : : · CIVIL ACTION - LAW : NO. 03- .3_5'~,.~ CIVIL TERM : IN DIVORCE NOTICE TO DEFEND 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. When the ground for the divome is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary at the Cumberland County Court House, High and Hanover Streets, Carlisle, PA. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 Phone: (717) 249-3166 or (800) 990-9108 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of Cumberland County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the Court, please contact our office. All arrangements must be made at least 72 hours prior to any hearing or business before the Court. You must attend the scheduled conference or hearing. ORDER/NOTICE TO WITHHOLD INCOME FOR :SUPPORT State ~Commonwealth of Pennsylvania Co./City/Dist of CUMBERSAND Date of Order/Notice 07/13/04 Tribunal/Case Number (See Addendum for case summary) RE: BOONE, MIC}{AEL Employer/Withholder's Federal EIN Number SYGMA NETWORK 4000 INDUSTRIAL RD HARRISBURG PA 17110-2947 C) Original Order/Notice C) Amended Order/Notice (~ Terminate Order/Notice Employee/Ob[igor's Name (Last, Eirst, MI) 164-52-8181 Employee/Ob[igor's Social Security Number 2241100412 Emp[oyee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associab?d with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUI, ggER~qD County, Commonweatth 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. $ o. 0o per month in current support $ o. oo per month in past-due support Arrears 12 weeks or greater? C)yes (~) no $ 0. o0 per month in medical support $ o. o0 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 fol[owing 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 paydateddate of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/oblJgor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #10 on pg. 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69.1 t2, Harrisburg, Pa .17.106-9.1 '12 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. Date of Order: ,JUL 1 4 200 Service Type M ~-,~-- ~ ~ ~i~ '; BYTHECOU~ / . J j,': : OM]] NO.: 09704)154 Form EN-028 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHO/DERS · · · r m lo ee. Ifyo remployee o s in a state that is [] ff. checke0 you, are r~qu.~lr_e.d:~t~.p_r~o.v~l;cl~e~ ~r,PYa ~fotoh, jSmf°urs~J~eO pYr°oUx~lc~e~o~our empgyee even ,ft~r~ox is not checked different trom tne stale [nat i~u~-u .,,2 ,,~ , r. ' ' ' ' 1. We appreciate the voluntary compliance of Federally recognized indian tribes, tribally-owned businesses, and Indian-owned businesses located on a reservation that choose to withhold in accordance with this notice, 2. Priority: withholding under this Order/Notice has prioriW over any other legal process under 5tale 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 contaCi the requesting agency listed below. 3. 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. :.,_t. ......... :-'- v~ges. You must comply with the law of the state of the empioyee'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. 5.* 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 Jaw of the state of employee's/obligor's principal place of employment· You must ho~or all Orders/Notices to the greatest extent possible. (See #10 below) 6. 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: 68350000z~$ EMPLOYEE'S/OBLIGOR'S NAME: gOO1~]3 ~ MTCI-IAi3T, EMPLOYEE'S CASE IDENTIFIER:. 22,1Z00~.~2 ~ DATE O1: SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 7. Lump Sum Payments: You may be required to report and withhold from Jump sum payments such as bonuses, commissions, or severance pay. if you have any questions about lump sum payments, contact the person or authority below. 8. 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/obi'got s income and other penalties set by Pennsylvania State law. Pennsylvania State Jaw 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. Anti.discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disclplina~y 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 Jaw of the State in which he or she is employed governs. 10.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. § 1673 (b)l; or 2) the amounts allowed by the 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, IocaJ taxes; Social Securib/taxes; and Medicare taxes. 11. Additional Info: *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. If you or your employee/obligor have any questions, Submitted By: pOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 contact WAGE ATTACHMENT UNIT by telephone at 1717) 240-6225 or by FAX at (717~ 240-6248 or by intemet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Worker ID ST.~.TT Service Type N OM~ No.:0970~0154 In the Court of Common Pleas of CUMBERLAND, Colmty, Pennsylvania DOMESTIC RELATIONS SECT]ION PENNY I. BOONE Plaintiff VS. MICHAEL BOONE Defendant ) Docket Number ) ) PACSES Case Number ) ) Other State ID Number 03-3503 CIVIL 202105935 ORDER AND NOW, to wit, on this 13TH DAY OF JULY, 2004 IT IS HEREBY ORDERED that the support order in this case be C) Vacated or C) Suspended or (~) Terminated without prejudice or C) Terminated and Vacated, effective MARCH 23, 2004 , due to: THE PARTIES, DECREE IN DIVORCE AND TffE BALANCE DUE IS PAID IN FULL. DRO: RJ Shadday , ,,: xc: plaintiff ~_ defendant ~-~- Mark Bayley, Esquire BY THE ~~ Edward E. Guido JUDGE Service Type M Form OE-504 Worker ID 2 lO o 5 PENNY I. BOONE, Plaintiff MICHAEL W. BOONE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 03- 5~o.~ CIVIL TERM IN DIVORCE COMPLAINT UNDER SECTION 3301(c) OF THE DIVORCE CODE 1. Plaintiffis Penny I. Boone, who currently resides at 500 First Street, Carlisle, Cumberland County, Carlisle, Pennsylvania, 17013. 2. Defendant is Michael W. Boone, who resides at 818 Torway Road, Gardners, Cumberland County, Pennsylvania. 3. Plaintiff and Defendant have both been bona fide residents in the Commonwealth for at least six months immediately previous to filing of this Complaint. 4. Plaintiff and Defendant were married on September 3, 1993, in Mechanicsbarg, Cumberland County, Pennsylvania. 5. There have been no prior actions of divome or for annulment between the parties hereto in this or any other jurisdiction. 6. The marriage is irretrievably broken. 7. 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. 8. Plaintiff requests the Court to enter a Decree in Divorce. WHEREFORE, Plaintiff respectfully requests this Honorable Court to enter a Decree in Divorce and such other Orders as may be just and appropriate. text. 10. COUNT II EQUITABLE DISTRIBUTION Paragraphs 1 through 8 are incorporated herein by reference as if set forth in their full Plaintiff and Defendant are joint owners of various items of personal and business property, furniture and household furnishing acquired during their marriage, which are subject to equitable distribution. 11. Plaintiff and Defendant have incurred debts and obligations during their marriage, which are subject to equitable distribution. WHEREFORE, Plaintiff requests this Honorable Court to enter a decree equitably dividing the parties' property and equitably apportioning the debts incurred by the parties. COUNT III ALIMONY, ALIMONY PENDENTE LITE 12. text. 13. Paragraphs 1 through I 1 are incorporated herein by reference as if set forth in their full Plaintiff is unable to provide for, or afford her counsel fees, expenses and costs during the pendency of this divorce action, and through its resolution. 14. Plaintiff is without sufficient property and otherwise unable to financially support herself. 15. Plaintiff is currently ill with cancer, and relies on various health insurance policies maintained by Defendant. 16. Defendant is presently employed and receiving substantial income and benefits and is able to pay for counsel fees, expenses and costs, alimony, and alimony pendente lite for Plaintiff. WHEREFORE, Plaintiffrequests this Honorable Court to enter an Order requiring for payment of alimony and/or alimony pendente lite for Plaintiff. Respectfully submitted, ROMINGER & BAYLEY Mark F. Bayley, Esquire 155 S. Hanover Street Carlisle, PA 17013 (717) 241-6070 Supreme Court I.D. # 87663 Attorney for Plaintiff VERIFICATION I verify that the statements made in this Complaint are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904, relating to unswom falsification to authorities. P{nny I. Bo~ne~, Plaintiff PENNY I. BOONE, Plaintiff MICHAEL W. BOONE, Defendant 1N THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 03-3503 1N DIVORCE CIVIL TERM MOTION FOR ALIMONY PENDENTE LITE AND NOW, comes Penny I. Boone, by and through her privately retained counsel, Mark F. Bayley, Esquire, and in support of this Motion avers as follows:: 1. Plaintiff filed a Divorce Complaint on July 23, 2003. 2. Plaintiff makes a claim for Alimony Pendente Lite in Count III of said Complaint. 3. As set forth in said Complaint, Plaintiff is unable to provide for, or afford her counsel fees, expenses and costs during the pendency of this divorce action, and through its resolution. 4. As also stated in said Complaint, Plaintiff is without sufficient property and otherwise unable to financially support herself. 5. As also stated in said Complaint, Plaintiff is currently ill with cancer and relies on vario~ health insurance policies maintained by Defendant. WHEREFORE, your Petitioner prays this Honorable Court to award Alimony Pendente Lit, in an amount equal to the Pennsylvania State support guidelines. Respectfully submitted, ROMINGER & BAYLEY Mark F. Bayley,~squire 155 S. Hanover Street Carlisle, PA 17013 (717) 241-6070 Supreme Court I.D. # 87663 Attorney [or Plaintiff tS CERTIFICATE OF SERVICE I, Mark F. Bayley, Esquire, attorney for Penny I. Boone, do hereby certify that I this day served a copy of the Motion for Alimony Pendente Lite upon the following by depositing same in tl~ United States mail, First Class Mail, Certified, Restricted and Remm Receipt Requested, postage paid~ at Carlisle, Pennsylvania, addressed as follows: Michael W. Boone P. O. Box 235 Gardners, PA 17324 and 818 Torway Road Gardners, PA 17324 Date Mark F. Bayley, Esquire Attorney for Plaintiff PENNY L. BOONE, Plaintiff/Petitioner VS. MICHAEL W. BOONE, Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION -. DIVORCE NO. 2003-3503 CIVIL TERM IN DIVORCE Pacses# 202105935 ORDER OF COURT AND NOW, this 18th day of November, 2003, upon consideration of the attached Petition for Alimony Pendente Lite and/or counsel fees, it is hereby directed that the parties and their respective counsel appear before R.J. Shadday on December 16~ 2003 at 9:00 A.M. for a conference, at 13 N. Hanover St., Carlisle, PA 1-7013, after which the conference officer may recommend that an Order for Alimony Pendente Lite be entered. YOU are further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W-2's as filed (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by Rule 1910.11© (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you IF you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. BY THE COURT, George E. Hoffer, President Judge Mail copies on Petitioner 11-18-03 to: < Respondent Mark Bayley, Esquire Date of Order: November 18, 2003 ' ' ~/J. Stmdday, Conference Officer '~, YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 CC361 C) ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist of Date of Order/Notice 12/16/03 Tribunal/Case Number (See Addendum for case summary) EmployerANithholder's Federal EIN Number RE: BOONE, MICHAEL (~) Original Order/Notice O Amended Order/Notice O Terminate Order/Notice SYOMA NETWORK 4000 INDUSTRIAL P~D F~%RRISBURG PA 17110-2947 Employee/Obligor's Name (Last, First, MI) 164-52-818:1. Employee/Obligor's Social Security Number 2241100412 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORD£R INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAI~D 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. $ 400.00 per month in current support $ 43.33 per month in past-due support Arrears 12 weeks or greater? Oyes (~) no $ 0. oo per month in medical support $ o. oo per month for genetic test costs $ per month in other (specify) for a total of $ 4a. 3 o 33 per month to be forwarded to payee below,, You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 3.0:2.31 per weekly pay period. $ 204.61 per biweekly pay period (every two weeks). $ 221.67 per semimonthly pay period (twice a month). $ 44:) .33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydateJdate of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing 'the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 5.5% of the employee's/obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #10 on pg. 2). If remitting by EFT/EDI, please call Pennsylvania 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, PAYMENTS 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 MALL. .... ~::,?:.- ,-'., ::.2, ~ii_:._, BY THE COURT: Date of Order: ~)'~; j- '!: Service Type M Form EN-028 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ~If on :edheck you am requ red to pr~)~/ide a ~:opy of this form to your (~mployee. If yogr emp oyeeifworlCSthe noxin as notState that, is checked ~'ii~ren~-f~om the state that issued th s oroer, a copy must be provioed to you employee even 1. We appreciate the voluntary compliance of Federally recognized Indian tribes, tribally.<)wned businesses, and Indian-owned businesses located on a reservation that choose to withhold in accordance with this notice. 2. 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. 3. 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. .............................................................................. 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. S.* 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 #10 below) 6. 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: 68380000,~8 EMPLOYEE'S/OBLIGOR'S NAME: ]~OO~113 ~ N'rc~3'~. EMPLOYEE'S CASE IDENTIFIER: 224'1 ~-00412 DATE OF SEF~ARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 7. 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. 8. 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 er she is employed governs. 9. 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. 10.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (1 5 U.S.C. § 1 673 (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. 11. Additional Info: *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. Submitted By: DOMESTIC RELATIONS SECTION 13 N, HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your e~rnployee/obti§or have any questions, contact WAGE A~fACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (71 71 240-6248 or by intemet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Service Type M OMB No.: 0970q]154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: BOONE, MICHAEL PACSES Case Number 202105935 Plaintiff Name PENNY I. BOONE Docket Attachment Amount 03-3503 CIVIL $ 443.33 Child(ren)'s Name(s): DOB :. [] f checked, you are required to enroll the child(ren) identified above in any health insurance coverage avai ab e through the employee's/obliger's employment, PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.0o Child(mn)'s Name(s): DOB ii: [] ff checkecb you am required to enroll the child(mn) identified above in any health insurance coverage available through the employee's/obliger's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB [] If checked, you are required to enroll the chi[d(ren) identified above in any health insurance coverage available through the employee's/obliger's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB : i i~iiiiiiiiiii iiiiiiii!iiiii!ii!i i~ii!i?ii!iiiiiii~iiiiiiiiiiiiiiiii ii !ii!~i!iii~iii!ii~ii~ii~iiiii~ii~iiiii~iiiii~ii~iii~i~iii~i~i!~(?!ii~iiiii~iiiiiii~iiiiiiiii~iiii~iii~i~ii~ii iii i il iii i li iii iii iii iii iii i li i iiililiiiiii!iiiiiiiiiiiiiiiiiiiiiiiii [] If checked, you are required to enroll the child(mn) identified above in any health insurance coverage available through the employee's/obliger's employment. PACSES Case Number Plaintiff Name Docket Attach ment Amount $ 0.0o Child(ren)'s Name(s): DOB ::: l--ill checked, you am required to enroll the child(mn) identified above in any health insurance coverage available through the employee's/obliger's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB [] If checked, you are required to enroll the child(mn) identified above in any health insurance coverage available through the employee's/obliger's employment. Addendum Form EN-028 Service Type M OMBNo.:O97~S4 WorkerlD $IATT PENNY I. BOONE, Plaintiff/Petitioner VS. MICHAEL BOONE, Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - DIVORCE NO. 2003-3503 CIVIL TERM IN DIVORCE ORDER OF COURT AND NOW, this 16th day of December, 2003, based upon the Court's determination that Petitioner's monthly net income/earning capacity is $873.56 and Respondent's monthly net income/earning capacity is $3,540.39, it is hereby Ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit, $443.33 per month payable monthly as follows; $400.00 for alimony pendente lite and $43.33 on arrears. First payment due next pay date. Arrears set at $800.00 as of December 16, 2003. The effective date of the order is October 23, 2003. This Order is based upon the fact that Wife is currently receiving short term disability benefits, that one of Wife's children is residing with Husband and that there is additional income in Wife's household. This Oder further considers that Husband maintains medical insurance coverage on Wife and her three children. Effective January 1, 2004, the Alimony Pendente Lite will be modified to $200.00 per month pursuant to Wife receiving long term disability benefits. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the 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 PA SCDU to: Penny Boone. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the defendant's PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. Unreimbursed medical expenses that exceed $250.00 annually are to be paid 0% by the respondent and 100% 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. J. Shadday Mailed copies on 12-19-03 to: < Petitioner Respondent BY THE COURT, ]~dward E. Guido ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist of CUMBERLAND Date of Order/Notice 01/02/04 Tribunal/Case Number (See Addendum for case summary) ~mployer/Withholder's Federal EIN Number O Original OrdedNotice (~) Amended Order/Notice O Terminate OrdedNotice RE: BOONE, MICF~%EL Employee/Obligor's Name (Last, First, MI) SyGMA NETWORK 4000 INDUSTRIA~ RD HARRISBURG PA 17110-2947 164-52-8181 EmpJoyee/Obligor's Social Security Number 2241100412 Employee/ONi§or's Case Identifier (See Addendum for plaintiff names associated with cases on affachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold tncome for Support based upon an order for support from CUMBERIaAATD County, 5ommon.,w. ealth 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. $ 200.00 per month in current support $ 43.33 per month in past-due support Arrears 12 weeks or greater? (~yes O 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 $ 243.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine bow much to withhold: $ 56.15 per weekly pay period. $ 112.31 per biweekly pay period (every two weeks). $ 121.67 per semimonthly pay period (twice a month). $ 243.33 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 pa/date/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work s~te of your employee for the allowable amount. The tota~ withheld amount, and your fee, cannot exceed 55% of the employee's/obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #10 on pg. 2). If remitting by EFT/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, PAYMENTS 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. '~ ' ~ - {~Y~THE COURT: . Date of Order: Service Type I4 Form EN-028 Worker ID $:I:~T~ OMB No.: 0970-0154 INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ITIONAL , ,~ -...- em,-Io,,ee works in a state that;is ADD ired to rovi.de a opy of th,s fo~m)~o ~y,o,,u,~i,~m~Yveoe~ ~ Y~ 'v e~' v~ if the box is not checked. t-] If ghec~e~_y_°u, ka..r~,',~'4 hat issued ths order a copy mull 1. We appreciate the voluntary compliance of Federally recognized Indian tribes, tribally-owned businesses, and Indian-Owned businesses located on a reservation that choose to withhold in accordance with this notice. 2. 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. . . an one employee/obligor's income in a single payment to '' men.: You can combine withheld amountS fro.~ m~ao..rnerl~hI ,~, nor(ion of the single payment that IS attributable tO each employee/obligor. _ ........ ............ L -,4 ~.,-..,"~he e,-~,loyee~ wa§~:-. You must comply with the law of the y'~y .......... place of employment with respect to the time periOdS within which you must implement the state of the employee's/obligor's principal withholding order and forward the support payments. · - : ' ban one OrdedNotice to Withhold Income for Support against s.. Em.lo.ee,ob"go. wi,h Mu.,p'e ' .. ;; ottices due to Federal or State withbo'ding limits, you must fo,lo. this emPioyee/oblig°r and you are uname the law of the state of employee's/obiigor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible, (See #10 below) You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you, 6, Termination Notification: Please provide the information requested and return a copy of this Order/Notice to the Agency identified below, WITHHOLDER'S ID: 6838000°~'8 EMPLOYEE'S/OBLIGOR'S NAME:- BOONE, MICHAEL EMPLOYEE'S CASE IDENTIFIER: 224'L3'004~'2 DATE OF SEPARATION:~ LAST KNOWN HOME ADDRESS: -- NEW EMPLOYER'S NAME/ADDRESS: - ired to renort and withhold from lump sum payments such as bonuses, commissions, or 7. Lump Sum Payments: You may b? requ_ -, '- .... a,,meets, contact the person or authority below. 8. 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 emptoyed governs. 9. 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 ie which he or she is employed governs. 10.* withholding Limits: You may not withhold more than the lesser of: 1 ) the amounts allowed by the Federal Consumer Credit Protection Act (~ S U.S.C. § t 673 (b)l; or 2) the amounts allowed by the State of the employee's/obligor's principal p~ace 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. 11. Additional Info: _ * 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. If you or your employee/obligor have any questions, Submitted By: ~OMESTIC RELATIONS SECTION I_.~N. HANOVER ST P.O. BOX 320 ~ARLISLE PA 17013 contact WAGE ATTACHMENT UNIT by telephone at 1717) 240.6225 _ or by FAX at [717~ 240-6248 or by intemet www.childsupport.state.pa.uS_ Form EN-028 Worker ID $IATT Page 2 of 2 Service Type M OMS No,: og~o.0~s~ ADDENDUM Summa of Cases on Attachment Defendant]Ob]igor: BooNE, MIC~L PACSES Case Numbe~r 202105935 Plaintiff Name pENNY ~- BOONg Attachment A_m~o~unt 03-3503 Chi[d(~n)'s Name(s): DOB PACSES Case Numbe~rr Plaintiff Name_ Attachment Amount Do__cke_t $ 0. o 0 ChiJd(ren)'s Name(s): DOB ou are required to enroll the child(ren) ~b e []If checked, y. ~--~*~. ~,~ rance coverage avah,~ identified above ~n any -~,~ y, ,,_;su _, ...... t. through the employee's/ob.gor s PACSES Case Nu~mb~r Plaintiff Name Attachment Amount Do_~kcket. $ o. o o Child(ren)'s Name(s): DOB are required to enroll the chi d(ren) [] if checked, ygu .... . ..... nce coverage available · entified above ~n any nea}n h.,.~,~..~ _. ~rough the employee's/ob.got s emptoymem PACSES Case Nu_ tuber Plaintiff Nam~e Attachment Amount D~ocke~t $ 0.0 o Child(ren)'s Name(s): DOB [] if checked, you are required to enroll the chi d(ren) · tiffed above in any health i?urance coverage available i~en L .~. .... vee's/obli or s employment PACSES Case Nu~mber Plaintiff Name Attachment Amoun~t D~ocket. $ 0.0 0 Child(renys Name(s): DOB []lf checked, you are required to enroll the ch d(ren) · ified above in any health _n, suraece coverage available ~dent ...... ~,~.,~.e's/obiigor s employment. through t.e ~.,.w,v~~ PACSES Case Nu~mbe-r Plaintiff Name Attachment Amount Do~cke_t $ 0.0 0 Child(ren)'s Name(s): DOB ou are requir~:'cl to enroll the child(ten) If checked y . ra e available .[] .... ,. ~ ;. ..,, hea th msurance cove g identmeq auow - ?~'i~,.,^blioor,s employment. through the emp oyuc ~, ~, ou are required to enroll the child(ren) [] f checked, Y ........... ~ra~e ava able ~gem,,,,_~yj~Z~ ~lo,,ee,s/obligor,s employment. Form EN-028 Addendum Worker iD OMB NO.: 097043154 5etwice Type 14 PENNY I. BOONE, Plaintiff MICHAEL W. BOONE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 03-3503 IN DIVORCE CIVIL TERM · Com~e items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. · Pdnt your name and address on the reverse so that we can return the card to you. · Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to; IA. Signature I 1o' 3. Service Type R ertified Mail [] Expre&s Mail egistered ~eturn ReCmpt for Merchandiae r-~ insured Mail [] C.O.D. 2. Article Number PS Form 3811, August 2001 Dorneetic Return Receipt 102595-02oM~1035 PENNY I. BOONE, Plaintiff MICHAEL W. BOONE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 03-3503 IN DIVORCE CIVIL TERM AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under §3301(c) of the Divorce Code was filed on September 13, 1993. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of the filing of the Complaint. 3. I consent to the entry of the final Decree in Divorce after service of Notice of Intention to request entry of the decree. I VERIFY THAT THE STATEMENTS MADE IN THE FOREGOING 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. E~te / I~lich'ael W. Boone PENNY I. BOONE, ' IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA MICHAEL W. BOONE, Defendant CIVIL ACTION - LAW NO. 03-3503 IN DIVORCE CIVIL TERM WAIVER OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER § 3301{c) OF THE DIVORCE CODF 1. I consent to the entry of a final 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 THE FOREGOING 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. ~at6 / ael W. Boone PENNYI. BOONE, Plaintiff MICHAEL W. BOONE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 03-3503 IN DIVORCE CIVIL TERM AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under §3301(c) of the Divorce Code was filed on September 13, 1993. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of the filing of the Complaint. 3. I consent to the entry of the final Decree in Divorce after service of Notice of Intention to request entry of the decree. I VERIFY THAT THE STATEMENTS MADE IN THE FOREGOING 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 Penny I.~oone PENNYI. BOONE, Plaintiff MICHAEL W. BOONE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 03-3503 IN DIVORCE CIVIL TERM WAIVER OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER § 3301~c) OF THE DIVORCE CODF 1. I consent to the entry of a final 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 THE FOREGOING AFFIDAVIT ARE TRUE AND CORRECT. I UNDERSTAND THAT FALSE STATEMENTS HEREIN ARE MADE SUBJECT TO THE PENALTIES OF 18 Pa.C.S, {}4904 RELATING T© UNSWORN FALSIFICATION TO AUTHORITIES. Date Penn~ I. Boone PENNY I. BOONE, Plaintiff MICHAEL W. BOONE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 03-3503 IN DIVORCE CIVIL TERM PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry ora divorce decree: 1. Grounds for divorce: irretrievable breakdown under § 3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: October 28, 2003 was served on Defendant by Certified, Return Receipt Requested and Restricted Delivery U.S. Mail. 3. Date of execution of the affidavit of consent required by § 3301(c) or The Divorce Code: by the Plaintiff March 18, 2004; by the Defendant March 19, 2004. 4. Related claims pending: None 5. Date and manner of service of the notice of intention to file Pmecipe to transmit record, a copy of which is attached: March 19, 2004. Date: March 19, 2004 155 South Hanover Street Carlisle, PA 17013 (717) 241-6070 Supreme Court ID No. 87663 IN THE COURT OF COMMON OF CUIVIBERLAND COUNTY STATE Of PENNA. Penny T. R~, Plaintiff VERSUS Michael W. Defendant N o. 03-3503 PLEAS DECREE IN DIVORCE AND NOW, DECREED THAT Penny I_ Boone , PLAINTIFF, AND Michael W. Boone , DEFENDANT, ARE DIVORCED FROM THE BONDS OF MATRIMONY. THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE SEEN RAISED OF rECOrD IN THIS ACTION FOR WHICH A FINAL OrDEr HAS NOT YET BEEN ENTERED; None ATTEST: PROTHONOTARY