HomeMy WebLinkAbout04-0723JANET I. SOLOMON IN THE COURT OF COMMON PLEAS
Plaintiff CUMBERLAND CO., PENNSYLVANIA
V. No. C)L(` 7;k3 Cz-t?-
BRUCE H. SOLOMON CIVIL ACTION -LAW
Defendant IN DIVORCE
NOTICE TO DEFEND AND CLAIM RIGHTS
You have been sued in Court. If you wish to defend against the claims set forth in the
following pages, you must take prompt action. You are warned that if you fail to do so, the
case may proceed without you and a decree of divorce or annulment may be entered against
you by the Court. A judgment may also be entered against you for any other claim or relief
requested in these papers by the plaintiff. You may lose money or property or other rights
important to you, including custody or visitation of your children.
When the ground for divorce is indignities or irretrievable breakdown of the marriage,
you may request marriage counseling. A list of marriage counselors is available in the Office
of the Prothonotary at the Cumberland County Courthouse, Carlisle, Pennsylvania.
IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY,
LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS
GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE
OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, PA 17013
(717) 249-3166
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MARITAL SETTLEMENT AGREEMENT
THIS AGREEMENT made this 6 F~ day of n,, v- c?, , 2008, by and
between BRUCE H. SOLOMON of York County, Pennsylvania (hereinafter referred to as
"Husband"), and JANET I. SOLOMON of Cumberland County, Pennsylvania, (hereinafter referred
to as "Wife").
WITNESSETH:
WHEREAS, Husband and Wife were lawfully married on July 2, 1976, in Altoona,
Pennsylvania, and;
WHEREAS, two children have been born of this marriage, Justin C. Solomon born on
February 21, 1985 and Daniel J. Solomon born on May 12, 1988, both of whom are emancipated;
and
WHEREAS, differences have arisen between Husband and Wife in consequence of which
they have been separate and apart from each other; and
WHEREAS, Husband and Wife desire to settle and determine their rights, obligations and
the support and maintenance of the Wife by the Husband; and
NOW, THEREFORE, the parties intending to be legally bound hereby do covenant and
agree:
1. SEPARATION: It shall be lawful for each party at all times hereafter to live
separate and apart from the other party at such place as he or she may from time to time choose or
deem fit. The foregoing provisions shall not be taken as an admission on the part of either party of
the lawfulness or unlawfulness of the causes leading to their living apart.
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2. INTERFERENCE: Each party shall be free from interference, authority, and contact
by the other, as fully as if he or she were single and unmarried except as 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.
3. DISTRIBUTION OF MARITAL ASSETS AND DEBTS:
The parties have come to agreement as to the ownership of their respective properties and
equitable distribution of the marital property. Except as set forth herein, the parties agree that they
shall indemnify and hold each other harmless from any and all responsibility for the assets or debts
that they are receiving pursuant to this Agreement.
A. Assets to be Distributed to Husband: Wife agrees to transfer any and all
right, title and interest which she may have and agrees to waive, release, renounce and forever
abandon whatever right she may have in the following property, to be transferred to Husband:
1. Husband's Thrift Savings Plan, with an approximate marital value of
$94,527.
2. Husband's annual leave accumulated during the marriage with an
approximate value of $11,298.
3. Husband's Vanguard IRA with a marital value of approximately
$69,812.
4. The parties' Christmas Club account, which has been previously
received by Husband, with an approximate balance of $2,000.
5. Husband's Fulton Bank Savings Account, with a marital value of
approximately $3,310.
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6. Husband's Fulton Bank Checking Account, with a marital value of
approximately $1,566.
7. Cruise refund money which has been previously distributed to
Husband with a balance of approximately $1,200.
8. A 2001 Mazda Protege LX, which has been previously distributed to
Husband, with an approximate value of $6,915.
9. Cash located in the marital residence, which has been previously
distributed to Husband, with a value of $500.
10. Copies of joint tax returns from 2000 to the present, Husband's
personal paperwork, a box of Husband's baby pictures, and a few pictures of the parties' children,
which will be delivered by Wife to Husband's attorney's office within 10 days of the execution of
this Agreement.
11. The portion of Husband's CSRS pension, which is not distributed to
wife pursuant to the Qualified Domestic Relations Order, a draft of which is attached hereto and
marked as Exhibit "A." Husband shall elect the Survivor Annuity for Wife. Wife shall be solely
responsible for any and all costs associated with the Survivor Annuity, which costs shall be paid
from and shall reduce her share of the monthly pension benefit.
B. Assets to be Distributed to Wife: Husband agrees to transfer any and all
right, title and interest which he may have and agrees to waive, release, renounce and forever
abandon whatever right he may have in the following property, to be transferred to Wife:
1. The marital residence located at 58 Bourbon Red Drive,
Mechanicsburg, Cumberland County, Pennsylvania, currently titled in the name of Husband and
Wife, which has a net equity of approximately $235,754. Counsel for Wife shall prepare a deed
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transferring title from joint names to Wife's name alone, which Husband shall sign
contemporaneously with the execution of this Agreement.
The parties agree that the mortgage encumbering the marital
residence shall remain in joint names until the loan is satisfied. Wife agrees to make timely
monthly mortgage payments and will indemnify and hold Husband harmless with regard to the
mortgage. Wife further agrees to indemnify and hold Husband harmless from responsibility for any
fees and costs, including but not limited to reasonable attorney's fees, incurred by Husband
associated with her failure to pay the mortgage, taxes, homeowners insurance, or any other fees
associated with the marital residence.
Husband agrees to cooperate and ensure that Wife receives the sole
benefit of any homeowners insurance claims that arise now or in the future. Husband's cooperation
in this regard shall include, but shall not be limited to, ensuring that his attorney, Sandra Meilton, is
kept apprised of Husband's current address and phone number so that Husband can be contacted
regarding the issuance of any homeowners insurance reimbursement checks, and cosigning and
returning to Wife or Wife's counsel any jointly-tilted reimbursement checks received as part of a
homeowners insurance claim within 10 days of said claim being presented to Husband's attorney,
Sandra Meilton.
2. Wife's SERS Pension Plan.
3. Entire portion of the parties' joint Vanguard money market account,
which has an approximate balance of $23,296.
4. The MBNA CD No. 1117-1, which Wife had previously received
with a balance of approximately $3,601.
' $7,500 of this account will be held in escrow by Wife's attorney until such time as Wife begins to receive her
monthly payment through CSRS. This $7500 will be used to cover reimbursement to Husband of any duplicate
payments made by Husband until Wife's monthly CSRS benefit begins to be paid to Wife.
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5. Bank of America Roth IRA owned individually by Wife, with a
marital value of approximately $61,544.
6. 1997 Honda Accord Station Wagon, which had a value as of the date
of separation of approximately $4,200.
7. The portion of Husband's CSRS pension set forth in the draft
Qualified Domestic Relations Order, a copy of which is attached hereto and marked Exhibit "A."
Husband shall elect the Survivor Annuity for Wife. Wife shall be solely responsible for any and all
costs associated with the Survivor Annuity, which costs shall be paid from and shall reduce her
share of the monthly pension benefit.
8. The entire contents of the marital residence, with the exception of
those items to be distributed to Husband as set forth above.
C. Equitable Distribution Payments: Beginning June, 2008 and continuing
until such time as Wife begins to receive payments from Husband's CSRS pension, Husband shall
pay Wife the sum of $2,105 per month, paid no later than the 15th day of each month. When Wife
begins to receive monthly payments from Husband's CSRS pension, this monthly payment shall
cease. Wife shall immediately notify her counsel upon receipt of her first monthly payment from
CSRS. Upon information and belief, CSRS pays one (1) month behind2 and they pay retroactively
to the date of Husband's retirement.
It is possible that if Wife's direct payments from CSRS are not distributed to her
commencing in June 20083, that she will receive a retroactive payment from CSRS once the
pension is in "pay status". If Husband has made any direct payments to Wife in the monthly
amount of $2,105 after May 31, 2008 and prior to the pension being placed into "pay status", and if
z For example, both Husband and Wife's payment for the month of July 2008 will not be paid to either party until the
month of August 2008.
3 Wife's June payment would be for May 2008.
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Wife receives retroactive funds, Wife shall, within ten (10) days of receipt of same, reimburse
Husband the total amount of any and all direct payments made by Husband to Wife after May 31,
2008, which were duplicated in the retroactive payments received by Wife from CSRS.
In the event that OPM withholds the cost of the survivor benefit from Husband's
monthly pension benefit, Wife shall reimburse Husband for the cost of the survivor benefit as paid
by Husband on Wife's behalf so long as OPM reimburses Wife for payment of the survivor benefit.
D. Marital Debts: Outstanding Joint Debts: Husband shall pay any outstanding
balance associated with the co-pays for health care costs associated with using Wife's insurance,
within 10 days of the signing of this Agreement. Wife agrees that she shall be solely responsible for
and shall promptly pay Conrad Siegel's actuarial fees associated with this matter. Except as set
forth herein, all other debts, contracts, obligations or liabilities incurred at any time in the past by
either of the parties will be paid promptly by said party, unless and except as otherwise specifically
set forth in this Agreement; and each of the parties hereto further promises, covenants and agrees
that each will now and at all times hereafter save harmless and keep the other or his or her estate
indemnified and saved harmless from all debts or liabilities incurred by him or her, as the case may
be, and from all actions, claims and demands whatsoever with respect thereto, and from all costs,
legal or otherwise, and counsel fees whatsoever appertaining to such actions, claims and demands.
Neither party shall, after the date of this Agreement, contract or incur any debt or liability for which
the other or his or her property might be responsible, and shall indemnify and save harmless the
other from any and all claims or demands made against her or him by reason of debts or obligations
incurred by her or him and from all costs, legal costs and counsel fees unless provided to the
contrary herein.
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A liability not disclosed in this Agreement will be the sole responsibility of the party who
has incurred or may hereafter incur it, and each agrees to pay it as the same shall become due, and
to indemnify and hold the other party and his or her property harmless from any and all such debts,
obligations and liabilities. From the date of execution of this Agreement, each party shall use only
those credit cards and accounts for which that party is individually liable and the parties agree to
cooperate in closing any remaining accounts which provide for joint-liability.
4. WIFE'S SUPPORT/ALIMONY: Husband's support obligation pursuant to the
PACSES Case No. 910105454 shall convert to non-modifiable alimony in the amount of $1,630.00
per month upon the entry of a Divorce Decree, and shall continue until May 31, 2008. These
support/alimony payments shall be taxable to Wife's income and deductible by Husband. Said
payments shall terminate upon the first to occur of the following: death of Wife, death of Husband,
remarriage of Wife, or May 31, 2008. The parties shall execute the Support Stipulation attached
hereto as Exhibit "B" simultaneously with the execution of this Agreement. Said Support
Stipulation and proposed Order shall immediately thereafter be filed by counsel for Husband with
the Cumberland County Domestic Relations Office.
5. MUTUAL RELEASE: Subject to the provisions of this Agreement, each
party has released and discharged, and by this Agreement does for himself or herself and his or her
heirs, legal representatives, executors, administrators and assigns, release and discharge the other of
and from all causes of action, claims, rights, or demands, whatsoever in law or equity, which either
of the parties ever had or now has against the other, except any or all causes of action for
termination of the marriage by divorce or annulment and except for all causes of action for breach
of any provisions of this Agreement. Husband and Wife specifically release and waive any and all
rights he or she might have to raise claims under the Divorce Code and any Amendments thereto
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including, but not limited to claims for equitable distribution of marital property, support, alimony,
alimony pendente lite, counsel fees or expenses. The fact that a party brings an action to enforce the
property agreement under the Divorce Code and any Amendments thereto, does not give either
party the right to raise other claims under, the Divorce Code, specifically waived and released by
this paragraph and all rights and obligations of the parties arising out of the marriage shall be
determined by this Agreement.
6. WAIVERS OF CLAIMS AGAINST ESTATES: Except as herein otherwise
provided, each party may dispose of his or her property in any way, and each party hereby waives
and relinquishes any and all rights he or she may now have or hereafter acquire, under the present
or future laws of any jurisdiction, to share in the property or the estate of the other as a result of the
marital relationship, including without limitation, dower, curtesy, statutory allowance, widow's
allowance, right to take in intestacy, right to take against the Will of the other, and 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 all such interests, rights and claims.
7. AGREEMENT BINDING ON HEIRS: This Agreement shall be binding on and
shall inure to the benefit of the parties hereto and their respective heirs, executors, administrators,
successors and assigns.
8. TAXES: By this Agreement, the parties have intended to effectuate and by this
Agreement have equitably divided their marital property. The parties have determined that such
division conforms to a right and just standard with regard to the rights of each party. The division
of existing marital property is not, except as may be otherwise expressly provided herein, intended
by the parties to constitute in any way a sale or exchange of assets, and the division is being
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effected without the introduction of outside funds or other property not constituting a part of the
marital estate. As a part of the equitable division of the marital property and the marital settlement
herein contained, the parties agree to save and hold each other harmless from all income taxes
assessed against the other resulting from the division of the property as herein provided.
The parties acknowledge that they have filed various joint income tax returns during the
course of their marriage. In filing each such return, each party has relied exclusively upon the other
party to provide truthful and accurate information relating to the other party's employment income,
business income or deductions, or income from any other source. In the event that any additional
taxes, penalties or interest are assessed as a result of any such joint return, the party responsible for
under-reporting income or claiming any improper deduction shall indemnify and save the other
party harmless from such tax liability, penalties, interest, attorney's fees or accountant's fees.
9. SUBSEQUENT DIVORCE: Both parties agree to execute Affidavits of Consent to
Divorce and Waiver of Notice of Intention to Request Entry of a Divorce Decree pursuant to
Section 3301(c) of the Divorce Code contemporaneous with the signing of this Agreement and
shall direct their respective counsel to immediately file with the Court said documents. Wife agrees
that she shall direct J. Paul Helvy, Esquire, her counsel, to immediately file with the Court a
Praecipe to Transmit the Record and a Decree in Divorce from the bonds of matrimony under
Section 3301(c) of the Divorce Code, and any other documents necessary to finalize the Divorce.
Time is of the essence due to Husband's pending retirement and therefore, it is the intention of the
parties to be divorced on or before March 20, 2008.
10. 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
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shall be responsible for payment of reasonable legal fees and costs incurred by the other in
enforcing their rights under this Agreement.
11. ADDITIONAL INSTRUMENTS: Each of the parties shall from time to time, at
the request of the other, execute, acknowledge, and deliver to the other party any and all further
instruments that may be reasonably required to give full force and effect to the provisions of this
Agreement.
12. VOLUNTARY EXECUTION: The provisions of this Agreement and their
legal effect have been fully explained to the parties by their respective counsel. The Wife has
employed and had the benefit of counsel of J. Paul Helvy, Esquire as her attorney. The Husband
has employed and had the benefit of counsel of Sandra L. Meilton, Esquire as his attorney. Each
party acknowledges that he or she has received independent legal advice from counsel of his or her
selection and that each fully understands the facts and has been fully informed as to his or her legal
rights and obligations, and each party acknowledges and accepts that this Agreement is, under the
circumstances, fair and equitable, and that it is being entered into freely and voluntarily after
having received such advice and with such knowledge, and that execution of this Agreement is not
the result of any duress or undue influence and that it is not the result of any collusion or improper
or illegal agreement or agreements. Also, each party hereto acknowledges that he or she has been
fully advised by his or her respective attorney of the impact of the Pennsylvania Divorce Code and
any Amendments thereto, whereby the Court has the right and duty to determine all marital rights
of the parties, including divorce, alimony, alimony pendente lite, equitable distribution of all
marital property or property owned or possessed individually by the other, counsel fees and costs of
litigation and, fully knowing the same and being fully advised of his or her rights thereunder, each
party hereto still desires to execute this Agreement acknowledging that the terms and conditions set
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forth herein are fair, just, and equitable to each of the parties and waives their respective right to
have the Court of Common Pleas of Cumberland County or any other Court of competent
jurisdiction to make any determination or order affecting the respective parties' right to a divorce,
alimony, alimony pendente lite, equitable distribution of all marital property, counsel fees and costs
of litigation.
Each party acknowledges that he or she fully understands the facts and his or her legal
rights and obligations, and each party acknowledges and accepts that this Agreement is, under the
circumstances, fair and equitable, and that it is being entered into freely and voluntarily, and that
execution of this Agreement is not the result of any duress or undue influence and that it is not the
result of any collusion or improper or illegal agreement or agreements.
13. 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.
14. 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 default of the
same or similar nature.
15. APPLICABLE LAW: This Agreement shall be construed under the laws of the
Commonwealth of Pennsylvania.
16. PRIOR AGREEMENTS: It is understood and agreed that any and all property
settlement agreements which may or have been executed prior to the date and time of-this
Agreement are null and void and of no effect.
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17. 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.
18. INDEPENDENT SEPARATE COVENANTS: It is specifically understood and
agreed by and between the parties hereto that each paragraph hereof shall be deemed to be a
separate and independent covenant and agreement.
19. DISCLOSURE: The respective parties do hereby warrant, represent, and
declare and do acknowledge and agree that each is and has been fully and completely informed of
and is familiar with and cognizant of the wealth, real and/or personal property, estate and assets,
earnings and income of the other and that each has made a full and complete disclosure to the other
of his or her entire assets and liabilities and any further enumeration or statement thereof in this
Agreement is hereby specifically waived, and the parties do not wish to make or append hereto any
further enumeration or statement. Each of the parties hereto further covenants and agrees for
himself or herself and his or her heirs, executors, administrators and assigns, that he or she will
never, at any time hereafter, sue the other party or his or her heirs, executors, administrators or
assigns, in any action or contention, direct or indirect, that there was any absence or lack of full
disclosure, fraud, duress, undue influence, or that there was any absence or lack of full, proper, and
independent representation.
20. DESCRIPTIVE HEADINGS: The descriptive headings used herein are for
convenience only. They shall have no effect whatsoever in determining the rights or obligations of
the parties.
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21. DATE OF THIS AGREEMENT: The date of this Agreement shall be the date on
which the Agreement is signed by both parties. In the event the parties do not sign this Agreement
on the same day, the date of the Agreement shall be the date that the last party has executed the
Agreement.
22. CONTRACT INTERPRETATION: For purposes of contract interpretation and for
the purpose of resolving any ambiguity herein, the parties agree that this Agreement was prepared
jointly by the parties.
IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and
year first above-written.
WITNESS:
J)kNET I. SOLOMON
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BRUCE H. SOLOMON
COMMONWEALTH OF PENNSYLVANIA )
SS.:
COUNTY OF ? NL P( 11Q? )
On this the A day of , 2008, before me, the undersigned officer, personally
appeared BRUCE H. SOLOMON, known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged that he executed- the same for the
purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal.
L NOTARIAL SFr4L
My Commission Expires: -
COMMONWEALTH OF PENNSYLVANIA )
SS.:
COUNTY OF ???Qh"'1 )
On this the day of ?C? Ljn , 2008, before me, the undersigned officer, personally
appeared JANET I. SOLOMON, known to me (or satisfactorily proven) to be the person whose
name is subscribed to the within instrument, and acknowledged that he executed- the same for the
purpose therein contained.
IN WITNESS WHEREOF, I have hereunto set my hand and notarial seal.
My Commission Expires: -
Muo"T ,LT}? ; ;sYLVANT,?
CMiche ;:r; Public
W dd ar? ?ounry
Oct. 2, 9
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COMMONWEALTH OF PENNSYLV
PATRICIA A. PATTON, Notary Public
Louaer Paxton Twp., Dauphin County
My Commission Expires June 20, 2010
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Janet I. Solomon IN THE COURT OF COMMON PLEAS
Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA
VS. CIVIL ACTION - LAW - IN DIVORCE
Bruce H. Solomon NO. 04-723 CIVIL
Defendant
DOMESTIC RELATIONS ORDER
1. This Domestic Relations Order ("DRO") creates and recognizes the existence of the
Alternate Payee's right to receive a portion of the benefits payable with respect to the Participant.
It is intended to constitute a DRO Acceptable For Processing under final regulations issued by the
Office of Personnel Management ("OPM").
2. This DRO is entered pursuant to authority granted under the applicable domestic
relations laws of the State of Pennsylvania.
3. This DRO relates to the provision of marital property rights to the Alternate Payee.
4. This DRO applies to the Civil Service Retirement System ("Plan") and any successor
thereto. Bruce H. Solomon ("Participant") is a Participant in the Plan. Janet I. Solomon
("Alternate Payee"), the former spouse, is the Alternate Payee for the purposes of this DRO.
5. The Participant's name, mailing address, Social Security number and date of birth are:
Bruce H. Solomon
332 Thorley Road
New Cumberland, PA 17070
Social Security No.: 169-46-1854
Date of Birth: July 5, 1955
6. The Alternate Payee's name, mailing address, Social Security number and date of birth
are:
DRO
Page 2 of 4
Janet I. Solomon
58 Bourbon Red Drive
Mechanicsburg, PA 17050
Social Security No.: 181-44-4077
Date of Birth: March 7, 1952
It is the responsibility of the Alternate Payee to keep a current mailing address on file
with the Plan at all times.
The Alternate Payee is entitled to a portion of the Participant's gross monthly annuity
under the Plan as set forth below. The OPM is hereby directed to pay Alternate Payee's share
directly to Alternate Payee.
This DRO assigns to Alternate Payee an amount equal to $2,465 of the Participant's
gross monthly annuity, less the cost of providing the Alternate Payee with the former spouse
survivor annuity specified in paragraph 11.
In addition to the above, when COLA's are applied to Participant's retirement benefits,
the same COLA shall apply to the Alternate Payee's share.
9. Payments to Alternate Payee shall commence the date payments commence to the
Participant. Participant agrees to arrange or to execute all forms necessary for the OPM to
commence payments to the Alternate Payee in accordance with the terms of the DRO.
10. Payments shall continue to Alternate Payee for the remainder of the Participant's
lifetime. If the Alternate Payee dies before the Participant, the Alternate Payee's share of the
Participant's pension shall be paid to her estate.
11. The Alternate Payee is awarded a former spouse survivor annuity in the amount of
$2,105 per month. This former spouse survivor annuity of $2,105 per month applies if the
Participant dies before his benefits commence or if the Participant dies after his benefits
commence. The costs associated with providing this former spouse survivor annuity coverage shall
be deducted solely from the Alternate Payee's benefits. Participant agrees to take all necessary
steps to elect Alternate Payee as designated beneficiary for the purposes of establishing and
DRO
Page 3 of 4
sustaining such former spouse coverage for Alternate Payee (including, but not limited to, electing
the appropriate base amount so that the Alternate Payee receives the monthly survivor annuity as
indicated in this paragraph).
12. If Participant leaves Federal service before retirement and applies for a refund of
employee contributions under the Plan, the OPM is directed not to pay the Participant a refund of
such employee contributions.
13. In no event shall the Alternate Payee have greater benefits or rights other than those
which are available to the Participant. The Alternate Payee is not entitled to any benefit not
otherwise provided by the Plan. The Alternate Payee is only entitled to the specific benefits
offered by the Plan as provided in this Order. All other rights, privileges and options offered by
the Plan not granted to Alternate Payee are preserved for the Participant.
14. The Plan shall issue individual tax forms to the Participant and Alternate Payee for
amounts paid to each such person.
15. In the event that the Plan inadvertently pays to the Participant any benefits that are
assigned to the Alternate Payee pursuant to the terms of this DRO, the Participant shall
immediately reimburse the Alternate Payee to the extent that he has received such benefit
payments, and shall forthwith pay such amounts so received directly to the Alternate Payee within
ten (10) days of receipt. In the event the Plan inadvertently pays to the Alternate Payee any
benefits that are not assigned to her pursuant to the terms of this DRO, the Alternate Payee shall
immediately reimburse the Participant to the extent she has received such benefit payments and
shall forthwith pay such amounts so received directly to the Participant within ten (10) days of
receipt.
16. In the event the Participant makes a one-time irrevocable election to transfer into the
Federal Employees Retirement System ("FERS") before his retirement, then Alternate Payee shall
be entitled to a portion of the Participant's Basic Annuity and/or a Refund of employee
contributions under FERS calculated in a manner similar to that which is enumerated in Sections
8, 9, 10, 11 and 12 above for the annuity and refund, respectively, and payable directly from FERS.
Additionally, Alternate Payee shall be entitled to a former spouse survivor annuity payable under
DRO
Page 4 of 4
FERS and determined in a similar manner to the survivor benefits set forth under Section 11
above. Further, such former spouse survivor annuity shall be payable directly from FERS.
17. If Participant takes any action that prevents, decreases, or limits the collection by
Alternate Payee of the sums to be paid hereunder, he shall make payments to Alternate Payee
directly in an amount sufficient to neutralize, as to Alternate Payee, the effects of the actions
taken by Participant.
18. The OPM shall notify the Alternate Payee and her legal representative when the
Participant makes an application for any benefit payments or withdrawals from the Plan.
19. The Court of Common Pleas of Cumberland County, Pennsylvania shall retain
jurisdiction to amend this Order, but only for the purpose of establishing it or maintaining it as a
Domestic Relations Order, provided, however, that no such amendment shall require the Plan to
provide any form of benefit or any option not otherwise provided by the Plan, and further provide
that no such amendment or right of the Court to so amend will invalidate this Order.
Accepted and Ordered this day of
CONSENT TO ORDER:
??, ?? Z , -/
aintiff/Alternate Payee Date
3i?1o&?
orney for lai iff/ Date
Alternate Pa
BY THE COURT
Judge
Defendant/Participant Date
Attorney for Defendant/ Date
Participant
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Sandra L. Meilton, Esquire
Daley Zucker Meilton Miner & Gingrich, LLC
1029 Scenery Drive
Harrisburg, PA 17109
(717) 6574795
smeilton Ddzmmzlaw.com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON, Docket No. 387 S 2004
Plaintiff
PACSES No. 910105454
V.
BRUCE H. SOLOMON,
Defendant (In Support)
ORDER OF COURT
AND NOW, this day of , 2008, upon presentation and
consideration of the attached Stipulation of the parties, it is hereby ORDERED and DECREED:
1) Upon issuance of a Decree in Divorce, Husband's Spousal Support obligation
shall convert to an alimony obligation terminable on the death of either party, or upon Wife's
cohabitation.
2) Husband's Spousal Support/Alimony obligation of One Thousand Six Hundred
Thirty ($1,630.00) Dollars per month, shall be terminated effective May 31, 2008; and
3) Any and all arrearages associated with PACSES Case Number 910105454 shall be
paid at Five Hundred ($500.00) Dollars per month until paid in full; and
4) Once any and all arrears are paid in full, this case shall be closed and marked
settled, discontinued and ended.
BY THE COURT,
Edward E. Guido, J.
0
Sandra L. Meilton, Esquire
Daley Zucker Meilton Miner & Gingrich, LLC
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
smeilton(d)dzmmglaw.com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON, Docket No. 387 S 2004
Plaintiff
PACSES No. 910105454
V.
BRUCE H. SOLOMON,
Defendant (In Support)
STIPULATION and AGREEMENT
.tr.
THIS AGREEMENT is made this & day of March, 2008, BY and BETWEEN Janet I.
Solomon of 58 Bourbon Red Drive, Mechanicsburg, Cumberland County, Pennsylvania,
hereinafter referred to as "Wife"
A
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Bruce H. Solomon of 332 Thorley Road, New Cumberland, York County, Pennsylvania,
hereinafter referred to as "Husband".
RECITALS
R.1: The Parties hereto were husband and wife joined in marriage on July 3, 1976 in
Altoona, Blair County, Pennsylvania; and
R.2: The Parties hereto are the natural parents of two (2) emancipated children; and
R.3: The Parties hereto separated on or about January 9, 2003; and
r
R.4: Wife previously filed an action for child and spousal support at the above-
referenced term and number and was awarded same; however, the child support has previously
terminated due to the emancipation of both children; and
R.5: An Order was entered by the Honorable Edward E. Guido on June 27, 2006,
wherein Husband was ordered to pay One Thousand Six Hundred Thirty ($1,630.00) Dollars per
month in spousal support effective June 9, 2006; and
R.6: Husband is planning to retire on May 3, 2008; and
R.7: The parties have reached a global agreement with regard to their divorce; and
R.8: The parties contemplate the issuance of a final Decree in Divorce on or before
March 20, 2008. Any payments made by Husband pursuant to this Stipulation after the issuance
of the Divorce Decree shall be considered alimony and as such, shall terminate on the death of
either party or Wife's cohabitation; and
R.9: The Parties agree that Husband's spousal support/alimony obligation shall be
terminated effective May 31, 2008; and
R.10: The Parties agree that any and all arrearages to PACSES Account Number
910105454 shall cease charging as of May 31, 2008, and that any and all arrearages shall be paid
at Five Hundred ($500.00) Dollars per month until paid in full; and
R.11: The parties are desirous of entering this support stipulation without the need for
further court intervention; and
R.12: Upon execution hereof, the Parties desire that this Stipulation and Agreement be
adopted as an Order of Court.
11
NOW THEREFORE, with the aforegoing recitals being hereinafter incorporated by
reference and deemed an essential part hereof and in consideration of the covenants and promises
hereinafter to be mutually kept and performed by each Party, as well as for other good and
valuable consideration, receipt of which is hereby acknowledged, and the parties, intending to be
legally bound, hereby agree as follows:
(1) The Parties agree that Husband's spousal support obligation of One Thousand Six
($1,630.00) Dollars shall convert to an alimony payment upon issuance of a Decree in Divorce.
(2) The Parties agree Husband's spousal suppordalimony obligation of One Thousand
Six Hundred Thirty ($1,630.00) Dollars per month, shall be terminated effective May 31, 2008;
and
(3) The Parties agree that any arrearage to PACSES Account Number 910105454
shall be paid at Five Hundred ($500.00) Dollars per month until paid in full; and
(4) The Parties agree that this matter should be closed and marked "settled,
discontinued and ended" upon payment in full of any and all arrearages; and
(5) All matters affecting the interpretation of this Agreement and the rights of the
parties hereto shall be governed by the laws of the Commonwealth of Pennsylvania; and
(6) This Agreement constitutes the entire understanding between the parties and there
are no covenants, conditions, representations, or agreements, oral or written, of any nature
whatsoever, other than those herein contained.
IN WITNESS WHEREOF, the parties hereto, intending to be legally bound hereby,
have hereunto set their hands and seals to this Agreement the day and year first above written.
WITNESS:
andra L. Meilton, Esq ire
Attorney for Defendant
anet I. Solomon, Plaintiff
LI)
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Bruce H. Solomon, Defendant
JANET I. SOLOMON, IN THE COURT OF COMMON PLEAS OF
Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA
V. No. 04-723-CIVIL
BRUCE H. SOLOMON, CIVIL ACTION - LAW
Defendant IN DIVORCE
AFFIDAVIT OF ACCEPTANCE OF SERVICE
I hereby accept service of the Divorce Complaint in the above matter.
Bruce H. Solomon
Dated: ?=?s Z b ) Z u D`?
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s,
M-n
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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON,
Plaintiff
V.
BRUCE H. SOLOMON
Defendant
No. 04-723-Civil
CIVIL ACTION -LAW
IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed
on February 18, 2004.
2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90)
days have elapsed from the date of the filing and service of the Complaint.
3. 1 consent to the entry of a final decree of divorce after service of notice of
intention to request entry of the decree.
I verify that the statements made in this affidavit are true and correct. I understand
that false statements herein are made subject to the penalties of 18 Pa.C.S.A. Section 4904
relating to unsworn falsification to authorities.
J net I. Solomon
Dated: ? A-/0 ?-
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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON,
Plaintiff
V.
BRUCE H. SOLOMON
Defendant
No. 04-723-Civil
CIVIL ACTION -LAW
IN DIVORCE
WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE
DECREE UNDER 1-53301(c) OF THE DIVORCE CODE
I consent to the entry of a final Decree of Divorce without notice.
2. 1 understand that I may lose rights concerning alimony, division of
property, lawyer's fees or expenses if I do not claim them before a divorce is granted.
3. 1 understand that I will not be divorced until a divorce decree is entered by
the Court and that a copy of the decree will be sent to me immediately after it is filed
with the Prothonotary.
I verify that the statements made in this affidavit are true and correct. I
understand that false statements herein are made subject to the penalties of 18 Pa.
C.S. §4904 relating to unsworn falsification to authorities.
A net I. Solomon
Dated: 3 /51M-
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Sandra L. Meilton, Esquire
DALEY ZUCKER MEILTON MINER & GINGRICH, LLC
1029 Scenery Drive
Harrisburg, Pennsylvania 17109
smeiltonAdzmmglaw.com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON,
Plaintiff Docket No. 2004-723 (Civil Term)
V.
CIVIL ACTION - LAW
BRUCE H. SOLOMON,
Defendant (In Divorce)
AFFIDAVIT OF CONSENT
1. A complaint in divorce under § 3301(c) of the Divorce Code was filed on
February 18, 2004.
2. The marriage of plaintiff and defendant is irretrievably broken and at least
ninety (90) days have elapsed from the date of filing and service of the Complaint.
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: 3 /oV/-L. 61? Bruce H. Solomon, Defendant
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Sandra L. Meilton, Esquire
DALEY ZUCKER MEILTON MINER & GINGRICH, LLC
1029 Scenery Drive
Harrisburg, Pennsylvania 17109
smeilton(a)dzmmglaw.com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON,
Plaintiff
Docket No. 2004-723 (Civil Term)
V.
BRUCE H. SOLOMON,
Defendant
: CIVIL ACTION - LAW
(In Divorce)
WAIVER OF NOTICE OF INTENTION
TO REQUEST ENTRY OF A DIVORCE DECREE
UNDER 43301(c) AND 63301(d) OF THE DIVORCE CODE
1. I consent to the entry of a final decree in divorce without notice.
2. I understand that I may lose rights concerning alimony, division of property,
lawyer's fees or expenses if I do not claim them before a divorce is granted.
3. I understand that I will not be divorced until a divorce decree is entered by the
Court and that a copy of the decree will be sent to me immediately after it is filed with the
prothonotary.
I verify that the statements made in this affidavit are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to
unworn falsification to authorities.
Date: 3 /1111 I-Loor
Bruce H. Solomon, Defendant
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J. Paul Helvy, Esquire
I.D. No. 53148
Audrey L. Buglione
Attorney I.D. No. 206587
McNees Wallace & Nurick LLC
100 Pine Street
P.O. Box 1166
Harrisburg, PA 17108-1166
(717) 237-5343
(717) 237-5300 (fax)
phelw@mwn.com
Attorneys for Plaintiff
JANET I. SOLOMON,
Plaintiff
V.
BRUCE H. SOLOMON,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
No. 04-723-CIVIL
CIVIL ACTION - LAW
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. Grounds for divorce: irretrievable breakdown under §3301(c) of the Divorce
Code.
2. Date and manner of service of the Complaint: Regular mail upon Defendant on
February 19, 2004.
1
3. Date of execution of the Affidavit of Consent required by § 3301(c) of the Divorce
Code: by Plaintiff: 3/05/2008; by Defendant: 3/04/2008. Plaintiffs Affidavit was
filed on 3/07/2008. Defendant's Affidavit was filed on 3/07/2008.
4. Related claims pending: N/A
5. Plaintiffs Waiver of Notice was filed on 3/07/2008. Defendant's Waiver of Notice
was filed on 3/07/2008.
MCNEES WALLACE & NURICK LLC
By
I.U. NO. 5314b
Audrey L. Buglione
I.D. No. 206587
100 Pine Street
P.O. Box 1166
Harrisburg, PA 17108-1166
(717) 232-8000
Attorneys for Plaintiff
Date:
a- A.
CERTIFICATE OF SERVICE
The undersigned hereby certifies that on this date a true and correct copy of the
foregoing Praecipe to Transmit was served by hand delivery upon the following:
Lindsay Gingrich Maclay, Esquire
Daley Zucker Meilton Miner & Gingrich LLC
1029 Scenery Drive
Harrisburg, PA 17109
k 9/
renda Williams
Dated: 3/06/2008
'C3 `• °°
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,:
JANET I. SOLOMON IN THE COURT OF COMMON PLEAS
Plaintiff CUMBERLAND CO., PENNSYLVANIA
V. No.
BRUCE H. SOLOMON CIVIL ACTION -LAW
Defendant IN DIVORCE
AVISO
Le ban demandado a usted en la corte. Si usted quiere defenderse de estas demandas
expuestas en las paginas siguientes, usted tiene viente (20) dias de plazo al partir de la fecha
de la demanda y la notificacion. Usted debe presentar una apariencia escrita o en persona o
por abogado y archivar en la corte en forma escrita sus defensas o sus objeciones a las
demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomara
medidas y puede entrar una orden contra usted sin previo aviso o notifcacion y por cualquier
queja o alivio que es pedido en la peticion de demanda. Usted puede perder dinero o
propiedad u otros derechos importantes para usted.
LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATAMENTE. SI NO TIENE
ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERICIO,
VAYA EN PERSONA O LLAMA POR TELEFONO A LA OFICINA CUYA
DIRECION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE
PUEDE CONSEGUIR ASISTENCIA LEGAL.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, PA 17013
(717) 249-3166
JANET I. SOLOMON
Plaintiff
V.
BRUCE H. SOLOMON
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND CO., PENNSYLVANIA
No. 611 - 1.2,3
CIVIL ACTION -LAW
IN DIVORCE
COMPLAINT UNDER SECTION 3301 (e)
OF THE DIVORCE CODE
AND NOW comes JANET I. SOLOMON, by and through her counsel, Killian &
Gephart, who represents as follows:
1. Plaintiff, JANET I SOLOMON, is an adult individual, who currently resides
at 58 Bourbon Red Drive, Mechanicsburg, Cumberland County, Pennsylvania 17050.
2. Defendant, BRUCE H. SOLOMON, is an adult individual whose last known
address was 5430 Oxford Circle, Mechanicsburg, Cumberland County, Pennsylvania 17055.
3. Plaintiff avers that she has been a bonafide resident of the Commonwealth of
Pennsylvania for a period of at least six (6) months prior to the filing of this Complaint.
4. The Plaintiff and Defendant were married on July 3,1976, in Altoona,
Pennsylvania.
5. Plaintiff avers that there is a child of the parties under the age of 18, namely:
Daniel J. Solomon, dob May 12, 1988.
6. There have been no other prior actions of divorce or annulment filed by either
of the parties hereto.
7. Plaintiff has been advised of the availability of counseling and that Plaintiff
has the right to request that the Court require the parties to participate in counseling.
The marriage is irretrievably broken.
COUNTI
CLAIM FOR EQUITABLE DISTRIBUTION OF
MARITAL PROPERTY UNDER SECTION 401
OF THE DIVORCE CODE
9. The averments of Paragraphs 1 through 8 are hereby incorporated by reference
thereto.
10. The Plaintiff and Defendant are the owners of various items of property
acquired during their marriage which are subject to equitable distribution by this Court.
COUNT II
CLAIM FOR ALIMONY
11. The averments of Paragraphs 1 through 10 are hereby incorporated by reference
thereto.
12. The Plaintiff believes and avers that she is entitled to an award of alimony
pursuant to the provisions of the Divorce Code.
COUNT III
CLAIM FOR ALIMONY PENDENTE LITE, COUNSEL
FEES COSTS AND EXPENSES
13. The averments of Paragraphs 1 through 12 are hereby incorporated by
reference thereto.
14. The Plaintiff believes and avers that she is entitled to an award of reasonable
alimony pendente lite, counsel fees, costs and expenses.
15. Defendant is able to pay Plaintiff alimony pendente lite, counsel fees, costs and
expenses incidental to this divorce action.
WHEREFORE, the Plaintiff requests the Court enter a Decree:
a. Dissolving the marriage between Plaintiff and Defendant;
b. Equitably distributing all marital property owned by the parties hereto;
C. Directing the Defendant to pay alimony to the Plaintiff,
d. Directing the Defendant to pay alimony pendente lite and Plaintiffs
counsel fees and the costs of this proceeding; and
e.
just.
Granting such further relief as the Court may determine equitable and
Respectfully submitted,
KILLIAN & GEPHART
Dated: a1111oq
J. P961 Helvy, Esquire
2 IS Pine Street
P.O. Box 886
Harrisburg, PA 17108
(717) 232-1851
Attorney I.D. #53148
Attorneys for Plaintiff
VERIFICATION
I hereby verify that the statements of fact made in the foregoing document are true
and correct to the best of my knowledge, information and belief. I understand that any false
statements therein are subject to the penalties contained in 18 Pa.C.S.A. §4904, relating to
unsworn falsification to authorities.
CERTIFICATE OF SERVICE
I do certify that I served a true and correct copy of the within document upon the
following by depositing a copy of same in the United States mail, postage prepaid,
addressed as follows:
Bruce H. Solomon
P.O. Box 366
Harrisburg, PA 17108
;e?tary ?to
Cl
Christy SJ. PAUL HELVY, ESQUIRE
Killian & Gephart
218 Pine Street
P.O. Box 886
Harrisburg, PA 17108-0886
(717) 232-1851
Dated: ' i f I io q
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JANET I. SOLOMON,
Plaintiff
v
BRUCE H. SOLOMON,
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
No. 04-723 - Civil
CIVIL ACTION LAW
IN DIVORCE
PRAECIPE TO ENTER APPEARANCE
TO THE PROTHONOTARY:
Please enter the appearance of Susan M. Kadel, Esquire, on behalf of the Defendant, Bruce
H. Solomon, in the above-captioned action.
Date: / a? any
By? /
Susan M. Kadel, Esquire
James, Smith, Dietterick & Connelly, LLP
Post Office Box 650
Hershey, PA 17033
(717) 533-3280
PA I.D. No. 44837
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JANET I. SOLOMON,
Plaintiff
V.
BRUCE H. SOLOMON,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY,
PENNSYLVANIA
NO. 04-723-Civil
CIVIL ACTION-LAW
IN DIVORCE
PLAINTIFF'S MOTION TO COMPEL
COMPLIANCE WITH DISCOVERY REQUESTS
Attorney Responsible: Steven K. Bainbridge, Esquire (pursuant to C.C.R.P. 206-2(b))
AND NOW comes the Plaintiff, by and through her attorneys, Killian & Gephart,
LLP, who hereby avers the following:
Plaintiff, JANET I. SOLOMON, and Defendant, BRUCE H. SOLOMON,
were lawfully married on July 3, 1976, in Altoona, Pennsylvania.
2. On February 18, 2004, Plaintiff filed a Complaint in Divorce.
Via correspondence dated February 20, 2004, Plaintiff's counsel sent to
Defendant Plaintiff's First Set of Interrogatories Directed to Defendant and Plaint's First
Request for Production of Documents Directed to Defendant.
4. In accordance with Pa.R.C.P. No. 4006 and 440(b), Plaintiff should have been
served with Answers to these requests within thirty (30) days, on March 22, 2004, and
Plaintiff has not received such Answers.
Plaintiff brings this Motion under the authority of Pa.R.C.P. No. 4019(a)(1),
and 4019(c)(5), in regards to Defendant's failure to serve answers to written interrogatories
submitted pursuant to Pa.R.C.P. No. 4005 and 1920.22(b), and in regards to Defendant's
failure to respond to requests for production of documents submitted pursuant to Pa.R.C.P.
No. 4009.
6. Since the Defendant has failed to Answer the Plaintiff's First Set of
Interrogatories Directed to Defendant and Plaints First Request for Production of
Documents Directed to Defendant, the Plaintiff has incurred reasonable counsel fees in
connection with preparation and presentation of this motion.
7. The failure of the Defendant to answer the requests impedes Plaintiffs efforts
to proceed to equitable distribution.
On March 23, 2004, the concurrence of prior opposing counsel was sought in
regard to this Motion; prior opposing counsel stated that the Defendant would not authorize
her to speak to Plaintiffs counsel in regard to this matter and other related matters, and thus
she withdrew from her representation of Defendant. Consequently, opposing counsel did
not concur with this Motion, stated herein pursuant to C.C.R.P. 206-2(c).
WHEREFORE, Plaintiff requests this Honorable Court to enter an order that:
1. Defendant shall answer Plaintiffs First Set o(Interrogatories Directed to
Defendant and Plaints First Request for Production of Documents Directed
to Defendant by April 26, 2004.
2
Failure to comply with this Order shall result in sanctions as the Court shall
deem proper, and shall / shall not _ include Plaintiff's reasonable
attorney's fees of $200 incurred in connection with preparation and
presentation of this Motion.
Dated: 16I a I
Respectfully submitted,
I"
J. Paul Helvy
Attorney I. D. #53148
Steven K. Bainbridge
Attorney I.D. #91018
Killian & Gephart, LLP
218 Pine Street
P.O. Box 886
Harrisburg, PA 17108
(717) 232-1851
CERTIFICATE OF SERVICE
I do hereby certify that I served a true and correct copy of the within document upon the
following by depositing a copy of same in the United States mail, postage prepaid, addressed
as follows:
Bruce Solomon
P.O. Box 336
Harrisburg PA 17108
Date: ? 6 0 y-
Steven K. Bainbridg
Killian & Gephart,
218 Pine Street
P.O. Box 886
Harrisburg, PA 17108-0886
(717) 232-1851
Attorneys for Plaintiff
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JANET I. SOLOMON,
Plaintiff
v
BRUCE H. SOLOMON,
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
No. 04-723 - Civil
CIVIL ACTION - LAW
IN DIVORCE
PRAECIPE TO WITHDRAWAL/ENTER APPEARANCE
TO THE PROTHONOTARY:
Please withdraw my appearance as counsel for the Defendant, Bruce H. Solomon, in the
above-captioned action.
Date: 4, tC C 'Waa
B . _-
usan . ICadlel, Esquire
James, Smith, Dietterick & Connelly, LLP
Post Office Box 650
Hershey, PA 17033
(717) 533-3280
PA I.D. No. 44837
TO THE PROTHONOTARY:
Please enter the appearance of the Defendant, Bruce H. Solomon, Pro Se, in the above-
captioned action.
Date: 313 D L D b y
By: L
Bruce H. Solomon
Post Office Box 336
Harrisburg, PA 17108
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JANET I. SOLOMON,
Plaintiff
V.
BRUCE H. SOLOMON,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. 04-0723 CIVIL TERM
ORDER OF COURT
AND NOW, this 5`s day of April, 2004, upon consideration of Plaintiff's Motion
To Compel Compliance with Discovery Requests, a Rule is hereby issued upon
Defendant to show cause why the relief requested should not be granted.
RULE RETURNABLE within 15 days of service.
BY THE COURT,
V6'.?Paw? ?Aelvy' 65$
Steven K. Bainbridge, Esq.
218 Pine Street
P.O. Box 886
Harrisburg, PA 17108\
Attorney for Plaintiff
/Bruce Solomon
P.O. Box 336
Harrisburg, PA 17108
Defendant, Pro Se
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JANET I SOLOMON, : IN THE COURT OF COMMON PLEAS
Plaintiff : OF CUMBERLAND COUNTY, PA
VS. : No. 04-723 CIVIL
BRUCE H. SOLOMON, : CIVIL. ACTION -LAW
Defendant : IN DIVORCE
PRAE.CIPE, TO ENTER APPEARANCE
TO THE PROTHONOTARY:
Please kindly enter the appearance of Jane M. Alexander, Esquire, as counsel for
Defendant, Bruce H. Solomon, in the above-captioned matter.
Date:
Respectfully submitted,
eyRT. Alexander 1 squir
1 8 S. Baltimore e reet
0. Box 421
illsburg, PA 17019-0421
717) 43,2-4514
Supreme Court ID #07355
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Revised. 4/28/04 11.2532 AM
]619x236
DICKINSON COLLEGE,
Plaintiff
V.
HEATHER R. BELLIS,
Defendant
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 04-761
CIVIL ACTION-LAW
JURY TRIAL OF TWELVE DEMANDED
PRAECIPE TO DOCUMENT SERVICE AND COST OF SERVICE
PURSUANT TO THE PENNSYLVANIA LONG ARM STATUTE
I hereby certify that a copy of the Complaint was served on Defendant Heather R. Bellis, by
the Tioga County Sheriff s Department of New York on April 17, 2004.
Attached is the Affidavit of Service dated April 19, 2004•, and cost of service was $17.76.
MARTSON
David R. Galloway,_E-4
I.D. No. 87326
Ten East High Street
Carlisle, PA 17013-3093
(717) 243-3341
WILLIAMS & OTTO
Date: April 28, 2004 Attorneys for Plaintiff
common ploaz 2=*.
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KIMBERLY J. WARD
Notary Public, State of New York
No. 01 WA5042923
Oualified in Tioga County nn
Commission Expires May 1, 20 nr
Martson Deardorff Wili Ott-
TER East High Strast.
saril l'e 131
CERTIFICATE OF SERVICE
I, Tricia D. Eckenroad, an authorized agent for Martson Deardorff Williams & Otto, hereby
certify that a copy of the foregoing Praecipe was served this date by depositing same in the Post
Office at Carlisle, PA, first class mail, postage prepaid, addressed as follows:
Ms. Heather R. Bellis
53 Ithaca Street
Waverly, NY 13837
MARTSON DEARDORFF WILLIAMS & OTTO
Y
ricia D. Eckenroad
Ten East High Street
Carlisle, PA 17013
(717) 243-3341
Dated: April 28, 2004
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McNEES WALLACE & NURICK LLC
By: J. Paul Helvy
Attorney ID No. 53148
100 Pine Street
Harrisburg, PA 17108-1166
(717) 232-8000
(717)237-5300 facsimile
phelvy@mwn.com
Attorneys for Plaintiff
Janet I. Solomon, IN THE COURT OF COMMON PLEAS OF
Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA
V. No. 04-723-CIVIL
Bruce H. Solomon, CIVIL ACTION - LAW
Defendant IN DIVORCE
MOTION FOR APPOINTMENT OF MASTER
Janet I. Solomon (Plaintiff) moves the court to appoint a master with respect to
the following claims:
(x) Divorce (x) Distribution of Property
( ) Annulment (x) Support
(x) Alimony (x) Counsel Fees
(x) Alimony Pendente Lite (x) Costs and Expenses
and in support of the motion states:
(1) Discovery is complete as to the claim(s) for which the appointment of a
master is requested.
(2) The defendant has appeared in the action by his attorney, Jane M.
Alexander, Esquire).
(3) The statutory grounds for divorce are 3301(c) and 3301(d).
(4) The action is contested with respect to the following claims: divorce,
alimony, alimony pendente lite, equitable distribution, counsel fees and costs and
expenses.
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(5) The action involves complex issues of law or fact.
(6) The hearing is expected to take one day.
(7) Additional information, if any, relevant to the motion: none.
Date: I r t
(P
ORDER APPOINTING MASTER
And now , 20 , Esquire,
is appointed master with respect to the following claims:
By the Court:
J
-2-
CERTIFICATE OF SERVICE
The undersigned hereby certifies that on the I ? "'day of May, 2006, a true and
correct copy of the foregoing document was served by first-class mail, postage prepaid,
upon the following:
Jane M. Alexander, Esquire
148 South Baltimore Street
P.O. Box 421
Dillsburg, PA 17019-0421
MCNEES, WALLACE & NURICK, LLC
By: i'?
Lynn B. Lo e, Secretary for
J. Paul Helvy, Esquire
Attorney ID No. 53148
100 Pine Street
Harrisburg, PA 17108-1166
(717) 237-5343
(717)237-5300 facsimile
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MAY 1 9 2006
McNEES WALLACE & NURICK LLC
By: J. Paul Helvy
Attorney ID No. 53148
100 Pine Street
Harrisburg, PA 17108-1166
(717) 232-8000
(717)237-5300 facsimile
phelvy@mwn.com
Attorneys for Plaintiff
Janet I. Solomon, IN THE COURT OF COMMON PLEAS OF
Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA
V. No. 04-723-CIVIL
Bruce H. Solomon, CIVIL ACTION - LAW
Defendant IN DIVORCE
MOTION FOR APPOINTMENT OF MASTER
Janet I. Solomon (Plaintiff) moves the court to appoint a master with respect to
the following claims:
(x) Divorce (x) Distribution of Property
() Annulment (x) Support
(x) Alimony (x) Counsel Fees
(x) Alimony Pendente Lite (x) Costs and Expenses
and in support of the motion states:
(1) Discovery is complete as to the claim(s) for which the appointment of a
master is requested.
(2) The defendant has appeared in the action by his attorney, Jane M.
Alexander, Esquire).
(3) The statutory grounds for divorce are 3301(c) and 3301(d).
(4) The action is contested with respect to the following claims: divorce,
alimony, alimony pendente lite, equitable distribution, counsel fees and costs and
expenses.
(5) The action involves complex issues of law or fact.
(6) The hearing is expected to take one day.
(7) Additional information, if any, relevant to the motion: none.
Date: I r a
ORDER APPOINTING MASTER
And now a a 20 (, &Ak It Esquire,
is appointed master with espect to the following claims: QLA A.J a?
By the urt:
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OS :C Vd N AN I'M
1\U iC,Nl(ll 1 W'-'d J?i JO
JANET I. SOLOMON,
Plaintiff
V.
BRUCE H. SOLOMON,
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 04-723- CIVIL
CIVIL ACTION - LAW
IN DIVORCE
PLAINTIFF'S PRE-TRIAL STATEMENT
IN COMPLIANCE WITH Pa.R.C.P 1920.33(b)
PROCEDURAL AND FACTUAL BACKGROUND:
The Plaintiff, Janet I. Solomon, (hereinafter referred to as "Wife"), and the
Defendant, Bruce H. Solomon, (hereinafter referred to as "Husband"), were married on
July 3, 1976, in Altoona, Pennsylvania. There are two children bom of the marriage.
Justin C., who is 21 years of age, and Daniel J., who is 18 years of age. Both sons live
at home with their Mother. Husband is employed as a Federal Agent in the Office of the
Inspector General. Wife is employed with the Pennsylvania Department of Public
Welfare as a Medicaid Program Specialist.
The parties have been separated since January 9, 2003. Wife filed a Divorce
Complaint raising the claims of Equitable Distribution, Alimony, Alimony Pendente Lite
and Counsel Fees, Costs and Expenses on February 18, 2004 indexed to the above
term and number in the Court of Common Pleas, Cumberland County, Pennsylvania.
On May 18, 2006, a Wife filed a Motion for Appointment of Master, and on May
22, 2006, an Order was entered appointing E. Robert Elicker II, Esquire, as Master.
II. MARITAL ASSET(S):
See Spreadsheet (attached hereto and marked as Exhibit "A")
III. NON-MARITAL ASSET(S):
To the best of Wife's knowledge, neither of the parties has significant non-marital
assets apart from the non-marital component of their employee benefits.
IV. WIFE'S INCOME AND EXPENSES:
Wife's Income and Expense Statement is attached hereto as Exhibit "B".
V. MARITAL DEBT(S):
Other than the debt associated with the marital residence, neither of the parties
has significant marital debt.
VI. WITNESSES:
A. The parties will testify regarding the marital assets and debts and the
factors relevant to equitable distribution and alimony;
B. Harry Leister, Actuary, will testify regarding the value of Husband and
Wife's pensions.
C. Mark Heckman, Appraiser will testify regarding the value of the
marital residence.
Wife reserves the right to supplement this list prior to the Hearing if
additional witnesses are identified.
VII. EXHIBITS:
1. Appraisal of the marital residence performed by Mark Heckman as of April
7, 2006.
2. Statement regarding the balance of the mortgage.
3. Documentation regarding expenses associated with maintaining the marital
residence.
2
4. Documentation regarding Wife's SERS pension plan including Harry
Leister's appraisal of said plan.
5. Documentation regarding Wife's PSERS pension.
6. Documentation regarding Husband's CSRS pension as well as an
appraisal of said pension performed by Harry Leister.
7. Documentation regarding Husband's Thrift Savings Plan.
8. Documentation regarding Husband's VanGuard IRA.
9. Documentation regarding the parties' joint VanGuard Money Market
account.
10. Documentation regarding the MBNA CD account.
11. Documentation regarding Wife's MBNA Roth IRA, Acct. #1117-1.
12. Documentation regarding MBNA Roth IRA, Acct. #6373-5.
13. Documentation regarding MBNA Roth IRA, Acct. #10139-4.
14. Documentation regarding the Waypoint Christmas Club.
15. Documentation regarding Husband's expenditures from the Waypoint
checking account.
16. Documentation regarding Husband's Fulton Bank savings account.
17. Documentation regarding Husband's Fulton Bank checking account.
18. Documentation regarding Husband's Commercial Bank savings account.
19. Documentation regarding refund from a cruise that the parties had paid for.
20. Documentation regarding Husband's accrued leave as of date of
separation. Wife reserves the right to supplement this list prior to trial.
3
VIII. COUNSEL FEES:
To be provided at trial.
IX. PERSONAL PROPERTY:
The vast majority of the personal property has been divided to the satisfaction of
the parties.
X. PROPOSED RESOLUTION:
Wife proposes that the marital assets be divided with Wife receiving sixty (60%)
percent and Husband receiving forty (40%) percent and Wife receiving alimony for an
indefinite period of time.
Respectfully submitted,
McNEES WALLACE & NURICK LLC
By
J. Pa elvy
Aud'rney N 148
100 Pine
Harrisburg, PA 17108-1166
(717) 237-5343
(717) 237-5300 facsimile
Attorneys for Plaintiff
Dated: August 7, 2006
4
Ago
Janet I. Solomon v. Bruce H. Solomon Date of Marriage: 7103!16
No. 04.723 Civil Date of Separation: 1109103
MARITAL ASSETS
Item Description of Property Names of all Marital Value (Net Date of Valuation Notes
No. ( Liens, encumbrances, non- Owners of any liens or
marital portion, etc., noted in (Husband, Wife, encumbrances)
parentheses) Joint)
1 Real Estate: 58 Bourbon Red Joint $ 220,854.00 5110/2006 Mark Heckman's
Drive, Mechanicsburg, PA appraisal assumes
(Note: Appraised by Mark that the repairs to
Heckman as of 4/7/08 for the marital
$275,000; subject to residence
Mortgage to Sovereign Bank; (required due to a
mortgage balance $54,146 as fire) in the amount
of 4/18/06; leaving equity of of -$4000 would
$220,854) be completed.
These repairs are
not yet complete
because Husband
has failed to sign
the insurance
check and return it
to Wife.
2 SERS Pension Plan through Wife $ 62,354.00 8/30/2004
the Department of Public
Welfare
3 PSERS Pension Wife 1,991.00 6/30/1998
4 CSRS Pension through Office Husband $ 965,106.00 8/30/2004
of Inspector General
5 Thrift Savings Plan (Note: Husband $ 78,197.00 4/30/2003 need current
ending balance as of January
12003) statement from
Husband
6 Value of Husband's accrued Husband $ 75,040.00 1/11/2003 Husband's
sick and annual leave as of paystub as of
the date of separation 1111/03 indicates
that he had
accrued 237 hours
of annual leave
and 1337 hours of
sick leave.
Husband's hourly
rate at that time
was $47.675/hour.
7 Vanguard IRA Husband $ 43,096.00 9/30/2003 need current
statement from
Husband
8 Vanguard Money Market Joint $ 18,997.00 3131/2006
Fund #5645
9 MBNA CD Account Joint $ 27,825.00 4/20/2003
#403950987 (Note: this
matured 4/20/03 with a value
of $27,825, was cashed in
and equally divided between
Husband and Wife on
4/20/03).
Janet I. Solomon v. Bruce H. Solomon Date of Marriage: 7/03176
No. 04.723 Civil Date of Separation: 1/09/03
10 MBNA Roth IRA #1117-1 Wife $ 3,601.00 9/30/2004
11 MBNA Roth IRA 06373-5 Wife 54 810.00 3/31/2006
12 MBNA Roth IRA #10139-4 Wife 2,426.00 3/31/2006
13 Waypoint Christmas Club Joint $ 2,000.00
(Note: this account contained
$2,000 and was withdrawn by
Husband (see Husband's
response to Interrogatory
14 Waypoint Checking Account Joint
#100064111 (Wife believes
that Husband improperly
utilized $14,550 from this
account about which she will
testify. Wife withdrew $8,500
from this account since date
15 Fulton Bank Savings Account Husband $ 5,269.00 1/1/2003
#1371-30517 (Note: 1/1/03
balance $5.269).
16 Fulton Bank Checking Husband $ 1,621.00 1120/2003
Account #3622-324330
(Note: 1/20/03 statement
indicates 1/7/03 balance of
Si 6211
-
17 Commerce Bank Savings Husband $ 1,150.00 9/30/2002
Account 26006951
18 Cruise Money Refund joint 1,200.00
19 Term Life Insurance Policy Husband
thro h employer)
20 Term Life Insurance Policy Wife
(through employer)
21 2001 Mazda Prot 696 LX Husband
22 1997 Honda Accord Station Wife
Wa on
23 PSECU Loan on 1998 Saturn Wife
24 Personal Joint
25 Cash Joint 500.00
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V
INCOME AND EXPENSE STATEMENT OF
JANET I. SOLOMON
SSN 181-444077 DR# 910105454 DATE 4/30/06
THIS STATEMENT MUST BE FILLED OUT
(If you are self-employed or if you are salaried by a business of which you are owner in whole or
in part, you must also fill out the Supplemental Income Statement which appears on the last
page of this Income and Expense Statement.)
INCOME
(a) Wages/Salary
Employer & Address PA Dept. o f Public W elfare, ON
Job Title/Description Human Ser vices Spe cialist
Pay Period (weekly,
Gross Pay per Pay Period .......... .............. .................
Payroll Deductions:
Federal Withholding... ... ............ ....... $ 235.72
Social Security ........................... .......$ 97.65
Local Wage Tax ......................... .......$ 25.20
State Income Tax ....................... .......$ 48.35
Retirement ................................. .......$ 98.44
Health Insurance ........................ .......$ n/a
Other (specify) Medicare ......... .......$ 22.84
Unemployment ......................... .......$ 1.42
TOTAL ...................................... .......$ 529.62
Net Pay per Pay Period ............................................................................................. $ 1045.38
(b) Other Income Week Month Year
Interest/Dividends .......................... ....$ $ $ 671.43
Pension/Annuity ............................. ....$ $ $
Social Security ............................... ....$ $ $
Rents/Royalties .............................. ....$ $ $
Expense Account ........................... ....$ $ $
Gifts ............................................... ....$ $ $
Unemployment Compensation ...... ....$ $ $
Workmen's Compensation... .......... .... $ $ $
Total, Other Income ................................... ....$ $ $_ 671.43
INCOME AND EXPENSE STATEMENT OF
I verify that the statements made in this Income and Expense
Statement are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.
C.S. §4904 relating to unsworn Isrific-a?[to a*orities.
Date: 4/30/06 e StJ c-?'"•+"??
Plaintiff
............................. $ 1575.00
d
Household Child Household Child
Week Week Month Month
EXPENSES
Home
Mortgage/Rent .................................$ $ $ 1.050.00 $
Maintenance .................................... $ $ $-A0-000 $
Utilities (telephone, heating
electric, etc.) ..................................$ $ $ 60200 $
Employment (transportation,
lunches) ........................................$ $ $ 100.00 $
Taxes
Real Estate .................................... .. $ $ $_ _Z42.00 $
Personal Property .......................... ..$ $ $ 100.00 $
Income ........................................... ..$ $ $ 162.00 $
Insurance
Homeowners .................................. .. $ $ $_ __E5.00 $
Automobile ..................................... .. $ $ $ 350.00 $
Life/Accident/Health (Justin)......... .. $ $ $- -3-50.00 $
Other Deductibles ......................... .. $ $ $_ _125.00 $
repairs)
..
fuel
Automobile (payments .. $ $ $ 700.00 $
..
,
,
Medical
Doctor, Dentist, Orthodontist .......... .. $ $ $ 100.00 $
Hospital .......................................... .. $ $ $ $
Special (glasses, braces, etc.) ....... .. $ $ $ 100.00 $
Education
Private, Parochial School ............... .. $ $ $ $
College Dan beginning $106......... .. $ $ $ 600.00 $
Personal
Clothing ............................................ $
Food ................................................ $
Other (household supplies,
barber, etc) ................................... $
Credit payments and loans .............. $
Miscellaneous
Household help/child care .................. .... $
Entertainment (inc. papers,
books, vacation, pay TV, etc.)... .... $
Gifts/Charitable contributions ....... .... $
Legal Fees ................................... ....$
Other child supportlalimony
payments ................................. ..... $
$ $ 100.00 $
$ $ 600.00 $
$ $ 150.00 $
$ $ 400.00 $
$ $ 150.00 $
$ $- --2-5-.00 $
$ $ 500.00 $
Other (specify) Pet ................................. $ $ $ 100.00 $
Total Expenses ...................................... $ $ $ 7.059.00 $
-2-
Ownerships
PROPERTY OWNED Description Value H W J
Checking Accounts ........ PSECU $ 1,000.00 x
SOVEREIGN $ 1.500.00 - x _
Savings Accounts .......... $ -
Credit Union ................... MONEY MARKET $10.000.00 - x _
$ -
Stocks/Bonds ................. VANGUARD $15.000.00 - x
$ - -
Real Estate .................... HOME $260.000.00 - x
Other ............................. CARS: HONDA $ 2.000.00
JETTA (lien) $ 2.000.00 x -
Total, Property ............... $291.500.00 -
Coverage
INSURANCE Company Policy No. H W C
Hospital ........... ..... Health America 850671337 x x x
Medical .......................... _
Health/Accident .............. _
Disability Income............ _
Other (dental, etc)........... PEBTF 181-44-4077 ?C x
(sH - Husband, W - Wife, J - Joint, C - Child)
SUPPLEMENTAL INCOME STATEMENT
A. This form must be filled out by a person who (check one):
(1) operates a business or practices a profession; or
(2) is a member of a partnership or joint venture; or
(3) is a shareholder in and is salaried by a closed corporation or similar entity.
B. Attach to this statement a copy of the following documents relating to the business,
profession, partnership, joint venture, corporation or similar entity,
1) the most recent Federal Income Tax Return, and
2) the most recent Profit and Loss Statement.
C. Name and Address of business:
Telephone Number
D. Name and Address (if different than C) of accountant, controller or other person in
charge of financial records:
E. (1) Annual income from business ...................................................... $
(2) How often is income received? .....................................................................................$
(3) Gross income per pay period ............. ................................... $
(4) Net income per pay period ........................................................... $
(5) Specific deductions if any ............................................................ $
-3-
CERTIFICATE OF SERVICE
AND NOW, on this r7?{ day of 2006, I, Lynn B.
Lowe, Secretary for J. Paul HeeIvy, Esquire, hereby certify that I have served a true and
correct copy of the within document via first class mail as follows:
Jane M. Alexander, Esquire
148 South Baltimore Street
P.O. Box 421
Dillsburg, PA 17019-0421
McNEES WALLACE & NURICK LLC
BY (V IA.A- & 6
P
Lyn B. Lo e, Secretary for
J. Paul Helvy, Esquire
I.D. No. 53148
100 Pine Street
P.O. Box 1166
Harrisburg, PA 17108-1166
Phone: 717 237-5343
Attorneys for Plaintiff
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JANET L SOLOMON, IN THE COURT OF COMMON PLEAS
Plaintiff OF CUMBERLAND COUNTY, PA
vs. NO. 04-723 CPA IL
BRUCE H. SOLOMON, : CIVIL ACTION - LAW
Defendant . IN CUSTODY
DEFENDANT'S PRE-TRIAL STATEMENT
IN COMPLIANCE WITH Pa. R- C. P, 1920.33(b)
AND NOW, this 18th day of August, 2006 comes the Defendant, Bruce H Solomon, by
and through his attorney, Jane M. Alexander, Esquire, and files this statement as follows:
1. HISTORY OF CASE:
1. Plaintiff; Janet I. Solomon, (hereinafter referred to as "Wife"), age 54, resides at
58 Bourbon Red Drive, Mechanicsburg, PA 17055.
2. Defendant, Bruce H. Solomon, (hereinafter referred to as "Husband"), age 51,
resides at 332 Thorley Road, New Cumberland, PA 17070.
3. The parties were married July 3, 1976 in Altoona, Pennsylvania and separate
January 9, 2003.
4. There were two (2) children born of the marriage: Justin C. Solomon, age 21, and
Daniel J. Solomon, born May 12, 1988, age 18. Both children, although no longer
minor, live with their mother.
5. Wife filed for divorce on February 18, 2003 to the above captioned number and
term in the Court of Common Pleas of Cumberland County, Pennsylvania.
6. The Divorce Complaint raised the claims of Equitable Distribution, Alimony,
Alimony Pendente Lite, and Counsel Fees, costs and expense.
Child support and spousal support has been paid by Husband for Wife and two (2)
children, now one (1) child, under a support order 387 S 2004, PACSES Case No.
910105454.
8. Extensive discovery and exchange of information and documentation has
occurred but no resolution of issues was achieved.
9. A Motion for Appointment of Master was filed by Wife on May 18, 2006 and on
May 22, 2006 E. Robert Elicker, II, Esquire was appointed as Master.
II. MARITAL ASSETS:
The marital assets of the parties are as set forth on the Inventory and
Appraisement with documentation attached.
III. NON-MARITAL ASSETS:
From information exchanged, Husband believes there are no non-marital assets to
be reported.
W. HUSBAND'S INCOME AND EXPENSES:
Statement is attached hereto. His income and expense have not changed since
submitted to Domestic Relations at last support hearing June 6, 2006.
V. MARITAL DEBTS:
The only significant marital debt is the mortgage to Sovereign Bank.
VI. WITNESSES:
Husband as to his knowledge of the marital assets, debts, equitable distribution
and basis for denying alimony.
2. Wife, as on cross-examination to marital assets, her income and expenses.
VII. EXPERT WITNESS:
1. Representative of Pension Appraisers, Inc (did valuation of Defendant's Pension
August 1, 2005)
Husband reserves the right to call additional witnesses with proper notice to court and
counsel.
VIII. EXHIBITS:
A. Husband's Income and Expense Statement with 2005 income tax return and pay
stubs.
B. CSRS Pension evaluation by Pension Appraisers, Inc. August 1, 2005
C. Thrift Savings Plan as of December 31, 2005 and April 30, 2003
D. 2003 Husband's Benefit Statement.
E. Husband's Vanguard statement April 4, 2006.
F. Vanguard Money Market -joint account no. 95645 as of April 9, 2006.
G. Waypoint Bank Checking Account as of January 5, 2003.
H. Fulton Bank Savings account no. 1371-30517.
I. Fulton Bank checking account no. 3622-324338.
J. Commerce Bank Savings account. Closed September 30, 2002.
K. List of Savings Bonds purchased for Daniel.
IX PERSONAL PROPERTY:
Some personal property has been divided but the majority of the personal
property, household furniture and fiunishing have been retained by Wife. Husband only
specific requests are grandfather clock, personal papers.
However, some value should be agreed upon for the furniture and appliances for
purpose of equitable distribution.
X. PROPOSED RESOLUTION:
Wife has resided in marital residence since date of separation. Husband is
requesting consideration for implied rents to date.
Husband proposes that because of the parties' respective employment, age of the
parties, and that three are no longer minor children that the assets of the parties be
divided 50/50.
The additional years that Wife can continue to be employed with attendant
increase in wages, benefits, and pension coupled with the value of the marital assets she
has Husband does not believe the award of alimony for any period of time is warranted.
Respectfully submitted,
rney for Pl ' tiff
,-eme Court I. D. #07355
S. Baltimore Street
;burg, PA 17019
(717) 4324514
CERTIFICATE OF SERVICE
I hereby certify that on this date a copy of the foregoing Inventory and Appraisement was
served on Plaintiffs counsel in the manner indicated below:
First Class Mail addressed as follows:
J. Paul Helvy, Esquire
McNees Wallace & Nurich LLC
100 Pine Street
Harrisburg, PA 17108-1166
BY:
Date:
J e . Alex der, Est
t torney for efent
#07355
148 S. Baltimore Street
Dillsburg, PA 17019
Phone (717) 432-4514
EXHIBIT "A"
In the Court of Common Pleas of CUMBERLAND County, Pennsylvania
DOMESTIC RELATIONS SECTION
13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013
Phone: (717) 240-6225 APRIL 28, 2006 Fax: (717) 240-6248
Plaintiff Name: JANET I. SOLOMON
Defendant Name: BRUCE H. SOLOMON
Docket Number: 00387 S 2003
PACSES Case Number: 910105454
Other State ID Number:
Please note: AB correspondence must include the PACSES Case Number.
Income and Expense Statement
THIS FORM MUST BE FILLED OUT
(If you are self-employed or if you are salaried by a business of which you are owner in whole or part, you must
also fill out the Supplemental Income Statement which appears on page two of this income and expense
statement.) R e
INCOME STATEMENT OF ?J Rv ?` ?a J ?? M D?J
Section I: Income and Insurance
INCOME:
Employer
Address o °k 11'1
NJC ST it?'T e,.
Type of Work
Payroll No. Gross Pay per Pay Period $ '•/ ;
Itemized Payroll Deductions:
NF HEALTH } HvMf+N SEhvtt=S
joy
*) o Pay Period (wkly., bi-wkly., etc.)
S-r L
W ttuz
Federal withholds $ Social Security $ Local Wage Tax $
Sate Income Tax $ Retirement $ Savings Bonds $
Credit Union $ Life Insurance $ Health Insurance $
Other Deductions (specify) S $
Net Pay per Pay Period $ i y S I
OTHER (Fill in A ro riate Column) Ownership
INCOME WEEK MONTH YEAR PROPERTY
hrterest $ $ o $ 6 s o OWNED DESCRIPTION VALUE H W J
Di
id
d
v
en
s
Pension Checking Accounts $ oD oD
Annuity Savings Accounts 00
o
S
i 0
oc
al Securi
Rents Credit Union
Royalties Stocks/Bonds
Expense Account
Gifu
E Real Estate
u
b nt Other
Work
n'
me
s
Compensation
Other
Other TOTAL $
TOTAL
TOTAL INCOME $ * H=Husband; W=Wife; J=Joint
Form IN-008
Service Type M Worker ID 21701
Income and Expense Statement
PACSES Case Number 910105454
Coverage *
INSURANCE
COMPANY
POLICY N H W C
Hospital 14EAL:T N A,tiuEw r•
Blue Cross
Other
Medical li ,A Lr} M1!?ti 1 e A ?
Blue Shield
Other
Health)Accidem
Disability Income
Dental Q E 1.-,7 A
Other
* H=Husband; W=Wife; C=Child
Section II: Supplemental Income Statement
a. This form is lo be filled out by a person
? (1) who operates a business or practices a profession, or
? (2) who is a member of a partnership or joint venture, or
? (3) who is a shareholder in and is salaried by a closed corporation or similar entity.
b. Attach to this statement a copy of the following documents relating to the partnership, jour venture, business, profession,
corporation or similar entity:
(1) the most recent Federal Income Tax Return, and
(2) the most recent Profit and Loss Statement
C. Name of business:
Address and telephone number:
d. Nature o business c k one)
E] (1) partnership
? (2) joint venture
? (3) profession
? (4) closed corporation
? (5) other
e. Name of accountant, controller or other person in charge of financial records:
f. Annual income from business:
(1) Now often is income received?
(2) Gross income per pay period:
(3)
(4)
Net income per pay period:
Specified deductions, if any:
Page 2 of 3 Form IN-008
Service Type M Worker ID 21701
Income and Expense Statement PACSES Case Number 910105454
Section III: Expenses
Instructions: Only show extraordinary expenses in this section unless you filled out Section E on page two. The categories
in BOLD FONT are especially important for calculating child support. If you are requesting Spousal Support/APL or if
you assert your case cannot be determined according to the guideline grids or formula, this section must be fully completed.
(Fill in Appropriate Column)
EXPENSES
WEEK
MONTH
YEAR
H me
MortgagcMent $ $ $
Maintenance
utilities
Electric $ $ is- $
Gas
Oil _00
Telephone 7 0
Water
Sewer
Employment
Public Transport. $ $
S
Lunch 100
Taxes
Real estate $ $ $
Personal Property
" e
Insurance
Homeowner's $ $ $
Automobile I 0 0
Life Q?,a?CrE Fran
Accident
Health YGpV Cr( F"h
Ocher
Automobile
Payments S $ $
Fuel Z
Repairs
o e
Medical
Doctor $ $ -7s $
Dentist r
Orthodontist
Hospital J o
Medicine Z-7
Pa
(glasses. braces,
EXPENSES (Fill in Appropriate Column)
(continued) WEEK MONTH YEAR
Education
Private School 5 $ $
Parochial School
College
Religious
personal
Clothing $ S 00 $
Food s n O
Rarberl
Hairdresser
3 S'
Credit Payments
Credit Card 3 D o
Charge
Memberships
Loans
Credit Union S $
S
Miscellaneous
Household Help $ $ $
Child ewe
Paperstbooks
Maeazines
o
Entertainment ZO
Pa TV '7S'
Vacation 3 00
Gifts r
Legal fees -t o s
to
r
Other CUd
nRart
A
limony
Paym
y 0 0
Other
$ $ $
Total WEEK MONTH YEAR
Ex ; S $ -!/ LZ• SOS
I verify that the statements made in this Income and Expense Statement are we and correct. I understand that false
statements heroin are subject to the criminal penalties of IS Pa. C.S. § 4904, relating to unworn falsification to authorities.
Date Plaintiff or Defendant
Page 3 of 3 Form IN-008
Service Type M Worker ID 21701
1. Pay Period End
05113/06
CIVILIAN LEAVE AND EARNINGS STATEMENT
2. Pay Date
05/19/06
3. Name 4. Pay Plan/Grade/Step: S. HourlylDally Rate 6. Bask OT Rate 7. Bask Pay + Locality Adj - Adjusted Buie
SOLOMON BRUCE H GS 13 09 44.96 44.96 Pay
83384.00 10440.00 93824.00
8. Soc Sac No 9. Locality % 10. FLSA Category 11. SCD Leave 12. Max Leave CwryOver 13. Leave Yw End
169-46-1854 12.52 E 12120/78 240 OIM/07
14. Financial lostltgflon - Net Pay 15. Financial Institution - Allotment 01 16. Financial Institution - Allotment a 2
FULTON BANK
17. Tax Marital Eumptlom Add'I 18. Tax Marital Eumptions Add'I Taxing Authority 19. Cumulative Retirement 20. Military Deposit
Status Status CSRS: 9264.90
FED M 0 125 420861 S 0 0 FAIRVIEW TS PA
PA S 1 0
21. Current Year to Date 22.
GROSS PAY 4496.00 44836.00
TAXABLE WAGES 3662.33 36444.59
NONTAXABLE WAGES 65.67 646.41
TAX DEFERRED WAGES 768.00 7745.00
DEDUCTIONS 2964.41 29463.42
AEIC
NETPAY 1531.59 15372.58
CURRENT EARNINGS
TYPE HOURS/DAYS AMOUNT TYPE HOURS/DAYS AMOUNT TYPE HOURS/DAYS AMOUNT
REGULAR PAY 80.00 3596.80 AVAIL PAY 899.20
DEDUCTIONS
TYPE CODE CURRENT YEAR TO DATE TYPE CODE CURRENT YEAR TO DATE
CHID SUP,GRN 805.57 8055.70 FEGLI DO 18.00 179.55
FEGLI OPTKL A 1.40 14.00 FEHB SW4 65.67 646.41
MEDICARE 64.24 640.75 RETIRE, CSRS 6 337.20 3362.70
TAX, FEDERAL 704.08 6921.13 TAX, LOCAL 420561 64.24 321.20
TAX, LOCAL 421101 220.37 TAX, STATE PA 136.01 1356.61
TSP SAVINGS 568.00 5945.00 TSP CUC 200.00 1800.00
LEAVE
TYPE PRIOR ACCRUED ACCRUED USED USED DONATED/ CURRENT USE-
YR PAYPD YTD PAYPD YTD RETURNED BALANCE LOSE/
BALANCE TERM DATE
ANNUAL 240.00 8.00 72.00 96.00 216.00 112.00
SICK 1575.00 4.00 36.00 13.00 33.50 1577.50
HOLIDAY 1600
REMARKS
YOUR PAYROLL OFFICE ID NU MBER IS 97381500 - DEPARTMENT OF HEALTH AND HUMAN SERVICES.
BUY US SAVINGS BONDS.
PRETAX FEHB EXCLUSION $ 65.67
THIS REPORT CONTAINS INFORMATION SUBJECT TO THE PRIVACY ACT OF 1974 AS AMENDED
` 1. Pay Period End
05/27/06
CIVILIAN LEAVE AND EARNINGS STATEM ENT 2. Pay Date
06/02/06
3. Name 4. Pay Plan/Grade/Step 5. Houdy/Dally Rate 6. Basic OT Rate 7. Basic Pay+ Locality Adj = Adjusted Basic Pay
SOLOMON BRUCE H GS 13 09 44.96 44.96 03384.00 10440.00 93824.00
Soc Sec No
B 9. Locality % 10. FLSA Category 11. SCD Leave 12. Max Leave Carry Over 13. Leave Year End
.
169-46-1854 12,52 E 12/20/10 240 01/06/07
14. Financial Institution - Net Pay 15. Financial Institution - Allotment #1 16. Financial Institution - Allotment #2
FULTON BANK
17. Tax Marital Exemptions Add'I 18. Tax Marital Exemptions Add'I Taxing Authority 19. Cumulative Retirement 20. Military Deposit
Status Status
FED M 0 125 420861 S 0 0 FAIRVIEW TS PA CSRS: 9602.10
PA S 1 0
21. Current Year to Date 22.
GROSS PAY 4496.00 49332.00
TAXABLE WAGES 3662.33 40106.92
NONTAXABLE WAGES 65.67 712.08
TAX DEFERRED WAGES. .765-.00. 8513.00
DEDUCTIONS - 2964.41 32427.83
AEIC
NET PAY 1531.59 16904.17
CURRENT EARNINGS
TYPE HOURS/DAYS AMOUNT TYPE HOURS/DAYS AMOUNT TYPE HOURSIDAYS AMOUNT
REGULAR PAY 80,00 3596.00 AVAIL PAY 899.20
DEDUCTIONS
TYPE CODE CURRENT YEAR TO DATE TYPE CODE CURRENT YEAR TO DATE
CHLD SUP,GRN 805.57 8861.27 - FEGLI - DO 18.04 197.55
FEGLI OPTNL A 1.40 15.40 FEHB SW4 65.67 712.08
MEDICARE 64.24 704.99 RETIRE, CSRS 6 337.20 3699.90
TAX, FEDERAL 704.08 7625.21 TAX, LOCAL 420861 64.24 385.44
TAX, LOCAL 421101 220.37 TAX, STATE PA 136.01 1492.62
TSP SAVINGS 568.00 6513.00 TSP CDC 200.00 2000.00
LEAVE
TYPE ACCRUED ACCRUED USED 'USED
PRIOR YR- DOMTED/ CURRENT USE-LOSEt
' .
- BALANCE 'PAY PD YTD PAY PD YTD RETURNED BALANCE TERM DATE
ANNUAL 240.00 8.00 80.00 96.00 224,00 112.00
SICK 1575.00 4.00 40.00 33.50 1581.50
HOLIDAY 16.00
REMARKS
YOUR PAYROLL OFFICE ID NUMBER IS 97381500 - DEPARTMENT OF HEALTH AND HUMAN SERVICES.
BUY US SAVINGS BONDS . -
PRETAX FENS EXCLUSION $ 65.67
THIS REPORT CONTAINS INFORMATION SUBJECT TO THE PRIVACY ACT OF 1974 AS AMENDED
9 1040
0, 1 Far the yw Jan. 1-Ow. 31, 2005, m oMs to ym
Label
(see L
A
on page 18) 9 LX 528 10
Use the Ills E BRUCE H SOLOMON
tabel. H 332 THORLEY RD
Otherwise, E NEW CUMBERLAND PA
please print R
or type. E
Filing Status
Check only
Exemptions
H more #w four
deperKWft, am
page 19.
Income
Attach Farm(ta
W-2 nerve Also
attach Foe
w-2e and
109" It tax
was wkhhWd.
If you did rat
get a W-2,
see page 22.
Enclose, but do
not attach, any
perm ft Alec,
pkwse use
Form 1040-v.
2005, w4kV
17070-3132
,20
Your soda) security rmmbar
t 169 :16 i Ivs`/
R spouse's nodal security msn
t 18( ;YYE Ya?1
S
I
Adjusted
Gross
Income
SCHEDULES A&B Schedule A-itemized Deductions
(Form 1040 (Schedule 8 Is on back)
DepwbneM
M w (1) ? Attach to Form 1040. ? See Inatru tlons for Schedules Aia (Form 100.
n. ,. Sw4
OMB No. 1 74
Aa.drr?nt
Name(s) sha on Form 1000
(tv?F ??. o Lo Mod Your soil r amity "19
I69 i Y6 i9 SOWr
'`l
Medical Caution
Do not include expenses reimbursed or paid by others
.
.
and 1 Medical and dental expenses (see page A-2) . 1
Dental 2 Ester amount from Form 1040
line 38 1 2 1 1
Expenses 3 ,
Multiply line 2 by 7.5% (.075). 3
4 Subtract line 3 from line 1. If line 3 is more than line 1 ente r -0 .
Taxes You 5 State and local (check only one box):
Paid a 1M Income taxes, or i 5
(See b ? General sales taxes (see page A-3) J
Page A-2d 6 Real estate taxes (see page A-5) . . . . . . . 6
7 Personal property taxes . . . . . . . 7
8 Other taxes. List type and amount R
-........_...------
8
9 Add lichee 5 throe h 8 9 S 3T.
Interest 10 Home mortgage Interest and points reported to you on Form 1098 10
You Paid 11 Hare mortgage interest not reported to you on Form 1098. If paid
(See to the person from wham you bought the hone, see page A-6
page A-5.) and show that person's creme, Ww*fAV no., and address ?
Note. ................................................................
....................................................... •----....
11 ., .,...
Personal
interest is 12 Points not reported to
you on Form 1098. See page A-6
not for special rules . . . . . . 12
deductible. 13 Investment Interest Attach Form 4952 if requred. (See
page A-8.) 13
14 Add unes 10th h 13 14
t3Hts to 15a Total gifts by cash or check H you made any gift of $250
Charity or more, see page A-7 . . . . . . . . . . . 15a 8
if you made a b Gifts by cash a check after August
a
giftak it
27, 2005, that you elect to treat as
1
l I
see page A-7. qualified contributions (see pageA-7)
15b
16 Other than by cash or check if arty gift of $250 or more
,
see page A-7. You must attach Form 8283 If over 5500 16
17 Carryover from prior year . . . . . . . . . . 17.
18 Add lines 15a, 16, and 17 . , t8 Vim;.. -
Casualty and
Theft Losses 19 Casualty or theit4ess(es). Attach Form 4684. (See pap A 8.) . . 19
Job Espouses 20 Unrelmbursed employee expenses--Job travel, union
and Certain dues, job education, etc. Attach Forth 2106 or 2106-FZ
Miscellaneous If required. (See page A-8.) ?-----------------------------
Deductions 21 Tax preparation fees. . . . . . . . . . . . 21
(See 22 Other expenses--Investment, safe deposit box, etc. List
page A 8.) type and amount ?.....-• ..................................
................................................................
23 Add lines 20 through 22 . . . . 23
24 Ester amount from Form 1040, Yne 38 24
25 Multiply line 24 by 2% (.02) 25
26 Subtract One 25 from line 23. N line 25 is more than line 23, enter -0- 26
Other
27
Other-from list on page A-9. List type and amount ? .
.............................
Miscellaneous
Deductions ----...--• .............•------...................--
27
Total 28 Is Form 1040, line 38, over $145,950 (over $72,975 If married filing separately)?
Itemized
D
d
ti ? No. Your deduction Is not limited. Add the amounts In the far right column
S 3 `fy
e
uc
ons for lines 4 through 27. Also, enter this amount an Form 1040, fine 40. ? 28
® Yes. Your deduction may be limited. See papa A-9 for the amount to enter.
29 1 you elect to hafte ded cdm even ft# they am Ins than your standard deduction, d" We o. ? .
Fpm
W-2
Wage
and
Tax
Statement
2005
D" =
tm
Tm"'"-
Irtierial
Revenue
Service
a Control number OMB No. 15454008 '
CSD095960
b Emgloyer identi8ostion number d Employee's social security number 1 Wages. tips, other compensation 2 Federal income tax wtbt
31-1575142 169-46-1854 67129.56 13632.42
c Employer's name, address and ZIP code 3 Social security wages 4 Social security tax will
DEFENSE FINANCE & ACTG SERV 0.00 0.00
ROOM 2983 ( Z PH ) Medicare wages and tips icare tax wt?
1290 E NINTH ST 77699.16 1126.64
CLEVELAND OH 99199 7 social "clarity tips
0.00 a Allocated Ups --
0.00
e Employee's name, address, and ZIP code 9 Advance EIC payment 10 Dependent care beneMs
0.0 0.00
12 Sea Instructors for box 12 14 Sea instructors for box
D 10569.60 V 996.
BRUCE H SOLOMON
PO BOX 336
HARRISBURG
PA 17108-0336
, 13 ?
eZemex 1:1 # 'a
= D a
sy
onPl
p
1s Stsu Employees state ID manber 18 Sus wag es, Bps, sic. 17 Stall Yrorm tax vn0as.tiPa. ek
S
Lo
cW 10 Loal ihcpma 20 l
PA 1844 4869
_________________________
77699.16
____________
238536
_________ [.
.3
8
84
958
___________ 1
563.3
-------- ---- FAM
IR'
------
O.00 0.00 38899.58 388.53 HARR
Depornoeet of He&M and Hanson Services
Division of Payroll
Pest Office Box 11950
Sower Spring. MD 20911
009311
D 4
96960
1
BRUCE H SOLOMON
PO BOX 336
HARRISBURG
FEHB-PC YD 467.24
7,302.47
PA 17101
47.00 HARRISBURG I v "y n - Aa se raea wan tasprayerc rCU'LRAL Tax Rob
This information is being furnished to the IRS.
Form w-2 wage and Tax statement 2005 oeeenmamwmernwerv. ~., seranYeM- a OMB No. 154
EXHIBIT "B"
08/18/2006 13:49 7172214536 OI6
FILE No.302 08/18 '06 1229 ID:ALEXANDER LAW OFFICE FA*5021087
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
JANST I. SOLOMON
PtalnO
VS.
BRUCE H. SOLOMON
Defendant
No, . 4 S 723
MWENTORY AM
OF
PACE 01/01
PAGE 1
gmas M. Seremen foes the follming Inventory and appralsenent of art property awned or
posewed by saw party at the fto oils aeon was commenced and all property transferred
within the preceding three years.
Bluge H. Salmon varlflas that the statements made in this Inventory and approlsammd are
true and correct Bruce H. 8vkffWn understands that felon statements heroin are made
subject to the ponaRles of Pa. C. S. §4804 relating to unawom FAIWCONOn to 2 be$.
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
INVENTORY AND APPRAISEMENT MANDATED BY R C P 1920,33
Janet I. Solomon No. 04 S 723
Plaintiffs full name
58 Bourbon Red Drive
Street and number
Bruce H. Solomon
Name of party filing
Mechanicsburg, PA 17055
City-State-Zip
VS.
Bruce H. Solomon
Defendant's full name
332 Thorley Road
Street and number
New Cumberland, PA 17070
City-State-Zip
J. Paul Helvy, Esquire
Plaintiff s attorney
Date Complaint served
Date this form filed
Jane M. Alexander, Esquire
Defendant's attorney
100 Pine Street
Street and number
Harrisburg, PA 17108-1166
City-State-Zip
(717) 232-8000
Phone number
148 S. Baltimore Street
Street and number
Dillsburg, PA 17019
City-State-Zip
(717) 4324514
Phone number
MARITAL PROPERTY
Defendant lists all marital property In which either or both spouses have a legal or equitable interest
individually or with any other person as of the date this action was commenced.
Item Number 1 Item Number 2 Item Number 3
Description of Property Marital Residence 58 Imputed rent for marital PSERS Pension Plan PA
Bourbon Red Drive, residence Department of Welfare
Mechanicsburg, PA 17055
Names of All Owners Janet I. Solomon and Owed by wife to husband Wife
Bruce H. Solomon
Date of Acquisition January 9, 2003 to date
Cost or Value as of Appraised by Mark
Date of Acquisition Hechison
Values as of Separation $275,000.00
Value 30 Days Prior to 43 months at $1,100.00 per $62,354.00 as of August
Hearing month 30, 2004
Stipulated between Parties agreed to accept
parties that value
Amount of any Lien Sovereign Bank Mortgage
as of April 18, 2006
$54,146.64
Form of Attached Bank statement
Documentation
Comments Need current balance Need current Statement
Page 1
MARITAL PROPERTY
Defendant lists all marital property in which either or both spouses have a legal or equitable interest
individually or with any other person as of the date this action was commenced.
Item Number 4 Item Number 5 Item Number B
Description of Property PSERS Pension CSRS Pension Thrift Savings Plan
Names of All Owners Wife Husband Husband
Date of Acquisition
Cost or Value as of
Date of Acquisition
Values as of Separation
Value 30 Days Prior to
Hearing $1991.00 as of June 30,
1998 $825,434.39 as of August
1, 2005 $130,029.72 as of
December 31, 2005
Stipulated between
parties
Amount of any Lien
Form of Attached
Documentation Pension appraisers
documentation
Comments Up dated value needed Updated value needed Need current statement
Page 2
MARITAL PROPERTY
Defendant lists all marital property in which either or loth spouses have a legal or equitable interest
individually or with any other person as of the date this action was commenced.
Item Number 7 Item Number 8 Item Number 9
Description of Property Husband accrued sick
leave & annual leave Vanguard IRS Vanguard Money Market
Account no. 95845
Names of All Owners Husband Joint
Date of Acquisition No value
Cost or Value as of
Date of Acquisition
Values as of Separation
Value 30 Days Prior to
Hearing $56,053.98 marital value
as of April 4, 2006 $19,163.61 as of April 4,
2006
Stipulated between
parties
Amount of any Lien
Form of Attached
Documentation
Comments Need current statement Need current statement
Page 3
MARITAL PROPERTY
Defendant lists all marital property in which either or both spouses have a legal or equitable interest
individually or with any other person as of the date this action was commenced.
Item Number 10 Item Number 11 Item Number 12
Description of Property MBNA MBNA Roth IRA 51117-1 MBNA Roth IRA 40373-5
Names of All Owners Joint Wife Wife
Date of Acquisition
Cost or Value as of
Date of Acquisition
Values as of Separation
Value 30 Days Prior to
Hearing Cashed April 20, 2003
$27,825 proceeds $3,601.00 as of June 30,
2004 $64,810.00 as of March 31,
2008
Stipulated between
parties Divided equally
Amount of any Lien
Form of Attached
Documentation
Comments Need current value Need current value
Page 4
MARITAL PROPERTY
Defendant lists all marital property in which either or both spouses have a legal or equitable interest
individually or with any other person as of the date this action was commenced.
Item Number 13 Item Number 14 Item Number 15
Description of Property MBNA Roth IRA #10138-4 Waypoint Bank Christmas
Club Waypoint Bank checking
account no. 100084111
Names of All Owners Wife
Date of Acquisition
Cost or Value as of
Date of Acquisition $20,000.00
Values as of Separation Cashed out to buy
Christmas gifts in 2002 $9,211.90 as of January 5,
2003
Value 30 Days Prior to
Hearing $2,420.00 as of March 31,
2006
Stipulated between
parties
Amount of any Lien
Form of Attached
Documentation
Comments Need current value
Page 5
MARITAL PROPERTY
Defendant lists all marital property in which either or both spouses have a legal or equitable interest
individually or with any other person as of the date this action was commenced.
Item Number 16 Item Number 17 Item Number 18
Description of Property Fulton Bank Savings
account no. 1371-30517 Fulton Bank Checking
account no. 3622-324330 Commerce Bank Savings
account no. 082800885
Names of All Owners Husband Husband Husband
Date of Acquisition
Cost or Value as of
Date of Acquisition $1,150.00
Values as of Separation Closed July 9, 2002
Value 30 Days Prior to
Hearing
Stipulated between
parties
Amount of any Lien
Form of Attached
Documentation
Comments
Page 6
MARITAL PROPERTY
Defendant lists all marital property in which either or both spouses have a legal or equitable Interest
individually or with any other person as of the date this action was commenced.
Item Number 19 Item Number 20 Item Number 21
Description of Property Cruise Money Refund Term Life Insurance Policy
(through employer) Tenn Life Insurance Policy
(through employer)
Names of All Owners Joint Husband Wife
Date of Acquisition
Cost or Value as of
Date of Acquisition $1,200.00
Values as of Separation Credited into joint MBNA
used for marital bills prior
to separation
Value 3D Days Prior to
Hearing
Stipulated between
parties
Amount of any Lien
Form of Attached
Documentation
Comments
Page 7
MARITAL PROPERTY
Defendant lists all marital property in which either or both spouses have a legal or equitable interest
individually or with any other person as of the date this action was commenced.
Item Number 22 Item Number 23 Item Number 24
Description of Property 2001 Mazda Prologue 1997 Honda Accord Station
Wagon U.S. Savings Bonds
Names of All Owners Husband Wife Purchased by husband by
Payroll deduction for
Daniel, son
Date of Acquisition 1988-1994
Cost or Value as of
Date of Acquisition
Values as of Separation
Value 30 Days Prior to
Hearing
Stipulated between
parties $8,000.00 $4,200.00 $5,344.74 - April 2008
Amount of any Lien
Form of Attached
Documentation
Comments
Page 8
MARITAL PROPERTY
Defendant lists all marital property in which either or both spouses have a legal or equitable interest
individually or with any other person as of the date this action was commenced.
Item Number 25 Item Number 26 Item Number
Description of Property US Savings Bonds - no list
available Personal Property
Household furnish
Names of All Owners Purchased by Husband
Payroll deduction for Justin Joint
Date of Acquisition 1980-1994 1976 to date
Cost or Value as of
Date of Acquisition
Values as of Separation $30,000.00
Value 30 Days Prior to
Hearing estimated value $5,177.00
Stipulated between
parties Husband wants grandfather
clock - % value
Amount of any Lien
Form of Attached
Documentation
Comments No list available May need appraisal
Page 9
EXHIBIT "C"
PENSION APPRAISERS INC.
P.O. Box 4396 • Allentown, PA 18105-4396
1-800-447-0084 • Fax 610-770-9342
August 1, 2005
Jane M. Alexander, Esq.
P.O. Box 421
Dillsburg, Pennsylvania 17019-0421
RE: Present Value of Bruce H. Solomon's Defined Pension Benefit
File No. 07-08.05-063-17498
Dear Attorney Alexander:
We have determined by the PBGC Actuarial and Mortality Table M
Bruce H. Solomon's defined pension benefit of $3,814.58 per me
adjusted for a hypothetical Social Security pension benefit of $1,13
age 62 to be $625,434.39. This valuation was developed and prep
at
requirements of the Actuarial Standards of Practice No. 34. These Standards were developed
by the Pension Committee of the Actuarial Standards Board of the American Academy of
Actuaries. The purpose is to set standards for Members and Other Persons Interested in
Actuarial Practice Concerning Retirement Plan Benefits in Domestic Relations Actions. Pension
Appraisers, inc. relies on the requestor to provide the information necessary to value pensions.
In some cases, information not provided by the requestor may be obtained from plan
summaries on file in Pension Appraisers, Inc.'s offices. All information received from the requester
is reviewed for practicability and reasonableness. Any information in question is verified with the
requestor, when possible. Any deficiencies in data may materially affect the results of the
appraisal. Pension Appraisers, Inc. utilizes the fractional rule allocation method in valuing all
pensions for equitable distribution purposes unless otherwise stated.
BIRTH DATE: July 5, 1955
VALUATION DATE: July 29, 2005
MARRIAGE DATE: July 3, 1976
SEX: Male
PENSION PLAN: Civil Service Retirement System (General service and LEO/FF service)
DATE EMPLOYMENT STARTED: December 20, 1978 (service computation date)
(Assumed date pension holder began participation in the plan)
DATE BENEFITS STOPPED ACCRUING: July 29, 2005
(Assumed date pension holder, ended participation in the plan)
ASSUMED DATE MARRIAGE ENDED: January 9, 2003
AGE WHEN BENEFITS COMMENCE: 52.06 years (Age on September 27, 2007-,20
years of LEO/FF service completed.)
"Valuators of Defined Pension Benefits for Equitable Distribution"
PBGC Actuarial and Mortality Tables Method
August 1, 2005
Bruce H. Solomon - File # 07-08-05-063-1749B
Page 2
MORTALITY TABLES AND INTEREST RATES:
Mortality Tables (1983 Group Annuity Mortality Tables), Interest Rates and Factors
used by the Pension Benefit Guaranty Corporation to determine the present value of
annuities for single-employer plans.
INTEREST RATE ASSUMPTIONS: Table LI - Annuity Rates
Rates as of July 29, 2005:
i1 = 4.90%, i2 = 5.25% and i3 = 5.25%
Estimated Plan Costof Living Adjustment: 2.70%
Adjusted Rates if Applicable:
ii = 2.20%, i2 = 2.55% and i3 =2.55%0
Estimated Social Security Cost of Living Adjustment: 2.70%
Adjusted Rates if Applicable:
i 1 = 2.20%, i2 = 2.55% and i3 = 2.55%
ASSUMED MONTHLY BENEFIT: $672.60 (general service benefit)
+3.141.98 (LEO?FF service benefit)
$3,814.58
Month)y pension benefit the pension holder would receive at retirement age
with a fully vested pension basedupon compensation and plan provisions
as of July 29, 2005.
Formula: General service
1 1/2% x "high-3" average payx 5 years of service,
PLUS
1 3/4% x "high-3" average pay xyears of service between 5 and 10,
PLUS
2% x "high-3" average pay x all service over 10 years.
Data:
Years of Service: 5.53 yrs (3/15/82 - 9/26/87)
+0:64 vrs(service purchased with marital funds)
6.17 yrs (as of 9/26187)
Assumed "High-3" Years Average Pay: $84,537.67
05 $53,225.00 (7months) $253.613.00 = $84,537.67
04 84,410.00 3 years
03 82,812.00
02 +33.166A0 (5 months)
$253,618.00
PBGC Actuarial and Mortality Tables Method
August 1, 2005
Bruce H. Solomon - File # 07-08-05-063-17498
Page 3
Analysis:
A 0.0150 x $84,537.67 x 5.00 Years =
B 0.0175 x $84,537.67 x 1.17 Years
C 0.0200 x $84,537.67 x 0 Years
Total Annual Benefit
$8,071.24 = $672.60 (Monthly Benefit)
12 Months
Formula: Law Enforcement and Firefighters
$6,340.33
1,730.91
.00
$8,070.24
2-112% x "high-3 average pay x first 20 years of service
PLUS
2%o x "high-3" average pay x years of service over 20
Data:
Years of Service: 17.84 yrs (9/27/87 - 7/29/05)
Assumed "High-3" Years Average Pay: $84,537.67 (see above)
Analysis:
0.0250 x $84,537.67 x 17.84 Years = $37,703.80
0.0200 x $84,537.67 x 0 Years = 0.00
Total Annual Benefit $37,703.80
$37.703.80 = $3,141.98 (Monthly Benefit)
12 Months
PRESENT VALUE OF ASSUMED SOCIAL SECURITY PENSION: $108,438.25
The present value of receiving a monthly Social Security benefit of $1,139.16 starting
at age 62 assuming the pension holder had participated in the Social Security System
from March 15, 1982 to July 29, 2005.
REDUCTION FOR NON-VESTING: 1.0000
Represents a reduction for the probability of service to 100 percent vesting as equal to
the portion already completed.
REDUCTION FOR MARITAL COVERTURE FRACTION: 0.8823
PBGC Actuarial and Mortality Tables Method
August 1, 2005
Bruce Solomon - File #07-08-05-063-17496
Page 4
REDUCTION FOR MARITAL COVERTURE FRACTION: 0.8823
$3,365.47 = 0.8823
$3,814.58
PRESENT VALUE BEFORE REDUCTIONS:
Less: Present Value of Assumed Social Security Benefit:
ADJUSTED PRESENT VALUE
Reduction for Non-Vesting:
Reduction for Marital Coverture:
PRESENT VALUE AFTER REDUCTIONS:
ESTIMATED NON-MARITAL, POST-SEPARATION
CONTRIBUTIONS AND INTEREST:
AVALUATION FOR EQUITABLE DISTRIBUTION:
$840,740.50
$108.438.25
$732,302.24
x 1.0000
x 0.8823
$646,110.27
$625,434.39
AThis valuation was prepared in compliance with our understanding of Act 175.
Estimated Value of Contributions as of the
Date of Valuation (7!29105):
Less:
Estimated Value of Contributions as of the
Separation (1/9/03):
Est. Non-Marital Post Separation Contributions
as of the Date of Valuation:
$103,707.18
$ 83.133.05
$ 20,675.88
PBGC Actuarial and Mortality Tables Method
August 1, 2005
Bruce Solomon - File #07-08-05-063-17498
Page 5
ESTIMATE OF HYPOTHETICAL MONTHLY SOCIAL SECURITY BENEFIT
Step #1: Calculate theTotal Indexed Earnings for determining the Hypothetical Social Security
Benefits.
MAXIMUM EARNINGS
COVERED BY
YfAB SOCIAL SECURITY
1982 $32,400.00
1983 $35,700.00
1984 $37,800.00
1985 $39,600.00
1986 $42,000.00
1987 $43,800.00
1988 $45,000.00
1989 $48,000.00
1990 $51,300.00
1991 $53,400.00
1992 $55,500.00
1993 $57,600.00
1994 $60,600.00
1995 $61,200.00
1996 $62,700.00
1997 $65,400.00
1998 $68,400.00
1999 $72,600.00
2000 $76,200;00
2001 $80,400.00
2002 $84,900.00
2003 $87,000.00
2004 $87,900.00
2005 $90,000.00
ESTIMATED
EARNINGS
HISTORY
$6,917.00
$19,694.00
$21,712.00
$23,493.00
$24,766.00
$27,787.00
$32,472.00
$38,906.00
$42,223.00
$46,596.00
$50,894.00
$53,253.00
$61,659.00
$66,578.00
$76,064.00
$76,649.00
$79,442.00
$84,024.00
$88,058.00
$91,468.00
$99,010.00
$100,757.00
$101,796.99
$60,800.25
Total Indexed Earnings
2005
2.2353444
2.1112366
2.0249624
1.9665918
1.8486925
1.761`9158
1.6948116
1.6199820
1.5617813
1.4852551
1.4725905
1.4341005
1.3788318
1.3145435
1.2420677
1.1802928
1.1179891
1.0594042
1.0347197
1.0244464
1.0000000
1.0000000
1.0000000
1.0000000
ESTIMATED
INDEXED
EARNINGS
$15,461.88
$41,578.69
$43,965.98
$46,201.14
$45,784.72
$48,958.35
$55,033.92
$63,027.02
$65,943.09
$69,206.95
$74,946.02
$76,370.16
$83,557.21
$80,450.07
$77,877.65
$77,191.1.5
$76,470.46
$76,912.74
$78,845.64
$82,365.41
$84,900.00
$87,000.00
$87,900.00
$60,800.25
$1,600,748.50
Step #2: Divide the Total Indexed Earnings by 35 to determine Average Indexed Yearly
Earnings.
Analysis: $1.600.748.50 = $45,735.67
35 Years
Step #3: Divide Average Indexed Yearly Earnings by 1°2 to determine Average Indexed
Monthly Earnings.
Anaylsis: $45,735.67 = $3,811.31
12 Months
PBGC Actuarial and Mortality Tables Method
August 1, 2005
Bruce Solomon - File #07-08-05-063-1749B
Page 6
Step #4: Determine the Hypothetical Basic Monthly Social Security benefit payable at Full
Retirement Age.
Formula:
(A) Multiply the first $627 of Average Indexed Monthly Earning by 90%.
(B) Multiply the next $3152 of AverageIndexed Monthly Earnings by 32%.
(C) Multiply any remaining Average Indexed Monthly Earnings by 1?5%.
(D) The sum of (A), (B) and (C) is the Estimated Basic Benefit payable at
Full Retirement Age.
Analysis:
$ 627.00 x 0.90 = $564.30
$ 3,152.00 x 0.32 = $1008.64
$ 32.31 x 0.15 = 94.85
Monthly Benefit $1,577.79
Step #5: Determine the Hypothetical Basic Monthly Social Benefit payable at age 62.
Formula: 0.722 % of the Monthly Benefit Payable at Full Retirement Age.
Analysis:
0.722 x $1,577.79 = $1139.16
EXHIBIT "D"
THRIFT SAVINGS PLAN Page t of3
PARTICIPANT STATEMENT For the period: l0/01/2005.12/31/2005
Please review this statement for accuracy, as the information in it is considered correct unless you notify us. To correct errors in contribution
allocations and interfund transfers, contact the TSP at the ThriftLine number below. For all other corrections, contact your agency or service.
83305381451N HE 101189 97381500 01106
Social Security Number:
"""•'1854
Date of Birth: 07/05/1955
Retirement Coverage: CSRS
Employment Status: Active
Beneficiary Designation: Yes, dated 11/13/2001
Contribution Allocation on 12/31/05:
G Fund=10% F Fund=10% C Fund=80%
BRUCE H. SOLOMON
PO BOX 336
HARRISBURG, PA 17108-0336
YOUR QUARTERLY ACCOUNT SUMMARY
Beginning Contributions Withdrawals Change in Ending Account
Balance and and Interfund Value from Balance Distribution
TSP FUNDS (10101105) Additions Deductions Transfers Previous Quarter (12/31/05) (12/31/05)
Individual funds
G Fund $71,108.70 $411.04 $0.00 $0.00 $840.64 $72,360.38 55%
F Fund 1,620.43 411.04 0.00 0.00 12.45 2,043.92 2%
C Fund 51,200.14 3,288.32 0.00 0.00 1,136.96 55,625.42 43%
Total $123,929.27 $4,110.40 $0.00 $0.00 $1,990.05 6130,029.72' 100%
"Your total balance includes: $3,750.00 in catch-up contributions this year
How your ending balance
is distributed among the funds
G Fund
F Fund
C Fund
TSP Web Site: www.tsp.gov
THRIFTLINE: 1-TSP-YOU-FIRST (1-877-968-3778) - Outside the U.S. and Canada, call 404-233-4400
TDD: 1 TSP-THRIFT5 (1-877-847-4385)
BRUCE H. SOLOMON Page 2 of 3
Social'hecurity Number: *******1854 For the period: 10/01/2005.12/31/2005
TRANSACTION DETAIL BY SOURCE
Payroll
Office Posting
Date
Transaction Type
Employee
Total
Beginning Balance $123,929.27 $123,929.27
97381500 10/06/05 Catch-up Contribution 150.00 150.00
97381500 10/06/05 Contribution 437.20 437.20
97381500 10/20/05 Contribution 437.20 437.20
97381500 10/20/05 Catch-up Contribution 150.00 150.00
97381500 11/03/05 Contribution 437.20 437.20
97381500 11103105 Catch-up Contribution 150.00 150.00
97381500 11/17/05 Contribution 437.20 437.20
97381500 11/17/05 Catch-up Contribution 150.00 150.00
97381500 12/01/05 Contribution 437.20 437.20
97381500 12/01/05 Catch-up Contribution 150.00 150.00
97381500 12/16105 Contribution 437.20 437.20
97381500 12116!05 Catch-up Contribution 150.00 150.00
97381500 12/29/05 Catch-up Contribution 150.00 150.00
97381500 12/29/05 Contribution 437.20 437.20
Increase/Decrease in Value 1,990.05 1,990.05
Ending Balance $130,029.72 $130,029.72
TRANSACTION DETAIL BY FUND
Government Securities Investment (G) Fund
Number
Posting Transaction Share of Dollar
Date Transaction Type Amount Price Shares Balance
Beginning Balance $11.03 6,446.8453
10/06/05 Catch-up Contribution $15.00 11.04 1.3587
10/06/05 Contribution 43.72 11.04 3.9601
10/20/05 Contribution 43.72 11.05 3.9566
10/20/05 Catch-up Contribution 15.00 11.05 1.3575
11/03/05 Contribution 43.72 11.07 3.9494
11/03/05 Catch-up Contribution 15.00 11.07 1.3550
11/17/05 Contribution 43.72 11.09 3.9423
11/17/05 Catch-up Contribution 15.00 11.09 1.3526
12/01/05 Contribution 43.72 11.11 3.9352
12/01/05 Catch-up Contribution 15.00 11.11 1.3501
12/16/05 Contribution 43.72 11.13 3.9281
12/16/05 Catch-up Contribution 15.00 11.13 1.3477
12/29/05 Catch-up Contribution 15.00 11.15 1.3453
12/29/05 Contribution 43.72 11.15 3.9211
Ending Balance $11.16 6,483.9050
$71,108.70
$72,360.38
Form TSP-8 (120061
BRUCE H. SOLOMON
Soclal curity Number: •"'••••1854
TRANSACTION DETAIL BY FUND
Page 3 of 3
For the period: 10/01/2005-12/31/2005
Fixed Income Index Investment (F) Fund
Posting
Date Transaction
Beginning Balance $10.61 152.7266
10/06105 Catch-up Contribution $15.00 10.60 1.4151
10106105 Contribution 43.72 10.60 4.1245
10/20/05 Contribution 43.72 10.57 4.1362
10120/05 Catch-up Contribution 15.00 10.57 1.4191
11/03/05 Contribution 43.72 10.48 4.1718
11/03/05 Catch-up Contribution 15.00 10.48 1.4313
11/17/05 Contribution 43.72 10.58 4.1323
11117/05 Catch-up Contribution 15.00 10.58 1.4178
12/01/05 Contribution 43.72 10.56 4.1402
12/01/05 Catch-up Contribution 15.00 10.56 1.4205
12/16/05 Contribution 43.72 10.63 4.1129
12/16105 Catch-up Contribution 15.00 10.63 1.4111
12/29/05 Catch-up Contribution 15.00 10.68 1.4045
12/29/05 Contribution 43.72 10.68 4.0936
Ending Balance $10.67 191.5575
Number
Transaction Share of Dollar
Amount Price Shares Balance
Common Stock Index Investment (C) Fund
Posting
Date Transaction
Beginning Balance
10/06/05 Catch-up Contribution
10/06/05 Contribution
10/20/05 Contribution
10/20/05 Catch-up Contribution
11/03/05 Contribution
11/03/05 Catch-up Contribution
11/17/05 Contribution
11/17/05 Catch-up Contribution
12/01/05 Contribution
12/01/05 Catch-up Contribution
12/16/05 Contribution
12/16/05 Catch-up Contribution
12/29/05 Catch-up Contribution
12/29/05 Contribution
Ending Balance
$1,620.43
$2,043.92
Dollar
Balance
$51,200.14
$55,625.42
Transaction
Amount
$120.00
349.76
349.76
120.00
349.76
120.00
349.76
120.00
349.76
120.00
349.76
120.00
120.00
349.76
Share
Price
$13.27
12.87
12.87
12.73
12.73
13.20
13.20
13.46
13.46
13.71
13.71
13.74
13.74
13.61
13.61
$13.55
Number
of
Shares
3,858.3378
9.3240
27.1764
27.4753
9.4266
26.4970
9.0909
25.9851
8.9153
25.5113
8.7527
25.4556
8.7336
8.8170
25.6988
4,105.1974
THRIFT SAVINGS PLAN For the
PARTICIPANT STATEMENT 11/01/2
TSP-8-8
Your Thrift Savings Plan (rSP) account statement is issued by the National Finance Center for the Federal Retirement Thrift
Investment Board. Review your statement carefully; to correct account information, contact your agency employing office.
Failure to report errors timely may preclude correction of financial transactions. (Report contribution allocation or
interfund transfer errors to the TSP Service Office, (504) 255-8777, within 30 days of receiving this statement.)
Name: BRUCE H SOLOMON
Social Security Number. 169-46-1854
Date of Birth 07/05/55
Retirement Coverage: CSRS (6)
Separation Status. Not separated
Beneficiary Designation on File:* Yes, dated 11/13/2001
elf you choose to submit a Beneficiary Designation (Form TSP-3), you are responsible for its correctness and completeness.
Account Summary
G FUND
Government Securities
Investment Fund
Beginning Balance
Transactions This Period
Earnings This Period
59,178.97
352.91
1,222.79
Ending Balance 60,754.67
Beginning Balance 5,218.66
F FUND Transactions This Period 1,411.64
Fixed Income Index Earnings This Period 259.92
Investment Fund
Ending Balance 6,890.22
C FUND Beginning Balance 11.545.75
1 764 61
Transactions This Period
Common Stock Index Earnings This Period 609.96
Investment Fund
Ending Balance 13,920.32
S FUND Beginning Balance
Transactions This Period
Small Capitalisation Stock Earnings This Period
Index Investment Fund
Ending Balance
Beginning Balance
I
FUND
Transactions This Period
International Stock Index Earnings This Period
Investment Fund
Ending Balance
TOTAL Beginning Balance 75,943.38
ACCOUNT Transactions This Period 3,529.16
Earnings This Period 2,092.67
BALANCE
Ending Balance 81,565.21
85305381451N HE 35 1704 75010098 05/03 Your Zip Code was changed only for this mail-
T-00011574 01920438 1 AV 0.278 2 ing to match the U.S. Postal Service Zip Code
for your address.
IIIIII [loll 11111111111111111111 loll IIIIIIIIII I 1I1I I loll 1 I 1 II
If you are still employed. provide your per- e
BRUCE H SOLOMON sonnel office with your correct address. If
58 BOURBON RED OR you have left Government service, contact the
MECHANICSBURG PA 17050-7901 TSP Service Office to correct your address.
s
Web site: www.tsp.gov - Thriftl' . 5041 255-8777
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V U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
OFFICE OF INSPECTOR GENERAL
s
"?-"lnae 2003 Benefits Statement
STATEMENT DATE-All benefit computations and figures below are based on payroll data as of this date: 5/31/2003
SERVICE COMPUTATION DATE: 12/20/1978 EMPLOYEE PAY PLAN
SCO is used for leave/RIF purposes. In some circumstances, GRADE/ STEP: GS-13-08
this date may differ for retirement purposes. Please contact BASE HOURS:
your Servicing Personnel Office if you have questions. 80
SICK LEAVE - If you are unable to work because of illness or -
injury, your full pay continues for the period of your accu- .. _ _ _ _ _ _ _
mulated sick leave. I
Your accumulated sick leave . 1439.5 1 EMPLOYEE NAME: BRUCE B SOL014ON
ANNUAL LEAVE-You may use this in place of or as an ex- 1 58 BOURBON RED DR
tension of sick leave. I NECBANICSBDRG, PA 17055
1 1 r
Your accumulated annual leave - 261 1 1
RETIREMENT BENEFITS
Total employee retirement system contributions to CSRS from most recent date of employment with your current payroll office, DHHS, to statement
date: $78,070.25
INCOME BENEFITS
CIVIL SERVICE RETIREMENT SYSTEM - Below are estimates of your
monthly retirement benefits starting at the dates indicated. The estimates
were ccmputed Using an assumed high-3 average salary equal to your
nln ?
It you retire on 7./5/2010 7/5/2015 7/5/2017
You would be age 65..yrs ; 0 raths 60 yrs ; 0 mths 62 yr•
Your Annuity Without
Survivor Benefits $S,125. 43 $5,988.06 $6,333
Your Annuity With
Survivor Benefits $4,635. 39 $5,411.75 - $5,722
Monthly Survivor Benefit $2y818. 99 $3,293.43 $3,483.21
Note: Maximum credit allowed is 41 years and 11 months (80%), ex-
cluding sick leave.
Note: PHYSICIANS SPECIAL PAY (PSP) EMPLOYEES -The above retirement
estimates are based on your annual salary plus your yearly PSP allow-
ance. However, for PSP to be included in the assumed high 3 average
pay for retirement purposes, you must have 15 years of Federal service
as a government Physician/Dental Officer. In addition, for service that
precedes the Agency's authorization of PSP under Title 38, there is an 8
year phase-in period of the use of PSP in the calculation of annuity. For
further information, contact your Servicing Personnel Office.
Note: PHYSICIANS' COMPARABILITY ALLOWANCES (PCA) EMPLOYEES --
-Ihe use of comparability allowances to calculate retirement annuity is
not reflected in the above estimates. Data available does net allow for
an actual calculation at this time. For further information, contact your
Servicing Personnel Office.
Note: LAW ENFORCEMENT (1811)EMPLOYEES -Thespecial lawenforce-
ment provision is not reflected in the above estimate. Data available
does not allow for an actual calculation due to the number of variables
required. Please contact your seiviong Personnel Office for a more
detailed estimate.
gineC l`/$]
Deductions from your gross monthly annuity would include health
benefits, life insurance, survivor benefits, unpaid deposits/redepos-
its and Federal/Slate taxes if applicable. As your salary increases,
your rMirament annuity and its value will also increase. Please read
the IMPOHTANT INr-QHIvlA-
TION included '-with this state
ment for further information on
how these and other retirement
system benefits shown for you
have been estimated. If seriously
considering retirement, you
should contact your Servicing
Personnel Office for a closer es-
timate of your annuity. Any So-
cial Security benefits would be in
addition to the benefits shown
here.
HEALTH INSURANCE - If eligible, you may continue coverage for yourself
and your eligible family members during retirement. Your surviving spouse
and eligible children may continue coverage after your death if retire-
ment system survivor benefits are payable.
BASIC LIFE INSURANCE- If eligible, you may continue full coverage to
age 65 at the same cost as if you were employed. At age 65, or retire-
ment if later, coverage continues at no cost to you and your coverage is
reduced by 2% a month to a minimum of 25% of your coverage at retire-
ment. You may elect to continue full or 50% coverage by paying an addi-
tional premium.
OPTIONAL LIFE INSURANCE - If eligible, you may continue full coverage-
Standard, Additional and Family-until age 65 or retirement it later at the
same cost as it you were employed. After age 65, or retirement if later,
Standard coverage is reduced by 2% per month to a minimum of $2,500.
Additional and Family coverage is reduced by 2% per month for 50 months
until coverage ends. This is at no cost to you. You may elect to continue
full Additional and Family coverage after age 65 by continuing to pay the
premium. ^,
-7 f &/ 6j2 1, Rge I of 4
THRIFT SAVINGS PLAN (TSP)
Each pay period you are contributing e ! to your TSP account. Below are estimates of y3ur projected TSP account balance at
various retirement ages based on your current contributions and three different average annual account growth rates. Also shown for each '
projected account balance is an estimate of the monthly single-life TSP annuity that could be purchased with the account balances at the ages
shown.
6% GROWTH TSP 8% GROWTH TSP 10% GROWTH TSP
AGE RATE ANNUITY RATE ANNUITY RATE ANNUITY
55 yrs;O mths $194,573.61 $1,414.55 $218.,915.74 $1,591.52 $246,647.46 $1,793.13
60 yrs;O mths $310,598.94 $2,413.35 $376,857.06 $2,928.18 $459,250.59 $3,568.38
62 yrs;0 mths $367,645.22 $2,955.87 $459,907.59 $3,697.66 $578,716.28 44,652.88
65 yrs;O mths $467,099.72 $3,975.02 $612,165.25 $5,209.53 $809,048.42 $6,885.00
The above estimates were made based on the assumptions that your
salary and contributions remain unchanged and that you make no loans
from your TSP account. The above projections include your TSP account
balance of $78,567.10 as of 2/28/2003
Currently, eligible employees can enroll in TSP during 2 open seasons
held each year (April 15 - June 30 and October 15 - December 31). You
can contribute up to 8% of your basic bi-weekly salary. There is no Gov-
ernment matching contribution for CSRS/CSRS offset employees. Your
contributions and earnings will be given favorable tax treatment by being
tax deferred until you begin to withdraw funds from your account.
March 31, June 30, September 30, and December 31.You may also view
your participant statement via the TSP web site (wwwtsp.gov).
1
Your account balance may be used to provide another source of income;
separate from your Government annuity when you retire. At retirement,
you may elect to receive the value of your account in a lump sum or in
equal payments over a designated period. You may also elect to pur-
chase a life annuity or to roll the balance over to an Individual Retire-
ment Account. Another option is to leave the balance in your TSP ac.
count, where it continues to earn interest, and deter payment to a later dale.
NOTE: Many of these provisions apply if you separate from Government
service before retirement eligibility.
Details on your TSP account are shown on the statement provided by
the Thrift Investment Board. Participant statements are issued quarterly,
DISABILITY BENEFITS
INCOME BENEFITS
RETIREMENT SYSTEM - if you have 5 or more years of creditable civil-
ian service and become disabled, you could receive a CSRS monthly
disability annuity of$ 3, 889.00 , This
monthly annuity will continue for life or until you recover from your
disability.
FEDERAL EMPLOYEES' COMPENSATION ACT (FECA) - If you become
totally disabled from an on-the-job injury, you can continue to receive
FULL PAY for up to 45 calendar days. Thereafter, it you remain disabled
and cannot work, you may receive a monthly benefit as follows:
It unmarried and there are no eligible dependents: $5, 750.86
It married and/or there are eligible dependents:$6, 469.69
Benefits start within 14 days and continue as long as you cannot work,
or for life in case of total and permanent disability. Benefits shown are based
on your current salary rate. Children eligible to receive benefits generally
are unmarried and under age 18, or, if full-time students, under age 23.
It you qualify for both Retirement System and FECA benefits, you may
choose the more advantageous benefit.
OTHER BENEFITS
ACCIDENTAL DISMEMBERMENT INSURANCE (under FEGLI) - Payable for
accidental loss of limbs or total eyesight:$106, 000.00
• Half that amount is payable for loss of one limb or eye.
LIFE INSURANCE PROGRAM-If you qualify for retirement system ben-
efits, Basic Life Insurance and Optional Lite Insurance (but not acciden-
tal death and dismemberment coverage) may be continued if you are
eligible.
HEALTH BENEFITS PROGRAM - If eligible, you may continue coverage
for yourself and your eligible family members.
DEATH-IN-SERVICE BENEFITS
FEDERAL EMPLOYEES' GROUP LIFE INSURANCE PROGRAM
BASIC LIFE INSURANCE - Payable at death from any
cause =$106, 000.00
ACCIDENTAL DEATH INSURANCE- Payable if death results from an acci-
dent, an additional $106, 000.00
OPTIONAL LIFE INSURANCE - Payable at death from
any cause
Standard Optional Life Insurance =$0.00
Additional Optional Life insurance -$312, 000. 00
If you are under age 45, Basic Lite Insurance includes the ..extra benefit"
See IMPORTANT INFORMATION for details.
Page 2 at 4
INCOME AND OTHER BENEFITS
RETIREMENT SYSTEM - If you have at least 18 months of creditable civil-
ian service, your eligible spouse could receive a monthly survivor annu-
ity of about $2,138.95 . A spousal survivor annuity is pay-
able for life, or until remarriage if before age 55. For remarriages ocCurring
after 01/01/1995, it the widow/widower remarries before age 55 and was
married for at least 30 years to the individual on whose service the sur-
vivor annuity is based, the survivor annuity will not be terminated. Eli-
gible children receive additional benefits.
HEALTH BENEFITS PROGRAM - Coverage for your enrolled dependents
may continue if they are eligible for retirement benefits or FECA survivor
benefits.
FAMILY OPTIONAL LIFE INSURANCE - Upon your death, covered family
members may apply to convert coverage to a private policy:
to $1,000, monthly benefits may be payable to your eligible spouse and/
or dependent children as follows:
To your spouse with no children $4.,.313...12
To your spouse with one child .45.,.115.,.75.
To your spouse with two or more children .$.6., 469.69
Or if there is no surviving spouse:
To one eligible child $3,.450..50 ...................
And to each additional eligible child .$1.293.94
Up to a maximum for all eligible children.$.6,469.69
Your spouse's coverage .$0...0.0 ....:......... Spouse's benefits are payable for life, or until remarriage if before age
55. A spouse who remarries before age 55 receives a lump sum pay-
Each eligible child's coverage $0...00... menl equal to 24 months benefits. Children's benefits continue as long
as they qualify as dependents. If your survivors are eligible for benefits
FEDERAL EMPLOYEES' COMPENSATION ACT (FECA) - If your death re- under both the retirement system and FECA, they may choose which-
sults from a job related injury or illness, in addition to a lump sum of up ever is the more advantageous.
HEALTH BENEFITS
PLAN NAME FN.40?1RfAARl01C.7,G.a.. )?fl0.t10y1'Vlnla
PLAN CODE..5...7 ..........................................
TYPE OF ENROLLMENT Sal! .....................
ENROLLMENT OPTIONNC.!40 ........................
If you separate from government before you are eligible for retirement,
your health insurance will terminate after 31 days. However, under the
Temporary Continuation of Coverage rules, you may elect to continue
your insurance for a period of up to 18 months, but you must pay the
FULL cost of the insurance plus a 2% administrative fee. The same rules
apply to a child who loses eligibility for insurance under a parent's enroll-
ment (due to attaining age 22 or marriage). A child may continue cover-
age for up to 36 months.
EMPLOYEE BI-WEEKLY DEDUCTION$35_AS
The health benefits shown are a summary only. You should refer to your
health plan brochure or contact your Servicing Personnel Office for com-
plete information. In addition, comparison charts and health plan bro-
chures are available on the OPM web site (www.opm.gov/ insure).
To continue coverage during disability or retirement, you must retire with
an immediate annuity or receive Federal Employees' Compensation Act
benefits. Also, you must have been enrolled for the 5 years preceding
retirement or, if less than 5 years, since you first became eligible. The
cost to you in retirement is the same as the cost while employed, but on
a monthly basis.
TOTAL COMPENSATION
Your Annual Salary $10.3.5.15.,.0.0 .............................
Estimated contributions by your agency for the year 2003$12.,.158..27..........
YOUR ESTIMATED TOTAL COMPENSATION FOR THE YEAR 2003 $115,673.27
Employee Agency These estimated contributions represent the approximate cost of
Contributions Contributions providing the benefits shown for you on this statement.
Retirement Fund ............ ... $7,687.68 $7,770.32 Your annual salary represents your pay rate excluding premium pay,
differentials and cost-of-living allowances. The total compensation
Medicare ......................... ... $1,473.18 $1,413.18 figure represents your base salary plus the agency contributions to
provide you the various benefits described.
Social Security ... . .... $0.00 $0.00
NOTE FOR LAW ENFORCEMENT EMPLOYEES: Your annual salary
FEGLI ............................. .... 91,151.41 $206.61 represents your pay rate excluding differentials and cost-ol-living
allowances. The total compensation figure represents your base
Health Benefits ............ .... $902, 55 $2,708.16 salary plus the agency contributions to provide you the various ben-
efits described.
Thrllt Savings Plan ...... .... $7,175.18 $0.00
For further information or questions, please contact your Servicing
TOTAL..... .......... .............. .... $18,390.00 $12,158.27 Personnel Office.
Page 3 of 4
IMPORTANT INFORMATION
This statement was prepared on data and Federal Government programs
in effect on the date shown at the top of you€ Benefits Statement and
does not include any changes, which may have occurred in the benefit
programs since that date. If any of the information shown for you ap-
pears to be incorrect, please contact your Servicing Personnel Office.
While every effort has been made to ensure the accuracy of the benefits
shown for you, errors can occur. In all cases, actual benefits paid will be
in accordance with the governing plan documents or insurance contracts.
If N/A appears on your statement instead of a benefit amount, it indi-
cates that you either are not eligible for or have elected not to participate
in that specific category.
CIVIL SERVICE RETIREMENT. SYSTEM (CSRS):
For purposes of this statement, retirement estimates have been based
on your current salary rate. The estimates assume that you have no
outstanding deposits, redeposits, or military service deposits. If you are
planning to retire within the next 3 years, you should contact your Serv-
icing Personnel Office for a more accurate estimate. The estimates pro-
vided here will be overstated since actual benefits will be determined on
your high-3 average pay, not current salary.
In all cases, estimates have been based on your total creditable service
using your service computation date as the start dale. NOTE: If you
have had any part-time service after 4/6/86, these retirement estimates
may be overstated. Data available does not allow for an actual calcula-
tion due to the number of variables required. You may contact your Serv-
icing Personnel Office for a more accurate estimate.
generally unmarried and under age 18 or -if full-time students under age
22, may also qualify for benefits. For 2003, each child could receive per
month the lesser of $384 (single orphan) or $461 (double orphan); or
$1,152 (single orphan) or $1,383 (double orphan) divided by the number
of eligible children. These benefits are subject to offset by any Social
Security children's benefits payable. -
CIVIL SERVICE OFFSET EMPLOYEES pay full Social Security taxes as
well as reduced civil service retirement deductions. Employees covered
under this system are subject to all of the above information regarding
the Civil Service Retirement System. You will collect the retirement
benefits shown until age 62. At age 62, however, your civil service
annuity will be reduced by a portion of your earned Social Security
benefit. The amount which will be deducted from your civil service
annuity will be the lesser of: (1) the portion of your total Social Secu-
rity benefit which is based on Federal employment after 12/31/83; or
(2) the total Social Security benefit for which eligible at age 62 multi
plied by the number of years you were under CSRS Offset and then
divided by 40. - ;
SOCIAL SECURITY RETIREMENT SYSTEM: If you were ever employed in a
Social Security covered position and you wish to obtain an estimate of
your current Social Security benefits, you may call (1-800) 772-1213 and
the appropriate forms will be mailed to you. You may also request a state-
ment on the SSA web site (www.ssa.gov). NOTE: Effects of the Windfall
Elimination Provision of the Social Security Act are not reflected in the
benefit estimate. As a result, benefits shown may be higher than your
entitlement.
Retirement system contributions are those that you have made since
your most recent employment under your current payroll office, DHHS.
Any amounts paid before that date are in addition to the amount shown.
ACtllal benefits paid will be based on your total creditable service and
your high-3 average pay, whether earned before, during, or after your
current period of service.
Estimated retirement benefits shown do not reflect: 1) any voluntary con-
tributions you have made in addition to your normal contributions, 2) use
of any accumulated sick leave to increase your total service, 3) any un-
paid deposit or redeposit of retirement deductions for past service, or 4)
any future cost-of-living adjustments.
You must have 5 years of creditable civilian service to qualify for ben-
efits. Unless you retire on disability, at least 1 year of your civilian serv-
ice must have been within the 2-year period before the separation upon
which your retirement is based.
You and your spouse must be married at least 9 months or have a child
in order for your spouse to qualify for survivor benefits. Eligible children,
LIFE INSURANCE: Coverage can continue during retirement if you retire
on an immediate annuity, including disability retirement, or you receive
FECA benefits. Both Basic and Optional Life Insurance can be contin-
ued if you have had coverage for the preceding 5 years or, if less than 5
years, for the full period it was available to you. The Basic Life Insurance
includes an extra benefit for participants under age 45. The extra benefit
doubles the amount of Basic Life Insurance if you are age 35 or younger.
Beginning on your 36th birthday, the extra benefit decreases 10% each
year until, at age 45, the extra benefit ceases. The Basic Life Insurance
amount shown on this. statement reflects the extra benefit if you were
under age 45 as of the date of this statement.
MEDICARE: YOU will quality for Medicare hospital insurance at age 65 (or
earlier if you are disabled and meet the requirements) if you have earned
enough Social Security credits. Also, Federal earnings in and after 1983
will help earn these credits. Under certain conditions, eligible depen-
dents may be entitled to Medicare on the basis of your earnings. For
specific information regarding your Medicare coverage, contact your lo-
cal Social Security office or call (1-800) 772-1213.
If you have comments about this Statement, e-mail us at EBSccirnFnents@)psc.gov.
We value your feedback. The address can be found in the HHS Global e-mail direc.
tory under "Benefits Statement Comments"
Page 4 of 4
.01b
Provided by N
Vanguard - Consolidated View
Page 1 of 1
4& MuWuwd.
Accounts & Activity-Consolidated ViewTM ®prtnt thin page
Total Vanguard Assets $82,082.35 (Compare to year-end balances.) ® oownloaa transaalnns
You can control which accounts display and print by creating a preferred account view.
Expand name and address information for your accounts.
.PTMUM,
F"??`ia"F. M '?.±I LS.?
Portfolio of Bruce H. Solomon
E • Bruce H. Solomon-Roth IRA
Buy & Sell I Transaction History Price as of 04/04/2006
Vanguard Health Care Fund Investor Shares 0052-
09927978960 447.884 $140.48 $0.59 $621918.74
Subtotal $62,918.74
Bruce H. Solomon Portfolio Total $62,918.74
Portfolio of Janet Irene Solomon Bruce_ H. Solomon
Janet Irene Solomon, Bruce H. Solomon-Joint Account
Buy & Sell I Transaction History I Cost Basis Price as of 04/04/2006
rv?P.r!rP .._.,?_..K ... i....iw...__.,. w::<.a....... 1_:..`.A?..'?. ?.,..._'p.. ' ...v_ i l
Vanguard 500 Index Fund Investor Shares 0040-
09920795645 159.325 $120.28 $0.76 $19,163.61
Subtotal $19,163.61
Janet Irene Solomon, Bruce H. Solomon Portfolio Total $19,163.61
i
utside Investments allows you to Include your non Vanguard accounts in Consolidated ViewT". Learn more
bout this service.
®1995-2006 The Vanguard Group, Inc. FUI rights reserved. Vanguard Marketing Corp., Distrib. Terms & Conditions of Use I Obtain
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https://flagship2.vanguard.comNGApp/hnw/TPView?TpvPrtAnc=1 4/5/2006
Vanguard - Transaction History
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Transaction History Search Results
Investment
VGI
type
Portfolio Bruce H Solomon
Account 09927978960
p wnload tranudions
Holding Health Care Fund Inv 0052-
09927978960 VGHCX
t
e range
i Da 01/03/2003 - 04/05/2006
Transaction Buy, Distribution, Conversion
types
Perform a new search or modify existing search
03/24/2006
Long-term capital gain
}
10.026!
$141.28 $1,416.42
447.884
. $63,277.05
03/24/2006 Short -term;oapifa[gain 0184 $141;26=I 1 f ifi E' 4 T:888 '$,61 8611,58
03/24/2006 Dividend 1.081 $141.28 $152.77 437.574 $61,820.45
12J1612005 Lohg-term rapitp] gain 10.227 $1$9 1 r ? 0444 , 436;493 ,ffi60;764.19
12/16/2005 Short-term capital gain 0.929 $139.21 $129.27 426.266 $59,340.49
12/1672005 Dividend 4.265 $1130.2f 425.337 $59,211.16
03118/2005 Long-term capital gain 4.355 $125.12 $544.95; 421.072 $52,684.53
03/18/2005 ShorW6rm capitaI?gain 0289 $125:12'i $36:79,(' 416:717 $521139;63
03/18/2005 Dividend 0.439 $12512 $54.91 416.428 $52,103.47
12/17/2004, Long-term capWgajn 10.305 $124,67,! $:1x284415.989 $51',,861.35
12/17/2004 ! Dividend 3.580 $124.67 $446.34405.684 $50,576.62
03/19/20.04 Long,46rm capitai$ain 7173 $121:'18 $214.9A '. 402.101 $48,,730.98
03/19/2004 Short-term capital gain 0.864 $121.19 $104.66 400.331 $48,516.11
0311912004 Dividend 0,007 $121,19 l $0:80 ; 399'AW
I $48,411,41
12/19/2003 Dividend 3.243 $118.50' $384.33' 399.460 $47,336.01
0810612003 Buy 75.774 $1A54,7 i 7,961"58,1 396:217 $41;830.52
03/21/2003 ! 5-year capital gain 0.310 $95.92 $29.76 1 289.364 $27,755.79
MOM /Wina niviriranrl n n7F i 'SCnri W) R7,47 12RD nF,A 0/076709 M
https://flagship2.vanguard.comNGApp/hnw/HistorySearchResult?vmfAccount=2&account... 4/5/2006
ri,,Waypjqint
P.O. Boa 174. Marrlsburg. PennsgWaNa 71054711
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BRUCE H SOLOMON
508 BOURBON REDODRN
MECHANICSBURG PA 17050-7901
010.594
STATEMENT DATE
1.05.03
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PREVIOUS BALANCE
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STATEMENT DATE
1-05.03
100064111
PAGE 3
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STATEMENT DATE
1-05-03
100064111
PAGE 2
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100064111
PAGE 4
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EXHIBIT "H"
BRUCE H SOLOMON
PO BOX 336
HARRISBURG PA 17108-0336
1057 0012 76874 Y
STATEMENT OF ACCOUNTS
1371-30517 X
STATEMENT PERIOD
npm THROUGH
1-01-03 3-31-03 0
PAGE 1 OF 1
0 ENCLOSURES
0
STATEMENT SAVINGS ACCOUNT: 1371-30517
PREVIOUS DEPOSITS/ WITHDRAWALS/ INTEREST ENDING
STATEMENT BALANCE CREDITS 3 DEBITS 2 PAID BALANCE
5.919.90 1.950.00 901.00 3.15 6,972. 05
ACCOUNT/INTEREST INFORMATION
INTEREST PAID THIS YEAR 3.15
DE
EDITS/ ITS ALS/
WI
DATE ACTIVITY DESCRIPTION REFERENCE
CRR DEB BALANCE
01-01 BEGINNING BALANCE 5,919. 90
01-30 DEPOSIT 02269408350 250.00 6,169. 90
01-31 WTHD' RWL 02470903370 900.00 5,269. 90
02-13 WITHDRAWAL REVERSAL 90020300005 900.00 6,169. 90
02-26 DEPOSIT 02373200740 800.00 6,969. 90
02-28 SERVICE FEE 1.00 6,968. 90
03-31 INTEREST CREDIT 3.15 6,972. 05
03-31 ENDING BALANCE 6,972. 05
••• ANNUAL PERCENTAGE YIELD EARNED DISCLOSURE FROM 1-01-03 THROUGH 3-31-03 • ••
ANNUAL PERCENTAGE YIELD EARNED .20%
VERAGEDAI COLLECTED BALANCE 6.391.22
INTEREST EARNED 3.15
••• SERVICE FEE DISCLOSURE FROM 2-01-03 THROUGH 2-2 8-03 •••
REGION 1 ATM INQUIRIES 1 AT 1.00 1. 00
TOTAL SERVICE FEE 1. 00
THERE IS STILL TIME TO OPEN YOUR INDIVIDUAL RETIREMENT
ACCOUNT. THE FUTURE WILL BE HERE BEFORE YOU KNOW IT, SO THE
TIME TO START SAVING IS NOW. WE HAVE A VARIETY OF WAYS TO
HELP YOU START PLANNING FOR YOUR RETIREMENTI
DIRECT N HAFRK
INQUIRIES TO: `[JI73I?ION
DIRECT BANKING CENTER
TELEPHONE: 1-800-FULTON4
EXHIBIT "I"
BRUCE H SOLOMON
PO BOX 336
HARRISBURG PA 17108-0336
1057 0012 57815 Y
STATEMENT OF ACCOUNTS
3622-32430 X
STATEMENT PERIOD
GH
12-18-02 1-20- 7
PAGE 1 OF 2
0 ENCLOSURES
0
SIMPLY FREE CHECKING ACCOUNT: 3622.32430
PREVIOUS DEPOSITS/ - CHECKS/ SERVICE ENDING
STATEMENT BALANCE CREDITS 3 DEBITS 10 FEES BALANCE
1,917.24 1 ,550.00 1,190.88 .00 2,276.36
DEPOSITS/ CHECKS/
DATE ACTIVITY DESCRIPTION REFERENCE CREDITS DEBITS BALANCE
12-18 BEGINNING BALANCE 1.917.24
12-19 CHECK 01055303750 97.85 ,
1,819.39
12-20 DEPOSIT 02774105680 750.00
12-20 CHK CARD PUR 339556 20.91
THEBONTO THEBONTONI3
CAMP HILL PA 2.548.48
12-23 CHECK 107 00350305750 99.56 2,448.92
12-30 CHK CARD FUR 228262 39.98
GEOFFREYB GEOFFREYBE
HERSHEY P
A 2,408.94
12-31 CHECK BOOK FEE 00077900000 12.25 2,396.69
01-06 CHECK 108 00807803570 775.32 1,621.37
01-07 CHK CARD PUR 984561 54.98
DUNHAMSIO DUNHAMSI05
MECHANICSBURGPA 1,566.39
01-13 DEPOSIT 02781005190 400.00
01-13 POS PURCHASE 009515 14.80
KOHL'SI03 6444CARLIS
MECHANICSBURGPA
01-13 POS PURCHASE 954710 37,82
WALWALMA 1886WALWAL7
MECHANI1886 PA 1
913.77
01-15 CHECK 109 00900606490 37.41 ,
1
876
36
01-17 RHS TREAS 310 00077900000 400.00 ,
.
FED SALARY 011703
169461854750100 2
276
36
01-20 ENDING BALANCE ,
.
2,276.36
CHECK SUMMARY
• INDICATES SKIP IN CHECK NUMBERS
CHECK NO AMOUNT CHECK NO AMOUNT
97.85 108 775.32
107 99.56 109 37.41
TOTAL NUMBER OF CHECKS 4 TOTAL AMOUNT OF CHECKS 1,010.14
DIRRU TIES TO: TON SION
DIRECT BANKING CENTER
TELEPHONE: 1.800-FULTON4
EXHIBIT "J"
Commerce
Bank
BRUCE H SOLOMON
P.O. BOX 11723
HARRISBURG, PA 17108
STATEMENT DATE
06/30/02
0626006951
ACCOUNT NO.
*** SAVINGS *** YES ADVANTAGE BEGINNING RATE 1.00000
ACCOUNT NUMBER 0626006951
PREVIOUS STATEMENT BALANCE AS OF 06/23/02 .00
PLUS 2 DEPOSITS AND OTHER CREDITS ................... 1,000.19
LESS 0 WITHDRAWALS AND OTHER DEBITS .00
CURRENT STATEMENT BALANCE AS OF 06/30/02 1,000.19
NUMBER OF DAYS IN THIS STATEMENT PERIOD 7
---------------------------------- - -----------------------------------------------
*** SAVINGS ACCOUNT TRANSACTIONS ***
DATE DESCRIPTION DEBITS CREDITS
06/24 DEPOSIT 1,000.00
06/30 INTEREST PAYMENT .19
-----------------------------------------------------------------------------------
*** BALANCE BY DATE ***
06/23 .00 06/24 1,000.00 06/30 1,000.19
PAYER FEDERAL ID NUMBER 23-2324730
INTEREST PAID YEAR TO DATE .19
-- - - ------------------------- - -------------------
*** INTEREST EARNED THIS STATEMENT PERIOD ***
DAYS IN PERIOD ......................... 7
INTEREST EARNED .19
ANNUAL PERCENTAGE YIELD EARNED (APY).... 1.00%
Commerce
w ank
BRUCE H SOLOMON
P 0 BOX 11723
HARRISBURG PA 17108
*** SAVINGS *** YES ADVANTAGE tsnUINNIA
ACCOUNT NUMBER 0626006951
PREVIOUS STATEMENT BALANCE AS OF 06/30/02 ........................
PLUS 1 DEPOSITS AND OTHER CREDITS ...................
LESS 1 WITHDRAWALS AND OTHER DEBITS ................
CURRENT STATEMENT BALANCE AS OF 09/30/02 .........................
NUMBER OF DAYS IN THIS STATEMENT PERIOD 92
STATEMENT DATE
09/30/02
1 0626006951 1
ACCOUNT NO. I
RATE 1.00000
1,000.19
150.00
1,150.19
.00
------------------------------------------- - -------------------------------------
*** SAVINGS ACCOUNT TRANSACTIONS ***
DATE DESCRIPTION DEBITS CREDITS
07/02 DEPOSIT 150.00
07/09 DEBIT MEMO 1,150.19
-----------------------------------------------------------------------------------
*** BALANCE BY DATE ***
06/30 1,000.19 07/02 1,150.19 07/09 .00
PAYER FEDERAL ID NUMBER 23-2324730
INTEREST PAID YEAR TO DATE .19
EXHIBIT "K"
i®®
04/2006 1440afs l
Series
EE Bonds
# Bonds Total Price
14 $3,125.00
Serial Number
42159506
64840401
40002645
39896641
32571395
33795986
38495573
43235245
43316202
44936896
44049863
254980498
1896956163
333676968
Issue Date Series
10/1994 EE
02/1995 EE
04/1994 EE
10/1993 EE
04/1992 EE
11/1992 EE
05/1993 EE
12/1995 EE
04/1996 EE
08/1995 EE
05/1995 EE
05/1990 EE
05/1989 EE
05/1998 EE
pin
Saving
?? J J
Denomination Serial Number Issue Date
$ 500 r_
Total In terest Total Value YTD Im
$2,219.74 $5,344.74 $55.1
Issue Interest Next Final
Denom Price Interest Value Rate Accrual Maturity
$500 $250.00 $161.60 $411.60 142% 10/2006 10/2024
1,000 500.00 303.60 803.60 3.44% 08/2006 02/2025
500 250.00 170.00 420.00 3.62% 10/2006 04/2024
500 250.00 180.40 430.40 3.35% 10/2006 10/2023
500 250.00 300.20 550.20 4.00% 10/2006 04/2022
500 250.00 278.80 528.80 4.00% 05/2006 11/2022
500 250.00 180.40 430.40 3.35% 05/2006 05/2023
500 250.00 119.40 369.40 3.41% 06/2006 12/2025
500 250.00 119.40 369.40 3.41% 10/2006 04/2026
500 250.00 129.20 379.20 3.41% 08/2006 08/2025
500 250.00 129.20 379.20 3.41% 05/2006 05/2025
100 50.00 66.76 116.76 4.00% 05/2006 05/2020
100 50.00 71.48 121.48 4.00% 05/2006 05/2019
50 25.00 9.30 34.30 3.61% 0512006 05/2028
?9iew loll Viewing Bonds 1-14
Note Description
NI Not Issued
NE Not Eligible for Payment
P5 Includes 3-month interest penalty
MA Matured and Not Earning Interest
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(P/ease print and/or save this page before submitting your survey)
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http://wwws.publiedebt.treas.gov/BC/SBCPrice 4/29/2006
LIABUffIES OF THE PARTIES
Defendant marks on the list below those items applicable to the case at bar and itemizes the
liabilities on the following pages.
Secured:
( X) 1. Mortgages/Rome Equity Loan
( ) 2. Judgments
( ) 3. Liens
( ) 4. Other Liabilities
Unsecured:
( ) 5. Credit Card Balances
( ) 6. Purchases
( ) 7. Loan Payments
( ) 9. Note Payable
( ) 9. Other Liabilities
Contingent or Deferred:
( ) 10. Contracts or Agreements
( ) 11. Promissory Notes
( ) 12. Lawsuits
( ) 13. Options
( ) 14. Taxes
( ) 15. Other Liabilities
LIABILITIES
Defendant lists all liabilities of either or both spouses alone or with any person as of the date this
action was commenced
Item Number 1 Item Number 2 Item Number 3
Description of Liability Mortgage on Marital
Residence
Names of All Creditors Bruce H. Solomon and
or Debtors Janet I. Solomon
Date Liability was 2-Feb-96
incurred
Amount of Liability $126,500.00
when Incurred
Amount Due as of
Separation
Current Amount Due Amount due as of April 16,
2006 $54,146.64
Date Balance Due Matures March 01, 2011
Payment Date and $1,341.62 1st day of the
Amount month
Comments Need current balance
Page 1
Loan Summary
Account Info Payment Info Year-End Info Escrow Info I Payment Options Q&A
Account Summary 4 Mortgage Account
Page 1 of
Account Number: 0356103453 Current Date: 04/18/2006
Current Loan Status
The date of the last transaction on your account was 03/29/2006
Your next payment is due on 05/01/2006
Your scheduled payment amount is $1,341.62
Payments received after the late charge assessment date In your Note are subject to a late charge of $52.94
Your principal balance Is $54,146.64
Your current Interest rate Is 5.8800/0
Original Loan Terms
The date of your note is 02102/1996
Your loan matures on 03/01/2011
Your original principal balance was $126,500.00
Your original Interest rate was 5.8750%
Customer Service Close Window
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Home i Find an ATM/Branch I Customer Service ; Contact Us
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Lindsay Gingrich Maclay, Esquire
DALEY ZUCKER MEILTON
MINER & GINGRICH, LLC
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
lmaclayAdzmmglaw. corn
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON,
Plaintiff Docket No. 04-723
V.
CIVIL ACTION-LAW
BRUCE H. SOLOMON,
Defendant (In Divorce)
PRAECIPE TO WITHDRAW APPEARANCE
TO THE PROTHONOTARY:
Kindly withdraw the appearance of Jane M. Alexander, on behalf of Defendant,
Bruce H. Solomon, in the above-captioned matter.
Date: By:
17 J e M. Alexa der, Esquix
upreme Court I.D. # 07 55
148 South Baltimore Street
Dills burg, PA 17019
(717) 432-4514
PRAECIPE FOR ENTRY OF APPEARANCE
TO THE PROTHONOTARY:
Kindly enter the apearance of Daley Zucker Meilton Miner and Gingrich, LLC,
and Lindsay Gingrich Maclay, Esquire, on behalf of Defendant, Bruce H. Solomon, in the
above-captioned matter.
DALEY ZUCKER MEILTON
MINER & GINGRICH, LLC
Date: 0 By:
in say lCourt grich aclay, s wire
Su remI.D. # 87954
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
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Sandra L. Meilton, Esquire
Daley Zucker Meilton Miner & Gingrich, LLC
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
smeilton(aAdzmmglaw. com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON, Docket No. 387 S 2003 (In Support)
Plaintiff
PACSES No. 910105454
V.
BRUCE H. SOLOMON,
Defendant
Docket No. 2004-723 (In Divorce)
STIPULATION and AGREEMENT
THIS AGREEMENT is made this 5"" day of March, 2008, BY and BETWEEN Janet I.
Solomon of 58 Bourbon Red Drive, Mechanicsburg, Cumberland County, Pennsylvania,
hereinafter referred to as "Wife"
A
N
D
Bruce H. Solomon of 332 Thorley Road, New Cumberland, York County, Pennsylvania,
hereinafter referred to as "Husband".
RECITALS
R.1: The Parties hereto were husband and wife joined in marriage on July 3, 1976 in
Altoona, Blair County, Pennsylvania; and
R.2: The Parties hereto are the natural parents of two (2) emancipated children; and
R.3: The Parties hereto separated on or about January 9, 2003; and
•
R.4: Wife previously filed an action for child and spousal support at the above-
referenced term and number and was awarded same; however, the child support has previously
terminated due to the emancipation of both children; and
R.5: An Order was entered by the Honorable Edward E. Guido on June 27, 2006,
wherein Husband was ordered to pay One Thousand Six Hundred Thirty ($1,630.00) Dollars per
month in spousal support effective June 9, 2006; and
R.6: Husband is planning to retire on May 3, 2008; and
R.7: The parties have reached a global agreement with regard to their divorce; and
R.8: The parties contemplate the issuance of a final Decree in Divorce on or before
March 20, 2008. Any payments made by Husband pursuant to this Stipulation after the issuance
of the Divorce Decree shall be considered alimony, payable through Domestic Relations, and as
such, shall terminate on the death of either party or Wife's cohabitation; and
R.9: The Parties agree that Husband's spousal support/alimony obligation shall be
terminated effective May 31, 2008; and
R.10: The Parties agree that any and all arrearages to PACSES Account Number
910105454 shall cease charging as of May 31, 2008, and that any and all arrearages shall be paid
at Five Hundred ($500.00) Dollars per month until paid in full; and
R.11: The parties are desirous of entering this support stipulation without the need for
further court intervention; and
R.12: Upon execution hereof, the Parties desire that this Stipulation and Agreement be
adopted as an Order of Court.
NOW THEREFORE, with the aforegoing recitals being hereinafter incorporated by
reference and deemed an essential part hereof and in consideration of the covenants and promises
hereinafter to be mutually kept and performed by each Party, as well as for other good and
valuable consideration, receipt of which is hereby acknowledged, and the parties, intending to be
legally bound, hereby agree as follows:
(1) The Parties agree that Husband's spousal support obligation of One Thousand Six
($1,630.00) Dollars shall convert to an alimony payment upon issuance of a Decree in Divorce,
which obligation shall be payable through Domestic Relations.
(2) The Parties agree Husband's spousal support/alimony obligation of One Thousand
Six Hundred Thirty ($1,630.00) Dollars per month, shall be terminated effective May 31, 2008;
and
(3) The Parties agree that any arrearage to PACSES Account Number 910105454
shall be paid at Five Hundred ($500.00) Dollars per month until paid in full; and
(4) The Parties agree that this matter should be closed and marked "settled,
discontinued and ended" upon payment in full of any and all arrearages; and
(5) All matters affecting the interpretation of this Agreement and the rights of the
parties hereto shall be governed by the laws of the Commonwealth of Pennsylvania; and
(6) This Agreement constitutes the entire understanding between the parties and there
are no covenants, conditions, representations, or agreements, oral or written, of any nature
whatsoever, other than those herein contained.
IN WITNESS WHEREOF, the parties hereto, intending to be legally bound hereby,
have hereunto set their hands and seals to this Agreement the day and year first above written.
WITNESS:
andra L. fteilton, Esq ire
Attorney for Defendant
anet I. Solomon, Plaintiff
Bruce H. Solomon, Defendant
t:
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
STATE OF PENNA.
Janet I. Solomon
VERSUS
Bruce H. Solomon
No. 04-723-Civil
DECREE IN
DIVORCE
AND NOW,
In &4' / /
DECREED THAT Janet I. Solomon , PLAINTIFF,
AND
Bruce H. Solomon
MIT IX ito ?p -w
2008 , IT IS ORDERED AND
,DEFENDANT,
ARE DIVORCED FROM THE BONDS OF MATRIMONY.
THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE
BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT
YET BEEN ENTERED;
None
PROTHONOTARY
,5p. Y/ - E,
ti
'/
MAR 0 72D08 ? ?"
Sandra L. Meilton, Esquire
Daley Zucker Meilton Miner & Gingrich, LLC
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
smeilton AdzmmRlaw.com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON, Docket No. 387 S 2003 (In Support)
Plaintiff
PACSES No. 910105454
BRUCE H. SOLOMON,
Defendant
V.
Docket No. 2004-723 (In Divorce)
ORDER OF COURT
AND NOW, this day of 2008, upon presentation and
consideration of the attached Stipulation of the parties, it is hereby ORDERED and DECREED:
1) Upon issuance of a Decree in Divorce, Husband's Spousal Support obligation
shall convert to an alimony obligation terminable on the death of either party, or upon Wife's
cohabitation, which obligation shall be payable to Domestic Relations.
2) Husband's Spousal Support/Alimony obligation of One Thousand Six Hundred
Thirty ($1,630.00) Dollars per month, shall be terminated effective May 31, 2008; and
3) Any and all arrearages associated with PACSES Case Number 910105454 shall be
paid at Five Hundred ($500.00) Dollars per month until paid in full; and
4) Once any and all arrears are paid in full, this case shall be closed and marked
settled, discontinued and ended.
BY T E COURT,
Edward E. Guido, J.
b' ?7
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Sandra L. Meilton, Esquire
Daley Zucker Meilton Miner & Gingrich, LLC
1029 Scenery Drive
Harrisburg, PA 17109
(717) 657-4795
smeilton i)dzmmglaw.com
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
JANET I. SOLOMON, Docket No. 387 S 2003 (In Support)
Plaintiff
PACSES No. 910105454
V.
Docket No. 2004-723 (In Divorce)
BRUCE H. SOLOMON, :
Defendant
STIPULATION and AGREEMENT
THIS AGREEMENT is made this 5"`' day of March, 2008, BY and BETWEEN Janet I.
Solomon of 58 Bourbon Red Drive, Mechanicsburg, Cumberland County, Pennsylvania,
hereinafter referred to as "Wife"
A
N
D
Bruce H. Solomon of 332 Thorley Road, New Cumberland, York County, Pennsylvania,
hereinafter referred to as "Husband".
RECITALS
R.1: The Parties hereto were husband and wife joined in marriage on July 3, 1976 in
Altoona, Blair County, Pennsylvania; and
R.2: The Parties hereto are the natural parents of two (2) emancipated children; and
R.3: The Parties hereto separated on or about January 9, 2003; and
R.4: Wife previously filed an action for child and spousal support at the above-
referenced term and number and was awarded same; however, the child support has previously
terminated due to the emancipation of both children; and
R.5: An Order was entered by the Honorable Edward E. Guido on June 27, 2006,
wherein Husband was ordered to pay One Thousand Six Hundred Thirty ($1,630.00) Dollars per
month in spousal support effective June 9, 2006; and
R.6: Husband is planning to retire on May 3, 2008; and
R.7: The parties have reached a global agreement with regard to their divorce; and
R.8: The parties contemplate the issuance of a final Decree in Divorce on or before
March 20, 2008. Any payments made by Husband pursuant to this Stipulation after the issuance
of the Divorce Decree shall be considered alimony, payable through Domestic Relations, and as
such, shall terminate on the death of either party or Wife's cohabitation; and
R.9: The Parties agree that Husband's spousal support/alimony obligation shall be
terminated effective May 31, 2008; and
R.10: The Parties agree that any and all arrearages to PACSES Account Number
910105454 shall cease charging as of May 31, 2008, and that any and all arrearages shall be paid
at Five Hundred ($500.00) Dollars per month until paid in full; and
R.11: The parties are desirous of entering this support stipulation without the need for
further court intervention; and
R.12: Upon execution hereof, the Parties desire that this Stipulation and Agreement be
adopted as an Order of Court.
i
NOW THEREFORE, with the aforegoing recitals being hereinafter incorporated by
reference and deemed an essential part hereof and in consideration of the covenants and promises
hereinafter to be mutually kept and performed by each Party, as well as for other good and
valuable consideration, receipt of which is hereby acknowledged, and the parties, intending to be
legally bound, hereby agree as follows:
(1) The Parties agree that Husband's spousal support obligation of One Thousand Six
($1,630.00) Dollars shall convert to an alimony payment upon issuance of a Decree in Divorce,
which obligation shall be payable through Domestic Relations.
(2) The Parties agree Husband's spousal support/alimony obligation of One Thousand
Six Hundred Thirty ($1,630.00) Dollars per month, shall be terminated effective May 31, 2008;
and
(3) The Parties agree that any arrearage to PACSES Account Number 910105454
shall be paid at Five Hundred ($500.00) Dollars per month until paid in full; and
(4) The Parties agree that this matter should be closed and marked "settled,
discontinued and ended" upon payment in full of any and all arrearages; and
(5) All matters affecting the interpretation of this Agreement and the rights of the
parties hereto shall be governed by the laws of the Commonwealth of Pennsylvania; and
(6) This Agreement constitutes the entire understanding between the parties and there
are no covenants, conditions, representations, or agreements, oral or written, of any nature
whatsoever, other than those herein contained.
IN WITNESS WHEREOF, the parties hereto, intending to be legally bound hereby,
have hereunto set their hands and seals to this Agreement the day and year first above written.
WITNESS:
anet I. Solomon, Plaintiff
andra L. Meilton, Esq 're
Attorney for Defendant
Bruce H. Solomon, Defendant
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MAR 0 7 200V
Janet I. Solomon IN THE COURT OF COMMON PLEAS
Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA
VS. CIVIL ACTION - LAW - IN DIVORCE
Bruce H. Solomon NO. 04-723 CIVIL
Defendant
DOMESTIC RELATIONS ORDER
1. This Domestic Relations Order ("DRO") creates and recognizes the existence of the
Alternate Payee's right to receive a portion of the benefits payable with respect to the Participant.
It is intended to constitute a DRO Acceptable For Processing under final regulations issued by the
Office of Personnel Management ("OPM").
2. This DRO is entered pursuant to authority granted under the applicable domestic
relations laws of the State of Pennsylvania.
3. This DRO relates to the provision of marital property rights to the Alternate Payee.
4. This DRO applies to the Civil Service Retirement System ("Plan") and any successor
thereto. Bruce H. Solomon ("Participant") is a Participant in the Plan. Janet I. Solomon
("Alternate Payee"), the former spouse, is the Alternate Payee for the purposes of this DRO.
5. The Participant's name, mailing address, Social Security number and date of birth are:
Bruce H. Solomon
332 Thorley Road
New Cumberland, PA 17070
Social Security No.: 169-46-1854
Date of Birth: July 5, 1955
6. The Alternate Payee's name, mailing address, Social Security number and date of birth
are:
DRO
Page 2 of 4
Janet I. Solomon
58 Bourbon Red Drive
Mechanicsburg, PA 17050
Social Security No.: 181-44-4077
Date of Birth: March 7, 1952
It is the responsibility of the Alternate Payee to keep a current mailing address on file
with the Plan at all times.
7. The Alternate Payee is entitled to a portion of the Participant's gross monthly annuity
under the Plan as set forth below. The OPM is hereby directed to pay Alternate Payee's share
directly to Alternate Payee.
8. This DRO assigns to Alternate Payee an amount equal to $2,465 of the Participant's
gross monthly annuity, less the cost of providing the Alternate Payee with the former spouse
survivor annuity specified in paragraph 11.
In addition to the above, when COLA's are applied to Participant's retirement benefits,
the same COLA shall apply to the Alternate Payee's share.
9. Payments to Alternate Payee shall commence the date payments commence to the
Participant. Participant agrees to arrange or to execute all forms necessary for the OPM to
commence payments to the Alternate Payee in accordance with the terms of the DRO.
10. Payments shall continue to Alternate Payee for the remainder of the Participant's
lifetime. If the Alternate Payee dies before the Participant, the Alternate Payee's share of the
Participant's pension shall be paid to her estate.
11. The Alternate Payee is awarded a former spouse survivor annuity in the amount of
$2,105 per month. This former spouse survivor annuity of $2,105 per month applies if the
Participant dies before his benefits commence or if the Participant dies after his benefits
commence. The costs associated with providing this former spouse survivor annuity coverage shall
be deducted solely from the Alternate Payee's benefits. Participant agrees to take all necessary
steps to elect Alternate Payee as designated beneficiary for the purposes of establishing and
DRO
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sustaining such former spouse coverage for Alternate Payee (including, but not limited to, electing
the appropriate base amount so that the Alternate Payee receives the monthly survivor annuity as
indicated in this paragraph).
12. If Participant leaves Federal service before retirement and applies for a refund of
employee contributions under the Plan, the OPM is directed not to pay the Participant a refund of
such employee contributions.
13. In no event shall the Alternate Payee have greater benefits or rights other than those
which are available to the Participant. The Alternate Payee is not entitled to any benefit not
otherwise provided by the Plan. The Alternate Payee is only entitled to the specific benefits
offered by the Plan as provided in this Order. All other rights, privileges and options offered by
the Plan not granted to Alternate Payee are preserved for the Participant.
14. The Plan shall issue individual tax forms to the Participant and Alternate Payee for
amounts paid to each such person.
15. In the event that the Plan inadvertently pays to the Participant any benefits that are
assigned to the Alternate Payee pursuant to the terms of this DRO, the Participant shall
immediately reimburse the Alternate Payee to the extent that he has received such benefit
payments, and shall forthwith pay such amounts so received directly to the Alternate Payee within
ten (10) days of receipt. In the event the Plan inadvertently pays to the Alternate Payee any
benefits that are not assigned to her pursuant to the terms of this DRO, the Alternate Payee shall
immediately reimburse the Participant to the extent she has received such benefit payments and
shall forthwith pay such amounts so received directly to the Participant within ten (10) days of
receipt.
16. In the event the Participant makes a one-time irrevocable election to transfer into the
Federal Employees Retirement System ("FERS") before his retirement, then Alternate Payee shall
be entitled to a portion of the Participant's Basic Annuity and/or a Refund of employee
contributions under FERS calculated in a manner similar to that which is enumerated in Sections
8, 9, 10, 11 and 12 above for the annuity and refund, respectively, and payable directly from FERS.
Additionally, Alternate Payee shall be entitled to a former spouse survivor annuity payable under
DRO
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FERS and determined in a similar manner to the survivor benefits set forth under Section 11
above. Further, such former spouse survivor annuity shall be payable directly from FERS.
17. If Participant takes any action that prevents, decreases, or limits the collection by
Alternate Payee of the sums to be paid hereunder, he shall make payments to Alternate Payee
directly in an amount sufficient to neutralize, as to Alternate Payee, the effects of the actions
taken by Participant.
18. The OPM shall notify the Alternate Payee and her legal representative when the
Participant makes an application for any benefit payments or withdrawals from the Plan.
19. The Court of Common Pleas of Cumberland County, Pennsylvania shall retain
jurisdiction to amend this Order, but only for the purpose of establishing it or maintaining it as a
Domestic Relations Order, provided, however, that no such amendment shall require the Plan to
provide any form of benefit or any option not otherwise provided by the Plan, and further provide
that no such amendment or right of the Court to so amend will invalidate this Order.
Accepted and Ordered this ? day of ?' ,
HE COU
CONSENT TO ORDER:
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