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HomeMy WebLinkAbout07-6753JOANNE HARRISON CLOUGH, ESQUIRE Attorney I.D. No. 36461 3 820 Market Street Camp Hill, PA 17011 Telephone: (717) 737-5890 Attorney for Plaintiff STEPHANIE BAILEY, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 07 - &753 0'ivi 1 7enN DUSTIN ILLINGSWORTH, CIVIL ACTION -LAW Defendant IN DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the Court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary, Room 101, Cumberland County Courthouse, 1 Courthouse Square, Carlisle, Pennsylvania. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 1-800-990-9108 JOANNE HARRISON CLOUGH, ESQUIRE Attorney I.D. No. 36461 3 820 Market Street Camp Hill, PA 17011 Telephone: (717) 737-5890 Attorney for Plaintiff STEPHANIE BAILEY, Plaintiff V. DUSTIN ILLINGSWORTH, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. CIVIL ACTION -LAW IN DIVORCE AVISO PARA DEFENDER Y RECLAIMAR DERECHOS USTED HA DISO DEMANDANDO EN LA CORTE. Is desea defenderse de las quejas expuestas en las paginas siguientes, debar tomar accion con prontitud. Se la avisa que is no se defiende, el caso purde proceder sin usted y decreto de divorcio o anulamiento puede ser emitado en su contra por la Corte. Una decision puede tambien ser emitida en su contra por caulquier otra queja o compensaction reclamados por el demandante. Usted puede perder dinero, o sus propiedades o otros derechos importantes para usted. Cuando la base para el divorcio es indignadades o rompimiento irreparable del matrimonio, usted puede solicitar consejo matrimonial. Una lista de consejeros matrimoniales esta disponible en la oficina del Prothonotary, en la Cumberland County Court of Common Pleas, Room 101, Cumberland County Courthouse, 1 Courthouse Square, Carlisle, Pennsylvania. SI USTED NO RECLAMA PENSION ALIMENTACIA, PROPIEDAD MARITAL, HONORARIOS DE ABOGADO U OTROS GASTOS ANTES DE QUE EL DECRETO FINAL DE DIVORCIO O ANULAM ENTO SEA EMITIDO, USTED PUEDE PERDER EL DERECHO A RECLAMAR CUALQUIERA DE ELLOS. USTED DEBE LLEVAR ESTE PAPEL A UN ABOGADO DE INMEDIATO. SI NO TIENE O NO PUEDO PAGAR UN ABOGADO, VAYA O LLAME A LA OFICINA INDICADA ABAJO PARA AVERIGUAR DONDE SE PUEDE OBTENER ASISTENCIA LEGAL. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 1-800-990-9108 I Y STEPHANIE BAILEY, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. DUSTIN ILLINGSWORTH, CIVIL ACTION -LAW Defendant IN DIVORCE COMPLAINT IN DIVORCE UNDER SECTION 3301(C) OR (D) OF THE DIVORCE CODE 1. Plaintiff is Stephanie Bailey, an adult individual who currently resides at 403 S. Baltimore Street, Apt B, Dillsburg, Pennsylvania 17019. 2. Defendant is Dustin Illingswort, an adult individual who currently resides at 23 Kenneth Avenue, Shippensburg, Pennsylvania 17257. 3. Plaintiff and Defendant have been bona fide residents in the Commonwealth for at least six (6) months immediately previous to the filing of this Complaint. 4. The Plaintiff and Defendant were married on September 28, 2001, in Ridgefield, Connecticut. 5. There have been no prior actions of divorce or for annulment between the parties. 6. Neither Plaintiff nor Defendant is in the military or naval services of the United States or its allies within the provisions of the Solders' & Sailors' Civil Relief Act of the Congress of 1940 and its amendments. 7. Plaintiff avers that there is one (1) child born of this marriage under the age of eighteen years, namely Kaylie Illingsworth, born on November 12, 2002. 8. The marriage is irretrievably broken. 9. Plaintiff has been advised that counseling is available and that Defendant may have the right to request that the court require the parties to participate in counseling. Plaintiff declines counseling. 10. After ninety (90) days have elapsed from the date of the filing of this Complaint, Plaintiff intends to file an Affidavit consenting to a divorce. Plaintiff believes that Defendant may also file such an affidavit. 11. In the alternative, Plaintiff will file a 3301(d) Affidavit and provide the appropriate Notices two (2) years from the date of separation. WHEREFORE, Plaintiff respectfully requests this Court to enter a decree of divorce pursuant to Section 3301(c) or (d) of the Divorce Code. COUNT IIII ALIMONY, ALIMONY PENDENTE LITE, COUNSEL FEES, COSTS AND EXPENSES 12. The averments contained in Paragraphs 1 through 11 of this Complaint are incorporated herein by reference as though set forth in full. 13. By reason of this action, Plaintiff Stephanie Bailey has incurred considerable expense in the preparation of her case and the employment of counsel and the payment of costs. 14. The Plaintiff Stephanie Bailey is without sufficient funds to support herself and to meet the costs and expenses of this litigation. 15. Plaintiff Stephanie Bailey's income is not sufficient to provide for her reasonable needs and to pay her attorneys' fees and the cost of this litigation and she is unable to appropriately maintain herself during the pendency of this action, or after the divorce has been granted. 16. Defendant Dustin Illingsworth, has adequate earnings to provide for the Plaintiff Stephanie Bailey's support and to pay her counsel fees, costs and expenses. 17. Plaintiff Stephanie Bailey lacks sufficient property to provide for her reasonable needs. 18. Plaintiff Stephanie Bailey is unable to support herself through appropriate employment. 19. Defendant Dustin Illingsworth has sufficient income and assets to provide continuing support for the Plaintiff Stephanie Bailey. WHEREFORE, Plaintiff Stephanie Bailey prays this Honorable Court enter an Order awarding her, alimony pendente lite, alimony, counsel fees, expenses and costs in her favor. Respectfully submitted, Date: \\-- S v D"? JOANNE HARRISON CLOUGH, PC i JoanheVlarrison Clou Attorney ID No.: 364 3 820 Market Street Camp Hill, PA 17011 (717) 737-5890 Attorney for Plaintiff Esquire VERIFICATION I, Stephanie Bailey, hereby verify and state that the facts set forth in the foregoing pleading are true and correct to the best of my information, knowledge and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn verification to authorities. C- DATE: Steph a Bailey 7b O ~f ` /A N i A 0- 1 9.31 cb STEPHANIE A. BAILEY, Plaintiff/Petitioner VS. DUSTIN L. ILLINGSWORTH, Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - DIVORCE NO. 07-6753 CIVILTERM IN DIVORCE PACSES CASE ID: 688109585 ORDER OF COURT AND NOW, this 8th day of November, 2007, based upon the Court's determination that Petitioner's monthly net income/earning capacity is $1,887.71 and Respondent's monthly net income/earning capacity is $2,260.29, it is hereby ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit One Hundred Forty Seven and 00/100 Dollars ($147.00) per month payable as follows: $147.00 per month for Alimony Pendente Lite and $0.00 per month on arrears. First payment due: next pay date in the amount of $67.85 bi-weekly. The effective date of the order is November 7, 2007. Arrears set at $115.99 as of November 8, 2007. 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: Stephanie Bailey. 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 PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. cc360 I N 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 31" 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. [X] Respondent [] Petitioner [] Neither party to provide medical insurance coverage. Within thirty (30) days after the entry of this order, the [] Petitioner [X] 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 Rule 1910.16 - 4 (e). 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 BY CO R Y Edgar B. Bayley, J. Mailed copies on: November 8. 2007 to: Petitioner Respondent Joanne H. Clough, Esq. DRO: R.J. Shadday ?__ rTa c 5ij LZ9 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 11/08/07 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number AMES TRUE TEMPER* PO BOX 8859 465 RAILROAD AVE CAMP HILL PA 17001-8859 124-60-2929 Employee/Obligor's Social Security Number 6413101893 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. $ 147.00 per month in current support $ 0. oo per month in past-due support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current and past-due medical support $ o . oo per month for genetic test costs $ 0.00 per month in other (specify) for a total of $ 147.00 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: $ 33.92 per weekly pay period. $ 67.85 per biweekly pay period (every two weeks). $ 73.5o per semimonthly pay period (twice a month). $ 147. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Date of Order: NOV 0 9 2007 BY E COURT v? G , JUDGE DRO: R. J. SHADDAY Service Type M OMB No.: 09700154 688108585 XQ Original Order/Notice 07-6753 CIVIL: O Amended Order/Notice O Terminate Order/Notice RE:ILLINGSWORTH, DUSTAN L. Employee/Obligor's Name (Last, First, MI) Form EN-028 Rev. 1 Worker I D $ IATT 147• x 12•+ 52•? 3.92* 14 7 & x 12•+ 2 ,6 . 67.85* go. ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If heck you are required to provide a opy of this form to your m loyee. If yo r employee works in a state that is diferent from the state that issued this order, a copy must be provideedpto your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this-order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employeelobligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporth ir, the Paydat&Date of Withholding. You must report the paydate/date of withholding vv' im i - - - ding LIM JJaynlel t. The paydateidate of wit! iholding it, the date on whicl i amount was withheld fron i tl ie 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: 2223354000 EMPLOYEE'S/OBLIGOR'S NAME: ILLINGSWORTH, DUSTAN L. EMPLOYEE'S CASE IDENTIFIER: 6413101893 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 0 5 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11.Submitted By: 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 Service Type M OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker I D $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: ILLINGSWORTH, DUSTAN L. PACKS Case Number 688109585 PACKS Case Number Plaintiff Name Plaintiff Name STEPHANIE A. BAILEY Docket Attachment Amount Docket Attachment Amount 07-6753 CIVIL$ 147.00 $ 0.00 Child(ren)'s Name(s): DOB 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. ? 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. ? 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 ? 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 ? 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. " Service Type M Worker I D $ IATT OMB No.: 0970-0154 9 CZ W vo ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 07-6753 CIVIL State Commonwealth of Pennsylvania OOriginal Order/Notice CO./City/Dirt. of CUMBERLAND , OAmended Order/Notice Date of Order/Notice 01/21/09 @Terminate Order/Notice Case Number (See Addendum for case summary) OOne-Time Lump Sum/Notice RE:ILLINGSWORTH, DUSTAN L. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 124-60-2929 Empioyee/Obligor's Social Security Number AMES TRUE TEMPER* 6413101893 PO BOX 8859 Employee/Obligor's Case Identifier 465 RAILROAD AVE (See Addendum for plaintiff names CAMP HILL PA 17001-8859 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. $ 0.00 per month in current child support $ o . oo per month in past-due child support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current medical support $ o . oo per month in past-due medical support $ o. oo per month in current spousal support $ 0-2-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 $ o. o0 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0.00 per weekly pay period. $ 0. 00 per semimonthly pay period (twice a month) $ o. 00 per biweekly pay period (every two weeks) $ o. 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). 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. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAMEAND THE PACSES MEMBER 1D (shown above as the Employee/Obligor's Case Identifier) OR SO C/ CU TY BER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: (;p v 1 f )ft WA, X J DRO; R.J. Shadday Edgar B. Bayley, gForm EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If heck you are required to pr vide a opy of this form to your m loyee. If yo r employee orks in a state that is different from the state that issuecPthis order, a copy must be provic?ec?to your emp?oyee even if tie 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 employeelobligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 2223354000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ? THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ? EMPLOYEE'S/OBLIGOR'S NAME:ILLINGSWORTH, DUSTAN L. EMPLOYEE'S CASE IDENTIFIER: 6413101893 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employeelobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employeelobligor from employment, refusing to employ, or taking disciplinary action against any employeelobligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev. 4 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: ILLINGSWORTH, DUSTAN L. PACSES Case Number 688109585 PACSES Case Number Plaintiff Name Plaintiff Name STEPHANIE A. BAILEY Docket Attachment Amount Docket Attachment Amount 07-6753 CIVIL$ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Service Type M Addendum OMB No.: 0970-0154 Form EN-028 Rev. 4 Worker ID $IATT «Tt r { --% STEPHANIE A. BAILEY, Plaintiff/Petitioner VS. DUSTAN L. ILLINGWORTH, Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - DIVORCE NO. 07-6753 CIVIL TERM IN DIVORCE PACSES CASE: 688109585 ORDER OF COURT AND NOW to wit, this 21st day of January 2009, it is hereby Ordered that the Alimony Pendente Lite is suspended, effective this date, pursuant to the Petitioner's request. The remaining balance of $88.15 is to be paid off with the current wage withholding order. This Order shall become final twenty (20) days after the mailing of the notice of the entry of the order to the parties unless either party files a written demand with the Domestic Relations Section for a hearing de novo before the Court. BY THE COURT: Edgar B. Bayley, J. DRO: R.J. Shadday xc: Petitioner Respondent Joanne H. Clough, Esq. Service Type: M Form OE-001 Worker: 21005 c-;r Mme' a ^, c'l ca K x c' m CD `~> C c y .. 4 G? G° DI - (n, 63 CI' 4\ 1 30% ? 4 ?? 4e- C"? ° ?i-t C .:o C ;? iry }i"` ...- ? ? ? ? ? ? ? i w ? `:+?3C-7 . w?? `? ?,`? ' '? .F"