Loading...
HomeMy WebLinkAbout07-3607 MARIA P. COGNETTI & ASSOCIATES KRISTOPHER T. SMULL, ESQUIRE Attorney I.D. No. 69140 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. NO. eL c, t L l ?1L. CRAIG W. BACHIK, 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. When the ground for 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, One Courthouse Square, Carlisle, Pennsylvania 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 Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 (800) 990-9108 MARIA P. COGNETTI & ASSOCIATES KRISTOPHER T. SMULL ESQUIRE Attorney I.D. No. 69140 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. O?' - 3Z d C? Iv il. l F/Z CRAIG W. BACHIK, CIVIL ACTION - LAW Defendant IN DIVORCE COMPLAINT UNDER SECTION 3301(c) and 3301U OF THE DIVORCE CODE AND NOW comes Plaintiff, Kathleen L. Bachik, by and through her attorney, Kristopher T. Smull, Esquire, and files the following Complaint in Divorce and in support thereof avers as follows: 1. Plaintiff is Kathleen L. Bachik, who has resided at 3822 Claverton Road, Mechanicsburg, Cumberland County, Pennsylvania, for the last six (6) years. 2. Defendant is Craig W. Bachik, whose current address is unknown and whose mailing address is 4 Lemoyne Drive, Suite 201, Lemoyne, Cumberland County, Pennsylvania. Defendant has resided outside of the marital home since January 12, 2005. 3. Plaintiff and Defendant have been bona fide residents in the Commonwealth for at least six (6) months immediately previous to the filing of this Complaint. 4. Plaintiff and Defendant were married on April 8, 1989 in York, York County, Pennsylvania. 5. There have been no prior actions of divorce or for annulment between the parties. 6. Neither of the parties in this action is presently a member of the Armed Forces. 46 7. Plaintiff and Defendant are both citizens of the United States. Plaintiff has been advised of the availability of marriage counseling and that she may have the right to request the Court to require the parties to participate in such counseling. Being so advised, Plaintiff does not request that the Court require the parties to participate in counseling prior to a divorce decree being handed down by the Court. 9. Plaintiff avers that there is one (1) child of the parties under the age of eighteen (18), namely: Laura E. Bachik, born January 1, 1993, age 14 years. COUNT I - DIVORCE 10. Plaintiff avers that the grounds on which the action is based are as follows: (a) That the marriage is irretrievably broken. (b) Plaintiff and Defendant have been living separate and apart for a period in excess of two (2) years. COUNT II - EQUITABLE DISTRIBUTION 11. During the marriage, Plaintiff and Defendant have acquired various items of marital property, both real and personal, which are subject to equitable distribution under Chapter 35 of the Divorce Code. COUNT III - ALIMONY PENDENTE LITE, ATTORNEY'S FEES AND COSTS 12. By reason of this action, Plaintiff will be put to considerable expense in the preparation of her case in the employment of counsel and the payment of costs. 13. Plaintiff is without sufficient funds to support herself and to meet the costs and expenses of this litigation and is unable to appropriately maintain herself during the pendency of this action. 14. Plaintiffs income is not sufficient to provide for her reasonable needs and pay her attorney's fees and the costs of this litigation. 15. Defendant has adequate earnings to provide for Plaintiffs support and to pay her counsel fees, costs and expenses. COUNT IV - ALIMONY 16. Plaintiff lacks sufficient property to provide for her reasonable needs. 17. Plaintiff is unable to sufficiently support herself through appropriate employment. 18. Defendant has sufficient income and assets to provide continuing support for the Plaintiff after the entry of a Decree in Divorce. WHEREFORE, Plaintiff requests this Honorable Court: a. Enter a decree of divorce; b. Equitably distribute all property, both personal and real, owned by the parties; c. Compel Defendant to pay alimony pendente lite to Plaintiff, d. Compel Defendant to pay post-divorce alimony to Plaintiff; e. Grant Plaintiff attorney's fees and costs; f. Grant such further relief as the Court may deem equitable and just. Date: Respectfully Submitted: M P. NETTI & ASSOCIATES By: I T PH R T. SMULL, ESQUIRE Attorney I.D. No. 69140 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorney for Plaintiff VERIFICATION I, KATHLEEN L. BACHIK, hereby verify and state that the facts set forth in the foregoing document are true and correct to the best of my information, knowledge and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unsworn verification to authorities. KATHLEEN L. BAC IK DATE: 6 1 (S(Oq C'N 40, W GJ ', "T 1! TIC ?J - (n - C,?J -- i n ? '- MARIA P. COGNETTI & ASSOCIATES KRISTOPHER T. SMULL ESQUIRE Attorney I.D. No. 69140 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. O'Y - ,3467 C«?L-Tsa-rvl CRAIG W. BACHIK, Defendant CIVIL ACTION - LAW IN DIVORCE MOTION FOR ALIMONY PENDENTE LITE CONFERENCE AND NOW, comes Plaintiff, Kathleen L. Bachik, by and through her attorney, Kristopher T. Smull, Esquire, and moves this Court to enter an Order setting this case for an Alimony Pendente Lite Conference, and in support thereof respectfully represents that: 1. Plaintiff, Kathleen L. Bachik (hereinafter "Mother"), is an adult individual currently residing at 3822 Claverton Road, Mechanicsburg, Cumberland County, Pennsylvania 17050. 2. Defendant, Craig W. Bachik (hereinafter "Father"), is an adult individual whose current mailing address is 4 Lemoyne Drive, Suite 201, Lemoyne, Cumberland County, Pennsylvania 17043. 3. (a) Husband and Wife were married on April 8, 1989 in York, York County, Pennsylvania. (b) Husband and Wife were separated on January 12, 2005. (c) Husband and Wife were divorced on (pending). (d) Wife is filing, simultaneously herewith, a Complaint in Divorce which includes a count for Alimony Pendente Lite. 4. The parties are the parents of the following minor child: Name Social Security Number Birth Date Age Residence Laura E. Bachik 177-74-6653 1/1/93 14 3822 Claverton Road Mechanicsburg, PA 5. Wife seeks support for the following persons: herself. 6. Husband has neglected the duty to support or sufficiently support Wife since April 2007. 7. (a) Wife is not receiving Public Assistance. (b) Wife is not receiving additional income. 8. No previous Support Order has been entered against Husband. 9. Wife last received support from Husband in the amount of $1,200.00. 10. Wife lacks sufficient property to provide for her reasonable needs. 11. Wife is unable to sufficiently support herself through appropriate employment. 12. Husband has sufficient income and assets to provide continuing support for Wife. 13. By reason of this action, Wife will be put to considerable expense in the preparation of her case in the employment of counsel and the payment of costs. 14. Wife is without sufficient funds to support herself and to meet the costs and expenses of this litigation and is unable to appropriately maintain herself during the pendency of this action. WHEREFORE, Plaintiffprays this Honorable Court enter an Order setting this matter for an Alimony Pendente Lite Conference. Respectfully Submitted: MARIA P. GNETTI & ASSOCIATES Date: 611SICT By: T HER T. S MULL, ESQUIRE Attorney I.D. No. 69140 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorney for Plaintiff VERIFICATION I, KATHLEEN L. BACHIK, hereby verify and state that the facts set forth in the foregoing document are true and correct to the best of my information, knowledge and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A. §4904 relating to unsworn verification to authorities. KATHLEEN L. BACHIK D4rE 6 1 11461 v 41 r G?J ? ?? 1VlV KATHLEEN L. BACHIK, THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-3607 CIVIL TERM CRAIG W. BACHIK, IN DIVORCE Defendant/Respondent PACSES CASE NO: 328109241 ORDER OF COURT AND NOW, this 20th day of June, 2007, upon consideration of the Petition for Alimony Pendente Lite and/or counsel fees, it is hereby directed that the parties and their respective counsel appear before R.J. Shadday on July 19, 2007 at 9:00 A.M. for a conference, at 13 N. Hanover St., Carlisle, PA 17013, after which the conference officer may recommend that an Order for Alimony Pendente Lite be entered. YOU are further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W2's as filed (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by Rule 1910.110 (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you If you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. BY THE COURT, Edgar B. Bayley, President Judge Copies mailed to: Petitioner Respondent Kristopher T. Smull, Esq. Date of Order: June 20, 2007 J. I day, onference Officer YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 cc361 i`?=t -- ?? ,-r; ' ;-' '' ?? t ?; ?? ?? _ ,? ? ?..:> MARIA P. COGNETTI & ASSOCIATES KRISTOPHER T. SMULL ESQUIRE Attorney I.D. No. 69140 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CRAIG W. BACHIK, Defendant NO. 07-3607 Civil Term CIVIL ACTION - LAW IN DIVORCE AFFIDAVIT OF SERVICE I, KRISTOPHER T. SMULL, ESQUIRE, do hereby certify that a true and correct copy of the Complaint Under Section 3301(c) and 3301(d) of the Divorce Code, was served upon the Defendant, Craig W. Bachik, byUnited States Mail, first class, postage prepaid, certified, restricted delivery, docketed to No. 7005 0390 0005 2244 1880, on the 26`h day of June, 2007, addressed as follows: Craig W. Bachik 4 Lemoyne Drive, Suite 201 Lemoyne, PA 17043 A COGNETTI & ASSOCIATES Date: By: KRI OPHER T. SMULL, ESQUIRE Attorney I.D. No. 69140 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorney for Plaintiff A ¦ Complete Roma 1, 2, and 3. Also complete Item 4 If Restricted Deliv y Is desired. ¦ Print your name and address on the reverse so that we can retum the card to you. ¦ Attact card to the back of the mallpiece, or on t If space permits. 1. Ardde Add aseed to: `^' Craig W. Bachik 4 LemoWe Drive, Suite 201 Lemoyne, PA 17043 Q?? Z by( 4kj -C. Date of D D. Is from item 1? ? Yes If YE% enter delkwy address below: ? No 3. lylpe CertMed Man ? Epeee Mall ? Registered ? Retum ReoW for Mer foxilse ? inured man ? C.O.D. , 4. Restricted D~ (Extra Fee) 2. ARkdeNiurrtm 7005 0392 0005 2244 7,882 MWWW nom I - ice Apbs9 PS Form 3$11, February 2004 DO I'M Retum Receipt *390- 12595.024+1540 r•s gi r .+ {? Z :jo N ,._. 1 C-7 N 4 KATHLEEN BACHIK, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-3607 CIVIL TERM CRAIG W. BACHIK, IN DIVORCE Defendant/Respondent , PACSES Case Number: 328109241 ORDER OF COURT - RESCHEDULE A CONFERENCE AND NOW, this 2nd day of July 2007, upon consideration of the Petition for Alimony Pendente Lite and/or counsel fees, it is hereby directed that the parties and their respective counsel appear before R.J. Shaddav on August 2, 2007 at 9:00 A.M. for a conference, at 13 N. Hanover St., Carlisle, PA 17013, after which the conference officer may recommend that an Order for Alimony Pendente Lite be entered. This date replaces the prior conference date of July 19, 2007. YOU are further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W-2's as filed (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by Rule 1910.11© (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you (6) IF you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. BY THE COURT, Edgar B. Bayley, President Judge Date of Order: July 2, 2007 Copies mailed to: Petitioner Respondent Kristopher T. Smull, Esq. -;4 ' t-" AL Sh day, nference Officer ?1- I' YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 cc361 am t >_ C?? c .: ^' In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KATHLEEN L. BACHIK ) Docket Number 07-3607 CIVIL Plaintiff ) VS. ) PACSES Case Number 328109241 CRAIG W. BACHIK ) Defendant ) Other State ID Number ORDER AND NOW, to wit on this 2ND DAY OF AUGUST, 2007 IT IS HEREBY ORDERED that the 0 Complaint for Support or 0 Petition to Modify or ® Other ALIMONY PENDENTE LITE REQUEST filed on 06/18/07 in the above captioned matter is dismissed without prejudice due to: AN ORDER OF SPOUSAL SUPPORT BEING ENTERED UNDER CASE #906109247 AND DOCKETED AT 462 S 2007 AND PLAINTIFF WITHDRAWING HER REQUEST FOR ALIMONY PENDENTE LITE AT THIS TIME. 0 The Complaint or Petition may be reinstated upon written application of the plaintiff petitioner. BY THE COURT: N -t ?? ? - M.L. EBE , JR., JUDGE DRO: R.J. SHADDAY Form OE-506 Service Type M Worker ID 21005 o -z, C7 MARIA P. COGNETTI & ASSOCIATES MARGARET M. SIMOK, ESQUIRE Attorney I.D. No. 89633 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. CRAIG W. BACHIK, Defendant NO. 07-3607 Civil Term CIVIL ACTION - LAW IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on June 18, 2007. 2. The marriage of Plaintiff and Defendant is irretrievably broken, and ninety (90) days have elapsed from the date of the filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. Date: ld- W& Al KATHLEEN L. BACH C? r ? Q ? -? ,. V' ' ? ; ' cx? ? -? 1 y .., -r- i +? W t? '7 ?? -?-- ?? ? r a ,` ? >? ;'rr ^ ? ?? -wC MARIA P. COGNETTI & ASSOCIATES MARGARET M. SIMOK, ESQUIRE Attorney I.D. No. 89633 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. CRAIG W. BACHIK, Defendant : NO. 07-3607 Civil Term CIVIL ACTION - LAW IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF DIVORCE DECREE UNDER § 3301(c) OF THE DIVORCE CODE 1) I consent to the entry of a final Decree of Divorce without notice. 2) I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3) I understand that I will not be divorced until a Divorce Decree is entered by the Court and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in 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. L Date: /W - a? 6`i? KATHLEEN L. BACH c? ? -rs ? ?i 1 ± ? m' t? rte---" c s ,1`? C?J r.? ?? ? ?-t ? ?? ? ? ? .? ^? MARIA P. COGNETTI & ASSOCIATES MARGARET M. SIMOK, ESQUIRE Attorney I.D. No. 89633 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. CRAIG W. BACHIK, Defendant NO. 07-3607 Civil Term CIVIL ACTION - LAW IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on June 18, 2007. 2. The marriage of Plaintiff and Defendant is irretrievably broken, and ninety (90) days have elapsed from the date of the filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. Date: t:)F?. -; 3 7411110S C? a mrt n { C 3 m . -s? -r-s rw . ?Y MARIA P. COGNETTI & ASSOCIATES MARGARET M. SIMOK, ESQUIRE Attorney I.D. No. 89633 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, Plaintiff V. CRAIG W. BACHIK, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. 07-3607 Civil Term CIVIL ACTION - LAW IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF DIVORCE DECREE UNDER § 3301(c) OF THE DIVORCE CODE 1) I consent to the entry of a final Decree of Divorce without notice. 2) I understand that I may lose rights concerning alimony, division ofproperty, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3) I understand that I will not be divorced until a Divorce Decree is entered by the Court and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unworn falsification to authorities. Date: zbc)6 w. - c a DEC-29-2003(MON) 13:00 r? Samuel Andes, Esq. (FRX)717 761 1435 PROPERTY SETTLEMENT AGREEMENT BE'T'WEEN KATHLEEN L. BACK IK AND CRAIG W. BACIF11K ?? N c.. 3 f17 O 1. 3 P. 001 /019 Q T1 ?T1 `t7 •? r-rT DEC-29-2008(MOM) 13:00 Samuel Rndes, Esq. (FAX)717 761 1435 P.002/019 INDEX OF PROPERTY SETTLEMENT AGREEMENT BETWEEN KATHLEEN L. BACHIK AND CRAIG W. BACHIK SUBJECT PAGE NUMBER 1, Separation 2 2. Interference 2 3. Agreement Not a Bar to Divorce Proceedings 2 4. Subsequent Divorce 3 5. Incorporation in Divorce Decree 4 6. Effective Date 4 7. Distribution Date 4 8. Mutual Release 4 9. Advice of Counsel 6 10. Warranty as to Existing Obligations 6 11. Warranty as to Future Obligations 7 12, Personal Property 7 13. Bank Accounts 7 14. Stocks 8 15. Distribution of Funds 8 16. Distribution of Individual RctircmcntAccounts 9 17, Pensions, Annuities and/or Retirement Benefits 10 18. Motor Vehicles 10 19. After-Acquired Property 11 20. Prior Income Tax Returns 11 21. Child Support 12 22. Bankruptcy 12 23. Attorneys' Fees for Enforcement 13 24, Effect of Divorce Decree 13 25. Broach 13 26. Waiver of Claims 13 27. Entire Agreement 14 28. Financial Disclosure 14 29. Agreement Binding on Heirs 14 30. Additional Instruments 15 31. Void Clauses 15 32. Independent Separate Covenants 15 33. Modification and Waiver 15 34. Descriptive Headings 15 . 35. Applicabie .Law 16 DEC-29-2008(MOM) 13;01 Samuel Rndes, Esq. (FRX)717 761 1435 P.003/019 PROPERTY SETTLEMENT AGREEMENT This Agreement made this day of 11021 pn jW-A„. , 2008, by and between Kathleen L. Bachik, of Cumberland County, Pennsylvania (hcrcinaRer referred to as and Craig W. Bachik, of Cumberland County, Pennsylvania (hereinafter referred to as "HUSBAND'): WiTNESSETH: WHEREAS, the parties were married on April 8,1989, in York County, Pennsylvania; and WHEREAS, one child has been born of this marriage, namely, Laura E. Bachik, born January 1, 1993; and WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of WIFE and HUSBAND to live separate and apart, and the parties hereto arc desirous of settling fully and finally their respective financial and properly rights and obligations as between each other, including, without limitation by specification: 'I'll e settling of all matters between them relating to the ownership and equitable distribution of real and personal property; settling of al l 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 all matters between them relating to the past, present and future support and/or maintenance of the child; the implementation of custody and visitation arrangements for the minor child of the parties; and in general, the settling of any and all claims and possible claims by one against the other or against their respective estates. 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, DEC-29-2008(MON) 13:01 Samuel Andes, Esq. (FRH)717 761 1435 P.004/019 receipt of which is hereby acknowledged by each ofthe parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby, covenant and agree as follows: 1. SEPARATION: HUSBAND and WIFE shall at all times hereafter have the right to live separate and apart from each other and to reside from time to time at such place or places as they shal I respectively deem fit, free from any control, restraint or interference whatsoever by the other. Neither party shall molest the other or endeavor to compel the other to cohabit or dwell with him or her by any legal or other proceedings. The foregoing provisions shall not be taken to be an admission on the part of either'RUSBAND or WIFE, of the lawfulness or unlawfulness of the causes leading to their living apart. 2. INTERFERENCE: Each party shall be free from interference, authority and contact by the other, as fully as if he or she were single and unmarried, except as maybe necessary to carry out the provisions of this Agreement. Neither party shall molest the other or attempt to endeavor to molest the other, nor compel the other to cohabit with the other,. nor in anyway harass or malign the other, nor in any way interfere with the peaceful existence, separate and apart from the other, and each of the panics hereto completely understands and agrees that neither shall do or say anything to the child ofthe parties at any time which might in any way influence the child adversely against the other party, it being the intention of both parties to minimize the effect of any such separation upon the child. 3. ACREEMFN'1' N'OT A BAR TO DIVORCE PROCEEDINGS: This Agreement shall not be considered to affect or bar the right of HUSBAND or WIFE to a divorce on lawful 2 DEC-29-2008(NON) 13;01 Samuel Andes, Esq. (FAX)717 761 1435 P.005/019 grounds as such grounds now exist or shal l hereafter. exist or to such defense as maybe 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 which have occurred prior to or which may occur subsequent to the date hereof. 4. SUBSEQUENT DIVORCE: The parties hereby acknowledge that W=- has filed a Complaint in Divorce in Cumberland County to Docket No. 07-3607, claiming that the marriage is irretrievably broken tinder Section 3301(e) of the Pennsylvania Divorce Code. Both 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(e) of the Divorce Code at the same time as they execute this Agreement. 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 ofproperty of the parties are accepted by each party as a final settlement for all purposes whatsoever, as 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; and that nothing in any such decree, judgment, order or further modification or revision thereofshall alter, amend or vary any term of this Agreement, whether or not either or both of the parties shall 3 DEC-29-2008(MON) 13:01 Samuel Rndes, Esq. (FRX)717 761 1435 P.006/019 remarry. '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. 5. INCORPORATION IN 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. 6. 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 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. 7. DISTRI"BU rl'ON DATE: 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 date of execution ofthis Agreement unless otherwise specified herein. However, the support and/or alimony payments, if any, provided for in this Agreement shall take effect as set forth in this Agreement. 8. MUTVAr. RF.LFASf:: HUSBAND and WIFE each do hereby mutuallyren3isc, release, quitclaim and forever discharge the other and the estate of such other, for all time to come, 4 DEC-29-2008(MON) 13;01 Samuel Andes, Esq. (FAX)717 761 1435 P.007/019 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 wheresoevcr 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 thereof, whether arising out of any former acts, contracts, engagements or liabilities of such other orbyway of dower or curtesy, or claims in the nature of dower or eurtesy 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 gift, 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 relationship 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 5 DEC-29-2008(MON) 13;01 Samuel Andes, Esq. (FAX)717 761 1435 P.008I019 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, alimonypendente lite or any other claims pursuant to the Pennsylvania Divorce Code or the divorce laws of any other jurisdiction. 9. ADVICE. O'F COUNSEL: The provisions of this Agreement and its legal effect have been fully explained to the parties by their respective counsel; MARGARET M. SIMOK, .Esquire, for WIFE and SAM><Tl+El",, L. ANDES, Esquire, for HUSBAND. HUSBAND and Vl IFE acknowledge that this Agreement is not the result of any duress or undue influence and that it is not the result of any collusion or improper or illegal agreement or agreements. The parties further acknowledge that they have each made to the other a full accounting ofthcir respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purpose of this Agreement. Each party agrees that he or she shall not, at any future time, raise as a defense, or otherwise, the lack of such disclosure in any legal proceeding involving this Agreement, with the exception of disclosure that may have been fraudulently withheld. 10. WARRAN'1'V AS TO EXISTING OBT.IGATIONS: 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 for 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. 6 DEC-29-2008(MON) 13:02 Samuel Rndes, Esq. (FAX)717 761 1435 P.009/019 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. 11. WARRANTY 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 ofthe othermay be liable. Each party shall indemnify and hold harmless the otherparty for and against any and all debts, charges and liabilities incurred bythe other alter the execution date of this Agreement, except as may be otherwise specifically provided for by the terms of this Agreement. 12. 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. Should it become necessary, the parties each agree to sign any titles or documents necessary to give effect to this paragraph upon request. 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. 13. BANK ACCOUN'T'S: HUSBAND and WIFE acknowledge that they each possess certain bank accounts and the like in their respective names. They hereby agree that each shall 7 DEC-29-2008(P10N) 13:02 Samuel Andes, Esq. (FAX)717 761 1135 P.010/019 become sole owner of their respective accounts and they each hereby waive any interest in, or claim to, any funds held by the other in such accounts. 14. STOCKS: The parties agree that any stocks held in that party's name alone shall remain the sole and exclusive property of that party and they each hereby waive any interest in, or claim to, any such stocks. 15. DiSTRYBUTION OF FUNDS: HUSBAND hereby acknowledges and agrees to pay WEE the amount of Forty-Three Thousand, Five Hundred Eighty-Five Dollars and 93/100 cents ($43,585.93) as non-terminable alimony payable through the Cumberland County Domestic Relations Office; said sum to be paid at the rate of Three Hundred Sixty-Five Doi tars ($365.00) per month starting thirty (30) days after the date of exectetion of this Agreement. The parties agree that the alimony provision contained in this Agreement may be enforceable by an action in support in accordance with Pa. R. Civ. P. 1910.1 et seq. However, the parties specifically acknowledge that payment through this office is not intended to confer upon the Court any authority to modify the terms of the alimony as set forth in this Agreement. Rather, payment through the Cumberland County Domestic Relations Office will be made for the convenience of the parties and for enforcement purposes only. bi the event either party attempts to change the amount of alimony pursuant to this Agreement, because it is payable through the Cumberland County :Domestic Relations Office, that party specifically agrees that they will indemnify and hold the other party harmless for any decrease or increase so obtained. They specifical ly acknowledge that in the event they would obtain such modification, the difference between the amount of alimony to be paid 8 DEC-29-2008(MON) 13:02 Samuel Andes. Esq. (FAX)717 761 1 05 P.011/019 pursuant to this Agreement and any modification made shall be payable from the personal assets of the parties. In addition, the parties agree that the party seeking such modification shall pay any and all attorney's fees, costs or consequential damages sustained by the nonmoving party. Tnie above amount includes the following moneys due to WIFE by HUSBAND: a) Nineteen Thousand, Five Hundred Eleven Doi lays and 18/100 ($19,511.15), which is one-half (1/2) of the amount HUSBAND withdrew from his 401(k) at Brinjac Engineering. b) One Thousand, Nine Hundred Fifty-One :Dollars and 12/100 ($1,951.12), which is the amount due by HUSBAND to WIFE for the ten percent (10%) penalty paid by WIFE to Internal Revenue Service due to HUSBAND's early withdrawal from his Brinjac Engineering 401(k). c) Four Thousand, Sixty Dollars and 27/100 ($4,060.27), which is one-half (1/2) of the loan amount WIFE provided to .HUSBAND from WIFE's 401(k). d) Eighteen Thousand, Sixty-Three Dollars and 361100 ($18,063.36), which is the total amount HUSBAND owes WIPE from two personal loans WIFE made to HUSBAND's business. WIFE accepts the alimony to be paid pursuant to this paragraph in full satisfaction of any claim she mayhave to any interest in or payment from HUSBAND'S corporation, and WIFE hereby waives and releases any claim to or interest in said corporation. 16. DISTRIBUTION OV IN DI VI DUA I. RETIREMENT ACCOUNTS: HUSBAND hereby acknowledges and agrees that WIFE shall retain, as her separate property, free and clear from 9 DEC-29-2008(MON) 13:02 Samuel Rndes, Esq. (FAX)717 761 1435 P.012/019 any claim, right, title or interest on the pert of HUSBAND, her individual Retirement Accounts. HUSBAND hereby acknowledges that he has no further claim, right, title or interest whatsoever in the Individual Retirement Accounts of WIFE, and further agrees never to assert any claim to the assets in the future. HUSBAND agrees to sign any documents required to ensure that WIFE retains her Individual Retirement Accounts as her sole property. 17. PENSIONS, ANNUITIES AND/OR RETIREMENT BENEFITS: WIFE agrees that any moneys which HUSBAND has acquired through his interests in either pensions, profit- sharing, savings and thrift plans, annuities and/or retirement benefits through his present or past employers shall remain his sole and exclusive property. WIFE agrees to waive any interest she may have in such property and further agrees that she will not assert'any such claim in the future. HUSBAND agrees that any moneys which WIFE has acquired through her interests in either pensions, profit-sharing, savings and thrift plans, annuities and/or retirement benefits through her present or past employers shall remain her sole and exclusive property. HUSBAND agrees to waive any interest he may have in such property and further agrees that he will not assert any such claim in the future, 18. MOTOR VEHICLES: With respect to the motor vehicles owned by one or both of the parties, they agree as follows: a) The 2007 Honda Odyssey shall be and remain the sole and exclusive property of WIFE. 10 DEC-29-2008(MON) 13:02 Samuel Andes. Esq. (FAX)717 761 1435 P.013/019 b) The 2000 Volvo S-80 shall be and remain the sole and exclusive property of HUSBAND, The titles to the said motor vehicles shall be executed by the parties, if appropriate for affecting transfer as herein provided, on the date of execution of this Agreement, and said executed titles shall be delivered to the proper party on the distribution date. Each party agrees to be solely responsible for the amounts presently due and owing against his or her respective automobile. 19. AFTER-ACQUIRED 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. 20. PRI.ORMCOME TAX RETURNS: Thepartieshave heretofore filedjointFcdcral and State tax returns. Both parties agree that in the event any deficiency in Federal or State income tax is proposed, or any assessment of any such tax is made against either of them, 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. 11 DEC-29-2008(MON) 13:02 Samuel Andes. Esq. (FAX)717 761 1435 P.0141019 21. CHILD SUPPORT: HUSBAND agrees to pay WIFE child support pursuant to the present Order, dated May 8, 2008, and docketed to Cumberland County Domestic Relations Office No. 004-62-S-2007. 22, BANKRUPTCY: The parties specifically agree that the payments called for in this Agreement are not intended to be a debt which is affected by a discharge in bankruptcy. Theyfurther specifically intend that HUSBAND's obligations under the terms of this Agreement shall not be subject to discharge in bankruptcy because they acknowledge that such arc necessary for WIFE to meet her financial obligations and to support and maintain her standard of living and that of the parties' child. HUSBAND represents there are no bankruptcy proceedings presently pending in which he is involved. HUSBAND expressly agrees not to file a bankruptcy action prior to the completion of his obligations pursuant to this paragraph. This debt shall not be discharged iii a bankruptcy action riled by or on behalf of HUSBAND. If HUSBAND riles for bankruptcy, this Agreement shall constitute conclusive evidence of the parties' intent that the obligations of this paragraph are in the nature of maintenance and are not dischargeable under current bankruptcy law or under any amendments thereto. Further, if HUSBAND institutes any action in bankruptcy or any other bankruptcy proceeding is instituted in which WTFE's right to these monthly payments becomes a matter for judicial review, HUSBAND agrees to consent to any motion filed by WTFE with the bankruptcy court wherein she may request that the bankruptcy court abstain from deciding the dischargeability of this obligation and any other 12 DEC-29-2008(MOM) 13;02 Samuel Andes, Esq. (FAX)717 761 1435 P.015f019 obligation to her hereunder in order to allow the appropriate Court of Common Pleas to rule upon this issue. 23. ATTORNEYS' FEES FOR ENFORCFMFNT: In the event that either party breaches any term of this Agreement and the other party retains counsel to assist in enforcing the tenns hereof, the breaching party shall pay all reasonable counsel fees and expenses which are incurred by the other party in enforcing this Agreement, whether enforcement is ultimately achieved by litigation or by amicable resolution. 24. 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. 25. BRRAC.Yt::Ifeitherparty breaches anyprovision ofthisAgrccmcnt,theother 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 his or her rights under this Agreement. 26. WAYVFR OF CLAYMS: except as herein otherwise provided, each party may dispose of his or her property in anyway, 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 the property or the estate of the other as a result of the marital relationship, including without limitation, dower, curtesy, statutory allowance, widow's allowance, widower's 13 DEC-29-2008(MON) 13:03 Samuel Andes, Esq. (FRX)717 761 1435 P.016/019 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. Each party will, at the request of the other, execute, acknowledge and deliver any and all instruments which maybe necessary or advisable to carry into effect this mutual waiver and relinquishment of all such interests, rights and claims. 27. ENTIRE AGREEMENT: This Agreement contains the entire understanding ofthe parties and there are no representations, warranties, covenants or undertakings other than those expressly set forth herein. 28. RNANCIALDISCLOSU'Itt+".: The parties confrmthattheyltavenotengaged inor completed formal discovery although each of them represents that they are generally aware of the assets, liabilities and other financial dealings of the other. Each of the parties represent that they have had the opportunity to engage in and pursue formal discovery in the divorce action pending between them and have elected, voluntarily, not to do so. The parties acknowledge that they enter into this Agreement on the basis of information known to them or otherwise provided by the other party and being satisfied that, although formal discovery was not complete, they are sufficiently aware of the assets, liabilities and other financial workings of the other party to enter into this Agreement of their own free will, and to be bound hereby. 29. AGRFFWNTBINDINGONFIRURS: This Agreement shall be binding and shall inure to the benefit of the parties hereto and their respective heirs, executors, administrators, successors and assigns. ].4 DEC-29-2008(MON) 13:03 Samuel Andes, Esq. (FAX)717 761 1435 P. 0 17/0 19 30. 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. 31. VOM CLAUSES: if any ter i, 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, c$cct and operation. 32. INDEPENDENT SEPARATE COVENANTS: Tt is specifically understood and agreed by and between the parties hereto that each paragraph hereof shall be deemed to be a separate and independent Agreement, 33. 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 awaiver of any subsequent defaults ofthc same or similar nature. 34. ARSC.R1<PTTV1. FMADTNGS: The descriptive headings used herein are for convenience only. They shall have no affect whatsoever in determining the rights or obligations of the parties. is DEC-29-2008(MON) 13;03 Samuel Rndes, Esq. (FAX)717 761 1x35 P.018/019 35. APPLICABLE LAW: This Agreement shall be construed under the laws of the Coirnnonwealth of Pennsylvania and more specifically under the Divorce Code of 1980 and any amendments thereto. IN WI'T'NESS WHEREOF, the parties hereto have set their hands and seals the date and year first above written, (SEAL) \g /?' 'I L -A 6AX A 41 -M? WITNESS KATM.ELN L. BAC (SEAL) WITNESS CR.AI . BAC 16 CEE-23-2000U(MC`d) 03 Samuel Andes, Esq. COMMONWEALTH OF PENNSYLVANIA ) )SS: m.6??.t,? ) COUNTY OF (FRY)1717 751 1aH °.2191019 On this, the day of1m,(?,tZ , 2008, before me, a Notary Public, the undersigned officer, personally appeared Kathleen L. Bachik, known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing Property Settlement Agreement, and acknowledged that she executed the same for the purposes therein contained. W WTrNESS WHEREOF, I hereunto set my hand and official seal. COMMONWEALTH OF PENNSYLVANIA COUNTY OF ('-? 1. e, j JVA - d- ? No :Public COMMONW F.ALTH OF PENNSYLVANIA Notarial Seal Karen A. Sheriff, Notary Public Palmyra Boro, Lebanon County. My CornmWori Exom May 16, 2010 Member, Pennsylvania Association of Notaries )SS: On this, the day of. s4p???p 2008, before me, a Notary Public, the undersigned officer, personally appeared Craig W. Bachik, known to me (or satisfactorilyproven) to be the person whose name is subscribed to the foregoing Property Settlement Agrccmcnt, and acknowledged that he executed the same for the purposes therein contained. IN WTINESS WHEREOF, .i hereunto set my hand and official seal, otaryublic 17 MARIA P. COGNETTI & ASSOCIATES MARGARET M. SIMOK, ESQUIRE Attorney I.D. No. 89633 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. DOCKET NO. 07-3607 CIVIL TERM CRAIG W. BACHIK, CIVIL ACTION - LAW Defendant IN DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry of a divorce decree: 1. Ground for divorce: Irretrievable breakdown under § 3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: Service was accepted by the Defendant on the 26 day of June, 2007, by certified mail, return receipt requested, receipt number 7005 0390 0005 2244 1880. 3. Date of execution of the Affidavit of Consent required by § 3301(c) of the Divorce Code: by Plaintiff, on December 26, 2008; by Defendant, on December 23, 2008. 4. Related claims pending: Settled by Agreement dated December 23, 2008. 5. Both Plaintiff's and Defendant's Waiver of Notice in §3301(c) Divorce is being filed concurrently with this Praecipe. Defendant's Waiver was filed on December 29, 2008. MARIA P. COGNETTI & ASSOCIATES Date: December 29, 2008 By: MARIA P. C TTI, ESQUIRE for MARGARET . SIMOK, ESQUIRE Attorney I.D. No. 89633 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorney for Plaintiff {?J ? ? ?-- CL'f t? _--1 Z i -;-.4'i"S J-? y?, ?? + _.?s- i? J : ? 11 ' ? ' ? .??"? IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KATHLEEN L. BACHIK V. CRAIG W. BACHIK DIVORCE DECREE AND NOW, 3e, 2[M , it is ordered and decreed that KATHLEEN L. BACHIK , plaintiff, and CRAIG W. BACHIK , defendant, are divorced from the bonds of matrimony. 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.") None. The terms of the parties' Property Settlement Agreement, dated December 22, 2008 and attached hereto are incorporated herein but not merged h NO. 07-3607 CIVIL TERM By Attest: J. Prbthonotary Court, 4w, ?? ?? tL ^ ? • MARIA P. COGNETTI & ASSOCIATES MARGARET M. SIMOK, ESQUIRE Attorney I.D. No. 89633 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 07-3607 Civil Term CRAIG W. BACHIK, CIVIL ACTION - LAW Defendant IN DIVORCE STIPULATION AS TO ALIMONY AND NOW, this 23rd day of December, 2008, comes Plaintiff, Kathleen L. Bachik (hereinafter referred to as "Wife"), and Defendant, Craig W. Bachik (hereinafter referred to as "Husband"), who file this Stipulation as to Alimony and state as follows: WHEREAS, the parties were married on April 8, 1989, in York County, Pennsylvania, and divorced on the 30th day of December, 2008. WHEREAS, on December 23, 2008, the parties entered into a Property Settlement Agreement, whereby the Husband agreed to pay Wife the sum of $365.00 per month as non-terminable alimony beginning January 1, 2009. Such payments would continue for ten (10) years, or until the sum of Forty-Three Thousand Five Hundred Eighty-Five Dollars ($43,585.00) has been paid. WHEREAS, the parties wish to avoid the anticipated expense of preparing for and pursing a conference and/or the appeals of any resulting Order. NOW, THEREFORE, intending to be legally bound hereby, the parties hereto ,,,•• stipulate and agree as follows: 1. Husband's monthly alimony payment to wife shall be set at $365.00 per month. 2. The affective date of this alimony obligation shall be January L, 2009. 3. The monthly payments of $365.00 will continue for ten (10) years or until the sum of $43,585.00 has been paid to Wife. 4. The parties acknowledge that said stipulation shall be adopted as an Order of Court. 5. The parties hereby waive their rights to have their case heard by Court at this time. IN WITNESS THEREOF, and intending to be legally bound thereby, the parties hereto have hereunto set their hands and seals this day and year first above written. Margai M. Simok, Esquire Attorney for Plaintiff Samuel L. Andes, Esquire Attorney for Defendant Kathleen L. Bac ik ylll? . ;. C3 Se on MARIA P. COGNETTI & ASSOCIATES MARGARET M. SIMOK, ESQUIRE Attorney I.D. No. 89633 210 Grandview Avenue, Suite 102 Camp Hill, PA 17011 Telephone No. (717) 909-4060 Attorneys for Plaintiff KATHLEEN L. BACHIK, Plaintiff v. CRAIG W. BACHIK, Defendant JAN U 9 2009 (? IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 07-3607 Civil Term CIVIL ACTION - LAW IN DIVORCE ORDER OF COURT AND NOW, this ?a day of , 20, it is hereby ORDERED and DECREED that the attached Stipulation as to Alimony is entered as an Order of this Court. Date: Distribution: Xargaret M. Simok, Esquire, 210 Grandview Avenue, Camp Hill, PA 17011 Samuel L. Andes, Esquire, 525 North 12th Street, P.O _Pox 168, Lemoyne, PA 17043 a???o ON r w r CJ t _ tyy? ? r ? ? N ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 906109247 Co./City/Dist. of CUMBERLAND 462 S 2007 Date of Order/Notice 08/27/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number KAIROS DESIGN GROUP, INC STE 201 4 LEMOYNE DR LEMOYNE PA 17043-1238 187-54-0702 Employee/Obligor's Social Security Number 9540101841 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. $ 522.00 per month in current child support $ o . oo per month in past-due child support Arrears 12 weeks or greater? O yes Q no $ 0.00 per month in current medical support $ 0.00 per month in past-due medical support $ o . oo per month in current spousal support $ 443.00 per month in past-due spousal support $ o . oo per month for genetic test costs $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ 965 . o0 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: $ 222..69 per weekly pay period. $ 482. so per semimonthly pay period (twice a month) $ 445.38 per biweekly pay period (every two weeks) $ 965.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the 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. § 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 NAMEAND THE PACSES MEMBER ID (shown above as the EmployeelObligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORD R TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: DRO: R.J. Shadday Service Type M OMB No.: 097"154 07-3607 CIVIL O Original Order/Notice OAmended Order/Notice 0Terminate Order/Notice (Done-Time Lump Sum/Notice RE:BACHIK, CRAIG W. Employee/Obligor's Name (Last, First, MI) Form EN-028 Rev.5 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS 114hecketl you are requirnrl to provide aopy of this form to you(gmployee. If your employee vyorks in a state that is di Brent ftrom the state that issu this o er, a copy must be provi edd 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 employeelobligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* 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'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. 3201100224 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:BACHIK, CRAIG W. EMPLOYEE'S CASE IDENTIFIER: 9540101841 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 emp)oyee%obligor from employment, refusing to employ, or taking disciplinary action against any employeelobligor 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) 0 5 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 0 5 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 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 Form EN-028 Rev.5 Service Type M OMB No.: 097"154 Worker ID $IATT ADDENDUM Summarv of Cases on Attachment Defendant/Obligor: BACHIK, CRAIG W. PACSES Case Number 328109241 Plaintiff Name KATHLEEN L. BACHIK Docket Attachment Amount 07-3607 CIVIL$ 365.00 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 $ 0.00 Child(ren)'s Name(s): DOB Service Type M Addendum OMB No.: 097"154 PACSES Case Number 906109247 Plaintiff Name KATHLEEN L. BACHIK Docket Attachment Amount 00462 S 2007 $ 600.00 Child(ren)'s Name(s): DOB LAURA ELIZABETH BACHIK 01/01/93 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Form EN-028 Rev.5 Worker ID $IATT Ft , EL f 2909 AUG 3 ! M 11: G 1 CUrr?i. ' ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 07-3607 CIVIL State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 09/01/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number KAIROS DESIGN GROUP, INC STE 201 4 LEMOYNE DR LEMOYNE PA 17043-1238 906109247 462 S 2007 RE:BACHIK, CRAIG W. OOriginal Order/Notice OAmended Order/Notice OTerminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 187-54-0702 Employee/Obligor's Social Security Number 9540101841 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. $ 601.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 443.00 $ 0.00 $ 0.00 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) Arrears 12 weeks or greater? 0 yes O no one-time lump sum payment for a total of $ 1,044.00 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: $ 240.92 per weekly pay period. $ 522.00 per semimonthly pay period (twice a month) $ 481.85 per biweekly pay period (every two weeks) $ 1, 044. 00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the 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. § 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. BY THE COURT: M 7 1:'hor? Tr Ti vi DRO; R.J. Shadday Service Type M OM8 No.: 0970-0154 Form EN-028 Rev.5 Worker I D $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If hecke? you are required to provide a opy of this form to your mployee. If yo r employee works in a state that is die rent from the state that issued this or?er, a copy must be provi?ed to your emp?oyee 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. 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 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. 3201100224 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: BACHIK, CRAIG W. EMPLOYEE'S CASE IDENTIFIER: 9540101841 LAST KNOWN HOME ADDRESS: DATE OF SEPARATION: 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 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 (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: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, 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 Form EN-028 Rev.5 Service Type M OMB No.; 0970-0154 Worker I D $ IATT ADDENDUM Summarv of Cases on Attachment Defendant/Obligor: BACHIK, CRAIG W. PACKS Case Number 328109241 PACSES Case Number 906109247 Plaintiff Name Plaintiff Name KATHLEEN L. BACHIK KATHLEEN L. BACHIK Docket Attachment Amount Docket Attachment Amount 07-3607 CIVIL$ 365.00 00462 S 2007 $ 679.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB LAURA ELIZABETH BACHIK 01/01/93 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M Addendum OMB No.: 0970-0154 PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Form EN-028 Rev.5 Worker ID $IATT FLU OF THE. R""' 2009 SEP -2 Pll 2. 19 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 07-3607 CIVIL State Commonwealth Pennsylvania OOriginalOrder/Notice Co./City/Dist. of CUMBERLAND 906109247 OAmended Order/Notice 462 S 2007 Date of Order/Notice 03/19/10 OTerminateOrder/Notice Case Number (See Addendum for case summary) OOne-Time Lump Sum/Notice RE:BACHIK, CRAIG W. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 187-54-0702 Employee/Obligor's Social Security Number UNITED PARCEL SERVICE, NC.* 9540101841 636 E SANDY LAKE RD Employee/Obligor's Case Identifier COPPELL TX 75019-3019 (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 Or er/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 employ e's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 601.00 per month in curr nt child support $ o . oo per month in past due child support Arrears 12 weeks or greater? ® yes Ono $ 0.00 per month in current medical support $ 0.00 per month in past due medical support ?_ 1 $ o. oo per month in current spousal support r? $ 443.00 per month in past due spousal support :M- $ 0.00 per month for genetic test costs $ o. oo per month in other (specify) w $ one-time lump su payment -' for a total of $ 1, 044.00 per m nth to be forwarded to payee below. `' ca _. v You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle d?s n(UtynatN the ordered support payment cycle, use the following to determine how much to withhold: $ 240.92; per weekly pay period. $ 522.00 per semimonthly pay period (twice a month) $ 481.85 per biweekly pay p riod (every two weeks) $ 1, 044.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Ord r/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 dis osable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (Se #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b) requires remittance by an electronic payment method if an employer is ordered to withhold income from mor than one employee and employs 15 or more persons, or if an employer has a history of two or more returned the ks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Em loyer 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 SC U, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INC UDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SEC 1TY N?(MBE 1N OR ER O BE PROCESSED. DO NOT SEND CASH BY MAIL. Ilk "'? BY THE COURT: j? DRO: R.J. Shadday Service Type M OMB No.: 0970-0154 M. L. Ebert, Jr., t'Idge Form EN-028 Rev.5 Worker ID $IATT ADDITIONAL INI If hecky you are required to p dikerent from the state that issue 1. Priority: Withholding under this Order/N Federal tax levies in effect before receipt of ti agency listed below. 2. Combining Payments: You can combine each agency requesting withholding. You m employee/obligor. RMATION TO EMPLOYERS AND OTHER WITHHOLDERS vide a?opy of this form to your egm loyee. If your employee works in a state that is his order, a copy must be providedpto your employee even if ?te box is not checked. ce has priority over any other legal process under State law against the same income. order have priority. If there are Federal tax levies in effect please contact the requesting iheld amounts from more than one employee/obligor's income in a single payment to however, separately identify the portion of the single payment that is attributable to each 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 employee/obligor and you are unable to h nor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's pri cipal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must prom tly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and etum a copy of this Order/Notice to the Agency identified below. 3624073810 THE PERSON HAS NEVER WORKED FORT IS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:BAOHIK, CRAIG W. EMPLOYEE'S CASE IDENTIFIER: LAST KNOWN HOME ADDRESS:. LAST KNOWN PHONE NUMBER: NEW EMPLOYER'S NAME/ADDRE 6. Lump Sum Payments: You may be requi severance pay. If you have any questions at 0101841 DATE OF SEPARATION: FINAL PAYMENT AMOUNT: to report and withhold from lump sum payments such as bonuses, commissions, or lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as t e Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income nd other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in wh ch case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fir a determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary actin against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in anotl1i er State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhol Protection Act (CCPA) (15 U.S.C. 1673 (b)); or employment. Disposable income is the net inc Security taxes, statutory pension contributions supporting another family and 60% of the disp( increased to 55% and that 60% limit is increasE deduct a fee for administrative costs. The suppc Arrears greater than 12 weeks : If the Order li employer should calculate the CCPA limit usinf allowed under the law of the issuing Tribe. For the limit set by the law of the jurisdiction in whi CCPA (15 U.S.C. 1673 (b)). Depending upon a care premiums in determining disposable incon 10. Additional info: *NOTE: If you or your agent are served with a i that issued this order with respect to these items 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit the amounts allowed by the State or Tribe of the employee's/obligor's principal place of )me left after making mandatory deductions such as: State, Federal, local taxes, Social id Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is sable income if the obligor is not supporting another family.However, that 50% limit is I to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may t amount and the fee may not exceed the limit indicated in this section. formation does not indicate whether the arrears are greater than 12 weeks, then the the lower percentage. For Tribal orders, you may not withhold more than the amounts ribal employers who receive a State order, you may not withhold more than the lesser of :h the employer is located or the maximum amount permitted under section 303(d) of the ,plicable State law, you may need to take into consideration the amounts paid for health e and applying appropriate withholding limits. of this order in the state that issued the order, you are to follow the law of the state If you or your employee/obligor have any questions contact WAGE ATTACHMENT UNIT 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.5 Service Type M OMB No.: 0970-0154 Worker I D $ IATT PACSES Case Number 328109241 Plaintiff Name KATHLEEN L. BACHIK Docket Attachment Amount 07-3607 CIVIL$ 365.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): ADDENDUM Summary of Cases on Attachment fir: BACHIK, CRAIG W. PACSES Case Number 906109247 Plaintiff Name KATHLEEN L. BACHIK Docket Attachment Amount 00462 S 2007 $ 679.00 DOB Child(ren)'s Name(s): DOB LAURA ELIZABETH BACHIK 01/01/93 DOB DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev-5 Service Type M OMB No.:0970.0154 Worker ID $IATT ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Sommonwealth of PennSyJvania Co.1City/Dirt. of CUMBERLAND Date of Order/Notice 09/30/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number KAIROS DESIGN GROUP, INC STE 201 4 LEMOYNE DR LEMOYNE PA 17043-1238 906109247 462 S 2007 07-3607 CIVIL OOriginal Order/Notice OAmended Order/Notice XOTerminate Order/Notice QOne-Time Lump Sum/Notice RE:BACHIK, CRAIG W. Employee/Obligor's Name (Last, First, MI) 187-54-0702 Employee/Obligor's Social Security Number 9540101841 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, Mq 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. $ o. oo per month in current child support $ o . oo per month in past-due child support Arrears 12 weeks or greateri ~ yes ®no $ o . oo per month in current medical support $ o.oo per month in past-due medical support ~:e~ ~ ~~' $ o . oo per month in current spousal support fi= -°- -~ ° .~ $ o . oo per month in past-due spousal support r~iQ' c~ ~! $ o . o o per month for genetic test costs ~ ~ ..~.~ -~ t-"' $ o. oo per month in other (specify) ~r I :x]~ ~~ $ one-time lump sum payment ~ r -~o ~~ ~~ -~ ~~ for a total of $ o . o o per month to be forwarded to payee below. ~ ~ ~ ~ c7 ~, c ~ ~ You do not have to vary your pay cycle to be in compliance with the support order. If your pay cyclepes-fi+ot rt~tch the ordered support payment cycle, use the following to determine how much to withhold: '-~~ "-~"' --~ $ o . oo Per weekly pay period. $ o . oo per semimonthly pay period (twice a month) $ o . oo per biweekly pay period (every two weeks) $ o • 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°!0 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. § 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 1-877-67b-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box b9112, Harrisburg, Pa 1710b-9112 /N ADD/T/ON, 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 i1N ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: M. L . Ebert , J~7udg~ DRO: F2.J. SHadday Form EN-028 Rev.S Service Type M OMB No.:0970.0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ~ If~hecke~l you are required to provide a~opy of this form to your~mployee. If your employee works in a state that is di Brent from the state that issued this or er, a copy must be provi edd 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 employeelobligor'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 respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Mukiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligoranct 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 OrderlNotice to the Agency identified below. 3201100224 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ~ THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ~ EMPLOYEE'S/OBLIGOR'S NAME: BACHIK, CRAIG W . EMPLOYEE'S CASE IDENTIFIER: 9540101841 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 employeelobligor'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%bligorfrorn employment, refusing to employ, or taking disciplinary action against any employeelobligor 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: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (7171 240-6225 or by FAX at (717) 240-6248 or by Internet www.childsu ort.state. a.us Page 2 of 2 Service Type M OMB No.:0970.0154 Form EN-028 Rev.5 Worker I D $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: BACHIK, CRAIG W. PACSES Case Number 328109241 Plaintiff Name KATHLEEN L. BACHIK Docket Attachment Amount 07-3607 CIVIL$ 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 Addendum Service Type M OMB No.: 0970-0154 PACSES Case Number 906109247 Plaintiff Name KATHLEEN L. BACHIK Docket Attachment Amount 00462 s 2007 $ o.oo Child(ren)'s Name(s): DOB LAURA ELIZABETH BACHIK 01/01/93 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 EN-028 Rev.S Worker I D $ IATT ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 07-3607 CIVIL OOriginal Order/Notice State Commonwealth of Pennsylvania 906109247 Co./City/DiSt. Of Ctn~ERLAND 462 S 2007 QAmended Order/Notice Date Of Order/NotlCe 10/12/10 OX Terminate Order/Notice Case Number (See Addendum for case summary) QOne-Time Lump Sum/Notice RE: BACAIK, CRAIG W. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 187-54-0702 Employee/Obligor's Social Security Number UNITED PARCEL SERVICE, INC.* 9540101841 636 E SANDY LAKE RD Employee/Obligor's Caseldentifier COPPELL TX 7 5 019 - 3 019 (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. ~ ~ $ o . oo per month in current child support -~3 ~, -..i $ o. oo per month in past-due child support Arrears 12 weeks or greaten ye~ $ o.oo per month in current medical support ~~ --t -~~ $ o.oo per month in past-due medical support ..,,~~ ~,. act $ o.oo per month in current spousal support ~',~ ~~ $ o.oo per month in past-due spousal support ~~ ~"' ~~ $ o. oo per month for genetic test costs ~~ '~ ~~ $ o . o o per month i n other (specify) ''" $ one-time lump sum payment ~g ~~ -•:, sV C for a total of $ o . 0 0 per month to be forwarded to payee below. You do not have to vary your pay cycle to be incompliance 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: $ o . oo per weekly pay period. $ o . oo per semimonthly pay period (twice a month) $ o . oo per biweekly pay period (every two weeks) $ o . 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. § 4374(b)) requires remittance by an electronic ~avment 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 1N ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. A_ ~ ~~ BY THE COURT: i DRO: R.J. Shadday Service Type M M. L. Ebert, Jr., OMB No.: 0970-0154 Form EN-028 Rev.5 Worker I D $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ~ If#hecke~l you are required to provide a~opy of this form to your mployee. If yorr employee v~orks in a state that is di Brent rrom the state that issued this or er, a copy must be provi~ed to your emp oyee 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%bl Igor. 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 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. 3624 03810 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : D THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: O EMPLOYEE'S/OBLIGOR'S NAME:BACHIK, CRAIG W. EMPLOYEE'S CASE IDENTIFIER: 9540101841 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 employeelobligorfvom 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 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: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 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 No.:0970-0754 Worker ID $IATT - ~ ADDENDUM Summary of Cases on Attachment Defendant/Obligor: BACHIK, CRAIG w. PACSES Case Number 328109241 Plaintiff Name KATHLEEN L. BACHIK Docket Attachment Amount 07-3607 CIVIL$ 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 Service Type M Addendum OMB No.: 0970-0754 PACSES Case Number 906109247 Plaintiff Name KATHLEEN L. BACHIK Docket Attachment Amount 00462 S 2007 $ 0.00 Child(ren)'s Name(s): DOB LAURA ELIZABETH BACHIK 01,/01/93, PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Children>'s Name(s): DOB Form E N-028 Rev.S Worker I D $ IATT In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KATHLEEN L. BACHIK Plaintiff vs. CRAIG W. BACHIK Defendant Docket Number: 07-3607 CIVIL } } PACSES Case Number: 328109241 } Other State ID Number R f lx7 M C„_ :Z, _.e., Z «€ r1 Order- AND NOW to wit, this JANUARY 23, 2012 it is hereby Ordered that:?c -~ ^-y > The Cumberland County Domestic Relations Section dismiss their interest, without prejudice, in the above captioned alimony matter. The account is closed with a balance of $43,585.93 owed to the Petitioner. BY THE COURT: )? -t ?14 ? M.L. Evert, Jr. JUDGE Form OE-520 02/11 Service Type M Worker ID 21205