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Home My WebLink About09-4227Pamela L. Purdy Attorney ID No. 85783 308 N. Second Street, Suite 200 Harrisburg, PA 17101 (717) 221-8303 (717) 221-8403 facsimile pipurdy@verizon.net Attorney for Plaintiff KELLY S. GLUMAC, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PA V. MICHAEL J. GLUMAC, Defendant NO. j 9- yaa-? &4j 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 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, PA. 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 32 S. Bedford Street Carlisle, PA 17013 (717) 249-3166 ATTORNEY FOR PLAINTIFF Pamela L. Purdy Attorney ID No. 85783 308 N. Second St., Suite 200 Harrisburg, PA 17101 (717) 221-8303 (717) 221-8403 facsimile plpurdy@verizon.net Attorney for Plaintiff KELLY S. GLUMAC, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PA V. NO. 67- ? c3 MICHAEL J. GLUMAC, Defendant IN DIVORCE COMPLAINT IN DIVORCE COUNTI Divorce Under Section 3301(c) of the Divorce Code 1. Plaintiff is Kelly S. Glumac who currently resides at 411 Gettysburg Pike, Mechanicsburg, Cumberland County, Pennsylvania. 2. Defendant is Michael J. Glumac who currently resides at 1777 Meadow Drive, Mechanicsburg, Cumberland County, Pennsylvania. 3. Plaintiff has been a bona fide resident in the Commonwealth of Pennsylvania for at least six months previous to the filing of this Complaint. 4. Plaintiff and Defendant were married on September 14, 1991 at Mechanicsburg, Cumberland County, Pennsylvania. 5. There have been no prior actions of divorce or for annulment between the parties. 6. The marriage is irretrievably broken. 7. The grounds on which the action for divorce is based on are: Section 3301(c): The marriage of the parties is irretrievably broken. After 90 days have elapsed from the filing of this Complaint, it is believed the parties will file Affidavits of Consent to a divorce. 8. Plaintiff has been advised of the availability of counseling and that she may have the right to request that the Court require the parties to participate in counseling. Plaintiff hereby waives her right to such counseling. WHEREFORE, Plaintiff requests this Court to enter a decree of divorce under Section 3301(c) of the Divorce Code. COUNT II Equitable Distribution 9. Plaintiff incorporates by reference paragraphs 1 through 8. 10. Plaintiff and Defendant have acquired various items of marital property which are subject to equitable distribution by this Court under Sections 3501 and 3502 of the Divorce Code. 11. Plaintiff and Defendant have not agreed on an equitable distribution of this property. WHEREFORE, Plaintiff requests the Court enter an Order equitably dividing all the marital property and marital liabilities. COUNT III Counsel Fees and Expenses 12. Plaintiff incorporates by reference paragraphs 1 through 11. 13. Plaintiff has employed Pamela L. Purdy, Esquire, to represent her in this proceeding. 14. Plaintiff is unable to pay her counsel fees, costs and expenses, and Defendant is more than able to pay them. 15. Defendant is employed and has the ability to pay Plaintiffs counsel fees, costs and expenses. 16. Reserving the right to apply to the Court for temporary counsel fees, costs and expenses prior to final hearing, Plaintiff requests that, after final hearing, the Court order the Defendant to pay Plaintiff reasonable counsel fees, costs and expenses. WHEREFORE, Plaintiff respectfully requests that, pursuant to Sections 3104(a)(1), 3323(b), 3702, and 4351(a) of the Divorce Code, the Court enter an Order directing Defendant to pay Plaintiff's reasonable counsel fees, costs and expenses. COUNT IV r 3701(a) and 3702 of the Divorce Code 17. Plaintiff incorporates by reference paragraphs 1 through 16. 18. Plaintiff is unable to sustain herself during the course of litigation. 19. Plaintiff lacks sufficient property to provide for her reasonable needs and is unable to sustain herself through appropriate employment. 20. Plaintiff requests this Court enter an award of spousal support er and/or alimony pendente lite until final hearing, and thereupon to enter an order of alimony in her favor pursuant to Sections 3701(a) and 3702 of the Divorce Code. WHEREFORE, Plaintiff respectfully requests this Court to enter an award of spousal support and/or alimony pendente lite until final hearing, and thereupon to enter an order of alimony in her favor pursuant to Sections 3701(a) and 3702 of the Divorce Code. Dated: (-, I 2, D/ 6 1 Respectfully submitted, Pa ela L. Purdy Attorney for Plaintiff VERIFICATION I verify that the statements made in the foregoing document are true and correct to the best of my knowledge, information and belief. I under stand that false statements ts are made subject to the penalties of 18 Pa. C.S. §4904, relating to unsworn falsification to authorities. Dated: Glzz/0? q ?Enf1 !s ,:.I 23 i,ttl1 ?c:: ?3? U 412 * s f34, -z ?" ,2? a 7 7a-5- KELLY S, GLUMAC, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 09-4227 CIVIL TERM MICHAEL J. GLUMAC, IN DIVORCE Defendant/Respondent : PACSES Case No: 185110956 ORDER OF COURT AND NOW, this 23rd day of June 2009, based upon the Court's determination that the Petitioner's monthly net income/earning capacity is $ 1,656.33 and the Respondent's monthly net income/earning capacity is $ 6,002.63, it is hereby ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit Nine Hundred Twenty-five and 00/100 Dollars ($ 825.00) per month payable bi-weekly as follows: $ 888.00 per month for Alimony Pendente Lite and $ 37.00 per month on arrears. First payment due: in accordance with Respondent's pay schedule. The effective date of the order is June 23, 2009. Arrears set at $ 233.56 as of June 23, 2009. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C.S.§ 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and, at its discretion, make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the PA SCDU to: Kelly S. Glumac. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the Respondent's name with their PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. cc360 The monthly support obligation includes cash medical support in the amount of $250 annually for unreimbursed medical expenses incurred for the obligee. Unreimbursed medical expenses of the obligee that exceed $250 annually shall be allocated between the parties. The party seeking allocation of unreimbursed medical expenses must provide documentation of expenses to the other no later than March 31" of the year following the calendar year in which the final medical bill to be allocated was received. The unreimbursed medical expenses are to be paid as follows: 0 % by the Respondent and 100 % by the Petitioner. [X] Respondent [] Petitioner to provide medical insurance coverage. Within thirty (30) days after the entry of this order, the [] Petitioner [X] Respondent shall submit written proof that the medical insurance coverage has been obtained or that application for coverage has been made. Proof of coverage shall consist of, at a minimum of. 1) the name of the health care coverage provide(s); 2) any applicable identification numbers; 3) any cards evidencing coverage; 4) the address to which claims should be made; 5) a description of any restrictions on usage, such as prior approval for hospital admissions, and the manner of obtaining approval; 6) a copy of the benefit booklet or coverage contract; 7) a description of all deductibles and co-payments; and 8) five copies of any claim forms. This Order is based upon the calculations done at the June 23, 2009 conference and considers that there is a child support obligation for the parties' three children. This Order shall become final twenty (20) after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary for a hearing de novo before the Court. Consented: Petitioner Respondent Petitioner's Attorney Respondent's Attorney Mailed copies on: June 24, 2009 to: Petitioner Respondent Pamela L. Purdy, Esq. Barbara Sumple-Sullivan, Esq. BY THE COURT, wEdgar B. Bayley, J. DRO: R.J. Shadday RLE,'; ; r A> `,'F THE Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KELLY S. GLUMAC, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 09-4227 PACSES NO. 185110956 MICHAEL J. GLUMAC, CIVIL ACTION -LAW Defendant IN DIVORCE APPEAL OF ORDER AND REQUEST FOR HEARING DE NOVO TO THE PROTHONOTARY: Please accept this as an Appeal of the Order dated June 23, 2009 and schedule the matter for De Novo Hearing before the Support Master. Dated: June 26, 2009 Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 Supreme Court No. 32317 Attorney for Defendant Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KELLY S. GLUMAC, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 09-4227 PACSES NO. 185110956 MICHAEL J. GLUMAC, CIVIL ACTION -LAW Defendant IN DIVORCE CERTIFICATE OF SERVICE I, Barbara Sumple-Sullivan, Esquire, do hereby certify that on this date, I served a true and correct copy of the APPEAL OF ORDER AND REQUEST FOR BEARING DE NOVO, in the above-captioned matter upon the following individual, via United States first-class mail, postage prepaid, addressed as follows: Pamela L. Purdy, Esquire 308 North 2nd Street, Suite 200 Harrisburg, PA 17108 DATE: June 26, 2009 Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070-1931 (717) 774-1445 Supreme Court I.D. 32317 Attorney for Defendant i ? FILED-OFFICE OF THE PPOTHMTARY 2009 JUN 29 PM 2: 02 CUM : -i-;- -4L; 6OU#t1TY PENfivS`lLVAN A In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KELLY S. GLUMAC ) Docket Number 09-4227 CIVIL Plaintiff ) VS. ) PACKS Case Number 185110956 MICHAEL J. GLUMAC ) Defendant ) Other State ID Number ORDER OF COURT You, MICHAEL J. GLUMAC plaintiff/defendant of 1777 N MEADOW DR, MECHANICSBURG, PA. 17055-5100-77 are ordered to appear at DOMESTIC RELATIONS HEARING RM C/O HEARING ROOM, DOMESTIC RELATIONS OFFICE, 13 NORTH HANOVER STREET, CARLISLE, PA. 17013 before a hearing officer of the Domestic Relations Section, on the AUGUST 13, 2009 at 8 : 3 OAM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. the Income Statement and the appropriate Expense Statement, if required, attached to this order, completed as required by Rule 1910.11 (c). 4. verification of child care expenses, and 5. proof of medical coverage which you may have, or may have available to you 6. information relating to professional licenses 7. other: Form CM-509 Rev. 1 Service Type M Worker ID 21302 GLUMAC v• GLUMAC PACSES Case Number: 185110956 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest and/or enter an interim support order. If paternity is an issue, the court shall enter an order establishing paternity. THE APPROPRIATE COURT OFFICER MAY ENTER AN ORDER AGAINST EITHER PARTY BASED UPON THE EVIDENCE PRESENTED WITHOUT REGARD TO WHICH PARTY INITIATED THE SUPPORT ACTION. Date of Order: ? ? 6) BY THE COURT: JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE-HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 2 4 0 - 6 2 2 5 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of 2 Form CM-509 Rev. Service Type M Worker ID 21302 ALL- fit" . OF ft NOTM'L 2009 JUN 29 FM 3: 24 CUMB,i-, i ?? a OWNTY PENNSYLVANIA r In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KELLY S. GLUMAC ) Docket Number 09-4227 CIVIL Plaintiff ) vs. ) PACSES Case Number 185110956 MICHAEL J. GLUMAC ) Defendant ) Other State ID Number ORDER OF COURT You, KELLY S. GLUMAC plaintiff/defendant of 411 GETTYSBURG PIKE, MECHANICSBURG, PA. 17055-5169-11 are ordered to appear at DOMESTIC RELATIONS HEARING RM CIO HEARING ROOM, DOMESTIC RELATIONS OFFICE, 13 NORTH HANOVER STREET, CARLISLE, PA. 17013 before a hearing officer of the Domestic Relations Section, on the AUGUST 13, 2009 at 8: 3 OAM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. the Income Statement and the appropriate Expense Statement, if required, attached to this order, completed as required by Rule 1910.11 (c). 4. verification of child care expenses, and 5. proof of medical coverage which you may have, or may have available to you 6. information relating to professional licenses 7. other: Service Type M Form CM-509 Rev. 1 Worker ID 21302 GLUMAC v• GLUMAC PACSES Case Number: 185110956 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest and/or enter an interim support order. If paternity is an issue, the court shall enter an order establishing paternity. THE APPROPRIATE COURT OFFICER MAY ENTER AN ORDER AGAINST EITHER PARTY BASED UPON THE EVIDENCE PRESENTED WITHOUT REGARD TO WHICH PARTY INITIATED THE SUPPORT ACTION. BY THE COURT: Date of Order: JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE-HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of 2 Form CM-509 Rev. Service Type m Worker ID 21302 pF THE PROTK? ARY 2009 JUN 29 PM 3: 24 PWZYWANIA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KELLY S. GLUMAC, ) rl -- Plaintiff ) NO. QQ - ' 122.'7 (?,"IL ? &z-p- 1. V. ) MICHAEL J. GLUMAC ) CIVIL ACTION- LAW Defendant ) IN DIVORCE ACCEPTANCE OF SERVICE I, MICHAELJ. GLUMAC, accept service of the Complaint in Divorce in the above-captioned action. Date: Q Z3 0g Mic ael J. Glumac 1777 Meadow Drive Mechanicsburg, PA 17055 Defendant FILED-04-FICE OF THE '?^;? _ cwt AY 2009 JUL -2 AM 11: 45 L?Y? KELLY S. GLUMAC, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : DOMESTIC RELATIONS SECTION MICHAEL J. GLUMAC, PACSES NO. 232110892 Defendant DOCKET NO. 441 SUPPORT 2009 KELLY S. GLUMAC, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : DOMESTIC RELATIONS SECTION MICHAEL J. GLUMAC, PACSES NO. 185110956 Defendant DOCKET NO. 09-4227 CIVIL TERM ORDER OF COURT AND NOW, this 12th day of August, 2009, this matter having been scheduled for a hearing de novo before the Support Master on the Plaintiffs complaint for child support and her claim for alimony pendente lite, and the parties having reached an agreement on all outstanding issues, upon recommendation of the Master it is ordered and decreed as follows: 1. The interim order for child support entered June 23, 2009 is affirmed as a final order. 2. Effective September 1, 2009 said order is modified such that the Defendant shall pay to the Pennsylvania State Collection and Disbursement Unit as support for his children, Mackenzie Glumac, born October 27, 1994, Brielle Glumac, born March 22, 1996, and Chloe Glumac, born April 25, 2000, the sum of $1,000.00 per month; in all other respects said order shall remain in full force and effect. 3. The interim order for alimony pendente lite entered June 23, 2009 is affirmed as a final order. 4. Effective September 1, 2009 said order is modified such that the Defendant shall pay to the Pennsylvania State Collection and Disbursement Unit as alimony pendente lite the sum of $200.00 per month; in all other respects said order shall remain in full force and effect. 5. Effective January 1, 2010 either party may filed for a modification of either or both orders of court. y th C ,. A cn??% Edgar B. Bayley, J. Cc: Kelly Glumac Michael Glumac Pamela L. Purdy, Esquire For the Plaintiff Barbara Sumple-Sullivan, Esquire For the Defendant DRO RED-07F)CE OF THE PRO '1OTARY. 109 AUG 13 PH 213 4 PDWSWA* ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dirt. of CUMBERLAND Date of Order/Notice 08/14/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal FIN Number PRISMWORKS TECHNOLOGY INC 1777 N MEADOW DR MECHANICSBURG PA 17055-5100 09-4227 CIVIL OOriginal Order/Notice OAmended Order/Notice 0Terminate Order/Notice OOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 166-54-3244 Employee/Obligor's Social Security Number 473.2102131 Employee/Obligor's Case Identifier (See s1 ddendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1,035.OC $ 0.00 $ 0.00 $ 0.00 $ 688.00 $ 0.00 $ 0.00 $ 0.00 per month in current child support per month in past-due child support per month in current medical support per month in past-due medical support per month in current spousal support per month in past-due spousal support per month for genetic test costs per month in other (specify) Arrears 12 weeks or greater? 0 yes © no one-time lump sum payment for a total of $ 1, 923.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 443.77 per weekly pay period. $ 961.50 per semimonthly pay period (twice a month) $ 887.54 per biweekly pay period (every two weeks) $ 1, 923 .00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDA E AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SO L SECURI U?f ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. r i % BY THE COURT: DRO: R.J. Shadday Service Type M OMB No.: 0970-0154 232110892 441 S 2009 RE:GLUMAC, MICHAEL J. N( yC•1 . Bayley, Jildge Form EN-028 Rev.5 Worker ID $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If checked you are required to provide a copy of this form to your em loyee. If your employee works in a state that is different from the state that issued this order, a copy must be provideto your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 7366100276 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : El THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:GLUMAC, MICHAEL J. EMPLOYEE'S CASE IDENTIFIER: 4732102131 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: NEW EMPLOYER'S NAME/ADD FINAL PAYMENT AMOUNT: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60"/" limit is increased to 65"/" if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: * NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 1 1. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Service Type M OMB No. 0970-01 s4 Form EN-028 Rev.5 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GLUMAC, MICHAEL J. PACSES Case Number 185110956 Plaintiff Name KELLY S. GLUMAC Docket Attachment Amount 09-4227 CIVIL$ 888.00 Child(ren)'s Name(s): DOB PACSES Case Number 2-32110892 Plaintiff Name KELLY S. GLUMAC Docket Attachment Amount 00441 S 2009 $ 1,035.00 Child(ren)'s Name(s): DOB MACKENZIE GLUMAC 10/27/94 BRIELLE GLUMAC x3/22/96 CHLOE GLUMAC 04/25/00 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev.5 Service Type M Worker ID $IATT OMB Nn.: 0970-0754 OF 3HE RPOT -Ct?')7ARY 2009 AUG 17 PM 2'. 35 t"n ^?el' Al M1 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dirt. Of CUMBERLAND Date of Order/Notice 09/01/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number PRISMWORKS TECHNOLOGY INC 1777 N MEADOW DR MECHANICSBURG PA 17055-5100 232110892 441 S 2009 RE:GLUMAC, MICHAEL J. 09-4227 CIVIL 0Original Order/Notice OAmended Order/Notice OTerminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obfigor's Name (Last, First, M0 166-54-3x44 Employee/Obligor's Social Security Number 4732102131 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1,000.00 per month in current child support $ 30.00 per month in past-due child support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current medical support $ o . oo per month in past-due medical support $ 200.00 per month in current spousal support $ o . oo per month in past-due spousal support $ o.00 per month for genetic test costs $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ 1,230.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 283.85 per weekly pay period. $ 615.00 per semimonthly pay period (twice a month) $ 567.69 per biweekly pay period (every two weeks) $ 1, 230.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDAN A AN E PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCI SECURI U IN RD,f<R TO BE PROCESSED. DO NOT SEND CASH BY MAIL. ??? BY THE COURT: DRO: R. J. Shadday Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If heckl you are required to provide a opy of this form to your mployee. If yo r employee orks in a state that is di erent from the state that issued this o?er, a copy must be provideed to your empYoyee even if tie box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employeelobligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 7366100276 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : O THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:GLUMAC EMPLOYEE'S CASE IDENTIFIER: 4732102131 LAST KNOWN HOME ADDRESS: DATE OF SEPARATION: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT- NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 13 N HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by intemet www.childsupport.state.pa.us Service Type M MICHAEL J. Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Rev.5 Worker I D $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GLUMAC, MICHAEL J. PACSES Case Number 185110956 Plaintiff Name KELLY S. GLUMAC Docket Attachment Amount 09-4227 CIVIL$ 200.00 Child(ren)'s Name(s): DOB PACSES Case Number 232110892 Plaintiff Name KELLY S. GLUMAC Docket Attachment Amount 00441 S 2009 $ 1,030.00 Child(ren)'s Name(s): DOB MACKENZIE GLUMAC 10/27/94. BRIP&L ? G?,tYI+?C> 03/:22 f 9`6. CHLOE GLUMAC 04/25/00 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment 6mount $ 0.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment A,,mount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker I D $ IATT OF THE OTARY 2009 SE - 2 P Z' {9 1?G?dC` v i i v^?i y ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State commonwealth of Pennsylvania Co./City/DISt. Of CUMBERLAND Date of Order/Notice 01/29/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number 232110892 441 S 2009 RE: GLUMAC , MICHAEL J . 09-4227 CIVIL OOriginal Order/Notice OAmended Order/Notice OTerminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 166-54-3244 Employee/Obligor's Social Security Number PRISMWORKS TECHNOLOGY INC 4732102131 1777 N MEADOW DR Employee/Obligor's Case Identifier MECHANI CSBURG PA 17 0 5 5 - 510 0 (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. h il f ' ' By law, you are required to detect these Order/N~'ice ~otGr~ if th ti amou er n urt s income unt s/obligor nts from the above-named employee ce even e o issued by your State. ~ ''~ ~ $ $ 1, ooo.oo per month in current child support ast-due child support Arrears 12 er month in `; weeks or greater? es ~ nct p so . oo p $ o. oo per month in current medical support ~~; i $ o . oo per month in past-due medical support ~ -~~ ~ ~~~ s $ 500.00 per month in current spousal support - t:;~ $ 3~.0o per month in past-due spousal support w $ o. oo per month for genetic test costs " $ o. oo per month in other (specify) $ one-time lump sum payment for a total of $ 1, 567 . oo per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 361.62 Per weekly pay period. $ 783.50 per semimonthly pay period (twice a month) $ 723.23. per biweekly pay period (every two weeks) $ 1, 567. ao per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 /N ADDITION, PAYMENTS MUST INCLUDE THE DEFEND NT'S NAME AND THE PACSES MEMBER 1D (shown above as the Employee/Obligor's Case Identi ier) ORS L SEC ITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: „J/1 ;'~ C/ ~~ Ip Z Z Q C) DRO: R.J. Shadday Service Type M J. Wesley Oler, Jr., Judge Form EN-028 Rev.S OMB No.: 0970-0154 Worker I D $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If ~hecke~i you are required, to provide a opy of this form to your. m loyee. If yo r employee works in a state that is di Brent rom the state that issued this o~er, a copy must be provic~edpto your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee%bligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee%bligorand you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee%bligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 7366100276 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ~ THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: O EMPLOYEE'S/OBLIGOR'S NAME:GLUMAC EMPLOYEE'S CASE IDENTIFIER: 4732102131 LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: DATE OF SEPARATION FINAL PAYMENT AMOUNT: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: •You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee%bligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee%bligorfrorn employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9. * Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (t 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60°/° of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by Internet www.childsupport.state.pa.us MICHAEL J. Page 2 of 2 Form EN-028 Rev.S OMB No.: 0970.0154 Worker I D $ IATT Service Type M ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GLUMAC, MICHAEL J. PACSES Case Number 185110956 PACSES Case Number 232110892 Plaintiff Name Plaintiff Name KELLY S. GLUMAC KELLY S. GLUMAC Docket Attachment Amount Docket Attachment Amount 09-4227 CIVIL$ 537.00 00441 S 2009 $ 1,030.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB MACKENZIE GLUMAC 10/27/94 ERIELLB GLUMAC 03/22/96 CHLOE GLUMAC 04/25/00 PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren}'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev.5 Service Type M OMB No.:0970-0154 Worker ID $IATT Oct. G. 2010 1:44PM KELLY S. GLUMAC, plaintiff V, MICHAEL J. GLUMAC, Defendant TELLY S. GILUMAC, Plaintiff V. MICHAEL J. GLUMAC, Defendant No-1130 P- 3 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA DOMESTIC RELATIONS SECTION CIVIL ACTION- SUPPORT Docket No. 441 SUPPORT 2409 PACSES Case Number: 232110892 : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : DOMESTIC RELATIONS SECTION : CB IM ACTION- SUPPORT .71 =T' Docket No. 09-4227 CIVIL TERM : PACSES Case Number: 185110956 AND NOW, to wit, this 19thday Of Nmrornhgr , 2010, upon consideration of the attached Stipulation and on motion of Barbara Sumple-Sullivan, Esquire, counsel for Defendant, Michael J. Glumac and Pamela L. Purdy, Esquire, counsel for Plaintiff, Kelly S. Gh- maw, it is hereby ordered, adjudged and decreed that the terms, conditions and provisions of the attached Stipulation are adopted as an Order of Court. BY TIE COURT, Distribution: Pamela L. Purdy, Esquire, 308 N. Second Street, Suite 200, Harrisburg. PA 17101 Barbara SunVle-Sullivan, E9quire, 549 Bridge Street, New Cumberland, PA 17070 DRO: R.J. Shadday .ter Y? ? r _T' Oct. 6. 2010 1:44PM Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KELLY S. GLUMAC, Plaintiff V. MICHAEL J. GLUMAC, Defendant KELLY S. GLUMAC, Plaintiff V. No.i130 P. 4 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA DOMESTIC RELATIONS SECTION CIVIL ACTION- SUPPORT Docket No. 441 SUPPORT 2009 PACSES Case Number: 232110992 IN THE COURT OF COMMON PLEAS CUMBERLAND :.OUNTY, PENNSYLVANIA DOMESTIC RELATIONS SECTION CIVIL ACTION- SUPPORT MICHAEL J. GLUMAC, Defendant : Docket No. 09-4227 CIVIL TERM PACSES Case Number: 185110956 STIPULATION FOR ENTRY OF ORDER This Agreement is made this /Z) day of October, 2010 by and between Kelly S. Gltunac (hereinafter referred to as "Wife") and Michael J. Glumac (hereinafter referred to as "Husband"). WITNESSETH: WHEREAS, the parties are subject to a Support Order dated August 12, 2009, a true and correct copy is attached hereto as Exhibit "A". Oct. 6. 2010 1:44PM No•1130 P. 5 WHEREAS, the parties desire to amicably amend said Orders of Court and are executing this Stipulation to enter modified Orders of Court. NO'VA' THEREFORE, the parties do set forth the terms of their agreement as follows: 1. Commencing October 15, 2010, Defendant shall pay to the Pennsylvania State Collection and Disbursement Unit as support for his children, Mackenzie Glumac,(born October 27, 1994), Brielle Glumac, (born March 22, 1996), and Chloe Glumac, (born April 25, 2000), the sum of One Thousand, One Hundred, Fifty-Two Dollars and Seventy-Nine Cents ($1,152.79) per month as support for the his children. 2. Commencing October 15, 2010, Defendant shall pay to the Pennsylvania State Collection and Disbursement Unit as alimony pendente lite, the sum of Eight Hundred, Forty-Three Dollars and Eighty-Eight Cents ($843.88) per month. 3. Effective April 15, 2011, either party may file Lor a modification of either or both of the orders. ' Oct, 6. 2010 1:44PM The parties intending to be legally bound, do set their signatures: SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF: J&t?)j z P'v ela L. Purdy, Esquf e Pam Attorney for Plaintiff Barbara Sample-Sullivan, Esquire Attorney for Defendant No-1130 P. 6 4 C, " OLI? 'A -1 L: ?. X--U Kell? S. Glunit lk==- Mich I umac Cc' n 201 :44PM No-1130 P. B KELLY S. GLUMAC, IN THE COURT OF COMM011" FLEAS OF Plaintiff CUMBERLAND COUNTY, PL-KINSYLVANIA V. : DOMESTIC RELATIONS SEC 1 .ON MICHAEL J. GLUMAC, : PACSES NO. 232110892 . Defendant : DOCKET NO. 441 SUPPOW1* 2009 KELLY S. GLUMAC, : IN THE COURT OF COMMON i'LEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : DOMESTIC RELATIONS S£C fON MICHAEL J. GLUMAC, PACSES NO: 1851108A Defendant : DOCKET NO. 094227 CIVIL. TERM ORDER OF COU'I!iT d AND NOW, this 12th day of August, 2009, this matter having 4 ? scheduled for a hearing de nova before the Support Master on the PI complaint for child support and her claim for alimony pendente life, a? ? parties having reached an agreement on all outstandft issues, upont,?-• recommendation of the Master it is ordered and decreed as failows: 1. The interim order for child support entered .iune 23, 200 is affirmed as a final order. 2. Effective September 1, 2009 said order is modified such that the Defiendant shall pay to the Pennsylvania State Collection and _ . -Q?.?rser? Ut]fiLa$saapp?t-far._ttf:?s?.iiidrdltx„-1?iacl?er?ai?-tii+?aa?; born October 27, 1994, Brielle Glumac, bom March 22, 19%, and Chloe Glumac, born April 25, 2000, the sum of $1,000.00 per month; in all other respects said order shall r®main in full force and 3. The interim order for alimony pendente lite entered June 23,; 200 is affirmed as a final order. 4. Effective September 1, 2009 said order it modified such that the Defendant shall pay to the Pennsylvania State Collection and Disburserwt Unit as alimony pendente lite the sum of $200.00 per month; in all other respects said order shall remain in full force and effect. EXMBIT A ` ' Oct. 6- 20 10 1:45PM No-1130 P, 9 5. Effective January 1, 2010 either party may filed for a modification of either or both orders of court. By the Court, 77 y Cc: Kelly Glumac Michael Glumac Pamela L. Purdy, Esquire For the Plaintiff Barbara Sumple-Sullivan, Esquire For the Defendant DRQ a" ORDERINOTICE TO WITHHOLD INCOME FOR SUPPORT 09-4227 CIVIL State Commonwealth of Pennsylvania OOriginal Order/Notice Co./City/Dist. of CUMBERLAND 441 50892 OAmended Order/Notice [Terminate Order/Notice Date of Order/Notice 11/15/10 441 S 2009 Case Number (See Addendum for case summary) OOne-Time Lump Sum/Notice RE: GLUMAC, MICHAEL J. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) PRISMWORKS TECHNOLOGY INC 487 SEEDLING CT MECHANICSBURG PA 17055-7016 166-54-3244 Employee/Obligor's Social Security Number 4732102131 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by vour State. , $ 1,152.79 $ 30.00 $ 0.00 $ 0.00 $ 843.88 $ 37.00 $ 0.00 $ 0.00 per month in current child support per month in past-due child support per month in current medical support per month in past-due medical support per month in current spousal support per month in past-due spousal support per month for genetic test costs per month in other (specify) Arrears 12 weeks or greater? one-time lump sum payment for a total of $ 2,063.67 per month to be forwarded to payee below. o ? s n rn :rm c:) - `ern v> -<> - CO ?04= 1 CD "fJ =-n -n ., w C)rmrt 7j , .,., You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered suooort payment cycle, use the following to determine how much to withhold: $ 476=23 per weekly pay period. $ 1, 031.84 per semimonthly pay period (twice a month) $ 952.46 per biweekly pay period (every two weeks) $ 2,063.67 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic Payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case Iden>tjfierj OR SOC%IECUQxTt) NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAII. BY THE COURT: DRO: R.J. Shadday Service Type M J. Wesley O? OMB No.: 0970.0154 Form EN-028 Rev.5 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS E3 If heck you are required to pr vide a copy of this form to your m loyee. If yo r employee works in a state that is diferent from the state that issued this order, a copy must be provic?edpto your employee even if the box is not checked 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4. * Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 7366100276 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:GLUMAC, MICHAEL J. EMPLOYEE'S CASE IDENTIFIER: 4732102131 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT- NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employeelobligor from employment, refusing to employ, or taking disciplinary action against any employeelobligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev.5 Service Type M OMB No, 0970.0154 Worker I D $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GLUMAC, MICHAEL J. PACSES Case Number 185110956 Plaintiff Name KELLY S. GLUMAC Docket Attachment Amount 09-4227 CIVIL$ 880.88 Child(ren)'s Name(s): DOB Addendum Service Type M OMB No.: 0970-01 S4 PACSES Case Number 232110892 Plaintiff Name KELLY S. GLUMAC Docket Attachment Amount 00441 S 2009 $ 1,182.79 Child(ren)'s Name(s): DOB MACKENZIE GLUMAC 10 /27 /94 . . , CHLOE GLUMAC_. 04,/25/00 Form EN-028 Rev.5 Worker ID $IATT rL . L: Of f IGL Barbara Sumple-Sullivan, Esquire 22 Supreme Court #32317 C; 0 { 9 ' 549 Bridge Street New Cumberland, PA 17070 CU-MBERLAND COUWT'1{ (717) 774-1445 FRNNSYLVAMIA KELLY S. GLUMAC, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 09-4227 CV MICHAEL J. GLUMAC, CIVIL ACTION -LAW Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on June 23, 2009. 2. The marriage of the Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements are made subject to the penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. DATE: MJ. GLUMAC Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 I "?.PR 19 -1111 22 CUMBERLAND COUNTY PENNSYLVANIA KELLY S. GLUMAC, Plaintiff V. MICHAEL J. GLUMAC, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4227 CV CIVIL ACTION -LAW IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER 43301(c) OF THE DIVORCE CODE I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statement herein are made subject to the penalties of 18 Pa.C.S.§4904 relating to unsworn falsification to authorities. DATE: 4AA'111_? MIC AEL J. GLUMAC MARITAL SETTLEMENT AGREEMENT" E' . THIS AGREEMENT, made this eday of , 2011, by ai l rW.> between MICHAEL J. GLUMAC, hereinafter referred to as "HUSBAND", and KELLY S. GLUMAC, hereinafter referred to as "WIFE". WITNESSETH, That: WHEREAS, the parties hereto are husband and wife, having been lawfully joined in marriage on September 14, 1991, in Mechanicsburg, Cumberland County County, Pennsylvania; WHEREAS, three (3) children were born of this marriage being Mackenzie Glumac, born October 27, 1994, and Brielle Glumac, born March 22, 1996; and Chloe Glumac, born April 25, 2000; WHEREAS, it is the intention of the parties to settle fully and finally their respective financial and property rights and obligations as between each other arising out of the marriage relationship or otherwise, including without limitation (1) the settling of all matters between them relating to the ownership of real and personal property; (2) the settling of all matters between them relating to the past, present and future support and/or maintenance of HUSBAND and WIFE; and (3) the settling of all matters between them relating to any and all rights, titles and interests, claims and possible claims in or against the estate of the other. NOW THEREFORE, with the foregoing recitals being hereinafter incorporated by reference and deemed an essential part hereof in consideration of the foregoing recitals, the mutual promises, covenants and undertakings herein set forth, and for good and valuable 4 r consideration, receipt of which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby, covenant and agree as follows: SECTION I GENERAL PROVISIONS 1. ADVICE OF COUNSEL HUSBAND and WIFE declare that they have each had a full and fair opportunity to obtain independent legal advice of counsel of their selection. HUSBAND has been independently represented by Barbara Sumple-Sullivan, Esquire. WIFE has been independently represented by Pamela L. Purdy, Esquire. Each party further declares that they are executing this Agreement freely and voluntarily, having obtained such knowledge and disclosure of their legal rights and obligations. Each party acknowledges that this Agreement is fair and equitable and is not the result of any fraud, coercion, duress, undue influence or collusion. Both parties further acknowledge and agree that each has fully disclosed their respective financial situations to the other, including their assets, liabilities and income. Each of the parties acknowledge and agree that, after having received such information and with such knowledge, this Agreement is fair, reasonable and equitable and that it is being entered into freely, voluntarily and in good faith and that the execution of this Agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal Agreement. n' k 2 AL ! i 2. PERSONAL RIGHTS HUSBAND and WIFE may and shall, at all times hereafter, live separate and apart. Each shall be free from all control, restraint, interference or authority, direct or indirect, by the other in all respects as if she or he were unmarried, except as may be necessary to carry out the provisions of this Agreement. Each may reside at such place or places as she or he may select. Each may, for his or her separate use or benefit, conduct, carry on and engage in any business, occupation, profession or employment which to him or her may seem advisable. This provision shall not be taken, however, to be an admission on the part of either HUSBAND or WIFE of the lawfulness of the causes which led to, or resulted in, the continuation of their living apart. HUSBAND and WIFE shall not molest, harass, or malign the other or the respective families of each other, nor compel the other to cohabit or dwell in any manner with him or her, nor in any way interfere with the peaceful existence, separate from each other. 3. FINANCIAL DISCLOSURE The parties have fully disclosed to each other the extent of each other's income, assets, liabilities, holdings and estate. Each party warrants that the information provided has fully and accurately described the extent of his or her holdings. Each of the parties acknowledge that he or she is aware of his or her right to seek discovery including, but not limited to, written interrogatories, motions for document production, depositions, and other means of discovery available through the Pennsylvania Rules of Civil Procedure. The parties acknowledge that they have had the right to have property fully appraised. Each party is fully satisfied that no additional information is necessary for the execution of this Agreement. 4. MUTUAL CONSENT DIVORCE The parties intend to secure a mutual consent, no fault divorce pursuant to the provisions of Section 3301(c) of the Divorce Code of 1980, as amended and will execute the documents necessary to effectuate a divorce under those provisions concurrently with the execution of this Agreement. The parties agree that the Affidavits of Consent and the Waivers of Notice shall be signed simultaneously with the execution of this Agreement. 5. SUBSEQUENT DIVORCE A decree in divorce, entered by the Court of Cumberland County, shall not suspend, supersede or affect the terms of this Agreement. This Agreement, and the terms and conditions contained herein, as well as the enforcement of said terms and conditions, shall not be contingent upon the granting of a Divorce Decree to either party by the Court of Common Pleas of Cumberland County, Pennsylvania, or any other Court of competent jurisdiction. This Agreement shall remain in full force and effect even if the parties reconcile, cohabit as HUSBAND and WIFE, or attempt a reconciliation. This Agreement shall continue in full force and effect and there shall not be a modification or waiver of any of the terms hereof unless the parties, in a writing signed by both parties, execute a statement declaring this Agreement or any term of this Agreement to be null and void. Both parties hereto agree that this Agreement shall 4 44?- be incorporated by reference but shall not be deemed merged into any judgment or decree for divorce obtained by either party. 6. OTHER DOCUMENTATION HUSBAND and WIFE covenant and agree that upon request of the other party, they will forthwith execute and deliver to the other party, any and all written instruments, assignments, releases, satisfactions, deeds, notes or such other writings as may be necessary or desirable for the proper effectuation of this Agreement. 7. MUTUAL RELEASES Except as otherwise expressly provided by this Agreement, A. Each party hereby absolutely and unconditionally releases and forever discharges the other and the estate of the other for all purposes from any and all rights and obligations which either may have or at any time hereafter have for past, present or future support or maintenance, alimony pendente lite, alimony, equitable distribution, counsel fees, costs, expenses and any other right or obligation, economic or otherwise, whether arising out of the marital relationship or otherwise, including all rights and benefits under the Pennsylvania Divorce Code of 1980, its supplements and amendments, as well as under any other law of any other jurisdiction, except and only except all rights, agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision thereof. Neither party shall have any obligation to the other not expressly set forth herein. 5 rk.n,_ B. Each parry hereby absolutely and unconditionally releases and forever discharges the other and his or her heirs, executors, administrators, assigns, property and estate from any and all rights, claims, demands or obligations arising out of or by virtue of the marital relationship of the parties or otherwise, whether now existing or hereafter arising. The above release shall be effective regardless of whether such claims arise out of any former or future acts, contracts, engagements or liabilities or the other or by way of dower, courtesy, widow's rights, family exemption or similar allowance, or under the intestate laws, or the right to take against the spouse's will, or the right to treat a lifetime conveyance by the other as testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of Pennsylvania, any state, commonwealth or territory or the United States, or any other country. It is expressly understood, however, that neither the provisions of this release nor the subsequent entry of a divorce decree are intended to defeat the right of either party to receive any insurance proceeds at the death of the other of which she or he is the named beneficiary (whether the beneficiary designation was made prior or subsequent to execution hereof), nor to defeat the right of either party to receive any legacy, bequest or residuary portion of the other's estate under his or her will, or to act as personal representative or executor if so named by the will of the other, whether such will was executed prior or subsequent to this Agreement. C. Except for any cause of action for divorce which either party may have or claim to have, and except for the obligations of the parties contained in this Agreement and such rights as are expressly reserved herein, each party gives to the other by the execution of this Agreement an absolute and unconditional release and discharge from all causes of action, claims, rights or 6 j 4 demands whatsoever, in law or in equity, which either party ever had or now has against the other. 8. SUCCESSOR'S RIGHTS AND LIABILITIES This Agreement shall, except as otherwise provided herein, be binding upon and inure to the benefit of the parties hereto, their respective heirs, executors, administrators, successors or assigns. 9. SEVERABILITY If any provision in this Agreement is held by a court of competent jurisdiction to be invalid, void, or unenforceable, the remaining provisions shall nevertheless continue in full force and effect without being impaired or invalidated in any way. 10. ENTIRE AGREEMENT HUSBAND and WIFE do hereby covenant and warrant that this Agreement contains all of the representations, promises and Agreements made by either of them to the other for the purposes set forth in the preamble hereinabove; that there are no claims, promises or representations not herein contained, either oral or written, which shall or may be charged or enforced or enforceable unless reduced to writing and signed by both of the parties hereto. 11. BINDING EFFECT OF AGREEMENT/WAIVER This Agreement shall remain in full force and effect unless and until terminated under 7 k ? and pursuant to the terms of this Agreement. The failure of either party to insist upon strict performance of the provisions of this Agreement shall not be construed as a waiver of any subsequent default of the same or similar nature, nor shall such failure be construed as a waiver of any other term, condition, clause or provision of this Agreement. 12. BREACH If either party breaches any provision of this Agreement, the other parry shall have the right, at his or her election, to sue for damages for such breach or seek such other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of reasonable legal fees and costs incurred by the other in enforcing their rights under this Agreement. 13. CONTROLLING LAW This Agreement shall be construed and governed in accordance with the laws of the Commonwealth of Pennsylvania. 14. TAX RETURNS The parties agree that in the future if any penalties or interest or any liability for failure to declare income or the wrongful claiming of any deduction shall be assessed by the United States Internal Revenue Service or the Commonwealth of Pennsylvania, or any other state as a consequence of the parties' Federal and State income tax returns which were filed jointly by the parties, said tax, penalties or interest shall be the sole responsibility of the party found to have intentionally been the cause of the problem and he or she shall be solely responsible for the misrepresentation or failure to report income or having taken an inappropriate deduction or exemption. The party responsible shall suffer the consequences solely and hold the opposite party harmless. However, if the liability is the result of a computation error or an error not attributable to the intentional or grossly negligent conduct of either parry, the parties shall share equally in all future tax liability or tax assessment, penalties and interest. SECTION II EQUITABLE DISTRIBUTION During the marriage, the parties have accumulated various assets and liabilities, the disposition of which is intended as follows: 1. ASSETS A. PERSONAL AND HOUSEHOLD PROPERTY HUSBAND and WIFE do hereby acknowledge that they have heretofore divided the non- marital and marital personal and household property, including but without limitation, jewelry, clothes, furniture, and other assets. HUSBAND agrees that all assets in the present possession of WIFE shall be the sole and separate property of WIFE and, WIFE agrees that all assets in the present possession of HUSBAND shall be the sole and separate property of HUSBAND. Each of the parties do hereby specifically waive, release, renounce and forever abandon whatever claims, if any, he or she may have with respect to any of the above said items which are the sole and 9 lk separate property of the other. This document shall constitute a bill of sale for each party's sole property. B. REAL ESTATE The parties jointly owned real property located at 177 North Meadow Drive, Mechanicsburg, PA. The house was sold by the parties after separation at a mutually agreed upon price. The sale of the house generated a loss of $14,822.58. Said loss was paid by HUSBAND. HUSBAND does hereby waive and release any and all claims against WIFE to receive any repayment of sums expended necessary to close and settle the transactions related to the sale of the home. C. MOTOR VEHICLES At the time of separation, the parties owned three vehicles. These vehicles include a 1998 Infinity Q-45, which vehicle is not encumbered by any loan. Said vehicle shall be the sole and separate property of HUSBAND. The other two vehicles are a 2007 Dodge Durango and a 30" Max Lite travel trailer. Neither of these vehicles are encumbered by loans. Said Durango and Mac Lite travel trailer shall be the sole and separate property of WIFE. Each party hereby waives, relinquishes and releases any claim in the vehicle(s) which shall be the sole and separate property of the other. Each party agrees to promptly coordinate and cooperate in the transfer of titles to the vehicles. Each party shall be responsible for securing the necessary insurance for his or her own vehicle. 10 D. FINANCIAL ASSETS: The parties acknowledge that the marital financial accounts which existed during the marriage have been spent for marital purposes and/or previously divided to the satisfaction of the parties. These accounts include, but are limited to MML Investor account and the Invesco AIM account. All jointly titled accounts have been closed. Each party hereby waives, relinquishes and releases any claims to the financial accounts in the possession of the other. E. PENSION AND RETIREMENT ACCOUNTS: During the marriage, HUSBAND accumulated certain retirement benefits. These benefits consisted of an American Funds IRA and a Fidelity IRA. The Fidelity IRA has been cashed since separation by HUSBAND to pay taxes and other marital and individual expenses related to HUSBAND's household. WIFE hereby waives any and all claims to the proceeds of said Fidelity IRA. HUSBAND's American Funds IRA had a December 31, 2010, balance of $76727.27. HUSBAND shall rollover the entire balance of the American Funds IRA to WIFE on the date of distribution to a qualified account of WIFE's choice. Said rollover funds shall be WIFE's sole and separate property. It is the intention of the parties that neither party shall incur any tax liability pursuant to the transfer. o D. ro49vaQa xWF WIFE agrees to indemnify and hold HUSBAND harmless for any and all i ? l M? costs and any tax liability, penalties and interest which he may incur as a result of the rollover to WIFE. A Qualified Domestic Relations Order shall be prepared by Kevin Benton, CPA, effectuating the tax free rollover from HUSBAND to a qualified account for WIFE. Said Qualified Domestic Relations Order shall be completed within sixty (60) days from the date of this Agreement. The parties hereby agree any and all costs associated with the same shall be paid equally by the parties. WIFE warrants that she has earned no retirement or other deferred employment benefits during the marriage. F. BUSINESS During the marriage, HUSBAND acquire a one half ownership interest in a technology business know as Prismworks Technology, Inc. and a related business entity known as Abble Software4, Inc. These businesses are operated in real estate located at 520 Hershey Road, Hummelstown, PA, which real estate HUSBAND also has a one-half ownership interest in through his ownership in the entity Prism Leasing. These businesses, as well as the real estate, are listed for sale. The Prism Leasing real estate is encumbered with loans due and owing to Orrstown Bank, which loans shall be satisfied upon sale of the real estate. Upon sale of either business and upon sale of the real estate, HUSBAND agrees to pay to WIFE 50% of the net proceeds he realizes from the sale. Net Proceeds shall be calculated as the gross selling price, less all costs incurred to effectuate and close the sale (including broker's fees, transfer costs, and any and all other costs and fees incurred in completing the sale) and payment of all liens, 12 4144 Ad I mortgages, and encumbrances, as well as reduction for payment of any and all tax liability HUSBAND may incur, including capital gains or any other taxes, due by HUSBAND as a result of sale. 2. DEBTS Each parry represents that they have not contracted any debt or liability for the other for which the estate of the other party may be responsible or liable except as otherwise provided herein, and that except only for the rights arising out of this Agreement, neither parry will hereafter incur any liability whatsoever for which the other party or the estate of the other parry will be liable. Each party agrees to indemnify and hold harmless from and against all future obligations of every kind incurred by them, including those for necessities. At the time of separation, the parties had debts due and owing to Capital One and Fidelity Visa. Said debts have been satisfied by HUSBAND after separation using marital investment funds. These accounts have been closed. To the best of the parties' knowledge, the parties affirm no other joint debts exist and all joint credit cards are terminated. SECTION III 1. ALIMONY. ALIMONY PENDENTE LITE, SUPPORT. MAINTENANCE Effective February 1, 2011, HUSBAND agrees to pay alimony pendent lite (which after the entry of the divorce decree shall be designated as alimony but which payment shall collectively in this Agreement be referred to as "alimony") the sum of EIGHT HUNDRED AND 13 FORTY FIVE DOLLARS ($845.00) for a period of thirty-six (36) months, or until January 31, 2014. Said alimony shall be non-modifiable in amount of duration. Said alimony payment shall terminate earlier upon the occurrence of any of the following events: 1) Wife's cohabitation; 2) Wife's remarriage; 3) Wife's death; or 4) Husband's death. All alimony paid shall be deductible by HUSBAND for tax purposes and includable in the income of WIFE for tax purposes. SECTION IV 1. COUNSEL FEES: Each party shall be responsible for payment of his or her attorney fees incurred and hereby waives any claim against the other fore reimbursement. SECTION V 1. CONDITION PRECEDENT TO THE AGREEMENT'S EFFECTIVENESS The parties acknowledge that this Agreement shall become effective when actually signed yd parties. SS WITNESS 14 MIC L I GLUMAC I I'- . I COMMONWE OF P SY VANIA ) ) SS. COUNTY OF ) Before me, the undersigned officer, a Notary Public in and for said Commonwealth and County, personally appeared MICHAEL J. GLUMAC, who being duly affirmed according to law, deposes and says that the facts and matter set forth in the within and foregoing Marital Settlement Agreement are true and correct to the best of his knowledge, information and belief to before me this 64"day 2011. NObMM SW ? Nwy Public Q+tv ARY PUBLIC My commission expires: COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND (SEAL) ) SS. Before me, the undersigned officer, a Notary Public in and for said Commonwealth and County, personally appeared KELLY S. GLUMAC, who being duly affirmed according to law, deposes and says that the facts and matter set forth in the within and foregoing Marital Settlement Agreement are true and correct to the best of her knowledge, information and belief. Affirmed and subscribed to before me this day of Oyu , 2011. A'U - 04 1 " TARY PUBLIC MZ&~L99&"WWLVAN1A Notarial Seal F Pamela L Purdy, Notary Public City of Harrisburg, Dauphin Count,/ u n,? s ;on Ex'plrt s June 19, 20M (SEAL) 15 Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 iBERLAND COUNTY PENNSYL1'WA KELLY S. GLUMAC, Plaintiff V. MICHAEL J. GLUMAC, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4227 CV 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. Ground for divorce: Irretrievable breakdown under §3301(c) of the Divorce Code. 2. Date and manner of service of the complaint: Acceptance of Service signed by Defendant on June 23, 2009, and filed with the Cumberland County Prothonotary's Office on July 02, 2009. 3. Date of execution of the Affidavit of Consent required by § 3301(c) of the Divorce Code: by Plaintiff: April 08, 201; by Defendant: April 15, 2011. 4. Related claims pending: None. All claims have been resolved pursuant to the Marital Settlement Agreement dated April 08, 2011, to be incorporated, but not merged into the Divorce Decree. 5. Date Plaintiffs Waiver of Notice in §3301(c) Divor was led Prothonotary: April 14, 2011. Date Defendant's Waiver ofNotice in §3301(c) D' rce wi Prothonotary: April 19, 2011. Dated: y 61- Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070-1931 (717)-774-1445 Supreme Court ID #32317 Attorney for Defendant N, Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KELLY S. GLUMAC, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 09-4227 CV MICHAEL J. GLUMAC, CIVIL ACTION -LAW Defendant IN DIVORCE CERTIFICATE OF SERVICE I, Barbara Sumple-Sullivan, Esquire, do hereby certify that on this date, I served a true and correct copy of the foregoing Praecipe to Transmit Record, in the above-captioned matter upon the following individual by first class mail, postage prepaid, addressed as follows: Pamela L. Purdy, Esquire 1820 Linglestown Road Harrisburg, PA 17110, DATED: l? Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 Supreme Court I.D. No. 32317 Attorney for Plaintiff KELLY S. GLUMAC V. MICHAEL J. GLUMAC IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 09-4227 CV DIVORCE DECREE AND NOW, April 29 2011 , it is ordered and decreed that KELLY S. GLUMAC , plaintiff, and MICHAEL J. GLUMAC , defendant, are divorced from the bonds of matrimony. Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") None. All claims have been resolved pursuant to the Marital Settlement Agreement dated April 08, 2011, to be incorporated, but not merged into the Divorce Decree. By the Court, J. Wesley Oler, Jr. Attest: J. C-- /) ?k rothonotary Certified Copy Issued: April 29, 2011 Date ?a9?? Qerfi Cop.:. ma iAed 40 atq ArViAl CtOXI o ? Maj (Ott INCOME WITHHOLDING FOR SUPPORT 0 ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT(IWO) S I I D Gt, ;23- a I I Uz;�9 a 0 AMENDED IWO 0 ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT Oq 495,-7 �I V 1 44 ) & 9,0D9 0 TERMINATION OF IWO Date: 06110/13 ❑ Child Support Enforcement(CSE)Agency [0 Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This 4Yl Q -,t ,, .be nular4ofi!tts face.Under certain circumstances you must reject this IWO and return it to the sender(see IWO ii,istructions.t'�bi//M�AN.acf.hhs. �e/newhire/emplover/publication/publication.htm-forms). If you receive this document from _gov/programs/c, someone othbf'tfiiin?b State or Tribal CSE agency or a Court,a copy of the underlying order must be attached., Staterrriberrerritory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 4732102131 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) PRISMWORKS TECHNOLOGY INC RE: GLUMAC, MICHAEL J. 520 HERSHEY RD Employee/Obligor's Name(Last,First,Middle) HUMMELSTOWN PA 17036-9414 166-54-3244 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial PartylObligee's Name(Last,First, Middle) Employer/Income Withholders FEIN NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last,First,Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see IWO instructions http://www,opf.hhs.noy/r)rograms/cse/"`newhire em2loyer/i)vblir-ation/publir-ation.htm-forms).If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. I 7366100276 See Addendum for dependent names and birth dates associated with cases on attachment ORDER INFORMATION. This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), You are required by law to deduct these amounts froV:<=the�7LV np ee/ C...) obligor's income until further notice. MOD $ 881.00 per month in current child support z: JW Fri $ 0.00 per month in past-due child support-Arrears 12 weeks or greater? 0 ym 1149- �u $ 0.00 per month in current cash medical support < 1710 cz),�, r—;Z-, $ 0.00 per month in past-due cash medical support $ 845.00 per month in current spousal support C:) $ 0.00 per month in past-due spousal support $ om per month in other(must specify) C:) for a Total Amount to Withhold of$ 1,726.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ C a I- per weekly pay period. $ 863.00 per semimonthly pay period,(twice a month) $ b,;? per biweekly pay period(every two weeks) $ 1,726.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (StatefTribe), you must begin withholding no later than the first pay period that occurs ten(10) working days after the date of this Order/Notice. Send payment within seven (7)working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor,withhold up to 550/0 of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact map. htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.:0970-0154 Form EN-028 06/12 Service Type M Worker ID 21205 ' .&� R Return 0m Sender[Completed bx Employer/Income Withho!der]. Payment must be directed hoanSDUin accordance with 42USC§0O0(b)(5)and (b)(6)or Tribal Payee(see Payments ho SOU be|mw). |t payment iunot ' ~ dhactedbmanSDU/Tiba| PayeeorUhiaIWOimnotreQu|aronitofooe. you /nuatoheuhUliaboxendreh/rnthe \VVO to the sender. Signature of Judge/issuing Official (if required by State or Trib Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: I 1 0 2013'Jundil; Date of Signature: JUN 10 2W If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy oy this|YVO must bo provided bo the omp|oyee/ob|igor. [] |f checked,the employer/income withholder must provide o copy ofthis form ho the omp|oyeo/ob|ignr. ADDITIONAL INFORMATION FOR E08PLOYERV|NCOK82WITHHOLDERS Pennsylvania law(23PAC.S. §4374(b))requires remittance hyan electronic payment method ifon employer ioordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two mr more returned checks due tonunaufHc|mntfunds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCOU) Employer Customer Service nt1-B77'67G'B58A for instructions. PAF|PS CODE 42 000 00 Make Remittance Payable to: p»A SCDtJ Send check to: Pennsylvania 0CDU, P.O. Box 69112, Harrisburg, Pal 17106~9112 IN ADDITION, PAYMENTS MUSTINCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID(shown above as theEmployeelObligor's CaseIdentifler)OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: Priority:Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). Ifa Federal tax levy isin effect,please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency,you may combine withheld amounts from � more than one employee/obligor's income in a single payment.You must,however, separately identify each employee/ obligor's portion of the payment. Payments To SDU You must send child support payments payable by income withholding to the d he SDU or to Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party,court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court,Attorney,or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency,you must follow the"Remit payment to"instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment.The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOls due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses,commissions,or severance pay.Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO,contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ,or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date—05/3112GI4.The OMB Expiration Date has no bearing on the termination clate of the IWO:it iaentiftes the version of the form currently in use. Form EN-028 06/12 Service Type M Page 2 of 3 Worker ID 21205 NNEWINEd Employer's Name: PRISMWORKS TECHNOLOGY INC Employer FEIN: Employee/Obligor's Name: GLUMAC, MICHAEL J. 4732102131 CSE Agency Case Identifier:(See Addendum for case summa rvl Order Identifier:(See Addendum for order/docket information) Withholding Limits:You may not withhold more than the lesser of: 1)the amounts allowed by the Federal Consumer Credit Protection Act(CCPA)(15 U.S.C. 1673(b));or 2)the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment(see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions;and Medicare taxes.The Federal limit is 50%of the disposable income if the obligor is supporting another family and 60%of the disposable income if the obligor is not supporting another family. However,those limits increase 5%-to 55%and 65%-if the arrears are greater than 12 weeks. If permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO,you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law,you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor,an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 7366100276 Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at:www.childsupport.state.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE, PA. 17013(Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at www.childsuppod.state.pa.us. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.:0970-0154 Form EN-028 06/12 Service Type M Page 3 of 3 Worker ID 21205 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GLUMAC, MICHAEL J. PACSES Case Number 185110956 PACSES Case Number 232110892 Plaintiff Name Plaintiff.Name KELLY S. GLUMAC KELLY S. GLUMAC Docket Attachment Amount Docket Attachment Amount 09-4227 CIVIL $ 845.00 00441 S2009 $ 881.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB BRIELLE GLUMAC 03/22/96 CHLOE GLUMAC 04/25/00 PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docke Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-028 06/12 Service Type M OMB No.:0970-0154 Worker ID 21205 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KELLY S. GLUMAC ) Docket Number: Plaintiff ) vs. ) PACSES Case Number: 185110956 MICHAEL J. GLUMAC ) Defendant ) Other State ID Number: Order AND NOW to wit, this JANUARY 7, 2014 it is hereby Ordered that: r ` The Cumberland County Domestic Relations Section dismiss their interest in the • Alimony matter as the Alimony obligation has been paid in full through January 31, 2014. - This order shall become final within twenty days after the mailing of the notice of the entry of this order unless either party files a written demand requesting a hearing before the Court. BY THE COURT: Thome A1PJacey" JUDGE Form 0E-520 02/11 Service Type M Worker ID 21205 INCOME WITHHOLDING FOR SUPPORT O ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT(IWO) 5 I i D°15i `-�l 1 l D Tl a 0 AMENDED IWO D9 SL !��L l v [� O ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT ") —t 11 1 LI y I I - `(- E .9O OCT O TERMINATION OF IWO Date: 01/31/14 ❑ Child Support Enforcement(CSE)Agency El Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This IWO must be rtegular on its fage...Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions http://www.acf.hhs:gov/programs/cse/forms/OMB-0970-0154 instructions.Pdf). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 4732102131 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket information) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) PRISMWORKS TECHNOLOGY INC RE: GLUMAC,MICHAEL J. 520 HERSHEY RD Employee/Obligor's Name(Last,First,Middle) HUMMELSTOWN PA 17036-9414 166-54-3244 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name(Last,First, Middle) Employer/Income Withholder's FEIN NOTE:This IWO must be regular on its face. Child ren's Name(s)(Last,First,Middle) Under certain circumstances you must reject ( ) ( )( ) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see IWO instructions htto://www,acf.hhs.gov/orograms/cse/forms/ OMB-0970-0154 instructions.odf).If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. 7366100276 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERVNEMourity, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts froze eijployre/ obligor's income until further notice. rri ._ $ 881.00 per month in current child support « ' mot...._ ,..'_ $ 0.00 per month in past-due child support-Arrears 12 weeks or greater? 0 yes--ft nom ci $ 0.00 per month in current cash medical support Vic* $ 0.00 per month in past-due cash medical support $ 0.00 per month in current spousal support $ 0.00 per month in past-due spousal support $ 0.00 per month in other(must specify) _4 -t_ cia for a Total Amount to Withhold of$ 881.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 3,03,31 per weekly pay period. $ 440.50 per semimonthly pay period (twice a month) $ 1-1-0 ,‘,2-per biweekly pay period(every two weeks) $ 881.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven (7)working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact map. htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No 0970-0154 Form EN-028 11/13 Service Type M Worker ID $IATT ❑ Return to Sender[Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC§666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): Print Name of Judge/Issuing Official: PutEEY Title of Judge/Issuing Official: JUDGE Date of Signature: If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ❑ If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law(23 PA C.S.§4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons,or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION,PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID(shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: htto://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact mao.htm Priority: Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments:When remitting payments to an SDU or Tribal CSE agency,you may combine withheld amounts from more than one employee/obligor's income in a single payment.You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU:You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney),you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court,Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the"Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State(or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State,or Tribal withholding limits,you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO,contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date—05/31/2014.The OMB Expiration Date has no bearing on the termination date of the IWO;it identifies the version of the form currently in use. Form EN-028 11/13 Service Type M Page 2 of 3 Worker ID $IATT . 4 Employer's Name: PRISMWORKS TECHNOLOGY INC Employer FEIN: Employee/Obligor's Name: GLUMAC, MICHAEL J. 4732102131 CSE Agency Case Identifier:(See Addendum for case summary) Order Identifier:(See Addendum for order/docket information) Withholding Limits: You may not withhold more than the lesser of: 1)the amounts allowed by the Federal Consumer Credit Protection Act(CCPA)(15 U.S.C. 1673(b));or 2)the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment(see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes;statutory pension contributions;and Medicare taxes.The Federal limit is 50%of the disposable income if the obligor is supporting another family and 60%of the disposable income if the obligor is not supporting another family. However,those limits increase 5%-to 55%and 65%-if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law,you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor,an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 7366100276 Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at (717) 240-6225, by fax at 1717)240-6248, by email or website at:www.childsupport.state.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST, P.O. BOX 320, CARLISLE,PA. 17013(Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at 1717) 240-6225, by fax at (717) 240-6248, by email or website at www.childsupport.state.pa.us. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.:0970-0154 Form EN-028 11/13 Service Type M Page 3 of 3 Worker ID$IATT 4 , , 4 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: GLUMAC, MICHAEL J. PACSES Case Number 232110892 PACSES Case Number Plaintiff Name Plaintiff Name KELLY S. GLUMAC Docket Attachment Amount Docket Attachment Amount 00441 S 2009 $ 881.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB BRIELLE GLUMAC 03/22/96 CHLOE GLUMAC 04/25/00 PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-028 11/13 Service Type M OMB No.:0970-0154 Worker ID $IATT