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HomeMy WebLinkAbout06-1906FRIEDMAN & KING, P.C. John F. King, Esquire ID #61919 600 N. Second Street Penthouse Suite P. O. Box 984 Harrisburg, PA 17108 Tel.: (717) 236-8000/Fax: (717) 236-8080 Attorney for Plaintiff ADAM C. TOSH, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. NO. O(e - IQ?? ?tUt ?? LYNN M. TOSH, COMPLAINT IN DIVORCE Defendant NOTICE TO DEFEND AND CLAIM RIGHTS You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary, Cumberland County Courthouse, 1 Courthouse Square, Carlisle PA. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, MARITAL PROPERTY, COUNSEL FEES OR EXPENSES BEFORE THE FINAL DECREE OF DIVORCE OR ANNULMENT IS ENTERED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 1-800-990-9108 717-249-3166 Res y submitted, F 777' By: Job' . King, Esquire N. Second St.5th Flr. . Box 984 PA 17108 (717) 236-8000 ADAM C. TOSH, Plaintiff V. LYNN M. TOSH, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. !9? l21 vrl ??lL COMPLAINT IN DIVORCE 1. Plaintiff is Adam C. Tosh, who currently resides at 2215 Spring Run Drive, Mechanicsburg, Cumberland County, Pennsylvania 17055. 2. Defendant is Lynn M. Tosh, who currently resides at 2215 Spring Run Drive, Mechanicsburg, Cumberland County, Pennsylvania 17055. 3. The parties have been bona fide residents in the Commonwealth for at least six (6) months immediately previous to the filing of this Complaint. 4. The Plaintiff and Defendant were married on July 6, 1996, in Mechanicsburg, Pennsylvania. 5. Plaintiff avers that there are children of the parties under the age of eighteen (18), namely: Annabelle Tosh (date of birth, 5/21/00), and Clara Tosh (date of birth, 12/9/02). 6. There have been no prior actions of divorce or for annulment between the parties. 7. Plaintiff has been advised that counseling is available and the Plaintiff may have the right to request that the Court require the parties to participate in counseling. 8. The marriage is irretrievably broken. 9. Neither Plaintiff nor Defendant is in the military service of the United States. WHEREFORE, Plaintiff requests the Court to enter a Decree of Divorce. COUNTI REQUEST FOR EQUITABLE DIVISION OF MARITAL PROPERTY PURSUANT TO 23 Pa.C.S.A. SECTION 3502 11. Paragraphs 1 through 10 incorporated herein by reference. 12. The Plaintiff and Defendant have legally and beneficially acquired property, both real and personal, during their marriage. 13. The Plaintiff and Defendant have been unable to agree as to equitable distribution of the said property to the date of the filing of this Complaint. WHEREFORE, the Plaintiff, Adam C. Tosh, requests this Court to equitably divide all marital property. Respectfully submitted, KING, P.C. Date: ?a) gA?& oh . King, Esquire 600 N. Second Street Penthouse Suite P O. Box 984 Harrisburg, PA 17108 (717) 236-8000 VERIFICATION I, Adam C. Tosh, hereby acknowledge that I am the Plaintiff in the foregoing action; that I have read the foregoing Complaint in Divorce; and the facts stated therein are true and correct to the best of my knowledge, information and belief. I understand that any false statements herein are made subject to Adam C. Tosh penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. Dated: 19- ? ? ° o C I n >.i ..?r,rl- (J t5 i L? ? r ADAM C. TOSH, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 06-1906 Civil Term LYNN M. TOSH, COMPLAINT IN DIVORCE Defendant INVENTORY OF ADAM C. TOSH Plaintiff files the following inventory of all property owned or possessed by either party at the time this action was commenced and all property transferred within the preceding three years. Plaintiff verifies that the statements made in this inventory are true and correct. Plaintiff understands that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. no-A-C ul?- Adam C. Tosh, Plaintiff ASSETS OF THE PARTIES Plaintiff marks on the list below those items applicable to the case at bar and itemizes the assets on the following pages. (XX) 1. Real Property (XX) 2. Motor vehicles (XX) 3. Stocks, bonds, securities and options ( ) 4. Certificates of deposit (XX) 5. Checking accounts, cash ( ) 6. Savings accounts, money market and savings certificates ( ) 7. Contents of safe deposit boxes ( ) 8. Trusts (XX) 9. Life insurance policies (indicate face value, cash surrender value and current beneficiaries) ( ) 10. Annuities ( ) 11. Gifts ( ) 12. Inheritances ( ) 13. Patents, copyrights, inventions, royalties ( ) 14. Personal property outside the home ( ) 15. Business (list all owners, including percentage of ownership, and officer/director positions held by a party with company) ( ) 16. Employment termination benefits-severance pay, worker's compensation claim/award ( ) 17. Profit sharing plans (XX) 18. Pension plans (indicate employee contribution and date) (XX) 19. Retirement plans, Individual Retirement Accounts ( ) 20. Disability payments ( ) 21. Litigation claims (matured and unmatured) ( ) 22. Military/V.A. benefits ( ) 23. Education benefits ( ) 24. Debts due, including loans, mortgages held (XX) 25. Household furnishings and personalty (include as a total category and attach itemized list if distribution of assets is in dispute) ( ) 26. Other MARITAL PROPERTY Plaintiff lists all marital property in which either or both spouses have a legal or equitable interest individually or with any other person as of the date this action was commenced: Item Description Names of Number of Property All Owners 1. Marital residence - H&W 2215 Spring Run Drive Mechanicsburg, PA 17055 2. 2003 Honda Odessey vehicle H&W 3. 1998 Toyota Camry H&W 4. PSECU account W & her mother (Marital portion) (Marilyn Puskarich) 5. PSECU account H 6. PSECU account H&W 6. SERS pension H 7. Deferred comp H 8. Highmark 401(k) W 9. Scudder Fund H&W 10. Japan Fund H&W 11. Citizens Checking H 12. Household personalty H&W 13. $500,000.00 North American Life Ins. Policy H 14. $250,000.00 North American Life Ins. Policy W 15. $10,000.00 Croatian Federation Credit Union Life Ins. Policy H 16. $10,000.00 Croatian Federation Credit Union Life Ins. Policy W NON-MARITAL PROPERTY Plaintiff lists all property in which a spouse has a legal or equitable interest which is claimed to be excluded from marital property: Item Description Reason for Number of Property Exclusion 1. Omega Savings Pre-marriage 2. Pioneer Fund Owned Pre-marriage with brother PROPERTY TRANSFERRED Item Description Date of Person to Whom Number of Property Transfer Consideration Transferred LIABILITIES Item Description Names of Names of Number of Property All Creditors All Debtors 1. Mortgage National City Mortgage H&W JFK/bp ADAM C. TOSH, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 06-1906 Civil Term LYNN M. TOSH, COMPLAINT IN DIVORCE Defendant CERTIFICATE OF SERVICE I, John F. King, Esquire, hereby certify that on July 12, 2006, I served a copy of the within Inventory of Adam C. Tosh, by depositing same in the United States Mail, first class, postage prepaid, addressed as follows: Lynn M. Tosh 2215 Spring Run Drive Mechanicsburg, PA 17055 , P.C. En?truse Suite P. O. Box 984 Harrisburg, PA 17108 (717) 236-8000 _: - i ?? ? ?_ ;: ADAM C. TOSH : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff Vs. LYNN M. TOSH Docket No. 06-1906 Civil Defendant MOTION FOR APPOINTMENT OF MASTER Adam C. Tosh (Plaintiff) (Befi=k at), moves the court to appoint a master with respect to the following claims: Divorce k)cDistribution of Property () Annulment ( ) Support ?k Alimony () Counsel Fees () Alimony Pendente Lite () Costs and Expenses and in support of the motion states: (1) Discovery is complete as to the claims (s) for which the appointment of a master is requested. (2) The defendant (has) (lka ?? appeared in the action (1 'ski) (by ?jt attorney, Quintina Laudermilch , Esquire). (3) The Staturory ground (s) for divorce (is) (are) irretrievable breakdown (4) Delete the inapplicable paragraph(s): a x x?1? ??c ? A431 ??b b. >Aa>agmm=k)bnxbmstx=ohcdx xDW=kAoxtbcxfo bo>miWxkm: c. The action is contested with respect to the following claims: ALL (5) The action (jRYW;(does not involve) complex issues of law or fact (6) The hearing is expected to take one (w=) (days). (7) Additional information, if any, relevant to the motion: Date: May 29, 2008, 6 A ey for (Plainti f) (Ik fit) Print Attorney Name ......... John F. King ORDER APPOINTING MASTER AND NOW, , 20 , Esquire is appointed master with respect to the following claims: By the Court: J. _? ?? ;-i _--r c,: -? ? , ; _.? r„ •• ,-- -?'' ?,> Friedman & King, P.C. John F. King, Esq. ID#61919 3820 Market Street Camp Hill, PA 17011 (717) 236-8000 (717) 236-8080 FAX friedmanandkina&hotmail.com ADAM C. TOSH, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 06-1906 Civil Term LYNN M. TOSH, COMPLAINT IN DIVORCE Defendant ; INCOME AND EXPENSE STATEMENT OF PLAINTIFF, ADAM C. TOSH I verify that the statements made in this Income and Expense Statement are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Date: Adam C. Tosh, Plaintiff INCOME Employer: Kentucky Retirement System Address: 1260 Louisville Road, Frankfort, KY 40601 Type of Work: Gov't Pension - Investment Management Payroll Number: G170446871 Pay Period (weekly, Biweekly biweekly, etc.): Gross Pay per Pay Period: $6,345 Itemized Payroll Deductions: Federal Withholding: $1,021 Social Security: $ 357 Local Wage Tax: $ 111 State Income Tax: $ 326 Retirement: $ 317 Savings Bonds: $ Credit Union: $ Life Insurance: $ Health Insurance: $ 266 Other (specify): $ 84 medicare $1,762 court order deduction Net Pay per Pay Period: $2,101 Other Income: Week Month Year Interest 1.00 Dividends Pension Annuity Social Security Rents Royalties Expense Account Gifts Unemployment Comp Workmen's Comp TOTAL INCOME $ $4,204 Home Weekly Monthly Yearly Mortgage/rent $716 Maintenance Utilities Electric $ 45 Gas $ 15 Oil Telephone $ 95 Water $ 14 Sewer Employment Public Transportatiop Lunch $120 Taxes Weekly Monthly Yearly Real Estate Personal Property Misc. Taxes Income Insurance Homeowners $ 60 Automobile $ 45 Life $ 70 Accident Health Other Automobile Payments Fuel $420 Repairs $130 Other Reg $ 7 EXPENSES Weekly Monthly Yearly Medical: Doctor: $35 Dentist: $35 Orthodontist: Hospital: Medicine: Special needs (glasses, braces, orthopedic devises: $45 Education: Private School: Parochial school College: Religious: Personal: Clothing: $250 Food: $220 Barber/hairdresser: $ 25 Credit payments: Credit card: Charge account: Memberships: $40 Loans: Credit Union: Miscellaneous: $100 Household Help: Child Care: Papersibooks/ magazines: Entertainment: Pay TV: Vacation: Gifts: $ 30 Legal Fees: $650 Charitable Contributions: Child Support $1,679.00 per order Spousal Support $1,844.04 per order Other - Medical $125.00 Insurance for W & C Visitation Expenses $700.00 these expenses vary depending on frequency and price of fuel TOTAL EXPENSES: $7,515.04 PROPERTY OWNED: Description Value Ownership (H, W, J) Checking Acct PSECU $100 H Savings Acct PSECU $2,000 H Credit Union Cmw Credit Union $4,000 H Stocks/Bonds Real Estate 2215 Spring Run Dr Mechanicsburg, PA $200,000 approx J Other: TOTAL $206,100 INSURANCE: Company Policy No. Coverage H, W, C Health Humana P6070018A H,W,C Disability Dental Other H = husband W = wife J =joint C = child N m-r °r; CD y o JUN 0 32008 ADAM C_ TOSH Plaintiff' Vs. LYNN M. TOSH : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA Docket No. 06-1906 Civil Defendant MOTION FOR APPOINTMENT OF MASTER Adam C. Tosh (Plaintiff) (Daft oda8t), moves the court to appoint a master with respect to the following claims: Divorce ( )cDistribution of Property () Annulment () Support (Ck Alimony () Counsel Fees () Alimony Pendente Lite () Costs and Expenses and in support of the motion states: (1) Discovery is complete as to the claims (s) for which the appointment of a master is requested. her (2) The defendant (has) (hAA*A*) appeared in the action (lrt?y) (by Wit attorney, Quintina Laudermilch , Esquire). (3) The Staturory ground (s) for divorce (is) (are) irretrievable breakdown (4) Delete the inapplicable paragraph(s): axxUpAW9&j& QR] . b. x aAMmmk t ?xwgkxmr AaxtmxkMcxm*cxlom: c. The action is contested with respect to the following claims: ALL (5) The action vW; (does not involve) complex issues of law or fact (6) The hearing is expected to take one (to=) (days). (7) Additional information, if any, relevant to the motion: Date: May 29, 2008 A ey for (Plainti f) (P fit) Print Attorney Name ......... John F. King AND NOW, , 20 0 Esquire is appointed mas wi respect to the following claims:??`o ,did( ,,(`1 ..?L ? 7 rwa .? Q C: -- L?? ? y j ,- , 3 1 a ?, Quintina M. Laudermilch, Esquire DALEY ZUCKER MEILTON MINER & GINGRICH, LLC 1029 Scenery Drive Harrisburg, PA 17109 (717) 6574795 tlaudermilch@dmunglaw.com IN THE COURT OF COMMON PLEAS CUMBERLAND, COUNTY, PENNSYLVANIA ADAM C. TOSH, Plaintiff CIVIL ACTION - LAW V. No. 2006-1906 (Civil Term) LYNN M. TOSH, (In Divorce) Defendant NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the Court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary at the Cumberland County Court House, High and Hanover Street, Carlisle, Pennsylvania. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 South Bedford Street Carlisle, Pennsylvania 17013 (717) 249-3166 DALEY ZUCKER MEILTON MINER& GINGRICH, LLC Date: 6/0/?0/109 By. Q intina M. Laudermilch, Esquire Supreme Court I.D. #94664 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 Attorneys for Defendant Quintina M. Laudermilch, Esquire DALEY ZUCKER MEILTON MINER & GINGRICH, LLC 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 tlaudermilchadzmmelaw.com IN THE COURT OF COMMON PLEAS CUMBERLAND, COUNTY, PENNSYLVANIA ADAM C. TOSH, Plaintiff V. LYNN M. TOSH, Defendant CIVIL ACTION - LAW No. 2006-1906 (Civil Term) (In Divorce) PETITION FOR EQUITABLE DISTRIBUTION, ALIMONY AND COUNSEL FEES AND EXPENSES AND NOW comes Defendant, Lynn M. Tosh, by and through her counsel Daley Zucker Meilton Miner & Gingrich, LLC, and files the within Petition for Alimony and Counsel Fees and Expenses: 1. The Plaintiff, Adam C. Tosh, filed a Complaint in Divorce on March 31, 2006 docketed at the above-captioned number. 2. The Honorable Edgar B. Bayley previously signed the Order appointing a Divorce Master in the above-captioned matter. In addition, the Honorable M.L. Ebert has signed Support Orders docketed to No. 00084 S 2007, PACSES 236108931. 3. On or about June 17, 2008, Defendant's Counsel contacted John F. King, Esquire counsel for Plaintiff, to advise that this Petition would be filed. Attorney King did not object to the Petition being filed on behalf of the Defendant. ALIMONY 4. Paragraph 1-3 are hereby incorporated by reference. 5. Defendant has inadequate means of support for herself except as provided for by Defendant. 6. Defendant has stayed home to raise the parties' children and has not been employed outside the home since approximately May 2000. 7. Plaintiff is currently employed as the Chief Investments Officer of the Kentucky Retirement Systems earning an annual gross income in excess of $164,000. COUNSEL FEES AND EXPENSES 8. Paragraphs 1-7 are hereby incorporated by reference. 9. Defendant does not have sufficient funds to support herself and pay counsel fees and expenses incidental to this action. 10. Plaintiff is full well and able to pay counsel fees and expenses incidental to this divorce action. WHEREFORE, Defendant requests this Honorable Court enter a Decree in Divorce from the bonds of matrimony; direct the Plaintiff to pay Alimony to the Defendant; direct the Plaintiff to pay Defendant's counsel fees and the cost of this proceeding; and grant such further relief as the Court may determine equitable and just. Respectfully submitted, DALEY ZUCKER MEILTON M!, ER & GINGRICH, LC Dated: By: (yuintina M. Laud rmilch, Esquire Supreme Court I.D. #94664 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 Attorneys for Defendant VERIFICATION I, Lynn A Tosh, verify that the statements made in this Petition are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to unworn falsification to authorities. I&AM , L :::?L Date: Lynn . Tosh, Defendant CERTIFICATE OF SERVICE AND NOW, this day of J y m , 2008, I, Amanda M. Shull hereby certify that I have this day served a copy of the within Petition for Alimony and Counsel Fees and Expenses, by mailing same by first class mail, postage prepaid, addressed as follows: John F. King, Esquire Friedman & King, P.C. 3820 Market Street Camp Hill, PA 17011 Counsel for Plaintiff DALEY ZUCKER MEILTON MINER & GINGRICH, LLC 0/m, 1).4AIIIIA4. I Amanda M. Shull 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 t"4 ?i 05 r t" 3 N bra t . Quintina M. Laudermilch, Esquire DALEY ZUCKER WILTON MINER & GINGRICH, LLC 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 tlaudermilch@dzmmglaw.com IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ADAM C. TOSH, Plaintiff Civil Action - Law V. No. 06-1906 Civil Term LYNN M. TOSH, (In Divorce) Defendant INCOME AND EXPENSE STATEMENT Attached hereto is the Income and Expense Statement of Defendant submitted pursuant to Pa. R.C.P. No. 1920.31. Q tina M. Laudermilch Attorney for Defendant INCOME AND EXPENSE STATEMENT OF LYNN M. TOSH INCOME Employer: Unemnloved Address: Type of Work: Payroll Number: Pay Period (weekly, biweekly, etc.): Gross Pay per Pay Period: Itemized Payroll Deductions: Federal Withholding Social Security Local Wage Tax State Income Tax Retirement Savings Bonds Credit Union Life Insurance Health Insurance Other (specify) Net Pay per Pay Period: Other Income: Interest/Dividends Pension/Annuity Social Security Rents/Royalties Expense Account Gifts Unemployment Comp. Workmen's Comp. Spousal Support Total TOTAL INCOME Week Month Year (Fill in Appropriate column) 1,844.03 $ $_ 1,844.03 $ $ 1,844.03 (per month) EXPENSES Weekly Monthly Yearly (Fill in Appropriate Column) Home Mortgage/rent $ $ 942.29 $ Maintenance $ $ $ 1,650.00 Cable/Internet $ $ 96.52 $ Electric $ $ $ 2,504.42 Home repairs $ $ $ 4,100.00 Oil/Gas $ $ $ Telephone $ $ 88 00 $ Water $ $ 35.00 $ Sewer $ $ $ 448.00 Trash $ $ $ 174.00 Employment Taxes Public $ $ $ Lunch $ $ 300.00 $ Real Estate $ $ $ Personal $ $ $ 4 90 . Income $ $ $ 150.00 Insurance Homeowners $ $ $ Automobile $ $ $ 974.80 Life Accident Health Other Automobile Payments Fuel Repairs/Maintenance Registration/Auto Club Medical Doctor Dentist Orthodontist Hospital Medicine Special needs (glasses, braces, orthopedic devices) Education Weekly Monthly Yearly (Fill in Appropriate Column) $ $ $ 479.30 $ $ 500.00 $ $ $ $ 910.00 $ $ $ 36.00 $ $ $ 878.00 $ $ $ 892.00 $ $ $ 85.45 $ $ $ 802.00 $ 400.00 Private school $ $ $ Parochial school $ $ $ College $ $ $ Books/Miscellaneous $ $ 20.00 $ Weekly Monthly Yearly (Fill in Appropriate Column) Personal Clothing $ $ $ 2,500.00 Food $ 150.00 $ $ Barber/hairdresser $ $ 82.00 $ Personal care $ $ $ Hobbies $ $ $ 1,259.00 Laundry/Dry Cleaning $ $ $ 200.00 Memberships $ $ 10.00 $ Loans Credit Union $ $ $ Miscellaneous Household help $ $ $ Child care $ $ 50.00 $ Papers/books/magazines $ $ $ 175 00 . Entertainment $ $ $ Vacation $ $ $ 500 00 . Gifts $ $ 40.00 $ Legal fees $ $ 1,056.00 $ Charitable contributions $ 5.00 $ $ Other Other child support Alimony payments Description West Shore EMS $ $ $ 75.00 Travel for Custody Exchan eg s_ $ $ $ 1,043.82* *Varies due to number of visits, type of transportation arrangements for visits, etc. TOTAL EXPENSES $ 155.00 $_ 3.219.81 $ 19.197.87 PROPERTY OWNED Checking accounts Savings accounts Credit Union Stockstbonds Real estate Other Value See Inventory and Appraisement See Inventory and Appraisement See Inventory and Aypraisement See Inventory and Appraisement See Inventory and Appraisement See Inventory and Appraisement TOTAL *H=Husband; W=Wife; J=Joint Ownership* H W J INSURANCE Hospital Blue Cross Medical Blue Shield Health/Accident Disability Income Dental Other Policy Coverage* Company No. H W C Humana P6070018A X X X Humana P6070018A X X X H=Husband; W=Wife; C=Child VERIFICATION I verify that the statements made m this Income and Expense Statement 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. a? M. Tosh, Defe t CERTIFICATE OF SERVICE r AND NOW, this 1 S day of 2008, I, Amanda M. Shull, Paralegal, hereby certify that I have, this day, served the within document on counsel for Plaintiff, by depositing a copy of the same in the United States Mail, first class, postage prepaid, at Harrisburg, Pennsylvania, addressed to: John F. King, Esquire FRIEDMAN & KING, P.C. 3820 Market St. Camp Hill, PA 17011 Attorney for Plaintiff DALEY ZUCKER MEILTON MINER & GINGRICH, LLC /Ariian(fa M. Shull, Paralegal 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 .--1 r.,? ?) 4 .? S ? g 1 1 ...,?,..? {?? f ? .. a ?1 r i \_.?% ? ?`.? 1 ? 1 -. ?> ... ? . 1?3 ??, ? , ? _? L ? am Quintim M. Laudermilch, Esquire Daley Zucker Meilton Miner & Gingrich, LLC 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-0795 daudennilch(oM mmalaw.com IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA ADAM C. TOSH, Plaintiff Civil Action - Law V. No. 06-1906 Civil Term LYNN M. TOSH, (In Divorce) Defendant INVENTORY AND APPRAISEMENT OF LYNN M. TOSH I, Lynn M. Tosh, file the following Inventory and Appraisement of all property owned or possessed by either party at the time this action was commenced and all property transferred within the preceding three years. I verify that the statements made in this Inventory and Appraisement 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. L M. Tosh, Defendant ASSETS OF PARTIES Defendant marks on the list below those items applicable to the case at bar and itemizes the assets on the following pages. If an item has been appraised, a copy of the appraisal report is attached. M 1. Real property (X) 2. Motor vehicles () 3. Stocks, bonds, securities and options () 4. Certificates of deposit (X) 5. Checking accounts, cash (X) 6. Savings accounts, money market and savings certificates () 7. Contents of safe deposit boxes () 8. Trusts (X) 9. Life Insurance policies (indicate face value, cash surrender value and current beneficiaries) () 10. Annuities () 11. Gifts () 12. Inheritances ( ) 13. Patents, copyrights, inventions, royalties ( ) 14. Personal property outside the home ( ) 15. Businesses (list all owners, including percentage of ownership, and officer/director positions held by a party with company) ( ) 16. Employment termination benefits - severance pay, workman's compensation claim/award ( ) 17. Profit sharing plans M 18. Pension plans (indicate employee contribution and date plan vests) M 19. Retirement plans, Individual Retirement Accounts ( ) 20. Disability payments ( ) 21. Litigation claims (matured and unmatured) ( ) 22. MilitaryN.A. benefits ( ) 23. Education benefits (X) 24. Debts due, including loans, mortgages held (X-) 25. Household furnishings and personalty (include as a total category and attach itemized list if distribution of such assets is in dispute) 0 26. Other MARITAL PROPERTY Defendant lists all marital property in which either or both spouses have a legal or equitable interest individually or with any other person as of the date this action was commenced: Item Number Description of Property Names of 41 Owners 1 2215 Spring Run Drive H/W Mechanicsburg, PA 17055 (marital residence) 2 2003 Honda Odyssey W 2 1998 Toyota Camry H 3 Scudder Investments H/W 3 Japan Fund H/W 3 Banc of America Investments H 3 Pioneer Investments H & Husband's Brother (marital portion) 5,6 PSECU Accounts H/W 5,6 PSECU Accounts H 5,6 Citizen's Bank Accounts H 5,6 PSECU Accounts W & Wife's Mother (marital portion) 6 Omega Savings H (marital portion) 9 North American Life Insurance W 9 Croatian Federation Credit Union W Life Insurance Policy 9 North American Life Insurance H 9 Croatian Federation Credit Union H Life Insurance Policy 18 SERS Pension H 19 Deferred Compensation H 19 Ameriprise (Highmark) 401(k) W 25 Household goods H/W NON-MARITAL PROPERTY Defendant lists all marital property in which a spouse has a legal or equitable interest which is claimed to be excluded from marital property: Name of Reason for Item Number Description of Property all Owners Exclusion 5,6 PSECU Accounts W & Wife's Mother Pre-Marital (non-marital portion) 6 PSECU Accounts W & Clara Children's 6 PSECU Accounts W & Annabelle Children's 9 Life Insurance Policies H/W Children's 18 SERS Pension W Pre-marital 18 PSERS Pension W Pre-Marital 18 Pioneer Investments H & Brother Pre-marital (non-marital portion) 18 Omega Savings H Pre-marital (non-marital portion) PROPERTY TRANSFERRED Defendant lists all property in which either or both spouses had a legal or equitable interest individually or with any other person and which has been transferred within the preceding three years: Item Number Description of ProneM Names of all Owners 2 2003 Honda Odyssey W (transferred to Wife after separation) 2 1998 Toyota Camry H (transferred to Husband after separation) LIABILITIES OF PARTIES Defendant lists all liabilities of either or both spouses alone or with any person as of the date action was commenced: Name of Names of Description of Debt Creditor All Debtors Mortgage on Marital Residence National City Mortgage H/W CERTIFICATE OF SERVICE AND NOW, this 5T day of U ? , 2008, I, Amanda M. Shull, Paralegal, hereby certify that I have, this day, served the within inventory and Appraisement on Plaintiff, by depositing a copy of the same in the United States Mail, first class, postage prepaid, at Harrisburg, Pennsylvania, addressed to: John F. King, Esquire FRIEDMAN & KING, P.C. 3820 Market St. Camp Hill, PA 17011 Attorney for Plaintiff DALEY ZUCKER MEILTON MINER & GINGRICH, LLC ?f/b]AAAd?il 1?1 ? ?LU? Amanda M. Shull, Paralegal 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 ?? r:? ??? - ?-:?:r ? :- ?.,;? -?n-? N `, C'',y ?t e 1 l „? ?;~r __:? i =;? ?.?. dw , ', ADAM C. TOSH, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 06-1906 Civil Term LYNN M. TOSH, COMPLAINT IN DIVORCE Defendant PLAINTIFF'S PRE-TRIAL STATEMENT 1. Assets Marital Assets (DOM: 07/1996; DOS: 09/2006) A. Marital residence - 2215 Spring Run Drive, Mechanicsburg, PA Appraised July 1, 2008, for $197,000.00 Wife is currently in possession. B. 2003 Honda Odyssey title transferred to Wife in June 2007 Value $11,915.00 C. 1998 Toyota Camry title transferred to Husband in June 2007 Value $2,615.00 D. Husband's SERS retirement - marital portion $91,758.00 E. Husband's deferred comp - $35,851.00 F. Wife's Highmark 401(k) - $42,169.00 G. Joint Scudder Fund - $4,648.00 H. Joint Japan Fund - $5,669.00 1. Checking - Citizens Bank - $11,526.00 J. Husband Checking - PSECU - $300.00 K. Joint Checking - PSECU - $600.00 L. Husband Money Market - PSECU - $9,910.00 M. Joint Money Market - PSECU - $363.00 II. III. IV. N. Husband Savings - PSECU - $79.00 0. Joint Savings - PSECU - $5,669.00 P. Household personalty - to be determined Non-Marital Assets A. Omega Savings Account opened pre-marriage - minimal value B. Pioneer Fund opened pre-marriage with Brother - minimal value C. That portion of Husband's SERS retirement which is not marital. Expert Witnesses None Witnesses (Other than the Parties) None Exhibits A. Home appraisal B. Husband's SERS valuation C. Wife's 401(k) statement D. Japan Fund statement E. Scudder Fund statement F. Husband's deferred compensation statement G. Kelley Blue Book automobile value statements H. PSECU joint and husband account statements 1. Citizens Bank account statement. V. Income See Plaintiff's income and expense statement which was previously filed. Husband presently pays $1,844.03 in spousal support and $1,679.00 child support per month. VI. Expenses See Plaintiff's income and expense statement which was previously filed. VII. Pension/Retirement Benefits See above. VIII. Counsel Fees Each party will pay his/her own counsel fees. IX. Tangible Property Personal property has been divided among the parties. X. Marital Debts A. Mortgage on marital residence - $106,331.00 XI. Proposed Resolution Wife to receive 55% of marital estate, and Husband to receive 45% of marital estate, as per attached report. All personalty to remain in the possession of party now in possession. Each party responsible for their own counsel fees. Given the short duration of the marriage and given the two plus years of generous spousal support, alimony of $1,844.03 for one year to be paid by Husband to Wife. Respectfully submitted, By: 4..John F. King, Esq. ID# 61919 3820 Market Street Camp Hill, PA 17011 717-236-8000 fiiedmanandking@hotmail.com Attorney for Plaintiff ?' ?"? ? -n ?=? `?; .a .w,. ?? ,-,mot cst ,?. `" ...- x'?z ? ?'. ?. .? I ' ADAM C. TOSH, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 06-1906 CIVIL TERM LYNN M. TOSH, IN DIVORCE Defendant PRAECIPE FOR WITHDRAWAL OF APPEARANCE TO THE PROTHONOTARY: Please withdraw the appearance of John F. King, Esquire, and Friedman & King, P.C., on behalf of Plaintiff, Adam C. Tosh, in the above-captioned matter. FRIEDMAN,& KING, P.C. By ( JoJin F. King '--? South Hanover S? Suite 103 Carlisle, PA 17013 (717) 258-4343 Dated: 3) t Z (717) 422-5526 (fax) PRAECIPE FOR ENTRY OF APPEARANCE Please enter the appearance of Debra D. Cantor, Esquire, and McNees Wallace & Nurick LLC, on behalf of Plaintiff, Adam C. Tosh, in the above-captioned matter. McNEES WALLACE & NURICK LLC By Dated: hjit /&. l Zy ol, " D for 1.11. No. 66378 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 237-5297 (717) 260-1667 (fax) dcantor .mwn.com CERTIFICATE OF SERVICE The undersigned hereby certifies that on this date a copy of the foregoing document was served by first class mail, postage prepaid, upon the following: Quintina M. Laudermilch, Esquire Daley Zucker Meilton Miner & Gingrich LLC 1029 Scenery Drive Harrisburg, PA 17109 .b nne M. Barnhart Dated: March ( Z,-,2009 n. ?',? i ^+ j ? i T m? r J ?? ? l '?,7L,,. .,, 7'? yy, .. ?' 7 ^y?? r? 4 ., f - 'rw"• "'a..f r ` Quintina A Laudemiilch, Esquire DALEY ZUCKER MEILTON MINER & GINGRICH, LLC 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 tlaudermi lch@dzmmglaw. com IN THE COURT OF COMMON PLEAS CUMBERLAND, COUNTY, PENNSYLVANIA ADAM C. TOSH, Plaintiff V. LYNN M. TOSH, Defendant CIVIL ACTION - LAW No. 2006-1906 (Civil Term) (in Divorce) PRAECIPE TO WITHDRAW DEFENDANT'S CLAIM FOR EQUITABLE DISTRIBUTION. ALIMONY AND COUNSEL FEES AND EXPENSES Prothonotary: Defendant hereby withdraws her claim for equitable distribution, alimony and counsel fees and expenses filed on July 1, 2008 in the above-captioned matter. DALEY ZUCKER MEILTON MINER & GINGRICH, LLC f Date: By: 4aa intina M. Laudermilch, Esquire Supreme Court I.D. #94664 1029 Scenery Drive Harrisburg, Pennsylvania 17109 (717) 657-4795 Attorneys for Defendant TH r ThRy OF E 2009 JUH 16 PH 1: 5 th McNEES WALLACE & NURICK LLC By: Debra Denison Cantor Attorney ID No. 66378 100 Pine Street Harrisburg, PA 17108-1166 (717) 232-8000 (717) 260-1667 facsimile dcantor mwn.com Attorneys for Plaintiff ADAM C. TOSH, Plaintiff V. LYNN M. TOSH, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 06-1906 Civil Term IN DIVORCE PRAECIPE TO WITHDRAW CLAIM FOR EQUITABLE DISTRIBUTION TO THE PROTHONOTARY: Plaintiff hereby withdraws his claim for equitable distribution as set forth in Count I of his Divorce Complaint. McNEES WALLACE & NURICK LLC By D antor Attorney ID No. 66378 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 237-5297 (phone) (717) 260-1667 (fax) Attorneys for Plaintiff Dated: June 16, 2009 CERTIFICATE OF SERVICE The undersigned hereby certifies that on the I (Q*_ day of June, 2009, a true and correct copy of the foregoing document was served by first-class mail, postage prepaid, upon the following: Quintina M. Laudermilch, Esquire Daley Zucker Meilton Miner & Gingrich LLC 1029 Scenery Drive Harrisburg, PA 17109 J Woodford, Paralegal RI_V v+ 1 E?,- OF THE r .;-?.. ? 10,'ARY 2009 JUN 17 PH IZ. 4 5 ADAM C. TOSH, Plaintiff vs. LYNN M. TOSH, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 06 - 1906 CIVIL IN DIVORCE ORDER OF COURT AND NOW, this O day of 2009, the economic claims raised in the proceed ngs having been resolved in accordance with a marital settlement agreement dated June 10, 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. BY THE COURT, cc: ? Debra A. Denison Cantor Attorney for Plaintiff ./ uuintina Laudermilch Attorney for Defendant calcu es / 2E LECL. 1.11 01,07 tzl" FILFL'-Ci°Fiv4 OF 'n' 2N 9 A 18 phi 1: 148 ?a t f. i , MARITAL SETTLEMENT AGREEMENT THIS AGREEMENT made this day of V , 2009, by and between Lynn M. Tosh, 2215 Spring Run Drive, Mechanicsburg, Cumberland County, Pennsylvania (hereinafter referred to as "Wife"), and Adam C. Tosh, 179 Regency Point Path, Lexington, KY, 40503 (hereinafter referred to as "Husband"), WITNESSETH: WHEREAS, the parties hereto are husband and wife, having been lawfully married on July 6, 1996 at Mechanicsburg, Pennsylvania, and are the parents of the following children: Name Date of Birth Annabelle L. Tosh Clara M. Tosh 5/21/00 12/09/02 WHEREAS, 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, the settling of all matters between them relating to the ownership of real and personal property, and in general, the settling of any and all claims and possible claims by one against the other or against their respective estates. AND NOW, THEREFORE, in consideration of these premises, and of the mutual promises, covenants, and undertakings hereinafter set forth, and for other good and valuable consideration, receipt and sufficiency of which is hereby acknowledged by jw , , each of the parties hereto, Husband and Wife, each intending to be legally bound hereby, covenant and agree as follows: 1. ADVICE OF COUNSEL. The provisions of this Agreement and their legal effect have been fully explained to the parties by their respective counsel, Quintina M. Laudermilch of Daley Zucker Meilton Miner & Gingrich, LLC for Wife, and Debra D. Cantor of McNees Wallace & Nurick, LLC for Husband. For purposes of contract interpretation and for the purpose of resolving ambiguity herein, Husband and Wife agree that this Agreement was prepared jointly by their respective attorneys. Each party acknowledges that he or she has received independent legal advice from counsel of his or her selection, and that each fully understands the facts and has been fully informed as to his or her legal rights and obligations, and each party acknowledges and accepts that this Agreement is, in the circumstances, fair and equitable, and that it is being entered into freely and voluntarily, after having received such advice and with such knowledge, and that execution of this Agreement is not the result of any duress or undue influence, and that it is not the result of any improper or illegal agreement or agreements. In addition, each party hereto acknowledges that he or she has been fully advised by his or her respective attorney of the impact of the Pennsylvania Divorce Code, whereby the court has the right and duty to determine all marital rights of the parties including divorce, alimony, alimony pendente lite, equitable distribution of all marital property or property owned or possessed individually by the other, counsel fees and costs of litigation and, fully knowing the same and being fully advised of his or her rights thereunder, each party hereto still desires to execute this Agreement, -2- I , 1 acknowledging that the terms and conditions set forth herein are fair, just and equitable to each of the parties, and waives his and her respective right to have the Court of Common Pleas of Cumberland County, or any other court of competent jurisdiction, make any determination or order affecting the respective parties' rights to a divorce, alimony, alimony pendente lite, equitable distribution of all marital property, counsel fees and costs of litigation. 2. DISCLOSURE OF ASSETS. Each of the parties hereto acknowledges that he or she is aware of his or her right to seek discovery, including but not limited to, written interrogatories, motions for production of documents, the taking of oral depositions, the filing of inventories, and all other means of discovery permitted under the Pennsylvania Divorce Code or the Pennsylvania Rules of Civil Procedure. Each of the parties further acknowledges that he or she has discussed with counsel the concept of marital property under Pennsylvania law and each is aware of his or her right to have the real and/or personal property, estate and assets, earnings and income of the other assessed or evaluated by the court of this Commonwealth or any other court of competent jurisdiction. Husband and Wife represent and warrant that each has disclosed to the other in full his or her respective assets, liabilities and income and that this Agreement was negotiated and entered into on the basis of those disclosures. The parties hereby acknowledge and agree that the division of assets as set forth in this Agreement is fair, reasonable and equitable and is satisfactory to them. The remedies available to either party for breach or violation of this provision shall be those remedies available pursuant to law and equity. Each party retains the right to assert a claim -3- against the other for failure to fully and fairly disclose his or her income, assets and liabilities, if it is later determined that there has been a failure to disclose, including but not limited to a claim of constructive trust. 3. PERSONAL RIGHTS. Husband and Wife may and shall, at all times hereafter, live separate and apart. Each shall be free from all control, restraint, interference and authority, direct or indirect, by the other in all respects as fully as if he or she were unmarried. Each may reside at such place or places as he or she may select. Each may, for his or her separate use or benefit, conduct, carry on or engage in any business, occupation, profession or employment which to him or her may seem advisable. This provision shall not be taken, however, to be an admission on the part of either Husband or Wife of the lawfulness of the cause that led to, or resulted in, the continuation of their living apart. Husband and Wife shall not molest, harass, disturb or malign each other or the respective families of each other, nor compel or attempt to compel the other to cohabit or dwell by any means or in any manner whatsoever with him or her. Neither party will interfere with the use, ownership, enjoyment or disposition of any property now owned by or hereafter acquired by the other. 4. MUTUAL CONSENT DIVORCE. Husband has filed an action for divorce in Cumberland County, Pennsylvania filed to No.06-1906. Said action shall be limited to divorce and neither party may assert any ancillary economic claims otherwise authorized by the Divorce Code, which are specifically waived by the terms of this Agreement. Counsel for each party shall execute a Praecipe withdrawing all such ancillary claims now pending of record at or prior to the execution of this Agreement. -4- The parties agree that each shall sign and have duly acknowledged an Affidavit of Consent to a divorce and a Waiver of Notice upon execution of this agreement. Said Affidavits and Waivers shall be promptly transmitted to counsel for Husband who will promptly file a Praecipe to Transmit Record and Vital Statistics form to precipitate the prompt entry of a decree of divorce. 5. EQUITABLE DISTRIBUTION 5.1 Marital Home. The parties acknowledge that they are the joint owners of that certain house and lot and all improvements thereupon situated at 2215 Spring Run Drive, Mechanicsburg, PA ("the Marital Home"). The parties agree that the Marital Home has an appraised value of $197,000. The Marital Home shall be transferred from the joint ownership of the parties to Wife by a Deed prepared by Wife and to be executed contemporaneously with this Agreement. Said Deed shall be held in escrow by Husband's attorney until such time as Wife refinances or otherwise assumes the mortgage pursuant to paragraph 5.2. 5.2. Mortgage on the Marital Home. National City Mortgage holds a mortgage on the Marital Home with a balance of $105,288 as of May 25, 2009. Wife agrees to be fully responsible and to indemnify and hold Husband harmless from any and all liability for the mortgage, insurance, taxes, utilities, maintenance and repairs on the Marital Home. Husband shall immediately execute, and within (10) days of the date of execution of this Agreement Wife will file, a request for assumption of the current mortgage to National City Mortgage. If National City does not approve the assumption, -5- Wife shall apply to refinance this mortgage within (90) ninety days of the date of execution of this Agreement and provide Husband with proof of the application. In the event Wife is unable to refinance, she will be granted an additional (90) ninety days in order to accomplish the refinance. Wife must demonstrate that she has applied and been rejected. Wife will continue to receive the additional (90) ninety days for refinance until one year from the date of execution of the Agreement. Wife must demonstrate that she has applied and been rejected in order to receive the extensions. In the event Wife fails to refinance or otherwise assume the mortgage within one year from the date of execution of this Agreement, the house shall be sold with a mutually agreeable realtor. If the parties cannot agree, their counsel shall select the realtor. The parties shall cooperate in the sale and after the payment of the mortgage and all reasonable costs and expenses associated with the sale including maintenance repairs. Wife shall retain all proceeds. In the event that any payments on the home are late or fail to be made, the house shall immediately be listed for sale. Wife must notify Husband immediately of a late or missed payment. Wife will bear responsibility for all costs of sale and shall receive the equity in its entirety. In the event Husband has to advance mortgage payments or costs and expenses associated with the home or incurs attorneys' fees and costs related to the home ( in order to compel the home's sale, seek court intervention for reimbursement by wife or the incurrence of late fees, penalties or additional interest or any other cost related to the home and enforcement of the agreement herein) -6- i. . ,reimbursement from Wife to Husband shall occur out of the proceeds of the home with Wife receiving the remaining balance. 5.3. Contents of Wife's Residence. Contents of Husband's Residence and Other Personal Property. 5.3.1. Husband shall and does hereby set over, transfer and assign to Wife all of his right, title, claim and interest in and to all of the contents of Wife's residence located at 2215 Spring Run Drive, Mechanicsburg, PA, including but not limited to all furniture, furnishings, rugs, carpets, household appliances and equipment, clothes, jewelry, personally and other items of tangible property of whatever nature currently located in Wife's residence as well as other jewelry and personal property in Wife's possession as of the date of this Agreement. 5.3.2. Wife shall and does hereby set over, transfer and assign to Husband all of her right, title, claim and interest in and to all of the contents of Husband's residence located at 179 Regency Point Path, Lexington, Kentucky, 40503, including but not necessarily limited to all furniture, furnishings, rugs, carpets, household appliances and equipment, clothes, jewelry, personalty and other items of tangible property of whatever nature currently located in Husband's residence, as well as other jewelry and personal property in Husband's possession as of the date of this Agreement. 5.3.3 The parties acknowledge that they have each retained family pictures and/or videos that were taken during the parties' marriage. Within 30 days of the execution of the agreement, the parties shall exchange a list of family -7- pictures/videos they have retained. Within 15 days of receipt of this list, each party shall identify the pictures/videos that they wish to have copied. Within 60 days thereafter, the parties shall copy the requested pictures and provide them to their respective counsel to be exchanged between counsel. The expense associated with obtaining the copies shall be paid by the party requesting the copies. 5.3.4 Concurrently with the execution of this agreement, each party shall execute the financial affidavits previously exchanged. 5.4. Financial Assets. 5.4.1. Joint DWS Scudder Investment Account # xxx0407 The parties agree that the Joint DWS Scudder Investment Account # xxx0407 had a value of $3,467 as of May 29, 2009. Wife does hereby set over, transfer and assign to Husband any and all of her right, title, claim and interest in and to all or any portion of the Joint DWS Scudder Investment Account # xxx0407 5.4.2. Joint Japan Funds. The parties agree that the Joint Japan Funds had a value of $4,219 as of May 29, 2009. Husband does hereby set over, transfer and assign to Wife any and all of his right, title, claim and interest in and to all or any portion of the Joint Japan Funds. 5.4.3. Joint PSECU Account # 1186xxx. The parties agree that at the time of separation they owned Joint PSECU Account# 1186xxx. Wife does hereby set over, transfer and assign to Husband any and all of her right, title, claim and interest in and to all or any portion of the Joint PSECU Account# 1186xxx. -8- 5.4.4 Husband's PSECU Account # 0186xxx. The parties agree that at the time of separation Husband had PSECU Account# 0186xxx. Wife does hereby set over, transfer and assign to Husband any and all of her right, title, claim and interest in and to all or any portion of Husband's PSECU Account# 0186xxx. 5.4.5. Wife's PSECU Account #0193xxx. The parties agree that at the time of separation Wife owned with her mother PSECU Account # 0193xxx. Husband does hereby set over, transfer and assign to Wife any and all of his right, title, claim and interest in and to all or any portion of Wife's PSECU Account# 0193xxx. 5.4.6. Citizens. The parties agree that at the time of separation Husband owned a Citizens Account #xxx264-7. Wife does hereby set over, transfer and assign to Husband any and all of her right, title, claim and interest in and to all or any portion of Husband's Citizens Account #xxx264-7. 5.5. Motor Vehicles. With respect to the motor vehicles owned by one or both of the parties, they agree as follows: 5.5.1. The 2003 Honda Odyssey shall hereafter be the sole and exclusive property of Wife, free of liens and encumbrances. Husband does hereby set over, transfer and assign to Wife any and all of his right, title, claim and interest in and to the 2003 Honda Odyssey. 5.5.2. The 1998 Toyota Camry shall hereafter be the sole and exclusive property of Husband, free of liens and encumbrances. Wife does hereby set over, transfer and assign to Husband any and all of her right, title, claim and interest in and to the 1998 Toyota Camry. -9- 5.6 Retirement Benefits. 5.6.1. Husband's SERS Pension. The parties agree that Husband's SERS pension has a value of $69,731 for purposes of equitable distribution. Wife does hereby set over, transfer and assign to Husband any and all of her right, title, claim and interest in and to all or any portion of Husband's SERS Pension. 5.6.2. Husband's Commonwealth of Pennsylvania Deferred Compensation. The parties agree that Husband's Commonwealth of Pennsylvania deferred compensation plan has a value of $18,981 for purposes of equitable distribution. Wife does hereby set over, transfer and assign to Husband any and all of her right, title, claim and interest in and to all or any portion of Husband's Commonwealth of Pennsylvania Deferred Compensation. 5.6.3. Wife's Ameriprise (Highmark) 401(k). The parties agree that Wife's Ameriprise (Highmark) 401(k) has a value of $23,395 for purposes of equitable distribution. Husband does hereby set over, transfer and assign to Wife any and all of his right, title, claim and interest in and to all or any portion of Wife's Ameriprise (Highmark) 401(k). 5.7. Educational Funds. 5.7.1. PSECU Account #8104xxx. The parties agree that the PSECU Account # 8104xxx is a non-marital asset to be used for Clara's educational purposes. Both parties hereby set over, transfer and assign any and all of their right, title, claim and interest in and to all or any portion of the PSECU Account # 8104xxx . Wife shall monitor and control this account. -10- 5.7.2. PSECU Account #0207xxx. The parties agree that the PSECU Account # 0207xxx is a non-marital asset to be used for Annabelle's educational purposes. Both parties hereby set over, transfer and assign any and all of their right, title, claim and interest in and to all or any portion of the PSECU Account # 0207xxx. Wife shall monitor and control this account. 5.7.3. 529 Plan. The parties agree that the 529 is a non-marital asset to be used for the children's educational purposes. Both parties hereby set over, transfer and assign any and all of their right, title, claim and interest in and to all or any portion of the 529 Educational Account. Husband shall monitor and control this account. 5.7.4. The parties agree that the accounts in paragraphs 5.7.1, 5.7.2, and 5.7.3 shall be used for the childrens' education only. The use of the funds shall be agreed upon by the parties and shall be used for the first applicable semester. Annually, either party may request an exchange of statements by providing copies of the statement(s) for the account(s) they control to the other party. Within ten (10) days of receipt, the other party shall provide the statement for the account in their control. Should a child predecease Husband and/or Wife or reach the age of 23 and the funds have not been used, the accounts shall be liquidated and the proceeds shall go to the person in control of the account. 5.8. Consideration Of Equitable Distribution In Future Hearings. The parties specifically acknowledge their intent that all transfers of property, including any increase in value of these assets, shall be excluded from income and shall not be given -11- any consideration whatsoever in any proceeding involving the payment of child support, spousal support, alimony pendente lite, maintenance or alimony. The parties acknowledge that the distributions under this paragraph are for equitable distribution of assets and that utilizing these assets or any increase in value of these assets in any manner in the calculation of income is prohibited. 5.9. 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 they real, personal or mixed, tangible or intangible, which are acquired by him or her after execution of this Agreement, with full power in him or her to dispose of the same as fully and effectively, in all respects and for all purposes, as though he or she were unmarried. 5.10. Propert y of Wife. The parties agree that Wife shall own, possess, and enjoy, free from any claim of Husband, the property awarded to her by the terms of this Agreement. Husband hereby quitclaims, assigns and conveys to Wife all such property, and waives and relinquishes any and all rights thereto, together with any insurance policies covering that property, and any escrow accounts relating to that property. This Agreement shall constitute a sufficient bill of sale to evidence the transfer of any and all rights in such property from Husband to Wife. 5.11. Propertv of Husband. The parties agree that Husband shall own, possess, and enjoy, free from any claim of Wife, the property awarded to him by the terms of this Agreement. Wife, hereby quitclaims, assigns and conveys to Husband all such property, and waives and relinquishes any and all rights thereto, together with any -12- insurance policies covering that property, and any escrow accounts relating to that property. This Agreement shall constitute a sufficient bill of sale to evidence the transfer of any and all rights in such property from Wife to Husband. 5.12. Assumption of Encumbrances. Unless otherwise provided herein, each party hereby assumes the debts, encumbrances, taxes and liens on all the property each will hold subsequent to the date of this Agreement, and each party agrees to indemnify and hold harmless the other party and his or her property from any claim or liability that the other party will suffer or may be required to pay because of such debts, encumbrances or liens. Each party in possession of property to be awarded to the other party warrants that all dues, fees, assessments, mortgages, taxes, insurance payments and the like attendant to such property are current, or if not current, notice of any arrearage or deficiency has been given to the receiving party prior to the execution of this Agreement. 5.13. Taxes. By this Agreement, the parties have intended to effectuate and equitably divide their marital property. The parties have determined that such division conforms to a right and just standard with regard to the rights of each party. Except as may be otherwise expressly provided herein, the division of existing marital property is not intended by the parties to constitute in any way a sale or exchange of assets, and the division is being effected without the introduction of outside funds or other property not constituting a part of the marital estate. As a part of the division of the marital property and the marital settlement herein contained, each party shall receive each item of property at the tax basis that existed for the item immediately -13- before the execution of this Agreement, and that this Agreement is not intended to affect the tax basis or tax status for the property received by the party. The parties agree to save and hold each other harmless from all income taxes assessed against the other resulting from the division of the property as herein provided. The parties acknowledge that they have filed various joint income tax returns during the course of their marriage. In filing each such return, each party has relied exclusively upon the other party to provide truthful and accurate information relating to the other party's employment income, business income or deductions, or income from any other source. In the event that any additional taxes, penalties or interest are assessed as a result of any such joint return, the party responsible for under-reporting income or claiming any improper deduction shall indemnify and save the other party harmless from such tax liability, penalties, interest, attorney's fees or accountant's fees. For calendar year 2009, unless otherwise agreed, each party shall report the year 2009 earnings on the assets distributed to them on their respective federal, state and local tax returns for 2009. For calendar year 2009, Husband shall be entitled to claim both children as deductions on his tax return. Thereafter, Husband shall be entitled to claim both children in any tax year where Wife has not held a full time job for more than half the calendar year. In the event Wife holds a full time job for greater than half the calendar year, each parent shall be entitled to claim one child as a deduction. Husband shall claim Clara, Wife shall claim Annabelle. -14- 5.14. Indemnification of Wife. If any claim, action or proceeding is hereafter initiated seeking to hold Wife liable for the debts or obligations assumed by Husband under this Agreement, Husband will, at his sole expense, defend Wife against any such claim, action or proceeding, whether or not well-founded, and indemnify her and her property against any damages or loss resulting therefrom, including, but not limited to, costs of court and attorney's fees incurred by Wife in connection therewith. 5.15. Indemnification of Husband. If any claim, action or proceeding is hereafter initiated seeking to hold Husband liable for the debts or obligations assumed by Wife under this Agreement, Wife will, at her sole expense, defend Husband against any such claim, action or proceeding, whether or not well-founded, and indemnify him and his property against any damages or loss resulting therefrom, including, but not limited to, costs of court and attorney's fees incurred by Husband in connection therewith. 5.16. Warranty as to Future Obligations. Except as set forth in this Agreement, Husband and Wife each represents and warrants to the other that he or she has not in the past or will not at any time in the future incur or contract any debt, charge or liability for which the other, the other's legal representatives, property or estate may be responsible. From the date of execution of this Agreement, each party shall use only those credit cards and accounts for which that party is individually liable and the parties agree to cooperate in closing any remaining accounts which provide for joint liability. Each party hereby agrees to indemnify, save and hold the other and his or her property -15- harmless from any liability, loss, cost or expense whatsoever incurred in the event of breach hereof. 5.17. Release of Claims. Wife and Husband acknowledge and agree that the property dispositions provided for herein constitute an equitable distribution of their assets and liabilities pursuant to Section 3502 of the Divorce Code. Wife and Husband hereby waive any right to division of their property except as provided for in this Agreement. Furthermore, except as otherwise provided for in this Agreement, each of the parties hereby specifically waives, releases, renounces and forever abandons any claim, right, title or interest whatsoever he or she may have in property transferred to the other party pursuant to this Agreement or identified in this Agreement as belonging to the other party, and each party agrees never to assert any claim to said property or proceeds in the future. The parties hereby expressly release and relinquish, each to the other, every claim, demand, right and interest he or she may have in or against the other, or against his or her estate, together with any income or earnings thereon, arising from and during the marriage and of or from any other reason growing out of the marital relationship. However, neither party is released or discharged from any obligation under this Agreement or any instrument or document executed pursuant to this Agreement. Husband and Wife shall hereafter own and enjoy independently of any claim or right of the other, all items of personal property, tangible or intangible, acquired by him or her from the date of execution of this Agreement with full power in him or her to dispose of the same as fully and effectively, in all respects and for all purposes, as though he or she were unmarried. -16- 6. LIFE INSURANCE. The parties agree that Husband and Wife shall maintain a life insurance policy on themselves with a beneficiary amount of $250,000. Husband and Wife agree to designate Annabelle and Clara, via trust, trustee or guardian, as equal beneficiaries of $250,000 of life insurance until Annabelle reaches 21 years of age. Thereafter, Husband and Wife shall maintain a beneficiary designation for the children of $125,000. When Clara reaches 21 years of age, Husband and Wife may designate any beneficiary he/she so desires. Husband shall also maintain Wife as a beneficiary on a $27,000 life insurance policy in order to protect Wife's alimony award. Such designation shall be declining in amount, based on the amount remaining on the alimony award. For example, after 12 months, the beneficiary designation shall be for $12,000. In the event Husband dies and has failed to reduce the beneficiary designation, Wife's entitlement is limited to the gross amount remaining on her alimony award and shall return any additional funds to Husband's estate within ten (10) days of receipt of payment. On an annual basis, either party may request proof of the beneficiary designation by providing proof of their designation to the other party. The responding party must provide proof of beneficiary designation within ten (10) days of receipt of the documentation. 7. DEPENDENCY EXEMPTIONS FOR TAX PURPOSES. Wife agrees to execute the Internal Revenue Service's form, "Release of Claim to Exemption for Child of Divorce or Separated Parents," each year so that Husband can claim Annabelle -17- t and/or Clara as dependents for tax purposes. Wife shall execute this document no later than January 31 of each year and provide same to Husband. 8. SPOUSAL SUPPORT/ALIMONY. 8.1. Commencing upon the fifth day of the month following the date of execution, Husband shall pay Wife alimony in the sum of $1,250 per month for a period of 12 months. From 13 months from the execution of this agreement to 24 months from the execution of this agreement, Husband shall pay Wife alimony in the sum of $1,000 per month. Husband's obligation to make such payments shall terminate upon the first to occur of the following events: (a) Wife's death; (b) Wife's remarriage; (c) Husband's death, or (d) 24 months from the execution of this Agreement. Once alimony terminates, it may not be reinstated for any reason. 8.2. The parties hereby confirm that they have negotiated their overall agreement based upon non-modifiability of the alimony payments set forth herein, and that it is their specific agreement and understanding that the said payments shall not be subject to modification by any court as to either duration or amount, for any reason, except as specifically set forth in this Agreement. 8.3. It is the intention of the parties that all payments made to Wife by Husband pursuant to the provisions of Paragraph 8.1 hereof while the parties are living apart are intended to be alimony payments, taxable as income to Wife and deductible from income by Husband for income tax purposes, and that no other payments made under this Agreement are to be deemed or treated as alimony. In the event of any action taken by Wife which affects Husband's rights to deduct any portion or all of the -18- alimony payments from Husband's income, Wife will be liable to Husband for the full amount of the increase in Husband's tax liability resulting from the loss of the deduction. In such event, Husband shall have the option either (1) to obtain full payment of the amount of Husband's increased taxes from Wife or (2) to offset the amount thereof against future payments due from Husband to Wife, and shall have the further option (3) to terminate all alimony payments required under this Agreement. All alimony payments shall terminate as set forth in Paragraph 8.1. 8.4 Spousal support /APL shall terminate upon the execution of this Agreement. The parties hereby agree that this alimony provision will be entered as an alimony order with the Domestic Relations Office and payments shall be made through the Cumberland County Domestic Relations Office. Wife shall prepare all necessary documentation for the entry of an alimony order. Pending entry of the order, Husband shall make these payments directly. The alimony payments shall be made on a bi- weekly basis or concurrently with Husband's pay schedule. 9. RELEASES. The parties acknowledge that by this Agreement they have each respectively secured sufficient financial resources to provide for his or her own comfort, maintenance and support. The parties do hereby acknowledge that inflation may increase or decrease, that their respective incomes and assets may substantially increase in value, that either may be employed or unemployed at various times in the future, and that notwithstanding these or other economic circumstances, which may be changes in circumstances of a substantial and continuing nature, the terms of this Agreement are just and reasonable. Therefore, except for the provisions of this -19- I ? Agreement, the parties hereby expressly waive, discharge and release any and all rights and claims which they may now or hereafter have, by reason of the parties' marriage, to alimony, alimony pendente lite, support or maintenance, and they further release any rights they may have to seek modification of the terms of this Agreement in a court of law or equity, it being understood that the foregoing constitutes a final determination for all time of either party's obligation to contribute to the support and maintenance of the other. Except as provided for in this Agreement, it shall be, from the execution date of this Agreement, the sole responsibility of each of the respective parties to sustain himself or herself without seeking any additional support from the other party. In the event that either of the parties shall seek a modification of the terms of this paragraph, or in the event that Wife makes any claim for spousal support or alimony other than as provided for by the terms of this Agreement, that party shall indemnify and hold the other party harmless from and against any loss resulting therefrom, including counsel fees and costs. 10. COUNSEL FEES. COSTS AND EXPENSES. Each party shall be responsible for his or her own legal fees, costs and expenses incurred in connection with their separation and/or the dissolution of their marriage. 11. WAIVER OF INHERITANCE RIGHTS. Effective upon the signing of this Agreement, Husband and Wife each waives all rights of inheritance in the estate of the other, any right to elect to take against the Will or any trust of the other or in which the other has an interest, and each of the parties waives any additional rights which said party has or may have by reason of their marriage, except the rights saved or created -20- I ,,,' by the terms of this Agreement. This waiver shall be construed generally and shall include, but not be limited, to a waiver of all rights provided under the laws of Pennsylvania, or any other jurisdiction, and shall include all rights under the Pennsylvania Divorce Code. 12. MODIFICATION. No modification, rescission, or amendment to this Agreement shall be effective unless in writing signed by each of the parties hereto. 13. SEVERABILITY. If any provision of this Agreement is held by a court of competent jurisdiction to be void, invalid or unenforceable, the remaining provisions hereof shall nevertheless survive and continue in full force and effect without being impaired or invalidated in any way. 14. BREACH. If either party hereto is in breach of any provision hereof, 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. The non-breaching party shall be entitled to recover from the breaching party all reasonable costs, expenses and legal fees actually incurred in the enforcement of the rights of the non-breaching party. 15. WAIVER OF BREACH. The waiver by one party of any breach of this Agreement by the other party will not be deemed a waiver of any other provision of this Agreement. 16. NOTICE. Any notice to be given under this Agreement by either party to the other shall be in writing and may be affected by registered or certified mail, return receipt requested. Notice to Wife will be sufficient if made or addressed to the following: -21- S ?. . ", Lynn M. Tosh 2215 Spring Run Drive Mechanicsburg, PA 17055 and to Husband, if made or addressed to the following: Adam C. Tosh 179 Regency Point Path Lexington, KY 40503 Each party may change the address for notice to him or her by giving notice of that change in accordance with the provisions of this paragraph. 17. APPLICABLE LAW. All acts contemplated by this Agreement shall be construed and enforced under the laws of the Commonwealth of Pennsylvania. 18. DATE OF EXECUTION. The "date of execution" or "execution date" of this Agreement shall be defined as the date upon which the parties signed the Agreement if they do so on the same date, or if not on the same date, then the date on which the Agreement was signed by the last party to execute this Agreement. This Agreement shall become effective and binding upon both parties on the execution date. 19. EFFECT OF RECONCILIATION OR RECONCILIATION ATTEMPT. This Agreement shall remain in full force and effect even if the parties effect a reconciliation, cohabit as Husband and Wife or attempt to effect a reconciliation. This Agreement shall continue in full force and effect and there shall be no modification or waiver of any of the terms hereof unless the parties in writing execute a statement declaring this Agreement or a term of this Agreement to be null and void. 20. HEADINGS NOT PART OF AGREEMENT. Any headings preceding the text of the several paragraphs and subparagraphs hereof are inserted solely of -22- I a convenience of reference and shall not constitute a part of this Agreement nor shall they effect its meaning, construction or affect. 21. AGREEMENT BINDING ON PARTIES AND HEIRS. This Agreement, except as otherwise expressly provided herein, shall bind the parties hereto and their respective heirs, executors, administrators, legal representatives, assigns, and successors in any interest of the parties. 22. ENTIRE AGREEMENT. Each party acknowledges that he or she has carefully read this Agreement, including other documents to which it refers; that he or she has discussed its provisions with an attorney of his or her own choice, and has executed it voluntarily and in reliance upon his or her own attorney; and that this instrument expresses the entire agreement between the parties concerning the subjects it purports to cover and supersedes any and all prior agreements between the parties. This Agreement should be interpreted fairly and simply, and not strictly for or against either of the parties. 23. MUTUAL COOPERATION. Each party shall on demand execute and deliver to the other any deeds, bills of sale, assignments, consents to change of beneficiaries of insurance policies, tax returns, and other documents, and shall do or cause to be done every other act or thing that may be necessary or desirable to effectuate the provisions and purposes of this Agreement. If either party unreasonably fails on demand to comply with these provisions, that party shall pay to the other party all attorneys' fees, costs, and other expenses reasonably incurred as a result of such failure. -23- 24. AGREEMENT NOT TO BE MERGED. This Agreement shall remain in full force and effect in the event of the parties' divorce. This Agreement shall not be merged into said decree. The parties shall have the right to enforce this Agreement under the Divorce Code of 1980, as amended, and in addition, shall retain any remedies in law or in equity under this Agreement as an independent contract. Such remedies in law or equity are not waived or released by this Agreement. IN WITNESS WHEREOF, the parties hereto set their hands and seals on the dates of their acknowledgments. ITNESS Lynn osh, Wife WITNESS Adam C. Tosh, Husband -24- % 1. l• COMMONWEALTH OF PENNSYLVANIA COUNTY OF Q. BEFORE ME, the undersigned authority, on this day personally appeared LYNN M. TOSH, known to me to be the person who executed the foregoing instrument, and who acknowledged to me that she executed same for the purposes and considerations therein expressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE this J-.h day o'4 ? 2009. N a Public COMMONWEALTH OF PENNSYLVANI NOTARIAL SEAL Janet M. Fisher-Notary Public Lower Paxton Twp., Dauphin County MY COMMISSION EXPIRES OCT. 19, 2012 -25- COMMONWEALTH OF KENTUCKY COUNTY OF FRANKLIN BEFORE ME, the undersigned authority, on this day personally appeared ADAM C. TOSH, known to me to be the person who executed the foregoing instrument, and who acknowledged to me that he executed same for the purposes and considerations therein expressed. GIVEN UNDER MY HAND AND SEAL OF OFFICE this ?n day of Off , 2009. Iv Notary Publi -26- McNEES WALLACE & NURICK LLC By: Debra Denison Cantor Attorney ID No. 66378 100 Pine Street Harrisburg, PA 17108-1166 (717) 232-8000 (717) 260-1667 facsimile dcantor a-mwn.com Attorneys for Plaintiff ADAM C. TOSH, Plaintiff V. LYNN M. TOSH, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 06-1906 Civil Term IN DIVORCE PROOF OF SERVICE I hereby certify that a true and correct copy of the Complaint in Divorce in the above matter was served on the Defendant, Lynn M. Tosh, by certified mail, return receipt requested on April 6, 2006. See Exhibit "A" attached. The Complaint in Divorce was received and signed for by the Defendant on April 8, 2006. The original of the return receipt is attached hereto as Exhibit "B". McNEES WALLACE & NURICK LLC By e- J Debr" iso cantor Attorney No. 66378 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 237-5297 (phone) (717) 260-1667 (fax) Attorneys for Plaintiff Dated: June 22, 2009 t ? io CERTIFIED . RECEIPT t (Domestic ? . Provided) Ir For delivery information visit f? our website at www.usps.com CO Postage $ 3 E3 Certified Fee 'C i? ?1 11l0 PSetum Reclapt Fee Postmark (Endorsement Required) Here C3 Restricted Delivery Fee u1 (Endorsement Required) M Total Postage & Fees $ r C3 Sent To ,,?,/? O •URW& AWF -&P -- • - -- .C`Cn--------------------- ----------- orPO Box No. `f -10/- aty ware, ztr? r S? PS Form 3800. June 2002 Sookevere for Instrtictio,s I 1 . '1 r ¦ 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 mailpiece, or on the front If space permits. 1. Article Addressed to: Ms. Lyrui M. Tosh 2215 Spring P.I.m Drive At-chanicsburg, PA 17055 2. Article Number"- (Transfer hum sere PS Form 3811, February A. Signature 1 X ? Agent ? Addressee B. Rec+ed by (Ante4i"i) C. D of?gelivery f 1, V) D. Is deliv6ry address different If YES, enter delivery address 9h Lti?+U /A 3. Service Type 7U ?Iff Certified Mall 0 Express Mail ? Registered Meturn Receipt for Merchandise 46 J6 4. Restricted Delivery? Exba Fee) Yes Receipt 102595.02-M-154( e RLEIu ",`? -RY 2009 JU(NI 23 PH 2: ; 6 vi..ifs._ +;??EY ADAM C. TOSH, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. No. 06-1906 Civil Term LYNN M. TOSH, Civil Action - Law Defendant (In Divorce) AFFIDAVIT OF CONSENT A Complaint in Divorce under § 3301(c) of the Divorce Code was filed on March 31, 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. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER & 3301(c) OF THE DIVORCE CODE I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities. Date: qnw, Tosh L y1W OF THE "'I'v, Z6 G9 J?J 123 P , 2= 16 { f`. • ? rti .„ ADAM C. TOSH, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 06-1906 Civil Term LYNN M. TOSH, IN DIVORCE Defendant AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on March 31, 2006. 2. The marriage of the plaintiff and defendant is irretrievably broken. Ninety days have elapsed since the date of service of the Complaint. 3. 1 consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. Adam C. Tosh G1i?1-0'0 Date: In2 l0, 2,60°1 Svior n k0 bef wt me, a N fa.ry Pleb 1 iC , by Adore, C. ToSh -ibis (o-tk day OP Jane, 7XI. ?a 1vl •'I'M??? " Twtr 2009 ,? ' 23 PFI 2* 16 ADAM C. TOSH, IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 06-1906 Civil Term LYNN M. TOSH, IN DIVORCE Defendant WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER Section 3301(c) OF THE DIVORCE CODE 1. I consent to the entry of a final decree in divorce without notice. 2. 1 understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. 1 understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unswom falsification to authorities. 4mC. C. Tosh zj ? Date: lure. ID, zcoo? Sworn 4o before, nee. , a 000 rY ?? bloc , by AMM 01- Tvsh -phis 10"' CaY ,Of -Tone 12W9 OF THE FTO" 2099 JUN 23 P 2: 16 t w McNEES WALLACE & NURICK LLC By: Debra Denison Cantor Attorney ID No. 66378 100 Pine Street Harrisburg, PA 17108-1166 (717) 232-8000 (717) 260-1667 facsimile dcantorO-mwn.com Attorneys for Plaintiff ADAM C. TOSH, Plaintiff V. LYNN M. TOSH, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 06-1906 Civil Term IN DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the court for entry of a divorce decree: 1. Grounds for divorce: irretrievable breakdown under §3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: Certified mail, restricted delivery, return receipt upon Defendant on April 6, 2006. Defendant signed for the certified mail on April 8, 2006. A Proof of Service is being filed contemporaneously with this Praecipe. 3. Date of execution of the Affidavit of Consent required by § 3301(c) of the Divorce Code: by Plaintiff: June 10, 2009; by Defendant: June 5, 2009. 4. Related claims pending: None w 5. Plaintiffs Waiver of Notice is being filed with the Court contemporaneously with this Praecipe. Defendant's Waiver of Notice is being filed with the Court contemporaneously with this Praecipe. Respectfully submitted, McNEES WALLACE & NURICK LLC By antor D3" 1. N . 6378 100 Pine Street P.O. Box 1166 Harrisburg, PA 17108-1166 (717) 237-5297 (717) 260-1667 (fax) dcantor )-mwn.com Attorneys for Plaintiff, Adam C. Tosh Dated: June 22, 2009 CERTIFICATE OF SERVICE The undersigned hereby certifies that on the aV? day of June, 2009, a true and correct copy of the foregoing document was served by first-class mail, postage prepaid, upon the following: Quintina M. Laudermilch, Esquire Daley Zucker Menton Miner & Gingrich LLC 1029 Scenery Drive Harrisburg, PA 17109 Vx _Oyal &fer Kee oodford, Paralegal " t??a Ft1..`?? ?`,,- ?r?^??J? . „?',? 23 ?, ?' ? ? 2D?? ,.., ,?,????r ?? r'UP?`1 ., 1 C .??E ?`i r ?,?1'i`?? Adam C. Tosh V. Lvnn M. Tosh IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 06-1906 DIVORCE DECREE it is ordered and decreed that AND NOW, -Drop Adam C. Tosh plaintiff, and Lynn M. Tosh , 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.") None the Court, 11 Attest: J. 4oronotary v'? 7s ?- ' 41r` C'et? - G'?y iur.??.?? ?' ?. ? nn+' ''`..+ r ,? ?? z ??` Y ?uw::/„ ???? ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Z3???g ??\ Co./City/Dist. of CUMBERLAND v? S 2COI Date of Order/Notice 07/01/09 Case Number (See Addendum for case summary) RE: TOSH, ADAM C. Employer/Withholder's Federal EIN Number KENTUCKY RETIREMENT SYSTEMS 1260 LOUISVILLE RD PERIMETER PARK W FRANKFORT KY 40601-6157 0(D- Iq Ot0 C+v ? 1 Z'MIaQ?0 0Original Order/Notice OAmended Order/Notice OTerminate Order/Notice OOne-Time Lump Sum/Notice Employee/Obligor's Name (Last, First, MI) 186-64-4057 Employee/Obligor's Social Security Number 4015101785 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. $ 1,679.00 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. oo per month in past-due medical support $ 1,250.00 per month in current spousal support $ o . oo per month in past-due spousal support $ o.00 per month for genetic test costs $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ 2,929.00 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: $ b-1512 per weekly pay period. $ 1, 464.50 per semimonthly pay period (twice a month) $ 1351.84 per biweekly pay period (every two weeks) $ 2, 929.00 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 MALL. _ . BY THE COURT: ?_k Ve ?) II `-' Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS El If hecke? you are required to provide a opy of this form to your m loyee. If yo r employee works in a state that is di ferent from the state that issued this order, a copy must be provisedpto 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 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. 8619100232 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ED THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME:TOSH, ADAM C. EMPLOYEE'S CASE IDENTIFIER: 4015101785 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) 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 If you or your employee/obligor have any questions, contact WAGE ATTACHMENT UNIT 13 N. HANOVER ST P.O. BOX 320 CARLISLE PA 17013 by telephone at (717) 240-6225 or by FAX at (717) 240-6248 or by internet www.childsupport.state.pa.us Page 2 of 2 Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: TOSH, ADAM C. PACKS Case Number 236108931 PACSES Case Number 288110950 Plaintiff Name Plaintiff Name LYNN M. TOSH LYNN M. TOSH Docket Attachment Amount Docket Attachment Amount 00084 S 2007 $ 1,679.00 06-1906 CIVIL$ 1,250.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): ANNABELLE L. TOSH 05/21/00 CLARA M.'TOSH 12/09/02 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 PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker I D $ IATT g: THE Pr,_ 'AIRY 20H JUL -6 Phi 3: } ?4 CJ" ?? f IY%:,i ter{ ?? ANGINO & ROVNER, P.C. Lisa M.B. Woodburn, Esquire Attorney ID# : 89397 4503 North Front Street Harrisburg, PA 17110-1708 (717) 238-6791 FAX (717) 238-5610 Attorneys for Plaintiff(s) LIZBANIA HYPES, Plaintiff THE COURT OF COMMON PLEAS MBERLAND COUNTY, PENNSYLVANIA V. KEYSTONE LODGING ENTERPRI D/B/A SLEEP INN, 3304 Market Street Camp Hill, PA 17011 Defendant ACTION - LAW 0.06-3710 - Civil Term Y TRIAL DEMANDED PLAINTIFF'S PRELIMINARY OBJECTIONS TO DEFENDANT'S ANSWERS TO REQUESTS FOR ADMISSION PURSUANT TO PA. R.C.P. 4014 1. On May 1, 2009 Plaintiff filed Plaintiff's Requests for Admission and Interrogatories to Defendant, pursuant to Pa.R.C.P. 4014. See, filed Requests for Admission attached hereto as Exhibit A. 2. Defendant filed answers to Plaintiff's Requests for Admission on May 28, 2009 denying all averments, and indicating that, "deposition testimony speaks for itself," as the basis of denial. See, Defendant's Answers to Plaintiff's Requests for Admission and Interrogatories attached hereto as Exhibit B. 3. Pursuant to Rule 4014(c) Plaintiff is requesting this Honorable Court determine the sufficiency of Defendant's answers. 413627 4. Plaintiff respectfully submits on its face, a Denial based upon an entire deposition testimony speaking for itself is not sufficient. 5. Plaintiff believes if the depositions of witnesses are read, the requested admissions should be admitted. 6. If Defendant does not agree that these facts were testified to and set forth in the deposition testimony, they can be denied and the reasons stated. 7. None of the requested admissions are a genuine issue to be determined by the trier of fact. 8. The purpose of this discovery tool is to clarify and simply issues raised in prior pleadings in order to expedite the litigation process. See, Brindley v. Woodland Village Restaurant, Inc. 438 Pa. Super 385, 396-397, 652 A.2d 865, 871 (1995). 9. The purpose of Requests for Admission is to limit facts to be determined by a jury and/or witnesses to be called at the time of trial. 10. The Requests for Admission attempt to do this. Wherefore, Plaintiff respectfully requests Defendant be Ordered to answer the Requests for Admission pursuant to Pa. R.C.P. 4014. Respectfully submitted, ANGINO & ROVNER, P.C. Lisa M. B. Woodburn, Esquire I.D. No. 89397 4503 N. Front Street Harrisburg, PA 17110 (717) 238-6791 Counsel for Plaintiff(s) Date: /g 413627 CERTIFICATE OF SERVICE I, Amyra W. Wagner, an employee of the law firm of Angino & Rovner, P.C., do hereby certify that I am this day of ?l? ( 2009 serving a true and correct copy of the foregoing upon Defendant via certified mail as follows: Jefferson J. Shipman, Esquire Johnson, Duffie, Stewart & Weidner 301 Market Street P.O. Box 109 Lemoyne, PA 17043 413627 F1 LEJ ._,w, _ .•t, r OF THE Pi 2009 JUL - 6 P11 2: ? a ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT State Commonwealth of Pennsylvania Co./City/Dirt. of CUMBERLAND Date of Order/Notice 07/01/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number KENTUCKY RETIREMENT SYSTEMS 1260 LOUISVILLE RD PERIMETER PARK W FRANKFORT KY 40601-6157 186-64-4057 Employee/Obligor's Social Security Number 4015101785 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, 679.00 per month in current child support $ o . oo per month in past-due child support Arrears 12 weeks or greater? Qyes ®no $ o . oo per month in current medical support $ o. oo per month in past-due medical support n d $ i, 000 . oo per month in current spousal support C ~, $ o.oo per month in past-due spousal support -.~`--i_- ~ --~ $ o . o o per month for genetic test costs `-''"' rte-- ~ rT'--. $ o . oo per month in other (specify) ~`.~ ~~-. i = ~ r $ one-time lump sum payment ,,-'~ a' `Y;~;-~, `° - _a for a total of $ 2, 679. oo per month to be forwarded to payee below. ~ ~ --~ ~.__ ~~ You do not have to vary your pay cycle to be incompliance with the support order. If your pay cycle c#~es n~,mat~t the ordered support payment cycle, use the following to determine how much to withhold: -~" '~ $ 618.23: Per weekly pay period. $ i, 339. so per semimonthly pay period (twice a month) $ 1236.46 per biweekly pay period (every two weeks) $ 2 , 679 • 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 OR ER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. ~ ~ ~ , BY THE COURT: M. L. Ebert, Jr. , Judge DRO: R.J. Shadday Service Type M OMB No.: 0970-0154 06-1906 CIVIL OOriginal Order/Notice 236108931 OAmended Order/Notice 84 S 2007 OTerminate OrderlNotice OOne-Time Lump Sum/Notice RE: TOSH, ADAM C. Employee/Obligor's Name (Last, First, MI) Form E N-028 Rev.S Worker I D $ IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS ~ If ~heckefi you are required. to provide a~opy of this form to your~mployee. If yoYr employee works in a state that is di Brent frrom the state that issued this or er, a copy must be provi ell 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%bligor. 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 respell 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%bligoranll 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. s6191o0232 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : O THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: D EMPLOYEE'S/OBLIGOR'S NAME:TOSH, ADAM C. EMPLOYEE'S CASE IDENTIFIER: 4015101785 DATE OF SEPARAT 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%bligorbBcause 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 respell 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 interne[ www.childsupport.state.pa.us Page 2 of 2 Service Type M OMB No.: 09740154 Form EN-028 Rev.S Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: TOSH, ADAM C. PACSES Case Number 236108931 Plaintiff Name LYNN M. TOSH Docket Attachment Amount 00084 S 2007 $ 1,679.00 Child(ren)'s Name(s): DOB ANNASELLE L. TOSH 05/21/00 CLAi~: M: TOSH ' 12/t19J02 PACSES Case Number 288110950 Plaintiff Name LYNN M. TOSH Docket Attachment Amount 06-1906 CIVIL$ 1,000.00 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 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 Addendum Form EN-028 Rev.S Service Type M OMB No.:0970.0154 Worker ID $IATT ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 06-1906 CIVIL State Commonwealth of Pennsylvania Co./City/Dist. of CUMBERLAND Date of Order/Notice 07/21/10 Case Number (See Addendum for case summary) Employer/Withholder's Federal EIN Number ROGERSCASEY 1 PARKLANDS DR DARIEN CT 06820-3627 Employee/Obligor's Name (Last, First, Mp 186-64-4057 Employee/Obligor's Social Security Number 4015101785 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, 679. oo per month in current child support $ o . oo per month in past-due child support Arrears 12 weeks or greateri' Oyes ~ no $ o . oo per month in current medical support ~ ~ ;~; $ o . oo per month in past-due medical support r;a ~:~' c.-. _ .-t $ i, 000 . oo per month in current spousal support --= _ "~~;-'~' $ o . oo per month in past-due spousal support ~ ~ ' r-' $ o . oo per month for genetic test costs f=... ~' r~.~ : . $ o. oo per month in other (specify) - ~? $ one-time lump sum payment r-_ _ ~~~ ~ , ;~,a for a total of $ 2, 679.00 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: $ 618.23 per weekly pay period. $ i, 339. so per semimonthly pay period (twice a month) $ 1236.46 per biweekly pay period (every two weeks) $ 2, 679. 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 iaayment 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 NAMEAND THE PACSES MEMBER ID (shown above as the Employee/Obligor's Case Identifier) OR SOClA! SECURITY NUMBER 1N ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. BY THE COURT: DRO: R.J. Shadday Service Type M 236108931 OOriginal OrderMotice 84 S 2007 OAmended Order/Notice OTerminate OrderMotice QOne-Time Lump Sum/Notice RE: TOSH , ADAM C . M. L. ~b6r~; Jr~; OMB No.: 0970-0154 Form EN-028 Rev.5 Worker I D $ IATT 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~ierent from the state that issued this order, a copy must be provideec~to your empYoyee 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 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%bligor. 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/obtigor'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%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 OrdersMotices 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. 0303930280 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : ~ THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: ~ EMPLOYEE'S/OBLIGOR'S NAME:TOSH, ADAM C. EMPLOYEE'S CASE IDENTIFIER: 4015101785 LAST KNOWN HOME ADDRESS: DATE OF SEPARATION: LAST KNOWN PHONE NUMBER: FINAL PAYMENT AMOUNT• NEW EMPLOYER'S NAMElADDRESS: 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%bligorhecause 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 Page 2 of 2 Form EN-028 Rev.S Service Type M OMB No.:0970-0754 Worker ID $IA~ ADDENDUM Summary of Cases on Attachment Defendant/Obligor: TOSH, ADAM c. PACSES Case Number 236108931 Plaintiff Name LYNN M. TOSH Docket Attachment Amount 00064 S 2007 $ 1,679.00 Child(ren)'s Name(s): DOB ANNABELLE L. TOSH 1/00 05/2 CLAi~A M, TOSH . 12/09J'0 PACSES Case Number 288110950 Plaintiff Name LYNN M. TOSH Docket Attachment Amount 06-1906 CIVIL$ 1,000.00 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 PACSES Case Number Plaintiff Name Docket Attachment Amount $ o.oo Child(ren)'s Name(s): DOB Addendum Form EN-028 Rev.5 Service Type M OMB No.: 0970-0754 Worker I D $ IATT ORDER/NOTICE TO WITHHOLD INCOME FOR SUPPORT 06-1906 CIVIL OOriginal Order/Notice State Commonwealth of Pennsylvania 236108931 Co./City/Dirt. of CUMBERLAND OAmended Order/Notice 84 S 2007 Date of Order/Notice 08/19/10 0 Terminate Order/Notice Case Number (See Addendum for case summary) QOne-Time Lump Sum/Notice RE: TOSH, ADAM C. Employer/Withholder's Federal EIN Number Employee/Obligor's Name (Last, First, MI) 186-64-4057 Employee/Obligor's Social Security Number KENTUCKY RETIREMENT SYSTEMS 4015101785 1260 LOUISVILLE RD Employee/Obligor's Case Identifier PERIMETER PARK W (See Addendum for plaintiff names FRANKFORT KY 40601-6157 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 $ o . oo per month in current medical support $ 0.0o per month in past-due medical support $ o. oo per month in current spousal support a $ o . oo per month in past-due spousal support - $ 0.00 per month for genetic test costs L' $ o . oo per month in other (specify) $ one-time lump sum payment for a total of $ 0. o0 per month to be forwarded to payee below. You do not have to vary your pay cycle to be in compliance with the support order. If your pay cycle does not match the ordered support payment cycle, use the following to determine how much to withhold: $ 0.00 per weekly pay period. $ o. 00 per semimonthly pay period (twice a month) N $ 0.00 per biweekly pay period (every two weeks) $ 0.00 per monthly pay period. REMITTANCE INFORMATION: You must begin withholding no later than the first pay period occurring ten (j 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: M. L. Ebert, Jr., Judges DRO: R.J. Shadday Form EN-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker ID $IATT ADDITIONAL INFORMATION TO EMPLOYERS AND OTHER WITHHOLDERS If hecked you are required to provide a copy of this form to your mployee. If yo r employee works in a state that is diherent from the state that issued this order, a copy must be provi ?ed to your emp?oyee 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. 8619100232 THE PERSON HAS NEVER WORKED FOR THIS EMPLOYER : O THE EMPLOYEE/OBLIGOR NO LONGER WORKS FOR: 0 EMPLOYEE'S/OBLIGOR'S NAME: TOSH, ADAM C. EMPLOYEE'S CASE IDENTIFIER: 4015101785 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) (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 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: 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-028 Rev.5 Service Type M OMB No.: 0970-0154 Worker I D $ IATT r77 ADDENDUM Summary of Cases on Attachment Defendant/Obligor: TOSH, ADAM C. PACSES Case Number 236108931 PACKS Case Number 288110950 Plaintiff Name Plaintiff Name LYNN M. TOSH LYNN M. TOSH Docket Attachment Amount Docket Attachment Amount 00084 S 2007 $ 0.00 06-1906 CIVIL$ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB ANNABELLE L. TOSH 05/21/00 CLARA M. TOSH 12/09/02 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): DOB 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): DOB Addendum Form EN-028 Rev.5 Service Type M OMB No, 0970-0154 Worker ID $IATT