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HomeMy WebLinkAbout07-5927Divorce Complaint Prepared By: Diane G. Radcliff, Esquire 3448 Trindle Road, Camp Hill, PA 17011 Supreme Court ID # 32112 Phone: 717-737-0100 • Fax: 717-975-0697 • Email: dianeradcliff @comcast.net Attorney for Dianne M. Gray IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DIANNE M. GRAY, Plaintiff NO. 07-5917 Civi I Term V. THOMAS M. GRAY, NOTICE TO DEFEND AND CLAIM RIGHTS YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for 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, Carlisle, Pennsylvania. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, COUNSEL FEES OR EXPENSES BEFORE THE FINAL DECREE OF DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDER YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 Telephone No. (717) 249-3166 : CIVIL ACTION - LAW. : DIVORCE Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DIANNE M. GRAY, , Plaintiff NO. V. CIVIL ACTION- LAW THOMAS M. GRAY, DIVORCE Defendant COMPLAINT Plaintiff, Dianne M. Gray by her attorney, Diane G. Radcliff, Esquire, and files this Complaint in Divorce of which the following is a statement: COUNT I DIVORCE 1. The Plaintiff is Dianne M. Gray, an adult individual who currently resides 2325 Greenbriar Lane, Enola, PA 17025 since 2002. 2. The Defendant is Thomas M. Gray, an adult individual residing at 2325 Greenbriar Lane, Enola, PA 17025 since 2002. 3. Plaintiff and/or Defendant have been bona fide residents in the Commonwealth for at least six (6) months previous to the filing of this Complaint. 4. Plaintiff and Defendant were married on September 8, 1984 at Ronkonoma, Long Island, NY. 5. Plaintiff avers that there are three (3) children of this marriage under the age of eighteen (18), namely, to wit: Michael Thomas Gray born 5/19/1991; Ryan Robert Gray born 1/22/1994; and Thomas John Gray born 8/14/1997 6. There have been no prior actions of divorce or annulment between the parties. 7. Plaintiff has been advised that counseling is available and that Plaintiff may have the right to request that the Court require the parties to participate in counseling. -1- 8. Defendant is not a member of the Armed Services of the United States or any of its Allies. 9. Plaintiff avers that the grounds on which the action is based is the marriage is irretrievably broken. WHEREFORE, Plaintiff requests this Honorable Court to enter a decree in divorce, divorcing the Plaintiff and Defendant. COUNT II EQUITABLE DISTRIBUTION 10. Paragraphs 1 through 9 are incorporated by reference hereto as fully as though the same were set forth at length. 11. Plaintiff and Defendant have acquired property, both real and personal, and incurred debts during their marriage during the period from September 8, 1984, the date of their marriage, until, the date of their separation, all of which are "marital property" or "marital debts". 12. Plaintiff and/or Defendant have acquired, prior to the marriage or subsequent thereto, "non-marital property" which has increased in value since the date of marriage and/or subsequent to its acquisition during the marriage, which increase in value is "marital property". 13. Plaintiff and Defendant have been unable to agree as to an equitable division of the marital property and marital debts as of the date of the filing of this Complaint. WHEREFORE, Plaintiff requests this Honorable Court to equitably divide all marital property and debts of the parties. COUNT III ALIMONY PENDENTE LITE, ALIMONY 14. Paragraphs 1 through 9 are incorporated by reference hereto as fully as though the same were set forth at length. 15. Plaintiff lacks sufficient property to provide for her reasonable means and is unable to -2- support herself through appropriate employment. 16. Plaintiff requires reasonable support to adequately maintain herself in accordance with the standard of living established during the marriage. WHEREFORE, Plaintiff requests this Honorable Court to enter an award of alimony pendente lite until final hearing and hereafter enter an award of alimony permanently thereafter. COUNT IV COUNSEL FEES, COSTS AND EXPENSES 17. Paragraphs 1 through 9 are incorporated by reference hereto as fully as though the same were set forth at length. 18. Plaintiff has employed legal counsel in this case, but is unable to pay the necessary and reasonable attorney's fees for said counsel. 19. Plaintiff has or will incur costs in this action including, but not limited to, costs for various experts to appraise the parties' marital assets, and does not have the funds to pay the necessary and reasonable fees , costs and expenses. WHEREFORE, Plaintiff requests this Honorable Court to enter an award of interim counsel fees, costs and expenses and to order such additional sums hereafter as may be deemed necessary and appropriate and at final hearing to further award such additional counsel fees, costs and expenses as are deemed necessary and appropriate. Respectfully submitted, -3- Camp Hill, PA 1701 1 Phone: (717) 737-0100 Supreme Court ID # 32112 Attorney for Plaintiff VERIFICATION Dianne M. Gray verifies that the statements made in this Complaint are true and correct. Dianne M. Gray understands that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. Dianne M. Gray Date: /0 /?/o 7 -4- SU D -c 2 T W IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DIANNE M. GRAY, Plaintiff NO. 07-5927 CIVIL TERM V. CIVIL ACTION - LAW. THOMAS M. GRAY, DIVORCE Defendant AFFIDAVIT OF SERVICE I, Diane G. Radcliff, Esquire, being duly sworn according to law, depose and say that on October 15, 2007, 1 served a true and correct copy of the Complaint in Divorce upon Thomas M. Gray, the Defendant, by Certified Mail, Restricted Delivery, addressed as follows: Thomas M. Gray 2325 Greenbriar Lane Enola, PA 17025 The Certified Mail return receipt mailing card, or a copy thereof, for the foregoing is attached hereto as Exhibit "A" and made a part hereof. Sworn to and subscribed before me a Notary Public in and for Cumberland County, Pennsylvania this 16th day of October , 2007. lb-kk4 ak NOTARY PUBLIC 344 Trindle Road Camp Hill, PA 17011 Supreme Court I.D. No. 32112 Attorney for Plaintiff My commission expires: M TH or, PENNSYLVANIA Seel Deborah L Do". NOWY Camp HIM eoro, ?, 23, 2011 Memb . Penl?s AssoGltion d tl?! f r ¦ Complete item, 1, 2, and 3. Also complete item 4 if Restricted Delivery Is desired. ¦ Print your name and address on the reverse so that we can return the card to you. ¦ Attach this card to the back of the mailpiece, or on the front if space permits. 1. Article Addressed to: ?afnf4 s M • (;gAy 2 ?'L?J (' ?-?ug7el,a L-4- A. SWwture B. Rejr ed by (Printed C. Date of Delivery D. Is delivery address different from 1? 0 Yes It YES, enter delivery address ow: 0 No ww 4? 1 3. Service Type ANOLA I Pfd- if ?0 25 Mail 0 Express mail 0 Registered 0 Return Receipt for Merchwxke 0 Insured Mail 0 C.O.D.. Pft Feel Yes 2. Article Number 7005 0390 0003 2641 5575 I'Mansfer from awvloe At PS Form 3811, February 2004 Domestic Return Receipt 10o2-s IMO EXHIBIT "All RETURN RECEIPT CARD C) o -' 3 r r.F gym. 'T3 , Y KOPE & ASSOCIATES, LLC BY: LESLEY J. BEAM, ESQ. ATTORNEY I.D. 91175 4660 Trindle Road, Suite 201 Camp Hill, PA 17011 (717) 761-7573 Ibearn0kopelaw.com Attorney for Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA DIANNE M. GRAY, Plaintiff, NO. 07-5927 Vs. CIVIL ACTION - LAW IN CUSTODY THOMAS M. GRAY, Defendant. PRAECIPE FOR ENTRY OF APPEARANCE TO THE PROTHONOTARY: Please enter my appearance on behalf of Thomas M. Gray, Defendant. Papers may be served at the address set forth below. Lesley J. Beam, Esquire ID # 91175 KOPE & ASSOCIATES, LLC 4660 Trindle Road Suite 201 Camp Hill, PA 17011 Telephone: 717-761-7573 Fax: 717-761-7572 By: " J;git7?? esle am, Esquire Date: I / W CERTIFICATE OF SERVICE I, Lesley J. Beam, Esquire, do hereby certify that on this the 14th day of November, 2007, 1 served a true and correct copy of the foregoing Praecipe for Entry of Appearance via regular U.S. First Class mail, postage prepaid, addressed as follows: Thomas Gray 507 Kentwood Drive Mechanicsburg, VA 17050 (Defendant) Diane G. Radcliff, Esq. 3448 Trindle Road Camp Hill, PA 17011 (Attorney for Plaintiff) Re By: LeZ1 J.'Beam, Esquire ID 175 Kope and Associates, LLC 4660 Trindle Road Suite 201 Camp Hill, PA 17011 (717) 761-7573 a r`- ?." CTS .:rte ..... O 7l C?3 r7-1 APL Conference Petition Prepared By: Diane G. Radcliff, Esquire 3448 Trindle Road, Camp Hill, PA 17011 Supreme Court ID # 32112 Phone: 717-737-0100 • Fax: 717-975-0697 • Email: dianeradcliff @comcast.net Attorney for Plaintiff /Petitioner, Dianne M. Gray IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DIANNE M. GRAY, Plaintiff : NO. 07-5927 CIVIL TERM V. : CIVIL ACTION - LAW THOMAS M. GRAY, DIVORCE Defendant PETITION FOR ORDER FOR ALIMONY PENDENTE LITE Petitioner, Dianne M. Gray, files the this Petition for Alimony Pendent Lite and respectfully represents that: 1. Petitioner is Dianne M. Gray, and the Plaintiff in the above captioned divorce action. 2. Respondent is Thomas M. Gray, and the Defendant in the above captioned divorce action. 3. The parties are husband and wife, having been married on September 8, 1984 . 4. The within action was instituted by the filing of a Divorce Complaint by Petitioner, Dianne M. Gray on 10/10/2008, which Complaint was duly served on Defendant/Respondent on 10/15/2008. 5. In the Divorce Complaint, Petitioner raised a claim for Alimony Pendente Lite. 6. This Petition is filed so that a conference is scheduled by Domestic Relations on this claim for alimony pendente lite and an order for alimony pendente lite is entered. 7. Respondent has not sufficiently provided support for the Petitioner. 8. Petitioner is not on a financial par with Respondent in prosecuting and/or defending this Divorce Action, and is unable to support herself in accordance with the standard of living established during the marriage. 9. Petitioner previously filed a complaint for spousal support and child support in the - 1 - J? Cumberland County, PA, docketed to No. 00351 S 2008; Pacses No. 412109987, which has been scheduled for a support conference on May 20, 2008 at 9:00 a.m.. 10. A background information sheet pertaining to the parties was filed with DRO in the aforesaid support action docketed to No. 00351 S 2008; Pacses No. 412109987 and therefore another background information sheet is not required to be filed. 11. The amount of Alimony Pendente Lite requested by the Petitioner is the maximum amount provided for under the guidelines. WHEREFORE, Petitioner prays that the Court enter an Order: a. Requiring the Respondent to pay the Petitioner Alimony Pendente Lite in the maximum amount provided for by law under the state support guidelines; b. Requiring the Respondent to provide medical insurance and support for the Petitioner. Respectfully submitted, ixCNE-Q-R DCLIFF, ESQUIRE e Road Camp Hill, PA 17011 Supreme Court ID # 32112 Phone: (717) 737-0100 Fax: (717) 975-0697 Attorney for Petitioner -2- U VERIFICATION I verify that the statements made in this Petition for Alimony Pendent Lite are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsw rn falsification to authorities. f DIANNE M. GRPY. Petit toner DATE: J ' u - 3 - a CERTIFICATE OF SERVICE I hereby certify that I am this day serving the foregoing document upon the person(s) and in the manner indicated below, which service satisfies the requirements of the Pennsylvania Rules of Civil Procedure: Service by First Class Mail Addressed as Follows: Lesley J. Beam, Esquire KOPE 8t ASSOCIATES 4660 Trindle Road • Suite 201 Camp Hill, PA 17011 (Counsel for Respondent) nn\rr NE G. RA CLIFF, ESQUIRE ,A istration No 32112) 448 Trindle oad Camp Hill, PA 17011 Email: dianeradcliff(@-comcast.net Phone: (717) 737-0100 Fax: (717) 975-0697 Counsel for Petitioner, Dianne M. Gray Dated: 1? ?2 U -4- ? ?.: s ??? 7t? b ". DIANNE M. GRAY, THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-5927 CIVIL TERM THOMAS M. GRAY, IN DIVORCE Defendant/Respondent : PACSES CASE NO: 824110005 ORDER OF COURT AND NOW, this 5th day of May, 2008, upon consideration of the Petition for Alimony Pendente Lite and/or counsel fees, it is hereby directed that the parties and their respective counsel appear before Charles C. Carothers, IV on May 20, 2008 at 9:00 A.M. for a conference, at 13 N. Hanover St., Carlisle, PA 17013, after which the conference officer may recommend that an Order for Alimony Pendente Lite be entered. YOU are further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W-2's as filed (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by Rule 1910.11© (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you. If you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. BY THE COURT, Edgar B. Bayley, President Judge Copies mailed to: Petitioner Respondent Diane G. Radcliff, Esq. Lesley J. Beam, Esq. Date of Order: May 5, 2008 ?P /? 44-ot4i R. J. S day, onference Officer 1 YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 cc361 ? 4 Y DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-5927 CIVIL TERM THOMAS M. GRAY, IN DIVORCE Defendant/Respondent PACSES CASE ID: 824110005 ORDER OF COURT AND NOW, this 20th day of May 2008, based upon the Court's determination that the Petitioner's monthly net income/earning capacity is $ 1,572.20 and the Respondent's monthly net income/earning capacity is $ 4,595.76, it is hereby ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement One Hundred Five and 00/100 Dollars ($105.00) per month payable bi-weekly as follows: $ 105.00 per month for Alimony Pendente Lite and $ 0.00 per month on arrears. First payment due: in accordance with Respondent's pay schedule at the rate of $48.46 bi-weekly. The effective date of the order is May 2, 2008. Arrears set at $ 103.56 as of May 20, 2008. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C.S.§ 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and, at its discretion, make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the PA SCDU to: Dianne M. Gray. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the Respondent's name with their PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. cc360 , i The monthly obligation includes cash medical obligation in the amount of $250 annually for unreimbursed medical expenses incurred for the spouse. Unreimbursed medical expenses of the oblige that exceed $250 annually shall be allocated between the parties. The party seeking allocation of unreimbursed medical expenses must provide documentation of expenses to the other party no later than March 31St of the year following the calendar year in which the final medical bill to be allocated was received. The unreimbursed medical expenses are to be paid as follows: 0% by the Respondent and 100% by the Petitioner. [] Respondent [X] Petitioner [] Neither party to provide medical insurance coverage. Within thirty (30) days after the entry of this order, the [X] Petitioner [] Respondent shall submit to the other party written proof that medical insurance coverage has been obtained or that application for coverage has been made. Proof of coverage shall consist, at a minimum, of. 1) the name of the health care coverage provider(s); 2) any applicable identification numbers; 3) any cards evidencing coverage; 4) the address to which claims should be made; 5) a description of any restrictions on usage, such as prior approval for hospital admissions, and the manner of obtaining approval; 6) a copy o the benefits booklet or coverage contract; 7) a description of all deductibles and co-payments; and 8) five copies of any claim forms. This Order is based upon a split custody arrangement with the parties' three children. This Order considers a mortgage adjustment of $382.67 per month. The Petitioner is to maintain her own medical insurance coverage. This Order shall become final twenty (20) after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary for a hearing de novo before the Court. Consented: Petitioner Respondent Mailed copies on: MU 21, 2008 to: Petitioner Respondent Diane G. Radcliff, Esq. Lesley J. Beam, Esq. Petitioner's Attorney Respondent's Attorney BY THE CO , Edward E. Guido, J. DRO: R.J. Shadday 07-5927 CIVIL ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 412109987 351 S 2008 Co./City/Dirt. of CUMBERLAND Date of Order/Notice 05/20/08 Case Number (See Addendum for case summary) E m pl oyer/With holder's Federal EIN Number COMMERCE BANK* 1701 RT 70 FL 3 CHERRY HILL NJ 08003-2390 Employee/Obligor's Name (Last, First, MI) 087-54-5037 Employee/Obligor's Social Security Number 7042101971 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 543 .72 per month in current support $ 43 .33 per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ 0.00 per month in current and past-due medical support $ o . oo per month for genetic test costs $ o . 00 per month in other (specify) for a total of $ 587.05 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 135.47.per weekly pay period. $ 270.95_per biweekly pay period (every two weeks). $ 293. 53 per semimonthly pay period (twice a month). $ 587.05 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COU MAY 2 120?? Date of Order: EDWARD E. GUIDO, JUDGE DRO: R.J. SHADDAY Form EN-028 Rev. 1 Service Type M OMBNo.:0970-0154 Worker ID $IATT RE:rRAY. THOMAS M. O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? di event fdrom thestate thadiss provide order, a ocopy must be provrided to your lemployee elvoen if works x is note that is 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2224860570 EMPLOYEE'S/OBLIGOR'S NAME: GRAY THOMAS M. EMPLOYEE'S CASE IDENTIFIER: 7042101971 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 01; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION rnntart WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Service Type M OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GRAY, THOMAS M. PACSES Case Number 412109987 Plaintiff Name DIANNE M. GRAY Docket Attachment Amount 00351 S 2008 $ 482.05 Child(ren)'s Name(s): THOMAS J. GRAY DOB 08/14/97 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number 824110005 Plaintiff Name DIANNE M. GRAY Docket Attachment Amount 07-5927 CIVIL$ 105.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in ysohealth blins ran overage available through the employee's/obligor's employment. through the emptoyee gor employment. Addendum Form EN-028 Rev. 1 Service Type M Worker ID $IATT OMB No.: 0970.0154 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DIANNE M. GRAY, Plaintiff V. THOMAS M. GRAY, Defendant NO. 07-5927 CIVIL TERM CIVIL ACTION - LAW IN DIVORCE : PACSES NO. 824110005\ APPEAL OF ALIMONY PENDENTE LITE ORDER AND REQUEST FOR HEARING DE NOVO DATE OF ORDER: May 20, 2008 AMOUNT OF ORDER: $105.00/month SUPPORT FOR: One child, Thomas J. Gray, born 8/14/1997 PARTY FILING APPEAL/DE NOVO HEARING REQUEST: Dianne M. Gray REASONS FOR APPEAL/DE NOVO HEARING REQUEST: Alimony Pendete Lite Order not calculated in accordance with guidelines. WHEREFORE, Dianne M. Gray requests this Honorable Court to hold a Hearing De Novo in the above captioned case and to enter an appropriate support order based on the facts of this case. SIGNATURE OF ATTORNEY/APPELLANT: DIANE G. RAOLIFF, ESQUIRE 3448 rT inn e Road Camp Hill, PA 17011 Phone: (7179 7 7-010 Date: 5 jj C7 r..? E T TI =C • • ? j Ca i y a J In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION DIANNE M. GRAY ) Docket Number 07-5927 CIVIL Plaintiff ) VS. ) PACSES Case Number 824110005 THOMAS M. GRAY ) Defendant ) Other State ID Number ORDER OF COURT You, THOMAS M. GRAY plaintiff/defendant of 2325 GREENBRIAR LN, ENOLA, PA. 17025-3302-25 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the JUNE 25, 2008 at 1:30PM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. the Income Statement and the appropriate Expense Statement, if required, attached to this order, completed as required by Rule 1910.11 (c). 4. verification of child care expenses, and 5. proof of medical coverage which you may have, or may have available to you 6. information relating to professional licenses 7. other: Service Type M Form CM-509 Rev. 1 Worker ID 21302 r GRAY V. GRAY PACSES Case Number: 824110005 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest and/or enter an interim support order. If paternity is an issue, the court shall enter an order establishing paternity. THE APPROPRIATE COURT OFFICER MAY ENTER AN ORDER AGAINST EITHER PARTY BASED UPON THE EVIDENCE PRESENTED WITHOUT REGARD TO WHICH PARTY INITIATED THE SUPPORT ACTION. BY THE COURT: Date of Order: $ !?A - 0I r. JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE-HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBER comply with the Americans with Disabilities Act of 1 facilities and reasonable accommodations available to before the court, please contact our office at: (717) made at least 72 hours prior to any hearing or business scheduled hearing. Service Type M Page 2 of 2 LAND County is required by law to 990. For information about accessible disabled individuals having business 240-6225 . All arrangements must be before the court. You must attend the Form CM-509 Rev. I Worker ID 21302 ?_. rya = :, -:::?. .. - . c? ---? T , m. - W ? --:- ;7?: -r ? - ??` ?. , -?` _ °3 s b° r?f s _ -? -? ?? 5"- In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION DIANNE M. GRAY ) Docket Number 07-5927 CIVIL Plaintiff ) VS. ) PACSES Case Number 824110005 THOMAS M. GRAY ) Defendant ) Other State ID Number ORDER OF COURT You, DIANNE M. GRAY plaintiff/defendant of 300 GEORGETOWN RD, MECHANICSBURG, PA. 17050-1828 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the JUNE 25, 2008 at 1: 3 0 PM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. the Income Statement and the appropriate Expense Statement, if required, attached to this order, completed as required by Rule 1910.11 (c). 4. verification of child care expenses, and 5. proof of medical coverage which you may have, or may have available to you 6. information relating to professional licenses 7. other: Service Type M Form CM-509 Rev. I Worker ID 21302 f GRAY V. GRAY PACSES Case Number: 824 1 1 0005 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest and/or enter an interim support order. If paternity is an issue, the court shall enter an order establishing paternity. THE APPROPRIATE COURT OFFICER MAY ENTER AN ORDER AGAINST EITHER PARTY BASED UPON THE EVIDENCE PRESENTED WITHOUT REGARD TO WHICH PARTY INITIATED THE SUPPORT ACTION. BY THE COURT: Date of Order: YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE-HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Service Type M Page 2 of 2 Form CM-509 Rev. Worker ID 21302 r?.? c?•n ^-- --i ; - , I'.: _? C.a7 "C't - _a G -?7 -?. _ ?,? ?? `- ?+? "G. DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : DOMESTIC RELATIONS SECTION THOMAS M. GRAY, PACSES NO. 412109987 Defendant DOCKET NO. 351 SUPPORT 2008 THOMAS M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : DOMESTIC RELATIONS SECTION DIANNE M. GRAY, PACSES NO. 232109994 Defendant DOCKET NO. 361 SUPPORT 2008 DIANNE M. GRAY, : IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner : CUMBERLAND COUNTY, PENNSYLVANIA V. : DOMESTIC RELATIONS SECTION THOMAS M. GRAY, : PACSES NO. 824110005 Defendant/Respondent: DOCKET NO. 07-5927 CIVIL INTERIM ORDER OF COURT AND NOW, this 1st day of July, 2008, upon consideration of the Support Master's Report and Recommendation, a copy of which is attached hereto as Exhibit "A", it is ordered and decreed as follows: A. In the case docketed to 351 Support 2008 the Husband shall pay to the Pennsylvania State Collection and Disbursement Unit as support for his child, Thomas J. Gray, born August 14, 1997, the sum of $391.00 per month effective April 24, 2008. B. In the case docketed to 07-5927 Civil the Husband shall pay to the Pennsylvania State Collection and Disbursement Unit as alimony pendente lite the sum of $164.00 per month effective May 2, 2008. C. The Husband shall pay to the Pennsylvania State Collection and Disbursement Unit the additional sum of $43.33 per month on arrearages. D. The Husband shall provide health insurance coverage for the benefit of his three children, Michael T. Gray, born May 13, 1991, Ryan R. Gray, born January 22, 1994, and Thomas J. Gray, born August 14, 1997, as is available to him through employment or other group coverage at a reasonable cost. E. The monthly support obligation includes cash medical support in the amount of $250.00 annually for unreimbursed medical expenses incurred for each child. Unreimbursed medical expenses of the children that exceed $250.00 annually shall be allocated between the parties. The party seeking allocation of unreimbursed medical expenses must provide documentation of expenses to the other party no later than March 31" of the year following the calendar year in which the final medical bill to be allocated was received. The unreimbursed medical expenses of the children are to be paid as follows: 74% by Husband and 26% by Wife. F. The interim order entered in 361 Support 2008 dismissing the Husband's complaint for child support is affirmed. IMPORTANT LEGAL NOTICE PARTIES MUST WITHIN SEVEN DAYS INFORM THE DOMESTIC RELATIONS SECTION AND THE OTHER PARTIES, IN WRITING, OF ANY MATERIAL CHANGE IN CIRCUMSTANCES RELEVANT TO THE LEVEL OF SUPPORT OR THE ADMINISTRATION OF THE SUPPORT ORDER, INCLUDING, BUT NOT LIMITED TO, LOSS OR CHANGE OF INCOME OR EMPLOYMENT AND CHANGE OF PERSONAL ADDRESS OR CHANGE OF ADDRESS OF ANY CHILD RECEIVING SUPPORT. A PARTY WHO WILLFULLY FAILS TO REPORT A MATERIAL CHANGE IN CIRCUMSTANCES MAY BE ADJUDGED IN CONTEMPT OF COURT, AND MAY BE FINED OR IMPRISONED. PENNSYLVANIA LAW PROVIDES THAT ALL SUPPORT ORDERS SHALL BE REVIEWED AT LEAST ONCE EVERY THREE (3) YEARS IF SUCH REVIEW IS REQUESTED BY ONE OF THE PARTIES. IF YOU WISH TO REQUEST A REVIEW AND ADJUSTMENT OF YOUR ORDER, YOU MUST DO THE FOLLOWING: CALL YOUR ATTORNEY. AN UNREPRESENTED PERSON WHO WANTS TO MODIFY (ADJUST) A SUPPORT ORDER SHOULD CONTACT THE DOMESTIC RELATIONS SECTION. ALL CHARGING ORDERS FOR SPOUSAL SUPPORT AND ALIMONY PENDENTE LITE, INCLUDING UNALLOCATED ORDERS FOR CHILD AND SPOUSAL SUPPORT OR CHILD SUPPORT AND ALIMONY PENDENTE LITE, SHALL TERMINATE UPON DEATH OF THE PAYEE. A MANDATORY INCOME ATTACHMENT WILL ISSUE UNLESS THE DEFENDANT IS NOT IN ARREARS IN PAYMENT IN AN AMOUNT EQUAL TO OR GREATER THAN ONE MONTH'S SUPPORT OBLIGATION AND (1) THE COURT FINDS THAT THERE IS GOOD CAUSE NOT TO REQUIRE IMMEDIATE INCOME WITHHOLDING; OR (2) A WRITTEN AGREEMENT IS REACHED BETWEEN THE PARTIES WHICH PROVIDES FOR AN ALTERNATE ARRANGEMENT. UNPAID ARREARAGE BALANCES MAY BE REPORTED TO CREDIT AGENCIES. ON AND AFTER THE DATE IT IS DUE, EACH UNPAID SUPPORT PAYMENT SHALL CONSTITUTE, BY OPERATION OF LAW, A JUDGMENT AGAINST YOU, AS WELL AS A LIEN AGAINST REAL PROPERTY. IT IS FURTHER ORDERED THAT, UPON PAYOR'S FAILURE TO COMPLY WITH THIS ORDER, PAYOR MAY BE ARRESTED AND BROUGHT BEFORE THE COURT FOR A CONTEMPT HEARING; PAYOR'S WAGES, SALARY, COMMISSIONS, AND/OR INCOME MAY BE ATTACHED IN ACCORDANCE WITH LAW. PAYOR IS RESPONSIBLE FOR COURT COSTS AND FEES. The parties are hereby advised that they may file written exceptions to the Support Master's Report and Recommendation within twenty (20) days of this order. Exceptions shall conform with the requirements of Rule 1910.12(f), Pa. R.C.P. If written exceptions are filed by any party, the other party may file exceptions within twenty (20) days of the date of service of the original exceptions. If no exceptions are filed within twenty (20) days of this interim order, this order shall then constitute a final order. By the Court Edwaf . Gu o, Cc: Dianne M. Gray Thomas M. Gray Diane G. Radcliff, Esquire For the Plaintiff Lesley J. Beam, Esquire For the Defendant DRO DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION THOMAS M. GRAY, PACSES NO. 412109987 Defendant DOCKET NO. 351 SUPPORT 2008 THOMAS M. GRAY, Plaintiff V. DIANNE M. GRAY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOMESTIC RELATIONS SECTION PACSES NO. 232109994 DOCKET NO. 361 SUPPORT 2008 DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION THOMAS M. GRAY, PACSES NO. 824110005 Defendant/Respondent: DOCKET NO. 07-5927 CIVIL SUPPORT MASTER'S REPORT AND RECOMMENDATION Following a hearing held before the undersigned Support Master on June 25, 2008, the following report and recommendation are made: FINDINGS OF FACT 1. The Plaintiff in 351 Support 2008 and 07-5927 Civil is Dianne M. Gray, who resides at 300 Georgetown Road, Mechanicsburg, Pennsylvania; she will hereafter be referred to as "the Wife." 2. The Plaintiff in 361 Support 2008 is Thomas M. Gray, who resides at 2325 Greenbrier Lane, Enola, Pennsylvania; he will hereafter be referred to as "the Husband." 3. The parties were married on September 8, 1984. EXHIBIT "A" 4. The parties are the parents of three minor children, Michael T. Gray, born May 13, 1991 and Ryan R. Gray, born January 22, 1994, both of whom reside with the Husband, and Thomas J. Gray, born August 14, 1997, who resides with the Wife. 5. On April 24, 2008 the Wife filed a complaint for spousal support and for the support of Thomas; said complaint is docketed to 351 Support 2008. 6. On April 29, 2008 the Husband filed a complaint for the support of Michael and Ryan; said complaint is docketed to 361 Support 2008. 7. On October 10, 2007 the Wife filed a complaint for divorce which is docketed to 07-5927 Civil. On May 2, 2008 the Wife filed a claim for alimony pendente lite in the divorce action. 9. The Wife was employed by Kohl's Department Store where she has an hourly rate of pay of $10.43 and average gross weekly income of approximately $382.00. 10. The Wife pays $13.64 per week for health insurance coverage on herself only. 11. The Wife will file her 2008 federal income tax return as head of household and will claim Thomas as a dependency exemption. 12. The Husband is employed by Commerce Bank where he has a gross bi-weekly salary of $2,594.81. 13. In 2008 the Husband has received an annual bonus of $1,200.00. 14. The Husband provides health insurance coverage on himself and the three children at a cost of $66.75 bi-weekly. 15. The Husband will file his 2008 federal income tax return as head of household and will claim Michael and Ryan as dependency exemptions. 16. The Husband continues to reside in the marital residence. 17. The marital residence is encumbered by a first mortgage with a monthly payment of $1,137.00 and a second mortgage (home equity loan) with a monthly payment of $279.00. 18. The home equity loan was taken for the purpose of credit card bill consolidation and payoff of the Husband's car loan. 19. Homeowners' insurance and real estate taxes on the marital residence average $266.59 per month. 2 20. The Husband is paying both mortgages, the homeowners' insurance, and the taxes. DISCUSSION Both parents have an obligation to support their children in accordance with their relative incomes and ability to pay. Depp v. Holland, 636 A.2d 204 (Pa. Super. 1994). This case involves divided or split physical custody of the children and is governed by Pa. R.C.P. 1910.16-4(d). The obligation of each parent for the support of the child or children in the physical custody of the other parent is calculated. The respective obligations are offset with the difference awarded to the obligee as support. The Wife has gross monthly income of $1,655.00 based upon an average gross weekly income of $382.00. Filing her federal income tax return as head of household and claiming one child as a dependency exemption, her net monthly income is $1,590.00.' The Husband has gross monthly income of $5,722.00 including salary and annual bonus. Filing his federal income tax return as head of household and claiming two children as dependency exemptions, he has net monthly income for support purposes of $4,496.00.2 With combined net monthly income of $6,086.00 the basic requirement for the support of one child in the Wife's custody is $1,030.00 per month.3 The Defendant's proportionate share of that amount is $761.00. The support obligation is adjusted downward to $751.00 for health insurance coverage provided on the child by the Husband.4 With combined net monthly income of $6,086.00 the basic requirement for support of the two children in the Husband's custody is $1,379.00.5 The Wife's proportionate share of that amount is $360.00. The support obligation is adjusted upward to $379.00 for health insurance coverage provided on the children by the Husband.6 Offsetting the two support obligations as set forth above results in a net child support obligation payable by the Husband of $391.00 per month. The Wife originally filed a claim for spousal support with her original complaint. She has withdrawn that claim and has elected to proceed only on her claim for alimony pendente lite filed in the divorce action. Alimony pendente lite is alimony or maintenance during the pendency of a divorce proceeding so as to enable a dependent spouse to proceed with or defend against the action. Jayne v. Jane, 663 A.2d 169 (Pa. Super. 1995). If entitlement to an award of alimony pendente lite is found, the amount of the award is 1 See Exhibit "A" for the tax deductions and credits. 2 See Exhibit "A" for the tax deductions from gross income. 3 See Pa. R.C.P. 1910.16-3. 4 See Exhibit "B" for the guideline calculation. 5 See Pa. R.C.P. 1910.16-3. 6 See Exhibit "C" for the guideline calculation. The withdraw and election were made orally to this Master before the start of the hearing. calculated in the same manner as spousal support. Little v. Little, 47 Cumberland L.J. 131 (1998). The Husband has not contested the Wife's entitlement to alimony pendente lite in this matter. The formula for calculation of spousal support or alimony pendente lite is set forth in Pa. R.C.P. 1910.16-4(a) Part IV. Deducted from the obligor's net income is his obligation for support of his children and the net income of the obligee. The Husband in this case has an obligation of support for the child in the Wife's custody of $751.00 per month and an obligation in-kind for the two children in his custody of $1,019.00. Deducting these figures and the Wife's net monthly income of $1,590.00 from the Husband's net monthly income of $4,496.00, and multiplying the difference by .30 results in a monthly obligation for alimony pendente lite of $341.00.8 The Husband continues to reside in the marital residence. The home is encumbered by a first mortgage with a monthly payment of $1,137.00 and a second mortgage with a monthly payment of $279.00. The second mortgage was taken to consolidate credit card debt and to payoff the loan on the Husband's car. Homeowners' insurance and real estate taxes are paid separately and together average approximately $267.00 per month. The Husband is paying both mortgages as well as the taxes and insurance. Pa. R.C.P. 1910.16-6(e) provides that if the obligor is residing in the marital residence and the mortgages, real estate taxes, and insurance exceed 25% of his net monthly income less any amount paid for spousal support, alimony pendente lite, and child support, "the court may make an appropriate downward adjustment in the obligor's support obligation." Whether to make such an adjustment is left to the discretion of the trier of fact, and no formula for calculating the adjustment is set forth in the rule .9 The Husband is making monthly payments on the first mortgage, insurance, and real estate taxes totaling $1,404.00.10 The Wife is paying monthly rent of $1,050.00 to provide a home for herself and Thomas. In the opinion of this Master an adjustment of the Husband's support obligation is justified under the circumstances. A recommendation is, therefore, made that the Husband's obligation for alimony pendente lite be reduced to $164.00 per month. RECOMMENDATION A. In the case docketed to 351 Support 2008 the Husband shall pay to the Pennsylvania State Collection and Disbursement Unit as support for his child, Thomas J. Gray, born August 14, 1997, the sum of $391.00 per month effective April 24, 2008. s See Exhibit "D" for the calculation. 9 The rule provides a formula only when the obligee is residing in the home and is making the payments. 10 The rule provides that only the first mortgage must be taken into consideration. Whether to include subsequent mortgages is discretionary with the trier of fact. The home equity loan in this case was used to consolidate credit card bills and to payoff the Husband's car loan. This Master has elected not to include that obligation in making the mortgage adjustment. 4 B. In the case docketed to 07-5927 Civil the Husband shall pay to the Pennsylvania State Collection and Disbursement Unit as alimony pendente lite the sum of $164.00 per month effective May 2, 2008. C. The Husband shall pay to the Pennsylvania State Collection and Disbursement Unit the additional sum of $43.33 per month on arrearages. D. The Husband shall provide health insurance coverage for the benefit of his three children, Michael T. Gray, born May 13, 1991, Ryan R. Gray, born January 22, 1994, and Thomas J. Gray, born August 14, 1997, as is available to him through employment or other group coverage at a reasonable cost. E. The monthly support obligation includes cash medical support in the amount of $250.00 annually for unreimbursed medical expenses incurred for each child. Unreimbursed medical expenses of the children that exceed $250.00 annually shall be allocated between the parties. The party seeking allocation of unreimbursed medical expenses must provide documentation of expenses to the other party no later than March 31St of the year following the calendar year in which the final medical bill to be allocated was received. The unreimbursed medical expenses of the children are to be paid as follows: 74% by Husband and 26% by Wife. F. The interim order entered in 361 Support 2008 dismissing the Husband's complaint for child support is affirmed. D Michael R. Rundle Support Master In the Court of Common Pleas of Cumberland County, Pennsylvania f -irt 47} t ?} r' F e•?i ?'? 'Ck. * ` r? ?y,T 4•- ?? z ,l'E?? ? . ? Plaintiff Name: Dianne M. Gray Defendant Name: Thomas M. Gray Docket Number: 351 S 2008 PACSES Case Number: 412109987 Other State ID Number: Tax Year: Current: 2008 t 1. Tax Method 1040 ES Manual 2. Fling Status Head of Household Head of Household 3. Who Claims the Exemptions Customize 4. Number of Exemptions 3 2 5. Monthly Taxable Income $5,722.10 $1,654.90 6. Deductions Method 7. Deduction Amount $666.67 $666.67 8. Exemption Amount $875.01 $583.34 9. Income MINUS Deductions and Exemptions $4,180.42 $404.89 10. Tax on Income $633.65 $40.49 11. Child Tax Credit $83.33 $40.49 12. Manual Adjustments to Taxes - - 13. Federal Income Taxes $550.32 -$130.42 13 a. Earned Income Credit - $130.42 14. State Income Taxes $180.82 $52.29 15. FICA Payments $437.74 $126.60 16. City Where Taxes Apply 17. Local Income Taxes $57.22 $16.55 TOTAL Taxes $1,2 6.10 $65.02 supportcak 2007 EXHIBIT " A" In the Court of Common Pleas of Cumberland County, Pennsylvania h r# rt r °Tx ri 3 s ?% 4 T : r ? : c J . r Itj. Defendant Name: Thomas M. Gray Docket Number: 351 S2008 PACSES Case Number: 412109987 Plaintiff Name: Dianne M. Gray Other Case ID Number: 1. Number of Dependents in this Case 1 2. Total Gross Month/ Income $5,722.10 $1,654.90 3. Less Month/ Deductions $1,226.10 $65.02 4. Monthly Net Income $4 496.00 $1 589.88 Line 2 minus Line 3 , , 5. Combined Total Monthly Net Income $6 085.88 Amounts on Line 4 Combined , 6. Plus Child's Month/ Soc. Sec. Retirement or Disability Derivative Benefit. - 7. Adjusted Combined Total Month/ Net Income - 8. PRELIMINARY Child Support Obligation based on Adjusted Income Line 7 - 9. Less Child's Monthly Social Security Retirement or Disability Derivative Benefit Line 6 _ 10. Basic Child Support Obligation 030 00 $1 From Rule 1910.16-3 Basic Child Su port Schedule Table Rev. 112006 , . 11. Net Income as a Percentage of Combined Amount 73.88 26.12 12. Each Parent's Monthly Share of the Child Support Obligation $760.96 $269.04 13. Adjustment for Shared Custody Rule 1910.16-4 c # of Overnights: - - 14. Adjustment for Child Care Expenses Rule 1910.16-6 a - 15. Adjustment for Health Insurance Premiums Rule 1910.16-6 b -$9.46 16. Adjustment for Unreimbursed Medical Expenses Rule 1910.16-6 c - 17. Adjustment for Additional Expenses Rule 1910.16-6 d - 18. Total Obli ation with Adjustments Line 8 minus Line 9, plus Lines 10, $751.50 19. Less Split Custody Counterclaim Rule 1910.16-4 d - 20. Obligor's Support Obligation Line 14 minus Line 15 $751.50 Prepared by: mrr Date: 6/25/2008 S1. PACSES Multiple Family Adjustment - S2. Spousal Support Award - S3. Adjustment for Excess Mortgage Payments (If Applicable) - S4. Custodial Parent Spousal Support Obligation (if Applicable) (-) - S5. Adjusted Support Obligation Line 16 (or S1, if applicable) plus Line S2 and S3 minus S4 (if applicable) Monthly: $751.50 Weekly: $172.96 TAX INFORMATION Tax Method Filing Status Exemptions S6. Defendant 1040 ES Head of Household 3 S7. Plaintiff Manual Single 2 S8. Total Support Amount if Deviating from Guidelines Calculation Monthly: Weekly: S9. Justification for Deviatinq from Guidelines Calculation and/or Other Case Comments: SupportCalc 2008 EXHIBIT "B" . In the Court of Common Pleas of Cumberland County, Pennsylvania .16 icy i' 1 _ x<i+ "Fnl?4t.i tl,:. Defendant Name: Dianne M. Gray Docket Number: 361S 2008 PACSES Case Number: 232109994 Plaintiff Name: Thomas M. Gray Other Case ID Number: F 1. Number of Dependents In this Case 2 2. Total Gross Monthly Income $1,654.90 $5,722.10 3. Less Monthly Deductions $65.02 $1,226.10 4. Monthly Net Income Line 2 minus Line 3 $1,589.88 $4,496.00 5. Combined Total Monthly Net Income Amounts on Line 4 Combined $6,085.88 6. Plus Child's Monthly Soc. Sec. Retirement or Disability Derivative Benefit. - 7. Ad usted Combined Total Monthly Net Income 8. PRELIMINARY Child Support Obligation based on Adjusted Income Line 7 - - 9. Less Child's Monthly Social Security Retirement or Disability Derivative Benefit Line 6 10. Basic Child Support Obligation From Rule 1910.16-3 Basic Child Support Schedule Table Rev. 112006 $1,379.00 11. Net income as a Percentage of Combined Amount 26.12 73.88 12. Each Parent's Monthly Share of the Child Support Obligation $360.19 $1,018.81 13. Adjustment for Shared Custody Rule 1910.16-4 c (# of Overnights: - - 14. Adjustment for Child Care Expenses Rule 1910.16-6 a - 15. Adjustment for Health Insurance Premiums Rule 1910.16-6 b $18.88 16. Adjustment for Unreimbursed Medical Expenses Rule 1910.16-6 c - 17. Adjustment for Additional Expenses Rule 1910.16-6 d - 18. Total Obligation with Adjustments Line 8 minus Line 9, plus Lines 10, 12,13 $379.07 19. Less Split Custody Counterclaim Rule 1910.16-4 d - 20. Obligor's Support Obligation Line 14 minus Line 15 $379.07 Prepared by: mrr Date: 6/25/2008 S1. PACSES Multiple Family Adjustment - S2. Spousal Support Award - S3. Adjustment for Excess Mortgage Payments (If Applicable) - S4. Custodial Parent Spousal Support Obligation (if Applicable) (-) - S5. Adjusted Support Obligation Line 16 (or S1, if applicable) plus Line S2 and S3 minus S4 (if applicable) Monthly: $379.07 Weekly: $87.24 TAX INFORMATION Tax Method Filing Status Exemptions S6. Defendant Manual Single 2 S7. Plaintiff 1040 ES Head of Household - 3 S8. Total Support Amount if Deviating from Guidelines Calculation Monthly: F Weekly: [ S9. Justification for Deviating from Guidelines Calculation and/or Other Case Comments: SupportCak 2008 EXHIBIT "C" In the Court of Common Pleas of Cumberland County, Pennsylvania r > r , ? - ? a ra Y +< JI - ' ? r. ,C r S a vr 4 • ? y+. ? h # _"St ??Y Lfi _ v r Yt ?Yi •} 4- S i ? i? Yt,? SS 1 Plaintiff Name: Dianne M. Gray Defendant Name: Thomas M. Gray Docket Number: 351 S 2008 PACSES Case Number: 412109987 Other State ID Number: 1.Obli oes Monthly Net Income $4,496.00 2. Less All Other Support $1,018.81 3. Less Obligee's Monthly Net Income $1,589.88 4. Difference $1,887.31 5. Less Child Support Obligation for Current Case $751.50 6. Difference $1,135.81 7. Multi 1 b 30% or 40% 30.00% 8. Income Available for Spousal Support $340.74 9. Adjustment for Other Expenses - 10. AMOUNT OF MONTHLY SPOUSAL SUPPORT OR APL $340.74 Prepared b : mrr Date: 6/25/2008 SupportCalc 2008 EXHIBIT "D" DIANNE M. GRAY, Plaintiff V. THOMAS M. GRAY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : DOMESTIC RELATIONS SECTION PACSES NO. 412109987 DOCKET NO. 351 SUPPORT 2008 THOMAS M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION DIANNE M. GRAY, PACSES NO. 232109994 Defendant DOCKET NO. 361 SUPPORT 2008 DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION THOMAS M. GRAY, PACSES NO. 824 1 1 0005 Defendant/Respondent: DOCKET NO. 07-5927 CIVIL INDEX OF EXHIBITS Plaintiff's Exhibit No. I - Income and expense statement Plaintiff's Exhibit No. 2 - Earnings statement Plaintiff's Exhibit No. 3 - 2007 joint federal tax return Defendant's Exhibit No. 1 - Earnings statement ?? v 'r'? C„? =? ?-.?. ?? ' ? 7 r?.a ""T .. ??.? ? i t) ms's ..,y` V% ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 07/01/08 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number COMMERCE BANK* 1701 RT 70 FL 3 CHERRY HILL NJ 08003-2390 087-54-5037 Employee/Obligor's Social Security Number 7042101971 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated` with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 391.00 per month in current child support $ 43.33 per month in past-due child support Arrears 12 weeks or greater? Oyes ® no $ o. oo per month in current medical support $ 0.00 per month in past-due medical support $ 164.00 per month in current spousal support $ o. oo per month in past-due spousal support $ o.00 per month for genetic test costs $ 0._00 per month in other (specify) $ one-time lump sum payment for a total of $ 598.33 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered suooort payment cycle, use the following to determine how much to withhold: $ 138.08 per weekly pay period. $ 299.17 per semimonthly pay period (twice a month) $ 276.15 per biweekly pay period (every two weeks) $ 598.33 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-67(5-9580 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 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAMEAND T above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY BE) DO NOT SEND CASH BY MAIL. ,.s BY THE COURT: Service Type M OMB No.: 0970-0154 412109987 351 S 2008 07-5927 CIVIL O O rig i na l Order/Notice @Amended Order/Notice 0Terminate Order/Notice (Done-Time Lump Sum/Notice RE: GRAY, THOMAS M. Employee/Obligor's Name (Last, First, MI) 17106-9112 MEMBER ID (shown :R TO BE PROCESSED. JUDGE Form EN-028 Rev. 3 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS t di e ent fdrom the state thatdssuffth d eorc?erpa copy must be proovi3edptlo your employee el?enif he box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2224860570 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : C3 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: GRAY, THOMAS M. EMPLOYEE'S CASE IDENTIFIER: 7042101971 LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: DATE OF SEPARATION: FINAL PAYMENT AMOUNT- NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family,However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev. 3 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GRAY, THOMAS M. PACSES Case Number 412109987 Plaintiff Name DIANNE M. GRAY Docket Attachment Amount 00351 S 2008 $ 434.33 Child(ren)'s Name(s): DOB THOMAS J. GRAY 08/14/97 ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number 824110005 Plaintiff Name DIANNE M. GRAY Docket Attachmenj Amount 07-5927 CIVIL$ 164.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ............... . ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Rev. 3 Service Type M OMB No.: 0970-0154 Worker ID $IATT C`3 r,,?, E" r„ Ca`:< ('? f (-- ? ? ?p f>;'< -'? ».? r t? t --_ ? t y „ F?f .. w.e,? _ ?. L? YYes ? ?? s ??+`?? DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-5927 CIVIL TERM THOMAS M. GRAY, IN DIVORCE Defendant/Respondent : PACSES Case No: 824110005 ORDER OF COURT AND NOW, this 17th day of June 2009, based upon the Court's determination that the Petitioner's monthly net income/earning capacity is $ 1,500.65 and the Respondent's monthly net income/earning capacity is $ 4,292.22, it is hereby ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit One Hundred and 00/100 Dollars ($ 100.00) per month payable bi-weekly as follows: $ 100.00 per month for Alimony Pendente Lite and $ 0.00 per month on arrears. First payment due: in accordance with Respondent's pay schedule. The effective date of the order is June 1, 2009. Arrears set at $ 123.87 as of June 17, 2009. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C.S.§ 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and, at its discretion, make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the PA SCDU to: Dianne M. Gray. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the Respondent's name with their PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. cc360 This Order is based upon the Petitioner agreeing to lower the Alimony Pendente Lite to $10.00 per month, effective June 1, 2009. This Order shall become final twenty (20) after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary for a hearing de novo before the Court. Consented: Petitioner Respondent Petitioner's Attorney Respondent's Attorney Mailed copies on: June 18, 2009 to: Petitioner Respondent Diane G. Radcliff, Esq. Lesley J. Beam, Esq. BY THE COURT, Edward . G ido, J. DRO: R.J. Shadday r ;c TH LA 19 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 07-5927 CIVIL State Commonwealth of Pennsylvania OOriginal Order/Notice Cc./City/Dist. of CUMBERLAND 412109 OAmended Order/Notice Dzte of Order/Notice 06/18/09 351 S 2008 OX Terminate Order/Notice Case Number (See Addendum for case summary) OOne-Time Lump Sum/Notice _ RE: GRAY, THOMAS M. Emoloyer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 087-54-5037 Employee/Obligor's Social Security Number T D UNIVERSITY 7042101971 4140 CHURCH RD Employee/Obligor's Case Identifier MOUNT LAUREL NJ 08054-2221 (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 0.00 per month in current child support $_ _ o . oo per month in past-due child support Arrears 12 weeks or greater? O yes ® no $ 0.00 per month in current medical support $ 0.00 per month in past-due medical support $ o.oo per month in current spousal support $ _ o . o o per month in past-due spousal support $ 0.00 per month for genetic test costs $ o. oo per month in other (specify) $ one-time lump sum payment for a total of $ 0 . oo per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0. 00 per weekly pay period. $ 0. oo per semimonthly pay period (twice a month) $ 0._00 per biweekly pay period (every two weeks) $ 0.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the 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 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY BE/ DO NOT SEND CASH BY MAIL. -.10 BY THE COURT: DRO: R.J. Shadday Service Type M OMB No.: 0970-0154 17106-9112 CSES MEMBER ID (shown IN RDER TO BE PROCESSED. Form EN-028 Rev.5 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If heckefi you are required to provide aSopy of this form to yourem loyee. If yo r employee works in a state that is di erent rrom the state that issued this or er, a copy must be proviedpto your employee even if the box is not checked 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2224860570 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: D EMPLOYEE'S/OBLIGOR'S NAME: GRAY, THOMAS M. EMPLOYEE'S CASE IDENTIFIER: 7042101971 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT- NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. AntWiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GRAY, THOMAS M. PAGES Case Number 824110005 PACSES Case Number Plairtiff Name Plaintiff Name DIANNE M. GRAY Docket Attachment Amount Docket Attachment Amount 07-5927 CIVIL$ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker ID $IATT {III' 11 1 , ?:, : " .i i o ; . 2039 o ; . CU N"%.,. '` 3 DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff/ CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-5927 CIVIL TERM THOMAS M. GRAY, IN DIVORCE Defendant PACSES CASE: 824110005 ORDER OF COURT AND NOW to wit, this 6th day of October, 2009, it is hereby Ordered that the Defendant is to pay an additional sum of $50.00 per month toward the accumulated arrears. BY THE COURT: ?I - <; Edward E. Gui , J. DRO: R.J. Shadday xc: Petitioner Respondent Diane G. Radcliff, Esq. Lesley J. Beam, Esq. Form OE-001 Service Type: M Worker: 21005 OF THE PROTHONOTARY 2009 OCT -7 PM 2; 4 7 CUIv _ JN' ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 412109987 Co./City/Dist. of CUMBERLAND 351 S 2008 Date of Order/Notice 10/06/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal [IN Number METRO BANK 3801 PAXTON ST HARRISBURG PA 17111-1418 RE: GRAY, THOMAS M. 07-5927 CIVIL OOriginal Order/Notice OAmended Order/Notice OTerminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 087-54-5037 Employee/Obligor's Social Security Number 7042101971 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1,060.00 $ 118.00 $ 0.00 $ 0.00 $ 100.00 $ 50.00 $ 0.00 $ 0.00 per month in current child support per month in past-due child support per month in current medical support per month in past-due medical support per month in current spousal support per month in past-due spousal support per month for genetic test costs per month in other (specify) Arrears 12 weeks or greater? (g) yes O no one-time lump sum payment for a total of $ 1,328.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 306.46 per weekly pay period. $ 664.00 per semimonthly pay period (twice a month) $ 612.92 per biweekly pay period (every two weeks) $ 1, 328.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa H IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAM Z above as the Employee/Obligor's Case Identifier) OR SOCIAL SECU NUM DO NOT SEND CASH BY MAIL. BY THE COURT: DRO: R.J. Shadday Service Type M OMB No.: 0970-0154 17106-9112 CSES MEMBER ID (shown ORDER TO BE PROCESSED. Form EN-028 Rev.5 Worker I D $ IATT 0 ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS E] If hecked you are required to provide a opy of this form to your mployee. If yo r employee works in a state that is dierent from the state that issued this or?er, a copy must be provided to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2323247300 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : O THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: O EMPLOYEE'S/OBLIGOR'S NAME: GRAY, THOMAS M. EMPLOYEE'S CASE IDENTIFIER: 7042101971 LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: DATE OF SEPARATION: FINAL PAYMENT AMOUNT: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev.5 Service Type M OMB No, 0970-0154 Worker ID $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GRAY, THOMAS M. PACSES Case Number 412109987 PACSES Case Number 824110005 Plaintiff Name Plaintiff Name DIANNE M. GRAY DIANNE M. GRAY Docket Attachment Amount Docket Attachment Amount 00351 S 2008 $ 1,178.00 07-5927 CIVIL$ 150.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): THOMAS J. GRAY 08/14/97 RYAN R. GRAY 01/23/94 MICHAEL T. GRAY 05/13/91 PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev.5 Service Type M Worker ID OMB No.: 0970-0154 $ IATT FILED-. i i+?L 2009 OC i -u c? J APL Modification Petition Prepared By: Diane G. Radcliff, Esquire 3448 Trindle Road, Camp Hill, PA 17011 Supreme Court ID # 32112 Phone: 717-737-0100 • Fax: 717-975-0697 • Email: dianeradcliff @comcast.net Attorney for Plaintiff /Petitioner, Dianne M. Gray IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DIANNE M. GRAY, Plaintiff NO. 07-5927 CIVIL TERM V. CIVIL ACTION - LAW THOMAS M. GRAY, DIVORCE Defendant PETITION FOR ORDER FOR ALIMONY PENDENTE LITE Petitioner, Dianne M. Gray, files the this Petition for Alimony Pendent Lite and respectfully represents that: 1. Petitioner is Dianne M. Gray, and the Plaintiff in the above captioned divorce action. 2. Respondent is Thomas M. Gray, and the Defendant in the above captioned divorce action. 3. The parties are husband and wife, having been married on September 8, 1984 . 4. The within action was instituted by the filing of a Divorce Complaint by Petitioner, Dianne M. Gray on 10/10/2008, which Complaint was duly served on Defendant/ Respondent on 10/15/2008. 5. In the Divorce Complaint, Petitioner raised a claim for Alimony Pendente Lite. 6. On June 17, 2009 an Order of Court was entered for Alimony Pendente Lite. A true and correct copy of the order is attached hereto, marked Exhibit "A" and made a part hereof. 7. Petitioner is entitled to an increase of this Order because of the following - 1 - material and substantial change(s) in circumstance: (A) increase in the income of Defendant; (B) increase in the needs of the Plaintiff (C) Respondent has not sufficiently provided support for the Petitioner and Petitioner is not on a financial par with Respondent in prosecuting and/or defending this Divorce Action, and is unable to support herself in accordance with the standard of living established during the marriage. WHEREFORE, Petitioner requests that the Court modify (increase) the existing order for alimony pendente lite. Respectfully submitted, r E G. CLIFF, ESQUIRE 344 rindle Road Camp Hill, PA 17011 Supreme Court ID # 32112 Phone: (717) 737-0100 Fax: (717) 975-0697 Attorney for Petitioner -2- VERIFICATION I verify that the statements made in this Petition for Modification of Order for Alimony Pendent Lite are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. -3- CERTIFICATE OF SERVICE I hereby certify that I am this day serving the foregoing document upon the person(s) and in the manner indicated below, which service satisfies the requirements of the Pennsylvania Rules of Civil Procedure: Service by First Class Mail Addressed as Follows: Lesley J. Beam, Esquire KOPE Et ASSOCIATES 4660 Trindle Road • Suite 201 Camp Hill, PA 17011 (Counsel for Respondent) CLIFF, ESQUIRE (Attorne gistration No 32112) Fin le Road Camp Hill, PA 17011 Email: dianeradcliff@comcast.net Phone: (717) 737-0100 Fax: (717) 975-0697 Counsel for Petitioner, Dianne M. Gray Dated: b -4- OF IIIMT M OCT 23 ph 3= 11 "WO&COUNTY MM DIANNE M. GRAY, THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-5927 CIVIL TERM THOMAS M. GRAY, IN DIVORCE Defendant/Respondent : PACSES CASE NO: 824110005 ORDER OF COURT AND NOW, this 26th day of October, 2009, a petition has been filed against you, Thomas M. Gray, to modify an existing Alimony Pendente Lite Order. You are ordered to appear in person at the Domestic Relations Section, 13 North Hanover Street, Carlisle, Pennsylvania, on December 8, 2009 at 10:30 A.M. for a conference and to remain until dismissed by the Court. If you fail to appear as provided in this Order, an Order of Court may be entered against you. You are further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W-2's as filed (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by the Rule 1910.11. (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you IF you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. Copies mailed to: Petitioner Respondent Diane G. Radcliff, Esq. Lesley J. Beam, Esq. Date of Order: October 26, 2009 BY THE COURT, Edward E. Guido Judge YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 cc361 FIED-OfFICF OF Tff- PRMCNOTARY 2009 OCT 27 PM 2= 29 4Lj k-, PSNNS`fLVANIA DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS Plaintiff, CUMBERLAND COUNTY, PA vs. NO. 07-5927 THOMAS M. GRAY, CIVIL ACTION - Defendant. LAW IN DIVORCE AFFIDAVIT OF CONSENT 1. A complaint in divorce under Section 3301(c) of the Divorce Code was filed on October 10, 2007. 2. The Complaint was served by certified mail signed for by defendant Thomas M. Gray on October 15, 2007. 3. The marriage of plaintiff and defendant is irretrievably broken and at least ninety (90) days have elapsed from the date of filing and service of the complaint. 4. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities Date: /,-t, /-1/ J119 r TFI PR-;)TFl'O N,0TARY 2009 DEC I I PM 1= 5 d CUtot??.: , ? ? i? FY DIANNE M. GRAY, Plaintiff, vs. THOMAS M. GRAY, Defendant. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 07-5927 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 in divorce without notice. 2. 1 understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. 1 understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities Date: ALED-,':J =i11 0"LE: F THE FPVI t i'''NARY 2009 DEC I I P 1: 58 cuiv, DIANNE M. GRAY, IN THE COURT OF COMMON PLEAS Plaintiff, CUMBERLAND COUNTY, PA vs. NO. 07-5927 THOMAS M. GRAY, CIVIL ACTION - Defendant. LAW IN DIVORCE AFFIDAVIT OF CONSENT 1. A complaint in divorce under Section 3301(c) of the Divorce Code was filed on October 10, 2007. 2. The Complaint was served by certified mail signed for by defendant Thomas M. Gray on October 15, 2007. 3. The marriage of plaintiff and defendant is irretrievably broken and at least ninety (90) days have elapsed from the date of filing and service of the complaint. 4. 1 consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Date: Dianne M. Gray r,c T! ?E Pr,0.T.r-!ONnTARY 2009 DEC 1 ! Pik t - 58 CUMw.......i: ^:,t, v Y PC- DIANNE M. GRAY, Plaintiff, vs. THOMAS M. GRAY, Defendant. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA : NO. 07-5927 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 in divorce without notice. 2. 1 understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. 1 understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Date: 7 lo q, - X-? Dianne M. Gray 1'LED-01'1's OF THE" PIP 7F r),jr)TARY 2009 DEC I I PH 1: 58 cur,-6.. .,: ,'LN y PE sit'#c? , LVr a !,M, R? E) ORIGINAL DIANNE M. GRAY, Plaintiff, vs. THOMAS M. GRAY, Defendant. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA NO. 07-5927 CIVIL ACTION - : LAW IN DIVORCE MARITAL SEPARATION AGREEMENT INTRODUCTORY PROVISION This Agreement is made by and between Dianne M. Gray of` Cumberland County, Pennsylvania ("Wife") and Thomas M. Gray of Cumberland County, Pennsylvania ("Husband"). 2. WHEREAS CLAUSES WHEREAS, the parties hereto are Husband and Wife, having been married on September 8, 1984, in Ronkonoma, Long Island, New York; WHEREAS, certain differences exist between the parties and they have decided to permanently live separate and apart from each other and they intend by this Agreement to fully and finally settle all of their respective rights and obligations as between each other, including, but not necessarily limited to the settling of all interests, rights and/or obligations between them or their estates, whether arising out of their marriage, including, but not limited to: (a) the past, present and future support, alimony pendente lite, alimony or maintenance of either party by the other party; and (b) the ownership of all assets of whatever nature, including assets acquired by either party prior to or subsequent to the date of execution of this Agreement; 3. CONSIDERATION NOW, THEREFORE, in consideration of the premises and of the mutual promises, covenants and undertakings set forth in this Agreement and for other good and valuable consideration, the receipt and adequacy of which is hereby acknowledged by each of the parties hereto, Husband and Wife, intending to be legally bound hereby, covenant kind agree ollows: r 1 of 19 DM T .???? SECTION I GENERAL PROVISIONS 4. INCORPORATION OF PREAMBLE The recitals set forth in the Preamble of this Agreement are incorporated herein and made a part hereof as if fully set forth in the body of the Agreement. 5. DEFINITIONS A. Divorce Code. The phrase "Divorce Code" or "Code" shall be defined as Pennsylvania C.S.A., Title 23, Section 101 et seq. (effective March 19, 1991). B. Date of Execution of This Agreement. The phrase "date of execution", "execution date" or "date of this Agreement" shall be defined as the date that the last party signs this Agreement. C. Date of Distribution. Except where indicated otherwise, the phrase "date of distribution" of this Agreement shall be defined as the earlier of the date of: (1) death of one of the parties; or (2) the thirty-first day subsequent to the date on which an initial divorce decree is entered without an appeal having been taken, or, if such an appeal has been taken, on the date of receipt of notice of final confirmation of the initial divorce decree by the appellate courts. If the distribution date falls on a date when the court which entered the decree in divorce or to which appeal was taken is closed for official business, then the distribution date shall be the next day on which that court is open for official business. D. Internal Revenue Code. The phrase "Internal Revenue Code" or "I.R.C." shall be defined as the Internal Revenue Code of 1986, as amended, or any successor statute thereto. References to sections of the Internal Revenue Code shall refer to sections of the Internal Revenue Code as of the date of execution of this Agreement. E. Asset. The word "Asset" shall be defined as anything of value, including, but not limited to, real and/or personal, tangible and/or intangible property and all financial interests however held. F. ffective Date of Agreement. This Agreement shall become effective 2of19 DM and binding upon both parties on the execution date of this Agreement. 6. DIVORCE DECREE A. The parties acknowledge that their marriage is irretrievably broken and that they will secure a mutual consent, no-fault Divorce Decree in the above captioned divorce action. Wife has filed a divorce action in the Court of Common Pleas of Cumberland County, Pennsylvania, Civil Term, 2008, No. 2007-5927, seeking a divorce decree pursuant to, among other provisions, Section 3301(c) of the Domestic Relations Code. The parties shall promptly file the affidavits and waivers required to obtain a divorce pursuant to § 3301(c) of the Domestic Relation Code. As defined in the Domestic Relations Code, the parties' marriage is irretrievably broken and they do not desire marital counseling. The parties shall also take all legal steps (including, but not limited to, the timely and prompt submission of all documents and the execution of appropriate waivers of the right to file exceptions and of the right to file an appeal) necessary to ensure that a divorce pursuant to § 3301(c) of the Domestic Relations Code is entered as soon as possible/within one (1) month from the date of execution of this Agreement. B. Responsibility for Proceeding with Divorce. Husband shall be responsible for the prompt filing of the Praecipe to Transmit the Record and the related required documents. C. Withdrawal of Other Actions. The parties further shall take all legal steps necessary to ensure that all pending petitions and actions between the parties (including, but not limited to counterclaims or petitions for economic relief), except for the divorce action referred to in Paragraph 6.A. (to the extent necessary to obtain the divorce), are dismissed with prejudice as soon as possible and that no similar actions are instituted, except to the extent necessary to enforce the terms of this Agreement. D. Penalty for Delay. Notwithstanding the foregoing, if, after the execution of this Agreement, either party unreasonably delays or contests the obtaining of a final, unappealed divorce decree, that party shall exonerate and indemnify the other party against and hold the other party harmless from any liability and/or TG , including reasonable counsel fees, incurred as a result of such delay or 3of19 DM contest in obtaining the decree. 7. EFFECT OF NO DIVORCE Except as otherwise provided for in this Agreement, this Agreement shall remain in full force and effect even if no final decree in divorce is entered. 8. EFFECT OF DIVORCE DECREE, INCORPORATION AND MERGER This Agreement shall continue in full force and effect after a final decree in divorce is entered in any jurisdiction, it shall survive and not merge into any such divorce, and its provisions shall not be affected by the entry of such a decree, surviving any such decree and remaining independent of any such decree. The terms of this Agreement shall be incorporated for enforcement purposes only, but not merged into the divorce decree. The Court entering the decree shall have all of the powers of enforcement, which, at the discretion of the non-breaching party, shall include, but not necessarily be limited to, all of the following: for breach of contract, under theories of equity, and under the Divorce Code, including under § 3105 (which includes contempt). The provisions of this Agreement shall not be modifiable for any reason. 9. ADVICE OF COUNSEL Wife and Husband declare that each has had a full and fair opportunity to obtain independent legal advice of counsel of their selection. Wife has been represented by Diane G. Radcliff, Esquire. Husband has been represented by Lesley J. Beam, Esquire. Each party represents that he or she understands that, in the absence of this Agreement and as a matter of law: (1) as a surviving spouse, he or she might be entitled to a greater share in the decedent's estate than is provided for in this Agreement; and (2) as a separated and/or divorced spouse, he or she might be entitled to greater support, maintenance, alimony pendente lite, counsel fees, costs, alimony, distribution of property, or other financial benefits arising from the marital relationship than is provided for in this Agreement. Notwithstanding the foregoing, the parties shall be bound by the terms of this Agreement. Each of the parties further acknowledges and agrees that, with such knowledge, and after having read this Agreement carefully and fully, this Agreement is fair, reasonable and equitable, that it is being entered into freely, voluntarily, and in good faith, and that its execution is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreement. 4of19 DMG T' 10. FINANCIAL DISCLOSURE The parties confirm that each has relied on the substantial accuracy of the financial disclosure of the other as an inducement to the execution of this Agreement, and each party acknowledges that there has been disclosure of the parties' marital assets and debts and the parties' respective incomes. The parties agree to waive any further disclosure and proceed with a settlement of all financial assets and/or debts. 11. DISCLOSURE AND WAIVER OF PROCEDURAL RIGHTS Each party understands that he or she has the right: (1) to obtain from the other party a complete inventory or list of all of the property that either or both parties own at this time or owned as of the date of separation; (2) to have all such property valued by means of appraisals or otherwise; (3) to compulsory discovery to assist in the discovery and verification of facts relevant to their respective rights and obligations, including the right to question the other party under oath; and (4) to have a Court hold hearings and make decisions on the matters covered by this Agreement, which Court decision concerning the parties' respective rights and obligations might be different from the provisions of this Agreement. Given said understanding and acknowledgment, both parties hereby waive the foregoing procedural rights. 12. BANKRUPTCY The parties hereby agree that the provisions of this Agreement shall not be dischargeable in bankruptcy and expressly agree to reaffirm any and all obligations contained herein. 13. MUTUAL RELEASES Except as otherwise expressly provided in this Agreement, Wife and Husband each do hereby mutually remise, release, quitclaim and forever discharge the other and the estate of such other, for all time to come, and for all purposes whatsoever, of and from the following: A. Claims Against Property or Estate: Any and all right, title, interest and/or claims in or against the other party, the property (including income and gain from property hereafter accruing) of the other or against the estate of the other, of whatever nature and wheresoever situated, which he or she now has or at any time hereafter may have against the other, the estate of such other pa r the property of the other party or any part thereof, whether arising out ' WDM JG- T 5of19 of any former acts, contracts, engagements or liabilities of such other. B. Life Time Conveyances: The right to treat a lifetime conveyance by the other as testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of (i) the Commonwealth of Pennsylvania, (ii) State, Commonwealth or Territory of the United States, or (iii) any other country; C. Marital Rights: Any rights which either party may have or at any time hereafter have for past, present or future support or maintenance, alimony, alimony pendente lite, counsel fees, equitable distribution, costs or expenses, whether arising as a result of the marital relation or otherwise. D. Breach Exception: The foregoing shall not apply to all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision thereof. It is the intention of Husband and Wife to give to each other by the execution of this Agreement a full, complete and general release with respect to any and all property of any kind or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and only except, all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provisions thereof. 14. WAIVER OR MODIFICATION No modification or waiver of any of the terms hereof shall be valid unless in writing and signed by both parties and no waiver of any breach hereof or default hereunder shall be deemed a waiver of any subsequent default of the same or similar nature. 15. MUTUAL COOPERATION Each party shall, at any time, and from time to time hereafter, and within five (5) business days of request, take any and all steps and execute, acknowledge and deliver to the other party, any and all further instruments and/or documents that the other party may reasonably require for the purpose of giving full force and effect to the provisions of this Agreement. 16. WAIVER OF BENEFICIARY DESIGNATION Unless otherwise specifically set forth in this Agreement, each party hereto 6of19 DMG G specifically waives any and all beneficiary rights and any and all rights as a surviving spouse in and to any asset, benefit or like program carrying a beneficiary designation which belongs to the other party under the terms of this Agreement, including, but not limited to, pensions and retirement plans of any sort or nature, deferred compensation plans, life insurance policies, annuities, stock accounts, bank accounts, final pay checks or any other post-death distribution scheme, and each party expressly states that it is his and her intention to revoke by the terms of this Agreement any beneficiary designations naming the other which are in effect as of the date of execution of this Agreement. If and in the event the other party continues to be named as beneficiary and no alternate beneficiary is otherwise designated, the beneficiary shall be deemed to be the estate of the deceased party. 17. WAIVER OF INHERITANCE RIGHTS Unless otherwise specifically provided in this Agreement, as of the execution date of this Agreement, the parties hereto waive all rights of inheritance in the estate of the other that he or she may have by virtue of the parties' marriage. The parties hereby waive any right to elect to take against the will or trust of the other that he or she may have by virtue of the parties' marriage. 18. AGREEMENT BINDING ON HEIRS This Agreement shall be binding and shall inure to the benefit of the parties hereto and their respective heirs, executors, administrators, successors and assigns. 19. INTEGRATION This Agreement constitutes the entire understanding of the parties and supersedes any and all prior agreements and negotiations between them. There are no representations or warranties other than those expressly set forth herein. 20. BREACH If for any reason either Husband or Wife fails to perform his or her obligations owed to or for the benefit of the other party and/or otherwise breaches the terms of this Agreement, then the other party shall have the following rights and remedies: A. Divorce Code Remedies: The right to all remedies set forth in the Pennsylvania Divorce Code, 23 Pa.C.S. § 3502(e), and any additional rights and remedies that may hereafter be enacted by virtue of the amendment of said-statute or replacement thereof by any other similar laws. 7of19 DM T B. Damages: The right to damages arising out of breach of the terms of this Agreement, which damages shall include reimbursement of all reasonable attorney's fees and costs incurred as the result of the breach and in bringing the damage action. C. Other Remedies: Any other remedies provided for in law or in equity. D. Consideration for Reasonable Attorneys Fees: Any award of "reasonable attorney's fees" as used in this paragraph shall be based on consideration of (1) the hourly rate charged; (2) the services rendered; and (3) the necessity of the services rendered. Determination of reasonableness shall not take into consideration the amount or nature of the obligation sought to be enforced or any possibility of settlement for less than the obligation sought to be enforced by the non-breaching party. E. Breach Notice: In the event of an alleged breach of any term of this Agreement, the aggrieved party shall provide written notice to the breaching party and his or her counsel of his or her intent to take action to enforce his or her rights under the Agreement and to remedy such breach. The breaching party shall have a period of five (5) days from the mailing of such notice to cure the alleged breach prior to the institution of any proceedings of any nature for enforcement of this Agreement. 21. INCOME TAX MATTERS With respect to income tax matters regarding the parties the following shall apply: A. Prior Returns: The parties have heretofore filed joint federal and state returns. Both parties agree that in the event any deficiency in federal, state or local income tax is proposed, or any assessment of any such tax is made against either of them arising out of such joint filing, Husband will be responsible for payment of such tax and any interest, penalty or other expense arising therefrom and shall indemnify and hold harmless Wife from and against any loss or liability as a result thereof. In the event that any refund is received after the execution of this Agreement, from any joint filing from a previous year, the parties hereby agree that the refund monies received shall be split equally between the two parties. ^, 8of19 DM T G B. Current Returns: The parties shall file individual tax returns for the current tax year and for every tax year hereafter. C. Preservation of Records: Each party will keep and preserve for a period of five (5) years from the date of their divorce all financial records relating to the marital estate, and each party will allow the other party access to those records as may be reasonably necessary from time to time. D. Dependency Exemptions: Husband shall receive the dependency exemptions for the parties' minor children Michael T. Gray, born May 19, 1991, and Ryan R. Gray, born January 22, 1994 for the tax year of 2009. Husband shall receive the dependency exemption for the parties' minor child Michael T. Gray for the tax year of 2010, if this child may be claimed pursuant to the Tax Code. Mother shall execute and deliver to said party IRS Form 8332 within five (5) business days of request in order to effectuate the provisions of this paragraph. Wife shall be entitled to claim the dependency exemption for the parties' minor child, Thomas John Gray, born August 14, 1997 for the tax year 2009. Wife shall receive the dependency exemption for the parties' minor children, Ryan R. Gray, born January 22, 1994 and Thomas John Gray, born August 14, 1997 for the tax year 2010 and thereafter as long as she remains the primary physical custodian of the children, and as long as each such child may be claimed pursuant to the tax code. 22. EFFECT OF RECONCILIATION This Agreement shall remain in full force and effect even if the parties reconcile, cohabit as Husband and Wife or otherwise, or attempt a reconciliation. This Agreement shall continue in full force and effect and there shall be no modification or waiver of any of the terms hereof unless the parties, in writing, signed by both parties, execute a statement declaring this Agreement or any term of this Agreement to be null and void. SECTION II EQUITABLE DISTRIBUTION OF PROPERTY 23. FINAL EQUITABLE DISTRIBUTION OF PROPERTY The parties agree that the division of all property and debts set forth in this Agreement is equitable and in the event an action in divorce has been or is hereafter commenc , both parties waive and relinquish the right to divide and distribute their 9of19 AM T G assets and debts in any manner not consistent with the terms set forth herein and further waive and relinquish the right to have the Court equitably divide and distribute their marital assets and debts. It is further the intent, understanding and agreement of the parties that this Agreement is a full, final, complete and equitable property division. 24. DISTRIBUTION OF PROPERTY AND DEBTS The parties' assets and debts shall be divided and distributed as follows: A. Real Estate: The parties hereto previously owned real estate, specifically a house and lot known and numbered as 2325 Greenbrier Lane, Enola, Cumberland County, Pennsylvania 17025 (the "Premises" or "Marital Residence"). The parties hereby acknowledge that the Premises have been sold as of the settlement date of April 28, 2009, satisfying all debt on said Premises, with a net profit to the parties of fourteen thousand, nine hundred and ninety-nine dollars and seventy-four cents ($14,999.74). The parties further acknowledge that said profits were divided, with eight thousand, two hundred and forty-nine dollars and eighty-seven cents ($8,249.87) of the profits received by Wife and six thousand, seven hundred and forty-nine dollars and eighty-seven cents ($6,749.87) of the profits received by Husband. B. Personal Property: The parties' tangible personal property including, but without limitation with specific reference to, jewelry, clothes, furniture, furnishings, rugs, carpets, household equipment and appliances, tools, pictures, books, works of art and other personal property ("the Personal Property") shall be divided and distributed as follows: (1) To Wife: All personal property currently in Wife's possession. (2) To Husband: All personal property currently in Husband's possession. C. Vehicle(s)and Vehicle Loan(s): The parties' vehicles (which shall be defined to include automobiles, boats, snowmobiles, motorcycles, trailers, campers and the like) owned by one or both of the parties, and loans associated therewith, shall be divided and distributed as follows: (1) To Wife: Wife shall receive all vehicles in her name, including but not limited to the 2007 Pontiac Grand Prix she obtained using the insurance proceeds from the parties' 2001 Nissan Maxima. '-I DMG T G To Husband: Husband shall receive all vehicles in his name, 10 of 19 including but not limited to the 2004 Jeep Liberty and any vehicle he may have acquired subsequent to the parties' separation. (3) The parties are responsible for securing and maintaining their own automobile insurance on the vehicles assigned to each, respectively, as of the date of execution of this Agreement. The parties agree that each party will solely and fully responsible for any uncovered expenses, costs and/or liability arising from any and all incidents and/or accidents involving their respective vehicles. (4) The parties are responsible the payment of any loans, liens or other debts encumbering the vehicles assigned to them, respectively, in this Agreement. (5) Title Transfer: After entry of the divorce decree, any vehicles assigned above shall be titled and owned in full by whomever receives ownership under this Agreement. If any vehicle awarded above should be titled in the name of another party, the parties shall take all steps required to transfer title of the vehicle into the name of the party with whom custody of the vehicle will lay in accordance with this Agreement. Said title transfer of any vehicle under this section must be made in accordance with the law within ninety (90) days of the signing of this Agreement. D. Monetary Distributions/Bank Accounts: All funds in joint and separate accounts, including but not limited to savings, checking, and money market accounts, should be divided and distributed as follows: (1) To Wife: Any funds in Wife's separate accounts. (2) To Husband: Any funds in Husband's separate accounts, and the remainder of the parties' CD, i.e., the remaining 50% of the account, upon its' maturation date of April 10, 2010. (3) Upon the division of the CD, the parties shall close this account. (4) As of the date of execution of this Agreement, the parties have already closed their joint checking and savings accounts, and the monies contained within those accounts have already been distributed to the mutual satisfaction of the parties. E. Investments: The parties' shares of stock, brokerage accounts and other investments (the "Investments"), which shall be defined to specifically exclude all forms of retirement plans, shall be divided and distributed as follows: To Wife: Wife shall receive any and all shares, accounts, 11 of 19 DMG JT and/or investments currently held in Wife's name alone. (2) To Husband: Husband shall receive any and all shares, accounts, and/or investments currently in Husband's name alone. F. Life Insurance: The parties' life insurance policies and the cash value of said policies shall remain in the possession of the party under whose name the policy is held. Neither party is entitled to the value or a portion of the value of the life insurance policy of his/her current spouse. G. Retirement Plans: The parties' Pension Plan, Retirement Plan, IRA Account, Profit Sharing Plan, 401(K) Plan, Keogh Plan, Stock Plan, Deferred Savings Plan, any employee benefit plan and/or any other retirement type plans (the "Retirement Plans") shall be divided and distributed as follows: (1) To Wife: The following Retirement Plans: (a) Any and all monies contained in retirement plans in Wife's name, specifically including Wife's ESOP plan through her employment at Kohls; (b) one-half (1/2) of the funds in Husband's Metro Bank IRA Certificate of Deposit (hereinafter "IRA CD"), upon its' maturation date of April 10, 2010, as the account is valued on that date. (2) To Husband: The following Retirement Plans: (a) Any and all monies contained in retirement plans in Husband's name, specifically including the entirety of his 401(k) account. (b) one-half (1/2) of the funds in Husband's Metro Bank IRA Certificate of Deposit (hereinafter "IRA CD"), upon its' maturation date of April 10, 2010, as the account is valued on that date. (3) Neither party shall withdraw funds from the IRA CD prior the maturation date, which action would cause a loss of value of the IRA CD in the form of a penalty. In the event either party attempts to remove money from the IRA CD prior to is maturation, that party shall be solely responsible for the loss incurred as a result, and that party's share of this account shall be reduced by the full amount of the loss incurred. (4) Wife shall receive her share of the IRA CD by way of tax free roll over of retirement benefits into an IRA account in her sole name. Should a qualified domestic relations order ("QDRO") be required to effectuate that transfer and roll over, then Husband's attorney shall prepare that 12 of 19 DMG T QDRO and the parties shall execute such consents necessary to secure the entry thereof by the court in sufficient time to permit the roll over of such benefits on the maturity date. H. Debts: The parties' marital debts, loans, credit cards and other obligations, not otherwise divided and distributed herein, shall be divided and distributed as follows: (1) To Wife: Wife shall be solely liable for the following debts: (a) The entirety of the balance owed on her GM credit card, account number ending in 5833; (b) The entirety of the balance owed on her American Express credit account, account number ending in 4009; and (c) All other debts and credit card obligations held in her name solely, and or obtained by Wife after the filing of the divorce complaint. (2) To Husband: Husband shall be solely liable for the following debts: (a) The entirety of the balance owed on the Home Depot credit account, account number ending in 2672; (b) The entirety of the balance owed on the AT&T Universal Platinum credit account, account number ending in 7564; (c) The monies owed to Ewing Roofing and for payment for the painting of the Marital Premises prior to sale, which monies have already been paid; (d) The entirety of the balance owed on the Best Buy credit account, account number ending in 3057; and (e) All other debts and credit card obligations held in his name solely, and or obtained by Husband after the filing of the divorce complaint. (3) The parties hereby agree that no joint debts exist as of the date of execution of this Agreement. In the event that one party has incurred debt in the name of the other party, specifically including the acquisition of a credit card account or other account in the names of both parties, the party which incurred the debt shall immediately pay said debt in full, to be paid no later than ten (10) business days from the date of execution of this Agreement. *DMG 13 of 19 TMG I 1. Cash Distribution: Husband shall make the following lump sum payment to Wife: (1) Husband shall pay the sum of two thousand, two hundred dollars and zero cents ($2,200.00) to Wife, no later than five business (5) days from the date of execution of this Agreement. (2) Payment shall be made by cash or check payable to Wife. 25. MISCELLANEOUS DISTRIBUTION PROVISIONS The following miscellaneous provision shall apply to the distribution of the parties' marital assets and debts: A. Waiver. Each of the parties specifically waives, releases, renounces and forever abandons whatever right, title and interest they may have in any property that is to become the sole and separate property of the other party pursuant to the terms of this Agreement. B. Liens: In the event any asset is subject to a lien or encumbrance the party receiving the asset as his or her property shall take it subject to said lien and/or encumbrance and shall be solely responsible and liable therefore. C. Debt Balances and Prior Payments: Any debt herein described shall be deemed to include the current balance owed on the debt. Unless otherwise herein specifically provided, there shall be no adjustment in the distribution provisions for the payment of any portion of the marital debts prior to the execution of this Agreement, whether or not that debt or the prior payment thereof is specifically referenced in this Paragraph, said payment having been taken into consideration in determining the distribution of marital assets and debts herein provided. D. Indemnification: Any party assuming an obligation pursuant to the terms of this Agreement shall indemnify, protect and hold the other party harmless from and against any and all liability thereunder, including, but not limited to, any attorney's fees and costs incurred by the other party as the result of defending against the obligation and/or enforcing the provisions of this indemnification. E. Cancellation of Joint Debts: Any joint debt shall be cancelled so that Jei arty can make any further charges thereunder, and if said charges are 14 of 19 "DM made in violation of this Agreement, then the party incurring said charge shall immediately repay the same. F. Non-Disclosed Liability: Any liability not disclosed in this Agreement shall be the sole responsibility of the party who has incurred or may hereafter incur it, and the party incurring or having incurred said debt shall pay it as it becomes due and payable. G. No Further Joint Debt: From the date of this Agreement, each party shall only use those credit accounts or incur such further obligations for which that party is individually and solely liable and the parties shall cooperate in closing any remaining accounts which provide for joint liability. H. No Additional Debt: Each party represents and warrants to the other party that since the separation he or she has not, and in the future he or she will not, contract or incur any debt or liability for which the other party or the other party or the other party's estate might be responsible. SECTION III COUNSEL FEES, SPOUSAL SUPPORT, APL, AND ALIMONY 26. COUNSEL FEES: Each party hereby agrees to be solely responsible for his or her own counsel fees, costs and expenses. Neither shall seek any contribution thereto from the other party except as otherwise expressly provided herein. 27. ALIMONY, APL, AND SPOUSAL SUPPORT: The parties acknowledge that by this Agreement they have respectively secured and maintained a substantial and adequate fund with which to provide for themselves sufficient financial resources for their comfort, maintenance and support. The parties acknowledge that the cost of living may increase or decrease, that their respective estates may increase or decrease in value, that either may be employed or unemployed at various times in the future, and that notwithstanding these or other economic circumstances, which may be changes in circumstances of a substantial and continuing nature, the terms of this Agreement are just and reasonable. Therefore the parties hereby expressly waive, and all rights and claims which they may now parties' mars e, separation or divorce to alimc of 19 NDM 15 discharge, give up and release any it hereafter have by reason of the ny, alimony pendente lite, spousal support or maintenance, and they further release any rights they may have to seek modification of the terms of this Agreement in a Court of law or equity, it being understood that the foregoing constitutes a final determination for all time of either party's obligation to contribute to the support and maintenance of the other. From the execution date of this Agreement it shall be the sole responsibility of each party to sustain himself or herself without seeking any support from the other. The parties further acknowledge and agree that Wife has entered into a state of cohabitation at the time of execution of this Agreement, and that no alimony could be warranted under the Divorce Code. Under no circumstances shall Husband be required to pay alimony to Wife. An award of alimony pendente lite ("APL") is currently in effect through Domestic Relations, in which Wife is receiving APL from Husband. This Order shall be terminated effective the date of execution of this Agreement. Any overpayments made as a result of delay in the termination of the wage attachment shall be applied as a credit to the child support owed by Husband. Otherwise any credits or arrears on the APL Order shall be transferred to the child support owed by Husband. There is currently a conference scheduled on a Petition to Modify APL filed by Wife, scheduled for December 8, 2009 at 10:30 am before R.J. Shadday. The parties agree that this conference shall be cancelled and the Petition withdrawn with prejudice. Counsel for Plaintiff shall prepare and submit a letter to Ms. Shadday enclosing a copy of the signed Agreement before this conference. 28. HEALTH INSURANCE FOR WIFE AND HUSBAND: Husband currently provides health insurance coverage for himself. Wife currently provides health insurance coverage for herself. The parties hereby agree that as of the date of execution of this Agreement, and for all times forward, no party shall be responsible for the costs of health care coverage of the other. SECTION IV CLOSING PROVISIONS AND EXECUTION 29. NO INTENDED THIRD-PARTY BENEFICIARIES: The parties agree that this Agreement constitutes a contract binding between the aforementioned parties and those parties only. This Agreement provides rights and obligations only to the aforementioned parties. To the extent that this Agreement may benefit another party other than Husband or Wife either directly or indirectly, said party constitutes merely an incident eneficiary of the Agreement and will be restricted from pursuing legal 16 of 19 DM -a . action should either Husband or Wife breach or allegedly breach this Agreement in any way. 30. DOCUMENT EXECUTION: Wife and Husband covenant and agree that they will forthwith and within at most five (5) days after demand therefore, execute any and all written instruments, assignments, releases, satisfactions, deeds, notes or other writings as may be necessary or desirable for the proper effectuation of this Agreement, and which shall be executed in order to carry out fully and effectively the terms of this Agreement. Such documents include, but are not limited to, an affidavit of consent, a life insurance change of beneficiary, a life insurance application, deeds, trusts, mortgage applications or refinancing documentation, bank account or safe deposit box releases, checks, Escrowee letters of direction, IRS forms and other tax forms, transfers of automobile, boat or other assets involving certificates of title, letters to creditors, and health insurance documents. 31. JURISDICTION: This Agreement shall be construed in accordance with the laws of the Commonwealth of Pennsylvania. While the parties understand that they may from time to time remove themselves from the jurisdiction, it is their understanding and their intention that this Agreement shall be valid and effective without respect to where the parties are domiciled ay any time in the future, or where in the world property owed or controlled by either party is located. If, under the laws of any other jurisdiction either party would be entitled to any right, power or interest under the laws of that jurisdiction, then only to the extent necessary to effect a complete waiver, release or relinquishment of such right, power or interest, and thereby effectuate this Agreement, the laws of such jurisdiction shall apply. If one or more provisions of this Agreement shall be held invalid or unenforceable under the laws of any jurisdiction, the parties intend that such invalidity or unenforceability shall not affect the remaining provisions, which shall nonetheless be valid and enforceable. If it is necessary that any invalid provision be replaced in order to interpret properly the remaining provisions of the Agreement, any such invalid provision shall be replaced by a valid provision which fulfills as closely as possible the intent and purposes of the invalid provision. It is intended by the parties that no additional rights be conferred on them other than as set forth in this Agreement by the laws of any jurisdiction whatsoever. 32. SEVERABILITY: If any term, condition, clause or provision of this Agreement shall be determined or declared to be void or invalid in law or otherwise, then only that term, condition, clause or provision shall be stricken from this Agreement, and in all other respects this Agreement shall continue in full force, effect and operation. 17 of 19 D G T G 33. COUNTERPARTS. This Agreement may be executed in counterparts, each of which shall be deemed to be an original, but all of which shall constitute one and the same agreement. 34. HEADINGS. The paragraph headings and other captions used in this Agreement are been inserted for convenience and reference only, and do not constitute matter to be construed in interpreting this Agreement, nor shall they be considered to modify the provisions which they precede. 35. BINDING EFFECT. By signing this Agreement, each party acknowledges having read and understood the entire agreement, and each party acknowledges that the provisions of this Agreement shall be binding upon the parties as if they were ordered by the Court after a full hearing. IN WITNESS WHEREOF, the parties hereto, intending to be legally bound hereby, have signed, sealed and acknowledged this Agreement the day and year below written. WITNESS: (1-1- a, ",=J= 7 1 (SEAL) Dianne M. Grav Date: SEAL) omas M. Gray Date: DMG T 18 of 19 I . COMMONWEALTH OF PENNSYLVANIA COUNTY OF ) SS: On this, the %? day ofl&,6,? ° 2009, before me, a Notary Public, the undersigned officer, personally appeared Dianne M. Gray, known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing Marital Settlement Agreement and acknowledged that she executed the same for the purposes therein contained. IN WITNESS THEREOF, I hereunto set my hand and official seal. COMMONWEALTH OV PENNSYLVANIA Notarial Seal I Deborah L. Donley, Notary Public Camp Hill Boro, Cumberland County My Commission Expires Sep,'. 23, 2011 NIernber, Penns ,an;a AS Ss )C!2 ?-0r C?? il0tarles COMMONWEALTH OF PENNSYLVANIA Notary Public: ) SS: COUNTY OF In t to On this, the Lt?v-' day of Cevn ?,?, 2009, before me, a Notary Public, the undersigned officer, personally appeared Thomas M. Gray, known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing Marital Settlement Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS THEREOF, I hereunto set my hand and official seal. Notary i (, IhYAI DMG SIM AM M UNK M NOWY Pubk MIDp1,ETOMM 4OR000M DAUPHIN COWN ] 19 of 19 FILED - 2009 DEC f 1 P; , I: Cti.rv= jN Y 1' o ON HOSN90 M VM A3J NQUO" "WIIiOCMM YtM)O? MINNaAQ DIANE M. GRAY, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 07-5927 CIVIL TERM THOMAS M. GRAY, IN DIVORCE Defendant/Respondent PACSES CASE: 824110005 ORDER OF COURT AND NOW to wit, this 10th day of December, 2009, it is hereby Ordered that pursuant to the parties' Marital Separation Agreement of December 7, 2009, the Alimony Pendente Lite is terminated, effective December 7, 2009. There is a remaining balance of $395.76 owed to the Petitioner and this sum will be directed to the child support account under PACSE #412109987, pursuant to the terms of the Marital Separation Agreement. The remaining balance will be paid off with an additional sum of $50.00 per month. This Order shall become final twenty (20) after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary's Office for a hearing de novo before the Court. BY THE CO Edward E. Guido, DRO: R.J. Shadday xc: Petitioner Respondent Diane G. Radcliff, Esq. Lesley J. Beam, Esq. Service Type: M J. Form OE-001 Worker: 21005 FILED -C ?ffiOE Y THE PROTHONOTARY 2009 DEC I I PM 2: 5 I PE. NSYWANLA ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 07-5927 CIVIL State Commonwealth of Pennsylvania 0Original Order/Notice Co./City/Dist. of CUMBERLAND 412109987 351 S 2008 OAmended Order/Notice Date of Order/Notice 12/10/09 OTerminate Order/Notice Case Number (See Addendum for case summary) QOne-Time Lump Sum/Notice RE: GRAY, THOMAS M. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 087-54-5037 Employee/Obligor's Social Security Number METRO BANK 7042101971 3801 PAXTON ST Employee/Obligor's Case Identifier HARRISBURG PA 17111-1418 (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee'slobligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 060. 0C $ 168.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 per month in current child support per month in past-due child support per month in current medical support per month in past-due medical support per month in current spousal support per month in past-due spousal support per month for genetic test costs per month in other (specify) one-time lump sum payment for a total of $ 1,228.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 283.38 per weekly pay period. $ 614.00 per semimonthly pay period $ 566.77 per biweekly pay period (ever two weeks) $ (twice a month) 1 228 00 hl y , . per mont y 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 AN ACSES MEMBER /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECUR/T MBER ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: Arrears 12 weeks or greater? O yes Q no DRO: R.J. Shadday Form EN-028 Rev.5 Service Type M OMB No.' 0970-0154 Worker I D $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If hecked you are required to provide gopy of this form to your m loyee. If yo r employee works in a state that is di ferent from the state that issued this or er, a copy must be provi?edpto your employee even if the box is not checked 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2323247300 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: GRAY, THOMAS M. EMPLOYEE'S CASE IDENTIFIER: 7042101971 DATE OF SEPARATION. LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60 limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 1.3 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev.5 Service Type M OMB No.: 09N1015 4 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GRAY, THOMAS M. PACSES Case Number 412109987 PACSES Case Number Plaintiff Name Plaintiff Name DIANNE M. GRAY Docket Attachment Amount Docket Attachment Amount 00351 S 2008 $ 1,228.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): THOMAS J. GRAY 08/14/97 RYAN R. GRAY 01/23/94 MICHAEL T. GRAY 05/13/91 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB Addendum Form EN-028 Rev.5 Service Type M oMBNo.:0970-0754 Worker ID $IATT FtLEi) '-1-1?e OF Tt?,,,r p.--)Tt-,?^.I4TARY 2009 DEC 1 I PIS 2: 51 Pi i f '`;YOY Q,jA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DIANNE M. GRAY, Plaintiff : NO. 07-5927 CIVIL TERM CIVIL ACTION - LAW. DIVORCE V. THOMAS M. GRAY, Defendant TO THE PROTHONOTARY: PRAECIPE OF TRANSMIT RECORD Transmit the record, together with the following information, to the court for entry of a divorce decree: 1. GROUND FOR DIVORCE: Irretrievable breakdown under Section 3301(c) of the Divorce Code. 2. DATE OF FILING AND MANNER OF SERVICE OF THE COMPLAINT: a. Date of Filing of Complaint: 10/10/2007 b. Manner of Service of Complaint: Certified Mail/Restricted Delivery C. Date of Service of Complaint: 10/15/2007 3. DATE OF EXECUTION OF THE AFFIDAVIT OF CONSENT REQUIRED BY SECTION 3301 (C) OF THE DIVORCE CODE: a. Plaintiff: 12/4/2009 b. Defendant: 12/7/2009 4. RELATED CLAIMS PENDING: No issues are pending. All issues have been resolved pursuant to the parties' Marital Agreement dated December 7, 2009, which Agreement is to be incorporated into but not merged with the Divorce Decree. 5. DATE WAIVER OF NOTICE IN SECTION 3301(C) DIVORCE WAS FILED WITH THE PROTHONOTARY: a. Plaintiff's Waiver: 12/11/2009 b. Defendant's Waiver: 12/11 /2009 DIANE GDCLIFF, ESQUIRE nndle Road Camp Hill, PA 17011 Supreme Court ID # 32112 Phone: (717) 737-0100 07 THE P "CNOTARY 2009 DEC IS AM 10: 23 r,? IN THE COURT OF COMMON PLEAS.OF DIANNE M. GRAY CUMBERLAND COUNTY, PENNSYLVANIA . V. THOMAS M. GRAY : NO 07-5927 DIVORCE DECREE lC•'f cif 4 '? AND NOW, it is ordered and decreed that DIANNE M. GRAY plaintiff, and THOMAS M. GRAY , defendant, are divorced from the bonds of matrimony. Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") No issues pending. All issues have been resolved pursuant to the parties' Marital Agreement dated December 7, 2009, which Agreement is to be incorporated into but not merged with the Divorce Decree. B ;3, Attest: J. /9 Prothonotary is 30 a ?