Loading...
HomeMy WebLinkAbout07-4922V Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, IN THE COURT OF COMMON PLEAS Plaintiff v. ALBERT J. FANELLI, JR., Defendant CUMBERLAND COUNTY, PENNSYLVANIA NO. 07- yQaa ~~~~ i Term CNIL ACTION -LAW IN DNORCE 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 maybe entered against you by the Court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody and visitation of your children. When the grounds for a divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Domestic Relations Office at the County Courthouse. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DNISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DNORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVENUE Carlisle, Pennsylvania 17013 (717) 249-3166 Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 717)774-1445 JEAN B. FANELLI, IN THE COURT OF COMMON PLEAS Plaintiff :CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 0 7- ~/ 9 ~ a CcvL! T~- ALBERT J. FANELLI, JR., :CIVIL ACTION -LAW Defendant IN DIVORCE COMPLAINT IN DIVORCE 1. Plaintiff is Jean B. Fanelli, an adult individual residing at 5004 Balmoral Court, Mechanicsburg, Cumberland County, Pennsylvania 17050. 2. Defendant is Albert J. Fanelli, Jr., an adult individual residing at 271 East Crestwood Drive, Wormleysburg, Cumberland County, Pennsylvania 17011. 3. Plaintiff has been a bona fide resident in the Commonwealth of Pennsylvania for at least six (6) months prior to filing this complaint. 4. The Plaintiff and Defendant were married on July 11, 1992 in Basking Ridge, New Jersey. 5. There are two (2) minor children born of this marriage: Albert J. Fanelli, III, born December 21, 1995 and Margaret J. Fanelli, born October 2, 1997. 6. The parties separated on July 28, 2007. 7. There have been no prior actions for divorce or annulment between the parties. Neither Plaintiff nor Defendant is in the military or naval service of the United States or its allies within the provisions of the Soldiers' and Sailors' Civil Relief Act of the Congress of 1940 and its amendments. 9. Plaintiffhas been advised that counseling is available and that Plaintiffhas the right to request that the court require the parties to participate in counseling. COUNT I -DIVORCE NO FAULT 10. The averments in paragraphs 1 through 9, inclusive, of Plaintiffs Complaint are incorporated herein by reference thereto. 11. The marriage is irretrievably broken and no possibility of reconciliation exists. WHEREFORE, Plaintiffrequestsentry of adivorce decree in her favor in accordance with 3 3301 of the Pennsylvania Divorce Code. 2 WHEREFORE, Plaintiff, Jean B. Fanelli, prays this Honorable Court to enter judgment: A. Awarding Plaintiff a decree in divorce; and B. Awarding other relief as the Court deems just and reasonable. Dated: Augustf 1~J, 2007 Barbara S Sullivan, Esquire Attorney for Plaintiff 549 Bridge Street New Cumberland, PA 17070-1931 (717) 774-1445 Supreme Court I.D. No. 32317 3 Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 r ct-~1~ ts. r AN 1~;LL1, Plaintiff v. ALBERT J. FANELLI, JR., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. CIVIL ACTION -LAW IN DIVORCE AFFIDAVIT REGARDING COUNSELING 1. I have been advised of the availability of marriage counseling and understand that I may request that the Court require that my spouse and I participate in counseling. 2. I understand that the Court maintains a list of marriage counselors in the Domestic Relations Office, which list is available to me upon request. 3. Being so advised, I do not require that the Court require that my spouse and I participate in counseling prior to a divorce decree being handed down by the Court. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A Section 4904 relating to unsworn falsificatio 1 Dated: ~ ~ , 2007 Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, IN THE COURT OF COMMON PLFA~ Plaintiff v. ALBERT J. FANELLI, JR., Defendant CUMBERLAND COUNTY, PENNSYLVANIA NO. CIVIL ACTION -LAW IN DIVORCE VERIFICATION I, JEAN B. FANELLI, hereby certify that the facts set forth in the foregoing COMPLAINT IN DIVORCE are true and correct to the best of my knowledge, information and belief. I understand that any false statements made herein are subject to penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. Dated: ~ , 2007 C-) ~ ~ W `~ ~ O O ~ f:l O ~ ..0 :i ~ ~-a c~ tw. ~ Barbara Sample-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, IN THE COURT OF COMMON PLEAS Plaintiff v. ALBERT J. FANELLI, JR., Defendant CUMBERLAND COUNTY, PENNSYLVANIA NO. 07 - 4922 CIVIL ACTION -LAW IN DIVORCE ACCEPTANCE OF SERVICE I, John F. King, Esquire, hereby accepts service and acknowledges receipt of the above- captioned Complaint in Divorce on behalf of my client, Albert J. Fanelli, Jr., having received said Complaint on the ~ day of s 2007. I hereby indicate I am authorized by my client to accept service on his behalf. ~--~ Jo F. King, Esquire edman and King, P.C. 600 N. Second Street Penthouse Suite Harrisburg, PA 17101 Telephone No. (717) 236-$000 Supreme Court LD. No. 61919 .r.~,, t'? ~ D ,~ 0 "' ~ -cz t ~° cn y f ` ' ,~ '~ f A. } ~ _. ~ ....~ ::~ ~ ~1 ~ ^-., t : ~ .. J%" i_ (~ ~ "~ ~ FRIEDMAN and KING, P.C. John F. King, Esq. ID #61919 3820 Market Street Camp Hill, PA 17101 (717)236-8000 (717)236-8080 (Fax) friedmanandking~a,hotmail.com Attorney for Defendant r~ G~ K a ~•~ ~. rr, . _ C7 ~' - yy Y~ . ; __ ~ - o ~~ ~ ! /..-~~j ~r a ;; rv L ,/. c~'z' _~ '~ ~ . ~`..i -'~. JEAN B. FANELLI, v. IN THE COURT OF COMMON PLEAS Plaintiff, CUMBERLAND COUNTY, PENNSYLVANIA . NO. 07-4922 CIVIL TERM ALBERT J. FANELLI, JR., Defendant. CIVIL ACTION -LAW 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 Defendant. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary, at the Cumberland County Courthouse, Courthouse Square, Carlisle, PA. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, MARITAL PROPERTY, COUNSEL FEES OR EXPENSES BEFORE THE FINAL DECREE OF DIVORCE OR ANNULMENT IS ENTERED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 32 S. Bedford Street Carlisle, PA 17013 1-800-990-9108 717-249-3166 Dated: October ~, 2007 Respectfully submitted, FRIEDMAN and KING, P.C. By; ~ I John F. King, Esqui e ID#61919 3820 Market Street Camp Hill, PA 17011 (717) 236-8000 Attorney for Defendant TO: Barbara Sumple-Sullivan, Esq. 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 Attorney for Plaintiff FRIEDMAN and KING, P.C. John F. King, Esq. ID #61919 3820 Market Street Camp Hill, PA 17101 (717)236-8000 (717)236-8080 (Fax) friedmanandking,(cr~,hotmail.com JEAN B. FANELLI, Plaintiff, v. ALBERT J. FANELLI, JR., Defendant. Attorney for Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA N0.07-4922 CIVIL TERM CIVIL ACTION -LAW IN DIVORCE ANSWER WITH COUNTERCLAIM AND NOW comes the Defendant, by and through his attorneys, Friedman & King, P.C., and answers the Complaint and brings this Counterclaim, averring as follows: ANSWER 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted. 6. Admitted. 7. Admitted. 8. Admitted. C 9. Admitted. COUNT I -DIVORCE NO FAULT 10. Paragraphs 1 through 9 of the Answer are incorporated herein by reference. 11. Admitted. WHEREFORE, Defendant requests Your Honorable Court to enter a Decree of Divorce in the above matter pursuant to 23 P.S. Section 3301. COUNTERCLAIM COUNT II EQUITABLE DISTRIBUTION 12. Paragraphs 1 through 11 of the Answer are incorporated herein by reference. 14. The Plaintiff and Defendant have legally and beneficially acquired property, both real and personal, during their marriage. 15. The Plaintiff and Defendant have been unable to agree as to equitable distribution of the said property to the date of the filing of the Complaint. WHEREFORE, the Defendant, Albert J. Fanelli, Jr., requests this Court to equitably divide all marital property. Dated: October , 2007 Respectfully submitted, FRIEDMAN and KING, P.C. BY~ '~ ~_~~ ~ . John F. King, Esqui ID#61919 3820 Market Street Camp Hill, PA 17011 (717)236-8000 Attorney for Defendant VERIFICATION I, Albert J. Fanelli, Jr., hereby acknowledge that I am the Defendant in the foregoing action; that I have read the foregoing Answer with Counterclaim; and the facts stated therein are true and correct to the best of my knowledge, information and belief. I understand that any false statements herein are made subject to penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsificati to authorities. Albert J. Fanell ; r. Dated: October ~ , 2007 CERTIFICATE OF SERVICE I, John F. King, Esquire, hereby certify that on October ~, 2007, I served a copy of the within Answer with Counterclaim, by depositing same in the United States Mail, first class, postage prepaid, addressed as follows: Barbara Sumple-Sullivan, Esq. 549 Bridge Street New Cumberland, PA 17070 !~-'rn.. Jo F. King 'S~~ . . ~y ,, , ~ . . e ~- - J ~( -~ ' ., ; -` ~ rrt ~ _, sv '-~C ~; FRIEDMAN and KING, P.C. John F. King, Esq. ID #61919 3820 Market Street Camp Hill, PA 17101 (717)236-8000 (717)236-8080 (Fax) friedmanandking~n.hotmail.com JEAN B. FANELLI, Plaintiff, v. ALBERT J. FANELLI, JR., Defendant. Attorney for Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA N0.07-4922 CIVIL TERM CIVIL ACTION -LAW IN DIVORCE INVENTORY OF DEFENDANT, ALBERT J. FANELLI, JR. Defendant files the following inventory of all property owned or possessed by either party at the time this action was commenced and all property transferred within the preceding three years. Defendant verifies that the statements made in this inventory are true and correct. Defendant understands that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. ~~~ ~~~~. Albert J. F li, Jr. Defendant ASSETS OF THE PARTIES Defendant marks on the list below those items applicable to the case at bar and itemizes the assets on the following pages. (x) 1. Real Property (x) 2. Motor vehicles (x) 3. Stocks, bonds, securities and options () 4. Certificates of deposit (x) 5. Checking accounts, cash (x) 6. Savings accounts, money market and savings certificates () 7. Contents of safe deposit boxes () 8. Trusts () 9. Life insurance policies (indicate face value, cash surrender value and current beneficiaries) () 10. Annuities () 11. Gifts () 12. Inheritances () 13. Patents, copyrights, inventions, royalties () 14. Personal property outside the home () 15. Business (list all owners, including percentage of ownership, and officer/director positions held by a party with company) () 16. Employment termination benefits-severance pay, worker's compensation claim/award () 17. Profit sharing plans () 18. Pension plans (indicate employee contribution and date) (x) 19. Retirement plans, Individual Retirement Accounts () 20. Disability payments () 21. Litigation claims (matured and unmatured) () 22. Military/V.A. benefits () 23. Education benefits (x) 24. Debts due, including loans, mortgages held (x) 25. Household furnishings and personalty (include as a total category and attach itemized list if distribution of assets is in dispute) (x) 26. Other -Federal Thrift Savings Plan MARITAL PROPERTY Defendant lists all marital property in which either or both spouses have a legal or equitable interest individually or with any other person as of the date this action was commenced: Item Description Names of Number of Property All Owners 1. 5004 Balmoral Court J Mechanicsburg, PA 17050 (marital residence) 2. Federal Thrift Savings Plan (portion) H 3. Federal retirement (portion) H 4. Roth IRA H 5. Roth IRA W 6. Traditional IRA W 7. One Fidelity Mutual Fund Account J 8. T-Rowe Price Mutual Fund Account J 9. Commerce Bank checking account J 10. Commerce Bank savings account J 11. 2005 Nissan Sentra J 12. 2005 Ford Freestar J NON-MARITAL PROPERTY Defendant lists all property in which a spouse has a legal or equitable interest which is claimed to be excluded from marital property: Item Description Number of Property Federal Thrift Savings Plan (portion) Reason for Exclusion Portion acquired premarriage 2. Federal Retirement Account (portion) Portion acquired premarriage PROPERTY TRANSFERRED Item Description Date of Number of Property Transfer Consideration Person to Whom Transferred None LIABILITIES Item Description Number of Property Names of All Creditors Marital residence (mortgage) Dated: October D , 2007 National City Mortgage Respectfully submitted, FRIEDMAN and KING, P.C. By: ohn F. King, Esquir ID#61919 3820 Market Street Camp Hill, PA 17011 (717) 236-8000 Attorney for Defendant TO: Barbara Sumple-Sullivan, Esq. 549 Bridge Street New Cumberland, PA 17070 Names of All Debtors (717) 774-1445 Attorney for Plaintiff CERTIFICATE OF SERVICE I, John F. King, Esquire, hereby certify that on October ~, 2007, I served a copy of the inventory, by depositing same in the United States Mail, first class, postage prepaid, addressed as follows: Barbara Sumple-Sullivan, Esq. 549 Bridge Street New Cumberland, PA 17070 Jo F. King ~ C~ ~ +~ c . ~-~: -~ .,-,:c: ~ ~_ _ M.d z T '} ~: t CJ ; _" ~ ~j ":?tJ ` ~ ..Q ~ - _; .~1 ~ 1 r~:~..~ (~ ~i '..:s N JEAN B. FANELLI, v. IN THE COURT OF COMMON PLEAS Plaintiff, CUMBERLAND COUNTY, PENNSYLVANIA N0.07-4922 CIVIL TERM ALBERT J. FANELLI, JR., Defendant. CIVIL ACTION -LAW IN DIVORCE MOTION FOR APPOINTMENT OF MASTER Albert J. Fanelli, ~Tr. ~irrtit~(Defendant), moves the court to appoint a master with respect to the following claims: (x) Divorce (x) Distribution of Property () Annulment () Support () Alimony () Counsel Fees () Alimony Pendente Lite () Costs and Expenses and in support of the motion states: (1) Discovery is complete as to the claims(s) for which the appointment of a master is requested. (2) The defendant (has) (lms-not) appeared in the action fpersoimliy) (by his attorney, John F. King. Esa.) (3) The Statutory ground(s) for divorce (is)(are) 3301(4) (4) Delete the inapplicable paragraph(s): a. b. c. The action is contested with respect to the following claims: etc uitable distribution of property (5) The action (inro'odves)(does not involve) complex issues of law or fact. (6) The hearing is expected to take _1_ (Itoars)(days). (7) Additional information, if any, relevant to the motion: Defendant Husband, yet been provided D~'endant Husband through counsel has requested a convof the June 2009 mortggge statement or a computer printout showing Date: August ~,3 , 2009 Esq. 1 x+19 for Defendant ORDER APPOINTING MASTER AND NOW, , 2009, ,Esq. is appointed master with respect to the following claims: By the Court: .• CERTIFICATE d~' SERVICE I, John F. King, Esquire, hereby certify that on August 13, 2009, I served a copy of the within Motion for Master, by depositing same in the United States Mail, first class, postage prepaid, addressed as follows: Bazbara Sample-Sullivan, Esq. 549 Bridge Street New Cumberland, PA 17070 ~~~, ~ ~~ ` AUG 14 20~9~, JEAN B. FANELLI, v. Plaintiff, . IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO.O?-4922 CIVIL TERM ALBERT J. FANELLI, JR., Defendant. CIVIL ACTION -LAW 1N DIVORCE MOTION FOR ATPPOINTMENT OF MASTER Albert J. Fanelli. Jr. ~n~(Defendant), moves the court to appoint a master with respect to the following claims: (x) Divorce (x) Distribution of Property O Annulment O Support O Alimony O Counsel Fees O Alimony Pendente Lite O Costs and Expenses and in support of the motion states: (1) Discovery is complete as to the claims(s) for which the appointment of a master is requested. (2) The defendant (has) (Itt~s-rtot) appeared in the action fpersernr~lq) (by his attorney, John F. King, Esa.) (3) The Statutory ground(s) for divorce (is)(are) 33011d1 (4) Delete the inapplicable paragraph(s): a. b. . c. The action is contested with respect to the following claims: eq_uitahle distribution of property (5) The action (im~eivts)(does not involve) complex issues of law or fact. (6) The hearing is expected to take _I_ (l~trs)(days). (7) Additional information, if any, relevant to the motion: Defendant Husband. through counsel, has requested an inventory of the parties' china.. crystal and silverware, all of which are in the possession of Plaintiff Wife. which has not yet been provided. Defendant Husband, thraq counsel; has reauested a Date: August f3 , O ER APPOINTING MASTER AND NOW, ~~ tZ , 2009, <~ ,Esq. is appointed master with respect to the follow g claims: By 1 ~~~~ ~~ ~: ~~ ~~ ~~ tit ~~ ~~~ ~~ ~~ ., C'~pti ~ ~'''' R''~" ~ ~ ~` N ` ~~ Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, IN THE COURT OF COMMON PLEAS Plaintiff :CUMBERLAND COUNTY, PENNSYLVANIA v. ALBERT J. FANELLI, JR., Defendant NO. 07 - 4922 CIVIL ACTION -LAW IN DIVORCE PETITION RAISING MARITAL CLAIMS UNDER THE DIVORCE CODE OF 1980 AND NOW, this 9~' day of September, 2009, comes Plaintiff, Jean B. Fanelli (hereib~after referred to as "PETITIONER"), by and through her attorney, Barbara Sumple-Sullivan, Esqui~~ and files this Petition Raising Marital Claims Under the Divorce Code of 1980 and in support tlh~reof states as follows: 1. 2. 3. 4. 5. 6. A Complaint in Divorce was filed on August 20, 2007. Petitioner is the Plaintiff in the above action. Respondent is the Defendant in the above action. Petitioner lacks sufficient assets to provide for her reasonable needs and is unak~le to support herself fully through appropriate employment. Respondent has sufficient assets to provide continuing support, alimonypendente like and alimony for Petitioner. Petitioner requests the Court to enter an order granting support, alimony pendente lil$ and alimony to your Petitioner as the Court deems reasonable pursuant to Sections 3701 and 3702 of the Divorce Code of 1980, together with any amendments thereto. 7. Petitioner is unable to sustain herself during the course of this litigation and has employed Barbara Sumple-Sullivan, Esquire as counsel, but is unable to pad the necessary and reasonable attorney's fees for said counsel, and the necessary' and reasonable costs and expenses. 8. Petitioner requests the Court to enter an award of counsel's fees and expenses. WHEREFORE, Petitioner requests this Honorable Court enter an order: 1. For an award of alimony pendente lite and/or spousal support, until ''final hearing, and thereupon enter an award of alimony; and 2. For an award of counsel's fees and costs. Respectfully submitted, DATE: September 9, 2009 Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070-1931 (717) 774-1445 Supreme Court I.D. 32317 Attorney for Plaintiff 2 Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, IN THE COURT OF COMMON PLEAS Plaintiff :CUMBERLAND COUNTY, PENNSYLVAP~IIA v. ALBERT J. FANELLI, JR., Defendant NO. 07 - 4922 CIVIL ACTION -LAW IN DIVORCE VERIFICATION I, Jean B. Fanelli, hereby certify that the facts set forth in the foregoing PETIiIj"ION RAISING MARITAL CLA:[MS are true and correct to the best of my knowledge, informatip~ and belief. I understand that any false statements made herein are subject to penalties of 18 Pa. CI'.S.A. §4904 relating to unsworn falsification to authorities. DATED: ~ ~~ /o~Oy 4 Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, IN THE COURT OF COMMON PLEAS Plaintiff :CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 07 - 4922 ALBERT J. FANELLI, JR., :CIVIL ACTION -LAW Defendant IN DIVORCE CERTIFICATE OF SERVICE I, Barbara Sumple-Sullivan, Esquire, do hereby certify that on this date, I served a true and correct copy of the foregoing PETITION RAISING MARITAL CLAIMS in the above-captioned matter upon the following individual(s) by first class mail, postage prepaid, addressed as follows: John F. King, Esquire John F. King Law, P.C. 19 South Hanover Street, Suite 103 Carlisle, PA 17013 DATED: September 9, 2009 Barbara Sumple-Sullivan, Esquire Attorney for Plaintiff 549 Bridge Street New Cumberland, PA 17070-1931 (717) 774-1445 Supreme Court I.D. No. 32317 F1LEL~-~;:~~~=GE ~,~, ; .fnn ~~T~Y 2Q~~ SEA 1 ! PPS 1 ~ S r^~ ~ ; ,~1~ i~j ~s'a.vo t~~~ e~ aqY/ 12~-- ~ 3 oy~ JEAN B. FANELLI, Plaintiff v. ALBERT J. FANELLI, JR. Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 07-4922 CIVIL IN DIVORCE DEFENDANT'S PRE-TRIAL STATEMENT Date of marriage: July 11, 1992 Date of separation: 3uly 28, 2007 Two children: Albert J. Fanelli, III, DOB: December 21, 1995; and Margaret J. Fanelli, DOB: October 2, 1997 I. Assets Marital Assets Item Value Notes ASSETS: 1. Marital residence $260,000.00 tentative, pending ($167,500.00 equity) appraisal 2. Commerce checking acct $ 10,332.89 (includes post separation deposit by Husband) 3. Fidelity Joint acct $ 8,937.04 parties in agreement 4. TRO Price Midcap acct $ 7,859.73 parties in agreement 5. TRO Price Smallcap acct $ 7,272.46 parties in agreement 6. Husband's Federal Retirement $100,846.00 Retirement age 62 7. Husband's Roth IRA $ 17,476.35 current balance minus $800 post separation contribution 8. Husband's Thrift Savings Plan $169,548.23 current balance minus date of marriage balance and post separation contributions 9. Wife's Roth IRA $ 14,798.34 parties in agreement 10. Wife's Traditional IRA $ 19,273.04 11.2005 Ford Freestar $ 12,175.00 12.2005 Nissan Sentra $ 10,240.00 13. Household personalty $ 10,184.00 H - $ 2,928.00 W - $ 7,256.00 II. Expert Witnesses 1. Alyssa Loney -Ibis Appraisals (personalty) -tentative. 2. Greg Rothman - RSR (marital residence) -tentative. Defendant reserves the right to supplement. III. Witnesses (Other than the Parties) None, at this time. Defendant reserves the right to supplement. IV. Exhibits 1. [Reserved] 2. Commerce checking account 3. Fidelity joint account balance statement 4. Midcap growth statement 5. Smallcap stock statement 6. Husband's Federal Retirement 7. Husband's Roth IRA balance statement 8. Husband's Thrift Savings Plan 9. Wife's Roth IRA balance statement 10. Wife's Traditional IRA balance statement 11. Kelley Blue Book -Ford Freestar 12. Kelley Blue Book -Nissan Sentra 13. Appraisal report summary -personal property (complete report to be provided at hearing) V. Income Husband's gross monthly income is $10,964.83 r VI. Ezpenses (monthly) 1. $1,537.50 for child support 2. $1,537.50 for spousal support 3. $725.00 for rent 4. $369.18 for TSP loan Additional expenses to be provided. VII. Pension/Retirement Benefits 1. Husband has an additional $18,743.83 which was earned pre-marriage, in his Thrift Savings Plan. 2. Husband has contributed $41,911.00 in his Thrift Savings Plan, post-separation. 3. The current total value of Husband's FERS pension contains anon-marital amount equalling $50,121.00. VIII. Tangible Property A. Crystal B. China C. Silverware D. Furniture E. Miscellaneous personalty F. Vehicles An appraisal of personalty has been performed and has been included in the asset chart and exhibit list. IX. Marital Debts Item Value Notes DEBTS: lA. Thrift Savings Plan loan (Funds purchased Wife's vehicle) $ 12,926.00 Husband has had sole responsibility since the date of separation 2A. Mortgage $ 92,500.00 as of 9/1/09 X. Proposed Resolution 1. 50% of qualified and non-qualified assets to Wife and 50% of qualified and non- qualified assets to Husband. 2. Husband to pay alimony of $1,500.00 per month for a period of three years post- divorce. 3. Each party to pay their own counsel fees and costs. Dated: September ~~ , 2009 Respectfully submitted, JOHN F. KING LAW, P. fC.~' By: ~~~ F. King, Esq. ID# 61919 19 S. Hanover Street Suite 103 Carlisle, PA 17013 (717) 258-4343 Attorney for Defendant EXHIBIT 1 EXHIBIT 2 ~.:a?llllll'rt,'+' t /1111110 w 0910 712 0 0 7 Withdrawal CHECK# 1892 '__-~ ,•raf -~ $1,000.00 55.pyg g0 ~ 09/07/2007 Wrthdrawal CHECK # 1891 ~ ~. ;~,,~ , $100.60 56.098 80 s/09/05!20G7 Withdrawal AC-VERIZON -PaymentREC - «'~ ~ " ••'`" '~' 1~/`' S1 98 56.198 80 09/041206/ VJdhdrawa! ~ POS DEBIT 09x02 SOU GIANT FOOD #2693629 CAMP HILL PA 5159 SOJJ• S6 276 r8 ~ 9.~Oa(2007 Withdrawal AC-NCMC -NCMC PYMT 51",444.41 56 436 2B 08130,'2007 W~thdrawa! XFER TO ACCT CK-000537479990 -- 51.000,00 57 880 69 08130'2007 Withdrawal AC-FID BKG SVC LLC -MONEYLINE 5100 00 58.880 69 08(30!200? Withdrawal AC-FID BKG SVC LLC -MONEYLiNE 5100 00 S8 980 Fy ~08i29%2007 Withdrawal CHECK # ? 901 l' 1~L _ 520 GO 59 086 69 08125/2007 Wrthdrawal } CHECK# 1884 ' +,~ I I1 trt%(r1:,tt~( ,~ $135 00 , S9.100 69 08/29/2007 Withdrawal CHECK # 1887 ~+ t ; >L:z~~ 5725.0 59 235 69 08127,'2007 Withdrawn! POS DE$fT 08/25 SOU GIANT FOOD STOR4609 ENOLA PA ., $166 Oly .. 59.960 69 /O8.!21'2007 Wrthdrawal AC-PAYPAL -INST XFER f~ ~+(r`~•Lt's~C~ 590.00 ; 510 126 10 •x`08127,'2007 Withdrawal AC-TRAVELERS INSUR -INSURANCE J 516 41 't ~ 510.216 70 0812_"2QC- Deposit DEPOSIT 52.7? 7 39 510 233 1 i 081242067 V~fIIhdrawal CHECK # 1888 ~ X11, $100.00 . 57:455 22 OS%22.'2007 Deposit INTEREST PAYMENT 51 37 57.555 22 ~-~ 08•'22'206' i'fhthdrawal CHECK # 1885 ~ + ` '~ `'r i `~-~"- 532.25 Sr X53 85 vtJB 2"-2001 'vV,thdrawa! POS DEBIT 08121 THE SHOE DCAPITAL CITY CAMP HILL PA _ S79 98 ~` ` ~~~'_ -~ 57 586 10 ~'~'8!~ <! AC-PAWC -PAYMENT '~' '! ~ildn~~ ~~L1 526.41 , S?.666 08 08~2u:2G07 VVithdrawai POS DEBIT OS!i8 WAL-MART #1886 MECHANICSBUR PA X31 528 22! t~ p; ='~ "-' Fr 51.692 49 ,08111/2607 Wdhdrawa' CKCD DEBIT 03.'15 OFFICE MAX NiECHANICSBURGPA , 5117 41Sc?,^~ I~~i IPS S1 120 71 08/17/2007 Wsthdrawai AC-FIA ONLINE PYMT-ONLINE PMT ~`' ~'= "~ `' ~'~ -~- 5121-75 ` ~"'~' 5r 8.,8 18 .'08116,'200% Wrthdrawal P05 DEBIT 08116 SOU GIANT FOOD STOR3618 ENOLA PA / 51'4 30+/ 57,959 93 OS/15(200% Withdrawal CHECK # i 850 ~ ' ~'<'~ "' ~x ''- ~ •' ' ~ ' S50 0~ ~_ , .t 58,134 23 _ _~__- 08/14/2007 Withdrawal CHECK # 1fi82 -UbVc i!E J'^S ~ $125 00 58.184 23 `~ 08!131200? Withdrawn( AC-TPAVELERS INSUR -INSURAN~ '; 595 41 _ 58.309 23 08110.'200? Withdrawal XFER TO ACCT CK-0005314?9990 - 52 600 00 ';"' ' - ` ~ 58.404.64 08l10I20C? Deposit AC-DFAS-CLEVELAND -FED SALARY S2771 89 510,404 64 ,08!09!200? Withdrawn: POS DEBIT 08109 SOU GIANT FOOD STOR6612 ENOLA PA 5158 43/ $7.626 75 408/0812007 irJithdrawal AC-TALBOTS -ONLINE PMT + `'~~; 5213 00-~ . - ' 57 785 18 ~. 08108'2007 Vllithdrawal + .+, a• )lI~ C 'r'!'.uL AC-PP -ELEC BILL J'p , ; i .. G+ , 5160 04 57 998 18 08/07/2007 Withdrawal CHECK # 1883 Cc~~'L ~~ 52,004.00 58.158 22 +08~07i2007 VVithdrawa! POS DEBIT 08.'07 KARNS QUALITY FOOD PJ;ECHANICSBURG 7 5 5 v ~ - PA ~ 9 510.162 22 t• 08/07!2001 Withdrawn' ~n( AC-COMCAST CENTRAL -CENTRAL PA'•~'''(i r . S86 33 $10,199 81 08/06/2007 Wrthdrawal CHECK # 1881 ;/ ~! ~, ?. ; $200.00 S 1 0 286 14 '.08/06/200/ Iltlithdravrai ~ AC-VERIZON -PaymentREC , 592 16 I- •' ,~ . 510. 486 14 OS103+'2007 Wrthdrawal ~ CHECK # 1879 Fib r ` ~i ~:,! ~ $1 234 55 . `•08!01!2007 Withdrawal ~ AC-NCMC "NCMC PYh1T , . S 1.444 41 S i 0 5?8 30 $1 1 312 35 •- 03%01200/ Withdrawn! P,C-HAhAPDEN TOWNSHIP-UTIL BIL! 5128 53 ~ $13251 26 07!31!200; Withdrawal CHECK # 1873 ~ 1• $75.00 513.385 79 01(3012007 Wrthdrawal AC-FID BKG SVC LLC -t>nONEYLINE 5100 00 513,460 r'9 G7i30`2G07'Jdrthdrawal AC-FID BKG SVC LLC -tv10NEYLINE 5100 00 513.560 79 07;3012007 Withdrawal AC-CHASE -.AUTOPAY ~ -- $65.60 513.660 79 - :07130/2007 Withdrawal AC-VERIZON IVIRELESS-PAYMENTS'% 543.33 513 726 39 07;21!200' Withdrawal _ CHECK # 1880 --- ---- - - 550 00 _ - _ 513 170 22 _ _._.__ _ 0?'27!2007 Withdrawal ~ XFER TO ACCT CK-000537479990-~ 5500 00 513 820 22 07/27/2007 De os~t _ P AG ~ DFAS-CLE JELAND -FED SALARY 52 777 88 514 320 22 - ''-0?126;2007 Vlhthdrawal AC-TRAVELERS INSUR -INSURANCE 516 41 Si i 542 34 '`~ 07!25?2007 Wthdrawal CHECK# 1874 'r ;~; `,' $45.00 511 558 15 ht11~s: Mill}~lil;~.rc~mt?~crrcE,r.cr~n1/accts!arci hia~~r~ f~rint.as~ ~) K'~U(?? ~~c)mm~rcr Onltnr . ;~ f'a+~ ._09'12!2007 Withdrawal CHECK # 1890 ~~ , :t\ 5136.18 -~-09%11x2007 '/Uithdra•vval AC-TRAVELERS INSUR -INSURANCE ! ,~ 1~' $95,41 ~ j ti , `. ~ } :•; `j ~A9'10/2007 i(U;thdrawa! AC-CHASE -CHECK PYMT CK-000000000001889 .~ ~` ~ $2.499 36 ' _..09!01!2007 'v'Vithdrawal CHECK # 1892 _- ~k ~ $1.000.00 _.--0910%'2001 V'Jrthdrawa! CHECK # 1891 _ 1-.1,~ $100.D0 , 09/05/2007 Withdrawal AC-VERIZON -PaymentREC -~ r'?'~'-"i ~ c~77,gg j ~ y ., 2 09r'04~200i Withdrawal POS DEBIT 09102 SOU GIANT FOOD #2693628 CAMP HILL PA $159.50 ~ ~ l.' ~~ , ; _; ! .5~. 09.'04'200% L~J~thdra~aal AC-NCMC -NCMC PYMT $1.444 41 08%30-2007 VVlthdrawal XFER TO ACCT CK-000537479990 ~1 --~~,~ i ~ 51.000.00-. Ala : j ; , ~ , ~ `; x---08+30'2001 Wdhdr2wai AC-FID BKG SVC LLC -MONEYLINE i i~ J 5100.00 ~ - ~~08i30i2001 Withdrawn! AGFID BKG SVC LLC -MONEYLINE -~ ~/W'' $100.00 08!2912001 VVithdcawa! CHECK # 1901 i- ~ ,r 52;3.00 •~, ; :. --08?29/200/ Withdrawal CHECK# 1834 .~ ~C~~~,)lil? $1° ...---08/29x'2007 1fJithdrawal CHECK # 1881 t.~ ~ ~t 1` i~ $725.00 , <: , b 1 ~~ 08'2112007 VV~thdrawal POS DEBIT 08125 SOU GIANT FOOD STOR4609 ENOL A PA $166.01 -~ ' ~ i 08;'27'200- 'v'`r;t'!drawai AC-PAYPAL-INSTXFER~ ~ .,„_ 1 ~ ~; ~ ~•~ 590.00 ~~~"%t~~( t U. , .. tl'. ,,; ~ , 08`2''2'.01 'v•J~hdra•.val AC-TRAVELERS INSUR -INSURANC~ $16 41 ~ _. nn-r - ~ -._._~ 0812~:2VJ: }pJSit DEPOSIT $2,r 17.8 --08;24x'200- Withdrawal' CHECK # 1888 . ~ ~~~'' $100.00 ~~ / C822.'2vL'- rpesd INTEREST PAYMENT -• o L 51 3? ~--08122:'200_ 'J:'tthdrawal CHECK# 1385 ~• {~L 1 ~ ~ $32.25 08x21r20J1 4'4hthdravral POS DEBIT Os%21 THE SHOE DCAP!T>o,L CITY CAMP HILL PA $79.9 ~'~~~ (j Y~~' j--- ----~-- 08`2i;'2001 Wrthdrawal AC-PAWC -PAYh7ENT ~ ~•i ~~'-'i i $26.41 A ~ ~__. -~'OS~'20i2007 4!'lthdrav.all~a :L' POS DEBIT 08118 1J~'AL-MART #';886 MECHANICSBUR PA - ~~.~ $28 22 ' 08111 2001 'Jthdrawal ja~!. 4 ``''~~~ DEBIT 08115 OFFICE MAX MECHANICSBURGPA .`,1?~;-! $117.47~~~ L. 7~ {tL ~ ~~,. 08%17 2001 Withdrawal AC-FIA ONLINE PYPAT -ONLINE PMT ;i ;.,!,_, ~„ ;' ; ~,,;, $121 75 ~ l~'_st~-r_->`la~~ ~-- 08.%i6/2D0i Withdrawal POS DEBIT 08x16 SOU GIANT FOOD STOR3618_ENOLA PA 5174.30-- ~ ! I , ~L - ; ~,;-: OSi 1512001 Withdrawal F 1 ~- ~ ( ~ ~ ~ `" CH~CK# 850- .~y.k- ,_t,'-,~>~+~ $5000 _ .__. J~ 08,'1412001 Withdrawal CHECK # 1882 -- ~~ i t ~,. •+ $125.00 t -~v"\ 1 i't s :) r ~ J \ 1-800-204-0541 t ii H L _~ '~ ~' ~~~ : ~,~, Copyright W 20032007?ennsylvania Commerce Bancorp. Inc. ~\ I ~... {~ L, ` , ' ~ ~t':ij i -~t~.,i I~\lt:~~ r `;it ~ iih~i`> ` ~~ A~ t ~'~' •~ J' 1 J 111 1' ~, ~/ ~ j I.} ,, ~ 1- -~ \..v. I~KY ~ ' t i t ,,1 r ....,.. ~'. ) ~.~ ~ ~{I,:. i 7"\-ail ~: ~ ~: j'\~~t ~ ~>'~...~`~!LLI~ ~ i 1 ); J piths: h~tnl:in~~.rumnlrr-~~4~~.~tu11 acrt~ acct hi~tt}r~ hrint.u~~, t) 17 mot)(!- ~ i-J ~, ~ e ; r, r i ' C'c~nini~~rr~ l )nlin~ - t'h~ck }i]l<'.~'~ I',r~~~ 1 ~~1 1 To pr!nt this page Click Here. Glose VVindow _ _ _ _ This is the front of your check ALBERT J_ FANELLt, JR. ~.,~,,.~____` 1858 JEAN B. FANELLI s 5004 BALMORAL CT. ~'~' 1 h1ECHANICSBURG, PA i7Q5fl z / ~1 UNE " ~y PAY ~ ~i ~ ~Q~/ TO THE d0 ORDER OF `' ~/ ~ ~/ ~ ''~~ J ~ 7~ ~' tel. ~~ ! ' .~ t./~ / • Y a~ ~~ DOLLARS C~ ~. ` COMMERCE HANK Ab7 Efi1CA'S MOST CONY EN1E NT 2ANK ~ -88s-vssoooa E ,~ j ~ FO3t~~L~/~/'T~ D~~OS/T __ _ . _~ ~.0 3 ~ 30 l8 ~, 6~.' S t 30B 76 3 5r+• jg 5g mlCti M !K Y4 ~.~mlLSUat .~ ~~..~~.~...~ This is the back of your check ! MTL Q=, i 4 95~C3~ O R 1 1 8 B5 PO O5/E5/c'GrJ7 1 :03 S PO 13bt~< ~j CC1M1~tERCE EPN}; J~iP.~p <O a z --. rrr~ ~c~-: w~O~~jrT10 FT7 T} ~ ~ =~ -r' o~~~~i: ~ ~.D !~!~ ~ a; ~ ~ 3:I i~r i7 i d _ ~ ?~ _J YT7 --r ,,~~ _ SJ ..L7 ~ V t!) CQi» SCI sl htth;: `hankin~'.r~unmcrcrhr.~um ~~uh>,r~ chocklma`_o.ash:'in~iox ~ (i ~ % ~UII~ Z 1~111111t1't't' (Illlllls; - l h~C}; Illlil~~t' To print this page Click Here. Close Window This is the front of your check t'il~~~ t UI I ALBERT J. FANEW, JR. ao-ia4.s,s 1877 JEAN B. FANEW s 5004 BALM 0 RAL CT. MECHANIC58URG, PA 77050 /~ ""' L ! ~ O~ PAY +~~ / TOO THE ! (/~~lL'~'l,' ~~~ ~~. ~ ~l U. ~Z €! OF DOLLAlS 8 a..._~ co ~ MERCE BANK AMER ICA'S M OSi CONVEN IctlT BAN K 1-88SYE5-000 FOit- ~~ I ~ - r t:0313018~.~~: SL 308?63 5~I• 1877 .o.~. M-~ ,~.-...,r.......~ This is the back of your check i 'IS lii.'ll h~3~ a: _..'1 .~!.:;(;;'S~?C: t~ Cf"i~'~,. '.'~C.. 1'1"1~3C ig I'ii' :?VAI'3t'"~~ ;= :..,t:.;i,:,,l;.i i I .~(_. .' ~~ G.:nt. ,'t:_. 5i ~:~iC~ F3-'(: -'~~rlt?.t1 r= .~~i l _:5`,~. 4~-. ':,~; ti Commerce Ba/]EC sl nrezr~ea's I'dnst Cnnven~Pnt Bank' ~.?l ~r htt~i~:''hat~~111`_.CC1111f11t1't'~(1C.C~~Il1 i1O~lU~'chocklnu>,~r.as~~''indu~ 1(> S 1 ~ DUI)? ~'Or771]71;1'~C Onlinr -('hack Inur_~ I'a~~r I n~ ~ To print this page Click Here. Close Window _ This is the front of your check ALBERT J. FANELLI, JR. so-,ae,aia 1879 JET' y B. FANELLI s 5004 EiALMQRAL CT. ' MECHANfCSBtJAG, PA 17050 p~a e%vL _ O 7 TO TFiE ~~~~~ ~ ~~ ~ ~s ORDER OF ~~ DOLLARS 8 ~,.__.., COMMERCE BANK - AMER[CA'SMOSTCONVFNiENTBANK ~ [ :~ FOR L ~S T '~ ~ C it T~-~ ---- -- ---,~[ r x:03 L30 L846~: 5l 308?63 5rr' l8?9 ~i`0000 ~ ~,55~'' eOf ~s~ w M Wl 1m *1a+~U r~ w..~ Lr~ RTT __-__ _ _ _ _ _ _ This is the back of your check Ii1L C)QCrJ~~ ~'~O L~8/O /LC107 t~-:~0273r~3_'.~~.~t^-~'~ 5.757~.ii28 i CCrM2~:E ~ iCE $I:P{?; f - I htths:I;'hankin~s.a,n7mcrre~c.c(>m'p(,I~lt~%~ChL'CkI117~i~~e.as~'.'incfrx = ; K%1?; ~(1O7 i'c,nu»cr-c:c (?r~linr = C'h~ch Ima~sc To print this page Click Here. Close Window ~ ALBERT J. FANELLI, JR. JEAN B. FANELL! 5D04 ~3ALMORAL CT. h4'cCrIArVICSBURG, F'A 17050 This is the front of your check co tBa.~» a ~ ~ ~ ~ ~' 7 1882 PAT ~_TO_7HE ---- • - - --- -- - --- - ---t'iC~ O~ER OF_ _L~L~...-_~VGV/rVS ~. J ~ /~ s _ ~. - COMMERCE SANK. _ ~ _ ~~ ~ ' ~A-~' DOLLARS ~ '~ ... AMFF~CA~S MCS rC0liVft~lE~1T BARK t-eNB.vES OCOa /1~. FOR--- --- ---- - ,~-"l.. C L~nwC.Li ~:0 3 1 30 L8 4 fit: 5 Z 308 76 3 5~~' i88 2 ~' 0000 X 2 5 O.'' ttn!caa w. •wi u4a f ro q)uu w,w...:o.4 tz•O~ This is the back of your check ~ ~ ._ -,-~ _ ----- ------ - -- -- --- -• -- -_ -----~-~ - _ -- ~ k -•----- 1 r ~ crE~ia~oo~ ~ J . ~ P!'.~ F j Fi'r' r~.:' TlY,li.~'~ ~~ f htt~,s:''hankin~u.cc~mm~rce~c.cc,mi~c~~tr)i:`chcclama~_c.~rs~i:'indcx 3 Ril ~ ?Ut)7 C'c>nui~~r-c~ ~)[]~l11C - ~ }~Cl~: Ji11~l~~t To print this page Cllck Here. Close Window This is the front of your check ALBE~tT J. FANELLI, JR. so-~sa,ais ~ 883 JEAN B_ FANELLI a sooa 6AlMORA~ CT. hSECHANICSBURG, PA 17050 ~ ,~~~ ~ ~ ~"- 2fl_ . , F+AY ~? n~ 60 TO THE /!~! ~ ~ ~QQ ~ ` ORDER OF ~ / Goo ~//0[lS~c•r ~ ~-~ / D v~~ ~ DoiLARS ~ COMMERCE BANK } AMERICA'S MOST CON~ENIEMLBAlFk 1G~1"E'ii !~'u-'/r'r''='J7 1 1:~'~,i•~`~ ~-SBgYE5.d0p4 ash ur J~ L;~_t- sr,i:l'3. ~~I FOR - -.- '! ~:0 3 L 30 L8 ~ 6~: 5 L 308 76 3 5~!' L8B 3 (OtCK1 s1 M WC I a~ TJ-~W -~ ~.r trr, fST*A This is the back of your check ?S :' L 04 1 1 9:~6~.~0 :>U~ 3 2C31 bU< RC1~,E~ ~~ PCi L:;:sl4ME);'CE RRt1); r;A C1E;t07/cUO~ CNi/F'RY t{ILL , TIJ • I r ~ I i ~ i https:":'hankie:~.c:c>»lmorro~~c.rc~m`}~~~~ui~i~I~ecklma~,c.ati~''ind~~ lU JJI I t` `\~ !~ i `~ ~)'K ?Utl? t (1111111CrC(' ~ )11I lIll' - ~ ~ht'C_li lllltl`?t To print this page Click. Here. Close Window This is the front of your check I't I~ ALBERT J. FANELlI, JR. co-fssr3ta X884 JEAN 6_ FANELLI ' 5004 BALMORAL CT. • !'JiECHnM111CSBURG, YA 17050 l~_.~~0~7_ , PAY ,~/~ /~,..f ~ ~ / 2 c?-~ 1 TO THE ~ -L.L eC~-= "' ^~f~ _J ~ lJS -- ORDER OF .~}'~ ~ ~~i~. ~~~~__L.1v~!"-}~'1!~C ~ DOLLARS 8 ~ COMMERCE 8ANK ! ~ f ~ ,r-~ attERICA'S M1A0~7 CONVENIENT AANX 1 ~.iFYF.S~0001 ' ,~ ~ r ~, FOR -- .._. - - - -- - -- ~ -~ ~:0 3 l~ 30 LB 46~: 5 ~ 308 ?E 3 511• i8b 4 ~~`OOQ00 L 3 00.'' This is the back of your check Ali ~ _~t~?~:~;~~~ `i ' -' T~'! •- 1 ~:-1:.-t r' }; i ~ ~ it ~r~" t ' ~ ~v~ r :..1 s ~C• '^•, :' n C ~ ~ ~! '33 9yy d ~ c~ ~ ~~ . C3. - `~ ~ V v lttt~s:.'hankin~~.rcmul?~rc~hc.cc'•nv'~clpuh. rhrcklma`~r.asp'?index=? -;O'~(1O7 Cammerce Online -Check Image To print this page Click Here. Close Window This is the front of your check Yage 1 of 1 ALBERT J. FANELLl, JR. SEAN B. FANELL( 80~'~`~"' 1886 5004 BALMOflAI CT. 3 MECHAFftCSBURG, PA 17050 23 /J ~ PAY ~~~ i0 THE ~ OR R OF ~• /~ COMMERCE BANK _ /_ AMERICA'S MOSTCONVENIEH7dAT,k: i ~•i '~_ j "; ; _; ;_': 1.888-YES-0001 ~;\ I1 (~ !1 .: i ':•p •I~ '_ -y FOR i:0 3 130 i846~: 5 i 3D8 76 3 5N' •a rti .:..... L886 ,1`00000 1 3 L00,~' YCKdtS M iM( Yti 1 ~ TyYr~ rY~ y/rw tarry RBI This is the back of your check ~'nG'~ FEGFF~`J. CFE61T ~' ~ ~ U91 E.C~~1~E,E;F ~~b3T4~7~1~ 'l9lZ4/<)+- ~ ~ £{d?-4Ci 17 'PA'C=4rl42 -f'~K'rki" ~.~ ::~~;:.i+~r:t"~:.':. `r+'1 ~t ~:tlZ.li~.I.::1~.I: !i. V .;~~ I i ' t _ ..-- , --- ~: t DOLLARS ~ ~~~ httns://hankinQ.commercenc.com/DODUn/checkImaee.asp?index=l 9/26/2007 (~crnam~rc~ Unl~n~ - (h~cl: Ima~~c To print this page Click Here. Close Window This is the front of your check *EJ31~i89O7* oa~za~2ao~ Cii7OOtiQ215D?~~62 Ths t5 a LF.GAC COPY O~ yOUf N check. You cui vse ~ th¢ same o O way you would use [hP ~ngi~ai ~ ~ ChPC'+. ~ ~ ~O ~ t7 QC a u~ F'l ''~ t` N n° e- ~ ~c a° m° ~O E7 AlSEKTJ. FAM1lELLl, JR, esta»u -- 1887 JEA1L B. FANELLI soda eau.+a~ cr. M.ECHANi:SBURG. PA 17050 zC/ ~'..j~~?6 Q rwr f/{~~ ~p -!- TO THE / J/'i~U: {~~2.kJ O~ ORDER Of rr'' ~S _.__._ I ~ 7Zs ~euC,t Ylir~i~ ~Pr f _ ~rr_ ~° C-~~---~I.{J. DOLLARS COMMERCE BANK tiNEw.:ns uo.r mra:nicrcr amcc f~wa.FScaow/~ .. p ~/~I~~ ------ TDt S~P,a-i+,a~ E:03i30i~46~: 51 308763 5~• t887 41:0 3 2 30 1846:5 2 308 76 3 5tt• :8A 7 This is the back of your check A n ~, _ _ LLf .fir.. ~~ _ ! co O ' L1i:cl"'t-' S tV' • ~ + ~ ' o-, Q _ 9 ~~ z N~ ru l'. f { [R ~ .'00000 7 c' S00.~' M- nrMnr .h~'vl~it l~~r .tom htt~s::`.'hankin`,!.Ct)I~lnll'rCl'~C.C11111'~1(>~~LI}1~111~C];Jillti`_',C.f1Sh~~lllC~l'X"' ~ ~: ail-?(IU7 C (1f11f11tfC~ Onllnc - C'hi:ck Inui~~c To print this page Click Here. Close Window This is the front of your check ~- BERT J. FANELlt, JR. EAN S. FANELLI aaa sALr.~oR,aL cr iECHANICSSURG, PA 17050 60•S Bt3t3 3 ~ ~ _ ~o a_? 1'a~~~ 1 i~i~ 1 PAY ,~ f~ To THE /Q~ 2c~~7AN a/1~ /~in~Q _/ ~. ORDER OF i~~l l - '- COMMERCE BANK AMEP.ICA'S N10SrCONVEN[ENTRANK 1-888-YL S •0004 FOR ~:03i~30L$46~: Si 3D8~63 1892 D~ /DOD, `~ DOLLARS ~ ~ ... ~~f~. 5n• L$9 2 ~O~:ai M M 1ti t ~-taaap ar. a. ~~+ ~~ This is the back of your check M'3'L 04C4~~~`i~~7U ----___-- -- _ -- _ R07~ S i PZ~3 - -- '£l4YCl7/L'C~©'r' I i I t i ~ ~ I i I ~U37 ~013E~Or C~f}411E~'Ct. sal~t~ F~tA CHERPY FfILF.:,~- - ~ - x ~= ~~~' C ~ r :~ .a C.'J ~~ .. -I r1 O ~, ~, •~ • ~~:.....:j https:~'hankiFlg.ci~tnmercepc.cimv}~i~puh`c}}eck[ma~~~.asi>:'in~{~x- 1 y.`X'~007 EXHIBIT 3 0 O 0 0 co 0 m w 0 O O O N W 0 rn .P V A O 0 0 v O N O W o ° 3 9 ~_ 7 3 L (q m A °- m C1 V m d a ~ D m D 0 w .y~ m A °i m 61 ~ V m ~ _n n ~ y~ p v~ m m r y~ i ~ C = ~ ~ _ ~ ~ D j D ~ ~ an d T. n Z 71 C z 3 " n C +, y . r W u y ~ c~~ pzoe ~~ ~ m D o ~ ~ ~ m p o x o o 3 ~ O ~' w Z ~ o Z ~ ~ ~ ~ .? c ~ ~ O a A ~ ~Q ~ D ~ ~ ' N ~ Cn ~ o y e 'T~ ~ ~ D ~ ~ m ~ X =~ N X v Q a O 0 s ~ e3 o~ mm°e ~ ~ op ~ V N ~ O .~ 0 ~ m ~9 N °O _ OD o m O ~ O ~ o c O O °m O ~ o ~ a ~ = ~ OD 0 N V po ~ A O - o b9 CO ~ ~ O m ° W A ~ N C 0 O N m 0 V ? ~ o d- b9 ~ OD pp ~ y CD o V W om ~. N C p W W om A V V °mm n O ~ m ~ No ~ 3 ~ a~~° n L O C O tG O 7~ o ~ c Q ~ ~ ~ ~ _ ~ M .~ 6 a m < ~ C 2 i ~ ~ m 3 ~ ~ ~ ~ ~ ° o ~ ~ C (D S y W 7 O ~. z .., ~ ~ L 3 ~ C rl ~ O ~p .~ u L C O i ao A to N V- E9 O 0o co ~ V A ~ D O m A ~ ~ ~ m :tl ^ "'~ ~ L ~ a ~ D ° • m m t0 r = r 3 ~ ~ Z 0 L m ., D Z ~ Y T W o° a D Z m r r o ~ t N -~ N ° _ ~ m ~ 0 C _~ "'~ O n ~ d Q i ~ h r I~ 0 rt O ~• V rt F~+• O ~ N ~ 01 ~ N n ~ 6 W m ~ a1 V! ~ O ~ ~ ~ W W O m O O O o V V O a V! o N O N ' OD O N °o Oi ? m t71 ~! OD m L C 3 ~ C CD ~ y N ~..F O ~ ~ ~ 3 L ~F C T 3 /Y CD ~ O 0 O ~,` O ^.^~ ~_ Z~ !, T~ H Y ~~ 2 y 1 g EXHIBIT 4 Balances As of market Gose on 07/02/2009* My Portfolio Total Mid-Cap Growth Account Type: Transfer on Death Account Number: 0522293695-7 Smalt-Cap Stock Account Type: Transfer on Death Account Number: 0522293687-6 Balance Details Shares Mid-Cap Growth -Transfer on Death 212.425 Small-Cap Stock -Transfer on Death 347.632 Registration: ALBERT J FANELLI JR JEAN B FANELLI JT TEN T O D 5004 BALMORAL CT MECHANICSBURG PA 17050-6307 Share Price $ Change $37.00 •-1.15 $20.92 Y-0.76 ~~Help vPnnt - $15;132.19 Available Balance Value .$7,859.73 $7,859.73 $7,272.46 $7,272.46 EXHIBIT 5 Balances As of market close on 07/02/2009* n Help Print My Portfolio Total $15,132.19 Mid-Cap Growth Registration: Account Type: Transfer on Death ALBERT ] FANELLI JR Account Number: 0522293695-7 JEAN B FANELLI JT TEN T O D 5004 BALMORAL CT MECHANICSBURG PA 17050-8307 Small-Cap Stock Account Type: Transfer on Death Account Number: 0522293687-6 Balance Details Shares Share Price $ Change Available Balance Value Mid-Cap Growth -Transfer on Death 212.425 $37.00 7-1.15- - $7,859.73 $7,859.73 Small-Cap Stock -Transfer on Death 347.632 $20.92 ~-0.76 $7,272.46 $7,272.46 EXHIBIT 6 Conrad Siegel A C T U A R I E S The Employee Benefits Company Conrad M. Siegel, F.S.A. Harry M. Leister, Jr., F.S.A. Clyde E. Gingrich, F.S.A. Robert J. Dolan, A.S.A. David F. Stirling, A.S.A. Robert J. Mrazik, F.S.A. David H. Killick, F.S.A. Jeffrey S. Myers, F.S.A Thomas L Zimmerman, F.SA Glenn A. Hafer, F.S.A. Kevin A. Erb, F.S.A Frank S. Rhodes, F.SA, ACAS. Holly A. Ross, F.S.A. Janel M. Leymeister, CEBS Mark A. Bonsall, F.S.A. John W. Jeffrey, F.S.A. Denise M. Polin, F.S.A. Thomas W. Reese, A.S.A. Jonathan D. Cramer. F.S.A. John D. Vargo, F.S.A. Robert M. Glus, F.S.A. Bruce A. Senft, CEBS Laura V. Hess, F.S.A. Vicki L Delligatti J. Scott Gehman, CEBS William J. Shipley, A.S.A. Joshua R. Mayhue, A.S.A. Charles A. Eberlin, E.A. Abigail S. Fortino, A.S.A. July 17, 2008 Barbara Sumple-Sullivan, Esq. 549 Bridge Street New Cumberland, PA 17070-1931 John F. King, Esq. Friedman & King, P.C. 3820 Market Street Camp Hill, PA 17011 501 Corporate Circle • P.O. Box 5900 • Harrisburg, PA 17110-0900 Phone (717) 652-5633 Fax (717} 540-9106 www.conradsiegel.com Re: Albert J. Fanelli, Jr., FERS Valuation Dear Ms. Sumple-Sullivan & Mr. King: You requested that I calculate the present value of Albert J. Fanelli's accrued Federal Employees' Retirement System ("FERS") benefits for consideration as a marital asset in the matter of a divorce. This report is based on the following information concerning Mr. Fanelli: 1. Date of birth - Apri127,-1963 2. Service computation date -June 19, 1985 3. Date married -July 11, 1992 4. Date separated -July 28, 2007 5. Earnings information as follows: Year W-2 Earnings 2004 $110,963 2005 $110,540 2006 $113,443 2007 $118,476 Basic annual earnings as of July 21, 2007 - $118,803 per year (includes locality adjustment). Currently, Albert J. Fanelli, Jr. is 45 years of age (age nearest birthday). Conrad Siegel A C T U A R I E S Barbara Sumple-Sullivan, Esq. John F. King, Esq. July 17, 2008 Page 2 FERS is a defined benefit pension plan. The figure that is marital property for divorce purposes is the present value of the pension earned during the marriage. The pension benefit is based upon the years of service and the high consecutive three-year average basic salary. The three-year average salary is computed on basic pay, including locality pay, and interim geographic adjustments. Normal retirement depends upon the year of birth and the years of service. If he continues to work, Mr. Fanelli will be eligible to retire on unreduced benefits at age 56 (after 30+ years of service). If the benefit starts before age 62, there is a supplement payable until age 62 in an amount equal to the estimated Social Security benefit. If he terminates service before completing 30 years of service, he will be eligible for unreduced benefits starting at age 60. The basic monthly pension is higher if it starts at age 62. Based upon the pension formula contained in the Federal Employees' Retirement System and the information concerning his pay as indicated in 5 above, I estimate that as of December 31, 2007, the accrued pension to start at age 62 is $2,358 per month. If the pension benefit started before age 62, the accrued monthly pension would be $2,144. As previously indicated, if Mr. Fanelli retires between age 56 and 62, there would be a supplemental benefit payable until age 62 based upon the estimated Social Security benefit. I estimate the marital portion of the supplemental benefit to be $629 per month. The following table shows the estimated accrued monthly pension as of December 31, 2007, the present value of the monthly pension, the "coverture fraction" and the present value of the pension earned during the marriage for retirement at age 56, 60 and 62: Present Value Accrued Monthly Present Value Coverture Pension Earned Retirement Aye Pension Monthly Pension Fraction Durin Marriaee 56 $2,144 $204,280 0.668 $136,459 $ 629* 19,661 $156,120 60 $2,144 $156,861 0.668 $104,783 $ 629* 5 749 110 532 62 $2,358 $150,967 0.668 $100,846 *Supplement payable until age 62, marital portion only. Conrad Siegel A C T U A R I E S Barbara Sumple-Sullivan, Esq. John F. King, Esq. July 17, 2008 Page 3 The benefits earned as of December 31, 2007, take into account 7.06 year of service before the date of marriage and 0.43 years of service after the date of separation. Therefore, it is necessary to multiply the present value of these benefits by a "coverture fraction" in order to determine the present value of the pension earned during the marriage. The numerator of the "coverture fraction" is 15.05 (the years from the date of marriage until the date of separation)-and the denominator is 22.54 (the years from the service computation date until December 31, 2007). Thus, the "coverture fraction" is 0.668 (15.05 divided by 22.54). The Federal Employees' Retirement System pension is indexed starting at age 62. Each year after age 62 the benefit increases in accordance with the Consumer Price Index. If the change in CPI is between 2.0% and 3.0%, the benefits are increased by 2.0%. The present value calculations are based on the assumption that the Consumer Price Index would increase at the rate of 2.75% per year, so that the assumed annual cost-of-living increase is 2.0%. The Consumer Price Index has increased on the average at the rate of 4.19% per year over the last 30 years, 3.05% per year over the last 20 years, and 2.59% per year over the last 10 years. The present value calculations have been based upon the assumptions promulgated by the Pension Benefit Guaranty Corporation from annuity valuations. The interest rate is 5.95% per year for 20 years followed by 5.02% per year. The mortality is in accordance with the 1994 Group Annuity Basic Mortality Table for males with Projection Scale AA to 2018. In my opinion, the assumptions promulgated by the Pension Benefit Guaranty Corporation for annuity valuations, are appropriate for the purpose of determining the present values. With best regards, Yours sincerely, Jonathan D. Cramer, F.S.A. Consulting Actuary JDC:ksl Encl. EXHIBIT 7 ~~ 4 _ __ 0 0 0 O CD 0 rn W 0 O O O N w rn O rn A O 0 0 N m O CA y t1 v 0 S O n N m n `G m v m 0 Q D -1 rn n „ u, ~ y ~ ~ ~ rrll ~ r ~1 C ~ °' ~ ~ ~ ~ { n mno ~ Z ~t T c , ~- o ~. x ~--~ Dc o o, ~0 3 m m . ~ ~ _ .... o a m w C m \ O n~i ~ m m ~« w~'^ c o rn o oo to ~ ~ 3 ~ ~ Q c ~ y C m ~ ~ y C7 ~ n ~ ~ D y ~ ~ ~ O. N T m C2 ~ m v m V a m n 0 0 ~~ ~z ~a 03 •+ s o s n o ~~ a m D o 0 o n o ~, o ~ m m~ ~ ~ 3 3, c co m ~ ~ ~ v, m .~. v Ni N < ~ C _ W o' m N ~ ~ ~ ~ ~ ~ -w m ~ ~ ~ ""' C 7 p<j C ~ m o m C N O O V- Efl i 1 ... ~ ~ _ N i Cn V W O ? ~ Ut O ~ (p O 41 O O IV ~ ~ O) O CO m x m m m ~ C ~ Y 1 V Q) j 0 ? (H N W o • W IV N ~+~ ti m ~I W V ° O A ~1 m .~ V n ~~ ~ m$ d ~ ~ ~ O W o n .~ o A ~ ec ~ c O CD ~ 0 00 ~ ~; 0 0 ~ ~, ~ ~ ~ ~ W n ~ o ~ a A . ~ = ~' a ~ oo co a Q p m cn ~ 3 o w. ~~ v a~ .. ~ =, = W Cb OD m ° 69 -~ e ~- a ~ j om o ~ ~ O ~ W D O 0 W 0 m s p p O a fn ~ Lp -+ Ul O u .~ EA m V ? ~I O COO o c ° p' ~ N qD ? ~ , < ~ O o ~ v O CO (n W m° o O m O s' Q ~G O 3 j1 Q1 Cit Of ~O O D 5 W ~ m. 0 3 ~ m to -~ D Z m r r TL N 1 N 0 __ Z 0 _C O C D Tr N m "~ m m z -~ D n n O C z "'~ '..~ n C7 C D Z Z = R o = O Q O Q- C o ~ ~ ~ °: ~ W Q O a ~ o p ~ D N ; ~ n_ c ' o ~ N m o 'O ~ m ~ m ~. m m 3 ~ ~ w .0. '~ o. ~ a ~ o ~ O D r m D Z m r o' r e L m 3 T O m ~ N 0 ~ C m „~~ T DV _n D Z -i s ~ ~ ~' O o '° ~ ~ 0 e ~i N ~ N o ,. O °m ~ ~ D r W ~~ ,' ~" ~ W o o ~ A o~ D o m~ Z m r r N:° m ~= om m N ~ n '7'I n ~ ~ CD m o W CO o °- N < ~ m -~ m m ~ ~ N pp. p 3 ~ ~ C ~ ~D o ~ N O O ,~ ~,_ Z~ C, m~ N y~ Z `I 8 EXHIBIT 8 Account Access, Account Balance Account Access Your Civilian Account Page 1 of 1 ~. Account Balance Your account balance, based on the most recent share prices as of close of business 06/19/2009, is shown below. This information is updated by 6 a.m. eastern time each business day. On occasion, heavy volume during the nightly processing cycle may delay the update by a few hours. Contributions to your account are being invested as follows: L 2040 0%, L 2030 0%, L 2020 0%, L 2010 0%, L Income 0% G Fund 0%, F Fund 0%, C Fund 60%, S Fund 20%, I Fund 20% Share Investment Fund Shares Balance Di stribution Price Lifecycle Funds: L 2040 0.0000 $13.1080 $0.00 0.00% L 2030 0.0000 132127 0.00 0.00% L 2020 0.0000 .13.4034 0.00 0.00% L 2010 0.0000 14.2012 0.00 0.00% L 0.0000 13.0970 0.00 0.00% Income Individual Funds: G Government 0.0000 12.9018 0.00 0.00% Fund Securities F Fund Fixed Income Index 0.0000 12.6883 0.00 0.00% C Fund Common Stock Index 15,927.7620 10.7941 171,925.86 74.68% Small Cap Stock S Fund 2,165.6949 13.1059 28,383.38 12.33°I° index International Stock I fund 1,969.5131 15.1783 29,893.86 12.99% Index . Total $230,203.10 100.00% To see the distribution of your account balance displayed as a pie chart, click here . Logout https://tspweb2.tspsec.tsp.gov/tsp/authenticate.do? name=nfclogin&SessionKey$=113840... 6/20/2009 ** THRIFT SAVINGS PLAN 10/16/2007 Albert J Fanelli 271 E Crestwood Dr Camp Hill, PA 17011-1209 Dear Mr. Fanelli: Thrift Savings Plan P.O. Box 385021 Birmingham, AL 35238 Prior to June 2003, TSP accounts were valued on a monthly basis as of the Last business day of the month. As of July,10, 1992, the balance in your TSP account was 18,743.83. If you have questions, call the ThriftLine number shown below. Callers outside the United States and Canada should call (404) 233-4400 (not atoll-free number). The TSP hours are Monday through Friday, 7 a.m. to 9 p.m., eastern time. You can also write to the TSP. Please include your daytime telephone number and TSP account number (or your Social Security number) on all correspondence so that we can identify your account. Note: If you are a member of the uniformed services, do not provide your Defense Switched Network (DSN) telephone number. Web: vl-ww.tsp.gov ThriftLine: 1-TSP-YOU-FRST (1.877.968-3778) TDD: 1-TSP-THRIFT5 (1-877-847-4385) Fax Number: 1-866.817-5023 ~- EXHIBIT 9 0 O 0 O O W O O O O N w O] 0 rn 0 A 0 w _O O (D O 0 m 6) 6) ~ m o O N N m 2 ~ o R u, m w vi p D D ~ n ~~ mD mD m '~ cn z cn z ~n ~~ ~~ ~ ~ tmn~ ~° ~° 2 C7 Z C7 Z rp rp ~X ~X v ~ v; < m_ < m ~ m = Q. ~ Q 3 m m m m ~ m m m a a O D ~ ~ ~ ~ to y ~ ~ m N u 0 w 1 R m O s o ,con cans ; C N W QD n (nm~ ° C o ~ 3 3 a a ~ N ~ ~ ~ m 3 _ ~. n ~ ~ ~ C7 O N C "~ a n C ~ ~ C C ~~ ~ T `c N m y m m y </) O l.11 e w w N OD °' m V n ~ m tD ° f0 s m o 3 O. ~ n a O C ~ m 0 ni 0 m 3 m ~_ D <' D O V7 0 N Ow0 ~ ~ Z w ° i p Al y O1 n v ~D r+ II1 N 0 S O a t0 N 3 d O m 'O I ~ Q a -~ ?~ n „ cn ~ _ a „~~ p ~ ~ D .C. ~ y °-' T~~m ~~c a •g p~--iD y°' S y ~. Xmc~o ~~z„c to m .. ccn~ moa a =... mZw °, j = ~ rn \ Op m° ~ o ~ m ~ sfD cDm,o* Nxo w o < ? n `° m O W Z~ ~ ~ ~ ~ T m o ~ ~ `~ T O j o ~ N y X~ y o n o y rn D m ~ a (n n T 01 (q Q o X ? `~ m H m A c~O w A v m v D `'c Z a ~e D .~ o ° ° Z ~, 3 m N o,' r o m; r c = ~ m ~ D Z -' w CD o c N N o ~ O A W _ ~°o .~ C D r :il ~~ m e» m o ~ °> w o ~ o g o ~ o~ ° ~ °o 0 0 ' m- m Z --I D o C7 a~ ~' C7 ~ ~o O a N ~ C1 O U Z a' ~ c ~ W ° CD V .p ~ -~1 n &9 Vt O° c -1 3 0 ~ ~ ~ S ~_ 0 ~ N O 1 N ~ _~ m v O W ~ D Z ~' L Ul CO ~ y O CO N ° o w; _ ~> ~ ~ N C w ~ ~ O C ~ (,J 0 m m 2~ C, ~~ W Y ~~ 2` '1 r a C ~ ~ ~ m ~ y N rF O ~ ~ ~ ~ L rt C T 7 /V m O N O O CD EXHIBIT 10 -~- 0 0 0 s® °~ °~ _~ °~~- O O O T W O O 0 0 w w (T rn rn 0 N 0 O O O C1 O CD O_ ~P ?~ C7 ~ v ~ 3 ~ ~ n ~ D D ~ ~ X T. n m n Z Z C c" fA X = ~ Cn 3 = z 3 O r ~ w ~ D c~° \ O Z o ° .c c m~ camo m m o Xy~o ° m ~<? ~z°, : °m~~ Q mm>• ~ ~ o ~ s EH 3 p '{ Q o ~° y ~ ~ 3 N 0 m D O H m ~ D ~ ~ N ~ T ~ ~ X V 4 'mC ~_ Q O C.Tt o\° ~ i s ~ e o ~ m s t e _ N ~ CD V OD N ~ N ~ ~ o~ N 3 p Qp p 'off O N -+ W W O 67 s O O O 7 O N ~ ~ U1 O C7 O A ~ o ao _v m O N ~~ c ~ ~ m o ea N O C o~ m n °m O V 3~ ~ O ' ~ m OD W ~1 N CO O N < O~ 41 O) °o v O W m m ~ ~ ~ ~ V ~ ~ N <D • o 00 N Vt W ~ ~ o = N m ? A °oc ~ m m n 0 D S C 3 ~~ fD 3 ~ d 0 n o ~ 0 3 ~ ~ ~ may, p O f0 fp ~ C , .~ N m < w = m O C1 y m ~' ~ ~ 3 Na ~ L 3 ~ ~, fl- ~ < ~ ~ ~ ~ m w c o ~ C N O 0 ao d- fA t0 s V W ~ ti V O C D W t0 W N O pD -i O (D A CO CT ~ 3 X ~ W ~ ~ z ~ m = a ~ d 1 fR ? m m ~ s ~ p O a EA m O o O O ~ m Q1 m Q. ~D "'~ o' N ~O N N V V 00 'o l1 C~ 1 O ~ W ~_ m n O y N ~ 3 O C ~ 3 m ~ 3 ~ ~ N 5 ~ Q 2? m O G Q ~ ~ ~ '~' y 0 m n O O ~ ~ ~ n~i ~, ? ~ O ~ n ~ p, m m l7 ~ _ ~, O `C G ? ~ ~ ? ~ ~ O ~ C n Q tp m O n 3 1 0 `~ rn o m` C1.OpZ ~_ ~ W D z ~ D -_ v'om - C D ~ ~ r ~ ~ D v O ~ [a] Ut ~ ~ O ~ ~ ~ - m W F,, O = ~ (D W . ~ W - o N C D7O o -I ~ ~ ~ O ~D O N ~ 01 m Q -i N O 7 CD O W O O O O '?~ I' O_ A A m ~P ? -. ~~n ~~~ I ~ ~_ Z~ ~, e~ N '1 n Z '1 a `G ~ N ~ O 0 m ~p i ~ L ~ C 7 O O O CD EXHIBIT 11 Average Consumer Rating (39 Reviews) Read Reviews BLJE PUOIi ?Rf'~fxTE PAF,gY'v'A~UE ''~ Condition _ Yalue -~ ~ Excellent $12,985 ,;~.. S~o~d $12,175 "~. Fair $11,iif5 More Photos ~" ~~ c"'Y` (" ~ ~" . Search Local Listings 66R~ J 11 ih. `J4 • Sell Your Yan/Minivan ~'".'%'~'~~~q~:`~ 4.1 out of 5Review This Vehicle ~~ey Blue Book -Private Party Pricing Report -Ford, Freestar Vehicle Highlights Mileage: 22,000 Engine: V6 3.9 Liter Transmission: Automatic Drivetrain: FWD Selected Equipment Change Equipment Standard Air Conditioning Power Door Locks Duai Front Air Bags Power Steering Tilt Wheel ABS (4-Wheel) Power Windows AM/FM Stereo Optional Rear Afr Single Compact Disc Roof Rack Cruise Control DVD System Privacy Glass Blue Book Private Party Value Private Party Value is what a huger can expect to pay when. buying a used car from a private party. The Private Party Value assumes the vehicle is sold "AS Is" and carries no warranty (other than the continuing factory warranty). The final sale price may vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market Value for insurance and vehicle donation purposes. Vehicle Condition Ratings Check Vehicle Title History Excellent ".._~.,°~:,;.,.~ F $12,985 "Excellent" condition means that the vehicle looks new, is in excellent Pag http://www.kbb.com/KBB/LTsedCars/PricingReport.aspx?Manufacturerld=15&Yearld=20... 9/21 /2007 EXHIBIT 12 .lley Blue Book -Private Party rncmg xepon - Ivi.s~ai>, ~ciiua BLJE EOOIC' PR14~ATE Pd~ ~Y V~(I_UE - . Condition . Value Excellent $10,935 ~aod $10,240 Fair X9,320 More Photos l f ~~.. J '~ .+~.~~~ -.jig P 3 ~ _..~~ Z; ;~.~ _ ~ ~ XT S1 E P 5 . Search Local Listings Sell Your Sedan Average Consumer Rating (92 Reviews) Read Reviews ~~?LL'~4~~~~` 4.3 out of SRev_iew This Vehicle Similar New Vehicles 2008 Nissan Sentra ~= Photos Pricing Vehicle Highlights 9/21 /2007 Mileage: 23,000 Engine: 4-Cyl. 1.8 Liter Transmission: Automatic Drivetrain: FWD Selected Equipment Standard Air Conditioning Power Steering Optional Power Windows Power Door Locks 2008 Mitsubishi Lancer .Photos Review -______.__" Pricing More Results » Change Equipment AM/FM Stereo Dual Front Air Bags Cruise Control Single Compact Disc Blue Book Private Party Value Private Party Value is what a buyer can expect [o pay when buying a used car from a private party. The Private Party Value assumes the vehicle is sold "AS Is" and carries no warranty (other than the continuing factory warranty). The final sale price may-vary depending on the vehicle's actual condition and local market conditions. This value may also be used to derive Fair Market http:/Iwww.kbb.com/KBB/LTsedCars/PricingReport.aspx?Manufacturerld=35&Yearld=20 EXHIBIT 1-A 1`/Iortgage/Loan Calculator with Amortization Schedule Loan Amortization Calculator Page 1 of 4 Almost any data field on this form may be calculated. F,nter the appropriate numbers in each slot, leaving blank (or zero) the value that you wish to determine, and then click "Calculate" to update the _ page. Principal 20000.00 Annual Interest Rate 4.1847 Balloon Payment Payments per Year 12 Number of Regular Payments 60 Payment Amount 370.00 f~ Show Amortization Schedule Calculate This loan calculator is written and maintained by Bret Whissel. See Bret'_s Blog for more information. Summary Principal borrosved: $20000.00 Annual Payments: 12 Total Payments: 60 (5.00 years) Annual interest rate: 4.18% Periodic interest rate: 0.3487% Regular Payment amount: $370.00 Final Balloon Payment: $0.00 Annual Debt Service Constant: 22.2000% Minimum amortizing payment for this Principal and Interest rate: $69.76 The following results are estimates which do not account for values being rounded to the nearest cent. See the amortization schedule for more accurate values. Total Repaid: $22200.00 Total Interest Paid: $2200.00 Interest as percentage of Principal: 11.000% http://www.bretwhissel.net/c~i-bin/amortize 3/16/2009 1~Iortgage/Loan Calculator with Amortization Schedule Page 2 of 4 httn://www.bretwhissel.net/c~i-bin/amortize 3/16/2009 MortgagelLoan Calculator with Amortization Schedule Pmt Principal Interest Cum Prin -Cum Int Prin Bal 1 300.25 69.75 300.25 69.75 19699.75 2 301.30 68.70 601.55 138.45 19398.45 3 302.35 67.65 903.90 206.10 19096.10 4 303.41 66.59 1207.31 272..69 18792.69 5 304.46 65.54 1511.77 338.23 18488.23 6 305.53 64.47 1817.30 402.70 18182.70 7 306.59 63.41 2123.89 466.11 17876.11 8 307.66 62.34 2431.55 528.45 17568.45 9 308.73 61.27 2740.28 589.72 17259.72 10 309.81 60.19 3050.09 649.91 16949.91 11 310.89 59.11 3360.98 709.02 16639.02 12 311.98 58.02 3672.96 767.04 16327.04 13 313.06 56.94 3986.02 823.98 16013.98 1-4 314.15 55.85 4300.17 879.83 15699.83 15 315.25 54.75 4615.42 934.58 15384.58 16 316.35 53.65 4931.77 988.23 15068.23 17 317.45 52.55 5249.22 1040.78 14750.78 18 318.56 51.44 5567.78 1092.22 14432.22 19 319.67 50.33 5887.45 1142.55 14112.55 20 320.79 4921 6208.24 1191.76 13791.76 21 321.90 48.10 6530.14 1239.86 13469.86 22 323.03 46.97 6853.17 1286.83 13146.83 23 324.15 45.85 7177.32 1332.68 12822.68 24 32528 44.72 7502.60 1377.40 12497.40 Page 3 of 4 25 326.42 43.58 7829.02 1420.98 ~- ~_ 12170.98 ~`~ 26 327.56 42.44 8156.58 1463.42 11843.42 27 328.70 41.30 8485.28 1504.72 11514.72 28 329.85 40.15 8815.13 1544.87 11184.87 29 331.00 39.00 9146.13 1583.87 10853.87 30 332.15 37.85 9478.28 1621.72 10521.72 31 333.31 36.69 9811.59 1658.41 10188.41 32 334.47 35.53 10146.06 1693.94 9853.94 33 335.64 34.36 10481.70 1728.30 9518.30 34 336.81 33.19 10818.51 1761.49 9181.49 35 337.98 32.02 11156.49 1793.51 8843.51 36 339.]6 30.84 11495.65 1824.35 8504.35 37 340.34 29.66 11835.99 1854.01 8164.01 38 341.53 28.47 12177.52 1882.48 7822.48 39 342.72 27.28 12520.24 1909.76 7479.76 40 343.92 26.08 12864.16 1935.84 7135.84 4l 345.12 24.88 13209.28 1960.72 6790.72 42 346.32 23.68 13555.60 1984.40 6444.40 43 347.53 22.47 13903.13 2006.87 6096.87 44 348.74 21.26 14251.87 2028.13 5748.13 45 349.95 20.05 14601.82 2048.18 5398.18 46 351.18 18.82 14953.00 2067.00 5047.00 47 352.40 17.60 15305.40 2084.60 4694.60 48 353.63 16.37 15659.03 2100.97 4340.97 49 354.86 15.14 16013.89 2116.11 3986.11 50 356.10 13.90 16369.99 2130.01 3630.01 51 357.34 12.66 16727.33 2142.67 3272.67 52 358.59 11.41 17085.92 2154.08 2914.08 53 359.84 10.16 17445.76 2164.24 2554.24 54 361.09 8.91 17806.85 2173.15 2193.15 55 362.35 7.65 18169.20 2180.80 1830.80 56 363.62 6.38 18532.82 2187.18 1467.18 57 364.88 5.12 18897.70 2192.30 1102.30 58 366.16 3.84 19263.86 2196.14 736.14 httn://www.bretwhissel.net/c~i-bin/amortize 3/16/2009 Mortgage/Loan Calculator with Amortization Schedule 59 367.43 2.57 19631.29 2198.71 368.71 60 *368.71 1.29 20000.00 2200.00 -0.00 *T'he final payment has been adjusted to account for payments having been rounded to the nearest cent. Page 4 of 4 http://www.bretwhissel.net/cgi-bin/amortize 3/16/2009 +~ *~ - ~' ~fi ltd L °~-°~~ t ' LOAD AG6~EE~EIVT Review the terms of the loan below. Read the instructions and conditions related to this Loan Agreement. Loan Ntrrnraer: If you accept the loan terms, you must complete Section III (if applicable) and Section IV. Do not alter any- ; ~ ;~,; ,'`__•',- preprinted information. if you want a loan under different terrns, cancel this loan by completing Section VI. Expiration Date: If this Form TSP-21-G is not received before the Expiration Date, your loan request will be cancelled ~^:v;%:I%%f Y;~, A $50 fee will be deducted from your loan, I, Name: =-;~!«t,=~~ ;-i~~t+~i~_~ Unless you complete Section V below, your check iNFORIUiATION , _ _ will be mailed to the following address: Social Security Number: ; ~ ~ ~' L`)~ ~ •^• n A - - AE~OUTYOU ~;rl~,T; K; ;~~~tl:.,t;; yL t„ rt-r+nr~ynn Payroll Office: . r .~r_:s_i _~~,~, enrr-~! lna+tr+~nl Ir-~r'•• r-in a-rn ~nr,n €vt~ ~ n~r~trt~4r_:f . r-~+~, '•-n t r t;,.t;;~,~ II. Annual Percentage Rate Amount Financed (This Interest (The interest you vrill Total Amount of Payments (The TERMS (The cost of your loan as a amount includes the $50 fee.) have paid when you have made amount you will have paid when you yearly interest rate) all scheduled payments) have made all scheduled payments) OF LOAN .i fifl/( ~.t,f i,i` ~ •r~n nrr~~ //~ $ .. L.l~l..l'.t.~lt ~ .e .c w r• $ «.; r+~'-t.~~~ nn ~ ~ ~ r_ n $ .t;...G; I'-fiLL.:.J ! Amount of Each Payment Frequency of Payments Total Number of Payments Repayment Period a "r fi r~ r1 $ ' ' "`~`" •~ ~ L'`" Per Year ~ ~ n ' 'ti c r~ Years ti Months if, at disbursement, the maximum loan amount is less than the amount financed but at least $1,000, your loan will be issued in the maximtun loan amount. In this case, the annual percentage rate wilt not change and your loan payrnsnt may be re- duced. Once your loan is issued, under certain conditions (such as return from nonpay status), the amount of your loan payment may be increased automatically to ensure that this loan is repaid in full by the required deadline. Idl. It you are covered by the Federal Employees' Retirement System and you are married (even if separated from SPOUSE'S Your spouse), your spouse must consent to your loan. If you are not able to get your spouse's signature, you CONSENT may be abie to obtain an exception by submitting Form TSP-16, Exception to Spousal Requirements. (If you are covered by the Civil Service Retirement System, your spouse's consent is not required.) To be completed by spouse of Spouse's Consent: By signing below, I consent to this loan from my spouse's Thrift Savings Plan account. FERS employee Married Lam- r:tt. ~r.,..., f.~ '^:. i. :. F. !. Ci{/l.l{!~ w~4CA{{ 1...l Lals ti'{;!} Typed or ?rir ed Nam~of P~rs±eiFa Sig Spouse's Social Security Number ~~ Date Sign d 11/. I agre~to the terms and conditions described above and I promise to repay the entire amount of this loan, PROMISE plus interest. I authorize the Amount of Each Payment shown above to be deducted from my pay each pay TO PAY ANIt? period to repay my TSP loan. I agree that I will not cancel these deductions. I certify that all information sub- CERTiFICATION mitted in conjunction with my loan request is true and complete to the best of my knowledge. I understand that any intentional false statetTterit or willful misrepresentation is a violation of law that is punishable by a fine of as much as $10 00 or imprisonment for as long as 5 years, or both (18 U.S.C. 1001). -C~ Qom.. ~ /,,~ 4S Participant's Signature Date Signe ~/, Deposit my loan directly into my account at the financial institution below. (f~Jote: Confirm with your financial REQUEST institution that the account information you provide is correct.) F®R®IRECT ~~,~~~~-i~f?C ~~~rJl~ O~/3of~~,~ ®EPOSIT Name of Financial Institution ~; ~ ,~^ ~7Routing Number (must be ° digits) Type of Account: Checking ^ Savings -,~i w.~ C~ l Account Number ~JI. LOt, N CANCELLATION I Complete ONLY to cancel this loan. {.: Complete this section only if you want to cancel your loan request. For faster results, you can submit your cancellation on the TSP Web site at www.tsp.gov or on the ThriftLine at 1-877-968-377^ (outside the U.S. and Canada, call 404-233-4400 (not toll-free)). (You must have your Sccial Security nurnber and TSP Personal Identification Number to do so.) ,4 cancellation on the Web site or ThriftLine wili be effective immediately and you can reapply at the same time. Otherwise, complete this section and return tl.is form to the TSP Service Of- fice; allow several days for mailing and processing before you reapply. ^ Cancel my loan application. Particioant'sSionah;re Date Sinned 9~'~~•T ~L.i~Tb~s~`~-' Before completing this agreement, read the booklet TS° Loans. TI.e booklet contains information about the cost of TSP loans, as well as borrowing restrictions and repayment requirements. The booklet is available from your agency personnel office or the TSP VVeb site at WWW.tSp.gOV. P,~ake a. copy of this completed form for your records and mail the original form 'to: 3-SP Service Office !'.O. Sox 61500 flew Orleans, L~ 70161-75u0 V'Uhen your loan is disbursed, the TSP Service Office will send your loan payment information to the payroll office listed in your TSP account record at that time. If the payroll office shown in Section I is not your current payroll office, ask your current payroll office to update your TSP records. After your loan is disbursed, check your earnings and leave statementsro make sure your loan payments are being deducted. TE~il~li~ ~3~ I he terms of this loan are set forth in Section 11 on the front of this form. The Annual Percentage Rate is the LOAi~! interest rate for the Government Securities Investment (G} Fund in effect on the date your Loan Application was processed; this rate remains in effect for the life of the loan. A loan fee of $50 is included in the Amount Financed. ~E~AYNlEIVT By signing Section IV of the Loan Agreement ® You are agreeing that you will pay principal and interest on this loan in substantially equal installments through automatic payroll deductions. o You are authorizing these deductions and agreeing that you will not cancel them (unless you are a debtor ir. a chapter 13 bankruptcy and a court order requires that you stop your loan payments). a You are certifying that alt intcrmation you submitted, including spouse information, is true and complete. if your deduction does not start in the first full pay period after you receive your loan, notify your agency. You may request that your loan be reamortized to change the payment amount or repayment period or fre- quency of your payments {if, for example, you transfer to another agency and your pay frequency changes). However, there are limits on the length of the repayment period, which are described below. You can make additional loan payments or repay your loan in full at any time without a prepayment penalty. Payments can be made by personal check or money order. They must be made payable to the Thrift Savings Plan and must include your loan number and Social Security number on the check or money order. Send your payment with a Loan Payment Coupon, which is available from the TSP Web site. Yotr can obtain a prepay- ment amount by accessing your account on the TSP Web site or the ThriftLine. TAXA~L!` The TSP may declare a taxable distribution of the outstanding balance of your loan, plus accrued interest, if: ®ISTR46lJTipr9 Y"our loan was identified as being in default and you did riot submit the required amount by the deadline; ''(our general purpose loan is not paid in full by the 5th anniversary of the loan issue date or your residential loan is not paid in full by the 15th anniversary of the loan issue date;* ® Yot.r separate frorrl Federal service and do not repay your loan in full; ® You are found to have provided false information; e You are a debtor in a chapter 13 bankruptcy action and a court order requires that you stop your loan payments; or ® You die before your loan is repaid in full. If the TSP declares a taxable distributign of yot.rr loan, This amount is subject to Federal income tax (and, in some jurisdictions, to state and local tax) and may also be subject to an early withdrawal penalty tax in the year in whicl ~ the taxable distribution is declared. xTl~ese term limits relay be extended if TSP records show that load payments were missed because you entered nonpay status in order to perform rnilitary service. ~RIV,fsf:Y ACS' 1•JC)1"IcF. 4Ve are authorized to renuesl ibis information under rnrestigating a violation of civil or criminal la~.v, or agencies implementing a statute, S IJ.S.C. chapter 84. Executive Order 9397 authorizes us to asi< for your Social rule. or order. It may be shared with congressional offices, private sector audit firm, Security number, which will Ge used to identify your account. VJe will use the infor- spouses, former spouses, and beneficiaries, and their attorneys. We may also dis- mation ;rou provide on this furm [o process yo! Ir request for a loan. This inforrnatien close relevant portions of the hlfonTl^aiiOrl to appropriate parties engaged in litigation. may be shared with other Federal agencies for statistical, auditing, or archiving `fuu are not required by ia~+i to provide this information, but if you do not provide it, r•llrpOSeS. Inaddlt!On, We may sYlare the InfOfmahOn With IeY1' enforcement agencies v~.~e v/ilf rat be able to process your rec,uest. w x x ~ e(r /~~9 ~ r( °r~' @~+~/ /,jam ' LOAN APPLiCAT(ON You must have at least $1,000 of your own contributions and earnings in your account to obtain a TSP loan. Before completing this _ _. _ _ form, read the booklet, TSP Loans, and the instructions for this form for additional information about TSP loan rules. Type or print the information requested in Sections I -III, and sign and date Section IV. I' 1. Narrte FAN_ELLf __ _ ALBERT _ J INFORMATION Last First Middle ABOUT YOU 181-52-1205 7'17 G05 _ G439 2. Social Security Number . 3. ( ). -'^ ~ Daytime Phone (Area Code and Number) _ ~ 4. Address 5004 6F;Ln^n~~.L C:T Street address or box number p,r`:~-~I-..I/~ hlfr:.~f'-::fJr`. !':?A. '~':r:)r•')1S~?(1 1' 5. clty . ., .., s. ~'. State/Country Zip Code ~__ ~. a. Are you paid biweekly (every two weeks, 26 times a year)? :' Yes No b. If no, check the box that indicates when you are paid. ^ Semimonthly (twice a month, 24 times a year) ^ Monthly (12 times a year) ^ Weekly (52 times a year) II, ..._----~ ...... ,. Q. Amount of Loan Requested: $.~~~u~; ___ _.______.._(must be $1,croo or more) YOUR LOAN REQUEST -I0. Type and Term of Loan: Specify the loan repayment period for either a General Purpose Loan or a Residential Loan. Genera! Purpose Loan: Time to Repay (1 to 5 years} ' years and t; months OR Residential Loan: For the purchase or construction of your primary residence only. Documenratinn wilt be required. Time to Repay (1 to 15 years) years and months III, 11. Are you married (even if separated from your spouse}? Yes No INFORMATION (If yes, complete Items 12 through 19. If no; go to Item 20.) ABOUT YOUR ~^naili Ir.c,n F~t.~h~;~,-~fc. SPOUSE 12. Spouse's Name _-_~_.___ _ - -•~- Last First Middle ~3. Spouse's Social Security Number '?`"'~ `"'-~~~ ~ ~' 14. Is your spouse's address the same as above? .' YeS (Skip to Item 19.) NO (Complete Items 15- 18.) 15. Spouse's Address O` I'''4 rsr'-s,i. t~.nt. ~~>«.L. s...: i ~I6. Clty `Vl=i_~i'Fr'vi'Jil-.c.+3iih~' 17 )•^r•i 18• I i Ui)k:~()r 5tatelCountry Zip Code 19. _ Check here if you are covered by FERS and you will not be able to obtain your spouse's signature on your Loan Agreement, or if you are covered by CSRS and you do not know the whereabouts Of your spouse.- (Read the instructions for this item.) IV. I certify that the above information is true and complete to the best of my knowledge. Warning: Any CER1'IFICATiON intentional false statement in this application or willful misrepresentation concerning it is a violation of AND law that is punishable by a fine of as much as $10,000 or imprisonment for as long as 5 years or both SIGNATURE {18 U.S.C. 1001). Participant`s Signature Date Signrd n-,iR-,p, ~~ - ' ~I~, Form TSP-20 (G/20U5j ED ITI OhIS PRIOR TO 8(02 OBSOL ETE • ii~3 TI~UCTi:`sN~ Before completing this application, read the booklet TSP Loans to understand the features of the loan pro- gram and your responsibilities when you borro~,v from your TSP account. The booklet is available frorrt your agency personnel office or the TSP VJeb site at www.tsp.gov. kAake a copy of this completed form for your records and mail the. original form to: f SP Service Gffice P.O. Sox 61500 iVew Orleans, LA 70161-1500 i, 1 - 7: Provide all the requested information. Your loan agreement package, the loan check, and other corre- iNS^ORMATION spondence regarding 'the loan will be sent to the address of record for your TSP account. If the address on AirrOUT YOU your last participant statement was incorrect or has since changed and you have not asked your agency to correct it, notify your agency personnel office imfnediately to ensure that the correct address is provided to the TSP Service Office. 8: Pay Schedule. Loan payments are deducted from your pay each pay period. Make sure you indicate the correct pay period or your loan payments will be incorrect. il. 9: Amount. You may not borrow more than the amount that you contributed to the TSP and the earnings on YOUR LOAN that amount. You may not borrow less than $1,000. To determine the maximum amount you may borrow, you REQUEST can visit the TSP Web site at www.tsp.gov, call the (toll-free) ThriftLine at 1-877-968-3778 (outside the U.S. and Canada, call 404-233-4400 (not toll-free)), or use the Worksheet for Estimating Maximum Loan Amount in the booklet TSP Loans. If you request a loan for more than the amount that you are eligible to borrow, the TSP will determine the maximum amount that you are eligible to borrow at the time that your Ican application is processed and your Loan Agreement is generated. 10: Purpose and Term of Loan. Choose either a General Purpose Loan or a Residential Loan and fill in the corespondirg repayment period. You can request a Residential Loan only for the purchase or construction of your primary residence. • For a General Purpose Loan: the minimum time to repay is 1 year; the maximum time is 5 years. No documentation is required. • For a Residentia! Loan, the minimum time to repay is 1 year; the maximum time is 15 years. Documen- tation of the amount will be required when you return your Loan Agreement. Do not send documentation for the amount of the loan with this form. When completing this item, use years and months. You should have a number in each blank. For example, if you want a loan for 4 years, write it as 4 years and 0 months. iii, i 1: Are you married (even !fi separated from your spouse}? If you are married, even if separated from your INB=ORMATiON spouse, check the ''Yes" box and complete Items 12 through 19. You must supply the requested information ABOUT YOUR about your spouse. SPOUSE 19: Notification or consent of spouse not possible. The TSP must notify the spouse of a CSRS participant before a loan can be made. Spouses of FERS participants must consent to the loan by signing the Loan Agreement. Therefore. check Item 19 if you are: - covered by FERS and you cannot obtain your spouse's signature because your spouse's whereabouts are unknown or exceptional circumstances make it inappropriate to obtain your spouse's signature, or covered by CSRS and your spouse's whereabouts are unknown. You may be able to obtain an exception by submitting Form TSP-16, Exception to Spousal Requirements. Yotl are strongly encouraged to mail Form TSP-16 and supporting documentation with this Loan Application. You can obtain Form TSP-16 from the TSP Web site or your agency personnel office. i1/, 20: Signat=.fre. Read the certification and sign your name. CERTiFiCATi2?N 21: Date. Enter the date you signed the form. Ai`iC SIGNA T iJRE PRIVACY L\CT f~IOTICE. VJe are authorized to request This information under 5 of civil or criminal law. or agencies imp!ementiny a statute, rule, or order. It may be U.S.C. chapter Ad. Executive Order 9397 authorizes us io ask for your Social Secu- shared with congressional offices, private sector audit firms, sf;ouses, former spouses, rily numher. ~~nrtrich will be used ;n identify your account VJe u~ill use the information and heneiiciaries, and their attorneys. we may also disclose relevani portions of the you provide on this lem'i to process your loan. This inforrna!ion may be shared with information (o appropriate parties engaged in liliyaticn. You are net required by law to other Federal agencies for sfatisiical, auditing, or archiving purposes. In addition, provide this information, but if you do not provide it, vre will not be ably !o process ~:ve may share fhe information with law enlacement agencies investigating a violation your lean application. Form TSP-'C t6l2uC5} EDITIOi~S PRIOR TO 8/C2 OBSOLETE EXHIBIT 2-A 11~~ri~_a~~~ ~ta?~m~rt Mortgage Sta Loan Number: Property Address: Borrower Name: Co-Borrower Name. ~tee~nent ooolsassea 5004 i3ALP~lORAL CT HA.h:1PUEN ?O':^1NSt11P PA 1?055-0000 ALBERT J FANELt..I JR JEAN B FANE.LI ----------- --------- Mlortgage Statement as of 08!0312009 -- -------- Billing Address Loan Due Date 09101/2009 5004 BALP~IORAL CT interest Rate 5 375% M~CHANICSEiURC;. PA ??050-8307 Past Due Paymenttsi SO 00 ;:npaid Late Charges SO.OG Other Charges 50 00 Scheduled Payment 51,x34.66 Property Address Total Amount Due 51 ,434.56 5004 BALMOP.AL CT HAM°D=N ?OVVNSHIP PA 17055 0000 Year to Date Year to Date Year to Date interest Paid Lat Charges Paid Taxes Paid 53,435 1l: ~U ~i~ 50? i 75 Current Principal Current Escrow Year to Date Balance Balance ?rincipal Paid S92 5x5.71 $<^ ? 2 3r 55,1?1.86 .. Pa<~r 1 c1f~ 1 C.opynght '~~ 2000 ~ [0(: ~+ Lender t>nxessrn~ Servrces. !nr A!! ~rlr•a-. ':eser veC EXHIBIT 13 TABLE OF CONTENTS Table of Contents 2 Appraisal Scope of Work 3 Appraisal Extraordinary Assumptions 4 Appraisal Hypothetical Conditions 4 Appraisal Summary 5 Digital Photograph & CD-ROM Instructions 6 Marital Personal Property Listing 7 Location: 5004 Balmoral Ct. Mechanicsburg, PA 17050 7 Location: 271 E. Crestwood Dr. Camp Hill, PA 17011 18 Non-Marital Personal Property Listing 23 Location: 5004 Balmoral Ct. Mechanicsburg, PA 17050 23 Location: 271 E. Crestwood Dr. Camp Hill, PA 17011 2S Appraisal Summary (Copy) 26 Glossary 27 Appraisal Certification 28 References 29 Privacy Notice 30 Statement of Qualifications 31 Ibis Appraisal Services Page 2 oE31 r ., ~ APPRAISAL SCOPE OF WORK pis Armraisa~ C.A. I hereby certify that, upon the clients' request for the appraisal of the marital personal property of Albert Fanelli & Jean Fanelli, 5004 Balmoral Ct. Mechanicsburg, PA 17050 & 271 E. Crestwood Dr. Camp Hill, PA 17011, that I have appraised the marital personal property to determine the Fair Market Value for the purpose of divorce distribution, effective date of September 17, 2009 and reported on September 17, 2009. The clients in this marital personal property appraisal are the legal counsel for Mr. Fanelli and Mrs. Fanelli: John F. King, Esq., 19 S. Hanover St., Suite 103 Carlisle, PA 17013 & Barbara Sumple-Sullivan, Esq., 549 Bridge St. New Cumberland, PA 17070. The intended users of this appraisal are Mr. Fanelli, Mrs. Fanelli, Atty. King, Atty. Sumple-Sullivan, Cumberland County Divorce Master & Courts and any other person(s) authorized by Atty. King & Atty. Sumple-Sullivan. The dates of inspection were September 9, 2009 & September 16, 2009. I have personally and physically inspected the listed personal property. The only item that I did not personally inspect was Mr. Fanelli's gold wedding ring. Mr. Fanelli did email me information on his wedding ring. The personal property was found to be in good to excellent condition, unless otherwise noted. All of the furniture and items were twentieth/twenty-first century objects and were in-use in both households. The china, silver and crystal were appraised as assemblages, rather than piece-by-piece. The information and values contained in this report are based upon my experience as an appraiser and other reliable sources using a Sales Comparison Approach to determine Fair Market Value. [Fair Market Value is used in divorces .and estates in the state of Pennsylvania.] A market data analysis with comparable sales transactions was used to reconcile the quality and quantity of data. Values are reported piece-by-piece, and/or as a whole. All values reported have been determined with consideration to the condition of the item, market conditions, and salability factors. All analyses, notes and paperwork are found in the workfile. Ibis Appraisal Sewices Director Page 3 of 31 ~ ~s A APPRAISAL EXTRAORDINARY ASSUMPTIONS c~a Assumes that Joseph James, Jeweler, 301 E. Main St. Mechanicsburg, PA 17055 is correct with his assessment of the diamond rings and necklace: approximately $2,000.00 for the rings and the necklace. c~a Assumes that Mr. and Mrs. Fanelli's definition of marital property &non-marital property are similar. Marital property acquired during the marriage. Non-marital property acquired either before the marriage or after separation. c~ Assumes that both children's personal items and toys are theirs and not considered marital property. c~a Assumes that both Norwich terrier dogs are the sole property of Mrs. Jean Fanelli and not marital property. APPRAISAL HYPOTHETICAL CONDITIONS c~a Mr. Fanelli's gold wedding band is real gold and was purchased for around $500.00. Ibis Appraisal Sewices Page 4 of 31 • ~~ ., APPRAISAL SUMMARY It is in my opinion, that, as of September 17, 2009, the Fair Market Value of the marital personal property of Albert Fanelli & Jean Fanelli residing at 5004 Balmoral Ct. Mechanicsburg, PA 17050: (Seven Thousand Two Hundred Fifty Six Dollars and Zero Cents) ($7,256.00) It is in my opinion, that, as of September 17, 2009, the Fair Market Value of the marital personal property of Albert Fanelli & Jean Fanelli residing at 271 E. Crestwood Dr. Camp Hill, PA 17011: (Two Thousand Nine Hundred Twenty Eight Dollars and Zero Cents) ($2,928.00) It is in my opinion, that, as of September 17, 2009, the Fair Market Value of the marital personal property of Albert Fanelli & Jean Fanelli residing at 5004 Balmoral Ct. Mechanicsburg, PA 17050 & 271 E. Crestwood Dr. Camp Hill, PA 17011: (Ten Thousand One Hundred Eight Four Dollars and Zero Cents) ($10,184.00) Ibis A~raisa~ The report must be read in its entirety. The ADDraisal Summary ONLY is not the aDDralsal reDOl~ Ibis Appraisal Services Page 5 oE31 ry .r ~ h STATEMENT OF QUALIFICATIONS Alyssa L. Loney, C.A. Presently Director and Founder of Ibis Appraisal Services. Member of Institute of Appraisal of Personal Property, American Society of Appraisers, International Society of Appraisers, and Professional Coin Grading Service. Professional Designations and Certifications ISA Course Completions - Core Course in Appraisal Studies -Antiques & Residential Contents USPAP - Uniform Standards of Professional Appraisal Practice C.A. -Certified Appraiser of Personal Property designation earned through course work and classes provided by the Institute of Appraisal of Personal Property. Archaeological Resources Protection Act Course - Archaeological Resources Protection Act of 1979, National Historic Preservation Act of 1966, the Native American Graves Protection and Repatriation Act and the American Antiquities Act of 1906. Professional Accomplishments ~ State Historical and Underwater Archaeologist for the State of Louisiana.. ~ Attended the Conservation of Indian Artifacts Symposium sponsored by the Smithsonian Institution and the Tunica-Biloxi Indian Reservation, Marksville, Louisiana. ~ Director of the West Virginia University Historical Costume Museum. ~ Research Archaeologist/ Artifact Instructor for CADW (Welsh Historic Monuments)/ University of York, England. ~ Research and Preservation Specialist for the Maryland Historical Trust. ~ Presented and published works for national and international organizations including the Society for Historical Archaeology, Middle-Atlantic Archaeology Conference, Southeastern Archaeological Conference, Louisiana Archaeological Society, and the Maryland Historical Trust. Education B.Sc. Historical Textiles and Clothing, 1992, West Virginia University, Morgantown, West Virginia, United States. M.A. Medieval Archaeology, .1995, University of York, York, England. C.A.P.P. Certified Appraiser of Personal Property, 2001, Institute of Appraisal of Personal Property, York, Pennsylvania, United States. A.R.P.A. Certified to conduct investigations and damage assessment that pertains to violations of the United States federal, state, and local laws pertaining to archaeological sites and cultural properties. S.B.D.C. First Step Entrepreneurial Series, 2001, Kutztown University of Pennsylvania, Small Business Developmern Center. Conducts extensive on-site appraisals, assessments, analyses, and authentication of personal and cultural property. Operates on local, national, and irnernational levels. Conducts research on all objects considered personal and cultural property. Ibis Appraisal Services Page 31 oF31 2GG~ 5:,~ ~ I F'~ !~~ t ~ j U,`1 - _ `'~j ;~ A f 1 4 r JEAN B. FANELLI, v. IN THE COURT OF COMMON PLEAS Plaintiff, CUMBERLAND COUNTY, PENNSYLVANIA N0.07-4922 CIVIL TERM CIVIL ACTION -LAW IN DIVORCE ALBERT J. FANELLI, JR., Defendant. INCOME AND EXPENSE STATEMENT OF ALBERT J. FANELLI, JR. I verify that the statements made in this Income and Expense Statement 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 : %~~Zz/O q ~yt~/V~- Albert J. Fanelli, Jr., De dant INCOME Employer: Naval Supply Systems Command Address: 5450 Carlisle Pike, Mechanicsburg, PA 17050 Type of work: Procurement Analyst Payroll Number: 97380600 Pay Period (weekly, biweekly, etc.): b iweekly Gross Pay per Pay Period: $ 5,044.00 Itemized Payroll Deductions: Federal Withholding: $ 1,007.04 Social Security: $ 297.00 Local Wage Tax: $ 71.46 State Income Tax: $ 147.06 Retirement: $ 292.5 5 Savings Bonds: $ Credit Union: $ Life Insurance: $ Health Insurance: $ 108.91 Other (specify): Flexible Spending Acct: $ 153.84 Medicare: $ 69.45 Charity $ 5.00 Net Pay per Pay Period: Other Income: None Week Interest Dividends Pension Annuity Social Security Rents Royalties Expense Account $2,891.69 Month Year -0- -0- -0- -0- -0- -0- -0- -0- Gifts Unemployment Comp. Workmen's Comp. Total TOTAL INCOME EXPENSES Weekl Home Mortgage/rent Maintenance Utilities Electric Gas Oil Telephone Water Sewer Employment Public Transportation Lunch Taxes Real Estate Personal Property Misc. Taxes-Borough Income Insurance Homeowners -o- -o- -0- $6,283.00 monthly net Monthly $725.00 $100.00 $ 47.00 $ 5.00 Yearly $ 19.60 Automobile Life Accident Health Other Automobile Payments Fuel Repairs EXPENSES Weekly Unreim. Med. expenses Doctor Dentist Orthodontist Hospital Medicine Special needs (glasses, braces, orthopedic devices) Education Private school Parochial school College Religious Personal Clothing Food Barber/hairdresser Credit payments $ 65.00 $ 28.75 $ 75.00 $ 60.00 Monthly $47.00 (avg. 2008) $ 50.00 $ 260.00 $ 20.00 Yearly Charge account Memberships Loans Thrift Savings Plan Miscellaneous Household Help Child Care Papers books/magazines Entertainment Pay TV Vacation Gifts Legal Fees Charitable Contributions Other Child Support Spousal Payments Other $500.00 (balance $5,250) $170.39 (loan for Wife's vehicle) $100.00 $ l oa.oo $ 50.00 $ 75.00 $450.00 $1,537.00 $1,537.00 TOTAL EXPENSES: $6,027.00 PROPERTY OWNED: Checking account Savings accounts Credit Union Stocks bonds Real estate Personalty INSURANCE: Medical/Dental Description Value Ownership HWJ Marital residence $260,000.00 TOTAL J $ 10,184.00 J $370,184.00 HWC ~~ ~ P~~~"~'~'~~ ~QQ~ ~~~ ~~? ~~ ~~ GG~tJ?~~•.~~~ ~~ ;'.~~~,~+fTY E:~ ~; ~ ~`r L~;=~~i ~!~ ~ "' i . -:"~ ~f Bazbara Sumple-Sullivan, Esquire J U L Aa a YI'( ~~ : ~ Supreme Court #32317 Z Q ~ ~ ,; ~E ~. C ~ t~~ i ~i . ~ ~ I l 549 Bridge Street New Cumberland, PA 17070 CL'~::~,_. ; . ,.;~J~~ fir` (717) 774-1445 `~ JEAN B. FANELLI, IN THE COURT~~F~l~O~VI1Vl~~N PLEAS Plaintiff :CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 07 - 4922 ALBERT J. FANELLI, JR., :CIVIL ACTION -LAW Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on August 20, 2007. 2. The marriage of the Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from 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 are made subject to the penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. DATE: , 2010 JEAN . F I Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, Plaintiff v. ALBERT J. FANELLI, JR., Defendant ~ TE _ _. `.:;Y ~u~zq ~~ ~~3a a~E~~~~~ ~~ x~t~~~ ~:: o r.:: ~ ~,;~~ d 1~~1~ IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 07 - 4922 CIVIL ACTION -LAW IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER &3301(cl 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 statement herein aze made subject to the penalties of 18 Pa.C.5.§4904 relating to unsworn falsification to authorities. DATE: V~1 ~ , 2010 '~ JEAN .FANEL Barbara Sample-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, Plaintiff v. ALBERT J. FANELLI, JR., Defendant ~I's~.~ ~<r 2~IQJ~~ ~ ~~ ~' 32 r~ . IN THE COURT(i~"~`E?l~!~1kIQN. PISS CUMBERLAND CCY`;.~'~TSYLVANIA NO. 07 - 4922 CIVIL ACTION -LAW IN DIVORCE AFFIDAVIT OF CONSENT A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on August 20, 2007. 2. The marriage of the Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from 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 are made subject to the penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. DATE: ~ 7 eZ-u ~- y , 2010 F~ '~ ALBERT J. ELLI, JR. =CL=i; . - T~-'" ~~ . -, ,, f`:!~ t Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 JEAN B. FANELLI, Plaintiff 201 ~~', '~ '., Jv~ atq Rm 6~3~ ` . ; y;, r ,;,: ~ , I ~ ' i i,.. '~ , +. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. ALBERT J. FANELLI, JR., Defendant NO. 07 - 4922 CIVIL ACTION -LAW IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER &3301(c) OF THE DIVORCE CODE 1. I consent to the entry of a 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 statement herein are made subject to the penalties of 18 Pa.C.S.§4904 relating to unsworn falsification to authorities. DATE: °~ ~ ~ y L ~ 2010 ~~~~~~ , ALBERT J. F ELLI, JR. JEAN B. FANELLI, IN THE COURT OF COMMON PLEAS OF Plaintiff' CUMBERLAND COUNTY, PENNSYLVAN IA Vs. NO. 07 - 492 2 CIVIL ALBERT J. FANELLI, JR., Defendant: IN DIVORCE OR DER OF COURT y. AND NOW, this day of , 2010, the parties and counsel having entered into an agreement and stipulation resolving the economic issues on Julv 27, 2010, the da---e set for a Master's heari?g, the agreement and stipulation having been transcribed, the appointment of the Master is vacated, and counsel can conclude the proceedings by the filing of a praecipe to transmit the record with the affidavits of consent of the parties so that a final decree in divorce can be entered. cc: ?/Karbara Sumple.-Sullivan Attorney for Plaintiff john F. King Attorney for Defendant t J ? n BY THE COURT, Kevi A. Hess, P.J. i .? 7 .* JEAN B. FANELLI, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. NO. 07 - 4922 CIVIL ALBERT J. FANELLI, JR., Defendant IN DIVORCE THE MASTER: Today is Tuesday, July 27, 2010. This is the date set for a Master's hearing in the above-captioned divorce proceedings. Present in the hearing room are the Plaintiff, Jean B. Fanelli, and her counsel Barbara Sumple-Sullivan, and the Defendant, Albert J. Fanelli, Jr., and his counsel John F. King. This action was commenced. by the filing of a complaint. in divorce on August 20, 2007. The complaint raised grounds for divorce of irretrievable breakdown of the marriage. With respect to the grounds for divorce, the parties have signed affidavits of consent and waivers of notice of intention to request entry of divorce decree today. The affidavits and waivers will. be filed by the Master's office with the Prothonotary office. The divorce can, therefore, conclude under Section 3301(c) of the Domestic Relations Code. The complaint; in divorce did not raise anv economic claims. An answer and counterclaim was filed on October 10, 2007, raising a claim for equitable 1 distribution. On September 11, 2009, wife filed a petition raising additional claims of alimony pendente lite, alimony, and counsel fees and costs. The Master has been advised that after considerable negotiations today and previously, the parties have reached an agreement with respect to the outstanding economic issues. An agreement is going to be placed on the record in the presence of the parties. 'The agreement as placE!d on the record. will be considered the substantive agreement of the parties, not subject to any changes or modifications except. for correction of typographical errors which may be made during the transcription. Consequently, when the parties leave the hearing room today, they are bound by the terms of the agreement as stated on the record. The agreement is going to be transcribed and sent to counsel to review for typographical errors. Those corrections, if any, will. be made and the parties will be asked to sign the agreement affirming the terms of settlement as stated on the record. However, in the event that one or both of the parties does not sign the agreement, they are nevertheless bound by the agreement when they leave the hearing room today. As indicated, the agreement will be transcribed and sent to counsel and the parties for signature. Upon receipt by the Master of a completed 2 agreement, the Master will prepare an order vacating his appointment and counsel can then file a praecipe transmitting the record to the Court requesting a final decree in divorce. The parties were married on July 11, 1992, and Separated July 28, 2007. They are the natural parents of two children, both of whom currently reside with wife. Ms. Sumple-Sullivan. MS. :RUMPLE-SULLIVAN: I will dictate what. constitutes the marital estate and the agreed upon distribution of those assets. 1. The parties had acquired real estate interest in the property designated as 5004 Balmoral Court in Mechanicsburg. That property shall become the sole and separate property of wife and husband does hereby waive and release any claims relative to that property. This transfer is subject to wife's refinancing. The current mortgage which is held by PNC Mortgage, loan No. 0001585894. Wife shall undertake the refinance within 90 days of the date of this settlement. Wife has been approved for said refinance and the parties agree that husband shall execute a deed transferring all his righ title and interest to wife which will be recorded as part of that finance. In clarification of the transfer of the (deed, wife shall present to husband a deed for his execution, which shall be held in escrow by Attorney King and released incident to the refinance of the debt. 2. The parties had two vehicles at the time of the separation. It is agreed that the 2005 Ford Freestar SE shall become the sole and separate property of wife and the 2005 Nissan Sentra shall become the sole and separate property of husband. Neither of these vehicles are encumbered and each releases any claim to the vehicle of the other. The parties shall cooperate to transfer titles as may be required relative to those vehicles. 3. At the time of separation there were various investment bank accounts. It is agreed that all remaining sums in the 3 T Rowe Price account which consisted of mutual fund, No. 36957 and T Rowe Price mutual fund, No. 36876 shall become the sole and separate property of wife and husband does hereby release any claims relative to those funds. Husband agrees not to take any withdrawals pending transfer and liquidation of those accounts. 4. The parties also had a Fidelity investment, No. 4920 and it is agreed that wife shall be the sole owner of that balance of that account. Husband, again, agrees to make no withdrawals of that account pending liquidation and transfer to wife. 5. The parties also had a Commerce checking account, No. 7635. That account. has been expended and has been closed. Neither party makes any claim against the other fcr the procE?eds in that account. 6. During the marriage various retirement accounts and pensions have been accrued by the parties. Husband has incurred an accrued benefit in the FERS pension. That pens:-on shall become the sole and separate property of husband. 7. Husband also has an interest in a thrift savings plan through his employment. It is agreed that from that thrift savings husband shall roll over into a cuali_fied account the sum of $91,500.00 to wife. After the roll over the remainder in the thrift savings plan shall become the sole and separate property of husband. It is further noted that at the time of separation there was a marital loan against the ---hrift savings plan. That loan shall become the sole and separate obligation of husband to satisfy if, in fact, that loan has not yet been satisfied. 8. Husband additionally had a Fidelity Roth IRA, No. 6690. Husband has liquidated that Roth IRA and the sole proceeds of t:zat Roth IRA shall be the sole and separate property of husband. 9. In regards to wife's retirement and pension account, wife has a Fidelity Roth IRA, No. 6712. That property shall be the sole and separate property of wife and husband waives any claims relative to that IRA. Additionally, wife had a Fidelity IRA which included various pre-marital pensions that she had acquired prior to the marriage. The Fidelity Traditional IRA shall become the sole and separate property of wife and husband waives any claims relative to that property. 4 10. The parties have previously divided all personal property and household items that were acquired during the marriage, and the parties agree that all property in their respective possession shall be the sole and separate property of that person who has possession of those items and they, in fact, will waive any claims to the personal property in the possession of the other. 11. Husband has acquired frequent flyer miles through the airlines of Delta Northwest, American Airlines, United Airlines, and US Air. Husband agrees to assign to wife the frequent flyer miles from the Delta Northwest and US Air. Husband shall retain. the miles through American Airlines and UnitE?d Airlines. The parties waive any claims to the respective miles retained by the other party. 12. Additionally husband had acquired certain annual and sick leave during the term of the marriage. That leave shall be his sole and separate property and wife waives any clairls relative to that leave. 13. The parties agree that husband shall provide the necessary documents relative to the transfer of the $91,500.00 to wife from the TSP Plan and wife shall cooperate by providing to husband the qualified account to which the $91,500.00 shall be transferred. 14. At the time of separation the parties had no outstanding debts that were not satisfied by the Commerce account. The parties did have the outstanding mortgage with PNC, which wife shall assume incident to the refinance and ---he only other debt was relative to the thrift savings plan loan, which husband has satisfied or is in the process of satisfying. All joint credit cards have been terminated and there is nothing outstanding at this time period. 15. Husband agrees to pay to wife upon the entry of the divorce decree an alimony payment of $1,000.00 per month. That alimony shall be payable for 60 months. The term and amount of the alimony shall be non-modifiable. The parties agree that the existing spousal support order which is filed at Domestic Relations to docket No. 274109388 shall terminate upon the divorce and the parties agree to submit this stipulation to Domestic Relations for an alimony order in the amount of $1,000.00 to be entered in that case number. The alimony can terminate earlier in the event of death of husband, death of wife, wife's co-habitation and/or remarriage. 16. Wife withdraws her claim for counsel fees. 5 17. The parties agree that they have or warrant that they had no life insurance policy with cash value. The only acquired insurance during the marriage was a term policy which husband has a death benefit through his employment. In regards to life insurance, husband agrees that he shall retain wife as beneficiary for an amount of $60,000.00 pending full satisfaction of the alimony payments required by this stipulation or until such time as the alimony obligation ceases to exist, and the balance of the policy shall be payable for the benefit of the children. 18. Except as herein otherwise provided, each party may dispose of his or her property in any way and each party hereby waives and relinquishes any and all rights he or she may now have or hereafter acquire under the present or future laws of any jurisdiction to share in the property or the estate of the other as a result of the marital relat=ionship including without limitation, statutory allowance, widow's allowance, right of intestacy, right to take against the will of the other, and right to act as administrator or executor in the other's estate. Each will at the request of the other execute, acknowledge, and deliver any and all instruments which may be necessary or advisable to carry into effect this mutual waiver and relinquishment of all such interest, rights, and claims. MS. SUMPLE-SULLIVAN: Jean, you've been in the ]tearing room today as I have dictated to you what the settlement which was derived at with Albert is; is that true? MS. FANELLI: Yes. MS. SUMPLE-SULLIVAN: And you've heard me dictate the terms of that settlement? MS. FANELLI: Yes. MS. SUMPLE-SULLIVAN: Do you understand the terms of that settlement? MS. FANELLI: Yes. 6 MS. SUMPLE-SULLIVAN: Are you accepting this settlement as full and final settlement of your claims against him arising out of your marital :relationship with him? MS. FANELLI: Yes. MS. SUMPLE-SULLIVAN: Are you doing that voluntarily? MS. FANELLI: Yes. MS. SUMPLE-SULLIVAN: And is anyone coercing you at that point to make this settlement? MS. FANELLI: No. MS. SUMPLE-SULLIVAN: And do you have any type of impairment today, whether it be through use of drugs or alcohol which would impair your judgment to accept this settlement? MS. FANELLI: No. MS. SUMPLE-SULLIVAN: Do you have any questions about the disclosure of assets that has been ongoing today? MS. FANELLI: No. MR. KING: Mr. Fanelli, you've been present today during the dictation of certain terms for an agreement between your wife and yourself; is that correct? MR. FANELLI: Yes. MR. KING: Do you understand that the terms 7 that were dictated fully and finally resolve the divorce between yourself and your wife? MR. FANELLI: Yes. MR. KING: And did you understand the terms as they were dictated today? MR. FANELLI: Yes. MR. KING: And are you in complete agreement with those terms as dictated? MR FANELLI: Yes. MR. KING: Do you have any questions regarding any of those terms? MR. :FANELLI: No. MR. :KING: And you understand that by agreeing to this, that ends any claim that you might have to any of the assets of the marriage or any defenses you might raise to the issue of alimony? MR. FANELLI: I understand, yes. MR. KING: That's all. THE MASTER: Thank you counsel. I acknowledge that I have read the above stipulation and agreement, that I understand the terms of settlement as set forth herein, and that by signing below I ratify and affirm the agreement previously made and intend to hind myself to the settlement as a contract obligating mysE>lf to the terms of settlement and subjecting myself to the methods and procedures of enforcement which may be 8 t imposed by law and in particular Section 3105 of the Domestic Relations Code. WITNF Barnara ?umpie-?5u.L L1.van Attorp,<v'for P1a,a-ntiff fohn F. King ?'t, orney for D dant DATE: `6 19 Z?IU ell 'Y /10 Albert J 9 JEAN B. FANELLI ~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. ALBERT J. FANELLI, JR. 2007-4922 NO. DIVORCE DECREE AND NOW, /'G..Gv g ~ , ze ~ o , it is ordered and decreed that JEAN B. FANELLI plaintiff, and ALBERT J. FANELLI, JR. 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 ire as follows: (ff'no claims remain indicate "None.") »None. Ali claims have been resolved pursuant to the Marital Settlement Agreement .reached at the Master's Hearing on July 27, 2010. Said Agreement shall be incorporated, but not merged into this Divorce Decree. By the Court, ~~<< i vo~c1 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 07-4922 CIVIL State Sommonwealth of Pennsylvania OOriginal Order/Notice CO./City/DiSt. Of CUMBERLAND 274109388 OAmended Order/Notice Date of Order/Notice 09/21/10 653 S 2007 OTerminate Order/Notice Case Number (See Addendum for case summary) OOne-Time lump Sum/Notice RE: FANELLI , ALBERT J . JR Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) DEPT OF DEFENSE CIVILIANS 181-52-1205 Employee/Obligor's Social Security Number 6595101866 Sent Electronically Employee/Obligor's Caseldentifier D O NOT ~ ~ ~ ~~ 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. $ i, 537.50 per month in current child support $ o . oo per month in past-due child support Arrears 12 weeks or greater? ~ yes ®no ~-.-, $ o . oo per month in current medical support L~y ,..,, $ o . oo per month in past-due medical support ~ ° ....~ $ i, 000. oo per month in current spousal support ~~ cn ~;~''"~ $ o . oo per month in past-due spousal support :~"=~ ~ -o $ o . o o per month for genetic test costs u ~'" rv ~ ~.t $ o . oo per month in other (specify) ~ ~ w --~c~ $ one-time lump sum payment . for a total of $ 2, 537.50 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.doestr~'bt ttch the ordered support payment cycle, use the following to determine how much to withhold: $ 583 97 per weekly pay period. $ 1, 26a . 75 per semimonthly pay period (twice a month). $ i, 167.95 per biweekly pay period (every two weeks). $ 2, 537. so 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 /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER 1N ORDER TO BE PROCESSED. DO NOT SEND CASH BY MA/L. BY THE COURT: KEVIN A HESS DRO: R.J. Shadday Form EN-428 Rev.1 Service Type M OMBNo.:0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If ~heckefl you are required, to provide a copy of this form to your~mployee. If your employee works in a state that is di Brent rrom the state that issued this order, 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 employee%bligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee%bligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with 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. 3115751420 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ~ THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ~ EMPLOYEE'S/OBLIGOR'S NAME:FANELLI, ALBERT J. JR EMPLOYEE'S CASE IDENTIFIER: 6595101866 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 employeelobligorfrorn 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 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 (1 S 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. 1 1. 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 Service Type M Page 2 of 2 OMB No.: 0970-0154 Form EN-428 Rev.1 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: FANELLI, ALBERT J. JR PACSES Case Number 274109388 Plaintiff Name JEAN B. FANELLI Docket Attachment Amount 00653 S 2007 $ 1,537.50 Child(ren)'s Name(s): DOB ALBERT J. FANELLI III 1.2/2.1/95 .., _. MAFt~A1t~iT i7 . .FAT+~~;L Y i 0 / 0 2 / 9'l` PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Service Type M Addendum OMB No.: 0970-0154 PACSES Case Number 844111955 Plaintiff Name JEAN B. FANELLI Docket Attachment Amount 07-4922 CIVIL$ 1,000.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Form EN-428 Rev.1 Worker I D $ IATT INCOME WITHHOLDING FOR SUPPORT ' C onmxwxLmcomsw�xnmLo/woonoemmoncs FOR SUPPORT 0wV' /_�^/ —z4. /69°39»r F44 / 1195-5' u AMswoEoIwu 07 — L1���^~ � / / O ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT ~ :ZD/ 7 @> TERMINATION orxwo mom: C] Child Support Enforcement(CSE)Agency Court E] Attorney Private Individual/Entity(Check One) NOTE:This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions http://www.acf.hhs.gov/proarams/cse/newhire/employer/Dublication/Dulalication.htm-forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. StatefTribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 6595101866 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for orderldocket informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) RE: FANELLI,ALBERT J. JR DEPT OF DEFENSE CIVILIANS Employee/Obligor's Name(Last, First,Middle) Sent Electronically Employee/Obligor's Social Security Number (See Addendum for plaintiff names DO NOT MAIL associated with cases on attachment) Custodial Party/Obligee's Name(Last, First, Employer/Income Withholder's FEIN 311575142 NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last, First,Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see IWO instructions you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. See Addendum for dependent names and birth dates associated with cases on attachment ORDER INFORMATION: This document is based on the support or withholding order from CUM=LAM Cnonty, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts the-4mp�t�ay_ee/ VV, --jr, obligor's income until further notice. f-r! $ 0.00 per month in current child support > M $ 0.00 Der month in past-due child support- Arrears 12 weeks or greater? 0 A—,C7�, Z2 $ 0.00 per month in current cash medical support $ 0.00 per month in past-due cash medical support rl $ 0.00 Der month in current spousal support $ 0.00 per month in past-due spousal support $ 0.00 per month in other(must specify) for a Total Amount to Withhold of$ 0.00 per month. AMOUNTS TO WITHHOLD: You do not have ho vary your pay cycle tobmin compliance with the Order Information, |f your pay cycle does not match the ordered payment cycle,withhold one of the following amount: $ OOO per weekly pay period. $ 0.00 per semimonthly pay period(twice omonth) $ 0.00 per biweekly pay period (every two weeks) $ 0.00 per monthly pay period. u Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: \f the emp|oyma/ob|ignr'o principal place ofemployment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten(10) wU3cKbg days after the date of . Send payment within seven L(7)working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 551/6 of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe). the employer can obtain withholding |imitahnno, time nequirarnenta, and any allowable employer fees at h1m for the employee/obligor's principal o|uca of employment, Document Tracking Identifier OMB No.:0970-0154 Form EN-428O8/12 Service Type YN Worker |D $|/TT ❑ Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6)or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: APRIL 12 2013 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ❑ If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law(23 PA C.S.§4374(b))requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID(shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://www acf hhs aov/programs/cse/newhire/employer/contacts/contact map.ht Priority: Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment.You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court,Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the"Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment.The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits,you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs,you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date—05/31/2014.The OMB Expiration Date has no bearing on the termination date of the IWO;it identifies the version of the form currently in use. Form EN-428 06/12 Service Type M Page 2 of 3 Worker ID $IATT � = Employer's Name: DEPT OF DEFENSE CIVILIANS Employer FEIN: Employee/Obigo/eNume: FANELLI,ALBERT J.JR 6595101866 CSE Agency Case Identifier: Order Identifier:(See Addendum for orderldocket information Withholding Limits:You may not withhold more than the lesser nt 1)the amounts allowed by the Fodom| Consumer Credit Protection Act(CCPA)(15U.S.C. 1073(b));or2)the amounts allowed by the State or Tribe of the emp|nyao/oWigor'a principal place of employment(see REMITTANCE INFORMATION). 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 in not supporting another family. However,those limits increase 5%-to 55%and 65%-if the arrears are greater than 12 weeks. |f permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employerslincome withholders who receive a State IWO,you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)), Depending upon applicable State or Tribal law,you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 3115751420 0 This person has never worked for this employer nor received periodic income. 0 This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: |f you have any questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at . by fax at by amoU orwebs|ho at Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE, PA. 17013(Issuer address). To Employee/Obliaor: |f the employee/obligor has questions,contact WAGE ATTACHMENT UNIT(Issuer name) by phone a1 . by fax ot . by email orwebsi\eot . IMPORTANT:The person completing this form is advised that the information may be shared with the employeelobligor, OMB wo.:osn-0*u Form EN-428O8/12 Service Type yW Page 3of3 Worker|[) Q/ATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: FANELLI, ALBERT J. JR PACSES Case Number 274109388 PACSES Case Number 844111955 Plaintiff Name Plaintiff Name JEAN B. FANELLI JEAN B. FANELLI Docket Attachment Amount Docket Attachment Amount 00653 S 2007 $ 0.00 07-4922 CIVIL $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB ALBERT J. FANELLI III _ 12/21/95 MARGARET J.FANELLI 10/02/97 PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-428 06/12 Service Type M OMB No.:0970-0154 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT Q ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT(IWO) /Z74 )0,7:3 ,9 ffqq 1 l/ 5y6��7 / Q AMENDED IWO /J p/( f} / 07— �,5; (-1 y! Q ONE-TIMEORDERINOTICE FOR LUMP SUM PAYMENT Gr✓ (�`�' O TERMINATION OF iWO Date; 04115113 ❑ Child Support Enforcement(CSE)Agency ® Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender(see iWO instructions http://wvvw.pcf hhs�gov/proorams/cse/newhire/emplQyer/pu lication/publication htm-forms). if you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 6595101866 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for orderldocket Informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) RE: FANELLI ALBERT J.JR DEPT OF DEFENSE CIVILIANS Employee/Obligor's Name(Last,First,Middle) 181-52.1205 Sent Electronically Employee/Obligor's Social Security Number D o NOT M A 1 L (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name(Last,First, Middle) Employer/Income Withholder's FEIN 311575142 NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last,First,Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see iWO instructions http://www.acf.hhs.00v/r)rograms/`cse/``newhire/ employer/publication/publication.htm-forms,If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. 3115751420 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based On the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts froth e�em playee/ obligor's income until further notice. $ 1,537.50 per month in current child support r ?f $ 0.00 per month in past-due child support- Arrears 12 weeks or greater? O Yea� go f, $ 0.00 per month in current cash medical support X- 3; S $ 0.00 permonth in past-due cash medical support ; —4 $ 1,000.00 permonth in current spousal support s C:> $ 0.00 per month in past-due spousal support 4 C7' $ 0.00 per month in other(must specify) for a Total Amount to Withhold of$ 2,537.50 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle,withhold one of the following amount: $ 583.97 per weekly pay period. $ 1,268.75 per semimonthly pay period(twice a month) $ 1,167.95 per biweekly pay period (every two weeks) $ 2,537.50 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten 10 working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor,withhold up to 55%of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at http//www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact map, hrm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No,:0970-0154 Form EN-428 06/12 Service Type M Worker ID$IATT ❑ Return to Sender[Completed by Employer/Income Withholder]. Payment must be directed to an SDU in Q— accordance with 42 USC §666(b)(5)and (b)(6)or Tribal Payee(see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: APRIL 15 2013 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ❑ If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law(23 PA C.S.§4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons,or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER/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. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://www acf hhs.ciov/programs/cse/newhire/employer/contacts/contact map htm Priority: Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court,Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the"Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages.You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits,you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date—05131/2014.The OMB Expiration Date has no bearing on the termination date of the IWO;it identifies the version of the form currently in use. Form EN-428 06/12 Service Type M Page 2 of 3 Worker ID $IATT ~ _^� Employers Name: DEPT OF DEFENSE CIVILIANS Employer FEIN: Emp|oyoe/Ob|igo/sName: FANELLI,ALBERT J.JR 6595101866 CSE Agency Case Identifier: On��|danU�ec IS 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 empfoyee/obligor's principal place of employment(see REMITTANCE INFORMATION). 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,those limits increase 5%-ho55%and G5%'if the arrears are greater than 12 weeks. |f permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe, For Tribal employers/income withholders who receive a State IWO,you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law,you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the OCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor,an employer must promptly notify the OSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 3115751420 0 This person has never worked for this employer nor received periodic income. 0 This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employerlincome Withholder: |f you have any questions, contact WAGE ATTACHMENT UNIT(issuer name) by phone at by fax at . by email orwabmitmat: . Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS.SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE, PA. 17013(issuer address). To Employee/Obligor: |f the employee/obligor has questions, contact WAGE ATTACHMENT UNIT(issuer name) by phone a1 by fax ot . by email o,websi1eot . IMPORTANT:The person completing this form ia advised that the information may be shared with the emp|oyeo/ob||gnr. OMB No'o97v-0,*^ Form EN-428D8/12 Service Type yW Page 3nf3 Worker |D $|ATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: FANELLI, ALBERT J. JR PACSES Case Number 274109388 PACSES Case Number 844111955 Plaintiff Name Plaintiff Name JEAN B. FANELLI JEAN B. FANELLI Docket Attachment Amount Docket Attachment Amount 00653 S 2007 $ 1,537.50 07-4922 CIVIL $ 1,000.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB ALBERT J. FANELLI III 12/21/95 MARGARET J. FANELLI 10/02/97 PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACKS Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-428 06/12 Service Type M OMB No.:0970-0154 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT / Q ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT(IWO) , � r^'i+ 1 D'"/.S? �'r L 1 ' )q SS Q. AMENDED IWO r 3 n WOD� Q Lo ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT J J issammir Q TERMINATION OF IWO Date: 12/02/13 ❑ Child Support Enforcement(CSE)Agency ® Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This IWO must be regular on its face.Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions http://www.acf.hhs.gov/programs/cse/forms/OMB-0970-0154instructions.pdf). If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 6595101866 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket information) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) RE: FANELLI,ALBERT J.JR DEPT OF DEFENSE CIVILIANS Employee/Obligor's Name(Last,First,Middle) 181-52-1205 Sent Electronically Employee/Obligor's Social Security Number D O NOT MAIL (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name(Last, First, Middle) Employer/Income Withholder's FEIN 311575142 NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last,First,Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see IWO instructions htto://www.act hhs,gov/programs/cse/forms/ OMB-0970-0154 instructions.Ddt).If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. 3115751420 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from the e y oyee/ obligor's income until further notice. + $ 1,537.50 per month in current child support ' $ 77.00 per month in past-due child support- Arrears 12 weeks or greater? 0 yeSQ) no $ 0.00 per month in current cash medical support c.) $ 0.00 per month in past-due cash medical support $ 1,000.00 per month in current spousal support Vic, $ 0.00 per month in past-due spousal support c;") :a $ 0.00 per month in other(must specify) h' - for a Total Amount to Withhold of$ 2,614.50 per month. - AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle,withhold one of the following amount: $ 601.69 per weekly pay period. $ 1,307.25 per semimonthly pay period(twice a month) $ 1,203.39 per biweekly pay period (every two weeks) $ 2,614.50 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven (7)working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55%of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact_map. htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.:0970-0154 Form EN-428 11/13 Service Type M Worker ID$IATT ❑ Return to Sender[Completed by Employer/Income Withholder]. Payment must be directed to an SDU in - accordance with 42 USC§666(b)(5)and (b)(6)or Tribal Payee(see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: DECEMBER 2,2013 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ❑ If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law(23 PA C.S.§4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons,or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIRS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID(shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact_map.htm Priority: Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the"Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages.You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date-05/31/2014.The OMB Expiration Date has no bearing on the termination date of the IWO;it identifies the version of the form currently in use. Form EN-428 11/13 Service Type M Page 2 of 3 Worker ID $IATT Employer's Name: DEPT OF DEFENSE CIVILIANS Employer FEIN: 311575142 Employee/Obligor's Name: FANELLI,ALBERT J.JR 6595101866 CSE Agency Case Identifier:(See Addendum for case summary) Order Identifier:(See Addendum for order/docket information) 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/obligor's principal place of employment(see REMITTANCE INFORMATION). 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,those limits increase 5%-to 55%and 65%-if the arrears are greater than 12 weeks. If permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO,you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law,you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 3115751420 Q This person has never worked for this employer nor received periodic income. Q This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at:www.childsuoport.state.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST, P.O. BOX 320. CARLISLE, PA. 17013(Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at www.childsupport.state.pa.us. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB No 0970-0154 Form EN-428 11/13 Service Type M Page 3 of 3 Worker ID$IATT 4. ADDENDUM Summary of Cases on Attachment Defendant/Obligor: FANELLI, ALBERT J. JR PACSES Case Number 274109388 PACSES Case Number 844111955 Plaintiff Name Plaintiff Name JEAN B. FANELLI JEAN B. FANELLI Docket Attachment Amount Docket Attachment Amount 00653 S 2007 $ 1,614.50 07-4922 CIVIL $ 1,000.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB ALBERT J. FANELLI III 12/21/95 MARGARET J.FANELLI 10/02/97 PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACS S Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-428 11/13 Service Type M OMB No.:0970-0154 Worker ID $IATT b INCOME WITHHOLDING FOR SUPPORT Q ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT(IWO) 01 3 2 8 {-,1} I C1 J Q AMENDEDIWO _ O ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT ��-� ��-17 -4 Q TERMINATION OF IWO Date: 12/03/13 ❑ Child Support Enforcement(CSE)Agency ® Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions hltp://www.acf.hhs.agv/proarams/esg/forms/OMB-0970-0154 instructions pdf). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. State/TribefTerritory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 6595101866 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket information) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) RE: FANELLI,ALBERT J. JR DEPT OF DEFENSE CIVILIANS Employee/Obligor's Name(Last, First, Middle) 181-52-1205 Sent Electronically Employee/Obligor's Social Security Number (See Addendum for plaintiff names DO NOT MAIL associated with cases on attachment) Custodial Party/Obligee's Name(Last, First, Middle) Employer/Income Withholder's FEIN 311575142 NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last, First, Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see IWO instructions htti)://www.acf.hhs.(iov/programs/cse/forms/ OMB-0970-0154 instructions odt). If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. 3115751420 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from the employee/ obligor's income until further notice. r=) r,:� cz: C:-z $ 1,537.50 per month in current child support ZK w $ 0.00 per month in past-due child support- Arrears 12 weeks or greater? Q yer3rP� rtm r- -w $ 0.00 per month in current cash medical support c-s ` cn�' $ 0.00 per month in past-due cash medical support $ 1,000.00 per month in current spousal support $ 0.00 per month in past-due spousal support 's $ 0.00 per month in other(must specify) ;_ for a Total Amount to Withhold of$ `' -- 2,537.50 per month. --+ -r AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 583.97 per weekly pay period. $ 1,268.75 per semimonthly pay period (twice a month) $ 1,167.95 per biweekly pay period (every two weeks) $ 2,537.50 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first a p y period that occurs ten 10 working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at http://www.acf.hhs gov/programs/cse/newhire/employer/contacts/contact maD htm for the employee/obligor's principal place of employment. --- Document Tracking Identifier OMB No.:0970-0154 Form EN-428 11/13 Service Type M Worker ID $IATT ❑ Return to Sender[Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6)or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: DECEMBER 3 2013 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order,a copy of this IWO must be provided to the employee/obligor. ❑ If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law(23 PA C.S. §4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons,or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER/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. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://www acf hhs gov/programs/cse/newhire/employer/contacts/contact map.htm Priority: Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment.You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court,Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the"Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment.The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date—05/3112014.The OMB Expiration Date has no bearing on the termination date of the IWO;it identifies the version of the form currently in use. Form EN-428 11/13 Service Type M Page 2 of 3 Worker ID $IATT a Employer's Name: DEPT OF DEFENSE CIVILIANS Employer FEIN: 311575142 Employee/Obligor's Name: FANELLI ALBERT J.JR 6595101866 CSE Agency Case Identifier:(See Addendum for case summary Order Identifier:(See Addendum for order/docket information 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/obligor's principal place of employment(see REMITTANCE INFORMATION). 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,those limits increase 5%-to 55%and 65%-if the arrears are greater than 12 weeks. If permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 31 15751420 Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at:www.childsupport.state.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE, PA 17013(Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at www.childsupport.state.pa.us. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.:0970-0154 Form EN-428 11/13 Service Type M Page 3 of 3 Worker ID $IATT t ADDENDUM Summary of Cases on Attachment Defendant/Obligor: FANELLI, ALBERT J. JR PACSES Case Number 274109388 PACSES Case Number 844111955 Plaintiff Name Plaintiff Name JEAN B. FANELLI JEAN B. FANELLI Docket Attachment Amount Docket Attachment Amount 00653S 2007 $ 1,537.50 07-4922 CIVIL $ 1,000.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB ALBERT J. FANELLI III 12/21/95 MARGARET J. FANELLI 10/02/97 PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-428 11/13 Service Type M OMB No.:0970-0154 Worker ID$IATT INCOME WITHHOLDING FOR SUPPORT \D9 3q2 L53 S D ORIGINAL INCOME WTHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) C) AMswosoxwo D ONE-TIMEORDERINOTICE FOR LUMP SLJM PAYMENT O TERMINATION OF IWO 11u1-\119 SS o Child Support Enforcement (CSE) Agency Court 0 Attorney OPrivate Individual/Entity (Check One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions hUp:6wvwv.00[hhogov/programo/cno/fn O .pdf)If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. Commonwealth of Pennsylvania CUMBERLAND Private Individual/EntityCSE Agency Case Identifier: (See Addendum for case summary) Remittance Identifier (include w/payment): 6595101866 Order Identifier: (See Addendum for order/docket information) DEPT OF DEFENSE CIVILIANS Sent ��U����'�����^����UU�� ~~^~'`~~^~~~~~-^--^~�v DO NOT MAIL Employer/Income Withholder's FEIN 311575142 ChiId(ren)s Name(s) (Last, First, MiddIe) ChiW(mn)'oBorth Date(s) RE: FANELLI, ALBERT J. JR Name (Last, First, Middle) 181'52'1305 Social Security Number (See Addendum forplaintiffnames associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO must be regular on its face, Under certain circumstances you must reject ths IWO and retum it to the sender (see IWO instructions http://www.acf.hhs.gov/programs/cse/forms/ Ows'097*01e4 instructions,od. If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached, 3115751420 See Addendum for dependent names and birth dates associated with caseon attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by Iaw to deduct these amounts from the employee/ obligor's income until further notice. $ 1.O8G.UOper month incurrent child uuppu� '' �� $ 0.00 per month in past -due child support - Arrears 12 weeks or greater? 0 ye nc7:7: -/ $ 0.00 per month in current cash medical support rn -c_ .r - $ 0.00 per month in past -due cash medical support , r ~ $ 1�OOl0per month incurrent souuoo support -<> cp 'cr $ 0.00 per month in past -due spousal support -ccz $ 0.00 per month in other (must specify) > for a Total Amount to Withhold of $ 2,086.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Orderinfonnotiun. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: � 480.07 per weekly pay period. s 1,043.00 per semimonthly pay period (twice a month) o 960.13 per biweekly pay period (every two weeks) $ 2,086.00 per monthly pay period. � Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) workinq days after the date of this OrderfNotice. Send payment within seven (7) working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (Gtota/Thba), the employer can obtain withholding |imitmtiono. time requiremanto, and any allowable employer fees at http:/h^wvw.anf.hhs.gov/progroma/noe/newhire/emp|oyer/contmctu/contoct map. htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.: 0970-0154 Service Type M Form EN -428 11/13 Worker ID $IATT • ❑ Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: JUNE 9, 2014 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. 0 If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State -specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf. hhs.gov/programs/cse/newhire/employer/contacts/contact_map.htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past -due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti -discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date — 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use. Form EN -428 11/13 Service Type M Page 2 of 3 Worker ID $IATT Employer's Name: DEPT OF DEFENSE CIVILIANS Employer FEIN: 311575142 Employee/Obligor's Name: FANELLI, ALBERT J, JR 8595101808 OSEAgenoyCome|don1ifinr:(8mmAdoendun/Mo case summary) Onder|dnntifiecfSeeA6dmndun/fbrwmden/ducket/nfornvadon) 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. 1 673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligors principal pace of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, Ioca taxes; SociaI Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the Iaw of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greaterthan 12 weeks? If the Order Information does not indicate thatthatthe arrears are greaterthan 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUSIf this employee/obligor you are no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address tisted in the Contact Information below: 3115751*20 0 This person has never worked for this employer nor received periodic income. 0 This person no Ionger works for this employer nor receives periodic income. Please provide the foliowing information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www.childsupportstate.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATION SECT|ON, 13 N. HANOVER ST. P,O. BOX 320 CARLISLE PA. 17013 (Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at C717) 240-6225, by fax at (717) 240-6248, by email or website at www.childsuoportstate.pa.us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.: 0970-0154 Service Type M Page 3 of 3 Form EN -428 11/13 Worker ID $1ATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: FANELLI, ALBERT J. JR PACSES Case Number 274109388 Plaintiff Name JEAN B. FANELLI Docket Attachment Amount 00653 S 2007 $ 1,086.00 Child(ren)'s Name(s): ALBERT J. FANELLI III MARGARET J. FANELLI PACSES Case Number 844111955 Plaintiff Name JEAN B. FANELLI Docket Attachment Amount 07-4922 CIVIL $ 1,000.00 DOB Child(ren)'s Name(s): 12/21/95 10/02/97 PACSES Case Number Plaintiff Name DocketAttachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name DocketAttachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M PACSES Case Number Plaintiff Name DocketAttachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): Addendum OMB No.: 0970-0154 Form EN -428 11/13 Worker ID $IATT