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HomeMy WebLinkAbout08-0139/ w F. \FILES\Clients\12882\ 12882. I . Complaint 1 Created: 6/1/06 8:50AM Revised: 1/2/08 11: HAM AM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff PENNY D. BROWN, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2008- 139 CIVIL ACTION - LAW TIMOTHY D. BROWN, Defendant 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. Upon your request, the Court may require you and your spouse to attend up to three sessions. A request for counseling must be made in writing and filed with the Prothonotary within twenty (20) days of receipt of this Notice. 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. 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 County Bar Association 32 South Bedford Street Carlisle, Pennsylvania 17013 Telephone (717) 249-3166 COMPLAINT IN DIVORCE 1. Plaintiff is Penny D. Brown, who currently resides at 48 South Pin Oak Drive, Boiling Springs, Cumberland County, Pennsylvania. 2. Defendant is Timothy D. Brown, who currently resides at 48 South Pin Oak Drive, Boiling Springs, Cumberland County, Pennsylvania. 3. Plaintiff has been a bona fide resident of the Commonwealth of Pennsylvania for a period of more than six (6) months immediately preceding the filing of this Complaint. 4. The parties were married on the 2"d day of January, in 1987. 5. There has been no prior action for divorce or annulment instituted by either of the parties in this or any other jurisdiction. 6. Plaintiff has been advised that counseling is available and that Plaintiffmay have the right to request that the Court require the parties to participate in counseling. COUNTI REQUEST FOR A NO-FAULT DIVORCE UNDER SECTION 3301(C) _ OR (D) OF THE DIVORCE CODE 7 8. 9. expired from the date of separation. WHEREFORE, Plaintiffrespectfully requests the Court to enter a decree of divorce pursuant to Section 3301 of the Divorce Code. MARTSON LA Date: /- J' t)"" The prior paragraphs of this Complaint are incorporated herein by reference thereto. The marriage of the parties is irretrievably broken. When at the appropriate time, Plaintiff will file an affidavit stating that two years have By Hubert X Gi oy, Esquire 10 East Hi Street Carlisle' ,0A 17013 (717) 243-3341 Attorneys for Plaintiff VERIFICATION The foregoing Divorce Complaint is based upon information which has been gathered by my counsel in the preparation of the lawsuit. The language of the document is that of counsel and not my own. I have read the Divorce Complaint and to the extent that the document is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the content of the document is that of counsel, I have relied upon counsel in making this verification. This statement and verification are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. Penny D. own FAFILESUients112882112882.1. Comphint 1 C-7 c> c If F:T1LES1CGentsU 2882 P Browny 12882.1.Mot I Created: 9/20/04 0:06PM Revised: 7/15/09 3:25PM Hubert X. Gilroy, Esquire I.D. No. 29943 MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Defendant PENNY D. BROWN, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. TIMOTHY D. BROWN, Defendant NO. 2008-139 CIVIL ACTION - LAW MOTION FOR APPOINTMENT OF MASTER Lori Ann Spiegel, Defendant, moves the Court to appoint a Master with respect to the following claims: (x) Divorce ( ) Annulment (x) Alimony (x) Alimony Pendente Lite and in support of the motion states: (x) Distribution of Property ( ) Support ( ) Counsel Fees ( ) Costs and Expenses (1) Discovery is complete as to the claims (s) for which the appointment of a Master is requested. (2) The Plaintiff has appeared in the action by his attorney, Kelly M. Knight, Esquire. (3) The statutory grounds for divorce are: 2 year separation (4) Delete the inapplicable paragraph(s): a. The action is not contested. b. An agreement has been reached with respect to the following claims: None c. The action is contested with respect to the following claims: All (5) The action does not involve complex issues of law or fact. (6) The hearing is expected to take 1 day. (7) Additional information, if any, relevant to the motion: None Dated: July, 2009 MARTSON LAW OFFICES By ubert X. G' roy, Esquire I.D. No. 2 43 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff 7 Tug ' .,. Y 2009 JUL I -1 Agri 1 l : i, Lu4v : 'ye p ??,..Ih 1 1?f1 ,43 F:\FILES\CGents\12882 P Brown\12882.1.Petl Created: 6/1/06 8:50AM Revised: 7/15/09 2:35PM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff PENNY D. BROWN, V. TIMOTHY D. BROWN, Defendant NO. 2008-139 CIVIL ACTION - LAW PETITION RAISING CLAIMS FOR ECONOMIC RELIEF Plaintiff, Penny D. Brown, by her Attorneys, Martson Law Offices, sets forth the following: 1. Petitioner, Penny D. Brown, filed the above captioned divorce action on January 9, 2008. 2. The parties possess various items of marital assets that are subject to equitable distribution. 3. Upon entry of a divorce decree, Plaintiff will not have sufficient assets to provide for her needs and support and will require alimony. WHEREFORE, Plaintiff respectfully requests the Honorable Court to Order as follows: A. Direct the equitable distribution of the marital property of the parties. B. Award the Plaintiff alimony. C. Such other relief as the Court deems appropriate. MART N LA FFICES BY Hubert X roy, Esquire 10 East High Street Carlisle, PA 17013 (717) 243-3341 Date: July, 2009 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA 2 0 0 9 JU,L 17 Tip { I = 0 CUP ` 45a.oo PA ATTI w al 335 pe aa8 la4 A n+5 PENNY D. BROWN, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2008-139 CIVIL ACTION - LAW TIMOTHY D. BROWN, Defendant ORDER APPOINTING MASTER AND NOW, 2009, ?d?C??squire, is appointed Master wit respect to the following claims: Divorce, Distribution of Property, Alimony and Alimony Pendente Lite. BY THE OURT, „ 1 CA% j FILED-OFFICE ` OF THE PROTHCYICTAR'Y 2009 JUL Z 1 PM 3= 51 VW:7?..:t ?..'.?L11?11 6f iPaiiSYLVr NIA PENNY D. BROWN, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2008-139 CIVIL TERM TIMOTHY D. BROWN, CIVIL LAW Defendant IN DIVORCE PRAECIPE TO WITHDRAW AND ENTER APPEARANCE TO THE PROTHONOTARY: Kindly withdraw the appearance of Kelly M. Knight, Esquire and Cunningham & Chernicoff, P.C., on behalf of Defendant Timothy D. Brown in the above-captioned divorce matter. Respectfully , P. Date: //_/ ?_ O TO THE PROTHONOTARY: Felly M. fight, Vif4uire Attorne I.D. No. 36-'L/, 2320 North Second Street Harrisburg, PA 17110 (717) 238-6570 Kindly enter the appearance of Debra R. Mehaffie, Esquire and Scaringi & Scaringi, P.C., on behalf of Defendant Timothy D. Brown in the above-captioned divorce matter. Respectfully Sub-mitted, I & SCARINGI, P.C. Date: /JI l Ill / ?ebra R. Mehaffie, Esquio / Attorney I.D. No. 90951 l? 2000 Linglestown Road, Suite 106 Harrisburg, PA 17110 (717) 657-7770 OF THE "TAY 2009 DEC -8 AM 9: 16 CUM`S . , yOUNTY PENNSYLVANIA PENNY D. BROWN, IN THE COURT OF COMMON PLEAS Plaintiff COUNTY, PENNSYLVANIA V. NO. 2008-139 TIMOTHY D. BROWN, Defendant IN DIVORCE ACKNOWLEDGMENT OF SERVICE I, TIMOTHY D. BROWN, Defendant in the above divorce action, hereby acknowledge receipt and service of the Complaint in Divorce filed in the above matter along with the Notice to Plead in the above case on or around January 9, 2008. i 5 DATE TIMOT D. BROWN c? ? m c a r { ? +M 7 N y? 'f 1 hF'a F TK P NOTARY Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES 2010 MAY 12 AM 10: 21 I.D. 29943 CUfutjqwC^,11Nt1r 10 East High Street Pt`JNSYLVANlA Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff PENNY D. BROWN, IN THE COURT OF COMMON PLEAS Plaintiff COUNTY, PENNSYLVANIA V. NO. 2008-139 TIMOTHY D. BROWN, Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under § 3301(c) of the Divorce Code was filed on January 9, 2008. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. Date: K M Penny D. wn, Pe€endant- PLFF Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff PENNY D. BROWN, Plaintiff V. TIMOTHY D. BROWN, Defendant OF THE M, TH03 * Y 2010 MAY 12 AM 10* 21 CLWBE.Rl ,*-O ?,,JUNTY MVNSYLVAraiA IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA NO. 2008-139 IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER §33010 AND § 3301(d) F THE DIVORCE CODE 1. I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the prothonotary. I verify that the statements made in this waiver 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. f,\ h - ?? &-ao A Date: 0 1 0 _ Penny D. B own, Dofewlant OFF Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff F 1?-T{ 1011 MAY 12 AM 10: 21 CUMBER! .A,Z? -'-,u? PNtv'SYLVA,N!A PENNY D. BROWN, Plaintiff V. TIMOTHY D. BROWN, IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA NO. 2008-139 Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under § 3301(c) of the Divorce Code was filed on January 9, 2008. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. Date: " 411 1 Q D. Brown, Defendant FLED-DJ RCE 1Y THE MR THR'.N IOTARY Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff 2818 MAY 12 AM 10: 21 CUM LA"10 COUNTY PENNSMWA PENNY D. BROWN, Plaintiff V. TIMOTHY D. BROWN, Defendant IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA NO. 2008-139 IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER §3301(c) AND 3301(d) OF THE DIVORCE CODE 1. I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the prothonotary. I verify that the statements made in this waiver 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: l S' Brown, Defendant F:\FILES\Clients\12882 P Brown\12882.I.marital settlement agreement Created: 7/30104 9:12AM Revised: 4/14/10 9:55AM FILED-?;=D=ICE O THE ??PC ? ` ,0• )T'ARY 2010 MAY 12 AM 10: 22 n Hubert X. Gilroy, Esquire UM rr.tf wFNiN4SYi b v%A I.D. 29943 ? MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER Ten East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff PENNY D. BROWN, Plaintiff V. TIMOTHY D. BROWN, Defendant IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA NO. 2008-139 IN DIVORCE MARITAL SETTLEMENT AGREEMENT THIS MARITAL SETTLEMENT AGREEMENT, made this 15 day of April, 2010, by and between Timothy D. Brown,(hereinafter referred to as "Husband") and Penny D. Brown (hereinafter referred to as "Wife"): WITNESSETH: WHEREAS, the parties were married on January 2, 1987, in New Mexico; WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the parties and it, is the intention of Wife and Husband to live separate and apart, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other, including, without limitation by specification: the settling of all matters between them in relation to the ownership and equitable distribution of real and personal property; settling of all matters between them relating to the past, present and future support, alimony and/or maintenance of Wife by Husband or of Husband by Wife; and in general, the settling of any and all claims and possible claims by either party against the estate of the other party. NOW, THEREFORE, in consideration of the premises and of the mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, Husband and Wife, each intending to be legally bound hereby covenant and agree as follows: 1 1. INTERFERENCE: Each party shall be free from interference, authority, and contact by the other, as fully as though he or she were single and unmarried, except as may be necessary to carry out the provisions of this Agreement. Neither party shall molest the other or attempt to endeavor to molest the other, nor compel the other to cohabit with the other, or in any way harass or malign the other, nor in any way interfere with the peaceful existence, separate and apart from the other. 2. AGREEMENT NOT A BAR TO DIVORCE PROCEEDINGS: This Agreement shall not affect or bar the right of Husband or Wife to a divorce on lawful grounds or to any defense as may be available to either party. This Agreement is not intended to condone and shall not be deemed to be a condonation on the part of either party hereto of any act or acts on the part of the other party which have occasioned the disputes or unhappy differences. 3. SUBSEQUENT DIVORCE: The parties hereby acknowledge that Wife filed a Complaint in Divorce in Cumberland County, Pennsylvania at the above captioned term and number, claiming that the marriage is irretrievably broken under Section 3301(c) of the Pennsylvania Divorce Code. The parties hereby express their agreement that the marriage is irretrievably broken and express their intent to execute any and all Affidavits or other documents necessary for the parties to obtain an absolute divorce pursuant to Section 3301(c) of the Divorce Code. The parties hereby waive all rights to request court ordered counseling under the Divorce Code. It is further specifically understood and agreed by the parties that the provisions of this Agreement as to equitable distribution of property of the parties are accepted by each party as a full and final settlement for all purposes whatsoever, as contemplated by the Pennsylvania Divorce Code. Should a decree, judgment or order of divorce be obtained by either of the parties in this or any other state, country or jurisdiction, each of the parties hereby consents and agrees that this Agreement and all of its covenants shall not be affected in any way by such separation or divorce; and that nothing in any such decree, judgment, order or further modification or revision thereof shall alter, amend or vary any term of this Agreement, whether or not either or both of the parties shall remarry. It is the specific intent of the parties to pen-nit this Agreement to survive any judgment and to be forever binding and conclusive upon the parties. 2 4. INCORPORATION OF DIVORCE DECREE: It is further agreed, covenanted and stipulated that this Agreement, or the essential parts hereof, shall be incorporated in any decree hereinafter entered by any court of competent jurisdiction in any divorce proceedings that have been or may be instituted by the parties for the purpose of enforcing the contractual obligations of the parties. This agreement shall not be merged in any such decree but shall in all respects survive the same and be forever binding and conclusive upon the parties. 5. EFFECTIVE DATE: The effective date of this Agreement shall be the "date of execution" or "execution date," defined as the date upon which it is executed by the parties if they have each executed this Agreement on the same date. Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. 6. DISTRIBUTION DATE: The transfer of property, funds and/or documents provided for herein, shall only take place on the "distribution" date which shall be defined as the date of execution of this Agreement unless otherwise specified herein. However, the support and/or alimony payments, if any, provided for in this Agreement shall take effect as set forth in this Agreement. 7. MUTUAL RELEASE: Husband and Wife each do hereby mutually remise, release, quit-claim and forever discharge the other and the estate of such other, for all time to come, and for all purposes whatsoever, of and from any and all rights, title and interest, or claims in or against the property (including income and gain from property hereafter accruing) of the other or against the estate of such other, of whatever nature and wheresoever situated, which he or she now has or at any time hereafter may have against the other, the estate of such other or any part hereof, whether arising out of any former acts, contracts, engagements or liabilities of such other or by way of dower or courtesy, or claims in the nature of dower or courtesy or widow's or widower's rights, family exemption or similar allowance, or under the intestate laws, or the right to take against the spouse's will; or the right to treat a lifetime conveyance by the other as a testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of (a) Pennsylvania, (b) any State, Commonwealth or territory of the United States, or (c) any country or any rights which either party may have or at any time hereafter shall have for past, present or future support or maintenance, alimony, alimony pendente lite, counsel fees, division of property, costs or expenses, whether arising as a result of the marital relations or otherwise, except, all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provisions thereof. It is the intention of Husband and Wife to give each other by the execution of this Agreement a full, complete and general release with respect to any and all property of any kind or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and only except all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision thereof. It is further agreed that this Agreement shall be and constitute a full and final resolution of any and all claims which each of the parties may have against the other for equitable division of property, alimony, counsel fees and expenses, alimony pendente lite or any other claims pursuant to the Pennsylvania Divorce Code or the divorce laws of any other jurisdiction. 8. REPRESENTATION BY COUNSEL: The provisions of this Agreement and their legal effect has been fully explained to the parties by their respective counsel, Hubert X. Gilroy, Esquire, counsel for Wife and Debra R. Mehaffie, Esquire, counsel for Husband. The parties acknowledge that each has received independent legal advice from counsel of his or her own selection, that each has fully disclosed his or her respective financial situations to the other, including his or her property, estate, assets, liabilities, income and expenses, that each is familiar with and fully understands the facts, including the property, estate, assets, earnings and income of the other, and that each has been fully informed as to his or her legal rights and obligations. Each of the parties acknowledges and agrees that, after having received such advice and with such knowledge, this agreement is, in the circumstances, fair, reasonable and equitable, that it is being entered into freely, voluntarily, and in good faith and that the execution of this agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreement. The parties further acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this agreement. The parties acknowledge that each has received or has had the opportunity to receive independent legal advice from counsel of their selection and that they have been informed fully as to their legal rights and obligations, including all rights available to them under the Pennsylvania Divorce Code of 1980, as amended, and other applicable laws. 4 Each party also acknowledges that each has fully disclosed his or her respective financial situations to the other, including his or her property, estate, assets, liabilities, income and expenses, that each is familiar with and fully understands the facts, including the property, estate, assets, earnings and income of the other, and that each has been fully informed as to his or her legal rights and obligations. Each of the parties acknowledges and agrees that, after having received such advice and with such knowledge, this agreement is, in the circumstances, fair, reasonable and equitable, that it is being entered into freely, voluntarily, and in good faith and that the execution of this agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreement. The parties further acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this agreement. 9. WARRANTY AS TO EXISTING OBLIGATIONS: Each party represents that they have not heretofore incurred or contracted for any debt or liability or obligation for which the estate of the other party may be responsible or liable except as may be provided for in this Agreement. Each party agrees to indemnify and hold the other party harmless from and against any and all such debts, liabilities or obligations of every kind which may have heretofore been incurred by them, including those for necessities, except for the obligations arising out of this Agreement. 10. WARRANTY AS TO FUTURE OBLIGATIONS: Husband and Wife covenant, warrant, represent and agree that, with the exception of obligations set forth in this Agreement, neither of them shall hereafter incur any liability whatsoever for which the estate of the other may be liable. Each party shall indemnify and hold harmless the other party from and against any and all debts, charges and liabilities incurred by the other after the execution date of this Agreement, except as may be otherwise specifically provided for by the terms of this Agreement. 11. PERSONAL PROPERTY: Except as otherwise provided herein, the parties have divided between them, to their mutual satisfaction, the personal effects, household furniture and furnishings, and all other articles of personal property which have heretofore been used by them in common, and neither party will make any claim to any such items which are now in the possession or under the control of the other. The parties agree, however, to divide all photographs evenly, and 5 each party shall be entitled to access to negatives. The parties will make duplicates of all camcorder tapes which currently exist so that each party has a full set. Any cost involved in the duplication of the videos will she shared equally. By these presents, each of the parties hereby specifically waives, releases, renounces and forever abandons whatever claims he or she may have with respect to any personal property which is in the possession of the other, and which shall become the sole and separate property of the other from the date of execution hereof. 12. DIVISION OF REAL PROPERTY: The parties jointly owned a marital residence located at 48' South Pin Oak Drive, Boiling Springs, Cumberland County, Pennsylvania. The real estate has been sold and the proceeds from the sale of the real estate have been distributed equally between the parties, and the parties acknowledge that they are satisfied with said equal distribution and that no further claim is made by either party in connection with the proceeds from the sale of the mentioned real estate. 13. BANK ACCOUNTS, CERTIFICATES OF DEPOSIT AND LIFE INSURANCE: Except as set forth below in this paragraph, Husband and Wife acknowledge that all joint bank accounts have been closed and divided to their mutual satisfaction. They hereby agree that each shall become sole owner of their individual bank accounts, certificates of deposit and life insurance policies, and they each hereby waive any interest in, or claim to, any funds held by the other in any bank accounts, certificates of deposit and the cash value of the other's life insurance policies. Husband shall pay to Wife the sum of $27,670.52. This payment shall be made by Husband depositing said sum in the trust account of Attorney Debra R. Mehaffie and, by the terms of this agreement, Attorney Mehaffie shall deliver said monies to Attorney Hubert X. Gilroy, as attorney for Wife, upon the signing of this agreement by both parties and a delivery of a copy of the agreement to Attorney Mehaffie. The parties have a joint account at GRO Financial Federal FCU. Wife will execute the necessary authorization to remove her name from the account and/or to authorize husband to close the account. 14. MOTOR VEHICLES: Husband and Wife agree that each will retain the vehicle in their possession as their own property and shall indemnify the other as to any liabilities, maintenance and insurance payments regarding their respective vehicles. The parties agree to execute any necessary documents to transfer title to their respective vehicles. 6 In conjunction with the execution of this agreement, Husband shall execute a Power of Attorney naming Wife as his Power of Attorney for the purpose of transfer of title of the Acura vehicle to Wife. Additionally, Husband will execute a Power of Attorney naming Wife as his Power of Attorney for purpose of transferring title of the 2001 Grand Am to Timothy J. Brown. 15. AFTER-ACQUIRED PROPERTY: Each of the parties shall hereafter own and enjoy, independently of any claim or right of the other, all items of property, be they real, personal or mixed, tangible or intangible, which are hereafter acquired by him or her, with full power in him or her to dispose of the same as fully and effectively, in all respects and for all purposes as though he or she were unmarried. 16. INCOME TAX: Husband and Wife agree to file separate tax returns for the tax year 2009. For any tax returns filed jointly in the past, 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, each will indemnify and hold harmless the other from and against any loss or liability for any such tax deficiency or assessment and any interest, penalty and expense incurred in connection therewith. Such tax, interest, penalty or expense shall be paid solely and entirely by the individual who is finally determined to be the cause of the misrepresentations or failures to disclose the nature and extent of his or her separate income on the aforesaid joint returns. 17. . APPLICABILITY OF TAX LAW TO PROPERTY TRANSFERS: The parties hereby agree and express their intent that any transfer of property pursuant to this Agreement shall be within the scope and applicability of the Deficit Reduction Act of 1984 (hereinafter the "Act"), specifically, the provisions of said Act pertaining to the transfers of property between spouses and former spouses. The parties agree to sign and cause to be filed any elections or other documents required by the Internal Revenue Service to render the Act applicable to the transfers set forth in this Agreement without recognition of gain on such transfer and subject to the carry-over basis provisions of said Act. 18. ALIMONY: There currently exists a spousal support order whereby Husband is paying to Wife spousal support through the Cumberland County Domestic Relations Office at PACSES Number 586109913. Effective April 1, 2010, said spousal support order shall be terminated and Husband shall pay all arrearage, if any, on said spousal support order to insure that obligation is brought current and paid in full through April 1, 2010. 7 Effective April 1, 2010, Husband agrees to pay wife alimony in the amount of $2,500.00 per month. Effective April 1, 2011, the alimony payment shall be $2,400.00 per month and shall correspondingly reduce $100.00 per year on April 1 of every year until terminated asset forth below. This award shall be paid through the Cumberland County Domestic Relations Office and shall be enforceable as an alimony award, and said alimony award shall be subject to the following provisions: A. The alimony obligation shall be non-modifiable unless Husband becomes disabled. In the event Husband believes he suffers from a disability that merits modification as set forth herein and the parties are unable to agree, Husband may petition the court and the Cumberland County Court of Common Pleas shall have jurisdiction over the matter and shall apply an analysis for purposes of determining modification consistent with the guidelines for award of alimony under the Pennsylvania Divorce Code. B The alimony award as contemplated herein will terminate upon: 1. The death of either party; 2. In the event wife remarries or cohabitates; or 3. Husband's retirement from active military service effective the first day of the month when Wife starts to receive a portion of Husband's military pension as outlined in paragraph 19 below. C. The parties acknowledge that said alimony payments shall be deductible by husband on his income tax returns and shall be included as income to Wife on her income tax returns. 19. PENSIONS / RETIREMENT/ INVESTMENT ACCOUNTS: The parties possess various pension or retirement accounts, and the parties agree to handle those accounts as follows: A. Wife shall retain her pension through her employment at Cumberland County, and shall also retain her Roth IRA and her standard IRA. Husband waives all claims in connection with these assets and agrees to execute any and all necessary documentation to accomplish the intent of this provision. 8 B. Husband will retain his Roth IRA and the Thrift Savings Plan. However, Husband will transfer $59,014.04 from his standard IRA account to Wife via a Qualified Domestics Relations Order to be prepared at Husband's expense by Harry Leister of Conrad Siegel. Except for the transfer as outlined herein Wife waives all claims in connection with these assets and agrees to execute any and all necessary documentation to accomplish the intent of this provision. Wife shall provide information to Conrad Siegel with respect to the account she will use in connection with the transfer of the monies as contemplated in this subparagraph. C. Husband is currently active duty military and is entitled to a pension benefit upon his retirement from the military, a portion of which the parties agree is Marital Property of the parties. The parties agree that this pension benefit shall be handled as follows: i. Upon Husband's retirement, the pension shall be distributed with the "marital portion" of the pension distributed 50150 between the parties. ii. The "marital portion" will be determined pursuant to a formula, the numerator of which will be 21 years and the denominator will be Husband's length of service in active military. For purposes of enforcing Wife's award of the marital portion of Husband's military pension the following formula shall apply: Wife is awarded a percentage of Husband's disposable military retired pay, to be computed by multiplying 50% times a fraction, the numerator of which is 21 years marriage during Husband's credible military service divided by Husband's total number of years and months of credible military service. For example, if Husband's length of service is 30 years, the marital portion of the pension shall be 70% of the total pension amount with Wife to receive 50% of the "marital portion" of the pension which results in the Wife receiving 35% of the total pension benefit. Upon Husband's retirement, Husband shall elect SBP Benefits to insure Wife continues to receive the Military Pension even in the event Husband predeceasing Wife. Costs of the SBP shall be paid off the top as an expense of the total pension with the balance after payment of costs of SBP to be distributed in accordance with subparagraph 2 above. 9 iiii. Counsel for Wife shall prepare all necessary documentation, to include a Qualified Domestic Relations Order if required, to file with the military in order to implement the provisions of this agreement as it relates to Husband's military pension. Husband agrees to sign all necessary documentation as may be reasonably required in connection with this matter. However, if for any reason the provisions of this agreement are not implemented through the military and Husband is paid his full military retirement pension without any payment from the military directly to Wife, Husband shall be responsible for payment of Wife's appropriate portion of his pension benefits directly to Wife as contemplated hereunder. iv. Both parties shall incur their own respective income tax consequences as those tax consequences relate to the portion of the military pension that each party receives. 20. MARITAL DEBT: All marital debt has been paid off or divided to mutual satisfaction. Each party shall indemnify, defend, and hold the other harmless from and against any claims, demands suits, actions or liabilities relating to or arising out of any debt in that party's name. 21. HEALTH INSURANCE: Each party is responsible for their own health insurance and uninsured medical expenses. However, upon entry of a divorce decree between the parties, Husband shall take a copy of the divorce decree to his local DEERS Office to verify Wife's eligibility for healthcare separate from Husband, after which Wife will enroll in TRICare with Wife maintaining at her own expense the TRICare insurance. 22. LIFE INSURANCE: Husband has life insurance through the military which currently names Wife as the beneficiary. The death benefits on the policy is $400,000.00. Husband shall maintain Wife as the sole beneficiary on said insurance even after the divorce decree is issued and shall continue Wife as the named beneficiary until such time as Husband retires and Wife starts receiving the portion of Husband's pension pursuant to paragraph 19(C) above. 23. EFFECT OF DIVORCE DECREE: The parties agree that, except as otherwise specifically provided herein, this Agreement shall continue in full force and effect after such time as a final Decree in Divorce may be entered with respect to the parties. 10 24. BREACH: If either party breaches any provision of this Agreement, the other party shall have the right, at his or her election to sue for damages for such breach or seek such other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of reasonable legal fees and costs incurred by the other in enforcing their rights under this Agreement. 25. WAIVER OF CLAIMS: Except as herein otherwise provided, each party may dispose of his or her property in any way, and each party hereby waives and relinquishes any and all rights he or she shall now have or hereafter acquire, under the present and future laws of any jurisdiction, to share in the property or the estate of the other as a result of the marital relationship, including without limitation, dower, courtesy, statutory allowance, widow's allowance, right to take in intestacy, right to take against the Will of the other, and the right to act as administrator or executor of the other's estate, and each will, at the request of the other, execute, acknowledge and deliver any and all instruments which may be necessary or advisable to carry into effect this mutual waiver and relinquishment of such interests, rights and claims. 26. ENTIRE AGREEMENT: This Agreement contains the entire understanding of the parties and there are no representations, warranties, covenants or undertakings other than those expressly set forth herein. 27. AGREEMENT BINDING ON HEIRS: This Agreement shall be binding on and shall inure to the benefits of the parties hereto and their respective heirs, executors, administrators, successors and assigns. 28. ADDITIONAL INSTRUMENTS: Each of the parties shall from time to time, at the request of the other, execute, acknowledge and deliver to the other any and all further instruments that may be reasonably required to give full force and effect to the provisions of this Agreement. 29. VOID CLAUSES: If any term, condition, clause or provision of this Agreement shall be determined or declared to be void or invalid in law or otherwise, then only that term, condition, clause or provision shall be stricken from this Agreement and in all other respects this Agreement shall be valid and continue in full force, effect and operation. 30. INDEPENDENT SEPARATE !COVENANTS: It is specifically understood and agreed by and between the parties hereto that each paragraph hereof shall be deemed to be separate and independent Agreement. 11 31. FINANCIAL DISCLOSURE: The parties confirm that they have relied on the completeness and substantial accuracy of the financial disclosure of the other as an inducement to the execution of this Agreement. 32. MODIFICATION AND WAIVER: A modification or waiver of any of the provisions of this Agreement shall be effective only if made in writing and executed with the same formality as this Agreement. The failure of either party to insist upon strict performance of any of the provisions of this Agreement shall not be construed as a waiver of any subsequent defaults of the same or similar nature. 33. DESCRIPTIVE HEADINGS: The descriptive headings used herein are for convenience only. They shall have no affect whatsoever in determining the rights or obligations of the parties. 34. APPLICABLE LAW: This Agreement shall be construed under the laws of the Commonwealth of Pennsylvania and more specifically under the Divorce Code of 1980 and any amendments thereto. IN WITNESS WHEREOF, the parties hereto have set their hands and seals the date and tten. BROWN /Glr WITNESS M-low, R.T Lr.mpk'•1) Wlc,usAF TIMOtHY D. COMMONWEALTH OF PENNSYLVANIA SS (SEAL) (SEAL) COUNTY OF CUMBERLAND On this, 10 day of 2010 before me a Notary Public, personally appeared Penny D. Brown, known to me to be the person whose name is subscribed to the within Marriage Settlement Agreement and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. 1iAWIA o naTteal Shelly Brooks, Notary Public Cadisle Boro, Cumberland County Notary P 1C Member, Pennsylvania Association of Notaries 12 COMMONWEALTH OF WITH THF, I iNITM STATES AIR FORCE : SS COUNTY OF Al APO AE 09094-0325 On this, the 115 day ofApril, 2010 before me, a Notary Public, personally appeared Timothy D. Brown, known to me to be the person whose name is subscribed to the within Marriage Settlement Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand ad official seal. Notary Pub 'c prc???c?- Vert, SS-j+ Me 10 U.S.C.1044a .. NCITAE?i?; . r -JiNER OF A `'''\,;; ED STATES , SUL AND OF ivCJTARY PUBLiC ?a? 10 ki.S.C, tom' ?'°? 13 PENNY D. BROWN, IN THE COURT OF COMMON PLF6S " Plaintiff CUMBERLAND COUNTY, PENNSY19ANt VS. NO. 08 - 139 CIVIL -? r-1- TIMOTHY D. BROWN , ;- " Defendant IN DIVORCE ORDER OF COURT j AND NOW, this day of /1fQy 2010, the economic claims raised in the proceedings having been resolved in accordance with a marital settlement agreement dated April 15, 2010, the appointment of the Master is vacated and counsel can file a praecipe transmitting the record to the Court requesting a final decree in divorce. BY THE COURT, cc: ? Hubert X. Gilroy Attorney for Plaintiff ebra R. Mehaffie Attorney for Defendant ?? £S rY1,? l? Kevi . Hess, P. J. C'l ^? C_- ° U Fro > !? l -5 A Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff PENNY D. BROWN, Plaintiff V. TIMOTHY D. BROWN, Defendant ?1LL h ,P Ti-' 1010 GZ N1 L• C tR 1'ra.- ?W I 1 v l'{ IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA NO. 2008-139 IN DIVORCE PRAECIPE TO TRANSMIT RECORD To the Prothonotary: Transmit the record, together with the following information, to the court for entry of a divorce decree: 1. Ground for divorce: irretrievable breakdown under Section 3301(c) or 3301 (d)(1) of the Divorce Code. 2. Date and manner of service of the complaint: January 9, 2008. 3. (Complete either paragraph (a) or (b).) (a) Date of execution of the Plaintiff's affidavit of consent required by Section 3301 (c) of the Divorce Code; May 10, 2010; by the Defendant; April 15, 2010. (b)(i) Date of execution of the Plaintiff's affidavit required by § 3301(d) of the Divorce code: May 10, 2010. (b)(ii) Date of filing and service of the Plaintiff's affidavit upon the respondent: April 15, 2010. 4. Related claims pending: None. 5. Date and manner of service of the notice of intention to file praecipe to transmit record, a copy of which is attached, if the decree is to be entered under Section 3301(d)(1)(i) of the Divorce Code: May 10, 2010. 0 (Complete either (a) or (b).) (a) Date and manner of service of the Notice of Intention to File Praecipe to Transmit Record, a copy of which is attached: May 10, 2010. (b) Date Plaintiff's Waiver of Notice in §3301(c) Divorce was filed with the Prothonotary: May 10, 2010. Date Defendant's Waiver of Notice in §3301(c) Divorce was filed with the Prothonotary: May 10, 2010. MARTSON LAW By Hubert Gilroy, Esquire Ten E t High Street Carl' e, PA 17013 (717) 243-3341 Attorneys for Plaintiff Date: May 10, 2010 PENNY D. BROWN V. TIMOTHY D. BROWN IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2008-139 DIVORCE DECREE AND NOW, V-&tdc L -0 Zs/a , it is ordered and decreed that PENNY D. BROWN plaintiff, and TIMOTHY D. BROWN , 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.") Marital Settlement Agreement dated April 15, 2010 is incorporated into this Order. By the Court, &,Q- ro cer- co?? m0..ke6 t -,,-I • 10 /lDo-h C-0- mou k6 -?O '11+? (3i v-0 O -?-o Pr4? /LA-..ha-4%e . ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania CO./City/DISC. Of CUMBERLAND Date of Order/Notice 06/04/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS AIR FORCE ACTIVE DUTY RE: BROWN, TIMOTHY D. Sent Electronically DO NOT MAIL ~~ - 13q CIVI OOriginal Order/Notice OAmended Order/Notice OTerminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 408-78-9334 Employee/Obligor's Social Security Number 3580101961 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/Not is ~ . J issued by your State. ~ a ,.~ $ o . oo per month in current child support ~ ~~ ~T - ~~ $ o . oo per month in past-due child support Arrears 12 weeks or greater? }yes ~ no ~ ~ $ o . oo per month in current medical support ' ~~ _S)~' c~~ ~ ~~~~ ~ $ o . oo per month in past-due medical support '~ c. ,= $ 2, 500. oo per month in current spousal support ~~_ ~~ ~ ~ t-. . $ o. oo per month in past-due spousal support ~ c~ _~r $ o . oo per month for genetic test costs ~ c, A $ o. oo per month in other (specify) ~ '~ $ one-time lump sum payment for a total of $ 2, 500.00 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: $ 575.34 per weekly pay period. $ i, 2so . oo per semimonthly pay period (twice a month). $ i, 150.68 per biweekly pay period (every two weeks). $ 2, soo. 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 (T) 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 ADD/T/ON, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: KEVIN A HESS Form EN-428 Rev.1 Service Type M OMBNo.:0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ~ If ~hecked you are required. to provide a copy of this form to your m loyee. If yol~ r employeev~orks in a state that is di Brent from the state that issued this order, 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%bligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 849s9oooo0 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : l~ THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ~ EMPLOYEE'S/OBLIGOR'S NAME:BROWN, TIMOTHY D. EMPLOYEE'S CASE IDENTIFIER: 3580101961 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOU 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%bligorfrnm employment, refusing to employ, or taking disciplinary action against any employee%bligorbBcause 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: S1:ate, 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. {f 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 ca{cufate 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 Service Type M OMB No.: 0970.0754 Form EN-428 Rev.1 Worker ID $IATT ADDENDUM Summary of Cases on Attachment DefendandObligor: BROWN, TIMOTHY D . PACSES Case Number 586109913 Plaintiff Name PACSES Case Number PENNY D. BROWN Plaintiff Name Docket Attachment Amount 08-139 CIVIL $ 2,500.00 Docket AttachmentAmount Child(ren)'s Name(s): DOB $ o . 00 Child(ren)'s Name(s): DOB PACSES Case Number Plainti_ 'ff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Addendum Form EN-428 Rev.1 Service Type M OMB No.: 0970-0154 Worker I D $ IATT G Respectfully Submitted, SCARINGI & SCARINGI, P.C. Date: Mary K. Lemm , Esquire Attorney I.D. No. 70923 2000 Linglestown Road, Suite 106 Harrisburg, PA 17110 (717) 657-7770 PENNY D. BROWN, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 2008-139 CIVIL TERM ?s TIMOTHY D. BROWN, CIVIL LAW Defendant IN DIVORCE PRAECIPE TO WITHDRAW AND ENTER APPEARANCE w TO THE PROTHONOTARY: Kindly withdraw the appearance of Debra R. Mehaffie, Esquire on behalf of Defendant Timothy D. Brown in the above-captioned divorce matter. Date: TO THE PROTHONOTARY: Respectfully Submitted, ebra R. Mehaffie, Esquire ttorney I.D. No. 909.51 Htm um Law N. Third Street Harrisburg, PA 17110 Kindly enter the appearance of Mary K. Lemmon, Esquire and Scaringi & Scaringi, P.C., on behalf of Defendant Timothy D. Brown in the above-captioned divorce matter. CERTIFICATE OF SERVICE I hereby certify that I served the foregoing Praecipe to Withdraw and Praecipe to Enter to Plaintiff by United States Postal Service, regular mail, postage prepaid, addressed as follows: Penny D. Brown c/o Hubert Gilroy, Esquire Martson Law Offices Ten East High Street Carlisle, PA 17013 Respectfully submitted, Date: 'L 01 C? l t? C J '(0 L4 - Desiree Brougher, Law Jerk Scaringi & Scaringi, P.C. 2000 Linglestown Road, Suite 106 Harrisburg, PA 17110 (717) 657-7770 ORDERMOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 04/01/11 Case Number (See Addendum for case summary) EmployerMithholder's Federal EIN Number DFAS AIR FORCE ACTIVE Dl Sent Electronically DO NOT MAIL 408-78-9334 Employee/Obligor's Social Security Number 3580101961 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachmen0 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 n@4 isss©d tFhyour State. -4 $ 0.00 per month in current child support rn r $ 0.00 per month in past-due child support Arrears 12 weeks or greater?tes jQ -;Dc= $ 0.00 per month in current medical support -< 5CS =-n $ 0.00 per month in past-due medical support -0 $ 2,400.00 per month in current spousal support CD CD t") rn $ 0.00 per month in past-due spousal support --, $ 0.00 per month for genetic test costs $ 0.00 per month in other (specify) $ one-time lump sum payment for a total of $ 2,400.00 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: $ 552.33 per weekly pay period. $ 1,200.00 per semimonthly pay period (twice a month). $ 1,104.66 per biweekly pay period (every two weeks). $ 2,400.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: KEVIN A HESS 08-139 CIVIL Q Original Order/Notice @ Amended Order/Notice 0 Terminate Order/Notice 0 One-Time Lump Sum/Notice RE: BROWN. TIMOTHY D. Employee/Obligor's Name (Last, First, MI) sh c OMB No.: 0970-0154 Form EN-428 Dom' Service ypey Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If hecked you are required to provide a copy of this form to your employee. If your employee works in a state that is digerent from the state that issued this order, a copy must be provided to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 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. 8499900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER: O THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: O EMPLOYEE'S/OBLIGOR'S NAME: BROWN, TIMOTHY D. EMPLOYEE'S CASE IDENTIFIER: 3580101961 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: NEW EMPLOYER'S NAME/ADDRESS: FINAL PAYMENT AMOUNT: 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 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M 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 OMB No.: 0970-0154 Page 2 of 2 Form EN-428 Worker ID $IATT ADDENDUM - ummarxof Cases on Attachment Defendant/Obligor: BROWN, TIMOTHY D. PACSES Case Number 586109913 Plaintiff Name PENNY D. BROWN Docket Attachment Amount 08-139 CIVIL $ 2,400.00 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 Service Type M 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 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name DQ kS a Attachment Amount $ 0.00 Addendum OMB No.: 0970-0154 Form EN-428 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT 5,:? Co I Cqq 13 O ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) C)0- i 3q C) V I (D AMENDEDIWO 0 ONE•TIMEORDERMOTICE FOR LUMP SUM PAYMENT Q TERMINATION OF IWO Date: 04/02/12 ? Child Support Enforcement (CSE) Agency ® Court ? Attorney ? Private Individual/Entity (Check One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions http://www acf hhs.gov/programs/cse/newhire/employer/publication/publication htm - forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier (include w/payment): 3580101961 City/County/Dist.[Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket lnformalton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) DFAS AIR FORCE ACTIVE DUTY Sent Electronically DO NOT MAIL Employer/Income Withholder's FEIN 849990000 Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) RE: BROWN, TIMOTHY D. Employee/Obligor's Name (Last, First, Middle) 408-78-9334 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions / http://www.acf.hhs,aov/proarams/cse/newhire employeripublication/publication.htm - form . If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. 8499900000 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts frcp tt employee/ obligor's income until further notice.-, $ 0.00 permonth in current child support I :I- [=tl _L $ 0.00 per month in past-due child support - Arrears 12 weeks or greater? O ? ago - rn cr t , $ 0.00 per month in current cash medical support $ 0.00 per month in past-due cash medical support $ 2,300.00 per month in current spousal support C- .? CI) --I $ 0.00 per month in past-due spousal support 7,C ;?D j .'. $ 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 2,300.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 529.32 per weekly pay period. $ 1,150.00 per semimonthly pay period (twice a month) $ 1,058.63 per biweekly pay period (every two weeks) $ 2,300.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), obtain withholding limitations, time requirements, and any allowable employer fees at httl2://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/ contact map.htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.: 0970-0154 Form EN-428 01/12 Service Type M Worker ID $IATT ? Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: APRIL 2, 2012 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ? If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case /dentil<er) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: hfto:/Lmm.acf.hhs.oov/pro grams/cse/newhire/em Toyer/contacts/contarA map htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Dale - 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use. Form EN-428 01/12 Service Type M Page 2 of 3 Worker ID $IATT Employer's Name: DFAS AIR FORCE ACTIVE DUTY Employer FEIN: 849990000 Employee/Obligor's Name: BROWN TIMOTHY D. 3580101961 CSE Agency Case Identifier: (See Addendum for case summary) Order Identifier: (See Addendum for order/docket information) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you a no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 8499900000 Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known address: Final Payment Date To SDU/Tribal Payee: New Employer's Name: New Employer's Address: Last known phone number: Final Payment Amount: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www.childsupport.state.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE. PA. 17013 (Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at www.chiIdsupport.state.pa.us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. Service Type M OMB No.: 0970-0154 Page 3 of 3 Form EN-428 01/12 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: BROWN, TIMOTHY D. PACSES Case Number 586109913 PACSES Case Number Plaintiff Name Plaintiff Name PENNY D. BROWN Docket Attachment Amount Docket Attachment Amount 08-139 CIVIL $ 2,300.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): 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 DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Duo ..ket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-428 01/12 Service Type M OMB No.: 0970-0154 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT , 0 ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT(IWO) 0 l U S� • AMENDEDIWO (� O ONE-TIMEORDERMOTICE FOR LUMP SUM PAYMENT Q TERMINATION OF IWO Date: 04/01/13 ❑ Child Support Enforcement(CSE)Agency ® Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions http://www.acf.hhs.9ov/programs/cse/newhire/employer/publication/publication.htm-forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 3580101961 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket Informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) RE: BROWN,TIMOTHY D. DFAS AIR FORCE ACTIVE DUTY Employee/Obligor's Name(Last, First,Middle) 408-78-9334 Sent Electronically Employee/Obligor's Social Security Number f (See Addendum for plaintiff DO NOT M A I L l associated with cases on attachment) 3 I Custodial Party/Obligee's Name(Last, First, Middle) Employer/Income Withholder's FEIN 849990000 NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last, First, Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see IWO instructions hftp:llwww.acf.hhs.gov/12rograms/cse/newhire employer/publication/publication.htm-forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. 8499900000 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from the en4pJoyee/ obligor's income until further notice. $ 0.00 permonth in current child support rrl X- $ 0.00 per month in past-due child support- Arrears 12 weeks or greater? 0 (• vlo -ID $ 0.00 per month in current cash medical support ��' f c $ 0.00 permonth in past-due cash medical support --+ $ 2,200.00 permonth in current spousal support $ 0.00 per month in past-due spousal support ��>1`-_r ry ,_ $ 0.00 per month in other(must specify) for a Total Amount to Withhold of$ 2,200.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 506.30 per weekly pay period. $ 1,100.00 per semimonthly pay period (twice a month) $ 1,012.60 per biweekly pay period (every two weeks) $ 2,200.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten 1 working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at http://www acf hhs aov/{ roarams/cse/newhire/employer/contacts/contact map htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.:0970-0154 Form EN-428 06/12 Service Type M Worker ID$IATT ❑ Return to Sender[Completed by Employer/income Withholder). Payment must be directed to an SDU in accordance with 42 USC §666(b)(5)and (b)(6)or Tribal Payee(see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the)WO to the sender. Signature of Judgelissuing Official(if required by State or Tribal law): �� KEVIN A 1 gSS Print Name of Judge/issuing Official: Title of Judge/Issuing Official Date of Signature: APRIL 1 2013 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this;IWO must be provided to the employee/obligor. ❑ If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYWWWCQW,WFTHtIOL $- Pennsylvania law(23 PA C.S.§4374(b))requires remittance by an if an employer is ordered to withhold income from more than one employee and employs IS or mof� wr4aons,I or£Ian employer has a ttory of two or more returned checks due to nonsufflicient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU)Employer Customer Service at 1-877-676-9580 for instructions.PA FlPS CODE 42 400 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER III(shown above as the Employea/Oibligor"s Case idensfer)OR SOCIAL SECLI'R TY wmwR/N.ORri R TO " ;' D. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: hft2//www acf hhs govinroomma (ernoloyerlcontacts/contar4 aw htm Priority: Withholding for support has priority over any other legal process under State law against the same income:,(USC 42 §666(bx7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency,you may combine withheld amounts from more than one employee/obligor's income in a single payment You must, however,separately Identify eadi employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU(e.g., pa"Neto the custodial party, court,or attorney),you must check the box above and return this notice to the sender.Exception: If this IWO was sent by a Court,Attorney,or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the"Remit payment to"'instructlons on this form. Reporting the Pay Date: You must report the pay date when sending the payment.The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits,you must honor all IWOs to the great extent possible,giving priority to current support before payment of any past-due support, f=ollow the State or Tribal law/procedure of the employe0lbbxigor's`principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay.Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO,contact the sender.If you fail to withhold income from the employee/obligor's income as the IWO directs,you are Ilable for both the accumulated amount you should have Withhold and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employeelobligor from employment, refusing to employ, or taking disciplinary action against an employe€lobilgor because of this IWO. OMB Expiration Date—05/31/2014.The OMB Expiration Date has no bearing on the termination date of the IWO;it identifies the version of the foot currently in use. Form EN-428 06/12 Service Type M Page 2 of 3 Worker ID $IATT Employers Name: DFAS AIR FORCE ACTIVE DUTY Employer FEIN: 8499900.00 Employee/Obligor's Name: BROWN,TIMOTHY D. 3580101961 CSE Agency Case identifier:(See Addendum for case summary) Order Identifier:Me Addendum for order/docket Info nnatioll Withholding Limits:You may not withhold more than the lesser of: 1)the amounts allowed by the Federal Consumer Credit Protection Act(CCPA)(15 U.S.C. 1673(b));or 2)the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment(see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes;Social Security taxes; statutory pension contributions;and Medicare taxes.The Federal limit is 50%of the disposable income if the obligor is supporting another family and 60%of the disposable income if the obligor is not supporting another family. However,those limits increase 5%-to 55%and 65%-if the arrears are greater than 12 weeks. If permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe, For Tribal employers/income withholders who receive a State IWO,you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law,you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits, Arrears greater than 12 weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor,an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 8499900000 0 This person has never worked for this employer nor received periodic income. 0 This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employers Name: New Employees Address: CONTACT INFORMATION: To Employer/income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at:www.childsul2port.state-12a.us. Send termination/income status notice and other correspondence to:DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P . BOX 320, CARLISLE, PA. 17013(Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at www.childsupport.state.pa.u�. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.:0970-0154 Form EN-428 06/12 Service Type M Page 3 of 3 Worker ID$IATT ADDENDUM Summary of Gagm on AnwhffWt Defendant/ObUgor: BROWN, TIMOTHY D. PACSES Case Number 586109913 PACSU gaseNumber Plaintiff Name piailf'ff Name PENNY D.BROWN Docket AttarbMgnt Amoun Dockke chment Amount 08-139 CIVIL $ 2,200.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number plaintiff Name Plaintiff amp Docket $Attachment Amoun t DocKW �(lltiM AmpAa Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PAQSSES Cast;Number PACSE$Case Number Plaintiff Name Pontiff Name Docket Attachment Amount Docke Allachment, 'mQunt $ 0.00a Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-428 06/12 Service Type M OMB No.:0970-0154 Worker ID$IATT" INCOME WITHHOLDING FOR SUPPORT O ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPOR (IWO) ® AMENDED IWO O owE-nMsonoenmonCe FOR LUMP SUM PAYMENT o TERMINATION OF IWO �� ,�8/~/0 7/3 12W-/39 Date: 04/01/14 O Child Support Enforcement (CSE) Agency gumn 0 Attorney 0 Private Individual/Entity (Check One) NOTE: This IWO mus be regular ori its face. Under certain circumstarices you must reject this IWO and return it to the sender (see IWO inxtmctionohttp:6/w^wwaof.hho.gov/pmgmmohmo/fonno/OwB'U97U'0154 instructionspdf). If you receive this document from someone other than a State or TribaI CSE agericy or a Court, a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania City/County/Dist1Tribe CUMBERLAND Private Individual/Entity Remittance Identifier (incl Order uontifie for order/docket information) CSE Agency Case Identifier: (See Addendum for case summary) DFAS AIR FORCE ACTIVE DUTY Sent ��U��»�������^����UQ�� ~~~~'.~ -~',~~'-' .~.'.~'~-.~.� DO NOT MAIL Employer/Income Withholders FEIN g^999OOVO Child(ren)'s Name(s) (Last, First, Middle) Child(renys Birth Date(s) RE: BROWN, TIMOTHY D. Name (Last, First, Middle) 408'78'9334 Employee/Obligors Social Security Number (See Addendum for plaintiff names associated with cases an attachment) Custodial Party/Obligoe's Name (Last, First, Middle) NOTE: This IWmmust be reguiar on its face. Under certain circu this IWO and return it 10 the sender (see IWO instructions xnn:xwwm*acthxo.nvv/proorams/cxonu"ns/ oMo'0970'015* instructions.Dd. if you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. 8499900000 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts m ettp|oveo/ obligor's income until further notice. � 0.00 per month in current child Support ' 'Fri rn�_ � 0.00 per month in past-due child support - Arrears 12 weeks or greater? ~ u �m-���` ~-/ u.. per month � mcu�ent cash meo� �o . support � 0.00permonthinpmot-dueuoohmedica(ouppod � 2100.00 per month in current spousal support � 0.00 per month in past-due spousal support � 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 2,100.00 per month. '-` �-r- r`� o AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: � 483.29 per weekly pay period. 1,050.00 per semimonthly pay period (twice a month) � 966.58 per biweekly pay period (every two weeks) $ 2,100.00 per monthly pay period. � Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (8teha/Tribe), the employer can obtain withholding |imitatiuno, time requirementm, and any allowable employer fees at httn:/k^wvw.oc[hhs.gov/onognamo/com/nmwhirm/mmp|oyarkcontacto/contont map. h.trn for the empoyee/obIigor's principal place of employment. Document Tracking Identifier OMB No.: 0970-0154 Service Type M Form EN-428 11/13 Worker ID $IATT [::] Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in ir-■ accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. � Signature of Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/lssuing Official: Date ofSignature: APRIL 1.3U14 If the employee/obligor work in a State or for a Tribe that is different from the State or Tribe that issued this orde a copy of this IWO must be provided to the employee/obligor. [] If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania Iaw (23 PA C.S. § 4374(b)) requires remittance by an Iectronic 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 caII the Pennsytvania 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 ADD!TION, PA YMENTS MUST INCLUDE THE DEFENDANTS NAME AND THE PACSES MEMBER ID (shown above as dheEmploywa*Obligor's Case Identifler) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http:0vmww.uothha.gnv/pmg,amo/osn/novvhinu/emp\oyer/oonbaots/oontecLnep.htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one em | a/ob|igo/oinuomeinaoing|epaymanLYoumu:t.hmwever.neparaVa|yidentifyeochnmp\oye*/ obiigor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SOU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the Remit payment to instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligors wages. Youmuutuomp/ywi1h the Iaw of the State (or Tribat Iaw if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple |W0m:|f there ia more than one |VV(} against this employee/obligor andyouaraunab|atnfu\iyhonorm|||VV{}sdueVz Federa|. S1a1e, or Tribal withholding |imito, you must honor all 1VV0o to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold Iump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal Iaw/procedure. Anti-discrimination: You are subjec to a fine determined under State or Tribal law for discharging an em from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date — 05/31/2014. The OMB Expiration Date has no bearing on the termination date mthe IW0 it identities the version of the form currently in use. Form EN-428 11/13 Service Type M Page 2 of 3 Worker ID SIATT Employer's Name: DFAS AIR FORCE ACTIVE DUTY Employer FEIN: 849990000 Employee /Obligor's Name: BROWN, TIMOTHY D. 3580101961 CSE Agency Case Identifier: (See Addendum for case summary) Order Identifier: (See Addendum for order/docket information) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee /obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs, The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers /income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer /income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee /obligor never worked for you or you are no longer withholding income for this employee /obligor, an employer must promptly notify the CSE agency and /or the sender by returning this form to the address listed in the Contact Information below: 8499900000 Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee /obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employerllncome Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240 -6225, by fax at (717) 240 -6248, by email or website at: www.childsupport.state.pa.us. Send termination /income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE. PA. 17013 (Issuer address). To Employee /Obligor: If the employee /obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240 -6225, by fax at (717) 240 -6248, by email or website at www.childsupport.state.pa.us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee /obligor. OMB No.: 0970 -0154 Service Type M Page 3 of 3 Form EN -428 11/13 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant /Obligor: BROWN, TIMOTHY D. PACSES Case Number 586109913 Plaintiff Name PENNY D. BROWN Docket Attachment Amount 08 -139 CIVIL $ 2,100.00 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 Service Type M PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum OMB No.: 0970 -0154 Form EN -428 11/13 Worker ID $IATT PACSES Case Number DOB Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number DOB Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): Addendum OMB No.: 0970 -0154 Form EN -428 11/13 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT CyORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (Iwo) O xwswnsoxwo O ONE-TIMEORDER!NOTICE FOR LUMP SUM PAYMENT O TERMINATION OF IWO ���Li���[q}� ~/ "~~ / ° . . .-' N-)sci c)\\\ Date: 06/03/14 O ChiId Support Enforcemerit (CSE) Agency [8] Court Omwmey 0 Private Individual/Entity (Check One) NOTE: This IWO mustbo regular on its face. Under certain circumstances circumstances you must reject (his IWO and return 1 to the sender (see IWO inn\mctionohttA:8vmw*`acf.hho.gnv/pmgroms/cmo/fonno/OMB-0970-0154jristructions.pclf). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. StatefTribefTerritory Commonwealth of Pennsylvania CUMBERLAND private|nmvmvaxsnoty Remittance Identifie(include w/payment): 3580101961 Order Identifier: (See Addendum for order/docket information) CSE Agency Case Identifier: (See Addendum for case summary) DFAS RETIRED MILITARY Sent Electronically DO NOT MANN Emptoyer/tncome Withholders FEIN 340727612 Child(ren)'s Name(s) (Last, First, Middle) CUU (e°)'aB|nhDate(s) RE: BROWN, TIMOTHY D. Employee/Obligor's Name (Last, First, Middle) 408-78-9334 SociaI Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO musbe regular on its face Under certain circumstances you must reject this IWO and retum it to the sender (see IWO instructions hnn:Vwwvam.^oo.00wnmgmms/cvaxx,mv/ owo'onro'n1s*/nn|ruvnono.nVO.nyou receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order mus( be attached. 3407276120 o See Addendum for dependent names and birth dates associated with casesmnmbtaohmmnCo- � = , ~_ ..._- ��... �- � ''— ORDER supportThis document iobased onthe orondar�om �UyN����ANT�Co��h�� withholding Commonwealth k . obligor's income until further notice. �� -`�� --r $ 0.00 per month in current child support c-) CD�n = ca ,�� $ 0.00 per month in past -due child support Arrears 12 weeks or greater? {} ym���� nw,� c��_ O.O0per month inou�entcash medical suppod ~'�� ' -� �. $ O.00per month inpast-due cash medical ouppo� -- cz _ $ 2.1UOD0perpnon�hincunon�npouma|nuppo� $ 0.00 per month in past -due spousal support $ 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 2.100.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 483.29 per weekly pay period. $ 1,050.00 per semimonthly pay period (twice a month) $ 966.58 per biweekly pay period (every two weeks) $ 2,100.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) workinq days after the date of this Order/Notice. Send payment within seven (7) working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this emp|uyem/ob|igor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe). the employer can obtain withh�lding |imitadono, time requirements, and any allowable employer fees at h#p://vmxmv.ocf.hhogov/prognamm/cme/newhira/emp|oyer/oontocta/oontoct map. h1Dlfor the employee/obligor's principal place of employment. Document Tracking Pdentifier Service Type M OMB No.: 0970-0154 Form EN -428 11/13 Worker |D0ATT ❑ Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: JUNE 3, 2014 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ❑ If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State -specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact jnap.htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past -due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti -discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date — 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use. Form EN -428 11/13 Service Type M Page 2 of 3 Worker ID $IATT ° Employer's Name: DFAS RETIRED MILITARY Employer FEIN: 34072yG12 Employee/Obligor's Name: BROWN, TIMOTHY D. 3580101981 CSE Agency Case identifler: (See Addendum for case sumnnaty) Ovder|denUfier:(SeeAdmendun*fbrordeo4docket/n0nanabon) Withholding Limits: You may not withhold more than the Iesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA)(15U.S.C1073b));or2>the amounts allowed bythe State orTribe ofthe amployne/ b|igor'sphncipo|pl0000f employment (see REMITTANCE INFORMATION). Disposable income is the net income Ieft after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no Ionger withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by retuming this form to the address Iisted in the Contact Inforrnation below: 3407276120 [] This person has never worked for this employer nor received periodic income. L) This person nulonger works for this employer nor receives periodic income. Please provide the foliowing information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDUITr1baI Payee: Final PaymenAmount: New Empioyer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) byphone at(717)240-G225.byfax et(717)24O-G248.byemail orwebsite at: vmww.chiNaupport.staha.pa.us. Send terminationhincome status notice and other correspondence to: DOMESTIC RELATIONS SECTON, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE. PA. 17013 (Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) byphone at(717)24O'82%5.byfax at(717)240'G24D.byemail orwebsite atvm^wv.ohUdouPoort.stahe.pmus. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.: 0970-0154 Service Type M Page 3 of 3Worker ID SIATT Form EN -428 11/13 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: BROWN, TIMOTHY D. PACSES Case Number 586109913 Plaintiff Name PENNY D. BROWN Docket Attachment Amount 08-139 CIVIL $ 2,100.00 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 PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum OMB No.: 0970-0154 Form EN -428 11/13 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT O ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPQRT (IWO) O AMswosoxwo O ONE.TIMEORDER/NOTICE FOR LUMP SUM PAYMENT @ TERMINATION OF IWO 5a, 10°1.913 - /�� `'u nale: 06/03/14 O Child Support Enforcement (CSE) Agency El Court OAttorney O Private Individual/Entity (Check One) NOTE: This IWO must be regular on its face, Under certain circumstances you must reject this IWO and return it to the sender (see IWO inu\mmionnhttp:Vw^w*.acf.hhu.gov/prigrams/cno/f/ o/OB ()-01 If you receive this documentfrom someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. StatefTribefTerritory Commonwealth of Pennsylvania CUMBERLAND Private Individual/Entity Remittance Identifie(include w/payment)3580101961 Order Identifier: for order/docket information) CSE Agency Case Identifier: (See Addendum for case summary) DFAS AIR FORCE ACTIVE DUTY Sent ��U��»���0�K�^�����8�� ~~.,-.~~..-....~~~~~� DO NOT MAIL Withholders FEIN 849990000 Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) RE: BROWN, TIMOTHY D. Name (Last, First, Middle) 408'78'9334 Employee/Obligors Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First. NOTE: This IWO must be regular on its face. Under certain circumust reject this IWO and returri it to the sender (see IWO instructions h«v:Vww*.om.hhslnv/pmnrammcvamonns/ Owo'097*0154 instructions.pd, If you receive (his document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. 8499900000 rz See Addendum for dependent names and birth dates associated with cases onattachment= C:73 `— ORDER INFORMATION: This document is based on the support or withholding order from C . --' Commonwealth of Pennsylvania be). You are required by Iaw to deduct these amounts '" obligor's income further. ^ . �' 0.00 per month in current child support O.00per month inpast-due child support ' Arrears 12weeks or greater? 0.00 per month in current cash medical support 0.00 per month in past -due cash medical support 0.00 per month in current spousal support 0.00 per month in past -due spousal support O.OUper month inother (must specify) for a Total Amount to Withhold of $ 0.00 per month. '.� AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: � 0.00 per weekly pay period. 8 0.00 per semimonthly pay period (twice a month) � 0.00 per biweekly pay period (every two weeks) $ 0.00 per mortthly pay period. Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) workinq days after the date of this Order/Notice. Send payment within seven (7) working days ofthe pay date. If you cannot withhold the full amount of support for any or alI orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding |imitetions, time requiremants, and any allowable employer fees at h#p:/k^mvw.aof.hhm.gov/orognomm/cae/nawhire/ernD|oyer/cmnbante/conbaot_mop. h1mfo, the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.: 0970-0154 Service Type MWorker ID $1ATT Form EN -428 11/13 ❑ Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: JUNE 3, 2014 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ❑ If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State -specific contact and withholding information can be found on the Federal Employer Services website located at: htto://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact map.htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past -due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti -discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date — 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use. Form EN -428 11/13 Service Type M Page 2 of 3 Worker ID $IATT P. Employer's Name: DFAS AIR FORCE ACTIVE DUTY Employer FEIN: 849990000 Employee/Obligor's Name: BROWN, TIMOTHY D. 3580101961 CSE Agency Case Identifier: (See Addendum for case summary) Order Identifier: (See Addendum for order/docket information) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by retuming this form to the address listed in the Contact Information below: 8499900000 Q This person has never worked for this employer nor received periodic income. Q This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www.childsupport.state.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST, P.O. BOX 320. CARLISLE. PA. 17013 (Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at www.childsuoport.state.oa.us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.: 0970-0154 Service Type M Page 3 of 3 Form EN -428 11/13 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: BROWN, TIMOTHY D. PACSES Case Number 586109913 Plaintiff Name PENNY D. BROWN Docket Attachment Amount 08-139 CIVIL $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): A . DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum OMB No.: 0970-0154 Form EN -428 11/13 Worker ID $IATT .`� INCOME WITHHOLDING FOR SUPPORT O ORIGINAL INCOME WITHHOLDING ORDER(NOTICE FOR SUPPORT ((WO) O AMswoEoxwo o ONE-TIMEORDERINOTtCE FOR LUMP SUM PAYMENT C) TERMINATION oFxwo 5E6 [c31l _ _ | �.c\ ��)U\ | '-' / . Date: 09/08/14 O Child Support Enforcement (CSE) Agency N Court O Attorney 0 Private IndividuallEnhity (Check One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO inotnuctionnhVp:6/www.ocf.hho bmu/foIf you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. Commonwealth of Pennsylvania City/County/Dist./Tribe CUMBERLAND Private Individual/Entity Remittance Identifier (include w/payment): 3580101961 Order Identifier: (See Addendum for order/docket informatio CSE Agency Case Ideritifier: (See Adder,dum or case summary) SentDFAS RETIRED MILITARY ��U��v~������^����UU�� -~.,~~'~'-~.''~~-''�� DO NOT MAIL Employer/lncome Withholders FEIN 340727612 Chitd(rens Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) RE: BROWN, TIMOTHY D. Employee/Obligor's Name (Last, First, Middle) 408'78'0334 Emp|oyoe/Omi0or'mSocial Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO mustbe regular on its face Under certain circumust this IWO and return it to the sender (see IWO instructions xnn:xww.v.acf.oho,gvwnmmramsmsexvnns/ owa'0970'0154 instructionsod. 11 you recoive this documerit from someone other than a State or Tnbal CSE agency or a Court, a copy of (he underlying order must be attached. 3407276120 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amountsto == �- v -nr (����in�����mup�'A��12��or greater? 0 y���� �� - _ CD - +` >o = -r >r.) zc �� obligors income until further notice, 0.00 per month in current child support 0.00 per month in current cash medical support 0.00 per month in past -due cash medical support 0.00 per month in current spousal support 0,00 per month in past -due spousal support 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 0.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: � 0.00 per weekly pay period. o 0.00 per semimonthly pay period (twice a month) � 0.00 per biweekly pay period (every twa weeks) $ 0.00 per monthly pay period. Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55°A)of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding |imitatione, time raquirementa, and any allowable employer fees at http:6/wxow.ac[hho`gov/programo/cue/newhire/omp|oyer/oontmcte/contaot map. Pim for the employee/obiigors principal place of emptoyment. Document Tracking Identifier OMB No.: 0970-0154 Service Type M Form EN -428 11/13 Worker ID $IATT 0 Return to Sender [Completed by Emcome Withholder]. Payment must be directed to an SDU in accordance with 42 USC §86G(b)(5)and (b)(G)mrTribal Payee (see Payments toSOUb*Jmw). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. �r � Signature of Judge/IssuiOfficial (if required by State or Tribalaw): KEVIN '4HESS Pr�tName ofJudoa/�uu�oOR��\: Th�ofJudoe8souingO�ua|� Date Signature: SEPTEMBER 8, ~ Th�ofJudoe8souingO�ua|� �a�/uf8' n�b�e� SEPTE�8ER2O14 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issuethis order, a copy of this IWO must be provided to the employee/obligor. 0 If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one ernployee and employs 15 or more persons, or if an emptoyer has a history of two or more returned checks due to nonsufficient funds. Please caII the Pennsylvania State Collections and Disbursement Unit (PA SCDU) mpIoyer 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, PA YMENTS MUST !NCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State -specific contact and withholding information can be found on the Federal Employer Services website located at: http:0wnww.ecf.hho.gov/Amgronmn/uow/novvhire/emp|oyor/oontooLo/oontootmep htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/Obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you Must follow the "Remit payment to" instructions on this form. Reporting tho Pay Date: You must report the pay date wheri sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withhoding and forward the support payments. Multiple IWOs: If there is more than one IWO against this emploe/ob|igurandynuarounob|etofu\|yhnnoro|||VVOsduoto Federal, State, or Tribal withholding limits, you must honor all 1W0s to the greatest extent possible, giving priority to current support before payment of any past -due support. Follow the State or Tribal law/procedure of the employee/obligor's principal pace of employment to determine the apprpriate aHocation rnethod. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this eniployee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold Iump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's inudme as the IWO dineoto, you are Iiable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti -discrimination: You ate subject to a fine determined under State or Tribal law for discharging an employee/obligorhnm employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB ExpimtiOnDate —05/31/20`4.The OMB Expirati�n Date has no bearing on the termination date of the WO; it identifies the verson of the form currenlly n usa, Form EN -428 11/13 Employer's Name: DFASRETIRED MILITARY Employer FEIN: 340727612 Name: BROWN, TIMOTHY D. 3580101981 CSE AgencyCase\dentifiec(SeeAddendum for case summary) Order tdentifier: (See Addendum for order/docket information) Withholding Ljmits: You may not wthhoId morethan the Iesser of: 1) the amounts allowed by the Federall Consumer Credit Protection Act (CCPA)(15U.S.C.1G73(b));or2)the amounts allowed bythe State nrTribe ofthe employee/obligors principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 596'to55%and O596'if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal ordersyou may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold morthan the Iesser of the limit set by the aw of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calcuiate the CCPA limit using the ower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never workefor you or you are no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address Iisted in the Contact Information below: 34072/6120 {] This person has never worked for this employer nor received periodic income. 0 This person no Ionger works for this employer nor receives periodic income. Please provide the foilowing information for the employee/obgor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: NmwEmpinye/oNomo: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) byphone ad(717)24O-G225.byfax at(717)24O'S24B.byemail nrwebsite at: vmxwv.chUdsupport.state.po.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS 8ECT|(]N, 13 N. HANOVER ST. P.O. BOX 320. CARLISLE. PA. 17013 (Issuer address). To If the has questions, contacWAGE ATTACHMENT UNIT (Issuer name byphone a1(717)340'8225'byfax sd(717)240'8248.byemail orwebsite otvmxmv.ohUdsupporLotak».pa.ua. IMPORTANT: The person completing this form is advised that the nformatiori may be shared with the employee/obligor. OMB No,: 0970-0154 Service Type M Page 3 of 3Worker ID $1ATT Form EN -428 11/13 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: BROWN, TIMOTHY D. PACSES Case Number 586109013 Plaintiff Name PENNY 0. BROWN Docket Attachment Amount 08-139 CIVIL $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount � 0.00 ChUd(ren)'oNamo(o): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount � 0.00 0.00 DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount � 0.00 Child(ren)'s Name(s): DOB Service Type M Docket Attachment Amount � 0.00 Child(ren)'s Name(s): DOB Addendum OMB No.: 0970-0154 Form EN -428 11/13 Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff l' -!LED -OFFICE THE PROTHONO l,;i' 28I4 CCT 29 AH I0: 29 CUMBERLAND COUNTY PENNSYLVANIA PENNY D. BROWN, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA v. : NO. 2008-139 : CIVIL ACTION - LAW TIMOTHY D. BROWN, Defendant : IN DIVORCE MILITARY QUALIFYING COURT ORDER 1. This Military Qualifying Court Order ("Order") creates and recognizes the existence of the Former Spouse's right to receive a portion of the benefits payable with respect to the Member. The Member and the Former Spouse intend that this Order qualify under the Uniformed Services Former Spouse's Protection Act, 10 U.S.C. Section 1408 and following. The jurisdiction requirements of 10 U.S.C. Section 1408 have been complied with, and this Order has not been amended, superseded, or set aside by any subsequent order. The court has the authority to divide military retired pay under USFSPA's jurisdictional requirements since the Member consents to the jurisdiction of this Court. 2. This Order is entered pursuant to authority granted under the applicable domestic relations laws of the Commonwealth of Pennsylvania. 3. This Order relates to the provision of marital property rights to the Former Spouse. 4. This Order applies to the Military Retirement System ("Plan") and any successor thereto. Timothy D. Brown ("Member") is a Member in the Plan. Penny D. Brown ("Former Spouse") is the Former Spouse for the purpose of this Order. 5. The Member's name, mailing address, Social Security Number and date of birth are: 6. birth are: Name: Address: Social Security No.: Date of Birth: Timothy D. Brown 198 East Yellow Breeches Road Carlisle, PA 17015 See Addendum See Addendum The Former Spouse's name, mailing address, Social Security Number and date of Name: Address: Social Security No.: Date of Birth: Penny D. Brown 204 Thorncrest Drive Carlisle, PA 17013 See Addendum See Addendum 7. The Member assigns to the Former Spouse an interest in the Member's disposable military retired pay. The Former Spouse is entitled to a direct payment in the amount specified below and shall receive payments at the same time as the Member. 8. The Member's rights under the Servicemembers' Civil Relief Act were observed by the Court as evidenced by the Member's affirmative signature on the Divorce Decree and/or Marital Settlement Agreement. 9. The Former Spouse is awarded a percentage of the Member's disposable military retired pay, to be computed by multiplying 50% times a fraction, the numerator of which is 252 months of marriage during the Member's creditable military service, divided by the total number of months of the Member's creditable military service. In addition, the Former Spouse shall receive a proportionate share of any post-retirement cost -of -living adjustments made to the Member's benefit. 10. Payments to Former Spouse shall commence as soon as administratively feasible upon Member's retirement, following the date this Order is approved by the appropriate Military Pay Center. 11. Payments shall continue to Former Spouse for the remainder of the Member's lifetime. If the Former Spouse dies before the Member, the Former Spouse's share of the Member's disposable military retired pay shall revert to the Member. 12. The Member agrees to elect to make the Former Spouse (and such Former Spouse shall be deemed) the irrevocable beneficiary under the Survivor Benefit Plan ("SBP"), to the extent survivor benefits were previously elected under the Survivor Benefit Plan. The Member shall make the necessary election in a timely manner to convert the SBP to Former Spouse coverage and shall execute such paperwork as is required. 13. The Member and the Former Spouse acknowledge that they were married for a period of more than ten (10) years during which time the Member performed more than ten (10) years of creditable military service. The parties were married on January 2, 1987, separated on January 7, 2008, and were divorced on June 2, 2010. 14. The Former Spouse agrees that any future overpayments to her are recoverable and subject to involuntary collection from her or her estate. 15. The Former Spouse agrees to notify DFAS about any changes in the Qualifying Court Order or the Order affecting these provisions of it, or in the eligibility of any recipient receiving benefits pursuant to it. 16. The Former Spouse shall be liable for any federal, state, or local taxes associated with any payments made directly to her from DFAS. 17. The Member agrees to cooperate with the Former Spouse to prepare an application for direct payment to the Former Spouse from the Member's retired or retainer pay pursuant to 10 U.S.C. Section 1408. The Member agrees to execute all documents that the United States Air Force may require to certify that the disposable military retired pay can be provided to the Former Spouse. 18. The parties acknowledge that the following items must be sent by the Former Spouse to DFAS-HGA/CL, Assistant General Counsel for Garnishment Operations, P.O. Box 998002, Cleveland, OH 44199-8002 and Defense Finance and Accounting Service, U.S. Military Retirement Pay, P.O. Box 7130, London, KY 40742-7130. The Member agrees to provide any of this information to the Former Spouse at the Former Spouse's request and to make all necessary efforts to obtain any of this information that the Former Spouse is unable to obtain. a. A certified copy of the Divorce Decree. b. A certified copy of this Domestic Relations order. c. A copy of the Marriage Certificate of Mr. and Mrs. Brown. d. An executed copy of Form 2293 entitled "Application for Former Spouse Payments From Retired Pay." e. An executed copy of Form 2656-1 entitled "Survivor Benefit Plan (SBP) Election Statement for Former Spouse Coverage." 19. The Court shall retain jurisdiction to enter such further Orders as are necessary to enforce this Order. Such orders shall not include orders modifying the percentage of disposable retired pay awarded to the Former Spouse or requiring the Member to pay alimony to the Former Spouse to maintain the intent of this Qualify Court Order should Member waive retirement pay to receive disability compensation or should Member elect to merge his military retired pay with another federal employee retirement plan. The Member intends to apply for Veterans Administration ("VA") disability compensation and to waive a portion of Member's retirement for same. Former Spouse understands and agrees that should Member qualify for and receive a VA disability compensation award ("VA award"), said VA award will result in a reduction of the Member's disposable military retired pay to Former Spouse. Former Spouse agrees to this reduction in the Member's disposable military retired pay payable to her and will not seek recoupment from Member for same. ACCEPTED AND ORDERED this Z 9 4 day of Ode* , 2014. BY THE COURT 1 C NSENT TO ORDER: (614 Penny D. B Plaintiff/Former Spouse // /Av.. Hubert X. Gilt- •y, Esquire late Attorney for r laintiff/Former Spouse Date nZal cam, io%.q/ey "2 Timotk D. Brown Defendant/Member •1 h -»I ate • /D 22- M ZM rc A. - a ingi, Esq ire Date Attorn:. fo 1 efendant/Member