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Home My WebLink About06-6932t ? IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW RODNEY L. KLINGER, Plaintiff V. CATHY C. KLINGER, Defendant :No. o? - Q3 -Z IN DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the Court. A judgment may also be entered against you for any other claim or relief requested in these papers by the Plaintiff. You may lose money or property or other rights important to you, including custody or visitation of your children. When the ground for divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary, Cumberland County Courthouse, One Courthouse Square, 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, PA 17013 (717) 249-3166 1-8oo-99o-91o8 AVISO PARA DEFENDER Y RECLAMAR DERECHOS LISTED HA SIDO DEMANDADO EN LA CORTE. Si desea defenderse de las quejas expuestas en las paginas siguientes, debe tomar action con prontitud. Se le avisa que si no se defiende, el caso puede proceder sin usted y decreto de divorcio 0 anulamiento puede ser emitido en su contra por la Corte. Una decision tambi6n ser emitida en su contra por cualquier otra queja o compensacion reclamados por el demandante. Usted puede perder dinero, o propiedades u otros derechos importantes para usted. Cuando la base para el divorcio es indignidades o rompimiento irreparable del matrimonio, usted puede solicitar consejo matrimonial. Una lista de consejeros matrimoniales esta disponible en la oficina del Prothonotary, en la Cumberland County Court of Common Pleas, One Courthouse Square, Carlisle, Pennsylvania. SI USTED NO RECLAMA PENSION ALIMENTICIA, PROPIEDAD MARITAL, HONORARIOS DE ABOGADO U OTROS GASTOS ANTES DE QUE EL DECRETO FINAL DE DIVORCIO O ANULAMIENTE SEA EMITIDO, USTED PUEDE PERDER EL DERECHO A RECLAMAR CUALQUIERA DE ELLOS. USTED DEBE LLEVAR ESTE PAPEL A UN ABOGADO DE INMEDIATO. SI NO TIENE O NO PUEDE PAGAR UN ABOGADO, VAYA O LLAME A LA OFICINA INDICADA ABAJO PARA AVERIGUAR DONDE PUEDE OBTENER ASISTENCIA LEGAL. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 (717) 249-3166 i-8oo-990-9108 AMERICANS WITH DISABILITIES ACT OF iooo The Court of Common Pleas of Cumberland County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the Court, please contact our office. All arrangements must be made at least 72 hours prior to any hearing or business before the Court. You must attend the scheduled Conference or Hearing. Cumberland County Bar Association 32 South Bedford Street Carlisle, PA 17013 (717) 249-3166 1-8oo-99o-9108 Maryann Murphy, Esquire PMB 246 4902 Carlisle Pike Mechanicsburg, PA 17050 (717) 730-0422 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW RODNEY L. KLINGER, Plaintiff v. CATHY C. KLINGER, Defendant No. C)6. - X43.2 IN DIVORCE el C' COMPLAINT UNDER SECTION g.3oi(e) and agoi(d) OF THE DIVORCE CODE AND NOW comes RODNEY L. KLINGER, by and through his attorney, Maryann Murphy, Esquire, who respectfully avers as follows: 1. Plaintiff/Husband is RODNEY L. KLINGER who resides at 3802 Candlelight Drive, Camp Hill, Cumberland County, Pennsylvania 17o11. 2. Defendant/Wife is CATHY C. KLINGER who resides at 389 North Sample Bridge Road, Enola, Cumberland County, Pennsylvania 17025 3. Husband and Wife have been bona fide residents in the Commonwealth for at least six months immediately previous to the filing of this Complaint. 4. Husband and Wife were married on April 26, 1975 in Dauphin County, Pennsylvania. 5. Husband and Wife have been separated for more than two years. 6. A Complaint in Divorce was filed by Wife on July 13, 2000 in Cumberland County, Pennsylvania. The action was purged on December 30, 2004. There have been no other actions for divorce or for annulment between Husband and Wife. 7. Wife is not a member of the Armed Forces of the United States of America or any of its Allies. 8. The marriage is irretrievably broken. 9. Husband has been advised of the availability of marriage counseling and that he may have the right to request the Court to require the parties to participate in such counseling. Being so advised, Husband does not request that the Court require the parties to participate in counseling prior to a Divorce Decree being handed down by the Court. 10. Husband requests this Court to enter a Decree in Divorce from the bonds of matrimony. WHEREFORE, Plaintiff/Husband requests this Honorable Court to enter a Decree dissolving the marriage between the Plaintiff/Husband and the Defendant/Wife. Respectfully submitted, Maryann urphy, Esquir PMB 246 4902 Carlisle Pike Mechanicsburg, PA 17050 (717) 730-0422 I.D. # 61900 Attorney for Plaintiff/Husband J AFFIDAVIT I, RODNEY L. KLINGER, verify that the statements made in the foregoing Complaint in Divorce are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. Date RODNEY L GER 1 0 C? No O a 0 K. "C7 cc) M ?t N M C") I 77 '-TAI MM ?Fn a ?rn _b IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW RODNEY L. KLINGER, Plaintiff V. CATHY C. I CLINGER, Defendant : No. o6-6932 Civil Term : IN DIVORCE AFFIDAVIT OF SERVICE I, Maryann Murphy, Esquire, depose and say: 1. That I am an adult individual residing in Cumberland County, Pennsylvania. 2. That on December 4, 2006, I sent the Complaint in Divorce to Defendant's attorney, Robert B. Lieberman, Esquire, by U.S. first class mail, postage prepaid, to the following address: 500 North Third Street, 12th Floor P.O. Box ioo4 Harrisburg, PA 17108-1004 3. That Defendant's attorney, Robert B. Lieberman, Esquire, accepted service of the Complaint in Divorce on behalf of Defendant and signed an Acceptance of Service dated December 5, 2006. The Acceptance of Service is attached hereto. a l a O ?O Date A 11 A IN &4:A P /Z Maryann urphy, Esqui6 PMB 246 4902 Carlisle Pike Mechanicsburg, PA 17050 (717) 730-0422 I.D. # 61900 Attorney for Plaintiff i % IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW RODNEY L. KLINGER, Plaintiff V. No. 06-6932 Civil Term IN DIVORCE CATHY C. KLINGER, Defendant ACCEPTANCE OF SERVICE I, Robert B. Lieberman, Esquire, counsel for Defendant, Cathy C. Klinger, do hereby depose and say that, on behalf of and on the authorization of Cathy C. Klinger, I personally received and accepted service of a true and correct copy of the Complaint in Divorce on the date written below. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. / Z " s^ a Date Robert B. Lieberman, Esquire 4 r Luther E. Milspaw, Jr., Esquire Attorney ID No. PA 19226 130 State Street, P.O. Box 946 Attorney for Defendant Harrisburg, PA 17108-0946 (717) 236-03141 FAX (717) 236-0791 Email: Lutliermilst)aw(imilspawlawfirm.com RODNEY L. KLINGER, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA VS. CATHY C. KLINGER, Defendant Docket No. 06 - 6932 CIVIL ACTION - LAW IN DIVORCE ENTRY OF APPEARANCE TO THE PROTHONOTARY: Please enter the appearance of Luther E. Milspaw, Jr., Esquire, as counsel for the Defendant in the above-captioned matter. tted, LUTHER 9. MSS AW, Jr. Attorney ID No. 1 ?226 130 State Street P.O. Box 946 Harrisburg, PA 17108-0946 (717) 236-3141 Dated: November 29, 2007 RODNEY L. KLINGER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. Docket No. 06 - 6932 CATHY C. KLINGER, CIVIL ACTION - LAW Defendant IN DIVORCE CERTIFICATE OF SERVICE I hereby certify that I served a true and correct copy of the above Entry of Appearance upon all counsel of record by depositing the same in the United States Mail, first class, postage prepaid, at Harrisburg, Pennsylvania, on the 29th day of November 2007, addressed as follows: Rodney Klinger 3802 Candlelight Drive Camp Hill, PA 17011 Maryann Murphy, Esquire 4902 Carlisle Pike, PMB 246 Mechanicsburg, PA 17050-3079 R;espe lly submitted, T EBQGHT ParalegalLe of Luther E. Milspaw, Jr. Street P.O. Box 946 Harrisburg, PA 17108-0946 (717) 236-3141 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION -- LAW RODNEY L. KLINGER, Plaintiff V. CATHY C. KLINGER, Defendant No. o6-6932 Civil Term IN DIVORCE PPAMPE TO MMDRAW APPEARANCE To the Prothonotary: Please withdraw my appearance as counsel for Plaintiff in the above action in Divorce. Respectfully submitted: Maryann 91u rP Y h? ?uire ! PMB 246 4902 Carlisle Pike Mechanicsburg, PA i7o5o (717) 730-0422 PRAECIPE TO ENTER APPEARANCE To the Prothonotary: Please enter my appearance as counsel for Plaintiff in the above action in Divorce. submitted: Joanne H. Clough, E 3820 Market Street Camp Hill, PA i7oii (717) 737-5890 . ? ??' art Co • ?:;: ? ??. .c.: ? . ?.:: „? `?'t.? ? _ .?; ---? W -,L ABRAHAM LAW OFFICES 45 East Main Street, Hummelstown, PA 17036 (717) 566-9380 RODNEY L. KLINGER : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 06 - 6932 CATHY C. KLINGER : CIVIL ACTION - LAW Defendant : DIVORCE PRAECIPE TO WITHDRAW APPEARANCE AND ENTER APPEARANCE TO THE PROTHONOTARY: Please withdraw the appearance of Luther E. Milspaw, Jr., Esquire as counsel for the Defendant, Cathy C. Klinger, in the above-captioned action and enter the appearance of James W. Abraham, Esquire, as counsel for the Defendant, Cathy C. Klinger. y sub tted: Respectfully submitt d: ( 4 Iq a,,, Luther E. Milspaw, Jr., Esqu 130 State Street PO Box 946 Harrisburg, PA 17108-0946 (717) 236-3141 D,,.?Z1? 2w? James W. Abraham, Esq. Abraham Law Offices 45 East Main Street Hummelstown, PA 17036 (717) 566-9380 DATE: 4?" `s A , -% CERTIFICATE OF SERVICE I, James W. Abraham, Esquire, the undersigned, hereby certify that I have served a true and correct copy of the foregoing document by first class mail upon the following person(s): Luther E. Milspaw, Jr., Esquire 130 State Street PO Box 946 Harrisburg, PA 17108-0946 Joanne Harrison Clough, Esquire Joanne Harrison Clough PC 3820 Market Street Camp Hill, PA 17011 DATE: `S d James W. Abraham, Esquire C'"1 rv ? c, rC1 33 ("r? '-z- v ?j°.. r • j <:_' ?? wf . ?'t i? 1 i "'f; ?,`' ABRAHAM LAW OFFICES 45 East Main Street, Hummelstown. PA 17036 (717) 566-9380 RODNEY L. KLINGER : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 06 - 6932 CIVIL TERM CATHY C. KLINGER : CIVIL ACTION - LAW Defendant : IN DIVORCE MOTION FOR APPOINTMENT OF MASTER Cathy C. Klinger, Defendant, moves the court to appoint a master with respect to the following claims: ( x) Divorce ( ) Annulment ( x) Alimony ( x) Alimony Pendente Lite (x) Distribution of Property ( ) Support (x) Counsel Fees (x) Costs and Expenses and in support of the motion states: 1. Discovery is complete as to the claim(s) for which the appointment of master is requested. 2. The Plaintiff has appeared in the action by his attorney, Joanne Harrison Clough, E uire 3. The statutory ground(s) for divorce is irretrievable breakdown. 4. The action is contested with respect to the following claims: Divorce, Equitable Distribution, Alimony APL Counsel Fees Costs & Expenses 5. The action does not involve complex issues of law or fact. 6. The hearing is expected to take 1 day. 7. Additional information, if any, relevant to the Motio • None. Date: 10/20/09 James W. Abraham, Esquire Attorney for Defendant, Cathy C. Klinger AND NOW, . 2009, Esquire is appointed master with respect to the following claims: BY THE COURT: CERTIFICATE OF SERVICE I, James W. Abraham, Esquire, the undersigned, hereby certify that I have served a true and correct copy of the foregoing document by first class mail on the following person(s) at the following address(es) on the date stated below: Joanne Harrison Clough, Esquire Joanne Harrison Clough, PC 3820 Market Street Camp Hill, PA 17011 DATE: 10/20/09 James W. Abraham, Esquire OF T`ar' • wir Ai 2009 0(; "20 fill to., 13 0i l k ABRAHAM LAW OFFICES 45 East Main Street, Hummelstown, PA 17036 (717) 566-9380 RODNEY L. KLINGER : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY. PENNSYLVANIA V. : NO. 06 - 6932 CIVIL TERM CATHY C. KLINGER : CIVIL ACTION - LAW Defendant : IN DIVORCE DEFENDANT'S INVENTORY Defendant, Cathy C. Klinger, files the following Inventory of all of the property owned or possessed by either party at the time this action was commenced and all property transferred within the preceding three (3) years as verified by Plaintiff pursuant to Plaintiff's Verification attached hereto and made part hereof ABRAHAM LA OFFICES James W. Abraham, Esquire 45 East Main Street Hummelstown, PA 17036 (717) 566-9380 Attorney for Defendant, Cathy C. Klinger DATE: 10/20/09 ASSETS OF THE PARTIES Defendant marks on the following list those items applicable to the above-captioned action and itemizes the assets on the following pages. (x) 1. Real Property ( x) 2. Motor Vehicles ( x) 3. Stocks, bonds, securities and options ( ) 4. Certificate of Deposit ( x) 5. Checking accounts, cash ( x) 6. Savings accounts, money market and savings certificates ( ) 7. Contents of safe deposit boxes ( ) 8. Trusts ( ) 9. Life Insurance policies (face, cash surrender value/ beneficiaries) ( ) 10. Annuities ( ) 11. Gifts ( x) 12. Inheritances ( ) 13. Patents, copyrights, inventions, royalties ( ) 14. Personal property outside the home ( ) 15. Business (owners, percentage of, positions held) ( ) 16. Employment termination benefits/severance pay, workers comp. ( ) 17. Profit sharing plans ( x) 18. Pension plans (employee contributions/date plan vests) ( x) 19. Retirement Plans, IRAs ( ) 20. Disability payments ( ) 21. Litigation claims (matured/unmatured) ( ) 22. Military/V.A. Benefits ( ) 23. Education benefits ( ) 24. Debts, including loans, mortgages ( x) 25. Household furnishings and personalty (include as total category; attach itemized list if distribution of assets is disputed. ( ) 26. Other: 2 MARITAL ASSETS ITEM NO. PROPERTY DESCRIPTION ALL OWNERS 1 3802 Candlelight Drive, Camp Hill, PA Joint ($129,000 net) 1 12 Long Road Newville, PA Joint ($88,400 net) 2 2001 Ford Windstar Wife 2 Hyndai Sante Fe Husband 3 United States Savings Bonds ($20,000) Joint 5 Members 1 sc: Wife Checking Account ($443 - 8/31/09) Savings Account ($1,206 - 8/31/09) 18 Husband's Pension Husband Federal Government Civilian Service Retirement System (Value pending) 19 IRA -Members 0 Bank Wife ($16,000) 25 Household furnishings Joint 3 MARITAL DEBTS ITEM NO. DESCRIPTION CREDITOR DEBTORS AMOUNTS Presently there are no marital debts in dispute. Defendant reserves her right as to any defenses or claims as to marital debts. NON-MARITAL ASSETS ITEM NO. DESCRIPTION 1. Wife's residence at 386 Sample Bridge Road, Enola, Pennsylvania. 12. Post-separation, Wife inherited approximately Thirty Thousand ($30,000.00) Dollars from the death of Wife's Father, who also died post- separation. NON-MARITAL DEBTS Defendant is not aware of any non-marital debts for purposes of equitable distribution, except as to Defendant's mortgage on her residence at 386 Sample Bridge Road, Enola, Pennsylvania.. Defendant has not transferred or converted any property and is not aware of any transfers or conversions by Plaintiff, except that both parties were provided with fifty (50%) percent of the net sales proceeds from the sale of their Newville, Pennsylvania real property. Defendant reserves her rights as to any claim or defense as to property transferred or converted by Plaintiff. VERIFICATION I, Cathy C. Klineer , the undersigned, hereby verify and confirm that I have reviewed the foregoing document and the information contained therein is true and correct to the best of my knowledge, information and belief. I further understand that any false statements made herein are subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unworn falsification to authorities. DATE: /O Cathy Kling CERTIFICATE OF SERVICE I, James W. Abraham, Esquire, the undersigned, hereby certify that I have served a true and correct copy of the foregoing document by first class mail on the following person(s) at the following address(es) on the date stated below: Joanne Harrison Clough, Esquire Joanne Harrison Clough, PC 3820 Market Street Camp Hill, PA 17011 DATE: 10/20/09 James W. Abraham, Esquire ?+r sr^L C UjUC, U tiIU': ! 8 ABRAHAM LAW OFFICES 45 East Main Street, Hummeistown, PA 17036 (717) 566-9380 RODNEY L. KLINGER Plaintiff V. CATHY C. KLINGER Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA NO. 06 - 6932 CIVIL TERM : CIVIL ACTION - LAW : IN DIVORCE DEFENDANT'S INCOME & EXPENSE STATEMENT Defendant, Cathy C. Klinger, files the following Income & Expense Statement in the above-captioned action in divorce in accordance with Pa.RC.P. 1920.31 as verified by Defendant pursuant to the Verification attached hereto and made part hereof. ABRAHAM LA OFFICES James W. Abraham, Esquire 45 East Main Street Hummelstown, PA 17036 (717) 566-9380 Attorney for Defendant, Cathy C. Klinger DATE: 10/20/09 INCOME Employer: None - Gross pay per period: Deductions: Federal Withholding: Social Security: Medicare: Local Wage Tax: State Income Tax: Unemployment: Retirement: Savings Bonds: Credit Union: Health Insurance: Life Insurance: Union Dues: Other (Specify): Net Monthly Income: Other Income (Net Amounts): Interest: Dividends: Annuity: Social Security: Rents: Royalties: Expense Account: Gifts: Unemployment compensation: Worker's compensation: Other (Specify): Spousal Support: Total: Disabled - restricted to wheelchair Month 2,370 $ 2,370 TOTAL NET INCOME: $---2.370 Year 28,440 $ 28,440 $ 28,440 2 EXPENSES Residence: Mortgage/Rent Maintenance Homeowners insurance Utilities: Electric Gas Telephone Water/Sewer Oil Personal: Food Clothing Other Automobiles: Payments: Insurance: Repairs/Maintenance/Fuel: Medical: Doctor: Dentist/Orthodontist Hospital Medicine Special Needs (eye care, etc.) Education: Private/Parochial School College: Credit Payments: Credit cards Charge accounts Memberships Outstanding Loans: Creditor: Month Year 927 11,124 200 2,400 90 1,080 75 900 200 2,400 300 3,600 150 1,800 50 600 50 600 3 Month Year Miscellaneous: Household help: Child care: Pay/Cable/TV/Computer 120 1,440 Legal Fees: 300 3,600 Charitable contributions Vacation Entertainment Gifts Other (specify) Support/Alimony TOTAL EXPENSES: $ 2,592 $ 31,104 Form Label L (Sw A arprtrolo e 6 an papa 14) E trer M r. lea H 011wwiee, E piss"prrnl R or"N. E Pna 1 3b" b" 2 Old" 3 EXemptbM $a p Mara sew W deawww" M tape 17. setaTearry•hraa+ Fwvvr assrw -- • r•• w w:r ¦ ww ps pR4lre rtatvalN or obvis in MNe spw Far ate sew *.14Dac. 31, 2=. ar afltar base _ ye. beakninc , soae, r?ro _ . 7n see no. 15"71 Yar AM MM at inu tea ramp seem* 4. Cathy 4; _ >!ciinver 159-48-7953 r a (n,c A&M. wanes tint route MM trmw - L* mute epmnn amr nerMt, end= flonte -401 (ra VW wd AMO.1 you hoe a P.O. bm ¦w papa 14. Apt. no. You mite enter 389 8anWI Hridge Road A yours"oebovs. A cky, town or poet WM, etw, eat Zip aids. r you raw a raW add-as. ice papa 14. Check boll If GMTW a Cal clam you o a ing a below Wiu na I1 .17025 change your tax or wand. to o to this fund (at page 14) ? I ' you I softse 4 J rued or horm *wm (wan WaM>TO > ((lose pries 15.)v ft atrwov paean a a amt be not yea wpartanM, seer thla C Nids sure: had. ? 5 . oualifyirlp widow(er) with dependent child do not check box 6a - p 'gppae .. _ C Dspsrximis: GOOopaaaMe I?o+pr *x a tai 'id (1> Flat ran+r Use rams "°dat aac'nry n"M°°r r.tai0rahroto ! d Total number of ewrolona cialmed . ? •` 7 Wsges, salaries, Up, atc. Attach Form(s) W-2 Income 9a Taxable interest Attach Schedule 8 if i d AUach Form(a) . requ re ...................... so W2 hen. Also b Tax-emu et k4west, Do not Include on line 8a ....... 18b aNrrefr Forma W go Ordinary divldentts. Attach Schedule 8 if required .......?......... ft -20 and b Qualified dAk*%p (sew pW 21) .............. L 9b1 , 1089-R N tax waawlthhafd. 10 Taoubia refunds, cw ts, or ottseh of site and local income tapes (see pegs 22) • .... 10 11 Alimonyrecleived ............................. . . . . . • , . 11 12 Business income or (lass). Attach Schedule c orC•EZ ................. . iZ* 13 Capital gain or (loss). MOM SdMduie 0 8 required. If not required, chock here ? 13 If you did not get a W-2 14 Other gains or (losses). Attach Form 4707 ......................... 14 , 10epege2l. 15a IRAdishtbuflons ..... lea b Texebleamoum (sea papa m 151; 18a Pensionsandennulies • 1tln b Twobleamount (ace papa 21) 1f=b Enclose, but do 17 Rental r"estate, royalties, partnerships, S corporations, trusts, etc, Attach Schedule E ... 17 not aftch, any peyment.Also, 18 Farm income or (1gee), Attach Schedule F ...... .......... 18 pl nowe 19 UnempioyowtoompmsaWn ..................... ....... . Form 1 040.V. 204 Social security benef+ts 20a b raxaaaamount (sea paps 28) L.. F2O 21 Otherincomo. wrar0tooe 1 weaeeMeb IV6.arahaan oneerrta e MwvAhvw ? ?reeaw rtofwa?wtiaaaw l assatrow ? 817 22 Add the amourxa in the far right column for lirw 7 through 21. Th is is tots income ..` 22 25,215 23 Educawe*enses(wepage 28) ............ • 23 i ; Adj&*W 24 Carlelrt outateu.Kreeee a roenleu, parlarntirp aAiMa, sense emu tw4mon goo o rm oMmis. MUM Fenn 2106 a 2,t M • • • • 24 income 25 Health savings account deduction. Pdtach Form 8889 .... 25 25 MovhV apenses. Attach Form 3903 ......... • 25 27 Oft-IMM 6f'elf-aM0*nw t twr. Altair Sdw*le SE ... 28 SON-em** SEP, 0APLE, and qu*NW plans ..... 27 28 20 SO-OmPloyad health irkpurenoe deduction (see page 29) 29 30 Penalty on early withdrawal of savings ..... 30 249 31a Allnony paid b Reco t% S8N ? 31a 32 IRAdwWibn (seepage 30) • • . , • • 32 33 Student loan interest deduction (am page 33) . • ...... 33 34 Tuihon AM tees deduction. Attach Form 8917 ....... 34 - 36 f7onwatitproductan vot"iesdedudion. Atgtch Form 8W3 !i 35 Add tines 23 through 31 a and 32 through 35 • • • • • • • ............... 35 249 37 SubtrM lino 36 from Itna 22. This is r ueted grow Income For Dfadosura, Privacy Act, and Paperwork Rsductian Act Notfco, we pegs 88. . • . .. • • . • . . . .? ttA 37 24,966 Form 1040 (2008) d f o (owed if only one had income) 9% UPWOMY. Enter epowe+s MN above nwa beta ? Z ebvd V91LVLLLIL V8£=0I 600Z'9Z M oretclkits" In" iataanw$euae Form 1040 U1. RiMduetl Intone Tax Rectum 2007 Rsureor rvr ea ion 143oc31, 2W, arWw 1 ywbapinnin .2W7, a%" :20 Labe L Yourl0 naneand bridal Laid rwne ? A laa a Caath C Klinger W Pape 12.) E r a )oath rMxn, r0auws late Hanle atxl inilal toot name UNINI ti8 L CM. NM 161d0M Ywo mr"UAWrawrbcs 159-48-7953 a Pesta'attaetaaaaNWIN oaer bimi. H Hwrte sdt+ (n.nbar and 16W). I you hsee a P.O. WK aw pipe 12. Apt, no. You tricot enkr A M=Pret n 389 Stele SxidQ..$4A11_- yourS81V(a)atlovs. artvpe. IF pry. mwn ar poM dirroa, errs, sw2r node. Kyw htsa a foierpn admese, see page 1T. Checking # boxbslow willnol proakantial Znal PA 17025 change your tax or refund. Cho* hero R YOU, or your Spouse 1bp )oi , want to go to is and (see pope 12) ? You Spam Filirlp Sngla 4 A mm ar rtouaertotd lwtth quwwD t vw cane pope i3.) v 1 2 ?lWarriedflinglointly(veenKongoneturdintone) M`rr,?"" ?? s wrwmmp ,amawy.r?rXvAevss dm arnar01 ?Jenniter !Clinger _-201-62-7103 OM U K? nano hm. ? s Qwl' widow(er) with dependent OW (sea pop 14) of YOLN"K. if someone can caul! you as a dependent, do not ctw* boot oA aaaado os.a M mom thinrw =1250". oft d Trial meoaadeb tea ordaiwr .................. ... ....... aneettan RI?P?+s's c tM hemt?da w awdt.latyeu N txrorrtxxungtranbcr .. ... You onld `?g1b1 psrdialoa ' ArfallrltaaQt 7 Wargss, srlatios, type, ate. Attoeh Form(s) W-2 InCOrrte •-----• 7 Att h Fa a so Taxable interest. Attach Schedule B if required ....... ........... ... Be 1,920 } ac yr1( W_2 here. Also b Tax?xantpt "onest. Do not include on We an ....... sb attach Forms 9a Ordinary dividends. Atbteh Schedule B if required ..... .. • • • • 90 W-20 and b Qualified dividends (sea paps 19) .... • • ....... 9b 100si-R if tax 10 Taxatle refunds, credits, or offsets of state and local kxvne taxes (see pope 20) • • • • 10 wnwibd d. 11 Alirnonyracs(ved ...................... ............... 11 ---•-.2 12 Business income or (lose). Attach Schedule C or C•EZ • . • • • • 12 13 Capital gain or (loss). Attach Schedule D it required. If not required , check here ? • • • • U 13 If you did not 14 Other gains or (losses). Attach Form 4797 ......... ............ • .. • 14 gtrtovl-Z, sae el9 e 15a IRAdrairitwtiorta 199 b Taxabluarnount Owpeae2l) 18b p p . lea Penskmsandarmuideo Ida a Taxablsamount oft pW 2z) lab Enol se, but do 17 mental reatestete, rayaltin, partnerah?s, Scorporstiono, trusts, etc. Attach Schedule E 17 notattach, arty a nnl 16 Farm incom or (Ines). Attach $chaduk F . . . . .. .. . . . . . . . . . . . . . . . . 1s p y - use please 19 Unompbytnatltoornpsrtsatbn 19 Form 1040-V. Ma Social securitybeneflta 20. I b toxameamount 24) lob 21 Otherincorne. 21 22 Add the amounts in the for" column for lines 7 through 21. This is your toms Incur io 22 30,348 23 F-duoattxettpanses(seepaga2tl} ........... 23 O *nU d 24 Cararn ar rte, pa?amirrp anttts, and GMU lee bans 9ft*VWV ! alnddra. Afb1h Fetm 2101 ur210662 244 feria! 28 I'leafth savings account deduction, Attach Form 8889 • • • 25 26 Moving explenties. Attach Form 3903 . . . . . . . . . .. 26 27 Ono-half otael(-entplopeat tax Attach Schedule SE 27 n Self-ornployed SEP, SIMPLE, andquallfledplans • • .... 26 29 Selfemployed health Insurance deduction (see page 26) 29 30 Peneltyonesriywithdrawalofwrvings ......... 30 Ise 31a Alimony paid b Ro dpie, s SSN ? 31o 32 )RA deduction (see Dirge 27) ............... 32 33 Student loan interest deduction (us page 30) ....... 33 U Tuition andfees deduction. Attach Form 8817 ........ 34 35 Domestieproduction activiesdsduction.AttachForme8o3 36 36 Add lines 23 through 31a and 32 through 35 ...... . .. ... ............ 36 88 37 Subtrad fns 30 from Nee 22. This is your atalsd gross incamo ....... . .. . . .? 37 30,260 For Dholoara'e, Privaey Act, and Paperwork Al 11 ' Non Act Natias, seo page s3. LEA Farm 1tM0 (2007) £ 8bvd MOLLLIL Y6£:OZ 600Z'9Z dHS Form 1040(2007)Cathv C Klinger 159-46-7953 ?ws? 38 AmounNmmltna37(14uatad9i'minwm) .. ... ..... 36 30,,•260 Tax and 398 Check You were born b*m January 2, 1943, Blind ii Total b1>xes CnK is if: qMw was born before January 2.1943. L BMitd. l drew 1392 Sbndaud b 5 your spots cam n" an a apse norm or you w"a duai•eww ak m, in po 318 cnuk horn ? 39b Dedueilon 40 Ibemixed detMwlions (from Schedule A) or your standard OwAxtion (sae left margin) 40 9,234 for- 41 Subtract lino 40 from line 38 .... • ......................... 411 21,0.24. OheOk? many 42 ff"35 is 5117,900, or im, nvApiy ft4oD Lyle wN nmbr at / npww amw on ke -- box on MneM42 3,400 or or w.rone35is owr5117,3M.ace the wakdieet m pop 33 art Oe da sea 43 Taxable Incooie. Subtract line 42 fmm fine 41. M line 42 is more than line 41, enter 4 43 17,626 see page 31, 44 Liu (see peas P. Cluck r any tat is ftm: a _ i FCmI(s) aB14 b I Form 4672 Fan(9) 8555 ' 44 2,084 e Alloeters: 45 Akwna&n wftfnum in (see per 36), Attach Form 6251 ................ 45 46 Add lines 44 and 45 .................................. ? 46 2,084 =fifirh9 47 crmmlordtdowdepandmo=vawaw.mindhFam aoi .. • • 47 35,350 46 Credit for the elderly or the disabled. Attach Schedule R ... 48 MarriedffMng 49 Education credits. Attach Form 8663 49 or 50 ResidentietenwiW credits. Attach Form 5695 .. • • ... 50 ,. 51 Foreign taxascilt. Attach Form 1116 If required • • • • • • . • 61 510, 52 Child tax cal (see page 39). Adech Form 8901 If required .. 52 Headof 53 Retirement savings wntributions welt. Attach Form 6880 ... 53 57?hob1 54 Cfwftfrom: s ; &W Is I am MM c FamOM 54 58 Othw erechis:. onn Mw IN rum, M1 e ?porm s6 56 Add knes 47 through 55. Thm are your :0181 credlte 56 57 Subtract line 56 from Ina 46. If Ina 58 is more than line 46, enter 4 • • • • • • • • ' • ? 67 2,004 50 Seta-employiwittax. AttachSCheduleSE .. , . • ........... • • • • • • ' 68 Clow .... . _ ... Taxes 59 Unreported social security and Medxxre tax*cm: a J Form 4137 b ! J Forum 8919 • 59 „ , • • _. _. _ ..... 60 Additional laxon lRAS, other qualified retkarnentplans, etc. Atteoh Form 5329 •W- Uired , 61 Advance earned income credit payments from Form(s) W-2, box O • • ........ 61 62 Household employment tam. Attach ScheduleH ........ • ......... 62 43 Add lines 67 through 62. This is your total tax . . . . .. . . . . . . . . . . . . . . . ? 42 2,084 payellertt8 64 Federal Income taxwithheldfrom Forms W-2 and 1090 64 85 z w Ownated tau peyrnens and wow eppead fMM MM Mwn . . 55 wn- -I Myou ha+re a 665 emned Incean credit (EIC) • ....... .... fee qua" CChk attach b pbr umm array pay aw om ..? 66b 5creduleEiC. 67 EMM60at111 iaaaaywdaertMVTAUKwtadwlainepopeMi 67 68 Additional child texwedd. Atiech Form 8812 ......... Be 68 Arncunt pet with request for wdertsion to file (see page 59) so 2,300 To Paymwdsfmm: a UForm2i38 b LFann4135 c LFonOMM ro 71 Rewxwk**afirprwVwmirdmumtwfMmfarm8801,Ww27 71 72 Add has 64, 65.66x, and 67 through 71. Thew are your total psymenb • • . • • • . • ? 72 2 9 3 0 0 R if and 73 a hew n w mowtha+ fins 53, stbkm One w norm war n 1h is Is Vw anent ya, overpaid . . • . • • . • 73 216 Diwd depwl? 740 Amount of One 73 you want taftstded to oar, if Form 8888 is attached, check here ? _J 74a 216 - soopew50 ? b Rouhngnumber X X X X X X E E E ?cType: Che(:khg 7Satrirtge ardesi74' ? d Accountriumt r X X X X X X X X X X X X 7C X % X 740, WO 745, ? or Fan OW 75 MnouM d me 73 ynu want N =aefaa Wd bK .001 75 Amour* , M ,.Amount you tsuw. Subtract Mme 72 from h9 63. For details on how to pay, see pegs 60 ? 76 YOU T7 Eattnlaledtoxw8Ry(we 61) 111,111,11 77 Third Party DO you want to allow another person to discuss this return vOth the IRS (see page 61)? ,Yes. Complete the tpNv*". X Na i DCS Dael>ltssrsrtrtro Prow no. PersaMiktaidacdron ?-?-(- ? ? nmdw (PIM -? I 1 I I I MbM Jointratum? See pope 13 KeM fou a ? i1' gs use Orgy ?EA eb>3d Uww pen ft d paittay, I dadaw err I rrwawitlrted ode nom artd aoasnlpanyina sdtedrAas ad rsaerresi. and 10Ow boat my aMMW and belid, they ago V cenact. and OW Me. Da WOW d pntpanr f*& Van iagwye) ie based on ail Wftmsk n d wntoh p Ww hn any WO Wades. YOUrapneas I Ore I You!oocupetion I Dep-phone-V- ana+ei s arptssn. r rein ratan ear nwst etgn. Ouch Spou6c s ooa?eaan s 0 1 Date Ohm* N pin'srr (w Timothy A. K ino CPA y01¦'r' New Second Street aeassa ate ' New Cumberland PA 17070 MOLLLIL Ph&wear. 717-979-7049 Form 1040 (2007) Y6£:Ot 600Z'9Z d9S P%M LL, 4 xAA_M" SCHEDIL"S AILS Schedule A - lflrni=0 UWuCt101'e ?'°•• • "•"'." 2W7 (Foram 1040) M h Ait +?°y ? Attach to Form 1040. ? 8sa Mdora 1or'ehadutes Aid (Form 1040) ao ra SOWNWINNO. Nnns{s}down onForm 1040 vtrrarer MoftnrshrtM Cathy C Kli>n er 159-48-7953 Me?oal Cahution Do not include alW&M reimbllMad or pain by others. and 1 Medical anddentalexpenses (see papA•1) ........... 7 Dental 2 Enter amount from Form 1040, fire 38 2 Express 3 Multiply One 2 by 7.5% (.075) ............... • ... 3 4 Sul I ct line 3 from line 1. If line 3 is more than line 1, enter- • • • • • • • • • • • • • 4 tam YOU 5 Stale and local (chsdc oM?r one box): Paid el Income taws, or . • • • • fi 406 biki Gerwalsa estaues ( peV A-2.) 6 Real estate tans (ese page A-5) ............. • ... 6 1 , 7 7 2 7 Prrsonalpropertyta?a • ............... • ... 7 $ Othertaaes. List type and amount ? _ 8 8 Add limes 5 through a .... • • • .. • • • • ... . • . 8 29178 10 Home mortgoo barest and points reported to You on Form 1098 10 6 4 81 Honw Pe?d You Paid 11 Onw tM 1098. l? ? - (0 INB h F he pe ? and adds 0, and show met i tiing no erson imnaYn s , . • p (See NOW. PersOrhat 11 _ interest is 12 Points rat reported to you on Form 1088, See page A-0 not forspecialrulas • . • deducible 12 . 13 4uafifledmortgMgein mr*epmmiums(S"ppA-7) 13 14 I nveabnent inMrerd. Attach Form 4M If required. (gee pegaA4.) ............................ 14 1s Add lines 10 through ••• . ••• . . . . . . . •••• . . . . . . ... ••••• . . 13 6,491 Gifb to 16 Gifts by cash or check. If you made any gift of 5250 or Charms more, nee page A-6 .................... • • . 16 225 ; 17 Other than by ca sh or chedr. if any gift of $ew at more, r you mnrae s sea gape A•8. You mad attach Ferri 8283 if over $500 ..... - bwnslraa, 16 Carryoverfromprioryear ..................... 1s 19 Add lines 16 through 18 ... • .... • ..... • ............ • .... • .. 19 373 CasuaNyand TheftLoeaas 10 Casual orihaft loss(es). Attach Form 4W. (See pt A-9.) 20 ,fp4Expensas 21 Unretmbur odamployseehef*nM-jobtraval,union and Certain dues, lob education, etc. Attach Form 2106 or 2106-EZ MlieOellaneorrs if required. (Sea page A-9.) ? 21 Deductions -- - - tSae :` i1P9eA-94 22 Taxpropsrationfees .............. • • . • • • • • 22 23 Other expenses • investment, safe deposit box, etc. List typeandamourd ? 23 24 Add linos 21 through 23 ..................... 24 i 25 Enter amount from Form 1040, line 38 Imo- _ 2e MuKipty fine 25 by 2% (.02) .................... 26 27 Subtract line 26 from tine 24. If line 26 is mare than line 24, enter -0- . • . • • • • .. • 27 06w 28 Other-from Rd on pays A•10, List type and amount ? MleoelNhrhaotrs Deducilorls TOW 29 Is Form 1040,line 38,over S186,400(over$78,200ifmarried fling separately)? Nona ed >f. No, Your deduction is not Nmited. Add the amounts in the far right ooiumn f Deductions for lines 4 through 28. Also, enter this amount on Form 1040, line 40. h.. • • ? " 29 9,234 Yes. Your dedrrotion maybe limited. Sse page A-10 forthe amount to enter. JI " • " ::: ''• •' ' 30 K yeu sra,Y ee irsn,? dbdutaiorrs own though dnry ee IN. then gar dridsrd dari+01i0n. choc l+ae ? 5 efmd V91LVLLLIL V6E:0t 600V9Z cISS !MIN Mr8 (Fain 1040) 2007 OMB Me. 1545-0074 pop 2 Nsne(s) shown on Form 1048. Do not eMar name and social security number if shown on page 1 Your sociat security rasnber Cathy C Klin •r - - Schedule B-In tierest and Ordirta q Dividends Abdw*M SoWenceNo. 08 Pitt ! 7 List narnecf payer. If any Interest is from a seller-11nanced rnorEpape and the Amount buyer used fie property u a personal nrsWice, seepage B-1 and list this IntW W interest first. Also, showthat buyds's sodol sacurty nunhbsr and aOOM ? {$te page B•1 -'----• andthe F?for 20 anssa.) 1 1#061. If you moeivedsForm 1099-INT, FQrm 1099-010, or substitute stawnernirorn a b roksragef rm. list the firm's nameasthe psyafandOrler _-._ ... . -- tthatotalinterast shown an that 2 Add the amourhts on lira 1 ....... • ....... • • ...... • . • • • • 2 g form. 3 Excludable trderast on series M and I U.S. swinge bonds issued after 1989. Attach Form 8818 ................................. 3 4 Subtract lithe 3 from line 2. Enter the result here and on Form 1040, line 8a • • • • ? 4 1 920 Nets If lino 4 is guar $1,500, you rwst complMt Part Ill ----- Amount 8 List name of peysr ? _-- Pat 9 Winary DivMdenck -- t(Ses op e-1 - -- .... _....__?.._. -. Instr u tionsfor Form 1048, Irhe9a.) Note. If you 5 mwivedaForm 1099-DNor substitute statemhantfrom sbrok "firm, No the firm's nameastfht theefdripy (IMOsrldsshown gn thstimm. 6 Add the amounts on Nne 3 EntertI; tots! here end on Form 1040, line 9e • • ? 6 Note. If Nms 0 b$ ostr $1,500, you must comoft Part III, Pad You must complete thin part W you (a) had over $1.500 of t?ahsble interest or ordinary dividends; or (b) had Yes No a foreign acoourht or (c) reouthisd a distribution fmm• or were a grantor of. or a transferor to, a foreign truer. Fla 7a At any time during 2007, did you haw an interest in or a signature or other aufhority over a financial account in a foreign country, such a a blank account, saw**$ account, or otherfinaftal sooount7 ` and Trtasts See pogo-'&2 for exceptions and filing rhquireme rhts for Form TO F 90-22.1 ................ g b if "Yes," enter the now of the foreign country ? ? B 2) 8 During 2007, 4W you npoeive a distribution from, or were you the grantor of, or transferor to, a foreign trust? If "Yes," you may nave b fat Form 3520. See pNe B-2 ..... .......... X For Paperwork Paducuon Aot Notice, see Form 1040 instructions, EEA Schedule 8 (Fora 1040) 2001 9 ebvd V91OLLM YOVOT 500Z'9Z cI'3S f, VERIFICATION I, Cathy C. Klinger , the undersigned, hereby verify and confirm that I have reviewed the foregoing document and the information contained therein is true and correct to the best of my knowledge, information and belief. I further understand that any false statements made herein are subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unsworn falsification to authorities. DATE: 6 1°2 --,() / a -*?r '01. Owjot . r-z? Cathy C. Klinger CERTIFICATE OF SERVICE I, James W. Abraham, Esquire, the undersigned, hereby certify that I have served a true and correct copy of the foregoing document by first class mail on the following person at the following address on the date stated below: Joanne Harrison Clough, Esquire Joanne Harrison Clough, PC 3820 Market Street Camp Hill, PA 17011 DATE: 10/20/09 James W. Abraham, Esquire PLED 20 UEi G ?ij 1 tfti dpp ABRAHAM LAW OFFICES 2 45 East Main Street, Hummelstown, PA 17036 OCR 2 ? (717) 566-9380 2009 r„ RODNEY L. KLINGER : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 06 - 6932 CIVIL TERM CATHY C. KLINGER : CIVIL ACTION - LAW Defendant : IN DIVORCE MOTION FOR .APPOINTMENT OF MASTER Cathy C. Klinger, Defendant, moves the court to appoint a master with respect to the following claims: ( x) Divorce ( x ) Distribution of Property ( ) Annulment ( ) Support (x) Alimony ( x ) Counsel Fees ( x ) Alimony Pendente Lite ( x ) Costs and Expenses and in support of the motion states: 1. Discovery is complete as to the claim(s) for which the appointment of master is requested. 2. The Plaintiff has appeared in the action by his attorney, Joanne Harrison Clouuh, Egguuire 3. The statutory ground(s) for divorce is irretrievable breakdown. 4. The action is contested with respect to the following claims: Divorce Equitable Distribution. Alimony APL Counsel Fees, Costs 8c Expenses 5. The action does not involve complex issues of law or fact. 6. The hearing is expected to take 1 day. 7. Additional information, if any, relevant to the Moti o - None. Date: 10/20/09 James W. Abraham, Esquire Attorney for Defendant, Cathy C. Klinger AND NOW, 2009, Esquire is appointed master with respect to the following claims: Ime smart" ANSO OT I" M.-a(Lc 44-1 -f - 126-tf 4L- ABRAHAM LAW OFFICES 45 East Main Street, Hummelstown, PA 17036 (717) 566-9380 RODNEY L. KLINGER Plaintiff V. CATHY C. KLINGER Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA NO. 06 - 6932 CIVIL TERM CIVIL ACTION - LAW IN DIVORCE DEFENDANT'S ANSWER & COUNTERCLAIM AND NOW, comes Defendant, Cathy C. Klinger, by and through her attorney, James W. Abraham, Esquire, Abraham Law Offices, Hummelstown, Pennsylvania, and files the following: 1. Admitted. 2. Admitted. 3. Admitted. 4. Admitted. 5. Admitted. 6. Admitted. 7. Admitted. 8. Denied. Defendant denies that the marriage is irretrievably broken as it was never Defendant's intention to be divorced. 9. Admitted. 10. Admitted as to Husband's request. WHEREFORE, Defendant respectfully requests Your Honorable Court that if a Decree in Divorce is entered, that it only be entered after granting the relief requested in Defendant's Counterclaim herein.. COUNTERCLAIM COUNT II - EQUITABLE DISTRIBUTION 11. Defendant's answers to paragraphs 1 through 10 are incorporated herein by reference. 12. Plaintiff and Defendant have accumulated real and personal property and other assets during the course of the marriage, which are marital property and marital assets; as well as debts during the marriage which are marital debts. 13. Defendant is entitled to the fair and equitable distribution of Defendant's equitable share of said property and assets in accordance with the Divorce Code of Pennsylvania. WHEREFORE, Defendant respectfully requests your Honorable Court to equitably distribute the marital property and debts hereto. COUNT III - ALIMONY, ALIMONY PENDENTE LITE, ATTORNEY FEES & COSTS 14. Defendant's answers to paragraphs 1 through 13 are incorporated herein by reference. 15. Defendant's income and/or earning capacity through appropriate employment is substantially and significantly less than Plaintiff s income and/or earning capacity and has been substantially and significantly less throughout the marriage. 16. Defendant has insufficient funds to support herself in accordance with the standard of living and station of life which the parties established during the marriage through appropriate employment; and Plaintiff's substantially higher income enables Plaintiff to contribute to the support and maintenance of Defendant and to pay alimony in accordance with the Divorce Code of Pennsylvania. 17. Defendant is without sufficient funds to support herself and is unable to appropriately maintain herself during the course of this litigation and the pendency of this action; and Plaintiff's substantially higher income enables Plaintiff to pay alimony pendente lite to Defendant in accordance with the Divorce Code of Pennsylvania. 18. Defendant is without sufficient funds to retain and/or continue to retain counsel to represent her in this matter; and without competent counsel, Defendant cannot adequately prosecute her claims against Plaintiff and adequately litigate her rights in this matter; and Plaintiff's substantially higher income enables Plaintiff to pay Defendant's attorney fees and costs of the litigation hereto. WHEREFORE, Defendant respectfully requests Your Honorable Court to award Defendant alimony, alimony pendente lite, attorney fees and costs. Respectfully sub 'tted: James W. Abraham, Esq. Abraham Law Offices 45 East Main Street Hummelstown, PA 17036 Attorney for Defendant, Cathy C. Klinger DATE: 10/29/09 VERIFICATION I, Cathy C. Klinger , the undersigned, hereby verify and confirm that I have reviewed the foregoing document and the information contained therein is true and correct to the best of my knowledge, information and belief. I further understand that any false statements made herein are subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to unworn falsification to authorities. DATE: /U C LA? C. Cathy C. Kl' ter CERTIFICATE OF SERVICE I, James W. Abraham, Esquire, the undersigned, hereby certify that I have served a true and correct copy of the foregoing document, by first class mail, upon the following person at the following address on the date stated herein: Joanne Harrison Clough, Esquire Joanne Harrison Clough, PC 3820 Market Street Camp Hill, PA 17011 DATE: 10/29/09 James W. Abraham, Esquire RfD-OFACE OF THE PP THONOTA 2009 OCT 29 AM iO: 06 PENNSY u A A , "` ,11;6` - r3-;? -X5 RODNEY L. KLINGER, IN THE COURT OF COMMON PLEAS Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOCKET NO. 06-6932 Civil rrtg n CATHY C. KLINGER, CIVIL ACTION - LAW -ox = --{ Defendant IN DIVORCE z? C rn- ZM G) -vr- % ©o AFFIDAVIT OF CONSENT ?n 3 fl z-n 54-- tV CD C fi 1. A Complaint i n Divorce under Section 3301(c) of the Divorce Code ? fip 010 December 1, 2006. 2. The marriage of Plaintiff and Defendant is irretrievably broken, and ninety (90) days have elapsed from the date of the filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree or upon filing of my Waiver of the Notice of Intention to Request Entry of the Decree. 4. I have been advised of the availability of marriage counseling and understand that the Court maintains a list of marriage counselors and that I may request the Court to require my spouse and I to participate in counseling and, being so advised, do not request that the Court require that my spouse and I participate in counseling prior to the divorce becoming final. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities. i Date: 85 1,211? Rodney L. Klinger RODNEY L. KLINGER, Plaintiff V. CATHY C. KLINGER, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 06-6932 Civil "Term CIVIL ACTION - LAW IN DIVORCE e-- NOTICE OF INTENTION TO REOUEST EN OF DIVORCE DECREE UNDER CAI § 3301(c) OF THE DIVORCE CODE x C= z --c 1 2 I consent to the entry of a final Decree of Di,orce without notice. 0 c? -Orr, `i' ? o ..o o- '.: C)m 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 : Rodney L,. linger RODNEY L. KLINGER Plaintiff V. CATHY C. KLINGER Defendant 1. A Complaint in Divorce under Section 3301 (c) of the Divorce Code was filed on December 1, 2006. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of service and filing of the Complaint. CD "-, --i o° 3- 3. I consent to the entry of a Final Decree of Divorce after service of notice of intention to request entry of the Decree. I verify that the statements made in the Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to the unsworn falsification to authorities. DATE: 9?-2 S 11 AFFIDAVIT OF CONSENT IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANkA C: C.5 NO. 06 - 6932 CIVIL TERM z CIVIL ACTION - LAW IN DIVORCE o „D -1-1' CA' C. 1. I consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this Waiver are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to the unsworn falsification to authorities. DATE: °2111 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA RODNEY L. KLINGER V. CATHY C. KLINGER NO. 06 - 6932 DIVORCE DECREE AND NOW, llod ri Lk-ag-, r - , it is ordered and decreed that RODNEY L. KLINGER , plaintiff, and CATHY C. KLINGER , 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.") AND, it is further ordered, adjudged and decreed that the terms of the parties' Settlement Agreement filed on November 2, 2011 are incorporated herein but not merged herewith. By the Court, Attest J. Prothonotary f/ a3 - t/' 66174 ?'op ma-'Deal ? . fry CA ?i "ec? ,br??/yl ? y INCOME WITHHOLDING FOR SUPPORT Q ORIGINAL INCOME WITHHOLDING ORDERMOTICE FOR SUPPORT (IWO) Q AMENDEDIWO Q ONE-TIMEORDERMOTICE FOR LUMP SUM PAYMENT Q TERMINATION OF IWO :35 ) 1 V5 i.D (O CL - Lg3g, C?vl 1 Date: 12/30/11 ? Child Support Enforcement (CSE) Agency ® Court ? Attorney ? Private Individual/Entity (Check One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions http://www acf hhs gov/programs/csetnewhire/em IR over/publication/publication htm - forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. State/Triberrerritory Commonwealth of Pennsylvania Remittance Identifier (include w/payment): 5538100108 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket Informaiton) Private Individual/Entity _ CSE Agency Case Identifier: (See Addendum for case summary) DFAS RETIRED MILITARY Sent Electronically DO NOT MAIL Employer/Income Wiithholder's FEIN Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) RE: KLINGER. RODNEY L. Employee/Obligor's Name (Last, First, Middle) 194-42-7852 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) See Addendum for dependent names and birth dates associated with cases on ORDER INFORMATION: This document is based on the support or withholding order from Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these am, obligor's income until further notice. $ 0.00 per month in current child support $ 0.00 permonth in past-due child support - Arrears 12 weeks or greater? $ 0.00 per month in current cash medical support $ 0.00 per month in past-due cash medical support $ 364.00 per month in current spousal support $ 0.00 permonth in past-due spousal support $ 0.00 permonth in other (must specify) for a Total Amount to Withhold of $ 364.00 per month. G : - --t uR D " t uni( '"- empJ Pe( =r- =ca -D f AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 83.77 per weekly pay period. $ 182.00 per semimonthly pay period (twice a month) $ 167.54 per biweekly pay period (every two weeks) $ 364.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), obtain withholding limitations, time requirements, and any allowable employer fees at http://www acf hhs gov/g_rograms/cse/newhire/employer/contacts/ contact map.htm for the employee/obligor's principal place of employment. Document Tracking Identifier OMB No.: 0970-0154 Form EN-428 11 /11 Service T pe M Worker ID $IATT ? Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: JAN If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ? If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case /denti>rer) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf.hhs.aov/proaramstese/newhire/employer/contacts/`conta gmaap.htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(bx7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SOU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, orattom6y) you must check the box above and 'return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date-05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use. Form EN-428 11/11 Service Type M Page 2 of 3 Worker ID $IATT Employer's Name: DFAS RETIRED MILITARY Employer FEIN: Employee/Obligor's Name: KLINGER RODNEY L. CSE Agency Case Identifier: (See Addendum for case summary Order Identifier: (See Addendum for order/docket information 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/obligor's principal place of employment (see REMITTANCE INFORMATION). 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, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: Q This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known address: Final Payment Date To SDU/Tribal Payee: New Employer's Name: New Employer's Address: Last known phone number: Final Payment Amount: CONTACT INFORMATION: To Employer/income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at 717 240-6225, by fax at (717) 240-6248, by email or website at: www childsupgortstate pa us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE PA 17013 (Issuer address). To Employee/Obligor. If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at 717 240-6225, by fax at (717) 240-6248, by email or website at www.childsupportstate. pa us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. Service Type M OMB No.: 0970-0154 Page 3 of 3 Form EN-428 11/11 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: KLINGER, RODNEY L. 333105686 CATHY C. KLINGER 06-6932 CIVIL $ 364.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Service Type M PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum OMB No.: 0970-0154 Form EN-428 11 /11 Worker ID $IATT INCOME WITHHOLDING FOR SUPPORT (V (D/n? 0 ORIGINAL INCOME WITHHOLDING ORDERMOTICE FOR SUPPORT (IWO) C ' 10G 7 d 0- IV I I 0 AMENDED IWO 0 ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT Q TERMINATION OF IWO Date: 02/02/12 ? Child Support Enforcement (CSE) Agency ® Court ? Attorney ? Private Individual/Entity (Check One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions http://www acf hhs aov/programs/cse/newhire/em Foyer/publication/publication htm - forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. StatefTribelrerritory Commonwealth of Pennsylvania Remittance Identifier (include w/payment): 5538100108 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for orderldocket lnformalton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) RE: KLINGER RODNEY L. DFAS RETIRED MILITARY Employee/Obligor's Name (Last, First, Middle) w ._ . _..,.,. _... __.r...._.. 194-42-7852 Sent Electronically Employee/Obligor's Social Security Number (See Addendum for plaintiff names DO NOT MAIL associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, _?..._..._ ..., ...... __.__Y._ _.. ?_......_.._?__.?._?_._ ..__....._.__. Middle) Employer/Income Withholder's FEIN 340727612 Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) 3407276120 See Addendum for dependent names and birth dates associated with cases on attachment. c. . cl ORDER INFORMATION: This document is based on the support or withholding order from MBE A C lx,, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts f he pplo " obligor's income until further notice. ' ` $ 0.00 per month in current child support r a+ C $ 0.00 permonth in past-due child support - Arrears 12 weeks or greater? O yes no-:a :X- $ 0.00 per month in current cash medical support 1:-) c-„ $ 0.00 per month in past-due cash medical support ?' $ 0.00 permonth in current spousal support px $ 0.00 permonth in past-due spousal support $ 0.00 per month in other (must specify) for a Total Amount to Withhold of $ 0.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 0.00 per weekly pay period. $ 0.00 per semimonthly pay period (twice a month) $ 0.00 per biweekly pay period (every two weeks) $ 0.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), obtain withholding limitations, time requirements, and any allowable employer fees at http://www.acf.hhs.aoy/proarams/cse/newhire/employer/contacts/ contact map.htm for the employee/obligor's principal place of employment. NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions l http://www.acf.hhs.aovlprograms/cse/newhire employer/publication/publication htm - form. If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. Document Tracking Identifier Service Type M OMB No.: 0970-0154 Form EN-428 01/12 Worker ID $IATT ? Return to Sender [Completed by Employerllncome Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): KEVIN A HESS Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: _ Date of Signature: FEBRUARY 2, 2012 If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ? If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS 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 /dentirrer) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: ht_tp://www acf hhs qov roarams/cse/-newhire/employer/contacts/contact_map htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date - 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use. Form EN-428 01/12 Service Type M Page 2 of 3 Worker ID $IATT Employer's Name: DFAS RETIRED MILITARY Employer FEIN: 340727612 Employee/Obligor's Name: KLINGER RODNEY L, 5538100108 CSE Agency Case Identifier: (See Addendum for case summary) Order Identifier: (See Addendum for order/docket information) 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/obligor's principal place of employment (see REMITTANCE INFORMATION). 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, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 3407276120 Q This person has never worked for this employer nor received periodic income. 0 This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known address: Last known phone number: Final Payment Date To SDU/Tribal Payee: New Employer's Name: New Employer's Address: Final Payment Amount: CONTACT INFORMATION: To Employer/income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www childsuaoort state pa us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST. P.O. BOX 320, CARLISLE. PA. 17013 (Issuer address). To Employee/Obligor: If the employeelobligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717240-6225, by fax at (717) 240-6248, by email or website at www.childsupport.state.pa.us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. Service Type M OMB No.: 0970-0154 Page 3 of 3 Form EN-428 01/12 Worker ID $IATT ADDENDUM Summary of Cases on Attachment Defendant/Obligor: KLINGER, RODNEY L. PACSES Case Number 333105686 PACSES Case Number Plaintiff Name Plaintiff Name CATHY C. KLINGER Docket Attachment Amount Doc Attachment Amount 06-6932 CIVIL $ 0.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-428 01/12 Service Tvoe M OMB No.: 0970-0154 Worker ID $IATT ' INCOME WITHHOLDING FOR SUPPORT Q ORIGINAL INCOME WITHHOLDING ORDERMOTICE FOR SUPPORT (IWO) Q AMENDEDIWO Q ONE-TIMEORDER/NOTICE FOR LUMP SUM PAYMENT (l TERMINATION OF IWO ``;_? 1() .? (C 9 t, C? \J Date: 02/03/12 ? Child Support Enforcement (CSE) Agency ® Court ? Attorney ? Private Individual/Entity (Check One) NOTE: This IWO must tie ri prtl ttrp_I; Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions http://www.acf.hh syov/programs/cse/newhire/employer/publication/publication.htm - forms). If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. State/Tribe/Territory Commonwealth of Pennsylvania mernmance iaenunel to w1UUV WI VOYI I-1 !- ,w .. City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for order/docket informalton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) DFAS C/O US MILITARY RETIREMENT PO BOX 7130 LONDON KY 40742-7130 Employer/Income Withholder's FEIN Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender (see IWO instructions http://www acf hhs gov/programs/cse/newhire! emr)loyer/publication/publication.htm - form . If you receive this document from someone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must be attached. 0925100193 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts from the employee/ obligor's income until further notice."? yf $ 0.00 per month in current child support t-rl $ 0.00 per month in past-due child support - Arrears 12 weeks or greater? O yes-n* nltrnn ri $ 0.00 per month in current cash medical support $ 0.00 per month in past-due cash medical support $ 364.00 per month in current spousal support tip -p q-'`t $ 0.00 per month in past-due spousal support pc? on $ o.00 per month in other (must specify)G ?`? A for a Total Amount to Withhold of $ 364.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order Information. If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 83.77 per weekly pay period. $ 182.00 per semimonthly pay period (twice a month) $ 167.54 per biweekly pay period (every two weeks) $ 364.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten (10) working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay date. If you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to 55% of disposable income for all orders. If the employee/obligor's principal place of employment is not CUMBERLAND County, Commonwealth of Pennsylvania (State/Tribe), obtain withholding limitations, time requirements, and any allowable employer fees at http://www.acf.hhs.aov/programs/cse/newhire/employer/contacts/ contact mao.htm for the employee/obligor's principal place of employment. Document Tracking Identifier Service -ype M OMB No.: 0970-0154 RE: KLINGER RODNEY L. Employee/Obligor's Name (Last, First, Middle) 194-42-7852 Employee/Obligor's Social Security Number (See Addendum for plaintiff names associated with cases on attachment) Custodial Party/Obligee's Name (Last, First, Middle) Form EN-028 01/12 Worker ID $OINC ? Return to Sender [Completed by Employer/Income Withholder]. Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): Print Name of Judge/Issuing Official: b" H Qr. . ..?. Title of Judge/Issuing Official: Date of Signature: w- -- j If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ? If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERS/INCOME WITHHOLDERS Pennsylvania law (23 PA C.S. § 4374(b)) requires remittance by an electronic payment method if an employer is ordered to withhold income from more than one employee and employs 15 or more persons, or if an employer has a history of two or more returned checks due to nonsufficient funds. Please call the Pennsylvania State Collections and Disbursement Unit (PA SCDU) Employer Customer Service at 1-877-676-9580 for instructions. PA FIPS CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the Employee/Obligor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: http://www.acf.hhs,aov/pro,grams/cse/newhire/em looyer/contacts/contacl map.htim Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(b)(7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment to an entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to" instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date - 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO, it identifies the version of the form currently in use. Form EN-028 01112 Service Type M Page 2 of 3 Worker ID $OINC Employer's Name: DFAS Employer FEIN: Employee/Obligor's Name: KLINGER, RODNEY L. 5538100108 CSE Agency Case Identifier: (See Addendum for case summary Order Identifier: (See Addendum for order/docket /nformationl 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/obligor's principal place of employment (see REMITTANCE INFORMATION). 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, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit indicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S.C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the sender by returning this form to the address listed in the Contact Information below: 0925100193 O This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known address: Last known phone number: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www.childsupport.state. oa us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS SECTION, 13 N. HANOVER ST P.O. BOX 320, CARLISLE PA 17013 (Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at www.childsupport.state.pa.us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. Service Tyoe M OMB No.: 0970-0154 Page 3 of 3 Form EN-028 01112 Worker ID $OINC ADDENDUM Summary of Cases on Attachmen Defendant/Obligor: KLINGER, RODNEY L. PACSES Case Number 333105686 PACSES Case Number Plaintiff Name Plaintiff Name CATHY C. KLINGER Docket Attachment Amount Docket Attachment Amount 06-6932 CIVIL $ 364.00 $ 0.00 Child(ren)'s Name(s): DOB Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): DOB Addendum Form EN-028 01/12 Service Type M OMB No.: 0970-0154 Worker ID $OINC Rodney L. Klinger Plaintiff vs. Cathy C. HIinger Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 06-6932 CIVIL IN DIVORCE DOMESTIC RELATIONS ORDER This Domestic Relations Order ("DRO") creates and recognizes the existence of the Alternate Payee's right to receive a portion of the benefits payable with respect to the Participant. It is intended to constitute a DRO Acceptable For Processing under final regulations issued by the Office of Personnel Management ("OPM") 2. This DRO is entered pursuant to authority granted under the applicable domestic relations laws of the Commonwealth of Pennsylvania. 3. This DRO relates to the provision of marital property rights to the Alternate Payee. 4. This DRO applies to the Civil Service Retirement System ("Plan") and any successor thereto. Rodney L. HIinger ("Participant") is a Participant in the Plan. Cathy C. Klinger ("Alternate Payee"), the former spouse, is the Alternate Payee for the purposes of this DRO. 5. The Participant's name, mailing address, Social Security number and date of birth are: Rodney L. Klinger 203 West Locust Street Enola, PA 17025 Social Security No.: See Addendum Date of Birth: See Addendum N f 'QDRO Page 2 6. The Alternate Payee's name, mailing address, Social Security number and date of birth are Cathy C. Klinger 389 North Sample Bridge Road Enola, PA 17025 Social Security No.: See Addendum Date of Birth: See Addendum It is the responsibility of the Alternate Payee to keep a current mailing address on file with the Plan at all times. 7. The Participant is currently receiving a monthly annuity under the Plan. 8. The Alternate Payee is entitled to a portion of the Participant's gross monthly annuity under the Plan as set forth below. The OPM is hereby directed to pay Alternate Payee's share directly to Alternate Payee. 9. This DRO assigns to Alternate Payee an amount equal to $2,004.00 of the Participant's gross monthly annuity. When cost-of-living adjustments (COLA's) are applied to Participant's retirement benefits, the Alternate Payee's share of the annuity shall be increased for such COLA at the same rate as the Participant's annuity is increased. 10. Payments to Alternate Payee shall commence as soon as administratively feasible following the date this DRO is approved by OPM. Participant agrees to arrange or to execute all forms necessary for the OPM to commence payments to the Alternate Payee in accordance with the terms of the DRO. 11. Payments shall continue to Alternate Payee for the remainder of the Participant's lifetime. If the Alternate Payee dies before the Participant, the Alternate Payee's share of the Participant's pension shall revert to the Participant. 12. Upon the death of the Participant, the Alternate Payee's share of the annuity shall cease to be paid by OPM. The Alternate Payee shall not receive a former spouse survivor annuity. QDRO Page 3 13. In no event shall the Alternate Payee have greater benefits or rights other than those which are available to the Participant. The Alternate Payee is not entitled to any benefit not offered by the Plan as provided in this Order. All other rights, privileges and options offered by the Plan not granted to Alternate Payee are preserved for the Participant. 14. The Alternate Payee assumes sole responsibility for the tax consequences of any payments made to her under this DRO. 15. In the event that the Plan inadvertently pays to the Participant any benefits that are assigned to the Alternate Payee pursuant to the terms of this DRO, the Participant shall immediately reimburse the Alternate Payee to the extent that he has received such benefit payments, and shall forthwith pay such amounts so received directly to the Alternate Payee within ten (10) days of receipt. In the event the Plan inadvertently pays to the Alternate Payee any benefits that are not assigned to her pursuant to the terms of this DRO, the Alternate Payee shall immediately reimburse the Participant to the extent she has received such benefit payments and shall forthwith pay such amounts so received directly to the Participant within ten (10) days of receipt. 16. If Participant takes any action that prevents, decreases, or limits the collection by Alternate Payee of the sums to be paid hereunder, he shall make payments to Alternate Payee directly in an amount sufficient to neutralize, as to Alternate Payee, the effects of the actions taken by Participant. 1 QDRO Page 4 17. The Court of Common Pleas of Cumberland County, Pennsylvania shall retain jurisdiction to amend this Order, but only for the purpose of establishing it or maintaining it as a Domestic Relations Order, provided, however, that no such amendment shall require the Plan to provide any form of benefit or any option not otherwise provided by the Plan, and further provide that no such amendment or right of the Court to so amend will invalidate this Order. EXECUTED this IP' -day of A4,CA , 201r- . BY THE COURT CONSENT TO ORDER: Judge Plaintiff/Participant f t0i _" e y for Plaintiff/Participant Signature Date D -f nd"nt/Alterna'.e Payee ?.? f-A Signature, Date t12 Attorney for Defend t/Alternate Payee Signature Date C- L, -?, ' F.T7 G7 ? _. , , M M Fri_ ?> C-1 _ ? C 3 r- ' C:: ? CM J> _T-imps t? br ke,04 F 14U4. I rYlt J?d ie, t JOANNE HARRISON CLOUGH, PC BY: JOANNE HARRISON CLOUGH, ESQUIRE Attorney I.D. No. 36461 3820 Market Street Camp Hill, PA 17011 Telephone: (717) 737-5890 Attorney for Plaintiff RODNEY L. KLINGER, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA V. CATHY C. KLINGER, Defendant DISTRIBUTION: Defendant: James W. Abraham Esquire 45 E. Main Street Hummelstown, PA 17036 DOCKET NO. 06-6932 Civil Term CIVIL ACTION -LAW IN DIVORCE Plaintiff. Joanne Harrison Clough, Esquire 3820 Market Street Camp Hill, PA 17011 CERTIFICATE OF SERVICE 1, Connie Lee Limric, secretary to Joanne Harrison Clough, Esquire, do hereby certify that on this date I served a copy of the foregoing document by United States First Class Mail to the following individual set forth below: James W. Abraham Esquire 45 E. Main Street Hummelstown, PA 17036 Date: Connie Lee Limric, secretary to Joanne Harrison Clough, Esquire Attorney ID No. 36461 3820 Market Street Camp Hill, PA 17011 (717) 737-5890 Attorney for Rodney Klinger ?• 7 c cs= t L; .. S INCOME WITHHOLDING FOR SUPPORT O ORIGINAL INCOME WITHHOLDING ORDER/NOTICE FOR SUPPORT (IWO) h '~ I CI ® AMENDEDIWO /f O ONE-TIMEORDERINOTICE FOR LUMP SUM PAYMENT C? l I V i L Q TERMINATION OF IWO Date: 07/19/12 ? Child Support Enforcement (CSE) Agency ® Court ? Attorney ? Private Individual/Entity (Che k One) NOTE: This IWO must be regular on its face. Under certain circumstances you must reject this IWO and return it to the sender see IWO instructions ht?p%/vim ash coy rograms/cse/newhire/employer/publication/publication htm - forms). If you receive this doc ment from someone owar'tnah a Stafe or Tribal CSE agency or a Court, a copy of the underlying order must be attached. Staterrriberrerritory Commonwealth of Pennsylvania Remittance Identifier (include w/payment): 5538100108 City/County/Dist./Tribe CUMBERLAND Order Identifier: (See Addendum for ordeddocket /nformaiton) Private Individual/Entity CSE Agency Case Identifier: (See Addendum for case summary) OFFICE OF PERSONNEL MANAGEMENT C/O COURT ORDER BENEFITS BRAN PO BOX 17 WASHINGTON DC 20044-0017 Employer/Income Withholder's FEIN Child(ren)'s Name(s) (Last, First, Middle) Child(ren)'s Birth Date(s) RE: KLINGER, RODNEY L Employee/Obligor's Name (Last, First, Middle) 194-42-7852 Employee/Obligor's Social Secur ty Number (See Addendum for plaintiff na es associated with cases on attac ment) Custodial Party/Obligee's Name Last, First Middle) NOTE: This IWO must be regular its face. Under certain circumstances you ust reject this IWO and return it to the sende (see IWO instructions f hh v r wit ! emoloverloublication/ ubli at' n - form . If you receive this document from so eone other than a State or Tribal CSE agency or a Court, a copy of the underlying order must attached. 2454100092 See Addendum for dependent names and birth dates associated with cases on attachment. ORDER INFORMATION: This document is based on the support or withholding order from CUMBF& A?W Commonwealth of Pennsylvania (State/Tribe). You are required by law to deduct these amounts frc- tht? ' obligor s income until further notice. 'v $ 0.00 per month in current child support "? r- $ 0.00 per month in past-due child support - Arrears 12 weeks or greater? O y§@"t,p r4 $ 0.00 per month in current cash medical support -?2? n $ 0.00 per month in past-due cash medical support '<;:Z' -rr $ 364.00 per month in current spousal support C-) $ 0.00 per month in past-due spousal support rU $ 0.00 per month in other (must specify) rv for a Total Amount to Withhold of $ 364.00 per month. AMOUNTS TO WITHHOLD: You do not have to vary your pay cycle to be in compliance with the Order I If your pay cycle does not match the ordered payment cycle, withhold one of the following amount: $ 83.77 per weekly pay period. $ 182.00 per semimonthly pay period (h $ 167.54 per biweekly pay period (every two weeks) $ 364.00 per monthly pay period. $ Lump Sum Payment: Do not stop any existing IWO unless you receive a termination order. REMITTANCE INFORMATION: If the employee/obligor's principal place of employment is within the Comi of Pennsylvania (State/Tribe), you must begin withholding no later than the first pay period that occurs ten working days after the date of this Order/Notice. Send payment within seven 7 working days of the pay c you cannot withhold the full amount of support for any or all orders for this employee/obligor, withhold up to disposable income for all orders. If the employee/obligor's principal place of employment is not within the Commonwealth of Pennsylvania (State/Tribe), the employer can obtain withholding limitations, time require and any allowable employer fees at http://www acf hhs gov/programs/cse/newhire/emDyer/contacts/contE htm for the employee/obligor's principal place of employment. Document Tracking Identifier r: r.r. C:) - t C:1 a month) of OMB No.: 0970-0154 Form EN-028 06 12 Service Type M Worker ID $OIN . ? Return to Sender [Completed by Employer/Income Withholder). Payment must be directed to an SDU in accordance with 42 USC §666(b)(5) and (b)(6) or Tribal Payee (see Payments to SDU below). If payment is not directed to an SDU/Tribal Payee or this IWO is not regular on its face, you must check this box and return the IWO to the sender. Signature of Judge/Issuing Official (if required by State or Tribal law): Print Name of Judge/Issuing Official: Title of Judge/Issuing Official: Date of Signature: If the employee/obligor works in a State or for a Tribe that is different from the State or Tribe that issued this order, a copy of this IWO must be provided to the employee/obligor. ? If checked, the employer/income withholder must provide a copy of this form to the employee/obligor. ADDITIONAL INFORMATION FOR EMPLOYERSIINCOME WITHHOLDERS 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 IS 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 FIFES CODE 42 000 00 Make Remittance Payable to: PA SCDU Send check to: Pennsylvania SCDU, P.O. Box 69112, Harrisburg, Pa 17106-9112 IN ADDITION, PAYMENTS MUST INCLUDE THE DEFENDANT'S NAME AND THE PACSES MEMBER /D (shown above as the EmpioyeWObtigor's Case Identifier) OR SOCIAL SECURITY NUMBER IN ORDER TO BE PROCESSED. DO NOT SEND CASH BY MAIL. State-specific contact and withholding information can be found on the Federal Employer Services website located at: //w ^1 acf hhs.gov( roaranislSselnewbire/employer/contacts/cGnLaG man htm Priority: Withholding for support has priority over any other legal process under State law against the same income (USC 42 §666(bx7)). If a Federal tax levy is in effect, please notify the sender. Combining Payments: When remitting payments to an SDU or Tribal CSE agency, you may combine withheld amounts from more than one employee/obligor's income in a single payment. You must, however, separately identify each employee/ obligor's portion of the payment. Payments To SDU: You must send child support payments payable by income withholding to the appropriate SDU or to a Tribal CSE agency. If this IWO instructs you to send a payment town entity other than an SDU (e.g., payable to the custodial party, court, or attorney), you must check the box above and return this notice to the sender. Exception: If this IWO was sent by a Court, Attorney, or Private Individual/Entity and the initial order was entered before January 1, 1994 or the order was issued by a Tribal CSE agency, you must follow the "Remit payment to instructions on this form. Reporting the Pay Date: You must report the pay date when sending the payment. The pay date is the date on which the amount was withheld from the employee/obligor's wages. You must comply with the law of the State (or Tribal law if applicable) of the employee/obligor's principal place of employment regarding time periods within which you must implement the withholding and forward the support payments. Multiple IWOs: If there is more than one IWO against this employee/obligor and you are unable to fully honor all IWOs due to Federal, State, or Tribal withholding limits, you must honor all IWOs to the greatest extent possible, giving priority to current support before payment of any past-due support. Follow the State or Tribal law/procedure of the employee/obligor's principal place of employment to determine the appropriate allocation method. Lump Sum Payments: You may be required to notify a State or Tribal CSE agency of upcoming lump sum payments to this employee/obligor such as bonuses, commissions, or severance pay. Contact the sender to determine if you are required to report and/or withhold lump sum payments. Liability: If you have any doubts about the validity of this IWO, contact the sender. If you fail to withhold income from the employee/obligor's income as the IWO directs, you are liable for both the accumulated amount you should have withheld and any penalties set by State or Tribal law/procedure. Anti-discrimination: You are subject to a fine determined under State or Tribal law for discharging an employee/obligor from employment, refusing to employ, or taking disciplinary action against an employee/obligor because of this IWO. OMB Expiration Date - 05/31/2014. The OMB Expiration Date has no bearing on the termination date of the IWO; it identifies the version of the form currently in use Form EN-028 06/12 Service Type M Page 2 of 3 Worker ID $OINC Employer's Name: OFFICE OF PERSONNEL MANAGEMENT Employer FEIN: Employee/Obligor's Name: KLINGER, RODNEY L. 5538100108 CSE Agency Case Identifier: (See Addendum for case s umma1y) Order Identifier: (Su Addendum. r orde r o k Inf rm i Withholding Limits: You may not withhold more than the lesser of: 1) the amounts allowed by the Federal Consumer edit Protection Act (CCPA) (15 U.S.C. 1673(b)); or 2) the amounts allowed by the State or Tribe of the employee/obligor's principal pla of employment (see REMITTANCE INFORMATION). Disposable income is the net income left after making mandatory de ctions such as: State, Federal, local taxes; Social Security taxes; statutory pension contributions; and Medicare taxes. The Federal I mit 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, those limits increase 5% - to 55% and 65% - if the arrears are greater than 12 weeks. If permitted by the State or Tribe, you may deduct a fee for administrative costs. The combined support amount and fee may not exceed the limit ndicated in this section. For Tribal orders, you may not withhold more than the amounts allowed under the law of the issuing Tribe. For Tribal employers/income withholders who receive a State IWO, you may not withhold more than the lesser of the limit set by the law of the jurisdiction in which the employer/income withholder is located or the maximum amount permitted under section 303(d) of the CCPA (15 U.S. C. 1673 (b)). Depending upon applicable State or Tribal law, you may need to also consider the amounts paid for health care premiums in determining disposable income and applying appropriate withholding limits. Arrears greater than 12 weeks? If the Order Information does not indicate that the arrears are greater than 12 weeks, then the Employer should calculate the CCPA limit using the lower percentage. Additional Information: NOTIFICATION OF EMPLOYMENT TERMINATION OR INCOME STATUS: If this employee/obligor never worked for you or you a no longer withholding income for this employee/obligor, an employer must promptly notify the CSE agency and/or the se der by returning this form to the address listed in the Contact Information below: 24 4100092 O This person has never worked for this employer nor received periodic income. O This person no longer works for this employer nor receives periodic income. Please provide the following information for the employee/obligor: Termination date: Last known phone number: Last known address: Final Payment Date To SDU/Tribal Payee: Final Payment Amount: New Employer's Name: New Employer's Address: CONTACT INFORMATION: To Employer/Income Withholder: If you have any questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at (717) 240-6225, by fax at (717) 240-6248, by email or website at: www.childsupp-o!j.s1ate.pa.us. Send termination/income status notice and other correspondence to: DOMESTIC RELATIONS S TION, 13 N. H/ P.O. BOX 320. CARLISLE. PA. 1701' (Issuer address). To Employee/Obligor: If the employee/obligor has questions, contact WAGE ATTACHMENT UNIT (Issuer name) by phone at 717) 240-6225, by fax at (717) 240-6248, by email or website at www.childsupport state pa us. IMPORTANT: The person completing this form is advised that the information may be shared with the employee/obligor. OMB No.: 0970-0154 Form EN-028 06/' Service Type M Page 3 of 3 Worker ID $OINC ADDENDUM Summary of Zass on glktachment Defendant/Obligor: KLINGER, RODNEY L. PACSES ase Number 333105686 Plaintiff Name CATHY C. KLINGER Docket AUGhmaniAmnUnt 06-6932 CIVIL $ 364.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Ate hment mount $ 0.00 DOB Child(ren)'s Name(s): DOB PACSES Case Number Plaintiff Name Docket Attach ment Amount $ 0.00 Child(ren)'s Name(s): PACSES Case Number Plaintiff Name Docket Attachment AMQW $ 0.00 DOB Child(ren)'s Name(s): ?nrGF.S ase Number Plaintiff Name Docket Attachment Amount $ 0.00 Child(ren)'s Name(s): Docket Attachment Amount $ 0.00 DOB Child(ren)'s Name(s): DOB DOB Service Type M Addendum OMB No.: 0970-0154 Form EN-028 06/12 Worker ID $OINC