Loading...
HomeMy WebLinkAbout06-0678 LISA G. OLSON, v IN THE COURT OF COMMON PLEAS Plaintiff : OF CUMBERLAND COUNTY, PENNSYLVANIA ROGER L. OLSON, Defendant CIVIL ACTION LAW NO. 2006- DIVORCE NOTICE TO PLEAD You have been sued in Court. If you wish to defend against the claims set forth in the following pages, you must take action within (20) days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. 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, Pennsylvania 717-249-3166 LISA G. OLSON, : IN THE COURT OF COMMON PLEAS Plaintiff : OF CUMBERLAND COUNTY, PENNSYLVANIA v ROGER L. OLSON, Defendant CIVIL ACTION LAW : NO. 2006 - L'%00 : DIVORCE COMPLAINT Plaintiff, Lisa G. Olson, by her attorneys, Broujos & Gilroy, P.C., sets forth the following: 1 Plaintiff, Lisa G. Olson, is an adult individual residing at 208 A Marshall Road, Carlisle, Cumberland County, Pennsylvania. 2 Defendant, Roger L. Olson, is an adult individual residing at 208 A Marshall Road, Carlisle, Cumberland County, Pennsylvania. 3 Plaintiff and Defendant were married in Warren County Illinois on December 10, 1988. 4 Both Plaintiff and Defendant have resided continuously in the Commonwealth of Pennsylvania and in Cumberland County for at least 6 months prior to the commencement of this action. 5 There have been no prior actions of divorce or for annulment between the parties. 6 The marriage is irretrievably broken. 7 The Plaintiff requests your Honorable Court to enter an Order divorcing her from the Defendant. WHEREFORE, the Plaintiff requests your Honorable Court to enter an Order divorcing her from the Defendant and such other relief as required. BROUJOS & GILROY, P.C. Hubert X. Gilroy, squ Attorney for Pla' tiff Broujos & Gil y, P.C. 4 North Han ver Street Carlisle, P 17013 717-243-4574 I verify that the statements in the foregoing pleading are true and correct. I understand that false statements herein are made subject to the penalties of 18 PaCS 4904 relating to unsworn falsification to authorities. Date Lisa . Olson, Plaintiff N T r -n f f5; G? {1u CJ 00 '?`? --NO LISA G. OLSON, IN THE COURT OF COMMON Plaintiff PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA V. : CIVIL ACTION LAW ROGER L. OLSON, Defendant No. 2006-678 Civil Term DIVORCE PRAECIPE TO ENTER APPEARANCE TO THE PROTHONOARY: Please enter my appearance on behalf of Roger L. Olson in the above-captioned matter. Date: C 6 16ro6 Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, PA 17013 (717) 241-6070 Supreme Court I.D. # 81924 LISA G. OLSON, : IN THE COURT OF COMMON Plaintiff PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA V. CIVIL ACTION LAW ROGER L. OLSON, Defendant No. 2006-678 Civil Term DIVORCE CERTIFICATE OF SERVICE I, Karl E. Rominger, Esquire, attorney for Roger L. Olson do hereby certify that I this day served a copy of the within Praecipe upon the following by depositing same in the United States mail, postage prepaid, at Carlisle, Pennsylvania, addressed as follows: Hubert X. Gilroy, Esquire Broujos & Gilroy, P.C. 4 North Hanover Street Carlisle, Pa 17013 Dated: f 6 1` ?-d Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, PA 17013 (717) 241-6070 Supreme Court I.D. # 81924 - - , , ?_> , ' ,; --; --? ???. _?.. „_- CJ ? G; T'? 1 ,r '.? i LISA G. OLSON, : IN THE COURT OF COMMON PLEAS Plaintiff : OF CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION LAW ROGER L. OLSON, : NO. 2006 - 678 Defendant : IN CUSTODY CUSTODY STIPULATION WHEREAS, Lisa G. Olson and Roger L. Olson are the parents of Alex T. Olson born June 26,1992, Kim E. Olson born October 26,1993 and Matt K. Olson born May 1,1995; WHEREAS, the parties are involved in a Divorce Action at the above referenced term and number; WHEREAS, the parties desire to reach a resolution of custody issues at this time; WHEREAS, the parties are currently living together and it is contemplated that Lisa G. Olson shall vacate the current marital home once a custody arrangement is put in place; WHEREAS, the parties enter into this Stipulation and agree that the Stipulation may be incorporated by the Court of Common Pleas of Cumberland County as a Court Order and this Stipulation shall act as a Court Order for purposes of enforcement of custody. The parties hereby agree and stipulate as follows: 1. At the time the parties stop living together in the same marital home, the following custody provisions shall be considered to an Order of Court: a. The Mother, Lisa G. Olson, and the Father, Roger L. Olson, shall enjoy shared legal custody and shared physical custody of Alex T. Olson born June 26, 1992, Kim E. Olson born October 26, 1993 and Matt K. Olson born May 1, 1995. ,., 11% b. Physical custody shall be handled on a 50/50 shared custody arrangement with the parties alternating weekly the custody of the minor children. The time and location of the exchange of custody shall be agreed upon by the parties. c. The parties shall handle custody on holidays such that the parties either share a holiday or alternate a holiday pursuant to a schedule agreed upon by the parties. d. Each party shall have the ability to take the children for a vacation during the summer months with the understanding that appropriate notice will be provided. e. The non-custodial parent shall always enjoy reasonable telephone contact with the minor children. 2. The Mother agrees that she will relocate from the marital home within thirty (30) days of the date of this Agreement as incorporated by Court Order. 3. The parties agree that the ultimate issue of child support, if any, payable by one party to the other, shall be determined subsequent to this Agreement by the Cumberland County Domestic Relations Office or by agreement of the parties. In the event it is determined that Father has an obligation to pay child support to Mother based upon the 50/50 custodial arrangement set forth above, Mother shall sign all necessary documents allowing Father the ability to claim all three children as a dependency deduction on his Federal Income Tax Return. In the event the custodial arrangement above changes or Father is not obligated to pay support to Mother, the claim for the dependency deduction relating to the three children shall be determined pursuant to appropriate IRS regulations. The parties hereby agree to the Stipulation as set forth above. WITNESS: C Hubert X. Gilroy, WITNESS: Karl E. Rominger, Esquire oger L. Olson SEP 1 q 2006 LISA G. OLSON, : IN THE COURT OF COMMON PLEAS Plaintiff : OF CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION LAW ROGER L. OLSON, : NO. 2006 - 678 Defendant : IN CUSTODY COURT ORDER AND NOW, this day of 2006, upon consideration of the attached Custody Stipulation filed in the above case, it is hereby ordered that the terms of the Stipulation are deemed to be a Court Order and are incorporated in this Order. BY THE COURT, ccubert X. Gilroy, Esquire Xrl E. Rominger, Esquire ,I ' Off/ i OE `Ty ?s r y,., J LLI ?L LLj .43 7i C) e C-4 A LISA G. OLSON, : IN THE COURT OF COMMON PLEAS Plaintiff : OF CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION LAW ROGER L. OLSON, : NO. 2006 - 678 Defendant : ALIMONY PENDENTE LITE PETITION RAISING CLAIMS OF ALIMONY, ALIMONY PENDENTE LITE, LEGAL FEES AND COSTS Petitioner, Lisa G. Olson, by her attorneys, Broujos & Gilroy, P.C., sets forth the following: 1. Petitioner is Lisa G. Olson, an adult individual, who resides at 11 Terri Drive, Carlisle, Cumberland County, Pennsylvania. 2. Respondent Roger L. Olson, is an adult individual residing at 208A Marshall Road, Carlisle, Cumberland County, Pennsylvania. 3. Petitioner and Respondent were married on December 10, 1988. 4. Petitioner has filed a Divorce Complaint against husband at the above captioned term and number. 5. Petitioner is without sufficient funds to support herself and to meet the costs and expenses of the litigation and to appropriately maintain herself during the pendency of this action. 6. Petitioner's income is not sufficient to provide for her reasonable needs and to pay attorney's fees. 7. Respondent husband has adequate earnings to provide Support and Alimony Pendente Lite to his wife and to pay her counsel fees and expenses. WHEREFORE, Petitioner requests your Honorable Court to award her Alimony Pendente Lite. Hubert X. ' roy Broujos Gilroy, P.C. R DRS ATTACHMENT FOR APL PROCEEDINGS NAME: Lisa G. Olson ADDRESS: 11 Terri Drive CITY: Carlisle STATE: PA ZIP CODE: 17013 SSN: 360-72-0776 PHYSICAL DESCRIPTION: Ht. 5'6" Wt. 1201bs. Eyes Brown Hair Brown Race White EMAIL ADDRESS: lisa.g.olson@us.army.mil EMPLOYER: Letort View Community Center EMPLOYER'S ADDRESS: 313 Lovell Avenue Carlisle, PA 17013 PHONE: (717) 245-3991 JOB TITLE/POSITION: Administrative Assistant PETITIONER'S ATTORNEY: Hubert X. Gilroy, Esquire PETITIONER'S ATTORNEY'S ADDRESS: 4 North Hanover Street Carlisle, PA 17013 PHONE: (717) 243-4574 MEDICAL INSURANCE CARRIER: AETNA MEDICAL INSURANCE CARRIER'S ADDRESS: P.O. Box 14586 LISA G. OLSON, Plaintiff : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION LAW NO. 2006 - 678 ALIMONY PENDENTE LITE V ROGER L. OLSON, Defendant Lexington, KY 40512 PHONE: 800-367-6276 POLICY NO: W144090816 GROUP NO: 721027-13-036 R RESPONDENT'S INFORMATION: NAME: Roger L. Olson ADDRESS: 208A Marshall Road CITY: Carlisle STATE: PA ZIP CODE: 17013 SSN: 332-64-5103 PHYSICAL DESCRIPTION: Ht. 6' Wt. 1901bs. Eyes Hazel Hair Bald Race White EMAIL ADDRESS: roger.olson@carlisle.army.mil EMPLOYER: U.S. Army EMPLOYER'S ADDRESS: Collins Hall Bldg. 650 Carlisle Barracks Carlisle, PA 17013 PHONE: (717) 245-3546 JOB TITLE/POSITION: Major-SEEG PETITIONER'S ATTORNEY: Karl E. Rominger, Esquire PETITIONER'S ATTORNEY'S ADDRESS: 155 South Hanover Street Carlisle, PA 17013 PHONE: (717) 241-6070 MEDICAL INSURANCE CARRIER: TriCare MEDICAL INSURANCE CARRIER'S ADDRESS: Tricare Management Activity Skyline 5, Suite 810 5111 Leesburg Pike Falls Church, VA 22041 PHONE:877-TriCare POLICY NO: Same as SSN GROUP NO: Same as SSN MARRIAGE INFORMATION: DATE MARRIED: December 10, 1988 DATE OF SEPARATION: September 15, 2006 PLACE OF MARRIAGE: Warren County Illinois ADDRESS OF LAST MARITAL DOMICILE: 208A Marshall Road, Carlisle, PA 17013 DESCRIPTION OF DOCUMENT RAISING APL CLAIM: Petition Raising Claim of Alimony, Alimony Pendente Lite, Legal Fees and Costs. DATE APL DOCUMENT FILED**: **Please Note: A copy of the filed document MUST be enclosed with this form.** I verify that the statements in the foregoing pleading are true and correct. I understand that false statements herein are made subject to the penalties of 18 PaCS 4904 relating to unsworn falsification to authorities. Date a i t- In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION LISA G. OLSON ) Docket Number 06-678 CIVIL Plaintiff ) VS. ) PACSES Case Number 229108790 ROGER L. OLSON ) Defendant ) Other State ID Number ORDER OF COURT You, LISA G. OLSON plaintiff/defendant of 11 TERRI DR, CARLISLE, PA. 17015-9295-11 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the DECEMBER 14, 2006 at 8: 3OAM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. verification of child care expenses, and 4. proof of medical coverage which you may have, or may have available to you 5. information relating to professional licenses 6. other: Service Type M Form CM-509 Worker ID 21302 r _-% OLSON V. OLSON PACSES Case Number: 229108790 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest or enter an order in your absence. If paternity is an issue, the court may enter an order establishing paternity. The appropriate court officer may enter an order against either party based upon the evidence presented without regard to which party initiated the support action. BY THE COURT: Date of Order: JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Service Type M Page 2 of 2 Form CM-509 Worker ID 21302 r j.,. -Ti ? t In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION LISA G. OLSON ) Docket Number 06-678 CIVIL Plaintiff ) VS. ) PACSES Case Number 229108790 ROGER L. OLSON ) Defendant ) Other State ID Number ORDER OF COURT You, ROGER L. OLSON plaintiff/defendant of 208A MARSHALL RD, CARLISLE, PA. 17013-5120-08 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the DECEMBER 14, 2006 at 8: 3 OAM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. verification of child care expenses, and 4. proof of medical coverage which you may have, or may have available to you 5. information relating to professional licenses 6. other: Service Type M Form CM-509 Worker ID 21302 OLSON V. OLSON PACSES Case Number: 229108790 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest or enter an order in your absence. If paternity is an issue, the court may enter an order establishing paternity. The appropriate court officer may enter an order against either party based upon the evidence presented without regard to which parry initiated the support action. BY THE COURT: Date of Order: -?-? -? JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of 2 Form CM-509 Service Type M Worker ID 21302 fl ? r?r;: O mm U c.? -50 24 :TF -? -.? 9 1 OV 9 0 LISA G. OLSON, : IN THE COURT OF COMMON PLEAS Plaintiff : OF CUMBERLAND COUNTY, PENNSYLVANIA v : CIVIL ACTION LAW ROGER L. OLSON, : NO. 2006 - 678 Defendant : ALIMONY PENDENTE LITE PETITION RAISING CLAIMS OF ALIMONY, ALIMONY PENDENTE LITE, LEGAL FEES AND COSTS Petitioner, Lisa G. Olson, by her attorneys, Broujos & Gilroy, P.C., sets forth the following: 1. Petitioner is Lisa G. Olson, an adult individual, who resides at 11 Terri Drive, Carlisle, Cumberland County, Pennsylvania. 2. Respondent Roger L. Olson, is an adult individual residing at 208A Marshall Road, Carlisle, Cumberland County, Pennsylvania. 3. Petitioner and Respondent were married on December 10, 1988. 4. Petitioner has filed a Divorce Complaint against husband at the above captioned term and number. 5. Petitioner is without sufficient funds to support herself and to meet the costs and expenses of the litigation and to appropriately maintain herself during the pendency of this action. 6. Petitioner's income is not sufficient to provide for her reasonable needs and to pay attorney's fees. 7. Respondent husband has adequate earnings to provide Support and Alimony Pendente Lite to his wife and to pay her counsel fees and expenses. WHEREFORE, Petitioner requests your Honorable Court to award her Alimony Pendente Lite. Hubert X. roy Broujos Gilroy, P.C. • w LISA G. OLSON, Plaintiff : IN THE COURT OF COMMON PLEAS : OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION LAW NO. 2006 - 678 ALIMONY PENDENTE LITE V ROGER L. OLSON, Defendant DRS ATTACHMENT FOR APL PROCEEDINGS NAME: Lisa G. Olson ADDRESS: 11 Terri Drive CITY: Carlisle STATE: PA ZIP CODE: 17013 SSN: 360-72-0776 PHYSICAL DESCRIPTION: Ht. 5'6" Wt. 1201bs. Eyes Brown Hair Brown Race White EMAIL ADDRESS: lisa.g.olson@us.army.mil EMPLOYER: Letort View Community Center EMPLOYER'S ADDRESS: 313 Lovell Avenue Carlisle, PA 17013 PHONE: (717) 245-3991 JOB TITLEIPOSITION: Administrative Assistant PETITIONER'S ATTORNEY: Hubert X. Gilroy, Esquire PETITIONER'S ATTORNEY'S ADDRESS: 4 North Hanover Street Carlisle, PA 17013 PHONE: (717) 243-4574 MEDICAL INSURANCE CARRIER: AETNA MEDICAL INSURANCE CARRIER'S ADDRESS: P.O. Box 14586 Lexington, KY 40512 PHONE: 800-367-6276 POLICY NO: W144090816 GROUP NO: 721027-13-036 RESPONDENT'S INFORMATION: NAME: Roger L. Olson ADDRESS: 208A Marshall Road CITY: Carlisle STATE: PA ZIP CODE: 17013 SSN: 332-64-5103 PHYSICAL DESCRIPTION: Ht. 6' Wt. 1901bs. Eyes Hazel Hair Bald Race White EMAIL ADDRESS: roger.olson@carlisle.army.mil EMPLOYER: U.S. Army EMPLOYER'S ADDRESS: Collins Hall Bldg. 650 Carlisle Barracks Carlisle, PA 17013 PHONE.: (717) 245-3546 JOB TITLE/POSITION: Major-SEEG PETITIONER'S ATTORNEY: Karl E. Rominger, Esquire PETITIONER'S ATTORNEY'S ADDRESS: 155 South Hanover Street Carlisle, PA 17013 PHONE: (717) 241-6070 MEDICAL INSURANCE CARRIER: TriCare MEDICAL INSURANCE CARRIER'S ADDRESS: Tricare Management Activity Skyline 5, Suite 810 5111 Leesburg Pike Falls Church, VA 22041 PHONE:877-TriCare POLICY NO: Same as SSN GROUP NO: Same as SSN MARRIAGE INFORMATION: DATE MARRIED: December 10, 1988 DATE OF SEPARATION: September 15, 2006 PLACE OF MARRIAGE: Warren County Illinois ADDRESS OF LAST MARITAL DOMICILE: 208A Marshall Road, Carlisle, PA 17013 DESCRIPTION OF DOCUMENT RAISING APL CLAIM: Petition Raising Claim of Alimony, Alimony Pendente Lite, Legal Fees and Costs. DATE APL DOCUMENT FILED**: **Please Note: A copy of the filed document MUST be enclosed with this form.** I verify that the statements in the foregoing pleading are true and correct. I understand that false statements herein are made subject to the penalties of 18 PaCS 4904 relating to unsworn falsification to authorities. Date 42?y c:a f rf 1 C 5 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION LISA G. OLSON ) Docket Number 06-678 CIVIL Plaintiff ) VS. ) PACSES Case Number 229108790 ROGER L. OLSON ) Defendant ) Other State ID Number 9RDER OF COURT You, ROGER L. OLSON plaintiff/defendant of 208A MARSHALL RD, CARLISLE, PA. 17013-5120-08 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the DECEMBER 14, 2006 at 8 : 30AM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. verification of child care expenses, and 4. proof of medical coverage which you may have, or may have available to you 5. information relating to professional licenses 6. other: Form CM-509 Service Type M Worker ID 21302 OLSON V. OLSON PACSES Case Number: 229108790 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest or enter an order in your absence. If paternity is an issue, the court may enter an order establishing paternity. The appropriate court officer may enter an order against either party based upon the evidence presented without regard to which party initiated the support action. BY THE COURT: Date of Order: JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of 2 Form CM-509 Service Type M Worker ID 21302 In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION LISA G. OLSON ) Docket Number 06-678 CIVIL Plaintiff ) VS. ) PACSES Case Number 229108790 ROGER L. OLSON ) Defendant ) Other State ID Number ORDER OF COURT You, LISA G. OLSON plaintiff/defendant of 11 TERRI DR, CARLISLE, PA. 17015-9295-11 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the DECEMBER 14, 2006 at 8: 3OAM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. verification of child care expenses, and 4. proof of medical coverage which you may have, or may have available to you 5. information relating to professional licenses 6. other: Form CM-509 Service Type M Worker ID 21302 OLSON V. OLSON PACSES Case Number: 229108790 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest or enter an order in your absence. If paternity is an issue, the court may enter an order establishing paternity. The appropriate court officer may enter an order against either party based upon the evidence presented without regard to which party initiated the support action. BY THE COURT: Date of Order: l t - A -U..' ? G JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (717) 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of CUMBERLAND County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office at: (717) 240-6225 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of 2 Form CM-509 Service Type M Worker ID 21302 C':? rv 0 OC5 LISA G. OLSON, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION ROGER L. OLSON, PACSES NO. 229108790 Defendant/Respondent DOCKET NO. 06-678 CIVIL ORDER OF COURT AND NOW, this 10' day of December, 2006, this matter having been scheduled for a hearing before the Support Master and the parties having reached an agreement on all outstanding issues, upon recommendation of said Master it is ordered and decreed that the Defendant shall pay to the Pennsylvania State Collection and Disbursement Unit as alimony pendente lite the sum of $300.00 per month effective December 1, 2006. B urt, ?1 G Edgar B. Bayley, J. Cc: Lisa G. Olson Roger L. Olson Hubert X. Gilroy, Esquire For the Plaintiff/Petitioner Karl E. Rominger, Esquire For the Defendant/Resondent DRO oa o.. 3 -n o 7 -n ;brn cn C!I ?"" ?l i L?ll "? ... a . [';?? fYF ?1 :? ...?, ?`" 0,g 7-/U ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT &7 S (,1 V iL State Commonwealth of Pennsylvania ?} /?{ 0Original Order/Notice CO./City/Dist. of CUMBERLAND 77 ID d htGyn^?? 0 Amended Order/Notice Date of Order/Notice 12/14/06 nG?LJ? O Terminate Order/Notice Case Number (See Addendum for case summary) RE:OLSON, ROGER L. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number DFAS CLEVELAND CENTER* 6586101731 C/O DFAS CODE L Employee/Obligor's Case Identifier GARNISHMENT OPS (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's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 383.00 per month in current support $ 66.00 per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ per month in other (specify) for a total of $ 1, 449.00 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: $ 334.38 per weekly pay period. $ 668.77 per biweekly pay period (every two weeks). $ 724.50 per semimonthly pay period (twice a month). $ 1.449.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. Date of Order: DEC 1 5 2006 Service Type M BY THE C RT: v G Form EN-028 Rev. 1 OMB No.: 0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecke? you are required to provide a opy of this form to your mployee. If yoU r employee yorks in a state that is Nerent 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.* 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: OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any 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 (15 U.S.C. §1673 01; 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: 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 r ? ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 300.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. Service Type M PACSES Case Number 974108664 Plaintiff Name LISA G. OLSON Docket Attachment Amount 00863 S 2006 $ 1,149.00 Child(ren)'s Name(s): DOB MATTHEW K. OLSON 05/01/95 ALEXANDER `P.'OLS0N 06/26/9:2 KIMBERLY E. OLSON 10/26/93 ? if checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. Addendum OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker ID $zATT ? ? -ri `_? ? ? ; . d ti <,.? .-?. ? LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTIN LAW ROGER L. OLSON, NO. 2006-678 Defendant IN CUSTODY The Honorable J. Wesley Oler MOTION TO COMPEL CUSTODY EVALUATION AND NOW, comes Roger L. Olson, by and through his counsel, Karl E. Rominger, Esquire, and in support of this Motion to Compel Custody Evaluation avers as follows: 1. Your petitioner resides at 208A Marshall Road, Carlisle, Cumberland County Pennsylvania. 2. Petitioner is the Father of the minor children, Matthew K. Olson, born May 1, 1995, Alexander T. Olson, born June 26, 1992, and Kimberley E. Olson, born October 26, 1993. 3. Father and Mother currently share legal and physical custody of the minor children, pursuant to a Custody Stipulation that was filed with the Court on September 18, 2006, and was signed by the Honorable J. Wesley Oler and entered as an Order of Court on September 21, 2006. 4. Petitioner believes that a custody evaluation is needed and would benefit the best interest of the children. 5. Dr. Stanley Schneider was contacted and is ready, willing and able to proceed with scheduling a custody evaluation. 6. Petitioner has received Orders from the United States Army on February 12, 2007, and is scheduled to report to training classes on May 3, 2007, and report to his assignment on September 17, 2007. 7. Petitioner would like to get the custody evaluation process underway to avoid any delays. 8. Hubert X. Gilroy, Esquire was contacted but was unavailable to state his position on this matter. It is assumed that he is opposed to this Motion but if counsel finds out otherwise counsel will supplement the same. WHEREFORE, your petitioner respectfully requests that this Honorable Court enter an order compelling a custody evaluation. Date: April 20, 2007 Respectfully submitted, Rominger & Associates /f Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, Pennsylvania 17013 (717) 241-6070 Supreme Court I.D. # 81924 Attorney for Petitioner LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTIN LAW ROGER L. OLSON, NO. 2006-678 Defendant IN CUSTODY The Honorable J. Wesley Oler CERTIFICATE OF SERVICE I, Karl E. Rominger, Esquire, attorney for Petitioner, do hereby certify that I this day served a copy of the Motion to Compel Custody Evaluation upon the following by depositing same in the United States Mail, first class postage prepaid, at Carlisle, Pennsylvania, addressed as follows: Hubert X. Gilroy, Esquire MARTSON LAW OFFICE 10 East High Street Carlisle, Pennsylvania 17013 Respectfully submitted, Rominger & Associates Date: April 20, 2007 Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, Pennsylvania 17013 (717) 241-6070 Supreme Court I.D. # 81924 Attorney for Petitioner rv HIM M « TM' e LISA G. OLSON, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. CIVIL ACTION - LAW ROGER L. OLSON, Defendant NO. 06-678 CIVIL TERM IN RE: DEFENDANT'S MOTION TO COMPEL CUSTODY EVALUATION ORDER OF COURT AND NOW, this 1St day of May, 2007, upon consideration of the attached letter from Hubert X. Gilroy, Esq., attorney for Plaintiff, and Karl E. Rominger, Esq., attorney for Defendant, Defendant's motion is deemed moot and the telephone conference previously scheduled for May 1, 2007, is cancelled. BY THE COURT, Hubert X. Gilroy, Esq. 10 East High Street Carlisle, PA 17013 Attorney for Plaintiff Karl E. Rominger, Esq. 155 South Hanover Street Carlisle, PA 17013 Attorney for Defendant a ?J J esley Oler, Jr., J. :rc Muv. t MI i J '# i cZ Wd 6 - MW LOOZ MARTSON DEARDORFF WILLIAMS OTTO GrILROY & FALLER MA]PTSON LAW OFFICES 10 EAST HIGH STREET CARLISLE, PENNSYLVANIA 17013 TELEPHONE (717) 243-3341 FACSIMILE (717) 243-1850 INTERNET www.martsonlaw.com April 30, 2007 HAND DELIVERY The Honorable J. Wesley Oler Jr. Cumberland County Courthouse One Courthouse Square Carlisle, PA 17013 Re Dear Judge Oler: Olson v. Olson WILLIAM F. MARTSON JOHN B. FOWLER III DANIEL K. DEARDORFF THOMAS J. VALLIAMS' No V. OTTO III HUBERT X. GILROY GEORGE B. FALLER JR.* CARL C. RISCH DAVID A. Fn7SIMONS CHRISTOPHER E. RICE JENNIFER L. SPEARS MICHAEL J. CDLLINS SETH T. MOSEBEY *BOARD CXMFIRD CML TRIAL SPECIALIST The telephone conference scheduled with you for May 1, 2007 at 1:15 p.m. is no longer needed and may be cancelled as counsel for the parties have worked the issues out. Attorney Karl Rominger is in agreement with this cancellation and has been copied on this correspondence. Very truly yours, MARTSON LAW Huberl'X. Gilroy HXG/srb Cc: Ms. Lisa Olson (VIA FIRST CLASS MAIL) Karl E. Rominger, Esquire (VIA FACSIMILE (717) 241-6878) F:\FILES\DATAFILE\General\C unent\12377\12377. JUDGE l INFORMATION • ADVICE • ADVOCACY SM MAY-01-2007 08:36 From: To:92406462 P.1/1 cry V.L V I r g'')`f r?'i-n1n'I1141]GfS a H??V?+ r.i rr;41di5r2S I'-Ilyb P0a1/R I )=-242 RO- MINGER & ASSOCIATES Attorneys at Law Karl t?, Rominger Michael O. Palermo, jr. Lobe A. Tonkeo* `Alga admitted to Nnw Jersey May 1, 2007 VIA Facsimile Dnh+ (717) 240-6462 'ncr. Honorable I Wesley Oler Cumberland County Courthouse One Courthouse Square Carlisle, Ponnsylvania 17013 RE: Olson v. Olson Dear Judge Oler: Ms. Olson has agreed to comply vvith the custody evaluation process for the above referenced matter. Please remove the phone confcmwe currently scheduled for today at 1;15 p. m. from your calendar. Rawl X. Gilroy, Esquirrt coucAw$ with the same. Should you have. ;any questions, please do not hrAitate to watact the ciffcce. Sincerely, Karl E. kominmer, Esquvt KER/tlp cc, Hubert Gilroy, Esquife 153 South Hanover Straw;, Grdia]e, Perrnsylvanv 17013 - Tel; (717) 247-6070 + Pax: (717) 211-6878 W'w1'w.-f*mi aperlawxum ADV'OCA(--'Y • ADVICE - ANSWERS MAY 01-2^007 08:34AM Froiii; 7172416878 ID; Pa9e:W1 R=`.)G% 229108790 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 06-678 CIVIL State Commonwealth of Pennsylvania 974108664 Co./City/Dist. of CUMBERLAND 863 S 2006 Date of Order/Notice 06/20/07 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice RE:OLSON, ROGER L. Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number DFAS CLEVELAND CENTER* 6586101731 C/O DFAS CODE L Employee/Obligor's Case Identifier GARNISHMENT OPS (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's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ 1, 656.00 per month in current support $ 66.00 per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ 0.00 per month in current and past-due medical support $ 0. 00 per month for genetic test costs $ 0. oo per month in other (specify) for a total of $ 1, 722.00 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: $ 397.38 per weekly pay period. $ 794.77 per biweekly pay period (every two weeks). $ 861. oo per semimonthly pay period (twice a month). $ 1. 722.0o 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 NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE C RT: Date of Order: JUN 2 1 Z007- W\CAl Edgar B. Bayley, Judge DRO: R.J. Shadday Form EN-028 Rev. 1 Service Type M OMB No.: 0970-0154 Worker ID $IATT I ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? Ifghecked you are required to provide a copy of this form to yourgmployee. If yo?r employee works in a state that is di Brent from the state that issued this order, a copy must be provi edd 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 ,. YoU MUSt repurt the paydate/date of withholding Mien sending the payment. The the Paydateffiate of Withholding You must comply with the law of the paydate/date of withholding is the date on which amount was withheld from the employee's vyar geso. state of the employee's/obligor's principal place of employment with respect to the time periods within which you must implement the withholding order and forward the support payments. 4.* Employee/Obligor with Multiple Support Holdings: If there is more than one Order/Notice to Withhold Income for Support against this employeelobligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employeelobligor 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: OLSON ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 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 ID $IATT f ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 300.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number 974108664 Plaintiff Name LISA G. OLSON Docket Attachment Amount 00863 S 2006 $ 1,422.00 Child(ren)'s Name(s): DOB MATTHEW... K .... OLSON... _... _ 0.5,/ 01/ 9 5 AS ?IC3ii ER T . <OLSON.. 06 / ? ? /`9 KIMBERLY E. OLSON 10/26/93 ......... ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Rev. 1 Service Type M Worker ID $IATT OMB No.: 0970.0154 C C= -V L-C c+ tTIpF C ? rn = 1 4 orn A EJ] n C F:\FILES\12377\12377.1. SGLIpet.wpd Hubert X. Gilroy, Esquire Jennifer L. Spears, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.Ds. 29943 and 87445 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, : IN THE COURT OF COMMON PLEAS OF Plaintiff, : CUMBERLAND COUNTY, PENNSYLVANIA V : NO. 2006-678 CIVIL TERM ROGER L. OLSON, : CIVIL ACTION - LAW Defendant : IN DIVORCE PETITION FOR SPECIAL RELIEF Petitioner, Lisa G. Olson, sets forth the following: 1. The Defendant in the above captioned divorce action is on Active Duty in the U.S. Army and has been in the military for over 22 years. He holds the rank of Major. 2. The parties have been separated since September of 2005. 3. The primary asset of the parties from their marriage is the military pension Husband will receive upon his retirement from the military. 4. Husband has an SGLI policy through the military in the amount of $100,000.00. Wife was always the named beneficiary on the SGLI policy during the course of the marriage. The cost for that insurance is $29.00 per month. 5. Wife learned that Husband has changed the beneficiary on the $100,000.00 SGLI policy to the children. 6. Husband also has a $500,000.00 life insurance policy which Wife believes Husband may have changed the beneficary on during the pending divorce. 7. Husband is currently paying Wife a child support obligation of $1,356.00 per month and APL of $300 per month. 7. In the event Husband dies prior to retirement, Wife will receive no benefits from the military and Wife will also not be receiving any support or alimony from the Husband for the remainder of her life. 8. The status quo of this case is the Husband maintaining Wife as the named beneficiary on the SGLI policy. 9. Wife will be irreparably harmed and essentially lose any retirement benefits or alimony benefits if Husband suffers an untimely death and Wife is not the named beneficiary of the SGLI policy and the $500,000.00 insurance policy. WHEREFORE, Petitioner requests your Honorable Court to enter an order directing that Husband name Wife as the beneficiary on the $100,000.00 SGLI military policy and the $500,000.00 private policy. Respectfully submitted, MARTSON DEARDO F WILLIAMS OTTO 64 GIL Y & F ER By Hubert X. Gilr y, Esquire I.D. Numbe 9943 Jennifer . Spears, Esquire I.D. Number 87445 Ten East High Street Carlisle, PA 17013 (717) 243-3341 Date: July 19, 2007 Attorneys for Defendant VERIFICATION The foregoing Petition for Special Relief is based upon information which has been gathered by my counsel in the preparation of the lawsuit. The language of the document is that of counsel and not my own. I have read the document and to the extent that it is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the content of the document is that of counsel, I have relied upon counsel in making this verification. This statement and verification are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. CERTIFICATE OF SERVICE I, Tricia D. Eckenroad, an authorized agent for Martson Deardorff Williams Otto Gilroy & Faller, hereby certify that a copy of the foregoing Petition for Special Relief was served this date by depositing same in the Post Office at Carlisle, PA, first class mail, postage prepaid, addressed as follows: Karl Rominger, Esquire Rominger & Associates 155 S. Hanover Street Carlisle, PA 17013 MARTSON LAW OFFICES (--Bv Tricia D. ckenroa -- Ten East High Street Carlisle, PA 17013 (717) 243-3341 Dated: July 19, 2007 C`7 jy., D , M v Hubert X. Gilroy, Esquire Jennifer L. Spears, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.Ds. 29943 and 87445 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, Plaintiff, v ROGER L. OLSON, Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2006-678 CIVIL TERM : CIVIL ACTION - LAW : IN DIVORCE 1G ORDER AND NOW, this z, ( day of J , 2007, upon consideration of the attached Petition for Special Relief, a hearing is schedule in Court Room No. / of the Cumberland County Courthouse on the /4t day of , 2007, at / - 3y __p.m. BY THE COUNT G J. 11 cc: Xubert X. Gilroy, Esquire .Xarl E. Rominger, Esquire 7/,x 1110 7 /el, J l ti0 "' ;7, !! J ?e r":!r L1")0Z s , F:\FH.PS\ChU0\ 12377112377. I .aplpet.wpd Created: 9/20/04 0:06PM Revised: 9/11/07 3:25PM Hubert X. Gilroy, Esquire Jennifer L. Spears, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.Ds. 29943 and 87445 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff /Petitioner LISA G. OLSON, Plaintiff/Petitioner V. ROGER L. OLSON, Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : NO. 06-678 CIVIL TERM PACSES No. 229108790 IN DIVORCE PETITION TO INCREASE ALIMONY PENDENTE LITE AND NOW, comes the Petitioner, Lisa G. Olson, by and through her attorneys, MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER, and sets forth the following: 1. An Order for alimonypendente lite is currently in place in the above captioned matter for $300.00 per month. 2. Pursuant to the Guidelines, alimony pendente lite would be over $1,000.00 per month; however, Plaintiff accepted a lower amount at the time of the entry of the Order in December 2006. 3. Defendant/Respondent has filed for a modification of the child support order between the parties, at PACSES No. 974108664. 4. Plaintiff now wishes to receive alimony pendente lite pursuant to a Guidelines calculation at 40% of the difference of the net income of the parties. 5. The Honorable J. Wesley Oler, Jr., has been involved in this matter. 6. Opposing counsel was contacted and does not concur with this Petition. +• , WHEREFORE, Petitioner requests your Honorable Court to enter an Order increasing Plaintiff's alimony pendente lite consistent with the Guidelines. MARTSON LAW OFFICES By Hebert:y. C?roy, Esquire Je f L. Spears, Esquire 10 East High Street Carlisle, PA 17013 (717) 243-3341 Date: September 11, 2007 Attorneys for Plaintiff/Petitioner VERIFICATION The foregoing Petition to Increase APL is based upon information which has been gathered by my counsel in the preparation of the lawsuit. The language of the document is that of counsel and not my own. I have read the document and to the extent that it is based upon information which I have given to my counsel, it is true and correct to the best of my knowledge, information and belief. To the extent that the content of the document is that of counsel, I have relied upon counsel in making this verification. This statement and verification are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unworn falsification to authorities, which provides that if I make knowingly false averments, I may be subject to criminal penalties. CERTIFICATE OF SERVICE I, Tricia D. Eckenroad, an authorized agent for Martson Deardorff Williams Otto Gilroy & Faller, hereby certify that a copy of the foregoing Petition was served this date by depositing same in the Post Office at Carlisle, PA, first class mail, postage prepaid, addressed as follows: Karl E. Rominger, Esquire Rominger & Whare 155 S. Hanover Street Carlisle, PA 17013 MARTSON LAW OFFICES B Olt, T cia D. Eckenroad Ten East High Street Carlisle, PA 17013 (717) 243-3341 Dated: September 11, 2007 ?a f-al tom' o •i 1 ORDERINOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania 974108664 0Original Order/Notice Co./City/Dirt. of CUMBERLAND 863 S 2006 O Amended Order/Notice Date of Order/Notice 09/11/07 229108790 O Terminate Order/Notice Case Number (See Addendum for case summary) 06_678 CIVIL RE:OLSON, ROGER L. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number DFAS CLEVELAND CENTER* 6586101731 C/O DFAS-HGA/CL Employee/Obligor's Case Identifier GARNISHMENT OPS (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, NIP 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. $ 300.00 per month in current support $ o. oo per month in past-due support Arrears 12 weeks or greater? Oyes Q 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 $ 300.00 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: $ 69.23,,per weekly pay period. $ 138.46.per biweekly pay period (every two weeks). $ 15o . oo per semimonthly pay period (twice a month). $ Soo , 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* lli? 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 NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE URT: Date of Order:. n v ?? by. DRO: R.J. SHADDAY Form EN-028 Rev. 1 Service Type M OMB No.: 0970-0154 Worker I D $IATT 300• x 12• 52•= 69.23 300• 12•? 26 136.46* ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? I heck you are required to prQ?ide a opy of this form to your m ioyee. If yo r employee orks in a state that 1s ierentom the state that issued this order, a copy must be provieedpto your employee even if ttie 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/6bligor'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 PaydateA3ate of Wit iholding. You must repoit the paydateldate of withholding when sending the payMeld. The paydate/date of withholding is the date on which ainotint was-withheld honilhe 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) S. Termination Notification: You must promptly notify the Requesting Agency when the employeelobligor 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 EMPLOYEEIOBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 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 employeelobligor'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 employeelobligor from employment, refusing to employ, or taking disciplinary action against any employeetobligor 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 employeelobligor 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. i Worker ID $iATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 300.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ?If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Rev. 1 Service Type M Worker ID OMB No.: 0970.0754 $ IATT Td LISA G. OLSON, IN THE COURT OF COMMON PLEAS OF Plaintiff/Petitioner CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - DIVORCE NO. 06-678 CIVIL TERM ROGER L. OLSON, IN DIVORCE Defendant/Respondent PACSES Case Number: 229108790 ORDER OF COURT AND NOW, this 12th day of September, 2007, a petition has been filed against you, Roger L. Olson, to modify an existing Alimony Pendente Lite Order. You are ordered to appear in person at the Domestic Relations Section, 13 North Hanover Street, Carlisle, Pennsylvania, on October 1& 2007 at 1:30 P.M. for a conference and to remain until dismissed by the Court. If you fail to appear as provided in this Order, an Order of Court may be entered against you. You are further ordered to bring to the conference: (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 the 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 isue a warrant for your arrest. BY THE COURT, Edgar B. Bayley, President Judge Copies mailed to: Petitioner Respondent Jennifer L. Spears, Esq. Karl Rominger, Esq. Date of Order: September 12, 2007 R. J. S day, 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 ra ca a FAFR"1237812377. t.stipt i Hubert X. Gilroy, Esquire Jennifer L. Spears, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.Ds. 29943 and 87445 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, Plaintiff, v ROGER L. OLSON, Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2006-678 CIVIL TERM : CIVIL ACTION - LAW : IN DIVORCE STIPULATION The parties hereby agree that the Court may sign and adopt the attached Order as a Custody Order in the above case. WITNESS: JWX'a HubertX. Gilro , Esquire WITNESS: Karl E. Rominger, Esquire Roger L. Olson o q t SEP S 82067 PTILES\Clients\12377\12377. l.CustodyOrder 1 Hubert X. Gilroy, Esquire Jennifer L. Spears, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.Ds. 29943 and 87445 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, : IN THE COURT OF COMMON PLEAS OF Plaintiff, : CUMBERLAND COUNTY, PENNSYLVANIA V ROGER L. OLSON, Defendant NO. 2006-678 CIVIL TERM : CIVIL ACTION - LAW : IN DIVORCE ORDER AND NOW, this Zr day of September, 2007, upon consideration of the attached Stipulation of the parties, it is ordered and directed as follows: 1. All prior Custody Orders entered in this case are vacated. 2. The mother, Lisa G. Olson, and the father, Roger L. Olson, shall enjoy shared legal custody of Alex T. Olson, born June 26, 1992, Kim E. Olson, born October 26, 1993 and Matt K. Olson, born May 1, 1995. 3. The father shall enjoy primary physical custody of the minor children during the school year at father's residence in Illinois. 4. The mother shall enjoy primary physical custody of the minor children during the summer months, with mother getting custody one week after school ends in Illinois and returning the children four days prior to school starting in August or September. L Z <:? ?:: L UiJ i a '. r 5. Holidays and vacations shall be handled as follows: A. The Christmas Holiday itself shall be shared between the parties, with the parties reaching an agreement on sharing the holiday. Absent an agreement, the holiday shall be divided into segments, with segment `A' being from December 24 at noon until December 25 at noon and segment `B' being from December 25 at noon until December 26 at noon. The parties shall alternate those segments with father having segment `A' in odd years and mother having segment `B' in odd years. Without regard to has segment `A' or segment `B', mother shall have custody of the minor children over the remainder of the Christmas Holiday from noon on December 26 through December 29 or 30 at noon, to be at mother's option. B. For the children's spring break from school, mother shall have custody from when the children are released at school until the day before school returns to session. C. The Thanksgiving Holiday shall be alternated on a year to year basis such that mother will have custody from Wednesday when the children are released from school until Sunday afternoon on alternating years. Mother shall have Thanksgiving on odd years and father having even years. D. If mother is in Illinois to visit family or otherwise, mother may exercise physical custody with the minor children upon mother giving father at least five days advance notice. E. In the event father visits Pennsylvania during the summer months and gives mother at least five days notice, father shall have a minimum of three days custody with the minor children as long as that time does not interfere with mother's previously scheduled vacation or otherwise. 6. Both parents will have reasonable telephone access with the minor children while they are in the other parent's custody. 7. Both parents will keep the other parent advised with respect to all medical, school, social and other appropriate issues relating to the children. This will include an obligation by the parents to provide the other parent with report cards, medical reports, athletic schedules, social schedules, etc. 8. For purposes of exchange of custody, this Order shall take effect August 21, 2.007. 9. The parties agree that the Commonwealth of Pennsylvania and the Cumberland County Court shall retain jurisdiction on this case for purposes of any modification of this Custody Order. However, in the event mother relocates to Illinois or relocates out of Cumberland County, Pennsylvania, the Illinois Courts within the jurisdiction where father is residing shall have jurisdiction for any modification of this Custody Order. 10. In the event father receives military orders whereby he is directed to leave Illinois either on active duty or otherwise, father shall notify mother with respect to receipt of this information within at least five days of father receiving such notification. 11. The parties may modify this Custody Order by written agreement of the parties. Otherwise, this Order may be modified by either party Petitioning the Court to modify the Order. cc: ert X. Gilroy, Esquire I E. Rominger, Esquire a i 10, LISA G. OLSON, Plaintiff v ROGER L. OLSON, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 2006-678 CIVIL TERM IN DIVORCE IN RE: PETITION FOR SPECIAL RELIEF ORDER OF COURT AND NOW, this 10th day of October, 2007, upon consideration of Plaintiff's Petition for Special Relief, and pursuant to an agreement reached in open court in the presence of Defendant's counsel, Karl E. Rominger, Esquire, and Plaintiff and her counsel, Hubert X. Gilroy, Esquire, it is ordered and directed as follows: 1. The Plaintiff, Lisa G. Olson, shall maintain the insurance policy which is on her life, and she shall pay the premiums on that policy. She shall maintain Roger L. Olson as the beneficiary on that policy; 2. The Defendant, Roger L. Olson, will maintain his military SGLI policy, and keep that policy in effect with his wife, Lisa G. Olson, as the beneficiary; 3. Defendant, Roger L. Olson, shall also maintain a separate private policy which he owns on his life, and shall maintain his wife, Lisa G. Olson, as the beneficiary; 4. Both parties shall within 20 days of this order provide evidence to the other party with respect to a confirmation that all three policies are currently in effect, and that the beneficiary designations are as required by this order; 5. This order shall not prejudice either party from advancing a different position in the event this matter needs to be litigated before the Divorce Master in equitable ,yi t^ -- a r '=5 u = ° : .LLJ = l LL. F_ C 'y N U distribution. By the Court, 'It44-' J. esley Oler, r., J. '/ubert X. Gilroy, Esquire 10 East High Street Carlisle, PA 17013 For Plaintiff arl E. Rominger, Esquire 155 South Hanover Street Carlisle, PA 17013 For Defendant mae V w. LISA G. OLSON, Plaintiff/Petitioner VS. ROGER L. OLSON, Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - DIVORCE NO. 06-678 CIVILTERM IN DIVORCE PACSES CASE ID: 229108790 ORDER OF COURT AND NOW, this 18th day of October, 2007, based upon the Court's determination that Petitioner's monthly net income/earning capacity is $ 1509.16 and Respondent's monthly net income/earning capacity is $ 5749.34, it is hereby ordered that the Respondent pay to the Pennsylvania State Collection and Disbursement Unit One Thousand Sixty Five and 00/100 Dollars ($1065.00) per month payable as follows: $1005.00 per month for Alimony Pendente Lite and $60.00 per month on arrears. First payment due: on or about November 1, 2007. The effective date of the order is September 11, 2007. Arrears set at $728.21 as of October 18, 2007. 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: Lisa G. Olson. Payments must be made by check or money order. All checks and money orders must be made payable to PA SCDU and mailed to: PA SCDU P.O. Box 69110 Harrisburg, PA 17106-9110 Payments must include the Respondent's PACSES Member Number or Social Security Number in order to be processed. Do not send cash by mail. cc360 This order is based upon Rule 1910.16-4 (e) as the Respondent has the case and custody of the parties' three children. This Order shall become final twenty (20) after the mailing of the notice of the entry of the Order to the parties unless either parry files a written demand with the Prothonotary for a hearing de novo before the Court. Consented: Petitioner Respondent Petitioner's Attorney Respondent's Attorney BY CO R v G, Edgar B. Bayley, J. Mailed copies on: October 18, 2007 to: Petitioner Respondent Hubert X. Gilroy, Esq. Karl Rominger, Esq. DRO: R.J. Shadday c? ? p c_ -?, ,. _, '?,F e ` ??' ,. ` ? r lC7 : 7 _ „ ? ? t W ? ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dirt. of CUMBERLAND Date of Order/Notice 10/18/07 Case N u m be r (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS CLEVELAND CENTER* C/O DFAS-HGA/CL GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 O Original Order/Notice 229108790 O Amended Order/Notice 06-678 CIVIL O Terminate Order/Notice RE:OLSON. ROGER L. Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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. $ 1, 005.00 per month in current support $ 0.00 per month in past-due support Arrears 12 weeks or greater? Oyes ® no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ 0.00 per month in other (specify) for a total of $ 1, 005.00 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: $ 231.92per weekly pay period. $ 463.8$per biweekly pay period (every two weeks). $ 502.50 per semimonthly pay period (twice a month). $ 1, oo5. 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 NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE ti Date of Order: OCT 19 2007 ?v, EDGAR B. BAYLEY, JUDOE DRO: R.J. SHADDAY Form EN-028 Rev. 1 Service Type M OMS No.: 0970-0154 Worker ID $IATT 1ao05*"x 120+ 52• 231 - 92* 1,00'5.• X 12. 26• 463*85*. 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 tha is di ferent from the state that issued this or?er, a copy must be provautio your employee even if the box is not chec?ed. 1. Priority: Withholding under this Order/Notice has priority over any other legal process under State law against the same income. Federal tax levies in effect before receipt of this order have priority. If there are Federal tax levies in effect please contact the requesting agency listed below. 2. Combining Payments: You can combine withheld amounts from more than one 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 employee/obligor. 3.* RepOrthir, the Paydate/Date of Withholding. You must report the paydate/date of withholding r, lie Pa In 11 lie paydate/date of withl toldii ig is the date v, , which amou, it was wit' rheld fron, 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 employeelobligor and you are unable to honor all support Order/Notices due to Federal or State withholding limits, you must follow the law of the state of employee's/obligor's principal place of employment. You must honor all Orders/Notices to the greatest extent possible. (See #9 below) 5. Termination Notification: You must promptly notify the Requesting Agency when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 2491016300 EMPLOYEE'S/OBLIGOR'S NAME: OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 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 employeelobligor'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 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 (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 ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 1,005.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. Service Type M PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 .Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. Addendum OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker ID $ IATT c? o c? .., ° ? M, dy 1 1 --{ n-n r ? 7-7 - 0? - 5930 229108790 ORDER/NOTICE TO WITHHOL191RI M RSUPPORT 06-678 CIVIL State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 11/01/07 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS CLEVELAND CENTER* C/O DFAS-HGA/CL GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 RE: OLSON. ROGER L. O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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. $ 1, 005.00 per month in current support $ 60. oo per month in past-due support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current and past-due medical support $ 0.00 per month for genetic test costs $ 0.00 per month in other (specify) for a total of $ 1, 065.00 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: $ 245.77_per weekly pay period. $ 491.54. per biweekly pay period (every two weeks). $ 532.50 per semimonthly pay period (twice a month). $ 1.065. 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 NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY T tURT: Date of Order: NOV 0 2 2007 EDGAR B. BAYLEY, JbGE DRO: R. J. SHADDAY Form EN-028 Rev. 1 Worker I D IATT Service Type M OMB No.: 0970-0154 $ 1#065. x 12-+ 5.2 « 24 5 77`* IjO 6 5 • x. 491 •5'4* N, ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecke? you are required to provide a opy of this form to your m loyee. If your employee works in a state that is di Brent from the state that issued this order, a copy must be provi?edpto 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 employee/obligor. 3.* Reporting the Paydate/Date of Withholding. You n iustieport t! ie paydateMate of wit' il ioldh is wl ie, , sending, the pay, i eI it. The You must comply with the law of the paydate/date of withholding is the date on Whit-11 dMOUIrt was withheld from the employee's wages. 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: OLSON ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 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 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 Service Type M OMB No.: 0970-0154 Form EN-028 Rev. 1 Worker ID $zATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 1,065.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-0 Service Type M Worker OMB No.: 0970A154 C`7 "`? _, ,-..., •??;r' ? _ -ra ' i `:.'? ? c.6 . LISA G. OLSON, : IN THE COURT OF COMMON Plaintiff : PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA V. CIVIL ACTION LAW ROGER L. OLSON, Defendant : No. 2006-678 Civil Term DIVORCE MOTION FOR APPOINTMENT OF MASTER Roger L. Olson, Defendant, moves the Court to appoint a Master with respect to the following claims: ( x ) Divorce ( x) Distribution of Property ( ) Annulment ( ) Support ( x) Alimony ( ) Counsel Fees ( ) Alimony Pendente Lite ( x ) Costs and Expenses and in support of the Motion states: 1. Discovery is complete as to the claim(s) for which the appointment of a Master is requested. 2. The Defendant has appeared in the action by his attorney, Karl E. Rominger, Esquire. 3. The statutory ground(s) for divorce is irreconcilable differences. 4. (a) The action is not contested. 5. The action does not involve complex issues of law or fact. 6. The hearing is expected to take 1 day. 7. Additional information, if any, relevant to the Motion: None. Date: January 22, 2008 Respectfully submitted, Rominger & Associates Kar E. Rominger, Esquire 155 South Hanover Street Carlisle, Pennsylvania 17013 (717) 241-6070 Supreme Court ID # 81924 Attorney for Defendant LISA G. OLSON, : IN THE COURT OF COMMON Plaintiff : PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA V. CIVIL ACTION LAW ROGER L. OLSON, Defendant : No. 2006-678 Civil Term DIVORCE CERTIFICATE OF SERVICE I, Karl E. Rominger, Esquire, certify that I this day served a copy of the within Motion for Appointment ofMaster upon the following by depositing the same in the United States Mail, postage pre-paid, first class, addressed as follows: Hubert X. Gilroy, Esquire 10 East High Street Carlisle, Pennsylvania 17013 Date: January 22, 2008 Respectfully submitted, Rominger & Associates Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, Pennsylvania 17013 (717) 241-6070 Supreme Court ID # 81924 Attorney for Defendant C-3 t_? C-43 ll ` y fit 1 C:7J `.::J JAN 8 4 2008 "" LISA G. OLSON, Plaintiff v. ROGER L. OLSON, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA CIVIL ACTION LAW No. 2006-678 Civil Term DIVORCE ?ORDER APPOINTING MASTER AND NOW, this a70 ?" day of Ad 11AAj, , 2008, Esquire, is appointed Master with respect to the following claims: 1. Expenses and costs. 2. Alimony. 3. Divorce. 4. Distribution of property. Distribution: Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, Pennsylvania 17013 ,Wulbert X. Gilroy, Esquire 10 East High Street Carlisle, Pennsylvania 17013 14 oo- By the Court: 7. > A CL e •i r CZ) f ._ c"i da_ a ".> s. J i , • . s 06-678 CIVIL ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 02/01/08 Case Number (See Addendum for case summary) Employe r/Withholder's Federal EIN Number DFAS CLEVELAND CENTER* C/O DFAS-HGA/CL GARNISHMENT OPS PO BOX 998002 CLEVELAND OH 44199-8002 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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. 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: $ 231.92 per weekly pay period. $ 463.85 ,per biweekly pay period (every two weeks). $ 502.50 per semimonthly pay period (twice a month). $ - 1005.00,per monthly pay period. $ 1, 005. oo per month in current support $ ?o . oo per month in past-due support Arrears 12 weeks or greater? Dyes ® no $ 0. oo per month in current and past-due medical support $ 0 . oo per month for genetic test costs $ 0.00 per month in other (specify) for a total of $ 1, 005.00 per month to be forwarded to payee below. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten 00) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If 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 NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE URT: Date of Order: FEB 0 A 2008 DRO: R. J. SHADDAY Service Type M O Original Order/Notice O Amended Order/Notice O Terminate Order/Notice RE: OLSON, ROGER L. Employee/Obligor's Name (Last, First, MI) NY, Vomvk, EDGAR B. BA EY, Form EN-028 Rev. 1 OMB No.: 0970-0154 Worker ID $IATT 0 *.* 0 . * 11005•X 12'} 52•' 231.92* 1,Q05•x 120+ 2.6 . se 4b3.85?* 2's 502050* ? < a c 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 orks in a state that is di event from the state that issued this or?er, a copy must be provic?edpto your employee even if tie 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 Paydate/Date of Wit' iholding. YoU 1111:15t report the paydateidate ol withholding when sendhir, tire payment. 1 1 -e paydate/date of vvithholding, is tire date on vvli*%.Ii amount was withheld from the employee's Yvages. 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: OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 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 employeelobligor 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 (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 w ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 1,065.00 Child(ren)'s Name(s): DOB ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available through the employee's/obligor's employment. ? If checked, you are required to enroll the child(ren) ? If checked, you are required to enroll the child(ren) identified above in any health insurance coverage available identified above in any health insurance coverage available through the employee's/obligor's employment. through the employee's/obligor's employment. Addendum Form EN-028 Rev. 1 Service Type M Worker ID $IATT OMB No.: 0970-0154 ? ra ? ? ? ? .? . i}?_ ? ? fi t-r?7 r?-? r ? ? cs? x ;?c:' .,? ?-, ors' ,? ? ? ? = '?" . ?.c? LISA G. OLSON, : IN THE COURT OF COMMON Plaintiff : PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA V. CIVIL ACTION LAW ROGER L. OLSON, : Defendant : No. 2006-678 Civil Term DIVORCE PETITION FOR CONTEMPT And now comes, Roger L. Olson, by and through his counsel, Karl E. Rominger, Esquire and in support of his Petition avers as follows: 1. Petitioner is Roger L. Olson, who resides at 239S E Street, Scott Air Force Base, Illinois, 62225. 2. Respondent is Lisa G. Olson, who resides at 11 Terri Drive, Carlisle, Pennsylvania 17013. 3. On October 10, 2007, an Order of Court was entered by the Honorable J. Wesley Oler, the same is attached as Exhibit "A". 4. Respondent had twenty (20) days form the date of the Order to provide evidence that Petitioner was listed as the beneficiary on her life insurance policy and that the insurance policies were still held as they were at the time of separation. 5. Respondent has never provided the same. 6. Respondent is in contempt of the Order of Court. WHEREDORE, your Petitioner respectfully requests that the Court find Respondent in contempt and award reasonable attorney's fees. Respectfully Submitted, Rominger & Associates Date: August 13, 2008 arl E. Rominger, Esquire 155 South Hanover Street Carlisle, Pennsylvania 17013 (717) 241-6070 Supreme Court ID # 81924 Attorney for Petitioner LISA G. OLSON, : IN THE COURT OF COMMON Plaintiff : PLEAS OF CUMBERLAND COUNTY :PENNSYLVANIA V. CIVIL ACTION LAW ROGER L. OLSON, Defendant : No. 2006-678 Civil Term DIVORCE CERTIFICATE OF SERVICE I, Karl E. Rominger, Esquire, certify that I this day served a copy of the within Petition for Contempt upon the following by depositing the same in the United States Mail, postage pre-paid, first class, addressed as follows: Hubert X. Gilroy, Esquire 10 East High Street Carlisle, Pennsylvania 17013 Date: August 13, 2008 Respectfully Submitted, Rominger & Associates Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, Pennsylvania 17013 (717) 241-6070 Supreme Court ID # 81924 Attorney for Petitioner i LISA G. OLSON, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION - LAW 2006-678 CIVIL TERM ROGER L. OLSON, Defendant IN DIVORCE IN RE: PETITION FOR SPECIAL RELIEF ORDER OF COURT AND NOW, this 10th day of October, 2007, upon consideration of Plaintiff's Petition for Special Relief, and pursuant to an agreement reached in open court in the presence of Defendant's counsel, Karl E. Rominger, Esquire, and Plaintiff and her counsel, Hubert X. Gilroy, Esquire, it is ordered and directed as follows: 1. The Plaintiff, Lisa G. Olson, shall maintain the insurance policy which is on her life, and she shall pay the premiums on that policy. She shall maintain Roger L. Olson as the beneficiary on that policy; 2. The Defendant, Roger L. Olson, will maintain his military SGLI policy, and keep that policy in effect with his wife, Lisa G. Olson, as the beneficiary; 3. Defendant, Roger L. Olson, shall also maintain a separate private policy which he owns on his life, and shall maintain his wife, Lisa G. Olson, as the beneficiary; 4. Both parties shall within 20 days of this order provide evidence to the other party with respect to a confirmation that all three policies are currently in effect, and that the beneficiary designations are as required by this order; 5. This order shall not prejudice either party from advancing a different position in the event this matter needs to be litigated before the Divorce Master in equitable E----v-kj b 4 11? t c-i ax n- t J l ~ r. 1L. O ? N V dr% distribution. By the Court, esley Oler, r., J. Abert X. Gilroy, Esquire 10 East High Street Carlisle, PA 17013 For Plaintiff /arl E. Rominger, Esquire 155 South Hanover Street Carlisle, PA 17013 For Defendant :mae V r C-0 i ? ?S7 J --i i'f's (?J LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v : CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN CUSTODY PETITION RAISING CLAIMS FOR EQUITABLE DISTRIBUTION Plaintiff, Lisa G. Olson, by her attorneys, Martson Law Offices, sets forth the following: 1. The parties possess various assets which are marital property and which are subject to equitable distribution in this case. 2. Plaintiff Wife requests that the Master equitably divide the martial assets of the parties in conjunction with an adjudication of this case. WHEREFORE, the Plaintiff requests your Honorable Court to equitably divide the marital property of the parties. Date: August 1 2008 Respectfully submitted, //"/X ?/ Hubert X. oy, Esquire Martson Law Offices 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff/Petitioner F \FELFS\C1ients\12377 01s n\12377.1 PetEgtDis rr- -414 V AUG 15 2008 Ai t - LISA G. OLSON, : IN THE COURT OF COMMON Plaintiff : PLEAS OF CUMBERLAND COUNTY PENNSYLVANIA V. : CIVIL ACTION LAW ROGER L. OLSON, Defendant : No. 2006-678 Civil Term DIVORCE ORDER OF COURT AND NOW, this day of 2008, upon consideration of the within Petition for Contempt, a hearing is scheduled for the ?--tk day of 2008, at S o'clock _ A.M., in Courtroom # at the Cumberland County Courthouse, Carlisle, Pennsylvania. Distribution: X arl E. Rominger, Esquire 155 South Hanover Street Carlisle, Pennsylvania 17013 ,?dubert X. Gilroy, Esquire 10 East High Street Carlisle, Pennsylvania 17013 s i c wd 61 gnv oooz LISA G. OLSON, Plaintiff v ROGER L. OLSON, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW 2006-0678 CIVIL TERM IN RE: PETITION FOR CONTEMPT ORDER OF COURT AND NOW, this 8th day of October, 2008, upon consideration of the Petition for Contempt filed in the above-captioned matter on behalf of Defendant, and following a conference in chambers with counsel for the Plaintiff in the person of Hubert X. Gilroy, Esquire, and counsel for Defendant in the person of Karl E. Rominger, Esquire, in which counsel have indicated that this particular issue is being amicably resolved, the Petition for Contempt is deemed moot, and the hearing scheduled for this date is canceled. Hubert X. Gilroy, Esquire 10 East High Street Carlisle, PA 17013 For Plaintiff Karl E. Rominger, Esquire 155 South Hanover Street Carlisle, PA 17013 For Defendant: Jo k- 6 :mae By the Court, Al - . ?? Ad JJ-;iV1,1, LISA G. OLSON, Plaintiff VS. ROGER L. OLSON, Defendant THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 06 - 678 CIVIL IN DIVORCE ORDER OF COURT AND NOW, this '6?- day of , 2009, the economic claims raised in the proceedings having been resolved in accordance with a marital settlement agreement dated March 5, 2009, 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. cc: ''Hubert X. Gilroy Attorney for Plaintiff /Karl E. Rominger Attorney for Defendant e '2TiLs 3j4jvq BY THE COURT, Q,, W?CA C-' Edgar B. Bayley, P.J. * ?t o •cC C)i LL Aty " CL _ p cr% co c.1 F FILES`ClienwID77Olson 12377. I.MSA final Cremed: 7 30 04 9.12ANI R,,ised: 3 5 09 11.50AA1 Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN CUSTODY MARITAL SETTLEMENT AGREEMENT THIS MARITAL SETTLEMENT AGREEMENT, made this 5day of March , 2009, by and between LISA G. OLSON (hereinafter referred to as "Wife'), and ROGER L. OLSON, (hereinafter referred to as "Husband'): WITNESSETH: WHEREAS, the parties were married on December 10, 1988; WHEREAS, three children were born of the marriage of the parties. They are Alex T. Olson, born June 26, 1992, Kim E. Olson, born October 26, 1993, and Matt K. Olson, born May 1, 1995. WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of Wife and Husband to live separate and apart, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other, including, without limitation by specification: the settling of all matters between them in relation to the ownership and equitable distribution of real and personal property; settling of all matters between them relating to the past, present and future support, alimony and/or maintenance of Wife by Husband or of Husband by Wife; and in general, the settling of any and all claims and possible claims by either party against the estate of the other party. NOW, THEREFORE, in consideration of the premises and of the mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, Husband and Wife, each intending to be legallybound hereby covenant and agree as follows: 1. INTERFERENCE: Each party shall be free from interference, authority, and contact by the other, as fully as though he or she were single and unmarried, except as may be necessary to carry out the provisions of this Agreement. Neither party shall molest the other or attempt to endeavor to molest the other, nor compel the other to cohabit with the other, or in any way harass or malign the other, nor in any way interfere with the peaceful existence, separate and apart from the other. 2. AGREEMENT NOT A BAR TO DIVORCE PROCEEDINGS: This Agreement shall not affect or bar the right of Husband or Wife to a divorce on lawful grounds or to any defense as may be available to either party. This Agreement is not intended to condone and shall not be deemed to be a condonation on the part of either party hereto of any act or acts on the part of the other party which have occasioned the disputes or unhappy differences. 3. SUBSEQUENT DIVORCE: The parties hereby acknowledge that Wife filed a Complaint in Divorce in Cumberland County, Pennsylvania, claiming that the marriage is irretrievably broken under Section 3301(c) of the Pennsylvania Divorce Code. The parties hereby express their agreement that the marriage is irretrievably broken and express their intent to execute any and all Affidavits or other documents necessary for the parties to obtain an absolute divorce pursuant to Section 3301(c) of the Divorce Code. The parties hereby waive all rights to request court ordered counseling under the Divorce Code. It is further specifically understood and agreed by the parties that the provisions of this Agreement as to equitable distribution of property of the parties are accepted by each party as a full and final settlement for all purposes whatsoever, as contemplated by the Pennsylvania Divorce Code. 1) Should a decree, judgment or order of divorce be obtained by either of the parties in this or any other state, country or jurisdiction, each of the parties hereby consents and agrees that this Agreement and all of its covenants shall not be affected in any way by such separation or divorce; and that nothing in any such decree, judgment, order or further modification or revision thereof shall alter, amend or vary any term of this Agreement, whether or not either or both of the parties shall remarry. It is the specific intent of the parties to permit this Agreement to survive any judgment and to be forever binding and conclusive upon the parties. 4. INCORPORATION OF DIVORCE DECREE: It is further agreed, covenanted and stipulated that this Agreement, or the essential parts hereof, shall be incorporated in any decree hereinafter entered by any court of competent jurisdiction in any divorce proceedings that have been or may be instituted by the parties for the purpose of enforcing the contractual obligations of the parties. This agreement shall not be merged in any such decree but shall in all respects survive the same and be forever binding and conclusive upon the parties. 5. EFFECTIVE DATE: The effective date of this Agreement shall be the "date of execution" or "execution date," defined as the date upon which it is executed by the parties if they have each executed this Agreement on the same date. Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. 6. DISTRIBUTION DATE: The transfer of property, funds and/or documents provided for herein, shall only take place on the "distribution" date which shall be defined as the date of execution of this Agreement unless otherwise specified herein. However, the support and/or alimony payments, if any, provided for in this Agreement shall take effect as set forth in this Agreement. 7. MUTUAL RELEASE: Husband and Wife each do hereby mutually remise, release, quit-claim and forever discharge the other and the estate of such other, for all time to come, and for all purposes whatsoever, of and from any and all rights, title and interest, or claims in or against the property (including income and gain from property hereafter accruing) of the other or against the estate of such other, of whatever nature and wheresoever situated, which he or she now has or at any time hereafter may have against the other, the estate of such other or any part hereof, whether arising out of any former acts, contracts, engagements or liabilities of such other or by way of dower or courtesy, or claims in the nature 3 of dower or courtesy or widow's or widower's rights, family exemption or similar allowance, or under the intestate laws, or the right to take against the spouse's will; or the right to treat a lifetime conveyance by the other as a testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of (a) Pennsylvania, (b) any State, Commonwealth or territory of the United States, or (c) any country or any rights which either party may have or at any time hereafter shall have for past, present or future support or maintenance, alimony, alimony pendente lite, counsel fees, division of property, costs or expenses, whether arising as a result of the marital relations or otherwise, except, all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provisions thereof. It is the intention of Husband and Wife to give each other by the execution of this Agreement a full, complete and general release with respect to any and all property of any kind or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and only except all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision thereof. It is further agreed that this Agreement shall be and constitute a full and final resolution of any and all claims which each of the parties may have against the other for equitable division of property, alimony, counsel fees and expenses, alimony pendente lite or any other claims pursuant to the Pennsylvania Divorce Code or the divorce laws of any other jurisdiction. 8. REPRESENTATION BY COUNSEL: The provisions of this Agreement and their legal effect has been fully explained to the parties by their respective counsel, Hubert X. Gilroy, Esquire, counsel for Wife, and Karl E. Rominger, Esquire, counsel for Husband. The parties acknowledge that each has received independent legal advice from counsel of his or her own selection, that each has fully disclosed his or her respective financial situations to the other, including his or her property, estate, assets, liabilities, income and expenses, that each is familiar with and fully understands the facts, including the property, estate, assets, earnings and income of the other, and that each has been fully informed as to his or her legal rights and obligations. Each of the parties acknowledges and agrees that, after having received such advice and with such knowledge, this agreement is, in the circumstances, fair, reasonable and equitable, that it is being entered into freely, voluntarily, and in good faith and that the execution of this agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreement. The parties further 4 acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this agreement. The parties acknowledge that each has received or has had the opportunity to receive independent legal advice from counsel of their selection and that they have been informed fully as to their legal rights and obligations, including all rights available to them under the Pennsylvania Divorce Code of 1980, as amended, and other applicable laws. Each party also acknowledges that each has fully disclosed his or her respective financial situations to the other, including his or her property, estate, assets, liabilities, income and expenses, that each is familiar with and fully understands the facts, including the property, estate, assets, earnings and income of the other, and that each has been fully informed as to his or her legal rights and obligations. Each of the parties acknowledges and agrees that, after having received such advice and with such knowledge, this agreement is, in the circumstances, fair, reasonable and equitable, that it is being entered into freely, voluntarily, and in good faith and that the execution of this agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreement. The parties further acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this agreement. 9. WARRANTY AS TO EXISTING OBLIGATIONS: Each party represents that they have not heretofore incurred or contracted for any debt or liability or obligation for which the estate of the other party maybe responsible or liable except as maybe provided for in this Agreement. Each party agrees to indemnify and hold the other party harmless from and against any and all such debts, liabilities or obligations of every kind which may have heretofore been incurred by them, including those for necessities, except for the obligations arising out of this Agreement. 10. WARRANTY AS TO FUTURE OBLIGATIONS: Husband and Wife covenant, warrant, represent and agree that, with the exception of obligations set forth in this Agreement, neither of them shall hereafter incur any liability whatsoever for which the estate of the other may be liable. Each party shall indemnify and hold harmless the other party from and against any and all debts, charges and liabilities incurred by the other after the execution date of this Agreement, except as may be otherwise specifically provided for by the terms of this Agreement. 11. PERSONAL PROPERTY: Except as otherwise provided herein, the parties have divided between them, to their mutual satisfaction, the personal effects, household furniture and furnishings, and all other articles of personal property which have heretofore been used by them in common, and neither party will make any claim to any such items which are now in the possession or under the control of the other. The parties agree, however, to divide all photographs evenly, and each party shall be entitled to access to negatives. The parties will make duplicates of all camcorder tapes which currently exist so that each party has a full set. Any cost involved in the duplication of the videos will she shared equally. By these presents, each of the parties hereby specifically waives, releases, renounces and forever abandons whatever claims he or she may have with respect to any personal property which is in the possession of the other, and which shall become the sole and separate property of the other from the date of execution hereof. 12. MILITARY PENSION: Husband has a military pension which the parties agree to handle as follows: A. Upon Husband's retirement, Husband will elect full SBP benefits in connection with the military pension with Wife as the named beneficiary of the SBP benefits. The cost of the SBP benefits shall be deducted from the gross disposable retirement pay prior to the allocation of the marital portion as set forth in subparagraph B below. B. Wife shall receive 50% of the "marital portion" of the Husband's military pension. The "marital portion" shall be calculated using a formula with a numerator of 165 months and a denominator equal to the total number of months Husband is in the military service. For purposes of the entry of an allocation to the Wife in connection with this Agreement, the following language shall apply: 6 The former Spouse is awarded a percentage of the Member's disposable military retired pay, to be computed by multiplying 50% times a fraction, the numerator of which is 165 months of marriage during the Member's credible military service, divided by the Member's total months of credible military service. C. Each party shall assume their respective obligations for any income tax consequences relating to their portion of the pension which they are receiving. D. The parties shall share the annual increases in the pension in accordance with the percentages ans calculated in subparagraph B. above. E. In the event Wife is delayed in receipt of her portion of the pension as the result of some administrative delay or other delay through the Military Accounting Office and Husband receives himself the full amount of the pension, Husband shall make payments directly to Wife for her percentage amount as applicable with the understanding that Wife shall incur all income tax obligations with respect to the payments received by her. F. Wife's attorney shall prepare documents in the nature of a QDRO or other applicable documents as the military may require in order to implement the allocation of the pension benefits as set forth herein. 13. LIFE INSURANCE: Consistent with the Order of Court entered in this case on October 10, 2007, the parties are required to keep each other named as a beneficiary on each party's respective life insurance policy. It is the desire of the parties that any insurance monies received upon the death of the party will be earmarked and intended for use for support of the minor children of the parties who are Alex T. Olson, born June 26, 1992, Kim E. Olson, born October 26, 1993, and Matt K. Olson, born May 1, 1995 (hereinafter referred to collectively as the "minor children"). The parties shall together create a life insurance trust (hereinafter referred to as "Trust") for the benefit of the children in a form as agreed upon by legal counsel for the parties. The Trust Agreement shall be prepared by legal counsel for the Wife subject to approval of legal counsel for the Husband, and the Agreement shall designate William Ray Olson, brother of Husband, as the Trustee. It is further 7 contemplated that William Ray Olson may review the draft Trust Agreement for input prior to signing by the parties. It shall be the intention of the parties that the Trust will provide for the receipt of insurance proceeds upon the death of either or both parties and the Trust to use those proceeds to pay for the normal health care, maintenance, support and education of the minor children. In connection with this Trust, the parties agree as follows: A. Wife shall continue to maintain a whole life insurance policy (#A005543843) In the amount of $25,000.00 with Liberty National Life Insurance Company. The beneficiary on the policy shall continue to be the Husband until such time as the Trust is created, at which time the beneficiary shall be changed to the Trust. Additionally, in the event Wife obtains any insurance through her employment, the same provision shall apply to that insurance relative to naming the Trust as the beneficiary. B. Husband shall continue to maintain his-$400,000.00 SGLI life insurance policy along with at least $200,000.00 of additional life insurance and shall continue to maintain Wife as the named beneficiary on said policies. Upon creation of the Trust, the beneficiary on these policies shall be changed to the Trust. The parties obligations to maintain the mentioned insurance policies as set forth in this paragraph shall be terminated upon all of the minor children having graduated from high school and having reached the age of 18. Upon such time, each party shall have the option of eliminating said insurance policies, or, in the alternative, changing the beneficiaries as they may determine in their sole discretion. At the same time, the parties may mutually agree to continue said insurance policies with the Trust as the named beneficiary for the benefit of the minor children. It is understood that the $400,000.00 SGLI life insurance policy will terminate upon Husband's retirement from the military and, at that time, Husband's obligation in connection with that policy as far as continuing it in effect and maintaining Wife or the Trust as named the beneficiary shall also terminate. 14. ALIMONY: The parties acknowledge the Husband has an alimony obligation to Wife that will become effective April 1, 2009. The parties agree that the APL'spousal obligation from 8 Husband to Wife currently docketed at the Cumberland County Domestic Relations Office shall be terminated effective April 1, 2009. Husband's alimony obligations to Wife starting April 1, 2009, shall be as follows: A. For the first six months, Husband shall pay Wife the sum of $400.00 per month. B. For the second six months from October 2009 through March 2010, Husband shall pay Wife the sum of $300.00 per month. C. For the next six months from April 2010 through September 2010, Husband shall pay Wife the sum of $200.00 per month. D. Starting October 2010 and subject to the provisions below, Husband shall pay Wife the sum of $100.00 per month. Husband's obligation to pay Wife alimony as set forth herein is a fixed obligation and shall not be subject to modification by the Courts or otherwise unless there is an agreement between the parties. Husband's obligation for alimony shall terminate upon Husband's death, Wife's death, Wife's remarriage, or Wife's cohabitation. Additionally, the alimony provisions as set forth herein shall also terminate upon Husband's retirement from the military and upon Wife receiving her applicable portion of the pension benefits as set forth in paragraph 12 above. Husband's alimony obligation pursuant to this Agreement shall be incorporated as an Order of Court through the Cumberland County Domestic Relations Office and enforced as such. The parties agree that the Cumberland County Domestic Relations Office may implement the provisions of this alimony Order upon the DRO receiving a signed copy of this Agreement. 15. CHILD SUPPORT: As set forth above, the parties are the parents of three minor children who currently reside with the Husband. Currently, Wife has a support obligation to Husband in connection with the minor children at the Cumberland County Domestic Relations Office (which 9 obligation is offset by a portion of the spousal support/APL that Husband owes to Wife as referenced above). The parties agree that effective April 1, 2009, the Wife's support obligation to Husband at the Cumberland County Domestic Relations Office shall be terminated. In further consideration for Wife's agreement to accept the portion of the military pension as set forth in paragraph 12 above and to accept the limited alimony as set forth in paragraph 14 above as part of the overall settlement of all financial claims between the parties in connection with their marriage, Husband agrees to make no requests whatsoever relative to financial support from the Wife for the minor children or any one of them while the minor children reside in the Husband's custody. Husband agrees to indemnify and hold Wife harmless for the entry of any obligation for child support against her by any Court in the future for the support of the minor children. Husband acknowledges that his obligation to indemnify Wife in connection with any support obligation she incurs for the minor children is a contractual obligation pursuant to the terms of this Agreement, it being the intent of this indemnification that Husband will make Wife whole for any support order that is entered against her for the minor children or any one of them while the children are in the custody of the Husband. Although the parties do not anticipate a change in the custodial circumstances and it is the intent at this time for the parties to continue to handle the custody arrangement consistent with the September 27, 2007, Order of Court issued at the above-captioned term and number, in the event there is any change in custody where Wife would become the primary custodian of one or more of the minor children and Wife sought child support from Husband, Husband would be entitled to seek child support from Wife for any of the minor children still in the Husband's custody consistent with the applicable support guidelines ofthe Commonwealth ofPennsylvania, and Husband's obligation to indemnify Wife for such a support claim pursuant to the terms of this paragraph shall be eliminated in those circumstances. It is acknowledged that the Husband shall be entitled to claim the three minor children as dependency deductions for Federal income tax purposes as long as the minor children continue in the primary custody of the Husband consistent with the mentioned Order of Court. 16. AFTER-ACQUIRED PROPERTY: Each of the parties shall hereafter own and enjoy, independently of any claim or right of the other, all items of property, be it real, personal or mixed, tangible or intangible, which are hereafter acquired by him or her, with full power in him or her to dispose 10 of the same as fully and effectively, in all respects and for all purposes as though he or she were unmarried. 17. INCOME TAX: Husband and Wife agree to file separate tax returns for the tax year 2008. For any tax returns filed jointly in the past, 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 either of 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. 18. APPLICABILITY OF TAX LAW TO PROPERTY TRANSFERS: The parties hereby agree and express their intent that any transfer of property pursuant to this Agreement shall be within the scope and applicability of the Deficit Reduction Act of 1984 (hereinafter the "Act"), specifically, the provisions of said Act pertaining to the transfers of property between spouses and former spouses. The parties agree to sign and cause to be filed any elections or other documents required by the Internal Revenue Service to render the Act applicable to the transfers set forth in this Agreement without recognition of gain on such transfer and subject to the carry-over basis provisions of said Act. 19. MARITAL DEBT: All marital debt has been paid off or divided to mutual satisfaction. Each party shall indemnify, defend, and hold the other harmless from and against any claims, demands suits, actions or liabilities relating to or arising out of any debt in that party's name. 20. HEALTH INSURANCE: Each party is responsible for their own health insurance and uninsured medical expenses. 21. EFFECT OF DIVORCE DECREE: The parties agree that, except as otherwise specifically provided herein, this Agreement shall continue in full force and effect after such time as a final Decree in Divorce may be entered with respect to the parties. 22. BREACH: If either party breaches any provision of this Agreement, the other party shall have the right, at his or her election to sue for damages for such breach or seek such other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of reasonable legal fees and costs incurred by the other in enforcing their rights under this Agreement. 23. WAIVER OF CLAINIS: Except as herein otherwise provided, each party may dispose of his or her property in any way, and each party hereby waives and relinquishes any and all rights he or she shall now have or hereafter acquire, under the present and future laws of any jurisdiction, to share in the property or the estate of the other as a result of the marital relationship, including without limitation, dower, courtesy, statutory allowance, widow's allowance, right to take in intestacy, right to take against the Will of the other, and the right to act as administrator or executor of the other's estate, and each will, at the request of the other, execute, acknowledge and deliver any and all instruments which may be necessary or advisable to carry into effect this mutual waiver and relinquishment of such interests, rights and claims. 24. ENTIRE AGREEMENT: This Agreement contains the entire understanding of the parties and there are no representations, warranties, covenants or undertakings other than those expressly set forth herein. 25. AGREEMENT BINDING ON HEIRS: This Agreement shall be binding on and shall inure to the benefits of the parties hereto and their respective heirs, executors, administrators, successors and assigns. 26. ADDITIONAL INSTRUMENTS: Each of the parties shall from time to time, at the request of the other, execute, acknowledge and deliver to the other any and all further instruments that may be reasonably required to give full force and effect to the provisions of this Agreement. 27. VOID CLAUSES: If any tern, 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. 12 28. INDEPENDENT SEPARATE COVENANTS: It is specifically understood and agreed by and between the parties hereto that each paragraph hereof shall be deemed to be separate and independent Agreement. 29. FINANCIAL DISCLOSURE: The parties confirm that they have relied on the completeness and substantial accuracy of the financial disclosure of the other as an inducement to the execution of this Agreement. 30. MODIFICATION AND WAIVER: A modification or waiver of any of the provisions of this Agreement shall be effective only if made in writing and executed with the same formality as this Agreement. The failure of either party to insist upon strict performance of any of the provisions of this Agreement shall not be construed as a waiver of any subsequent defaults of the same or similar nature. 31. DESCRIPTIVE READINGS: The descriptive headings used herein are for convenience only. They shall have no affect whatsoever in determining the rights or obligations of the parties. 32. APPLICABLE LAW: This Agreement shall be construed under the laws of the Commonwealth of Pennsylvania and more specifically under the Divorce Code of 1980 and any amendments thereto. [Signatures are found on the following page.] 13 IN WITNESS WHEREOF, the parties hereto have set their hands and seals the date and year first above written. WITNESSETH: arl E. Rominger Hubert X. G. Olson TH OF PENNSYLVANIA COUNTY OF CUMBERLAND . SS (Seal) (Seal) On this 5' day of March , 2009, before me, a Notary Public, personally appeared LISA G. OLSON, known to me to be the person whose name is subscribed to the within Marriage Settlement Agreement and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. COMMONWEALTH OF PENNSYLVANIA Notarial Seal Shelly Brooks, Notary Public Carlisle Boro, Ctxrtrland County My commission Expires Aug. 5, 2009 My comm,aa w,expine ,ia Association of Notaries Not Publ 11slW COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS On this 5`h day of March, 2009, before me, a Notary Public, personally appeared ROGER L. OLSON, known to me to be the person whose name is subscribed to the within Marriage Settlement Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. My commission expires: 7 z Notary P lic COMMONWEALTH OF P NSYLVANIA .J Notarial Seal Shelly Brooks, Notary Public Carlisle Boro, Cumberland County My Commission Expires Aug. 5, 2009 Member, Pennsylvania Association or Notaries 1 LISA G. OLSON, Plaintiff/Petitioner VS. ROGER L. OLSON, Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - DIVORCE NO. 06-678 CIVIL TERM IN DIVORCE PACSES CASE: 229108790 ORDER OF COURT AND NOW to wit, this 1 l th day of March 2009, it is hereby Ordered that pursuant to the parties' Marital Settlement Agreement of March 5, 2009, the Alimony Pendente Lite is terminated, effective April 1, 2009. To date, there is a balance of $1,005.00 owed on the account. The Respondent is to report to the Domestic Relations Section, within ten (10) days, with a payment plan to liquidate said arrearage. Pursuant to the same Marital Settlement Agreement, effective April 1, 2009, an Alimony obligation is to be paid through PA SCDU and facilitated by the Cumberland County Domestic Relations Section. BY TH OURT: r2 1S Edgar B. Bayley, DRO: R.J. Shadday xc: Petitioner Respondent Hubert X. Gilroy, Esq. Karl E. Rominger, Esq. Service Type: M J. Form OE-001 Worker: 21005 cr% Fite FW opbo is "* Navigaton MOemi PACES HeIP Func: C? ©SLE Fman" Obligation Entry SHAOQAR3 03111109 09:50 CASE 0?- 22970879th Case Type - H Case Status- O Date Entered: 12114106 ORDER 13: 06-678 CNILL Order Type: S Docket Num 06-678 C11t0_ Payer: 658610f731 OLSOK ROGER L Mod/ Error: ? Payee: 3586101735 OLSON, LISA G. Worker 8'1: 21005 Periodic Amt this page only: 140500 Ordered On And this page air: Arrears Dare Amt: Date Due: DEBT lamer Pesi(Kk Amt Normal Arrs TYPE 1) 1 Name Ordered On Amt Et€ Date End Date Retro Arcs ® ? 5586701733 ® ® 0410119 ® OAO AUMOttIIISO LISA 000 ¦ 8Mt1A9 ® O t ® ? 5588701735 700300 ® 09H7A7 03131119 100510 APLtSO LISA ® M 83111109 O11A9 ? 0 ? 0 0 ?? r F-I ? ? 0 ? 0 L? 0 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dirt. of CUMBERLAND Date of Order/Notice 03/11/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS ARMY ACTIVE DUTY 06-678 CIVIL OOriginal Order/Notice OAmended Order/Notice OTerminate Order/Notice tone-Time Lump Sum/Notice RE:OLSON, ROGER L. Employee/Obligor's Name (Last, First, MI) Sent Electronically DO NOT MAIL 332-64-5103 Employee/Obligor's Social Security Number 6586101731 Employee/Obligor's Case Identifier (See Adden&m 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. $ 0.00 per month in current child support $ O. oo per month in past-due child support Arrears 12 weeks or greater? Dyes ® no $ 0.00 per month in current medical support $ 0.00 per month in past-due medical support $ 1,005.00 per month in current spousal support $ o. oo per month in past-due spousal support $ o . o o per month for genetic test costs $ 0.00 per month in other (specify) $ one-time lump sum payment for a total of $ 1, oo5. oo 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: $ 231.29 per weekly pay period. $ 502.50 per semimonthly pay period (twice a month). $ 462-58 per biweekly pay period (every two weeks). $ 1, 005. 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. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: EDGAR B BAYLEY Service Type m OMB No.: 0970-0154 Form EN-428 Worker I D $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If heck you are required to provide a Gopy of this form to your loyee. If yo r employee orks in a state that is die rent from the state that issued this order, a copy must be proviempded to your employee even if t?1e 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. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ED THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT- 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 (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA 0 5 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: If you or your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by Internet www.childsupport.state.pa.us Page 2 of 2 Form EN428 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 1,005.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum OMB No.: 0970-0154 Form EN-428 Worker I D $ IATT a C r-? -n -ro m L C 7 ?T C,..- ro FARLEWfients\12377 Olson\12377.I.M.Plaint Created: 9/20/04 0:06PM Revised: 3/5/09 8:44AM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under § 3301(c) of the Divorce Code was filed on February 2, 2006. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree 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. § 4904 relating to unworn falsification to authorities. Date: oger L. Olson, Plaintiff CA) I g __ 4I s Pl co F:\RLFS\CGents\ 12377 Olson\ 12377.1. Waiver.Plaint Created: 9/20/04 0:06PM Revised: 3/5/09 8:46AM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v : CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER §3301(c) AND 6 3301(d) OF THE DIVORCE CODE I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the prothonotary. I verify that the statements made in this waiver are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. § 4904 relating to unworn falsification to authorities. Date: S/ M110.5i? oger L. Olson, Plaintiff ev r >,Fn co F:\FILEMCIieety\12377 Ob=\12377.I.AHDef Crested: 9/20/04 0:06FM Revived: 3/10/09 10:05AM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1 • A Complaint in Divorce under § 3301(c) of the Divorce Code was filed on February 2, 2006. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree 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. 49 relat' falsification to authorities. §/ 'Om Date: x OD C F:\FILES\Clients112377 01son\12377.1.Waiver.Def Created: 9/20/04 0:06PM Revised: 3/5/09 8:45AM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v : CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER §3301(c) AND § 3301(d) OF THE DIVORCE CODE 1. I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the prothonotary. I verify that the statements made in this waiver are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C? o orn falsification to authorities. Dat 41140 9 Lisa G. son, Defendant W - CO c: ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 04/01/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS ARMY ACTIVE DUTY RE:OLSON, ROGER L. Sent Electronically DO NOT MAIL 06-678 CIVIL 0Original Order/Notice OAmended Order/Notice 0Terminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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. $ 0.00 per month in current child support $ o . o o per month in past-due child support Arrears 12 weeks or greater? O yes ®no $ 0.00 per month in current medical support $ 0.00 per month in past-due medical support $ 400.00 per month in current spousal support $ o . oo per month in past-due spousal support $ o . oo per month for genetic test costs $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ 400.00 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: $ 92. 05 per weekly pay period. $ 200.00 per semimonthly pay period (twice a month). $ 184.11 per biweekly pay period (every two weeks). $ 400.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). If required by Pennsylvania law (23 PA C.S. § 4374(b)) to remit by electronic payment method, please call Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: EDGAR 8 BAYLEY Form EN-428 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS r-1 If hecke? you are required to provide aSopy of this form to your3WIoyee. If yoyr employee works in a state that is di erent 1Trom the state that issued this or er, a copy must be provi ed to your emp ogee 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. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : Il THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ED EMPLOYEE'S/OBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT: 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 employeelobligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (bl). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Service Type M OMB No.: 0970-0154 Form EN-428 Worker ID $IATT r i ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 400.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-428 Service Type M Worker ID $IATT OMB No.: 0970-0154 FLED--3 -FRCE OF THE '0TARY 2009 AF R -2 PM 3: 10 F:\MES\C1ients\12377 01son\12377.1.Affidav.ser divorcr.wpd Created: 9/20/04 0:06PM Revised: 4/29/09 9:23AM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v : CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN DIVORCE AFFIDAVIT OF SERVICE I, Hubert X. Gilroy, being duly sworn according to law do depose and state that a copy of the Complaint and Notice to Plea filed in the above referenced matter was served on Defendant, Roger L. Olson, by certified mail on February 9, 2006. A copy of the Certified Mail - Return Receipt Requested, Restricted Delivery, is attached hereto and marked Exhibit A. hy'a . tA- d? G?i D TE Hubert X. lroy, Esquire Attome for Plaintiff Martson Deardorff Williams Otto Gilroy & Faller 10 East High Street Carlisle, PA 17013 (717) 243-3341 Sworn and subscri ed before me this 767 day of April, 2 0 COMMONWEALTH OF PENNSYLVANIA Notarial Seal Shely Brooks. Notary Public ?ary Publ c Carlisle Boro, Crxrlbeti" 5 county N My C,orrxrtiseion Expires Aug Member, Pennsylvania Association of Notaries .' . • ¦ Complete items 1, 2, and 3. Also complete item 4 if Restricted Delivery is desired. ¦ Print your name and address on the reverse so that we can return the card to you. ¦ Attach this card to the back of the maiipiece, or on the front if space permits. A. Articie Addressed to: `?Pqe' x , ?l isv ?? A d V,'a /1'k?sh 1 B. Received by( Printed Name) C. Date of Delivery D. Is delivery address different from item 17 0 Yes If YES, enter delivery address below: 1xNo 3. Service type XfCertI ted Mall O Express Mail PIIOgiatered G'Astum Receipt for Merchandise E3 Insured Mail ? C.O.D. 4. Restricted Delivery? (Extra Fee) Yes 2. Artide Number (lf>3rWw ftm swylce laboo 9b /,] J .J O 0003 -,71Xt3 6A, PS Form 3811, February 2004 Domestic Return Receipt 102595.02-M-1540 UNITED STAT04ft 4 113 FED, S ? us ? ffI t 'gender. Please print your name, address, and ZJP+4 in this b • ox i am* Pte. j 4 N01 Wwoli GrrOdes PA 1 i ?S2 Q t 3. f=1:3:'--??+^.a?? ?r?r?rf?t?t??t???rul??rr?lr?r?l*r?ltrrrlir??ril?I,lrrl,lr,tt,r?1 , i EXHIBIT 41 . L `may t.;F F:\FILES\CGents\12377 Olson\12377.I.MSA Fmal Created: 7,30.04 9:12AM Revised: Y5;09 5:09 11:50AM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN CUSTODY MARITAL SETTLEMENT AGREEMENT THIS MARITAL SETTLEMENT AGREEMENT, made this 5`'day of March , 2009, by and between LISA G. OLSON (hereinafter referred to as "Wife"), and ROGER L. OLSON, (hereinafter referred to as "Husband" ): WITNESSETH: WHEREAS, the parties were married on December 10, 1988; WHEREAS, three children were born of the marriage of the parties. They are Alex T. Olson, born June 26, 1992, Kim E. Olson, born October 26, 1993, and Matt K. Olson, born May 1, 1995. WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of Wife and Husband to live separate and apart, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other, including, without limitation by specification: the settling of all matters between them in relation to the ownership and equitable distribution of real and personal property; settling of all matters between them relating to the past, present and future support, alimony and/or maintenance of Wife by Husband or of Husband by Wife; and in general, the settling of any and all claims and possible claims by either party against the estate of the other party. NOW, THEREFORE, in consideration of the premises and of the mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, Husband and Wife, each intending to be legallybound hereby covenant and agree as follows: 1. INTERFERENCE: Each party shall be free from interference, authority, and contact by the other, as fully as though he or she were single and unmarried, except as may be necessary to carry out the provisions of this Agreement. Neither party shall molest the other or attempt to endeavor to molest the other, nor compel the other to cohabit with the other, or in any way harass or malign the other, nor in any way interfere with the peaceful existence, separate and apart from the other. 2. AGREEMENT NOT A BAR TO DIVORCE PROCEEDINGS: This Agreement shall not affect or bar the right of Husband or Wife to a divorce on lawful grounds or to any defense as may be available to either party. This Agreement is not intended to condone and shall not be deemed to be a condonation on the part of either party hereto of any act or acts on the part of the other party which have occasioned the disputes or unhappy differences. 3. SUBSEQUENT DIVORCE: The parties hereby acknowledge that Wife filed a Complaint in Divorce in Cumberland County, Pennsylvania, claiming that the marriage is irretrievably broken under Section 3301(c) of the Pennsylvania Divorce Code. The parties hereby express their agreement that the marriage is irretrievably broken and express their intent to execute any and all Affidavits or other documents necessary for the parties to obtain an absolute divorce pursuant to Section 3301(c) of the Divorce Code. The parties hereby waive all rights to request court ordered counseling under the Divorce Code. It is further specifically understood and agreed by the parties that the provisions of this Agreement as to equitable distribution of property of the parties are accepted by each party as a full and final settlement for all purposes whatsoever, as contemplated by the Pennsylvania Divorce Code. 2 Should a decree, judgment or order of divorce be obtained by either of the parties in this or any other state, country or jurisdiction, each of the parties hereby consents and agrees that this Agreement and all of its covenants shall not be affected in any way by such separation or divorce; and that nothing in any such decree, judgment, order or further modification or revision thereof shall alter, amend or vary any term of this Agreement, whether or not either or both of the parties shall remarry. It is the specific intent of the parties to permit this Agreement to survive any judgment and to be forever binding and conclusive upon the parties. 4. INCORPORATION OF DIVORCE DECREE: It is further agreed, covenanted and stipulated that this Agreement, or the essential parts hereof, shall be incorporated in any decree hereinafter entered by any court of competent jurisdiction in any divorce proceedings that have been or may be instituted by the parties for the purpose of enforcing the contractual obligations of the parties. This agreement shall not be merged in any such decree but shall in all respects survive the same and be forever binding and conclusive upon the parties. 5. EFFECTIVE DATE: The effective date of this Agreement shall be the "date of execution" or "execution date," defined as the date upon which it is executed by the parties if they have each executed this Agreement on the same date. Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. 6. DISTRIBUTION DATE: The transfer of property, funds and/or documents provided for herein, shall only take place on the "distribution" date which shall be defined as the date of execution of this Agreement unless otherwise specified herein. However, the support and/or alimony payments, if any, provided for in this Agreement shall take effect as set forth in this Agreement. 7. MUTUAL RELEASE: Husband and Wife each do hereby mutually remise, release, quit-claim and forever discharge the other and the estate of such other, for all time to come, and for all purposes whatsoever, of and from any and all rights, title and interest, or claims in or against the property (including income and gain from property hereafter accruing) of the other or against the estate of such other, of whatever nature and wheresoever situated, which he or she now has or at any time hereafter may have against the other, the estate of such other or any part hereof, whether arising out of any former acts, contracts, engagements or liabilities of such other or by way of dower or courtesy, or claims in the nature of dower or courtesy or widow's or widower's rights, family exemption or similar allowance, or under the intestate laws, or the right to take against the spouse's will; or the right to treat a lifetime conveyance by the other as a testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of (a) Pennsylvania, (b) any State, Commonwealth or territory of the United States, or (c) any country or any rights which either party may have or at any time hereafter shall have for past, present or future support or maintenance, alimony, alimony pendente lite, counsel fees, division of property, costs or expenses, whether arising as a result of the marital relations or otherwise, except, all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provisions thereof. It is the intention of Husband and Wife to give each other by the execution of this Agreement a full, complete and general release with respect to any and all property of any kind or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and only except all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision thereof. It is fiuther agreed that this Agreement shall be and constitute a full and final resolution of any and all claims which each of the parties may have against the other for equitable division of property, alimony, counsel fees and expenses, alimony pendente lite or any other claims pursuant to the Pennsylvania Divorce Code or the divorce laws of any other jurisdiction. 8. REPRESENTATION BY COUNSEL: The provisions of this Agreement and their legal effect has been fully explained to the parties by their respective counsel, Hubert X. Gilroy, Esquire, counsel for Wife, and Karl E. Rominger, Esquire, counsel for Husband. The parties acknowledge that each has received independent legal advice from counsel of his or her own selection, that each has fully disclosed his or her respective financial situations to the other, including his or her property, estate, assets, liabilities, income and expenses, that each is familiar with and fully understands the facts, including the property, estate, assets, earnings and income of the other, and that each has been fully informed as to his or her legal rights and obligations. Each of the parties acknowledges and agrees that, after having received such advice and with such knowledge, this agreement is, in the circumstances, fair, reasonable and equitable, that it is being entered into freely, voluntarily, and in good faith and that the execution of this agreement is not the result of any duress, undue influence, coercion, collusion anchor improper or illegal agreement. The parties finther 4 acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this agreement. The parties acknowledge that each has received or has had the opportunity to receive independent legal advice from counsel of their selection and that they have been informed fully as to their legal rights and obligations, including all rights available to them under the Pennsylvania Divorce Code of 1980, as amended, and other applicable laws. Each party also acknowledges that each has fully disclosed his or her respective financial situations to the other, including his or her property, estate, assets, liabilities, income and expenses, that each is familiar with and fully understands the facts, including the property, estate, assets, earnings and income of the other, and that each has been fully informed as to his or her legal rights and obligations. Each of the parties acknowledges and agrees that, after having received such advice and with such knowledge, this agreement is, in the circumstances, fair, reasonable and equitable, that it is being entered into freely, voluntarily, and in good faith and that the execution of this agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreement. The parties further acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this agreement. 9. WARRANTY AS TO EXISTING OBLIGATIONS: Each party represents that they have not heretofore incurred or contracted for any debt or liability or obligation for which the estate of the other party maybe responsible or liable except as maybe provided for in this Agreement. Each party agrees to indemnify and hold the other party harmless from and against any and all such debts, liabilities or obligations of every kind which may have heretofore been incurred by them, including those for necessities, except for the obligations arising out of this Agreement. 10. WARRANTY AS TO FUTURE OBLIGATIONS: Husband and Wife covenant, warrant, represent and agree that, with the exception of obligations set forth in this Agreement, neither of them shall hereafter incur any liability whatsoever for which the estate of the other may be liable. Each party shall indemnify and hold harmless the other party from and against any and all debts, charges and liabilities incurred by the other after the execution date of this Agreement, except as may be otherwise specifically provided for by the terms of this Agreement. 11. PERSONAL PROPERTY: Except as otherwise provided herein, the parties have divided between them, to their mutual satisfaction, the personal effects, household fumiture and furnishings, and all other articles of personal property which have heretofore been used by them in common, and neither party will make any claim to any such items which are now in the possession or under the control of the other. The parties agree, however, to divide all photographs evenly, and each party shall be entitled to access to negatives. The parties will make duplicates of all camcorder tapes which currently exist so that each party has a full set. Any cost involved in the duplication of the videos will she shared equally. By these presents, each of the parties hereby specifically waives, releases, renounces and forever abandons whatever claims he or she may have with respect to any personal property which is in the possession of the other, and which shall become the sole and separate property of the other from the date of execution hereof. 12. MILITARY PENSION: Husband has a military pension which the parties agree to handle as follows: A. Upon Husband's retirement, Husband will elect full SBP benefits in connection with the military pension with Wife as the named beneficiary of the SBP benefits. The cost of the SBP benefits shall be deducted from the gross disposable retirement pay prior to the allocation of the marital portion as set forth in subparagraph B below. B. Wife shall receive 50% of the "marital portion" of the Husband's military pension. The "marital portion" shall be calculated using a formula with a numerator of 165 months and a denominator equal to the total number of months Husband is in the military service. For purposes of the entry of an allocation to the Wife in connection with this Agreement, the following language shall apply: 6 The former Spouse is awarded a percentage of the Member's disposable military retired pay, to be computed by multiplying 50% times a fraction, the numerator of which is 165 months of marriage during the Member's credible military service, divided by the Member's total months of credible military service. C. Each party shall assume their respective obligations for any income tax consequences relating to their portion of the pension which they are receiving. D. The parties shall share the annual increases in the pension in accordance with the percentages ans calculated in subparagraph B. above. E. In the event Wife is delayed in receipt of her portion of the pension as the result of some administrative delay or other delay through the Military Accounting Office and Husband receives himself the full amount of the pension, Husband shall make payments directly to Wife for her percentage amount as applicable with the understanding that Wife shall incur all income tax obligations with respect to the payments received by her. F. Wife's attorney shall prepare documents in the nature of a QDRO or other applicable documents as the military may require in order to implement the allocation of the pension benefits as set forth herein. 13. LIFE INSURANCE: Consistent with the Order of Court entered in this case on October 10, 2007, the parties are required to keep each other named as a beneficiary on each party's respective life insurance policy. It is the desire of the parties that any insurance monies received upon the death of the party will be earmarked and intended for use for support of the minor children of the parties who are Alex T. Olson, born June 26,1992, Kim E. Olson, born October 26, 1993, and Matt K. Olson, born May 1, 1995 (hereinafter referred to collectively as the "minor children"). The parties shall together create a life insurance trust (hereinafter referred to as "Trust") for the benefit of the children in a form as agreed upon by legal counsel for the parties. The Trust Agreement shall be prepared by legal counsel for the Wife subject to approval of legal counsel for the Husband, and the Agreement shall designate William Ray Olson, brother of Husband, as the Trustee. It is further 7 contemplated that William Ray Olson may review the draft Trust Agreement for input prior to signing by the parties. It shall be the intention of the parties that the Trust will provide for the receipt of insurance proceeds upon the death of either or both parties and the Trust to use those proceeds to pay for the normal health care, maintenance, support and education of the minor children. In connection with this Trust, the parties agree as follows: A. Wife shall continue to maintain a whole life insurance policy (#A005543843) In the amount of $25,000.00 with Liberty National Life Insurance Company. The beneficiary on the policy shall continue to be the Husband until such time as the Trust is created, at which time the beneficiary shall be changed to the Trust. Additionally, in the event Wife obtains any insurance through her employment, the same provision shall apply to that insurance relative to naming the Trust as the beneficiary. B. Husband shall continue to maintain his-$400,000.00 SGLI life insurance policy along with at least $200,000.00 of additional life insurance and shall continue to maintain Wife as the named beneficiary on said policies. Upon creation of the Trust, the beneficiary on these policies shall be changed to the Trust. The parties obligations to maintain the mentioned insurance policies as set forth in this paragraph shall be terminated upon all of the minor children having graduated from high school and having reached the age of 18. Upon such time, each party shall have the option of eliminating said insurance policies, or, in the alternative, changing the beneficiaries as they may determine in their sole discretion. At the same time, the parties may mutually agree to continue said insurance policies with the Trust as the named beneficiary for the benefit of the minor children. It is understood that the $400,000.00 SGLI life insurance policy will terminate upon Husband's retirement from the military and, at that time, Husband's obligation in connection with that policy as far as continuing it in effect and maintaining Wife or the Trust as named the beneficiary shall also terminate. 14. ALIMONY: The parties acknowledge the Husband has an alimony obligation to Wife that will become effective April 1, 2009. The parties agree that the APL/spousal obligation from Husband to Wife currently docketed at the Cumberland County Domestic Relations Office shall be terminated effective April 1, 2009. Husband's alimony obligations to Wife starting April 1, 2009, shall be as follows: A. For the first six months, Husband shall pay Wife the sum of $400.00 per month. B. For the second six months from October 2009 through March 2010, Husband shall pay Wife the sum of $300.00 per month. C. For the next six months from April 2010 through September 2010, Husband shall pay Wife the sum of $200.00 per month. D. Starting October 2010 and subject to the provisions below, Husband shall pay Wife the sum of $100.00 per month. Husband's obligation to pay Wife alimony as set forth herein is a fixed obligation and shall not be subject to modification by the Courts or otherwise unless there is an agreement between the parties. Husband's obligation for alimony shall terminate upon Husband's death, Wife's death, Wife's remarriage, or Wife's cohabitation. Additionally, the alimony provisions as set forth herein shall also terminate upon Husband's retirement from the military and upon Wife receiving her applicable portion of the pension benefits as set forth in paragraph 12 above. Husband's alimony obligation pursuant to this Agreement shall be incorporated as an Order of Court through the Cumberland County Domestic Relations Office and enforced as such. The parties agree that the Cumberland County Domestic Relations Office may implement the provisions of this alimony Order upon the DRO receiving a signed copy of this Agreement. 15. CHILD SUPPORT: As set forth above, the parties are the parents of three minor children who currently reside with the Husband. Currently, Wife has a support obligation to Husband in connection with the minor children at the Cumberland County Domestic Relations Office (which 9 obligation is offset by a portion of the spousal support/APL that Husband owes to Wife as referenced above). The parties agree that effective April 1, 2009, the Wife's support obligation to Husband at the Cumberland County Domestic Relations Office shall be terminated. In further consideration for Wife's agreement to accept the portion of the military pension as set forth in paragraph 12 above and to accept the limited alimony as set forth in paragraph 14 above as part of the overall settlement of all financial claims between the parties in connection with their marriage, Husband agrees to make no requests whatsoever relative to financial support from the Wife for the minor children or any one of them while the minor children reside in the Husband's custody. Husband agrees to indemnify and hold Wife harmless for the entry of any obligation for child support against her by any Court in the future for the support of the minor children. Husband acknowledges that his obligation to indemnify Wife in connection with any support obligation she incurs for the minor children is a contractual obligation pursuant to the terms of this Agreement, it being the intent of this indemnification that Husband will make Wife whole for any support order that is entered against her for the minor children or any one of them while the children are in the custody of the Husband. Although the parties do not anticipate a change in the custodial circumstances and it is the intent at this time for the parties to continue to handle the custody arrangement consistent with the September 27, 2007, Order of Court issued at the above-captioned term and number, in the event there is any change in custody where Wife would become the primary custodian of one or more of the minor children and Wife sought child support from Husband, Husband would be entitled to seek child support from Wife for any of the minor children still in the Husband's custody consistent with the applicable support guidelines of the Commonwealth of Pennsylvania, and Husband's obligation to indemnify Wife for such a support claim pursuant to the terms of this paragraph shall be eliminated in those circumstances. It is acknowledged that the Husband shall be entitled to claim the three minor children as dependency deductions for Federal income tax purposes as long as the minor children continue in the primary custody of the Husband consistent with the mentioned Order of Court. 16. AFTER-ACQUIRED PROPERTY: Each of the parties shall hereafter own and enjoy, independently of any claim or right of the other, all items of property, be it real, personal or mixed, tangible or intangible, which are hereafter acquired by him or her, with full power in him or her to dispose 10 of the same as fully and effectively, in all respects and for all purposes as though he or she were unmarried. 17. INCOME TAX: Husband and Wife agree to file separate tax returns for the tax year 2008. For any tax returns filed jointly in the past, 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 either of 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. 18. APPLICABILITY OF TAX LAW TO PROPERTY TRANSFERS: The parties hereby agree and express their intent that any transfer of property pursuant to this Agreement shall be within the scope and applicability of the Deficit Reduction Act of 1984 (hereinafter the "Act'), specifically, the provisions of said Act pertaining to the transfers of property between spouses and former spouses. The parties agree to sign and cause to be filed any elections or other documents required by the Internal Revenue Service to render the Act applicable to the transfers set forth in this Agreement without recognition of gain on such transfer and subject to the carry-over basis provisions of said Act. 19. MARITAL DEBT: All marital debt has been paid off or divided to mutual satisfaction. Each party shall indemnify, defend, and hold the other harmless from and against any claims, demands suits, actions or liabilities relating to or arising out of any debt in that party's name. 20. HEALTH INSURANCE: Each party is responsible for their own health insurance and uninsured medical expenses. 21. EFFECT OF DIVORCE DECREE: The parties agree that, except as otherwise specifically provided herein, this Agreement shall continue in full force and effect after such time as a final Decree in Divorce may be entered with respect to the parties. 11 22. BREACH: If either party breaches any provision of this Agreement, the other party shall have the right, at his or her election to sue for damages for such breach or seek such other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of reasonable legal fees and costs incurred by the other in enforcing their rights under this Agreement. 23. WAIVER OF CLAIMS: Except as herein otherwise provided, each party may dispose of his or her property in any way, and each party hereby waives and relinquishes any and all rights he or she shall now have or hereafter acquire, under the present and future laws of any jurisdiction, to share in the property or the estate of the other as a result of the marital relationship, including without limitation, dower, courtesy, statutory allowance, widow's allowance, right to take in intestacy, right to take against the Will of the other, and the right to act as administrator or executor of the other's estate, and each will, at the request of the other, execute, acknowledge and deliver any and all instruments which may be necessary or advisable to carry into effect this mutual waiver and relinquishment of such interests, rights and claims. 24. ENTIRE AGREEMENT: This Agreement contains the entire understanding of the parties and there are no representations, warranties, covenants or undertakings other than those expressly set forth herein. 25. AGREEMENT BINDING ON HEIRS: This Agreement shall be binding on and shall inure to the benefits of the parties hereto and their respective heirs, executors, administrators, successors and assigns. 26. ADDITIONAL INSTRUMENTS: Each of the parties shall from time to time, at the request of the other, execute, acknowledge and deliver to the other any and all further instruments that may be reasonably required to give full force and effect to the provisions of this Agreement. 27. 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. 12 28. INDEPENDENT SEPARATE COVENANTS: It is specifically understood and agreed by and between the parties hereto that each paragraph hereof shall be deemed to be separate and independent Agreement. 29. FINANCIAL DISCLOSURE: The parties confirm that they have relied on the completeness and substantial accuracy of the financial disclosure of the other as an inducement to the execution of this Agreement. 30. MODIFICATION AND WAIVER: A modification or waiver of any of the provisions of this Agreement shall be effective only if made in writing and executed with the same formality as this Agreement. The failure of either party to insist upon strict performance of any of the provisions of this Agreement shall not be construed as a waiver of any subsequent defaults of the same or similar nature. 31. DESCRIPTIVE HEADINGS: The descriptive headings used herein are for convenience only. They shall have no affect whatsoever in determining the rights or obligations of the parties. 32. APPLICABLE LAW: This Agreement shall be construed under the laws of the Commonwealth of Pennsylvania and more specifically under the Divorce Code of 1980 and any amendments thereto. [Signatures are found on the following page.] 13 IN WITNESS WHEREOF, the parties hereto have set their hands and seals the date and year first above written. WITNESSET • Karl E. ominger Hu ert. Gilroy 000- ee-0110, L. Olson Lisa G. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND : SS On this 5`' day of March , 2009, before me, a Notary Public, personally appeared LISA G. OLSON, known to me to be the person whose name is subscribed to the within Marriage Settlement Agreement and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official sea]. COMMpNyy?gLALTH OF PENNSYLVANIA Notarial Seal Notary Public bn E iras k4 5,2009 My commissi em Sylvania Association of Notaries A 5 COMMONWEALTH OF P SYLVANIA No Pub i : SS COUNTY OF CUMBERLAND On this 5' day of March, 2009, before me, a Notary Public, personally appeared ROGER L. OLSON, known to me to be the person whose name is subscribed to the within Marriage Settlement Agreement and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. t -- d&A i" My commission expires: Notary Pu lic COMMONWEALTH OF PENNSYLVANIA Noauial Seal Shelly Brooks Notary Public cadwe Bor% Cumberland Courdy 14 My Commission Expires Aug. 5, 2008 Member, Pennsylvania Association of Notaries HE P ` ! Ap , M9 APR 30 AM 11: 14 Of qh F:IMESTIlente112377 0b9n112377.1.Praeeipe dfv.wpd Created: 9/20/04 0:06PM Revised: 4129/09 9:29AM Hubert X. Gilroy, Esquire MARTSON DEARDORFF WILLIAMS OTTO GILROY & FALLER MARTSON LAW OFFICES I.D. 29943 10 East High Street Carlisle, PA 17013 (717) 243-3341 Attorneys for Plaintiff LISA G. OLSON, IN THE COURT OF COMMON PLEAS Plaintiff OF CUMBERLAND COUNTY, PENNSYLVANIA v CIVIL ACTION LAW ROGER L. OLSON, NO. 2006 - 678 Defendant IN DIVORCE PRAECIPE TO TRANSMIT RECORD To the Prothonotary: Transmit the record, together with the following information, to the court for entry of a divorce decree: 1. Ground for divorce: irretrievable breakdown under Section 3301(c) or 3301 (d)(1) of the Divorce Code. 2. Date and manner of service of the complaint: Certified Mail Return Receipt dated February 9, 2006. 3. (Complete either paragraph (a) or (b).) (a) Date of execution of the Plaintiffs affidavit of consent required by Section 3301 (c) of the Divorce Code; March 5, 2009; by the Defendant; March 5, 2009. (b)(i) Date of execution of the Plaintiffs affidavit required by § 3301(d) of the Divorce code: (b)(ii) Date of filing and service of the Plaintiffs affidavit upon the respondent: 4. Related claims pending: None. 5. Date and manner of service of the notice of intention to file praecipe to transmit record, a copy of which is attached, if the decree is to be entered under Section 3301(d)(1)(i) of the Divorce Code: I( . . .0 (Complete either (a) or (b).) (a) Date and manner of service of the Notice of Intention to File Praecipe to Transmit Record, a copy of which is attached: April 28, 2009. (b) Date Plaintiffs Waiver of Notice in §3301(c) Divorce was filed with the Prothonotary: March 5, 2009. Date Defendant's Waiver of Notice in §3301(c) Divorce was filed with the Prothonotary: March 5, 2009. MARTSON LAW OFFICES By Hubert Gilroy, Esquire Ten E t High Street Carl' e, PA 17013 (717243-3341 Attorneys for Plaintiff Date: April ot-9 , 2009 F!LED-i l'C THE F "a ; _; ^, ' TAPY g- 20-99 APR 30 AM 1 I : 41 LISA G. OLSON V. ROGER L. OLSON IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2006-678 DIVORCE DECREE AND NOW, (VI 1. 2 oc J t is ordered and decreed that LISA G. OLSON plaintiff, and ROGER L. OLSON , defendant, are divorced from the bonds of matrimony. Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (if no claims remain indicate "None.") Marital Settlement Agreement dated March 5, 2009, is incorporated into this Order. By the Court, ,Dz. 26 ?&..dd J. honotary ..?` ` -L9 ?F 6W 0 c j4t?A . ,,1 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania CO./City/Dist. Of CUMBERLAND Date of Order/Notice 10/01/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS ARMY ACTIVE DUTY RE:OLSON, ROGER L. Sent Electronically DO NOT MAIL 06-678 CIVIL OOriginal Order/Notice OAmended Order/Notice OTerminate Order/Notice OOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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. $ 0.00 per month in current child support $ 0.00 per month in past-due child support Arrears 12 weeks or greater? Oyes ® no $ 0.00 per month in current medical support $ 0.00 per month in past-due medical support $ 300.00 per month in current spousal support $ o . oo per month in past-due spousal support $ 0.00 per month for genetic test costs $ 0.00 per month in other (specify) $ one-time lump sum payment for a total of $ 300.00 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: $ 69.04 per weekly pay period. $ 150. oo per semimonthly pay period (twice a month). $ 138.08 per biweekly pay period (every two weeks). $ 300.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: EDGAR 8 BAYLEY Form EN-428 Rev.1 Service Type M OMBNo.:0970-oisa Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ifhhecked you are required to provide a?opy of this form to you=loyee. If your employee works in a state that is di erent from the state that issued this or er, a copy must be provi eedd 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. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : C--l THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT. NEW EMPLOYER'S NAME/ADDRESS: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Antidiscrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9. * Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by internet www.childsupport.state.pa.us Service Type M Page 2 of 2 OMB No.: 0970-0154 Form EN-428 Rev.1 Worker I D $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 PACSES Case Number Plaintiff Name Plaintiff Name LISA G. OLSON Docket Attachment Amount Docket Attachment Amount 06-678 CIVIL $ 300.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB DOB Addendum Form EN-428 Rev.1 Service Type M OMB No.: 0970-0154 Worker ID $IATT FlIFD-OFFI('F OF THE P" )THn"d01'AAY 2009 OCT -2 PM 2= 30 I?fry ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania CO./City/Dirt. Of CUMBERLAND Date of Order/Notice 11/17/09 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS ARMY ACTIVE DUTY RE:OLSON, ROGER L. Sent Electronically DO NOT MAIL 06-678 CIVIL OOriginal Order/Notice @Amended Order/Notice 0Terminate Order/Notice QOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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. $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 300.00 $ 50.00 $ 0.00 $ 0.00 for a total of $ per month in current child support per month in past-due child support per month in current medical support per month in past-due medical support per month in current spousal support per month in past-due spousal support per month for genetic test costs per month in other (specify) one-time lump sum payment Arrears 12 weeks or greater? Q yes ® no 350.00 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: $ 80.55 per weekly pay period. $ 175.00 per semimonthly pay period (twice a month). $ 161.10 per biweekly pay period (every two weeks). $ 350.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: EDGAR B BAYLEY Form EN-428 Rev.1 Service Type M OMB No.: 0970-0154 Worker I D $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If heckeo you are required to provide a copy of this form to your mloyee. If yo r employee works in a state that is diherent from the state that issued this order, a copy must be provid' dpto 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. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ID EMPLOYEE'S/OBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT- 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 (CCPA) 0 5 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Service Type M OMB No.: 0970-0154 Form EN-428 Rev.1 Worker ID $ IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 PACSES Case Number Plaintiff Name Plaintiff Name LISA G. OLSON Docket Attachment Amount Docket Attachment Amount 06-678 CIVIL $ 350.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number PACSES Case Number Plaintiff Name Plaintiff Name Docket Attachment Amount Docket Attachment Amount $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): Addendum Service Type M OMB No.: 0970-0154 DOB DOB DOB Form EN-428 Rev.1 Worker ID $zATT OF THE PFrOTHONOTARY 2009 NOV 18 PM 2: 24 Ctli: - , w?JU i'Y r?t?'yi?J i`EVr`1A?IA ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 01/06/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS ARMY ACTIVE DUTY RE:OLSON, ROGER L. Sent Electronically DO NOT MAIL 06-678 CIVIL 0Original Order/Notice @Amended Order/Notice o Terminate Order/Notice OOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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. $ 0.00 per month in current child support $ o . oo per month in past-due child support Arrears 12 weeks or greater? Oyes ® no $ o . oo per month in current medical support ,,,,, $ 0.00 per month in past-due medical support -° CD C= $ 300.00 per month in current spousal support _r) C__ $ o. oo per month in past-due spousal support r- $ 0.00 per month for genetic test costs;; .. t -w3 m $ o . oo per month in other (specify) rte- C '`i C: $ one-time lump sum payment for a total of $ 300.00 per month to be forwarded to payee below.- tv Om You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle oes ft match the ordered support payment cycle, use the following to determine how much to withhold: $ 69.04 per weekly pay period. $ 150.00 per semimonthly pay period (twice a month). $ 138.08 per biweekly pay period (every two weeks). $ 300. 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). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: KEVIN A HESS Form EN-428 Rev.1 Service Type M OMB No.:097aoi54 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ? If hecked you are required to provide a opy of this form to your m loyee. If yo r employee works in a state that is di4erent from the state that issued this or?er, a copy must be provided pto 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. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 13 THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ED EMPLOYEE'S/OBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: NEW EMPLOYER'S NAME/ADDRE FINAL PAYMENT AMOUNT: 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: * NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 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-428 Rev.1 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 PACKS Case Number Plaintiff Name Plaintiff Name LISA G. OLSON Docket Attachment Amount Docket Attachment Amount 06-678 CIVIL $ 300.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-428 Rev.1 Service Type M OMB No.: 0970-0154 Worker I D $ IATT ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 06-678 CIVIL State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 04/01/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS ARMY ACTIVE DUTY RE: Sent Electronically DO NOT MAIL L. Q Origi nal Order/Notice OAmended Order/Notice QTerminate Order/Notice OOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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 dat ORDER INFORMATION: This is an Order/Notice to Withhold from CUMBERLAND County, Commonwealth of Pen amounts from the above-named employee's/obligor's income unt issued by your State. $ 0.00 per month in current child support $ o . oo per month in past-due child support $ 0.00 per month in current medical support $ o. oo per month in past-due medical support $ 200.00 per month in current spousal support $ o.oo per month in past-due spousal support $ 0.00 per month for genetic test costs $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ 200.00 per month to be forwarded to p You do not have to vary your pay cycle to be in compliance with the ordered support payment cycle, use the following to determin $ 46.03 per weekly pay period. $ $ 92.05 per biweekly pay period (every two weeks). $ associated with cases on attachment. -ome for Support based upon an order for support sylvania. By law, you are required to deduct these i further notice even if the Order/"ice%not r rrears 12 weeks or greater? es no r..- en rQ below. e support order. If your pay cycle does not match how much to withhold: loo. oo per semimonthly pay period (twice a month). 200.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no 1 ter than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment w thin seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of ithholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withh d amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. F r the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by a electronic payment method if an employer is ordered to withhold income from more than one employee and a ploys 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient fun s. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, H rrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S AME AND THE PACSES MEMBER ID (shown above as the EmployeelObligor's Case Identifier) OR SOCIAL SEC RITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: KEVIN A HESS Form EN-428 Rev.1 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO El If ghecke you are required to provide asopy of this form to di Brent rom the state that issued this or er, a copy must be 1. Priority: Withholding under this Order/Notice has priority over any of Federal tax levies in effect before receipt of this order have priority. If the agency listed below. 2. Combining Payments: You can combine withheld amounts from more each agency requesting withholding. You must, however, separately iden employee/obligor. :RS AND OTHER WITHHOLDERS >ur mployee. If yo r employee works in a state that is ovi?ed to your employee even if the box is not checked. ?r legal process under State law against the same income. are Federal tax levies in effect please contact the requesting than one employee/obligor's income in a single payment to ify the portion of the single payment that is attributable to each 3. * Reporting the Paydate/Date of Withholding: You must report the pay ate/date of withholding when sending the payment. The paydate/date of withholding is the date on which amount was withheld fro the employee's wages. You must comply with the law of the state of the employee's/obligor's principal place of employment with respe t 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 th n one Order/Notice to Withhold Income for Support against this employeelobligor and you are unable to honor all support Order/Noti s 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 Ag ncy when the employee/obligor is no longer working for you. Please provide the information requested and return a copy of this Order/N tice to the Agency identified below. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : 0 HE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 ATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT- 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, conta t the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you re liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pen sylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State i which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State la for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/oblig r because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the la of the State in which he or she is employed governs. 9. * Withholding Limits: You may not withhold more than the lesser of: 1) t Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the employment. Disposable income is the net income left after making mandatc Security taxes, statutory pension contributions and Medicare taxes. The Fede supporting another family and 60% of the disposable income if the obligor is increased to 55% and that 60% limit is increased to 65% if the arrears are gre deduct a fee for administrative costs. The support amount and the fee may no Arrears greater than 12 weeks : If the order information does not indicate % employer should calculate the CCPA limit using the lower percentage. For Tri allowed under the law of the issuing Tribe. For Tribal employers who receive the limit set by the law of the jurisdiction in which the employer is located or CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may r care premiums in determining disposable income and applying appropriate m 10. Additional info: amounts allowed by the Federal Consumer Credit itate or Tribe of the employee's/obligor's principal place of y deductions such as: State, Federal, local taxes, Social al limit is 50% of the disposable income if the obligor is of supporting another family.However, that 50% limit is ter than 12 weeks. If permitted by the State, you may exceed the limit indicated in this section. hether the arrears are greater than 12 weeks, then the ial orders, you may not withhold more than the amounts 1 State order, you may not withhold more than the lesser of he maximum amount permitted under section 303(d) of the ed to take into consideration the amounts paid for health hholding limits. *NOTE: If you or your agent are served with a copy of this order in the state t at issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: If you r your employee/obligor have any questions, DOMESTIC RELATIONS SECTION contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST by telep? one at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by inte et www.childsupport.state.pa.us Service Type M Page 2 of 2 OMB No.: 0970-0154 Form EN-428 Rev.1 Worker ID $IATT DefendanWbligor: OLSON, ROGER L. PAC--- Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 200.00 Child(ren)'s Name(s): DOB PACSES Case Number Plainti_ ff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB locket Attachment Amount $ o.oo ild(ren)'s Name(s): DOB Service Type M Addendum Form EN-428 Rev.1 OMB No.: 0970-0154 Worker ID $IATT ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State CommonweaIth of Penn ylvania Co./City/Dist. of CUi~ERLAND Date of Order/Notice os/o2/io Case Number (See Addendum for case summary) EmployerM/ithholder's Federal EIN Number DFAS ARMY ACTIVE DUTY 06-678 CIVIL OOriginal Order/Notice OAmended Order/Notice i X Terminate Order/Notice QOne-Time Lump Sum/Notice RE: OLSON, ROGER L . Employee/Obligor's Name (Last, First, MI) Sent Slectroaically DO NOT MAIL 332-64-5103 Employee/Obligor's Social Security Number 6586101731 Employee/Obligor's Case Identifier (See Addendum for plai~rtiff names associated with cases on attachment) Custodial Parent's Name (Last, First, Mq See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ o. oo per month in current child support c--,~~-1 O ~'' -' $ o . oo per month in past-due child support Arrears 12 weeks or greater? (~-yeses ~ nd"' $ o.oo per month in current medical support "~•~ ° ~'~ -={ o. oo per month in past-due medical support ~ ~ `~= ! 7" $ o . oo per month in current spousal support - ~.; ' $ o . oo per month in past-due spousal support J' -- $ o . oo per month for genetic test costs ~ ~_' $ o . oo per month in other (specify) ~ '>.~~v $ one-time lump sum payment ~~ ~ ~F ~; for a total of $ o . 00 per month to be forwarded to payee below. ~ M 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: $ o . oo Per weekly pay period. $ o . oo per semimonthly pay period $ o . oo per biweekl (twice a month). y pay period (every two weeks). $ o . 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). Pennsylvania law (23 PA C.S. S 4374(b)) requires remittance by an electronic aavment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 1 71 06-9 1 1 2 1N ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER /N ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: KEVIN A HESS DRO: R.J. Shadday Form EN-428 Rev.1 Service Type M OMBNO.:0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ~ If heck you are required to pr vide a opy of this form to your m loyee. If yo r employee orks in a state that is di~erent from the state that issuedthis order, a copy must be provic~edpto your emproyee even if tie 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. Federa{ 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%bligor'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/obl igor. 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'slobligor'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: 1f there is more than one Order/Notice to Withhold Income for Support against this employee%bligoranct 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%bligor is no longer working for you. Please provide the information requested and return a copy of this Order/Notice to the Agency identified below. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : D THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ~ EMPLOYEE'SlOBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: DATE OF SEPARATION: FINAL PAYMENT AMOUNT• 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%bligor'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%bligorfrorn employment, refusing to employ, or taking disciplinary action against any employee%bligorbecauw 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 Ad (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60°!° of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: * NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT N. HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 by Internet www.childsupport.state.pa.us Page 2 of 2 Form EN-428 Rev.1 Service Type M OMB No.: 0970-0154 Worker I D $ IATT r ADDENDUM Summary of Cases on Attachment DefendandObligor: OLSON, ROGER L . PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount S o.oo Child(ren)'s Name(s>: DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Addendum Service Type M OMB No.: 09740154 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB _. PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Form EN-428 Rev.1 Worker ID $IATT ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 09/13/10 Case N u m ber (See Addendum for case summary) Employer/Withholder's Federal FIN Number DFAS ARMY ACTIVE DUTY RE:OLSON, ROGER L. Sent Electronically DO NOT MAIL 06-678 CIVIL (D O Original Order/Notice OAmended Order/Notice OTerminate Order/Notice OOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 Employee/Obligor's Case Identifier (See Addendum for plaintiff names associated with cases on attachment) Custodial Parent's Name (Last, First, MI) See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This is an Order/Notice to Withhold Income for Support based upon an order for support from CUMBERLAND County, Commonwealth of Pennsylvania. By law, you are required to deduct these amounts from the above-named employee's/obligor's income until further notice even if the Order/Notice is not issued by your State. $ o. oo per month in current child support $ 0. oo per month in past-due child support Arrears 12 weeks or greater? O yes ® no $ 0.00 per month in current medical support $ o. oo per month in past-due medical support . $ 200.00 per month in current spousal support ?- '' $ o. 0o per month in past-due spousal support -?;6 $ o . o o per month for genetic test costs ?' f :n $ o . oo per month in other (specify) $ one-time lump sum payment r=? r, for a total of $ 200.00 per month to be forwarded to payee below. m? < 5 n You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle 4?e not matt the ordered support payment cycle, use the following to determine how much to withhold: $ 46.03 per weekly pay period. $ loo. oo per semimonthly pay period (twice a month). $ 92 . 05 per biweekly pay period (every two weeks). $ 200.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ obligor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT': KEVIN A HESS DRO: R.J. SHADDAY Service Type M OMB Na: 0970-0154 Form EN-428 Rev.1 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If checked you are required to provide a copy of this form to your eemployee. 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. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER: M THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ED EMPLOYEE'S/OBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: NEW EMPLOYER'S NAME/AD DATE OF SEPARATION: FINAL PAYMENT AMOUNT 6. Lump Sum Payments: You may be required to report and withhold from lump sum payments such as bonuses, commissions, or severance pay. If you have any questions about lump sum payments, contact the person or authority below. 7. Liability: If you fail to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the erriployee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) (15 U.S.C. 1673 (b)); or 2) the amounts allowed by the State or Tribe of the employee's/obl'igor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted udder section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: *NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 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-428 Rev.] Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 PACSES Case Number Plaintiff Name Plaintiff Name LISA G. OLSON Docket Attachment Amount Docket Attachment Amount 06-678 CIVIL $ 200.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACKS Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-428 Rev.1 Service Type M OMB No.: 0970-0154 Worker ID $IATT LISA G. OLSON, Plaintiff/Petitioner VS. ROGER L. OLSON, Defendant/Respondent IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - DIVORCE NO. 06-678 CIVIL TERM IN DIVORCE PACSES CASE: 229108790 ORDER OF COURT C*) ?1rr? -TI -t i r1 AND NOW to wit, this 14"i day of September. 2010, it is hereby Ordered that, pursuant to the Petitioner's request, the Alimony is terminated effective this date with no balance due. 'The Cumberland County Domestic Relations Section dismisses their interest in this matter. This Order shall become final twenty (20) days after the mailing of the notices of the entry of the Order to the parties unless either party tiles a written demand with the Office of the Prothonotary for a hearing de novo before the Court. BY THE COURT: Albert H. Masland, V J. DRO: R.J. Shadday xc: Petitioner Respondent Form OF-001 Sernice Type. M Worker: 21005 ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 09/14/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number DFAS ARMY ACTIVE DUTY RE:OLSON, ROGER L. Sent Electronically DO NOT MAIL 06-678 CIVIL O Original Order/Notice OAmended Order/Notice OTerminate Order/Notice OOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 332-64-5103 Employee/Obligor's Social Security Number 6586101731 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. $ 0.00 per month in current child support $ o. oo per month in past-due child support Arrears 12 weeks or greater? ryes ® no $ o . oo per month in current medical support C c> r $ 0.00 per month in past-due medical support ro car t $ o . o o per month in current spousal support ?, rt r ij M $ o . oo per month in past-due spousal support 1 ++ $ 0.00 per month for genetic test costs ? . - 7 $ o . oo per month in other (specify) r ?F -c? $ one-time lump sum payment for a total of $ o. oo per month to be forwarded to payee below. ' 1z You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0.00 per weekly pay period. $ 0. oo per semimonthly pay period (twice a month). $ o . oo per biweekly pay period (every two weeks). $ o . 00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (10) working days after the date of this Order/Notice. Send payment within seven (7) working days of the paydate-/date of withholding. You are entitled to deduct a fee to defray the cost of withholding. Refer to the laws governing the work state of your employee for the allowable amount. The total withheld amount, and your fee, cannot exceed 55% of the employee's/ ob#igor's aggregate disposable weekly earnings. For the purpose of the limitation on withholding, the following information is needed (See #9 on page 2). Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: KEVIN A HESS DRO : R . J . Shaciday Service Type M OMB No.: 0970-0154 Form EN-428 Rev.1 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If checked you are required to provide a copy of this form to your 4 loyee. If yo r employee works in a state that is different from the state that issued this order, a copy must be provic edpto your employee even if the box is riot 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. 3599900000 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : M THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 1:3 EMPLOYEE'S/OBLIGOR'S NAME:OLSON, ROGER L. EMPLOYEE'S CASE IDENTIFIER: 6586101731 DATE OF SEPARATION: LAST KNOWN HOME ADDRESS: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT: 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 fait to withhold income as the Order/Notice directs, you are liable for both the accumulated amount you should have withheld from the employee/obligor's income and other penalties set by Pennsylvania State law. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 8. Anti-discrimination: You are subject to a fine determined under State law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against any employee/obligor because of a support withholding. Pennsylvania State law governs unless the obligor is employed in another State, in which case the law of the State in which he or she is employed governs. 9.* Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer Credit Protection Act (CCPA) 0 5 U.S.C. 1673 IN); or 2) the amounts allowed by the State or Tribe of the employee's/obligor's principal place of employment. Disposable income is the net income left after making mandatory deductions such as: State, Federal, local taxes, Social Security taxes, statutory pension contributions and Medicare taxes. The Federal limit is 50% of the disposable income if the obligor is supporting another family and 60% of the disposable income if the obligor is not supporting another family.However, that 50% limit is increased to 55% and that 60% limit is increased to 65% if the arrears are greater than 12 weeks. If permitted by the State, you may deduct a fee for administrative costs. The support amount and the fee may not exceed the limit indicated in this section. Arrears greater than 12 weeks : If the Order Information does not indicate whether the arrears are greater than 12 weeks, then the employer should calculate the CCPA limit using the lower percentage. For Tribal orders, you may riot withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers who receive a State order, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State law, you may need to take into consideration the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. 10. Additional info: _ * NOTE: If you or your agent are served with a copy of this order in the state that issued the order, you are to follow the law of the state that issued this order with respect to these items. 11. Send Termination Notice and other correspondence to: DOMESTIC RELATIONS SECTION If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT _ 13 N. HANOVER ST by telephone at (717) 240-6225 or P.O. BOX 320 by FAX at (717) 240-6248 or CARLISLE PA 17013 - by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-428 Rev.1 Service Type M OMBNo.:0970-0,54 Worker ID $IATT ? a ADDENDUM Summary of Cases on Attachment Defendant/Obligor: OLSON, ROGER L. PACSES Case Number 229108790 Plaintiff Name LISA G. OLSON Docket Attachment Amount 06-678 CIVIL $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number_ Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Service Type M oMBNo.:0970-0154 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Narne(s): DOB Form EN-428 Rev.1 Worker ID $IATT