HomeMy WebLinkAbout95-02640
f
-~
~~
'~
o.
':t
.ri
I
It)!
:r
,
~
,
1'/ 7 (
, ,
f 1,lf)
A,'fl,'
I' I
( I, ,,' A" J, .
ii' . I 'r (
DORY I.. JACOBS. ) IN TUE COURT OF COMMON
l'laintiff ) PLEAS OF CUMBERLAND
) COUNTY. PENNSYLVANIA
VII )
) CIVIL ACTION .I.AW
AI.BERT I. JA< 'OBS )
Defcndant ) NO. 9j -2640 CIVIL TERM
) IN DIVORCE
TO TIlE PROTHONOTARY:
Tranlimitthe recold, together with the following infonnation, to the Court for entry
ora divorce decree:
I. Oroundll for Divorce: JJOl(c):
2. D.te and manner of Ilervice of the Complaint: Complaint filed 011 17 May 1995,
aerved by certified mail on 26 May 1995.
J. Date ofexccution of the Affidavit ofConscntlequired by Sectioll J301(c)
of the Divorce Code: (..nd the \~i.liver of Notice) I
By Plaintiff: (, 'I.. Y 11) l) 6
By Defendant: II) Api i 1 1l)l)(,
4. Related claims pending: None.
c - rtb('
../ . )
By _~::._:-C:}..J\J"-l.... \, / twJb.
Samuel LAndes
Attomey 1'01 Plaintiff
l1t ';1
t .1
ill ,.-
U! ,:1
h,
(,i
~
If' .. "
" ~'( 'f
'-;. .
~.( YJ ~
"
.. tol
" \P
~
(fl \
, Ins
. '. ii J
/'It;.<X)/;y./' ail
'-~' tt);rI ,~IiI"~T
C, t' 11:r/ /3
f# d ~;5(1'i?
, J 5' ( '0 (laJ. Rf...t/
.\NIH'.H. \'AI'OIlN ~ B^N(t~
A'ltuUNt,;,'k .-\'1 I,M'"
",Wl'1 NUlI,1I 1Wt.1J'111 h'It":f'l
1'1.1 UfHI IUn
J.ltMUYNf!, f.tJ.HN",,"'t,\'ANh\ .,O,-&.:I
IlORY I,. JAl:OBS
I'lalnllll
I H THB COUllt' 01' ClJHItON PI,IIU
or CUHllIlIlLANU COUNTY.
PENNBYlNANU
VS.
ALBEIIT I. JACOBS. III
Uelelldant
CI V II, AC'I'I11N " LAlli
NO. ~~-
IN IIIVulln,
CIVU. TEIIl1
imleR (If AVAlMIU t.lTY Qf m\ltfnt.ullJ
TO TIIB WITHIN-NAHEIl IlEI'ENIlAN1':
You have been na.ed as the Ilelendalll III a Co.plalnt In 4 dlvorc~e 1'llIceedlnQ IIled
In the Court ot C.-.on l'len 01 Cu.berland County. This notll'e la to adyl.. you that In
accordance with 8ectlon JJO~(dl of the III vorce Code, YOII .ay I"quest that the courl
require you and your spoule 10 attend .lrrlaQe counlellllQ pllol to a divorce belnQ
handed down by the court. A list 01 plohulonal .i1rrIaQe 1'0ulIs"lon II ual1abls at
the DOIInUc RelaUone Otllce, J) North lIanovf!r 81leet, Cnlhle, l'ennsylvanla, You are
advleed that. thle list 18 kept as a convelllelll'e to you and you ate not bound to {'hoole
a counselor frOM this IIsI. All lIeeouary anlllQeMents Ind ths ('Ult 01 I~OUn8ll1lIlQ
8e881001 are to be borne by you Ind YOUI apoule.
It you dellre to purlue {'oulIseIIIlQ, you MUlt make youl lequest lor counsellnQ
within twenty days 01 lhe date 011 which you Il!('ehl' tltls 1I01lce. 1'IIIuIII to do 10 will
conltltute a waiver 01 your rlQltt 10 lequell eoulllellllQ.
~
VHBlBPOIB, Plllnlllt r.qU'111 lhtl Courl 10 enler I decree tn divorce purlulnt 10
lbe Dtvorce Code o( Pennlylvlnll.
I verity lhll lhe BllleMenlo Made In lhlB COMplalnl Ire true and correcl. I
underellnd thai any hIBe BtaleRlentB In thh Cn.plalnl lie oubject III the l,e"llIl8I 01
18 Pa. C.B. 4904 (unslIorn I8lolllcallon to aUlholillul,
. dJ-11 /(~___
. Dale 4-
'loiy~ht~~t
I \~(1 f (uJ/
ANDB8. VAUGHN . BANG8
\\ %V\
~,~.. ;Wl~~
Be.uel L, dea
Attorney lor Plalntlll
4
I,.
"
,:
. "'f ~'s
li.b.Q, ;'d. 44
OJ('~t
SAMllltl. L. ANIII~1i
Al'TuIIHItt" A1' 1.AW
"II" ..ownl HUt,,1I "'ltlll
.., u. am. HiD
1,KNOYWIt, '"J{HNSYI,VANIA 110--1:1
DOn 1... JACOBS
PlIlnllll
IN THIl coun 01' COIIItON PLBAS
01' CUHBBIILANIl COUNTY,
PENNBYI,VANI A
VS,
C1VU. ACTIIlN - I,AW
ALBEIIT I, JACOBS, III
\lelendant
NO. 9~-~b.U CIVIL TBII"
IN IlIV01lC~
I!QTICll \If mU..AJlltITY OJ' "'ll1t!'IIU!I!l
TO THB liITHIN-NAHI!Il Illll'BNDAN'I'1
You have been na.ed II the Delendant In a Co.plalnt In a divorce proceedina l1led
in the Court of C~n "leu 01 Cu.berland Cuunty. 'I'hle nollce II 10 advlee you that in
accordance vllh Section 1101ldl 01 Ihe Illvurce Code. VOU .av requesl Ihat lhe court
require you and yuur Ipouse to allend .,rrllae counlellnQ prlur to a divorce belna
baDded dovn by the cuurt. A llet ul pruleulunal ...rleue counlelurl h available at
the DOIIeltlc 1Ielatlunl Olllee, II Nurth IIlnuveI Street, Carlhle, Penuyhanla. You are
advlled lhat lhle liet h kepi n I l'unvenlenl'e \u you Iud yuu are nut bound tu cboole
I counular trlltl tbh liet. All neenury II unae..nll and lbe cult ut counselina
leuluu I.e to be burne by yuu and your IpUUIe,
If you dellre to purlue cuunl.llnG, vou .Ult .eke vuur requelt lur counlellna
vilbln tv,nty daVI III tho dalll un vbll~b VOU IUcoho thh notice. failure \0 do 10 vlll
conltll ule I vltve. 01 yuur r IQhl III uqullt l'uunl,t1I11V,
~
DORY L. JACOBS
VlaintHf
IN THB COURT OP COHHON VLBAS
OP CUHBHRLAND COUNTY,
PBNNSYLVANIA
VB,
CIVIL AC'I'lUN - LAW
ALBERT I, JACOBS, III
Delendant
NO. 9~-~640 CIVIL TERM
IN DIVORCE
W!II!III!
\,'QtII'1A lIlT IN Jlli'QIg!
!OO!M_m;r~l~l!il~l 01 J~!!H!!lJ~!'_ ftll!l!! VOIC~ ._COIlI!
AND NOW c~es the above-naMed Plaintiff, DORY L. JACOBS, by her attorney, Samuel
L. Andes, and Makes the 10110vln9 AMunded C~plalnt In Divorce I
1. 1'he Vlaintlff Is DORY I.. JACOBS, an adult Individual vho currently resides at
~lt~ Bast Trlndle Road. Hechanlcsbur9, CUMberland County, Vennsylvanla.
~. "he Defendant 18 ALBERT 1. JACOBS. 111, an adult Individual vho currently
resides at I~O Pairvay Drive, Etters. York County, Pennsylvania.
J. Both the l'laintifl and Delendant have been bona lido residents at tbe C~n-
vealth of Pennsylvania for at least six months IMmediately previous to the 1illn9 01
this COBIplalnl.
t. The Plaintiff and Delendant vere Married on I~ Hay 1990 In Dover,
PennsylVania.
~. Tbero have been no prior actions uf divurce or annulMent betveen the parties,
6. This Marrlage Is Irretrievably broken,
1. Vlalotlff hiS been advised of the availability of Marrlage counselin9 and the
Vlalntllf May have the 1'19ht to request that the Court require the parties to partlci-
pate In counsellnq.
1
~... - JPJ!'fIlU!YAILI! UI!A~
8. The Plaintitt requests this Coart to enter a Decree 01 Olvorce,
lIHBIBl'OIJI, Phlnl1l1 requests this Court to .mter a decree In divorce pUrBuant to
the Divorce Code 01 Pennsylvania,
!,'Q1l!lJ !L::.J!IH!ITA!I1ILP!l!nrnrr..~
9. OuriM the course at the ilia rrlage, the parlles have acquired nUlllerous Helll' 01
property. both real and personal. vhich are held In joint nallles and In the Individual
na.ea 01 each at the parlles hereto,
1IIIBlIIl'OIUI, PlaintHt prays this Ilnnorable Court, alter requirln" 11I11 disclosure
.by the Oelendant, to equitably divide the property, bolh real and person,l, ovned by
tbe parties hereto as lIIarltal property,
couwrJ.IL:.~~ItR!Y
10. Although the Plalnlltl VI8 elllployed outside 01 the hOllle durin" the lIIarrh"e,
her pursuit 01 a career VI8 alvays secondary to her prllllary careor 01 .akln" a Qood
hOlll8 tor the Defendant.
II. Plaintitf lacks sutliclent propcrty to provide lor her rcasonable needs In
accordance vith the standard 01 livln" ot the vartjp6 established during tbe .arriave.
13. Plaintill Is unable to support herselI in accordancc vlth the atandard 01
livinv 01 the parties established during the lIIarriage through appropri't' ..pluYlllent.
13. The Oelendsnt is elllployed and enjoys a substantial Inco.e 11'011I vhlch he I,
able to contribute to the support and Maintenance 01 I'lainlltl and to PlY her aUBlllny
In accordance with thl! III vorce Code 01 Pennsylvanla.
4
IIIlIllIlI'OlB. 1'111111 III prays Ihls 1I01l0rable Coull tu enter IIn Ordn awarding I'laln-
till trOll Detendallt pllllllnent IlIlIony In Burh lUll all are rellollablo Ind adequlto to
lupport and lIallllaln l'ldjlltlll III the ulallllll ul lilt! III which ahe has becOllo
accultOlled durlnQ the IIUllaQB.
W\lHT IV... ^!;lltQlly !'Mll/1Im! ltlT!!
14. Phlntlll 1M without Bulllclenl IncOllo 10 nupport and lIalnteln herult durlnQ
tho pendency ot this IIctllln.
I~. Detendlnt enjoYI a eubltalllldl 1III'II11e and II woll ablo to contribute to the
lupport and .alnt,nlnce ot Plalntltt durlnQ the courle ot thll aCllon,
1IIIIUftII1. Plalntllt I'raya thla IInnoublll CIlUrt In order Delllndant to pay lieI'
renonable al1lK1ny pl/ldente lite durlnQ Ihe pendency III thla acUon.
I verily that llle Ilah.entl .Ide III I/l1s COllphlnt lie true and correct. I
undentand that any lallll nlaleMentl In thla COllplalllt 118 SUbject to the penalties of
18 Pa, C,8. 4904 (unsworll lalulllcallllll to luthllritlesl.
eJt.J (/'. {'t'
(Jate
Ji. ()It)
.."
I ~/ / /
. \ / ", /fA. {t..;J
__~_ __.~i_:J..';.__~.._"___._,__
(" ..) \ ..f (; (,
"' '.'" (~.\ {.'.V'
-' .... ...",J
""U8 I I.. And..
AlIlllllllY lor l'talnU II
~a' Nurth lalh Dtloel
I,ellllyne, I'A 1'104.1
1'11'11 '/bl" 'dId
"
q,"""",'
~,!!.
JUH 3D
//31 AH t95
, .
'/i'
I ':'1' ~ Ah r
.. ',.y
", "
i'
ANlms, VAIJGHN & BANOS
A1'1'OUNJ!\"H AT I.AW
nUl'\ NO"')"" TWELrTII HTltlnn
I~ C). nux Inll
UOIOYNR. JIUNNHYI,\'ANIA )10,,:1
1l0RY L, JACOBB
Plalnl1lt
IN 1'1I1l COUR1' O~' COKItON PLIlAB
01' CUHBIlRLAND COUN1'Y.
PIlNNBYLVANIA
vs,
ALBBRT 1. JACOBS, III
Ilelendant
CIVIL ACTION - LAW
NO, 9~- 2(,40 CIVlI, TBRH
IN IlIVORCIl
APFIDAYlT..ill' J!J~!.Yl!;'!.L,I!X. cun 1'1lYU'~.!.!>
LOU ANN GRISSINGER. bolng duly sworn according to law, deposes and says HB
follows I
1. That she Is an employee 01 Andes, Vaughn' 8angs. attorneys for the Plalntllf
herein,
~, That on 24 May
199~. she delivered to the U,B. Postal Bervice in
LellOyne, Pennsylvania. as corUlled mall (Receipt No, Z402 537 03cJ return receipt
requested, addressed to the Delendant heroin. a lrull and correcl copy 01 the COIIplaiPt
In III vorce tiled In the above-captioned action duly endorsed with a Notice to Ilefend
and Clal. Rights,
3. Bald rlllurn receipt card Is altached herllto as Exhlbll A showing a date 01
delivery lo the Ilelendant 01 2(, M'lY t 'Jl)',.
Sworn to and SUbscribed
before 11I8 thl s ;!~., day
of 1 \lU! ,l'l'l~.
, fI C
UlLl~ llI};XQ/~ Il')J
I,ou Ann llrlBBln'911r')
Nilt a l:tV~lt~ 1~' '.',
Nllla;,~fJtll.
l~fjr\Kit'1l1lf '.Jl;lT,I'I.~il'
tO~'IV'I~ tlt.llrJ t;J :'nhwll"1 i.( ,11111
M)f (W1llllil..,.-~"y!rrJ~'rr!\l.ll: I~"~
..
.
&,-=:."'....";.-- _.
... ...... .. 1M _ ., tHo - eo .... .. ...
"you.
. ~~.. ... - of 1M .......... ... ... - " ......
.....n.'" '1]1 f' .................. ........~
,..... _ to............ WIll........... lilt...
, .... willi It ,... \hi
''''<lilI1I tINItlIt ct. Ii!.... J
_Ii . .
t, OA"IIIIf"~
t. 0 1!~4lIIo'" .... I
I
f
,
J
I
.
I . II I
DORY J.. ,JACOBI!,
PI il lilt III
I
)
)
)
I
)
I
)
I
IN IllvnUn:
I N TilE COUH'I' (IF COMMoN
PLFAlI OF t'tIMIII:ULANIl (,OlIN'I'Y.
PI':NNlI\'J.VAN I A
VB.
(~I V I J. A(''I'toN - LAW
NO. 'l!)-I.("IO CIVIL 1'~~RM
ALBERT 1. JACOBa, Ill,
Ih~tl'lIdttllt
I! AFFIDAVIT OF CON DEN'!'
1. A Comp1aillt III nlvol'cP IIlIdel- lI"cl Ion :11()) II'} 01 Ihl' Divorce Code
,WilS f I led 011 1'1 MilY 1 'J95 illld W,16 [wrvoII IIpOIl t h.. Ill'l f'lIdttl1t 011 or' IIboul 26
I May 1995,
2. TIll! milrJ'lilljP 01 Plaint ifl illld 1l"lnlldillll In ilTl'tri"vllbIy hloken
ii
"nnd ninety (90) days havl! l!laplwd from Ihe (Iilll' 01 II I IIIIJ 01 thp
compIilinl unct I.h'e datn of Iwrvl('(> of thl' (~llIn\llii lilt 011 till! llofllnllilll!.
3. I consent 1.0 tho ell!)'y of Ii IIlIul IIm:I"1' ill dlvol'l'p pi tlUll' IIlter'
service or a Nollee of Intentioll to RI!qIWSt Ellt ry 01 lhll IlIH:nw or 111'011
filing of my Waiver of thl! Not lel' of Illtenlioll to Rl'queBt ElIlry of lha
Del~ree .
4. 1 havlI beell udvlsed of I.hl' ilvaililbllity 01 mill'I'lilY" eounuellny
Ii und unde\'f;l.alld thil! tho COlll-t mullltainll u 1 lilt of mlil'r!ilYI' ('o(HluolorB and
that I may ,'eqUl'llt till! ('oUl'l to n!qulre my npOUIlI' ill11.l I to 11itrtle1patll In
, counselIng allo. Iwlllg [;0 aovlued, do 1101. II.qUI.st that till! ('OUI'! require
il
that my IlIH)UIII! ilnd I llilrlietpate III COIII!!H!IIII'J llltor III Ih" IlIvnr':l!
:becomlng final.
I vnrify thill Ihl! utiltemPlltfl 11I1111<' ill thill Afftllllvlt illl! lnle 8 I III
1~lIrT['cl ulld 1 lJllIlfll'nllllllI llliIl Inl[;r< flt.ltl!m,,"tu h..p<ill ill'" 11I1111" uubjelJt to
\.tIp Ill"'" I t j l!n IIf 10 PiI. t' .11. 11['('1 tllll 4904 I"I! I ilt IIlIJ III 1111111101'11
Iillulllcat!oll 10 tllll.horilipfl.
(.jl. II"',
"_____~_ __L~___'t_n__~___m~__
llATE
, I ;
\~)A\ \ \ ~ ,/ 1. i:(
11011'" l..fAl'Oilll ~.
r' ( /<<';J/
t)(IRY I., .JAClllIlI,
PlilJllt III
I N TilE ClltJlfl' OV COMMON
I'I.I';AII IW c\J~lIlERI.ANIl COUNTY,
I'ENNlIYI.VANIA
VIl.
CIVIl. ACTION - LAW
NO, 'l!,-:.!h40 ('IV] I. TERM
ALBI\R'I' ]. .JACOBO, III,
Ih'Il'lIdtlllt
I N III VllRCI'~
WAIVER OF NOTICE OF INTENTION TO REOUEBT ENTRY
OF A nIVORCl! I)l!CRF.... minER 8ECTION nOlfel OF nlE nIVORCl! CODE
l. 1 l'OIlIJ!!lIt to IIII' ,,"tlY 01 it IllIdJ d""I"" In dJvol"'l' without
nut II''''
:.I. I UlldellltdlHI that I milY I<lIi.. lliJhtn 1'1I11l'''lllt1l1J i1llmollY, divisioll
of propp-Ity, IIlWYOI'1l II"HI, III l'X"..IIIH'1l II t 1111 lIot ..Iillm thl"m IlRforo fI
III VOIp,! III <jlil/lt IHI.
:\. I IIIH1<" nt 111111 t hilt J 101 III IIl1t I... III VOl l'l'd ullt J I iI Iii VUI'l~l! doeree
I B '!Ilt"lell by till' 1'lIl1l't IllId t llilt II .'111'\' III thl' ,1"1'/'('" will 1m /lent to me
J,"m",llllt"ly 111t!!1 It III IIII'd wllh th.. 1'1 lit hlllllltilry.
I vellly that th.. Iltilt!!mt'lItlJ llIild.. III thi" Allillavlt /11'(' \.Iu.. ilnd
COII"..t, 1 1I11111.llltllllll thllt lidll!! Ilt<lt!!llIl'lItll h"'1"11I 11l'!! lIIiHh~ uubJl!l~t to
Ihe IW/litlli!!1J ot III I',\. (',lI, lI"I'ttulI ,1'104 Ildlltt/llJ III III1IlWOIIl
fill Ii II I l'i1t i 1111 tll <lilt hili I t lOll.
',}' '( (
,JIUr.::'"o, \. . ;,~( lL_
ll/ltfHl1
DORY L. JACOBS,
Plaintiff
vs.
ALBERT I. JACOBS, III,
Defendant
I
)
)
1
)
)
)
)
)
IN THE COUR1' Of COMMON
PLEAS OF CUMIlERLAND COUNTY,
PENNSYLVANIA
CIVIL ACTION - LAW
NO. 95-2640 CIVIL TERM
IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under Bection 3301lcl of the Divorce Code
filed on 17 May 1995 and lo/a6 served upon the Defendant on or about 26
was
I
I May
,
!
1995.
2. The marriage of Plaintiff and Defendant ia irretrievably broken
land ninety (90) days have elapsed from the date of filing of the
"
jicomPlaint and the date of service of the complaint on the Dofendant.
i 3. I consent to the entry of a final decree in divorce either after
"
Ii service of a Notice of Intention to Request Entry of the Decree or upon
I: filing of my Waiver of the Notice of Intention to Request Entry of the
I! Decree.
" 4.
I,
Iland understand that the Court maintains a list of marriage counselors and
Ilthat I may request the Court to require
,
i counseling
I
that my spouse and I participate in counseling prior to the divorce
1
,becoming f ina 1.
I verify that the statements made in this Affidavit are true and
I have been advised of the availability of marriage counseling
my spouse and I to participate in
and, being so advised. do not request that the Court require
!correct and I
I the penalties
I
falsification
understand that false statements herein are made subject to
of III Pa. C.B. Bection 4904 relaling lo unsworn
to authorities.
Yf;/t~
DATE
/j~",/ . "/~"I
. . /,:::;/:(; /// '- '::~-
/ /U/t~,,.- ,// ;>
( / . ,
LBERT I. ,ACO . III
/
DOR\' L. JACOIlS, I IN 'rHE COUR'l' Of COMMON
Plaintiff I PLEAS Of CUMIlERLAND COUNTY,
) PENNSYLVANIA
)
VB. ) CIVIL ACTION - LAW
I
I NO. 95-2640 CIVIL TERM
ALBERT J. JACOBS, III, I
Defendant I IN DIVORCE
WAIVER OF NOTICE OF INTENTION TO REOI1EST ENTRY
OF A DIVORCE DECREE tlNnER BECTION 3301 (r.l OF THE DIVORCE CODE
1. I consent to the entry of a final decree in divorce without
notice.
2. I understand that I may lose rights concerning alimony, division
of property, lawyer's fees, or expenSRS if I do not claim them before a
divorce is granted.
3. I understand that 1 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 16 Pa. C.S, Section 4904 relating to nnsworn
falsificstion to authorllien.
- Y-;!ttjc;
Dat0 L(
/-,
// '~J /~
~;;'-::; (~,-:tc~ ../ /
{../l %;:l / / ~
ALBERT I. ,JACOBS, III
/
l"""
i!
l)(lllY I.. ,IM:llIW,
1'1'JilltJII
IN TilE COUIlT OF COMMON PLEAS OF
CUMI3EIlLANtJ COUNTY, PENNSYLVANIA
C I V I I, ACT 1 ON - LAW
VB.
ALllElI'1' I. .IACOIlS. I J I .
/ll1ll1lld,lnl
NO. /h4 ()
CIVIL
19 '.is
IN lllWlIlCE
B1'A1'UB BIIEET
-------,-..- .--....-_.._-
nA!.~ I
III1tel5
ACTIVITIES;
..-to....;;......-.___
fJdn~A euL~t27119~ .
\}H.l \\lo,?\~',.,1-'~ rl'\".io \.I\~ - :iTf~ ....' . lU^.d.",:'t
~~._d~...~~_\~_L\.+L.L._ ~ '.ff' t'. - .~ --+-- ,t.
Ii. I .,' .t ., \'-.. .",r!, . I "'l~ .l. " ,.., j i t/
Ll(___c~.!.fLJ...I".,1--:~.. .< 1.1'" "?"""{
.r
J2--J J..r t;
,...""-" -~.----,"-'--"'--'-,--,--~- --'--"-'--'-""--'- - ---'-~'---~~'---_.-
..
.
.
OFFloe OF OIVORce MASTeR
ClJMlllHI AND COlJN1Y
COlJll1 01 CUMMON PitAS
9 North Hanover Strool
Carllslo,l'A 17013
(717) 24065:15
I. Robert IlIcker, II
Divorce Mute,
Tr.cl .10 Col~er
Oflice Menage"nepMe,
Samuel L. Andes, Esquire
525 North Twelfth Street
P.O. Box 168
Lemoyne, PA 17043
w... Shore
697.0371 Exl 6535
November 1, 1995
Dennis J. Shatto, Esquire
CLECKNER , FEAREN
31 North Second street
Ilarrisburg, PA 17101
REI Dory L. Jacobs vs. Albert I. Jacobs, III
No. 95 - 2640
In Divorce
Dear Mr. Andes and Mr. Shatto:
By order of Court of President Judge Ilarold E. Sheely
dated October 31, 1995, the full-time Master has been appointed
in the above referenced divorce proceedings.
A divorce complaint was filed on May 17, 1995, raising
grounds for divorce of irretrievable breakdown of the marriage.
No economic claims were raised in the complaint.
On September 25, 1995, an amended complaint was filed
raising the grounds for divorce of irretrievable breakdown of
the marriage and adding economic claims of equitable
distribution, alimony, and alimony pendente lite.
I assume that grounds for divorce are not at issue and
that both parties are willing to sign affidavits of consent
under Section 3301(c) of the Domestic Relations Code. Based on
that assumption, I am directing each counsel in accordance with
P.R.C.P. 1920.33(b) to file a pre-trial etatement on or before
Monday, November 27, 1995. Upon receipt of the pre-trial
statements I will immediately schedule a pre-hearing conference
'"
DORY L" JACOB:;,
I'I,AINTIFP'
IN 'I'IlP; COURT OF COMMON I'LEA8
CUMBER1,AND COUNTY, PENNSYI,VANIA
v,
No, Y';-21140 CIVIl. TERM
1\1.11IlRT I, .II\COI.l8, I I I ,
IJIH'IlNIJAN'I'
IN DIVORCIl
PRAKCIPK
IJ iI,
Defendant's I~equest tor counseling, filed June 26, 1995, is
Ill'" eby with(lraWIl,
Respectfully submitted,
CL"iC"LZ- {!J~
By
Dennis J, S~atto
31 North Second Street
Harrisburg PA 17101
(717) 238-1731
Attorney for Defendant
DORY L. JACOBS,
PLAINTIFF
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
V.
ALBERT I. JACOBS, III,
DEFENDANT
95.2640 CIVIL TERM
PRPER OF COI,JRT
AND NOW, this 5' day of October, 1995, alimony pendente lite Is
awarded to wile In the amount of $385 per month, effective SePte~~Y5, 1995,
By the Court,
~,
Samuel L. Andes, Esquire
For Plaintiff _ c~... mHl~.L ID/.l/9!i.
-I] ..b 6'.
Dennis J, Shatto, Esquire
For Defendant
:S88
~r I" ('t I' DO
~l'. .'
L' ..
95.2640 CIVIL TERM
In deciding whether to deviate from the guidelines, Pa, Rule of Civil Procedure
1910,16-4(b) requires consideration 01:
(1) unusual needs and unusual liKed obligations;
(2) other support obligations of the parties;
(3) other Income In the household;
(4) ages 01 the children;
(5) assets of the parties;
(6) medical eKpenses not covered by Insurance;
(7) standard of living 01 the parties and their children; and
(8) other relevant and appropriate factors, Including the best
Interests of the child or children,
Wife has been driving a vehicle on which there Is a $366 per month payment.
Husband has been driving a vehicle on which there Is a $260 per month payment.
They have been dividing the cost of car Insurance, Wife Is making monthly payments
on a VISA account that Include money borrowed for a big screen television that Is In
the marital residence, Wife pays rent In the amount of $475 per month, Husband
has remained In the marital residence for which he pays the mortgage of $820 per
month, That payment, together with upkeep, preserves thaI marital asset to the
benefit of wife, Pa, Rule of Civil Procedure 1910,16.5(g) assumes that the spouse
occupying the marital residence will be solely responsible for the mortgage payment,
real estate taxes, and homeowners' Insurance, unless there are unusual
circumstances such as an unusually high mortgage payment. In light of the fixed
.2.
05-2640 CIVIL TERM
obligation' 01 the partlel, we will deviate from the guideline computation In thl, 6fL
caee, and award plaintiff $365 per month'
O.BDER OF COURT
AND NOW, thll .;it day 01 October, 1005, alimony pendente lite Ie
awarded to wife In the amount of $385 per month, effective Septembef a5: 1995,
/
By the Court,
,
~ /.'
'-.~~
Edgar a, aayley, J,
')
Samuel L, Andel, Esquire
For Plaintiff
Oennl, J, Shatto, Esquire
For Defendant
:...
1, In Spink v. Spink, 422 Pa, Super, 126 (1092), the Superior Court 'lated
that alimony pendente lite focueee on the ability of the Individual who recelvee It
during the couree of the litigation to delend hereelf, The leeue Ie whether the amount
awarded Is reasonable for that purpoee, which turne on the economic r.eourc.,
available to that spouse,
.3-
~ ,
~!.
SAM \lEI. L, ANI>ES
ATTORNEY AT LAW
811a "UIIY" TWILrTlt STREIT
I', D. 110X 100
U"'WYNI!, l'I!NNsYLVANIA Iw.n
''''I1.yt..".- I>~~' <L
'1/u../fJ"
.A,~'
DORY L. JAC08S
Plalnlllt
1 N THE COURT 01' COHIlON l'I.EAS
01' CUKBBRl,ANII CUUNTY,
HNNSYLVANIA
vs,
CIVil. ACTION - l.AW
ALBBRT I. JACOBS, III
lIetendant
NO, 9~-3b40 CIVIl. TERK
IN IIIVORn
QlJ!I!I !If OOVIT
AND NOlI this ;t.(.lday 01 J.f'l." 1.1((, 199~, a lIearinq Is hereby scheduled belore
. tbe undersigned In Court RoolI No.3 01 the CUllberland County Court HOUle in Culille,
Pennsylvania, on Plalntl11's request lor aliMOny pendente lite, said lIearlng to
cu.ence at 1 (.P 0' clock " .11I, on .I 'AI'Jaj , the
,: and to be held In conjunclion wllh our hearing on the
1.1'(1 day 01 i (, ( , '({
, .. ( J ~ (" (
199~,
request 01 1I0ry I.. Jacobi lor
spousal support, now pending belore the 1I0lleslic Relations Olllce to Its nu.ber, DR
U4,3~3.
/
J.
(
DORY L, JACOBS,
I'lalntlll
I
I
I
I
)
)
)
IN THB COUIl1' 01' COMMON
PLBAS 01' CUMBERLAND
COUNTY, I'ENNSYINANIA
NO, 9~-~640 CIYIL TBIlH
IN IlIYuliCE
Plaintiff Is ellployed on d lull-lime bulB by lilte-Ud Corpontion, Her oroll
IncOlII II 81.134,63 every tllo ",ekl, She doel nol receive any additional clllIpenlltion
1011011I1
aroll Pay
Payroll Deductions I
Yedlnl Incllae TIX
SOC. Bec. IOABDI)
Medicare Tax (HI)
PIT
Local Tn
Dental Inlurancl (IIhleh
roverl the Ilelendant)
8111 , 30
869,66
816. )0
Sll.1'I
811 , J~
I hilI!
VI.
ALBBli'r I. JACOBS, III,
Dlllondanl
IlJl.!IQ!.Mn!Jgl'.!!!!.U mTlIt!!f!'J'
vr
oon lo. ./A!:QllI
lllmll
or IIork IIvertlme, Thu. her earnlnOI, on a bl-weekly balla, nel 01 Laxe.. are al
Totll Deduction.
81.114.63
NlIl ..ay livery TIIO links, , ,. 'II). J4
uu.u
Thai II '1,91),90 per lIonlh,
lI\r.\'\')
!"". .. . ~"";
k'1040
Labal
Ulllh.
IRS l.b.1.
Othorwise,
pl.... p"nt
or typ..
~r"ld.nll'l
I.cllor.
am I gn
Filing Status
Check only
one bOll:.
Exemptions
If more than
6 dependents,
see instrs
Income
AU.ch
Copy B of
your Farma
W-ZL W,ZG, ..
lOb-R h...,
II you did
nolgell
W.2, .el
instructions.
E.nclose
but do nol
.ttach any
payment
With your
return.
Adjustments
to Income
CautIOn: See
instructions,
Adjusted
Gross Income 31
DI81
Deparlment uf the TrcBsury -Internal Hc\'onUD Sunnco
U,S. Individual Income Tax Return 1994
For the year Jan 1 . Ope 3', 1994, or oltle, laJl j'f"a~~li
I /7i~/~yt~s ' C~/)'
~1l\'Of1I, -OUIUlIM".or'lll,....nl'M"pllt'
,1994, e"dmg ,19 --1-r~::;"
~oUlII,.lnllm.
MI
1.llnam,
Your IOCIIII.curllr Ho.
ALBE T I JACOBS III
"'1011'1 "turn, 'POilU I 11111 nllm, MJ
Iln\nltrT1,
202-48-3810
'pou....locl. '.cwlly No.
DORY L JACOBS
~'Wn' aad'a" (mJ'Tlbel ,rId 1".tO II ~vu 1vI~. P 0 001,'" I".truchon,
"'I)dll~nlno
163-48-0656
For Prlv.cy Act
Ind P,plrwork
R.ducllon Acl Nollc.,
...In.lrucllon.,
VII No
150 FAIRWAY DR
ell, town Of 1'1111 Ullll' II you h.lv, .IOlelgn .diJren, '" lrl,truttltml
!>tilt. ltP Cod.
ETTF.RS PA 17319
Do you want $3to go to VIIS funo?
.. II 0 OInt return, does our spouse want 53 to 0 to VlIS lund 1
1 Slnglo
2 Martled fdlng IDmt return (even If only one had mcome)
3 Married filing separate rtn. Enter spouse', S5N above & full name he'e ..
4 Head of household (WIth QualifYing person). If the QualifYing person IS a child hut not your dependent,
enter thiS child's name here. , . .
Qualll In wldowet With dependent child ear sPouse died" 19
Yourself. If your parent (or someone else) can claim you as 8 dependent on hiS 0'
her tal{ return, do not check bOI{ 6a. But be sUle to check the bOI{ on In 33b on pg 2.
bxl S DUll.
C Doplndlnl.:
Not. el.elllllQ
'l"wII111otchltngl
)'Il~ tJuDlledut'
)'OIJ'I"~ld
sn
6029
} No. 01 ~....
dltchllon
I..",.. .
2,
1 f'.Iclm'lh'~IH1lt,.1 IHldlilstnnml!)
(2)Ck"
undel
..,
No.of)'DW
~hllt"'non
kwho:
"Ivlcfwtth
'0.
(3) 118gl' or olde,.
dlpendClrlt' socl.1
"cutll numbel
(4) Dependent'
'elatloll~t~p
10 au
(5)Mo.
In)'DIJ'
ham.
d If )'Out child dldn'lllv, With you bvt II clllmed a, your dependent undO' 8 Jl" 1985 III'foment. t~ heft . . tot
e Total number of e/(emphons claimed.
7 Wage., sala"e., tips, ele. Attach Form(.) W.2 , , 7
8. TIKlble Interest income. Attach Schedule 8 If over $400. 81
b TIK-eKlmpt Interest. Don't mclude on line 8a, , . , 8 b
9 DIVidend Income, Attach Schedule B If Dve. 5400 9
10 Tuable refunds, Cledlts, or offsets of state and loc:almcome talles 10
11 Alimony received , , , 11
12 8uslness Ineomo 01 (loss). Altach Sehedul. C 01 C EZ . 12
13 Capllal gain or (loss). If ,eqUlred, Attach Schedule D, , 11
14 Olher gains 01 (losses). Attach Fo,m 4797. , " 14
15. TolallRA dlsl"bullons. . .llliJ Ib Taxablo omount. lib
16. Tot pensions & annUities . . O!:!I ,b Tauble amount, 1. b
17 Rental real eslate, royalties, partnerships,S corporations. trusts, etc, Attach Seh E, 17
18 FI'm Ineomo 01 (loss). Attach Selledule F 18
19 Unemployment compensatIOn, . . . 19
20. Social security benellls ~ Ib Tallable amount. 20 b
21 Oll1e'lncom.. _______________________________________ 21
22 Add the amounts In Ule far'l ht column lor lInes 7.21, ThiS IS our tollllncome. .... U
23. Vou, IRA deducllOn. . 23.
b SpOllS.'S IRA deducllOn , 23 b
24 MOVing e'pense.. Altaeh Form 3903 or 3903 F 24
25 One hall 01 .ellemployrnenllax. 25
to 26 Self employed health Insurance deductIon. 26
27 t\eogh rellfernenl plan 'f,j sell employed $lP deduction 27
28 Penalty on early wlt"cHawal 01 savings, 28
29 Alimony paid, ReCipient's S~N ... 29
, d1cfn1hwl
wlthrou"",
to d1woru or
",,"on.
D.pt,",,"" on
knot.nllllcf
ob..,
Acldn~ltl
''''If.dDn
11.,lbDWI to
37
293,
0,
0,
7
59
30 ^dd Imes 23a 1t1l0U h 29. Theso are ow tolal ad uslmenls .
. 3D
SlAllllIll hn. ]Ollllm 111I.?2 ThI,l. ~o" .~u.ltd IfDl.lncom. It Ie" UldOl '25 296 lI11d. ~t~ld h~l!d
"'Hl~(le'~U\itn '9 Ol)O III dllld d'dllll've W11h~au} ~I'e [lImod l"fD'ne C'e(j'11ll ul~lllJt:I'UlI'
. J1
_---.21L.222.,.
fUlnl 1040(1994)
Tu
Computallon
If yuu ....."1
lilt Ins I"
flguII ~(JLJ'
lall. in
I"Itrulllon'
Credit.
Olher
Tax..
Iyment.
Anlt.h f urml
W 2, W 20
.nd 1099 It
011 flag. 1
Refund or
Amount You
Owe
Sign
liere
t<eep. (Up)'
of UHI "hull
'{If your "flJrrh
P,ld
P"plrer'.
U.. Only
A, "^l:()Il~; III I. p, ,IM'()IHI
12 Amount IIurn tllll II (UUJlJ.jfllj U'UI.Iro 11\\ IHI1ft)
II I Ck II ! 1 Yuu 'I't"" (,5/u1tllll. ! ! llllllll i 5fJou" ....it!;, tl!J/l1lr!l".
Add lhe fl\jlllbt" uIIJUA'" (.1lf'llo.fld aIHl...... and pllh" 111f" lotall."'",
.
i Hhl1iJ
lit
JIb
b II yOU! pal lUll (UI \(Hl1ftllll' LIIU) {1l!111j1i111 you jlflllll~II(I!\dl'!ll. (... hl'l"
C If you I" m."lpd lil'flij ""pYlalrly an\J YUill ~pllllU '11'11\"1'10 dl',IlH IIO'11i
ur YOu I" . dllll ilithii a!lt!fl, "fie IllLlllll tIO!l' "11l1 I tlp( k 11'''n
54 [nhlt jlt.mlnd d.ductlona f'ul11 !;t!'fI[!lllu A, 111lfll'J, or
II.
I.'g., u 5tlnd.rd d,d r.1\(I~1l tlf!ltll'e 10' )'l1ur fdlllY Iolahil but If )lUU c"d
oj ..In~ bo. Dn IIn. III Of b l.f'e In"IIl.J{ Iqlll" 10111111 ~!hjl "litfHlll'lt
ymH
.f1l!IJ II tllIJ (h~L"tlll bOl Ilc, YU\d ,landllflJ lj~ddl IIWII!. lfifO
· ~;"l\,ll! UlWll . Hf'lIcJ 1llllllIJI>f111lilcJ t!) Wll . Milft'f.lJ ldlllU 10'I\1Iy
pi O,jiJl,IYHlU will(l...(P1f) 16 j~JO , M.)f!;t*lf IdillY Iof'IHU81t'ly Sll/~
II SuIJIIlH_IIIfIO 14 IIOfll II/I' :U
II
>
.
IS.
11
II
11111 :U I' SflUi'lO (II lll~', IIlUIII"!)' $.2 ,4bO b)' Iii! 1IIIal fl(J u! f'JfHl'pIHlf1" , lill''''''(1
u'lln6. II In 'J'J I~ ll~-el $hl H~O, .~, till 111.11\,(111"11 10.\11' ilIlllllJllllu "111ft'
'.l.bl.lncon11. ~ju\Jl'11( I III 36 IIp,Illn JJ 11111 Jb " IIHllt! lI'allln :t~, 1!1I1t!. (J
1ar Ctll!l-kl!lrofll ':,Xlllu !tlllle, bl ] 1iufl,l1e!~LiII~tJjjlf'r., ci (:iJp,lnl{ialllliu
Wo,kSihnl. II', c( ) I Will f:!615 AII1(J\IIl! hum' lO'fll{l.) Hk 14 ~. _ .____".~ ~_
AddltIWllllalt!" Ck If luml .' j f olml\lJ/U b ) 'tlffTolll)!?
It
40
41
42
41
44
A.dU Ilf\('I 38 and ;ilJ
Cu:!dlt lur {luld Ind (JcIJ LlII, e'l1 AllilC1l1 Olin 2441
Cr..dlllol Iti' '1l1.1I)'!J/ tll' dlubled AlltH..h SU1'~
r OI~lun lal tlfflll AI1i:lCh f (JI fl1 111 (I
Ott.ellfelJd, Chtll.k If flUfTl .! 1
f urm 8396 c( ] 'lllfTl HHO I d: 1
Aljd IH,et. 4\ th,olJUn 44
5iJb118c:11111' 45 horn lille 40 Illlne 45 Ii /flore lhanl'loe 40 t'l1hH 0
Self emplo}'fTlenll81 AU~Lfl 5ct;.r1,jie SE
A!le/nalfve fTlifllrllurn tu Al1alll fu,'., b~J!> 1
He{,pphlf,Ialli Ck II IIum I: I I llIrnll;J:l!) b; j f (JIIII B611 t~
~~ 'nd Medll,lllu un lip ,ntulII. nullfll/ltfl.d 10 I!mpl(l~tl 1I1111n flll"O 41jl
T tt_ on qlJ,III,elJ .elll'tflllnl pla/Il, Illt_lut.Jlllg IHAs Ille!lulIluJ, 1111 , IITl ~J?9
Adv.'lel IIffled 11l( om, (./,dlt pIYlflllnls "om f olin "IV 2
Add Inl U. ~11111$1' ulllla"l tJJ
hdlll.llr1(,Omt laa llI'llhhtld Il.ny IIi h(jm fwn(5) 1099, I ~
to
41
q~
4~
'(I/m 3B(J(J
f u'm (~IJf.I)
44
41
41
47
4.
41
ao
&1
52
&I
114
..
FOlm HatR
.
~- ..___~.~!!J HL
1994 "illf11811.'1l1u IJlf)'1I1t!nll ifnd .HtlllUfI! 9PIIIII<I1
flum 199] "tu.n
Earnld l"tom. c,.dll jf rfQlJllid, all ~tll Fie
r>lonlautJl, urllflcJ Il1llJlTl' amount.
No
De
H
and tY'JI . _ .____,_.. ______,_, .________""
17 Afl1uulIl fJ8.(f W.ttl f 01'1\ 4868 (ti..len!ol('" IrQuesI)
&1 Elce" soe-al uruld)' and l~fHA la.l w.lIll1eld
II Othll 'JI)'nllllll Chll{.~ II ho,n ~ I form 24JlJ
~ J r",m411ij
A\ld Inl ~4 ~g !heu '" )'//\JI tot.lp,)'m.nta .
11111I. &0 II mulllh.n Iml ~], 1I/1lI11d hnl 53 hum Ime 6(l 1 hlllllhl .rfllllJnl yuu OVllp.ld
AnHllJfll of 1m! Ii I )'ou WIIIII R.fund,d tD You
Amt of !n (d rOu ....aill Appll.d to Your ",. fal,.. .1 1,...1. .__ ___~__ u
II In 53 II InUII H,III 1/1 bOo t.llblqnlln &0 ',wn In!J] 1111\ III tI,fl' Amoun' You OWl
E 'Ii/filled tu .t~!t. Alllo lIlt lul.ll on 11118 64 ,.
~~
17
SI
al
&D
II
.2
II
14
II
14
!~-
.~~.J.H.L.
II
17.
n P~" 2J.. ill....
l!.-
It
. 40
_-L2Q.L
9
41
. 4.
.R. .
41
.~ ~-~'-~-'-
10
!L__
u
> II
9
5
1.
> !t
>j!
. _.......Q4
H.
1, n7,
,. "i"
YUllf"\l"lllul,
H)Uf UlluII~l!un
Undtl Pt"tlhO' utl"'I"11 U,l.I.I, "...111...... '''''''11.,11 1I~. Ilflulfi .Ild 1111 ("'ll'''h,I''~ hlliotJuItt. 1I11tJ 'litlllrl1t;/\'. !trIll III tIlt bOll lI' m, kl\(I........ llli
Ilffllt' "wr." Ifllll 1.0" il 11"11 I "'I".lfilt I.., IHI;I!;I'" "r 1"IlI>1<l'IJlluU.' Ullllol~'I'.t.') o. t...'.d 111I III Ulhllf'l\lllillll 01 ",llI<-" Jlfll'''ltl hili In, kllUl!/1.eOVt
IMII
.
r",IIII'" "lIn~lljf' ,I. 11....1 I~",." It, /111 111,,\, "\I';
(,..II
f'!WVR.l\M .[\..NA\';Y~L _m_~_
~,''''''''I , l.H I "1...1'1'11
.
~l'Ilt"IlI;IU,t'1l ~
OF F I ('!~ Wo l
[fir" ~ II "(1"'111/' f:"otHlI ",,~'l, NtJ
.'__""~h~____.~__ __m~_
l;<lI,
"'.11.11"
~'.k"~~~! ~
fllm,ullil"
!!iI/PUrlll
U'\ IJlllliilJ,"'lt
,,"dll,lll,(!n
II, 'liNt; fULl/,
. 1! 11) I 'IIJ!AP J Ii l~ HP,
I".NUL I'A
III~
~IP ~ IHI,
11""(;\:; 1(lft'IM
lQ~' ;;li:llQ~_
1 'Ill'
. - iI...... -flI1lr711Dl..
rnrm,~\,.._.-<.,
. ...
Eehldull A Schedule A - Itemized Deductions OMO No 1,"1001.
(Form 1040) 1994
. Alllth 10 Form 1040,
f"PA"n=,\! 0111. l I.uurr . S..I".\lucllon. for Schld" I A (Form 104D), 07
nl.m,l t....lI~ &t!rVII.t (9111
hlm.(,) ,11Ollt'n un , otm HMO I: low loclIlIHWftt)> HunMr
A JACOBS III & D, JACOB8 202-48-3810
MIJltl' Clutlon: Do flDl mcludt './len11lS felmburJ,d Of IId/d IIi' llthm
In 1 Medlcol and "entlll [!ljlfl/lt.CI 1
Dlntll
bpln... 2 tnt.! ImuunlfmrnFlIfm HMO, llIl']} L..LL...._m..'71~i2..2..,
J MUl1lpl)1ll1\8 2 above hy I ~% ( 0/;). J 5 370,
4 Subh act line 3 110m Ime 1 II lillll 3 1& lTlillU than hne I, f'nler O. . 4 0
TUJ'VO" I Slale and loc:olll1wme hues S 2.713"
PII . neal estate lakCS. . 1. 552
7 Pen.unal propelty tall,fHi 7
B Ottlel taKes -Lllit type Blld amount.. ,
rb_Y..9_ )Jl}___Q~(li..r.'.J.'.IlIY_;J.Q _ __ _ ___ ___ 8 127 ,
8 Add lines f) ttlrouyllB . ... . . . 8 4 392.
Int....t 10 Home murtgaUt! Inlfrest .nd rlulnts 't'llUrt~d 10 ym.t on 'orlll 1O~8 10 5 262, .
Vou Plld
11 Home mOrl~aqf Inlrrelit nul rellulted to YUII un form 1098 II/laid lu
the person rom 'Whom you htlUghllht home, ~t'e mslrurllOns and !Olio.,..
lhal person's nlme, Ide nIl lYing numlJer, and address. . ,. '" .
Nol..
Personal -----------------------------------
intelelilll -----------------------------------
flat 11
deductllJle, -----------------------------------
12 POlnls not repOIted 10 you on r arm 1098 12 58,
11 Irwelitment Interest. II lequlled, attac~l FOlm 4952,
(See Instruchons) 11
14 Add Iin.. 10 tl1'ough 13. .. . .. . 14 5 320,
Glltlto 11 Gills by cash or check. If any gift of $250 Of more
Chlrllv see instructions 15 750
II vou madl 1. nUle, than by cash 01 check. If any gift 01 $250 or more, see
"fi'"""d Instructions. If over $500, you must at1alh Form 62133 . , .
~Ol bln.t,l 1.
or III'"
Instructions 17 Carryo\l8r from pFlor year 17
1. Add Iin.. 15 111lOuol1 17. . , . 18 750.
C"ulllv Ind Casualtv 01 th.1t 10..ro.\ AlIatl1 rOlm 4664.
Theft Lo.... l' , . . . 18 o.
Job E.~n"" .
Ind Mo.' 20 Unl8lmbursed employee eJl;pellses - Job tl8vol, unIOn dues,
athlr kob education, elc. II required, you must attach Form 2106 Of . .
Iltlll~n'ouI 106EZ , , . . . .
Dldutt onl .?~11_ A. .M...i_s_c_ .PJtc! JiQ};:..lif!lW~L _ _ _ _ __ _ __ 20 6 035
21 lall preparation fee. , , 21 45 ......
22 Othef expense. - In\'estment, sale depOSit bOJl;, etc.
(Sit lIlt type and amount. ----------------
Inlttucllons
10f t!';hent.el -----------------------------------
to dl ucl ----------------------------------- 22
here) 21 Add 1m.. 20 thlOugl1 22 .. . i . . . . . 2J 6 080,
24 Enlo, ami ltom Form 104D, 1"'8 32 24 I 71~99, I
28 Mull'ply lin8 24 atHlVI hy 2'1\ ( 02) 25 1 432
2' Subhec;t line 25 from Ime 23. II line 25 IS more thlm line 23, enlerO. . . . 2' 4 /;4A
~lhl' 27 MovlnliJ eJl;penUi IncUlred befole 1994, AlIach f olm 3903 at 3903,F. .. . 27 0
iK.lllnlOul 28 OUUtf - horn hit In the inslru[\loflS, t 151 type and amount ..
DodutUOnl ---------------
----------.-------------------------------------. . 0
. 28
Tolll 28 Ii form 1040, line 32, {Jvet $111,800 {over "55,900 II malrled MillO ti.opalalely}1
IIlmlnd ]-
Dlducllon. · No. Your deducllOn Ii l1ut Ilmlled ^cN tho arnmJf11f.1Il tho liu flylll Ullumn fur
Imei 4111toLJUh 28, Also, enter UIl form HMO, Ime 34, the larger 01 thl&
ammml 01 YOUllilandord detlut.1HHl. . 28 15
· VOl, You, dndlJllmn mllV ho Ilfllllf'11. !jee IflSI'iJrflllllti lor !tIe amount 10 enlul.
D181 For Plplrwork Rlduttlon Att Nollcl, .uln.trucllon.,
Schedule A (Form 1040) 19M
IDIMlJol l/1f111!M
'---
Schedule A Miscellaneous Deductions 1994
IA.. JACOBS III & n JACOBS 2 0 2 - 4 8 - 3 !!lQ_~ Schedul. A
MI.c.llen.oue D.ductlon. Subjlctto thl 2% of AGI Limit
Unrelmburald Employ.. bpln..11
1 UnrDimbw5ed employee ekpenses !rom f OIm 2106,
2 Form 2555 unrelmbursed empluyee ekpenscs I'Iktluded.
1 Other unrelmburud employee expenses (lIst):
199~~_Y~1l_~Q~~__________________ ~n,
~PY~llTJ~}l_~~~~_tQ_i~ERQY~_Q~I~~9' 4 /;Q
1lW'l~'p_O.R.'I:NttQl'l. J~.~J?J;;!i12J;; _ _ _ _ _ _ _ _ _ _ . 1 14C
4 Total unulltnuursed employee bUSiness Ckpenses. /; nl~
Olh.. Expln..l:
5 Depreciation transfer from DepreCiatIOn Worksheet.
. Amortization transfer from Depreciation Worksheet,
7 Port1ollo income, ekcen deductIons and miscellaneous deductions from K.1'"
8 Calually/tllell of prope,ly 110m Form 4684, Secl'on B and/m Fmm 4797, I,ne 20b(I).
. Secllon 212 ..pcn.. of REMIC I,om Sclledule E, hne 37, column e.
10 Investment ekpenseslrom DIVidend Income Worksheet,
11 Form 2555 miscellaneous deductIOns excluded.
12 Oll1e, e.pense. (hit):
Investment publications . , ,
Safe depo,,1 box . , ,
Oll1er:
----------------.----- ' ,
---------------------- ' ,
---------------------- ' , , , , ,
---------------------- ' , '"
----------------------
11 Total other ekpenses, , ,
Olher Mllcelllnloul DlducliDnl:
14 Other miscellaneous deductions from K.1 Worksheets , ,
15 Form 2555 other miscellaneous deduction, excluded,
1. Gambling IDuel (10 lI1e ..lent of gambling Income), , ,
17 Federal eltate tBX on income in respect of decedent , ,
1. Amo,tlzable bond premium on bondl aCQuiled before 10/23/86.
18 Repaymenl of amounls under claim 01 "gill II greale' lI1en $3000, , ,
20 Certain unrecovered investment In a pemuon , ,
21 Impairment-relaled work BjIl;penses of disabled person
22 Other miscellaneous deductions (lIst):
--------------------------------- ' , , ,
--------------------------------- ' ,
21 Total other miscellaneous deductions,
rulJIIOl 111"194
Label
=.c11On.
on P1U1121
u.. ... IRI
Ieltel,
01_''''
pIN.. P<lnl
01 type.
P'III.tntlll
Elactlon Clmpllgn
(S.. plgl 12.)
Filing StltUI 1
a
(SH pegl 12.) 3
Chick only 4
on. box.
I
E..mpllonl
(8.. plgl 13)
II more Ihln Ii.
dep'nd""",
_ plgI 14,
Income
AlIaeh
Copy . 0' vour
Forml w-a.
Woao, .nd
'llIHl h_,
If vou did nol
g'l I W-2, ...
pagl 10,
II you I..
.Itlchlng .
Check Dr mon.y
Old", pullt on
lop of tny
Form. W'2,
W-2G,0,
101lV-R.
AdJultmentl
to Income
(SH p.gl 201
Otlpwtmenl or the T,...ury-Inletnal A....enu. IlInIlC. <1l5\13
U.S. tndlvldulllncome Till Return 101 Ul!!!
For the Jln '-o.c. 3'. UN3, Of olhef ,.. )'tIt 11V'l1'" . '"3. ending
'tOUt' tnl name and !nIhil la., nlm,
L
A
I
I
L
...... CAR-RT-SORT"RROl
OF 202-48-5810 165-48-0656 S28 10
ALBERT I III & DORV L JACOBS
150 FAIRWAV DR
ETTERS PA
I
R Api no
018 S
II
7ixplfy.i,u I c!"l,Y
-OonulllWillIDl "....tnlhlt..IK.
, 11 OMU No "'&-00"
V.........._urllr_
~roJ. i1o't: .JJo/r:l
,""..'I _101 ,,",,",,"'-
"'11"'r1 <,(J't
Fa, PltvlcV Act Ind
PlplrwOrtl Rlducllon
Act Nollel, 1M plgl 4,
V.I No Noll' Choc''''1 "Y..o
(' will no, ch.nQl rou'
lu 01 ,..tuc, )'OUt
.- IWfund
Slngll
k Mamed filing loinl relurn (Iven If onlv on. had Income)
Menltd filing uparlt' r,lum, Entlf .paUII" SOCial leCunty no. above and tuK name htrI, ..
Hlld of hou.ahold (Wllh qUllltylng ""IOn). (S.. peg. 13.) If Ihl qUllllylng plllOn II' Child but nol you, dlp.ndlnl,
Int.r thll child'. name he,.. ..
Quail in wldow.t wllh de end.nt child 'M' DUll died" 1& 8M ..13,
II W You,...f, It )lour parent (01' aomton. .1111 can claim you .1 . dependent on hll or hlf t&.lI
Ilium, do nol chick boo 81. But be 'UlI 10 chick IhI boo on IInl 33b on pagl 2 ,
b . UI.,
e Depend.nto:
'" Nlme (hrll. InlIlat, Ind "II name)
H
I
~
I
17319
" .....
lo.I"""
~l
liIa. It ....,
.., ." II
.....
Iill. 'I flur
..II.... I. I.
will:
. "'" wltll p.
1.1l.'llIn..
"......
I.. ..
-,1'.(11'
,... 11)
aa,e."1III ..I.
11I.011..."... _
.., lum',,,
..... ,ft
II ,,,. .
',.."
00 you wanl $3 to go to (hiS luruJ1
II. oint relurn, do.. our I UII want $3 to u 10 this rund? .
d II V.ur child dldn'llI" wllh V.u buill claimed II lOur dependenl undll. ple'1985 .g,"m.nl. ChICk hell. 0
. Total numb.r 0' IlIem tlonl claimed . . . , I . , . .
) I age or Oldll.
d'Plnd,nl'llOCJIllICuflty
m ,
J .pend.n!'.
"lIltOn,nip 10
1
II
b
.
10
11
12
13
14
\I
III
111
'8
\I
20
all
12
13
a4.
b
l!I
n
U
aa
III
:JO
1
Wlgl., 1I'"nll, lipl, lie. Attlch Forml'l W-2 ",'
Tu.bl. Inl....t Incoml (... plgl 181 Attlch Schedull B II OVII S400
T......mp! Inll""I'" P"O" , 7). DON'T includl on Ilnl 81 Ib
Olvld.nd Incom., Attach Schedul. B II OVII '400 , , , ,
TlXable refund.. creditl, or offl.la of atl'l end loclllncoml I..... (IN page 17)
Alimony receiv,d . , . . . ,
Bu.ln...lncom. 0' (lOll). Mlch Schedull C 0' C,EZ , , ,
Clpllll glln 0' (lOll). Attlch Schedule 0 , , , , , ,
Clpill' glln dlllnbullon. nol reportld on IInl 13 I'" pig. 17)
Othll g.lnl 01110...11. Attlch Form 47S7, , , , , , , , , , , , , ,
TotlllRA dl.lllbullon. , ~ U b roublelmounl (1M pigl 18/
Total plnSlon. .nd .nnultle. l...11!J U b lulbl. amount IIH p.g. 18)
Rental real IItatl, royalties, par1nerships, S corporaliona, tru.ts, .te. Attach Schedule E
F.rm Incom. 0' (lOll) AUlch Sch.dull F ,
Unlmploymlnl comp.n.allon (I.. plgl 1S) , , , , , , , , , , , , ,
BocIIIHCur1ly b""lfIIl 1111 I I I b TOlb11 amount I... plgl 19/
Olhl' Incom.. Ult typ. Ind amount-I" plgl 20 ....................................
Add thl amount. In the far ri ht column 'or IIn81 7 throu h 22. Thi. I. our tate. Income ..
4.
Ub
II
at
..!L
18
Vou, IRA deducllon (I" p.g. 201 ' ,
Spou..'. IRA deducllon (... pig. 201 .
On.-hlll 01 I.II-employm""t IIll (... PIS' 21)
Sell-.mployed hllllh Inau'tnc. dlducllon (III plSI 22)
Keogh retirement plan and ..If-emploved BEP deducllon
P,nalty on ,arty WIthdrawal of ..vingl, , , , ,
Ailmonv plKl Reciplll1l'. 66N . I
Add lin.. 241 throu h 29, TIl."." our 101.1 .d ullmenl. , , ..
Sublr.r.llin. 30 tr(lm line 23 hi' tl you' Idlulted ,roll Incom.. II thll .mount " Itn rNn
'23,050 ,nd I child II"~ ~lth you, IN plge fIC.' to find OU' II you C,r1 cl"m 'h. -E,rn.d
Incom. Cffillt- on line 66 ..
Cal No '132U8
.
10
11
la
13
14
11
lib
17b
11
11
20
11b
12
3
....
31
.L
11.
Compu-
..tlon
(8M PIg.
Ul
II
IN
II VOU w.n! 17
lhe IRS 10 II
IIgur. vour
tll, aN
peg. 14 II
010
C...dlt. 41
..
~8M peg. ~
I.) 44
Oth.r
11...
P.ymlnt.
AlllCh
Fonn. W'2,
W.2QL .nd
lllil-H on
Ih. front
10
R.fund or '1
Amount II
You OWl U
14
Sign
H....
~.... . oopy
of thi. ilium
fill your
,eoOrd.
P.ld
prep.r.r'.
u.. Only
Amounl ~om "n. 11 (....Iu.l.... uro.. OlGorn., ' , , ,
Cheok II. 0 Vou w.. II 1If _, 0 Blllld, 0 IpoUIl.... ea 1If oldor,
Add the numb" 01 bo... theGked IbuVI and ,ut" \h, tut,l hl'l .
II II vour p'"1I1 (Ill _.. .1.., C'" cia." you II . d_,lorll, o".d h..1
o II you "1 married 'Ulnu NP""lal~ 11m yOU! l'lOU" M.rnill' dtdlKiliunl 01
vou "' . dual .11101 .HII\, 'M p.g. U ,"d ""..k h... . .. .. ~ No
lI.mliotl ....._n. ~o'" Ik:h.dulo A, Hili U, OR
.Iand.rd dldllllUon .hown b.,ow fo, VOIII llling .11101 'U! II VOO ._kld
.nv bOI IIfI hn, Nt or b, go 10 p.g. U 10 All&! VOUI ...rulll&! alduel...
If you chlllkld boo No, VOU, "'"0.'0 OIdOG'IOIl 11...0
. .1nfl1......l.100 . Ii,"d of IlOu."_' '1,410
. M.ffl.... IIHlIg "'1f.IIV .. Ou.llfVlllll wldo..(..)'~UOO
. M.m.... IIllng .""...llly-tJ,loo
8ublll01101l 34 Iro'" IIn' 32 ,
If IInl 32 I. 18',310 01 Iel', multiply '~,3hO bV 1l1,lnl,1 nWIlI.." ul ...mplIOfll tllll,"'" on
lin. O. IIlln. ~2 II OYII 11I1,310, 1M 1111 wOf..hHl 011 peg. U lor Ill, '''1OulIlln '"111
f...bl. Incume. tubtflct 11111 31 hum llnl 3& If Iln, 36 I' mUl' Ihln hll, 36. I"tll ,()
T.... ChICk II from .I-tlt... lobi., b [] lo. R.I. 8c,..<lul... 0 [) 1l""oclul. tJ h. Wo,..
IhHI,o, d [] Fa,,,, 1611(... peg. U} Amounl flom Fo"nl" .114 .. . _.____J_
AddIlIOl1.,'....(_ pig. U) C....k II horn a [] FIl"" 4170 b [) FOIl" 417~
Add IIn.. 38 end 31
Credll for Wild end d.p.nd.m CIII "pin.. "'heon FUlm 2441 ..1L....__..... ~.~.
Clldll for 01. .'dllr1~ 0' 0" dl..bl.d "'"..n luhldul. R . ,jL .._ ......~~ _..._.....
fOlllgn I... crldll. AIIaeh fo,m 11" , , , , ..ii.. .....
Olhll c'edll. (_ p~. UI Ch... II from . 0 fo,m 3.00
b 0 'onn 8111 0 0 fo,," 1801 II 0 fonn ('llI<lllyl-.._..
Add IIn.. 41 U1,ough 44 , , , , , , , ,
eybtrtct IIn .0 from IIn. 40 If Un. U It mort thl" llll, 40, ,nl." .0. ..
OSIIIul
~~
~13b
14
Entlf
the
la....
o!
~our:
J!I..".~ ~ I I J 1. iL
~
48
48
47
48
48
10
.,
n
t2
14
..
M
.7
Ita
II
18
S.If...mploym.ml.... A11loh 8chlldul. IE. ...1.0, .H lIn. 211.
Alllm.IIYI mllllmum I... Ah.ch Fonn 8281 ,
RIC.,"UII 1......(... p.g. II) ChICk II horn .0 Fonn 4211 _ CJ fo,m BIll . U fuml 1128
BOCIIII..ur1ty and MlIdlclI.1IA Oil lip Inoom. nol IIponld 10 .mploy... An.on Fonn 4137
T... on qu.llll.d """",.nl pl.n., IncludlnglMl. II IIqul'ld, .nl." FO"l! U~U .
Advane. ..rold Income credit paymenl. from Form W-2
Add IIn.. 41 lhrou h 12 7",. I. au' \olalla.. . ,
fl1l.111Incom.II' "'llnn.11I Il.ny II from fOlml'll011 Chm ~ []
1113 '.lIm.11d I.. p.vlflInl. and lI110unl .ppllld nom 1 H2 ilium .
lamld Inoom. 0..../1. AIl.oh 8chedull E IC
Amounl plIO wllh Fo,m 4881 (..I.n.,on 'lqU..'} ,
UCIII.OCIIlllCu,IIV. Mlllletl., Inll ARIA II' wllnn.'1I (III p'I,'81 .
D.f_ of IddlllOnallIU3I1... An.w fonn 184' .
Othll p.ymllll. (." p.g. III CnlCk II nom . 0 Funn ~'ll
II 0 Fonn 4131 , , , , , , , , , , , , , ,
Add IIn.. 04 UIIOU "sa Th....1I ou' lolal . .nll ..
If IIno 10" mOl. thin IInI 63, IOblloctll... 63 from IInllO II". II iI1IIInoUfIl you OVIR'AlD ~
Amounl 0111". 01 you wlnl RIFUNDID TO YOU ",. , ~
Amounl 011101'1 you wlnl A"UlD to YOU" lI1H.lIl1ATfO IAI ~ lJiJ.. ....._...~~_L_
n 11n. 13 I. m,," U111l1l". 00, .ubllloll1,," 00 horn hn. U II"." Ih. ;.MOUNT YOU OWl
Fill d.1I111 on how 10 p.y, Includlnll w".IIO wnl. on Vow p'Ylfllnt, .H peg. 18 , , ,
hllmllld ,.. ",.11 . I . AI Inolo " II" 4
.Ii
It,
~
......i'ir..L If'
..J!
..lit
.tD.
II
U'~II ptnAttlft 01 ptfJUt), I d~laI. '1'1,11 ~\I' "'f1llflld tfll' re1um ''lit 'UiOIflJ*lVlI'V ~". Ill" tI,llmen", Ind tv thl tlH4 Df m~ ~"
billet, th.y It, true, Wlfe1. Ind OQ1fIpI,I, OIuiItIU(j1l 01 J.lflPlllljolllll' itllfllUplr.,-'II llJlld 011 III IIIfoun'II(,II\ of whKih P'.... I'll anr...........
~ Yout tlgf\lturl
Dill.
.fiUI (ll;-GupllluU
Pi ~l~...:~_.J''.!''''-:l,[ 1 ~
IpoIiN" O{;CUPll1OO
~/"j'(: ,~"Jl.J(J
"_'1 _III...........
...Lfr j J~ 1""'0{"'
i
.....--_.....~-,,;
('7), r
,
.po".... 'Ignlh". II. fUlfil IlIum, ItOftt mull ''U"
O"t
.___". ~~f'- ~
IJ.~.. (l {t~
, .
Ctlflt'tl If
..II -"lfJlO,,~
"--~rr;-~~.
'U. o...,...,.,.,...c--. '._ ....t.
.cHIOUl.I. All
('orm 10401
01041 N. '~I'OO"
Schedule A-Itemized Deduction.
~H3
A"",,,"""l . 07
ltQuI"lC' No
Your 10C'-I ..curttr numbw
J~.L: 0(1' : J ,0
lloh.dul. . ,. on b.okl
...- .. .~ "......, (8)
thtft ".....~ .....
H.mlitJ thuw" on Fo"" '040
Ldu, T:r: ... ()~A I., -r.f~.tJ~
M.dlo.1 C.ulIon: Do nOl,ncludt ..pen... /"IImbur..d or ~'d by olhel1
.nd 1 Mftdic.1 .nd d.ntal ..p.nlll (... Ilaga A-') ,
O.nl.1 2 [nllr Imounll,om Form 1040. IInl 37. L! J
lapen'.1 3 Mulliply IIn. 2 above by 7.5% (.075) .
4 Subtracl IIna 3 tlllm line'. II zero or Ie.., enler .0. .
I Slate end local income la>es , . . , ,
I R.el IIlal. laxe. (18e page A.2). , , , , . ,
7 ~~ht.~ ~am ~.~'~I~~n~~:'.~tr:~rt. Pf~~~,rty t~~~s. , . ~,
I Addllne.5lhrou h7, . . . ,
II. Homl mortglgllnlllBlllnd pOints reported 10 you on Form 1098
b Ham. mortgsge Interesl nol reported toyou on FOIm 1098. II pSld
to the person from whom you boughtth. ham., .81 page A.3
snd show thlt pe'lOn'. nam., id.ntlfylng no., end eddrns .
~ AMoh 10 form 1~. ~ ... In.tru.tions lor Ich.dul.. A and' farm 10401,
Inl.,..11
VOU P.ld
~
,
~~
3
T.... Vou
P.ld
(II..
p.g.A'l )
:Uo(e.
IS..
page A'2 I
Noler
PI,lonal '0
Inl",,11I
nDI
c:LJuclibll 11
12
Olftl 10
Ch.rtty
(s.. 13
page A.3) 14
III
II
POlnls nol reported 10 yo~ on rorrp 10,98. See page A-3
fa, specIal rule. ,.40:""''''' ~of'.~ 1\tF;'''1N~L, ~rr~, 10
Inveltmenl rntere.t. II required, a"ach Form 4952. (See
page A'3.) , , , , , , , , , , , , , , ,
Addlineegelhrou hI' "",.,.,
Caullon: If you made a chanrabl. conlnbulion and ~
,.celved. benef,' In relurn, see page A,3, ~
Contribution. by cash or check , , , , , , " 13
Oth., than by ca.h or check, If over $500, you MUST
."ach FOIm 8283, , , 14
Carryover from prior yaer I II
Add hne. 13 throu h '5 ,
,.
.r ~ 1,"<'
CllUIl" In'
Th.n lo.... I 7
Moving
.x n... ,.
Jo' b,.n... III
.n' M...
Olhll
MIIe.n.n.ou.
O,'uetlon. 20
IBH
p.o. A,a lor
..pen... 10
dlduct h.'..)
Caluall or thell loss(es). A"ach Form 4684. (See pa e A,4.)
,. 17
Un",mbu..ad amploy.e e>penus-job travel, union
dues. Job educ.llon, atc, If requrred, you MUST att.ch
Form 2~6, (See page A.4.). ",,'''' .",,,,, """",."
.... ""..~ ~,'-',If.t,(l~ .~,C.". ,,,., """. "."."",
Other expen.a.-investment, tax preparation, ule
d.poslt box, ate, L1et type and amount. .....",.,..,..
..............................................................,.
Add lin.. 19 and 20 , ,
Enlll Imount from Form 1040, Ilnl 32. 22
Multiply line 22 above by 2% (.021 '
f,ubtract line 23 from lina 21. If zero or Illss, enter .0, .
Other-from liat on page A-5, L1.t type and emount .
21
22
23
24
Oth.r 2lI
MIIe.llln"u.
O,'uetlon.
Tol.1
II.mlled
O.ductlon.
..,,,,,..,.,,,,,.,,,,,,,,,,,,,,,,,,.,.,,,,,,,.,,"""''''''''''''''',,.,,'''',.,,'',..,....'.
21 I. Ih. amount on Form 1040, lin. 32, mar. Ihan $108,450 (mar. th.n $54,225 If
m.",.d tiling aaparalely)?
a NO, Your deduction is nol hmllld, Add IIn.. 4, 8,12,10,17, 18,24, .nd 25 }
and .nter the tot.1 h.re. Also .nl.r on Fonn 1040, hn. 34, the I.ro., of thlt
.mounl or you, .t.nda,d deduction,
. VII, You, deduction may be limited. See page A,5 for the amount 10 enler,
'or "....rworl1 Alductlon Act Notlc., "" Form 1~ In.ll\lcllon., Cat No, 126110
Schedule A 1'- I_I.
IHI, 1111..
;' Ni'llWI I I'LlIJIi
i'l1.t.IIIIIl I l'"IIIJIIIl.
\11.,
1'1. 1"'1",',
\'Ilfl, "
, MUll" llll! ....ilyl't. ,,"Ii Ilplo
'~,'_tJJ'?l \~~~
ti Mfldl(flfu!iu \/IlllllhfjllJ
---I
I
I
I
I
I
I
--- - --I-V~~dl-ll1l. tlllllllll,IIIlHl Ib 11"1"\lllJ~\I\111lI1 hI 11111 !illl'l!',11 11"\iIIIl,lj 'lllr~1I ~ II ,,111 it'll ~'1I11~l!~II-111
IJ 1111:/ ala. '!llwll .. 'lIltjl'U'HlIII plHltl+lr 1,1 ..\I.lt. \'1'1111\'" Illn, hi' 1IllplJllvll Uti you ~ !Ilia
~__.__ H(I\!!II~ I~ I,l'~' ~I~l r"ll hltlhi 11'1"ltI 'I
b Employ.r. lll,"Ulu.:A!fOll numbu! t l"ili/n, I'PI oil,..,! ll"'lil"'~,III"') i f tldllltllull "Hlft III' wlll,tll:lkl
'{~ t II:, I, 'I,! I (j .'f1
3 boujtl Ii'tllllll, l\'l\l"~ . ~Urlll! JlIH:lJllly Jill Wlthhuld
" 1",",'1.
. Cunllolllultlllll
,
a Employe!'. nsrue. 8L1dle!tl, ,lltJ liP Hllhl
~!lt!l J I'! 't!'
1 GUUlIl follumlV III'~
''''\~I)! I;'
I All."""".! l'pl
d Employee', JOWII .ecuflly IlWHIlel
. AIIYR!Jl;U lie p;ltlf'lilll
tU IJhlJlllUhml1 aUit llfillltthl.
_l:112..-'llL.Jlll.t.L.- .. _~ ~
. Employee. name, IlhJt8511, ImlllP wllu
,t NOnljlJ8hl'Vd plOllli
II' Bltller.l' iW;!lIlletJ in 80a I
IlLlIEH I JIIU/I,!!, III
13 Stolt Intilll lw Du. 1.1
14 Ojhli'
1',,1 I 1111I11111 "'" VI.
f. f ,rtH'lt PH I'!:~ I t}
\. ...,t.-'
\.. ,0,11
l' 61all Employe, Illal, 1,0 No
1'i4.Lj!Hl:i';4'~' '" ,., ",.
lIsiiMQ;',' L~(ei1~~ Pel'l'J) If'ljl 9~;' l>,;i;luI.i"^I~~;.fo
17 s.. .1Qt. ...., " .Iala .,;;;;[~: iR",;a""q,,,. r":o;;. f[';",.~al;~~::':
d\'..~:;.J.; d.'/;,..., lJ.. . __j::.~I;'~'~J40.(
IRI APP Oepl1ll!l181l1 ullhll '1916111)' Hlll:1l11HI Alh',n\JI Be'vllt,
@ W 2 Wage end Tax
l . Statement
Copy C for EMPLOYEE'. RECOADa tS.. Nolle. on batlt_1
1993
UMU flu .r,4f>\XHl8
L
~._."._- ,......._ _____" ~___. _~._,_ ...._. _____ 0-..""
i
-, ,,----. ,~-"- _-.~__I
. ._...""_ 2:r-1m034
'lmI*>lJ'tntr~M~ · ffON
??oo2
PO lOX 3165
HARRISBURG, PA 17105
11 S"Ullllut;tlU'IIIoI8al13
.11'" J,f~ r: ~O"'II'.li(JI,
OCIa! .tctlu'~ "IU"
23231. 50
r~J;ti;t;iqf' and 1'Ill
23231. 50
f GlJt;I.tl"CtII~' 'iI"
MWlIIy ". WiiltlMt
tHO,3!
. ~'If' -*11,",
338 ,18
. .....'. name, Iddr,,,,.nd ZIP COd.
DORY L JACOBS
t50 FAIRWAY DRIVE
EnERS, PA 173 9
STORE' 09837
~;:..,:; "r.~::_~ ~,l~"~',~',::~~:: I~"r~~
W'.ru."""""".fll"'IlI."''''''''~'''''''
;::r:::,7=.;:;.r~lIJ~u'''.'fiIf1It1..~.tIH 11
riv..lt. 1. ~,tI1.'lI
tOtl'~"dll1l~.btI"'-lIt
nqullll&dplllll
1Tit;;oliit~..... I
Copy C for
Employees Records
See ooliee on bad(
If Emilio,... tuel'! '.qml~ numb"
, '. t13-48,0656
It loc.hllOOlW I 8BO
\~lihrllT 2J],50
c,.
~, .. J(. ,.
O,p.rlm.,,1 ollh. Tr"IUl~--h'lfI'n.1 fl",""u. S,IYlce
i >>..,...-. b4~U;Jil8-~--
~ l1~~~~:'6u'~ ~~~':".~~" _ _ _
____.._. __ _._______, ~____-_~_~J ~__.o,__,__ _._...._.______
tllfJr C tut 'lnp1or.n .........
Home
MortgagelRent ... , ..........., ,
Maintenance ,.....,...."..,..,....,......,..".,' ,,"
Utilities (telephone, heating
eler.trlc, etc,) .................,.....
Employment (IrOnsporlatlol1,
lunches) ..............,...
Taxes
Real Estate ..,....,.....
Personal Properly.........., .............
tncome ..,............,...., ............ ..................
I Occuoation
nsurance
Homeowners ..,..'""", ,..', ,...,..'""""."....,'
Automobile ..J2...ClltlIL..,..
L1fe/AccldenI/Health .....,
Othor. ...............
Automoblte (payments, fuel,
repairs) ............,..........
Medical
Doctor, Denl."I, Orthodonli~l,
Hospital............ , ......."..,....
Special (glassos, braces, ole,) .....
Education
Private, Parochial School.....................
Coltege ..,StlJdent..l..oan....................
Personal
Clothing ....,..,....... .................
Food ...................,................... ...............
Other (hOuseholo supplies,
barber, etc,) .............................,...........,
Credit payments and loans ,..................,
Miscellaneous
Household help/child care ..,.................,
Entertainment (Inc, papers,
books, vacallon, pay TV, etc.) ............
Gifts/Charitable contributions ..............
Legal Fees ..............................................,
Other chllo suppoll/allmony
payments ......,....,....,..........",......,.......,
Other (specify) ....P.o.<il...............................,....
I tt)u~iolh)ld
Wed,
$ -.
$.
$.
$ ..'-
$ ._.-_.~.-
$ _._~-_...
$ _...~._._..-....
$
$---
$ -~_...-
<
....---,.
C1.i1d
\\",,'f
$ . .---
$ .. ...-...~..~.~.
$ ..--'--'-'
$
$ -.. .-.--...-.
$ ....-.....-
$ ---..
$
$.._...___
$___.
$
t \1 'H',I-lll dll
',11'11111
$ a12.00~-
$ ..60.00 ~
$ ....~~lQ. ~O ..
$ . 130.00
$ . .....-- . ...."-
<
~ ..
$ '''~-'''~''''~--
$ 16.75
$---
$ JJ1.00_
< 52.15
... -_._----,~----
<
... ----~-
"
I:IlIld
f.1, 1111.
$.
$,
$ 'n~' ~~
$ .....-.
$...~--
$ ......~.~-~-~
$~~---
$
$
$
$
L $ ~ 70. oo-<Jas
--w.GO-npaf'rs
$ $ ~ ..~~:~*.:" - rYMENTS
s~_ $ $ $
S _____._.__ S , <
. ... ....---
$ S S $
$ $ $ .......55.52...- $
$__
$---
S
$
$
$
$
$
$
$
Total Expenses ............................,................ $
* includes taxes snd homeowner'e insurance
** Wife has reimbursed $781.74 of $3,132.40
<
...--.------
$
$ __BO.oo-
$ 140.00
s
$
$ < 1', 00 $
~
S S ~Q.QO__ S
$ $ 50.00 $
$ S~OO- S
$ $ ~oo. _ $
$ S.......5Q..OO_ $
$ S $
$ $ 111 ';0 $
$ $ 3.t.lfio..~ $
...
1'1101'11" ,
I II'! I Ill{'
, (,\111\';
[liJ'flll\J~j 'I! I I 'ulll:,
Clltdit UnlUIl
fjtoc~f./nt)llllfj
Real r "Iale
OItWI
10tal, Plllptilly
INSURANCE
Hospllal
Medical
lieallh//lcclilenl
DISiJllII11': llj(,urlil~
Diller (11""101, vie)
(J\'.tl,I.,lllll'
I, , , \",dlll" I'
Rt<Jullr 29.\17 X
Pratt. '. ~H.41l II
,
Rwul.r " ~.28 X
,
Prath Ci 2~O.64 J\
s
1
Mutual t'undl 48.684 5h 'I no.on II
Nat 23,000 )(
I
5
1.
S
ClJrllpany Policy No. Coverage'
Ii W C
Il, If. U..lthcn. X
u. 5. llea1thcara II
U. 8. 1!I.lthca,rl ~X
('Ii. HUtth1nd, \t,' V/lIl, " ,I, il,1, I ft.II':)
LUIIII '.IUll M IIlClJI.Il (,1 AH MU,l
A, lhis 101m lT1lJr.t tl; ldlttj Cui II :i 11.1: I'll \',111- ((I'I'll cnlij
_"_,,,,__ ('l operalE!; c tilt 11'(" ! t I' .'.' III f.. !_- i1 f,fJ."fl:': ': ((1'1, (Jr
(2) i~ n mEllol,-r ,1;; 1,[.,/IIlHthll' 1'1 I' !l.t.,. (dill!', I r
__~~~> (3) i5 a thi1r(t!()h~(1 In ir,d 1,-: r,-',I, 'IH~ t); {I, ~.f'11 ((;q,_..la1tLf) u tllHd:,1 Hltlly
I ,dli" I< Ie 111"'" I", "',1;", I', '.1 II". I,ll...,,,,,.: ,'" "Ii" "I' ",I."""~ \. I", I U'.""".' 1 ,<:1<1 u, 1(11, r ,1Itn"'sl<'p.
1()Ull Vl'ntult;, (cq,r:liilllll (f [lllilli!f l'nld,
(1) the m(J~:.' leu [.\ i t(~i';Ii::ll!lcr'''\l' 1,H li.dulll, 1,0<1
l;:) 011: IIlc:.:t rp'u;flt F,dll ~lt!1It ! '. :_ !;jl(lfHLl i
C. tialtH~ and f.ddf€~4 1.1 tULH;t;~!,
lijlqL' r,t. 1~1l11,\ r r
D. tJame Bnd A{jdres! (If dlllefen! than I ) 1.,1 l)f;UAJntant, GIJfltf0I1f'J:1 fJI tillllH pfH5Dfl ill charge 01 financial
recordn'
[. (1) AnnlJallncome frOIllI'IJLllle5..
(2) How ollelllslncrHn" lVCElvc,j'/ .
(3) Gr055 Income pel pay perrOl! .
(4) Net Inr.oll1l! per pay 1'<111011...
(5) Gpeclfk deducl"'''4 II allY.
J_
J.
J
I
l
lUllY I., .JACOIJS
, I'LA INTIFF
DR 24,252
IN '11 IE COURT OF COMMON PLEAS OP
CUMBERLAND COUNTY. PENNSYLVANIA
DOMES11C RELA110NS !)EcnON
CIVIL AcnON . SUPPORT
...
..,
VS
AI.IlEI(I' I. ,JACOBS. 11 I
. DEFENDANT
NO, U77
SUPPORT 19. 95
II EA LTII INSURANCE COVEI{AGE REI'ORT
,1nI""".uon mill. bo ""mpl.1Ild IIJId retwned whhln to da)'l, Flilw. ID comply IIIJY ...uh in IlIuonce .1. .ubpoeno or olller oppropioIAI.IIlClloIII,
ploy.... Nom.. ALUEI(r 1. IN:OBS. 111
,pl.y..'. .ocIaI......lry.: 202-46- 3810
1, ..Ih. ""pl.y.. mlh modl<:ol. 11....11. 'Y' cara. ptucripU.n 0' .!h.. In.IW'IIl,,. co...... ...illblllD Ih. anptoy.a1
unl rho dcpendonu ...arod under rho omploy..'. Inruronce. lOll indJclll ..hlch 'YI* .1 co.....,. !hey .....lIuuuan y.1Il company,
Y.. III
No 0
TYPE OF COVERAOE
SSI Ilorpillliution Medical OcnLII EYI Pruaipuon Othor
1. Jacoba. III 202-48-3810 a il 0 a 1UI 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
.
..Ida 1h.InI.nnlli.n InJIcu.d lorll<h rype.llruuron". which II ...nobl. \0 1h. .mploy.... wh.1her or no. any olllll .bo'.'IW11ed depcndenlJ Irl
..lId III/11J lim.:
I~ oompony tpovldor):
.up':
l..un .......... daIo: 1/1/95
III 01.......... far dopondenla'
U S Hea1thcare
Plan .:
T)'JII 01 co.....'"'
N/A
Policy I:
MAdicAl, BORpit-IIl1i!1f4t-inn
iW'..... compony (pavldor)'
aup"
""'.. ........ clIIa:
,I af ........ lor dopondonII:
Pion I,
T)'JII of co.......'
Pallcy':
,"'""'" COll1fIIIIy tpo.ldor):
"'P .,
"'".. ........ clIIa:
II of .......... for dopoIIdonIr.
PIon I:
_ T)'JII of co.......'
rallcy',
Ill..... company (po.ldor~
,up" PIon .: PoUcy .,
'1CIl.. ",v....,. dII4: T)'JII 01 COVin'.'
I of ""v....,. for dopendenIa:-
. obov.-lWl1od cIopondanll .... no. cunlllllly covered by lrullll/lce. pi.... IW. !h. urU"1 daIo ""ver... could bo povlcled.
. PLl!ASE PROVIDE FORMS NECESSARY TO ADD OI!PI!NDEm'S.
I AS 11m EMPLOYEE MAYBE ORDERED TO PROVIDE COVERAOE FOR 1111!M.
if)' 1h0l1h. .lIIOnIIJIII mado in thU Il..hlt In&uronce Covcnsc lnI.nnatl.n I.nn .... 1lU. lOll ""rrea.I underolllld 1hII1alJ. IlIIelIIenlJ herein Il1l made
I .... \0 rho penolu.. 0111 PL c.s, I 49G4 r.IIIIn.1D IlII1Wom f.hincIU.n lD .u1harid..,
I
i .. SlsnOlwc:
I ftl m: I Hili: lIU
i 11111111. p, 'lid" 11
II'" II". 1 I. :'''',1111
I, II,
\~11Jjl~H 'llUl~lI ~nijQ~IAIU,lHO~
........... ~"")IH:JIOlI/lj . ~/30/11~, . ":0;' -1..1.R.,ti
','~ JA18i0 l5 -,..~,.... E17.31
lt9'i~- JVuiii...a'I~:-.]d7f~~" T~
7P,OO 1_ 11.00 0.00 87.00
Wi, unoiid . ~ ~.II nil;,i'-~'
n."!) 138.73 0.00
._.. Y1U~pJ("10 ~Qi!~!.30 vac~~~~,lO'
~'TO'O^Tt II~llON
,,~,'j,1,,\1' ~t
k, ,'I ,I ..
11 t!.'.. ,
--=--,.\...........
t-~~E~IIiO~~Bg l~
tTTlms, PA 17~i9
-"'--.".""--' -.
Glr," r,y
1608.68
1 n! 97
I'M1i1'T'Wl
f.lCA
,
'ill
.
PERIOD l:NlIINIlO'/U/18
.:TAniO "'1 Iln~ .... Ih~7,H
'f.I.j,~oo Ef.'oo I, 6V:'oo .1, Ii.n. 00
vii.'iiliiir' 'H,J;ij- .. I., Imno
7~.43 0.00 471,'4
Y16VK'lAtJli,j VTbV;;;' ..,. "11.-
'110 ..3- Glr7 .30 llQlli.e~
t~gE=It~~CeB~nl^i
ETTERS, p~ 17318
..... "V
r.t\lrll T..
---.-...---..
fiCA
OlJanENT r11l.l0V IKJ'IIIlMATION
~...~._-
1914.82 1','5
:l28.lllI II ,y,o 00 01\,111"0 00
113 . 04 · Iiii~;~ II \i~i'8
~..,-.-..._.,..,
6S.57 · of 1307.33 ;
1:("&"---' .
138.92 ._ 159.... .1"\';:
lilt, T&lI
.
.'
II
PlAINTlI'I"8
EXlillNT
J
!_~.{!~J'j'.L..._._^",< -,
"tNtI
;11.'.1
..
DORY L, JACOBS,
PlalnlHf
v,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
ALBERT I, JACOBS, Ill,
Defendant
NO, 95-2640 CIVIL TERM
IN DIVORCE
REOUEST FOR COUNSELING
The undersigned pursuant to Section ]]02 of the Divorce Code
herewith requests counseling and prays the Court to enter an Order
requiring up to a maximum of three counseling sessions within 90
days from May 17, 1995,
o /2 4t /71)
Date { I
VlfWlnvJ.'J;\'~d
11.'-...... '., ." 'c"v'n'"
'. ~. \ ,"I
'!;'/I Ill' L -11Ii{' 96
t.t '\~(.,.:.i.:': :-!.:'"', j .ld1 :10
lM;I;IlKJJli.:/
Each par'ty acknowle(1gea that he or ohe hao r'eceived
independent, legal advice from cOllnael of Ida or her' aelection and
that each fully under'olau,!o the facto aud hae been fully infonned
aB to hill 01: her' legal dghta and obligations am1 each party
acknowl ed~ltHl and acceplll I hat Ih i Il Agr'eemenl
i 6,
in the
circumstanceo, fail and equitable, a Ill! thaI it rs being entered
into freely and voluntadly afler having leceived such advice and
with such knowledge, an,! thaI execution of tllio Agr'eement io not
the result of any collusion 01' impropel' 01' illegal agreement or'
agr'eemento.
NOW, THEREFORE, in consider'ation of the premioes and of the
"mtual promisee, covenante and undertakings hereinatter eet forth
and for other' gOO(! aud valuable conoldelalion, receipt of which io
hereby acknowledged by each ot the parlies her'eto, WIFE and
1II1S1H\ND, each intending to be 1 egall y 00uI1<1, hereby covenant and
agree as follows:
flI.C1'1Qli A.
QIJ:NERALl'RQYlUQlffl
A. 1 flII'ABATlQli I
11 8hall be lawful for each party at all
times hereaftel to I I ve BeptH Ill., alii! Ilpall f I um the ot hel' party at
~
.~
ouch place ao he 01' ohe lIlay hum tlmB In tlllle choooe 01' deem fit.
co,.
The foregoing pl'ovialoll uhall lIot l,e I akeu liB IlII a'!llIiBelou on the
pan. of tlither palty ot' III" ldWf'ullloull (JI 1I1l1uwfllll1tlBB of the
causee leading to their Iivlll'l a(Jilll
lLilch palty allilll he free
I
.'
from interference, authori ty, and contact by the other" / as fully as
if he or she were single and unmarried, except as may be necessary
to carry out the provioions of thio Agreement. Neither party shall
mole6t the other or attempt to molest the other, nor compel the
other to cohabit with the other, or in any way harass or malign the
other / nor in any way interfere with the peaceful existence,
separate and apart from the other.
A.2 MUTUAL CONSENT DIVORCE I The parties acknowledge that
WIFE has commenced an action for divorce in the Court of Common
Pleas of Cumberland County at Docket No. 95-2640. The parties
further acknowledge that the ninety (90) day period provided under
Section 3301(c) of the Code has expired and agree that
contemporaneous with the execution of this Agreement, each shall
sign and have acknowledged an Affidavit of Consent to a divorce
with the intent that said Affidavits shall be illUUediately
transmitted to WIFE'S counsel to be filed with a Praecipe to
Transmit Record and Vital Statistics form to precipitate the prompt
entry of a decree of divorce.
A.3 IFFECT OF DIVORCE DECREE I The parties agree that unless
otherwise specifically provided herein, this Agreement shall
continue in full force and effect after such time as a final Decree
in Divorce may be entered with respect to the parties.
3
A.4 DISTRlBUTION DATil The transfer' of pt'operty, funds
and/or documents provided for herein, shall only take place on the
"distribution date" which shall be defined as the date of execution
of this Agreement unless otherwise specit ied herein.
A.S ~UTION DATil The pht'ase "date of execution" or
"execution date" of this Agreement ahall Ile defined as the date
upon which the last party signed this Agreement.
A.6 MUTUAL RELEASE I HUSBAND and WIFE each do hereby mutually
remise, release, quitclaim and forever discharge the other and the
estate of ollch other, for all time to come, and for all purposes
whatsoever, of and from any and all dghts, title and interests, or
claims in or against the property (including income and gain from
property hereafter accruing) of the other and againat the estate of
such other, of whatever nature and wheresoever' Bituate, which he or
she now has or at any time I~reafter may have against such other,
the estate of such other or any part thereof, whether adsing out
of any former acts, contracts, engagementB Ot' 1 iabU i ties of Buch
other or by way of dower or curtesy, or claims in the nature of
dower or curtesy or widow's or widower's rights, family exemption
or similar allowance, or under' the intestate laws, Ot' the dght to
take against the spouse's wi ll; ot- the right to treat a lifetime
conveyance by the other as teBtamentary, 01' all other d ght II of a
surviving apouse to participate in a deceaas,! spouBe's eetflte,
whether adsing under the 1 aws of (a) pennsyl valli a, (Ill any State,
4
conunonwealth, or territory of the United States, or (c) any other
country, or any rights which either party llIay have or at any time
hereinafter have for past, present, or future support or
maintenance, alimony, alimony pendente lite, counsel fees, costs or
expellses, whether arising as a result of the marital relation or
other'wise, except, and anI y except, all ri ghts, agreements and
obligations of whatBoever natUl:e arising or which may arise under
this Agreement or for the breach thereof. It is the intention of
HUSBAND and WI FE to give to each other by the execution of this
Agreement a full, complete, and general release with respect to any
and all property of any kind or nature, real, personal or mixed,
which the other now owns or may hereafter acquire, except and only
except all rights and agreements and obligations of whatsoever
nature arising or which may arise under this Agreement or for the
breach thereof.
A.7 WARRANTY AS TO EXISTING OBLIGATIONS. During the course
of the marriage, WIFE and HUSBAND have incurred certain liabilities
and it is hereby agreed, without the necessity of ascertaining for
what purpose and to whose use each of the bills was incurred, that
of the liabilities which were incurred prior to the date of the
execution of this Agreement, WI FE and HUSBAND each covenants,
represents, war-rants and agrees that, except as may be otherwise
specifically provided for by the tenns of this Agreement, as of the
date of execut i on of thi B Agreement, liD ullpai d liabil it i es remain
which Wlll'e incurred by him or her' or on his or her behalf for which
5
the other party may he deemed I iahle, 1II1l!, II' nllY 1111.:11 Ilulllll 01'
obligations should be detennltlt~<1 to hilvl! "XlIII",! 1111 of 11111 dnln of
execution of this Agreement, llxcapl illI llut f'lrth IlUlow, Ihe pliny
who incut'r"ed that debt shall ill<!el1lni I'}' 0111,1 hol,! I hu 01 hlil party
harmless f t'om and aga inst any I nUll or 11 illd III y IllId COllI B 01'
expense, including attol'nay'u feau, IIICIIII'IJ(! nu II 1'1l1l1l11 01' those
liabilities.
In the event that WIFE 01' HlJliUANlJ (1<1I111 lIot pay when due any
such bills, obligations or debtB, 11m othur plH'ty Ilhall have the
right, hut nnt the obI igation, to pay Ullclt hi Illl, ollllgalionB 01'
debts. If one party paYIl such hillu, ohli!/illiollu 01' <!ehtu which
the other party Is obligated to llilY punllllllll to thiu par'agraph
after giving the defaulting llillty l'ivu ,'aYIl wlillulI II<Hice, the
party making the paymtlnt uhall be lllllilllld 10 Iucuive Illillllllll'l~elllent
from the other pany 1I0\: anI y for paymlJlIl. u lIIade, but al uo for' Rny
related costs, incl uding lilt onltlYu' hH~U.
A.8 IfARRANU,.AILT~Lltl1'URI,OI.LIQAnOlUI' W I I'll i'lIl<l IIIHlUAND each
covenant, represellt, walTllIll ilnd a!JIHI! I hal, except as lIIay be
other'wise specifically provided fOI by thu lellllo of this Agreement,
neither of them shall hel'lliltlur illcur illlY I ialJi I i\:y wha\:1luever for
which the othel' 01' the llllla\:e ot I I III lIlh<!1 lIIay be liilblB and each
now and al: all limBS hel'Bal'lllr ullllll I 11l!f!1II11 lty, dufell<l and hold the
other pany hannl eUIl f 1011I all<1 f11lilllllll. allY lluch 1 i abi lit ies, costs
or expeneeu, inclll<ling allOIlIl!Yll' '!lUll, n;lfllinlJ Ihal'slo incurred
"
by the othet' party after the date of the execution of this
Agt'eemellt .
A.9 IUJlCLQ&ll1\I I IIlJSBAND am! W I FE each represent and warrant
to the othel- that he or Ilhe hall made a full alld complete disclosure
to the otllsr of all aallets of any nature whatsoeVB1' in which such
part y hall an i nterBllt, tl16 aOUlces alll! amount ot the incomB of such
party of evety type wllataoevet allll of all other facts I'slating to
the suoj ect mat tel' of t.h is Agleement.
JlI!::TlQli_I..
ALlHlmY....,ALIIlQlfLI'KNDENTI r. COUNSEL, rus
B.1 ALIHmiY..AliltALIHWfi.,fIlfl2IliTIJ..IIII IIlJSBAND ill pt'esently
under On1et' for alimony pendente lite in favor of WIFE tot' $385.00
per month. lJpon enlry of a Ileclee in Divorce this obligation shall
ceaoe. Any and all auear-ages llhall be paid by IllJSBAND on or
before the exscution date. WI FE a91 eea to wai VI! any right II aha may
have, Ot' at any time IUHsafl.el have, f(n futur-e support,
maintenance, alimony, 01 alimony pendente lite.
B.:l
CQWIIL . . fllll I
Each patty ohall pay his or her own
counsel fesa, coats and expenaell.
7
fIIC1'lOB n.c .
IQUlTAIlLI DlUTIUDUTlOti Of I'ROi'UU
C.1 CQlUIIDIBATlQliIl lOR IQUlTADLI DUlTRlDUTlQti I The par-t iea
have altelllpte(! t.n (IlUlllllllll! 111..1111I,1111111 prnpel'ly in a manner
which ('llllfOllllll In 1111.1 clillHl1I Ill!l I(Jllh III Chapt.er' 35 of the
l'ellllllylv.'llllll Illv'IITI~ l'()(!" , .llll!laklll'l 11110 ,lCCOllllt the factora and
conllldtllllt.lnllll Ulll 101lh 1111.110111,
Tile dlvllllnll 01 l!XIIIIIII'l 111011 II/II IJloperty ill not intended by
the IJillltell to ('''1I111ttllll! III ,lilY w"y" lHlIl! 01' excllange of aaaeta;
and lllc (Ilvtulnn III 1""11'1 l'IIIH'Il!d wlllltllll the introduction of
olltllt(!e 111I1'!1l "I "III... pi "I"" 1 ~' 111,1 ('''1111111111 ing marital property.
The ,Ilvluioll nl pllllltlll}' 1111,1," I hill Aqlel!lIItlnt shall be in full
llatiBfllctiDlI'lf 1111 11IiU It III 11'.111111 III lhu lliu'tiea.
C.2 DIVllllOlf Of 1'IIIl0lfAL 1'R0i'IRU I The partiea hereby
diviclfl Ihell pflllHlllitl I'IOI'"lty, tllcllldillg, but not limited to
househol(1 ",)()(!U /1I1t1 fill III IIhlll'lll, I"Jlllollal effects and all other
iLemll 01 I"HIIIlIllII PI"I"'lt~' 1111"'\ IIY them III cOllunon aa followa:
HUSBANIl shill I 1"!('Olllu uol" OWII"I 1111,1 lilFE shall waive any claims to
the (11'\1, I hu '.lillI \J I t II Hill! ,111 llhillell Df Amed can Mutual Funds
(llpplllXllIIlll ul~' 4") IIIHiIlAlllluhdl1 l"U:ollle lIole owner' and WIFE shall
waive allY <'I,llmu t" .'III}' "lhul Itl!lllll III ill remaining in the home,
exc"pl I,ll tllll (,..lilli/II It,jtlplllllll! /1I11!lllllall window air conditioner,
whlcll ullilll 1"'Cllm" III" plnplllty of WIFE and as to which HUSBAND
ullnl I w...lv.. /lilY cliillllll, All other items of personal property have
1""111 ,lIvl'!H'! lIotlllllotd nI'l Iy by the pal'liell and neither shall make
u
any claim to any such property presently in possession of the
other.
Should at any time it become necessary for either party to
execute any titles, deeds or similar documents to give effect to
this paragraph, he or she shall do so promptly upon request of the
other party.
C.3 MOTOR VEHICLES I With respect to the motor vehicles owned
by or leased to the parties, they agree as follows:
1) The 1995 Nissan Pathfinder (titled in HUSBAND)
shall become the sole and exclusive property of WIFE;
2) WIFE hereby transfers and assigns to HUSBAND any
and all intereot she may have in the 1991 Honda Accord
(leased to HUSBAND) .
The titles to the said motor vehicles or any other documents
necessary or appropriate for effecting transfer as herein provided,
shall be executed by the parties on the date of execution of this
Agreement, and said executed titles or other documents shall be
delivered to the proper parties on the distribution date. Each
party agrees to be solely responsible for the amount a presently due
and owing against his or her automobile, and shall indemnify the
other against any liability he or she may illcur on the outstanding
9
loalls or 1 ease (!ocumenl tl. WI I'll aha II, aa aDon as pract i cal, have
HlJSlll\ND lemoved aa an olJI igElI 1,,1 pi.l1ty IIIHlel the loall tor the 1995
Niuslllll'llthtin,!el. If necesllllry, WIFE shall lefillance /laid vehicle
solely ill hel name, IIIHI pay all CDSI6 alld t1xplilnslilll in cllllllect.ion
t.herewi I h,
C.4 CABU,I'AlHiIiTI 1llJ:JI3I\ND IJllall pay to WIl'U:, on tlla date of
execUI ion, tile sum 01 $l~, 500.00.
C.5 RIAlt_...l'iUI'IRTII WIFE "'lre",s In tlllntlfer all of he/'
I'I\Jht, title and illlereat in aJl<!to the reill (Hltate flilullted at 150
~'ailway Ddve, lillelll, YtHk Cuunty, Pennsylvania, now titled ill the
nllma of IIUSI1ANIl and WIFll all tenants lJy tile Emtil'etiell tu HUSBANIl
alld agnles to promptly execute 1I0W 01 ill tile tUUne any <llld all
deeds, documents, 'H papen. necel.lBary 10 eft8ct such trilnsfer of
title, WIFE further acknowledges that ahe haa no claim, light,
intlHest, 01 tlU", whalrJOeVel in said IJlopeny Dl in any incn:lule
in value to silld plOpen y and further 1l!J1 eBS never to asselt any
claim 10 said propelLy in tile fill me, Said lnlnufer BI)'l11 IJ"
effective illune(lIalely awl flllall be ldJl<!jll~J If!<janileaa of the
marllal status of the !,ii/tieB,
IllHlIII\NIl horeby cov(wanla an,l a<jIt!HIl t () aUBum8 anti pay in lu 11
the lI.,mallllnlj hala,lC'" of Ilia mlJrt'jil'lfJ I'letHmlly cDnlJtillltin<j a
Ilell IIl'lJn nW! tml'lllIIla'l 111'l III'" IJtlll",' I"PIII\ IJHb. dll,l t III tiltH covenantll
aw! agleeH that 1I11 will illl!emnlfy all'! t;av" Wll"I, halllllellH from any
III
and all lialJil i ty, expanse, cost, 01 loss whataoevel' as a I'eoul t of
hi II non-payment 01: 1I011-pflr'fol1l1allCe of sail! mOI"tgage.
C.6 8ELEASI_Or,1liT&UIlTa..IlLIHl'LQYHlULUlilllTa I Each pat'ty
hereby J"eleasea and relinquisheu any alH! all claims which he or she
may have to any penB ion bens f it u, i nUllt'ance bene f it: B or proceeds,
defet'led compensation, oalat'y continuation, of any other employment
uenefits to which the other' is now or' may hereafter become
ent it led.
a&1'ION D.
KISCELLANEOUS PROVISIQHj
D.l INCOME TAX PRIOR RETUBWiI The (Janies have heretofore
filed joint federal and state income tax t'eturno, and ohall do so
for the tax year of 1995, each paying one,half of the tax due with
the returno, and each payi ng one- half of the accountant's tax
return preparation feea. Both pan,ies agt'ee that in the event any
deficiency in fedet'al, state or' local income tax is proposed, or
any aooessment of any such tax is made against either of them, each
will indemnify and hold hannleBu the other' ft'om and against any
loss or liability fat' any such tax deficiency Ot' asoeaument and any
illtereBt, penal ty ant! expenBe i nCIlJTe,l in connect ion thet"ewith.
Such tax, intereBt, penal ty 01' expenlle uhall be paid solely and
entit'ely by the individual who is finally detet'mined to be the
caUBa of the misrepreoentations or failures to disclose the nature
11
and extent of his or her separate income on the afol'ellaid joint
returns.
SECTION E.
ENFORCEMENT AND STANDARD l'.RQYUIQlffl
&:.1 BREACH. It is expressly stipulated that if either party
fails in the due performance of any of hi s at' het' material
obligations under this Agreement, the other party ahall have the
right, at his or her election, to sue for damages fat' breach
thereof, to sue for sped f ic performance, or to seek any other
legal remedies as may be available, and the defaulting party shall
pay the reasonable legal fees for any servi ces rendered by the non-
defaulting party's attorney in any action or proceeding to compel
performance hereunder.
E.2 ADDITIONAL DOCUKENTS. Each party shall, at any time and
from time to time hereafter, take any and all steps and execute,
acknowledge and deliver to the other party any and all further
instruments and/or documents that the other pat'ty may reasonably
require for the purpose of givi.ng full fOl'ce and effect to the
provisions of this Agreement.
E.3 ENTIRE AGREEMENT I This Agreement cOllstitutefl the entire
understanding of the part ies and superaedefl any and a 11 prior
12
WHEREFORE, the parties have oigned this Agreement with the
intention of being mutually
'.g."y bO~"~~~ ~ ~..
~r:; ,41;"''7, ,~.,
(, ALBt~3'(' JACOBS, r I I
WITNESS
~) !:{-Q),Q
'~S
\.Jz/!i-k
14
('OMMONWli:AI,'l'Il ()It \'U:NNl,Y1NAN I A
('oUNTV 01" UAIJI'lIrN (.....'/,'1/'(' /..
I ,II
Olltlltll, lilt! _ (lay of
-' I..L~{L
, 199,1. balol'8
llIe, II N',liIlY I'lIbll(', tile IIIHIE!llllllnll,l office!!', [1E!lliUIlIIIIy appeared
IJOfIY 1.< .lACliB!;, l\IluWII III 11111 (01 lJalilllactol ily [HOven) 10 be tile
plH 6011 WIiOIHI nam" i I.l 1l1I1'''Il'li lIe(! to I h" t nt egoing PI-opel't y
tJetllllllll'lllt '11j1"'tlllltllll all(! a('kllowle(lqe<1 tliat lie execlIl ",I lilt! SIimt! frn
tile 1'11I[)(JI.lIJIl thereill (,olllaillE!(I,
IN Wl1'NlWIl WIIKI1EOf', 1 herllunl.o eel. illY II a lie! aile! official Ileal.
--- ~t!~ ft/~:tf;tj;;'-"'''- '----
ItMIW ll8II
LlmIGt1btl.~
~~__n.
16