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Home My WebLink About07-2882I JOANNE L. METZGER, * IN THE COURT OF COMMON PLEAS Plaintiff * CUMBERLAND COUNTY, PENNSYLVANIA * VS. NO. 01 u". WILLIAM H. METZGER, III, * CIVIL ACTION - LAW Defendant * IN DIVORCE NOTICE TO DEFEND AND CLAIM 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. WHEN THE GROUND FOR THE DIVORCE 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 COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE, PA 17013. 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 LAWYER REFERRAL SERVICE 2 LIBERTY AVENUE CARLISLE, PA 17013 (717) 249-3166 a JOANNE L. METZGER, * IN THE COURT OF COMMON PLEAS Plaintiff * CUMBERLAND COUNTY, PENNSYLVANIA * VS. NO. WILLIAM H. METZGER, III, * CIVIL ACTION - LAW Defendant * IN DIVORCE COMPLAINT COUNT I - DIVORCE UNDER §3301(c) or §3301(d) OF THE DIVORCE CODE 1. Plaintiff is Joanne L. Metzger, who currently resides at 4101 York Street, Unit C, Harrisburg, Dauphin County, Pennsylvania, 17111. 2. Defendant is William Hentry Metzger, III, who currently resides at 204 Valley Road, Summerdale, Cumberland County, Pennsylvania 17093. 3. Plaintiff has been a bona fide resident in the Commonwealth of Pennsylvania for at least six months immediately previous to the filing of this Complaint. 4. Plaintiff and Defendant were married on September 9, 1978 in Mechanicsburg, Pennsylvania. 5. The parties are the parents of no minor children. 6. There have been no prior actions of divorce or for annulment between the parties. 7. Neither party is presently a member of the Armed Forces on active duty. 8. Plaintiff has been advised that counseling is available and that she may have the right to request that the court require the parties to participate in counseling. Being so advised, Plaintiff does not request that the Court require the parties to participate in counseling prior to a Divorce Decree being issued. w 9. The cause of action and sections of the Divorce Code under which Plaintiff is proceeding are: (a) §3301(c). The marriage of the parties is irretrievably broken; and (b) §3301(d). The marriage of the parties is irretrievably broken and, at the appropriate time, Plaintiff will submit an affidavit stating that the parties have been living separate and apart for a period of at least two (2) years. 10. Plaintiff requests This Honorable Court enter a Decree of Divorce. WHEREFORE, Plaintiff respectfully requests This Honorable Court enter an Order dissolving the marriage between Plaintiff and Defendant. Respectfully submitted, WILEY, LENOX, COLGAN & MARZZACCO, P.C. Dated: .-- to - 07 axItA4 Timothy J. , Esq ' e 130 West Church Street Dillsburg, PA 17019 (717) 432-9666 I.D. # 77944 JOANNE L. METZGER, Plaintiff VS. WILLIAM H. METZGER, III, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA * NO. * CIVIL ACTION - LAW * IN DIVORCE VERIFICATION 1, Joanne L. Metzger, verify that the statements made in this Complaint are true and correct to the best of my knowledge, information. and belief. l understand that false statements herein are made subject to the penalties of 18 Pa. CS. §4904, relating to unsworn falsification to authorities. 519/0-/ Date: JOANNE L. METZGER Plaintiff W 1_ ??L DD I O--Z> rf ? V JOANNE L. METZGER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 07-2882 Civil Term WILLIAM H. METZGER, III, Defendant CIVIL ACTION -DIVORCE AFFIDAVIT OF SERVICE I, Jeanette L. Roberts, being duty sworn, deposes and says that she is an adult and that she served the within Divorce Complaint on the Defendant, at the Defendant's last known address as follows: 204 Valley Road, Summerdale, PA 17093, by certified mail, restricted delivery, return receipt requested on the 25"' day of May, 2007. The Certified Mail Receipt and PS Form 38111 is attached hereto, marked Exhibit "A" and made a part hereof by reference thereto. Date: May 31, 2007 WILEY, LENOX, COLGAN & MARZZACCO, P.C. B a n ahl - k?j bj,?_ L. oberts 4eJe- COMMONWEALTH OF PENNSYLVANIA : : SS COUNTY OF YORK On this, the 31ST day of May, 2007, before me, a notary public, personally appeared Jeanette L. Roberts known to me or satisfactorily proven to be the whose name is subscribed to the within Affidavit and acknowledged that she executed the same for the purposes therein contained. WITNESS, my hand and notarial seal the day and year aforesaid. NO PUBL C My Commission Expires: COMMONWEALTH OF PENNSYLVANIA Notarial Seal S. Dawn Gladfelter, Notary Public Dillsburg Boro, York County SCortxnlsslon Expires May 17, 2009 Member, Pennsylvania Association of Notaries ¦ Complete items 1, 2, and 3. Also complete item 4 If Restricted Delivery is desired. ¦ Print 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: WILLIAM H. METZGER, III 204 VALLEY ROAD SUMMERDAIEE: X17093 A._ Signature 5. Recalyed by ? Agent Addressee 0. Date of Delivery D. Is delivery address different from Item 11 Yes If YES, enter delivery address below: ? No d - ?61C 1 l ?SI?rK i?uprd?(o ??- I7ag3 3. Type yvice ? QS -4 Express Mail zeertifled Mail 0 Registered C] Return Receipt for Merchandise ? Insured mail ? C.O.D. W 4. Rewlo?.raf?wnl??. 2. Article Number CJ-.'s/-"7006 0100 0004 7137 7672 omnsw from servroe Ps Form 3811, February 2oo4 DWONC Ream Receipt 1025e5-0e-W1540 EXHIBIT "A" ` t"? i.h? ?""= "'i"S ? 4? _ ?sr ? _? ,?- - '?_ S? ., ? ? ?? r? -? '? ? ? JOANNE L. METZGER, Plaintiff V. WILLIAM H. METZGER, III, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. 07-2882 Civil Term : CIVIL ACTION -DIVORCE PETITION FOR ALIMONY PENDENTE LITE AND NOW, comes the Plaintiff, by and through her attorney, Timothy J. Colgan, Esquire of WILEY, LENOX, COLGAN & MARZZACCO, P.C., and submits this Petition for Alimony Pendente Lite as follows: 1. The Plaintiff is Joanne Metzger, who currently resides at 4101 York Street, Unit C, Harrisburg, Dauphin County, Pennsylvania 17111. Plaintiff's social security number is 208-52-9850. 2. The Defendant is William H. Metzger, III, who currently resides at 204 Valley Road, Summerdale, Cumberland County, Pennsylvania 17093. Defendant's social security number is 162-48-0904. 3. A Complaint in Divorce was filed on May 14, 2007. 4. Plaintiff is without sufficient funds to support herself and unable to meet the costs and expenses of this litigation or support herself during the pendency of this action. 5. Plaintiffs income is insufficient to provide for her reasonable needs and to pay her attorney's fees and the costs of this litigation. 6. Defendant has adequate earnings to provide alimony pendente lite for Plaintiff and to pay her counsel fees, costs and expenses. WHEREFORE, Plaintiff respectfully requests than an order be entered requiring Defendant to pay to Plaintiff such alimony pendente lite as the Honorable Court deems reasonable. Date: 7-31-07 Respectfully submitted, WILEY, LENOX, COLGAN & MARZZACCO a4lt4??? Timothy Co a , squire 130 West Church Street Dillsburg, PA 17019 (717) 432-9666 I. D. # 77944 VERIFICATION I, Joanne Metzger, verify that the statements made in this Complaint 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. CS. '4904, relating to unsworn falsification to authorities. Date: '3 I,. ;7 ?1?U i Joanne Metzger, Plaintiff CERTIFICATE OF SERVICE I, Timothy J. Colgan, Esquire, hereby certify that I have served a true and correct copy of the foregoing Petition for Alimony Pendente Lite by first class mail, postage pre-paid as follows: Diane G. Radcliff, Esquire 3448 Trindle Road Camp Hill, PA 17011 WILEY, LENOX, COLGAN & MARZZACCO By: l Timothy J. an, Esquire Dated: 0'7 JOANNE L. METZGER, Plaintiff V. WILLIAM H. METZGER, III, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. 07-2882 Civil Term : CIVIL ACTION -DIVORCE DRS ATTACHMENT FOR APL PROCEEDINGS PETITIONER / PLAINTIFF NAME Joanne Metz er ADDRESS 4101 York St Unit C, Harrisburg, PA 17111 BIRTH DATE 03/29/1960 SOCIAL SECURITY NUMBER 208-52-9850 HOME PHONE 717 576-0475 WORK PHONE 717 234-2441 EMPLOYER NAME N.F. Strin , Inc. EMPLOYER ADDRESS 1380 Howard Street, Harrisburg, PA 17104 JOB TITLE / POSITION Administrative Assistant DATE EMPLOYMENT COMMENCED Aril 2007 GROSS PAY $1080.00 biweekly NET PAY $789.00 biweekly OTHER INCOME Part time 12-15 hrs per week at $7.54 / hr ATTORNEY'S NAME Timothy J. Colgan, Esquire ATTORNEY'S ADDRESS 130 W. Church Street, Dillsbur , PA 17019 ATTORNEY'S PHONE NUMBER 717 432-9666 RESPONDENT/DEFENDANT NAME William H. Metzger, III ADDRESS 204 Valle Rd, Summerdale, PA 17093 BIRTH DATE 11/29/1956 SOCIAL SECURITY NUMBER 162-48-0904 HOME PHONE 717 576-1392 WORK PHONE 717 234-8065 EMPLOYER NAME Inclinator Co. of America EMPLOYER ADDRESS 601 Gibson Blvd, Harrisburg, PA 17104 JOB TITLE / POSITION Electrician DATE EMPLOYMENT COMMENCED September 1977 GROSS PAY $845.53 weekly NET PAY $2777.14 monthly OTHER INCOME ATTORNEY'S NAME Diane Radcliff, Esquire ATTORNEY'S ADDRESS 3448 Trindle Rd, Cam Hill, PA 17011 ATTORNEY'S PHONE NUMBER 717 737-0100 MARRIAGE INFORMATION DATE OF MARRIAGE 09/09/1978 PLACE OF MARRIAGE Mechanicsburg, Pennsylvania DATE OF SEPARATION 10/01/2005 ADDRESS OF LAST MARITAL HOME 204 Valle Rd, Summerdaie, PA 17104 DOCUMENT RAISING APL CLAIM Petition for APL DATE APL DOCUMENT FILED r? ? o w ?5y mac, ._ D C'3 JOANNE METZGER, V. WILLIAM H. METZGER, Plaintiff Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOMESTIC RELATIONS SECTION Docket No.: 07-2882 Civil Term PACSES NO. 209109528 STIPULATION AND NOW this W71?kday of Nvv1Y *^, , 2007, the parties to the above captioned matter having reached an agreement with regard to the spousal support / alimony pendente lite, the parties stipulate and agree that an Order for alimony pendente lite shall be entered in Cumberland County as follows: 1. Plaintiff is Joanne Metzger who currently resides at 4101 York Street, Unit C, Harrisburg, Dauphin County, Pennsylvania 17111. 2. Defendant is William H. Metzger, who currently resides at 204 Valley Road, Summerdale, Cumberland County, Pennsylvania 17093. 3. A Divorce action is pending at docket number 07-2882. 4. Plaintiff filed a spousal support action in Dauphin County and an Order was entered on July 9, 2007 for $243.00 per month in spousal support with $502.73 as arrears as of July 9, 2007. 5. Defendant appealed this Order and an appeal hearing was scheduled for August 30, 2007, but has been continued pending the entry of the within stipulation by the parties. 6. Plaintiff filed a Petition for Alimony Pendente Lite at the above docket. 7. The parties agree and request that the Dauphin County Order should be transferred to Cumberland County as an Order for alimony pendente lite. 8. The parties agree that an order for alimony pendente lite should be entered in Cumberland County. 9. The parties agree that Defendant shall pay to Plaintiff the amount of $243.00 per month as alimony pendente lite. 10. The parties agree that the effective date of the Order shall be changed to July 9, 2007. 11. The arrears balance as of July 9, 2007 shall be $0.00. 12. All arrears, if any shall continue to be collected. 13. Defendant is entitled to credit for any payments made since July 9, 2007 to the present. 14. Funds shall be collected from Defendant via a wage attachment issued by PASCDU. 15. The parties agree that the appeal in Dauphin County shall be withdrawn and the scheduled hearing cancelled. 16. The parties stipulate and agree that the amount of supportis fair and reasonable given the circumstances of the parties. 17. The parties agree that the amount of support and/or the incomes upon which it has been based shall not be binding upon the parties in any Master's hearing. Both parties reserve all arguments that they have regarding the amount and duration of alimony to be awarded by the Master, as well as all arguments regarding incomes of the parties. 18. Any Order entered per this Stipulation is subject to modification in the event of a material change in circumstances of either party. 19. The parties stipulate and agree that the terms and conditions of this Stipulation shall be entered as an Order of Court. 19. This Agreement may be signed in counterparts. S:IClientslCOLGAMMETZGER.JOANNEICumberland Support Stip.wpd WHEREFORE, the parties so stipulate on the date first written above. ?_ ?, ? ?.. ?7 S. f , ? ? 1..J ... - 5 , : ' ?? - .. , r , ? , ? {? ? E COURT OF COMMON pLEAS OF IN TH Ty, PENNSyLVANIA JOANNE METZGE114 CUMBERLAND COUN plaintiff/petitioner • CIVIL ACTION - DIVORCE VS. NO. 07-2882 CIVIL TERM • IN DIVORCE 1VIETZGER, WILLIAM H• Defendant/Respondent PACSES CASE ID: 209109528 ORDER OF COURT based upon the Court's determination that D NOW, this 30th day of November, 2007, ondent, s monthly n lvania capacity is $ NIA and Re Respondent a to the Pennsy net income/earning p y petitioner s monthly NIA, it is hereby ordered that the Six -three and 00/100 Dollars ($ mo ? Drier arning capacity is $ Pendente Lite and $20.00 per income/e Unit ion and Disbursement month f Two for A MO Y i-weekly month payable as follows: $243.00 per to in December 2007 at a rate of $121.38 b arrears. First payment due: first pay 1 ? 2007. effective date of the order is December Arrears set at $192.67 as of November 30, 2007• become subject to ant on time and in full will cause all o e Father, if the Court Failure to make each payment rovided by 23 Pa.C.S.§ s Order, it may declare all of the means asp failed to comply with ? immediate collection by ondent has willfully ro r' Order, eed six ate that the Resp at its discretion, make an app p finds, after hearing, it contempt of Court and, dent to prison for a period not to exc the Respondent in civ fitment of the Respondent including, but not limited to, commitment months. : Joanne Metzger. Payments must be made to be turned over by the PA made to able to PA SCDU and Said money t 11 checks and money orders must be e pay by check or money order. A mailed to: pA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 P,CSES Member Number or Social Security Respondent, s P Payments must incl ads d e Do of send cash by mail. Number in order to be proc cc360 This Order is based upon the parties' Stipulation of November 27, 2007. Cumberland County DRS accepts the remaining balance of $192.67 from Dauphin County DRS under PACSES #525109214. This Order shall become final twenty (20) after the mailing of the notice of the entry of the hearing de Order to the parties unless either party files a written demand with the Prothonotary or a novo before the Court. Consented: Petitioner Petitioner's Attorney Respondent Mailed copies on: November 30.2007 to: Petitioner Respondent Diane G. Radcliff, Esq. Timothy J. Colgan, Esq. Respondent's Attorney BY THE COURT, r } " \ oI Edgar B. Bayley, J. DRO: R.J. Shadday C'1 c?? ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State _Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 12/03/07 Case Number (See Addendum for case summary) Employer/withholder's Federal EIN Number INCLINATOR CO OF AMERICA 601 GIBSON BLVD HARRISBURG PA 17104-3215 O Original Order/Notice 209109528 O Amended Order/Notice 07-2882 CIVIL O Terminate Order/Notice RE: METZGER, WILLIAM H. Employee/Obligor's Name (Last, First, MI) 162-48-0904 Employee/Obligor's Social Security Number 9605101836 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. ORDER INFORMATION: 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. $ 243 .00 per month in current support $ 20.00 per month in past-due support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ 0.00 per month in other (specify) for a total of $ 263.00 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: $ 60.,69,_ per weekly pay period. $ 121.38 per biweekly pay period (every two weeks). $ 131.50 per semimonthly pay period (twice a month). $ 263 . oo 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 allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA 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. BY THE C Date of Order: DEC 0 4 2007 Qp%wvoo EDGAR B. BAYLEY, JUDGE DRO: R. J . SHADDAY Form EN-028 Rev. 1 Service Type M OMB No.: 0970-0154 Worker I D $ IATT 2 6 3 x 12.: 52 60•69* 263•;x 2 6 • 121.35* A, ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecked you are required to provide a?opy of this form to your employee. If your employee works in a state that is di 'rent from the state that issued this order, a copy must be provided to your employee even if the box is not checked. 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. .,w'ieiiseiidiiir,tliepaypiieiit. The 3.* Reporting the Paydate/Date of WithlioldiFir paydateMate of wit' il ioldh ig is the date oi i which anioui it was withheld fi*oIn the eniployee's wases. 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 information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2307221000 EMPLOYEE'S/OBLIGOR'S NAME: METZGER, WILLIAM H. EMPLOYEE'S CASE IDENTIFIER: 9605101836 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. §1673 (b)1; 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. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. 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. 11.Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker I D $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: METZGER, WILLIAM H. PAC:SES Case Number 209109528 Plaintiff Name JOANNE METZGER Docket Attachment Amount 07-2882 CIVIL$ 263.00 Child(ren)'s Name(s): DOB ? 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 Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ................... ? 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 Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? 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 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) 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): DOB ? 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 Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? 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 OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker I D $ IATT i FT"? Prepared By: Diane G. Radcliff, Esquire 3448 Trindle Road Camp Hill, PA 17011 Supreme Court ID # 32112 Phone: 717-737-0100 Fax: 717-975-0697 Email: dianeradcliff @comcast.net Attorney for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA JOANNE METZGER, Plaintiff NO. 07-2882 V. CIVIL ACTION - LAW WILLIAM H. METZGER, IN DIVORCE Defendant PETITION TO WITHDRAW AS LEGAL COUNSEL AND NOW, comes the Petitioner, Diane G. Radcliff, Esquire and files the above referenced Petition and represents that: 1. Your Petitioner is Diane G. Radcliff, Esquire an Attorney duly authorized to practice law in the Commonwealth of Pennsylvania and having a principal place of business located at 3448 Trindle Road, Camp Hill, PA 17011. 2. Plaintiff is Joanne Metzger and is currently represented by Timothy J. Colgan, Esquire. 3. Defendant is William H. Metzger and is ostensibly represented by Diane G. Radcliff, Esquire. 4. Petitioner, Diane G. Radcliff, Esquire, never officially entered her appearance on behalf of the Defendant. However due to the fact that she witnessed an APL Stipulation she has 1 been listed as Defendant's attorney in the above captioned case. 5. Diane G. Radcliff, Esquire can no longer represent the Defendant because the Defendant has not paid the required retainer fee and has incurred a substantial account balance owed to Petitioner and has failed or is unabl-, to pay the balance owed when due. 6. On May 12, 2008, Petitioner has contacted Plaintiff's legal counsel regarding this Petition, and Plaintiff's legal counsel advised PetitionEi* that he is not opposed to the requested relief. 7. On May 12, 2008, Petitioner has contacted Defendant regarding this Petition, and Defendant has failed to respond. 8. This case was previously assigned to the Honorable Edgar E. Bayley, who was involved in the following matters: A. Judge Bayley entered the November 30, 2007 APL Order upon stipulation of the parties. WHEREFORE, the Petitioner respectfully requests this Honorable Court to enter an Order granting her leave to withdraw as legal counsel for Defendant, William H. Metzger. Respectfully submitted, LIFF, ESQUIRE 3448 Trindle Road Camp Hill, PA 17011 Phone: (717) 737-0100 Fax: (717) 975-0697 Supreme Court iD # 32112 2 VERIFICATION I verify that the statements made in the foregoing document are true and correct. I understands that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. 3 CERTIFICATE OF SERVICE AND NOW, this 4th day of June, 2008, I, DIANE G. RADCLIFF, ESQUIRE, hereby certify that I have this day served a copy of the foregoing document upon the following named person(s), by mailing same by first class mail, postage prepaid, addressed as follows: Timothy J. Colgan, Esquire 130 W. Church Street • Suite 100 Dillsburg, PA 17019 William H. Metzger 5261/2 Enola Road West Fairview, PA 17025 CLIFF, ESQUIRE ndl Road Camp Hill, PA 17011 Phone: (717) 737-0100 Fax: (717) 975-0697 Supreme Court ID # 32112 4 q' F n Ik _? IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA JOANNE METZGER, Plaintiff NO. 07-2882 V. CIVIL ACTION - LAW WILLIAM H. METZGER, IN DIVORCE Defendant ORDER C' AND NOW, this day of)QINQ_, 2008 upon consideration of the within Petition, IT IS HEREBY ORDERED that Diane G. Radcliff, Esquire is hereby granted leave to withdraw her appearance as legal counsel for the Defendant, William H. Metzger. Juuut Distribution to: lelfendant: torney for Plaintiff: Timothy J. Colgan, Esquire, 130 W. Church Street • Suite 100, Dillsburg, PA 17019 William H. Metzger, 204 Valley Road, Summerdale, PA 17093 ?Petitioner: Diane G. Radcliff, Esquire, 3448 Trindle Road, Camp Hill, PA 17011 ????1v8 } C7D t17 mm cra a: 1-6 LL ..7 rj- ' . D N ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 07_2882 CIVIL O Origi nal Order/Notice ginal State Commonwealth of Pennsylvania Order/Notice OAm Co./City/Dist. of CUMBERLAND 0 Terminate Order/Notice Date of Order/Notice 10/29/08 (Done-Time Lump Sum/Notice Case Number (See Addendum for case summary) RE:METZGER, WILLIAM H. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 162-48-0904 Employee/Obligor's Social Security Number INCLINATOR CO OF AMERICA 9605101836 601 GIBSON BLVD Employee/Obligor's Case Identifier HARRISBURG PA 17104-3215 (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. ORDER INFORMATION: 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 child support $ o . oo per month in past-due child support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current medical support $ o . oo per month in past-due medical support $ 243. oo per month in current spousal support $ o.oo per month in past-due spousal support $ 0.00 per month for genetic test costs $ o.00 per month in other (specify) $ one-time lump sum payment for a total of $ 243.00 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: $ 56.08: per weekly pay period. $ 121.50 per semimonthly pay period (twice a month) $ 112.15 _ per biweekly pay period (every two weeks) $ 243 . oo 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 allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. S 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 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 SECU NU BE ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: OCT 3 0 2008 EDGAR B. BAYLEY, JUDGE o Form EN-028 Rev. 4 D}ZO: R.J. SHADDAY OMB No.: 0970-0154 Service Type M Worker ID $IATT 243•x 12- 52•= 56.08* 243• x 12•: 26•? i12.15* ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS k. Ifheckel you are required to pry idea opy of thismust be P ovieed o your Iemp Yoyeme evoenof tie box is not state that ed di erent rom the state that issued this orSer, a copy 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 employeelobligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. 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 employeelobligor 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'slobligor'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 information requested and return a copy of this Order/Notice to the Agency identified below. 2307221000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEEIOBLIGOR NO LONGER WORKS FOR: O EMPLOYEE'S/OBLIGOR'S NAME:METZGER, WILLIAM H. EMPLOYEE'S CASE IDENTIFIER: 9605101836 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT• 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 employeelobligor 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 (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. 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. 11. Send Termination Notice and other correspondence to: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by internet www childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Rev. 4 Worker ID $IATT Service Type M ADDENDUM Summary of Cases on Attachment Defendant/obligor: METZGER, WILLIAM H. PACKS Case Number 209109528 Plaintiff Name JOANNE METZGER pocket Attachment Amount 07-2882 CIVIL$ 243.00 DOB Child(ren)'s Name(s): PACKS Case Number Plaintiff Name PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Addendum PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Form EN-028 Rev. 4 Worker ID $IATT Service Type M OMB No.: 0970-0154 C-) c r..z a3 rr '=: F ? -a rTI CD In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Defendant Name: WILLIAM H. METZGER Member ID Number: 9605101836 Please note: All correspondence must include the Member ID Number. ORDER OF ATTACHMENT OF UNEMPLOYMENT COMPENSATION BENEFITS Financial Break Down of Multiple Cases on Attachment Plaintiff Name JOANNE METZGER PACSES Docket Case Number Number 209109528 07-2882 CIVIL TOTAL ATTACHMENT AMOUNT: $ 243.00 Attachment Amount/Frequency $ 243.00 MONTH Now, by Order of this Court, the Department of Labor and Industry, Office of Unemployment Compensation Benefits (OUCB), is hereby directed to attach the lesser of $ 55.92 per week, or 50 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, WILLIAM H. METZGER Social Security Number XXX-XX- 0904 , Member ID Number 9 6 0 51018 3 6 . OUCB is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from OUCB to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearages, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673 (b)(2) and 23 Pa. C.S.A. § 4348 (g). This Order shall be effective upon receipt of the notice of the Order by the OUCB and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated MAY 31, 2 0 0 9 is exhausted, expired or deferred. OUCB shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. Date of Order: JUN 2 3 2009 BY THE COURT £d qar 8, Bay (e y JUDGE Form EN-530 Rev.2 Service Type M Worker ID $ IATT Zile vji; 2 i ?t tc;1 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION ~ ~ 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 ~" c7 "'T `'' (r Defendant Name: WILLIAM H . METZGER ~-", ` ' Member ID Number: 9 6 0 5 i o i s 3 6 ~~~> `~ ' coo ~- ~_ Please note: All correspondence must include the Member ID Number. , . Financial Break Down of Multiple Cases on Attachment Plaintiff Name JOANNE METZGER PACSES Docket Case Number Number 209109528 07-2882 CIVIL TOTAL ATTACHMENT AMOUNT: Attachment Amount/Freouenc $ 243.00 MONTH $$$ ~ $ / $ % $ / $ 243.00 --{ ~~ - Now, by Order of this Court, the Department of Labor and Industry, Office of Unemployment Compensation Benefits (OUCB), is hereby directed to attach the lesser of $ 55.92 per week, or 50 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, WILLIAM H. METZGER Social Security Number XXX-XX- 0904 , Member ID Number 9605101836 OUCB is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from OUCB to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearages, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673 (b)(2) and 23 Pa. C.S.A. § 4348 (g). This Order shall be effective upon receipt of the notice of the Order by the OUCB and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated MAY 3 0 , 2 01 o is exhausted, expired or deferred. OUCB shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: .IUN 0 $ 2p~p DRO: R.J. SHADDAY Service Type M ~ ~ JUDGE ALBERT H. MASLAND, Form EN-530 Rev.2 Worker ID $ IATT ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pen~ylvania Co./City/Dirt. Of CUMBERLAND Date of Order/Notice o7/0l/10 Case Number (See Addendum for case summary) Employer/Withholder's federal EIN Number INCLINATOR CO OF AMERICA 601 GIBBON BLVD HARRISBURG PA 17104-3215 162-48-0904 Employee/Obligor's Social Security Number 9605101836 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachme~ 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 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. n N $ $ $ 0.00 o.oo o.oo $ o.oo $ 243.00 $ 20.00 $ o.oo $ o.oo for a total of $ per month in current child support per month in past-due child support per month in current medical support per month in past-due medical support per month in current spousal support per month in past-due spousal support per month for genetic test costs per month in other (specify) one-time lump sum payment 263.00 per month to be forwarded to payee below. C n C~;yes ~ no ~ r i ~ N 1 ~ --c ~ ~i ~... ...~ 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: $ 60.69 per weekly pay period. $ 131.50 per semimonthly pay period (twice a month) $ 121.38 per biweekly pay period (every two weeks) $ 263 . oo 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 allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. 5 4374(b)) requires remittance by an electronic aayment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 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 NAMEAND 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 MA/L. /Jw . y~ w . .~ ~.-~ BY THE COURT: DRO: R.J. Shadday Service Type M Arrears 12 weeks or greateri• OMB No.: 0970-0154 07-2882 CIVIL OOriginal Order/Notice OAmended Order/Notice OTerminate Order/Notice QOne-Time Lump Sum/Notice RE:METZGER, WILLIAM H. Employee/Obligor's Name (Last, First, MI) Judge Form EN-028 Rev.5 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ~ If ~heckes! you are required to p~r vide a~opy of this form to your~em~loyee. If yorr employee v~orks in a state that is i Brent rom the state that issu this o er, a copy must be prove to your emp ogee even if t e box is not checked. 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%bligor'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%bligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respell 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%bligoranct 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%bligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2307221000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ~ THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ~ EMPLOYEE'S/OBLIGOR'S NAME:METZGER, WILLIAM H. EMPLOYEE'S CASE IDENTIFIER: 9605101836 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT: 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%bligor'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%bligorfr0m employment, refusing to employ, or taking disciplinary action against any employee%bligor 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 Ad (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Omer Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. 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. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by Internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev.S Service Type M OMB Wo.:0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: METZGER, WILLIAM H . PACSES Case Number 209109528 Plaintiff Name JOANNE METZGER Docket Attachment Amount 07-2882 CIVIL$ 263.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Service Type M Addendum OMB No.: 0970-0154 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Form E N-028 Rev.S Worker ID $IATT In the Court of Common Pleas of CUMBEIU,AND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (71'n 240-6225 Fax: (71'n 240-6248 Defendant Name: WILLIAM H. METZGER Member ID Number: 9 6 0 51018 3 6 Please note: All correspondence must include the Member H) Number. MODIFIED ORDER OF ATTACI~IENT OF UNEMPLOYMENT BENEFITS Financial Break Down of MWtiple Cases on Attachment Plaintiff Name JOANNE METZGER PACSES Docket Case Number Number 209109528 07-2882 CIVIL $ S S TOTAL ATTACHMENT AMOUNT: S 263.00 263.00 N /~ ue ° n ~ ~ r ~ C7~ 7 ~- -~ ~ .a _.,: ~..~ C . .~. -. t~ r-- C+3 ..~' sA ..~ Now, by Order of this Court, the Department of Labor and Industry, Office of Unemployment Compensation Benefits (OUCB), is hereby directed to attach the lesser of $ 60.53 per week, or 5 0 . o %, of the Unemployment Compensation benefits otherwise payable to the Defendant, WILLIAM H. METZGER Social Security Number XXX-XX-0904 ,Member ID Number 9 6 0 5101 s 3 6 OUCB is ordered to remit the amount attached to the Department of Public Welfaze (DPW). DPW shall forwazd the amount received from OUCB to the Domestic Relations Section of this Court for support and/or support arreazages. If the Defendant's Unemployment Compensation benefits aze attached by another Court or Courts for support and/or support arreazage, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673(b)(2) and 23 Pa. C.S. § 4348(g). This Order shall be effective upon receipt of the notice of the Order by the OUCB and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated Mpy 3 0 , 2 010 is exhausted, expired or deferred. OUCB shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: ,f tll 0 6 2010 ALB H. MASLAND, JUDGE DRO: R.J. SHADDAY Form EN-034 Rev.2 Service Type M Worker ID $ IATT 0 JOANNE L. METZGER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 07-2882 Civil Term WILLIAM H. METZGER, III, C'. Defendant CIVIL ACTION - DIVORCE ''Ico - AFFIDAVIT OF CONSENT' r' -t 1. A Complaint in Divorce under §3301(c) of the Divorce Code was 64 orL?4ay34k 2007. -r ? ? 2. The marriage of Plaintiff and Defendant is irretrievably broken and:ttiety-?-90)4 have elapsed from the date of filing and service of the Complaint. - C' , 3. I consent to the entry of a Final Decree in Divorce after service of notice of intuition 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: Joanne L. Metzger, Plaintif WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER X3301(0 OF THE DIVORCE CODE 4. I consent to the entry of a final decree of divorce without notice. 5. 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. 6. 1 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 Waiver are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsifications to authorities. Date: 1 l ? L Joanne L. Metzger, Plaintiff 0 f= ! ED -0FTICr l E P ;OTHONOTAR`i' 2il 11 LI0 15 PPP (:05 JOANNE L. METZGE?"?,'IBERLAND COU ' PENNSYLVANIA HE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 07-2882 Civil Term WILLIAM H. METZGER, III, . Defendant CIVIL ACTION - DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under §3301(c) of the Divorce Code was filed on May 14, 2007. 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 in 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 unswom falsification to authorities. Date: William H. Metzger, III, Defendant WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER 0301(c) OF THE DIVORCE CODE 4. I consent to the entry of a final decree of divorce without notice. 5. 1 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. 6. 1 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 Waiver are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsifications to authorities. DateS- \\ ?? William H. Metzger,III, Defendant JOANNE L. METZGER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA CD V. . NO. 07-2192 Civil Term -0- o -? ?.. M WILLIAM H. METZG€R, III, Defendant CIVIL ACTION - DIVORCE , = =r-'--n c-, C.3 , r MARITAL SETTLEMENT AGREEMENT > iro b THIS MARITAL SETTLEMENT AGREEMENT, made this ~day of August, 2011, by M\ and between JOANNE L. METZGER, of Harrisburg, Dauphin County, Pennsylvania (hereinafter referred to as "WIFE") and WILLIAM H. METZGER, III, of Etters, York County, Pennsylvania (hereinafter referred to as "HUSBAND"): WITNESSETH: WHEREAS, the parties were married on September 9, 1978, in Mechanicsburg, Pennsylvania; WHEREAS, HUSBAND and WIFE have no minor children; WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of HUSBAND and WIFE to live separate and apart, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other, including, without limitation by specification: the settling of all matters between them in relation to the ownership and equitable distribution of real and personal property; settling of all matters between them relating to the past, present and future support, alimony and/or maintenance of WIFE by HUSBAND or of HUSBAND by WIFE; settling of custody matters and in general, the settling of any and all claims and possible claims by either party against the estate of the other party. NOW, THEREFORE, in consideration of the premises and of the mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby covenant and agree as follows: INTERFERENCE: Each party shall be free from interference, authority, and contact by the other, as fully as though he or she were single and unmarried, except as may be necessary to carry out 11P e the provisions of this Agreement. Neither party shall molest the other or attempt to endeavor to molest the other, nor compel the other to cohabitate with the other, or in any way harass or malign the other, nor in any way interfere with the peaceful existence, separate and apart from the other. 2. AG MMENT NOT A UNTO DIVORCE PROCEEDMIGS: This Agreement shall not affect or bar the right of HUSBAND or WIFE to a divorce on lawful grounds or to any defense as may be available to either party. This Agreement is not intended to condone and shall not be deemed to be a condonation on the part of either party hereto of any act or acts on the part of the other party which have occasioned the disputes or unhappy differences. 3. SUBSEQUENT DIVORCE: The parties hereby acknowledge that WIFE filed a Complaint in Divorce (Docket No.: 07-2882) in Cumberland County, Pennsylvania, claiming that the marriage is irretrievably broken under Section 3301(c) of the Pennsylvania Divorce Code. The parties hereby express their agreement that the marriage is irretrievably broken and express their intent to execute any and all Affidavits or other documents necessary for the parties to obtain an absolute divorce pursuant to Section 3301(c) of the Divorce Code. The parties hereby waive all rights to request court ordered counseling under the Divorce Code. It is further specifically understood and agreed by the parties that the provisions of this Agreement as to equitable distribution of property of the parties are accepted by each party as a full and final settlement for all purposes whatsoever, a contemplated by the Pennsylvania Divorce Code. Should a decree, judgment or order of divorce be obtained by either of the parties in this or any other state, country or jurisdiction, each of the parties hereby consents and agrees that this Agreement and all of its covenants shall not be affected in any way by such separation or divorce; nothing in any such decree, judgment, order or further modification or revision thereof shall alter, amend or vary any term of this Agreement. It is the specific intent of the parties to permit this Agreement to survive any judgment and to be forever binding and conclusive upon the parties. 4. INCOIIIKRATION OF DIVORCE DECREE: It is further agreed, covenanted and stipulated that this Agreement or the essential parts hereof, shall be incorporated in any decree hereinafter entered by any court of competent jurisdiction in any divorce proceedings that have been or may be instituted by the parties for the purpose of enforcing the contractual obligations of the parties. This agreement shall not be merged in any such decree but shall in all respects survive the same and be forever binding and conclusive upon the parties. 5. EFFECTIVE DATE: The effective date of this Agreement shall be the "date of execution" or "execution date," defined as the date upon which it is executed by the parties if they have each 21Paoe executed this Agreement on the same date. Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. 6. DISTRItUTION DATES: The transfer of property, funds and/or documents provided for herein, shall only take place on the "distribution" date, which shall be defined as the effective date of this Agreement, unless otherwise provided for herein, including any spousal support and/or alimony payments. MUTUAL RELEASE: HUSBAND and WIFE each do hereby mutually remise, release, quit- claim and forever discharge the other and the estate of such other, for all time to come, and for all purposes whatsoever, of and from any and all rights, title and interest, or claims in or against the property (including income and gain from property hereafter accruing) of the other or against the estate of such other, of whatever nature and wheresoever situated, which he or she now has or at any time hereafter may have against the other, the estate of such other or any part hereof, whether arising out of any former acts, contracts, engagements or liabilities of such other or by way of dower or courtesy, or claims in the nature of dower or courtesy or widow's or widower's rights, family exemption or similar allowance, or under the intestate laws, or the right to take against the spouse's will; or the right to treat a lifetime conveyance by the other as a testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of (a) Pennsylvania, (b) any State, Commonwealth or territory of the United States, or (c) any country or any rights which either party may have or at any time hereafter shall have for past, present or future support or maintenance, alimony, alimony pendente lite, counsel fees, division of property, costs or expenses, whether arising as a result of the marital relations or otherwise, except, all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provisions thereof. It is the intention of HUSBAND and WIFE to give each other by the execution of this Agreement a full, complete and general release with respect to any and all property of any kind or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and only except all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision thereof. It is further agreed that this Agreement shall be and constitute a full and final resolution of any and all claims which each of the parties may have against the other for equitable division of property, alimony, counsel fees and expenses, alimony pendente lite or any other claims pursuant to the Pennsylvania Divorce Code or the divorce laws of any other jurisdiction. 31P u aglz; e 8. REPRESENTATION BY COUNSEL: WIFE has been represented by Timothy J. Colgan, Esquire, and WIFE acknowledges that she has signed this Agreement freely and voluntarily after full consultation with his counsel. This Agreement has been prepared by Timothy J. Colgan, Esquire, counsel for WIFE. At one time, HUSBAND was represented by Diane G. Radcliff, Esquire, however she no longer represents HUSBAND. At the commencement of and at all stages during the negotiations of this Agreement, HUSBAND has been informed that Timothy J. Colgan, Esquire has acted solely as counsel for WIFE and has not advised nor represented HUSBAND in any manner whatsoever. HUSBAND, at the commencement of and at all stages during the negotiation of this Agreement, has been advised that he could be represented by counsel but at all times has elected not to be so represented. HUSBAND has read this Agreement carefully and thoroughly, fully understanding each of its provisions, and therefore signs it clearly and voluntarily. The parties acknowledge that this Agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreement. The parties further acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this Agreement. 9. WARPMTY AS TO EXISTING OBLIGATIONS: Each party represents that they have not heretofore incurred or contracted for any debt or liability or obligation for which the estate of the other party may be responsible or liable except as may be provided for in this Agreement. Each party agrees to indemnify and hold the other party harmless from and against any and all such debts, liabilities or obligations of every kind which may have heretofore been incurred by them, including those for necessities, except for the obligations arising out of this Agreement. 10. WAJITY AS TO FUTURE OBLIGATIONS: HUSBAND and WIFE covenant, warrant, represent and agree that, with the exception of obligations set forth in this Agreement, neither of them shall hereafter incur any liability whatsoever for which the estate of the other may be liable. Each party shall indemnify and hold harmless the other party from and against any and all debts, charges and liabilities incurred by the other after the execution date of this Agreement, except as may be otherwise specifically provided for by the terms of this Agreement. 11. PERSONAL PROPERTY: The parties have divided between them, to their mutual satisfaction, the personal effects, household furniture and furnishings, and all other articles of personal property which have heretofore been used by them in common, and neither party will make any claim to any such items which are now in the possession or under the control of the other. 4 1F;j ge By these presents, each of the parties hereby specifically waives, releases, renounces and forever abandons whatever claims he or she may have with respect to any personal property which is in the possession of the other, and which shall become the sole and separate property of the other from the date of execution hereof. 12. RETIREMENT ACCOUNTS: HUSBAND is the owner of a pension benefit through his employment with Inclinator Company of America, administered by IAM National Pension Fun. It is agreed that WIFE shall receive 50% of the marital portion of HUSBAND's pension consistent with the Qualified Domestic Relations Order (QDRO) attached hereto as Exhibit A. HUSBAND shall be responsible for any and all costs associated with the preparation and implementation of the QDRO. 13. UFE INSURANCE: Each party shall retain sole ownership of any life insurance policy they may have acquired in their individual name and shall make any beneficiary designation they deem appropriate. It is acknowledged that WIFE has life insurance through her employment and HUSBAND expresses his understanding that WIFE shall be free to remove him as the beneficiary of that policy if she chooses. 14. HEALTH INSURANCE; Each party shall be responsible for their own health insurance coverage. 15. AUMONY: In recognition of the criteria set forth in Section 3701 of the Divorce Code 23 Pa.C.S. 3701, commencing on the first day of the month following the entry of the Divorce Decree in this matter HUSBAND shall pay to WIFE as alimony the monthly sum of Two Hundred Sixty Three Dollars ($263.00). The duration of the alimony obligation shall be 36 months. This amount shall be non- modifiable. The current Order for APL shall be converted to an Order for alimony at the monthly amount of Two Hundred Sixty Three Dollars ($263.00) to be paid in bi-weekly installments. Arrears on the current APL Order, if any, shall be collected at the rate specified in the current APL Order. If the current Order for APL is terminated for any reason or cannot be converted to an Order for alimony, HUSBAND shall pay WIFE directly on the first day of each month. Payments shall be considered late if paid after the fifth day of the month for which they are due. Following the last payment and the collection or all arrears, WIFE agrees to release and discharge HUSBAND absolutely and forever for the rest of their lives for all claims and demands, past, present or future, for alimony, alimony pendente lite or for any provisions for support and maintenance. The Alimony payments shall be deductible to HUSBAND and are income to WIFE for Federal Income Tax purposes. 5 (Parse 16. AFTER•ACOUIRED PROPERTY: Each of the parties shall hereafter own and enjoy, independently of any claim or right of the other, all items of property, be they real, personal or mixed, tangible or intangible, which are hereafter acquired by him or her, with full power in him or her to dispose of the same as fully and effectively, in all respects and for all purposes as though he or she were unmarried. 17. INCOME TAX: HUSBAND will reimburse WIFE $700.00 representing the tax and penalty for the Tax Year 2007 WIFE paid based on HUSBAND's deficiencies. Both parties agree that in the event any deficiency in Federal, State or local income tax is proposed, or any assessment of any such tax is made against either of them for any year in which they filed a joint Federal or State return, each will indemnify and hold harmless the other from and against any loss or liability for any such tax deficiency or assessment and any interest, penalty and expense incurred in connection therewith. Such tax, interest, penalty or expense shall be paid solely and entirely by the individual who is finally determined to be the cause of the misrepresentations or failures to disclose the nature and extent of his or her separate income on the aforesaid joint returns. 18. APPUCADJUTY OF TAX LAW TO PROPERTY TRANSFERS: The parties hereby agree and express their intent that any transfer of property pursuant to this Agreement shall be within the scope and applicability of the Deficit Reduction Act of 1984 (hereinafter the "Act"), specifically, the provisions of said Act pertaining to the transfers of property between spouses and former spouses. The parties agree to sign and cause to be filed any elections or other documents required by the Internal Revenue Service to render the Act applicable to the transfers set forth in this Agreement without recognition of gain on such transfer and subject to the carry-over basis provisions of said Act. 19. EFFECT OF DIVORCE DECREE: The parties agree that, except as otherwise specifically provided herein, this Agreement shall continue in full force and effect after such time as a final Decree in Divorce may be entered with respect to the parties. 20• RACHI,: 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 such other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of reasonable legal fees and costs incurred by the other in enforcing their rights under this Agreement. 21. WAIVER OF CLAIMS: 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 shall now have or hereafter acquire, under the present and future laws of any jurisdiction, to share in 6?` f n the property or the estate of the other as a result of the marital relationship, including without limitation, dower, courtesy, statutory allowance, widow's allowance, right to take in intestacy, right to take against the Will of the other, and the right to act as administrator or executor of the other's estate, and 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 such interests, rights and claims. 22. 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. 23. AGREEMENT BINDING ON HEIRS: This Agreement shall be binding on and shall inure to the benefits of the parties hereto and their respective heirs, executors, administrators, successors and assigns. 24. ADDITIONAL INSTRUMENTS: Each of the parties shall from time to time, at the request of the other, execute, acknowledge and deliver to the other any and all further instruments that may be reasonably required to give full force and effect to the provisions of this Agreement. 25. VOID CLAUSES: If any term, condition, 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. 26. INDEPENDENT SEPARATE COVENANTS: It is specifically understood and agreed by and between the parties hereto that each paragraph hereof shall be deemed to be separate and independent Agreement. 27. FINANCIAL DISCLOSURE: The parties confirm that they have relied on the completeness and substantial accuracy of the financial disclosure of the other as an inducement to the execution of this Agreement. The parties acknowledge that neither party has filed an inventory as required by Section 3505(b) of the Pennsylvania Divorce Code. Notwithstanding the foregoing, the rights of either party to pursue a claim for equitable distribution, pursuant to the Pennsylvania Divorce Code, of any interest owned by the other party in an asset of any nature at any time prior to the date of execution of this Agreement that was not disclosed to the other party or his or her counsel prior to the date of the within Agreement is expressly reserved. In the event that either party, at any time hereafter, discovers such an undisclosed asset, the party shall have the right to petition the Court of Common Pleas of Cumberland County to make equitable distribution of said asset. The non-disclosing party shall be responsible for 7I i> , payment of counsel fees, costs or expenses incurred by the other party in seeking equitable distribution of said asset. Notwithstanding the foregoing this Agreement shall in all other respects remain in full force and effect. 28. MODIFICATION AND WAIVER: A modification or 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 defaults of the same or similar nature. 29. DESCRIPTIVE HEADINGS: The descriptive headings used herein are for convenience only. They shall have no affect whatsoever in determining the rights or obligations of the parties. 30. APPUCAKE LAW: This Agreement shall be construed under the laws of the Commonwealth of Pennsylvania and more specifically under the Divorce Code of 1980 and any amendments thereto. IN WITNESS WHEREOF, the parties hereto have set their hands and seals the date and year first above written. E L. METZGER j ,. G . Ct?- Itness WILLIAM H. METZGER, IN ?Ak, Witness 8 1Pare COMMONWEALTH OF PENNSYLVANIA COUNTY OF : SS. On this, day of 2011, before me a Notary Public, personally appeared William H. Metzge , 111, know to me to be the person whose name is subscribed to the within Marital Settlement Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. N01ARIAL SEAL HAMPDEN NW*W Public TWP- CUMSULANp COMM AMY Commialon Expires Feb 1 S, 2012 tj'j &I, a. otary Public COMMONWEALTH OF PENNSYLVANIA COUNTY OF : SS. On this, the "day of 2011, before me a Notary Public, personally appeared Joanne L. Metzger, known t me to be the person whose name is subscribed to the within Marital Settlement Agreement and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. NOTARIAL SEAL SHARON A SHEAFFER Notpry Pao HAMPDEN 1" CUMSERLANp Cotj MY Commission Expires Fob 1 5.2012 MTV 0 otary Public 91P? e ?WIU+ +Oi?g1A 8MUD 9*1 0000" .wY•NMa.^'p^•nsnMi6MM'?q,?rt.'nfi fi t - R j iNppR{{ n`=t Joanne L. Metzger IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL TERM NO. 07-2882 William H. Metzger. III Defendant QUALIFIED DOMESTIC RELATIONS ORDER The parties to this action have entered into a Property Settlement Agreement following their marriage on September 9, 1978, and separation on October 1, 2005. The Court incorporated the Property Settlement Agreement into its Decree of Dissolution of Marriage dated This Order creates and recognizes the existence of an Alternate Payee's right to receive a portion of the Participant's benefits payable under an employer sponsored defined benefit plan which is intended to be qualified under Section §401(a) of the Internal Revenue Code of 1986 ("Code"), as amended. The Court intends this order to be a Qualified Domestic Relations Order ("QDRO") within the meaning of Code §414(p). The Court enters this QDRO pursuant to its authority under the 23 P.C.S.A. §3502. In accordance with the agreement of the parties, the following disposition is made of the Participant's pension benefit accrued through his participation in the pension plan named below. I.A.M. National Pension Fund, National Pension Plan 1300 Connecticut Avenue, N.W., Suite 300 Washington, DC 20036-1703 1. Plan Participant Information: Name: William H. Metzger, III Address: 1310 Old Quaker Road Etters, PA 17319 SS#: See Addendum DOB: See Addendum 2. Alternate Payee Information: Name: Joanne L. Metzger Address: 1035 South 18th Street Harrisburg, PA 17104 SS#: See Addendum DOB: See Addendum 3. Date of Marriage and Divorce: The Participant and the Alternate Payee were married on September 9, 1978, and were granted a divorce on 4. Assignment of Benefits to Alternate Payee: The Alternate Payee is hereby assigned a portion of the monthly pension benefit that would otherwise be payable to the Participant. The Fund is to make payment of the Alternate Payee's benefit directly to her. 5. Formula for Determining Alternate Payee Benefit: The Fund shall determine the Alternate Payee's portion of the Participant's benefit as follows: 50% x Pension Credit Accrued 9/9/1978 to 10/1/2005 x Benefit Amount on Alternate Total Pension Credit on Alternate Payee's Payee's Effective Date Effective Date "Marital Share Fraction" 6. Form of Payment to Alternate Payee: The Alternate Payee shall receive her benefit as a separate entitlement, payable for the Alternate Payee's lifetime. The Alternate Payee may choose to have her benefit paid in any form provided by the Fund, with the exception of the 50% Spouse Pension or the 100% Spouse Pension. Upon the Alternate Payee's death, survivor benefits, if any, will be paid in accordance with the benefit form elected by the Alternate Payee and will be payable to her designated beneficiary(ies). 7. Form of Payment for Participant: The Participant may elect any form of payment available from the Fund for the portion of the benefit not covered by this Order. This entitlement includes the right to elect a joint and survivor annuity form of benefit with a subsequent spouse. 8. Commencement of Payments to Alternate Payee: The Alternate Payee may, upon written application to the Fund, choose to begin receiving her portion of the Participant's benefit at any time after the Participant becomes eligible to receive benefits. Should the Alternate Payee predecease the Participant before establishing an Effective Date of Benefits, her portion will revert to the Participant. If the Alternate Payee has not entered pay status prior to the Participant, she will begin receiving her portion of the benefit covered by the Order as of the Participant's Effective Date of Benefits. 9. Early Retirement Subsidy: The Alternate Payee will be entitled to a portion of any Early Retirement Subsidy that becomes payable to the Participant. The amount of this entitlement will be proportionate to the portion of the benefit assigned to the Alternate Payee by the Order. If the Alternate Payee has already commenced receiving benefits at the time the Participant becomes eligible for the Early Retirement Subsidy, the Alternate Payee's benefit shall be recalculated to take the subsidy into account. 10. Pre-retirement Surviving Spouse Pension: In the event the Participant predeceases the Alternate Payee before the Alternate Payee's Effective Date of benefits, the Fund shall treat the Alternate Payee as the surviving spouse of the Participant for purposes of the 50% Spouse Pre-retirement Death Benefit. The amount of her entitlement will equal the 50% Spouse's Benefit multiplied by the marital share fraction. In addition, the Alternate Payee shall be treated as the designated beneficiary of the Participant for the portion of any lump sum Pre-retirement Death Benefit payable upon the Participant's death. The amount of her entitlement will equal the lump sum death benefit multiplied by the marital share fraction. 11. Savings Clause: This Order is not intended, and shall not be construed in such a manner as to require the fund to do the following: (a) to provide any form of benefit option not otherwise provided under the terms of the Plan of Benefits; (b) to require the Fund to provide increased benefits determined on the basis of actuarial value; or (c) to require the payment of any benefits to the Alternate Payee which are required to be paid to another Alternate Payee under another order which was previously deemed to be a Qualified Domestic Relations Order. 12. Federal Tax Reporting: For Federal income tax purposes, the Alternate Payee and not the Participant shall be treated as the distributee of all benefits made by the Fund to the Alternate Payee pursuant to this Order. The Fund will issue a Form 1099-R to the Alternate Payee at the end of calendar year and report such income to the IRS under the Alternate Payee's name and Social Security number. 13. Continued Jurisdiction: The Court shall retain jurisdiction over this matter to amend this Order if necessary to establish or maintain its status as a Qualified Domestic Relations Order under the provisions of the Retirement Equity Act and the rules of the I.A.M. National Pension Fund. EXECUTED this day of , BY THE COURT Judge CONSENT TO ORDER: Plaintiff/Alternate Payee Date Defendant/Participant Date Attorney for Plaintiff/ Alternate Payee Date N/A - Pro Se Attorney for Defendant/ Date Participant 0 JOANNE L. METZGER, Plaintiff V. WILLIAM H. METZGER, III, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 07-2882 Civil Term CIVIL ACTION - DIVORCE C7-? ?m >? C) r:/ Cq -za CD o --a rY- PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry of a divorce decree: 1. Grounds for Divorce: Irretrievable breakdown under Section 3301(c). 2. Date and manner of service of the Complaint: Defendant was served the Divorce Complaint b way of Certified Mail Restricted Delivery, Return Receipt Requested on May 25, 2007, said Affidavit of Service was filed with the Court on June 5 2007. 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 Plaintiff. August 11, 2011; By Defendant: August 11, 2011. (b) (1) Date of execution of the Affidavit required by Section 3301(d) of the Divorce Code: N/A (2) Date of filing and service of the Plaintiffs Affidavit upon the Respondent: N/A. 4. Related claims pending: All related claims were settled b a Marital Settlement A reement dated August 11, 2011 and being filed simultaneously with this Praecipe 5. Complete either (a) or (b): (a) Date and manner of service of the Notice of Intention to File Praecipe to Transmit Record, a copy of which is attached: (b) Date Plaintiffs Waiver of Notice in Section 3301(c) Divorce was filed with the Prothonotary: being filed simultaneously with this Praecipe; Date Defendant's Waiver of Notice in Section 3301(c) Divorce was filed with the Prothonotary: being filed simultaneously with this Praecipe Respectfully Submitted, COLGAN & ASSOCIATES, LLC d By Timothy J. . olg , E ire Attorney ID 77944 130 West Church Street Suite 100 Dillsburg, PA 17019 Tel: (717) 502-5000 Fax: (717) 502-5050 Dated: ?-12 -11 cc'J L'-'U -Jr (F i r i t{ ? ill E i k4??1?7t.. r) 2011 AUG 16 PH 1i- 114 CUMSERLA''u i;-U,°iI PENNSY! VAN1k, Joanne L. Metzger IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL TERM NO. 07-2882 William H. Metzger, III Defendant QUALIFIED DOMESTIC RELATIONS ORDER The parties to this action have entered into a Property Settlement Agreement following their marriage on September 9, 1978, and separation on October 1, 2005. The Court incorporat d the Property Settlement Agreement into its Decree of Dissolution of Marriage dated Lr c . 'e? l/ This Order creates and recognizes the existence of an Alternate Payee's right to receive a portion of the Participant's benefits payable under an employer sponsored defined benefit plan which is intended to be qualified under Section §401(a) of the Internal Revenue Code of 1986 ("Code"), as amended. The Court intends this order to be a Qualified Domestic Relations Order ("QDRO") within the meaning of Code §414(p). The Court enters this QDRO pursuant to its authority under the 23 P.C.S.A. §3502. In accordance with the agreement of the parties, the following disposition is made of the Participant's pension benefit accrued through his participation in the pension plan named below. I.A.M. National Pension Fund, National Pension Plan 1300 Connecticut Avenue, N.W., Suite 300 Washington, DC 20036-1703 1. Plan Participant Information: Name: William H. Metzger, III Address: 1310 Old Quaker Road Etters, PA 17319 SS#: See Addendum DOB: See Addendum 2. Alternate Payee Information: Name: Joanne L. Metzger Address: 1035 South 18th Street Harrisburg, PA 17104 SS#: See Addendum DOB: See Addendum 3. Date of Marriage and Divorce: The Participant and the Alternate Payee were married on September 9, 1978, and were granted a divorce on 4. Assignment of Benefits to Alternate Payee: The Alternate Payee is hereby assigned a portion of the monthly pension benefit that would otherwise be payable to the Participant. The Fund is to make payment of the Alternate Payee's benefit directly to her. 5. Formula for Determining Alternate Payee Benefit: The Fund shall determine the Alternate Payee's portion of the Participant's benefit as follows: 50% x Pension Credit Accrued 9/9/1978 to 10/1/2005 x Benefit Amount on Alternate Total Pension Credit on Alternate Payee's Payee's Effective Date Effective Date "Marital Share Fraction" 6. Form of Payment to Alternate Payee: The Alternate Payee shall receive her benefit as a separate entitlement, payable for the Alternate Payee's lifetime. The Alternate Payee may choose to have her benefit paid in any form provided by the Fund, with the exception of the 50% Spouse Pension or the 100% Spouse Pension. Upon the Alternate Payee's death, survivor benefits, if any, will be paid in accordance with the benefit form elected by the Alternate Payee and will be payable to her designated beneficiary(ies). 7. Form of Payment for Participant: The Participant may elect any form of payment available from the Fund for the portion of the benefit not covered by this Order. This entitlement includes the right to elect a joint and survivor annuity form of benefit with a subsequent spouse. 8. Commencement of Payments to Alternate Payee: The Alternate Payee may, upon written application to the Fund, choose to begin receiving her portion of the Participant's benefit at any time after the Participant becomes eligible to receive benefits. Should the Alternate Payee predecease the Participant before establishing an Effective Date of Benefits, her portion will revert to the Participant. If the Alternate Payee has not entered pay status prior to the Participant, she will begin receiving her portion of the benefit covered by the Order as of the Participant's Effective Date of Benefits. 9. Early Retirement Subsidy: The Alternate Payee will be entitled to a portion of any Early Retirement Subsidy that becomes payable to the Participant. The amount of this entitlement will be proportionate to the portion of the benefit assigned to the Alternate Payee by the Order. If the Alternate Payee has already commenced receiving benefits at the time the Participant becomes eligible for the Early Retirement Subsidy, the Alternate Payee's benefit shall be recalculated to take the subsidy into account. 10. Pre-retirement Surviving Spouse Pension: In the event the Participant predeceases the Alternate Payee before the Alternate Payee's Effective Date of benefits, the Fund shall treat the Alternate Payee as the surviving spouse of the Participant for purposes of the 50% Spouse Pre-retirement Death Benefit. The amount of her entitlement will equal the 50% Spouse's Benefit multiplied by the marital share fraction. In addition, the Alternate Payee shall be treated as the designated beneficiary of the Participant for the portion of any lump sum Pre-retirement Death Benefit payable upon the Participant's death. The amount of her entitlement will equal the lump sum death benefit multiplied by the marital share fraction. 11. Savings Clause: This Order is not intended, and shall not be construed in such a manner as to require the fund to do the following: (a) to provide any form of benefit option not otherwise provided under the terms of the Plan of Benefits; (b) to require the Fund to provide increased benefits determined on the basis of actuarial value; or (c) to require the payment of any benefits to the Alternate Payee which are required to be paid to another Alternate Payee under another order which was previously deemed to be a Qualified Domestic Relations Order. 12. Federal Tax Reporting: For Federal income tax purposes, the Alternate Payee and not the Participant shall be treated as the distributee of all benefits made by the Fund to the Alternate Payee pursuant to this Order. The Fund will issue a Form 1099-R to the Alternate Payee at the end of calendar year and report such income to the IRS under the Alternate Payee's name and Social Security number. 13. Continued Jurisdiction: The Court shall retain jurisdiction over this matter to amend this Order if necessary to establish or maintain its status as a Qualified Domestic Relations Order under the provisions of the Retirement Equity Act and the rules of the I.A.M. National Pension Fund. EXECUTED this / V day of le& a ;BuYdT "$OURT ge CONSENT TO ORDER: Plaintiff/Alternate Pa Date Defendant/Participant Date l &-<< N/A -Pro Se Attorney in ' / Date Attorney for Defendant/ Date Alternate Payee Participant IN THE COURT OF COMMON PLEAS OF JOANNE L. METZGER CUMBERLAND COUNTY, PENNSYLVANIA V. WILLIAM H. METZGER, Ila NO. 2007=2882 DIVORCE DECREE AND NOW, AS d 167 G??71/ , it is ordered and decreed that JOANNE L. KETZGER , plaintiff, and WILLIAM H. METZGER, III bonds of matrimony. defendant, are divorced from the Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") All related claims were settled by a Marital Settlement Agreement ("the Agreement") dated August 11, 2011 and filed simultaneously with this Praecipe. It is further ordered and decreed, pursuant to Pennsylvania Divorce Code,Section 23 Pa.C.S.A. §3101 et seq. and Pa.R.C.P. 1920.1 et seq., and in accordance with Paragraph 4, Page 2, of said Agreement, the terms of said Agreement shall be incorporated, but not merged, into this Divorce Decree. By the Court, Attest: J. Prothonotary 117zle ?la?1 c e ? ct?? ?nal lPo( "fa #,? ev d F In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (717) 240 -6225 Fax: (717) 240 -6248 Defendant Name: WILLIAM H. METZGER Member ID Number: 9605101836 Please note: All correspondence must include the Member ID Number. ORDER TO VACATE ATTACHMENT OF UNEMPLOYMENT BENEFITS Plaintiff Name JOANNE METZGER Financial Break Down of Multiple Cases on Attachment PACSES Docket Case Number Number 209109528 07 -2882 CIVIL Attachment Amount/Frequency TOTAL ATTACHMENT AMOUNT: $ 243.00 / MONTH /: IC.r. 243. <� c fV The prior Order of this Court directing the Department of Labor and Indust) r,7ffi+ of = Unemployment Compensation Benefits (OUCB), to attach $55.92 or 50% per week of the Unemployment Compensation benefits of WILLIAM H. METZGER, Social Security Number XXX -XX -0904, Member ID Number 9605101836 is hereby vacated. This Order to Vacate shall be effective upon receipt of the notice of the Order by the Department and shall remain in effect until a further Order of the Court is filed. Date of Order: MAY 2 2 2014 Service Type M BY THE COURT Form EN -035 Worker ID $IATT In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (717) 240-6225 Defendant Name: WILLIAM H. METZGER Member ID Number: 9605101836 Fax: (717) 240-6248 Please note: All correspondence must include the Member ID Number. r -a c.... r-,._ ccn r- t . <c° 3 c+ -i ORDER TO VACATE ATTACHMENT OF UNEMPLOYMENT BENEFIce , Z3 , Plaintiff Name JOANNE METZGER Financial Break Down of Multiple Cases on Attachment PACSES Docket Case Number Number 209109528 07-2882 CIVIL Attachment Amount/Frequency 243.00 / MONTH / / $ / / / / $ / TOTAL ATTACHMENT AMOUNT: $ 243.00 The prior Order of this Court directing the Department of Labor and Industry, Office of Unemployment Compensation Benefits (OUCB), to attach $55.92 or 50% per week of the Unemployment Compensation benefits of WILLIAM H. METZGER, Social Security Number XXX -XX -0904, Member ID Number 9605101836 is hereby vacated. This Order to Vacate shall be effective upon receipt of the notice of the Order by the Department and shall remain in effect until a further Order of the Court is filed. BY THE COURT Date of Order Service Type M JUN 0 3 2x14 / 1Albfftlf, DGE Form EN -035 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT • ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) O AMENDED wm O ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT C) TERMINATIQ.14,10F IWO ~ c-~ --Chtic(Support Enkiftemept (GSE) Agency "*-•'' • Z: Court 0 Attorney 0 Private Individual/Entity (Check One) NOTE: This IWO Must beregular onhofaca Undercertain circumstances you must rejectthis IWO and return 1 to the sender (see IWO instructions htto://"mww.on[hhu 54inotruoUono.ndq.Uyuueoomotk|sdooume*fromaomouno other than a State or Tribal CSE agoncy or a Court, a copy of the underlying ordermust be attached. ��/� � ��/ / `' /—/��o 67- —/ / 09/11/14 Commonwealth of Pennsylvania CUMBERLAND • Privatemdividual/sntity Remittance Identifier (include vwpuym*n): 9605101836 Order Identifier: (See Addendum for order/dockef informatlon) CSE Agency Case Identifier: (See Addendum for case summary) INCUNATOROO OF AMERICA 601 GIBSON BLVD HARRISBURG PA 17104-3215 Employer/Income WithnWer'spE|N23O7221OO Child(ren)'s Name(s) (Las . First, Middle) CW|U(nm)'s Birth Date(s) RE: METZGER, WILLIAM H. Employee/Obligor's Name (Last, First, Middle) 162-48-0904 Employee/Obligor's SociaI Security Number (See Addendum for plaintiff names as5oc:ated with cases on aUachment) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO must be regular on its face. Under certain circugo st reject this IWO and return it 10 the sender (see IWO instructions xnn:0www.ocf.hho.nvv/pmgramomse/mnms/ Omn'0970'0154 inm,ucopnsouy.|fyou receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached, 2307221000 See Addendum for dependentaammsand b!rth dates associated with cases on ORDER INFORMATION: This document is based on the support or withholding order from CUM R D Cqunty, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amountsrfp1n ern7-blbyee/ obligor's income until further notice. •-:--') - r- $ 0.00 per month in current child support Cnr— $ 0,00 per month in past -due child support - Arrears 12 weeks or greater?0 �c- !�� $ O.0Oper month incu�ardcash medical ouppn� ��r� ...7x— $ 0.UOper month inpast-due cash medical suppo� 7.-_,;','''c� �� _°7.-_,;',''' $ 0.00 per month in current spousal support '~�� _L-- �44.44. � $ 040O per month in past -due spousal support _‹: ra _' $ 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 0.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: � 0.00 per weekly pay period. s 0.00 per semmonthIy pay period (twice a month) o 0.00 per biweekly pay period (every two weeks) $ 0.00 per monthly pay period. � Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (101 working days after the date of this Order/Notice. Send payment within seven (7) working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 5 5 %of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (8babeiTriUm), the employer can obtain withholding limitations, time rmquinamento, and any allowable employer fees at http:/hxwvw.acf.hho.gov/prognsmn/ooe/nawh|re/emV|oymrhcnntacto/conbact map. !itrn for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.: 0970-0154 Service Type M Form EN -028 11/13 Worker ID 21205 ❑ Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in l accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: SEP 1 1 Z014 Albert H. Ma and If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. 0 if checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 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. State -specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf. hhs.gov/programs/cse/newhire/employer/co_ntacts/contact_map.htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past -due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti -discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date — 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO: it identifies the version of the form currently in use. Form EN -028 11/13 Service Type M Page 2 of 3 Worker ID 21205 F1 Employer's Name; INCLINATOR CO OF AMERICA Employer FEIN: 23O72210U Emp|nyeo/Obi(gohaName: METZGER, WILLIAM H. 0805101836 CSEAgenoyCaoe|dentifiec(See Addendum for case summary) Order\denUfioc(SeeAddendum/frordevdooket/n6ornatiom) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the FederalConoumarCmddProbeuVun Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, Iocal taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribaorders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold morthan the esser of the limit set by the Iaw of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATON OR INCOME STATUS:If thigor never worked for you or you are no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by retuming this forrn to the address Iisted in the Contact Information below: 2307221000 0 This person has never worked for this employer nor received periodic income. {� This person no Ionger works for this employer nor receives periodic income. Please provide the foliowing inforrnation for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDUITribaI Payee: Final Payment Amount: NmwEmp|oye/nNomo: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www.childsupport.state.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST,. P.O. BOX 320. CARLISLE, PA. 17013 (Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) byphone et(717)24O-8225.byfax at(717)24O-G248.byemail orwebsite atvw^mv.chi|dsupport.state.paus. MPORTANT: The person completing this form is advisethat the information may be shared with the employee/obligo OMB No.: 0970-0154 Service Type M Page 3 of 3 Form EN -028 11/13 Worker ID 21205 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: METZGER, WILLIAM H. PACSES Case Numbe209100528 Plaintiff Name JOANNE METZGER Docket Attachment Amount 07-2882 CIVIL $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Numbe Plaintiff Name Docket Attachment Amount � 0.00 Child(ren)'s Name(s): DOB PACSES Case Number PAC8BCase Number Plaintiff Name Plaintiff Name Docket Attachment Amont � 0.00 ChibKranynName(o): DOB Docket Attachment Amount � 0.00 Child(ren)'s Name(s): DOB PACSES Case Number PACSS Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount � 0.00 Child(renys Name(s): DOB Service Type M Docket Amount � 0.00 ChiId(renrs Name(s): DOB Addendum OMB No.: 0970-0154 Form EN -028 11/13 Worker ID 21205 • JOANNE METZGER, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-2882 CIVIL TERM WILLIAM H. METZGER, IN DIVORCE Defendant/Respondent : PACSES Case No: 209109528 ORDER OF COURT '73 AND NOW to wit, on this 1 lth day of September, 2014, it is hereby Ordered that the Cumberland County Domestic Relations Section dismiss their interest in the above captioned Alimony matter as the obligation has been paid in full and the obligation is to be terminated on October 1, 2014. This Order shall become final twenty (20) days after the mailing of the notices of the entry of the Order to the parties unless either party files a written demand with the Office of the Prothonotary for a hearing de novo before the Court. BY THE COURT: Albert H. Masland, DRO: R.J. Shadday xc: Petitioner Respondent Timothy J. Colgan, Esq. Diane G. Radcliff, Esq. Service Type: M Form 0E-001 Worker: 21005