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HomeMy WebLinkAbout05-4010 LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYL VANIA v. CIVIL ACTION - LAW NO.2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant. IN DIVORCE AFFIDAVIT OF SERVICE OF COMPLAINT PURSUANT TO PA. R.C.P. RULE NO. 1920.4 (a)(1)(O COMMONWEALTH OF PENNSYLVANIA : SS: COUNTY OF CUMBERLAND NOW, Marcus A. McKnight, ill, Esquire, being duly sworn according to law, does depose and state: 1. That he is a competent adult and attorney for the plaintiff in the captioned action in divorce. 2. That a certified copy of the Complaint in Divorce: was served upon the defendant, Kenneth E. Small, on August 6, 2005, by certified, restricted delivery mail, addressed to him at 3 I 6 West Juniata Parkway, MiIIerstown, Pennsylvania 17062, with Return Receipt Number 7003 3 I 10 0004 5770 5520. 3. That the said receipt for certified mail is signed and attached hereto and made a part hereof. I verify that the statements made in this affidavit are ue and correct. I understand that false statements herein made are subject to the penalties 0 Pa. C. . Section 4904, relating to unsworn falsification to authorities. GHT, III, ESQUIRE tiff ..... Date: August 10, 2005 D ru Ul Ul D HAM(JJ!fbF I MIA r'- r'- ,n Ul -' ::r- ClNtlflodFee 2,30 D D D l, D 3,50 .-'l .-'l g,3 . ", Total Postage & Fees $ <:) ", D D r'- ("') ~ -vr~: Q}rr ~;;;:'.. ",::".' (.i;l< ...., = = c..n ... c:= c;? C> ~ ~ ~:o~ :.0 o ~3 oM ~ ~ ..." :x ~ (}'I C> LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW ; }tl))- '1010 CIVIL TERM KENNETH E. SMALL, Defendant. 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 of the Prothonotary, Cumberland County Courthouse, Carlisle, Peunsylvania 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 ALA WYER 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 32 South Bedford Street Carlisle, Pennsylvania 17013 717-249-3166 1-800-990-9108 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of Cumberland County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office. All arrangements must be made at least 72 hours prior to any hearing or husiness before the court. You must attend the scheduled conference or hearing. LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW ~ oS' ~ tf >;> 10 CIVIL TERM KENNETH E. SMALL, Defendant. IN DIVORCE COMPLAINT IN DIVORCE PURSUANT TO SECTIONS 3301(C) ~ ill} m: THE DIVORCE CODE AND NOW, comes the Plaintiff, Linda M. Small, by and through her attorneys, Irwin, & McKnight, and files this Complaint in Divorce against the Defendant, Kenneth E. Small, representing as follows: 1. The Plaintiff is Linda M. Small, an adult individual residing at 21 Furnace Hollow Road, Shippensburg, Cumberland County, Pennsylvania 17257. 2. The Defendant is Kenneth E. Small, an adult individual currently residing at 316 West Juniata Parkway, Millerstown, Pennsylvania 17062-9208-16. 3. The Plaintiff and Defendant have been residents of the Commonwealth of Pennsylvania at least six months prior to the filing of this action in divorce. 4. The Plaintiff and the Defendant were married on August 2, 1996 in Cumberland County, Pennsylvania. 5. There have been no prior actions of divorce or for annulment between the parties. 6. Pursuant to the Divorce Code, Sections 3301{c) and 3301{d), the Plaintiff avers as the grounds upon which this action is based that the marriage between the parties is irretrievably broken. WHEREFORE, the Plaintiff respectfully requests judgment dissolving the marriage between the two parties. Respectfully submitted, IRWIN & McKNIGHT Dated; August 5, 2005 13-3222 VERIFICATION The foregoing Complaint in Divorce is based upon infonnation which has been gathered by counsel and myself in the preparation of this action. I have head the statements made in this document and they are true and correct to the best of my knowledge, infonnation and belief. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S.A. Section 4904, relating to unsworn falsification to authorities. Date: August 5, 2005 LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW CIVIL TERM KENNETH E. SMALL, Defendant. IN DIVORCE PLAINTIFF'S MARRIAGE COUNSELING AFFIDAVIT The plaintiff, being duly sworn according to law, deposes and says: 1. I have been advised of the availability of marriage counseling and understand that I may request that the court require that my spouse and I participate in counseling. 2. I understand that the court maintains a list of marriage counselors in the Prothonotary's Office, which list is available to me upon request. 3. Being so advised, I do not request that the court require that my spouse and I participate in counseling prior to a divorce decree being handed down. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Date: August 5, 2005 @ t""'-,j ,-:,,-,:> ("."} <"..n :? ~ r-h u, ~ (J ---- I --0 ( ~,"1 it:t ~ '0 '" V', -,'. ~ Q y-. ,,) ~ -Sl ~ c,-: -:l U,) L'u, 9-..:l L, <;:) ---c. LINDA M. SMALL, PetitionerlPlaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYL VANIA v. CML ACTION - LAW NO.05"-l{oto CIVIL TERM IN DIVORCE KENNETH E. SMALL, Respondent/Defendant PETITION FOR ALIMONY PENDENTE LITE AND NOW, comes LINDA M. SMALL, by and through her attorneys, IRWIN & McKNIGHT, and petitions this Honorable Court as follows: 1. The petitioner/plaintiff is Linda M. Small who currently resides at 21 Furnace Hollow Road, Shippensburg, Pennsylvania. 2. The respondent/defendant herein is Kenneth E. Small who currently resides at 316 West Juniata Parkway, Millerstown, Pennsylvania 17062-9208-16. 3. Petitioner and respondent were married on August 2, 1996, in Cumberland County, Pennsylvania and were separated on May 19, 2005. 4. ". Petitioner is without the ability to earn income sufficient to meet her reasonable needs. WHEREFORE, petitioner, Linda M. Small, respectfully requests that this Honorable Court order alimony pendente lite in an amount equal to the Pennsylvania State Support Guidelines. Respectfully submitted, IRWIN & Me By: Date: August S, 200S .... 2 VERIFICATION The foregoing document is based upon infonnation which has been gathered by counsel and myself in the preparation of this action. I have read the statements made in this document and they are true and correct to the best of my knowledge, infonnation and belief. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S.A. Section 4904, relating to unsworn falsification to authorities. ~d{ INDA M. SMALL Date: August 5, 2005 ... 3 ) "'\) ,-' ,--- i;-{-<. \ 0; - - <.....< '., c:- O IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVk~IA LINDA M. SMALL Plaintiff NO.O'>' L/010 V. CIVIL ACTION - LAW IN DIVORCE KENNETH E. SMALL Defendant DRS ATTACHMENT FOR nPL PROCEEDINGS PETITIONER NAME LINDA M. SMALL ADDRESS 21 FURNACE HOLLOW ROAD, SHIPPENSBURG, PA BIRTH DATE 2/27/45 SOCIAL SECURITY NUMBER 164-36-5365 HOME PHONE 717.532.2514 WORK PHONE N/A EMPLOYER NAME N/A EMPLOYER ADDRESS JOB TITLE/POSITION DATE EMPLOYMENT COMMENCED GROSS PAY NET PAY OTHER INCOME N/A ATTORNEY'S NAME IRWIN & McKNIGHT ATTORNEY'S ADDRESS 60 WEST PO SUt""H CARLISLE, PA 17013 ATTORNEY'S PHONE NUMBER 717.249.2353 RESPONDENT NI\ME KENNETH E. SMALL .>10 W~:;T A PARKWAY ADDRESS HlLLERSTOWN, PA 17062-9208-16 BIRTH DATE AUGUST 5. 1926 SOCIAL SECURITY NUMBER 174-20-3268 HOME PHONE 717.589.3275 WORK PHONE N/A EMPLOYER NAME RETIRED EMPLOYER ADDRESS JOB TITLE/POSITION DATE EMPLOYMENT COMMENCED . GROSS PAY $1,614.25 NET PAY OTHER INCOME ATTORNEY'S NAME SAMUEL L. ANDES, ESQ. ADDRESS :>L:> STMET ATTORNEY'S P.O. BOX 168, LEMOYNE, PA 17043 ATTORNEY'S PHONE NUMBER 717.761.5361 MARRIAGE INFORMATION DATE OF MARRIAGE AUGUST 2, 1996 PLACE OF MARRIAGE CUMBERLAND COUNTY, PA DATE OF SEPARATION MAY 19, 2005 ADDRESS OF LAST MARITAL HOME DESCRIPTION OF DOCUMENT RAISING APL CLAIM DATE APL DOCUMENT FILED AUGUST 5, 2005 ,"'> ;:% ~ ~ -I--... ~ ~ (;1 f'-:?, Z; _.I ...-(. -' ,-, ~:f; --:-! (J\ -" -".~ r:"; - ~ C) ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsvlvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 08/10/05 Case Number (See Addendum for case summary) -,<=1510,555 O'=>- 4010 C2.iv\l o Original Order/Notice o Amended Order/Notice o Terminate Order/Notice SOCIAL SECURITY ADMINISTRATION C/O BETH GRONINGER 200 S SPRING GARDEN ST # CARLISLE PA 17013-2578 RE: SMALL, KENNETH E. Employee/Obligor's Name (Last, First, Ml) 174-20-3268 Employee/Obligor's Social Security Number 3683101504 Employee/Obligor's Case Identifier (S("e Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (last First MD EmployerMlithholder's Federal EIN Number See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA 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. $ 646.00 per month in current support $ 54.00 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 $ 700.00 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 161.54 per weekly pay period. $ 323.08 per biweekly pay period (every two weeks). $ 350.00 per semimonthly pay period (twice a month). $ 700.00 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 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 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If remitting by EFT/EDI, please call Pennsylvania State Collections and Disbursement Unit (SCDU) Employer Customer Service at '-877-676-9580 for instructions. Make Remittance Payable to: P A SCOU Send check to: Pennsylvania SCOU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PA YMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER 10 (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Date of Order: AUG 1 1 2005 Form E~ Worker ID $OINC Service Type M OMB No.: 0970.0154 ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o If ~hecked you are required to provide a copy of this form to your ~mployee. 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 em ployee/ob I igor. 3. * Repolt;hg tile fayddte'Dale of 'vV;LI.lloldhlg. YOu '!lUst lepolt tIle fJdydate-fdClte vi vvitlll,old;"5 vvl,ell ,elldill~ tIn;::: jJaYlllellt. TIle jJayddte/Jatc: of vv;tl,lloldil'5;;:' tLe Jale 011 VVII;d\ d.1\I0Ulll '1''1(\;:. vv;tlllleld flUII, 'llle elllpluyt't::';:! vva5fs. You must comply with the law of the state of the employee's/obiigor'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 ali support Order/Notices due to Federal or State withholding limits, you must foliow the law of the state of empioyee's/obligor's principai 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: 8384100092 EMPLOYEE'S/OBlIGOR'S NAME: SMALL , KENNETH E. EMPLOYEE'S CASE IDENTIFIER: 3683101504 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 iaw 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 discipiinary 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 iesser of: 1) the amounts aliowed by the Federal Consumer Credit Protection Act (15 U.s.c. 91673 (b)l; or 2) the amounts aliowed by the State of the employee's/obligor's principal piace of employment. The Federal iimit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income ieft 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/obiigor 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 EN-028 Worker iD $OINC Service Type M QMB No.: 0970-0154 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: SMALL. KENNETH E. PACSES Case Number 795107555 Plaintiff Name LINDA M. SMALL Docket Attachment Amount 05=4010 CIVIL$ 700.00 Child(ren)'s Name!s): PACSES Case Number Plaintiff Name 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 through the employee's/obligor's employment. you are required to enroll the child(ren) in any health insurance coverage available 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): 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 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): 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's/obligor's employment. you are required to enroll the child(ren) above in any health insurance coverage available the employee's/obligor's employment. Addendum Form E N-028 Worker ID $OINC Service Type M OMBNo.:0970-Q154 ~ ::\\ ~ ~ ;: '" . -r-' > - ~ ?A ........ ')-) ~ ~ 'e :. " ...;.- "'\ ". ~ LINDA M. SMALL Plaintiff/Petitioner IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE KENNETH E. SMALL, DefendantlRespondent NO. 05-4010 CIVIL TERM IN DIVORCE PACSES# 795107555 ORDER OF COURT AND NOW, this 11th day of August, 2005, based upon the Court's detetmination that Petitioner's monthly net income/earning capacity is $0.00 and Respondent's monthly net income/earning capacity is $1,614.25, it is hereby Ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit, $700.00 per month payable monthly as follows; $646.00 for alimony pendente lite and $54.00 on arrears. First payment due within ten (10) days of this order. Arrears set at $646.00 as of August 10, 2005. The effective date of the order is 08/05/05. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C.S.s 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and its discretion make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the P A SCDU to: LINDA M. SMALL. Payments must be made by check or money order. All checks and money orders must be made payable to P A SCDU and mailed to: P A SCDU P.O. Box 69110 Harrisburg, P A 17106-9110 Payments must include the defendant's P ACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. Unreimbursed medical expenses that exceed $250.00 annually are to be paid as follows: 0% by Respondent and 100% by Petitioner. The Petitioner is responsible to pay the first $250.00 annually in unreimbursed medical expenses. Respondent to provide medical insurance coverage. Within thirty (30) days after the entry of this Order, the Respondent shall submit to Petitioner written proof that medical insurance coverage has been obtained or that application for coverage has been made. Proof of coverage shall consist, at minimum, of: 1) the name ofthe health care coverage provider(s); 2) any applicable identification numbers; 3) any cards evidencing coverage; 4) the address to which claims should be made; 5) a description of any restrictions on usage, such as prior approval for hospital admissions, and the manner of obtaining approval; 6) a copy of the benefit booklet or coverage contract; 7) a description of all deductibles and co-payments; and 8) five copies of any claim forms. Other Conditions: The defendant's social security benefits will be attached for the APL, however SSA will likely only deduct fifty percent of his social security benefits for the APL amount. Therefore, the defendant will have to make direct payment to the State Collection and Disbursement Unit for the difference of the deducted amount. The plaintiff is to report to the Domestic Relations Section, immediately, upon approval of any disability benefits. This Order shall become final ten days after the mailing of the notice of the entry of the Order to the parties unless either party files a written demand with the Prothonotary for a hearing de novo before the Court. Copies mailed to parties 08/11/05. Consented: Petitioner Petitioner's Attorney Respondent Respondent's Attorney BY THE COURT, DRO: R.J. Shadday Plaintiff/Petitioner Defendant/Respondent Marcus McKnight, III, Esquire Samuel Andes, Esquire EdW~~ Judge ..,..-~ 1:;' C~; fl. -;-7' ~~-' r- ~-;; ":::."1-, .~~~~ _.--1 -< o c .- ,..., t,";:.::.,') C"..o "" t= c-> ~ :r!...,., "'F -om ",0 c+:, :i:::H ~?(:s om -_.~ ;p- -:0 '-< N -0 ::J,: C? ..::J In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION LINDA M. SMALL ) Docket Number 05-4010 CIVIL Plaintiff ) vs. ) PACSES Case Number 795107555 KENNETH E. SMALL ) Defendant ) Other State ID Number ORDER OF COURT You, KENNETH E. SMALL plaintiff/defendant of c/o KENDALLE WILT, 316 W JUNIATA PKWY, MILLERSTOWN" PA. 17062-9208-16 are ordered to appoor at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 . before a hearing officer of the Domestic Relations Section, on the SEPTEMBER 26, 2005 at 1: 30PM for a hearing. You are further required to bring to the hearing: I. a true copy of your most recent Federal Income Tax Return, including W -2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. verification of child care expenses, and 4. proof of medical coverage which you may have, or may have available to you 5. information relating to professional licenses 6. other: Service Type M Form CM-509 Worker ID 21302 SMALL V. SMALL P ACSES Case Number: 795107555 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest or enter an order in your absence. If paternity is an issue, the court may enter an order establishing paternity. The appropriate court officer may enter an order against either party based upon the evidence presented without regard to which party initiated the support action. BY THE COURT: Date of Order: I-,).)..-{)) ,'-- ) .=-r ~ JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of2 Form CM - 509 Worker ID 21302 Service Type M o s;;: -;""" ~:.:c~ eel.: ~..-;.; -:-1 th~, (:: :.~, '.. ~ c.> "" :to" c: G) N W ~ccc. )>..c 2, :< .~ -.:J :z: '-? ~ ~~ rl1p en ~o ";.....1.. C.... () .-,~ "':'-1 -:::-b i,- z~ o .04 ;B:; :2: c:::> In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION LINDA M. SMALL ) Docket Number 05-4010 CIVIL Plaintiff ) vs. ) PACSES Case Number 795107555 KENNETH E. SMALL ) Defendant ) Other State 10 Number ORDER OF COURT You, LINDA M. SMALL plaintiff/defendant of 21 FURNACE HOLLOW RD, SHIPPENSBURG, PA. 17257-9611-21 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS ope, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the SEPTEMBER 26, 2005 at 1: 30PM for a hearing. You are further required to bring to the hearing: I. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. verification of child care expenses, and 4. proof of medical coverage which you may have, or may have' available to you 5. information relating to professional licenses 6. other: Service Type M Form CM-509 Worker 10 21302 SMALL v. SMALL PACSES Case Number: 795107555 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest or enter an order in your absence. If paternity is an issue, the court may enter an order establishing paternity. The appropriate court officer may enter an order against either party based upon the evidence presented without regard to which party initiated the support action. BY THE COURT: Date of Order: ) -) )-0'\ ~ ~-r1' JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. TIllS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGmLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE FA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of2 Form CM-509 Worker ID 21302 Service Type M ~ <3> ~ (;"> tj, Cl c:; "",""- ....0\\-, \^}:,\,', ", ~..::;. \, tz~~'~: \<-', .<~~ ~~::~ .~ ~- q, ~~~ :\V:) .,,;) (-) ~~;\..c..\i.. -(~76 e.d (\\ '0 .,~ ~ "'" ...,:. ,-,' .' /' o - Commonwealth of Pennsylvania County of Cumberland, 55: LINDA M. SMALL, Plaintiff In the Court of Common Pleas of Cumberland County, Pennsylvania vs. No. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant Motion for Appointment of Master KENNETH E. SMALL, Defendant moves the court to appoint a Master with respect to the fOllowing claims: ) Divorce ( ) Annulment (XX) Alimony ( ) Alimony Pendente Lite (XX) Distribution of Property ( ) Support lXX) Counsel Fees (XX) Costs and Expenses and in support of the motion states: 1. Discovery is complete as to the claimlsl for which the appointment of a Master is requested. 2. The Plaintiff has appeared in the action by her attorney, Marcus A. McKnight. m, Esquire. 3. The statutory ground(s) for divorce are: !l 330 \ (<-) 4. Check the applicable paragraph(s). ( ) The action is not contested. ( ) An agreement has been reached with respect to the following claims: ex ) The action is contested wIth respect to thp following claims: AhM~"'h f2Q.\i),~'f, I ~\ te-e~ 5. The action does not irlvolve complex issues of law or fact. 6. The hearing is expected to take Y, day. 7. Additional information, if any, relevant to the motion: 21 A'~d~~ Date ~~~~~ Sam L. Andes Attorney for Defendant AND NOW, 2005, , Esquire, is appointed Master with respect to the following claims: alimony, counsel fees, costs and expenses. BY THE COURT. J. ....., """ ~ "'" c:: c") f\J ~ ~ 'i! nl f!1 :t1,.,., :lJC _~::?C-', -,_J ~r s~i~ c;rrr ',-j "'" ::0 -< t) -,- ~. S:.) .::- "" Commonwealth of Pennsylvania County of Cumberland, ss: Plaintiff In the Court of Common Pleas of Cumberland County, Pennsylvania LINDA M. SMALL, vs. No. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant Motion for Appointment of Master KENNETH E. SMAll, Defendant moves the court to appoint a Master with respect to the fOllowing claims: ) Divorce ( ) Annulment (XX) Alimony ( ) Alimony Pendente Ute (XX) Distribution of Property ( ) Support (XX) Counsel Fees (XX) Costs and Expenses and in support of the motion states: 1. Discovery is complete as to the c1aim{s) for which the appointment of a Master is requested. 2. The Plaintiff has appeared in the action by her attorney, Marcus A. McKnight, III, Esquire. 3. The statutory ground(s) for divorce are: ~ 3301 (<:) 4. Check the applicable paragraph(s). ( ) The action is not contested. ( ) An agreement has been reached with respect to the following claims: it< ) The action is contested wlth respect to thfil following claims: AhMo,,"'/) EQ..~:':.'T. i ~\ te-e"> 5. The action does not involve complex issues of law or fact. 6. The hearing is expected to take % day. 7. Additional information, if any, relevant to the motion: 21 A. ~(<.,-\:-2qb Date s3\~~; ~ Attorney for Defendant '- .~ .3 2005, [!~ ~ESqUire, ect to the following claims: alimony, counsel fees, costs and I AND NOW, -,'-u is appointed Master with re expenses. BY T~J1 AIV\ ( II' f--V-Y---1 ~ J. ""\("":;;s~., N-'''' ,",~V.,~ q ~ :G\ Ie'::] \ S 'J\\';J \'.\U~ . "f-'" 1,""" \. ('.\,,~,...\ ::'11 \\ ..10 I\dg}:"iI',u"\;;'j,,,~ .,n.l. .. I ,X'\u4".{\:\lB .........1."....'-' '" S5 <-, ::I'",.},O. :;:: ~ - '" lO 'f? :J! III :0 :D F;; t,[:;tC::' . __/""t -,j ~,-~ :;:? iEi (3n~ ::..-! ..~ ;:0 -< ~,;;? -. G~ " .!:.- W II ~. ~. Plaintiff ) ) ) ) ) ) ) ) ) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA LINDA M. SMALL, vs. CIVIL ACTION - LAW NO. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant IN DIVORCE PETITION FOR EQUITABLE DISTRIBUTION AND NOW comes the above-named Defendant, by his attorney, Samuel L. Andes, and makes the following claim for equitable distribution in this matter: 1. Petitioner herein is the Defendant. The Respondent herein is the Defendant. 2. During the parties' marriage, they acquired an interest in real property and personal property, much of which is now in the possession of Plaintiff and some of which is titled in Plaintiff's name alone. Those assets are, nevertheless, marital property. 3. Defendant requires action by this court to award to him his reasonable portion of the marital assets and asks that the court equitably distribute those assets in this divorce action. WHEREFORE, Defendant prays this court to equitably divide and distribute the marital assets of the parties. ~ Attorney for Defendant Supreme Court ID # 17225 525 North 12th Street Lemoyne, Pa 17043 (717) 761-5361 II .- I verify that the statements made in this document are true and correct. I understand that any false statements in this document are subject to the penalties of 18 Pa. C.S. 4904 (unsworn falsification to authorities). Date: ~J~Q IDJ) ~~if#C \~ KENNETH E. SMALL CI 0-0 = 0 ~ c = , <.n ,., ",. :::l ~ c:: ,,;J~ ." G') Il1p .. \,-.') Ire3 ~ \D (-::?,\ ~ : ....~ \... ..~. :J~ :.~; _.,,- ,,;C) "<\ GJ :'=';;;rn ~ :::::\ ~ ~ ~. cn ~ N .< '-..1 (', ~ II I , LINDA M. SMALL, Plaintiff vs. ) ) ) ) ) ) } ) ) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301 (cl of the Divorce Code was filed on 5 August 2005 and served on 9 August 2005. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of both the filing and service of the complaint. 3. I consent to the entry of a final decree in divorce after service of a Notice of Intention to Request Entry of the Decree. WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(c) OF THE DIVORCE CODE 1. I consent to the entry of a final decree in 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. Section 4904 relating to unsworn falsification to authorities. ~ J;)QJ05" Date: cY~~,~ ~~~ KENNETH E. SMALL , "-> ~ c..., en :b. .- '- i:;-;;' ," l....0 :~" ~ ~ f"11::D ,-- _-:0 fl; -/JCJ ~.? ,.1 _:T:~T"::,' '~) !'j C.," ('5 '-511/ fE,1 ." c,) - .. C) II i' LINDA M. SMALL, ) IN THE COURT OF COMMON Plaintiff ) PLEAS OF CUMBERLAND ) COUNTY, PENNSYLVANIA ) vs. ) CIVIL ACTION - LAW ) ) NO. 2005-4010 CIVIL TERM KENNETH E. SMALL, ) Defendant ) IN DIVORCE ACCEPTANCE OF SERVICE I hereby enter my appearance in the above matter for the Defendant, KENNETH E. SMALL, and accept service of the Complaint in Divorce and acknowledge receipt of a copy of the same. ~Qn DATED: 9 August 2005 Attorney for Defendant Supreme Court 10 # 17225 525 North 12th Street Lemoyne, Pa 17043 (717) 761-5361 c::-'- ~.:::~; -< ,..., = = CJ' "" c: G' ", \.!:) J \, ~--rl rnp -om -.',0 ~:~<!.') .::".T. ,~: -r) <~(~ ;:sm -..; ~' :~ -n ::r: f.;'? o In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION LINDA M. SMALL ) Docket Number 05-4010 CIVIL Plaintiff ) vs. ) PACSES Case Number 795107555 KENNETH E. SMALL ) Defendant ) Other State ID Number ORDER OF COURT - RESCHEDULE A HEARING You, LINDA M. SMALL of 21 FURNACE HOLLOW RD, SHIPPENSBURG, PA. 17257-9611-21 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 on the 8TH DAY OF NOVEMBER, 2005 at 9: OOAM for a hearing. This date replaces the prior hearing date of SEPTEMBER 26, 2005. ..... = ~ :=J ~Q ~D::::~ ~C'i"~- .- if-;-'-, You are further required to bring to the hearing: ,::..: CJ ,..C10 1. a true copy of your most recent Federal Income Tax Return, including W -2s, ~ m~, J> 2. your pay stubs for the preceding six (6) months,'~:~r'\ q 3. the Income and Expense Statement attached to this order as required by Rule liii~ll (c). 0 4. verification of child care expenses, and {.l> ..0 5. proof of medical coverage which you may have, or may have available to you 6. information relating to professional licenses 7. other: c/' rn -0 cr Service Type M Form CM-5l4 Worker ID 213 02 SMALL v. SMALL PACSES Case Number: 795107555 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest or enter an order in your absence. If paternity is an issue, the court may enter an order establishing paternity. The appropriate court officer may enter an order against either party based upon the evidence presented without regard to which party initiated the support action. BY THE COURT: Date of Order: '1-\b-(,)~ :::.~ JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of 2 Form CM-514 Worker ID 21302 Service Type M In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION LINDA M. SMALL ) Docket Number 05-4010 CIVIL Plaintiff ) vs. ) PACSES Case Number 795107555 KENNETH E. SMALL ) Defendant ) Other State ID Number ORDER OF COURT - RESCHEDULE A HEARING You, KENNETH E. SMALL of c/o KENDALLE WILT, 316 W JUNIATA PKWY, MILLERSTOWN, PA. 17062-9208-16 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 on the 8TH DAY OF NOVEMBER, 2005 at 9: OOAM for a hearing. This datereplac~ :i.g ~ '-~~F ~ wr-, -0 ~~o ._,,::no ----,-q -"01-rl ~~rc=-) '~~rrl 0- the prior hearing date of SEPTEMBER 26, 2005. You are further required to bring to the hearing: :I> -j.::.:::.,J 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed:,iji 2. your pay stubs for the preceding six (6) months, 3. the Income and Expense Statement attached to this order as required by Rule 1910.11 (c). 4. verification of child care expenses, and 5. proof of medical coverage which you may have, or may have available to you 6. information relating to professional licenses 7. other: q co ..D Service Type M Form eM -514 Worker ID 21302 SMALL v. SMALL PACSES Case Number: 795107555 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest or enter an order in your absence. If paternity is an issue, the court may enter an order establishing paternity. The appropriate court officer may enter an order against either party based upon the evidence presented without regard to which party initiated the support action. BY THE COURT: Date of Order: --3., \ \:,-() \" c;~ JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For infonnation about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of2 Form CM-S14 Worker 10 21302 Service Type M o C ->' '!~: -r-:,;.:,' t\\!'. , f;;?'j ..... ~ -, c.Q ~~:~ .' ~~: 2:' :2 ~ ~ '6j - Cl" ..." - -"" ~ ~~ ""~ :3 \~:,{ 90 --.-f'r\ ~?\ 2::>- ~ 'i? U1 "" ~ LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant. IN DIVORCE PLAINTIFF'S AFFIDAVIT OF CONSENT 1. A complaint in divorce under Section 330l(c) or 330l(d) of the Divorce Code was filed on August 5, 2005. 2. The marriage of plaintiff and defendant is irretrievably broken and ninety days have elapsed from the date of the filing of the complaint. 3. I consent to the entry of a final decree in divorce. 4. 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. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Date: r;; ;?g >>c.J (; I P1 S;;~ff NDA M. SMALL laintiff ( (,') LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant. IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REOUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(c) OF THE DIVORCE CODE 1. I consent to the entry of a final Decree of Divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court 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 made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Date: 6b;L~ ..)00, . ( ~-) LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant. IN DIVORCE DEFENDANT'S AFFIDAVIT OF CONSENT 1. A complaint in divorce under Section 3301(c) or 3301(d) of the Divorce Code was filed on August 5, 2005. 2. The marriage of plaintiff and defendant is irretrievably broken and ninety days have elapsed from the date of the filing of the complaint. 3. I consent to the entry of a final decree in divorce. 4. 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. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa. C. S. Section 4904 relating to unsworn falsification to authorities. Date: 2l$" ~ 2Q"h ~/?V'r~ c? (G-O??~ KEN TH E. SMALL . Defendant " LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant. IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(c) OF THE DIVORCE CODE 1. I consent to the entry of a final Decree of Divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court 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 made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Date: 4?M 2u:;x:.. J/~/7'~ C- 1~y.rV""'# KENNETH E. SMALL Defendant (,:' LINDA M. SMALL, Plaintiff, : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW NO. 2005-4010 CIVIL TERM KENNETH E. SMALL, Defendant. IN DIVORCE DEFENDANT'S MARRIAGE COUNSELING AFFIDAVIT The plaintiff, being duly sworn according to law, deposes and says: I. I have been advised of the availability of marriage counseling and understand that I may request that the court require that my spouse and I participate in counseling. 2. I understand that the court maintains a list of marriage counselors in the Prothonotary's Office, which list is available to me upon request. 3. Being so advised, I do not request that the court require that my spouse and I participate in counseling prior to a divorce decree being handed down. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Date: ~ fu 2.u:b ;;/r;/h/r'dA~;;, ~/ KENNETH E. SMALL . Defendant ,'~, LINDA M. SMALL, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA vs. NO. 05 - 4010 CIVIL KENNETH E. SMALL, Defendant IN DIVORCE ORDER OF COURT AND NOW, this \ C\-U... day of C~ 2006, the parties and counsel having entered into an agreement and stipulation resolving the economic issues on February 28, 2006, the date set for a Master's hearing, the agreement and stipulation having been transcribed, and subsequently signed by the parties and counsel, the appointment of the Master is vacated and counsel can conclude the proceedings by the filing of a praecipe to transmit the record with the affidavits of consent of the parties so that a final decree in divorce can be entered. BY THE COURT, 'd~~~~ cc: ~rcus A. McKnight, III Attorney for Plaintiff ~muel L. Andes ~ Attorney for Defendant "~...' , "..~, ( ;''''- . LINDA M. SMALL, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA VS. NO. 05 - 4010 CIVIL KENNETH E. SMALL, Defendant IN DIVORCE THE MASTER: Today is Tuesday, February 28, 2006. This is the date set for a hearing in the above captioned divorce proceedings. Present in the hearing room are the Plaintiff, Linda M. Small, and her counsel Marcus A. McKnight, III, and the Defendant, Kenneth E. Small, and his counsel Samuel L. Andes. This action was commenced by the filing of a complaint in divorce on August 5, 2005, raising grounds for divorce of irretrievable breakdown of the marriage. The Master has been provided affidavits of consent and waivers of notice of intention to request entry of divorce decree signed and dated today by both parties. The Master will file the affidavits and waivers with the Prothonotary. The divorce can be concluded under Section 3301(c) of the Domestic Relations Code. On August 29, 2005, the defendant filed a claim for equitable distribution. That appears to be the only economic claim pending before the Master; the motion 1 ~ for appointment of Master indicates that alimony and counsel fees have been raised, however, both counsel agree that those claims have not been raised and we are simply dealing with the petition for equitable distribution filed by the Defendant. The parties were married on August 2, 1996, and separated May 19, 2005. The Master has been advised that after negotiations this morning the parties have reached an agreement with respect to the claim for equitable distribution. The agreement is going to be placed on the record in the presence of the parties. The agreement as stated on the record will be considered the substantive agreement of the parties not subject to any changes or modifications except for correction of typographical errors which may be made during the transcription. After the agreement has been transcribed, it will be sent to counsel for review for typographical errors. Corrections, if any, can then be made and the parties will be asked to sign the agreement affirming the terms of settlement as stated on the record. Even though the parties, however, do not sign the agreement, they are bound by the terms of the agreement when they leave the hearing room today. Upon receipt by the Master of a completed agreement, the Master will prepare an order vacating his 2 ~ appointment and counsel can then file a praecipe transmitting the record to the Court requesting a final decree in divorce. Mr. Andes. MR. ANDES: The parties have agreed to resolve all of the economic issues in this case on the following terms: 1. Mr. Small hereinafter referred to as husband is currently paying alimony pendente lite through this Court and through the Domestic Relations Office in the amount of $700.00 per month. He will continue to make those payments through the end of September 2006. They will not be subject to modification or termination prior to the end of September 2006 unless either of the parties die in which case the APL will cease in accordance with the law. 2. All other economic claims, including claims for equitable distribution, alimony, alimony pendente lite beyond what is provided for herein, counsel fees and expenses are waived by the parties. The parties have exchanged information about the assets and liabilities of the marriage and although they do not agree upon all of that information, they have agreed not to pursue those claims further and each of them waive any further claim to pursue those rights. 3. The parties have executed consents today which will be filed with the Court and wife's attorney will file a praecipe to transmit the record in early September 2006 so that the divorce can be completed by the end of September 2006. 4. Except as herein otherwise provided, each party may dispose of his or her property in any way and each party hereby waives and relinquishes any and all rights he or she may now have or hereafter acquire under the present or future laws of any jurisdiction to share in the property or the estate of the other as a result of the marital relationship including without limitation, statutory allowance, widow's allowance, right of intestacy, right to take against the will of the other, and right to act as administrator or executor in the other's estate. Each will at the request of the other execute, acknowledge, and deliver any and all instruments which may be necessary or 3 , advisable to carry into effect this mutual waiver and relinquishment of all such interest, rights, and claims. 5. During the marriage the parties incurred a debt owed to Orrstown Bank secured by a home equity loan which constitutes a lien on real estate owned by the Plaintiff. Plaintiff agrees that she shall pay and satisfy in accordance with its terms that debt and shall indemnify and save the Defendant, Kenneth E. Small, harmless from any loss, cost, or expense caused to him by her failure to do so. Otherwise, the parties represent that there were no marital debts incurred during the marriage for which either party would be liable. MR. MCKNIGHT: Linda, you've heard the terms of the agreement read today? MS. SMALL: Yes, sir. MR. MCKNIGHT: Do you understand those terms? MS. SMALL: Yes, sir. MR. MCKNIGHT: And are you in agreement with those terms? MS. SMALL: Yes, sir. MR. MCKNIGHT: And you understand that you will continue to receive alimony pendente lite at $700.00 until the end of September and then at the end of September the divorce will be finalized and your health coverage ends then? MS. SMALL: Yes, sir. MR. MCKNIGHT: And you are okay with that? MS. SMALL: Yes, sir. MR. ANDES: Mr. Small, you've heard what I 4 , dictated here today and what we discussed. Is that what you are willing to do to settle the case? MR. SMALL: Well MR. ANDES: I didn't say if you are happy with it; I asked if you are willing to do it? MR. SMALL: I am willing to do it but I want to say one thing to all of you, the Union will not pay her insurance if we -- MR. ANDES: When the divorce is final? MR. SMALL: I don't even know if it will pay it now. MR. ANDES: Okay. MR. SMALL: And I don't have no key that belongs to you. Nothing. MR. ANDES: Otherwise, are you satisfied and willing to do what we described here today? MR. SMALL: Not satisfied but I got -- my hands are tied. MR. ANDES: So you are willing to do it? MR. SMALL: I've been paying for nine years, what's another nine months. MR. ANDES: You just have to say yes or no. MR. SMALL: Yes. I acknowledge that I have read the above stipulation and agreement, that I understand the terms of 5 " ~ . . settlement as set forth herein, and that by signing below I ratify and affirm the agreement previously made and intend to bind myself to the settlement as a contract obligating myself to the terms of settlement and subjecting myself to the methods and procedures of enforcement which may be imposed by law and in particular Section 3105 of the Domestic Relations Code. WITNESS: DATE: 41##OG c ~f; ~~~9~ g,M~ 'ao ~v'~t. <f?Yfff Kenneth E. Small Attorney for Defendant 6 .. State Commonwealth of Pennsylvania Co.lCity/Dist. of CUMBERLAND Date of Order/Notice 08/08/06 Case Number (~Addendum for case summary) ORDER/NOTICE TO WITHHOlD INCOME FOR SUPPORT 795107555 05-4010 CIVIL o Original Order/Notice @ Amended Order/Notice o Terminate OrderINotice SOCIAL SECURITY ADMINISTRATION C/O BETH GRONINGER STE 1 200 S SPRING GARDEN ST CARLISLE PA 17013-2578 RE;SMALL, KENNETH E. Employee/Obligor's Name (last, flrst, MI) 174-20-3268 Employee/Obligor's Social Security Number 3683101504 Employee/Obligor's Case Identifier ISH Addendum for plaintiff names associated with cases on attachmetltJ Custodial Parent's Name (Last, First, MI) Employer'\vjthholder's Federal EIN Number See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA 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'sfobligor's income until further notice even if the Order/Notice is not issued by your State. $ 646.00 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 $ 646.00 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: $ 149.08 per weekly pay period. $ 298.15 per biweekly pay period (every two weeks). $ 323.00 per semimonthly pay period (twice a month), $ 646.00 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 paydateldate of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee'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 (SCOU) 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. Date of Order: AUG 0 9 2006 Edward\ E. Judge Form EN-028 Worker 10 $OINC DRO: R.J. Shad day Service Type M OMB No.: 0970-0154 , ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o If.~hecked you are required, to proville a copy of this form to your~mployee. Ifyouremploye~ works in,a state that is dltterent from the state that ISSUed thiS order, a copy must be proVided to your employee even If the box IS not checked. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same Income. Federal tax levies in effect before receipt of this order have priority, If there are Federal tax levies in effect please contact the requesting agency listed below. 2, Combining Payments: You can combine withheld amounts from more than one employee/obligor's income in a single payment to each agency requesting withholding, You must, however, separately identify the portion of the single payment that is attributable to each employee/obligor. 3. * R(;tJVll;l1g lite rC1ydattdD~le vf \V;U,I,old;1I5_ Yvu IIIU:lL 1'I;;l-'vIl tile tJayddb:dddtt of n:LLI,vldihg nLICII ;)'Clld;lIg lite tJa)'IIICIlt. TLe pg)'dabddah:: of n;LLLvld;lIg;;:l lilt:: Jolt:: 011 nll;,-Ir CllIlOUlIl \'Va;) vv;U.ln;;IJ f,vIII lire e'"t-'lv)'It7C';, vvage$. You must comply with the law of the state of the employee's1obligor'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'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 ionger 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: 8384100092 EMPLOYEE'S/OBLlGOR'S NAME: SMALL , KENNETH E. EMPLOYEE'S CASE IDENTIFIER: 3683101504 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, Antkliscrimination: 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.S.c. ~1673 (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 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 ATTACHMENT UNIT by telephone at (717) 24()..622S or by FAX at (7171 24()"6248 or by internet www.childsupport.state.pa.us Service Type M Page 2 of 2 Form EN-028 Worker ID $OINC OMS No.: 0970-0154 " ADDENDUM Summarv of Cases on Attachment Defendant/Obligor: SMALL, KENNETH E. PACSES Case Number 795107555 Plaintiff Name LINDA M. SMALL Docket Attachment Amount 05=4O:iO CIVIL $ 646.00 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 availabie the employee's/obligor's employment. you are required to enroll the child(ren) in any health insurance coverage available employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s); PACSES Case Number Plaintiff Name 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) in any health insurance coverage available 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): 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) in any health insurance coverage available employee's/obligor's employment. Service Type M Addendum Form EN-028 Worker ID $OINC OMB No.; 097()..(l1 54 ~ "'Ow ~?; ~l.'... v<!~. :;<.-- !:2C' 2;:0 ~2 :z :::<. ~ ~ ~ ~~ ~ ~~\ '"'0 t)~ :s: i5i'f1 c.:> ;=..0 .. ;e:. c.:> ~ Cf' Plaintiff ) ) ) ) ) ) ) ) ) IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA LINDA M, SMALL, vs. CIVIL ACTION - LAW NO. 2005-4010 CIVIL KENNETH E. SMALL, Defendant IN DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry of a divorce decree: 1, Grounds for Divorce: Irretrievable breakdown under Section 3301 (c). 2, Date and manner of service of the Complaint: Acceotance of Service filed bv Plaintiff's counsel indicatinlZ service on Defendant bv certified mail on 6 AUlZust 2005 3. Complete either Paragraph (a) or (b): (a) Date of execution of the Affidavit of Consent required by Section 3301 (c) of the Divorce Code: By Plaintiff: 28 Februarv 2006 By Defendant: 28 Februarv 2006 (b) (1) Date of execution of the Affidavit required by Section 3301 (d) of the Divorce Code: (2) Date of filing and service of the Plaintiff's Affidavit upon the Respondent: 4, Related claims pending: None, 5. Complete either (a) or (b): (a) Date and manner of service of the Notice of Intention to File Praecipe to Transmit Record, a copy of which is attached: (b) Date Plaintiff's Waiver of Notice in Section 3301 (c) Divorce was filed with the Prothonotary: Dated 28 Februarv 2006 and filed on 3 March 2006 Date Defendant's Waiver of Notice in Section 3301 (c) Divorce was filed with the Prothonotary: Dated 28 Februarv 2006 and filed on 3 March 2006, Date: ~~(;, () ....., 0 = c = T1 s:: cro ""tJ C'; C/) :r S) L rr1 m:!J -0 -FM 7l'. I -::f"jr-1 0'} " (Jl 9~\ r: ..- :w. :;:1+ -:; ;?t"5 . - ..<:~. -"- 7':::;1"11 J> \_- 25 c ~ .-,. "'- 'po -" W ~ -< c:> IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY STATE OF PEN NA. LINDA M. SMALL, . 2005.4010 Plaintiff No. . VERSUS . KENNETH E. SMAll, Defendant . DECREE IN DIVORCE e:::r $. ''1~~ . . . . ~~ LINDA M. SMALL 2006 , IT IS ORDERED AND . AND NOW, . DECREED THAT , PLAINTIFF, . . KENNETH E. SMALL AND , DEFENDANT, . ARE DIVORCED FROM THE BONDS OF MATRIMONY. THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT YET BEEN ENTERED; NONE . . . . ATTES"(v(u&. J. ~prP'OTHONOTA" . ~~2.~~#> ?~-L-p ~ r <$'P~4V;?n 'JIl L-; . , . .",,- ' ~ '\ ~ .~.. ...... ~~. LINDA M. SMALL, Plaintiff/Petitioner IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE KENENTH E. SMALL, Defendant/Petitioner NO. 05-4010 CIVIL TERM IN DIVORCE PACSES # 795107555 ORDER OF COURT AND NOW to wit, this 7th day of September, 2006, it is hereby Ordered that pursuant to the parties' agreement before the Divorce Master on February 28, 2006, the Alimony Pendente Lite is terminated effective October 1, 2006. The account has been paid through September, 2006 and there is no balance due the Petitioner. BY THE COURT: ~W~ ], DRO: RJ. Shadday xc: Petitioner Respondent Samuel L. Andes, Esq, Marcus A. McKnight, III, Esq. Service Type: M Fonll OE-OOl Worker: 21005 ,.--:) ---j ( ."~ "---~-,_..--,.__.--'--- t' ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co.lCity/Dist. of CUMBERLAND Date of Order/Notice 09/07/06 Case Number (See Addendum for case summary) 795107555 05-4010 CIVIL o Original Order/Notice o Amended Order/Notice o Terminate Order/Notice SOCIAL SECURITY ADMINISTRATION C/O BETH GRONINGER STE 1 200 S SPRING GARDEN ST CARLISLE PA 17013-2578 RE: SMALL I KENNETH E. Employee/Obligor's Name (last, First, Mil 174-20-3268 Employee/Obligor's Social Security Number 3683101504 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (last, First, Mil EmployerMithholder's Federal EIN Number See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMA 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. $ 0 . 00 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? Oyes (X) 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 INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's! obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If 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: P A 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. Date of Order: SEP 0 8 7006 Jlrlge Form EN-028 Rev. 1 Worker I D $OINC Edward E. DRO: R. J. Shadday Service Type M OMB No,; 0970-0154 c] . ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS o If ~hecked you are required to provide a (:opy of this form to your employee. If YOl,Jr employee works in a state that is differentfrom 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. * Repolting ti,e PaydatelDate of 'Withl,olding. YOu I"ust lepoltthe paydateldate of witl,l,oldi"g wl,ell se"dillg ti,e payl"ellt. Ti,e paydateldate of w;t1II,oldi"g is the date 011 vvl,id, allloullt was will,l,eld (,01" ti,e en,ployee's 1I\oages. You must comply with the law ofthe state of the employee' slob I igor'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: 8384100092 EMPLOYEE'S/OBLlGOR'S NAME: SMALL , KENNETH E. EMPLOYEE'S CASE IDENTIFIER: 3683101504 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. AntkUscrimination: 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. 51673 (b)1; or 2) the amounts allowed by the State of the employee'slobligor'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: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (7171 240-6248 or CARLISLE PA 17013 by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev. 1 Worker I D $OINe Service Type M OMS No.: 0970-0154 I tf . ~ '" ADDENDUM Summary of Cases on Attachment Defendant/Obligor: SMALL I KENNETH E. PACSES Case Number 795107555 Plaintiff Name LINDA M. SMALL Docket Attachment Amount 05=4'01'0 CIVIL $ 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. PACSES Case Number Plaintiff Name 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. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ...D.;;..~~~c~~,..y~u.. ~r~..r~~i.~~...t~..:~.~~II...th~...~~.il~(~~.~)................... ... .... .......... identified above in any health insurance coverage available through the employee's/obligor's employment. SelVice Type M OM8 No.: 097()..()154 PACSES Case Number Plaintiff Name 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. PACSES Case Number Plaintiff Name 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. PACSES Case Number Plaintiff Name 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. Addendum Form EN-028 Rev. 1 Worker I D $OINe (") s; ~::t' ~,::'; \""-0> c::::> c;;" C1"' (/) ,'"ti -0 , co -0 -,,;' ~ ~ -\ :L.,., rne -0\\1 -;39 ;:~(2'! '<<)0 ;i~.fn ~::::4 ?J5 :< $''' ., J:,:'" .};.