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: IN THE COURT OF COMMON PLEAS :
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OF CUMBERLAND COUNTY
STATE OF *. PENNA.
RICHARD A.. KAUFFMAN
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Plaintiff
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, ELAINE A. KAUFFMAN
Defendant
DECREE IN
DIVORCE
d. 19"'1 .. d d d
AND NOW, ".." Arl:~..., 7."", ,(,..., It IS or ere an
decreed that ,,~,i,c~~.r~, ~:. !,-,a~.f.f~,a.n, , , .,. , . . . , , , . , . ,. , . , , . . . . . .. plaintiff,
and........... ,~~'!~~~ ,~: ,~'!'!~~'!''!~".............".......,... defendant,
are divorced from the bonds of matrimony.
The court retains jurisdiction of the following claims which have
been raised of record in this action for which a final order has not yet
been entered;
see concurrent order
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D. The True Temper Retirement/Savings Plan and any interest
thereon, said plan titled in the name of Plaintiff,
Richard A. Kauffman, shall be the exclusive property of
Richard A. Kauffman.
E. From the money held in the escrow account of Broujos and
Gilroy, P.C., which money represents sale of the marital
real estate, the sum of $21,977.38 shall be paid to
Plaintiff, Richard A. Kauffman, and shall be his
exclusive property. This sum represents his 50% portion
of the escrow funds totalling $16,701.30 and an
adjustment owing by Defendant, Elaine A. Kauffman, to
Plaintiff, Richard A. Kauffman, in the amount of
$5,276.08.
F. All insurance policies in the name of Defendant, Elaine
A. Kauffman, and any interest earned thereon shall be the
exclusive property of Defendant, Elaine A. Kauffman. The
1994 Dodge Caravan vehicle shall be the exclusive
property of Defendant, Elaine A. Kauffman. The VIP
Pension Plan that Defendant, Elaine A. Kauffman, owned at
Pennsylvania Blue Shield and any interest earned thereon
shall be the exclusive property of Defendant, Elaine A.
Kauffman.
G. From the escrow account held by Broujos and Gilroy, P.C.,
which represents proceeds from the sale of the marital
real estate, the sum of $11,239.91 shall be paid to
Defendant, Elaine A. Kauffman, and shall be the exclusive
property of Defendant, Elaine A. Kauffman. This sum
represents Hrs. KaUffman's share of the escrow fund
totalling $16,515.99 less an adjustment for monies owing
by her to her husband in the amount of $5,276.08.
H. Any monies remaining in the mentioned escrow account at
Broujos and Gilroy, P.C., which would represent interest
earned on those monies subsequent to April 30, 1997,
shall be divided and paid equally to Plaintiff, Richard
A. Kauffman, and Defendant, Elaine A. Kauffman.
3
Both parties shall, wi thin 30 days of final order in these
proceedings, sign any and all documents, including vehicle titles,
necessary to effectuate the equitable distribution as set forth
herein.
4
Any and all other claims raised in the divorce action are hereby
dismissed.
BY
THE COURT:
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RICHARD A. KAUFFMAN : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
.
.
v . CIVIL ACTION - LAW
.
.
. , '/;,L;,
ELAINE A. KAUFFMAN, . NO. 95 - ,jti.~ '/ (((" Ul,...
.
Defendant .
.
. IN DIVORCE
.
NOTICE TO DEFEND AND CLAIM RIGHTS
You have been sued in Court. If you wish to defend against the
claims set forth in the following pages, you must take prompt
action. You are warned that if you fail to do so, the case may
proceed without you and a decree of divorce or annulment may be
entered against you 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 grounds for divorce is indignities or irretrievable
breakdown of the marriage, you may request marriage counseling. A
list of marriage counselors is available in the Prothonotary's
Office at the Cumberland County Courthouse, 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.
COURT ADMINISTRATOR
CUMBERLAND COUNTY COURTHOUSE
CARLISLE, PENNSYLVANIA 17013
TELEPHONE: 717 - 240-6200
RICHARD A. KAUFFMAN,
Plaintiff
:IN THE COURT OF COMMON PLEAS OF
:CUMBERLAND COUNTY, PENNSYLVANIA
.
.
V
:CIVIL ACTION - LAW
.
.
IN DIVORCE
ELAINE A. KAUFFMAN,
Defendant
:NO. 95 -
.
.
CCMPLAINT
Plaintiff, Richard A. Kauffman, by his attorneys, Broujos, Gilroy
& Houston, P.C., sets forth the following:
1
Plaintiff, Richard A. Kauffman, is an adult individual residing at
1397 Creek Road, Apartment 4, Boiling Springs, PA 17007.
2
Defendant, Elaine A. Kauffman, is an adult individual residing at
305 North Ridge, Hallettsville, Texas 77964.
3
Plaintiff and Defendant were married on August 2, 1980.
4
Plaintiff has resided continuously in the Commonwealth of
Pennsylvania for at least six months prior to the commencement of
this action.
5
There have been no prior actions for divorce or annulment of this
marriage except for an action filed by Defendant against Plaintiff
at 94-7195 in Cumberland County.
discontinued.
This action has been
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RICHARD A. KAUFFMAN, : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
:
v : NO. 9.5" - 3959
.
.
ELAINB A. KAUFFMAN, .
.
Defendant . IN DIVORCE
.
AFrIDAVIT or 8ERVIC~
I, Hubert x. Gilroy, being duly sworn according to law do depose
and state that a copy of the Complaint and Notice to Plea filed in
the above referenced matter was served on Defendant Elaine A.
Kauffman, by certified mail on August 3, 1995.
A copy of the
Certified Mail - Return Receipt Requested, Reatricted Delivery, is
attached hereto and marked Exhibit A.
q!;//??
Hubert X. G
Attorney f Plaintiff
Broujos, Gilroy, Houston, P.C.
4 North Hanover Street
Carlisle, PA 17013
717 - 243-4574
Sworn and subscribed
before me this ..J/~t
day of ('.:1" iJ. ,.. ,
.~
1996
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PUblJ.c
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Notary
Notarl." Seal
Shem L, Murphy. NOlmy PUolllc
Carllal. Bora, Curnoflr'and Counl\'
My Comml.alon ~'plr.. Jon, 4, 1999
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RICHARD A. KAUFFMAN, . IN THE COURT OF COMMON PLEASE OF
.
Plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA
.
.
.
vs. . NO. 95 - 3959 CIVIL
.
.
.
ELAINE A. KAUFFMAN, : IN DIVORCE
Defendant .
.
NOTICE
To: Elaine A. Kauffman
305 North Ridge Street
Hallettsville, TX 77964
If you wish to deny any of the statements set forth in this
Affidavit, you must file a Counter-Affidavit within twenty (20)
days after this Affidavit has been served on you or the statements
will be admitted.
AFFIDAVIT UNDER SECTION 3301(d)OF THE DIVORCE CODE.
1. The parties to this action separated on November 1, 1994 and
have continued to live separate and apart for a period of at
least two years.
2. The marriage is irretrievably broken.
3. I understand that I may loose rights concerning alimony,
division of property, lawyer's fees or expenses if I do not
claim them before divorce is granted.
4. 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
DATE: .31d.LJ Q'1
, I
vs.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 95 - 3959 CIVIL
RICHARD A. KAUFFMAN,
plaintiff
ELAINE A. KAUFFMAN,
Defendant,
IN DIVORCE
,,'
Notice of Filina Master's Recort
The report of the Master has been filed this date and
copies have been sent with this notice to counsel of record and
the parties.
In accordance with P.R.C.P 1920.55 within ten (10) days
after the mailing of this notice and report exceptions may be
filed to the report by any party. If no exceptions are filed
within the ten (10) day period, the Court shall receive the
report, and if approved, shall enter a final decree in
accordance with the recommendations contained in the report.
f1Z,ic",/' {&r~~-"
Date: 6/10/97
E. Robert Elicker, II
Divorce Master
Note: If exceptions are filed, file the original with the
Prothonotary and a copy with the Master's office. At
that time, the party filing the exceptions should notify
the court reporter in the Master's office so arrangements
can be made for a transcript. upon completion of the
transcript and receipt of payment the entire file will be
returned to the prothonotary's office for transmittal to
the Court at time of argument on the exceptions.
If no exceptions are filed, counsel shall prepare an
order of Court consistent with the recommendations and
provide a proposed order of Court to the Master.
""'"
FOR THE PLAINTIFF
Hubert X. Gilroy
Richard A. Kauffman
,.-,
INDEX TO WITNESSES
DIRECT CROSS
7
10
REDIRECT
RECROSS
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INDEX TO EXHIBITS
FOR THE PLAINTIFF IDENTIFIED ADMITTED
Ex. No. 1 -- Letter (March 20, 1997) ,
affidavit under section
3301(d), and counter-
affidavit 10 10
Ex. No. 2 plaintiff's proposed
Listing of Marital Assets 10 10
Ex. No. 3 Financial Trust corp
statement 10 10
Ex. No. 4 Prudential statement
December 17, 1996 10 10
Ex. No. 5 Black and Decker
statement 10 10
Ex. No. 6 Blue Shield VIP
statement 10 10
Ex. No. 7 True Temper statement 10 10
Ex. No. B Letter Blue Shield
December 6, 1995 10 10
Ex. No. 9 -- Expenses paid by Husband
for real estate while
property was vacant and
pending sale 10 10
.
.
1 THE MASTER: Today is Thursday, June 5, 1997. This
2 is the date set for a Master's hearing in the above captioned
3 action. present in the hearing room today is the plaintiff,
4 Richard A. Kauffman, and his counsel Hubert x. Gilroy. The
5 Defendant, Elaine A. Kauffman has not appeared nor has any
6 counsel appeared on her behalf.
7 Notice of today's hearing was sent to the parties
8 and Mr. Gilroy. The date of the order and notice of hearing was
9 March 17, 1997. The address that we used to send notice to Mrs.
10 Kauffman was 305 North Ridge street, Hallettsville, Texas 77964.
11 No return of any mail was received by the Master's office. The
12 notice was sent by regular mail. In addition to the lack of. any
13 return of the mail, which would indicate that the notice was
14 received, the Master's office had a telephone call on June 2,
15 1997, from Mrs. Kauffman. She spoke to the court
16 reporter/secretary and advised that she would not be attending
17 the hearing and that she has no counsel.
18 The remarks that are being made by the Master are
19 to the action captioned to No. 95 - 3959. This was in the
20 action filed by Mr. Kauffman. previously, on December 27, 1994,
21 Mrs. Kauffman filed an action in divorce in Cumberland County,
22 which was docketed to No. 94 - 7195. Mr. Kauffman in his action
23 raised the economic issue of equitable distribution; likewise,
24 Mrs. Kauffman raised the economic issue of equitable
25 distribution. No other economic claims have been raised by
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1 either party.
2 On June 4, 1997, Judge Hess signed an order
3 consolidating the two divorce actions.
4 Mr. Gilroy filed an affidavit under Section 3301(d)
5 of the Domestic Relations Code on June 5, 1997. Mr. Gilroy is
6 going to offer testimony regarding the filing of the affidavit
7 and previous service of the affidavit and any responses made to
8 the affidavit. We note that a counter-affidavit was filed by
9 Mrs. Kauffman in the prothonotary's office on April 18, 1997.
10 The parties were married on August 2, 1980, and
11 separated November 1, 1994. They are the natural parents of one
12 child Erin E. Kauffman born August 2, 1983. she is in the
13 custody of the husband.
14 Mr. Kauffman has submitted a stipulation which the
15 Master requested be filed under Local Rule 1920.53-2 which will
16 be made part of the record.
17 Mr. Gilroy is going to offer remarks, as indicated,
18 regarding the filing and serivce of the affidavit under section
19 3301(d) so that the divorce can conclude under that section.
20 Also, Mr. Gilroy is going to offer certain exhibits which will
21 be marked and make comments regarding the value of the marital
22 assets and the claim for credits which are being made by husband
23 showing a net distribution of assets based on the total value of
24 assets and claim for credit that each party will then be
25 entitled to receive using a 50/50 distribution.
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1 The Master is satisfied to proceed on the basis
2 that the parties will receive an equal distribution of assetS.
3 This is based on Hr. Kauffman's assent to the schedule of
4 distribution and on the information which Mrs. Kauffman has
5 provided in her pre-trial statement. That pre-trial statement
6 is dated January 1, 1997, and upon review of the statement, the
7 Master is satisfied that the distribution and any allocation of
8 debt should be on a 50/50 basis. Mrs. Kauffman does dispute the
9 credit for payment of debt which Mr. Kauffman is asking the
10 court to allow, but that issue in and of itself does not go to
11 the percentage of distribution, and Mrs. Kauffman is not present
12 today to offer any testimony in rebuttal to Mr. Kauffman's
13 statement (Exhibit No.9) that Mr. Gilroy is going present
14 followed by Mr. Kauffman's testimony regarding how the marital
15 debt came to be owed.
16 subsequently, the Master is satisfied to proceed on
17 the basis that the assets that are identified in the exhibit,
18 that are going be offered, will be distributed on a 50/50 basis
19 and the marital debt will be allocated on a 50/50 basis. Using
20 the exhibits that Mr. Gilroy will provide is a statement as to
21 how much of the escrow fund will be payable to husband and how
22 much of the fund will be payable to wife. The Master's
23 recommendations will reflect the statements made in the exhibits
24 supplemented by the testimony of Mr. Gilroy and Mr. Kauffman.
25 Would you swear Mr. Gilroy, please.
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1 Whereupon,
2 HUBERT X. GILROY, ESQUIRE
3 having been duly sworn, testified as follows:
4 DIRECT EXAMINATION
5 MR. GILROY: For the record, my name is Hubert X.
6 Gilroy from the firm of Broujos & Gilroy. I'm counsel for the
7 plaintiff, Mr. Kauffman, in this case.
8 Mr. Kauffman signed, in my office, an affidavit
9 under section 3301(d) of the Divorce Code on March 26, 1997. I
10 mailed a copy of that notice to Mrs. Kauffman at 305 North Ridge
11 street, Ha11ettsville, Texas 77964 and a copy of my letter to
12 her, which included the affidavit. And also because she was not
13 represented by an attorney, included a form for a
14 counter-affidavit.
15 My letter, although dated March 20th, was prepared
16 in advance of Mr. Kauffman signing the affidavit on March 26; so
17 my letter was mailed to Mrs. Kauffman on March 26 and I'm
18 submitting for the record as plaintiff's Exhibit No. 1 a copy of
19 that letter.
20 I would note that Mrs. Kauffman obviously received
21 the affidavit because she filed a counter-affidavit with the
22 Court which was docketed on April 18, 1997.
23 And finally, the March 26, 1997, affidavit signed
24 by Mr. Kauffman was actually filed with the cumberland county
25 Prothonotary on June 5, 1997.
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1 That's all I have on that issue. I now go into
2 summary of the other exhibits.
3 with respect to our exhibit list, we have a
4 proposed listing of marital assets which is a two-page document
5 and which we have marked as plaintiff's Exhibit No.2. In
6 connection with that list, Plaintiff's Exhibit No. 2 lists the
7 first asset as monies in the escrow account.
8 This is an escrow account currently held with the
9 firm of Broujos & Gilroy that has a balance as of April 30,
10 1997, in the amount of $33,217.29. We will offer as Plaintiff's
11 Exhibit No. 3 a statement from Farmers Trust company bank to
12 verify that value.
13 Item 2 on Exhibit P-2 is a John Hancock insurance
14 policy which is owned by Mr. Kauffman and which we suggest has a
15 date of separation value of $3,300.00. In support of that, we
16 offer a letter from Prudential that's marked as Plaintiff's
17 Exhibit 4 and verifies that representation.
18 Mr. Kauffman will testify concerning Items 4, 5,
19 and 6 on the plaintiff's Exhibit 2.
20 In connection with Item No.7, Mr. Kauffman had a
21 401(k) type of plan with his former employer, True Temper, and
22 that's listed as Item No. 7 on plaintiff's Exhibit No. 2 as
23 having a value of $16,000.00. In connection with that, we will
24 offer a two-page document which is marked as Plaintiff's Exhibit
25 P-5 which verifies the approximate $16,000.00 value of that
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1 asset.
2 Item No. B on plaintiff's Exhibit p-2 is a VIP plan
3 which wife had similar to a 401(k) type of savings plan with her
4 former employer Blue Shield. Mr. Kauffman estimates that the
5 value of that plan as of date of separation is $10,000.00, and
6 we will offer exhibit P-6 as documentation to support that and
7 we will also offer testimony from Mr. Kauffman is connection
B with that item.
9 Item No. 9 on Exhibit p-2 is a summary of Mr.
10 Kauffman's defined benefit retirement plan through True Temper,
11 and we will mark as plaintiff's Exhibit No. 7 a one-page
12 document from True Temper which verifies the information
13 included on Exhibit p-2.
14 Item No. 10 on Exhibit p-2 summarizes Mrs.
15 Kauffman's defined benefit retirement plan through Blue Shield.
16 And we will offer in support of that a document which we will
17 mark as plaintiff's Exhibit No. B which is a five-page document
1B that Mra. Kauffman had received from pennsylvania Blue Shield
19 and is, in fact, a document which she has submitted to the
20 Master along with her pre-trial statement. We will Suggest that
2~ the information included in Exhibit p-B verifies the information
22 Suggested in Item NO. 10 of plaintiff'S Exhibit No.2.
23 Mr. Kauffman will also testify concerning various
24 expenses which he paid and which were joint expenses. And in
25 connnection with that, we will offer a summary of those expenses
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on an exhibit which we are marking as Plaintiff's Exhibit No.9.
And finally, Mr. Kauffman's proposed distribution
of the assets with adjustment for expenses is as set forth on
Plaintiff's Exhibit P-l0 which we will offer. And that's a
summary of our exhibits.
(Whereupon, Plaintiff's Exhibit Nos. 1 - 10
were identified and admitted into evidence.)
THE MASTER: All right. Would you swear Mr.
Kauffman, please.
Whereupon,
RICHARD A. KAUFFMAN
having been duly sworn, testified as follows:
DIRECT EXAMINATION
BY MR. GILROY:
Q Mr. Kauffman, can you please state your full name
and address for the record?
A Richard A. Kauffman. I live at 1397 Creek Road,
Apartment 4, Boiling Springs, Pennsylvania.
Q And you are the Plaintiff in this particular
divorce action?
A That's correct.
(A discussion was held off the record.)
BY MR. GILROY:
Q Mr. Kauffman, in connection with Plaintiff's
Exhibit No.2, which lists what you believe to be the marital
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assets in your case, the first item listed on plaintiff's
Exhibit No. 2 is assets from the proceeds from the sale of the
marital home totalling $33,217.29. Did you and your wife own a
home together during your marriage?
A That's correct.
Q And after separation did you and your wife list
that property for sale and sell that property?
A Yes.
Q And were all of the proceeds then put in an
interest bearing escrow account with my office?
A Yes.
Q And that figure as shown on plaintiff's Exhibit
P-2 is the amount currently in the escrow?
A That's correct.
THE MASTER: That's the amount as of April 30,
1997?
THE WITNESS: Right.
THE MASTER: And you're willing to split any
interest earned from that date with your wife?
THE WITNESS: That's correct.
BY MR. GILROY:
Q The second item, a Prudential insurance policy,
that's a policy that's held in your name alone?
A Yes.
Q You are the owner of that policy?
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1 A Yes.
2 Q And you have suggested that that had a value at
3 the time you and your wife separated of $3,300.00; is that
4 right?
5 A That's correct -- based on information I received
6 from Prudential.
7 Q And that's as set forth in Exhibit P-4, correct?
8 A Correct.
9 Q Item No. 3 is a John Hancock insurance policy
10 which you suggest is a -- first of all, that's a policy that's
11 owned by you?
12 A That's correct.
13 Q And you suggested that had a separation value of
14 $4,964.00; is that right?
15 A Yes, sir.
16 Q How did you arrive at that figure?
17 A Through phone contact with John Hancock.
18 Q Item No. 4 on Plaintiff's Exhibit P-2 you list an
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24 just based on my values, I felt it was worth $1,500.00. I have
25 no concrete facts to say that but it is my opinion.
insurance policy owned by your wife that has a value of
$1,500.00. Can you tell the Master about that policy?
A That was a policy that was held in Mrs.
Kauffman's name and she was the owner and I was -- in my
opinion, on the value of the policy when it was purchased and
12
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1 Q That policy was similar to yours; that it was
2 building up cash value?
3 A Yes, sir.
4 Q And were premiums being paid during the time that
5 you and your wife were living together?
6 A Yes.
7 Q Item No. 5 on your list of marital assets is a
8 1994 Dodge Caravan and you list that value at $17,000.00. When
9 was that vehicle purchased?
10 A July of '94.
11 Q What was the purchase price?
12 A It was listed at $27,000.00.
13 Q And how did you arrive at a value of $17,000.00?
14 A When we were talking about the settlement, I had
15 contacted a banker and asked for the blue book value at that
16 time and he gave me that figure over the phone, which is
17 probably conservative.
18 Q But you paid about $27,000.00 for it in the
19 summer of '94?
20 A That's correct.
21 Q And you're suggesting that it had a value of
22 $17,000.00 in November of 1994 when you and your wife separated?
23 A That's correct.
24 Q At least $17,000.00?
25 A At least.
13
..
~
1 Q That vehicle is in joint names?
2 A Yes, sir.
3 Q It's currently in your wife's possession?
4 A That's correct.
5 Q She has had possession of that vehicle since
6 separation?
7 A Except for a brief period when she left for Texas
8 for two months. That was in the summer of '95.
9 Q And you're prepared to, in distribution, have
10 that vehicle awarded to her and sign the title over?
11 A Yes.
12 Q Item No. 6 on plaintiff's Exhibit P-2 is a 1987
13 Dodge pickup; is that your vehicle?
14 A Yes.
15 Q Is that the vehicle that you had at the time you
16 and your wife separated?
17 A Yes.
18 Q And you list that as having a value of $3,000.00.
19 How did you arrive at that value?
20 A Once again, when I talked to the banker about the
21 Dodge Caravan, he also gave me the book value that the truck was
22 worth $3,000.00. That's also in joint names.
23 Q YoU still using that truck?
24 A Yes.
25 Q Item No. 7 on Exhibit P-2 is your True Temper
14
.....
........
1 retirement savings plan and you list that as having a value of
2 $16,000.00 at the time you and your wife separated?
3 A Yes.
4 Q And you have offered Exhibit P-5 in support of
5 that?
6 A Yes, sir.
7 Q And P-5 is a two-page document which shows a
8 putnam investment account and a Black & Decker. These were two
9 accounts you had?
10 A Yes.
11 Q And from those documents you're assuming that as
12 of November '94 that the fund had a value of about $16,000.00?
13 A That's correct.
14 Q Okay. Mr. Kauffman, Item No. 8 on P-2 is a
15 suggested VIP plan your wife had with Blue Shield and you
16 suggested a value of $10,000.00. During the course of the
17 marriage, did your wife have a VIP type of retirement savings
18 plan with Blue Shield?
19 A Yes, she did.
20 Q And you offered an exhibit -- Plaintiff's Exhibit
21 No.6 in support of that $10,000.00 value; is that right?
22 A Yes.
23 Q How did you arrive at $10,000.00?
24 A Based on the document that I provided there, it
25 shows a balance as of December of '91 as being $16,000.00.
15
..
,......
1 Q Did your wife continue to work with Blue Shield
2 after December of 1991 and up until November of '94 when you
3 separated?
4 A Yes, she did.
5 Q And were contributions made by your wife to that
6 plan?
7 A Yes, there were.
B Q Was there a specific reason why you and your wife
9 were making contributions to that plan?
10 A Beside the point of saving money for the future,
11 also she has a son from a previous marriage that we were saving
12 money for to withdraw for his college education.
13 Q And does Exhibit P-6 actually show at the second
14 page copies of two documents which indicate that monies were
15 withdrawn for that college education?
16 A Yes. There were two 1099s that were submitted by
17 IRS and they show withdrawals out of the savings plan.
1B Q So during your marriage, your wife withdrew
19 $12,000.00 from that account to pay for her child's education?
20 A That's correct.
21 Q And was the account still in existence at the
22 time of separation?
23 A Yes.
24 Q And does the third page of Exhibit P-6 show that
25 the account was still in existence by virtue of a document
16
...
,.....
1 verifying that your wife withdrew $3,000.00 after you and your
2 wife separated?
3 A Yes.
4 Q Now, your estimate of $10,000.00 is based upon
5 the fact that even though $12,000.00 was withdrawn from the
6 account, there were additional payments made by your wife into
7 that account after December of '91?
8 A After December of '91 she continued to contribute
9 to the fund and __
10 Q So there would have been contributions plus
11 appreciation in the fund?
12 A Yes.
13 Q Now, Item No. 9 on your Plaintiff's Exhibit No. 2
14 summarizes your retirement plan with True Temper. You don't
15 work for True Temper anymore, do you?
16 A No, sir.
17 Q But you have a vested retirement plan that upon
18 you obtaining age 65 you will receive about $406.00 per month?
19 A That's correct.
20 Q And that's verified through Exhibit P-7?
21 A Yes.
22 Q Now, Item No. 10 on Exhibit P-2 suggests your
23 wife has a monthly benefit due to her upon retirement at age 65
24 of $706.00 from a pension fund with Blue Shield; is that right?
25 A That's what she submitted, yes.
17
~
r,-.
1 Q And that's verified by your Exhibit P-8?
2 A That's correct.
3 Q Now, even though your wife's monthly benefit
4 exceeds yours, are you prepared, for purposes of the Master
5 distributing the assets, to suggest that your retirement plan
6 your defined benefit retirement plan is equal in value for
7 purposes of distribution to your wife's defined benefit
8 retirement plan?
9 A Yes.
10 Q And, in fact, did your wife work at Blue Shield a
11 few years before you married, and part of her plan would be
12 nonmarital property anyhow?
13 A Yes.
14 Q And is it also correct that you didn't feel in
15 light of the situation that you could afford to spend the money
16 to have an actuary determine the current value of these plans?
17 A Yeah. I felt it wasn't worth spending money for.
18 Q Did you understand from prior discussions from
19 your wife that she was agreeable that you would get your
20 retirement plan; she would get her retirement plan?
21 A Yes.
22 Q Now, Mr. Kauffman, we have presented an exhibit
23 marked P-9. Is that exhibit a list of expenses which you claim
24 you paid and which are actually marital expenses?
25 A Yes.
18
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
.
.
Q Were those expenses related to the marital real
estate?
A Yes, they were.
Q You suggested in your testimony that you
separated in November of 1994. Did you actually leave the
marital home at that time?
A No.
Q You were living in the marital home but you were
not living as husband and wife as of November; is that right?
A That's correct.
Q Then your wife filed for divorce in December that
year?
A That's correct.
Q When did you move out of the marital home?
A February 13, 1995.
Q What was your understanding when you moved out?
Was your wife going to continue to live there and work with Blue
Shield?
A She was working at Blue Shield. She was
continuing to live in the house, and I left with the presumption
that she was going to stay there.
Q Did your minor child continue to live with your
wife?
A Yes, she did.
Q Did your wife's older child live there at the
19
,
Q
of 1995?
A
Q
point?
A
Q
A
Q
.
...
20
--
~
1 A Yes.
2 Q Had she maintained the home from February through
3 June of 1995?
4 A Not through June. Up through May she did and she
5 did not pay the June mortgage.
6 Q But she lived in the house a portion of June?
7 A A portion of June, yes.
8 Q Was there a mortgage payment owing on the house?
9 A Yes.
10 Q What was the monthly mortgage payment?
11 A $606.01.
12 Q Was there a home equity loan on the house?
13 A Yes.
14 Q What was that monthly payment?
15 A $448.83.
16 Q Was the home equity loan a lien against the home?
17 A Yes.
18 Q And was that a loan that helped purchase the
19 Dodge Caravan that we talked about previously?
20 A Entirely.
21 Q Did your wife make any of those payments after
22 she moved out of the home in June of 1995?
23 A She had made the June home equity loan payment
24 before she had left but she did not make the mortgage payment.
25 Q Did you make the mortgage payments subsequent to
21
.
-
1 June of 1995?
2 A Yeah. starting in June of 1995 I made the
3 mortgage payment up until the time the house was sold.
4 Q Did you also make the home equity payments
5 starting in would be July of '95?
6 A Yes.
7 Q Did you make all of those payments until the
8 house was sold?
9 A Yes.
10 Q How long was the house on the market?
11 A The house was on the market from August of 1995
12 until December at which time it was taken off the market because
13 a realtor and a private individual approached me about buying
14 it. It was sold and completed in May of 1996.
15 Q If you did not make the mortgage payments on the
16 the home, would the home have gone into foreclosure?
17 A Yes.
18 Q Was your wife willing to make any of the
19 payments?
20 A No.
21 Q If you would have not made the payments would
22 there have been penalities and interest that would have accrued?
23 A Yes.
24 Q In connection with both mortgages?
25 A Yes.
22
...
-
1 Q And, in effect, if the house went to foreclosure
2 would you and your wife have lost the proceeds from the sale of
3 the home?
4 A Yes.
5 Q That is one of the primary marital assets of over
6 $30,000.00?
7 A That's correct.
8 Q So did you feel it was required for you to make
9 these payments in order to preserve marital property?
10 A Not only marital property but also for future
11 considerations for both of us.
12 Q For credit reasons?
13 A Yes.
14 Q In addition to the mortgage payments did you make
15 other payments?
16 A Yes, I did.
17 Q In connection with the home? Did you have to pay
18 any electric bills?
19 A Yes. The electric had been turned off and I
20 turned the electric back on just to get the house ready for Bale
21 and to have it on for heating purposes through the winter --
22 Q Was it practical to maintain electric in the
23 house if you're going to show it to prospective buyers?
24 A Yes.
25 Q And did the house need to keep heat during the
23
.
.
1 winter so that you could try and show it to prospective buyers?
2 A Yes.
3 Q So do you feel that it was required to maintain
4 the electric payments?
5 A Yes, I do.
6 Q How about any utilities such as water bills?
7 A I had to have the water -- I turned the water on.
8 I felt it was necessary first to clean the house up and second
9 of all if anybody -- to show the house to know that the toilets
10 flushed and the plumbing worked.
11 Q Did you also pay homeowner's insurance?
12 A Yes.
13 Q What was your total payments with respect to the
14 first mortgage?
15 A The mortgage payment was $6,060.10.
16 Q And with respect to the second home equity loan?
17 A It was $3,499.93.
18 Q And with respect to electric bills that you paid?
19 A They were $653.49.
20 Q And water bills that you paid?
21 A $65.63.
22 Q And homeowner's insurance?
23 A $273.00.
24 Q So the total amount of money that you paid on all
25 of these debts relating to preserving the marital home was what?
24
1 A $10,552.15.
2 Q Now, those payments benefited you but also
3 benefited your wife?
4 A That's correct.
5 Q Now, Mr. Kauffman, we have marked as Plaintiff's
6 Exhibit No. 10 a proposed distribution of the marital assets.
7 You are satisfied to distribute the marital assets on a SO/50
8 basis after you receive a credit for the payments that you made
9 to preserve the home; is that right?
10 A Yes, sir.
11 THE MASTER: Excuse me. He is willing to accept a
12 SO/50 distribution of the assets and a SO/50 allocation of the
13 marital debt?
14 THE WITNESS: That's correct.
15 THE MASTER: I think that's stated a little
16 differently than the way you asked the question.
17 MR. GILROY: That's fine.
18 BY MR. GILROY:
19 Q For purposes of computing marital debt, your
20 position is that the marital debt totalled $10,552.15?
21 A That's correct.
22 Q And that's debt that you paid and you want a
23 credit of $5,276.07 in connection with that payment?
24 A That's correct.
25 Q And that marital debt is related to preserving
25
.....-
,.-...
1 the marital home; is that right?
2 A Yes.
3 Q Now, with respect to your defined benefit
4 retirement plan and wife's defined benefit retirement plan, are
5 you willing to suggest that they are of equal value and that
6 your wife can receive hers with no claim from you and that you
7 should receive yours with no claim by your wife?
8 A That's correct.
9 Q And on the second page of Exhibit P-10, are you
10 suggesting to accomplish a 50/50 distribution that your wife
11 would receive in addition to her retirement plan, that she would
12 receive the following items: No.1, any VIP plan that still
13 remains and that which you suggest had a value of at least
14 $10,000.00 at separation?
15 No.2, the 1994 Dodge Caravan, No.3, the
16 insurance policy that your wife had at time of separation and
17 No.4, that she receive from the escrow monies $10,714.57; is
18 that right?
19 A That's correct.
20 Q And are you suggesting that the Master award to
21 you the following items in addition to your retirement plan
22 through True Temper: No.1, the True Temper savings plan which
23 we estimate at $16,000.00. No.2, your Dodge pickup, No.3,
24 your John Hancock insurance, No.4, your Prudential insurance,
25 and No.5, $22,502.72 from the money in the escrow account?
26
..
.
1 A That's also correct.
2 Q And assuming that there will be additional
3 interest earned on the escrow account at time of final
4 distribution and closing of that account, are you suggesting
5 that the Master award a 50/50 split between you and your wife on
6 any additional interest?
7 A That's correct.
8 MR. GILROY: I think I covered everything.
9 THE MASTER: Mr. Kauffman, is your wife under an
10 obligation to pay child support?
11 THE WITNESS: It is suspended right now.
12 THE MASTER: It is suspended?
13 THE WITNESS: Yes.
14 THE MASTER: Is there any arrearage on the order?
15 THE WITNESS: Yes, there is.
16 BY THE MASTER
17 Q And how much is that?
18 A I think it's $671.00 or somewhere in that area.
19 I know she had called me about a month ago and said that the
20 income tax for this year has been -- her income tax had been
21 confiscated but I haven't seen it yet so -- I'm expecting the
22 arrearage to go down to about $470.00.
23 THE MASTER: All right. I don't have any
24 questions. We will prepare all of this that was stated on the
25 record today and then I'll do my recommendations.
27
......
,,-..
RICHARD A. KAUFFMAN,
plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. 95 - 3959 CIVIL
.
.
VB.
ELAINE A. KAUFFMAN,
Defendant
IN DIVORCE
MASTER'S REPORT
Proceedings held before
E. Robert Elicker, II, Divorce Master
Cumberland county courthouse,
9 North Hanover street, Carlisle, Pennsylvania
proceedings held on June 5, 1997,
commencing at 9:00 a.m.
APpEAMNCES:
Hubert X. Gilroy
Attorney for plaintiff
Elaine A. Kauffman (Did not appear)
Pro Se
...
FINDINGS OF FACT
""""
>.. .
The marital assets and values assigned to those
assets ars as follows:
Proceeds from sale of marital
home held in escrow account
(balance as of 4/30/97)
Cash value ot Prudential Insurance
policy as of 11/1/94
(in husband's name)
Interest earned on marital
portion of Prudential Insurance
policy from 11/1/94 to 7/1/97
at 3' interest compounded
annually
Cash value of John Hancock
Insurance policy as of 11/1/94
(in husband's name)
Interest earned on marital portion
of John Hancock Insurance policy
from 11/1/94 to 7/1/97 at
3' interest compounded annually
Cash value of insurance policy
(in wife's name) as of 11/1/94
Interest earned on marital portion
of wife's policy from 11/1/94 to
7/1/97 at 3' interest compounded
annually
1994 Dodge Caravan vehicle
1987 Dodge pickup truck
True Temper retirement/savings
plan as of 11/1/94
Interest earned on marital portion
of True Temper retirement/savings
plan from 11/1/94 to 7/1/97 at
3' interest compounded annually
$ 33,217.29
$ 3,300.00
$ 271.28
$ 4,964.00
$ 408.02
$ 1,500.00
$ 123.30
$ 17,000.00
$ 3,000.00
I. I.
, ,
$ 16,000.00
1 I
~,
$ 1,315.16
..
-
VIP plan - Pennsylvania Blue
Shield as of 11/1/94
$ 10,000.00
Interest earned on marital portion
of VIP Plan - pennsylvania Blue
Shield from 11/1/94 to 7/1/97 at
3% interest compounded annually
$
820.46
Total value of marital assets
subject to distribution 1
$ 91,919.51
Husband paid the following expenses to maintain the
marital real estate pending sale following wife's abandonment of
the property to date of settlement:
Mortgage payments $ 6,060.10
Home equity loan/auto loan $ 3,499.93
Electric service $ 653.49
Water service $ 65.63
Homeowner's insurance $ 273.00
Total marital debt $ 10,552.15
Based on a 50/50 distribution of assets and a 50/50
allocation of debt, each of the parties is entitled to receive,
1. Husband d d not have spec f c values for h s def ned benef t
plan at True Temper or wife's defined benefit plan at Blue
Shield. Based on husband's analysis, using monthly benefit
amounts for each plan, husband stated he is satisfied to let
each party retain his or her interest in the plan in which
each party is a participant. Therefore, no value is used in
the equitable distribution computation for either plan.
..
Interest earned on marital portion
of True Temper retirement/savings
plan from 11/1/94 to 7/1/97 at
3' interest compounded annually
portion of escrow fund from sale
of marital real estate
TOTAL
,....
$ 1,315.16
$ 16.701.30
$ 45,959.76
MARITAL ASSETS AND VALUES ASSIGNED TO WIFE
cash value of insurance policy
(in wife's name) as of 11/1/94
Interest earned on marital portion
of wife's policy from 11/1/94 to
7/1/97 at 3' interest compounded
annually
1994 Dodge Caravan vehicle
VIP Plan - Pennsylvania Blue
Shield as of 11/1/94
Interest earned on marital portion
of VIP Plan - Pennsylvania Blue
Shield from 11/1/94 to 7/1/97 at
3' interest compounded annually
portion of escrow fund from sale
of marital real estate
TOTAL
$ 1,500.00
$ 123.30
$ 17,000.00
$ 10,000.00
$ 820.46
$ 16.515.99
$ 45,959.75
Any interest earned on the escrow fund from April
30, 1997, to date of distribution, shall be divided equally
between the parties.
Wife shall pay to husband from her share of the
escrow fund the sum of $5,276.08 representing her share of the
marital debt. consequently, wife's payment from the escrow fund
RICHARD A. KAUFFMAN, . IN TilE COURT Of' COMMON PLEASE OF
.
Plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA
.
.
.
vs. : NO. 95 - 3959 CIVIL
.
.
ELAINE A. KAUFFMAN, . IN DIVORCE
.
Defendant .
.
NOTICE
To: Elaine A. Kauffman
305 North Ridge Street
Hallettsville, TX 77964
If you wish to deny any of the statements set forth in this
Affidavit, you must file a Counter-Affidavit within twenty (20)
days after this Affidavit has been served on you or the statements
will be admitted.
AFFIDAVIT UNDER SECTION 3301(dJOF THE DIVORCE CODE.
1. The parties to this action separated on November 1, 1994 and
have continued to live separate and apart for a period of at
least two years.
2. The marriage is irretrievably broken.
3. I understand that I may loose rights concerning alimony,
division of property, lawyer's fees or expenses if I do not
claim them before divorce is granted.
4. I verify that the statements made in this Affidavit are true
and correct. I understand that false statements Ilerein are
made subject to the penalties of 18 l'a.C.S. Section 4904
relating to unsworn
"
DAn:: ~
.-..- - . -...._....- .":
RICHARD A. KAUFFMAN, . IN THE COURT OF COMMON PLEASE OF
.
Plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA
.
.
.
vs. . NO. 95 - 3959 CIVIL
.
.
.
ELAINE A. KAUFFMAN, . IN DIVORCE
.
Defendant .
.
COUNTER-AFFIDA VIT UNDER SECTION
3301 (d) OF THE DIVORCE CODE
1. Check either (a) or (b):
(a) I do not oppose the entry of a divorce decree.
(b) I oppose the entry of a divorce decree because
(Check (i),(ii) or both):
(i) The parties to this action have not lived separate and
apart for a period of at least two years.
(ii) The marriage is not irretrievably broken.
2. Check either (a) or (b):
(a) I do not wish to make any claims for economic relief. 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.
(b) I wish to claim economic relief which may include alimony,
division of property, lawyer's fees or expenses or other important
rights.
I verify that the statements made in the counter-affidavit are
true and correct. I understand that false statements herein are
made subject to the penalties of 18 Pa.C.S. Section 4904 relating
to unsworn falsification to authorities.
DATE:
Elaine A. Kauffman/Defendant
RICHARD A. KAUFFMAN : IN THE COURT OF COMMON PLEAS OF
Plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA
.
.
.
V : CIVIL ACTION - LAW
.
.
ELAINE A. KAUFFMAN . NO 95 - 3959
.
Defendant .
.
. IN DIVORCE
.
PLAINTIFF'S PROPOSED LISTING OF ~ITAL ASSETS
1. Proceeds from sale of marital home -
monies held in escrow - balance as of 4/30(97
$ 33,217.29
2. Prudential Insurance Policy -
held in husband's name -
date of separation value $3,300.00 -
cllrrent value approximately $3,871.00
$ 3,300.00
3. John Hancock Insurance Policy -
held in husband's name -
date of separation value $4,964.00 -
current value approximately $6,893.00
$ 4,964.00
4. Insurance policy ol wile, in wile's
possession, value as ol separation
was $1,500.00
$ 1,500.00
5. 1994 Dodge Caravan - held in joint names
- in possession of wife
$ 17,000.00
6. 1987 Dodge Pickup - held in both names -
in possession of husband
$ 3,000.00
7. True Temper Retirement/Savings Plan -
held in husband's name -
current value of approximately $25,000.00 -
date of separation value of $16,000.00
$ 16,000.00
I
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RUN DAlE: 08/01/9\
PENSION CALCULA110N FOR: KAUFf"AN,ELAINE ANN
NDRNAL REIIRENENI HONlt!: 9 2012
RETIREMENt SERVICE DUE: 1 14 69
IERNINAIION DAlE: S 11 9\
ACCRUED SERVICE: 24,01
IOIAL SERVICE: 41 ,30\003422
BlAIN DAlE: 8 S 41
"ARJlAL SIAIUS: "
"NINLV QUALIFIED BENEFII: 1106.18
QUALIFIED FINAL AVE SAL: 128,223.48
COVERED CONP LEVEL: 1S2,680
ANNUAL QUALIFIED 8ENEFIT: 18,474.18
LUNP 5U" A"QUNT:
LUNP SUN FACTOR:
00263 PBS
~
'1' \
v
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
RICHARD A. KAUFFMAN
Plaintiff
ELAINE A. KAUFFMAN
Defendant
NO 95 - 3959
IN DIVORCE
EXPENSES PAID BY HUSBAND FOR REAL ESTATE
WHILE PROPERTY WAS VACANT AND PENDING SALE
Total
$ 6,060.10
$ 3,499.93
$ 653.49
$ 65.63
$ 273.00
$10,552.15
Mortgage Payments
Home Equity Loan - Auto Loan
Electric Bills
Water Bills
Homeowners Insurance
, EXHIBI~
I-IOLl5i~ 4um ;; / ~c..I. \/...!?l 1'=1<
(tJe tocro ,01
(LI fcOfo .0 rJ 4t./S .113 /::,..80
.itS, foC0 . D/ '-f tfg J?3 1 ;).,97
'p- 1000,Of LfLf8.8'3 ,R?, 'tV /3 ' L-{.7)
:: I
,,- f.o00pl LfLf g .g? !J.O,??
-'.
01. ~ croPf / 7 q po '-1-7, +q
~c. .. 000.0f 17q .00 J /5 . feo I ~3. ?t-/-
11-1 ,=,00.01 L/t./-'6.Er3 IJCj,OI
::13 foofc, pi L/-l./ 8, ,~ 1109 . 3 u
Jill? 0{)ta 91 L/-l./ 'S .~"3 &~. &3 ~ I. /Lf
~ 38, /5
J~I .. /3.3'1 17. t/-$
--.-
'i rqL. .. t&()~o./o .:3tf9ot ,93 t:,~ 3 . 1./-9 0$"', "3
cm~O~Nt;:;R... IN~.
t ~7.3 ,~O
,
i,
;..!-
I
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,I
i
.,
RICHARD A, KAUFFMAN . IN TilE COURT OF COMMON PLEAS OF
,
Plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA
.
,
,
V , CIVIL ACTION - LAW
.
:
ELAINE A, KAUFFMAN . NO 95 - 3959
,
Defendant :
. IN DIVORCE
,
PLAINTIFF HUSBAND'S PROPOSED DISTRIBUTION OF MARITAL REAL ESTA7E
1
Plaintiff Husband suggests a distribution of marital property on a
50/50 per cent basis after sUbtracting for various debts,
2
Husband suggests he should receive a credit from the money in the
escrow account in the amount of ~lQ,SSZ.15 for reimbursement for
S',~7~. 07
expenses he paid to preserve the marital real estate.
3
Husband suggests that his Defined Benefit Retirement Plan from True
Temper and Wife's Defined Benefit Retirement Plan from Blue Shield
are essentially worth the same, Husband suggests that he receive
his benefits exclusive of Wife and the r.,ife receive her benefit
exclusive of Husband as a SO/50 split,
EXHIB?i,
J t~9 f
. I
.
4
Husband suggests the following distribution:
TO WIFE
Wife's VIP Plan $ lO,OOO.OO
1994 Dodge Caravan $ 21,000.00
Wife's Insurance Policy $ l,500,OO
Cash from money in escrow account $ 20,724,57
TO HUSBAND
True Temper Retirement Savings Plan
1987 Dodge Pickup
John Hancock Insurance
Prudential Insurance
Remaining cash from escrow account
TOTAL
$ l6,000.00
$ 3,000.00
$ 4,964,00
$ 3,300,00
$ 22,502,72
$ 88,981.29
5
Any additional interest earned on the money in the escrow account
shall be split equally.
"
,
OFFICI OF DIVORCI MASTIIt
CUMBERLAND COUNTY
COURT OF COMMON PLEAS
9 North Hanover Sfreel
Carlisle, PA 17013
(717) 240.6535
.. Rollert ."cker, "
Dlvorca Maslar
Tr.c:1 "0 Colrer
OIIiea Managar/Raportar
w... Iho,.
697.0371 EllI, 6535
November 14, 1996
Hubert X. Gilroy, Esquire
BROUJOS, GILROY , HOUSTON
4 North Hanover Street
Carlisle, PA 17013
RE: Richard A. Kauffman vs. Elaine A. Kauffman
No, 95 - 3959 Civil
In Divorce
Elaine A, KaUffman
305 t'orthridge
Hallettsville, TX 77964
Dear Mr. Gilroy and Ms KaUffman:
By order of Court of President JUdge Harold E. Sheely
dated November 6, 1996, the fUll-time Master has been appointed
in the above referenced divorce proceedings,
A divorce complaint was filed on JUly 26, 1995, raising
groUnds for divorce of irretrievable breakdown of the marriage,
The complaint also raised the economic claim of equitable
distribution, I note that Elaine Kauffman is not represented by
counsel which is the reason I am communicating directly to her.
In the event Ms. Kauffman obtains an attorney, the attorney
shoUld advise my office immediately.
I assume that the parties are willing to consent to a
divorce by filing affidavits of consent under Section 3301(c) of
the Domestic Relations Code. Based on that assumption,
I am directing Mr, Gilroy, counsel for Mr. Kauffman and Elaine
A. KaUffman, who apparently is representing herself, to each
file a pre-trial statement in accordance with P.R,C.p.
1920.33(b) on or before Monday, December 9, 1996, Upon receipt
of the pre-trial statements I will immediately schedule a
pre-hearing conference with counsel for Mr. Kauffman and Ms.
Kauffman, if she remains unrepresented, If Ms. KaUffman in the
.
Mr. Gilroy, Attorney at Law and Hs. Kauffman, Defendant
14 November 1996
Page 2
meantime gets an attorney, then that attorney can be present at
the conference on her behalf.
Very truly yours,
E. Robert Elicker, II
Divorce Master
NOTE: Sanctions for failure to file the pre-trial statements
are set forth in subdivision (c) and (d) of Rule 1920,33.
THE ORIGINAL PRE-TRIAL STATEMENT SHOULD BE FILED IN THE
MASTER'S OFFICE AND A COpy SENT DIRECTLY TO OPPOSING
COUNSEL.
RICHARD A. KAUFFMAN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
NO. 95 - 3959 CIVIL
IN DIVORCE
vs.
ELAINE A, KAUFFMAN,
Defendant
NOTICE OF PRE-HEARING CONFERENCE
TO: Hubert X. Gilroy
Elaine A. Kauffman
, Counsel for Plaintiff
Defendant
A pre-hearing conference has been scheduled at the
Office of the Divorce Master, 9 North Hanover street, Carlisle,
Pennsylvania, on the 17th day of March
1997, at 9:30 a,m.,
at which time we will review the pre-trial statements previously
filed by counsel, define issues, identify witnesses, explore the
possibility of settlement and, if necessary, schedule a hearing,
r
Very truly yours,
Date of Notice: 12/24/96
E, Robert Elicker, II
Divorce Master
HUbert x. Gilroy, Attorney for Plaintiff, filed a pre-trial
statement on December 9, 1996,
Elaine A, KaUffman, Defendant, has not filed a pre-trial
statement as of the date of this notice.
I
vs.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
: NO. 95 - 3959 CIVIL
RICHARD A, KAUFFMAN,
plaintiff
ELAINE A, KAUFFMAN,
Defendant IN DIVORCE
RE: Pre-Hearing Conference Memorandum
DATE: Monday, March 17, 1997
Present for the Plaintiff, Richard A, Kauffman, was
attorney Hubert X. Gilroy. Elaine A, Kauffman has not appeared
personally or with counsel. We received a pre-trial statement
on January 7, 1S97, followed by a telephone call from Legal
Services in Texas last week inquiring as to whether or not the
documents have been received. Also, on March 4, 1997, the
Master spoke to an attorney from Texas Legal Services regarding
a divorce action filed in Cumberland county, Pennsylvania,
docketed to No. 94 - 7195. The Master determined after looking
at the docket that that case was not discontinued and that
attorney Griffie was representing the Plaintiff, Elaine A,
Kauffman, The Master in talking to Mr. Gilroy indicated that
Mr. Griffie or Mr, Kauffman should attempt to either discontinue
that action or consolidate, by motion to the court, the action
in 1994 with the present action docketed to 95 - 3959,
The parties were married on August 2, 1980, and
separated on November 1, 1994, That date is when the parties
moved into separate rooms in the marital residence, In February
1995 husband vacated the marital residence; in June 1995 wife
vacated the marital residence.
The parties are the natural parents of one child,
Erin J, Kauffman, born August 2, 1983. Husband has custody of
the child, He is entitled to receive by order of court the sum
of $39.00 per week from wife for that child; however, that order
was suspended pending wife's production of documents to the
Domestic Relations Office showing that her medical condition
prevents her from gainful employment, We do not know whether or
not such information has been provided, although Mr, Gilroy
indicated that as far as he is aware the order of support is
still suspended,
A divorce complaint was filed on July 26, 1995,
raising grounds for divorce of irretrievable breakdown of the
marriage. No affidavits have been filed and the Master is not
aware as to whether or not wife will sign an affidavit of
consent, The Master assumes, however, that the parties have
been separated in excess of two years and requests that Mr.
Gilroy file an affidavit under Section 3301(d) averring the two
year separation so that the divorce can conclude even if we do
not have Mrs. Kauffman's consent. The complaint also raised the
economic issue of equitable distribution. No other economic
claims have been raised in the action,
Husband is 41 years of age and resides at 1397
Creek Road, Apartment 4, Boiling springs, Pennsylvania, where he
lives with the child born of the marriage, He is a traffic
manager with Orotown and reports his gross income at $30,000.00
annually. He has one year of college. He has not raised any
health issues.
Wife is 49 years of age and resides at 305
Northridge, Hallettsville, Texas 77964. The information we have
regarding wife's employment situation is that currently she is
unable to work because of emotional problems and depression. We
will need to have some update on her medical/emotional condition
for the hearing to determine whether or not she is still in a
situation where she is not able to work, We do not know wife's
educational background nor do we know her living arrangements,
Husband previously worked for True Temper and there
was a savings plan he participated in, the date of separation
value being approximately $16,000.00. The current value is
around $29,000,00, which was around the date when husband's
pre-trial statement was filed on December 9, 1996. with respect
to the pension plan, the Master does not have a specific number,
although Mr, Gilroy indicated that 95% of that plan was marital.
The Master requests that Mr. Gilroy reduce that percentage to a
number in terms of dollars so we can determine the total value
of the savings plan and the pension plan representing a martial
interest.
Wife was involved in a pension plan with
Pennsylvania Blue Shield where she worked for a number of years
prior to the separation and we need to have some information
regarding the value of that plan. Husband's position currently
is that the two plans, wife's Blue Shield plan and his True
Temper plan were about equal in value. We do not know, however,
whether or not wife has removed the funds from her plan or
whether that plan still remains with the monies available for
her retirement.
Husband owns an insurance policy with prudential
and reports that the cash value of that policy as of December
31, 1994, was $3,300,00.
,
There are two vehicles involved in this case, a
1994 Dodge Caravan in wife's possession which husband has valued
at around $17,000,00 and a 1987 Dodge pickup in husband's
possession which he has valued at around $3,000,00. We do not
have any values specifically from wife on those vehicles;
however, wife in her pre-trial statement indicates that she
agrees with the documented values and titles that husband has
set forth with respect to the vehicles and insurance policy.
The escrow funds from the sale of the marital real
estate as of February 28, 1997, were $33,070,00.
The parties own cemetery plots at Tri-County
Memorial Gardens, We do not have a value for those plots. We
do not at this point know whether either of the parties wants to
retain the plots or whether they should be sold.
There are no joint debts of the parties, the debts
being paid at time of separation, However, wife noted in her
pre-trial statement that there was a debt of at least $2,200,00
incurred mutually on a Visa card which has been in her name
since 1973, She claims that the debt on that card was for
family gifts and households tangible personal property and
clothing.
Wife has stated in her pre-trial statement that she
is willing to agree to a distribution of 50% of the value to
each of the parties, The Master suggests that perhaps Mr,
Gilroy prepare a summary of assets and values and submit that to
wife to see if she is willing to ar.cept the distribution in
accordance with his summary, In response wife can provide her
information regarding the values of assets so that perhaps we
can come to some resolution regarding the distribution of the
remaining assets.
The Master is assuming that the household tangible
personal property has been satiSfactorily distributed between
the parties and that no value will be used for that property in
the equitable distribution computation,
HUsband has made a claim for approximately
$10,000.00 based on his maintenance of the marital home
including the mortgage, home equity loan, and utilties, Wife in
her pre-trial statement states that she does not agree with
husband's request for reimbursement, She specifically states,
"see response dated August 29, 1996, Item No.7. I was never
personally notified or billed for the mortgage, electric, or
water since June 1995."
\
RICHARD A, KAUFFMAN,
plaintiff
IN THE COURT OF COMMON PLEAS 01'
CUMBERLAND COUNTY, PENNSYLVI\NII\
CIVIL I\CTION - LAW
vs.
: NO. 95-3959
CIVIL
ELAINE A. KAUFFMAN,
Defendant
IN DIVORCE
ORDER AND NOTICE SETTING HEARING
To:
Richard A, Kauffman
Hubert X. Gilroy
Elaine A, Kauffman
, plaintiff
, counsel for Plaintiff
, Defendant
counsel for Defendant
--------------
You are directed to appear for a hearing to take
testimony on the outstanding issues in the above captioned
divorce proceedings at the office of the Divorce Master, 9 Nortl.
Hanover Street Carlisle, pennsylvania, on the 5th
day of June ,19U, at 9: 00 a ,m, at which place and
time you will be given the opportunity to present witness",,; ilnd
exhibitB in support of your case.
By the Court,
~~ \:::::
Harold E. Sheely I Presi 'n .Iud-y
Date of Order and
Notice: 1/17/Q7
By:
Divorce Master
IF YOU no NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO O~
TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT \mERE YOU
CAN GET LEGAL HELP,
Court Administrator
Fourth Floor, East Wing
cumberland County courthou,;"
carlisle, PA 17013
Telephone (717) 240-6200
.
RICHARD A. KAUFFMAN , IN THE COURT OF COMMON PLEAS OF
.
Plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA
,
.
.
V . CIVIL ACTION - LAW
.
, NO 95 - 3959/'
,
ELAINE A. KAUFFMAN .
.
Defendant . q'( - "'") ('lr;---
,
: IN DIVORCE
COURT ORDER
AND NOW, this
iI' day of June, 1997, upon consideration of the
attached Petition, it is hereby ordered that the divorce actions
filed at Docket . 95-3959 and Docket . 94-7195 are hereby
consolidated for purposes of the Master's hearing scheduled on June
5, 1997,
ce:
BY THE COURT
Hobort X. Gilroy. ...,'re.lv. ..., .t~:Lt, a.o;
Elaine A. Kauffman
Bradley L, Griffie, Esquire ') .~( C-'r'L~ 4. '1-. <)7
RICHARD A. KAUFFMAN . IN THE COURT OF COMMON PLEAS OF
,
Plaintiff , CUMBERLAND COUNTY, PENNSYLVANIA
,
,
,
V . CIVIL ACTION - LAW
.
,
,
ELAINE A, KAUFFMAN . NO 95 - 3959
,
Defendant , NO 94 - 7195
,
, IN DIVORCE
,
..
MOTION FOR CONSOLIDATION
Richard A, Kauffman, by his attorneys, Broujos , Gilroy, P.C., sets
forth the following:
1
The divorce case at the above captioned number of 95-3959 is an
action filed by Richard A, Kauffman against his wife Elaine A,
Kauffman,
2
The action filed at Docket . 95-3959 has been referred to the
Master with a Master's hearing scheduled for June 5, 1997.
3
The action filed at Docket. 94-7195 is a divorce action which was
filed by Elaine A, Kauffman against Richard A. Kauffman. No
activity has taken place on that matter.
4
The Master has requested that, for purposes of clarification of the
record, the two divorce actions be consolidated as one so that the
Master can adjudicate both cases at the Master's hearing scheduled
for June 5.
......
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RICHARD A, KAUFFMAN, . IN THE COURT OF COMMON PLEAS
.
plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA
,
.
.
vs, : CIVIL ACTION - LAW
.
.
ELAINE A. KAUFFMAN, . NO, 95-3959 CIVIL TERM
,
Defendant , CUSTODY
.
PRE-HEARING MEMORANDUM OF PLAINTIFF RICHARD A. KAUFFMAN
1
Plaintiff Richard A, Kauffman (Husband) and Defendant Elaine A,
Kauffman (Wife) were married on August 2, 1980, Husband was born
on April 9, 1955 and Wife was born on August 5, 1947.
2
The parties have one child, Erin E, Kauffman, born August 2,
1983.
3
Erin is in the custody of Husband, There was a prior support
order issued against Wife in the amount of $39.00 per week plus
$5,00 on arrearage. This Order was suspended November 14, 1996
pending Wife supplying the ORa with documents from her doctorS
concerning her medical/psychiatric condition and her
ability/inability to be employed,
4
The parties separated November 1, 1994, At that time, Husband
and Wife started to llve in separate rooms in the marital home,
Husband vacated the /lIarital home in February of 1995, Wife
vacated the marital home in June of 1995,
5
Marital home was sold by agreement of the parties ill May of 1996.
Mortgage and costs of sale was paid at time of sale. Proceeds
have been escrowed in an interest bearing joint account which had
a balance of $32,784.51 as of October 31, 1996,
6
Husband is currently employed at Orotown in Harrisburg at a
salary of approximately $30,000 per year, Husband is a Traffic
Manager. His education level is one year of college, Wife, to
the knowledge of Husband, is currently not employed. She had
been employed at Pennsylvania Blue Shield for approximately 24
years as a Utilization Claims Specialist. Wife quit that
employment in May of 1995 and has not worked since that time,
except for working at the Boak-of-the-Month Club from August of
1995 through June of 1996 when she moved to Texas with her
mother. Husband was previously employed at True Temper Hardware
for approximately 12 years, and lost that job through a corporate
reorganiza tion,
7
Husband has a savings plan that was provided through True Temper
Hardware and a pension plan through that firm. Current value of
the savings plan is $25,885,84 with value as of time af
separation being approximately $16,000, Pension plan provides
Husband with unreduced benefits in accordance with the attached
statement. Approximately 95% of the pension plan would be
marital property,
8
Husband believes that Wife had a similar savings plan and similar
pension plan payable through Pennsylvania Blue Shield. Wife has
not disclosed the nature of those assets and Husband hereby
requests documentation concerning those assets,
9
After separation and after Wife left the marital home, Wife
refused to make any payments on the marital home. Husband
maintained the mortgage, the electric, the water, and a home
equity loan that was a lien on the property that was to secure a
vehicle in possession of the Wife. A listing of bills paid by
Husband up until sale of the Home is attached with the
approximate total being $10,000,
10
The parties own a 1994 Dodge Caravan in the possession of the
Wife l"hich Husband believes has a va lue of $17,000, and a 1987
Dodge pickup which is in the possession of the Husbana and has a
value of approximately $3,000,
11
The parties have various life insurance policies, two policies on
Husband carrying an approximate value of $6,000 and $1,500 for
face value. There is a policy on the Wife with an approximate
value of $1,500. Husband will obtain updated values on those
policies,
12
The parties had various items of personal property which they
distributed at time of separation and Husband is not at this time
suggesting that those items of personal property be considered in
the divorce.
13
The parties also own cemetery plots at Tri-County Memorial
Gardens, Husband will try to get a value on that asset and he
believes it is worth no more than a few hundred dollars,
14
There are no joint marital debts at this time with all of the
debts having been paid upon sale of the real estate.
15
Husband's proposed distribution of marital assets is as follows:
A. Husband be reimbursed $10,000 from the monies in the escrow
account for the mortgage payments and other bills he paid,
B, After making appropriate adjustments for values of vehicles
owned by the parties and values of insurance policies owned
by the parties, all assets would be distributed on a 50/50
basis.
C. Each party would retain their own savings plan and pension
plan through their respective former employers.
D, Insurance policies would be cashed in or allocated to the
parties with all remaining assets distributed 50/50.
December 4, 1996
Hu ert ,Gilroy, Esquire
BROUJOS, GILROY & HOUSTON, PC
4 North Hanover Street
Carlisle, Pennsylvania 17013
717/243-4574 717/766-1690
FAX 717/243-8227
Aeenllllt 11If'ormlltioll
ACTIVITY SUMMARY
(Continued)
'o"nnln, Contribution.
".Ien.. andOthor
Cnldlto
, Eomln..
Gain/Lou
Wlthdra_1s
and Other
D.blto
Tranlf...
(Eachan,..)
Employee Alt..... Tu
Geara' Putnam fund of Bonon 562102 $000 $000 $000 $1911
Putnilm Voyazt!r Fund $98111 $000 $000 $000 $2887
SUBTOTAL $1,60719 $000 $000 $000 $1828
Com....., Hatch
Georlt! Putnam Fund of Bonon $1,29161 $000 $000 $000 $ III 81
Putnam Voy.pr fund $7.58710 $000 $0.00 $000 $222.19
SUBTOTAL $11.88171 $000 $0.00 $000 $l56l0
T_I Account Acttvlty '",
, ..". -,:,.;.:. ".f;)" ,
Period.lo-Date $25,lll21 ~O.OO $000 $000 $752,6l
Year..TooOate $22,89919 $0,00 $000 $000 $2,986,l5
----~---- ---.. -.---------------
PORTFOLIO BREAKDOWN
Your current account balance by Investment type
. ---'-.._- ~--__.__ _ _u_.____~____________~._
SUI.esled allocations lor an Investor your _.., 40 to '0
'O"c.p,rol
Pr.,.rvaoon
H"Growth
and Income
I 0% Income
66X Growth
lOX-Growth
and Income
60~ Growth
End'n,
Salone.
5612.1l
$1,01331
$1.655.77
$1,12812
$7,809.59
$12,2l801
$25.885,81
$25,885.81
The hypothetical pie chan on the right renecu optimal combinations of t:meu. (ooslde"ng the time horizon remalnin! to ale 65. historical infliltion rates
and risk and return relatlonshlps of the asset classes shown and IS net Intended as Investment advice, No other assumptions have been made, When
cemparin, the pie chart to rour situation, consIder your ether asseU,lnceme and investmenu, e'l. the equity In rour home, other retirement plan and
IRA asseu and rour savinls, in addition to rour plan account Please conUtt a financial advisor to rC!view rour financial situation. Call the toll,lree
number on this pa&e If rau wish to chan,. your allocations.
INVESTMENT PERFORMANCE
Totol return at NAV 'or the penod ended September lO. 1996,
. .~". ";: \' '.t;:_".,:~,>j~',.'{:'.-:~..,":__;_,~~
" .;.
. Stat.ment
'orlod
" ~'
'.'1 ,Y.ar'~'~:;l"ji:y.... . I Yo.. 10 Y..rl
... .,- .:' .'
, ; .' ',A"'i...lI.... Ann...llzed UI.
".'" . :'.: .,' Annuol'red
'YTD
"
G.-!I
Putnam Voyager Fund
EuroPaclfic Growth Fund
2.9l %
1.70%
1508%
Ill9%
22,97 %
1101 %
19l8%
120B%
19.10%
12,96%
.
PAGE20fl
For 'n'ormatlon, Call
Putnam Reclrement Plans
1-800-752.9891
PUTNAM INVESTMENTS
"
.1~~:H~"1:~)"l)JIHil \llr.~~\
1868%
Il85%
Account Information
INVESTMENT PERFORMANCE (Continued)
Tot~l return It NAV!~rthl!l penod ende~ September lO. 1996
.' c, ':-.'~ ..
Statement
Period
YTD ' ..',I'Y.... J Year S Year
Annualized Annuall.ed
,.""."',
...;
0.'...'..,.
10 Vea.1
'Ufe
Annuallzell
Growth and Income
Georl' PuUliUll Fund of Boston
Putnam Growth and Income fund
Hulfy Stock Fund
'ncan1- .._ , ,. ;.;,.. ');,.';'~.l:.....
PuUIm U,S. Government Income
tal '~...~~' .."
Cap! P,.............. ",.;....." "
Putnam Money Market fund
1.78%
!.,
9,26 % 15,11% 12,76 " Ill5% 1209 "
IU2" 1951 " 1608 " 15 I) % 14,11 %
2621 " 22,24 " .8,59% ...,57 % 12,71 %
"." .......-.
.:.::~-,:~j::i-~ .:.:",., ~;. . ;...
066% 4,11 " 4,68 " 5,88% 7,55 "
:. ,,: :;;~l-,,:, ,:i:L,._ . . ... '~-.,,:: " .;~'.u' ,
. ~.; , '.
180" 5,19 " 4,59 " 401% 5,54 "
112%
2.94 %
HI %
.' ,'" ~ ,
...... :".j,~~:~ ;..;";>,,,;.;.;, . ..:, . '. ,,'
<~. ~
',i...:._.",
1.24%
For more information about any of the fundi offered In 'your plan, pluso read each fund', prospectus carefully before invenin.. Total return Is the chang'
of an investment's value. anumln! all dividends and capital gains were reinvened, You do not pay sales charles on contributions made throuch your
,..tlrement plan, Thu perlol mili'U:.e d~ta ,hu~1l reflect thb, Investment return and prindpal value will fluctuue so your shares when redeemed may be
worth more or less than their anginal COSl Performance data represent pan results. Put performance is no zuarantee 01 future resulu. The above
f1aures are all representative 01 clau A shares. Performance of other share c1anes will vary,
EuroPaclfic Growth Fund: Forei!" investments may be sublect to cenain risks. such as currency lluctuations and political developments. This fund
provides an oppo"unlty for lonl'term growth 01 capital through invesunenu ouuide the United States, Source 01 Inlonnation: Upper Analytical
Services. Inc.
Putnam U.S, Government Income: Althouzh the U.S. government guanntees the timely payment 0' principal and Interen on the underlYing securitJes.
the value of the fund shares Is not guaranteed and will Iluctuate. MO"lage.backed secunties are subject to prepayment risk.
Putnam Money Market Fund: An investment In the fund is neither insured nor guaranteed by the U.S, government. No anurance can be made that the
fund will maintain I stable share price ofSI.oo.
.
PAGE J OF 2
For Information, Call
Putnam Retirement Planl
1.800.152.9894
PUTNAM I NVESTt4ENTS
o
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. 1 fANE tocro .a I
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1c.'~ focf'c, . 01 t.f t-I!!; . s> :3 I d..97
X3.PT Iooe: .01 t./-tf 8.8] b? 1, YV /3,t...{.()
Jc.;- (000.01 LfLl g .Er? P.O,11
.
"/01. t:; eta.CJf / 7 q po '-f 7. +q
!)E.c. , 00(0,01 17q pc J /5. feD / ~3. 7c./-
)AtJ ~00. 01 L/-Lf g .8"'3 /JCI.OI
- iOorc f)1 Lf L/ 8 ,g:'s
'~13 lloq.3u
J)fjR fo{lfc. 91 L./-L/ '&.~?' ~~. "3 .;( / ./ '-f
tPR. 38.15
I YJ~I /3,'8'7 I 7, 1-$
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INCOME AND EXPENSE STATEMENT OF
"
^ lei-lrllI ~ f1
SSN IL} 3 . L/ fo . t./ 'IS"b
/!';.ILI ~ r, /) 1.),,1
DR. DATE
THIS STATEMENT MUST BE FILLED OUT
11- 30 10
(If you are sell.employed or il you are salaried by a business of which you are owner In whole or In part. you must
also till out the Supplemenlll Income ,Slllemenl which appears on lhe lasl page of this Income Ind Expense
Slltlmln!.)
INCOME
(a) Wages/Salary /l .J J.I /J
Employer & Address OJfc; rcw /.;(13 ~x <<AI CUldl'/J ,!::,} R(",. r:~ / 7/10
Job Tille/Description
Pay Period (weekly. bl.weekly, monlhly) 131 . Wt:.E.K'{ "
T II -~ [{,,-
Gross Pay per Pay Period ....................................................................................................................1 -''''' -~.
Payroll Deducllons:
Federal Withholding ..................1
Social Security ...........................1
Local Wage Tax ..........................1
Stale Income. Tax ;'/"..................1
Retlremenl ..........~Q/.!5............1
Health Insurance ........................1
Other (specily) M@/.r.tlKt.:..u'..1
PA S.tI,l/{Jk~....r;,.~...1
.........................$
/.;(3 7 g
'70. 3 D
//.;5.!L
3.:?3 /
1I.5Y-
~('), C C'
I (.;. ". If
.35
Net Pay per Pay Period ....,............................"......'..........'.:.......".,...................................................... S
'?fo7. 54
(b) Other Income
Interesl/Dlvldends ......................1
Pension/Annuity .........................1
Social Security ...........................$
Rents/Royallles ..........................1
Expense Accounl .......................$
Gills ,...,................,.......................$
Unemployment Compensation .$
Workmc'l's Compensation .......,$_
Total. Olher Income .......................$
Week
Month
$ 1
$ 1
$ 1
$ 1
. $
.
$ $
$ $
$ $
$ $
Year
INCOME AND EXPENSE STATEMENT OF
I verltv thlt the Italements made In this Income and e.pena8 State,
ment are true and correct. I understand thai talae atatements herein
are made subject 10 the penallles 01 Ie Pa,C.S. .90. 'e'a\lng 10
unsworn IllSlfl allon to aUlhor,lYUI.;, /!~.~"
Dale .1.l1{3g .~~_ Ku,IIJ1,rJ..J..k.. ,id. - "-'>-
PI Inti DOlanda"1
,..
EXPENSES
Home
Mortgage/Aenl ........................................ $
Malnlenance ........................................... $
UtlllUes (telephone, heating
eleclrlc, elc,) ........................................ $
Employment (transportation,
lunches) ............................................... $
Taxes
Aeal Estate .............................................. $
Personal Property................................... $
Income ..................................................... $
Insurance
Homeowners ........................................... $
Automobile .............................................. $
Llle/Accldenl/Heallh .............................. $
Other ........................................................ $
Automobile (payments, fuel,
repairs) ................................................. $
Medical
Doctor, Dentist, Orthodontist ................ $
Hospital ............~........................ $
Special (glasses~ace;'etc.) ............... $
Education
Private, Parochial SchoOl....................... $
College ..................................................... $
Peraonal
Clothing ................................................... $
Food ..............................,...........,...,.......... S
Other (household supplies,
barber, etc.) .......................................... $
Credit payments and loans .................... $
Miscellaneous
Household help/child care ..................... $
Entertainment (Inc. papers,
books, vacation, pay TV, etc.) ............ $
Gilts/Charitable conlrlbutlons .............. I
Legal Fees ............................................... S
Other child Supporllallmony
payments ,..,...,..................................... S
Other (speclly)............................................... I
Total Expenses ..................,.......,........,......,.. S
Household
Week
$
I
$
$
$
$
$
$
$
$
$
$
S
$
$
$
$
$
I
I
I
$
$
$
$
Child
Week
Household
Month
$
$
$
$ i./-9S $
$ $
$ /q~ $
$ las $
$ $-
I diD $
$ $
I I
$ ~lJ. I
$ ?s $-
$ $
I /IS $
I I
$ $
$ JDO $
$ $
$ I
I .30 $
I ISC) $
$ ~O I
$ .~OO $
$ $ ----.
$ /00 $
$ I (j;() $_
$ $
$ $ -
$ $
$ /If+ .Ie $
Child
Monlh
Ownerahlp'
PROPERTY OWNED
De.crlpllon
Value
H
W
J
Checking Accounts ........ $
$
Savings Accounts ........... $
$
Credit Union .................... S'l1v'/;/(,S /m~II}i3,t:.K'S I srI $
................... U-IO:.t../,.}(j C 11' 6.547/ :J $
Stocks/Bonds .................. 5.;l . (1(1(" :5,~VI"'r. 5 St'N,):' $
.................. & ((i~/"'~ L:...lL.' ('JJ .~/'.V) S
Real Estate ...................... $
...................... $
Other ................................ $
................................ $
Total, Property..................... $
---
---
---
/.3y. '::'
64. DC
-"7--
-"7==
---
---
---
----
---~
---
----
Hospital........................... LLS
Medical............................
Health/Accident ..............
Disability Income ............
Other (dental, etc,) .......... i,
('H . Husband. W. Wile. J. Joint, C . Child)
Comp.ny
/-/(;;.JL 'TH{'J}x'~
/,
Policy No.
Q$ZM()C)JO/z.o
,
Coverage'
H W C
-L-_~
-L _ -L-
INSURANCE
---
---'
."A 2!> 1/ 8 /J
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SUPPLEMENTAL INCOME STATEMENT
A. This form must be IIlIed out by a person who (check one):
_ (1) operates a business or pracllces a profession; or
_ (2) Is a member of a partnership or Joint venture; or
_ (3) Is a shareholder In and Is salaried by a closed corporallon or similar entity.
B. Attach to this statement a copy of the following documents relating to the business, profession, partnership,
Joint venture, corporation or similar entity.
(1) the most recent Federal Income Tax Return, and
(2) the most recent Pro lit and Loss Statemant.
C. Name and Address of business:
Telephone Number
D. Name and Address (II different than C) at accountant, controller or other person In charge of IInanclal
records:
E. (1) Annual Income tram business ............................................................................................. $
(2) How otten 15 Income received? ............................................................................................ $
(3) Gross Income per pay period ............................................................................................... $
(4) Net Income per pay period ................................................................................................... $
(5) Speclllc deductions II any .................................................................................................... $
RICHARD A. KAUFFMAN
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY, PENNSYLVANIA
.
.
V
: CIVIL ACTION - LAW
ELAINE A. KAUFFMAN
Defendant
,
.
: NO 95 - 3959
.
,
: IN DIVORCE
PLAIN'l'IFF HUSBAND'S PROPOSED DIS'l'RIBUTION OF MARITAL REAL JlS'l'A:rE
1
Plaintiff Husband suggests a distribution of marital property on a
SO/50 per cent basis after subtracting for various debts.
2
Husband suggests he should receive a credit from the money in the
escrow account in the amount of $iO,~~.15 for reimbursement for
r, .:I.'''. ()'7
expenses he paid to preserve the marital real estate.
3
Husband suggests that his Defined Benefit Retirement Plan from True
Temper and Wife's Defined Benefit Retirement Plan from Blue Shield
are essentially worth the same. Husband suggests that he receive
his benefits exclusive of Wife and the Wife receive her benefit
exclusive of Husband as a SO/50 split.
EXHIBIT
I /"/( ~
4
Husband suggests the following distribution:
TO WIFE
Wife's VIP Plan $ 10,000.00
1994 Dodge Caravan $ 17,000.00
Wife's Insurance Policy $ 1,500.00
Cash from money in escrow account $ 10,714,57
TO HUSBAND
True Temper Retirement Savings Plan
1987 Dodge Pickup
John Hancock Insurance
Prudential Insurance
Remaining cash from escrow account
$ 16,000.00
$ 3,000,00
$ 4,964,00
$ 3,300.00
$ 22,502,72
TOTAL
$ 88,981.29
5
Any additional interest earned on the money in the escrow account
shall be split equally.
..'
RICHARD A. KAUFFMAN , IN THE COURT OF COMMON PLEAS OF
.
Plaintiff , CUMBERLAND COUNTY, PENNSYLVANIA
,
.
,
V . CIVIL ACTION - LAW
,
.
.
ELAINE A. KAUFFMAN , NO 95 - 3959
.
Defendant ,
.
, IN DIVORCE
,
EXPENSES PAID BY HUSBAND FOR REAL ESTATE
W!lILE PROPERTY WAS VACANT AND PENDING SALE
Mortgage Payments
Home Equity Loan - Auto Loan
Electric Bills
$ 6,060.10
$ 3,499,93
$ 653.49
$ 65,63
$ 273.00
$10,552.15
Water Bills
Homeowners Insurance
Total
EXHIBIT
'21
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ftJE tocro .0 I
fLY fcDfo .0 t1 4t.fS.~3 15..80
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:PT foo~ .01 LfL/8.8"3 ~?r1 /3 ' t..{-l)
,,- too~pl LfLf g .f!;? P,O,?f}
-'.
01. 00foPI / 7 q po '-f 7, '-11
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.-B fOO(cJ'J/ L/-tf 8 .~ Iloq . 3 u
'fiR 0Clfc, P/ '-/-4. '8 .~ 3 &~. 02> c;( /. / '-f
PR 38. /5
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r m~OfA.:JNt;; ~
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"
..
Elaine ^nn KnuITman
December 6, 1')9~
Pnge 2
If you accept the Pre-relirement Death Renetit, indicate by circling the number 3 beside "I ac('ept
the Pre-retirement Death Renetit for Illy spouse," then sign where indicated. YOUR SIGNATIIHE
NEED NOT RE NOTARIZED IF YOU ACCEPT THE PRE-RETIREMENT DEA TII RENEF'T.
AND YOUR SPOUSE'S SIGNATURE SHOULD ~ APPEAR.
If you are married, but do not know the whereabouts of your spouse, you may cire/e the nllmher 4.
and have your signature notariled In this case, no reduction to YOur future benefit will be applied
Service with Pennsylvania mue Cross plans will be subsidized by Pennsylvania Blue Shield. When
you elect 10 iniliate payment of your benefil from Pennsylvania Blue Shield, we will ask you to
provide your employmenl dales wilh any Pennsylvania Blue Cross Plan, verity them, and nOI Counl
lhallime in determining any benetit reduction. If you are currently employed with a Pennsylvania
Blue Cross Plan and leave thaI company, you may wish to waive your Pre-Retirement Death
Benefit atlhattime to avoid a benefit reduction,
You may change your election al any time by requesling, completing and returning another Pre-
retirement Death Benefil Election, If YOur marital status changes you must also make a new
election based on your new slalus. Remember, lhe Retirement Equity Act assumes that you are
married and wish to provide a benefit for your spouse. Therefore, TO A VOID UNNECESSAR Y
REDUCTION OF YOUR FUTURE RETIREMENT BENEFIT, YOU MUST ACT, Please
complete the Pre-retirement Death Benefit Election and relum to me in the relum envelope wilhin
30 days from the date of this leller to avoid I eduction of your future retirement benefit,
Questions about this or any other aspect of your employee benefits may be addressed to me althe
following address:
Benefits Plan Administrator
Pennsylvania Blue Shield
1'.0, BOl( 890089
Camp Hill, I' A 17089-0089
Sincerely,
SLS/ddh
Enclosure
Susan L. Sloane
Benefits Plan Administrator
~')/
RUN DATE: 08/01/95
PENSION CALCULATION fOR: kAUfFNAN,ELAINE ANN 00263 PBS
NORNAL RETIREHENT ~NTN: 92012
RETIREHENT SERVICE DATE: 7 14 69
TERHINATlON DATE: 5 17 95
ACCRUED SERVICE: 24.01
TOTAL SERVICE: 41.305003422
BIRTH DATE: 8547
HARITAL STATUS: N
NNTHLY OUALIFIED BENEfIT: 1706,18
OUALlflED FINAL AVE SAL: 128,223.48
COVERED CDHP LEVEL: 152,680
ANNUAL QUALIFIED BENEfiT: 18,474,18
LUNP SUH ANOUNT:
LUHP SUN FACTOR:
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l'f'"~.,,~, ..... '~.)' .~I~"n."'~';\".", .......1":- -;n..r,~ Vl'.. ...'.,....;~:.: .. ;....,~;-::; .::r-.l;\~1 \....~.-.....~ '~""!""""'''''''I'!~:~'~~'~~''''-~.;:''''~.v'~ij\ '''TJ~~~l: '~I
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,'-
PYS510
1994-07195
Filed........:
Time......... :
Execution Date
Sat/Dls/Gntd. .
Jury TrIal, . . .
HIgher Court 1
Hlaher Court 2
......**.**.................****.r***....*****...***..******.....**........**....
Genora1 Index Attorney Info
KAUFFMAN ELAINE A PLAI~T:FF GRIFFIE BRADLEY L
308 WERTZ AVENUE
MECHANICS BURG PA
KAUFFMAN RICHARD
308 WERTZ AVENUE
MECHANICSBURG PA
Reference No,.:
Case Type.....:
Judgment...... :
Judge AssIgned:
Cumberland County Prothonotary's OffIce Page
CIvil Case InquIry
KAUFFMAN ELAINE A (VS) KAUFFWiN RICHARD A
1
COMPLAINT - DIVORCE
.00
12/27/1994
10:25
0/00/0000
0/00/0000
17055
A
17055
::>EFENDANT
................**.***.....****.......*******......**.................***.......
* Date Entries *
.........w.*....*...****.*.W~WW~II**..*~~ww*w~****.w.*.**........*......**.......
12/27/94 COMPLAINT - DIVORCE
WAIVER OF COUNSELING
ADDITIONAL COUNT - EQUITABLE DISTRIBUTION
01/09/95 AFFIDAVIT OF SERVICE
02/28/95 PRAECIPE TO WITHDRAW APPEARANCE FOR PLAINTIFF BY PAUL J ESPOSITO
PRAECIPE TO ENTER APPEA..NACE Fen PLAINTIFF BY BRADLEY L GRIFFIE ESO
........***.................***....********.**....**.............**.*****.***,...
* Escrow InformatIon *
* Fees & Debits Beq Bal Pymts/Adi End Bal *
.**.*...*.*.**..***...*****w~*w*:t.****.w*w~~w***'***.*************...*.....*****
DIVORCE
TAX ON CMPLT
SETTLEMENT
MASTER'S FEE
DIV PA SURCHG
JCP FBE
JCP FEE
ADD'L COUNTS
~j,OO j~.OO .00
.50 .50 .00
5,00 5.00 .00
125,00 125.00 .00
10,00 10.00 ,00
5,00 5.00 ,00
!j,OO 5.00 .00
l~,OO 10,00 .00
------------------------ ------------
195.50 195.50 .00
******************************......**.*...,...*.************.****.**.**.*******
· I:;nd of Case InformaLJ.ulI *
**.....***.***....**.*****.*..****.*****..****...........***.**...**************
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and we stipulate that said facts can be made part of the record
as if specifically testified to under oath at a hearing in these
proceedings.
plaintiff:
Datel
couneel for plaintiff:
i/~~ 6!~1
Defendant:
Datel
counsel for Defendant:
-,
RICHARD A, KAUFFMAN . IN THE COURT OF COMMON PLEAS OF
.
Plaintiff , CUMBERLAND COUNTY, PENNSYLVANIA
.
.
.
V , CIVIL ACTION - LAW
,
.
,
ELAINE A, KAUFFMAN . NO 95 - 3959
,
Defendant : ql..(- "1' fir-
, IN DIVORCE
,
COURT ORDER
AND NOW, this " ~
day of June, 1997, upon consideration of the
attached Petition, it is hereby ordered that the divorce actions
filed at Docket * 95-3959 and Docket * 94-7195 are hereby
consolidated for purposes of the Master's hearing scheduled on June
5, 1997.
BY THE COURT
/~/ .,d,..... D. ~
, I
cc: Hubert x. Gilroy, Esquire
Elaine A. Kauffman
Bradley L. Griffie, Esquire
TALJE COpy FROM RECORD
In TIISUrlIQIlY whnrool. I Mow unto set my haM
nlld too :1<'1,11 uf ~hj Coull ;If GJrl~. Pa.
This '" u.. ;I1JV 01 ~'i' '. 19~'7
"-- ...I.J a. ~I'f.~~ ~'t1
1 PrlIltloncltarY
RICHARD A. KAUFFMAN , IN THE COURT OF COMMON PLEAS OF
.
Plaintiff . CUMBERLAND COUNTY, PENNSYLVANIA
,
.
.
V . CIVIL ACTION - LAW
.
.
.
ELAINE A, KAUFFMAN . NO 95 - 3959
,
Defendant , NO 94 - 7195
.
. IN DIVORCE
.
MOTION FOR CONSOLIDATION
Richard A. Kauffman, by his attorneys, Broujos & Gilroy, P.C., sets
forth the following:
1
The divorce case at the above captioned number of 95-3959 is an
action filed by Richard A, Kauffman against his wife Elaine A.
Kauffman,
2
The action filed at Docket * 95-3959 has been referred to the
Master with a Master's hearing scheduled for June 5, 1997.
3
The action filed at Docket * 94-7195 is a divorce action which was
filed by Elaine A. Kauffman against Richard A. Kauffman, No
activity has taken place on that matter,
4
The Master has requested that, for pUrposes of clarification of the
record, the two divorce actions be consolidated as one so that the
Master can adjudicate both cases at the Master's hearing scheduled
for June 5.
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BROUJOS, GILROY & IIOUSTON, I'.C.
ATIOltNI:YS AT l.AW
4 NORTIIIIANOVI:R STRr:H
CARI.ISI.I:, l'ENNSYl. VANIA 17013
717-243.4574
71"'66'16~1l
"AX: 243.8227
JOliN II. IIROUJOS
IIUUI:RT X. GILROY
CIlRISTOPItl,R C. 1I0USTON
December 4, 1996
Robert Elicker, Esquire
Di vorce Master
N, Hanover Street
Carlisle, PA 17013
~(Q)[P1f
RE: Kauffman VB. Kauffman
Dear Bob:
Enclosed is the Plaintiff's Pre-Trial Memorandum in the above-
referenced matter. I will look forward to hearing from you with
respect to the scheduling of a Pre-Trial Conference.
Sincerely yours,
slm
cc: Richard A, Kauffman
Elaine A, Kauffman
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OFFICE OF DIVORCE MASTER
CUMBERLAND COUNTY
COURT OF COMMON PLEAS
9 North Hanover Street
Carlisle, PA t7013
(717) 240-6535
I. Robe,. IlIck.r, II
Divorce Master
Treel .10 Col,.r
Office ManageriAaporter
w... Shore
697.0371 Exl,6535
November 14, 1996
Hubert X. Gilroy, Esquire
BROUJOS, GILROY & HOUSTON
4 North Hanover Street
Carlisle, PA 17013
RE: Richard A. Kauffman vs. Elaine A. Kauffman
No. 95 - 3959 civil
In Divorce
Elaine A. Kauffman
305 Northridge
Hallettsville, TX 77964
Dear Mr. Gilroy and Ms Kauffman:
By order of Court of President Judge Harold E. Sheely
dated November 6, 1996, the full-time Master has been appointed
in the above referenced divorce proceedings.
A divorce complaint was filed on July 26, 1995, raising
grounds for divorce of irretrievable breakdown or the marriage.
The complaint also raised the economic claim of equitable
distribution. I note that Elaine Kauffman is not represented by
counsel which is the reason I am communicating directly to her.
In the event Ms. Kauffman obtains an attorney, the attorney
should advise my office immediately.
I assume that the parties are willing to consent to a
divorce by filing affidavits of consent under section 3301(C) of
the Domestic Relations code. Based on that assumption,
I am directing Mr. Gilroy, counsel for Mr. Kauffman and Elaine
A. Kauffman, who apparently is representing herself, to each
file a pre-trial statement in accordance with P.R.C.P.
1920.33(b) on or before Monday, December 9, 1996. Upon receipt
of the pre-trial statements I will immediately schedule a
pre-hearing conference with counsel for Mr. Kauffman and Ms.
Kauffman, if she remains unrepresented. If Ms. Kauffman in the
DRAFT
QOt.PaDa. IC.AT1IIAII . OIIU"NI. ,.c.
raul J. Rapoaito - t.D. 125.'.
,\ttO",.ya for rhintiU
l201 M.rk.t otr..t
p.o. Box 1261
Uarriaburg, PA 11101.1211
tll'Jl 2H-41U
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
ELAINE A, KAUFFMAN,
plaintiff
v.
CIVIL ACTION -
NO. '{If. 717~IVIL
IN DIVORCE
LAW
RICHARD A. KAUFFMAN,
Defendant
1994
NOTICE TO DEPEND 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 at the Cumberland County Courthouse, 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.
COURT ADMINISTRATOR
pourth ploor
Cumberland County Courthouse
Carlisle, pennsylvania 17013
(717) 240-6200
I.J.. .
ELAINE A. KAUFFMAN,
Plaintiff
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
v.
RICHARD A. KAUFFMAN,
Defendant
NO. 94-7195 CIVIL TERM
CUSTOD'{
ORDER OF COURT
AND NOW, this
day of
1995, the
attached Stipulation and Agreement is hereby made an Order of
Court and all prior Orders on this matter are hereby vacated.
BV THE COURT,
:t
13,
J.
ELAINE A. KAUFFMAN,
Plaintiff
v.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
RICHARD A. KAUFFMAN,
Defendant
NO. 94-7195 CIVIL TERM
: IN CUSTODY
CUSTODY
STIPULATION AND AGREEMENT
THIS AGREEMENT AND STIPULATION
entered into the day and
year hereinafter set forth, by and between Elaine A. Kauffman,
(hereinafter referred to as "Mother") and Richard A. Kauffman,
(hereinafter referred to as "Father").
WHEREAS, the parties are the natural parents of Erin
Elizabeth Kauffman, born August 2, 1983 (hereinafter the
"child"); and
WHEREAS, tho parties are presently separated and living in
separate residences; and
WHEREAS, the parties wish to enter into an agreement
relative to custody and partial custody of the child; and
NOW, THEREFORE, in consideration of the mutual covenants,
promises and agreements as hereinafter set forth, the parties
agree as follows:
1. The parties shall have shared legal custody of the
child.
2. Mother shall have primary physical custody of the child.
3. Father shall have temporary or partial physical custody
of the child on the following basis:
(a) On alternating weekends from Friday at 4:30 p.m.
until Sunday at 8:30 p.m.;
!If,
(b) Two evenings per week from 4:30 p.m. until 7:30
p.m.: and
(c) At other times as the parties may agree.
4. Each party shall be entitled to two uninterrupted weeks
of vacation with the child each summer with Father notifying
Mother by no later than April 15 of each year of his desired
weeks of vacation. These weeks shall not be consecutive unless
otherwise agreed upon by the parties.
5. During the Christmas holiday season, the parties will
alternate physical custody of the child during the following
periods:
(a) The period from 4:30 p.m. on December 23 until
l:OO p.m. on December 25: and
(b) The period from December 25 of each year at 1: 00
p.m. until 7:30 p.m. on December 27 of each year.
Mother shall have the first period set forth above for
Christmas, 1995 and the parties alternating from that time
forward.
6. During the Thanksgiving holiday season, the parties will
alternate physical custody of the child during the following
periods:
(a) The period from 4:30 p.m. on Wednesday before
Thanksgiving until 7:30 p.m. on the Friday after Thanksgiving:
and
(b) The period from 7:30 p.m. on the Friday after
Thanksgiving until 7:30 p.m. on the Sunday after Thanksgiving.
I....
,~
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\
, .
Father shall have the first period for Thanksgiving, 1995
and the parties alternating from that time forward.
7. The parties agree to alternate physical custody of the
child on the following holidays: New '{ear's Day, Easter Day,
Memorial Day, 4th of July and Labor Day. Mother shall have
Memorial Day, 1995 and the parties alternating from that time
forward. When a holiday occurs during the period of time that
the child is in the physical custody of the other party, the
party who is to enjoy the holiday shall have the child from 9:00
a.m. until 7:30 p.m. on that day. In the event that Father's
alternating holiday coincides with an alternating weekend period
of physical custody that he has the child, he may simply retain
physical custody of the child on Sunday evening through Monday
morning of the holiday until 7:30 p.m. on the holiday.
8. The child shall always be with Mother on Mother's Day
and with Father on Father's Day, with those periods on those
respective days being from 9:00 a.m. until 7:30 p.m.
9. Father shall be responsible for transportation of the
child during his periods of physical custody with the child.
Further, Father's periods of over night visitation are based upon
Father securing appropriate sleeping accommodations for the child
prior to these visits current.
10. The parties agree that in the event they would leave
the area for a weekend or other extended period, they will notify
the other party of their whereabouts so that contact may be made
with the child in the event of emergency circumstances. In
addition, neither party shall drink alcoholic beverages nor
(~.,
should they partake in any type of ill ici t drugs during the
period of time that they have physical custody of the child or
preceding that period of time.
11. The parties will keep each other advised immediately
relative to any emergencies concerning the child and shall
further take any necessary steps to insure that the health and
well being of the child is protected.
12. Neither parent shall do anything which may estrange the
child from the other party, or injure the opinion of the child as
to the other party, or which may hamper the free and natural
development of the child's love or affection for the other party.
lJ. Any modification or waiver of any of the provisions of
this Agreement shall be effective only if made in writing and
only if executed with the same formality as this Stipulation and
Agreement.
14. The parties desire that this Stipulation and Agreement
be made an Order of Court to the Court of Common Pleas of
Cumberland County, and further acknowledge that the Court of
Common Pleas of Cumberland county does. in fact, have
jurisdiction over the issue of custody of the parties' minor
child and shall retain such jurisdiction should circumstances
change and either party desire or require modification of said
Order.
15. The parties agree that in making this Agreement, there
has been no fraud, concealment, overreaching, coercion, or other
unfair dealing on the part of the other.
11,
I
\
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CUMBERLAND
SS
On this the
day of
, 1995, before
me, the undersigned officer, personally appeared Elaine A.
Kauffman, known to me (or satisfactorily proven) to be the person
whose name is subscribed to the within Agreement and acknowledged
that she executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and off icial
seal.
COMMONWEALTH OF PENNSYLVANIA )
) SS
COUNTY OF CUMBERLAND )
On this the
day of
, 1995, before
me, the undersigned officer, personally appeared Richard A.
Kauffman, known to me (or satisfactorily proven) to be the person
whose name is subscribed to the within Agreement and acknowledged
that he executed the same for the purposes therein contained.
IN WITNESS WHEREOF, I hereunto set my hand and official
seal.
(( I
ELAINE A. KAUFFMAN
PLAINTIFF
DR ...21.M2
IN 11m COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
VS
DOMESTIC RELATIONS SECTION
CIVIL ACTION. SUPPORT
RICHARD A. KAUFFMAN
DEFENDANT: NO 216 SUPPORT 19~
ORDER OF COURT
AND NOW, this 26th day of Apri 1 ' 19..25-0 based upon the Court's
determination that Plaintiffs monthly net incomclcaming capacity is S nl a , IlIld Defendant's
monthly net incomclearning capacity is S nl a , it is hcrcby ordcred that the Defendant pay to
the Domestic Relations Section, Court of Common Picas, S 322.00 a month payable
$322.00/I1'Onth effective, 4-1-95
Arrears set at S 322.00 as of 4-26-95 arc due in fulllMMEDlATEL Y.
Contempt proceedings, credit burcau reporting, tax refund offset certification and entrance of a judgcment
may be held in abeyance as long as Defendant pays S -0- on arrears caeh payment date,
Failure to make each paymcnt on time and in full will cause all arrcars to become subject to immediate
collection by all of the means listed above,
For the support of: ~ child. Erin E. Kauffman. born 8-2-83. This order is
based on an a..... nt. No incaros and expenses were considered bv the 000.
This order takes into consideration the parties will eauallv share in the
cost of necessarv child care exPBnses.
Said money to be tumcdover by the Domestic Relations Section to: 01 "inti ff
. Payments must be made by cash, check or money order,
Cash paymcnts must be made in person, All checks IlIld money orders must be made payable to Domestic
Relations Section and delh'Crcd or mailed to Domestic Relations Section, 13 North Hanover Street, P.O.
Box 320, Carlisle, pcnnsylvania 17013, Each payment must bcar your Domestic Relations number in
order to be processed,
Unreimburscd medical expenses are to be paid 50 % by Defendant IlIld 50 %
by Plaintiff. l1AferrlRnt to provide medical insurance coverage
, Within 30 days after the entry of this order, the
~fendant shall submit to the person having custody of the child(ren) written proof that medical
insurance coverage has been made, Proof of coverage shall consist, at a minimum. of: (I) the name of the
health can: coverage provider(s); (2) any applicable identification numbers; (3) IlIlY cards evidencing
coverage; (4) the address to which claims should be made; (5) a description of any restrictions on usage,
such as a prior approval for hospital admissions. and the manner of obtaining approval; (6) a copy of the
benefit booklet or coverage contmct; (7) a description or all deduetibles IlIld co.payments; IlIld (8) five
copies of any claim forms,
^~.
Ill! 2),M2
IMPORTANT I.E(iAI. NOTICE
l'ARTIES MUST WITIIIN SEVEN DAYS INFORM TIlE DOMESTIC RELATIONS SECTION AND
TilE O'I1IER PARTIES, IN WRITING. OF ANY MATERIAL CIIANGE IN CIRCUMSTANCES
RELEVANT TO '11 IE LEVEL OF SUPPORT OR TIlE ADMINISTRATION OF TIlE SUPPORT
ORDER. INCLUIJING, BUT NOT LIMITED TO, LOSS OR CIIANGE OF INCOME OR
EMPLOYMENT AND CIIANGE OF PERSONAL ADDRESS OR CIIANGE OF ADDRESS OF ANY
CHILD RECEIVING SUPPORT, A I'ARTY WIIO WILLFULLY FAILS TO REPORT A MATERIAL
CHANGE IN CIRCUMSTANCE MAY BE ADJUDGED IN CONTEMPT OF COURT, AND MAY BE
FINED OR IMPRISONED
PENNSYLVANIA LAW PROVIDES TItAT ALL SUPPORT ORDERS SHALL BE REVIEWED AT
LEAST ONCE EVERY TItREE (3) YEARS IF SUCII A REVIEW IS REQUESTED BY ONE OF nlE
PARTIES, IF YOU WISH TO REQUEST A REVIEW AND ADJUSTMENT OF YOUR ORDER,
YOU MUST DO THE FOLLOWING: AN UNREPRESENTED PERSON WHO WANTS TO
MODIFY (ADJUST) A SUPPORT ORDER SHOULD FILE A PETITION FOR MODIFICATION,
FORMS ARE AVAILABLE AT THE DOMESTIC RELATIONS OFFICE,
A MANDATORY INCOME ATIACHMENTWILL ISSUE UNLESS THE DEFENDANT IS NOT IN
ARREARS IN PAYMENT IN AN AMOUNT EQUAL TO OR GREATER THAN ONE MONTH'S
SUPPORT OBLIGATION AND (I) THE COURT FINDS mAT THERE IS GOOD CAUSE NOT TO
REQUIRE IMMEDIATE INCOME WITHHOLDING; OR (2) A WRITIEN AGREEMENT IS
REACHED BElWEEN THE PARTIES WHICH PROVIDES FOR AN ALTERNATE
ARRANGEMENT,
DELINQUENT ARREARAGE BALANCES MAYBE REPORTED TO CREDIT AGENCIES, ON
AND AFI'ER THE DATE IT IS DUE, EACH UNPAID SUPPORT PAYMENT SHALL CONSTITlITE
A JUDGMENT AGAINST YOU,
IT IS FURTHER ORDERED that, upon defendant's failure to comply with this order, defendant
may be arrested and brought before the Court for a Contempt hearing; defendant's wages, salary,
commissions, and/or income may be attached in accordance with the law, this Order will be increased
without further hearing to S nfa a month until all arrearages arc paid in full. Defendant is
responsible for court costs and fees as determined by the Domestic Relations Section..
This order shall become final ten days after the mailing of the notice of the entry of the order to the
panies unless either party files a wrinen demand with the Domestic Relations Section for a hearing de novo
before the Court,
Copies delivered to panies on
Consented:
ElAINE A. KAUFFMAN HI flF.R'1' X (;TT ,ROY
Plaintiff Plaintifl's Attorney
RICHARD A. KAUFFMAN
Defendant
J.
DR:): F. Goshorn
bjh
ORO//SIS
-;.!!J
.'
.-----.
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RICHARD A. KAUFFMAN,
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
:CUMBERLAND COUN'l'Y, PENNSYLVANIA
:
:NO. 3959 - CIVIL - 1995
:
:
:CIVIL AC'l'ION - CUS'l'ODY
CUS'l'ODf S'l'IPULATION
'l'he parti.a to the above captioned action hereby stipulate and
v
ELAINE A. KAUFFMAN,
Def.ndant
agr.e a. follows:
1. Th. parti.. ar. Husband and 'fife having been marri.d on
Augu.t 2, 1980.
2. Th. parties are the natural parents of Erin E. Kauffman, born
August 2, 1983.
3. 'l'h. parti." agree that they "hall enjoy .hared l.gal cu"tody
of their minor child.
4. Th. partie" agr.e that the Father, Richard A. Kauffman,
.hall have primary physical custody of Erin.
5. The parties agree that the Mother, Elaine A. Kauffman, shall
enjoy liberlll periods of temporary physical custody with Erin
at such times as agreed upon by the parties.
6. The parties agree that this Stipulation may be incorporated
as a Court Order.
1I'1tne"s
~~
Richard A. Kauffman
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,OR YOU AND ANY ELIQIBLI DI~INDINTCI)
. ILUI C"OIl' ~AY' ' MAtlORM!DICAL
100"*',01' IIMUI'UVATI. RDOM AND ICAItD AND AI'TIIt A YURLY DEDUCTIBLE (315\1
COVIRID HOI'llAL EXPINIII, UP 'IR PBRION, 11SO FAMILY MAKIMw
TO 1'0 DAYI, ' 801. D, THI 'I"IT 11,000 1M EXCESS
0' IMIItGINCY OUT~ATIINT I.PENIEI~ IC/BI COVIRAQE, AND THEN
II' TRUTMENT IlliINI iUTHIN 71 1001t 01' AI.I.' DTHlR COVERED EXPEllSfl,
HOURI DI' AN ACCIDENT OR ONIET OF 11,00D,000 MAX I.I'ETIME BEN!I'IT PER PERIL'
A IUDDIN AND IUIOUI ILI.NUS, D.ntalP'otram
',)VEHAli! 901 I' IN A NON.MEMIIRHOI~nAL, 1001 of uaual,customaryand reasonablo,:ha,o". lor dO',
BLUE IHULD ~An services,
OF UIU'1. CUSTOM'R" 'NO RE'.ON'BLE ICo.."d..rvlmlnclud'Ofll,..mlnot,on', x,.,.,..""""",,,
" " III! , 11II III! gill, Ippllc.lIon, prophyl..II. ,.plll, ot bro).,." 11";11111"1, l1I'IlIHl'd,'...,
'EEI 'OR PHYIIC IANI' IIRV ICEI. tilling', "mpl...Ir'Ctionl,.ndodonll,..n,' 'I"""""""""'" ,
8ENI' IT IDOKL!T 'OR MENTAL/NIRVOUI 11,000 maximum benefit per person lor nil <lonllll "or vi, ,,"
, CRUra ADD ICTlON AND ALCOHOL, 11M COV!RAGE, provided In any calendar year,
. SICkNESS AND DISABILITY BENEFITS SURVIVORS' BENEFITS
8hort T.rm Lump.8um
If you b.come sick or temporarily disabled and a,e In Ibe even' of your dealh, your bIllIl'III:lalln. w'"
unehl. 10 work, you may be ellglbla to racelve: receive:
PAY 'DR UP TO 1 OAYI 'ROM 0 BaalcLllelnsurance,
THE liCK L!AVE PROIlRAMa 0 Supplemental Lila Insurance,
S Social Security daolh benefit lor your I'IIIl,hlo "nv'
U5~
tong rarm
If your dllablllly conllnuea beyond Iho short term
period. you may be eligible lor:
WEEKLY ,ROM THE WEEKLY DIIABILITY
INCOMI PLAN '0" UP TO '6 WEEKS.
P.rman.nt Dlaablllty
" you become 10tRlly and permnnently dls.blod fnr ony
occupation, you may be nllglhle for:
MONTHLY I'ROM 10CIAL SECURITY
FOR YOU.
MONTHLY 'ROM SOCIAL SECURITY
!'OR YOUR DEPENDENTS,
IIluII Cron end Blue Shlnld covnrRgR lor you Rnd your
,'IIU'hlq dependonts o.onlll1lll'5 ot no cost 10 yo" Yo"
lllilY continue your Malor Medlcol coveragq If ym' pay
lhe roll rate remlum,
'57'5
,ass
IU,OOO
121,000
'SO,OOO
NOT ELECnO
NOT ELICTED
illS 0
Tolal lump-aum paymeot,
Addltlona' Accld.nla' O..th Benefll.
Basic Accldenlal Death eod DI.mlllnh"IIl""tlw'"
SupplementRI AccldentRI Death ourl DIS"'''IllI1.,,,,,
Inluraoce.
Travel Accldeotlo,urnnce. If .II'RI" ""f."", whll,' \,
'ravallng on CompanY-Ruthorlzed h""lnp,"
Dapendant Lit. Inlurance
for your 'POUOR,
lor each child
Eltlmatad Mon'hly Banaflla
from Social Securlly for your cj''''rwllflnlll falllllv
YOU HAVE WAIVED COVE~AGE FOR
YOUR SURVIVING SPOUSE FROM THI
lfi) l't'nns~'I\'Ilnill
V IIhl('silic'lcI
('BIllI" 11i11.I)t'"I\)hani;11111HI'
.~ ....~_l....,.......... ftIu.r..." ,,,1,,,,..11,,",,,,1 Au....."'...
December 6, 1995
Elaine Ann Kauffman
305 North Ridge
Halleltsville, TX 77924
Dear Ms, Kauffman:
Enclosed is a Deferred Vested Benefil Slatemenl which certifies Ihe benefit payable to you as a
Slraighl Life Annuity commencing on your Normal Retirement Dale, Other fonns of benefit may
be available 10 you at the time your benefit commences, Also, payment of a benefit before your
Normal Reliremenl Date may be available, Any optional benefit will be equivalent in value to the
fonn of benefit described above, If you terminated with at least ten years ofcrediled service, you
may receive your benefit on the first of the month following your 62nd birthday without an
actuarial reduction,
Also enclosed is a "fact sheet" which describes the variables used in determining your vested benefil
under the "Plan", In addition, you will find an election fonn on which you may opt to provide your
spouse with a Pre-retirement Dealh nenefit, If you were married a year or more, this should
provide your spouse with 50% of your retiremenl benefit amount al the time you would have
reached age 55, should you die prior to that age,
While you were actively employed, Pennsylvania Blue Shield subsidized the cost of the Pre-
retirement Death Benefit guaranteed by the Relirement Equity Act of 1984. The "Act" assumes
that you are married unless you indicale otherwise on Ihe enclosed Pre-retirement Dealh Benefit
Eleclion form, Now Ihat you are no longer actively employed by Pennsylvania Blue Shield or an
affiliated company, you must decide whether to accepl or reject the Pre-retirement Death Benefit.
If you accept the Pre-retirement Death Benefit. your future benefit will be reduced according to the
following table:
Belween ages 35 and 44 - , I % per year
Between ages 45 and 54 - ,2% per year
Between ages 55 and S9 - ,S% per year
Between ages 60 and 65 - ,7% per year
If you are single, you should waive the Pre-retiremenl Dealh Benefit by circling number I beside "I
swear thai I have no living spouse" found on the eleclion form, Then have your signllure notarized
where indicated, If you are married and you wanllo waive Ihe Pre-relirement Death Benefit, circle
the number 2, Your spouse must consent with his or her signature witnessed by I NOlary Public
Ilong with your signature
i
i-'
I
Pre. retirement Dealh Benellt Election
Please print the following:
Name of Former Employee
Address
Social Security Number
Name of Spouse
Social Security Number
Circle one ofthe following:
1. I swear that I have no living spouse,
2. With my spouse's signature of consent appearing below, I reject the Pre-
retirement Death Benefit for my spouse,
3. I accept the Pre-retirement Death Benelil for my spouse,
4. I swear that I do not know the whereabouts of my spouse.
CONSENTING SPOUSE'S SIGNATURE
(Sign only if you are waiving the
Pre-retirement Death Benellt)
DATE
FORMER EMPLOYEE'S SIGNATURE
DATE
SIGNATURE OF WITNESSING NOTARY PUBLIC
DATE
RUN DATE: 08/01/95
PENSION CALCULATION FOR: KAUFFNAN,ELAINE ANN 00265 PBS
NORNAL RETIRENENT NONTH: 9 2012
RETIRENENT SERVICE DATE: 7 14 69
TERNINATION DATE: 5 17 95
ACCRUED SERVICE: 24,01
TOTAL SERYICE: 41,505005422
BIRTI! DATE: 8 5 47
NAR !TAL STATUS: N
NNTHLV QUALIFIED BENEFIT: 1706.18
OUALIFIED FINAL AVE SAL: 128,225,48
COVERED CONP LEVEL: 152,680
ANNUAL QUALIFIED BENEFIT: 18,474.18
LUNP SUN ANOUNT:
LUNP SUN FACTOR:
.
,/
~S
la..
JAMEs A, EVANS
AlTORNEy ATLAW
p,O, BOX 'OJ
HALLElTSVlLLE TX 77964
CLmNT:
Elaine Klu/linan
30' North RldSC
fWletllville TX 77964
REGARDING:
DIYllrce
DESCRIPTION
AUomey fee for COnferences w/Ih Elaine Klufmar on 0810919' cl 0811019',
lelephone COnference w/Ih Tracy Krull on 0811019' and correspondence w/Ih her
on 0811119', and review of maler/a!
.............
I ~P- Ss
~/I (\0
:p 15 -
Atnounl Paid 0,00
InYOIce No. 1214
invoice Dare 0811119'
TAXABLE
AMOUNT
7',00
SubtOlal
7',00
TOTAL 575.00
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GRIFFIE & ASSOCIATES
200 North Hanover Street
carlisle, PA 17013
Invoice submitted to:
ELAINE A. KAUFFMAN
P.O. BOX 1264
MECHANICS BURG PA 17055
uctober :J, 1995
Hours Amount
09/01/95 Telecon with Client 0.10 3.00
09/07/95 Correspondence to client; 0.20 30.00
Correspondence to Attorney Gilroy
09/27/95 Telecon with Client. 0.10 3.00
09/28/95 Receipt and Review of custody 0.10 l5.00
order; correspondence and documents
to client
09/29/95 Receipt and Review of 0.20 30.00
correspondence from Attorney
Gilroy; correspondence to client
For professional services rendered
0.70
$81. 00
($81.00)
lO/03/95 Payment from account
Balance due
$0.00
~=============
THIS STATEMENT REFLECTS ALL SERVICES RENDERED AND PAYMENTS RECEIVED
AS OF SEPTEMBER 30, 1995
f.#.
It '~\
Page 2
ELAINE A. l<AUFFMAN
Amount
previous balance of client funds
10/03/95 payment from account
$335.00
($81.00)
New balance of client funds
$254.00
. ,
.
GRIFFIE & ASSOCIATES
200 North Hanover street
carlisle, PA 17013
Invoice submitted to:
ELAINE A. KAUFFMAN
305 NORTH RIDGE
HALLETTSVILLE TX 77964
september 6, 1995
Hours
Amount
08/01/95 Telecon with Client
08/03/95 Telecon with Client
Preparation of praecipe to Withdraw
Preparation of Praecipe;
correspondence to Attorney Schwartz
08/08/95 Receipt and Review of
correspondence and documents from
Attorney Gilroy; correspondence and
documents to client
NO CHARGE
O.lO
NO CHARGE
3.00
0.20
30.00
0.30
45.00
08/10/95 Telecon with Attorney in Texas
08/1l/95 Receipt and Review of
correspondence from Attorney Evans
0.20
6.00
NO CHARGE
08/l4/95 Telecon with Client
Receipt and Review of fax and
complaint from ATtorney Evans
08/l5/95 Telecon with WEaver at Detweiler
Real Estate
0.10
0.10
3.00
15.00
NO CHARGE
08/16/95 Telecon with Client
NO CHARGE
08/17/95 Telecon with Attorney schwartz's
office
NO CHARGE
,/
~l:7
GRIFFIE & ASSOCIATES
200 North Hanover Street
Carlisle, PA 17013
Invoice submitted to:
ELAINE A. KAUFFMAN
308 WERTZ AVENUE
MECHANICS BURG PA 17055
June 5, 1995
Hours Amount
05/01/95 Telecon with Client NO CHARGE
Telecon with Client, correspondence 0.30 45.00
to Attorney Gilroy
05/08/95 Telecon with Client ~ 0.50 75.00
Preparation of revisions on custody 0.30 45.00
aqreement, correspondence and
documents to Attorney Gieg
05/12/95 Correspondence to client and to 0.20 30.00
Attorney Gilroy
05/l6/95 Telecon with Client NO CHARGE
Receipt and R~vi~w of 0.10 15.00
correspondence from Attorney
GilroYI Correspondence to Attorney
Gilroy
OS/24/95 Receipt and Review of 0.30 45.00
correspondence from Attorney
GilroYI Correspondence to client
and to Domestic Relations Office
(Goshorn)
OS/25/95 Office conference 0.80 120.00
......
Correspondence to Attorney Gilroy 0.10 15.00 r
~\
GRIFFIE , ASSOCIATES
200 North Hanover street
Carlisle, PA l7013
Invoice submitted tOI
ELAINE A. KAUFFMAN
308 WERTZ AVENUE
MECHANICS BURG PA 17055
, ..(
May 4, 1995
Hour.
Amount
04/l0/95 Telecon with Richard
Receipt and Review of
correspondence from Attorney
Gilroy; Review file; correspondence
to client
04/17/95 Receipt and Review of
correspondence and documents from
client
04/24/95 Office conference; Correspondence
to Attorney Gilroy
04/25/95 Preparation of support documents;
correspondence to Domestic
Relations Office (Goshorn);
Preparation of custody agreement;
correspondence to client and to
Attorney Gilroy
Telecon with Client
NO CHARGE
0.20
30.00
0.30
45.00
1.40
210.00
1.30
195.00
NO CHARGE
Telecon with Client
Telecon with Gilroy's office
04/26/95 Receipt and Review of
correspondence from Attorney Gilroy
NO CHARGE
NO CHARGE
0.10
15.00
For professional services rendered
$495.00
(.~ "P
?
3.30
ELAINE A. KAUFFMAN Page 2
Amount
Additional chargesl
04/24/95 Costs advanced for fax to Hubert Gilroy 3.00
04/25/95 coats advanced for fax to Hubert Gilroy 3.00
costs advanced for fax to Frank Goshorn 3.00
$9.00
Total costs
Total amount of this bill
$504.00
$50.00
($50.00)
($150.00)
previous balance
04/24/95 payment from account
05/04/95 payment from account
,.
($200.00)
Total payments
$354.00
Balance due
=========-====
THIS STATEMENT REFLECTS ALL SERVICES RENDERED AND PAYMENTS RECEIVED
AS OF APRIL 30, 1995
__._.______~.==aa====.=a==.=======a==__=_=_=a____=.___=.-_.~=
previous balance of client funds
04/24/95 Deposit to account
04/24/95 payment from account
05/04/95 payment from account
$0.00
$200.00
($50.00)
($150.00)
New balance of client funds
$0.00
&f.f
GRIFFIE , ASSOCIATES
200 North Hanover street
carlisle, PA 17013
Invoice submitted tOI
ELAINE A. KAUFFMAN
308 WERTZ AVENUE
MECHANICSBURG PA l7055
April 5, 1995
Hour. Daunt
03/08/95 Telecon with Client NO CHARGE
03/16/95 ottice conterence 1.00 150.00
03/20/95 Correspondence to Client, 0.20 30.00
Correspondence to Attorney Gilroy,
Receipt and Rsview of
corre.pondence tram Attorney Gilroy
03/21/95 Telecon with Attorney Gilroy'S NO CHARGE
otfice
03/22/95 Corre.pondence to client 0.10 15.00
03/24/95 Receipt and Review of Notice, NO CHARGE
Correspondence and Notice to client
For prOfessional services rendered
04/05/95 Payment trom account
1.30
$195.00
($145.00)
Balance due
$50.00
...............-
THIS STATEMENT REFLECTS ALL SERVICES RENDERED AND PAYMENTS RECEIVlD
AS OF MARCH 3l, 1995
"
....~.
c,
GRIFFIE , ASSOCIATES
200 North Hanover Street
carlillle, PA 17013
Invoice .ubmitted to:
ELAINE A. KAUFFMAN
308 WERTZ AVENUE
MECHANICSBURG PA 17055
March 3, 1995
Hourll Amount
02/15/95 Initial Office Conference with 1.30 40.00
cUent
Fee letter NO CHARGE
correllpondence to Attorney Ellpollito 0.10 15.00
02/20/95 Talecon with Client, Preparation of 1.50 225.00
CUlltody complaint, Preparation of
Praecipe, Corre.pondence to
Attorney Gilroy
02/23/95 Receipt and Review of 0.30 45.00
correllpondence and documentll frail
Attorney E.pollito
02/28/95 Receipt anu Review of 0.20 30.00
corre.pondence froll Attorney
Gilroy, correllpondence to client
Filinq of praecipe 0.20 30.00
For profe.llional lIervices rendered
3.150
$385.00
($31).00)
($355.00)
02/17/95 Payment - thank you
03/03/95 Payment froll account
Total payments
($385.00)
.('1
?
FAMILY HEALTHCARE CENTER
RI. 5, BOK 242
Hallellsvllle, Texas 77964
(512) 798.3284
Novenber 6, 1996
To Whan Il Nay Concern:
Rei Elaine A. Kauffman
Date of birth: 8-5-47
SS #465-74-7090
Elaine Kauffman has been a patient since 7-01-96 and has
been continuously' unable to work due to physical and
psychiatric problems.
i~;~7~
Karlsn Downing, N.D.
KDlja
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RICHARD A KAUFFMAN
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EMPLOYER TRUE TEI'lPER "AROWA:
GROUP NUMBER 50" 1\1- 5 0 411
SOCIAL SECURITY NO: 1 n-4 6- 4 7 5 ~\
dENEFIT' PAID TOI RICHARD A KAUFFMAN
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~E~EFITS ~AID TO: MICHARD A KAUffMAN
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LAVACA FAMILY HEALTH CUNIC
" 1400 N. TEXAII^
" tlAUf:11SVlLLE, TX 77ee4
PAtIENt FINANCIAL 1I1110RY 8Y 01 SERVICE PI;e
LAVACA FAMILY ilEAL III CLINIC
Accounts 1901 - 7901 Oltes 01/01/91 . 08/02/91
Acct OIL.
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07/01/9\ ChIck p.rmt 07019\ PIU"l -15,00
01106/9\ 0 kAUFFMAN,ElAINE 9 BI023 AUTOMAIEO IIEMOGRA" 3lI 1.00 18.00
07/06/9\ 0 KAUmAN,ELAI"E 9 BOOt9 CIIE"lsIRY PROFILE (IMACl 311 1.00 30,00
07/06/9\ 0 KAUFF"AN,ElAINE 9 BOOI1 IIIRYOIO PANEl III 1.00 10,00
0110619\ 0 kAUFF"AN ,ELAINE 9 BIOOO URINAlYslI YIIII "ICROICOPY 311 1.00 \2 .00
07/12/9\ 0 KAUmA",ELAINE 9 9m2 omCE VIlli, Ell. PI. LEVEL 2 40\.9 1.00 33.00
07/1219\ Ch.ck hrmt 7/6.\2 p.Uent -t2l,00
0112\/9\ 0 KAUmAN,ElAINE 9 99212 OFFICE Villi, Elt. PI. LEVEL 2 40\.9 1.00 13.00
071l1/9\ 0 KAUFF"AN,ELAINE 9 BlOOO URINALYIIS YIIII "ICROICOPY 40\.9 1.00 \2 ,00
0712\/91 0 KAUFF"AN,ELAINE 9 B\023 AUtOMAtED IIEMOGRA" 401. 9 1.00 10,00
07126/9\ Ch.ck Paymt 072m paUent '63,00
08101/9\ 0 KAUFF"AN ,ELAINE 1 99212 OFFICE Vlllt, E\I. PI. LEVEL 2 401.9 1.00 33.00
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tOlALS FOR ACCOU"I 7901 PAY"ENI\ : 231.00 AOJUs IS 0.00 CIIARGEs : 264.00 10,00 )),00
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LAVACA FAMILY HEALTH CLINIC
11\06 N TEXANI'I
HALLETTSVILLE TX 77961\
(512) 798-4313
DR. BARBARA N. CONNER. F.I'I.A.F.P
DR. HI'IRVEY RENGER JR.. D.A.A.F.P
LILLIAN S. STONEKING, PI'I-C
LAWERENCE PALMER. PA
MEDICARE "
MEDICAID II
BC/BS II
TAX 1.0. "
67399/\
R0673"94 t
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74-6240031
ELAINE KAUFFMAN
305 N. RIDGE
7907
07/2h/95
Page No. 1
HALLETTSVILLE TX 77964
DATE
----------------------------------------------------------------------------
DR
PATIENT DESCRIPTION
Ml0l.ltfl
07/25/95 H R ELAINE 99212 OFFICE VISIT. EST. PT. LEVEL 2
1\01.9 UNSPECIFIED ESSENTIAL HYPER TEN :33.00
07/25/95 H R ELAINE 81000 URltll'lLYSIS WITH MICROSCOPY
1\01.9 UNSPECIFIED ESSENTIAL. HYPER TEN 12.00
07/25/95 H R ELAINE 85023 AUTOMATED HEMOGRI'IM
401.9 UNSPECIFIED ESSENTIAL HYPER TEN 18.00
07/26/95 H R ELAINE Payment ... . Thank You
-6:1.00
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PATIENT NAME: KAUFMAN
PATIENT NUMBER: 4133
CALL NUHBER:6HI097
CURRENT DATE: 12/31/96
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