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HomeMy WebLinkAbout02-3256 NMIn the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 170113 Defendant Name: PATRICK T. NEMEC Member ID Number: 1835101084 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 C7,, Plaintiff Name - - PACSES Docket Case Number Number Attachment Amount/Frequency t QfVDIESfk?MA 268105092 02-3256 CIVIL $ 1,020.00 MONTH ? $ Fx / TOTAL ATTACHMENT AMOUNT: $ 1,020.00 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 $ 234.74 per week, or 5 0 %, of the Unemployment Compensation benefits otherwise payable to the Defendant, PATRICK T. NEMEC Social Security Number XXX-XX- 2551 , Member ID Number 1835101084 . 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 theIOUCB and shall remain in effect until the Defendant's entitlement to Unemployment Compensation benefits, under the Application for Benefits dated JULY 18 , 2 010 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 I w It,v 10 DRO: R.J. SHADDAY JUDGE Service Type M Worker ID $ IATT Form EN-530 Rev.2 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania CO./City/Dist. of CUMBERLAND Date of Order/Notice 10/29/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number COMMONWEALTH OF PA C/O STATE EMPLOYEES RET. SYST 30 N 3RD ST STE 150 HARRISBURG PA 17101-1726 02-3256 CIVIL OOriginal Order/Notice OAmended Order/Notice 0Terminate Order/Notice OOne-Time Lump Sum/Notice RE:NEMEC, PATRICK T. Employee/Obligor's Name (Last, First, MI) 1?1-42-2551 E6ployee/Obligor's Social Security Number 135101084 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 greater? Oyes ® no $ o . oo per month in current medical support $ o . oo per month in past-due medical support , $ 920.00 per month in current spousal support $ 100. oo per month in past-due spousal support 7 ?r- $ o . oo per month for genetic test costs I = $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ 1,020.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does nlot rx " h the ordered support payment cycle, use the following to determine how much to withhold: $ 234.74 per weekly pay period. $ 510.00 per! semimonthly pay period (twice a month) $ 469.48 per biweekly pay period (every two weeks) $ 1, 020. 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. Refelr 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 a m nt 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 fr 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 ACSES MEMBER ID (shown above as the Employee/Obligor's Case Ident{fie) OR SOCIAI?ECURIJ.I? NUMBER N ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. 1 /JJ 7 BY THE COURT: J. sYy Oler, Jr., Judge r ??pp Form EN-028 Rev.5 URO: RyyeShMdday OMB No.: 0970-0154 Worker ID $OINC ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If gheckeyi 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 iron the state that issued this order, a copy must be provi?ed to your employee even if the box is not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding, when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wage. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 7676100114 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ED THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 17-1 EMPLOYEE'S/OBLIGOR'S NAME:NEMEC, PATRICK T. EMPLOYEE'S CASE IDENTIFIER: 1835101084 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: NEW EMPLOYER'S NAME/ADDRE FINAL PAYMENT AMOUNT: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the order information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240}6225 or by FAX at (717) 240-6240 or by internet www.childsupi?ort.state.pa.us Page 2 of 2 Form EN-028 Rev.5 Service Type M oMBNo,:0970-0154 Worker ID $oINC ADDENDUM Summary of Cases on Attachment Defendant/Obligor: NEMEC, PATRICK T. PACSES Case Number 268105092 PACSES Case Number Plaintiff Name Plaintiff Name CLAUDIA DESOMMA Docket Attachment Amount Docket Attachment Amount 02-3256 CIVIL$ 1,020.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Service Type M OMB No.: 0970-0154 PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attai hment Amount $ 0.00 Child(ren)'s Name(s): DOB Form EN-028 Rev.5 Worker ID $OINC In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA Plaintiff Docket Number: 02-3256 CIVIL vs PATRICK T. NEMEC PACSES Case Number: 268105092 Defendant TO: Commonwealth of Pennsylvania Treasury Department Bureau of Unclaimed Property PO Box 1837 Harrisburg, PA 17105 - ?? dP Gr. N -4C-+ ::r_ --, Lump Sum Order of Attachment of Income C-, c rO ` Pursuant to the laws of the Commonwealth of Pennsylvania, the income of PATRICK T. NEMEC Defendant, Social Security Number 161-42-2551, Treasury Claim Number, 4352349, is hereby attached as follows: You are directed to pay to the CUMBERLAND County Domestic Relations Section a lump sum payment in the amount $5,449.96 due from Defendant's unclaimed property. The attachment payment must be sent to the CUMBERLAND County Domestic Relations Section as soon as administratively possible. The check should be made payable to and mailed to the CUMBERLAND County Domestic Relations Section, 13 N. HANOVER ST, P.O. BOX 320, CARLISLE PA 17013. Advise the Domestic Relations Section if no property is found for the defendant. THE MEMBER NUMBER, 1835101084, AND NAME OF DEFENDANT MUST APPEAR ON THE FACE OF THE CHECK TO APPLY CREDIT TO THE PROPER ACCOUNT. This order of attachment for support is binding upon you until further notice and shall have priority over any attachment, execution, garnishment or wage attachment under state or local law except one relating to a prior support order. Service Type M Form EN-700 Worker ID 21104 DESOMMA v. NEMEC PACKS Case Number: 268105092 You are notified further that pursuant to law: 1. The Defendant has been notified that an order of attachment for support would be issued. 2. Willful failure to comply with this order may result in i) you being adjudged in contempt of court and committed to jail or fined by the court; ii) you being held liable for any amount not withheld or withheld but not forwarded to the Domestic Relations Section; and iii) attachment of your funds or property. 3. The attachment of income or the possibility thereof as a basis, in whole or in part, for the discharge of an employee or any disciplinary action against or demotion of an employee is prohibited. Violation may result in i) you being adjudged in contempt and committed to jail or fined by the court and ii) an action against you by the employee for damages. 4. The term "income" as defined by law includes compensation for services, including, but not limited to, wages; salaries; fees; compensation in kind; commissions and similar items; income derived from business; gains derived from dealings in property; interest; rents; royalties; dividends; annuities; income from life insurance and endowment contracts; all forms of retirement; pensions; income from discharge of indebtedness; distributive share of partnership gross income; income in respect of a decedent; income from and interest in an estate or trust; military retirement benefits; railroad employment retirement benefits; social security benefits; temporary and permanent disability benefits; Worker's compensation and unemployment compensation; or other entitlements to money or lump sum awards, without regard to source, including lottery winnings; income tax refunds; insurance compensation or settlements; awards or verdicts; and any form of payment due to and collectible by an individual regardless of source. BY THE COURT MAY 1, 2012 DATE Service Type M S,JUDGE Form EN-700 Page 2 of 2 Worker ID 21104 INCOME WITHHOLDING FOR SUPPORT (D ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) O AMENDEDIWO O ONE-TIMEORDERMOTICE FOR LUMP SUM PAYMENT O TERMINATION OF IWO RE: NEMEC, PATRICK T. Employee/Obligor's Name (Last, First, Middle) 161-42-2551 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) ? Child Support Enforcement (CSE) Agency ® Court ? Attorney ? Private Individual/Entity (Check One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions hfl2://www acf hhs gov/programs/cse/newhire/emFoyer/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. JL0tV "1IVC1 1 CnRUry _wmmonweann or rennsyrvama Remittance Identifier (include w/payment): 1835101084 City/County/Dist.frdbe CUMBERLAND Order Identifier: (See Addendum for orderldocket lm'oDn a/ton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) SOCIAL SECURITY ADMINISTRATION STE 1 200 S SPRING GARDEN ST CARLISLE PA 17013-2578 Employer/Income Withholder's FEIN Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) (? ? 105n9? v/ l Date: 05/14/12 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 htto•/A~ acf hhs gov/programs/cse/newhire/ employer/publication/publication htm - forma. 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. 8384100092 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 "unty, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts fr t tfWempfbyee/ obligor's income until further notice. r-n $ 0.00 per month in current child support =M 70 0 ? $ 0.00 permonth in past-due child support - Arrears 12 weeks or greater? O yf - ti?-i+.?e--^ l_J $ 0.00 per month in current cash medical support .,? cn $ 0.00 per month in past-due cash medical support -v ?-, $ 920.00 permonth in current spousal support c-) =: $ 100.00 per month in past-due spousal support " tv $ 0.00 permonth in other (must specify) -_a for a Total Amount to Withhold of $ 1,020.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 234.74 per weekly pay period. $ 510.00 per semimonthly pay period (twice a month) $ 469.48 per biweekly pay period (every two weeks) $ 1,020.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), obtain withholding limitations, time requirements, and any allowable employer fees at http://www.acf.hhs.-aov/proarams/cse/newhir /emDlover/contacts/ contact map.htm for the employee/obligor's principal place of employment Document Tracking Identifier OMB No.: 0970-0154 Form EN-028 01112 Service Type M Worker ID $OINC ? Return to Sender [Completed by Employerlincome 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 EMPLOYERSIINCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs IS 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 1-877-676-8580 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 17106-8112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case /dendrier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: htto //www acf hhs.goy./-nrQgrams/cWnewhire/emplgyerlcontacts/cont cl map #r m Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(bX7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past--due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date - 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use. Form EN-028 01/12 Service Tvoe M Page 2 of 3 Worker ID $OINC Employer's Name: SOCIAL SECURITY ADMINISTRATION Employer FEIN: Employee/Obligor's Name: NEMEC, PATRICK T. 1835101084 CSE Agency Case Identifier: (See Addendum for case summa rvl Order Identifier: (See Addendum for order/docket Information) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you 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: 8384100092 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 address: Last known phone number: Final Payment Date To SDU/Tribal Payee: New Employer's Name: New Employer's Address: Final Payment Amount: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www.childsupporLstate.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 Em looyee/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.childsupoort.state. 12a. us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. Service Type M OMB No.: 0970-0154 Page 3 of 3 Form EN-028 01/12 Worker ID $OINC ADDENDUM Summary of Cases on Attachment Defendant/Obligor: NEMEC, PATRICK T. PACSES Case Number 268105092 PACSES Case Number Plaintiff Name Plaintiff Name CLAUDIA DESOMMA Docket Attachment Amount Docket Attachment Amount 02-3256 CIVIL $ 1,020.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Chiid(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB PACSES Case Number Plaintiff ame Docket $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 01/12 Service Type M OMB No.: 0970-0154 Worker ID $OINC In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA ) Docket Number: 02-3256 CIVIL vs. Plaintiff ) PACSES Case Number: 268105092 PATRICK T. NEMEC Defendant ) Other State ID Number: PETITION FOR CONTEMPT - DEFENDANT TO THE HONORABLE, THE JUDGES OF SAID COURT: = t? 1. Petitioner is CUMBERLAND County Domestic Relations Section. 2. Defendant is PATRICK T. NEMEC who resides at: may; 41 GREEN RIDGE RD, MECHANICSBURG, PA. 17050-1507-41 3. On APRIL 22, 2003 an order of support was entered by the Honor Court directing Defendant to pay the sum of20his/her .00 p dependent(s). $100.00 per month in arrears for the support 4. Defendant has failed to comply with the order as entered by the Court by failing to: ® pay as ordered. ® provide information which was ordered. ® appear as ordered. ® other: maintain employment, last payment was on 1/6/12 from UC benefit. 5. The arrearages under the Order amount to $5,449.96 as of MAY 24, 2012. `.. _ ?t WHEREFORE, Petitioner prays that the Court issue an order directing the attendance of Defendant at a hearing of said Petition and hereafter to make an and adjudication of contempt. I verify that the thamfalse statements herein are correct to the best of my knowledge. I understand made to the penalties of 18 Pa.. C.S. § 4904 relating to unsworn falsification to authorities. Derek R. Clepper, MAY J4 2012- - Date Signature Form EN-007 03/11 Worker ID 21600 Service Type M In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA Plaintiff V. Docket Number: 02-3256 CIVIL PACSES Case Number: 268105092 PATRICK T. NEMEC Defendant Other State ID Number: ORDER OF COURT Legal proceedings have been brought against you alleging you have willfully disobeyed an Order of Court. 1. A critical issue in the contempt proceeding is your ability to pay and comply with the terms of the support order. If you wish to defend against the claims suet forth in the attached Petition for Contempt, you may, but are not required to, file in writing with the Court your defenses or objections. r 2. You, PATRICK T. NEMEC, Respondent, must appear in person intro: JUNE 15, 2012, at 9:OOAM? j frr _n ? t COURT ROOM 6 CUMBERLAND CO COURTHOUSE -? #r 4TH FLOOR 1 COURTHOUSE SQUARE CARLISLE PA 17013 IF YOU DO NOT APPEAR IN PERSON, THE COURT MAY ISSUE A WARRANT FOR YOUR ARREST AND YOU MAY BE COMMITTED TO JAIL. 3. If the Court finds that you have willfully failed to comply with its order you may be found to be in contempt of court and committed to jail, fined, or both. You will have the opportunity to disclose income, other financial information and any relevant personal information at the conference/ Nearing so that the Court can determine if you have an ability to pay. You may also tell the Court about any unusual expenses that may affect your income. Fill out the enclosed Income and Expense Statement form and bring it with you. At the above scheduled proceeding, the contempt may be dismissed, new and/or modified purge conditions may be imposed, or the judge may order you to go to jail. If the plaintiff fails to appear, the Court will proceed with the case and enter an appropriate order. The parties are to remain until dismissed by the Court. Form EN-528 04/12 Service Type M Worker ID 21600 DESOMMA v. NEMEC PACSES Case Number: 268105092 YOU ARE REQUIRED TO BRING: • The completed Income and Expense Statement form. • Cash, credit card in your name, cashier/bank check or money order payable to DOMESTIC RELATIONS SECTION. o Contact your local DRS before the hearing date to verify which of the payment methods listed above are accepted. • Most recent pay stub for any and all employers. • Payroll address, phone number, fax number and contact person. • Proof of medical coverage. • Any other documentation relevant to your case and the issue of contempt as stated in the petition. YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE/HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO 'PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible !Facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. BY THE COURT: Date of Order: Thanas A. Placey, JUDGE Form EN-528 04/12 Service Type 'M Page 2 of 2 Worker ID 21600 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA Docket Number: 02-3256 CIVIL vs. Plaintiff PACSES Case Number: 268105092 PATRICK T. NEMEC Defendant Other State ID Number: BENCH WARRANT - DEFENDANT AND NOW, this 15TH DAY OF JUNE, 2012 the Sheriff of CUMBERLAND County, or any constable, or police officer, or other law enforcement officer is hereby ordered to take PATRICK T. NEMEC residing at 41 GREEN RIDGE RD, MECHANICSBURG, PA. 17050-1507-41 into custody for appearance before this Court. This Bench Warrant is issued because it appears that PATRICK T. NEMEC has failed to appear, after notice, before the Court for a scheduled conference and/or hearing. We command you, the arresting officer, forthwith to convey and deliver the party into the custody of the Court of Common Pleas of CUMBERLAND County, at Cumberland County Courthouse, One Courthouse Square, Carlisle, Pa 17013 for a hearing. Descriptive Information Name: PATRICK T. NEMEC SSN: 161-42-2551 Sex: M DOB: 03/17/49 Age: 63 years Height: 6 ft 00 inches Weight : 230 Ibs Alias: Last Known Employer: Race: W c w__ Eyes: BU j Hair: GY Distinguishing features (scars, tattoos, facial hair, etc.) Telephone: (717) 766-3753 Form EN-048 02/11 Service Type M Worker ID 21005 DESOMMA v. NEMEC PACKS Case Number: 268105092 You are further commanded that if the Court is unavailable, the party may be held in the County Jail until the Court is opened for business, at which time the party shall be promptly conveyed and delivered into the custody of the Court at: Cumberland County Courthouse, One Courthouse Square, Carlisle, Pa 17013 for a hearing. The authority in charge of the County Jail shall notify the Sheriffs Office and the Director of the Domestic Relations Section forthwith that the party is being held pursuant to the Bench Warrant. Under no circumstances may the party be held in the county jail of the county that issued this bench warrant for more than seventy-two hours or the close of the next business day if the 72 hours expires on a non-business day. See Pa.R.Crim.P 150(A)(5). Bail in this matter shall be set as follows: O No bail Stipulations - O Bail to be set in the amount of $ 3,000.00 THE COURT lg 2?2 Date A. PkbW JUDGE Served by: Date and Time Served: Type of Service: Warrant Number: Form EN-048 02/11 Service Type M Page 2 of 2 Worker ID 21005 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA ) Docket Number: 02-3256 CIVIL vs. Plaintiff ) PACSES Case Number: 268105092 PATRICK T. NEMEC ) Defendant ) Other State ID Number: Request for Bench Warrant and Supporting Affidavit 1 Patrick T. Nemec did not appear for a conference and/or hearing in the Court of Common Pleas of CUMBERLAND County on June 16, 2012, which was scheduled by an Order of Court compelling this person's appearance, a copy of which is attached to this request. 2. The party received the Order of Court scheduling the conference and/or hearing in the following manner: O (a) The Order of Court (i) was served upon the party by ordinary mail with the return address of the court thereon; (ii) the mail was not returned to the court within fifteen (15) days after mailing; and (iii) at a date after the Order of Court was mailed, the United States Postal Service has verified that mail for the party was being delivered at the address to which the court order was mailed. p (b) The party signed a receipt indicating acceptance of the court order. O (c) An employee of the court handed a copy of the court order to the party. The employee's affidavit of service is attached. p (d) A competent adult handed a copy of the court order to the party. The adult's affidavit of service is attached. 3. N This request for Bench Warrant is made within sixty (60) days following the party's failure to appear for the conference and/or hearing; and N I have reviewed the records of the Court and the Domestic Relations Section concerning this case, and attest that the party has not appeared for any domestic relations matter involving the same parties since the date upon which the party failed to appear in violation of the attached Order of Court. Form EN-046 Service Type M Worker ID 21005 DESOMMA v. NEMEC PACSES Case Number: 268105092 4. In my capacity as hearing officer or conference officer, I request that the attached Bench Warrant be issued against the party named on account of the party's failure to appear for a schedule conference and/or hearing in violation of an Order of Court. The records of the Domestic Relations Section show that: ® the party owes support arrearages in the amount of $6,369.96, ® the party has failed to appear for hearings relating to this case. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unsworn falsification to authorities. JuN 15 2012 Date ... 4. #0 afne/ icial itle Form EN-046 Service Type M Page 2 of 2 Worker ID 21005 r In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA ) Docket Number: 02-3256 CIVIL Plaintiff ) vs. ) PACSES Case Number: 268105092 PATRICK T. NEMEC ) Defendant ) Other State ID Number: BENCH WARRANT - DEFENDANT AND NOW, this 15TH DAY OF JUNE, 2012 the Sheriff of CUMBERLAND County, or any constable, or police officer, or other law enforcement officer is hereby ordered to take PATRICK T. NEMEC residing at 41 GREEN RIDGE RD, MECHANICSBURG, PA. 17050-1507-41 into custody for appearance before this Court. This Bench Warrant is issued because it appears that PATRICK T. NEMEC has failed to appear, after notice, before the Court for a scheduled conference and/or hearing. We command you, the arresting officer, forthwith to convey and deliver the party into the custody of the Court of Common Pleas of CUMBERLAND County, at Cumberland County Courthouse, One Courthouse Square, Carlisle, Pa 17013 for a hearing. Descriptive Information Name: PATRICK T. NEMEC Race: W SSN: 161-42-2551 Eyes: BU Sex: M Hair: GY DOB: 03/17/49 Distinguishing features (scars, tattoos, facial hair, etc.): Age: 63 years Height: 6 ft 00 inches Weight: 230 Ibs Alias: Telephone: (717) 766-3753 Last Known Employer: VINVAIASNH3d ! Z :£ fwd ZZ nr ZICZ i. l i`i 16 ",j cl , t i - Form EN-048 02/11 Service Type M Worker ID 21005 DESOMMA v. NEMEC PACSES Case Number. 268105092 You are further commanded that if the Court is unavailable, the party may be held in the County Jail until the Court is opened for business, at which time the party shall be promptly conveyed and delivered into the custody of the Court at: Cumberland County Courthouse, One Courthouse Square, Carlisle, Pa 17013 for a hearing. The authority in charge of the County Jail shall notify the Sheriffs Office and the Director of the Domestic Relations Section forthwith that the party is being held pursuant to the Bench Warrant. Under no circumstances may the party be held in the county jail of the county that issued this bench warrant for more than seventy-two hours or the close of the next business day if the 72 hours expires on a non-business day. See Pa.R.Crim.P 150(A)(5). Bail in this matter shall be set as follows: O No bail Stipulations - O Bail to be set in the amount of $3,000.00 THE LOUR Lim Date 101111111111W JUDGE Served by: Date and Time Served: Type of Services Mr Warrant N"1 olseig11 l JLU(IE C 3i? bum D Form EN-048 02/11 Service Type M Page 2 of 2 Worker ID 21005 f t In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA Plaintiff vs. PATRICK T. NEMEC Defendant Docket Number: 02-3256 CIVIL PACSES Case Number: 268105092 Other State ID Number: Request for Bench Warrant and Supporting Affidavit 1 - Patrick T. Nemec did not appear for a conference and/or hearing in the Court of Common Pleas of CUMBERLAND County on June 16, 2012, which was scheduled by an Order of Court compelling this person's appearance, a copy of which is attached to this request. 2. The party received the Order of Court scheduling the conference and/or hearing in the following manner: O (a) The Order of Court (i) was served upon the party by ordinary mail with the return address of the court thereon; (ii) the mail was not returned to the court within fifteen (15) days after mailing; and (iii) at a date after the Order of Court was mailed, the United States Postal Service has verified that mail for the party was being delivered at the address to which the court order was mailed. p (b) The party signed a receipt indicating acceptance of the court order. p (c) An employee of the court handed a copy of the court order to the party. The employee's affidavit of service is attached. p (d) A competent adult handed a copy of the court order to the party. The adult's affidavit of service is attached. 3. ® This request for Bench Warrant is made within sixty (60) days following the party's failure to appear for the conference and/or hearing; and ® 1 have reviewed the records of the Court and the Domestic Relations Section concerning this case, and attest that the party has not appeared for any domestic relations matter involving the same parties since the date upon which the party failed to appear in violation of the attached Order of Court. Service Type M Form EN-046 Worker ID 21005 DESOMMA v. NEMEC PACSES Case Number: 268105092 4. In my capacity as hearing officer or conference officer, I request that the attached Bench Warrant be issued against the party named on account of the party's failure to appear for a schedule conference and/or hearing in violation of an Order of Court. The records.of the Domestic Relations Section show that: ® the party owes support arrearages in the amount of $6,369.96, ® the party has failed to appear for hearings relating to this case. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. C§ 4904 relating to unsworn falsification to authorities. JtJN 1, S 2Q12 Date am cial itle NVP Form EN-046 Service Type M Page 2 of 2 Worker 10 21005 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: PATRICK T. NEMEC -0 a Member ID Number: 1835101084 rn _,, cn� Please note:All correspondence must include the Member ID Number. co C:: ORDER TO VACATE ATTACHMENT OF UNEMPLOYMENT BENEFITS Financial Break Down of Multiple Cases on Attachment PACSES Docket uenc Attachment Amount/Frequency Name Case Number Number 9 Y CLAUDIA DESOMMA 268105092 4111111NIMMIlik 1,020.00 / MONTH $ / $ / TOTAL ATTACHMENT AMOUNT: $ 1,020.00 The prior Order of this Court directing the Department of Labor and Industry, Office of Unemployment Compensation Benefits (OUCB), to attach$234.73 or 50% per week of the Unemployment Compensation benefits of PATRICK T. NEMEC, Social Security Number XXX-XX-2551, Member ID Number 1835101084 is hereby vacated. This Order to Vacate shall be effective upon receipt of the notice of the Order by the Department and shall remain in effect until a further Order of the Court is filed. BY THE COURT Date of Order: APR 16 2013 JUDGE Form EN-035 Service Type M Worker ID $IATT In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA ) Docket Number: 02-3256 CIVIL Plaintiff ) vs. ) PACSES.Case Number: 268105092 PATRICK T. NEMEC ) Defendant ) Other State ID Number: ORDER FOR BOND OR SECURITY AND NOW, this 22ND DAY OF JULY, 2013 it is hereby Ordered that the Defendant, PATRICK T. NEMEC, deposit with the Court the amount of$ ����, Yeas a security for the purpose of ensuring: O Appearance in court for hearing scheduled on August 16, 2013 at 9:00 am. This hearing will be conducted by J. Placey in Courtroom Number 6. O Payment in accordance with your support order. C'j C: O Other: -v=im M � CD <a BY THE COURT: JUDGE Date Form EN-518 Service Type M Worker ID 21600 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA ) Docket Number: 02-3256 CIVIL Plaintiff ) vs. ) PACSES Case Number: 268105092 PATRICK T. NEMEC ) Defendant ) Other State ID Number: Order AND NOW to wit, this JULY 19, 2013 it is hereby Ordered that: the defendant shall pay the sum of$34.00 to the Cumberland County Domestic w _j Relations Section for costs incurred during his arrest on July 19, 2013. (18 miles @$.50 =$9.00 plus $25.00 bench warrant fee totals$34.00) The defendant shall pay$5.00 per month until the above fees are paid in full. BY THE COURT: Thomas A. Placey, JUDGE Form OE-520 02/11 Service Type M Worker ID 21600 r In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA Docket Number: 02-3256 CIVIL V. Plaintiff PACSES Case Number:268105092 PATRICK T. NEMEC Defendant Other State ID Number: CZ _ n CID J ZZ ORDER OF COURT �-0 r- Legal proceedings have been brought against you allegingXpu have wJc disobeyed an Order of Court for support. z ?-r,' 1. A critical issue in the contempt proceeding is your ability to pay and,-comply-4. with the terms of the support order. If you wish to defend against the claim set forth in the following pages, you may, but.are not required to, file in writing with the Court your defenses or objections. 2. You, PATRICK T. NEMEC, Respondent, must appear in person in court on AUGUST 16, 2013, at 9:OOAM in COURT ROOM 6, C/O CUMBERLAND CO COURTHOUSE, 4TH FLOOR, 1 COURTHOUSE SQUARE, CARLISLE, PA. 17013. IF YOU DO NOT APPEAR IN PERSON, THE COURT MAY ISSUE A WARRANT FOR YOUR ARREST AND YOU MAY BE COMMITTED TO JAIL. 3. If the Court finds that you have willfully failed to comply with its order for support, you may be found to be in contempt of court and committed to jail, fined, or both. You will have the opportunity to disclose income, other financial information and any relevant personal information at the conference/ hearing so that the Court can determine if you have the ability to pay. You may also tell the Court about any unusual expenses that may affect your ability to pay. You may fill out the enclosed Income Statement and Expense Statement forms and submit them to the court. At the conference/hearing, the contempt petition may be dismissed, new and/or modified purge conditions may be imposed, or the judge may order you to jail. If the obligee fails to appear, the court will proceed with the case and enter an appropriate order. Form EN-528 03/13 Service Type M Worker ID 21600 DESOMMA v. NEMEC PACSES Case Number: 268105092 YOU ARE REQUIRED TO BRING: Your most recent pay stub for any and all employers Payroll address, phone number, fax number and contact person Proof of medical coverage Any other documentation relevant to your case and the issue of contempt as stated in the petition, including the completed Income Statement and Expense Statement forms. For example, other documentation that may be relevant includes documents related to claims for unemployment compensation, workers' compensation and Social Security benefits. If a physician has determined that a medical condition affects your ability to earn income you must obtain a Physician Verification Form from the domestic relations section, sign it, have it completed by your doctor, and bring it with you to the conference. If you intend to offer the Physician Verification Form as evidence at any record proceeding, you must comply with the timeframes established by PA Rule of Civil Procedure 1910.29(b)(2). YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE- HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302- (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Date of Order: JUL 22 2M r---� Thomas A. Placey, JUDGE Form EN-528 03/13 Service Type M Page 2 of 2 Worker ID 21600 INCOME WITHHOLDING FOR SUPPORT 0 ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT(IWO) (j) AMENDED IWO CiVII 0 ONE-TIMEORDERINOTICE FOR LUMP SUM PAYMENT 0 TERMINATION OF IWO Date: 07119/13 ❑ Child Support Enforcement(CSE)Agency Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This IWO must be•regular")n its face.Onder certain circumstances you must reject this IWO and return it to the sender(see IWO instructions http: acf hhs go programslcge/newhire/emQloyer/publication/publication.htm-forms). If you receive this document from someone other than:a Sthtbior Tribal CSE age acy or a Court,a copy of the underlying order must be attached. State/TribefTerritory Commonwealth of Pennsylvania Remittance Identifier(include w1payment): 1835101084 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket Informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) COMMONWEALTH OF PA RE: NEMEC,PATRICK T. C/O STATE EMPLOYEES RET. SYST Employee/Obligor's Name(Last,First,Middle) 30 N 3RD ST STE 150 161-42-2551 HARRISBURG PA 17101-1726 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name(Last, First, Middle) Employer/income Withholder's FEIN NOTE:This IWO must be regular on its face. 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 hUp://www.aef.hhs.aov/programs/cse/newhi em2loor/publir-ati6n/publication,htm-form ,If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. 7676100114 L 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 Count, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from the employee/ obligor's income until further notice. $ 0.00 per month in current child support $ 0.00 per month in past-due.child support-Arrears 12 weeks or greater? O yes 0 rn $ 0.00 per month in current cash medical support C= $ 0.00 per month in past-due cash medical support _-3: Co C_ --I: $ 920.00 per month in current spousal support C= I"I $ 100.00 per month in past-due spousal support $ 5.00 per month in other(must specify) Court costs fees, and/or recovery. for a Total Amount to Withhold of$ 1,025.00 per month. zz C-) _X CD AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Ob _71nfa=afloh,-: If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 235.89 per weekly pay period. $ 512,50 per semimonthly pay pericidl(twitela month)$ 471.78 per biweekly pay period(every two weeks) $ 1,025.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION. If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven(7)working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at httl2://www.acf.hhs,ciov/programs/ese/newhire/employer/contacts/contact mag. htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.:0970-0154 Form EN-028 06/12 Service Type M Worker ID$OINC ❑ 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 I Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: 16 wwL- 4 4 LUIJ-7--- If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order,a copy of this IWO must be provided to the employee/obligor. ❑ If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law(23 PA C.S.§4374(b))requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 16 or more persons,or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU)Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION,PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID(shown above as the Employeel0bligor'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/proarams/cse/­newhire/­employer/contacts/contact map.htm Priority: Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency,you may combine withheld amounts from more than one employee/obligor's income in a single payment.You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU(e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court,Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency,you must follow the"Remit payment to"instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment.The pay date is the date on which the amount was withheld from the employee/obligor's wages.You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State,or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method, Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs,you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ,or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date—05/3112014,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$OINC Employees Name: COMMONWEALTH OF PA Employer FEIN: Employee/Obligor's Name: NEMEC,PATRICK T. 1835101084 CSE Agency Case Identifier:(See Addendum for case summary) Order Identifier:(See Addendum for orderldocket information Withholding Limits:You may not withhold more than the lesser of: 1)the amounts allowed by the Federal Consumer Credit Protection Act(CCPA)(15 U.S.C. 1673(b));or 2)the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment(see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes.The Federal limit is 50%of the disposable income if the obligor is supporting another family and 60%of the disposable income if the obligor is not supporting another family. However,those limits increase 5%-to 55% and 65%-if the arrears are greater than 12 weeks. If permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO,you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits, Arrears greater than 12 weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor,an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 7676100114 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 SDLI/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.chiidsupport.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 Emp1gyeelObli-gor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(,Z1 7)240-6225, by fax at(717)240-6248, by email or website at www.childsupport.state.pg.us. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.:0970-0154 Form EN-028 06/12 Service Type M Page 3 of 3 Worker ID$OINC � l• 1 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: NEMEC, PATRICK T. PACSES Case Number 268105092 PACSES Case Number Plaintiff Name Plaintiff Name CLAUDIA DESOMMA Docket Attachment Amount Docket Attachment Amount 02-3256 CIVIL $ 1,025.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docke Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-028 06/12 Service Type M OMB No.:0970-0154 Worker ID $OINC Jf INCOME WITHHOLDING FOR SUPPORT ORIGINAL INCOME WITHHOLDING ORDERMOTICE FOR SUPPORT(IWO) • AMENDED IWO Q ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT Q TERMINATION OF IWO Date: 07/19/13 ❑ Child Support Enforcement(CSE)Agency, ® Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This IWO,musJ,,b r u( ortjt5;-f6ce. Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions http://www acf hhs gov/programs/cse/newhire/employer/publication/publication htm-forms). If you receive this document from someone other than a State'or Tribal CSE agency or a Court,a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 1835101084 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) SOCIAL SECURITY ADMINISTRATION RE: NEMEC,PATRICK T. STE 1 Employee/Obligor's Name(Last, First,Middle) 200 S SPRING GARDEN ST 161-42-2551 CARLISLE PA 17013-2578 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name(Last, First, Middle) Employer/Income Withholder's FEIN NOTE:This IWO must be regular on its face. 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 htti)://www.acf.hhs.00v/2rograms/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. 8384100092 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 CUMB"ERLANND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from thmployee/ obligor's income until further notice. w -- $ 0.00 per month in current child support r,� , r $ 0.00 per month in past-due child support- Arrears 12 weeks or greater? O y&S;F 0 rr R9 $ 0.00 per month in current cash medical support C-'� $ 0.00 per month in past-due cash medical support $ 920.00 per month in current spousal support,, $ 100.00 per month in past-due spousal support c'';r $ 5.00 per month in other(must specify) Court costs fees, and/or recovery. = -- for a Total Amount to Withhold of$ 1,025.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 235.89 per weekly pay period. $ 512.50 per semimonthly pay period (twice a month) $ 471.78 per biweekly pay period (every two weeks) $ 1,025.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten 10 working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of . disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at http•//www acf hhs gov/programs/cse/newhire/employer/contacts/contact map htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.:0970-0154 Form EN-028 06/12 Service Type M Worker ID $OINC t • ❑ 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 la Print Name of Judge/Issuing Official: AA,ft 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 EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law(23 PA C.S. §4374(b))requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons,or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER/D(shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf.hhs.gov/programs/ese/`newhire/employer/contacts/contact map.htm Priority: Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency,you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the"Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date—05131/2014.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 Service Type M Page 2 of 3 Worker ID $OINC Employer's Name: SOCIAL SECURITY ADMINISTRATION Employer FEIN: Employee/Obligor's Name: NEMEC, PATRICK T. 1835101084 CSE Agency Case Identifier:(See Addendum for case summa Order Identifier:(See Addendum for order/docket information Withholding Limits:You may not withhold more than the lesser of. 1)the amounts allowed by the Federal Consumer Credit Protection Act(CCPA)(15 U.S.C. 1673(b));or 2)the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment(see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as:State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes.The Federal limit is 50%of the disposable income if the obligor is supporting another family and 60%of the disposable income if the obligor is not supporting another family. However,those limits increase 5%-to 55%and 65%-if the arrears are greater than 12 weeks. If permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section, For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe, For Tribal employers/income withholders who receive a State IWO,you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law,you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor,an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 8384100092 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 Employer's Name: New Employees Address: CONTACT INFORMATION: To Employer/Income Withholder., If you have any questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at:www,childsupport.state.pa.us Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE, PA. 17013(Issuer address). To Employee/Obligor: If the employee/obligor has questions,contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at www.childsupport.state.pa.us. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB No,:0970-0154 Form EN-028 06/12 Service Type M Page 3 of 3 Worker ID$OINC s ADDENDUM Summary of Cases on Attachment Defend ant/O bI Igor: NEMEC, PATRICK T. PACSES Case Number 268105092 PACSES Case Number Plaintiff Name Plaintiff Name CLAUDIA DESOMMA Docket Attachment Amount Docke Attachment Amount 02-3256 CIVIL $ 1,025.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACKS Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-028 06/12 Service Type M OMB No.:0970-0154 Worker ID $OINC In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA ) Docket Number: 02-3256 CIVIL Plaintiff ) vs. ) PACSES Case Number: 268105092 PATRICK T. NEMEC ) Defendant ) Other State ID Number: Order AND NOW to wit, this JULY 25, 2013 it is hereby Ordered that: The Defendant, Patrick T. Nemec, has paid the security amount of$18,267.40 and r , he is to be released from the Cumberland County Prison. ry C.3 -G C.A Cr <CD C' BY THE COURT: JUDGE 0 ` i Form OE-520 02/11 Service Type M Worker ID 21005 �c In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION . CLAUDIA DESOMMA ) Docket Number: 02-3256 CIVIL r Plaintiff ) vs. ) PACSES Case Number: 268105092 PATRICK T. NEMEC ) Defendant ) Other State ID Number: PETITION FOR MODIFICATION OF AN EXISTING SUPPORT ORDER 1. The petition of PATRICK T. NEMEC respectfully represents that on APRIL 22, 2003, an Order of Court was entered for the support of CLAUDIA DESOMMA CD z a c� A true and correct copy of the order is attached to this petition. Form OM-501 Service Type M Worker ID 21205 DES.OMMA v. NEMEC PACSES Case Number: 268105092 y 2. Petitioner is entitled to O increase Xdecreasefi termination O reinstatement O other of this Order because of the following material and substantial change(s) in circumstance: Petitioner, has not worked in nearly three years. Petitioner has no income and does not receive social security. It is believed that Respondent is employed and accordingly has an income. Additionally, Petitioner has,over the ten years since the support order was entered paid to Respondent the sum of $118,356.00 in APL. Petitioner and Respondent were married on 2-12-1991 and have been separated since 7-10-2002; accordingly, Petitioner has paid APL to Respondent for nearly as long as they were married. Petitioner is without means to pay the current monthly obligation of$920:00. Petitioner respectfully requests that his APL obligation to Respondent be terminated or in the alternative,reduced. WHEREFORE, Petitioner requests that the Court modify the existing order for support. 0 0 3 6-0 titioner Attorney for Petitioner 1311 yA L, L,,/,yS�k oo k, FsQ I p 13 a / / A It k h Pq /-70 r f 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. 2 Date Petitioner Form OM-501 Service Type M Page 2 of 2 Worker ID 21205 G • 1 CLAUDIA DESOMMA, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION PATRICK T. NEMEC, PACSES NO. 688105080 Defendant No. 1081 SUPPORT 2002 CLAUDIA DESOMMA, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION PATRICK T. NEMEC, PACSES NO. 268105092 Defendant No. 02-3256 CIVIL PATRICK T. NEMEC, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA, . PACSES NO. 797105136 Defendant No. 1158 SUPPORT 2002 INTERIM ORDER OF COURT AND NOW, this ,UaA day of April, 2003, upon consideration of the Support Master's Report and Recommendation, a copy of which is attached hereto as Exhibit "A", it is ordered and decreed as follows::..,' A. For the period of December 6, 2002 through April 30, 2003 the Husband shall pay to the State Collection and Disbursement Unit for trans rr lion to the Wife as alimony pendente lite the sum of$1,068.00 pert'month. B. Effective May 1, 2003 the Husband shall pay to the State Collection and Disbursement Unit for transmission to the Wife as alimony.pende%.'e lite the sum of$920.00 per month. C. The Husband shall pay to the State Collection and Disbursement Unit an additional sum of$100.00 per month on arrearages until paid in full. D. The awards of alimony pendente lite set forth above take into consideration the Wife's obligation for child support as required by Pa. R.C.P. 1910.16-4(e). Consequently the order of January 31, 2003 dismissing the Husband's complaint for support is affirmed. E. Because pursuant to Pa. R.C.P. 1910-16-1(c) awards of spousal support and alimony pendente lite shall not be in effect simultaneously, the order of January 31, 2003 dismissing the Wife's complaint for spousal support is affirmed. The parties are hereby advised that they may file written exceptions to the Support Master's Report and Recommendation within ten (10) days of this order. Exceptions shall conform with the requirements of Rule 1910.12(f), Pa. R.C.P. If written exceptions are filed by any party, the other party may file exceptions within ten (10) days of the date of service of the original exceptions. If no exceptions are filed within ten (10)days of this interim order, this order shall then constitute a final order. By the Court, e esley 41era., J4. Cc: Claudia DeSomma Patrick T. Nemec Carol J. Lindsay, Esquire For the Plaintiff Jay R. Braderman For the Defendant DRO f CLAUDIA DESOMMA, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION PATRICK T. NEMEC, PACSES NO. 688105080 Defendant No. 1081 SUPPORT 2002 CLAUDIA DESOMMA, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION PATRICK T. NEMEC, PACSES NO. 268105092 Defendant No. 02-3256 CIVIL PATRICK T. NEMEC, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA, PACSES NO. 797105136 Defendant No. 1158 SUPPORT 2002 SUPPORT MASTER'S REPORT AND RECOMMENDATION Following a hearing held before the undersigned Support Master on April 9, 2003, the following report and recommendation are made: FINDINGS OF FACT 1. The Plaintiff is Claudia DeSomma, who resides at 2528 Silver Oak Drive, Pittsburgh, Pennsylvania. She will hereafter be referred to as "the Wife." 2. The Defendant is Patrick T. Nemec, who resides at 41 Greenridge Road, Mechanicsburg, Pennsylvania. He will hereafter be referred to as "thy, Husband." 3. The parties were married on February 12, 1991. 4. The parties are the parents of one minor child, Ross Nemec; barn October 29, 1988,who resides with the Husband. r:XHIBIT "A" 5. The parties separated on December 4, 2002 when the Wife moved from the marital residence. 6. On December 4, 2002 the Wife filed a Complaint for spousal support docketed to 1081 Support 2002. 7. On December 6, 2002 the Wife filed a Complaint in divorce docketed to 02-3256 Civil containing therein a claim for alimony pendente lite.' 8. On December 27, 2002 the Husband filed a complaint for child support docketed to 11,58 Support 2002. 9. The Wife is currently residing with her parents in Pittsburgh, Pennsylvania but desires to return to the Cumberland County area. 10.The Wife is 50 years of age and has a bachelor's degree in elementary education. 11. The Wife taught as a substitute teacher in the late.1 970's and early 1980's, but she has not taught in any capacity since that time. 12.The Wife has work experience as a waitress, bartender and cook in a restaurant, as a data technician, in advertising sales, and most recently as a landscape laborer. 13.The Wife's last employment prior to separation was as a landscape laborer at the Felicita Resort where she earned $8.50 per hour full time., 14.The Wife was laid off by Felicita in November, 2002 and was determined eligible for unemployment compensation benefits of$158.00 per week:- 15.The Wife has found minimal part time work, from five to ten hours per week, earning $8.50 per hour in Pittsburgh. 16.The Wife may earn $64.00 per week without reducing her unemployment compensation benefitS.2 17.The Wife has been offered full time employment with the City of Pittsburgh Parks and Recreation Department commencing in late spring or early summer at a rate of$6.50 to $7.50 per hour. 18.The Wife will file her federal income tax return as married/separate. 'Following the taking of testimony in which allegations of misconduct were made by both parties against the other,the parties stipulated that the Wife's claim would be limited to alimony pendente lite. Therefore, no factual findings will be made related to the Wife's claim for spousal support which has been withdrawn. See Plaintiffs Exhibit 1. 19.The Husband is employed by the Pennsylvania State System of Higher Education and has a net monthly income of$4,646.87.3 20.The Husband pays$1,500.00 per month on a first mortgage encumbering the martial home, which sum includes taxes and insurance. 21.The Husband pays $320.00 per month on a home equity loan encumbering the marital residence, the purpose of which was bill consolidation. DISCUSSION The purpose of an award of alimony pendente cite is to enable a dependent spouse to prosecute or defend a divorce action. Litmans v. Litmans, 673 A.2d. 382 (Pa. Super. 1996). The amount of the award must be fair, non- confiscatory and attendant to the circumstances of the parties. Calabrese v. Calabrese, 682 A.2d. 393 (Pa. Super. 1996). Where an award of APL is warranted, the amount of the award is calculated pursuant to the support guidelines. Little v. Little, 47 Cumberland L.J. 131 (1998). Factors to consider in determining entitlement to an award of APL include the separate estate and income of the claimant, the ability of the other party to pay, and the character, situation and surroundings of the parties. Litmans v. Litmans, S_ upra. Both parents must contribute to the support of their child based upon their relative incomes and ability to pay. Depp v. Holland, 636 A.2d. 204(Pa. Super-, 1994). In determining a parent's ability to pay support for a child, the focus is on the parent's earning capacity, not on his or her actual earnings. Mooney v. Doubt, 766 A.2d. 1271 (Pa. Super. 2001). Earning capacity is not an amount which a party can theoretically earn, but rather what a party can realistically earn based upon his or her age, health, physical and mental condition and training. Riley v. Foley, 783 A.2d. 807(Pa. Super. 2001). At the present time the Wife has actual income of$158.00 per week from unemployment compensation benefits and part time earnings of$42.50 to $85.00 per week from employment. Her actual earnings total, on average, $222.00 per week from both sources. She will be imputed with an earning capacity of $222.00 per week through April 30, 2002, after which she will be imputed to have an earning capacity of$340.00 per week based upon a 40 hour work week at $8.50 per hour, her actual income prior to being laid off in November, 2002. It is certainly reasonable to expect that the Wife has the ability to earn that amount considering her age, health, work experience and training. One would also hope 3 The parties stipulated to the Husband's income. f that the winter of 2002-2003 will be over by April 30, 2003 providing the Wife an opportunity to work as a landscape laborer again should she so choose.4 The parties stipulated to the Husband having a net monthly income of $4,646.87. The significant disparity in the incomes of the parties and the absence of any separate estate with which to support herself justify the Wife's entitlement to an award of alimony pendente lite in this case. Because the Husband is the custodial parent of the parties' child, the application of the three- step procedure set forth in Pa. R.C.P. 1910.16-4(e) is required. In the first step the APL obligation of the Husband is calculated as if there were no children. With gross income of$222.00 per week($158.00 from unemployment compensation and $64.00 from earnings), the Wife has gross monthly income of $962.00 and net monthly income of$893.00.5 The step one APL obligation of the Husband is $1,502.00.6 This figure is then added to the incomes of the parties in step two, and the child support obligation of the non-custodial parent is calculated. With recomputed net monthly incomes for the Wife of$2,395.00 and for the Husband of$3,145.00, the Wife's child support obligation is $434.00.7 In the third step the wife's child support obligation is deducted from the Husband's APL obligation computed in step one, and the difference is awarded to the Wife as alimony pendente lite. In this case that difference is $1,068.00. This figure will change effective May 1, 2003 because of the imputed earning capacity for the Wife of$340.00 per week. The Wife's new gross monthly income is $1,473.00, and her net monthly income is $1,196.00.8 The same three-step calculation is performed as was done above. The step one APL obligation of the Husband is $1,380.00.9 This figure is added to the Wife's net monthly income and deducted from the Husband's, resulting in incomes of$2,576.00 and $3,267.00 respectively. The Wife's child support obligation based on the recalculated net monthly incomes is $460.00 per month.1() Deducting this amount from the step one calculation results in a difference of$920.00 per month as the Husband's APL obligation. The Husband argues that consideration should be given to his payment of the $1,500.00 per month first mortgage and the $320.00 per month home equity loan under Pa. R.C.P. 1910.16-6(e), which provides as follows: 4 It is not reasonable to expect that the Wife has the present ability to work as a teacher,even a substitute teacher,at present considering her 20 year hiatus from that occupation. 5 The Wife's unemployment compensation benefits are subjected only to federal taxes. See Exhibit"A"for the deductions from gross income. 6 See Exhibit"B"for the calculation. 'See Exhibit"C"for the guideline calculation. 8 See Exhibit"D"for the deductions from gross income. 9 See Exhibit"E"for the calculation. 10 See Exhibit"I'"for the guideline calculation. (e) Mortgage Payment. The guidelines assume that the spouse occupying the marital residence will be solely responsible for the mortgage payment, real estate taxes, and homeowners' insurance. Similarly, the Court will assume that the party occupying the marital residence will be paying the items listed unless the recommendation specifically provides otherwise. If the obligee is living in the marital residence and the mortgage payment exceeds 25% of the obligee's net income (including amounts of spousal support, APL and child support), the Court may direct the obligor to assume up to 50% of the excess amount as part of the total support award. For purposes of this subdivision, the term "mortgage" shall include first mortgages, real estate taxes and homeowners' insurance and may include any subsequent mortgages, home equity loans and any other obligations incurred during the marriage which are secured by the marital residence. Because the husband is the obligor in this case as the party who is subject to a support order, and he is residing in the marital residence,-the rule is not applicable to this case.' RECOMMENDATION A. For the period of December 6, 2002 through April 30, 2003 the Husband shall pay to the State Collection and Disbursement Unit for transmission to the Wife as alimony pendente lite the sum of$1,068.00 per month. B. Effective May 1, 2003 the Husband shall pay to the State Collection and Disbursement Unit for transmission to the Wife as alimony pendente lite the sum of$920.00 per month. C. The Husband shall pay to the State Collection and Disbursement Unit an additional sum of$100.00 per month on arrearages until paid in full. D. The awards of alimony pendente lite set forth above take into consideration the Wife's obligation for child support as required by Pa. R.C.P. 1910.16-4(e). Consequently the order of January 31, 2003 dismissing the Husband's complaint for support is affirmed. " See Explanatory Comment to Rule 1910.16-6-1998. E. Because pursuant to Pa. R.C.P. 1910-16-1(c) awards of spousal support and alimony pendente lite shall not be in effect simultaneously, the order of January 31, 2003 dismissing the Wife's complaint for spousal support is affirmed. Date Michael R. Rundle Support Master CLAUDIA DESOMMA, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 02-3256 CIVIL TERM PATRICK T. NEMEC, IN DIVORCE , - Defendant PACSES CASE: 268105092 -. Co rT1 =� r ORDER OF COURT "= AND NOW, this 26th day of July, 2013, a petition has been filed against you, Claudia DeSomma, to modify an existing Alimony Pendente Lite Order. You are ordered to appear in person at the Domestic Relations Section, 13 North Hanover Street, Carlisle, Pennsylvania, on August 15, 2013 at 10:30A.M. for a conference and to remain until dismissed by the Court. If you fail to appear as provided in this Order, an Order of Court may be entered against you. You are further ordered to bring to the conference: (l) a true copy of your most recent Federal Income Tax Return, including W-2's as filed (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 CC361 e + 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: July 26, 2013 Thomas At Placey, 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 72 hours prior to any hearing or business before the court. You must attend the scheduled conference. � , INCOME WITHHOLDING FOR SUPPORT [l��y)�� , .. -��~ /p, O ORIGINAL INCOME WITHHOLDING onosmwonns FOR SUPPORT(IWO) ����'�L G) AMswoEoxwo ^^�n ~�o��~", D ows-T/msonosmmonoe FOR LUMP SUM PAYMENT O TERMINATION oFxwo Date: 0 Child Support Enforcement(CSE)Agency Court n Attorney 0 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 hth): acf.hhs.gov/programs/Gse/newhirg�/employer/publication/publication.htm-forms). If you receive this document from someone other than a Statebr Tribal CSE agency or a Court,a copy of the underlying order must be attached. State/Triberrerritory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 1835101084 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for orderldocket informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) SOCIAL SECURITY ADMINISTRATION RE: NEMEC,PATRICK T. STE I Employee/Obligor's Name(Last,First,Middle) 200 S SPRING GARDEN ST 161-42-2551 CARLISLE PA 17013-2578 Employee/Obligor's Social Security Number (See Addendum fiDr plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name(Last.First, Employer/income Withholder's FEIN NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last,First,Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see IWO instructions 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. 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 CUMBE-ELAN'D Cgvnty, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amountSA , pyee/ obligor's income until further notice. M $ 0.00 Der month in current child support U) :7,3 CD $ 0.06 'per -month in past-due child support- Arrears 12 weeks or greater? 0 yof(i) $ 0.00 Der month in current cash medical support $ 0.00 per monLh in past-due cash medical support $ 920.00 per month in current spousal support per month in past-due spousal support $ om per month in other(must specify) ' for m Total Amount tmWithhold of$ 920.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay myn|m does not match the ordered payment cycle,withhold one of the following amount $ 21173 per weekly pay period. $ 46 per semimonthly pay period(twice amonth) $ 423.45 per biweekly pay period(every two weeks) $ 920.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing |VV(]unless you receive atenninmUnn 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 working days after the date of . Send payment within 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 (8tate/Tribe), the employer can obtain withholding Umitehono, time naquirennento, and any allowable employer fees at http://www.acf.hhs,ciov/procirams/cse/newhire/employer/contacts/contact map. htm for the mmp|oyae/obUgor'a principal place ofemployment. Document Tracking Identifier ome wv '0970-0154 Form EN-028OG/12 Service Type W Worker |D 0 }|NC NN �� [] Return to Sender[Completed by Employer/income Withholder]. Payment must be directed to an SDU in ° accordance with 42USC§G8GbV6)and (b)(8>orTribal Payee(see Payments io8DUbe|mw). |f payment isnot directed to an SDUfTribal 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: A Title of Judge/Issuing Official: Date of Signature: all-also 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 bo provided hu the emp|oyoahbUgor [1 If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EK8PLOYERVINCOA8EVVITHMOLDERS Pennsylvania law(23PAC.S.§4374(b))requires remittance by an electronic payment method ifmu employer isordered to withhold income from more than one employee and employs 15 or more persons,or if an employer has a history of two ar more returned checks due tononsufMcientfunds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCOU)Employer Customer Service at1'87?'67G-&588 for instructions. PAFIPS CODE 430O0O0 Make RemmNftamce Payable to: PA SCDW Send check to: Pennsylvania SCDW. P.O. Box 69112. Harrisburg, Pa 17106'9112 IN ADDITION, PAYMENTS&VQST0VCLUDE THE DEFENDANT'S NAME AND THE PACS£S MEMBER/D(shown above as the£mvploye*YOb/igor)s Case/dnmd0er) OR SOCIAL SECURITY NUMBER 0V ORDER 7%JBEPROCESSED. DO NOT SEND CASH BYMAIL. 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 §66G(b)(7)). |fa Federal tax levy imin effect,please notify the sender. Combining Payments: When remitting payments 0oenSDUorThbe|CSEagonoy.youmayoombinewithhe|damountshnm more than one employee/obligor's income in a single payment.You must, however, separately identify each employee/ obligor's portion cd 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 |VV(]instructs you to send a payment to an entity other than an SDU (e.g.. payable 0o the custodial party, court, or ottonney), you must check the box above and return this notice 0o the sender. Exception: If this |VVD 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 aThba( CSE egenoy, 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 doho is the date on which the amount was withheld from the emp|nyee/ob|igo/ 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 |VVOs: !f there ia more than one |VVOagainst this employee/obligor ondyouuvaunoblehmfuUyhonoroU |VV(]ndua10 Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support behove payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment tn 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/ob|igorouoh as bonuomu, commisoionn, 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 }awxprocodune. Ant<'d|aodnminet|on: You are subject toa fine determined under State or Tribal law for discharging an employeelobligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date-05131/2014,The OMS Expiration Date has no bearing on the termination date of the IWO;it identifies the version of the form currently in use. Form EN'028U{V12 Service Type K8 Page 2of3 Worker |D $0NC Y r Employer's Name: SOCIAL SECURITY ADMINISTRATION Employer FEIN: Employee/Obligor's Name: NEMEC, PATRICK T. 1835101084 CSE Agency Case Identifier:(See Addendum for case summary Order Identifier:(See Addendum for order/docket information) Withholding Limits:You may not withhold more than the lesser of: 1)the amounts allowed by the Federal Consumer Credit Protection Act(CCPA)(15 U.S.C. 1673(b));or 2)the amounts allowed by the State or Tribe of the employee/obligor's principat 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 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 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: 8384100092 Q This person has never worked for this employer nor received periodic income. Q This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribai 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/iincome status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N HANOVER ST P.O. BOX 320. CARLISLE, PA. 17013(Issuer address). To Employee/Obligor: If the employee/obligor has questions,contact WAGE ATTACHMENT UNIT(Issuer name) by phone at(717)240-6225, by fax at(717)240-6248, by email or website at www.childsupport.state,.pa.us. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB Ho.:0970-0454 Form EN-028 06/12 Service Type M Page 3 of 3 Worker ID $OINC ADDENDUM Summary of Cases on Attachment Defendant/Obligor: NEMEC, PATRICK T. PACSES Case Number 268105092 PACSES Case Number Plaintiff Name Plaintiff Name CLAUDIA DESOMMA Dock e Attachment Amount Docket Attachment Amount 02-3256 CIVIL $ 920.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACKS Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB _ PACKS Case Number PACKS Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount docket Attachment Amount $ 0.00 $ OM Child(ren)'s Narne(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-028 06112 Service Type M OMB No.:0970-0154 Worker ID$OINC ^ IL �����E�������O����Q��W����� �u/? i LJL71 O onxawAL INCOME WITHHOLDING owoenmqnCE FOR SUPPORT(»wo) /l~) _ -3-asL /`)�> � E) AMENDEDIWO O ume-T/msonocnwonns FOR LUMP SUM PAYMENT O TERMINATION opIwm Date. 0 Child Support Enforcement(CSE)Agency N Court 0 Attorney C1 Private Individual/Entity(Check One) NOTE:This IWO,MuStb6 ri Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions http://ww.w.aefhhs.gov/programs/4��e/newhire/employ r/6ublication/publication.htm-forms). If you receive this document from someone other than 6,S!6fe bir Tribal CSE agency or a Court,a copy of the underlying order must be attached. StatefTribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w1payment): 1835101084 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for orderldocket informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) COMMONWEALTH OF PA RE: NEMEC,PATRICK T. C/O STATE EMPLOYEES RET, SYST Employee/Obligor's Name(Last,First,Middle) 30 N 3RD ST STE 150 161-42-2551 HARRISBURG PA 17101-1726 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name(Last, First, Employer/Income Withholder's FEIN NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last,First,Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see IWO instructions you receive this document from someone other than a State or Tribal CSE agency or a Court,a py of the underlying order must be attached. See Addendum for dependent names and birth dates associated with cases on attachmept:,2. ORDER INFORMATION. This document is based on the support or withholding order from CUM5ti,.RLrND OuLin'­tv, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amountstAnim thelem * ' (" obligor's income until further notice. $ 0.00 Der month in current child support $ 0.00 Der month in past-due child support- Arrears 12 weeks or greater? 0 yeF�C $ 0.00 Der month in current cash medical support $ 0.00 Der month in past-due cash medical support $ 920.00 per month in current spousal support $ 0.00 per month in past-due spousal support u 0.00 per month in other(must specify) . for a Total Amount to Withhold of$ 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: $ 211.73 per weekly pay period. $ 460.00 per semimonthly pay period(twice omonth) $ 423.45 per biweekly pay period (every two weeks) $ 920.00 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 (Stote/Tribe). you must begin withholding no later than the first pay period that occurs working days after the date of . Send payment within 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/Triba), the employer can obtain withholding UmitaUonm, time requirements, and any allowable employer fees at http://www.acf.hhs.ciov/programs/cse/newhire/employer/contacts/contact map, MITI for the emp\oyee/ob|igor'e principal place ofemployment. Document Tracking Identifier OMB wv.oem*,m Form EN-02808/12 Service Type K8 Worker |D $OiNC m� F71 Return to Sender[Completed by Employer/Income WithhmldeM. Payment must be directed to anGDUin y accordance with 42USC§88O(b)(5)and (b)(8)or Tribal Payee(see Payments to8OUba|ow). If payment ionot � directed hoan8OU/Trbm| Payee or this |VVOia not regular on its face, you must check this box and return the KNOho the sender. Signature of Judge/issuing Official (if required by State or Tribal law): Print Name of Judge/issuing Official: I "A ef!Mig"A.MOM Title of Judge/issuing Official: ,if 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 ba provided hm the amp|oyee/ob|igor. [] If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR Eh8PLOYERS/INCO&4EVV1TMHOLDEFKS Pennsylvania law(23 PAC.S. §4374(b)) requires remittance byan ifan employer iaordered 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 towonsuthcierdfunds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. 9A F|PS CODE 42QUO OU Make Remittance Payable to: PA SCDQ Send check to: Pennsylvania SC0U, P'O' Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSE8 MEMBER 6D(shown above as theEmployeelOb0gp 's Case Identifler) OR SOCIAL SECURITY NUMBER 0V ORDER TO8E PROCESSED. DO NOT SEND CASH BY MA/L. 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(USC42 §GGG(b)(7)). !fa Federal tax levy ioin effect, please notify the sender. Combining Payments: When remitting payments 0oonSDUorThbu|CSEagenny.youmaynombinewithheNomountohnm 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 SDW: You must send child support payments payable by income withholding 0o the appropriate SDUor&na Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SOU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent bya Court,Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued bya 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 emp|oyee/obUgor'm 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 IVVOs: |f there iu more than one|VV{J against this employee/obligor andynuunounab|eVufuUyhonoraU |VVOsdue0o Federal, State,or Tribal withholding limits,you must honor all IWOs to the greatest extent possible,giving priority tocurrent support before payment of any past-due support, Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment ho determine the appropriate allocation method. Lump Sum Payments: You may be required to notify o State or Tribal CSE agency of upcoming lump sum payments 0mthis 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 lo*/pvooedure. Ant|-d|surinminmUon: 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-uom,uow.The OMB Expiration Date has""bearing=the termination date w the/wm;/'identifies the version m the form currently/nuse, Form EN'O28UH/12 Service Type K4 Page 2ofB Worker|O$O|NC ���� Employer's Name: COMMONWEALTH OF PA Employer FEIN: Name: NEMEC,PATRICK T. 1835101084 CSE Agency Case Identifier: Order Identifier:(See Addendum for orderldocket information Withholding Limits:You may not withhold more than the lesser of: 1)the amounts allowed by the Federal Consumer Credit Protection Act(CCPA)(15U.S.C. 1673(b));or2)the amounts allowed by the State or Tribe of the emp|oyoe/ob|igor'n 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 nf the jurisdiction inwhich 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: 7676100114 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 Employer's Name: New Employees Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone ot . by fax o\ . by email orwmbai0eat: . 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: |f the employee/obligor has questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone at . by fax at . by email orvvobeitoat . IMPORTANT:The person completing this form isadvised that the information may be shared\Atith theemployee/obligor. OMB w`.o97oo,o4 Form EN-O38O6/12 Service Type yW Page 3of3 Worker |D$O|NC � ADDENDUM Summa!y of Cases on Attachment Defewdmnt/Ob|igwrNEK8EC. PATRICK T. 268105092 PACSES Case Number Plaintiff Name ' Plaintiff Nam� CLAUD|ADESOKXW1A '^ ' Docke Attachment Amoun Docke 1 Attachment Amount 02-3256 CIVIL $ 920.00 $ 0.00 Chi|d(non)'aNamo(a): DOB Chi|d(neo)'aName(o): DOB PACSES Case Number PACSES Case Number Plaintiff Nam Pumnmz Nam� Docke Attachment Amount Docke U Attachment Amount ChUd(mn)'mNome(o): DC)8 Chi|d(v*n)'mNoma(n): DOB Plaintiff Nmme Plaintiff Nam Docke Aftachment Amoun Docke Attachment Amount ChUd(von)'oNamn(e): DDS Chi|d(nen)'eName(m): DOB Addendum Form EN-U2808/12 Service Type M OMB No.:0970-0154 Worker ID$OINC In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION CLAUDIA DESOMMA ) Docket Number: 02-3256 CIVIL Plaintiff ) vs. ) PACSES Case Number: 268105092 PATRICK T. NEMEC ) Defendant ) Other State ID Number: Order AND NOW to wit, this AUGUST 2, 2013 it is hereby Ordered that: the contempt petition filed May 24, 2012 is dismissed. - U1 CIO t 'C": r Z. OUR tea , aL AUGUST 2, 2013 Date Thomas A. Placey, JUDGE Form OE-001 Service Type M Worker ID 21600 ^ � INCOME WITHHOLDING FOR SUPPORT 05 D9142 D ORIGINAL INCOME WITHHOLDING omoswwonns FOR SUPPORT( mo) O AMsmosoxwo - /7��/~ /^)V/ / Oowe-nmEonosn/woncE FOR LUMP SUM PAYMENT '*-'"' - (j) TERMINATION ormvo omw: C3 Child Support Enforcement(CSE)Agency 0 Court 0 Attorney 0 Private Individual/Entity(Check One) NOTE:This IWO rrijgt'be'*%AriMtd�MAT Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions http:L/m4.acf.hhs-gov/programs/ese/newhire/emplpyer/publication/publication.htm-forms). If you receive this document from someone other than a SWR6-0-r Tribal CSE agency or a Court,a copy of the underlying order must be attached, State[Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 1835101084 City/County/Dist.fTribe CUMBERLAND Order Identifier: (See Addendum for orderldocket informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) COMMONWEALTH OF PA RE: NEMEC,PATRICK T. C/O STATE EMPLOYEES RET. SYST tmployee/Obligor's Name(Last,Firsi,Middle) 30 N 3RD ST STE 150 161-42-2551 . HARRISBURG PA 17101-1726 Employee/Obligor's Social Security Number (See Addendum thr plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name(Last,First, Employer/income Withholder's FEIN NOTE:This IWO must be regular on its face. Under certain circumstances you must reject Child(ren)'s Name(s)(Last,First,Middle) Child(ren)'s Birth Date(s) this IWO and return it to the sender(see two instructions 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. 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 CUMBE-REAND-County.- Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts froll�e ei�, obligor's income until further notice. Ln 0.00 per month in current child support $ 0.00 Der month in past-due child support- Arrears 12 weeks or greater? 0 yes $ 0.00 per month in current cash medical support / ° per month m past-due cash medical support c::: ':�? $ 0.00 per month in current spousal support $ 0.00 per month in past-due spousal support $ 0.00 per month in other(must specify) for o Total Amount tmWithhold of$ 0.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle bobein compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: o 0.00 per weekly pay period, $ O per semimonthly pay period(twice emonth) $ 0.00 per biweekly pay period(every two weeks) $ o.0o per monthly pay period. $ Lump Sum Payment: Do not stop any existing |VVO 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 working days after the date of . Send payment within 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 (Stotm/Tr\bm), the employer can obtain withholding limitations, time requirements, and any allowable employer fees at httg://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact map. htm for the emp|oyoe/ob|igor'a principal place ofemployment. Document Tracking Identifier OMB mn ..oonm/s* Form EN-028 06/12 Service Type yW Worker (O$O(N{} n Return tm Sender[Completed 6w �mm ncmmm�VV�hh�h�eN. Payment � ' . - ' ' � accordance with 42USC§688(b)(5)and (b)(0)or Tribal Payee(see Payments to8DUbe|oxv . If payment ksnot directed toanSDU/Trba| Payee or this {VVOio not regular on its face, you must check this box and return the }VVO to the sender, Signature of Judge/Issuing Official (if required by State or Tribal law Print Name of Judge/Issuing Official: I Thoffia-SA.. Title of Judge/Issuing Official: Doi If the for a Tribe that ia different from the State or Tribe that issued this order,a copy of this|WO must oa provided tn the emp|nyoe/ob|/gur. | Fl If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EK8PLOYERV|NCOK0E WITHHOLDERS Pennsylvania law(23 PA C.S.§437z(b))requires remittance by an electronic payment method ifmm employer isordered to withhold income from more than one employee and employs IS or more persons,or ifmm employer has a history of two mr more returned checks due uommmsuffic\entfunds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU)Employer Customer Service mt1-877-67S-95$0 for instructions. PA F\PS CODE 42oU0o0 � Make Remittance Payable to: PA SCDU / | Send check to: Pennsylvania SCDU, P.O~ Box 69112, Harrisburg, Pa 17106,9112 IN ADDITION, PAYMENTS MUST INCLUDE ItHE DEFENDANT'S NAME AND THE PACSES MEMBER ID(shown above as the 's Case Identirtwr) OR SOCIAL SECURITY NUMBER I0 ORDER 7OBE PROCESSED. DO NOT SEVDCASHBYMAKL. 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(USC42 §8GS(b)(7)). |fo Federal tax levy iain effect, please notify the sender. Combining Payments: When remitting payments VoonSDUor Tribal CSE agency, you may combine withheld amounts from more than one arnployee/ob|iQor'o income)na single payment.You must, however, separately identify each employee/ obligors portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate 8OUortoo Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU(e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: if this IWO was sent by 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}o the date on which the amount was withheld from the amp|oyee/ob//gor'a 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 iVVOs: (f there is more than one!VV0 against this employee/obligor andyouoreuoob|ohofu|k/honoraU |VVOnduehu Federal, State, or Tribal withholding limits,you must honor all IWOs to the greatest extent possible, giving priority Vocurrent support before payment cf any past-due support. Follow the State or Tribal law/procedure of the erriployee/obligor's principal place ufemployment to determine the appropriate allocation method. Lump Sum Payments: You may be required bo notify a State or Tribal C8E agency of upcoming lump sum payments tothis 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 fall to withhold income from the employeelobligor'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 }aw/procedune. 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-me1oo,4.The OMB Expiration Date has n"bearing v^the termination date m the w*;u identifies the version m the form currently muse. Form EN-O28OG/12 Service Type WY Page 2of3 Worker|D$O|NC ^ ~ Employer's Name: COMMONWEALTH OF PA Employer FEIN: Name: CSE Agency Case|denbfiec Order Identifier:(—See Addendum for orderldocket information Withholding kjnnito: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 cf the jurisdiction inwhich 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: 7676100114 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 SDUITribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: |f you have any questions,contact WAGE ATTACHMENT UNIT(Issuer name) by phone at . by fax at . by email orwabs|heat: . 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/Oblicior. If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT(Issuer name) by phone mi . by fax ot . by email orvvebniteot . IMPORTANT:The person completing this form imadvised that the information may he shared with the emp|oyee/oWigor. OMB w°'oenm`m Form EN'O28DG/12 Service Type K4 Page 3of3 Worker |OSOiNC ADDENDUM Summary of Cases on Attachment Defendant/Obligor: NEMEC, PATRICK T. PACSES Case Number 268105092 PACSES Case Number Plaintiff Name Plaintiff Name CLAUDIA DESOMMA - Do ke Attachment Amount Doc ke Attachment Amount 02-3256 CIVIL $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOS PACSES Case Number PACSES Case Number Plaintiff Nam Plaintiff Nam- Docke t Attachment Amount Docke Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Number Plaintiff Name Plalntiff.Name Doc et Attachment Amount Do_ c�k'k Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendum Form EN-028 06112 Service Type'M OMB No.:0970-0154 Worker 10$OINC CLAUDIA DESOMMA, • IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION- DIVORCE • NO. 02-3256 CIVIL TERM PATRICK T. NEMEC, • IN DIVORCE Defendant/Respondent : PACSES Case No: 268105092 rr ORDER OF COURT cior „ AND NOW to wit, on this 15th day of August, 2013, it is hereby Ordered the Alimony Pendente Lite order is terminated, effective August 1, 2013 with no balance due. This Order shall become final twenty(20) days after the mailing of the notices of the entry of the Order to the parties unless either party files a written demand with the Office of the Prothonotary for a hearing de novo before the Court. BY T E OURT: Tho . Placey, J. DRO: R.J. Shadday xc: Petitioner Respondent Marylou Matas, Esq. Bryan W, Shook, Esq. Form 0E-001 Service Type:M Worker:21005 INCOME WITHHOLDING FOR SUPPORT Q ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT(IWO) O AMENDED IWO 2-(DX Q ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT w✓ ` Q TERMINATION OF IWO Date: 08115/13 ❑ Child Support Enforcement(CSE)Agency ® Court ❑ Attorney ❑ Private Individual/Entity(Check One) NOTE:This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender(see IWO instructions httg://www.acf.hhs.govt programs/cse/newhire/employer/publication/i)ublication.htm-forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court,a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania Remittance Identifier(include w/payment): 1835101034 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for orderldocket informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) SOCIAL SECURITY ADMINISTRATION RE: NEMEC PATRICK T. STE 1 Employee/Obligor's Name(Last,First,Middle) 200 S SPRING GARDEN ST 181-42-2551 CARLISLE PA 17013-2578 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 Wiithholder's FEW 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/i)rograms/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. 8384100092 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 frorq-t'he"ployee/ obligor's income until further notice. $ 0.00 per month in current child support $ 0.00 per month in past-due child support- Arrears 12 weeks or greater? Q yes no,-,> $ 0.00 per month in current cash medical support '' - c $ 0.00 per month in past-due cash medical support $ 0.00 per month in current spousal support $ 0.00 per month in past-due spousal support $ 0.00 per month in other(must specify) —1 �l c-� for a Total Amount to Withhold of$ 0.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 0.00 per weekly pay period. $ 0.00 per semimonthly pay period(twice a month) $ 0.00 per biweekly pay period(every two weeks) $ 0,00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. MITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Commonwealth Penns Ivania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten 10 rkin days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If cannot withhold the full amount of support for any or all orders for this employee/obligor,withhold up to 551/o of osable income for all orders. If the employee/obligor's principal place of employment is not within the monwealth Of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time requirements, ny allowable employer fees at http://www aef hhs aov/programs/cse/newhire/employer/contacts/contact map. r the employee/obligor's principal place of employment. �erit Tracking Identifier OMB No.:0970-0154 Form EN-028 06/12 rvice Type M Worker ID$OINC ❑ Return to Sender[Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USG§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: firv, Date of Signature: AMIRM ' If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order,a copy of this IWO must be provided to the employee/obligor. ❑ If checked,the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law(23 PA C.S.§4374(b))requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 16 or more persons,or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit(PA SCDU)Employer Customer Service at 1-877-676-9580 for instructions.PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID(shown above as the EmployeelObligor's Case Identirter)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: hftp://www.acf.hhs.-gov/programs/cse/newhire/`employer/contacts/contact map.htm Priority: Withholding for support has priority over any other legal process under State law against the same income(USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency,you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney),you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court,Attorney,or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency,you must follow the"Remit payment to"instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment.The pay date is the date on which the amount was withheld from the employee/obligor's wages.You must comply with the law of the State(or Tribal law if applicable)of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: if there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits,you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses,commissions,or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO,contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an ernployee/obligor from employment, refusing to employ,or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date—05/3112014.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 06112 Service Type M Page 2 of 3 Worker ID $OINC Employer's Name: SOCIAL SECURITY ADMINISTRATION Employer FEIN: Employee/Obligor's Name: NEMEC, PATRICK T. 1835101084 CSE Agency Case Identifier:(See Addendum for case summary) Order Identifier:(See Addendum for orderldocket information Withholding Limits:You may not withhold more than the lesser of- 1)the amounts allowed by the Federal Consumer Credit Protection Act(CCPA)(15 U.S.C. 1673(b));or 2)the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment(see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as:State, Federal,local taxes;Social Security taxes;statutory pension contributions;and Medicare taxes.The Federal limit is 50%of the disposable income if the obligor is supporting another family and 60%of the disposable income if the obligor is not supporting another family. However,those limits increase 5%-to 55%and 65%-if the arrears are greater than 12 weeks. If permitted by the State or Tribe,you may deduct a fee for administrative costs.The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders,you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO,you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d)of the CCPA(15 U.S.C. 1673(b)). Depending upon applicable State or Tribal law,you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks?If the Order Information does not indicate that the arrears are greater than 12 weeks,then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you are no longer withholding income for this employee/obligor,an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 8384100092 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 SDLI[Tribal Payee: Final Payment Amount: New Employees Name: New Employees Address: CONTACT INFORMATION: To Empipyer/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.childsugport.state.pa.us. Send termination/income status notice and other correspondence to:DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST, P.O. BOX 320, CARLISLE, PA. 17013(Issuer address). To Employee/Obligor: If the employee/obligor has questions,contact WAGE ATTACHMENT UNIT(issuer name) by phone at(717)240-6225, by fax at(717)_,240-6248, by email or website at www.childsupport.state.pa.ua. IMPORTANT:The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.:0970-0154 Form EN-028 06/12 Service Type M Page 3 of 3 Worker ID$01NC 3 y ADDENDUM Summary of Cases on Attachment Defendant/Obligor: NEMEC, PATRICK T. PACSES Case Number 268105092 PACSES Case Number Plaintiff Name Plaintiff Name CLAUDIA DESOMMA Docket Attachment Amount Docket Attachment Amount 02-3256 CIVIL $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB P8CSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Do et Attachment Amount D cke Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number PACSES Case Numbe Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB Addendurn Form EN-028 06/12 Service Type M OMB No.:0970-0154 Worker ID$OINC CLAUDIA DESOMMA, • IN THE COURT OF COMMON PLEAS Plaintiff • COUNTY OF CUMBERLAND, PENNSYLVANIA • v. • NO. 2002-3256 CIVIL TERM • P 1 ICK T. NEMEC, • CIVIL ACTION — LAW T Defendant • IN DIVORCE — —� PLAINTIFF'S AFFIDAVIT OF CONSENT cv cn CO W 1. A Complaint in Divorce under§ 3301(c) of the Divorce Code was filed July 10, 2002. E 2. The marriage of plaintiff and defendant is irretrievably broken and ninety days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final Decree in Divorce after service of notice of intention to request entry of the Decree. I verify that the statements made in this Affidavit are true and correct 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. 4904 relating to unsworn falsification to authorities. Date: .140 c77,51)0/7t CLAUDIA DeSOMMA �^ PLAINTIFF'S WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER§ 3301 (c) OF THE DIVORCE CODE 1. I consent to the entry of a final Decree of Divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a Divorce Decree is entered by the Court Law Offices of and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. Saudis I verify that the statements made in this Affidavit are true and correct to the best of my Sullivan & Rogers knowledge, information and belief. I understand that false statements herein are made subject to the 26 west High Street penalties of 18 Pa.C.S. 4904 relating to unsworn falsification to authorities. Carlisle,PA 17013 p g Date: n, S)0/ CLAUDIA DeSOMMA CLAUDIA DESOMMA, • IN THE COURT OF COMMON PLEAS Plaintiff • COUNTY OF CUMBERLAND, PENNSYLVANIA v. : NO. 2002-3256 CIVIL TERM PATRICK T. NEMEC, • CIVIL ACTION — LAW Defendant • IN DIVORCE DEFENDANT'S AFFIDAVIT OF CONSENT - -,-,4,j_ 1. A Complaint in Divorce under§ 3301(c)of the Divorce Code was,Ailed JiJy,10j2€ 2. 2. The marriage of plaintiff and defendant is irretrievably broken a icninely)days'have Wl. elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final Decree in Divorce after service of notice of intention to request entry of the Decree. I verify that the statements made in this Affidavit are true and correct 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. 4904 relating to unsworn falsification to authorities. • Date: �`� P TRICK T. NEMEC DEFENDANT'S WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER§ 3301 (c) OF THE DIVORCE CODE 1. I consent to the entry of a final Decree of Divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a Divorce Decree is entered by the Court Law Offices of and that a copy of the Decree will be sent to me immediately after it is filed with the Prothonotary. Saidis I verify that the statements made in this Affidavit are true and correct to the best of my Sullivan & Rogers knowledge, information and belief. I understand that false statements herein are made subject to the 26 West High Street penalties of 18 Pa.C.S. 4904 relating to iinsworn falsification to authorities. Carlisle,PA 17013 Date: -)-(q-/y-/y PATRICK T. NEMEC Law Offices of Saidis Sullivan & Rogers 26 West High Street Carlisle, PA 17013 CLAUDIA DESOMMA, Plaintiff L D- 0E F100 U T iiUrio 2014 HAR 26 P11 2: 2 l PE 'jT OF COMMON PLEAS N Y OF CUMBERLAND, PENNSYLVANIA v. • NO. 2002 -3256 CIVIL TERM PATRICK T. NEMEC, CIVIL ACTION — LAW Defendant IN DIVORCE PRAECIPE TO TRANSMIT RECORD To the Prothonotary: Kindly transmit the record, together with the following information, to the Court for entry of a Decree in Divorce: 1. Grounds for Divorce: Irretrievable breakdown under Section 3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: Defendant accepted service of the Complaint on July 5, 2002, attorney, Jay Braderman, Esquire, signing an Acceptance of service. Proof of service was filed with the Court on July 29, 2002. 3. Date Affidavit of Consent required under Section 3301(c) or (d) of the Divorce Code was signed: By Plaintiff: February 25, 2014, and filed with the Prothonotary on February 27, 2014. By Defendant: March 19, 2014, and filed with the Prothonotary on March 20, 2014. 4. Related claims pending: None. 5. Date Waiver of Notice under Section 3301(c) of the Divorce Code was signed: By Plaintiff: February 25, 2014, and filed with the Prothonotary on February 27, 2014. By Defendant: March 19, 2014, and filed with the Prothonotary on March 20, 2014. SAIDIS, SULLIVAN & ROGERS ct7t0 Marylo'u_Mat,i Esquire' v Supreme Court ID No. 84919 26 West High Street Carlisle, PA 17013 717- 243 -6222 Attorney for Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA Claudia DeSomma V. • • Patrick T. Nemec : NO. 2002-3256 DIVORCE DECREE AND NOW, 447 Z , Zvi/ , it is ordered and decreed that Claudia DeSomma , plaintiff, and Patrick T. Nemec , defendant, are divorced from the bonds of matrimony. Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") None. ,.�21r By the Court, Bf ifffllffif tt ArrA. ;,-,410,, 4 - /I _.y - - Attest J. r � •ow, ,. • , ♦._ gswaymmigtad 11111w rothonotary ?err Cp may Ied -lo � Ma+as Notice+�?op1 fnailed-foQ Shook Ha'led a 4)3I