HomeMy WebLinkAbout02-0907 NM
ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 02-907 CIVIL
State Commonweal!,th of pgnnsylvania OOriginal Order/Notice
Co./City/Dirt. of CUMBERLAND OAmended Order/Notice
Date of Order/Notice 10/04/10 (Terminate Order/Notice
Case Number (See Addendum for case summary) OOne-Time Lump Sum/Notice
RE: COLLEGE , GLEN E .
Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI)
207-34-6816
Employee/Obligor's Social Security Number
TYCO ELECTRONIC PENSION CENTER 8610100935
PO BOX 8100 Employee/Obligor's Caseldentifier
ROLLING MEADOWS IL 6 0 0 0 8 - 810 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. 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.
$ o . oo per month in current child support
$ o. oo per month in past-due child support Arrears 12 weeks or greaten' t~yes ®ao
$ o . oo per month in current medical support :~~'v _f;
$ o . oo per month in past-due medical support ~`--.__", o M~..,.~
$ 682.50 per month in current spousal support .~., ~ cam;
„' ~°~ c~
$ o . oo per month in past-due spousal support -=m :~? --~ ~~~
$ o. oo per month for genetic test costs ~~~ ~ ~_
$ o . o o per month i n other (specify) ~~" ~~' ~~ ~---~ `~~
~-.:, ~~
$ one-time lump sum payment °~~' ~° '_~~`
W ~ c~ r,-t
for a total of $ 682.50 per month to be forwarded to payee below. w~~~W
You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle~d'oes not match
the ordered support payment cycle, use the following to determine how much to withhold:
$ 157.50 Per weekly pay period. $ 341.25 per semimonthly pay period
(twice a month)
$ 3~5, 00 per biweekly pay period (every two weeks) $ 6e2.5o 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 pavment method if an employer is
ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has
a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections
and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE
42 000 00
Make Remittance Payable to: PA SCDU
Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112
IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown
above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER 1N ORDER TO BE PROCESSED.
DO NOT SEND CASH BY MAIL.
BY THE COURT:
~A1b~ri' H. Masland, Judg+e~ Form EN-028 Rev.5
DRO: R.J. Shadday
Service Type M OMBNO.:0970-0154 Worker ID $oINC
1
ADDITIONAL INFORMATION TO EMPLOYERS AND OTMER WITHHOLDERS
~ If heck you are required. to pr vide a opy of this form to your m loyee. If yo r employee orks in a state tha is
di~erent from the state that issuedthis order, a copy must be providedpto your emp~oyee even if i~ie box is not chec~ed
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'slobligor's principal place of employment with respell 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 OrderlNotice to Withhold Income for Support against
this employee%bligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow
the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent
possible. (See #9 below)
5. Termination Notification: You must promptly notify the Requesting Agency when the employee%bligor is no longer working for you.
Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 3509100244
THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ~ THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: D
EMPLOYEE'S/OBLIGOR'S NAME: COLLEGE , GLEN E .
EMPLOYEE'S CASE IDENTIFIER: 8610100935
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 govems 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%bligorfrnm employment,
refusing to employ, or taking disciplinary action against any employee%bligorhecause 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 X17) 240-6225 or
P.O. BOX 320
CARLISLE PA 17013 by FAX at (717) 240-6248 or
by interne[ www.childsupport.state.pa.us
Page 2 of 2 Form EN-028 Rev.5
Service Type M OMB No.:09740154 Worker I D $oINC
~, :
ADDENDUM
Summary of Cases on Attachment
Defendant/Obligor: COLLEGE, GLEN E.
PACSES Case Number 835104263
Plaintiff Name
JEANNETTE M. COLLEGE
Docket Attachment Amount
02-907 CIVIL $ 682.50
Child(ren)'s Name(s); DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)'s Name(s): DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)'s Name(s): DOB
Addendum
Service Type M
OMB No.: 0970-0154
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)`s Name(s): DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)'s Name(s): DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)'s Name(s): DOB
Form EN-028 Rev.S
Worker ID $olNc
ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 02-907 CIVIL
State _Commonwealth of Pennsylvania OOriginal order/Notice
Co./City/Dirt. of CUMBERLAND OAmended Order/Notice
Date of Order/Notice 10 f 04 f 10 X~Terminate Order/Notice
Case Number (See Addendum for case summary) QOne-Time Lump Sum/Notice
RE: COLLEGE, GLEN E .
Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI)
207-34-6816
Employee/Obligor's Social Security Number
TYCO ELECTRONICS 8610100935
M S 161 051 Employee/Obligor's Case Identifier
PO BOX 3 6 0 8 (See Addendum for plaintiff names
HARR I 5 BURG PA 1710 5 - 3 6 0 8 associated with cases on attachment)
Custodial Parent's Name (last, First, Mp
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 CiJN®ERLAND 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.
$ o . oo per month in current child support
$ o. oo per month in past-due child support Arrears 12 weeks or greater? Qyes ®no ",`"'~
$ o . oo per month in current medical support
$ o.oo per month in past-due medical support ~ ~' -`~
~~
$ o . oo per month in current spousal support '~"
$ o . o o per month in past-due spousal support t r ~ ~'~ ~ ~
$ o . oo per month for genetic test costs ~~='' `~ ^' °-`•~`
$ o. oo per month in other (specify) ~°;. cn `-~,~
$ one-time lump sum payment ~,-~:~ ~'°`~
°~? ~ ~ ~~
for a total of $ 0.00 per month to be forwarded to payee below. '-=~ ~°.~. N `
"~' _,.. A
,~:_.
You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle-(ioe~tot+~atch
the ordered support payment cycle, use the following to determine how much to withhold: ~ #
$ o . oo Per weekly pay period. $ o. oo per semimonthly pay period
(twice a month)
$ o . oo per biweekly pay period (every two weeks) $ o . oo per monthly pay period.
REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10)
working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydateldate 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 taw (23 PA C.S. li 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 1D (shown
above as the Employee/Obligor's Case Identifier) OR SOC/AL/~SEj-~CURITY NUMBER IN ORDER TO BE PROCESSED.
DO NOT SEND CASH BY MA/L. i~i~
BY THE COURT:
Albert H. Masland, Judge
DRO: R.J. Shadday Form EN-028 Rev.5
Service Type M OMBNo.:0970.0154 Worker ID $IATT
ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS
~ If heck you are required, to pr vide a opy of this form to your m loyee. If yo r employee orks in a state tha is
di~erent from the state that issuedthis order, a copy must be provideedpto your emproyee even if tie box is not chec~ed
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%bligor'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%bligoranct you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow
the taw 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. 2303325750
THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : D THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: l~
EMPLOYEE'S/OBLIGOR'S NAME: COLLEGE , GLEN E .
EMPLOYEE'S CASE IDENTIFIER: 8610100935 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%bligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law govems unless
the obligor is employed in another State, in which case the law of the State in which he or she is employed govems.
8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee%bligorfrnm employment,
refusing to employ, or taking disciplinary action against any employee%bligorhecause 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 govems.
9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit
Protection Act (CCPA) (15 U.S.C. 1673 (b)}; or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of
employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social
Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is
supporting another family and 60°!° of the disposable income if the obligor is not supporting another family.However, that 50% limit is
increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may
deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section.
Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the
employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts
allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of
the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the
CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health
care premiums in determining disposable income and applying appropriate withholding limits.
10. Additional info:
* NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state
that issued this order with respect to these items.
11. Send Termination Notice and
other correspondence to:
DOMESTIC RELATIONS SECTION
13 N. HANOVER ST
P.O. BOX 320
CARLISLE PA 17013
If you or your employee/obligor have any questions,
contact WAGE ATTACHMENT UNIT
by telephone at X717) 240-6225 or
by FAX at (717) 240-6248 or
by Internet www.childsupport.state.pa.us
Page 2 of 2 Form EN-028 Rev.S
Service Type M OMBNo.:0970.015A Worker ID $IATT
~.
ADDENDUM
Summary of Cases on Attachment
Defendant/Obligor: COLLEGE, GLEN E.
PACSES Case Number 835104263
Plaintiff Name
JEANNETTE M. COLLEGE
Docket Attachment Amount
02-907 CIVIL $ 0.00
Child(ren)'s Name(s): D08
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
Service Type pq
Addendum
OMB No.: 0970A154
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ 0.00
Child(ren)'s Name(s): DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)'s Name(s): DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)'s Name(s): DOB
Form EN-028 Rev.S
Worker I D $ IATT
ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT
State Commonwealth of Pennsylvania
Co./CitylDist. of CUMBERLAND
Date of Order/Notice 10/08/10
Case Number (See Addendum for case summary)
Employer/Withholder's Federal EIN Number
TYCO ELECTRONIC PENSION CENTER
PO BOX 8100
ROLLING MEADOWS IL 60008-8100
207-34-6816
Employee/Obligor's Social Security Number
8610100935
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.
$ o . oo per month in current child support
$ o. oo per month in past-due child support Arrears 12 weeks or greateri Qyes ®no
$ o.oo per month in current medical support
$ o.oo per month in past-due medical support ~~
$ o . oo per month in current spousal support -•~ ~ -;
$ o. oo per month in past-due spousal support ~, t
$ o . oo per month for genetic test costs i -`yam ~ ~=•~;,~y
$ o. oo per month in other (specify) :~;'~ ~ -'~
$ one-time lump sum payment ~~~~ t =~c.~
for a total of $ 0.00 per month to be forwarded to payee below. '~='_' -~
°~ c-~ =tea _
-,~ c=~
You do not have to vary your pay cycle to be in compliance with the support order. If your pay cyoe~;rtbt ~~
the ordered support payment cycle, use the following to determine how much to withhold: "'° -•-• =~'
~,
$ o . oo per weekly pay period. $ o . oo per semimonthly pays pe'rit}d -,
(twice a month)
$ o . oo per biweekly pay period (every two weeks) $ o . oo per monthly pay period.
REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10)
working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of
withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work
state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55°l0 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 aavment 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 lNC[UDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown
above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED.
DO NOT SEND CASH BY MAIL. ~ , , i ~ _ ~ ~•-~
BY THE COURT:
H. Masland, Judge
DRO: R.J. Shadday
Service Type M
OMB No.: 0970-0154
02-907 CIVIL
OOrigi nal Order/Notice
OAmended OrderJNotice
XOTerminate Order/Notice
QOne-Time Lump Sum/Notice
RE: COLLEGE, GLEN E.
Employee/Obligor's Name (Last, First, MI}
Form EN-028 Rev.S
Worker ID $oINC
ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS
(~ If heck you are required, to provide a opy of this form to your mployee. If yo r employee works in a state that is
di~erent from the state that issued this o~er, a copy must be provi~ed to your emplyoyee even if the box is not checked.
1. Priority: Withholding under this OrdedNotice has priority over any other legal process under State law against the same income.
Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting
agency listed below.
2. Combining Payments: You can combine withheld amounts from more than one employeelobligor's income in a single payment to
each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each
employee%bligor.
3.* Reporting the Paydate/Date of Withholding: You must report the paydateldate of withholding when sending the payment. The
paydateldate 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 respell 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%bligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow
the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent
possible. (See #9 below)
5. Termination Notification: You must promptly notify the Requesting Agency when the employee%bligor is no longer working for you.
Please provide the information requested and return a copy of this OrderlNotice to the Agency identified below. 3509100244
THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : O THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: i~
EMPLOYEE'S/OBLIGOR'S NAME: COLLEGE, GLEN E .
EMPLOYEE'S CASE IDENTIFIER: 8610100935 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%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•iiscrimination: You are subject to a fine determined under State law for discharging an employee%bligor from employment,
refusing to employ, or taking disciplinary action against any employee%bligorbecouse 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'slobligor's principal place of
employment, Disposable income is the net income left after making mandatory deductions such as: State, Federal, focal 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°t° of the disposable income if the obligor is not supporting another family.However, that 50°1° limit is
increased to 55°I° 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 tb)). 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.
t 1. Send Termination Notice and
other correspondence to: If you or your employee/obligor have any questions,
DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT
t 3 N HANOVER ST by telephone at X71 ~ 240-6225 or
P.O, BOX 320 by FAX at (717) 240-6248 or
CARLISLE PA 17013
by interne[ www.childsu rt.state. a.us
Page 2 of 2 Form EN-028 Rev.5
Service Type M OMB No.:0970-0154 Worker ID $oINC
~ r
ADDENDUM
Summary of Cases on Attachment
Defendant/Obligor: COLLEGE, GLEN E.
PACSES Case Number 835104263
Plaintiff Name
JEANI3ETTE M. COLLEGE
Docket Attachment Amount
02-907 CIVIL $ 0.00
Child(ren)'s Name(s): DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)'s Name(s):
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ 0.00
Child(ren)'s Name(s): DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
DOB Child(ren)'s Name(s): DOB
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(ren)'s Name(s): DOB
Service Type M
Addendum
OMB No.: 0970-0154
PACSES Case Number
Plaintiff Name
Docket Attachment Amount
$ o.oo
Child(reN's Name(s): DOB
Form EN-028 Rev.S
Worker ID $oINC