Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
10-0422
t) Barbara Sumple-Sullivan, Esquire ' ? OTA?Y Supreme Court #32317 549 Bridge Street 2010 A NJO A` 10. New Cumberland, PA 17070 (71 774-1445 CLI.M s KAREN D. MILLER, IN THE CO I'MO IM N PLEAS Plaintiff V. DREW J. MILLER, SR., Defendant CUMBERLAND COUNTY, PENNSYLVANIA NO. 16 - y l? ?! v t CIVIL ACTION -LAW IN DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS YOU HAVE BEEN SUED IN COURT, if you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the Court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody and visitation of your children. When the grounds for a 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 County Courthouse. 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, 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 COUNTY BAR ASSOCIATION 2 LIBERTY AVENUE Carlisle, Pennsylvania 17013 (717) 249-3166 4 3s2, o? -3 AldtC* i?7a. Sp PE A4 89sv 1g4k Z3`1j7, Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KAREN D. MILLER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA ? Col. V. NO. -fe IA, DREW J. MILLER, SR., CIVIL ACTION -LAW Defendant IN DIVORCE COMPLAINT IN DIVORCE 1. Plaintiff is Karen D. Miller, an adult individual residing at 11 Gale Circle, Camp Hill, Cumberland County, Pennsylvania 17011. 2. Defendant is Drew J. Miller, Sr., an adult individual residing at 11 Gale Circle, Camp Hill, Cumberland County, Pennsylvania 17011. 3. Both Plaintiff and Defendant have been bona fide residents in the Commonwealth of Pennsylvania for at least six (6) months prior to filing this complaint. 4. The Plaintiff and Defendant were married on September 8, 1997 in Marysville, Perry County, Pennsylvania. 5. There are three (3) minor children born of this marriage being Grayson J. Miller (Born: September 18, 1996); Drew J. Miller, Jr. (Born: January 27, 1998) and Emma K. Miller (Born: September 11, 1999). 6. There have been no prior actions for divorce or annulment between the parties. 7. Neither Plaintiff nor Defendant is in the military or naval service of the United States or its allies within the provisions of the Soldiers' and Sailors' Civil Relief Act of the Congress of 1940 and its amendments. 8. Plaintiff has been advised that counseling is available and that Plaintiff has the right to request that the court require the parties to participate in counseling. COUNT I - DIVORCE NO FAULT 9. The averments in paragraphs 1 through 8 of Plaintiffs Complaint are incorporated herein by reference thereto. 10. The marriage is irretrievably broken and no possibility of reconciliation exists. INDIGNITIES 11. Plaintiff is the innocent and injured party, and Defendant has offered such indignities to the person of the Plaintiff and has been mentally cruel to her so as to make her life burdensome and her condition intolerable, in violation of the marriage vows and of the laws of the Commonwealth. WHEREFORE, Plaintiff requests this Court to enter a decree in divorce in accordance with the Pennsylvania Divorce Code. COUNT II EQUITABLE DISTRIBUTION 12. The averments in paragraphs 1 through 11 of Plaintiffs Complaint are incorporated herein by reference thereto. 13. The Plaintiff requests the Court to equitably divide, distribute or assign the marital property between the parties in such proportion as the Court deems just after consideration of all relevant factors. WHEREFORE, Plaintiff requests this Court to equitably divide said property in accordance with Section 3501 of the Pennsylvania Divorce Code. COUNT III SUPPORT, ALIMONY PENDENTE LITE AND ALIMONY 14. The averments in paragraphs 1 through 13 of Plaintiffs Complaint are incorporated herein by reference thereto. 15. Plaintiffrequires reasonable support to adequately sustain herself with the standard of living established during the marriage. WHEREFORE, Plaintiffrequests an award of Support, Alimony and Alimony Pendente Lite. COUNT IV ATTORNEY'S FEES AND COSTS 16. The averments in paragraphs 1 through 15 of Plaintiffs Complaint are incorporated herein by reference thereto. 17. Plaintiff is unable to sustain herself during the course of this litigation and has employed Barbara Sumple-Sullivan, Esquire as counsel, but is unable to pay the necessary and reasonable attorney's fees for said counsel, and the necessary and reasonable costs and expenses. WHEREFORE, Plaintiff requests an award of counsel's fees and expenses. WHEREFORE, Plaintiff, Karen D. Miller, prays this Honorable Court to enter judgment: A. Awarding Plaintiff a decree in divorce; B. Equitably distributing the marital property; C. Awarding Plaintiff support, alimony and alimony pendente lite; D. Awarding Plaintiff counsel fees, costs and expenses; and E. Awarding other relief as the Court deems just Dated: January 12, 2010 Barbara Sumple-Sullivan, Esquire Attorney for Plaintiff 549 Bridge Street New Cumberland, PA 17070-1931 (717) 774-1445 Supreme Court I.D. No. 32317 Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KAREN D. MILER, IN THE COURT OF COMMON PLEAS Plaintiff V. DREW J. MILLER, SR., Defendant : CUMBERLAND COUNTY, PENNSYLVANIA : NO. CIVIL ACTION -LAW IN DIVORCE AFFIDAVIT REGARDING COUNSELING I have been advised of the availability of marriage counseling and understand that I may request that the Court require that my spouse and I participate in counseling. 2. I understand that the Court maintains a list of marriage counselors in the Domestic Relations Office, which list is available to me upon request. 3. Being so advised, I do not require that the Court require that my spouse and I participate in counseling prior to a divorce decree being handed down by the Court. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S.A Section 4904 relating to unsworn falsification to authorities. Dated: 20A N D. MILLER Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KAREN D. MILER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA v. DREW J. MILLER, SR., Defendant : NO. CIVIL ACTION -LAW IN DIVORCE VERIFICATION I, Karen D. Miller, hereby certify that the facts set forth in the foregoing Pleading are true and correct to the best of my knowledge, information and belief. I understand that any false statements made herein are subject to penalties of 18 Pa. C.S.A. Section 4904 relating to unsworn falsification to authorities. /I A Dated: z , 200 KARIEN D. MILLER w . ~ Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717)774-1445 KAREN D. MILLER, Plaintiff v. DREW J. MILLER, SR., Defendant IN THE COURT OF COM1G~(1f~1'~I~~EAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 10 - 422 CIVIL ACTION -LAW IN DIVORCE AFFIDAVIT OF SERVICE I, Bazbaza Sumple-Sullivan, Esquire, do hereby certify that I served a copy of the Divorce Complaint in the above-captioned matter by United States Mail, Restricted Delivery, Certified No. 7007 2680 0002 4649 5512, Return Receipt Requested, on the above-named Defendant, Mr. Drew J. Miller, Sr., on January 26, 2010 at Defendant's last known address: 11 Gale Circle, Camp Hill, PA 17011. The original receipt and return receipt card aze attached hereto as Exhibit ..A.. I hereby certify that the facts set forth above aze true and correct to the best of my knowledge, information and belief. I understand that any false statements made herein aze subject to penalties of 18 Pa. C.S.A. §4904 relating to unsworn fals~lcation to authorities. Dated: January 27, 2010 Bazbaza Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070-1931 (717)-774-1445 Supreme Court ID #32317 Attorney for Plaintiff rU ~ ~. ~ to Q' "~ Postage $ ~ Certified Fee $~ ~ 0 Return Receipt Fee E d t R i 3Q O ( n orsemen equ red) Restricted Delivery Fee E d R i ~ TO p n ( orsement red) equ J N Total Postage & Fees $ ~ .a~ ent o ---------- O S`lreef, Apt No.; /~ T r~ or PO Box No. , 1 I; ti 1 ' • ~ p ~ D --- City, State, ZIP+4 ~ ~; 11 ~ ~~ O ` I z ` i• Complete items 1, 2, and 3, Also complete tiem 4 ff Restricted Delivery is desired: A Print your name and address on the reverse so that we can return the~card to you. A Attach this card to the back of the mailplece, or on the front ff space permits. 1. Article{{A~~ddressed to: mf . IJr' ~w -S. 1Y1, l~~Q.r, Sr'~ 1l ale C; ~c~Q c~~,p ~.~1- ,P~ l~~~i f~..• ~... ~ r ~ a ~t ~, 4 ~ ~• ~ ~ ~(irere ~ :',' r ~~ i~? ~, M S ~2"~~ ffApent O Addro ~ c~ ... D. la delNery address kem ? If YES, enter delivery address bebw: ^ No 9. Servb.lype ! CMtlMd Mall O l3gxees Mail O Repstered O Reoelpt fbr Mard,.,a.. v Insured Maa D co.D. ~' N`""~` 720? 268 oao2 4649 5512 (narsrer Irorn sertrk~e fabeq PS Form 3811; Febrta•rx tow DonnMic FMU,rn ri.o.ipc ,a2aYS~m.M-ts~o EXHIBIT "A" KAREN D. MILLER, :1N THE COURT OF COMMON PLEAS Plaintiff :CUMBERLAND COUNTY, PENNSYLVANIA ~ o [S v. : NO. 10-422 ~ -o ~, a -*~ ~' • I'T`I r Tl ~ _~- ~ ~ W Ct1 ~ DREW J. MILLER, SR., CIVIL ACTION -LAW ~ t c~~ ~- ~ Defendant : IN DIVORCE ~C~' ~ ^~-,r' ~~ . {-' a ~~1 ~? rii o ~ PRAECIPE TO ENTER APPEARANCE TO THE PROTHONOTARY OF SAID COURT: Please enter my appearance on behalf of the Defendant, Drew J. Miller, Sr., in the above-captioned action. Respectfully submitted, Laurie SAN ~'a'~~gdi~er, quire Attorney I.D. 13 2 Meyers, Desfor, Saltzgiver & Boyle 410 North Second Street P.O. Box 1062 Harrisburg, PA 17108 (717)236-9428 Attorney for Defendant MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET P.O. BOX 1062 HARRISBURG, PA 17108 (717) 236-9428 FAX (717) 236-2817 KAREN D. MILLER, : IN THE COURT OF COMMON PLEAS Plaintiff :CUMBERLAND COUNTY, PENNSYLVANIA v. : NO. 10-422 DREW J. MILLER, SR., :CIVIL ACTION -LAW Defendant : IN DIVORCE CERTIFICATE OF SERVICE I hereby certify on this 3`d day of February, 2010, that a copy of the foregoing Praecipe to Enter Appearance was mailed, first-class, postage prepaid to: Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070-1931 ~~aau Laurie A. Sa Attorney for MEYERS, DESFOR, SALTZGiVER & BOYLE 410 NORTH SECOND STREET P.O. BOX 1062 HARRISBURG, PA 17108 (717) 236-9428 FAX (717) 236-2817 r KAREN D. MILLER, : IN THE COURT OF COMMON PLEA, 4 Plaintiff :CUMBERLAND COUNTY PENNS-~AI~ ~ , z i,- v• : NO. 10-422 ~.0.:~ cis ?r ~ ~ .~ DREW J. MILLER, SR., :CIVIL ACTION -LAW n ~ Defendant : IN DIVORCE ~ ~+ ~ ~ -- ?~ 'il DEFENDANT'S ANSWER TO COMPLAINT IN DIVORCE AND NOW, comes the Defendant, Drew J. Miller, Sr., by and through his attorneys, Meyers, Desfor, Saltzgiver & Boyle and files the following Answer to Complaint in Divorce and in support thereof avers as follows: 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted. 6. Admitted. 7. Admitted. 8. No answer required. COUNT I -DIVORCE NO FAULT 9. No answer required. 10. Admitted. MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET P.O. BOX 1062 HARRISBURG, PA 17108 (717) 236-9428 FAX (717) 236-2817 INDIGNITIES 11. Denied. Defendant denies offering any indignities to Plaintiff, and he denies any cruelty towards her. Furthermore, Defendant denies that Plaintiff is in anyway innocent or injured. WHEREFORE, Defendant requests this Honorable Court deny Plaintiff's request for a divorce based upon indignities. Defendant requests this Honorable Court divorce the parties pursuant to sections 3301(c) and 3301(d) of the Divorce Code. COUNT II EQUITABLE DISTRIBUTION 12. No answer required. 13. No answer required. However, Defendant joins in Plaintiff's request for equitable distribution of the marital estate. WHEREFORE, Defendant requests this Honorable Court equitably distribute all marital property pursuant to the Divorce Code. COUNT III SUPPORT, ALIMONY PENDENTE LITE AND ALIMONY 14. No answer required. 15. Denied. Plaintiff is capable of full-time employment and is fully capable of supporting herself. WHEREFORE, Defendant requests this Honorable Court deny Plaintiffls request for support, alimony and alimony pendente lite. 2 MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET P.O. BOX 1062 HARRISBURG, PA 17108 (717) 236-9428 FAX (717) 236-2817 COUNT IV ATTORNEY'S FEES AND COSTS 16. No answer required. 17. Denied. Plaintiff is capable of full-time employment and fully capable of supporting herself as well as paying her own attorney fees, costs and expenses. WHEREFORE, Defendant requests this Honorable Court deny Plaintiff's request for counsel fees, costs and expenses. WHEREFORE, Defendant, Drew J. Miller, Sr., requests this Honorable Court enter judgment: a. Awarding the parties a Decree in Divorce pursuant to 3301 (c) or 3301(d) of the Divorce Code. b. Equitably distribute all marital property pursuant to the Divorce Code. c. Deny Plaintiff's request for support, alimony and alimony pendente lite. d. Deny Plaintiff's request for counsel fees, costs and expenses. e. Provide the parties with relief pursuant to the Divorce Code, as the Court deems appropriate. 3 MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET P.O. BOX 1062 HARRISBURG. PA 17108 (717) 236-9428 FAX (717) 236-2817 Respectfully submitted, Attorney I.D. 61382 P.O. Box 1062 Harrisburg, PA 17108 (717)236-9428 Attorney for Defendant MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET P.O. BOX 1062 HARRISBURG, PA 17108 (717) 236-9428 FAX (717) 236-2817 Meyers, Desfor, Saltzgiver & Boyle 410 North Second Street VERIFICATION I, Drew J. Miller, Sr. verify that the statements made in this Defendant's Answ r to Complaint in Divorce are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. Dated: 2/3/10 (g ) Defendant MEYERS, DESFOR, SALTZGIVER 8~ BOYLE 410 NORTH SECOND STREET P.O. BOX 1062 HARRISBURG, PA 17108 (717) 236-9428 FAX (717) 236-2817 KAREN D. MILLER, : IN THE COURT OF COMMON PLEAS Plaintiff :CUMBERLAND COUNTY, PENNSYLVANIA v : NO. 10-422 DREW J. MILLER, SR., :CIVIL ACTION -LAW Defendant : IN DIVORCE CERTIFICATE OF SERVICE I hereby certify on this ~~~-~1-\day of ~ 2010, that a co of the PY foregoing Defendant's Answer to Complaint in Divorce was m filed, first-class, postage ~ prepaid to: Barbara Sumple-Sullivan, Esquire 549 Bridge Street New Cumberland, PA 17070-1931 c Laurie A. Sa Attorney for MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET P.O. BOX 1062 HARRISBURG, PA 17108 (717) 236-9428 FAX (717) 236-2817 KAREN D. MILLER, Plaintiff/Petitioner N'S. DREW J. MILLER, SR., Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - DIVORCE NO. 10-422 CIVIL TERM c= IN DIVORCE PACSES CASE: 482112105 ,r ?,,, zap f -r ORDER OF COURT -, AND NOW. this 24th day of November, 2010, based upon the Court's determination that the Petitioner's monthly net income/earning capacity is $ n/a and the Respondent's monthly net income/earning capacity is $ n/a, it is hereby ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit Three Hundred Seventy and 00/100 Dollars ($ 370.00) per month payable bi-weekly as follows: $ 370.00 per month for Alimony Pcndente Lilt, and $ 0.00 per month on arrears. First payment due: in accordance with Respondent's pay schedule. The effective date of the order is October 29, 2010. Arrears set at $ 199.23 as of November 24, 2010. 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 imay 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: Karen D. Miller. 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 PACSESS Member Number or Social Securit} 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 each child and/or spouse. Unreimbursed medical expenses of the obligee or children that exceed $250 annually shall be allocated between the parties. The party seeking allocation of unreimbursed medical expenses must provide documentatiion of expenses to the other party no later than March 31" of the year following the calendar year in which the final medical bill to be allocated was received. The unreimbursed medical expenses are to be paid as follows: 70 °% by Respondent and 30 % by Petitioner. [X] Respondent [] Petitioner [] Neither party to provide medical insurance coverage. Within thirty (30) days after the entry of this order, the [] Petitioner [X] Respondent shall submit written proof that medical insurance coverage has been obtained or that application for coverage has been made. Proof of coverage shall consist, at a minimum, of: 1) the name of the health care coverage provider(s): 2) any applicable identification numbers; 3) any cards evidencing coverage; 4) the address to which claims should be made: 5) a description of any restrictions on usage, such as prior approval for hospital admissions, and the manner of obtaining approval; 6) a copy of the benefit booklet or coverage contract; 7) a description of all deductibles and co-payments; and 8) five copies of any claim forms. Other conditions: This Order is based upon an agreement of the parties pursuant to a Stipulation for Entry of an Order. The Respondent is given credit in the amount of $170.77 for direct payment to the Petitioner. This Order shall become final twenty (20) after the mailing of the notice of the entry of the Order to the patties unless either party files a written demand with the Office of the Prothonotary for a hearing de novo before the Court. Mailed copies ow Novernber 29, 2010 BY THE COURT Albert H. Masland, J. Petitioner Respondent Barbara Sumple-Sullivan. Esq. Laurie A. Saltzgiver. Esq. DRO: R.J. Shadday ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 9500JOU46 Co./City,/Dirt. of CUMBERLAND 1162 S 96 Date of Order/Notice 11/24/10 Case Number (See Addendum for case summary) EmployerAVithholder's Federal EIN Number JDK CATERING INC 1 BISHOP PL CAMP HILL PA 17011-580:_ RE: MILLER, DREW J. SR ! J-4;? 2 CIVIL (DOrigira OrderlNotice Amended Orcler/Notice OTermimAe Order/Notice OOne-Time I ump Sum/Notice Employee/Obligor s Name (Last, First, MI) 187-44-7800 Employee/Obligors Social Security Number 4796000021 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 INFORMA F,'ON: 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_ $ a30. o , per month in current child support $ _ c.. oc? per month in past-due child support Arrears 12 .veeks or greater? yes no $ _ o. oo per month in current medical support $ o.oo per month in past-due medical support `0 ca -?? $ 370.00 per month in current spousal support ri _ ?r.._.. $ o . oc per month in past-clue spousal support ^?'= $ _ o. oo per month for genetic test costs -.; NO ?? $ _ o. oo per month in other (specify) -L r tC) $ one-time lump sum payment for a total of $ 1,200.00 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. 11 your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 276.92. per weekly pay period. $ 600.00 per semimonthly pay period (twice a month) $ 553.85 per biweekly pay period (every two weeks) $ 1, 200.00 per monthly pay period. REA11T7ANCE liyJOR,11ATIOV': You must begin withholding no later than the first pay period occt rring 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 550,,0 of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation ;,n 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 P.ACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: JRO: R. J. S'-.adcja_y Form EN-028 Rev.5 Service Type m n,a o-:n<nu-msa Worker ID $IATT r ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS li checked 1 ou are re({aired to provide a copy of this form to your om nlovee. If your emplo?ce_v.or s in a state that is direrent from the state that issued this order, a copv must be providedto your employee even it the ?)ox is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law again -,t 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 i 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 In(a,ne 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 49 belo?,%5. Termination Notification: You must promptly notify the Requesting Agenc} when the employee/obligor is no longer working for you. Please: provide the intomi ition requested and return a copy of this Order/Notice to the Agency identified below. 2516068960 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER: ? THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: O EMPLOYEE'S/OBLIGOR'S NAME:M:ELLER, DREW J. SR EMPLOYEE'S CASE IDENTIFIER: 4_796000021 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER:- FINAL PAYMENT AMOUNT- NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You mad, be required to report and withhold from lump sum payments such as bonuse; commissions, or severance pay. If you hive am, 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 emplovee/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 en-?ployed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (C(-'PA) l15 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 stalutor?. I, n>ir;n r r,ntrit,ulio(1s and Medicare taxes. I he Federal limit is of the disposable inc?; re if the obligor is supporting another famik and E,0 of the disposable income if the obligor is not ,ruppor0n- another family.Hov e), er, that 50% limit is increased to 55' x, and th,v 00's, limit is increased to 65", if the arrears are greater than 1 ? weeks. If permitted by thsc State, you may deduct a fee for admiw,,tf.,h,,e costs. The support amount and the fee m..i\ not exceed the limit indicated in this ?ec!ion. Arrears greater than 12 weeks : It the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should r alculate the (CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the yaw of 0 ?e issuing I ribe. For Tribal employers who receive a State order, you may not withhold ncore than the lesser of the limit set by the law or line jurisdiction in which the employer is located or the rnaximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)1. Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 1 7 01 > 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.chi]dsupport.state.pa.us Page 2 of 2 Service Type M cr.iB No.: n9rCtinr,.r Form EN-028 Rev.5 V'Vorker ID $ IATT 1 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: MILLER, DREW J. SR PACSES Case Number 9:82112105 PACSES Case Number 950000046 Plaintiff Name Plaintiff Narne KAREN D. MILLER KAREN D. MILLER Docket Attachment Amount Docket Attachment AnlOUnl 10-422 CIVIL $ 370.00 1162 S 96 $ 830.00 Child(ren) s Name(s): DOB Child(ren)'s Name(s): EMMA K. MILLER GRAYSON MILLER DREW J. MILLER JR PACSES Case Nr.mher Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number_ Plaintiff Name Docket Attach,nent Amount 0.00 Child(hen) " N3iP10 1: PACSES Case Number Plaintiff Narre Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount s 0 0 Child(ren)', Narne(s?: DOB 09/11/99 09/18/96 01/27/98 DOB DOB Addendum Form EN-028 Rev.5 Service Type M Worker ID $IATT t ti ?, a No n<„o-o, 1- Barbara Sumple-Sullivan, Esquire Supreme Court #32317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KAREN D. MILLER, Plaintiff v. DREW J. MILLER, SR., Defendant tL 4? `? 7 '_:wiii''i 3EIIAND C')Jj'sN .I. P ENVI}SYLV; -4lA, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. 10 - 422 CIVIL ACTION - LAW IN DIVORCE Y RULE AND NOW, this 6 day of ? U K,, , 2012 on consideration of the Motion to Withdraw Appearance, a RULE is issued on Plaintiff and Defendant to show cause, if any, why the Court should not grant the relief requested. The Rule is returnable within I days from the date of service hereof. BY THE COURT: 'f kQ rGn 6. M . //" -`"arbam 5U1t1,,4ile, -S'u11-Jan ? "Op PS H'tQ, ? ed )E/GL INCOME WITHHOLDING FOR SUPPORT Q ORIGINAL INCOME WITHHOLDING ORDERINOTICE FOR SUPPORT (IWO) C r .\t \ , Q AMENDED IWO I"_?vVcoC)`?L O ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT (} IU - t}?" , C1\1 i Q TERMINATION OF IWO I -I Date: 06/05/12 ? Child Support Enforcement (CSE) Agency ® Court ? Attorney ? Private Individual/Entity (Check One) NOTE: This IWO,rhutt be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions M://www.acf.hhs.aov/programs/cse/newhire/employer/publication/publication.htm - forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. State/rriberrerritory Commonwealth of Pennsylvania Remittance Identifier (include w/payment): 4796000021 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket /nforma/ton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) JDK CATERING INC 1 BISHOP PL CAMP HILL PA 17011-5801 Employer/Income Withholder's FEIN 251606896 Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) RE: MILLER, DREW J. SR Employee/Obligor's Name (Last, First, Middle) 187-44-7800 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions httrr//www acf hhs gov/psgrams/cse/newhire/ j employer/pubticationbublication.htm - form. If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. 2516068960 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from the employee/ obligor's income until further notice. c-) ^a $ 0.00 per month in current child support o Pw -`' $ 0.00 per month in past-due child support - Arrears 12 weeks or greater? dpes f -no I= Ti $ 0.00 per month in current cash medical support c ;a ?j - , $ 0.00 per month in past-due cash medical support C5 $ 370.00 per month in current spousal support c i $ 0.00 per month in past-due spousal support kr ± $ 0.00 per month in other (must specify) :'- .. cz r\) y, for a Total Amount to Withhold of $ 370.00 per month. G? ma 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: $ 85. fl per weekly pay period. $ 185.00 per semimonthly pay period (twice a month) $ 170;7"1 per biweekly pay period (every two weeks) $ 370.00 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 5555% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at http://www acf hhs aov/proarams/cse/newhire/emplover/contacts/contact maa htm for the employee/obligor's principal place of employment Document Tracking Identifier OMB No.: 0970-0154 Form EN-028 06/12 ? 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 Title of Judge/Issuing Official: 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 EMPLOYERSANCOME, WIT14HOLDERS 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 PIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17185.9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employeal4bligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND' CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf.hhs.gov/gaammsicseinewhir,etemfoyerico- a taLc,mao map Zhtm 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 IO 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 1WOs 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 taw/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 06/12 Employer's Name: JDK CATERING INC Employer FEIN: 251606896 Employee/Obligor's Name: MILLER, DREW J. SR 4796000021 CSE Agency Case Identifier: (See Addendum for case summary Order Identifier: (See Addendum for ordeddocket information) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you a no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 2516068960 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.chiIdSUPQgrt.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 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: MILLER, DREW J. SR PACSES Case Neer 482112105 PACSES Case Number Plaintiff Name Plaintiff Name KAREN D. MILLER Docket Attachment Amoun a Attachment A=unt 10-422 CIVIL $ 370.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): P Plaintiff Name Plaintiff Name Docket A chment Amunt D Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSE,S Case Number POSES Case Number Plaintiff Name Plaints Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB DOB Addendum Farm EN-028 06/12 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KAREN D. MILLER ) Docket Number: 10-422 CIVIL Plaintiff ) vs. ) PACSES Case Number: 482112105 DREW J. MILLER SR ) Defendant ) Other State ID Number: Order AND NOW to wit, this JUNE 6 2012 it is hereby Ordered that: , The credit of $1,375.82 from PACSES #950000046 is directed to this APL case . The current credit balance on the APL account is +$641.83. -a ,>w. - The Respondent will be refunded until the current credit of $641.83 is liquidated. rn 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 requsting a hearing before the Support Master. BY THE COURT: ter. r JUDGE Form OE-520 02/11 Service Type M Worker ID 21205 Barbara Sumple-Sullivan, Esquire Supreme Court 432317 549 Bridge Street New Cumberland, PA 17070 (717) 774-1445 KAREN D. MILLER, Plaintiff V. DREW J. MILLER, SR., Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. 10 - 422 CIVIL ACTION -LAW IN DIVORCE ORDER AND NOW, this day of '2012 upon consideration of the Petition to Make Rule Absolute, it is hereby ORDERED and DECREED that the Petition is granted and leave to withdraw is granted to Barbara Sumple-Sullivan, Esquire. BY THE COURT: ;/ koetn 6- AlAtei, 71gli ,e c J. f-? 3 rn t r-n -. cnr'" { rr" C) ` -? S:' C-? 3 - YC tV _ O ^'t KARE DREVN Karen I appear Pennsy dismiss entered You ar( IN 1). MILLEK, 1N THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA , VS. CIVIL ACTION - DIVORCE NO. 10-422 CIVIL TERM r? 'J. MILLER, SR, IN DIVORCE Defendant PACSES CASE: 482112105 ri i ORDER OF COURT AND NOW, this 10th day of August, 2012, a petition has been filed against you, ). Miller, to modify an existing Alimony Pendente Lite Order. You are ordered to in person at the Domestic Relations Section, 13 North Hanover Street, Carlisle, Ivania, on September 6, 2012 at 9:00 A.M. for a conference and to remain until ed by the Court. If you fail to appear as provided in this Order, an Order of Court may b e against you. further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W-2's as file (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by the Rule 910.11. (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you CC3 1 The appropriate court officer may modify or terminate the existing order in any manner based upon the evidence presented. BY THE COURT, Date of Order: August 10, 2012 Albert H. Masland, Judge YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE 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 COUNTY BAR ASSOCIATION 32 S. BEDFORD ST. CARLISLE, PENNSYLVANIA 17013 (717)249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of 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 2 hours prior to any hearing or business before the court. You must attend the schedul d conference. In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KAREN D MILLER vs. DREW J MILLER Defendant ) Other State ID Number: c? C'n { r.. "C O L ; < > ?t PETITION FOR MODIFICATION ' OF AN EXISTING SUPPORT ORDER = ^' Docket Number: 10-422 CIVIL Plaintiff ) PACSES Case Number: 482112105 1. The petition of DREW J MILLER respectfully represents that on 11/24/2010, an Order of Court was entered for the support of A true and correct copy of the order is attached to this petition. Form OM-501 Service Type Worker ID CSWS- MILLER v. MILLER PACSES Case Number: 482112105 2. Petitioner is entitled to O increase O decrease O termination O reinstatement O other of this Order because of the following material and substantial change(s) in circumstance: August 4, 2012 was my last day of paid employment with The JDK Group. I recently applied for Unemployment Compensation benefits until I find full time employment. According to my records, I do NOT currently pay child support but do pay alimony PDL. My ex-wife lost overnight visita- tion of our three chidren until September 1, 2012. At this time, the previous order for chid support is scheduled to be reinstated. At this time, I'm asking for a hearing to review the amount of child support payments based on my change of employment as well as other changes in my personal finances. WHEREFORE, Petitioner requests that the Co modify the existing order for su p r ' Attorney for Petitioner ?>QE?J M. Inc v? I verify that the statements made in this complaint are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. 89 Z Date Form OM-501 Service Type Page 2 of 2 Worker ID CSWS- In the Court of Common Pleas of CUMBERLAND County, Pennn DOMESTIC RELATIONS SECTION Z 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013N+L z CD CD Defendant Name: DREW J. MILLER SIR Member ID Number: 4796000021 Please note: All correspondence must include the Member ID Number. ORDER OF ATTACHMENT OF UNEMPLOYMENT COMPENSATION BENEFITS Financial Break Down of Multiple Cases on Attachment Plaintiff Name KAREN D. MILLER PACSES Docket Case Number Number 482112105 10-422 CIVIL TOTAL ATTACHMENT AMOUNT: Attachment Amount/Freauen?y 370.00 MONTH 370.00 Now, by Order of this Court, the Department of Labor and Industry, Office of Unemployment Compensation Benefits (OUCB), is hereby directed to attach the lesser of $ 85.15 per week, or 50%, of the Unemployment Compensation benefits otherwise payable to the Defendant, DREW J. MILLER SR Social Security Number XXX-XX-7800, Member ID Number 4796000021 . OUCB is ordered to remit the amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from OUCB to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearages, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant to 15 U.S.C. § 1673 (b)(2) and 23 Pa. C.S.A. § 4348 (g). This Order shall be effective upon receipt of the notice of the Order by the OUCB and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated AUGUST 5, 2012 is exhausted, expired or deferred. OUCB shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: 1 1 ?vi2 Albert H.,Masland JUDGE Form EN-530 Service Type M Worker ID $IATT In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013 Phone: (717) 240-6225 Fax: (717) 240-6248 Defendant Name: DREW J. MILLER SR Member ID Number: 4796000021 Please note: All correspondence must include the Member ID Number. MODIFIED ORDER OF ATTACHMENT OF UNEMPLOYMENT BENEFITS Financial Break Down of MultiQle Cases on Attachment PACSES Docket Attachment Amount/Frequency Plaintiff Name Case Number Number KAREN D. MILLER 482112105 10-422 CIVIL 370.00 /ERION~ :,~' KAREN D. MILLER 950000046 1162 S 96 830.00 /E6$ON$~ w I ~ '~a r- .~ a $ ...:'.. -- ., -d TOTAL ATTACHMENT AMOUNT: $ 1,200.1 x •,. ,.,~ "'~ Now, by Order of this Court, the Department of Labor and Industry, Office of Unemp~yment -~. Compensation Benefits (OUCB), is hereby directed to attach the lesser of $276.16 per week, or 50.0%, of the Unemployment Compensation benefits otherwise payable to the Defendant, DREW J. MILLER S Social Security Number XXX-XX-7800, Member ID Number 4796000021. OUCB is ordered to remit th amount attached to the Department of Public Welfare (DPW). DPW shall forward the amount received from OUCB to the Domestic Relations Section of this Court for support and/or support arrearages. If the Defendant's Unemployment Compensation benefits are attached by another Court or Courts for support and/or support arrearage, DPW may reduce the amount attached under this Order so that the total amount attached does not exceed the maximum amount subject to garnishment pursuant tc 15 U.S.C. § 1673(b)(2) and 23 Pa. C.S. § 4348(g). This Order shall be effective upon receipt of the notice of the Order by the OUCB and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated AUGUST 5, 2012 is exhausted, expired or deferred. OUCB shall comply with this Order, unless it is amended or vacated by subsequent Order of this Court. All questions, challenges or obligations to this Order shall be directed to the Domestic Relations Section of this Court. BY THE COURT Date of Order: SEP 0 4 2U~12 H. Masland Form EN-034 Service Type M Worker ID $IATT _. _ _ i _ ~ INCOME WITHHOLDING FOR SUPPORT Q ORIGINAL INCOME WITHHOLDING ORDERlNOTICE FOR SUPPORT (IWO) ~-g a 1 ~ ~,1 D5 15 ~~~~~ ~ Q AMENDEDIWO // { Q ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT ~ ~ - ?~~ ~ ~'~ /' / ~ ~~ Q TERMINATION OF IWO Date: 09 03!12 ^ Child Support Enforckment (CSE) Agency- ® Court ^ Attorney ^ Private Individual/Entity (Check ne) NOTE: This IWO must be'regwlare-rt t$ face. Under certain circumstances you must reject this IWO and return it to the sender (s IWO instructions http //vvww act hhs oovl~rams/cse/newhire/emDloyer/publication/publication htm -forms). If you receive this docum nt from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. Staterrribe/Territory Commonwealth of Pennsylvania Remittance Identifier (include w/payment): 4796000021 City/County/Dist.lTribe CUMBERLAND Order Identifier: (See Addendum for order/docket lrtformalton) Pmate Individual/Entity __ CSE Agency Case Identifier: (See Addendum for case summary) JDK CATERING INC 1 BISHOP PL CAMP HILL PA 17011-5801 Employer/Income Withholder's FEIN 251606896 Child(ren)'s Name(s) (Last, First. Middle) Child(ren)'s Birth Date(s) RE: MILLER, DREW J. SR Employee/Obligor s Name (Last, Fi st, Middle) 187-44-7800 Employee(Obligor's Social Security Number (See Addendum for plaintiff nam s associated with cases on attach enf) Custodial Party/Obligee's Name ( st, First, Middle) NOTE: This IWO must be regular on is face. Under certain circumstances you mu t reject this IWO and return it to the sender ( ee IWO instructions h v wh'r / m r i n .If you receive this document from som one other than a State or Tribal CSE agency o a Court, a copy of the undedying order must be attached. 2516068960 See Addendum for dependent names and bifth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from MB N Co mmonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts fro©t th '' m ~ obligor's income until further notice. "c'~ r''s ~ $ 830.00 per ITtonth in current child support r,.~ ~ ra ..e, reater? eeks or 12 A hild t d ~ I $ g w rrears suppor - 0.00 per month in past- ue c y ~ $ 0.00 per month in current cash medical support Z --,t $ 0.00 perm n h in past-due cash medical support ~~ -o $ 370.00 per month in current spousal support Vic, z $ 0.00 per month in past-due spousal support ~• ~ ~? ....~ $ 0.00 per month in other (must specify) ~ -- ~ ~ ~ for a Total Amount to Withhold of $ 1,200.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Info ation. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 027!0 ~93 per weekly pay period. $ 600.00 per semimonthly pay period (twice a month) $ X53 ;k5~ Per biweekly pay period (every two weeks) $ 1,200.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the mmo w I of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs n 1 working days after the date of this Order/Notice. Send payment within v n 7 working days of the pay dat If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to ° 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 requirem nts, and any allowable employer fees at h t :/ www. f.hh v/ r rams/c e/n white/em I r nt cts/contact m htm for the employee/obligor's principal place of employment. Document Tracking Identifier oMe na.: os~o-o~sa Form EN-028 0 /12 Service Type M Worker ID $IA Return to Sender (Gompleted by Employerllncorne-Withholder]. Payment must be directed to an SDU in accordance with 42 USA §666(b)(5) and (b}(6) or Tribal Payee (see Payments to SDU below). If payment. is not directed to an SDU~rribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the ~~ender. Signature of Judge/Issuing Official (if required by State or Tribal law): Print Name of Judge/Issuing Official: __ '~ ~ H ~s~ .Title of Judge/Issuing Official Date of Signature: ~` P ~ 1 ~ne7 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 I WO must be provided to the employee/obligor. ^ If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDtTtONAL tNFORAAATIOW FOR EMPLOYERS/INCOME WITHktBL©ERS Pennsylvania law (23 PA C.S. § 437~b)) requires remittance by an electronic itayment methodrf an employer +s ordered- to withhflld irt~ome from mare than one employee and employs 15 or more persons, or if an employer has a history of twC or more re#urned dhecks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Emiployer Customer Service at 1-8T7-ti76-9580 far instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU ~d checl~ to: Pennsylvania SGDU, P.Q. 13ox 6`8112, Harrisburg, P~ 17146-9412 lf~€AQQ/TtFJf+l, PAYMENTS MUST tf~ICiE.tJDE THE DEPENDANT'S NAME AND THE PACSES MElidi~Eft tD (shiown shave as >l grttploy+bslObttgor"s Case tdistr>Fti~rerf Oft SOGIAL SECURITY Nt1A~Eft 1N ORE?ER TO ~ PRt7elaS3ED. DO NOT SENO CASH 8'Y MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: htto~//www acf hhs gov/~rogramcrrsPlnewhir~/e~lover/rdpntactslcontac~l,~p htsn Priority: Withholding for support has priority over any other legal process under State law against the same income (USG 42 §6t36(b)E7)). If a Federal tax levy is in effect,. please notify tt-e sender. Cornbaung Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more titan ono employee/obiigor's income in ~ single payment..You must, however, separately identify each employee! obligor's poraor of:tFie payment. Payments To ~Dlt; You must send. child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE ~ency. tf this IWO instructs. you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, ot~,attomey.), you must check the box above and return this notice to the sender. Excetstion: ~ this IWO was sent by a Court, Attomey~, or Private )ndividuaUEntity and the initial order was entered before January 1, 1994 or the order was issu®d try a T'dbal CSE agency, you must follow the "Remit payment to" instru>vttorts 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 firom 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 ernploymertt 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 ibis 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. Liabilityr: If you have any doubts about the validity of,this lWO, contact the sender. If you fail to withhold income from the employeelobkgor's income as the IWO diirects, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal taw/procedure. Anti-di~scrirs~iinStign: 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 employeelobtigor because of this IWO. OM8 Expiration Date - 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the1W0; d identifies the version of the form currently in use. Form EN-02$.06/12 Service Type M Page 2 of 3 Worker lD $IATT Employer's Name: JDK CATERING INC Employee/Obligor's Name: MILLER, DREW J. SR CSE Agency Case Identifier: (See Addendum for case summary Order Identifier: 1 Withholding limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credi 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 o employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deducti ns 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 supp rting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted y the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit ind Gated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal emplo ers/incon withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdictio in which the employerlincome 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 i 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, the 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 no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sen returning this form to the address listed in the Contact Information below: 251 Q This person has never worked for this employer nor received periodic income. ~ 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: or you are r by 068980 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 (7171240-6248, by email or website at: www childsupport state na us. Send termination/income status notice and.other correspondence to: DOMESTIC RELATIONS SECTION, P.O BOX 320 CARLISLE PA 17013 (Issuer address). 7o Em2loyge/Obligor If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-624$, by email or website at www childsuQOOrt state a us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. oMa no.: oe~o-o,sa Form EN-028 0 /12 Service Type M Page 3 of 3 Worker ID $IA Employer FEIN: 25 4 ADD~NDUr~ Sumrnarv of Ga~t~s on e~a•-~ -• peferttR2uttlC)k~ligor. MILLER, DREW ,1, SR P¢jCS~S ~a~e Nu^~b~r 482112105 PACSES Cas~N~!mber 950004046 Pontiff Name Plaintiff Name ltEN 0. MILLER KAREN b. MILLER Attachment Amount Docket Attachment Aunt 10-422 ClVll $ 370.40 1162 S 96 $ 830.04 Child(r8n)'s N~arnee(s): DUt3 Child(ren)`s Name(s): 'DOB EMMA K. MILLER (?9111/99 GRAYSOtd MILLE 0911 DREW J. MILLER JR 01/27/98 PAGSE~ G~se Number PgC~~~~ase ~Iure~s.~r Plainti Name Pontiff N,s~me ~m~ L~t13Q-~t $ 0.44 $ 0.00 Child(ren)'s Name(s): DOB Chiid(ren)'s Na+ne(s): DflB PACSES .Ease. Number PQ~$~~Case Number Plaintiff Name Piantf# Name Docket Atiae-t~ment Rmo~'r!t Q~ Atts~c nt ount $ o.oo $ 4.oa Child(ren)'s Name(s): DOB Child(ren)'s Name(s): Dpg Addendum Form EN-028-46/12 Service Type M OMB No.: 0979-0154 Wt~fker ID $IATT In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KAREN D. MILLER ) Docket Number: Plaintiff ) vs. ) PACSES Case Number: DREW J 'MILLER SR ) 10-422 CIVIL 482112105 Defendant ) Other State ID Number: rnw MvIrn CAT-wOrder' z0 AND NOW to wit, this SEPTEMBER 6, 2012 it is hereby Ordered tF8 The Alimony Pendente Lite order is suspended effective August 4, 2012 pursuant to the Respondent receiving unemployment compensation benefits and the parties having a 50/50 shared custody arrangement with the parties' three children. The order is suspended with a credit of $418.51. This order shall become final within ten 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 Support Master. BY THE COURT: -0 3 t;J _? m Albert H. Masland JUDGE Form OE-520 02/11 Service Type M Worker ID 21205 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION KAREN D. MILLER Plaintiff vs. DREW J. MILLER SR CJOCket Number: 10-422 CIVIL F'ACSES Case Number; 48211~?105 Defendant ~ Other State ID Plumber: ~ M1, `~;'. ~ C 'D~ e --1 ~ ~ ~ ~ ~~ ~ N Order <~".. r v' _~, - - ,,CC~ 9. ~ { ~ AND NOW to wit, this OCTOBER 23, 2012 it is hereby Ordered that: x ~ x} ~ `~~~" x ~ ,~ cx~ , 1. The Defendant shall pay to the Pennsylvania State Collection and Disbursement Unit as alimony pendente lite the sum of $75.85 per month. 2. Payrnents are deferred until the credit of $418.51 set forth in the order oi` 09/06/12 is depleted. 3. The effective date of this order is 10/01/12. 4. This order is entered by agreement of the parties, both of whom are represented by counsel. OCTOBER 23, 2012 Date Service Type M BY THE COURT: ,,•;~ -M ._ ~.. Albert H. Masland JUDGE Form 0E-001 Worker iD 21300 INCOME WITHHOLDING FOR SUPPORT 0 ORIGINAL INCOME WITHHOLDING ORDERiNOTICE FOR SUPPORT(IWO) 4,R J �_i o s L)L,r}/::)D ` Q AMENDED IWO {{ } 1 V 1 O ONE-TIMEORDERINOTICE FOR LUMP SUM PAYMENT L' Q TERMINATION OF IWO Date: 04109113 ❑ ChildSupport Enforce*tICSE)Agency ® Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This iWO must be regular on its face.Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions hht(w/uvww acf hh oov/Dr rams/csetn hire! mQlgYer/Dublicationt u�blication htm-forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include wlpayment): 4796t1M21 City/County/Dist.[Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket informalton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) METALAYE ENTERPRISES INC RE: MILLER,DREW J.SR 148 SHERATON DR Employee/Obligor's Name(Last, First,Middle) NEW CUMBERLAND PA 17070-2440 18744-7800 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 454857643 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.aef.hhs.gov/RE.Qgrams/cse/newhire/ employgd bkcation/eaubiication.htm-form if you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. 4548576430 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 frorn the4npl ee/ obligor's income until further notice. .- $ 806.25 per month in current child support o3 - y,. $ 0.00 per mon in past-due child support- Arrears 12 weeks or greater? Q yes"M no�°o '0 r-1 $ 0.00 per month in current cash medical support =r�- -- p� $ 0.00 permonth in past-due cash medical support -tom C $ 75.85 permonth in current spousal supporter -v ©'n $ 0.00 permonth in past-due spousal support " 3 $ 0.00 per month in other(must specify) �G for a Total Amount to Withhold of$ $82,10 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: $ 203,57 per weekly pay period. $ 441.05 per semimonthly pay period(twice a month) $ 40'1.13 per biweekly pay period(every two weeks) $ 882,10 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 Omer/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/c ntacts/contact maD hhtm 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 ❑ Return to Sender[Completed by Employer/income Withholder] Payment must be directed to an SOU iIj 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: Title of JudgetIssuing Official Date of Signature: AN &Q-JAIJ 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. ADDITK)NAL INFORMATION FOR EMPL©YEISfINCOME 1 ITMHOLi3ER5 Pennsylvania taw(23-PA C.S.§4374(b))requires remittance by an if an ernpt9yer is orderad to withh4ti!It ttrle*W m that's of MAP"and employs 16 by molt 004oft,lor lf arr a o two or more returned ctwKft due to'norm0ficient ftwids. PWse catt 04'PiarmylvAnto State Cb060 end Disbursement Unit(PA SCOU)Employer Customer Service at IV147't `for lost"Actions.PA' . ;CADS 42 040,ai M ft sae to: PA SCDU Send cheat to: Pannsylvoila SQDU, P.O. ll ax 1- 2,: : - Pa 17106.9112 IN AiDDlTiON,PAXMENTS.MufST INCLUDE THE 5FAF1 tlfT'S~ANDITHE PACSE$ the E pto Iiftoes C► Id0 S00AL IN` SEND CA SY 4l-AJL. 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(bX7)). If a Federal taxis In " ,01111111111101wo _ Combinir nts: When remittjng payn is Q an U or T I C n t,you rxuey corrtbrne aef t�l unt frig more than tine empl ee/obNgor's incvrne in a si ant. Yoo r�srt, , Aye obligor's portion o'F"payment. PaymenUt }SD,U': You must send child support payments payable by income wi dr.= to the� � 1.1 aria a Tribal CSIengrm If ttti,I~WO instructs you to senIl a, try ? ( g party,court,.or attttme .you must check"the box abode entj t� t wit.- by a Court-'Attor y, or Rmrate Individual/Entity and the initi4ior�rr► �' W . was issued by a TribliMSE-; ncy, you must follow the"Remit to" a . o► � ttr�. Repo #he�/[1a; You must report the pay date when sendir ilia#�?eo The pay ra deb on wtxiclt the amount w wll el'a the empioyeelobligor's wages. You must 6>' low ' `T 1f applicableyr>f 64 err yee/obligor's principal place of ernpidymerit reg 041 p Go �i h you m6if Irrrps the withholding find forward the support payments. Multiple IWO*: If there.is more than one IWO against thr o r, d ars una#le,to fly € � � Federal, Stele,or Tribal withholding limits, you i�t .. . . support before payment of any past-due supoor- �'" place of employment to dAtOrmline 111 meth od. Lump Sum Payments:You may be required to rv#1y a, „ rar Ttiia .4 of �_� fonts to this employee/obligor such as bonuses, comrnlarlons,be yf.Cl tc y� to report and/or withhold lump sum payments. Liability: If you have any doubts about e 3 empl©yea/oblgors inure as the IWdiree Z4f Inrs.LO r If you fl ttr wr trr r r ff�.tlte any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine dqW. rm**..: to ter Trtb*,alga qr,ot char front employment, refusing to employ, or Ming diiscip ' a666K t set 4.. ef OMB Expiration Date-0513112014.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 06/12 Service Type M Page 2 of 3 Worker ID 21205 Employer's Name: METALAYE ENTERPRISES INC Employer FEIN:454857643 Employee/Obligor's Name: MILLER, DREW J. SR 4796000021 CSE Agency Case Identifier:(Ste Addendum for case summis Order Identifier:($ee Addendum for o 2aktLh1&MUt&Jn 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 THbe. 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: 4548576430 0 This person has never worked for this employer nor received periodic income. 0 This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employees 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.childsupgort.state.pa.us. Send term i nation/income status notice and other correspondence to:DOMESTIC RELATIONS SECTION,13 N, HANOVER ST. P.O. BOX 320, CARLISLE. PA. 17013(issuer address). If the has questions, contact WAGE ATTACHMENT UNIT(issuer name) by phone at by fax ag by email orvvnbo|hmot . IMPORTANT:The person completing this form io advised that the infomnotionmay be shared with the emp)oyeo/ob|igm. OMB~m'o97n-0,o^ Form EN-O2B06/12 Service Type K8 Page 3of3 Worker |O312O5 D**uIaft " r: MILLER, DREW J. SR EAS F.s Case NUOU 482112105 950,000W KAREN D. MILLER 10-422 CIVIL Mx5 1162§ 6 $$ Child(ranys Name(s): 0013: Chiid(ran)'s Name(s): Dos D A' PACES Cass.Number BACALS CaabumW r Plaintiff Mgme �h Children)"s Name(s): DOB Child(renys Name(s): DOB MSES Cass umber Plaintiff Name . . �?�s4i€ti � 0.00 $ Children)"s Name(s): DOB Child(renys Narne(s): DOB Addendum Farm EN-0,2&06/12 Service Type fill OMB No.:0970-0154 Worker ID 21205