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04-6235
JACK SHINDEL, IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA * NO. Plaintiff VS. TERRY SHINDEL, Defendant * CIVIL ACTION - LAW IN DIVORCE * NOTICE TO DEFEND SAND CLAIM RIGHTS YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND AGAINST THE CLAIMS SET FORTH IN THE FOLLOWING PAGES, YOU MUST TAKE PROMPT ACTION. YOU ARE WARNED THAT IF YOU FAIL TO DO SO, THE CASE MAY PROCEED WITHOUT YOU AND A DECREE OF DIVORCE OR ANNULMENT MAY BE ENTERED AGAINST YOU BY THE COURT. A JUDGMENT MAY ALSO BE ENTERED AGAINST YOU FOR ANY OTHER CLAIM OR RELIEF REQUESTED IN THESE PAPERS BY THE PLAINTIFF. YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS IMPORTANT TO YOU, INCLUDING CUSTODY OR VISITATION OF YOUR CHILDREN. WHEN THE GROUND FOR THE DIVORCE IS INDIGNITIES OR IRRETRIEVABLE BREAKDOWN OF THE MARRIAGE, YOU MAY REQUEST MARRIAGE COUNSELING. A LIST OF MARRIAGE COUNSELORS IS AVAILABLE IN THE OFFICE OF THE PROTHONOTARY AT THE CUMBERLAND COUNTY COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE, PA 17013. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY LAWYER REFERRAL SERVICE 2 LIBERTY AVENUE CARLISLE, PA 17013 (717) 249-3166 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JACK SHINDEL, Plaintiff x NO. VS. TERRY SHINDEL, Defendant CIVIL ACTION - LAW IN DIVORCE COMPLAINT COUNT I - DIVORCE UNDER §3301 QF THE DIVORCE CODE 1. The Plaintiff is Jack Shindel, who currently resides at 210 North Bedford Street, Carlisle, Cumberland County, Pennsylvania. 2. The Defendant is Terry Shindel, who currently resides at 423 4th Street, New Cumberland, Cumberland County, Pennsylvania. 3. Plaintiff and Defendant have been bona fide residents in the Commonwealth of Pennsylvania for at least six months immediately previous to the filing of this Complaint. 4. Plaintiff and Defendant were married on January 4, 1974, in Mechanicsburg, Pennsylvania. 5. There have been no prior actions of divorce or for annulment between the parties. 6. Neither party is presently a member of the Armed Forces on active duty. 7. Plaintiff has been advised that counseling is available and that he may have the right to request that the court require the parties to participate in counseling. Being so advised, Plaintiff does not request that the Court require the parties to participate in counseling prior to a Divorce Decree being issued. 8. The cause of action and sections of the Divorce Code under which Plaintiff is proceeding are: (a) §3301(c). The marriage of the parties is irretrievably broken. (b) §3301(d). The marriage of the parties is irretrievably broken and, at the appropriate time, Plaintiff will submit an affidavit stating that the parties have been living separate and apart for a period of at least two (2) years. 9. Plaintiff requests This Honorable Court to enter a Decree of Divorce. WHEREFORE, Plaintiff respectfully requests This Honorable Court to enter an Order dissolving the marriage between Plaintiff and Defendant. COUNT H - CLAIM FOR EOUITABLE DIVISION OF MARITAL PROPERTY UNDER §3502(a) OF THE DIVORCE CODE 10. Paragraphs one (1) through nine (9) are incorporated herein by reference as if set forth in full. 11. Plaintiff and Defendant have individually or jointly acquired real and personal property during the marriage in which they individually or jointly have legal or equitable interest, which marital property is subject to equitable distribution. WHEREFORE, Plaintiff respectfully requests This Honorable Court to determine and equitably distribute, divide or assign said marital property pursuant to §3502(a) of the Divorce Code. Respectfully submitted, WILEY, LENOX, COLGAN & MARZZACCO, P.C. Dated: 1 ? 8 /0 Bra y . Winnick, Esquire 130 Church Street Dillsburg, PA 17019 (717) 432-9666 I.D. # 78413 VERIFICATION I, Jack Shindel, verify that the statements made in this Complaint 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. CS. §4904, relating to unsworn falsification to authorities. Date: /Z ' 7 - 0 ACK SHNDEL Plaintiff 1 ,;Ti I Ti IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JACK SHINDEL, * NO. 04-6235 Civil Term Plaintiff VS. * CIVIL ACTION - LAW IN DIVORCE TERRY SHINDEL, Defendant AFFIDAVIT OF SERVICE I, Sherie A. Minich, being duly sworn, deposes and says that she is an adult and that she served a Complaint in Divorce upon the Defendant, at the Defendant's last known address as follows: Terry Shindel, 423 4`' Street, New Cumberland, PA 17070, by certified mail, return receipt requested, restricted delivery, on December 15, 2004, and the same was received by her on December 17, 2004. The Certified Mail Receipt and PS Form 38111 are attached hereto, marked Exhibit "A" and made a part hereof by reference thereto. Date: December 22, 2004 WILEY, LENOX, COLGAN & MARZZAC?O, P.C. By: Slierie A. Munch COMMONWEALTH OF PENNSYLVANIA : SS COUNTY OF YORK On this, the 22nd day of December, 2004, before me, a notary public, personally appeared Sherie A. Minich known to me or satisfactorily proven to be the whose name is subscribed to the within Affidavit and acknowledged that she executed the same for the purposes therein contained. WITNESS, my hand and notarial seal the day and year aforesaid. iL 1 + O ARY PUB Notarial Seal My Commission Expires: 3. Dawn Gladfelter, Notary Public Dlllsburg Boro, York County My Commission Expires May 11, 2005 Member, PennspanraAssopationotNotaries Ln I CERTIFIED U1 ¦ ¦ Ln m (Domestic N Ln For delivery information a visit our w eb-site? -0 Postage $ z O Certified Fee O C3 Return Reciept Fee (Endorsement Required) Postmark Here f O Restricted Delivery Fee d i J ?+ t 5 1004 Ln orsement Reu (En red) r- C3 Total Postage & Fees $ C3 t° Terry Shind ------ i r reei, o. "'423 ------------- 4th -- ----------------------------- Street o PO No. Box x a CRY, State, ZIP+4 New Cumberland,, PA 17070 1 VpWnwti nd a1cYfts "'"MAO* ** we c *WM the 17th to you. qt Mf t'Fre tom ?sr l 4M I 4ndai 4, 1-- 4thl'-'Otmprt l sw duo '.risrd-, Phi 17070 3. Bt3. rtK' daMM1t?? adr?tafetr AW Q AWNWAR E+P 1? © Yes 0 No Rp'-t1MO*t ° CC7 MOM E? ?i?%tl tiiiissilApR for Msrcheric,Mett 4• PAW1C*4 O biWY? AW 7004 0750 0003 6355 2355 11 MI M1 i I ! ?' +?+eMK ?aeeee aaa?neo EXHIBIT "A" c? 3 L JACK SHINDEL, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant DEFENDANT'S PETITION FOR ADDITIONAL CLAIMS AND NOW COMES, Defendant, Terry Shindel, by and through her Attorney, Jane Adams, Esquire, and respectfully represents the following: COUNT I - ALIMONY 1. Plaintiff is Jack Shindel, who currently resides at 210 N. Bedford St., Carlisle, Cumberland County, Pennsylvania, 17013. 2. Defendant is Terry Shindel, who currently resides in the marital home located at 423 4th St., New Cumberland, Cumberland County, Pennsylvania. 3. On December 13, 2004, Plaintiff filed an action in Divorce under the above-captioned number. 4. Plaintiff left the marital home on April 9, 2004, and is currently not paying any expenses to help Defendant maintain the marital home. 5. Plaintiff lacks sufficient property or income to provide for her reasonable needs in accordance with the standard of living of the parties established during the marriage. 6. Plaintiff is unable to support herself in accordance with the standard of living of the parties established during the marriage through appropriate employment. 7. The Plaintiff is employed at the Army Depot and enjoys a substantial income from which he is able to contribute the support and maintenance of Defendant and pay her alimony in accordance with the Divorce Code of Pennsylvania. WHEREFORE, Plaintiff prays this Honorable Court to enter an Order awarding Defendant from Plaintiff permanent alimony in such sums as are reasonable and adequate to support and maintain Plaintiff in the station of life to which she has become accustomed during the marriage. COUNT II - ALIMONY PENDENTE LITE 8. Paragraphs 1 - 7 are incorporated herein by reference. 9. Defendant lacks sufficient property to provide for her reasonable means and her needs during the course of this litigation and is unable to support herself through appropriate employment. 10. Defendant requires reasonable support to adequately maintain herself in accordance with the standard of living established during the marriage. 11. Plaintiff enjoys a substantial income and is well able to contribute to the support and maintenance of Plaintiff during the course of this action. WHEREFORE, the Defendant requests that this Honorable Court enter an award of Alimony Pendente Lite until final hearing. COUNT III - COUNSEL FEES, COSTS AND EXPENSES 12. Paragraphs 1- 11 are incorporated herein by reference. 13. Defendant is without sufficient funds to retain counsel to represent her in this matter. 14. Without counsel, Defendant cannot adequately prosecute her claims against Plaintiff and cannot adequately litigate her rights in this matter. 15. Plaintiff enjoys a substantial income and is well able to bear the expense of Defendant's attorney and the expense of this litigation. WHEREFORE, Defendant requests this Honorable Court to enter an award of counsel fees, costs, and expenses. Respectfully submitted, Date: J e Adams, Esquire .D. No. 79465 64 South Pitt Street Carlisle, Pa. 17013 (717) 245-8508 ATTORNEY FOR DEFENDANT VERIFICATION I verify that the statements made in this PETITION are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to unsworn falsification to authorities. ,/ : Date: Ju.r,. 1$ SOS J Terry Shindel, Defendant V? rte, f? 3 ?Jl it { JACK SHINDEL, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant PRAECIPE TO APPEAR TO THE PROTHONOTARY: Please enter Jane Adams, Esquire as attorney of record for Defendant, Terry Shindel, in the above-captioned matter. Date: `_ [ 3 - U 5 Respectfully l Adani Esquire I.D. 0.794 465 outh Pitt Street Carlisle, Pa. 17013 (717) 245-8508 ATTORNEY FOR DEFENDANT JACK SHINDEL, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant AFFIDAVIT OF SERVICE; AND NOW, this January 28, 2005, I, Jane Adams, Esquire, hereby certify that on or about January 24, 2005, a certified true copy of Defendant's Petition for Additional Claims was served, via certified mail, return receipt requested, addressed to: Brad Winnick, Esquire The Wiley Group 130 W. Church St. Dillsburg, Pa. 17019 DEFENDANT ¦ Compote kerns 1, 2, and 3. Also complete kern 4 k Restricted DelWery is deek0d. ¦ Prim your name and address on the revwss so that we can return the card to you. ¦ Attach this card to the back of the mallplea! or on the front k space perms 1. ANcle Addressed to: Br,a Esq. -at W01rj (troop 130 W. Gkvr A -S+. S6vnq, PA-, it" 2.AdMe N 7003 3110 0004 5775 4320 Oti?r seer ssrvrae ybe4 -S Farm 3811, February 2004 Dmwft IMI mft=W aeaswehua A. B. D. k& wryaddrMdMlerentbemtternt? ?Yes k YES, enter desvery address beau:. O. No I3. Ssrvk+styps A WrtMSd Men O E?reee Men OR 01 1- 13 Ran PAoept for Mwdwdn o Yee ? agent Respectfully Subbmitte : Vouth dams, Esquire 1. o. 79465 Pitt Street Carlisle, Pa. 17013 (717) 245-8508 ATTORNEY FOR DEFENDANT :.o ,,.,,? ` ,,..? ?O ' . ...e n r__ ?? T 1 ='? = i : rj i - r [?.) ? C? '. .'t? l `-::II?1 _ ny JACK SHINDEL, IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA Ys. CIVIL ACTION - DIVORCE NO. 2004-6235 CIVIL TERM TERRY SHINDEL, IN DIVORCE Defendant/Petitioner PACSES # 473107088 ORDER OF COURT AND NOW, this I" day of February, 2005, upon consideration of the attached Petition for Alimony Pendente Lite and/or counsel fees, it is hereby directed that the parties and their respective counsel appear before R.J. Shaddav on February 24. 2005 at 10.30 A.M. for a conference, at 13 N. Hanover St., Carlisle, PA 17013, after which the conference officer may recommend that an Order for Alimony Pendente Lite be entered. YOU are further ordered to bring to the conference (1) 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 Rule 1910.11© (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you IF you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. BY THE COURT, George E. Hoffer, President Judge Mail copies on Petitioner ,2-/-65 to: < Respondent Jane Adams, Esquire Date of Order: February 1. 2005 . J. Shadday, Conference Officer D YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 CC361 1 JACK E. SHINDEL, Plaintiff/Respondent VS. TERRY L. SHINDEL, Defendant/Petitioner IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - DIVORCE NO. 2004-6235 CIVIL TERM IN DIVORCE PACSES# 473107088 ORDER OF COURT AND NOW, this 24`h day of February, 2005, based upon the Court's determination that Petitioner's monthly net income/earning capacity is $1,170.75 and Respondent's monthly net income/earning capacity is $2,597.67, it is hereby Ordered that Respondent pay to the Pennsylvania State Collection and Disbursement Unit, $646.00 per month for APL and $54.00 on arrearages, payable bi-weekly as follows; 5298.16 for alimony pendente lite and $24.92 on arrears. First payment due next pay date at 323.08. Arrears set at $1,292.00 as of February 24, 2005. The effective date of the order is January 13, 2005. This order considers that the petitioner is residing in the marital home and there is a mortgage contribution of $131.88 per month included in this order. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C.S.§ 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and its discretion make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the PA SCDU to: Terry Shindel. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the defendant's PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. Unreimbursed medical expenses that exceed $250.00 annually are to be paid as follows: 0% by Respondent and 100°10 by Petitioner. The Petitioner is responsible to pay the first $250.00 annually in unreimbursed medical expenses. Respondent to provide medical insurance coverage. Within thirty (30) days after the entry of this Order, the Respondnet shall submit to Petitioner written proof that medical insurance coverage has been obtained or that application for coverage has been made. Proof of coverage shall consist, at minimum, of`. 1) the name of the health care coverage provider(s); 2) any applicable identification numbers; 3) any cards evidencing coverage; 4) the address to which claims should be made; 5) a description of any restrictions on usage, such as prior approval for hospital admissions, and the manner of obtaining approval; 6) a copy of the benefit booklet or coverage contract; 7) a description of all deductibles and co-payments; and 8) five copies of any claim forms. This Order shall become final ten days after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary for a hearing de novo before the Court. DRO: R. J. snadday BY THE COURT, Mailed copies on Petitioner Respondent Jane Adams, Esquire Bradley Winnick, Esquire J?sley Oler, Jr ,1, r, r ? ?; c ? =; r7 "? .-. s -r? ::.1_-.. ?.. ?- '? ' t' `?'- t 3 ? `-: ; z- -c. ;? ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Original Order/Notice Co./City/Dist. of CUMBERLAND O Amended Order/Notice Date of Order/Notice 02/24/05 O Terminate Order/Notice Case Number (See Addendum for case summary) RE: SHINDEL, JACK E. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, M0 198-44-7777 Employee/Obligor's Social Security Number DFAS CLEVELAND CENTER* /'? 6504101361 C/O DFAS CODE L 4 /) 10-7 09? Employee/Obligor's Case Identifier GARNISHMENT OPS 144 ?J (See Addendum for plaintiff names PO BOX 998002 associated with cases on attachment) CLEVELAND OH 44199-8002 4 _ f 3S Custodial Parent's Name (Last, First, MI) /U,1' C l V l' 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. $ 646 . oo per month in current support $ 54. 00 per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ o. oo per month in current and past-due medical support $ o . 00 per month for genetic test costs $ per month in other (specify) for a total of $ 700.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 161.54 per weekly pay period. $ 323 . os per biweekly pay period (every two weeks). $ 35o. go per semimonthly pay period (twice a month). $ loo. go per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to. Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: Date of Order: ooS ? Form EN-028 Service Type M OMBNo.:097"] Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If. hecked you are required, to provide a opy of this form to youremployee. If your employee works in a state that is drfpferent from the state that issued this orr?er, a copy must be provi ded 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.* You must comply with the law of the paydate/date 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. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: SHINDEL. JACK E. EMPLOYEE'S CASE IDENTIFIER: 6504101361 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below, 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. 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 amounts allowed under the law of the state that issued the order. 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. I I. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type m If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No, 0 7"154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: SHINDEL, JACK E. PACSES Case Number 473107088 Plaintiff Name TERRY L. SHINDEL Docket Attachment Amount 04-6235 CIVIL$ 700.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ?If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment, through the employee's/obligor's employment. Addendum Form EN-028 Service Type M OMB No.09J-015C WorkerlD $IATT N (? ?.i (_: ? `'? -ri a 'ri rT) i ', _. .z ? '? w .. ?:? ? ? IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA JACK E. SHINDEL, * NO. 04-6235 CIVIL TERM Plaintiff CIVIL ACTION - LAW IN DIVORCE VS. * PACSES # 473107088 TERRY L. SHINDEL, Defendant AGREEMENT AND STIPULATION FOR SUPPORT AND NOW, this ??j day of !?, Je 6</" , 2005, the parties, having reached an agreement to the Order for Alimony Pendente Lite (APL) entered on February 24, 2005, desire to legally obligate themselves to adhere to the terms of said Agreement: WHEREAS Plaintiff filed a Complaint in Divorce at the above-captioned docket on December 13, 2004; and WHEREAS Defendant filed a Petition for Additional Claims, including APL, on January 13, 2005; and WHEREAS on February 24, 2005, an Order was entered directing Plaintiff to pay Defendant the amount of $646.00 per month in APL; and WHEREAS the above-referenced Order specifically stated that the amount of APL considered and included a mortgage contribution of $131.88 per month; and WHEREAS on July 31, 2005, Defendant vacated the former marital residence located at 423 4th Street, New Cumberland, Cumberland County, Pennsylvania 17070, and has failed to make any payments towards the mortgage since that date; and WHEREAS since July 31, 2005, Plaintiff has been making all payments towards the mortgage y v - and is currently residing in the former marital residence; and WHEREAS the parties, having reached an agreement regarding support, are desirous of avoiding further legal proceedings and are desirous of entering into a support Stipulation for entry as a court Order. NOW, THEREFORE, it is hereby agreed and stipulated by the parties as follows: The APL Order, dated February 24, 2005, shall be modified to remove that part of the payment attributable to the mortgage contribution. 2. Effective July 31, 2005, and until further Order of Court, Plaintiff shall pay to Defendant the amount of $512.00 per month in APL. 3. All other standard terms and conditions, as detailed in the Order of February 24, 2005, shall remain in full force and effect. ack E. Shindel, Plaintiff 05 DATE Bradl/ Winnick, Esquire Terry C. Shindel, Defendant z J e dams, Esquire lI??Oi DATE DATE U-((,6S DATE r ? ) ? ?:1 o ;S ? _? ?.,., ?, ?? -r ?`: c +? C G `; '' 4 JACK E. SHINDEL, IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 04-6235 CIVIL TERM TERRY L. SHINDEL, IN DIVORCE Defendant/Petitioner PACSES # 473107088 MODIFIED ORDER OF COURT AND NOW, this 29th day of November, 2005, based upon the Court's determination that Petitioner's monthly net income/earning capacity is $0 and Respondent's monthly net income/earning capacity is $0 it is hereby Ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit, $566.00 per month payable monthly as follows: $512.00 for alimony pendente lite and $54.00 on arrears. First payment due next pay date. Arrears set at $483.66 as of November 29, 2005. The effective date of the order is July 31, 2005. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C.S.§ 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and its discretion make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the PA SCDU to: Terry L. Shindel. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the Respondent's PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. cc360 le . Unreimbursed medical expenses that exceed $250.00 annually are to be paid as follows: 0% by Respondent and 100% by Petitioner. The Petitioner is responsible to pay the first $250.00 annually in unreimbursed medical expenses. Respondent to provide medical insurance coverage. Within thirty (30) days after the entry of this Order, the Respondent shall submit to Petitioner written proof that medical insurance coverage has been obtained or that application for coverage has been made. Proof of coverage shall consist, at minimum, of. 1) the name of the health care coverage provider(s); 2) any applicable identification numbers; 3) any cards evidencing coverage; 4) the address to which claims should be made; 5) a description of any restrictions on usage, such as prior approval for hospital admissions, and the manner of obtaining approval; 6) a copy of the benefit booklet or coverage contract; 7) a description of all deductibles and co-payments; and 8) five copies of any claim forms. This Order shall become final ten days after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary for a hearing de novo before the Court. This Order is based upon an agreement and stipulation of the parties on November 22, 2005. Consented: Petitioner Respondent DRO: R. J. Shadday Mailed copies on: Petitioner November 29, 2005 Respondent Jane Adams, Esq. Bradley A. Winnick, Esq. Petitioner's Attorney Respondent's Attorney BY THE COURT, r_., _ 1? i c. - C_i CJ, 1 ORDERINOTICE TO WITHHOLD INCOME FOR SUPPORT O Original Order/Notice State Commonwealth of Pennsylvania 473107088 Amended Order/Notice Co./City/Dist. of CUMBERLAND 04-6235 CIVIL Date of Order/Notice 11/29/05 O Terminate Order/Notice Case Number (See Addendum for case summary) RE: SHINDEL, JACK E. Employer/withholder's Federal FIN Number Employee/obligor's Name (Last, First, MI) DFAS CLEVELAND CENTER* C/O DFAS CODE L GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 198-44-7777 Employee/Obligor's Social Security Number 6504101361 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. $ 512.00 per month in current support $ 54. 00 per month in past-due support Arrears 12 weeks or greater? Dyes ® no $ o.0o per month in current and past-due medical support $ 0. 00 per month for genetic test costs $ per month in other (specify) for a total of $ 566.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 13 0.62 per weekly pay period. $ 261.23 per biweekly pay period (every two weeks). $ 283 . o0 per semimonthly pay period (twice a month). $ 566 . oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% 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). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: 7 Date of Order: p V p J. es ey et, ge DRO: R.J. Shadday Form EN-028 Service Type M OMBNo.:09J60154 Worker ID $IATT 1 ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? Ifhecked you are required to provide a copy of this form to your employee. If your employee works in a state that is di Brent from the state that issued this order, a copy must be provided 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 identity the portion of the single payment that is attributable to each employee/obligor. 3. *-Reporting the-Paydate/Date of Withholdfng: -You-must -report-rhe paydateMate of withholding when sending the payment. The paydate/date of withholding -is-thedat"nwhieh-amount was withheld-frorathe employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this OrderlNotice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: SHINDEL. SACK E. EMPLOYEE'S CASE IDENTIFIER: 6504101361 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an 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 (15 U.S.C. § 1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. 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 amounts allowed under the law of the state that issued the order. 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. I (.Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type m by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or byinternet www.childsupport.state.pa.us Page 2 of 2 OMB Nay 0970-0154 Form EN-028 WOrkerlD $IATT I ADDENDUM Summary of Cases on Attachment Defendant/Obligor: SHINDEL, JACK E. PACSES Case Number 473107088 Plaintiff Name TERRY L. SHINDEL Docket Attachment Amount 04-6235 CIVIL$ 566.00 Child(ren)'s Name(s): DOB ?lf checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(reN's Name(s): DOB ?lf checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT oma No.: oe7o-oisx -,? :. -? .. JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant NOTICE If you wish to deny any of the statements set forth in this Affidavit, you must file a counter- affidavit within twenty days after this affidavit has been served on you or the statements will be admitted. AFFIDAVIT OF SEPARATION 1. The parties to this action separated on April 9, 2004 and have continued to live separate and apart for a period of at least two years. 2. The marriage is irretrievably broken. 3. I understand that I may lose my rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. a Date: Terry Shindel, Defendant C7 z. czz) 0 V, Ao r- Ul ` z ?. ' N r 77 JACK SHINDEL, Plaintiff V. TERRY SHINDEL, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA :NO. 04 - 6235 Civil Action : IN DIVORCE AFFIDAVIT OF SERVICE AND NOW, this June 14, 006, I, Jane Adams, Esquire, hereby certify that on or about May 31, 2006, a certifi true copy of Defendant's AFFIDAVIT OF SEPARATION was served, via certified mail, return receipt requested, addressed to: Brad Winnick, Esquire r ' The Wiley Group SENDER: • 130 W. Church St. ¦ plet items 1, 2, and 3. Also complete A. Sig Dillsburg, Pa. 17019 4 if Delivery' Is desired. E x DEFENDANT nt you name and address on the reverse Addressee so that return the card to you. ¦ A card to the back of the mailpiece, B. Roo" by (Printed ) of or nt If space permits. ( bh 1. Ankle Addressed to: D. Is delivery address different from item 1 ? es If YES, enter delivery address below: -RNo 3RAD WINNICK ESQ THE WILEY 3ROUP 130 W CHURCH ST DILLSBURG ?OA 1 701 9 3, twvIce type Ptieertifiaed Mall ? Express Mail ? Registered ? Return Receipt for Merchandise O Insured Mail ? C.O.D. ?j 4. Restricted Delivery? (Extra Fee) ? Yes 2. Article Number 7004 (nans/er fr m service kW 1350 0003 7288 4585 PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 ; e Adams, Esquire No. 79465 64 South Pitt Street Carlisle, Pa. 17013 (717) 245-8508 ATTORNEY FOR DEFENDANT { GS JACK SHINDEL, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant MOTION FOR APPOINTMENT OF MASTER Defendant moves this Court to appoint a master with respect to the following claims: (?) Divorce ( ) Annulment Qe) Alimony ( ) Alimony Pendente Lite and in support of the motion states: k) Distribution of Property ( )Support Counsel fees f Costs and Expenses (1) Discovery is substantially complete as to the claim(s) for which the appointment of a master is requested. (2) The Plaintiff is represented by Brad Winnick, Esquire. (3) The statutory ground(s) for divorce is 3301 (d), (4) Delete the inapplicable paragraph(s): (a) The action istiot contested. (b) An agreement has been reached with respect to the following claims: NONE. (c) The action is contested with respect to the following claims: ALL. (5) The action does not involve complex issues of law or fact. (6) The hearing is expected to take one half day. (7) Additional information, if any, relevant to the motion: NONE. Date: ane Adams, Esquire homey for Plaintiff (717) 245-8508 ORDER APPOINTING MASTER AND NOW, this , 2006, Robert Elicker, Esquire, is appointed Master with respect to the following claims: ALL. BY THE COURT: J. c? " _a __ '_ ` c_,.. JACK SHINDEL, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant MOTION FOR APPOINTMENT OF MASTER Defendant moves this Court to appoint a master with respect to the following claims: () Divorce ( ) Annuhnent QC) Alimony ( ) Alimony Pendente Lite and in support of the motion states: (?() Distribution of Property { ) Support Counsel fees (xj Costs and Expenses (1) Discovery is substantially complete as to the claim(s) for which the appointment of a master is requested. (2) The Plaintiff is represented by Brad Winnick, Esquire. (3) The statutory ground(s) for divorce is 3301 (d). (4) Delete the inapplicable paragraph(s): (a) The action is not contested. (b) An agreement has been reached with respect to the following claims: NONE. (c) The action is contested with respect to the following claims: ALL. (5) The action does not involve complex issues of law or fact. (6) The hearing is expected to take one half day. (7) Additional information, if any, relevant to the motion: ?(7 Date: ) Ito b dams, Esquire ey for Plaintiff 17)245-8508 8 ORDER APPOINTING MASTER AND NOW, this - f Z 2006, Robert Elicker, Esquire, is appointed Master with respect to the following claims: ALL. URT: J By v -a:xmv? J. t D K" C 7 At ORDERINOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 07/28/06 Case Number (See Addendum for case summary) 473107088 04-6235 CIVIL 0 Original Order/Notice O Amended Order/Notice O Terminate Order/Notice EmployegWithholder's Federal EIN Number RE: SHINDEL, JACK E. Employee/Obligor's Name (Last, First, MI) 198-44-7777 Employee/Obligor's Social Security Number DFAS CLEVELAND CENTER* 6504101361 C/O DFAS CODE L Employee/Obligor's Case Identifier GARNISHMENT OPS (See Addendum for plaintiff names PO BOX 998002 associated with cases on aftacitment) CLEVELAND OH 44199-8002 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'slobligor's income until further notice even if the Order/Notice is not issued by your State. $ 512.00 per month in current support $ 0. oo per month in past-due support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 512.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 118.15 per weekly pay period. $ 236.31 per biweekly pay period (every two weeks). $ 256. oo per semimonthly pay period (twice a month). $ 512. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten 00) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: , /"/ /? Date of Order: A J? I , 1&" ? J. esley Oler DRO: R.J. Shadday Service Type M OMB No.: o9760154 Form EN-028 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? I?Zeckef(f you are required, to prp idea jopy of this form to your Qmployee. If your employee orks in a state tha is 'rent rom the state that issue U Xis o er, a copy must be provitled to your emp oyee even if tX' box is not chec ed. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligor 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. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: SHINDEL. JACK E. EMPLOYEE'S CASE IDENTIFIER: 6504101361 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employeetobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of. 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. 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 amounts allowed under the law of the state that issued the order. 10. Additional *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. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717)240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Service Type M Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: SHINDEL, JACK E. PACSES Case Number 473107088 Plaintiff Name TERRY L. SHINDEL Docket Attachment Amount 04-6235 CIVIL$ 512.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Service Type M Worker ID $IATT OMB No, 09]60154 ? ? w <C' -o ?#+ ?y s r „? r JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant PETITION FOR SPECIAL RELIEF AND NOW COMES, Terry Shindel, by and through her counsel, Jane Adams, Esquire, and asks this Court for Special Relief pursuant to the Divorce Code as follows: 1. Plaintiff is Terry Shindel, (hereinafter referred to as "Wife"), who currently resides at 2208 Warren Way, Mechanicsburg, Cumberland County, Pennsylvania, 17055. 2. Defendant is Jack Shindel, (hereinafter referred to as "Husband"), who is believed to reside at 2112 Newville Road, Carlisle, Pennsylvania, 17013. 3. The parties were married on January 4, 1975. 4. A divorce was filed in the above-captioned matter on December 13, 2004. 5. During the marriage, the parties lived at the marital home, which is located at 423 4th St., New Cumberland, Pennsylvania, 17070. 6. The marital home was listed for sale RE/MAX Realty Associates, Incorporated at 3425 Market St., Camp Hill, Pennsylvania, and the parties recently entered into a sales agreement regarding the property. 7. Before the home was listed for sale, foreclosure proceedings were started against the property. 8. A public tax sale of the property is scheduled for September 21, 2006 because 2004 taxes remain unpaid. 9. The sale of the marital home is scheduled to occur on Friday, August 18, 2006. 10. On July 21, 2006, during a meeting with Wife and the realtor, Husband said he would "not come to settlement unless he received" a check for half the proceeds on the settlement date. 11. On July 26, 2006, Husband called Wife and said that he was "not going to come to settlement unless he got half of the check, and he was not going to let" Wife's lawyer tell him that the proceeds needed to go into escrow. He further stated he "would let the house go into foreclosure, rather than not have the money, because" his credit was already ruined. 12. On August 7, 2006, when the realtor was speaking to Husband, Husband said he would not come to settlement if he did not walk out of settlement with a check for half of the proceeds. 13. Although negotiations have been attempted, the parties currently have no marriage settlement agreement regarding the division of marital property. 14. It is anticipated that the proceeds from the sale of the marital home will total approximately $80,000.00 and this amount represents a large portion of the marital estate. 15. Wife's Counsel has repeatedly requested cooperation from Husband through his attorney and has contacted Husband's attorney several times. As of August 11, 2006, Husband's counsel indicated that Husband had not returned any phone calls and that cooperation with the settlement could not be guaranteed. 16. Distribution of the marital proceeds to Husband without a comprehensive marriage settlement agreement would cause great harm to Wife as this amount represents a large percentage of the marital estate and distribution could jeopardize her settlement proceeds. 17. If the sale of the Marital Home does not occur due to Husband's failure to cooperate, great cost and expense would accrue to the parties, thereby constituting waste of the remaining marital assets. 18. Wife has incurred substantial additional counsel fees due to Husband's non- cooperation. 19. Wife is requesting an Order of Court containing the following provisions: a. A provision giving Wife the power to sign the Deed and all other settlement documents on Husband's behalf in Order that the settlement may proceed in a timely manner. b. A provision directing that Husband shall be solely responsible for any and all costs and fees incurred, including Attorney's fees, due to Husband's non- cooperation with the settlement of the marital home. Such fees and costs may be paid directly by Husband, or, if he refuses to pay, deducted from the proceeds of the marital home. However, such costs shall not be deducted from Wife's share of the marital estate. c. A provision that all proceeds from the sale of the marital home shall be held in the escrow account of Jane Adams, Esquire, until further agreement of the parties or further Order of Court. 20. Failure to grant these above requests would irreparably harm Plaintiff, and immediate relief is required. WHEREFORE, Plaintiff respectfully requests that this Honorable Court grant her Petition for Special Relief and any other relief this Honorable Court deems necessary and appropriate. Respectfully s itted, Date: J dams, Esquire .D. N .79465 64 So th Pitt Street CArksle, Pa. 17013 (717) 245-8508 ATTORNEY FOR PLAINTIFF VERIFICATION 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 unworn falsification to authorities. Date: 6 ci, Terry S nde1, Plaintiff CERTIFICATE OF SERVICE AND NOW, this August l ?, 2006, I, Jane Adams, Attorney for Plaintiff, Terry Shindel, hereby certify that a copy of the PETITION FOR SPECIAL RELIEF has been duly served upon the DEFENDANT by fax and by placing such in the custody of the United States Postal Service, via first class mail, postage pre-paid addressed to: Tom Clark, Esquire Brad Winnick, Esquire THE WILEY GROUP 130 W. Church St. Dillsburg, Pa. 17019 (717) 432-9666 Attorneys for Defendant Adams, Esquire No. 79465 P outh Hanover St. C lisle, Pa. 17013 7) 245-8508 ATTORNEY FOR PLAINTIFF ?ti ? ?? ?; ., . ?._ . ?;,, __ .?? ? :) 1 ? 4.. ? f.., ? ?? w ? ?? ?- ra .? ?. .w 4,? ?? N .?-?1,? E•.7 W JACK SHINDEL, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW TERRY SHINDEL, Defendant NO. 04-6235 CIVIL TERM ORDER OF COURT AND NOW, this 18th day of August, 2006, upon consideration of Defendant's Petition for Special Relief, following a telephone conference on this date in which Tom Clark, Esq., represented the Plaintiff, and Jane Adams, Esq., represented the Defendant, and it appearing that the parties are in the process of resolving the issue amicably, no action on the petition will be taken by the court at this time. Counsel are requested to contact the court at such time as the motion may be deemed moot or action by the court is sought. Tom Clark, Esq. The Wiley Group 130 W. Church Street Dillsburg, PA 17019 Attorney for Plaintiff Jane Adams, Esq. 64 South Hanover Street Carlisle, PA 17013 Attorney for Defendant ,C.& Q.1/.oG :rc BY THE COURT, r?. ?. . ??`, ? ??? 9??ti ??' ?31'S ??L?ti }?????? JACK SHINDEL, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW TERRY SHINDEL, Defendant NO. 04-6235 CIVIL TERM ORDER OF COURT AND NOW, this 25'x' day of August, 2006, upon consideration of the attached letter from Jane Adams, Esq., attorney for Defendant, Defendant's Petition for Special Relief is deemed moot. Xom Clark, Esq. The Wiley Group 130 W. Church Street Dillsburg, PA 17019 Attorney for Plaintiff ? 'ane Adams, Esq. 64 South Hanover Street Carlisle, PA 17013 Attorney for Defendant J 0`9 0 :rc BY THE COURT, F,- CS :6 WV 83 SAV goat AI?ilOldvHi?:?'!d 3N.1 ?? w Jane Adams ATTORNEY AT LAW 64 SOUTH PITT STREET CARLISLE, PA. 17013 (717) 245-8508 voice (717) 243-9200 fax esoadamsAa wl.com August 24, 2006 Judge Wesley Oler, Jr. Cumberland County Courhouse One Courthouse Square Carlisle, Pa. 17013 Re: Shindel v. Shindel No. 04 - 6235 Civil Term Dear Judge Oler: Please be advised that Mr. Shindel signed the Deed and settlement authorization as we requested in the above-captioned matter. Therefore, we will not be requesting a hearing on the Petition for Special Relief. Very tndy yours, CX/ J e Adams, Esquire cc: Terry Shindel Mary Dissinger, Esquire, for Jack Shindel I JACK SHI4L, Plaintiff, VS. TERRY SHINDEL , Defendant IN THE COURT OF COMMON PLEAS OF PENNSYLVANIA CUMBERLAND COUNTY CIVIL ACTION - LAW NO. 04-6235 PRAECIPE TO WITHDRAW APPEARANCE To the Prothonotary: At the request of the Jack Shindel, Plaintiff, please withdraw my appearance as counsel of ecord. Thomas M. Clark Attorney for Plaintiff PRAECIPE TO ENTER APPEARANCE Please enter my appearance on behalf of Jack Shindel, the above-named Plaintiff. Respectfully Submitted, DISSINGER AND DISSINGER Date .2 ( 0'6 T Mary A. Etter Dissinger Attorney for Plaintiff Supreme Court I.D. 27736 28 N. 32nd Street Camp Hill, PA 17011 (717) 975-2840 RECEIVED SEP 19 2006 DI AGER & DlSSING-R I JACK SHINDEL, Plaintiff, VS. TERRY SHINDEL Defendant IN THE COURT OF COMMON PLEAS OF PENNSYLVANIA CUMBERLAND COUNTY CIVIL ACTION - LAW NO. 04-6235 CERTIFICATE OF SERVICE I, Mary A. Etter Dissinger, Esquire, hereby certify that on the date set forth below I served a true and correct copy of the foregoing document upon Thomas M. Clark, Esquire and the firm of The Wiley Group, Jane Adams, attorney for Defendant, by First Class United States mail addressed as follows: Thomas M. Clark, Esquire 130 W. Church Street Suite 100 Dillsburg, PA 17019 Jane Adams, Esquire 64 South Pitt Street Carlisle, PA 17013 Date: Mary A. Etter Dissinger, Esq. C) h.] 1=3 0 (7- Cl- i -- C:._ YI I r r ry? ~ co (_ ? VJ t l? C:D 10 JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff, OF PENNSYLVANIA VS. CUMBERLAND COUNTY TERRY SHINDEL CIVIL ACTION - LAW Defendant NO. 04-6235 PETITION FOR LEAVE TO WITHDRAW AS COUNSEL And now comes Mary A. Etter Dissinger, Esquire, respectfully requesting this Honorable Court to grant her request for Leave to Withdraw as Counsel for Plaintiff and in support of that avers as follows: 1. Petitioner is Mary A. Etter Dissinger, Esquire, of Dissinger & Dissinger, Attorneys at Law, who currently represents Plaintiff in the above action. 2. Plaintiff is Jack Shindel. 3. Plaintiff hired Petitioner to represent him as counsel on August 18, 2006. 4. Plaintiff has been unable to provide Petitioner with a comprehensive proposal for resolution of all marital issues. 5. Plaintiff has since fired Petitioner via a phone message dated February 13, 2008, and indicated that he would be submitting a letter of termination of services to Petitioner. (See Exhibit "A" attached) 6. Defendant's counsel was notified of Plaintiff's orders to terminate Petitioner's services and Defendant's counsel has no objections to Petitioner's withdrawal as counsel of record. wherefore, Petitioner requests that she be granted permission for Leave to Withdraw as Counsel for Plaintiff. Respectfully submitted DISSINGER & DISSINGER Mary A. Etter Dissinger, Esq. Petitioner Supreme Court ID #27736 28 N. 32nd Street Camp Hill, PA 17011 (717)975-2840 (717)975-3924 - fax 02/18/2008 13:50 FAX 17179753924 DISSINGER DAT ` P H FROM ? ( ) Q OF CaLt ) FAX( ) N 1 E ? M S E A v. M G E 0 E RESS SIGNED PFIOWED WFWADO TCO WAS IN [] UN MC] EXHIBIT aAn Z02 JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff, OF PENNSYLVANIA VS. CUMBERLAND COUNTY TERRY SHINDEL CIVIL ACTION - LAW Defendant NO. 04-6235 CERTIFICATE OF SERVICE I, Mary A. Etter Dissinger, Esquire, hereby certify that on the date set forth below I served a true and correct copy of the foregoing document upon Plaintiff, Jack Shindel, and upon Jane Adams, attorney for Defendant, by First Class United States mail addressed as follows: Mr. Jack E. Shindel 210 N. Bedford Street Carlisle, PA 17013 Jane Adams, Esquire 64 South Pitt Street Carlisle, PA 17013 Date: 24 a d Mary A. Etter Dissinger, Esq. c?__" ?? F`S"! - _,-_; it . ; ? .)t. .y,-? l? _[.. ,,,,ly, . ,. ?' (.?7 '?? ? Y* ?? ,f r? .?` JACK SHINDEL, Plaintiff, VS. TERRY SHINDEL , Defendant IN THE COURT OF COMMON PLEAS OF PENNSYLVANIA CUMBERLAND COUNTY CIVIL ACTION - LAW NO. 04-6235 AMENDED PETITION FOR LEAVE TO WITHDRAW AS COUNSEL And now comes Mary A. Etter Dissinger, Esquire, respectfully requesting this Honorable Court to grant her request for Leave to Withdraw as Counsel for Plaintiff and in support of that avers as follows: 1. Petitioner is Mary A. Etter Dissinger, Esquire, of Dissinger & Dissinger, Attorneys at Law, who currently represents Plaintiff in the above action. 2. Plaintiff is Jack Shindel. 3. The Honorable J. Wesley Oler, Jr., signed an Order in this case on August 25, 2006 decreeing that a Petition for Special Relief filed by counsel for Plaintiff was moot. (See Exhibit "B") 4. The Honorable Edgar B. Bailey signed an Order July 12, 2007 appointing the Divorce Master. (See Exhibit "C") 5. Plaintiff hired Petitioner to represent him as counsel on August 18, 2006. 6. Plaintiff has been unable to provide Petitioner with a comprehensive proposal for resolution of all marital issues. 7. Plaintiff has since fired Petitioner via a phone message dated February 13, 2008, and indicated that he would be submitting a letter of termination of services to Petitioner. (See Exhibit "A" attached) 8. Defendant's counsel was notified of Plaintiff's orders to terminate Petitioner's services and Defendant's counsel has no objections to Petitioner's withdrawal as counsel of record. Wherefore, Petitioner requests that she be granted permission for Leave to Withdraw as Counsel for Plaintiff. Respectfully submitted DISSINGER & DISSINGER Mary A.`Etter Dissinger, Esq. Petitioner Supreme Court ID #27736 28 N. 32nd Street Camp Hill, PA 17011 (717)975-2840 (717) 975-3924 - fax 02/18/2008 13:50 FAX 17179753924 DISSINGER PC A ( ) H tit ) 0t ) N EM E Ms w E A Wai 5. 42 0 E ff S13NOD .Moles 0 EXHIBIT All Q02 JACK SHINDEL, Plaintiff V. TERRY SHINDEL, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW Defendant NO. 04-6235 CIVIL TERM ORDER OF COURT AND NOW, this 25`h day of August, 2006, upon consideration of the attached letter from Jane Adams, Esq., attorney for Defendant, Defendant's Petition for Special Relief is deemed moot. Tom Clark, Esq. The Wiley Group 130 W. Church Street Dillsburg, PA 17019 Attorney for Plaintiff jar Adams, Esq. South Hanover Street lisle, PA 17013 Attorney for Defendant :rc EXHIBIT "B" BY THE COURT, JACK SHINDEL, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant MOTION FOR APPOINTMENT OI• MASTER Defendant moves this Court to appoint a master with respect to the following claims: , k) Divorce k?<) Distribution of Property ( ) Annulment ) Support Q?) Alimony Counsel fees ( ) Alimony Pendente Lite UQ Costs and Expenses - and in support of the motion states: ?° - (1) Discovery is substantially complete as to the claim(s) for which the appointment of a master is requested. (2) The Plaintiff is represented by Brad Winnick, Esquire. (3) The statutory ground(s) for divorce is 3301 (d). (4) Delete the inapplicable Paragraph(s): (a) The action is nat contmte& (b) An agreement has been reached with respect to the following claims: NONE. (c) The action is contested with respect to the following claims: ALL. (5) The action does not involve complex issues of law or fact. (6) The hearing is expected to take one half day. (7) Additional information, if any, relevant to the motion: NONE. Date: J/ ?j ane Adams, Esquire ttomey for Plaintiff (717) 245-8508 RDER APPOINTING MASTER AND NOW, this , 2006, Robert Elicker, Esquire, is appointed Master with respect to the following claims: ALL. BY THE COURT: J. EXHIBIT C„ JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff, OF PENNSYLVANIA VS. CUMBERLAND COUNTY TERRY SHINDEL , CIVIL ACTION - LAW Defendant NO. 04-6235 CERTIFICATE OF SERVICE I, Mary A. Etter Dissinger, Esquire, hereby certify that on the date set forth below I served a true and correct copy of the foregoing document upon Plaintiff, Jack Shindel, and upon Jane Adams, attorney for Defendant, by First Class United States mail addressed as follows: Mr. Jack E. Shindel 210 N. Bedford Street Carlisle, PA 17013 Jane Adams, Esquire 64 South Pitt Street Carlisle, PA 17013 Date: 313104' Mary A. Etter Dissinger, Esq. JACK SHINDEL, Plaintiff, VS. TERRY SHINDEL , Defendant IN THE COURT OF COMMON PLEAS OF PENNSYLVANIA CUMBERLAND COUNTY CIVIL ACTION - LAW NO. 04-6235 RULE TO SHOW CAUSE AND NOW, this day of 0 zl C,? , 2008, upon review of the foregoing Motion, a Rule is hereby entered against the Plaintiff, Jack Shindel, and Defendant's attorney, Jane Adams, to show cause why the Court should not enter an Order granting the Petitioner for Leave to Withdraw as Plaintiff's Counsel. Rule returnable 10 days from the date of the service hereof. Za . tribution: A. Etter Dissinger, Esq.- 28 N. 32n,, St., Camp Hill, PA 17011 Jack E. Shindel - 210 N. Bedford Street, Carlisle, PA 17013 J,arfle Adams, Esquires - 64 South Pitt Street, Carlisle, PA 17013 BY THE COURT: VINV IASWd 8Z =s Wd L- dvw owl ?&IONO 4 i. *1 JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant AFFIDAVIT OF CONSENT 1. A complaint in divorce under section 3301(c) of the Divorce Code was filed on January 13, 2005. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the date of the filing and service of the Complaint. 3. 1 consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I also understand that false statements herein are made subject to the penalties of 18 Pa.C.S. 4904, relat+?g to unsworn falsification to authorities. Date: r ntiff WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE. UNDER 63301(c) AND§3301(d) OF THE DIVORCE CODE 1. 1 consent to entry of a final decree of divorce without notice. 2. 1 understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. 1 understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I under nd that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relatin sworn falsification to authorities. Date: ack Shindel, Plaintiff JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant : AFFIDAVIT OF CONSENT 1. A complaint in divorce under section 3301(c) of the Divorce Code was filed on January 13, 2005. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the date of the filing and service of the Complaint. 3. 1 consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I also understand that false statements herein are made subject to the penalties of 18 Pa.C.S. 4904, relating to unsworn falsification to authorities. Date: V! ?? c I Terry S Kindel, Plaintiff WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER 3301(c) AND F 43301(d) OF THE DIVORCE CODE 1. 1 consent to entry of a final decree of divorce without notice. 2. 1 understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. 1 understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. Date: ?J)0!4 Terry Shinc el, Plaintiff . e--_? ti i, ? ?:'? ,W.1 ?s? 3 ? . ?F? ?_? ?y i r x ? ?S? .4 ? .t ( 6 '? . • ?? JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant MARRIAGE SETTLEMENT AGREEMENT THIS AGREEMENT, made this 1 ?? day of , 2 008, by and between, TERRY SHINDEL, of Mechanicsburg, Cumberland County, Pennsylvania, hereinafter referred to as "WIFE", and JACK SHINDEL, of Carlisle, Cumberland County, Pennsylvania, WITNESSETH: WHEREAS, Husband and Wife were lawfully married on January 4, 1975, in Cumberland County, Pennsylvania, and, WHEREAS, there were two children born of this marriage; WHEREAS, disputes and difficulties have arisen between the parties and it is the intention of Husband and Wife to live separate and apart, and the parties desire to settle their respective financial property rights and obligations as between each other, in general, the settling of any and all possible claims by one against the other or against their respective estates; NOW THEREFORE, Husband and Wife, hereby covenant and agree as follows: 1. FULL DISCLOSURE OF ASSETS. Each party warrants that he or she has made a full and fair disclosure of income, assets, and their valuation prior to the execution of this Agreement as well as any other fact relating to this agreement. These disclosures are part of the consideration made by each party for entering into this agreement. Each party agrees that he or she shall not, at any future time, raise as a defense, or otherwise, the lack of such disclosure in any legal proceedings involving this agreement, with the exception of disclosure that may have been fraudulently withheld. In the event that either party, at any time hereafter, discovers such a fraudulently undisclosed asset, that party shall have the right to petition the Court of Common Pleas of Cumberland County to make equitable distribution of such asset. The non-disclosing party shall be responsible for payment of counsel fees, costs, or expenses incurred by the other party in seeking equitable distribution of such asset. A JS J? TS y 2. ADVICE OF COUNSEL. The Husband is PRO SE and does not have an attorney. The Wife has had the benefit of having Jane Adams, Esquire as her attorney. Each party has carefully and completely read this agreement and has been advised and is completely aware not only of its contents but of its legal effect. Husband and Wife acknowledge that this agreement is not a result of collusion, improper or illegal agreements. Husband has been advised of his right to counsel, voluntarily elected to forego representation, and understands that Jane Adams, Esquire is only representing Wife. 3. SEPARATION. The parties intend to maintain separate and permanent domiciles and to live apart from each other. Neither party shall harass, annoy, injure, threaten, or interfere with the other party in any manner whatsoever. Neither party shall interfere with the uses, ownership, enjoyment, or disposition of any property now owned and not specified herein or property hereafter acquired by the other. 4. SUBSEQUENT DIVORCE. The parties hereby acknowledge that Husband has filed a Complaint in Cumberland County, Pennsylvania, claiming that the marriage is irretrievably broken under the no-fault mutual consent provision of Section 3301(c) of the Pennsylvania Divorce Code. The parties express their agreement that the marriage is irretrievably broken and express their intent to execute any and all affidavits or other documents necessary for the parties to obtain an absolute divorce pursuant to Section 3301(c) of the Divorce Code. The parties hereby waive all rights to request Court Ordered counseling under the Divorce Code. The provisions of this Agreement relating to equitable distribution of property of the parties are accepted by each party as a final settlement for all purposes whatsoever, as contemplated by the Pennsylvania Divorce Code. Should a decree, judgment, or order of separation or divorce be obtained by either of the parties in this or any other state, country or jurisdiction, each of the parties hereby consents and agrees that this Agreement and all of its covenants shall not be affected in any way by any such separation or divorce; and that nothing in any such decree, judgment, order, or further modification or revision thereof shall alter, amend, or vary any term of this Agreement, whether or not either or both of the parties shall remarry. It is specifically agreed that a copy of this Agreement or the substance of the provisions thereof, may be incorporated by reference into any divorce, judgment, or decree. This incorporation shall not be regarded as a merger, it being the specific intent of the parties to permit this Agreement to survive any judgment and to be forever binding and conclusive upon the parties. 5. DATE OF EXECUTION. The "date of execution" or "execution date" of this agreement shall be defined as the date upon which it is executed by the parties if they have each executed the Agreement on the same date. Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. All provisions of this agreement a is - IVS TS shall be effectuated by the parties within thirty (30) days of the execution date of this agreement unless otherwise specified within this agreement. 6. MUTUAL RELEASE OF ALL CLAIMS. Other than as provided in this agreement, each party may dispose his or her property in any way and each party hereby waives and relinquishes any and all rights he or she may now have or hereafter acquire under the present or future laws of any jurisdiction to share in the property or the estate of the other as a result of the marital relationship, including without limitation, statutory allowance, widow's allowance, right of intestacy, right to take against the will of the other, and right to act as administrator or executor in the other's estate. Each will at the request of the other, execute, acknowledge, and deliver any and all instruments which may be necessary or advisable to carry into effect this mutual waiver and relinquishment of all such interest, rights, and claims. 7. WARRANTY OF DEBTS AND FUTURE OBLIGATIONS. Each party warrants that they have not contracted any debt or liability for the other or which the estate of the other party may be responsible or liable, and except only for the rights arising out of this agreement, neither party will hereafter incur any liability whatsoever for which the other party or the estate of the other party, will be liable. Each party agrees to indemnify or hold harmless from the other and against all future obligations of every kind incurred by them. The parties agree as follows regarding the debts: (a) Wife agrees that the following debts are her own personal responsibility and therefore agrees to completely and finally pay on the following debts and obligations. Any and all debts in her name alone or incurred by her after separation. Wife will pay any amount due and owing on the Lowe's VISA. (b) Husband agrees that the following debts are his own personal responsibility and therefore agrees to completely and finally pay on the following debts and obligations. Any and all debts in his name alone or incurred by him after separation. Husband will pay any and all amounts due and owing on his Member's First and Capitol One credit cards. (c) The parties will take any steps necessary to close any joint credit card accounts, if they have not already done so. JS TES TS /4-? 8. EQUITABLE DIVISION OF MARITAL PROPERTY. The parties have attempted to distribute their marital property in a manner which conforms to the criteria set forth in the Divorce Code at 23 Pa.C.S.A. s3501 et. seq. The division of existing marital property is not intended by the parties to constitute in any way a sale or exchange of assets, and the division is being effected without the introduction of outside funds or other property not constituting marital property. The division of property under this Agreement shall be in full satisfaction of all the marital rights of the parties. 9. BANKRUPTCY. The parties further warrant that they have not heretofore instituted any proceedings pursuant to the bankruptcy laws nor are there any such proceedings pending with respect to them which have been initiated by others. It is stipulated and agreed by the parties that the terms of this Agreement as they resolve the economic issues between the parties incidental to their divorce and the obligations of the parties to each other resulting therefrom shall not be dischargable in bankruptcy, should either party file for protection under the Bankruptcy Code at any time after the date of execution of this Agreement. Should Husband or Wife pursue an action in bankruptcy and be successful in extinguishing his or her obligation to pay any debts for which he or she had taken sole obligation as set forth herein, he or she shall immediately be obligated to pay alimony to the other party in an amount equal to the monthly obligation on such debts that he or she otherwise had assumed and for which he or she had taken sole obligation and responsibility, plus an additional fifteen percenl (15%) in consideration of the tax consequences associated with receipt of alimony. 10. OTHER PERSONAL PROPERTY. Husband and Wife do hereby acknowledge that they have previously divided all their tangible personal property. Except as may otherwise be provided in this Agreement, Wife agrees that all of the property of Husband or in his possession shall be the sole and separate property of Husband; and Husband agrees that all of the property of Wife or in her possession shall be the sole and separate property of Wife. The parties do hereby specifically waive, release, renounce, and forever abandon whatever claim, if any, he or she may have with respect to the above items which shall become the sole and separate property of the other. 11. VEHICLES. With respect to these items, owned by one or both of the parties, they agree as follows: (a) Husband shall retain the 1999 Ford F-150, the 1995 Honda Goldwing Motorcycle, and the 1984 1100 Honda. (b) Wife shall retain the 1991 Pontiac. (c) Husband shall retain the 1997 Polaris Sport four-wheeler and Wife shall retain the 1999 400 Scrambler four-wheeler. JS /IDj TS The titles to the said motor vehicles shall be executed by the parties, if appropriate for effecting transfer as herein provided, within thirty days of the execution date of this Agreement, and said executed titles shall be delivered to the proper parties on the distribution date. Each party agrees to be solely responsible for the amounts presently due and owing against his or her respective automobiles. Wife's counsel will prepare limited Power of Attorneys to effectuate the transfer of all vehicle titles. 12. REAL ESTATE. Regarding jointly-titled real estate, the parties agree as follows: (a) Husband and Wife held title to real estate known as 423 4th Street, New Cumberland, Pennsylvania, 17070, which was the marital home. That property was sold on August 23, 2006, and the proceeds were $33,525.81. Since the sale of the home, the parties agreed to use a portion of the proceeds to pay back taxes owed on their Lucas Ridge Road property. The parties agree that Wife shall receive all remaining proceeds from the sale of the marital home. (b) The parties also hold a property located on Lucas Ridge Road, Moshannon, Centre County, Pennsylvania. The parties agree that Wife shall receive this property, and Husband waives all right, title and interest to this property. The parties shall cooperate in executing a Deed, or any other documents necessary to transfer all right, title and interest in the cabin to Wife. Wife shall be responsible for the cost of preparation and filing of the Deed. As of the date of this agreement, Wife shall be responsible for all costs, fees, or other expenses associated with this property. 13. MUTUAL WAIVER OF EMPLOYMENT BENEFITS AND INSURANCE. The parties agree to waive any and all rights they have in and to each other's employment benefits, including but not limited to both parties IRA's, 401(k)'s, stock savings plans, pensions, Thrift Savings Plans, CSRS retirement benefits, Incentive Savings Plans or any other benefit of any nature. The parties agree never to assume any claim to such benefits of the other at any time in the future. The parties also waive any and all interest in each other's life insurance policies. Wife understands that upon entry of the final Decree in Divorce, she will be removed from Husband's health insurance and shall be no longer covered under Husband's medical benefits. Until Wife is removed from Husband's benefits, pursuant to the final Divorce Decree, Husband and agrees that Wife is entitled to CJs Ts all information and reimbursement payments for all her medical expenses under the current insurance. Within three days of this agreement, Husband shall sign the spousal certification for Blue Cross and Blue Shield. 14. ALIMONY, ALIMONY PENDENTE LITE and LEGAL FEES. Other than as provided herein, each party hereby waives any right to spousal support, alimony, or alimony pendente lite, counsel fees and costs, and each party agrees to be responsible for his or her own legal fees and expenses. The parties herein acknowledge that by this Agreement, they have respectively secured and maintained a substantial and adequate fund with which to provide for themselves sufficient financial resources to provide for their comfort, maintenance, and support in the station of life to which they are accustomed. All alimony to be paid under this agreement shall terminate upon the recipient's remarriage or cohabitation with a person of the opposite sex who is not a member of the family of the petitioner within the degrees of consanguinity or recipient's cohabitation with a person of the same sex with which she is involved in a same-sex relationship. For purposes of this paragraph, a cohabitation arrangement means two persons living in the same residence in the same or similar relationship as would a married couple, but without the benefit of a legal marriage. Immediately upon the final Decree in Divorce, Husband shall pay Wife the amount of $236.31 every two weeks in alimony. Such payments shall be made by Husband in a bi-weekly manner, and shall be paid through Domestic Relations. Such alimony shall continue indefinitely, and shall be modifiable upon a substantial change of circumstances of either party. The parties shall cooperate in executing a stipulation to effectuate payment of alimony through Domestic Relations. 15. TAXES. The parties have previously filed joint State and Federal Tax returns. The parties intend on filing separately from this point forward. The transfers of property pursuant to this Agreement are transfers between Husband and Wife incident to their divorce and as such are non-taxable, with no gain or loss recognized. The transferee's basis in the property shall be the adjusted basis of the transferor immediately before the transfer. The transfers herein are a division of marital property for full and adequate consideration and as such will not result in any gift tax liability. 16. RECONCILIATION; WAIVER OR MODIFICATION TO BE IN WRITING. No modification or waiver of any of the terms hereof shall be valid unless in writing and signed by both parties, and no waiver of any breach hereof or default hereunder shall be deemed a waiver of any subsequent default of the same or similar nature. Notwithstanding reconciliation between the parties, this agreement shall continue to remain in full force and effect absent a writing signed by the parties stating that this Agreement is null and void. ??JS 7?-S TS 17. MUTUAL COOPERATION. Each party shall, at any time and from time to time hereafter, take any and all steps and execute, acknowledge, and deliver to the other party any and all further instruments and/or documents that the other party may reasonably require for the purpose of giving full force and effect to the provisions of this Agreement. 18. APPLICABLE LAW. The Agreement shall be construed in accordance with the laws of the Commonwealth of Pennsylvania which are in effect as of the date of execution of this Agreement. 19. INTEGRATION. This Agreement constitutes the entire understanding of the parties and supersedes any and all prior agreements or negotiations between them. There are no representations or warranties other than those expressly set forth herein. 20. OTHER DOCUMENTATION. Wife and Husband covenant and agree that they will forthwith execute any and all written instruments, assignments, releases, satisfactions, deeds, notes, or such other writings as may be necessary or desirable for the proper effectuation of this Agreement. 21. NO WAIVER OF DEFAULT. This Agreement shall remain in full force and effect unless and until terminated under and pursuant to the terms of this Agreement. The failure of either party to insist upon strict performance of any of the provisions of this Agreement shall in no way affect the right of such party hereafter to enforce the same, nor shall the waiver of any default or breach of any provision hereof by construed as a waiver of any subsequent default or breach of the same or similar nature, not shall it be construed as a waiver or strict performance of any other obligations herein. 22. SEVERABILITY. If any term, condition, clause, or provision of this Agreement shall be determined or declared to be void or invalid in law or otherwise, then only that term, condition, clause, or provisions shall be stricken from this Agreement; and in all other respects, this Agreement shall be valid and continue in full force, effect, and operation. Likewise, the failure of any party to meet his or her obligations under any one or more of the paragraphs herein, with the exception of the satisfaction of the conditions precedent, shall in no way avoid or alter the remaining obligations of the parties. 23. BREACH. If either party breaches any provisions of this agreement, the other party shall have the right, at his or her election, to sue for damages for such breach, or seek other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of reasonable legal fees and costs incurred by the other in enforcing their rights under this agreement. 24. INFORMED AND VOLUNTARY EXECUTION. Each party to this agreement acknowledges that he or she is fully informed as to the facts relating to the subject matter of this agreement, is entering into this agreement voluntarily, free from fraud, undue influence, coercion or duress of any kind, has given careful thought to the is -`S TS making of this agreement, has carefully read each provision of this agreement, and fully and completely understands each provision of this agreement. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above written: WITNESS: YYl C.L W ess Date: y 1 141 fix COMMONWEALTH OF PENNSYLVANIA ) -10 ):ss COUNTY C'4ERLAND ) On this, the day of JL , 2008, before me, the undersigned officer, ppersonally apileared JACK SADEL, known to me, (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my han and official seal. C?bqm2ft jary Public COMMONWEAL-TH OF PENNSYLVANIA c Notart? Seal ommission expires: Jane Adams, Carlisle Bolo, Cumber and Public County SEAL My Commission Expires Sept. 6, 2008 I-J)4?11yvl t ess Terry Shi del, Wife e: A is Ts .ter z t=.' FU- c JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Plaintiff is PRO SE. Please accept this request from Defendant to transmit the record, together with the following information to the Court for entry of a divorce decree: 1. Ground for divorce: irretrievable breakdown under 3301 c of the Divorce Code. 2. Date and manner of the service of the Complaint: Via certified mail, return receipt requested, accepted by Defendant on or about served on December 17, 2004. 3. Date of execution of the affidavit of consent required by 3301(c) of the Divorce Code: By Plaintiff By Defendant: April 14, 2008 April 14, 2008 4. Related claims pending: None. 5. Date Defendant's Waiver of Notice in §3301(c) Divorce was filed with the Prothonotary: April 22, 2008. Date Plaintiffs Waiver of Notice in §3301(c) Divorce was filed with the Prothonotary: April 22, 2008. Respectfully Submitted: Date: l!!,0 q's 0? J Adams, Esquire IV No. No. 79465 17 W. South St. Carlisle, Pa. 17013 (717) 245-8508 Attorney for Plaintiff t.... Z ?? .C' v G?- ?y ? ?' IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY STATE OF PENNA. Jack Shindel, Plaintiff N O. No. 04 - 6235 Civil Term VERSUS Terry Shindel, Defendant DECREE IN DIVORCE AND NOW, .1 uLjr? c I -2-60'F IT IS ORDERED AND DECREED THAT Jack Shindel , PLAINTIFF, AND Terry Shindel DEFENDANT, ARE DIVORCED FROM THE BONDS OF MATRIMONY. THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT YET BEEN ENTERED; None; The marriage settlement agreement which was filed on April 22, 2008, and signed BY THE COU ROTHONOTARY by the parties on April 17, 2008, shall be incorporated and not merged into this Decree. «! +. 3,11 'fr. ?. JACK SHINDEL, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04 - 6235 Civil Action TERRY SHINDEL, : IN DIVORCE Defendant : Pacses #473107088. ORDER FOR PAYMENT OF ALIMONY AND NOW, this 11 K Day of TLcn c- 2008, upon the Joint Motion of Plaintiff and Defendant, and to implement a provision of the marriage settlement agreement, which was entered on April 17, 2008, it is hereby Ordered and Decreed as follows: 1. Terry Shindel, Wife, has an address of 2208 Warren Way, Mechanicsburg, Pa. 17050 2. Jack Shindel, Husband, as an address of 210 N. Bedford St., Carlisle, Pa. 17013. 3. There has been open spousal support case in this matter, under the above- captioned Pacses number. 4. Pursuant to an agreement of the parties, Jack Shindel, Husband, shall pay Terry Shindel, Wife, alimony as follows: A. Immediately upon the date of the entry of a final Decree in Divorce, Defendant shall pay alimony in the current amount of spousal support, or $236.31 every two weeks. Arrears, if any, shall be added in the amount of $50.00 per month. B. The alimony shall continue indefinitely, and shall be modifiable upon a substantial change of circumstances of either party. C. All alimony to be paid under this agreement shall terminate upon the recipient's remarriage or cohabitation with a person of the opposite sex who is not a member of the family of the petitioner within the degrees of consanguinity or recipient's cohabitation with a person of the same sex with which she is involved in a same-sex relationship. D. The alimony payment shall be made directly by Husband's employer to the Pennsylvania State Collection and Disbursement Unit (PA SCDU) at Pennsylvania SCDU, P.O. Box 69110, Harrisburg, Pennsylvania, 17106-9110. A,Nf ,7rNVAjA§yV3d .9 nnr gaol ?1titr11.' 3RL Payments shall continue to be forwarded as before, on a bi-weekly basis on Husband's pay day. E. The alimony payments due under this Order shall commence as directed on Husband's first pay day after entry of this Order and the Order shall be retroactive to the date of the Divorce Decree. F. This Order shall be implemented as soon as administratively possible, and the parties shall cooperate in making any modifications necessary to carry out the intent of this agreement. 5. The parties have indicated their agreement to such terms by their signature. WITNESSETH: djaX41-- Hess ?Witness ORDERED and DECREED this 0 TerryShi del, Wife Date: (o - L aacckk Shindel, Husband Date: ?--? Z - d day of BY THE COURT: g, a J. cc: -Jane Adams, Esquire, for wife ,/'Jack Shindel, Husband, pro se 12008 JACK SHINDEL, IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 04-6235 CIVIL TERM TERRY SHINDEL, IN DIVORCE Defendant/Petitioner PACSES Case No: 473107088 ORDER OF COURT AND NOW to wit, this 16th day of June 2008, it is hereby Ordered that the Order for Alimony Pendente Lite is terminated, effective June 11, 2008, pursuant to the parties' final Decree in Divorce and an order of Alimony being entered. This Order shall become final twenty (20) days after the mailing of the notice of the entry of the order to the parties unless either party files a written demand with the Domestic Relations Section for a hearing de novo before the Court. J. DRO: R.J. Shadday xc: Petitioner Respondent Jane Adams, Esq. Form OE-001 Service Type: M Worker: 21005 BY THE COURT: =? --? ?c,_ ? ?.? ? ` _ ? ...t =' i,. ' ; ? ti.- c.'?. L? .,? t INCOME WITHHOLDING FOR SUPPORT ?? , ?.? ? O ORIGINAL INCOME WITHHOLDING ORDERMOTICE FOR SUPPORT (IWO) Q AMENDED IWO tP ?,!) E) G VI O ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT Q TERMINATION OF IWO Date: 04/16/12 ? Child Suppo4t 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 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/Terdtory Commonwealth of Pennsylvania Remittance Identifier (include w/payment): 6504101361 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket Informalton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) OPM COURT ORDER SECTION C/O BENEFIT BRANCH PO BOX 17 WASHINGTON DC 20044 Employer/Income Withholder's FEIN Child(ren)'s Name(s) (Last, First, Middle) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from the employee/ obligor's income until further notice. $ 0.00 per month in current child support -? $ 0.00 per month in past-due child support - Arrears 12 weeks or greater? Q yep n' $ 0.00 per month in current cash medical support $ 0.00 per month in past-due cash medical support try,' $ 512.00 per month in current spousal support - $ 0.00 per month in past-due spousal support $ 0.00 per month in other (must specify) = `--? c rv c?1 ?; for a Total Amount to Withhold of $ 512.00 per month..... AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the 03 deft' nforfilation. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 117.83 per weekly pay period. $ 256.00 per semimonthly pay period (twice a month) $ 235.66 per biweekly pay period (every two weeks) $ 512.00 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.gov/proarams/cse/newhire/employer/contacts/ contact map.htm for the employee/obligor's principal place of employment. Child(ren)'s Birth Date(s) RE: SHINDEL, JACK E. Employee/Obligor's Name (Last, First, Middle) 198-44-7777 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions hftp://www. acf. hhs.aov/programs/cse/newhire/ employer/publication/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. 6683100092 Document Tracking Identifier Service Type M OMB No.: 0970-0154 Form EN-028 01/12 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. A Signature of Judge/Issuing Official (if required by State or Tribal law): _ "' +'T1rl? Print Name of Judge/Issuing Official: ?ev 3 n t' 1??, ?„? Title of Judge/Issuing Official: Date of Signature: An 17 zui?. 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 /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/cse/newhire/employer/contacts/contacl 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 - 05/31/2014. 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 Type M Page 2 of 3 Worker ID $OINC Employer's Name: OPM COURT ORDER SECTION Employer FEIN: Employee/Obligor's Name: SHINDEL, JACK E. 6504101361 CSE Agency Case Identifier: (See Addendum for case summary) Order Identifier: (See Addendum for order/docket Information) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you 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: 6683100092 Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known 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.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. 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: SHINDEL, JACK E. PACSES Case Number 473107088 PACSES Case Number Plaintiff Name Plaintiff Name TERRY L. SHINDEL Docket Attachment Amount Docket Attachment Amount 04-6235 CIVIL $ 512.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB DOB Addendum Form EN-028 01/12 Service Type M OMB No.: 0970-0154 Worker ID $OINC INCOME WITHHOLDING FOR SUPPORT O ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) O AMENDEDIWO O ONE-TIMEORDERMOTICE FOR LUMP SUM PAYMENT Q TERMINATION OF IWO 473ID-7057 U4-- In a35 Clv)L Date: 04/16/12 ? 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 hhtp://www act hhs gov/programs/ese/newhire/em foyer/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. Jtatet I nbei I erntory commonwealth of Pennsylvania Remittance Identifier (include w/payment): 6504101361 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for ordeNdocket Informaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) DEPT OF DEFENSE CIVILIANS Sent Electronically DO NOT MAIL Employer/Income Withholder's FEIN 311575142 Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions http://www.acf.hhs.oov/proarams/-cse/newhire / employerlpublication/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. 3115751420 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from the employee/ obligor's income until further notice. $ 0.00 permonth in current child support $ 0.00 per month in past-due child support - Arrears 12 weeks or greater? $ 0.00 per month in current cash medical support $ 0.00 per month in past-due cash medical support $ 0.00 permonth in current spousal support $ 0.00 per month in past-due spousal support $ 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 0.00 per month. y U3 @: o s> ?' Iv o ?_. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order lnfaPmation. 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. 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 act hhs gov/programs/cse/newhire/employer/contacts/ contact map.htm for the employee/obligor's principal place of employment. Document Tracking Identifier RE: SHINDEL. JACK E. Employee/Obligor's Name (Last, First, Middle) 198-44-7777 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) OMB No.: 0970-0154 Form EN-42801/12 Service Type M Worker ID $IATT ? Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVINA HESS Print Name of Judge/Issuing Official: _ Title of Judge/Issuing Official: Date of Signature: APRIL 16 2012 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ? If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://w m acf hhs aov/programs/cse/newhire/emFoyer/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 - 05/31/2014. 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-428 01/12 Service Tvpe M Page 2 of 3 Worker ID $IATT Employer's Name: DEPT OF DEFENSE CIVILIANS Employer FEIN: 311575142 Employee/Obligor's Name: SHINDEL, JACK E. 6504101361 CSE Agency Case Identifier: (See Addendum for case summary Order Identifier: (See Addendum for order/docket information) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you 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: 3115751420 Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: New Employer's Name: Final Payment Amount: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www.childsupport.state.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE. PA. 17013 (Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at www.childsupport.state.pa.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-428 01/12 Worker ID $IATT ADDENDUM Summarv of Cases on Attachment Defendant/Obligor: SHINDEL, JACK E. PACSES Case Number 473107088 PACSES Case Number Plaintiff Name Plaintiff Name TERRY L. SHINDEL Docket Attachment Amount Docket Attachment Amount 04-6235 CIVIL $ 0.00 $ 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 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-428 01/12 Service TVDe M OMB No.: 0970-0154 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT O ORIGINAL INCOME WITHHOLDING ORDERMOTICE FOR SUPPORT (IWO) U-7 V 0/, O AMENDED IWO 04 , b _?3S C1\0 O ONE-TIMEORDERMOTICE FOR LUMP SUM PAYMENT O TERMINATION OF IWO nArp• Hain>»Q ? Child Support Enforcement (CSE) Agency ® Court ? Attomey ? 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 http•//www acf hhs gov/p!roarams/ese/newhire/em looyer/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. •I?? .?... wly Vwtn„Vi-vat I U rZlmbvrvania Kemittance identifier (include w/payment): 6504101361 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for orderldocket informa/ton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) OPM COURT ORDER SECTION C/O BENEFIT BRANCH PO BOX 17 WASHINGTON DC 20044 Employer/Income Withholder's FEIN Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) RE: SHINDEL, JACK E. Employee/Obligor's Name (Last, First, Middle) 198-44-7777 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First Middle) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions blip://www.acf.hh,6. gov/programs/cse/newhire/ employer/publication/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. 6683100092 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 frpm 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? Q y'Q r no $ 0.00 per month in current cash medical support ,+ t $ 0.00 per month in past-due cash medical support $ 512.00 per month in current spousal support $ 50.00 per month in past-due spousal support r $ 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 562.00 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: $ 129.34 per weekly pay period. $ 281.00 per semimonthly pay $ 258.67 per biweekly pa Y P Y Period (twice a month) y period (every two weeks) $ 562.00 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.-oov/proQrams/cse/newhire/emplover/ contacts/contact maD. 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 e 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 EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877.676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case IdentiEer) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: htto //www acf hhs..gov/programstcse/-newhire/`employer/contactsicontacl ma{htm 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 withheldand 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 employeelobligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date - 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use. Form EN-028 06/12 Service TVDe M Page 2 of 3 Worker ID $OINC Employer's Name: OPM COURT ORDER SECTION Employer FEIN: Employee/Obligor's Name: SHINDEL, JACK E. 6504101361 CSE Agency Case Identifier: (See Addendum for case summary Order Identifier: (See Addendum for order/docket information) Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal place of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family. However, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you 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: 6683100092 Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known address: Final Payment Date To SDU/Tribal Payee: New Employer's Name: Last known phone number: Final Payment Amount: 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.childsUpDort.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. child support. state. pa. 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 06/12 Worker ID $OINC ADDENDUM Summary Qf Cases on Attachment Defendant/Obligor: SHINDEL, JACK E. PACSES Case Number 473107088 Plaintiff Name TERRY L. SHINDEL Docket Attachment Amount 04-6235 CIVIL $ 562.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 06/12 Service Type M OMB No.: 0970-0154 Worker ID $OINC JACK SHINDEL, Plaintiff/Petitioner V. TERRY SINDEL, Defendant/Respondent : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA NO.04-623 5 IN DIVORCE ORDER IN RE: MOTION FOR THE APPOINTMENT OF A MASTER OR COURT HEARING TO MODIFY OR TERMINATE AN EXISITING ALIMONY ORDER (PURSUANT TO 23 Pa.C.S. 3701(c) AND NOW, this GAtfitc Tlivwwa Mactfr is directed to schPdnle thie matter fnr hearil?E. OR AND NOW, this Z$ ~ day of , 2012 this matter is set for a hearing on " the / day of , 2012, at -X36 o'clock .In. in courtroom number __? of the Cumberland County Courthouse, Carlisle, Pennsylvania. BY THE COURT, J. C a r' -? -?? cc: Benjamin Yoffee, Esquire ?Jane Adams, Esquire D co ca ' Cumberland County Divorce Master O -r7 01PP yam, . /?? LQ f '? ° ca '?= ?? rV y:w (J) c:•;, r'; F-0 - Fi S.?l?- 1 P L FR041,0t4U l,,tp `t' 1012 JUL 17 Pit 3: 32 11MBERLAN0 COUNT,' PENNSYLVANIA JACK SHINDEL, : IN THE COURT OF COMMON PLEAS Plaintiff/Petitioner : CUMBERLAND COUNTY, PENNSYLVANIA vs. : No. 04 - 6235 Civil Term TERRY SHINDEL, : IN DIVORCE Defendant/Respondent ORDER OF COURT AND NOW, this /-I- day of . +:7vk? , 2012, Defendant's Claim for Contempt will be considered at the hearing already scheduled regarding the Modification of Alimony set for July 18, 2012 at 2:30 p.m. By the Court: cc: V Jane Adams, Esquire, for Defendant '? Benjamin Yoffee, Esquire, for Plaintiff JACK SHINDEL, Plaintiff/Petitioner VS. TERRY SHINDEL, Defendant/Respondent : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 04-6235 CIVIL IN RE: PLAINTIFF'S MOTION TO MODIFY OR TERMINATE EXISTING ALIMONY ORDER ORDER AND NOW, this ?q day of July, 2012, the motion of the plaintiff/petitioner to modify or terminate an existing alimony order is DENIED. The plaintiff/petitioner is ordered and directed to pay to the defendant/respondent the sum of $500.00 on account of attorney's fees. BY THE COURT, Kevin . ess, P. J. V Benjamin Yoffee, Esquire For the Plaintiff/Petitioner rnw =rn V Jane Adams, Esquire For the Defendant/Respondent -la( 7?f9?iz :rlm 6p ;es ltit ?c , p ?s " r-T"i -a lti INCOME WITHHOLDING FOR SUPPORT Q ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) O AMENDED IWO Q ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT Q TERMINATION OF IWO L731 b-1oH O - - ( 35 C,\)0 Date: 06/02/14 ❑ Child Support Enforcement (CSE) Agency ® Court 0 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 http://www.acf.hhs.gov`/programs/cse/forms/OMB-0970-0154 instructions.pdf). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. Slate/Tribe/Territory Commonwealth of Pennsylvania City/County/Dist./Tribe CUMBERLAND Private Individual/Entity Remittance Identifier (include w/payment): 6504101361 Order Identifier: (See Addendum for order/docket Information) CSE Agency Case Identifier: (See Addendum for case summary) OPM COURT ORDER SECTION C/O BENEFIT BRANCH PO BOX 17 WASHINGTON DC 20044 Employer/Income Withholders FEIN Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) RE: SHINDEL, JACK E. Employee/Obligor's Name (Last, First, Middle) 198-44-7777 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions http://www.acf.hhs.gov/programs/cse/forms/ OMB -0970-0154 instructions.pdt). 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. 6683100092 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.CoLinty, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts fronalheTxtployee/ obligor's income until further notice. ' - C;13 C- 0.00 per month in current child support z 0.00 per month in past -due child support - Arrears 12 weeks or greater? 0 yescwT not c c' cse zj = Vii., 0.00 per month in current cash medical support tea• —4 (I, <C.) C) –7, D(--) .. =c.) TN..) e.:_)_ r, (". 0.00 per month in past -due cash medical support 512.00 per month in current spousal support 0.00 per month in past -due spousal support 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 512.00 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: $ 117.83 per weekly pay period. $ 256.00 per semimonthly pay period (twice a month) $ 235.66 per biweekly pay period (every two weeks) $ 512.00 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 Service Type M OMB No.: 0970-0154 Form EN -028 11/13 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 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. 0 If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State -specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf.hhs.gov/programs/cse/newhire/employer/contacts/contact maa.htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past -due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti -discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date — 05/31/2014. The OMB Expiration Date has no Dealing on the termination date of the IWO; it Identifies the version of the form currently in use. Form EN -028 11/13 Service Type M Page 2 of 3 Worker ID $OINC Employer's Name; OPM COURT ORDER SECTION Employer FEIN: Emp|nyooK}b|igor'nName: SHINDEL, JACK E. 6504101361 CSE/genoyCana|dendfioc(SemA6dendumnfbroamemumnn/ary) 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)(15U.S.C.1873b));or2)the amounts allowed bythe State nrTribe cf 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, Iocal taxes; SociaI 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 obigor is not supporting another family. However, those limits increase 5%'hu5596and O5%'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 withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the Iaw 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 STATUSIf this employee/obligorthis employee/obHgor never worked for you or you are no Ionger withholdingincome for this plr, 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: 6683100092 {] This person has never worked for this employer nor received periodic income. [J This person no Ionger works for this employer nor receives periodic income, Please provide the foliowing information for the employeelobligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Empioyer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) byphone ot(717)24O'O225.byfax et(717)24O-G248.byemail nvwebsite at: vm^mv.chi|dsuopmt.staba.paua. 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) byphone et(717)240'6225.byfax at(717)24O'0248.byemail orwebsite atvmww.chi|dsupoortsto8e.pauo. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.: 0970-0154 Service Type M Page 3 of 3 Form EN -028 11/13 Worker ID $OINC ADDENDUM Summary of Cases on Attachment Defendant/Obligor: SHINDEL, JACK E. PACSES Case Number 473107088 Plaintiff Name TERRY L. SHINDEL Docket Attachment Amount 04-6235 CIVIL $ 512.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number PACSES Case. Number Plaintiff Name Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): Addendum OMB No.: 0970-0154 Form EN -028 11/13 Worker ID $OINC