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Home My WebLink About05-5746McNEES WALLACE & NURICK LLC By: Debra Denison Cantor Attorney ID No. 66378 100 Pine Street Harrisburg, PA 17108-1166 (717) 232-8000 (717) 237-5300 facsimile dcantor(a)mwn.com Attorneys for Plaintiff STEVEN M. NAGORZANSKI, Plaintiff V. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. OS'- S"v7tlL AVIS D. NAGORZANSKI, Defendant 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 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 at the Cumberland County Courthouse, One Courthouse Square, Carlisle, PA 17013. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 32 South Bedford Street Carlisle, PA 17013 (717) 249-3166 or (800) 990-9108 McNEES WALLACE & NURICK LLC By en on Cantor Attorney I.D. No. 66378 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 232-8000 Attorneys for Plaintiff Dated: November 4, 2005 McNEES WALLACE & NURICK LLC By: Debra Denison Cantor Attorney ID No. 66378 100 Pine Street Harrisburg, PA 17108-1166 (717) 232-8000 (717) 237-5300 facsimile dcantoramwn.com Attorneys for Plaintiff STEVEN M. NAGORZANSKI Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA v. NO. OS- 5'1y4? c[vLC ??t? AVIS D. NAGORZANSKI, Defendant IN DIVORCE COMPLAINT IN DIVORCE UNDER 3301(c) OR 3301(d) OF THE DIVORCE CODE 1. Plaintiff is Steve Nagorzanksi, who currently resides at 3815 Chippenham Road, Mechanicsburg, Cumberland County, Pennsylvania. 2. Defendant is Avis D. Nagorzanski, who currently resides at 3815 Chippenham Road, Mechanicsburg, Cumberland County, Pennsylvania. 3. Plaintiff and Defendant have been bona fide residents in the Commonwealth of Pennsylvania for at least six months previous to the filing of this Complaint. - 1 - 4. Plaintiff and Defendant were married on October 3, 1987, in San Diego, California. 5. There have been no prior actions of divorce or for annulment between the parties. 6. Plaintiff avers that there are three (3) children of this marriage under the age of eighteen years, namely Michael, age 17, Lauren, age 16, and David, age 13. 7. The marriage is irretrievably broken. 8. Plaintiff has been advised of the availability of counseling and that he may have the right to request that the Court require the parties to participate in counseling. Plaintiff hereby waives his right to such counseling. 9. After 90 days have elapsed from the filing of this Complaint, Plaintiff intends to file an affidavit consenting to a divorce. Plaintiff believes that Defendant may also file such an affidavit. 10. In the alternative, Plaintiff will file a 3301(d) Affidavit and provide the appropriate Notices two years from the date of separation. WHEREFORE, Plaintiff respectfully requests the Court to enter a decree of divorce under Section 3301(c) or (d) of the Divorce Code. COUNT II ADULTERY 11. Paragraphs 1 through 10 of this Complaint are incorporated herein by reference. -2- 12. Through the course of the marriage, Defendant engaged in adulterous affairs to the detriment of the marital relation. WHEREFORE, Plaintiff respectfully requests the court to enter a decree of divorce pursuant to 3301(a) of the Divorce Code. COUNT III EQUITABLE DISTRIBUTION 13. Plaintiff incorporates by reference paragraphs I through 12 of this Complaint. 14. Plaintiff and Defendant possess various items of personal marital property, as well as marital debts, which are subject to equitable distribution by this Court. WHEREFORE, Defendant requests your Honorable Court to equitably distribute all property, both real and personal, owned by the parties, as well as all marital debts. McNEES WALLACE & NURICK LLC By I eb De ' on ntor orney I. 6378 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 232-8000 Dated: November 4, 2005 Attorneys for Plaintiff -3- NOV-3-2005 15:41 FROM:MWN VERIFICATION TO:96056422 P.7,7 Subject to the penalties of 18 Pa. C.S.A. § 4904 relating to unsworn falsification to authorities, I hereby certify that the facts set forth in the foregoing document are true and correct to the best of my information and belief. Steve Nag anski Dated: November] , 2005 V c r ?,rn C STEVEN M. NAGORZANSKI, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant AFFIDAVIT OF SERVICE I, Debra Denison, Esquire of McNees Wallace & Nurick LLC, do hereby certify that I served a certified copy of the Divorce Complaint on the Defendant, Avis D. Nagorzanski, by Certified Mail, Restricted Delivery on the 5`^ day of November, 2005, as is evidenced by the signature of the Defendant on the Return Receipt card attached hereto as Exhibit "A." Said Complaint in Divorce was mailed to Defendant by depositing a true and exact copy thereof in the United States mail, first class, Certified Mail, Restricted Delivery, Return Receipt Requested postage prepaid, addressed as follows: Avis D. Nagorzanski 3815 Chippenham Road Mechanicsburg, PA 17050 McNEES WALLACE & NURICK, LLC By D a De so antor, Esquire Attorney ID #66378. 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 Phone: 717 237-5197 Attorneys for Plaintiff, Steven M. Nagorzanski Dated: November 8, 2005 Article Number i?si?i?ime K. 7160 3901 9644 4445 7617 j 3. Service Type CERTIFIED MAIL 4. Restricted Delivery? (Extra Fee) KlYes 1. Article Addressed to: Avis D. Nagorzanski 3815 Chippenham Road Mechanicsburg, PA 17050 Is delivery address different from If YES, enter delivery address be 24160-0001 g -p p15ppVppt? Debra Denison Cantor, Esquire Domestic Return EXHIBIT A c ., " , = --_?' _-., ?'? ? ? r?,? . ,?:?: : .:: ? __ ?? `? ?' -;, ,__ = ' _ ; , ?? ?. G AVIS D. NAGORZANSKI, Petitioner vs. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOMESTIC RELATIONS SECTION STEVEN M. NAGORZANSKI, DOCKET NUMBER: a S Respondent PASCES Case Number: PETITION FOR SUPPORT (ALIMONY PENDENTE LITEI AND NOW, this 19th day ofNovember, 2005 comes AVIS D. NAGORZANSKI, Petitioner herein, by and through her attorney, Michael D. Rentschler, Esquire, who files the within Petition by respectfully averring as follows: 1. Petitioner is AVIS D. NAGORZANSKI, an adult individual who currently resides at 3815 Chippenham Road, Mechanicsburg, Cumberland County, Pennsylvania. 2. Respondent is STEVEN M. NAGORZANSKI, an adult individual who currently resides at 3815 Chippenham Road, Mechanicsburg, Cumberland County, Pennsylvania. 3. Respondent's date of birth is May 16, 1958. 4. Petitioner and Respondent were married on October 3, 1987, in San Diego, California. 5. Petitioner and Respondent were separated on November 4, 2005. 6. Petitioner and Respondent are married. 7. Petitioner seeks Alimony Pendente Lite for herself from Respondent. 8. Petitioner is not receiving public assistance. 9. Petitioner is not receiving income from any other source. 10. There is no previous support order for Petitioner against Respondent. 11. There are no arrears. 12. Petitioner has not received any support from Respondent. WHEREFORE, Petitioner requests that an order be entered against Respondent and in favor of the Petitioner for reasonable APL payments. Respectfully submitted, LAW OFFICE OF MICHAEL D. RENTSCHLER, P.C. Michael D. Rentschler, Esquire Attorney for Petitioner Supreme Court I.D. #45836 28 North 32nd Street Camp Hill, PA 17011 (717) 975-9129 VERIFICATION I, AVIS D. NAGORZANSKI, verify that the statements made in the Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unworn falsification to authorities. AVIS D. NAGORZANS I, Petitioner CERTIFICATE OF SERVICE I, MICHAEL D. RENTSCHLER, ESQUIRE, do hereby certify that on this date I served a copy of the foregoing Petition for APL, by first class mail, postage prepaid and addressed to the Respondent's counsel who is the following person at the following address: Debra Denison Cantor 100 Pine Street PO Box 1166 Harrisburg, PA 17108-1166 Date: -? MICHAEL D. RENTSCHLER, ESQUIRE Attorney for Petitioner r' ?' -?, fl ? ' ?J = '= --+ ,. ? cti 'r. ,?,?:.? ca Q .. Q AVIS D. NAGORZANSKI, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 05-5746 CIVIL TERM STEVEN M.NAGORZANSKI, IN DIVORCE Defendant/Respondent PACSES # 580107845 ORDER OF COURT AND NOW, this 21" day of November, 2005, upon consideration of the Petition for Alimony Pendente Lite and/or counsel fees, it is hereby directed that the parties and their respective counsel appear before R .J. Shadday on December 12. 2005 at 10:30 A.M. for a conference, at 13 N. Hanover St., Carlisle, PA 17013, after which the conference officer may recommend that an Order for Alimony Pendente Lite be entered. YOU are further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W-2's as filed (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by Rule 1910.110 (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you IF you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. Mail copies on November 21, 2005 to: Petitioner Respondent Michael D. Rentschler, Esquire Debra Denison-Cantor, Esquire Date of Order: November 21, 2005 BY THE COURT, George E. Hoffer, President Judge 4JS y,onferenceOfficer YOU YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 cc361 jV f . MCNEES WALLACE & NURICK LLC BY: DEBRA DENISON CANTOR, ESQUIRE Attorney I.D. No. 66378 100 Pine Street Harrisburg, PA 1717108-1166 Telephone: (717) 232-8000 Attorneys for Plaintiff STEVEN M. NAGORZANSKI, Plaintiff V. AVIS D. NAGORZANSKI, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY. PENNSYLVANIA NO. 05-5746 CIVIL TERM IN DIVORCE PLAINTIFF'S PETITION FOR SPECIAL RELIEF REQUESTING EXCLUSIVE POSSSESSION OF THE MARITAL HOME PURSUANT TO 23 PA C.S. § 3502(c) AND NOW, comes the Plaintiff, Steven M. Nagorzanski, by and through his counsel, McNees Wallace & Nurick LLC, and alleges as follows: 1. Plaintiff, Steven M. Nagorzanski (hereinafter "Petitioner"), is'an adult individual residing at 3815 Chippenham Road, Mechanicsburg, Cumberland County, Pennsylvania. 2. Defendant, Avis D. Nagorzanski (hereinafter "Respondent"), is an adult individual residing at 3815 Chippenham Road, Mechanicsburg, Cumberland County, Pennsylvania. 3. The parties hereto are husband and wife, having been married on October 3, 1987 in San Diego, California. 4. The parties are the parents of three minor children, namely Michael Nagorzanski, age 17, Lauren Nagorzanski, age 16, and David Nagorzanski, age 13, all of whom reside in the marital home. 5. On September 8, 2005, Respondent returned to the marital home from a trip to Hawaii and confirmed that she had fallen in love with another man and wished to move to Hawaii. 6. On September 16, 2005, Respondent moved from the marital home and relocated to Hawaii, her home state. 7. Respondent relocated to Hawaii leaving behind her three minor children with Petitioner in the marital home. 8. After discovering Petitioner would not finance her extra marital affair, Respondent returned to the marital home on October 21, 2005 where she has continued to reside. 9. The parties are joint owners of the marital home, which is located at 3815 Chippenham Road, Mechanicsburg, Pennsylvania. 10. Since her return, Respondent has engaged in a pattern and practice of behavior which sets forth to disrupt the harmonious living of Petitioner and his children. 11. Since Respondent's return, Petitioner has attempted to maintain the residence with all family members in a peaceful manner, but recent events demonstrate that living together peacefully is impossible and contrary to the best interests of the children. 12. On Wednesday, November 16, 2005, Respondent went to military officials at the Dunham U.S. Army Health Clinic in Carlisle alleging child abuse. The alleged 2 abuse took place while Respondent was in Hawaii. As a result of military protocol, a restraining order was issued against Petitioner on November 17, 2005. 13. This Order restricted all access to the home and family members pending investigation and was issued while Respondent was in Washington, D.C. on assignment. 14. Ms. Ann Walker, of the Behavior Health Services Department at Dunham U.S. Army Health Clinic, investigated the allegations, including interviewing Petitioner, Respondent, and all three children, and determined that the allegations were unfounded. 15. Respondent moved to Hawaii to maintain her extra marital affair with Manuel Lopes, a Hawaiian resident. Mr. Lopes calls the home several times a day and Respondent talks to her boyfriend in the presence of the children, which is upsetting and disruptive to their home life. 16. Michael Nagorzanski, the parties' 17-year-old son, answered a phone call from Manuel Lopes on November 19, 2005 that is best categorized as confrontational. During that November 19, 2005 telephone call, Mr. Lopes threatened Michael, stating "if you come around here, I'll get my hands around your neck you little F......" 17. It is also believed and therefore averred that Mr. Lopes has repeatedly attempted to call Lauren Nagorzanski, the parties' 16-year-old daughter. Lauren refuses to answer her phone when the caller W. lists a private caller. Lauren continues to live in fear each time the telephone rings, that she may inadvertently take a call from Mr. Lopes, which will result in a confrontation. It is unreasonable and emotionally 3 damaging to the children for Respondent to blatantly flaunt her extra-marital affair and have Mr. Lopes further involve the children via telephone. 18. On Sunday, November 20, 2005, Petitioner was residing in a hotel as a result of the military protective order. The three children had remained in the home. 19. Respondent engaged in inappropriate conversations with her son, Michael Nagorzanski, including baseless and false allegations that Petitioner was engaged in an extra-marital affair. These false accusations resulted in a large argument. Respondent threw a large basket at her son, Michael. The youngest son, David, also threw a bottle at Michael. The police were ultimately called to the house, but no arrests or reports were made. The two older children then stayed with Petitioner at his hotel. 20. Despite her decision to engage in an affair, and to temporarily relocate to Hawaii, Respondent has engaged in a regular and consistent pattern of behavior in an effort to alienate Petitioner from his children. The older children, Michael and Lauren, will not be swayed. However, Respondent has worked to successfully alienate David from his father. 21. In addition, without knowledge or consent of Petitioner, Respondent unilaterally withdrew David from school and has indicated an intention to home school the child. 22. This withdrawal is clearly not in David's best interests, as David has had a long history of difficulties in school, is currently diagnosed with ADHD, and suffers from anger management and behavioral difficulties. Removal from a structured school environment will only serve to elevate these conditions. 4 23. On November 20, 2005 Petitioner received a call from a family member of Respondent indicating that Respondent was prepared to issue false accusations of an inappropriate sexual nature at Respondent's workplace, thus impacting his good name, income, and spotless military record. Such allegations are completely baseless and it is instead Respondent's adulteress activity that led to the filing of this divorce. 24. In the month since her return, Respondent has alienated the youngest child and withdrawn him from school; has made a false allegation of child abuse; has allowed her boyfriend to harass and threaten her children; was involved in an altercation with her children that resulted in the police being called; and has threatened to impugn Petitioner's reputation at work and stellar military record. 25. Without Court intervention, the atmosphere in the marital home will continue to escalate and the children will continue to live in fear of contact from Manuel Lopes, and in fear of the behavior of their mother. 26. Petitioner intends to remain in the marital home indefinitely and would like to assume possession of the home in the ultimate equitable distribution of this matter. He also intends to serve as primary physical custodian of the children, and therefore it is best that he remain in the marital home. 27. Petitioner has suggested that Respondent move from the marital home in the best interests of the children, as a separation is ultimately what she seeks. Instead, she continues to act in a disruptive manner. 28. Section 3502(c) of the Divorce Code states "[t]he Court may award, during the pendency of the action or otherwise to one or both of the parties the right to reside in the Marital Home." 23 Pa. C.S. §3502(c). 5 29. Section 3323(f) of the Divorce Code states: In all matrimonial causes, the court shall have full equity power in jurisdiction, and may issue injunctions or other orders which are necesssary to protect the interests of the parties or to effectuate the purposes of this part, and may grant such other relief or remedy as equity and justice require against either party or against any third person over whom the court has jurisdiction and who is involved in or concerned with the disposition of the cause. WHEREFORE, Petitioner, Steven M. Nagorzanski, requests that this Honorable Court grant him exclusive possession of the marital home until the conclusion of the divorce proceedings. Respectfully submitted, McNEES WALLACE & NURICK, LLC B Debra Denison Cantor, Esquire Attorney ID #66378. 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 237-5297 Attorneys for Plaintiff, Steven M. Nagorzanski Dated: November 23, 2005 6 VERIFICATION Subject to the penalties of 18 Pa. C.S.A. § 4904 relating to unsworn falsification to authorities, I hereby certify that the facts set forth in the foregoing document are true and correct to the best of my information and belief. Steve gorzanski Dated: November?3, 2005 CERTIFICATE OF SERVICE I hereby certify that on the date set forth below a true and correct copy of the Petition for Special Relief Requesting Exclusive Possession of the Marital Home Pursuant to 23 Pa. C.S. § 3502(c) was served on the following individuals via first-class mail, postage prepaid, as follows: Michael D. Rentschler Rentschler Law Office 28 N. 32nd Street Camp Hill, PA 17011 1 Pamela L. Purdy C Dated: November 23, 2005 r'i 1 i` ?? `,lam . ? G r ?? J ' c' Ci 11/23/2005 '123 FAY; 717 237 5300 STEVEN M NAGORZANSKI. Plaintiff V. AVIS D. NAGORZANSKI, Defendant li NOV 2 2005 [BY: -_-- i IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. U5-5746 CIVIL TERM IN DIVORCE y? ORD'EeRI AND NOW, this ?n day of'&^` 2005, upon consideration of the within Pctition for Special Relief Requesting Exclusive Possession of the Marital Home Pursuant to 23 Pa. C.S- § 3502(c), filed by Plaintiff Steven M- Nagerzanski, it is hereby ORDERED and DECREED that a hearing is scheduled for ? Z.S*4 2005, p l:30 o'clock K m, in Courtroom?o J , ,1. MCNEES WALLACE & NURICK 5 0 - Z-65- ? _?:' __, ,'-? In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION AVIS D. NAGORZANSKI ) Docket Number 05-5746 CIVIL Plaintiff ) VS. ) PACSES Case Number 580107845 STEVEN M. NAGORZANSKI ) Defendant ) Other State ID Number ORDER AND NOW, to wit on this 20TH DAY OF JANUARY, 2006 IT IS HEREBY ORDERED that the 0 Complaint for Support or 0 Petition to Modify or © Other ALIMONY PENDENTE LITE filed on NOVEMBER 18, 2006 in the above captioned matter is dismissed without prejudice due to: THE PETITIONER WITHDRAWING HER REQUEST FOR AN APL CONFERENCE AND THE PARTIES' SETTLEMENT AGREEMENT. 0 The Complaint or Petition may be reinstated upon written application of the plaintiff petitioner. BY THE COURT: Edward e° JUDGE ,I??n Shadday Form OE-506 SCTViCe lR9t7 ?e' M Worker ID 21005 AVIS D. NAGORZANSKI, : IN THE COURT OF COMMON PLEAS OF Petitioner : CUMBERLAND COUNTY, PENNSYLVANIA vs. DOMESTIC RELATIONS SECTION STEVEN M. NAGORZANSKI, DOCKET NUMBER: 05-5746 Civil Respondent PASCES Case Number: 580107845 PRAECIPE Kindly withdraw the Petition for Alimony Pendente Lite filed by Avis Nagorzanski in the above captioned case. Michael D. Rentschler, Esquire 28 N. 32nd Street Camp Hill, PA 17011 717-975-9129 Supreme Court ID # 45836 Attorney for Petitioner -: : __. ?,?<- AVIS D. NAGORZANSKI, Plaintiff V. STEVEN M. NAGORZANSKI, Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION LAW - IN DIVORCE NO. 2005-5746 CIVIL TERM PRAECIPE TO WITHDRAW APPEARANCE To Curtis R. Long, Prothonotary: Please withdraw my appearance from this case or, behalf of the Plaintiff, Avis D. Nagorzanski. Respectfully submitted, Date: May ?, 2007 RENTSCHLER LAW OFFICES By: Michael D. Rentschler, Esquire 28 North 32°d Street Camp Hill, PA 17011 PRAECIPE TO ENTER APPEARANCE To Curtis R. Long, Prothonotary: Please enter my appearance on behalf of the Plaintiff, Avis D. Nagorzanski. Respectfully submitted, IRWIN & Mc IGHT By: arc A. Mc ight, II , sq. 60 West Pomfret Street le, PA 17013 Date: May 4, 2007 C'> . ?. F _ ' , JC3 IFOITIV Iv1AY - S 2401 NO; 'SIGIAT IV, STEVEN M. NAGORZANSKI, Plaintiff/Respondent V. AVIS D. NAGORZANSKI, Defendant/Petitioner : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO. 2005 - 5746 CIVIL TERM IN DIVORCE PETITION FOR ALIMONY PENDENTE LITE AND NOW, comes AVIS D. NAGORZANSKI, Petitioner, by and through her attorneys, IRWIN & McKNIGHT, and petitions this Honorable Court as follows: 1. The Petitioner herein is Avis D. Nagorzanski, who currently resides at 1233 Young Street #101, Honolulu, Hawaii 96823. 2. The Respondent herein is Steven M. Nagorzanski, who currently resides at 3815 Chippenham Road, Mechanicsburg, Pennsylvania 17055 3. Petitioner and respondent were married on October 3, 1987, in San Diego, California and were separated approximately December 15, 2005. 4. Petitioner is without the ability to earn income sufficient to meet her reasonable needs. . A WHEREFORE, Petitioner, Avis D. Nagorzanski, respectfully requests that this Honorable Court order alimony pendente lite in an amount equal to the Pennsylvania State Support Guidelines. Respectfully submitted, IRWIN & MIGHT By: Marcus . McKnig Let 60 West omfret Str Carlisle, PA 17013 Supreme Court I.D. No: 25476 (717) 249-2353 Attorney for the Petitioner Date: June 29, 2007 2 VERIFICATION The foregoing document is based upon information 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, information 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. AVIS NAGOR ANSKI Date: JUNE 29, 2007 ?C 4 V 74 0 n. ? ^? N STEVEN M. NAGORZANSKI, THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant/Petitioner PACSES CASE NO: 580107845 ORDER OF COURT AND NOW, this 9th day of July, 2007, upon consideration of the Petition for Alimony Pendente Lite and/or counsel fees, it is hereby directed that the parties and their respective counsel appear before R.J. Shadday on August 7. 2007 at 9:00 A.M. for a conference, at 13 N. Hanover St., Carlisle, PA 17013, after which the conference officer may recommend that an Order for Alimony Pendente Lite be entered. YOU are further ordered to bring to the conference: (1) a true copy of your most recent Federal Income Tax Return, including W2's as filed (2) your pay stubs for the preceding six (6) months (3) the Income and Expense Statement attached to this order, completed as required by Rule 1910.11© (4) verification of child care expenses (5) proof of medical coverage which you may have, or may have available to you If you fail to appear for the conference or bring the required documents, the Court may issue a warrant for your arrest. BY THE COURT, Edgar B. Bayley, President Judge Copies mailed to: Petitioner Respondent Marcus A. McKnight, III, Esq. Debra Denison-Cantor, Esq. Date of Order: July 9, 2007 t 4J.adddday, Conference Officer / YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU MAY GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 2 LIBERTY AVE. CARLISLE, PENNSYLVANIA 17013 (717) 249-3166 cc361 ? ? ?ri C.= --? c?. ?? ?j ?' ?,,?.. C ;,?_.. i , ?.? ? ?-? S. J: ? fi'?? ..»!. Cry ORDERJNOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 09/03/07 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number 580107845 0 Original Order/Notice 05-5746 CIVIL O Amended Order/Notice O Terminate Order/Notice RE:NAGORZANSKI, STEVEN M. Employee/Obligor's Name (Last, First, MI) DFAS CLEVELAND CENTER* C/O DFAS-HGA/CL GARNISHMENT OPS 331-46-5594 Employee/Obligor's Social Security Number 4701101596 Employee/Obligor's Case Identifier (See Addendum for plaintiff names PO BOX 9 9 8 0 0 2 associated with cases on attachment) CLEVELAND OH 44199-8002 Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee'stobligor's income until further notice even if the Order/Notice is not issued by your State. $ 2, 600. 00 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? Oyes (D no $ 0.00 per month in current and past-due medical support $ 0.0 o per month for genetic test costs $ 0.0 0 per month in other (specify) for a total of $ 2, 600.00 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: $ 600.00 per weekly pay period. $ 1200.00 ,per biweekly pay period (every two weeks). $ 1.300. oo per semimonthly pay period (twice a month). $ 2.600. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If 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, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAMEAND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: S E P 0 4 2007 Date of Order: EDWARD E. GUI MI IT - - DRO: R.J. SHADDAY Form EN-028 Rev. 1 Service Type M OMB No.; 097"154 Worker I D $ IATT #5801C7845- 2, 6 C', x ,n• 2,604 • x 2 rj n n n n 1? 2 1j U ? '.1 li "?` ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If heck you are required to provide a opy of this form to your m loyee. If yo r employee works in a state that is diferent from the state that issued this order, a copy must be provideedpto 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 employeelobligor's income in a single payment to each agency requesting withholding. You must, however, separately identify the portion of the single payment that is attributable to each employeelobligor. 3.* Reporting the Paydat&Date of Withholding. You ri=t report the paydate/date of withholding Mien sendins the payinent. f lie paydate/date of withholding is the date on which amount was withheld hoen the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/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 employeetobligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: NAGORZANSKI, STEVEN M. EMPLOYEE'S CASE IDENTIFIER: 4701101596 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 employeetobligor from employment, refusing to employ, or taking disciplinary action against any employeelobligor 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 0 5 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. Submitted By: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker ID $zATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: NAGORZANSKI, STEVEN M. PACSES Case Number 580107845 PACSES Case Number Plaintiff Name Plaintiff Name AVIS D. NAGORZANSKI Docket Attachment Amount Docket Attachment Amount 05-5746 CIVIL$ 2,600.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB ® If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 ..................... ........................................................................ ?ou are required ?If checked, ren to enroll the, child(. Y ) 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 X. X ?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 ? 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 r-..) a ,. a ),I tp 5VI 2 lp q ub McNEES WALLACE & NURICK LLC By: Debra D. Cantor Attorney ID No. 66378 Cheryl B. Krentzman Attorney ID No. 203463 100 Pine Street Harrisburg, PA 17108-1166 (717) 232-8000 (717) 237-5300 facsimile dcantora-mwn.com ckrentzman ,mwn.com STEVEN M. NAGORZANSKI, Plaintiff V. AVIS D. NAGORZANSKI, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. 05-5746 CIVIL TERM : IN DIVORCE MOTION FOR APPOINTMENT OF MASTER Steven M. Nagorzanski, Plaintiff, moves the court to appoint a Master with respect to the following claims: ® Divorce ? Annulment ® Alimony ? Alimony Pendente Lite ® Distribution of Property ? Support ® Counsel Fees ® Costs and Expenses And in support of the Motion states: 1. Discovery is complete as to the claims for which the appointment of master is requested. 2. The Defendant has appeared in the action by her attorney, Michael D. Rentschler. As of July 2, 2007 Marcus A. McKnight, III appeared in the support action. 3. The statutory grounds for divorce are 3301(c) (d) and (a). 4. An agreement has been reached with respect to the following claims: (i) Plaintiffs Petition for Special Relief in that the parties agreed that Husband shall have exclusive possession. (ii) Alimony Pendente Lite: by Order dated August 7, 2007. Advance on Equitable Distribution to Wife (Defendant) of $22,300 on December 16, 2005. 5. The action does not involve complex issues of law or fact. 6. The hearing is expected to take 5 hours. 7. Additional information, if any, relevant to the motion: Defendant is a resident of Hawaii. Date: November 7, 2007 Na . Cantor Attorney for Defendant AND NOW. 2007, appointed master with respect to the following claims: BY THE COURT: Esquire, is J. MOVING PARTY NAME: Steven M. Nagorzanski ATTORNEY'S NAME: Debra D. Cantor ATTORNEY'S ADDRESS: 100 Pine Street Harrisburg, PA 17101 ATTORNEY'S TELEPHONE NO.: 717-237-5297 ATTORNEY'S E-MAIL: dcantor ,mwn.com NUMBER IF NOT REPRESENTED BY COUNSEL NON-MOVING PARTY NAME: Avis D. Nagorzanski ATTORNEY'S NAME: Marcus A. McKnight, III ATTORNEY'S ADDRESS: 60 W. Pomfret Street Carlisle, PA 17013-3222 ATTORNEY'S TELEPHONE NO. 717- 249-2353 ATTORNEY'S E-MAIL: mmckni t(ZD,irwinmckni t.com PARTY'S ADDRESS & TELEPHONE NUMBER IF NOT REPRESENTED BY COUNSEL: -2- CERTIFICATE OF SERVICE The undersigned hereby certifies that on the day of 2007, a true and correct copy of the foregoing document was served by first-class mail, postage prepaid, upon the following: Michael D. Rentschler, Esquire Rentschler Law Office 28 N. 32nd Street Camp Hill, PA 17011 Marcus A. McKnight, III Irwin & McKnight Attorneys at Law 60 W. Pomfret Street Carlisle, PA 17013-3222 Deb . Ca for I -3 e ? Gov a'soalf McNEES WALLACE & NURICK LLC By: Debra D. Cantor Attorney ID No. 66378 Cheryl B. Krentzman Attorney ID No. 203463 100 Pine Street Harrisburg, PA 17108-1166 (717) 232-8000 (717) 237-5300 facsimile dcantor@mwn.com ckrentzmana-mwn.com STEVEN M. NAGORZANSKI, Plaintiff V. AVIS D. NAGORZANSKI, Defendant MOTION FOR APPOINTMENT OF MASTER Steven M. Nagorzanski, Plaintiff, moves the court to appoint a Master with respect to the following claims: ® Divorce ? Annulment ® Alimony ? Alimony Pendente Lite And in support of the Motion states: IN THE COURT OF. COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 05-5746 CIVIL TERM : IN DIVORCE ® Distribution of Property ? Support ® Counsel Fees ® Costs and Expenses 1. Discovery is complete as to the claims for which the appointment of master is requested. 2. The Defendant has appeared in the action by her attorney, Michael D. Rentschler. As of July 2, 2007 Marcus A. McKnight, III appeared in the support action. 3. The statutory grounds for divorce are 3301(c) (d) and (a). 4. An agreement has been reached with respect to the following claims: (i) Plaintiffs Petition for Special Relief in that the parties agreed that Husband shall have exclusive possession. (ii) Alimony Pendente Lite: by Order dated August 7, 2007. (iii) Advance on Equitable Distribution to Wife (Defendant) of $22,300 on December 16, 2005. 5. The action does not involve complex issues of law or fact. 6. The hearing is expected to take 5 hours. 7. Additional information, if any, relevant to the motion: Defendant is a resident of Hawaii. Date: November 7, 2007 Na . Cantor Attorney for Defendant AND NOW. IM&A& q , 2007, tom. le&L "g, Esquire, is appointed master with respect to the following claims: BY THE R J. MOVING PARTY -NON-MOVING PARTY /NAME: Steven M. Nagorzanski NAME: Avis D. Nagorzanski ATTORNEY'S NAME: Debra D. Cantor ATTORNEY'S NAME: Marcus A. McKnight, III ATTORNEY'S ADDRESS: ATTORNEY'S ADDRESS: 100 Pine Street 60 W. Pomfret Street Harrisburg, PA 17101 Carlisle, PA 17013-3222 ATTORNEY'S TELEPHONE NO.: ATTORNEY'S TELEPHONE NO. 717-237-5297 717- 249-2353 ATTORNEY'S E-MAIL: ATTORNEY'S E-MAIL: dcantora,mwn.com mmcknigl, t a,irwinmcknight.com NUMBER IF NOT REPRESENTED BY PARTY'S ADDRESS & TELEPHONE COUNSEL NUMBER IF NOT REPRESENTED BY COUNSEL: 107 -2- ?l ? ?Yl VINVA-Mt d KtN ! Tly7 o :1 pfd 6- AON LODZ ?0-UY ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 336109963 Co./City/Dist. of CUMBERLAND 334 S 2008 Date of Order/Notice 05/20/08 Case Number (See Addendum for case summary) RE: NAGORZANSKI Employer/Withholder's Federal EIN Number DFAS CLEVELAND CENTER* C/O DFAS-HGA/CL GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 05-5746 CIVIL O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice STEVEN M. Employee/Obligor's Name (Last, First, MI) 331-46-5594 Employee/Obligor's Social Security Number 4701101596 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 2 , 970.00 per month in current support $ o . oo per month in past-due support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current and past-due medical support $ o . 00 per month for genetic test costs $ 0 .00 per month in other (specify) for a total of $ 2, 970.00 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: $ 685.38 per weekly pay period. $ 1370.77 _per biweekly pay period (every two weeks). $ _ 1, 485. oo per semimonthly pay period (twice a month). $ 2. 970. oo per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If 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, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAMEAND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT Date of Order: MAY 2 1 2008 -A E. GUIDO, JUDO DRO: R.J. SHADDAY Form EN-028 Rev. 1 Service Type M OMB No.: 0970-0154 Worker ID $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If checked 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 employee/obligor. 3.* Reporting the Paydate/Date of Withholding: You must report the paydate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld from the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4. * Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employee/obligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: NAGORZANSKI, STEVEN M. EMPLOYEE'S CASE IDENTIFIER: 4701101596 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (15 U.S.C. §1673 (b)1; or 2) the amounts allowed by the State of the employee's/obligor's principal place of employment. The Federal limit applies to the aggregate disposable weekly earnings (ADWE). ADWE is the net income left after making mandatory deductions such as: State, Federal, local taxes; Social Security taxes; and Medicare taxes. For tribal orders, you may not withhold more than the amounts allowed under the law of the issuing tribe. For tribal employers who receive a state order, you may not withhold more than the amounts allowed under the law of the state that issued the order. 10. Additional Info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Submitted By: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 Service Type M If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker I D $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: NAGORZANSKI, STEVEN M. PACSES Case Number 336109963 PACSES Case Number 580107845 Plaintiff Name Plaintiff Name AVIS D. NAGORZANSKI AVIS D. NAGORZANSKI Docket Attachment Amount Docket Attachment Amount 00334 S 2008 $ 1,191.00 05-5746 CIVIL$ 1,779.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DAVID A. NAGORZANSKI 01/17/92 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ?If checked, you are required to enroll the child(ren) ?Ifchecked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Rev. 1 Service Type M OMB No.: 0970-0154 Worker ID $IATT STEVEN M. NAGORZANSKI, IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant/Petitioner PACSES Case No: 580107845 ORDER OF COURT AND NOW to wit, this 20th day of May 2008, it is hereby Ordered that the credit, in the amount of $1,234.50, on the above captioned case be directed to the child support account under PACSES #336109963 and docketed at 334 S 2008 to offset the retroactive arrears. This Order shall become final twenty (20) days after the mailing of the notice of the entry of the order to the parties unless either party files a written demand with the Domestic Relations Section for a hearing de novo before the Court. BY THE C Edward E. Guido, J. DRO: R.J. Shadday xc: Petitioner Respondent Marcus A. McKnight, III, Esq. Debra Denison Cantor, Esq. Form OE-001 Type: M Worker: 21005 STEVEN M. NAGORZANSKI, IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant/Petitioner PACSES Case No: 580107845 ORDER OF COURT AND NOW, this 20th day of May 2008, based upon the Court's determination that the Petitioner's monthly net income/earning capacity is $ 1,551.97 and the Respondent's monthly net income/earning capacity is $ 8,672.00, it is hereby ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement One Thousand Seven Hundred Seventy-nine and 00/100 Dollars ($1,779.00) per month payable monthly as follows: $ 1,779.00 per month for Alimony Pendente Lite and $ 0.00 per month on arrears. First payment due: in accordance with Respondent's pay schedule. The effective date of the order is April 17, 2008. Credit set at -$ 1,234.50 as of May 20, 2008. Failure to make each payment on time and in full will cause all arrears to become subject to immediate collection by all of the means as provided by 23 Pa.C.S.§ 3703. Further, if the Court finds, after hearing, that the Respondent has willfully failed to comply with this Order, it may declare the Respondent in civil contempt of Court and, at its discretion, make an appropriate Order, including, but not limited to, commitment of the Respondent to prison for a period not to exceed six months. Said money to be turned over by the PA SCDU to: Avis D. Nagorzanski. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the Respondent's name with their PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. cc360 The monthly obligation includes cash medical obligation in the amount of $250 annually for unreimbursed medical expenses incurred for the spouse. Unreimbursed medical expenses of the oblige that exceed $250 annually shall be allocated between the parties. The party seeking allocation of unreimbursed medical expenses must provide documentation of expenses to the other party no later than March 31St of the year following the calendar year in which the final medical bill to be allocated was received. The unreimbursed medical expenses are to be paid as follows: 0% by the Respondent and 100% by the Petitioner. [X] Respondent [] Petitioner [] Neither party to provide medical insurance coverage. Within thirty (30) days after the entry of this order, the [] Petitioner [X] Respondent shall submit to the other party written proof that medical insurance coverage has been obtained or that application for coverage has been made. Proof of coverage shall consist, at a minimum, of. 1) the name of the health care coverage provider(s); 2) any applicable identification numbers; 3) any cards evidencing coverage; 4) the address to which claims should be made; 5) a description of any restrictions on usage, such as prior approval for hospital admissions, and the manner of obtaining approval; 6) a copy o the benefits booklet or coverage contract; 7) a description of all deductibles and co-payments; and 8) five copies of any claim forms. This Order is based upon the fact that the Respondent is now paying on a child support order under PACSES #336109963 and docket at 334 S 2008 for the parties' son that resides with the Petitioner. This Order shall become final twenty (20) 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. Consented: Petitioner Respondent Mailed copies on: May 21.2008 to: Petitioner Respondent Marcus A. McKnight, III, Esq. Debra Denison Cantor, Esq. DRO: R.J. Shadday Petitioner's Attorney Respondent's Attorney BY THE COURT, Edward E. Guido, J. STEVEN M. NAGORZANSKI, IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant/Petitioner PACSES Case No: 580107845 NOTICE OF RIGHT TO REQUEST A HEARING The parties are hereby advised that they have until June 10, 2008 to request a hearing do novo before the Court. File request in person at: Office of the Prothonotary 1 Courthouse Square Carlisle, PA 17013 Or mail to: Office of the Prothonotary 1 Courthouse Square Carlisle, PA 17013 CC363 STEVEN M. NAGORZANSKI, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on November 4, 2005. 2. The marriage of the plaintiff and defendant is irretrievably broken. Ninety days have elapsed since the date of service of the Complaint. 3. 1 consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unswom falsification to authorities. -77 Steven M. Nagorzanski r Date: d ('V Cf? C5 ^'? s STEVEN M. NAGORZANSKI, Plaintiff V. AVIS D. NAGORZANSKI, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 05-5746 CIVIL TERM IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER Section 3301(c) OF THE DIVORCE CODE I consent to the entry of a final decree in divorce without notice. 2. 1 understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. 1 understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unswom falsification to authorities. ve-r?- -ZC4 Steven M. Nagorzanski Date: -'? cx:; ac o rn -:, r "T . C. CC) CTi ..i STEVEN M. NAGORZANSKI, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on November 4, 2005. 2. The marriage of the plaintiff and defendant is irretrievably broken. Ninety days have elapsed since the date of service of the Complaint. 3. 1 consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. la.. ?y ?iro8 h a Avis D. Nagorzan ci '49±? Date: t rr rn a ` ` ? r t s-* ? ? ? STEVEN M. NAGORZANSKI, Plaintiff VS. . AVIS D. NAGORZANSKI, Defendant THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. -9fT - 5746 CIVIL IN DIVORCE ORDER OF COURT -4 AND NOW, this day of , 2008, the economic claims raised in the proceedings having been resolved in accordance with a marital settlement agreement dated November 18, 2008, the appointment of the Master is vacated and counsel can file a praecipe transmitting the record to the Court requesting a final decree in divorce. BY THE COURT, .. 1 0" Edgar B. Bayley, P.J. cc: v/ Debra A. Denison Cantor Attorney for Plaintiff ? Marcus A. McKnight, III Attorney for Defendant Cap i 4.4 rrMt 6CL r ON r v -? ` CL 1iLu LL- a EV V MARITAL SETTLEMENT AGREEMENT THIS AGREEMENT, made this day of LL-e , 2008, by and between STEVEN M. NAGORZANSKI, of Mechanicsburg, Pennsylvania, (hereinafter "HUSBAND") and AVIS D. NAGORZANSKI of Harrisburg, Pennsylvania, (hereinafter "WIFE"). WITNESSETH: WHEREAS, the parties hereto were married on October 3, 1987, in San Diego, California; and WHEREAS, HUSBAND filed a divorce action in the Cumberland County Court of Common Pleas, on November 4, 2005, docketed to No. 2005-5746 Civil Term; and WHEREAS, there are three children of the marriage, two emancipated: Michael Nagorzanski, born March 25, 1988; and Lauren Nagorzanski, born September 17, 1989; and one minor child: David Nagorzanski, born January 17, 1992. WHEREAS, difficulties have arisen between the parties and it is therefore their intention to live separate and apart for the rest of their lives and the parties are desirous of settling completely the economic and other rights and obligations between each other, including but not limited to: the equitable distribution of the marital property; past, present, and future spousal support; alimony, alimony pendente lite, and in general, any and all other claims and possible claims by one against the other or against their respective estates. NOW THEREFORE, in consideration of the covenants and promises hereinafter to be kept and performed by each party and for other good and valuable consideration, the parties, intending to be legally bound hereby, the parties do hereby agree as follows: 1. ADVICE OF COUNSEL. The provisions of this agreement and their legal effect have been fully explained to the parties by their respective counsel. HUSBAND is represented by Debra Denison Cantor, Esquire of McNees Wallace & Nurick. WIFE is represented by Marcus A. McKnight, Esquire of Irwin & McKnight. Each party acknowledges that he or she has had the opportunity to discuss with counsel of their choosing, the concept of marital property under Pennsylvania law and each is aware of his or her right to have the real and/or personal property, estate and assets, earnings and income of the other assessed or evaluated by the courts of this Commonwealth or any other court of competent jurisdiction. The parties further declare that each is executing the Agreement freely and voluntarily having either obtained sufficient knowledge and disclosure of their respective legal rights and obligations or expressly waiving the right to obtain such knowledge. The parties each acknowledge that this Agreement is fair and equitable and is not the result of any fraud, coercion, duress, undue influence or collusion. 2. DIVORCE ACTION. The parties acknowledge that their marriage is irretrievably broken and that they shall secure a mutual consent no fault divorce pursuant to § 3301(c) of the Divorce Code. Promptly upon the execution of this Agreement the parties agree to execute Affidavits of Consent and Waivers of Notice of Intent to Request Entry of a Divorce Decree. This Agreement shall remain in full force and effect after such time as a final decree in divorce may be entered with respect to the parties. This Agreement shall not merge with the Divorce Decree, but shall continue to have independent contractual significance and shall be enforceable as provided in 23 Pa. C. S. § 3502(e). 3. DATE OF EXECUTION. The "date of execution" or "execution date" of this Agreement shall be defined as the date upon which it is executed by the parties if they have each executed the Agreement on the same date. -2- Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the last party executing this Agreement. 4. MUTUAL RELEASES. Each party absolutely and unconditionally releases the other and the estate of the other from any and all rights and obligations which either may have for past, present, or future obligations, arising out of the marital relationship or otherwise, including all rights and benefits under the Pennsylvania Divorce Code of 1980, and amendments excepts as described herein. Each party absolutely and unconditionally releases the other and his or her heirs, executors and estate from any claims arising by virtue of the marital relationship of the parties. The above release shall be effective whether such claims arise by way of widow's or widower's rights, family exemption, or under the intestate laws, or the right to take against the spouse's will, or the right to treat a life time 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 laws of Pennsylvania, any state, Commonwealth, or territory of the United States or any other country. Except for any cause of action for divorce which either party may have or claim to have, each party gives to the other by the execution of this Agreement an absolute and unconditional release from all claims whatsoever, in law or in equity which either party now has against the other. 5. FINANCIAL DISCLOSURE. Each of the parties hereto acknowledges that he or she is aware of his or her right to seek discovery, including but not limited to, written interrogatories, motions for production of documents, the taking of oral depositions, the filing of inventories, and all other means of discovery permitted under the Pennsylvania Divorce Code or the Pennsylvania Rules of Civil Procedure. Each of the parties further acknowledges that he or she has discussed with counsel the concept of marital property under Pennsylvania law and each is aware of his or her right to have the real and/or personal property, estate and assets, earnings and income of the other assessed or evaluated by the court of this -3- Commonwealth or any other court of competent jurisdiction. HUSBAND and WIFE represent and warrant that each has disclosed to the other in full his or her respective assets, liabilities and income and that this Agreement was negotiated and entered into on the basis of those disclosures. The parties hereby acknowledge and agree that the division of assets as set forth in this Agreement is fair, reasonable and equitable and is satisfactory to them. The remedies available to either party for breach or violation of this provision shall be those remedies available pursuant to law and equity. Each party retains the right to assert a claim against the other for failure to fully and fairly disclose his or her income, assets and liabilities, if it is later determined that there has been a failure to disclose, including but not limited to a claim of constructive trust. 6. SEPARATION-INTERFERENCE. WIFE and HUSBAND may and shall, at all times hereafter, live separate and apart. They shall be free from any interference, direct or indirect, by the other in all respects as if fully as if they were unmarried. Each may, for his or her separate use or benefit, conduct carry on and engage in any business, occupation, profession or employment which to him or her may seem advisable. WIFE and HUSBAND shall not harass, disturb or malign each other or the respective families of each other. 7. EQUITABLE DISTRIBUTION. 7.1 Real Property The parties are the joint owners of residential real estate located at 3815 Chippenham Road, Mechanicsburg, Pa., 17050. The property is encumbered by a mortgage with Navy Federal Credit Union. HUSBAND shall retain this property. HUSBAND shall refinance the property within ninety (90) days of the date of this divorce decree. HUSBAND shall remit to WIFE twenty-six thousand dollars ($26,000) with the funds from the house refinance. HUSBAND shall prepare and WIFE shall execute a deed transferring her interest in this property to HUSBAND concurrently with the Marital Settlement Agreement. Said deed will be held in escrow by WIFE'S attorney and shall be released to -4- HUSBAND upon the refinance of these obligations. Pending the refinance, HUSBAND shall remain solely responsible for all costs and obligations associated with this property, including but not limited to the mortgage,, insurance, taxes, and utilities. HUSBAND shall indemnify and hold WIFE harmless from such. If HUSBAND is unable to refinance or otherwise remove WIFE from the mortgage and pay her $26,000 within 90 days of the execution of this agreement, the issues regarding the marital home including its sale, value and distribution of equity shall be determined by the Master. 7.2 Retirement HUSBAND and WIFE shall execute a Stipulation for the Entry of a Qualified Domestic Relations Order, granting WIFE fifty percent (50%) of the marital portion of his military pension. The Qualified Domestic Relations Order is attached hereto as Exhibit A, and incorporated by reference The QDRO has been reviewed by all parties. WIFE shall examine the QDRO and shall make any proposed changes within 48 hours. If none are made, it is deemed acceptable and shall be executed by the parties within 10 days. In the event that changes are proposed to which the parties do not agree, then the issue of the QDRO language shall be determined by the Master. WIFES expert may propose that language from the QDRO be placed in the body of the agreement rather than be attached as an Exhibit to the document. The parties shall agree to amend such language if it facilitates the processing of the QDRO. 7.3 Investments. Attached hereto as Exhibit "B", is a chart which contains a distribution of the mutual funds effective November 13, 2008. WIFE waives right, title and interest to any mutual fund balance in HUSBAND'S column specifically; Dodge & Cox Fund #4503, FMI Focus #2819, Vanguard #7403, -5- Oakmark Global #0106. HUSBAND hereby waives any right, title and interest to any mutual funds in WIFE'S column specifically, Clipper Fund #1374, Dodge & Cox Fund #4903, Harbor Fund #9716, Mairs & Power #6364 and Oakmark Fund. WIFE received the Harbor Fund, Oakmark and Mairs & Power as an advance on equitable distribution. HUSBAND will cooperate with WIFE to transfer the Clipper Fund and Dodge & Cox Fund to WIFE. All funds shall be subject to market growth and loss, but WIFE shall only be entitled to receipt of these funds in their entirety and HUSBAND shall only be entitled to maintain the funds in his column subject to market growth and loss. Upon the execution of the QDRO and the entry of the divorce decree, HUSBAND shall pay to WIFE $1,003 in cash owed under Exhibit B. 7.4 Vehicles: WIFE shall retain her vehicles, a 2001 BMW 325 and a 2000 Ford Windstar. HUSBAND shall retain his vehicle, a 1966 Porsche 911. Consideration for these vehicles is factored into the payment as outlined in Paragraph 7.4. HUSBAND shall also retain the 1967 Alfa Romeo, 1986 Porsche 944 and the 2003 BMW 330i, which are non-marital. There is an outstanding loan on the 1966 Porsche and HUSBAND shall be solely responsible for such payments and shall indemnify and hold WIFE harmless from such payments. Within 10 days of the execution of this agreement, HUSBAND and WIFE shall make arrangements to transfer the titles of the vehicles retained by WIFE to WIFE'S name alone. 7.5 529 COLLEGE SAVINGS PLAN. HUSBAND is the owner of three (3) 529 College Savings Plan. The plan beneficiaries are the children, Michael, Lauren and David. HUSBAND shall remain the sole owner of the 529 Plans for Michael and Lauren. WIFE shall be entitled to copies of statements on Michael and Lauren's -6- accounts on an annual basis upon request. The parties stipulate and agree that the WIFE shall be added as a co-signor on David's plan. Both parties acknowledge they will have access, as co-signors, to the statements regarding David's plan. The parties further stipulate that the funds in this account be used for expenses related to each child's post high school education, such as tuition, books, and dorm fees and may not be unreasonably withheld. In the event that the oldest child has not used all of the funds following the completion of his course of secondary education, funds in the account shall pass to the next youngest child, Lauren. In the event Lauren has not used all of the funds following completion of her course of secondary education, funds in the account shall pass to the youngest child's plan. In the event there are any funds remaining after the completion of David's secondary education, the funds shall be split, 50/50 between HUSBAND and Wife after the payment of any taxes thereon. If David reaches the age of 22, and has failed to complete his secondary education, the funds shall be split between the parties as outlined herein. 7.6 Personal Property: The parties have divided the personal property by private agreement. Attached hereto, as Exhibit "C" is a list of items which WIFE shall pick up within 90 days of the execution of this agreement. If she fails to do so, she waives her right to these items. Michael's furniture is specifically excluded. 8. DEBTS. HUSBAND represents and warrants to WIFE that since 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 and demands made against her by reason of such debts or obligations incurred by him since September 15, 2005. -7- WIFE represents and warrants to HUSBAND that since separation she has not, and in the future 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 and demands made against him by reason of such debts or obligations incurred by her since September 15, 2005. The parties agree that any remaining joint credit card accounts will be closed and shall promptly cooperate in that effort. 9. SPOUSAL SUPPORT/ALIMONY. Beginning December 1, 2008, HUSBAND shall pay alimony to WIFE in the monthly amount of one thousand two hundred ($1,200) until such time as Wife begins receiving her marital portion of the pension. On December 1, 2008, WIFE'S spousal support/APL order shall terminate. The parties agree that the above referenced alimony obligation shall be subject to the following terms and conditions: (a) The alimony obligation shall terminate upon the death of either party or WIFE'S remarriage. (b) HUSBAND'S payment to WIFE shall occur monthly and shall be direct between the parties. (c) The parties agree and intend that for purposes of federal income taxation, said payments are includable in WIFE'S income and tax deductible to HUSBAND. (d) The payment amounts shall not be subject to increase or upward modification. WIFE'S agreement to this provision is subject to HUSBAND continuing to carry life insurance at declining levels to secure the equivalent of a payment of $1200 per month until June 2010. (e) WIFE'S alimony income shall be included with her income/earning capacity in subsequent reviews of HUSBAND'S child support obligation. (f) WIFE intends to exercise her right to military benefits to which she is entitled including health, dental and insurance benefits, access to the bases, and maintaining a military I.D. Husband shall cooperate as needed, but shall not be individually responsible to provide these benefits himself. WIFE may elect any insurance of her choice, and for which she qualifies, including CHAMPUS PRIME. WIFE shall be solely responsible for all costs associated with her coverage. 10. CHILD SUPPORT. -8- HUSBAND currently pays WIFE child support in the amount of one thousand one hundred ninety-one ($1,191) dollars per month, pursuant to an existing Domestic Relations order. These payments are subject to the following terms and conditions: (a) HUSBAND shall provide health insurance coverage for the son. (b) HUSBAND'S child support obligation shall terminate upon the child's graduation from high school, and the attainment of age 18 or pursuant to applicable law at the time. (c) HUSBAND'S child support obligation shall be modifiable at any time through Domestic Relations. (d) The current Domestic Relations order at PACSES # 580107845 shall remain in effect. 11. LIFE INSURANCE. HUSBAND shall maintain a military life insurance policy of which Wife shall be the beneficiary. The proceeds designated for WIFE will be sufficient to cover the remaining balance of alimony at twelve hundred dollars ($1,200) per month and child support at one thousand one hundred ninety-one ($1,191) per month or the amount deemed appropriate by Domestic Relations. The insurance shall be declining in amount as support is paid. 12. EFFECT OF RECONCILIATION. The parties agree that the terms of this Agreement shall not be affected by their subsequent reconciliation, cohabitation with each other or resumption of marital relations, unless the parties otherwise specifically agree in a witnessed, notarized writing executed with the same formality as this Agreement. 13. MODIFICATION/ WAIVER. No modification or waiver of any of the provisions of this Agreement shall be valid or effective unless it is specifically documented in a witnessed, notarized writing executed with the same formality as this Agreement. The failure of either party to insist upon strict performance of any of the provisions -9- of this Agreement shall not be construed as a waiver of any subsequent default of the same or similar nature. 14. TAXES. The parties have heretofore filed joint Federal and state tax returns. Both parties agree that in the event any deficiency in Federal, state or local income tax is proposed, or any assessment of any such tax is made against them, each will indemnify and hold harmless the other from and against any loss or liability for any such tax deficiency or assessment and any interest, penalty and expense incurred in connection therewith. Such tax, interest, penalty or expense shall be paid solely and entirely by the individual who is finally determined to be the cause of the misrepresentations or failures to disclose the nature and extent of his or her separate income on the aforesaid joint returns 15. COOPERATION. WIFE and HUSBAND shall mutually cooperate with each other in order to carry through the terms of the Agreement, including but not limited to the signing of deeds, titles, and/or documents. Contemporaneously with the execution of this Agreement, the parties will sign Affidavits of Consent and Waivers of Notice of Intent to Request Entry of a Divorce Decree. 16. ATTORNEY FEES. COURT COSTS. Each party hereby agrees to be solely responsible for the balance of his or her own counsel fees, costs and expenses. Neither shall seek contribution thereto from the other party except as otherwise expressly provided herein. 17. ATTORNEYS' FEES FOR ENFORCEMENT. In the event that the either party breaches any provisions of this Agreement and the other party retains counsel to assist in enforcing the terms thereof, the breaching party will pay all reasonable attorneys' fees, court costs and expenses (including interest and travel costs, if applicable) which are incurred by the other party in enforcing the Agreement, whether enforcement is ultimately achieved by litigation or by amicable resolution. However, the alleged breaching party shall not be required to pay -10- the other party's attorney's fees, costs and expenses of the other party in the absence of a written demand provided to the counsel of record or to the party alleged to be in breach at their last known address. Demand shall be adequate if it is sent via certified mail to the alleged breaching party, or by regular U. S. mail to counsel of record, and provides at least fourteen (14) calendar days for compliance. For purposes of this provision, and in absence of notice to HUSBAND to the contrary, the presumptive correct address for notice to the WIFE shall be: AVIS D. NAGORZANSKI 2139 St. Clair Court Harrisburg, Pennsylvania 17110 For purposes of this provision, and in absence of notice to the WIFE to the contrary, the presumptive correct address for notice to the HUSBAND shall be: STEVEN M. NAGORZANSKI 3815 Chippenham Road Mechanicsburg, Pennsylvania 17050 In absence of a notice to the other party of change of address, a breaching or alleged breaching party shall not be relieved of obligation for attorney's fees, costs and expenses under this paragraph for failure to receive written demand. It is the specific Agreement and intent of the parties that a breaching or wrongdoing party shall bear the obligation of any and all costs, expenses and reasonable counsel fees incurred by the nonbreaching party in protecting and enforcing his or her rights under this Agreement. 18. WAIVER OF RIGHTS. Both parties hereby waive the following procedural rights: (a) The right to obtain an inventory and the appraisement of all marital and non- marital property; (b) The right to obtain an income and expense statement of either party; - 11 - (c) The right to have all property identified and appraised; (d) The right to discovery as provided by the Pennsylvania Rules of Civil Procedure and the Pennsylvania Divorce Code, including but not limited to, written interrogatories, motions for production of documents, the taking of oral deposition, any all other means of discovery permitted under the law; (e) The right to have the court make all determinations regarding marital and non-marital property, equitable distribution, spousal support, alimony pendente lite, alimony, counsel fees and costs and expenses; and 19. VOID CLAUSES. 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 continue in full force, effect and operation. 20. APPLICABLE LAW. This Agreement shall be construed under the laws of the Commonwealth of Pennsylvania. 21. 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 for herein. 22. CONTRACT INTERPRETATION. For purposes of contact interpretation and for the purpose of resolving any ambiguity herein, the parties agree that this Agreement was prepared jointly by the parties. -12- IN WITNESS WHEREOF, the parties hereto have set their hands and seals of the day first written above. \\?\ LAje2L Witness STEVEN M. NAGORZANSKI AVIS D. NAGO KI -13- COMMONWEALTH OF PENNSYLVANIA: . ss. COUNTY OF On the day of , 2008, before me, a Notary Public in and for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared STEVEN NAGORZANSKI, known to me (or satisfactorily proven) to be one of the parties executing the foregoing instrument, and he acknowledges the foregoing instrument to be his free act and deed. IN WITNESS WHEREOF, I have hereunto set my hand a notarial seal the day and year first above written. Notary Public COMMONWEALTH OF PENNSYLVANIA: COUNTY OF ss. On the day of , 2008, before me, a Notary Public in and for the Commonwealth of Pennsylvania, the undersigned officer, personally appeared AVIS D. NAGORZANSKI, known to me (or satisfactorily proven) to be one of the parties executing the foregoing instrument, and she acknowledges the foregoing instrument to be her free act and deed. IN WITNESS WHEREOF, I have hereunto set my hand a notarial seal the day and year first above written. Notary Public -14- Steven Namorzans ' IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA VS. : CIVIL. ACTION - LAW Ayig Q NUmanski NO. 05.57_46 Defendant IN DIVORCE DOMESTIC RELATIONS ORDER 1. This Domestic Relations Order ("DRO") creates and recognizes the existence of the Alternate Payee's right to receive a portion of the benefits payable with respect to the Participant. It is intended to constitute a Qualifying Court Order under the Uniformed Services Former Spouse's Protection Act, 10 U.S.C. Section 1408 and following. 2. This DRO is entered pursuant to authority granted under the applicable domestic relations laws of the State of Pennsylvania and relates to the provision of marital property rights to the Alternate Payee. 3. This DRO applies to the Military Retirement System ("Plan") and any successor thereto. Steven M. Nagorzanski ("Participant") is a Participant in the Plan. Avis D. Nagorzanski ("Alternate Payee"), the former spouse, is the Alternate Payee for the purpose of this DRO. 4. The Participant's name, mailing address, Social Security number and date of birth are: Steven M. Nagorzanski 3815 Chippenham Road Mechanicsburg, PA 17050 Social Security No.: 331-46-5594 Date of Birth: May 16, 1958 5. The Alternate Payee's name, mailing address, Social Security number and date of birth are: Avis D. Nagorzanski To Be Completed Social Security No.: 562-53-3514 Date of Birth: August 30, 1964 6. The Participant assigns to the Alternate Payee an interest in the Participant's disposable military retired pay. The Alternate Payee is entitled to a direct payment in the amount specified below and shall receive payments at the same time as the Participant. do, DRO Page 2 7. This Order assigns to Alternate Payee an amount equal to $1,814 per month of the Participant's disposable military retired pay under the Plan as of his benefit commencement date. In addition to the above, the Alternate Payee shall receive a pro rata share of any cost- of-living adjustments made to the Participant's benefits. 8. The monthly payments under Paragraph 7 shall commence to the Alternate Payee as soon as administratively feasible following the commencement of Participant's retirement benefits and shall continue during the joint lives of the parties, and, to the extent permitted under law, irrespective of the future marital status of either of them; the benefits shall terminate only upon the death of either the Participant or the Alternate Payee. 9. The Participant agrees to elect to make the Alternate Payee (and such Alternate Payee shall be deemed) the irrevocable beneficiary of the survivor's Survivor Benefit Plan ("SBP"), with the survivor's annuity determined by an initial base amount of $3,298. The base amount shall be adjusted for cost-of-living after the Participant's benefit commencement date. The Participant shall make the necessary election in a timely manner to effectuate the SBP coverage for the Alternate Payee and shall execute such paperwork as is required. 14. The Participant's rights under the Servicemembers Civil Relief Act were observed by the Court as evidenced by his affirmative signature on the divorce decree and/or separation agreement. 11. This court has the authority to divide Participant's military retired pay under the USFSPA's C-4 jurisdictional requirement since the Participant consents to the jurisdiction of this court. 12. The Participant and the Alternate Payee acknowledge that they have been married for a period of more than ten years during which time the Participant performed more than ten years of creditable military service. The parties were married on October 3, 1987 and separated on September 16, 2005. 13. The Alternate Payee agrees that any future overpayments to her are recoverable and subject to involuntary collection from her or her estate. 14. The Alternate Payee agrees to notify DFAS about any changes in the Domestic Relations Order or the order affecting these provisions of it, or in the eligibility of any recipient receiving benefits pursuant to it. 15. The Participant agrees to cooperate with the Alternate Payee to prepare an application for direct payment to the Alternate Payee from the Participant's retired or retainer pay pursuant to 10 U.S.C. Section 1408. The Participant agrees to execute all documents that the United States Navy may require to certify that the disposable military retired pay can be provided to the Alternate Payee. 16. The Participant agrees not to merge the Participant's disposable military retired pay with any other pension and not to pursue any course of action that would defeat the Alternate Payee's right to receive a portion of the disposable military retired pay of the Participant. The Participant agrees not to take any action by merger of the military retirement pension so as to DRO Page 3 cause a limitation in the amount of the total retired pay in which the Participant has a vested interest and, therefore, the Participant will not cause a limitation of the Alternate Payee's monthly payments as set forth above. The Participant agrees to indemnify the Alternate Payee for any breach of this Paragraph 16 as follows: If the Participant becomes employed or otherwise has his military pension merged, which employment or other condition causes a merger of the Participant's disposable military retired pay, the Participant will pay to the Alternate Payee directly the monthly amount provided in Paragraph 7 under the same terms and conditions as if those payments were made pursuant to the terms of this Order. 17. If in any month, direct payment is not made to spouse by DFAS (or the appropriate military pay center) pursuant to the terms of this Order, Participant shall pay the amounts called- for above directly to Alternate Payee by the fifth day of each month in which the military pay center fails to do so, beginning on the date that Alternate Payee would have otherwise been entitled to commence her payments. This includes any amounts received by the Participant in lieu of disposable retired pay, including but not limited to, any amounts waived by Participant in order to receive Veterans Administration (i.e., disability) benefits or any amounts received by Participant as a result of an early-out provision, such as VSI or SSB benefits. 18. If the Participant takes any action that prevents, decreases, or limits the collection by the Alternate Payee of the sums to be paid hereunder, he shall make payments to the Alternate Payee directly in the amount sufficient to neutralize, as to the Alternate Payee, the effects of the actions taken by the Participant. 19. The Participant hereby waives any privacy or other rights as may be required for the Alternate Payee to obtain information relating to the Participant's date and time of retirement, last unit assignment, final rank, grade and pay, present or past retired pay, or other information as may be required to enforce the award made herein, or required to revise this Order so as to make it enforceable. 20. The Participant shall be required to notify the Alternate Payee, in writing, within thirty (30) days prior to Participant's actual date of retirement. Such notice shall indicate his intentions to retire and elect benefit commencement date. The notice shall be sent via regular first-class mail. For this purpose, the Alternate Payee shall notify the Participant of any changes in her mailing address. 21. The parties acknowledge that the following items must be sent by the Alternate Payee to DFAS, U.S. Military Retired Pay, P.O. Box 7130, London, KY 40742-7130 and to DFAS. CLIGAG, Garnishment Operation, P.O. Box 998002, Cleveland, OH 44199-8002. The Participant agrees to provide any of this information to the Alternate Payee at the Alternate Payee's request and to wake all necessary efforts to obtain any of this information that the Alternate Payee is unable to obtain. a. Deemed Election Letter. b. A certified copy of the Divorce Decree. C. A certified copy of this Domestic Relations Order. DRO Page 4 d. A copy of the Marriage Certificate of Steven M. Nagorzanska and Avis D. Nagorzanski. e. An executed copy of Form 2656-1 entitled "Survivor Benefit Plan (SBP) Election Statement for Former Spouse Coverage." f. An executed copy of Form 2293 entitled "Application for Former Spouse Payments From Retired Pay." 22. The Court shall retain jurisdiction to enter such further orders as are necessary to enforce the award to the Alternate Payee of the military retirement benefits awarded herein. EXECUTED this day of , BY THE COURT CONSENT TO ORDER: Plaintiff/Participant Date Attorney for Plaintiff/ Date Participant Judge Defendant/Alternate Payee Date Attorney for Defendant Date Alternate Payee SURVIVOR BENEFIT PLAN (SBP) ELECTION STATEMENT FOR FORMER SPOUSE COVERAGE (Please reed Pdivery Act StetemeW and Inat'nctiorts at back BEFORE compWkq Form.) SECTION I.- ELECTION OF COVERAGE - RETIRED MEMBERS ONLY RETIRED. MEMBERS chenging kom a I pmsa or spouse and child(ren) eovetape to former spouse or•tormor spouse and ddid(ron) covers" RETUtING MEMRERS must complete required soctlon of DD Farm 2656 to elect coverage for former. spout* or former spouse and chiWmn). 1. DUE TO DIVORCE, CHANGE MY SBP COVERAGE TO (X ons) -NOTE: amt eweuon klcfudedd?Md(mn). Ilst M Ilarn to ONLY ate a>wpsn) 7 F-1 FORMER SPOUSE FORMER SPOUSE AND CHILD(REN)- from ate nlsnlaye ofMe momberend the *wmerspouse. kwoude tar dare or bkM and SSN for suds d*d. SECTION N - RETIRED AND RETIR ING MEMBERS 2. ARE YOU CURRENTLY MARRIED? IX one. It 'YES,' complete a. - d.) YES No a. NAME OF CURRENT SPOUSE bast Fkst ASMe InsW b. SON OF CURRENT SPOUSE c~ DATE OF CURRENT MARRIAGE (YYYYMMOO) d. ADDRESS OF CURRENT SPOUSE: (1) Street (k * de apartment rtturtber) (2) City (3) State (4) ZIP Code YES NO 3. IS THIS ELECTION BEING MADE PURSUANT TO THE REQUIREMENTS OF A COURT ORDER? (tone) 4. IS THIS ELECTION BEING MADE PURSUANT TO A WRITTEN AGREEMENT PREVIOUSLY ENTERED INTO VOLUNTARILY AS PART OF OR INCIDENT TO A PROCEEDING OF DIVORCE, DISSOLUTION OR ANNULMENT? (Xons) 5. IF "YES" TO ITEM 4, WAS SUCH A VOLUNTARY WRITTEN AGREEMENT INCORPORATED IN, RATIFIED, OR APPROVED BY A COURT ORDER? (Xone) S. DATE BIRTH OF FORMER T. DATE MARRIED TO FORMER 8. DATE DIVORCED FROM [7dMo MARK (a `Y&S ; yi?w HAS FORM&R.R SPOUSE (YYYYMMOD) SPOUSE (YYYYMMOO) FORMER SPOUSE (YY "WDO) - YY YYA#WDQ) M64'01-30 Icrin- to-o3 NO YES 10. DEPENDENT CHILDREN (robe compArted ortty by eaHrod members etectkp Ibmw spouse and ehild(ran) covwepn. Con*w In Mom 11, Remarks,' if necessary.) a. NAME Haar. Fist ANddle **0 b. DATE OF IRTH c. SON d. R TIONSNfP (Sank dauprrlr, ski 9.De)£D? 11. REMARKS SECTION W --CERTMATIOtO =RETIRED AND RETiRiNG. MEMBERS ANO FORMER SPOUSES 1Z MEMBER 13. FORMER SPOUSE TO BE COVERED a. NAME (Last Fkat k*** btigaQ Na or-2:ansl,i: M. b. SON 331-46-55 Lt a. NAME (Cast First Mddk kW*o N4 or=gnsk: Avis D. b. SON 561-53.3514 c. SIGNATURE c. SIGNATURE d. ADDRESS d. ADDRESS (1) Street (ktchrde apatment number) 3815 Ct,*IPPP.itCA , RbC1b (1) Street (tndude apartment number) (2) City MI!0lX0 vr ?R (3)Staft (4) ;ZIP Code PO? (2) City (3) State (4) ZIP Code 14. MEMBER'S WITNESS 15. FORMER SPOUSE'S WITNESS a. NAME (Last. FW hAddro b0aQ a. NAME (teat First Aeddb k*169 b. SIGNATURE c. DATE SIGNED b. SIGNATURE c. DATE SIGNED d. ADDRESS CL ADDRESS (1) Street (Incks0r moiOrtant numbs) (1) Street (Indude apartment rarmber) (2) City (3) State (4) ZIP Code (2) City (3) State (4) ZIP Code DO FORM 2656-1, APR 2006 FREVIOU5 EOFTIQN 15055METE. ^oooe r-o PRIVACY ACT STATEMENT AUTHORITY: Public Law (PL) 92425, September 21,1972; PL 97-252, September 8,1982; PL 98-94, September 24,1983; PL 98-525, October 19, 1984; PL 99-145. November 14,1986; and EO 9397. PRINCIPAL PURPOSE(S): To establish a Survivor Benefit Plan election for a servicemember's former spouse. ROUTINE USE(S): Informadon may be provided to the Internal Revenue Service to resolve matters relating to an individuars claim for tax withholding; and, to the Department of Justice or to state and local governments when a question of law, court order or offmer conflicting interest is raised concerning an individual's declaration. DISCLOSURE: Voluntary; however, failure to furnish requested information may result in delay in initiating Survivor Benefit Plan. INSTRUCTIONS GENERAL. Type or print all Information in ink. ITEMS 3.4. and 5. Mark the block that reflects legal basis for coverage. RETIRED MEMBERS: Compete Sections 1, II, and Ill. If electing former spouse and child(ren) coverage, provide information pertaining to elide child(ren) in Item 10, "Dependent Children.' RETIRING MEMBERS: Complete Sections II and 111, but make the election on DD Form 2656, "Data for Payment of Refired Personnel." ALL MEMBERS AND FORMER SPOUSES must complete Section III. When the form has been completed (ensure It Is signed by both member and former spouse, and Is properly witnessed), submit it to: DFAS - US Military Retirement Pay PO Box 7130 London, KY 40742-7130 Attach a cardW copy of the divorce decree, amendment, or other documentation as described in Items 3, 4, and 5. If not received by DFAS within the first year following the date of divorce, the election will be invalid. SECTION I. ITEM 1. Retired member places an X in the appropriate block to indicate whether election is for former spouse, or former spouse with child(ren) coverage. SECTION IL ITEM 2. Indicate members marital status by marking appropriate block. If "Yes," complete 2.a. through 2.d. a. Provide name of members current spouse. b. and c. Self-explanatory. d. Provide members current spouse's address, if different from the member's address. Enter "Same* if the member and spouse have the same correspondence address. ITEMS 6 and 7. Setf=explanatory. ITEM 8. Enter date of divorce decree, or amendment requiring SBP. ITEM 9. Mark the appropriate block. If *Yes," provide the date that member's former spouse remarried. Former spouse may remarry after age 55 and eligibility will not be affected. If former spouse remarries before age 55, coverage is suspended and premiums are not deducted from member's retired pay for the duration of that marriage. If former spouse's marriage ends by death, divorce, or annulment, coverage will resume. Retiree or former spouse must notify DFAS of any changes in former spouse's marital status, providing appropriate documentation. ITEM 10. Retired members electing former spouse and child(ren) must fist eligible children in this section. Only children resulting from the marriage of the member and the former spouse are covered in a former spouse and child(ren) election. The former spouse is the primary beneficiary; children receive an annuity only if the former spouse remarries before age 55 or dies. Indicate in block 10.e. if the child is incapable of self support and attach substantiating documentation, If available. Eligible children of refiring members should be fisted in Block 25 of DD Form 2656. ITEM 11. This block may be used for comments or additional information not covered in the form. SECTION Ili. ITEMS 12 through 15. Self-explanatory. APPLICATION FOR FORMER SPOUSE PAYMENTS FROM RETIRED PAY OMB No. 0730-M OMB approval ex#ms (Please read insfrudians on bedr and the Pdvacy Ad Statement before corr?Owkv tide form.) Jan 31, 2011 TM pubis wewen3 bfrdea br ell oasasYon d nternMion own.na w aMerape t3 mows Pr n.p.s. ^0 dw wrM tar ier+awMq taasucsona FOR O ICIAL USE esaryhbq ealydrg dw eouron iMMMYri and aMlwidn0 ant dra rMade' end ooahI l -and reIM" sM oo0ea I a YdonrMtlorr. send commnxs nearly dda W ao eeWmMa a say dMr saPed Of ede adMaean Of MAN ft"+. tnaWdbg wppadaM ifs radufte do Mrdan, to I" nepraW" d t3a1110% W".-,A* FMad OMrlaR 8rMton. EMaeudMa swvkas DwedwaW MAmmNfon Msiapaarant CW I&% IW 041w" f nvow4 wnhyiyMn, DC 20.701.1153 ".000q." Ill. ill So" be aware MM aaeMMtW"" oq WW PrwA" d Mw, ae PM^ shd be aubjw fo my l -low lauv ieoerphr wbh s a", ft r d Ydo l -110n i N does ash dboay a curs W Maid OMB coMrd numbs. PLEASE PQ NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. RETURN COMPLETED FORM TO THE APPROPRIATE SERVICE ADDRESS LISTED ON BACK. PRIVACY ACT STATEMENT AUTHORITY: Title 10 tJSC 1408: DoD 7000.14, Vol. 78. Chapter 29; and EO 9397. PRINCIPAL PURPOSE(S): To request direct payment through a Uniformed Service designated agent of court ordered child support, alimony, or division of property to a former spouse from the retired pay of a Uniformed Service member. ROUTINE USE(S): In addition to slim disclosures genW811y permitted under 5 U.S.C. Section 552a(b) of the Privacy Act, these records or information contained therein may specifically be dlsdosed outside the DoD as a routine use pursuant to 5 U.S.C. Section 552a(b)(3) as follows: Records are provided to the khtemel Revenue Service for normal wage and tax withtwilding purposes. The " Blarket Routine Uses' published at the beglrming of the DoO compliallon of systems of records (notices also apply. DISCLOSURE: Voluntary; however, failure to provide requested information may delay or make impossible processing this direct payment request. 1. APPLICANT IDENTIFICATION 2. SERVICE MEMBER IDENTIFICATION a. NAM (As sppears on Dot0 on:00 (Last Fuel, AftWe 1N*Q a. NAME (Last, F7rst, Middle InX* NQ orzAniki Av.t O Na ersgn:kt ? S+Cvfre M b. CURRENT NAME (Last, First Middle IrWhOL b. BRANCH OF SERVICE ilia or7,ansW, A,;,s Navy. c. SOCIALSECURITY NUMBER 5b2-53-3314 c. SOCIAL SECURITY NUMBER 731-46-599y d. TELEPHONE NUMBER (Mdude Area Code) d. TELEPHONE NUMBER (Include Area Code) (ifknowm) e. EMAIL ADDRESS a. EMAIL ADDRESS (Nkaown) C ADDRESS (Street, City, State, ZIP Code) f. ADDRESS (Street, City, State, ZIP Code) (Nltnown) -3915 C'610-pr^ 60- Road /4 a insA r r $ bv?5 PA 11050 3. REQUEST !STATEMENT I request direct payment from the retired pay for one or more of the IoNowirig categories of the above named Uniformed Service member based on the enclosed court order. I acknowledge that the payment priority will be (1) division of property: (2) child support. and (3) alimony unless I designate otherwise in Item 4.e. I request payment of: 1A 14 (1) A division of properly in the amount of $ _,Or_ percent of disposable retired pay per month. (2) Child support in the amount of $ per month. (3) Alimony, spousal support or maintenance in the amount of E or pwcwA of disposable retired pay per month. I cedly that any request for current child and/or spousal support is not being collected under any other wage withholding or garnishment procedure authorized by statute. Furthermore, I certify that the court order has not been amended, superseded or set aside and Is not subject to apped. As a condition precedent to payment, i agree to refund all overpayments and that they we otherwise recoverable and subject to involuntary collection from me or my estate, and I will notify the appropriate agent (as fisted on bads) If the operative court order, upon which payment Is based, is vacated, modified, or set ast&. I also agree to notify the appropriate agent (as listed on back) of a change in eligiblity for payments. This includes notice of my remarriage. if under the terms of the court order or the laws of the jurisdiction where it was issued remarriage causes the payments to be reduced or terminated: or notice of a change in eligibility for child support payments by reason of the death. emancipation. adoption, or attainment of ma)ority of a child whose support is provided through cilmd payments from retired pay. I hereby acknowledge that any payment to me roust be paid from disposable retired pay as defined by the statute and implementing regulations. DD FORM 2293, FEB 2008 PREVIOUS EDITION IS OBSOLETE. Adobe PM%m arrd 7.0 TO INCLUDE: a. A copy of the operative court order and other accompanying documents 00 provide for payment of child support. alimony or a division of retired pay as property, containing a certification dated by the dads of the court within 90 days preceding the data the application Is received by the designated agent. b. Evidence of the date(s) of my marriage to the member if the application is for the direct payment of a division of the mmernbees disposable retired pay as property. c. If and DATE OF BIRTH ' I d. If applying under Title 10 US.C. 14Wh), Dependent Victims of Abuse provision, in addition to 4.a. above, enclose both a copy of the member's court martial order and the member's statement of service. e. Other information (please klsaNW or remarks. INSTRUCTIONS FOR COMPLETION OF DD FORM 2293 GENERAL. These instructions govern an application for direct payment from retired pay of a Uniformed Servtoe member in response to court child support, alimony, w a division of property, tinder the audmrty of 10 USC 1405. SERVICE OF APPLICATION. You may serve the application by mad on the appropriate Uniformed Service designated agent. The Unarmed Services' designated agents are: (1) ARMY, NAVY, AIR FORCE; AND MARINE CORPS: Attn: OFAS-HGAICL, Assistant General Counsel for GamishmeM Operations, P.O. Box 996002, Clavelard, OH 44199.8002. Application may also be served by fax to 877-622-5930 (toll-free) or (216) 52246960. (2) COAST GUARD: Commanding Ofbcer (I GL), United States Coast Guard, Personnel Service Center, 444 S.E. Quincy Street, Topeka. KS 66683-3691. Application may also be served by tax to 786.339-3786. (3) PUBLIC HEALTH SERVICE: Attn: Retired Pay Section, CB, Division of Commissioned Personnel, PUBLIC HEALTH SERVICE, Room 4-50, 5600 Fishers Lane, Rockville, MO 208674001. (4) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION: Safine as U.S. Coast Guard. IMPORTANT NOTE: Making a false statement or claim against the United States Government is punishable. The penally for wdittdly making a false claim or false statement is a maximum fine of S10,000 or maximum imprisonment of 5 years or both (18 USC 287 and 1001). ITEM 1. a. Enter full name as it appears on the court order. Applicant's signature required: the form may not be signed by a member or attorney. b. Enter current name if different than it appears on court order. c. Enter Social Security Number. d. Enter telephone number. e. Enter email address, if applicable. t Enter kxurent address. Fait"to apprise WAS of address changes may result in the suspension of payments. ITEM 2. a. Enter member's full name as it appears on the court order. b. Enter member's branch of service. c. Enter member's Social Security Number. d. Enter member's telephone number. If known. e. Enter members email address. If known. 1. Enter member's current address, if known. ITEM 3. Read the Request Statement carefully. ITEM 4. A certmRed copy of a court order can be obtained from the court that issued the court order. Other documents include, but are not limited to, final divorce decree, property settlement order, and any appellate court orders. If the court order does not state that the former spouse was married to time member for ten years or more while the member performed ten years creditable service and the request is fw payment of a division of property, the applicant must provide evidence to substantiate the ten years' marriage condition. Additional evidence must show that the ten years' requirement has been met, Including; Uniformed Service orders, marriage certificate, and other documents that establish the period of marriage. Other information or documents Included with the request should be dearly identified by the document's title and date. Remarks may be provided to clarify specific points. 2293 DEEMED ELECTION LETTER DFAS U.S. Military Retired Pay P.O. Box 7130 London, KY 40742-7130 DFAS-CL(GAG Garnishment Operations P.O. Box 998002 Cleveland, QH 44199-8002 RE: Steven M. Nagorzanski - SSN: 33146-5594 Avis D. Nagorzanski - SSN: 562-53-3514 Deemed Election Letter To Whom It May Concern: The following documents are enclosed for Avis D. Nagorzansid's Deemed Election within one year of date of Divorce Decree: 1. A certified copy of Divorce Decree dated 2. A certified copy of Domestic Relations Order dated 3. A copy of the Marriage Certificate of Steven M. Nagorzanski and Avis D. Nagorzanski. 4. Form 2656-1 entitled "Survivor Benefit Plan (SBP) Election Statement for Former Spouse Coverage," whereby Avis D. Nagorzanski is named as the former spouse for benefits of the survivor annuity. Steven M. Nagorzanski has executed this form. 5. Form 2293 entitled "Application for Former Spouse Payments from Retired Pay." This has been executed by Steven M. Nagorzanski. With best regards, Yours sincerely, Encl. This letter has been reviewed by me and is acceptable to me. Avis D. Nagorzans ' Debra: Mr. Leister did point out one thing that will require us to revise this DRO. When you award a fixed dollar amount in a Military DRO, DFAS won't calculate COLAs on this fixed amount. To give the Alt Payee COLAs, we need to re-write Paragraph 7 so it is a percentage award. Paragraph 7 should be rewritten as follows: 7. This Order assigns to Alternate Payee an amount equal to X% of the Participant's actual disposable m' nary retired pay with X determined by dividing (a) by (b) where (a) and (b) are as follows: (a) $1,$14.00, and (b) The Participant's actual disposable retired pay as of the date of his retirement. It is understood that on the date the monthly payments commence to the Alternate Payee that the amount of the initial payment shall be $1,814.00 and that subsequent payments shall take into account a pro rata share of any cost-of=living adjustments made to the Participant's benefits. The pro rata share shall be calculated in the same manner as the Alternate Payee's share of the Participant's retirement benefits is calculated pursuant to this Paragraph 7. Once the other side reviews the DRO, we can revise it to take this necessary change. and any others?? into account. 4 Jon Cramer NAGORZANSKI SETTLEMENT SPREADSHEET Asset Valuation -11/13/08 W - H- li r Fund Acct. #87121374 $ 12,494.00 $ 12,494.00 Dodge & Cox Stock Fund Acct. #300274503 $ 18,409.00 $ 18,409.00 Dodge -& Cox Income Fund #300274503 $ 5,787.00 $ 5,787.00 FMI Focus Fiduciary Funds Acct. #1360002819 $ 14,354.00 $ 14,354.00 Vanguard Emerging Mkts # 0114/88009479858(previouslyjt. acct. #0533/09960887403 $ 9,179.00 $ 9,179.00 Vanguard Strategic Equity #922038-10-4(previously jt. Acct. #0114/09960887403 $ 11,883.00 $ 11,773.00 Oakmark Global #777000106 $ 3,717.00 $ 3,717.00 Harbor Fund #29709716 $ 11,572.00 $ 11,572.00 airs & Ppwer Roth IRA Acct. #2480016364 $ 11,590.00 $ 11,590.00 Oak-mark Fund $ 10,981.00 $ 10,981.00 Total: $ 109 966.00 $ 52 424.0 $ 57 432.00 Advanced Cash fund, tax and Cars $ 12,552.00 TOTAL: $ 64,976.00 Cash Paid to Wife: $ 1,003.00 Household Assets value Avis Steve Dispute Neither c? Y ?' v r1 V` E Kitchen 1Gtchenette set x Ceramic Chickens X Pitchers X M' ' Bowl coPection x Ceramic Figurines X Dishes X Ceramic sun faces 4 X Decorative lasses x Av is Inheritance Mugs v x Nick-nacks in cadets X Av is Inheritan ce 00 Wooden roN 'n LmpAcA X Blender x Microwave (portable) J X -1iuiMllirrl x i Dinin Room Table / chairs x Server X China cabinet x Mirror x Metal Cross X Hawaiian girl H adro X Ch I stemware x Old Scale X Pi lam on server 2 X Old water skis x Entry foyer rug x Farm Room While Sofa / kweseat x Coffee and and table x Van Gogh ad! ti s 2 x Lam x 0, 1, >6- 6- E v v Spinning Wheel X Oki Japanese Box x Oki tool box x Cad level tool x Old plane tool x DVD Collection x X Hanging fish x Hand carved rock' horse x Bathroom Downstairs Wall cabinet x Hawaiian cohectables x Master Bedroom &V/7 -zza4- m i ,Bedroom suite 2jj 2" x Avis I nheritance cash Sleigh bed x Avis i nheritance cash TO dresser x Avis I nheribnce cash Lon dresser with mirror x Avis I nheritance cash l i t stand x Avis I nheritance cash Dresser in closet x -Red shaded lamps 2 x Large Bombay Co print framed x Lame bkn/whee planter vase x Pin i x Brown rnagazine basket x Dhama x Pond yacht x Japanese vases/bottie 3 x Ja anese habachi x T r X An ' ue boxes 2 x Master Bath awaiian 'nti S (2) v x Polynesian girl busts 7 x Blue art ghm vase x S 2 BEd 8l m# wkcftn and bowls x Haniwa x Laumn's roam Bedroom Hutch X Av is tmherftan ce 2 night stands x Av is Inheritance oRocki chair x Av is Inherka me Basement Did green sofa / loveseat x Hoiday decorations x -Col?s??? x VHS Tape collection x Books x Draffing table x R !Ms odes 2 x Decorative ladder x Pictures x Pier 1 Bamboo ladder x Pier 1 Mkror/Table x Misc - Afghani tribal rug x La from MikWs room x Old toot box from Mike's mom x Cars 3.251 2001 $16,555 Windstaar .2000 Honda $7 073 $4,000 Porsche 911 $1,655 6j T Rvm&v 1._7 STEVEN M. NAGORZANSKI, Plaintiff V. AVIS D. NAGORZANSKI, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 05-5746 CIVIL TERM : IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER Section 3301(c) OF THE DIVORCE CODE I consent to the entry of a final decree in divorce without notice. 2. 1 understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. 1 understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unswom falsification to authorities. Date: ova, tu." fig, ?0$ Avis D. Nagorza ki "`? '?7 ?? -;s -= ' _ . ? , 1 V ? j " r..... . ^l ? 1 ?,v STEVEN M. NAGORZANSKI, IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant/Petitioner PACSES CASE: 580107845 ORDER OF COURT AND NOW to wit, this 1st day of December 2008, it is hereby Ordered that the Order for Alimony Pendente Lite is terminated effective December 1, 2008 pursuant to the parties' Marital Settlement Agreement. There is a remaining balance of $370.00 owed to the Petitioner and will be paid off with the current wage attachment. This Order shall become final twenty (20) days after the mailing of the notice of the entry of the order to the parties unless either party files a written demand with the Domestic Relations Section for a hearing de novo before the Court. BY THE COUR Edward E. Guido, J. DRO: R.J. Shadday xc: Petitioner Respondent Debra D. Cantor, Esq. Marcus A.McKnight, III, Esq. Form OE-001 Service Type: M Worker: 21005 CM -? Fil i l 4 y :1 McNEES WALLACE & NURICK LLC By: Debra D. Cantor Attorney ID No. 66378 100 Pine Street Harrisburg, PA 17108-1166 (717) 237-5478 (717) 260-1667 facsimile dcantor -mwn.com Attorneys for Plaintiff STEVEN M. NAGORZANSKI, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. AVIS D. NAGORZANSKI, Defendant NO. 05-5746 CIVIL TERM 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 §3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: Regular and certified mail upon Defendant on November 4,2005 and signed for by Defendant on November 5, 2005. An Affidavit of Service was filed with the Court on November 8, 2005. 3. Date of execution of the Affidavit of Consent required by § 3301(c) of the Divorce Code: by Plaintiff: November 18, 2008; by Defendant: November 18, 2008. Plaintiffs Affidavit was filed with the Court on November 20, 2008. Defendant's Affidavit was filed with the Court on November 20, 2008. AR 4. Related claims pending: None 5. Plaintiffs Waiver of Notice was filed with the Court on November 20, 2008. Defendant's Waiver of Notice was filed with the Court on December 2, 2008. Respectfully submitted, McNEES WALLACE & NURICK LLC By 4b . C tvf _ No. 66378 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 237-5297 (717) 260-1667 (fax) dcantor _mwn.com Attorneys for Plaintiff, Steven M. Nagorzanski Dated: December 2, 2008 2 00 CERTIFICATE OF SERVICE AND NOW, this PI& day of December 2008, 1 hereby verify that I have caused a true and correct copy of the foregoing document to be placed in the U.S. mail, first class, postage prepaid and addressed as follows: Marcus A. McKnight, III, Esquire Irwin & McKnight 60 W. Pomfret Street Carlisle, PA 17013-3222 Je if L. Keen, P aleg . 3 ?- ? ; ?... ? ,? Cx., TT c-, ? ? _,- ?? s -- ca .: ;? ? ?' , , -? -.; ?? _?: .?, -? _. .. - "` _ y? .? STEVEN M. NAGORZANSKI IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. AVIS D. NAGORZANSKI NO. 2005 - 5746 CIVIL TERM ORDER OF COURT AND NOW, this 10TH day of DECEMBER, 2008, it appearing to the Court that Plaintiffs Affidavit of Consent is not dated, the request for the entry of a final decree is DENIED without prejudice. Debra Denison Cantor, Esquire 100 Pine Street P.O. Box 1166 Harrisburg, Pa. 17108-1166 Avis D. Nagorzanski 3815 Chippenham Road Mechanicsburg, Pa. 17050 Edward E. Guido, J. L? :sld i ;? C, ? (3,.. 'w ?;: ...y, :.. L- -i_ .. , ??.. ? .ems' ? p?p??y 4J STEVEN M. NAGORZANSKI, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 05-5746 CIVIL TERM AVIS D. NAGORZANSKI, IN DIVORCE Defendant AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on November 4, 2005. 2. The marriage of the plaintiff and defendant is irretrievably broken. Ninety days have elapsed since the date of service of the Complaint. 3. 1 consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Steven M. Nagorzanski Date: Y -Io ar€4" 1 a 5 l.? Tom STEVEN M. NAGORZANSKI, Plaintiff V. AVIS D. NAGORZANSKI, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 05-5746 CIVIL TERM IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER Section 3301(c) OF THE DIVORCE CODE I consent to the entry of a final decree in divorce without notice. 2. 1 understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. 1 understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. Date: ?? / -?Zk ?) Steven M. Nagorzanski ' ut + r>> -''T1 McNEES WALLACE & NURICK LLC By: Debra D. Cantor Attorney ID No. 66378 100 Pine Street Harrisburg, PA 17108-1166 (717) 237-5478 (717) 260-1667 facsimile dcantor(@-mwn.com Attorneys for Plaintiff STEVEN M. NAGORZANSKI, Plaintiff V. AVIS D. NAGORZANSKI, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 05-5746 CIVIL TERM IN DIVORCE AMENDED 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 §3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: Regular and certified mail upon Defendant on November 4,2005 and signed for by Defendant on November 5, 2005. An Affidavit of Service was filed with the Court on November 8, 2005. 3. Date of execution of the Affidavit of Consent required by § 3301(c) of the Divorce Code: by Plaintiff: December 12, 2008; by Defendant: November 18, 2008. Plaintiffs Affidavit is being filed contemporaneously with this Praecipe. Defendant's Affidavit was filed with the Court on November 20, 2008. 4. Related claims pending: None 5. Plaintiffs Waiver of Notice is being filed contemporaneously with this Praecipe. Defendant's Waiver of Notice was filed with the Court on December 2, 2008. Respectfully submitted, McNEES WALLACE & NURICK LLC B J Y D a D-tantor I.D. No. 66378 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 237-5297 (717) 260-1667 (fax) dcantor a--)mwn.com Attorneys for Plaintiff, Steven M. Nagorzanski Dated: December 15, 2008 2 CERTIFICATE OF SERVICE AND NOW, this day of December 2008, 1 hereby verify that I have caused a true and correct copy of the foregoing document to be placed in the U.S. mail, first class, postage prepaid and addressed as follows: Marcus A. McKnight, III, Esquire Irwin & McKnight 60 W. Pomfret Street Carlisle, PA 17013-3222 J ' r L. Kee Paral I 3 y ? F Steven M. Nagorzanski IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. Avis D. Nagorzanski No. 2005-5746 DIVORCE DECREE J- b t,. 3 P.M. AND NOW, -O&? 1 50' it is ordered and decreed that Steven M. Nagorzanski plaintiff, and Avis D. Nagorzanski bonds of matrimony. defendant, are divorced from the Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") None (fBy the Co Attest: J. Prothonotary 7 ?y 72 ??4 R STEVEN M. NAGORZANSKI IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA V. AVIS D. NAGORZANSKI NO. 2005 - 5746 CIVIL TERM ORDER OF COURT AND NOW, this 10TH day of DECEMBER, 2008, it appearing to the Court that Plaintiff's Affidavit of Consent is not dated, the request for the entry of a final decree is DENIED without prejudice. Debra Denison Cantor, Esquire 100 Pine Street P.O. Box 1166 Harrisburg, Pa. 17108-1166 Avis D. Nagorzanski IQ15 ('hinnPnham Rnmi EDWARD E. GUIDO JUDGE ONE COURTHOUSE SQUARE CARLISLE, PE NSYLVANIA 17QJ3-3387 5494 PQ%\ 7 ® pTNET B( ME5 02 1A $ 00.42 0004631598 DEC 11 201 MAILED FROM ZIP CODE 1 70' Avis D. Nagorzanski N T? 3815 Chippenham Road Mechanics) NIXIE 176 CE 1 64 :0/1 co RETURN TO SENDER NOT DELIVERADLE AS ADDRESSr-o UNABLE TO FORWARD Oc:: 1 70 13 *0119-f??S1O- 11 1 IM11111? t1 t III? ttttrl trili?ltit? Edward E. Guido, J. APR 0 5 2010 Tin, E P"IC1 OTAPY 2016AH -7 F, Iis 45' CUM- Steven M. Nagorzanski F'tf`Jl: ?kr?iE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - LAW Avis D. Nagorzanski NO. 05-5746 Defendant IN DIVORCE DOMESTIC RELATIONS ORDER 4. The Participant's name, mailing address, Social Security number and date of birth are: Steven M. Nagorzanski 3815 Chippenham Road Mechanicsburg, PA 17050 Social Security No.: 331-46-5594 Date of Birth: May 16, 1958 1. This Domestic Relations Order ("DRO") creates and recognizes the existence of the Alternate Payee's right to receive a portion of the benefits payable with respect to the Participant. It is intended to constitute a Qualifying Court Order under the Uniformed Services Former Spouse's Protection Act, 10 U.S.C. Section 1408 and following. 2. This DRO is entered pursuant to authority granted under the applicable domestic relations laws of the State of Pennsylvania and relates to the provision of marital property rights to the Alternate Payee. 3. This DRO applies to the Military Retirement System ("Plan") and any successor thereto. Steven M. Nagorzanski ("Participant") is a Participant in the Plan. Avis D. Nagorzanski ("Alternate Payee"), the former spouse, is the Alternate Payee for the purpose of this DRO. are: 5. The Alternate Payee's name, mailing address, Social Security number and date of birth Avis D. Nagorzanski 2139 St. Clair Ct. Harrisburg, PA 17110 Social Security No.: 562-53-3514 Date of Birth: August 30, 1964 6. The Participant assigns to the Alternate Payee an interest in the Participant's disposable military retired pay. The Alternate Payee is entitled to a direct payment in the amount specified below and shall receive payments at the same time as the Participant. DRO Page 2 7. This Order assigns to Alternate Payee an amount equal to X% of the Participant's actual disposable military retired pay with X determined by dividing (a) by (b) where (a) and (b) are as follows: (a) $1,814.00, and (b) The Participant's actual disposable retired pay as of the date of his retirement. It is understood that on the date the monthly payments commence to the Alternate Payee that the amount of the initial payment shall be $1,814.00 and that subsequent payments shall take into account a pro rata share of any cost-of-living adjustments made to the Participant's benefits. The pro rata share shall be calculated in the same manner as the Alternate Payee's share of the Participant's retirement benefits is calculated pursuant to this Paragraph 7. 8. The monthly payments under Paragraph 7 shall commence to the Alternate Payee as soon as administratively feasible following the commencement of Participant's retirement benefits and shall continue during the joint lives of the parties, and, to the extent permitted under law, irrespective of the future marital status of either of them; the benefits shall terminate only upon the death of either the Participant or the Alternate Payee. 9. The Participant agrees to elect to make the Alternate Payee (and such Alternate Payee shall be deemed) the irrevocable beneficiary of the survivor's Survivor Benefit Plan ("SBP"), with the survivor's annuity determined by an initial base amount of $3,298. The base amount shall be adjusted for cost-of-living after the Participant's benefit commencement date. The Participant shall make the necessary election in a timely manner to effectuate the SBP coverage for the Alternate Payee and shall execute such paperwork as is required. 10. The Participant's rights under the.Servicemembers Civil Relief Act were observed by the Court as evidenced by his affirmative signature on the divorce decree and/or separation agreement. 11. This court has the authority to divide Participant's military retired pay under the USFSPA's C-4 jurisdictional requirement since the Participant consents to the jurisdiction of this court. 12. The Participant and the Alternate Payee acknowledge that they have been married for a period of more than ten years during which time the Participant performed more than ten years of creditable military service. The parties were married on October 3, 1987 and separated on September 16, 2005. 13. The Alternate Payee agrees that any future overpayments to her are recoverable and subject to involuntary collection from her or her estate. 14. The Alternate Payee agrees to notify DFAS about any changes in the Domestic Relations Order or the order affecting these provisions of it, or in the eligibility of any recipient receiving benefits pursuant to it. 15. The Participant agrees to cooperate with the Alternate Payee to prepare an application for direct payment to the Alternate Payee from the Participant's retired or retainer pay pursuant DRO Page 3 to 10 U.S.C. Section 1408. The Participant agrees to execute all documents that the United States Navy may require to certify that the disposable military retired pay can be provided to the Alternate Payee. 16. The Participant agrees not to merge the Participant's disposable military retired pay with any other pension and not to pursue any course of action that would defeat the Alternate Payee's right to receive a portion of the disposable military retired pay of the Participant. The Participant agrees not to take any action by merger of the military retirement pension so as to cause a limitation in the amount of the total retired pay in which the Participant has a vested interest and, therefore, the Participant will not cause a limitation of the Alternate Payee's monthly payments as set forth above. The Participant agrees to indemnify the Alternate Payee for any breach of this Paragraph 16 as follows: If the Participant becomes employed or otherwise has his military pension merged, which employment or other condition causes a merger of the Participant's disposable military retired pay, the Participant will pay to the Alternate Payee directly the monthly amount provided in Paragraph 7 under the same terms and conditions as if those payments were made pursuant to the terms of this Order. 17. If in any month, direct payment is not made to spouse by DFAS (or the appropriate military pay center) pursuant to the terms of this Order, Participant shall pay the amounts called- for above directly to Alternate Payee by the fifth day of each month in which the military pay center fails to do so, beginning on the date that Alternate Payee would have otherwise been entitled to commence her payments. This includes any amounts received by the Participant in lieu of disposable retired pay, including but not limited to, any amounts waived by Participant in order to receive Veterans Administration (i.e., disability) benefits or any amounts received by Participant as a result of an early-out provision, such as VSI or SSB benefits. 18. If the Participant takes any action that prevents, decreases, or limits the collection by the Alternate Payee of the sums to be paid hereunder, he shall make payments to the Alternate Payee directly in the amount sufficient to neutralize, as to the Alternate Payee, the effects of the actions taken by the Participant. 19. The Participant hereby waives any privacy or other rights as may be required for the Alternate Payee to obtain information relating to the Participant's date and time of retirement, last unit assignment, final rank, grade and pay, present or past retired pay, or other information as may be required to enforce the award made herein, or required to revise this Order so as to make it enforceable. 20. The Participant shall be required to notify the Alternate Payee, in writing, within thirty (30) days prior to Participant's actual date of retirement. Such notice shall indicate his intentions to retire and elect benefit commencement date. The notice shall be sent via regular first-class mail. For this purpose, the Alternate Payee shall notify the Participant of any changes in her mailing address. 21. The parties acknowledge that the following items must be sent by the Alternate Payee to DFAS, U.S. Military Retired Pay, P.O. Box 7130, London, KY 40742-7130 and to DFAS- CL/GAG, Garnishment Operation, P.O. Box 998002, Cleveland, OH 44199-8002. The Participant agrees to provide any of this information to the Alternate Payee at the Alternate Payee's request and to make all necessary efforts to obtain any of this information that the Alternate Payee is unable to obtain. ?DRO Page 4 a. Deemed Election Letter. b. A certified copy of the Divorce Decree. C. A certified copy of this Domestic Relations Order. d. A copy of the Marriage Certificate of Steven M. Nagorzanski and Avis D. Nagorzanski. e. An executed copy of Form 2656-16entitled "Survivor Benefit Plan (SBP) Election Statement for Former Spouse Coverage." f. An executed copy of Form 2293 entitled "Application for Former Spouse Payments From Retired Pay." 22. The Court shall retain jurisdiction to enter such further orders as are necessary to enforce the award to the Alternate Payee of the military retirement benefits awarded herein. EXECUTED this 7A*day of BY E COURT Judge CONSENT TO ORDER: Plaintiff/Part nt Date At ne or P ntiff/ ate Participant Corks Yl7l?o 10 Defendant/Altern e Payee Date Commonwealth of Pennsylvania SS: County of m On this, the 9? day of ?Q/? , 2010, before me, a Notary Public, the undersigned officer, personally appeared STEVEN M. NAGORZANSKI (known to me or satisfactorily proven) to be the person whose name is subscribed to the within document and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal: By: JV! &? - otary Public My Commission Expires: ? A ZD/D Commonwealth of Pennsylvania County of ?Ny ?/ SS: COMMONWEALTH OF PENNSYLVANIA Notarial Seal Dawn M. Zmuda, Notary Public Hampden Twp., Cumberland County My Commission Expires Oct 11, 2010 Member, Pennsylvania Association of Notaries On this, the ?- day of M,?A2-Gti? , 2010, before me, a Notary Public, the undersigned officer, personally appeared AVIS D. NAGORZANSKI (known to me or satisfactorily proven) to be the person whose name is subscribed to the within document and acknowledged that he/she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal: By: Notary Public My Commission Expires: COMMONWEALTH OF PENNSYLVANIA BeritT. ?ryPublic ?' 1p 2013 Member, PennsYbanle Association of Notaries