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HomeMy WebLinkAbout02-0947 METFORD K. JACKSON, Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA vs. ; No. O~- '7'17 Civil Term JUANA L. JACKSON, Defendant : ACTION IN DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS You have been sued in Court. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the Court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. Where the ground for the divorce is indignities or irretrievable breakdown ofthe marriage, you may request marriage counseling. A list of marriage counselors is available at the Office of the Prothonotary, Cumberland County Courthouse. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES AND EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO, OR TELEPHONE, THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 2 Liberty A venue Carlisle, Pa. 17013 (717) 249-3166 METFORD K. JACKSON, Plaintiff : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. No.O;;-Cf41 Civil Term JUANA L. JACKSON, Defendant ACTION IN DIVORCE COMPLAINT IN DIVORCE 1. Plaintiff is Metford K. Jackson, a competent adult individual, who has resided at 2 I 8 S. 18th St., Camp Hill, Cumberland County, Pennsylvania, since 1999. 2. Defendant is Juana L. Jackson, a competent adult individual, who currently resides at 33 Weston Road, Somerset, New Jersey. 3. Plaintiff has been a bona fide resident of the Commonwealth for at least 6 months immediately previous to the filing of this Complaint. 4. The Plaintiff and the Defendant were married on October 25, 1980 in Rahway, New Jersey. 5. There have been no prior actions of divorce or for annulment between the parties. 6. Plaintiff has been advised that counseling is available and that plaintiff may have the right to request that the court require the parties to participate in counseling. 7. Plaintiff and Defendant have no children together. 8. Plaintiff and Defendant are both citizens of the United States of America. 9. Neither Plaintiff or Defendant are a member ofthe Armed Forces of the United States of any of its allies. 10. The Plaintiff avers that the grounds on which this action is based are: That the marriage is irretrievably broken; WHEREFORE, Plaintiff requests the court to enter a decree in divorce. I verify that the statements made in this Complaint are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. ~4904 relating to unsworn falsification to authorities. ~!:~ Date: c9 ( ~ ~ I ~ Jane 'Adams, Esquire L . No. 79465 17 South Hanover St. Carlisle, Pa. 17013 (717) 245-8508 ATTORNEY FOR PLAINTIFF 'f"" t "'-i. (") <::) 0 c: r" '1 "- ......... ~~ .." -:/ ~ '? ~ -N ,." :';r~,;::: IJ'I fn CO Y) -:0 N .ItTl ~ 655;; ic) :r; -s- < ~ en ~ ~ ~6 '"1:J .,.;.,1-. .......... C1 lo :J:: 6:.:!J .z:hi ~ ~ ~ ~ 8 - 0 .. ~ SD ~ ~ &:- -- -< --t: ~ :-e "- ",!i- s:. ~ t , METFORD K. JACKSON, Plaintiff : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. No. Oa:-q'l1 Civil Term JUANA L. JACKSON, Defendant ACTION IN DIVORCE AFFIDAVIT OF SEPARATION 1. The parties to this action separated on October 18, 1998 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] 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. Date: :;} ~ ~ ~ ~s~~ , <.f.'\ '!iil',' .() 0 Sf:? c: N "D~ ..., .-./ !]2m g; :~;il~ (&::b ~. N "."/"'l' 0') .gg ~"'" ~O \::I ~jj :EQ ::J::: :>2 - fjF;4 " ~ t::- 35 '" -< METFORD K. JACKSON, Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA vs. : No. 947 Civil Term 2002 JUANA L. JACKSON, Defendant : ACTION IN DIVORCE AFFIDAVIT OF SERVICE OF THE AFFIDAVIT OF SEPARATION. NOTICE TO DEFEND ANDCOMPLAINT AND NOW, this March 5, 2002, I, Jane Adams, Esquire, hereby certify that on March 2, 2002, a true and correct copy of the AFFIDAVIT OF SEPARATION, NOTICE TO DEFEND, AND COMPLAINT were served, via certified mail, restricted delivery, return receipt requested, addressed to: Juanita L. Jackson a/k/a Juana L. Jackson 33 Weston Road Sommerset, N.J. 08873 DEFENDANT Respectfully Submitted: J e Adams, Esquire . No. 79465 117 South Hanover St. Carlisle, Pa. 17013 (717) 245-8508 ATTORNEY FOR PLAINTIFF () C> 0 C N ""7j s: :;;: n~ "0 OJ ''''' "-'t" t!!en ::0 .:'l.JJ z:~. flr'1l --\,...' I z:c ~;l(r en",':,: -.I "'--,. ~'". .~ .:'; ( -; ~C) "'" ~:~? iI5 i8 :x OITl c: :p! ~ ".. ~ .".. - --- -.-- .1 ~ I t ~ 15. H ~ l\i g 1 ~ olS~! ~ ~ f \)-.. ~ lj l ~ ~ "" . ~ i .::t- . ~ :s 15. ~DqJ iJI ~,~ ~J r~l!~l ~ Q ( ., i~~sl. I ~ (j, 1--; C\ ~ .r!! ..~ ~ ~ 1""'J ~ -cr ii~lB! -1 It -i' -~I~ ~ -d El ~ Tiij,~ ~.! ~ ! s ~.9 IJ 9J 'J. .~ 1 J)hij I:: 3 ; ,1 ~ i""i;~l ~e jY) 6 ~~ ~ ~i!f!q ~ r'\ rJl !l: --.--- --.----.-- - -----.-.-.--..- . ~ 1 * i .. HAROLD S. IRWIN, III, ESQUIRE ATTORNEY ID NO. 29920 35 EAST HIGH STREET CARLISLE PA 17013 (717) 243-6090 ATTORNEY FOR PLAINTIFF METFORD K. .JACKSON, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 02 - 0947 CIVIL TERM .JUANA L. .JACKSON, Defendant CIVIL ACTION - LAW IN DIVORCE NOTICE 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 in 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 divorce is indignities or irretrievable breakdown of the marriage, you may request marriage 'Counseling. A list of marriage counselors is available in the Office ofthe Prothonotary, Cumberland County Courthouse, Carlisle, Pennsylvania 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 Bar Association 2 Liberty Avenue Carlisle, Pennsylvania 17013 717 -249-3166 HAROLD S. IRWIN, III, ESQUIRE ATTORNEY ID NO. 28820 35 EAST HIGH STREET CARLISLE PA 17013 (717) 243-8080 ATTORNEY FOR DEFENDANT METFORD K. .JACKSON, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 02. 0947 CIVIL TERM .JUANA L. .JACKSON, Defendant CIVIL ACTION. LAW IN DIVORCE COUNT I ANSWER TO COMPLAINT IN DIVORCE NOW, comes the defendant, Juana L. Jackson, by her attomey, Harold S. Irwin, III, Esquire, and responds to the complaint in divorce as follows: 1. The averments of fact contained in paragraph one of plaintiff's complaint are denied by reason that after reasonable investigation defendant is without knowledge sufficient to prove the truth of the averment and proof thereof at trial is demanded, if relevant. 2. The averments of fact contained in paragraph two of plaintiff's complaint are admitted. 3. The averments of fact contained in paragraph three of plaintiff's complaint are denied by reason that after reasonable investigation defendant is without knowledge sufficient to prove the truth of the averment and proof thereof at trial is demanded, if relevant. 4. The averments of fact contained in paragraph four of plaintiff's complaint are admitted. 5. The averments of fact contained in paragraph five of plaintiff's complaint are admitted. 6. The averments of fact contained in paragraph six of plaintiff's complaint are admitted. 7. The averments of fact contained in paragraph seven of plaintiff's complaint are admitted. 8. The averments of fact contained in paragraph eight of plaintiff's complaint are admitted. 9. The averments of fact contained in paragraph nine of plaintiff's complaint are admitted. 10. The averments of fact contained in paragraph ten of plaintiff's complaint are admitted. WHEREFORE, the Defendant demands judgment dissolving the marriage of the parties. COUNT II EQUITABLE DISTRIBUTION 11. Defendant's responses to the averments of paragraphs one through ten of plaintiff's complaint are incorporated herein by reference as though fully set forth herein. 12. During the marriage, the parties accumulated certain personal property which is subject to equitable distribution. WHEREFORE, the defendant requests that this Honorable Court determine the parties' marital property and to order equitable distribution thereof. COUNT III COUNSEL FEES. COSTS AND EXPENSES 13. Defendant's responses to the averments of paragraphs one through ten of plaintiffs complaint are incorporated herein by reference as though fully set forth herein. 14. Defendant is not employed due to various medical problems and has never worked throughout the parties' marriage. 15. Defendant lacks sufficient income to pay her attorney fees and the costs of this litigation. 16. Plaintiff is gainfully employed and is in a position to pay the reasonable expenses of defendant's attorney fees and costs in this litigation. WHEREFORE, the Defendant requests that this Honorable Court enter an order requiring the plaintiff to pay defendant's attorney fees and costs. COUNT IV SUPPORT. ALIMONY AND ALIMONY PENDENTE LITE 17. Defendant's responses to the averments of paragraphs one through ten of plaintiffs complaint are incorporated herein by reference as though fully set forth herein. 18. Defendant is not employed due to various medical problems and has never worked throughout the parties' marriage. 19. Defendant lacks',sufficient property and income tc ~'~";ds! 1-1... with a reasonable income and cannot a1lequately support herself. 20. Plaintiff is 9alnfullyeh1pl~yed and is in a position to pay/support, alimony and I or alimony pandanta lite in ordE;lr for the defendant to adequately maintain hersE;llf. 21. Plaintiff is subject to ~ Somerset County, New/Jersey orde~ of sq:!I:C:1' in favor of defendant; however plClintiff remains in arreaf8,of the reqwements of,:;aid or,der In an amount in eXCEl13s of $5;000.00, / ''('VHEREFORE, ,the Defendant requests that this Honorahle Court enter 2n order requiring the plaintiff to pay sPousal support, alimony and! or alimony pendente lite to defendant. I verify that the facts contained herein are true and correct. I :'l'lderstand that false statements herein rrf;'lde are subiect to the penalties of 18 Pa, C: S. Section 4904 "'':llating to unsworn falslfiCEltion te authorities. ' , March ) 1J . 2002 hlO:OW S. Il~wm, 1I Attcmejl fol' t:lefeil.cla 60'd OOZ6-'-r.::'t'::1-1-l ~ L a''';'');.J.::.e r:,\:1' '~f!""~^J. d'Ttr:T.O ~o-t'[-.l'VW NillTl'ORD K.. .JACKpGN. PI.lntlff ; IN TH~ COURT OF CO MON' PLI!AS OF CUM.~RLAND Ch':.lt'':' i, PI!'>!I;-'lIY1.'(..I-",\,\t', Y. I , Me,., t;ll!. OI;-.i" ~!Vlr..': rre", I I C!VIL ACTION. LAW IN DIVORCI! .JUANA L. .JACK.ON, " D~n".nt ; DEFENDANT'S MARRIAGE COUNSELlN _.~FF'IQAY.:r \ -....--- ..-.- The """J"" "',' "'y._ ~"'i,g to ,_, d'P~~ 'M "y, , , I , 1. I have been advised of the avail,,:,;!:'.:. rf rr:&:,J~.: c;o!.'nseih',! ,,'ld understand tha~ I may request that the court require that my spoube and I participate in C<iu.nseling. 2. I understand that the court maintains a list of marriage counselors in the ;.. <u;gj:, '. : I, i Prothonotary's Office, which list is available to me upon request. 'u '~ :, 3.Seing so advised, J do not request that the ccurt require that my spouse and I participate in counseling prior to a divorce decree bei11g handed down. I verify that the statements mad~ in this affidavit are true and correct. I understand that false statements, herei'n made are sl,Ibject to the penalties of 18 Pa. i ,e"J..", e.s. Sectlon 4904 relating to unswom falsification to authorities. '" 'r' o " ~_<... , ~ March t!.. 2002 Ot'd C'O<l6"'E~<l"'L 1 L ":>~J.J.O M"i U~r-'l d<l~:10 <lO-ll-...."W ~ lu (_:~"' ,t;:~ ( " (,i -, r._, U, -, i..L:. ( ....' '>- E~ .,(": I.' C, "{',: 0,. C', c' .',; ~- ("I (:_) J ~ 1 ~ 4l c ::s ~ ~ ::) ('" " , "" " " --(: ~ c::::: s- ~ ~ f;{ ~~, \ ') ~ 'I '"'- "- (l) ~ ~ , ._q,',,,' ,- HAROLD S. IRWIN, III, ESQUIRE ATTORNEY ID NO. 29920 35 EAST HIGH STREET CARLISLE PA 17013 (717) 243-6090 ATTORNEY FOR DEFENDANT METFORD K. .JACKSON, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. : NO. 02 - 0947 CIVIL TERM .JUANA L. .JACKSON, Defendant CIVIL ACTION - LAW ; IN DIVORCE COUNTER-AFFIDAVIT UNDER SECTION 3301(d) OF THE DIVORCE CODE 1. Check either (a) or (b): X (a) I do not oppose the entry of a divorce decree. (b) I oppose the entry of a divorce decree because (Check (i), (ii) or (both): (i) The parties to this action have not lived separate and apart for a period of at least two years. (ii) The marriage is not irretrievably broken. 2. Check either (a) or (b): (a) I do not wish to make any claims for economic relief. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. X (b) I wish to claim economic relief which may include alimony, division of property, lawyer's fees or expenses or other important rights. I understand that in addition to checking (b) above, I must also file all of my economic claims with the prothonotary in writing and serve them on the other party. If I fail to do so before the date set forth on the Notice of Intention to Request Divorce Decree, the divorce decree may be entered without further delay. Mar--ll-02 02,:09P Irwin Law OT-F1ce 717+243+9200 P.03 t verify that the statements made In this affidavit are true and correct. I understand that false statements herein are made subject e penalti s of 18 Pa.C.S, Section 4904 relating to unsworn falSlft~to authorltle March /3 , 2002 . ~\-~. NOTICE: If you do not wilh to oppose the entry of a divorCe-decree and you do not wlah to make a claim for economic reUef, you need not file thl. counteraffldavlt. " . . ,_,_",' "'-_ __ ,-.u (") co 0- C '''' -n S 3: --I -0 (JJ ,~"'" m [,., '"~ ;::P. .. ;';0 Z :"J' Z C N [Tl '::2 C) : " I ~C) () -0 ";-?::r"i "-,~ :s:: zC) \}(~ ----C) )::,c-~ ~':? ('jrn -:7 <-1 _..~ :N :'0 -< -< .~ METFORD K. JACKSON, PLAINTIFF : IN THE COURT OF COMMON PLEAS OF : CUMBERLANIJI COUNTY, PENNSYLVANIA VS. : NO. 02-0947 JUANA L. JACKSON, DEFENDANT : CIVIL ACTION - LAW : IN DIVORCE PETITION FOR SPECIAL RELIEF Plaintiff, Husband, files this Petition for Special Relief and in support thereof, avers as follows: I. Plaintiff is the Husband in the above-captioned divorce action. 2. Defendant is the Wife in the above-captioned divorCll action. 3. Husband and Wife have been separated since September 18, 1998. 4. Wife kept all the tangible marital assets. 5. Husband filed a Complaint in Divorce in 2002, when he was able to financially afford to do so. 6. Husband believes Wife's only reason for being unwilling to agree to finalize this divorce is to enable her to continue to collect spousal support. 7. Husband suffered a work related injury after the parties' separated and has been unable to be employed for several years and is facing ongoing medical treatment and additional surgery for his injury. 8. Husband has a young daughter, not of this marriag'~, who resides primarily with him and for whom he bears the primary financial responsibility. 9. Husband's only income is from his worker's compensation. 10. Husband has reason to believe Wife has continued to be employed since the parties' separation, but Wife has not acknowledged any of her income. II. Husband has not been able to afford to obtain the services of counsel in New Jersey to contest the present spousal support order in effect from New Jersey. 12. In addition to the spousal support the Wife continues to receive from Husband, Husband believes Wife is also receiving Social Security Disability Income, housing assistance and food stamps in addition to other types of assistance. 13. Husband believes Wife is residing in Virginia with her daughter and is not residing in New Jersey. WHEREFORE, Plaintiff, METFORD K. JACKSON, respectfully requests that this Honorable Court grant the Plaintiff a divorce from the Defendant, JUANA L. JACKSON, and terminate all past, present or future spousal support. Respectfully submitted, LAW FIRM OF SUSAN KAY CANDIELLO, P.C. Dated: August ~ 2004 17050 VERIFICATION The undersigned hereby verifies that the facts averred in the foregoing document are true and correct to the best of his knowledge, information, and belief. This verification is made subject to the penalties of 18 Pa. C.S.A. ~4904 relating to unsworn falsification to authorities. DATED: 5Jt(~t r ~1~~ '" '--' C':":, I: ..1 .,r~"~ C~; -'I, C', r"., c' I',) .r~-" -., o METFORD K. JACKSON, PLAINTIFF : IN THE COUUT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA VS. : NO. 02-0947 JUANA L. JACKSON, DEFENDANT : CIVIL ACTION - LAW : IN DIVORCE PRAECIPE FOR WITHDRAWAL OF APPEARANCE Please withdraw my appearance on behalf of the Plaintiff, Metford K. Jackson. Respectfully subrrcitted, J e Adams, Esquire D. # 79465 I outh Hanover Street Carlisle P A 17013 (717) 245-8508 Dated: 8 \8' \. PRAECIPE FOR ENTRY OF APPEARANCE Please enter my appearance on behalf of the Plaintiff, Metford K. Jackson. Respectfully submitted, LAW FIRM OF SUSAN KAY CANDIELLO, P.C. - Dated: ~o( 3/0f r'~ t::~, C.,;~ ..! r,,) -.' f',J o -"...1 c ~/ AUG 2 3 LG04 f vs. : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 02-0947 METFORD K. JACKSON, PLAINTIFF JUANA L. JACKSON, DEFENDANT : CIVIL ACTION - LAW : IN DIVORCE RULE AND NOW, this Z 6.' day of ~v , 2004, upon consideration of the within Petition for Special Relief, a Rule is hereby entered against Defendant, JUANA L. JACKSON, to show cause why the relief requested should not be granted. RULE is issued upon the Defendant to show cause why the Plaintiff is not entitled to the relief requested. The Defendant shall file an answer to the p,etition within .:l 0 days of ~bi5 <jat". $ql/,:""" .sf ~ I'~'h;'" RULE RETURNABLE with hearing thereon the ~~ day of (Jl ~/J.vv , 2004, at '5 :LG/i in Courtroom tf , Cumberland County Courthouse, I Courthouse Square, Carlisle, Pennsylvania. BY THE COURT: ~"/Jd 7 ~. ~ \llNVA1ASNN3c1 AlNnoa ONV11:B8rlflO 02 : I Wd LZ 91W ~OOZ AtlV10N0Hl00:l 3Hl ~o 3Ol:J.:1Q-03ll:! HAROLO S. IRWIN, III, ESQUIRE ATTORNEY ID NO. 29920 64 SOUTH PITT STREET CARLISLE PA 17013 (717) 243-6090 ATTORNEY FOR DEFENDANT METFORD K. JACKSON, : IN THE COURT OF COMMON PLEAS OF PlaIntIff : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION. LAW JUANA L. JACKSON, : NO. 2002 - 0947 Defendant : IN DIVORCE NOTICE TO PLEAD To: SUSAN KAY CANDIELLO ESQ 5021 E TRINDLE RD STE 100 MECHANICSBURG PA 17050 You are hereby notified to file a written response to Ithe New Matter contained herein within (20) days of service or judgment may, be entered against you. September n ,2004 HAROLD S. IRWIN, 1\1 Attorney for deflend t 64 South Pitt Street Carlisle, PA 17013 (717) 243-6090 Supreme Court 10 No. 29920 METFORD K. JACKSON, PlaIntIff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION. LAW v. . . JUANA L. JACKSON, : NO. 2002 - 0947 Defendant : IN DIVORCE ANSWER TO PLAINTIFF"S PETITION FOR SPECIAL RELIEF NOW comes Harold S. Irwin, III, Esquire, attorney for the defendant. JUANA L. JACKSON. and responds to the plaintiffs petition for special relief. representing as follows: 1. The averments of paragraph one of the petition are admitted. 2. The averments of paragraph two of the petition are admitted. 3. The averments of paragraph three of the petition are admitted. 4. The averments of paragraph four of the petition are denied. The defendant did not keep all of the marital assets. On the contrary. the parties equitably divided the marital assets. 5. The averments of paragraph five of the petition are admitted. although defendant believes and therefore avers that plaintiff could have filed the divorce action at any time following the parties' separation. 6. The averments of paragraph six of the petition are admitted in part and denied in part. Defendant has at all times since her execution of the Section 3301 (d) counter-affidavit been ready. willing and able to finalize this divorce and in her affidavit indicated that she has no objection to the entry of a divorce decree. However, defendant has insisted, and continues to insist, that she is entitled to spousal support now and alimony following a divorce, which claims the plaintiff has refused to address. 7. The averments of paragraph seven of the petit'ion are denied by reason that after reasonable investigation, defendant is without knowledge sufficient to form a belief as to the truth of these averments and proof thereof at trial is demanded, if relevant. 8. The averments of paragraph eight of the petition are admitted in part and denied in part. It is admitted that the plaintiff has a young daughter not of this marriage. The remaining averments of this paragraph, however, are denied by reason that after reasonable investigation, defendant is without knowledge sufficient to form a belief as to the truth of these averments and proof thereof at trial is demanded, if relevant. 9. The averments of paragraph nine of the petition are denied by reason that after reasonable investigation, defendant is without knowledge sufficient to form a belief as to the truth of these averments and proof thereof at trial is demanded, if relevant. 10. The averments of paragraph ten of the petition are specifically denied. Defendant receives disability pay of $484.00 per month due to a diagnosis of fibrosis of both lungs. Furthermore, defendant has always acknowledged whatever little income she has had, as evidenced by plaintiffs averments in paragraph twelve of his petition in which he details defendant's income. 11. The averments of paragraph eleven of the petition are denied by reason that after reasonable investigation, defendant is without knowledge sufficient to form a belief as to the truth of these averments and proof there,of at trial is demanded, if relevant. 12. The averments of paragraph twelve of the petition are admitted in that defendant does receive disability. Medicaid and food stamps. 13. The averments of paragraph thirteen of the petition are denied by reason that after reasonable investigation. defendant is without knowledge sufficient to form a belief as to what plaintiff believes about defendant's present residence and proof thereof at trial is demanded. if relevant. WHEREFORE, for the reasons set forth herein and as stated in New Matter below, defendant demands that the plaintiffs petition be dismissed. NEW MATTER 14. Defendants' responses to the petition, paragraphs one through thirteen, iinclusive, are incorporated herein by reference as if fully set forth herein at length. 15. The plaintiff is over $13,000.00 behind in thEl payment of court ordered spousal support to defendant. 16. The plaintiff has not filed for any modification of the current support order. 17. Defendant filed a Section 3301 (d) counter--affidavit wherein she indicated that she has no objection to the entry of a divorce decreEl. However, defendant has insisted. and continues to insist, that she is entitled to spousal support now and alimony following a divorce. which claims the plaintiff has refused to address. 18. The appropriate manner in which to address these issues is for plaintiff to file a petition for bifurcation, which would permit the plaintiff to obtain a divorce while preserving defendant's right to seek payment of alimony from the plaintiff. 19. Defendant's counsel suggested to plaintiff's cOIJnsel that she convert the present petition for special relief to a motion for bifurcation; however, plaintiff's counsel has not responded to that request. 20. Plaintiff's failure to utilize the correct procedun3 for this process has caused the defendant to incur additional and unnecessary expense for legal fees for which the plaintiff should be required to reimburse her. WHEREFORE, defendant requests that plaintiff's petition be dismissed and that plaintiff be assessed with defendant's attorney fees for the defense of this petition. September ~, 2004 ~1 64 South Pitt Street Carlisle, PA 17013 (717) 243-6090 Supreme Cour1: 10 No. 29920 VERIFICATION The facts stated in this answer and new matter are true and correct to the best of my knowledge, information and belief. I understand that false statements made herein are subject to the penalties of 18 Pa.C.S.A. Section 4094, rlelating to unsworn falsification to authorities. \ ~~ L. JACKSION September \ '? ,2004 0 "-> 0 ~ ~~ C:::'":l " .r- V) ::;:! "'1 rTj fi, -1; F':~ -c (n -"C"J 0' ;:~}~) --I ~-:;; ..." :'-.H ( ~~~:~ C' G) ~~I ~-:: . ", '1 C) ~, -<C, 0' -< METFORD K. JACKSON, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA vs. CIVIL ACTION - LAW NO. 2002 - 0947 JUANA L. JACKSON, Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301 (c) of the Divorce Code was filed on March 26, 2002. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. 4. I understand that I may lose rights concerning alimony, division of property, lawyer's fees and 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. Section 4904, relating to unsworn falsification to authorities. Date: qu:f Ilf. 'lJ!Jd:;;- ~..~ -it", .'- NOlAA'lAl SEAl CaIhy L Youngblood, Notary Public lemoyne Bo.o, Cumberland Counfy "'" Commission Expires June 22. ZW6 ~J ,..;....,....".~ r'.,.,~.-.~. ""\,,.<.. ~ ,.....'-.~:. ':-,. ,-,' ",..' :,-1 \ " n~ ('] t~,) Li"', - ~- METFORD K. JACKSON, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA vs. CIVIL ACTION - LAW NO. 2002 - 0947 JUANA L. JACKSON, Defendant IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER *3301 (C) OF THE DIVORCE CODE ]. I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. ~ 4904 relating to unsworn falsification to authorities. Date:~ {ll. {'Q)OS' ~~~~I Metford . Jackson, Plaintiff ....- NOTARIAl SEAL Cathy l. Youngblood. Notary Public Lemoyne Boro, Cumberland County M; Commission Expires June 22, 2006 ~ ~.-;.,.,'v.. r".~ .,.,.,~..l,... ""." . .~..,..,,... ~':~., ,.,' ~.I...f:>. :.". \",j - .",' 0' ~..." ._.....,..~~...~,<-,.-..- METFORD K. JACKSON, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, : PENNSYLVANIA vs. : CIVIL ACTION - LAW : NO. 2002 - 0947 JUANA L. JACKSON, Defendant : IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301 (c) of the Divorce Code was filed on March 26, 2002. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. 4. I understand that I may lose rights concerning alimony, division of property. lawyer's fees and 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. Section 4904, relating to unsworn falsification to authorities. Date: sfJ(a,,- ,....'. I"C r:-? ..- -:< --- METFORD K. JACKSON, Plaintiff : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA VS. CIVIL ACTION - LAW : NO. 2002 - 0947 JUANA L. JACKSON, Defendant : IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER 6 3301 (C) OF THE DIVORCE CODE 1. I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if! do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary . I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. ~ 4904 relating to unsworn falsification to authorities. Date: 5/9(oS- '\ ., (") ,-, c:> C~ C...I'1 (,) -il ~:, ('" f',) -"'; ..",~-,--,,-- METFORD K. JACKSON, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNA vs. CIVIL ACTION - LAW NO. 2002 - 0947 JUANA L. JACKSON, Defendant IN DIVORCE Prior Assignment: The Honorable George E. Hoffer, President Judge STIPULATION AND NOW, come the parties to the above-captioned proceeding, by and through their counsel, Linda A. Clotfelter for Plaintiff, Metford K. Jackson, and Harold S. Irwin, III, Esquire, 1. Plaintiff, Metford K. Jackson, filed a Petition for Special Relief on or about for Defendant, Juana L. Jackson, who file this Stipulation resolving Plaintiff's Petition for Special Relief and Defendant's Answer with New Matter, as follows: August 20, 2004, requesting that the Court enter a divorce decree between the parties. 2. Defendant, Juana L. Jackson, field an Answer to Plaintiff's Petition for Special Relief with New Matter on or about September 16, 2004, wherein Defendant agreed to the entry of a divorce decree but raised the issues of spousal support and alimony. 3. A hearing was scheduled for October 6, 2004, before the Honorable President Judge George E. Hoffer on Plaintiff's Petition for Special Relief and Defendant's Answer with New Matter. The hearing was cancelled due to the parties oral agreement of the issues that are now being resolved in writing by this Stipulation. 4. The parties now seek to have the terms of this Stipulation entered as an Order of Court resolving the issues as described in paragraphs one (1) and two (2) above. 5. The parties specifically agree to resolve the issues as follows: a. The parties shall take the steps necessary to finalize their divorce proceeding as soon as is administratively possible and to effectively resolve any and all outstanding issues between the parties that are related to the parties' marital separation, the support proceeding presently pending in the state of New Jersey, and the issues raised in this divorce proceeding. b. Effective October 6, 2004, (the date scheduled for the hearing in this matter), Plaintiff shall pay to Defendant spousal support or alimony at a rate of $250.00 per month for Twenty-Four (24) months. Plaintiff shall also pay to Defendant the spousal support arrears as of October 6, 2004, same being $13,103.13. It is the intent of the parties to have Plaintiff pay the spousal support arrears to Defendant in lump sum form as soon as Plaintiff is financial able to do so. Until such time as Plaintiff is able to pay the spousal support arrears in full, Plaintiff shall continue to make payments to Defendant at a rate of $100.00 per week in an effort to pay down some of the spousal support arrears, although the spousal support or alimony shall accrue at the rate of $250.00 per month as specifically described above. c. The parties shall execute a Marital Settlement Agreement addressing the specific issues resolved in this Stipulation and the pleadings filed related to same and the Marital Settlement Agreement shall be incorporated, but not merged into the parties' Divorce Decree for the purposes of enforcement only. d. It is further agreed that the parties will take the steps necessary to coordinate the administration of the terms of this Stipulation through the spousal support proceeding in the State of New Jersey and the Order for alimony that will be entered in Cumberland County, Pennsylvania upon the entry of the divorce decree, thereby ensuring that the proper amount of support or alimony is paid. e. The parties acknowledge that an accounting may have to be completed with the support office in the state of New Jersey to resolve the matter pursuant to the terms of this Stipulation and to ensure that only one (1) wage attachment order for the payment of spousal support or alimony is issued at anyone time. The parties further acknowledge that the court ordered spousal support is filed in docket number FD 1832499, CS 22327606A and the caseworker assigned to the spousal support matter is Danielle Gualemi. WHEREFORE, the parties to this proceeding, by and through their counsel, respectfully request that this Court enter an Order that incorporates the terms of this Stipulation thereby resolving Plaintiff's Petition for Special Relief and the claims raised in Defendant's Answer with New Matter. Counsel for the parties in the above-referenced action hereby stipulate and agree that the terms of this Stipulation encompass the intent of their respective client and that it may be adapted as a Court Order. inda . Clotfelter, Esquire ttorney I.D. No. 72963 021 East Trindle Road, Suite, 100 Mechanicsburg, PA 17050 (717) 796-1930 Harold S. Irwin, III, Esquir Attorney I.D. 29920 64 South Pitt Street Carlisle, PA 17013 (717) 243-6090 Attorney for Plaintiff Attorney for Defendant 0, , METFORD K. JACKSON, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNA vs. CIVIL ACTION - LAW NO. 2002 - 0947 JUANA L. JACKSON, Defendant IN DIVORCE CERTIFICATE OF SERVICE AND NOW, on this date, the undersigned hereby certifies that a true and correct copy of the foregoing STIPULATION was served upon the interested parties as follows: Harold S, Irwin, III, Esquire Attorney for Defendant 64 South Pitt Street Carlisle, PA 17013 (via facsimile and first class mail, postage prepaid) LAW FIRM OF LINDA A CLOTFELTER Date: slulOS" , inda . Clotfelter, Esquire ttorney 1.0. No. 72963 5021 East Trindle Road, Suite 1 Mechanicsburg, PA 17050 (717)796-1930 telephone (717)796-1933 facsimile ,., , ,~} ....-,., ,"" ::11 ,,-~ r",,) u., -- .: METFORD K. JACKSON, Plaintiff RECEIVED MAY 18 Z005 r~t{I : IN THE COURT OF COMMON PLEAS OF : CUMBERlAND COUNTY, PENNA vs. : CIVILACTION-IAW : NO. 2002 - 0947 JUANA L. JACKSON, Defendant : IN DIVORCE ORDER AND NOW, this ~3d- day of Mvo ,2005, upon consideration of the Stipulation of the parties to this proceeding, it is hereby ORDERED and DECREED that the the terms of the Stipulation are incorporated by reference into this Order of Court. BY THE COURT: , J. s: IS, I\- 'I-' 2:: .t:. .~( L \ '.' VI C IA. ~ t ...., f"o" t .~ .' 'V" 1.., ,', \','" ,~ :1 \}:/Jv , . -\i. >l.,':\:\ _i,\-\)'" _" i'" - - MARITAL SETTLEMENT AGREEMENT THIS AGREEMENT, made this 1+l"odayof A;'J2'l.. ,2005 between JUANA L. JACKSON, (hereinafter referred to as WIFE) and METFORD K. JACKSON (hereinafter referred to as HUSBAND). WITNESSETH: WHEREAS, Husband and Wife were lawfully married on October 15, 1980, in Rahway, New Jersey; and WHEREAS, there are no children born of this marriage; and WHEREAS, disputes and difficulties have arisen between the parties, and it is the present intention of Husband and Wife to live separate and apart, and the parties hereto are desirous of settling their respective financial and property rights and obligations as between each other, including without limitation by specification: the settling of all matters between them relating to the past, present, and future support and/or maintenance of Wife by Husband or Husband by Wife; the settling of all matters between them relating to the equitable division of marital property; and, in general, the settling of any and all claims and possible claims by one against the other or against their respective estates; and WHEREAS, Husband and Wife declare that each has had a full and fair opportunity to obtain independent legal advice of counsel of his or her selection; that Husband has been represented by Linda A. Clotfelter, Esquire, and that Wife has been represented by Harold S. Irwin, III, Esquire in this proceeding. The parties represent and warrant that they have fully disclosed to each other all assets of any nature owned by each, all debts or obligations for which the other party may be liable in whole or part, and all sources and amounts of income. WHEREAS, the parties acknowledge that they fully understand the facts, and they -1- acknowledge and accept that this Agreement, is, under the circumstances, fair and equitable, and that it is being entered into freely and voluntarily, with such knowledge and that execution of this Agreement is not the result of any duress or undue influence and that it is not the result of any improper or illegal agreement or agreements. NOW THEREFORE, in consideration of the premises and of the mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, Husband and Wife, each intending to be legally bound hereby, covenant and agree as follows: 1. PERSONAL RIGHTS. It shall be lawful for each Husband and Wife at all times hereafter to live separate and apart from the other party at such place as he or she may from time to time choose or deem fit. The parties shall be free from any control, restraint, interference or authority, direct or indirect, by the other in all respects as fully as if they were unmarried, except as may be necessary to carry out the provisions of this Agreement. Husband and Wife shall not molest, harass, disturb or malign each other or the respective families of each other nor compel or attempt to compel the other to cohabit or dwell by any means in any manner whatsoever with him or her. The foregoing provision shall not be taken as an admission on the part of either party of the lawfulness or unlawfulness of the causes leading to their living apart. 2. MUTUAL RELEASE. Husband and Wife each do hereby mutually remise, release, quitclaim and forever discharge the other, for all time to come, and for all purposes whatsoever, of and from any and all rights, titles and interests, or claims in or against the property (including income and gains from property hereinafter accruing) of the other or against the estate of such other, of whatever nature and wheresoever situate, which he or she now has or at any time hereafter may have against such other, the estate of such other or any part thereof, -2- whether arising out of any former act, contracts, engagements or liabilities of such other or by way of dower or curtesy; or claims in the nature of dower or curtesy or widow's or widower's rights, family exception or similar allowance, or under the intestate laws, or the right to take against the spouse's will; or the right to treat a lifetime conveyance by the other as testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's estate, whether arising under the law of Pennsylvania, any state, commonwealth or territory of the United States, or any other country, or the right to act as personal representative of the estate of the other; or any rights which any party may now have or any time hereafter have for past, present, future support, maintenance, alimony, alimony pendente lite, counsel fees, costs or expenses, whether arising as a result of the marital relation or otherwise; except all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for breach of any provision hereof. It is the intention of Husband and Wife to give to each other, by the execution of the Agreement, a full, complete and general release with respect to any and all property of any kind or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and only except all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision hereof. It is further specifically understood and agreed by and between the parties hereto that each accepts the provisions herein made by the other in lieu of and in full settlement and satisfaction of any and all of their rights against the other or any past, present and future claims on account of support and maintenance; that it is specifically understood and agreed that the payments, transfers and other considerations herein recited so comprehend and discharge any and all such claims by each other against the other, and are, inter alia, in full settlement and -3- -------- satisfaction and in lieu of their past, present and future claims against the other in account of maintenance and support, and also alimony, alimony pendente lite, counsel fees, costs and expenses, as well as any and all claims to equitable distribution of property, both real and personal, and any other charge of any nature whatsoever pertaining to any divorce proceedings which may have been or may be instituted in any court in the Commonwealth of Pennsylvania or any other jurisdiction, including any other counsel fees, costs and expenses incurred or to be charged by any counsel arising in any manner whatsoever, except as may be incurred in connection with a breach of the Agreement as set forth hereinafter in Paragraph 16. 3. RELEASE OF TESTAMENTARY CLAIMS. Except as provided for in this Agreement, each of the parties hereto shall have the right to dispose of his or her property by last will and testament or otherwise, and each of them agrees that the estate of the other, whether real, personal or mixed, shall be and belong to the person or persons who would have become entitled thereto as if the decedent had been the last to die. Except as set forth herein, this provision is intended to constitute a mutual waiver by the parties of any rights to take against each other's estate whatsoever, and is intended to confer third-party beneficiary rights upon the other heirs and beneficiaries of each. Either party may, however, make such provision for the other as he or she may desire in and by his or her last will and testament; and each of the parties further covenants and agrees that he or she will permit any will of the other to be probated and allowed administration; and that neither Husband nor Wife will claim against or contest the will and estate of the other except as necessary to enforce any breach by the decedent of any provision of this Agreement. Each of the parties hereby releases, relinquishes and waives any and all rights to act as personal representative of the other party's estate. However, it is expressly understood that neither the provisions of this release nor the subsequent entry of a divorce decree -4- --- are intended to defeat the right of either party to receive any insurance proceeds at the death of the other of which she or he is the named beneficiary (whether the beneficiary designation was made prior or subsequent tot the execution hereof), nor to defeat the right of either party to receive any legacy, bequest or residuary portion of the other's estate under his or her will, or to act as personal representative or executor if so named by the will of the other, whether such will was executed prior or subsequent to this agreement. Each of the parties hereto further covenants and agrees for himself and herself and his or her heirs, executors, administrators or assigns, for the purpose of enforcing any of the rights relinquished under this Agreement. 4. FINANCIAL DISCLOSURE. The parties waive their rights to require the filing of financial statements by the other, although the parties have been advised by their respective attorneys that it is their legal right to have these disclosures made prior to entering into this Agreement and by entering into this Agreement without reliance upon financial disclosure, the parties are forever waiving their right to request or use that as a basis to overturn this Agreement or any part thereof. 5. INCOME TAX CONSIDERATIONS. The transfers of property pursuant to this Agreement are transfers between Husband and Wife incident to their divorce and as such are nontaxable, 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 an equal division of marital property for full and adequate consideration and as such will not result in any gift tax liability. 6. DISCLOSURE AND WAIVER OF PROCEDURAL RIGHTS. Each party understands that he or she has the right: (1) to obtain from the other party a complete inventory or list of all of the property that either or both parties own at this time or owned as of the date of -5- --- separation; (2) to have all such property valued by means of appraisals or otherwise; (3) to compulsory discovery to assist in the discovery and verification of facts relevant to their respective rights and obligations, including the right to question the other party under oath; and (4) to have a court hold hearings and make a decision on the matters covered by this Agreement, which court decision concerning the parties' respective rights and obligations might be different from the provisions of this Agreement. Each party acknowledges that this Agreement is fair and equitable, that it adequately provides for his or her needs and is in his or her best interests, and that the agreement is not the result of any fraud, duress, or undue influence exercised by either party upon the other or by any other person or persons upon either party. Given said understanding and acknowledgment, both parties hereby waive the following procedural rights: a. Determination of Marital and Non-Marital Property: The right to have the court determine which property is marital and which is non-marital, and equitably distribute between the parties that property which the court determines to be marital. b. Other Rights and Remedies: The right to have the court decide any other rights, remedies, privileges, or obligations covered by this Agreement, including, but not limited to, possible claims for divorce, spousal support, alimony, alimony pendente lite (temporary alimony), counsel fees, costs and expenses. 7. EQUITABLE DISTRIBUTION OF MARITAL PROPERTY. The parties have attempted to distribute their marital property in a manner which conforms to the criteria set forth in Section 3502 of the Pennsylvania Divorce Code. 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 -6- this Agreement shall be in full satisfaction of all marital rights of the parties. A. MOTOR AND OTHER VEHICLES. With respect to the motor vehicles owned by one or both of the parties, the parties agree as follows; a. Vehicles in Possession: Each party shall have exclusive use and ownership of the vehicle that is presently in his or her possession and it shall be that party's sole property. Accordingly, each party shall be solely responsible for any and all financial obligations related to the vehicle retained by him or her and each party shall hold the other party harmless for same. Each party shall execute upon request and as soon as administratively possible, any titles to said vehicles to carry out the intentions of this paragraph. b. Identification: Identification of a vehicle herein shall include not only the Vehicle, but also the sale or trade-in value thereof if it has been sold or traded in prior to the date of this Agreement. c. Transfer of Titles: The titles to the Vehicles shall be executed by the parties, if appropriate, for effectuating the transfer as herein provided on the date of execution of this Agreement and said executed titles shall be delivered to the proper party on the distribution date. d. Title and Power of Attornev: For purposes of this Paragraph the term "title" shall be deemed to include "power of attorney" if the title to the Vehicle is unavailable due to financing arrangements or otherwise. e. Liens: In the event that any Vehicle is subject to a lien or encumbrance, the party receiving the Vehicle as his or her property shall take it subject to said lien and/or encumbrance and shall be solely responsible therefor and said party further agrees to indemnify, protect and save the other party harmless from said lien or encumbrance. f. Waiver: Each of the parties hereto does specifically waive, release, renounce and forever abandon whatever right, title and interest they may have in the Vehicles that shall be come the sole and separate property of the other party pursuant to the terms of this Paragraph. B. RETIREMENT ACCOUNTS. PENSION PLANS AND INVESTMENT ACCOUNTS. Each of the parties does specifically waive, release, renounce and forever abandon all of their right, title, interest or claim, whatever it may be, in any Pension Plan, Retirement Plan, IRA Account, Profit Sharing Plan, 40l-K -7- Plan, Keogh Plan, Stock Plan, Tax Deferred Savings Plan, any employee benefit plan, and/or other retirement type plans or investment accounts of the other party, whether acquired through said party's employment or otherwise (hereinafter "the Retirement Plans"). Hereafter the Retirement Plans shall become the sole and separate property of the party in whose name or through whose employment said plan or account is held or carried. If either party withdraws any sums from the Retirement Plans distributed to him or her pursuant to the terms of this Paragraph, that party shall be solely liable for any and all taxes and penalties resulting from that withdrawal. C. DIVISION OF HOUSEHOLD AND PERSONAL PROPERTY. The parties hereto have divided between themselves, to their mutual satisfaction, all items of tangible and intangible marital property. Neither party shall make any claim to any such items of marital property designated to the other party, or of the separate personal property of either party, which are now in the possession and/or under the control of the other. Should it become necessary, the parties each agree to sign, upon request, any titles or documents necessary to give effect to this paragraph. D. DISTRIBUTION OF CASH ASSETS. STOCKS AND BONDS. The parties agree that they have distributed to each, to their mutual satisfaction, the sums deposited in the marital bank accounts. The parties further agree that they shall retain as their respective sole and separate property any other depository or brokerage accounts, stocks, or bonds held in their respective individual names, except any such funds or accounts otherwise designated in this Agreement. 8. DEBTS. b. Husband's Debt. Husband represents and warrants to Wife that since the separation he has not, and in the future he will not contract or incur any debt or liability for which Wife or her estate might be responsible, and he shall indemnify and save Wife harmless from any and all claims or demands made against her by reason of such debt or obligation incurred by him since the date of said -8- ---- separation, except as otherwise set forth herein. c. Wife's Debt. Wife represents and warrants to Husband that since the separation she has not, and in the future she will not, contract or incur any debt or liability for which Husband or his estate might be responsible, and she shall indemnify and save Husband harmless from any and all claims or demands made against him by reason of such debts or obligations incurred by her since the date of said separation, except as otherwise set forth herein. d. Marital and Non-Marital Debt. During the course of the marriage, Husband and Wife have incurred certain bills and obligations and have amassed a variety of debts, and it is hereby agreed, without ascertaining for what purpose and to whose use each of the Marital Debts were incurred, the parties agree on the distribution of both marital and non-marital debt as follows: 1. General Provision: Any debt herein described shall be deemed to include the current balance owed on the debt. Unless otherwise specifically provided herein, there shall be no adjustment for the payment of any portion of the Marital debts that a party may have made prior to the execution of this marital Agreement, whether or not that debt is specifically referenced in this Paragraph. 2. Wife's debts: Wife shall be solely responsible for the following bills and debts: 1. Retirement Funds: Any and all taxes and/or penalties resulting from her withdrawal of funds from any Retirement Plans as referenced in Paragraph 7(C) herein; and ii. Other Debts: Any and all other debts, liabilities, obligations, loans, credit card accounts, and the like incurred in Wife's sole name, and not otherwise provided for herein. 3. Husband's Debts: Husband shall be solely responsible for the following bills and debts: i. Retirement Funds: Any and all taxes and/or penalties resulting from his withdrawal of funds from any Retirement Plans as referenced in Paragraph 7(C) herein; and ii. Other Debts: Any and all other debts, liabilities, obligations, loans, -9- - credit card accounts, and the like incurred in Husband's sole name, and not otherwise provided for herein. B. Indemnification: Each party agrees to hold the other harmless from any and all liability which may arise from the aforesaid bills which pursuant to the terms herein are not the responsibility of the other party. This includes but is not limited to any attorney's fees and costs incurred by the other party as the result of defending against the obligation and/or enforcing the provisions of this indemnification. C. No Further Charnes on Joint Debts: Neither party shall make any further charges on any joint debt for which the other party may be responsible, and if said charges are made in violation of this Agreement, then the party incurring said charge shall immediately repay the same. D. Non-Disclosed Liabilitv: Any liability not disclosed in this Agreement shall be the sole responsibility of the party who has incurred or may hereafter incur it, and the party incurring or having incurred said debt shall pay it as it becomes due and payable. E. No Further Joint Debt: From the date of this Agreement, each party shall only use those credit accounts or incur such further obligations for which that party is individually and solely liable and the parties shall cooperate in closing any remaining accounts which provide for joint liability. 9. COUNSEL FEES AND COSTS. Husband and Wife each agree to pay and be responsible for their own attorney's fees and costs incurred with respect to the negotiation of this property settlement agreement and the divorce proceedings related thereto. Each party hereby waives any right and/or claim each may have, now or in the future, against the other for counsel fees, costs and expenses. 10. SPOUSAL SUPPORT. ALIMONY PENDENTE LITE AND ALIMONY. Except as otherwise provided herein, both parties accept the provisions of this Agreement in lieu of and in full and final settlement and satisfaction of all claims and demands that they may now or hereafter have against the other for spousal support, alimony, alimony pendente lite, counsel fees or expenses. It is acknowledged that Husband has paid to Wife spousal support through a -10- proceeding in New Jersey filed to docket number FD 1832499, CS 22327606A and the caseworker assigned to the spousal support matter is Danielle Gualemi. It is further acknowledged that the parties have reached an Agreement resolving the spousal support and alimony claim asserted by Wife in this divorce proceeding. Said Agreement is memorialized in the Stipulation of counsel for the parties docketed to this civil docket and incorporated into the Order executed by the Honorable Judge George E. Hoffer on , 200S. The parties have agreed to resolve the spousal support and alimony claims as follows: a. Effective October 6, 2004, Husband shall pay to Wife spousal support or alimony at a rate of $250.00 per month for Twenty-Four (24) months, with the last payment being in September, 2006. Husband's payments shall be termed "spousal support" until the divorce decree is issued, and shall become "alimony" upon the entry of the divorce decree. b. Husband shall also pay to Wife the spousal support arrears as of October 6, 2004, same being $13,103.13. It is the intent of the parties to have Husband pay the spousal support arrears to Wife in lump sum form as soon as Husband is financial able to do so. Until such time as Husband is able to pay the spousal support arrears in full, Husband shall continue to make payments to Wife at a rate of $100.00 per week in an effort to pay down some of the spousal support arrears, although the spousal support or alimony shall accrue at the rate of $250.00 per month as specifically described above. c. The spousal support payments from Husband to Wife shall be taxable as income to Wife and shall be a tax deduction for Husband for federal income tax purposes. d. It is the intent of the parties that the spousal support and alimony payments shall not be modifiable except that same shall tenninate at the end of the at the expiration of Twenty-Four (24) months from October 6, 2004, upon Wife's remarriage, cohabitation with an individual of the opposite sex or upon her demise. e. The parties agree to take all steps necessary to necessary to coordinate the administration of the terms of their agreement for spousal support and alimony through' the spousal support proceeding in the State of New Jersey and this divorce proceeding. The parties also agree that they may stipulate to the entry of the alimony agreement as an Order of Court through the Domestic Relations in Cumberland County, Pennsylvania, but only upon the closing of the New Jersey proceeding for spousal support and/or alimony, as the parties stipulate and agree that only wage attachment for spousal support and/or alimony shall be effective at anyone time. -11- f. The parties also agree to cooperate fully with any documentation or any accounting that may be required to effectively complete the terms of this provision for spousal support and alimony as same related to the matter in the state of New Jersey and in the Commonwealth of Pennsylvania. It is the clear intent of the parties to resolve the matter pursuant to the terms of the Order of Court executed by the Honorable Judge George E. Hoffer entered ,2005. 11. RECONCILIATION. Notwithstanding a 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. 12. INCORPORATION IN FINAL DIVORCE DECREE. It is the intent of the parties to complete their divorce proceeding docketed to Civil Docket Number 200-0947 in the Court of Common Pleas of Cumberland County, Pennsylvania. Either party is free to pursue the divorce proceeding and both parties specifically agree to execute any and all documents necessary to obtain a divorce decree, including but not limited to an affidavit of consent and waiver of notice, within seven (7) days of a request for same. The terms of this Agreement shall be incorporated but shall not merge in the final divorce decree between the parties. The terms shall be incorporated into the final divorce decree for the purposes of enforcement only and any modification of the terms hereof shall be valid only if made in writing and signed by both of the parties. Any Court having jurisdiction shall enforce the provision of this Agreement as if it were a Court Order. This Agreement shall survive in its entirety, resolving the spousal support, alimony, equitable distribution and other interests and rights of the parties under and pursuant to the Divorce Code of the Commonwealth of Pennsylvania, and no court asked to enforce or interpret this Agreement shall in any way change the terms of this Agreement. This Agreement may be enforced independently of any support order, divorce decree or judgment and its terms shall take precedence over same, remaining the primary obligation of each party. This Agreement shall remain in full force and effect regardless of any change in the marital status of the parties. It is warranted, covenanted and represented by Husband and Wife, each to the other, that this Agreement is lawful and enforceable, and this warranty, covenant and representation is made for the specific purpose of inducing the parties to execute the Agreement. 13. DATE OF EXECUTION. The "date of execution" or "execution date" of the Agreement shall be defined as the date upon which it is executed by the parties if they have each -12- ----- 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 the Agreement. 14. FULL DISCLOSURE. Each party asserts that he or she has made or shall make a full and complete disclosure of all the real and personal property of whatsoever nature and wheresoever located belonging in any way to each of them, of all debts and encumbrances incurred in any manner whatsoever by each of them, and of all sources and amounts of income received or receivable by each party. 15. ENTIRE AGREEMENT. This Agreement contains the entire understanding of the parties, and there are no representations, warranties, covenants or undertakings other than those expressly set forth herein. 16. BREACH. If either party breaches any provision of this Agreement, the other party shall have the following rights and remedies, at his or her election, all of which shall be deemed to be cumulative and not in the alternative, unless said cumulative effect would have an inconsistent result or would result in a windfall of the other party: a. Specific Performance: The right to specific performance of the terms of this Agreement, in which event the non-breaching party shall be reimbursed for all reasonable attorney's fees and costs incurred as the result of said breach and in bringing the action for specific performance. b. Damages: The right to damages arising out of breach of the terms of this Agreement, which damages shall include reimbursement of all reasonable attorney's fees and costs incurred as the result of the breach and in bringing the damage action. c. Divorce Code Remedies: The right to all remedies set forth in Section 3502(e) of the Pennsylvania Divorce Code, 23 Pa.C.S.A. 789 3502(e), and any additional rights and remedies that may hereafter be enacted by virtue of the amendment of said statute or replacement thereof by any other similar laws. d. Other Remedies: Any other remedies provided for in law or in equity. e. Considerations for Reasonable Attornevs Fees: Any award of "reasonable -13- attorney's fees" as used in this paragraph shall be based on consideration of (1) the hourly rate charged; (2) the services rendered; and (3) the necessity of the services rendered. Determination of reasonableness shall not take into consideration the amount or nature of the obligation sought to be enforced or any possibility of settlement for less than the obligation sought to be enforce by the non-breaching party. 17. PENNSYLVANIA LAW. The parties agree that the terms of this Agreement and any interpretation and/or enforcement thereof shall forever be governed by the Laws of Pennsylvania. 18. WAIVER OR MODIFICATION TO BE IN WRITING. No modification or waiver of any of the terms hereof shall be valid unless made in writing and signed by both of the parties. 19. ADDITIONAL INSTRUMENTS. Each of the parties shall from time to time, at the request of the other, execute, acknowledge, and deliver to the other party any and all further instruments, including Deeds and other real estate-related documents, titles, or other documents that may be reasonably required to give full force and effect to the provisions of this Agreement. 20. 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 provision shall be stricken from this Agreement, and in all other respects this Agreement shall be valid and shall continue in full force, effect and operation. 21. WARRANTY. Husband and Wife again acknowledge that they have each read and understand this Agreement, and each warrants and represents that it is fair and equitable to each of them. 22. DESCRIPTIVE HEADINGS. The descriptive headings used herein are for convenience only. They shall have no effect whatsoever in determining the rights or obligations of the parties. -14- . , 23. BINDING EFFECT. BY SIGNING THIS AGREEMENT, EACH PARTY ACKNOWLEDGES HAVING READ AND UNDERSTOOD THE ENTIRE AGREEMENT, AND EACH PARTY ACKNOWLEDGES THAT THE PROVISIONS OF THIS AGREEMENT SHALL BE AS BINDING UPON THE PARTIES AS IF THEY WERE ORDERED BY THE COURT AFTER A FULL HEARING. IN WITNESS WHEREOF, and intending to be legally bound hereby, the parties hereto have hereunto set their hands and seals the day and year first above written. This agreement is executed in duplicate, and each party hereto acknowledges receipt of a duly executed copy thereof. WITNESSES: 74 - ~~ -15- '.. STATE OF '~n^sy.lc.Hrnl/l- COUNTY OF CJA.lIyL/.U1f'> - SS. On this 1!:- day of M/>'1 ' 2005, before me, the undersigned officer, personally appeared JUANA L. JACKSON, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Agreement, and acknowledged that she executed the same for the purposes therein contained. NOTARIAL SEAl ~ HAROLDS.IRWlN,III. NOTARY PUBLIC CARLISLE BOROUGH, COllN1Y OF CUMBERLAND M:t COMMISSION EXPIRES OCTOBER 22 2006 _.. ' COMMONWEALTH OF PENNSYLVANIA COUNTY OF ro)~WAtiJD SS. On this ill day of ~ ,2005, before me, the undersigned officer, personally appeared METFORD K. JACKSON, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within Agreement, and acknowledged that he executed the same for the purposes therein contained. NO'''Y~ NOTARlAlSfAL l Calhy L. Youngblood. Notary Public ^~9 Bora. Cumberland CotJn'. ..., ommlsslon Expires June 22, 2(Ki<J ; ~.~~1l"~)N'. f'l~!"'rm~1'J,~~<': .""'Mci-,Ih,.. 01 "t.. .-' ". _ .,,'C~' I', .:~"-' ;'''';, -16- --c ( r:L';:_~ ~r'. te' , - ~\< ::':<1 -<. (1 r:; ~ ~ c% I -! ":."', ",. :r:; "':? ~ ~F1 ']~ ~~ __ :D ':.; (...; '5{1"\ '~.;...j, to :.< C> 0> - METFORD K. JACKSON, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYL VANIA v. : NO. 2002 - 0947 JUANA L. JACKSON, Defendant : CIVIL ACTION - LAW : IN DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Kindly transmit the record, together with the following information, to the Court for entry of a divorce decree: 1. The ground for divorce is irretrievable breakdown under Section 3301 (c) of the Divorce Code. 2. The Complaint was filed on February 26, 2002. 3. Date and manner of Service of the Complaint: March 2, 2002, by Certified Mail, Restricted Delivery, Return Receipt Requested, as evidenced by the Affidavit of Service filed on March 7, 2002. 4. The Plaintiffs Affidavit of Consent was executed by the Plaintiff on April 14, 2005, and filed on May 12,2005. The Defendant's Affidavit of Consent was executed on May 9, 2005, and filed on May 12,2005. 5. Plaintiff executed a Waiver of Notice of Intention to Request Entry of a Divorce Decree under 3301 (c) of the Divorce Code on April 14, 2005, and said waiver was filed on May 12, 2005. Defendant executed a Waiver of Notice of Intention to Request Entry of a Divorce Decree under 3301 (c) of the Divorce Code on May 9, 2005, and said waiver was filed on May 12, 2005. 6. There are no related claims pending. The parties have resolved all related issues by written Marital Settlement Agreement dated April 14, 2005, that will be incorporated by reference into the Divorce Decree pursuant to Paragraph 12 on page 12. Respectfully submitted, LAW FIRM OF LINDA A. CLOTFELTER Date: slh,los t mda A. Clotfelter, Esquire ttomey ID No. 72963 021 East Trindle Road, Suite 100 Mechanicsburg, P A 17050 (717) 796-1930 telephone (717) 796-1933 facsimile 0 "-> = ~ c => "':"" <:.n ~~ ~::!l -Dee <- IT:r: c: :::::: .'! :;0:: r- ~::~: I ~~ -.l ~f .'?~ ~: c ",. :;:: ()- .:S::-C) -;>. PC'::' 'f? 15 ::5 ;g .-< 0 .J:J '" .< . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. IN THE COURT OF COMMON PLEAS Of ~ '" +' ~ ~ +' +. . . . . . .. ... . ~+,:f. Of :f <+: Of. :Ii'+: :.: 'to 0+ :f.;+; Of. Of. Of. '+::+: Of. :f. Of.:f. + :f. :f.;t, Of:f.:f. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . , PLAINTIFF, . . . . . . . . . . OFCUMBERLANDCOUNTY PENNA. STATE OF METFORD K. JACKSON PLAINTIFF JUANA L. JACKSON VERSUS DEFENDANT AND NOW, DECREED THAT AND Juana L. Jackson cA [f, 't..(oIC.;1 2005 No. 02-947 DECREE IN DIVORCE r I)" Metford K. Jackson , iT is ORDERED AND * ARE DIVORCED FROM THE BONDS OF MATRIMONY. . . , DEFENDANT, . . . . . . . . . . . . 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; * IT IS FURTHER ORDERED that the terms of the Marital Settlement Agreement of the parties dated . . . . . . . . April 14, 2005, shall be incorporated herein, but not merged, for the purposes of enforcement only, as per Paragraph 12 on page 12 of same. :f.:f. +' :t' :f. 'f.:+:+:t.:f. :+: 'to 'I' +. + ATTEST: .. ... +' :f.'+:f.:f.+ '+ 'f.'+'+ . . . . . . . . . . .. J. . . . . . . . PROTHONOTARY . . . . . :+: ;f:f.:f.'f'l':f.+ +:f.'+'f'f ~ yJ,11'1 ~ 9P z ~#fl f"l $l.11'~ ~~~.~'. ., ------- ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsvlvania Co.lCity/Dist. of CUMBERLAND Date of Order/Notice 08/26/05 Case Number (See Addendum for case summary) o Original Order/Notice @ Amended Order/Notice o T erm;nate Order/Notice Emp(oyerANithholder's Federal fIN Number RE, JACKSON, SEDGWICK CLAIMS MANAGEMENT PO BOX 8006 PHILADELPHIA PA 19101-8006 SVC Ji{. ~~ l>~ -9'17 ev ~/"/D7.(pO).. METFORD K. Employee/Obligor's Name (last, First, MIl 211-32-1806 Employee/Obligor's Social Se<::urity Number 8306100950 Employee/Obligor's Case Identifier (See Adtkndum for plaintiff names associated with cases on attachment) Custodial Parent's Name (last, First, Mil :uI. ;:1IaSf.5 ..3/~ S ~.l>~ 711rJ I O'i:.r 7D See Addendum for dependent names and birth dates associated with cases on attachment. ORDER lNFORMA TlON: 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. $ 250.00 per month in current support $ 183.34 per month in past-due support Arrears 12 weeks or greater? @yes 0 no $ 0.00 per month in current and past-due medical support $ 0 . DOper month for genetic test costs $ per month in other (specify) for a tolal of $ 433.34 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: $ 100.00 per weekly pay period. $ 200.00 per biweekly pay period (every two weeks). $ 216.67 per semimonthly pay period (twice a month). $ 433.34 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 paydateJdate 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 5.5% 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, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's ca~MI1., ~lf1'R~.. SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. 8!'~~~ THE COU . Date of Order: AUG 3 0 2005 .JV~IE:: Form EN-028 Worker ID $OINC Service Type M OMB No.: 0970-0154 ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o If hhecked you are required to prpvide a (Copy of this form to your employee. If your employee works in a state that is ditterent 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 identify the portion of the single payment that is attributable to each employee/obligor. 3. * RepVllillg, the r ,iydJ'te/Dille of '1/;tlll.old;rllS' YOu n,ust tepo.l ti,e- jJayJatel'date of ",.;tl,l,old;"5 vvll~ll 5c:"d;"g llle pa'1111e11L Tlle- pciydat6'-ddlc vf vvitlrl,oldjj,g is tll't: dA~ 0.. vvl.;dr dlllUUlIt "vas vv;t1,I,eld flOll1 tIle clllployee's vvdge~. 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 piace 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 EMPLOYEEfOBlIGOR NO LONGER WORKS FOR: 8917100183 EMPLOYEE'SJOBlIGOR'S NAME: JACKSON, METFORD K. EMPLOYEE'S CASE IDENTIFIER: 830610095 0 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAMEfADDRESS: 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 accumuiated 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 (1 5 U.s.c. 91673 (bi1; or 2i 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 (ADWEI. 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. 11. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your empioyee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at [Zl7) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Worker ID $OINC Service Type M OMBNo,:(}970-0154 ADDENDUM Summary of Cases on Attachmenl Defendant/Obligor: JACKSON, METFORD K. PACSES Case Number 417107602 Plaintiff Name JUANA JACKSON Docket Attachment Amount 02~CIVIL $ 250.00 Child(ren)'s Name(s): DOB PACSES Case Number 716105370 Plaintiff Name JUANA J;~CKSON Docket Attachment Amount OOIDS 2003 $ 183.34 Chi/dlren)'s Name(s): DOB you are required to enroll the child(ren) in any health insurance coverage available employee's/obligor's employment. If you are required to enroll the child(ren) in any health insurance coverage available employee'slobligor's employment. PACSES Case Number Plaintiff Name PACSES Case Number Plaintiff Naml~ Docket Attachment Amount $ 0.00 Chi/d(ren)'s Name(s): DOB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB you are required to enroll the child(ren) in any health insurance coverage available employee's/obligor's employment. you are required to enroll the child(ren) above in any health insurance coverage available employee's/obiigor's employment. PACSES Case Number Plaintiff Name PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Docket Attachment Amount $ 0.00 Chi/d(ren)'s Name(s): DOB you are required to enroll the child(ren) above in any health insurance coverage available the employee's/obligor's employment. you are required to enroll the child(ren) in any health insurance coverage available employee's/ob/igor's employment. Addendum Form EN-028 Worker ID $OINC Service Type M OM6 No,; 0970-0154 n r-' (") <= r,- c:.:> -n en , ::r,"'" -l ',': :I:.,..-. c:= f1'e: Cd) C'> :~~:"l _I. ;"" Cl ) (1.) , " ~.:' ; -:-;, " , -) (i'i :p" , N ~- "\ -":l' ?o ~.~ '" .-< CP :..:: ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsvlvania Co./City/Dist. of CUMBERIJWD Date of Order/Notice 04/14/06 Case Number (See Addendum for case summary) ~ XI \ OlLo02_ 02..- C\L\.\ C\\J; \ o Original Order/Notice @ Amended Order/Notice o Terminate Order/Notice RE: JACKSON, METFORD K. Employee/Obligor's Name (last, First, MI) Employer/Withholder's Federal E1N Number SEDGWICK CLAIMS MANAGEMENT SVC PO BOX 8006 PHILADELPHIA PA 19101-8006 \ \\.1)\ 0 5~\O 3\2. S 2COO 211-32-1806 Employee/Obligor's Social Security Number 8306100950 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA nON: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERIJWD County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee'sfobligor's income until further notice even if the Order/Notice is not issued by your State. $ 250.00 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? ayes (Xl 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 $ 250 . 00 per month to be forwarded 10 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: $ 57.69 per weekly pay period. $ 115.38 per biweekly pay period (every two weeks). $ 125.00 per semimonthly pay period (twice a month). $ 250.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydatefdate 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 SS% of the employee'sf 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, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR scgoc TY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAtL. ~ YOUR . ~ v\ 0..\..1 Date of Order: APR 1 7 2006 I OM.NO.M7~':~ ~. ~~' Form E~~ Worker 10 $0 C Service Type M ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o If (;hecked you are required to provide a I'opy of this form to your employee. If yo~r employee works in a state that is different 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 identify the portion of the single payment that is attributable to each employee/obligor. 3. * Repvd;"g llle r ayJale/Dak- uf W;lllllold;1I5' Yuu IIIIJst lepolt llle f-'oydale!ddtt uf yy;lllllvld;1l5 vvlle.. selld;h5 llll:: paYIIII::IIl. Tile ()a.ydalddatt: of yy;tl11Ivld;115 ;::lLIII;::: date VII vvL;d, 0.11I01,.11 It VYO;:) yy;U.lu::ld flOll1 tile cllljJlvyec';, YV<J~S. 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 withhold ing 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's1obligor'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: 8917100183 EMPLOYEE'S/OBlIGOR'S NAME: JACKSON, METFORD K. EMPLOYEE'S CASE IDENTIFIER: B306100950 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 govems unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 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.5.c. 91673 (b)l; or 2) the amounts allowed by the State of the employee's1obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income leh aher making mandatory deductions such as: State, Federal; local taxeSi 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. 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 Page 2 of 2 Form E N-028 Worker ID $OINC Service Type M OM8 No.: Q<J7Q.OIS4 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: JACKSON. METFORD K. PACSES Case Number 417107602 Plaintiff Name JUANA JACKSON Docket Attachment Amount 02=-947CIVIL $ 250.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name DOB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB If you are required to enroll the child(ren) in any health insurance coverage available through the employee's1obligor's employment. If checked, you are required to enroll the child(ren) in any health insurance coverage available employee's1obligor's employment. PACSES Case Number Plaintiff Name PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB D 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. D If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's1obligor's employment. PACSES Case Number Plaintiff Name PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Namels): DOB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB o If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's1obligor's employment. o If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's1obligor's employment. Addendum Form EN-02a Worker ID SOINC Service Type M OM! No.: 0970.01 S4 c (- c ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 4-11 ) 0'7 to 00:2 0,1 - CJ4-1 C/V lL " State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 10/09/06 Case Number (See Addendum for case summary) o Original Order/Notice o Amended Order/Notice o Terminate Order/Notice SEDGWICK CLAIMS MANAGEMENT SVC PO BOX 8006 PHILADELPHIA PA 19101-8006 RE: JACKSON, METFORD K. Employee/Obligor's Name (last, First, MI) 211-32-1806 Employee/Obligor's Social Security Number 8306100950 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (last, First, MI) EmployerMithholder's Federal EIN Number See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA nON: 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. $ 0.00 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? Oyes @ 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 $ 0.00 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: $ 0 . 00 per weekly pay period. $ 0.00 per biweekly pay period (every two weeks). $ 0.00 per semimonthly pay period (twice a month). $ 0.00 per monthly pay period. REMITTANCE INFORMA nON: 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 required by Pennsylvania law (23 PA C.S. ~ 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA 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, PA YMENTS 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 COUR~ n'-. ,. , ~) 2nr~f Date of Order:-':c; - ........., Service Type M OMB No.: 0970-01 S4 Form EN-028 Rev. 1 Worker I D $OINC .; ~ ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o If ~hecked you are required to provide a copy of this form to your employee. If your employee works in a state that is different 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 identify the portion of the single payment that is attributable to each em p loyee/ob I igor. 3. * Repoltil.g tl,e Paydate/Date of'vVitl,l,olding. You n,ust leport ti,e paydate/datt: ofvvitl,I,oldil.g wkell selldillg ti,e paylllel,t. Ti,e paydate/date of vvitl.l,oldil,g is tl,e date 01, vvl.ich al"ount was witl.l,eld flOI" ti,e el"ployee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4. * Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 8917100183 EMPLOYEE'S/OBLlGOR'S NAME: JACKSON, MET FORD K. EMPLOYEE'S CASE IDENTIFIER: 8306100950 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. g 1673 (b)l; 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. 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 AITACHMENT 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 Form EN-028 Rev. 1 Worker I D $OINC Service Type M OMB No.: 0970-0154 .' " ADDENDUM Summary of Cases on Attachment Defendant/Obligor: JACKSON, METFORD K. PACSES Case Number 417107602 Plaintiff Name JUANA JACKSON Docket Attachment Amount 02-947 CIVIL $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name DaB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DaB If checked, you are required to enroll the child(ren) above in any health insurance coverage available through the employee's/obligor's employment. o 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 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DaB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DaB o 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) above in any health insurance coverage available the employee's/obligor's employment. PACSES Case Number Plaintiff Name PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DaB Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DaB If checked, you are required to enroll the child(ren) above in any health insurance coverage available the employee's/obligor's employment. If checked, you are required to enroll the child(ren) in any health insurance coverage available employee's/obligor's employment. Addendum Form EN-028 Rev. 1 Worker J D $OINC Service Type M OMB No,: 0970-0154 c. ~~~~ o -n .-1 :I:-n rn~~ _.,'-' 'f;~ o ~- ,.,.\,.- f",) 0-'