gee FL150 “RTORREY GR PARTY WIGUT ATTORNEY (ae, Sl Ba i Sn BABE FOR COURT USED | MICHAEL A. GOSS Michael A. Goss, Esq. cA Bar #84109 GOSS & GOSS-A Professional Law Corporation Ti1$ Twelfth Street Modesto, CA 95354 ‘rasmoneno: (208) 576-1871 UAL ADDRES (Ope: ATromEYFOR Nanay GREGORY BOWERMAN SUPERIOR COURT OF CALIFORNIA, COUNTY OF STANISLAUS emnceraooress: 800 Eleventh Street manovooress 1100 "I" Street crvmozrcoce Modesto, CA 95354 PETITONERPLAINTIFF, GREGORY BOWERMAN IRESPONDENTIDEFENDANT: KAREN BOWERMAN | orien PARENTIGLAIMANT. i Coan li INCOME AND EXPENSE DECLARATION 455 922 i} +, Employment (Give information on your current job or, i you're unemployed, your most recent ob.) ‘a. Employer: California Emergency Physicians “Rich copies] b- Employer's address: 2100 Powell St., #920,Bmeryville, CA 94608 ofyourpay | 6. Employers phone number: (888) 267-3880 stubs forlast | 4. Occupation: physician Tecan | & Datejob startet: 9/1/89 cal f. lfunemployed, date job ended: n/a | security 9. Iwork about 50 hours per week. numbers) h. Igetpaid$ 35,661 gross (before texes) [3] per month [—] perweek [_] per hour. (ifyou have more than one job, attach an 8Y-by-11-inch sheet of paper and list the same information as above for your other jobs. Write “Question 1—Other Jobs" atthe top) 2. Age and education a. Myageis (specify: 58 ®. [have completed high school or the equivalent: (2) Yes [—] No tfno, highest grade completed (specify): c. Number of years of colege completed (specif): 3 Tcl Degree(s) obtained (speciy!: BS 4. Number of years of graduate school completed (Speci: 4 Li] Degree(s) obtained (spec): MD ©. Ihave: [30] professionalioceupatonalcense(s) (spect): physician 5) vocational training (spect 3. Taxinformation a. [5] last fed taxes for tax year (speci year: 2009 . Mytoxfing status is [J single] head ot household (—) manted, ing separately GE marred, fling jointy with (specify name): Karen Bowerman . [fle state tax returns in [i] California (—) other (specify tate): {| claim the following number of exemptions (Including myself) on my taxes (specify): 5 4, Other party's income. | estimate the gross monthly income (before taxes) ofthe other party inthis case at (specify): $ unknown This estimate is based on (explain): however, Respondent should be ordered to submit to a vocational examination/assessment {ifyou need more space to answer any questions on this form, attach an 8%-by-11-inch sheet of paper and write the ‘question number before your answer.) Number of pages attached: | declare under penalty of perjury under the laws of the State of Califomia thatthe information contained on all pages of this form enc any attachments is true and correct. Date: November Jj , 2011 GREGORY BOWERMAN 2 aT ae 2 INCOME AND EXPENSE DECLARATION maggie eee so SSFL PETITIONERIPLAINTIFF: GREGORY BOWERMAN CASE BER RESPONDENTIDEFENDANT: KAREN BOWERMAN 455 922 (OTHER PARENTICLAIMANT: ‘Attach copies of your pay stubs for the last two months and proof of any other income. Take a copy of your latest federal tax return to the court hearing. (Black out your social security number on the pay stub and tax return.) x1 5. income (For average monthly, edd up all he income you received in each category in the lest 12 months 12/21 Average ‘and divide the total by 12,) Last month monthly ‘a. Salary or wages (gross, before taxes) 7 5 -+$.35,661 37,149 b. Overtime (gross, before taxes) cece deson eg o 0 ©. Commissions or bonuses . oe oO 0 di. Pub assstance (or example: TANF, Sl, GAIGR) J currently recehing ceed, 9 0 fe. Spousal support (_] from this marriage [_] from a different mariage. 8 0 0 {. Partner support [__] from this domestic partnership [from a different domestic partnership $_ 0. 9. Pension/retirement fund payments... oe oo 8 0 o h. Social security retirement (aot SSI) . woe $0 |. Disability: [—] Soctal security (not SSI) [—] State cisabilty (SD) [J Priateinsuranee «8 oO o |. Unemployment compensation . . : 8 0 0 k. Workers! compensation . 8 9 Q 1 Ofer (itary BA, ryaty payment, etc.) (spect) ad 9 0 6. Investment income (Attach @ schedule showing gross receipts less cash expenses for each piece of property.) a. Dividends/interest : Fi so 9 b. Rental property income. . — a0 8 0 o ©. Trustincome oe aac a oe aeeaiO® 9 d. Other (specify)... : 5 . E 8 0 o 7. Income from self-employment, after business expenses for all businesses... 8 9 0 lamthe [] ownerisole proprietor (_] business partner [__] other (specify): Number of years in this business (specify): Name of business (specify) Type of business (specty) ‘Attach a profit and loss statement for the last two years or a Schedule C from your last federal tax return. Black out your ‘social security number. If you have more than one business, provide the information above for each of your businesses. 8. (7) Additional amount): \come. | received one-time money (lottery winnings, inheritance, etc.) in the last 12 months (specify source and 9. [1] Change in income. My financial situation has changed significantly over the last 12 months because (specify): 10. Deductions Last month ‘a. Required union dues 5 5 s 0 D._ Requied etrement payments (ot soil secu. FIGA, 4010), oF RA). an o ©. Medical, hospital, dental, and other health insurance premiums (total monthly amount). Child support that | pay for children from other relationships fe. Spousal support that | pay by court order from a different mariage {. Partner support that | pay by court order from a different domestic partnership, 1g. Necessary job-related expenses not reimbursed by my employer (attach explanation labofed "Question 10g"). . .$ 0 11, Assets, Total ‘a. Cash and checking accounts, savings, credit union, money market, and other deposit accounts . cee $_4,000_ b. Stocks, bonds, and other assets | could easily sell RLY, contents, of, storage wnAits.......... § unknown cc. Allother property, [20] real and [32] personal (estimate fair market value minus the debts you owe) $1,000,000 Per PpD served herewith, approx, $2.0 million in assets (including retirement] and ‘FLeomerJauays,2097 $1.0 million deb§XCOME AND EXPENSE DECLARATION PaperPETITIONERIPLAINTIFF: GREGORY BOWERMAN CSE RESPONDENTIDEFENDANT: KAREN BOWERMAN 455 922 (OTHER PARENTICLAIMANT: 12. The following people live with me: How the person is | That persor’s gross | Pays some of the Name Age __| related to me? (x: son)| monthly income household expenses? a. William 17 [son 0 | Cives Gln », Olivia 13. | daughter o | Dives | « Elizabeth @ | daughter 0 | Sl¥es GzJ No 4 0 | Clves Lino °. 0 | Clyes LIN 13. Average monthly expenses Lk) Estimated expenses [_) Actual expenses [_] Proposed needs a. Home:net 33707; andef13907 S0d-838 Laundry and clean s 30. 7 rd cleaning () CofRentor Cac] mongage.....,,$___B.us5*_ Ny 5 an Wmorgage:*Currently not paying bepiteeeerre arn 00 (@) average principal: §. 0 j. Education... covers S200 lessons, lunches {) average interest; $__O k. Entertainment, gifts, and vacation $_____s00_ (2) Real property taxes... $___488 |, Auto expenses and transportation (3) Homeowner's or renter's insurance (insurance, gas, repairs, bus, etc.) ..... $___550__ (ifnot included above) .........,..., $826 umbrella minsurance (if, accident, ete do not o,home, inourance) 4 (4) Maintenance and repair $ include auto, home, or health insur ) S. 17 ee 0 b. Health-care costs not Sedogs and mene! i. paid by insurance : s 400 o.Chantable contributions. .....s-s.s.+ 8 2 rane — .Monthly payments listed in tom 14 on 2 $1000" temize below in 14 and inser total here) $_11, 923 4. Groceries and houschold supplies ....... $1200. 4 ower (opeciny: aol. yards......$ 310 . Eating out -. os 400_ personal grooming f. Utilities (gas, electric, water, trash) Pers. | 990 fr TOTAL EXEEN 38 (=<) (de not eel the amounts in a(7)(@) and () s 232 4. Telephone, cl phone, and em s 380 s.Amount of expenses paid by others § 14, Installment payments and debts not listed above Paid to For “Amount Balance Date of fast payment s 0. 9 s ols 0 $ ols 0 s ots 0 $ ots 9 s ols 0 45. Attomey fees (This is required If ether party is requesting atfomey fees): 0 €. To date, | have paid my attorney this amount for fees and costs (specify): $ 5, 000 b. The source ofthis money was (specify): earnings . [still owe the following foes and costs to my attomey (specily fotal owed): $ 4, 687 d, My attomey's hourly rate is (specify): $ 345 | conf ts fe arengement Date: NovemberZ|, 2011 MICHAEL A. Goss » ——— Deus SE eae See Fe dom 207) INCOME AND EXPENSE DECLARATION PronaoraFL-150 PETITIONERPLAINTIFE: GREGORY BOWERMAN SENN RESPONDENTIDEFENDANT: KAREN BOWERMAN 455 922 (OTHER PARENTIOLAIMANT: CHILD SUPPORT INFORMATION (NOTE: Fill out this page only if your case involves child support.) 18. Number of children fa. Ihave (specify number): 3. children under the age of 18 withthe other parent in this case. . The children spend 80 percent oftheir ime with me and 20. percent oftheir time with the other parent. (if you'te not sure about percentage or it has not been agreed on, please describe your parenting schedule here.) 17. Children’s health-care expenses do [—] Idonot have health insurance available to me forthe children through my job. . Name of insurance company: Anthem Blue Cross ‘e, Address of insurance company: 4d, The monthly cost forthe children's health insurance is or would be (specify): $ 0 (Do not include the amount your employer pays.) 18, Additional expenses for the children in this case Amount per month ‘8, Child care so I can work or get job training ...... fe 0. '. Children's health care not covered by insurance sree, 0 due to increase . Travel expenses for visitation +1, 8708 to 9550: in 2012 Children's educational or other special needs (seaty below): s__o. 49, Special hardships. | ask the court to consider the following special financial circumstances {attach documentation of any item listed here, including court orders): ‘Amount per month For how many months? ‘a, Extraordinary health expenses not included in 18 8. 0 D. Major losses not covered by insurance (examples: fe, he, other ingured loss) 6. (1) Expenses for my minor ciren who are fom other tlt and are living with me. s—_0_ (@) Names and ages of those citren (speci () Child suppot | receive for those children Berrie ‘The expenses listed in 8, b, and c create an extreme financial hardship because (explain): 20. Other information | want the court to know concerning support in my ease (specif): FN et ee a INCOME AND EXPENSE DECLARATIONATTACHMENT TO INCOME & EXPENSE DECLARATION (Page 3 - Continued) PAYMENT MONTHLY DATE LAST. CREDITOR NAME FOR PAYMENT BALANCE PAYMENT MADE 2009 IRS debt | taxes 2,000 58, 805 2010 IRS debt | taxes 2,000 106, 289 2010 PTB debt | taxes 1,000 16,925 2011 quarterly |taxes - presumably | comparable |to 2010 tax rake Charge am. [credit cards 2,953 27,067 |current Bloxham mortgages [1st & 2nd 15 143,000 |current Psychologist counseling 200 ongoing |ourrent children's counseling 100 ongoing |current State Farm umbrella; insurances 647 ongoing |current which includes $130 | for Karen's vehicle Bloxham taxes, utilities, etc. 500 ongoing current Profit sharing [loan unknown, 45,000 Storage unit rental 1,808 ongoing current Toial: 11,923 ___397, 086Earnings Statement Page 1 of 1 SEMA 2100 Powell Street, Suite 900, Emeryville, California 94608 sevoaaae eg eel ee overran, Gregory Paul 0: 05 Yer tums! Exempt Tax Adjustments Fert Marin ° fed: 0.00 ‘ate Maries ° owe: 680 SS Goren] YO] VS] To) Standard tx eeductlons te | eycote | rat |soure|Unte| esrming|Houre| Unto Earnings 1 a) VEMFOSPOF LOS SANOS re tee Oe sacoon RoR man ted MEM HOSP OF = Lospanos MEETING 200.00 FEDMC ‘MTAT 052.49 EM Hose oF a soso rwas0o FeDss ware 190087 MEMHOSPOF pecuan 10500 05.09 snats00 FESS, i ew Hose OF a Tors ase x00 MEMHOSEOF srpeno zea 2400 240000 TOTALS se Sbas0 ew weD orR Aer dd Som MGHT OFF 12500 1200 —«2g0ks0 44g0 seo ; 1 Sodtsro ese caret] 8) Mew MED ovR co 7 sonny BRU Taos Baa? Sohn REGULAR T0000 12700 1970000 289007590000 pve : ile oree ae eeeas NEWNEDCTR gue cove : 7 Sou 70. 19000 MODESTO OFF deductions: Sons aoe ame aera [tose | coon] vO SEAL wie ars vsacer geo 480750 weDeUN iaioe 71092 ‘sion mae 2872 Special norman: Taxable Les: Loss a EQNet “Bay Dist puto: ose] Wages | fa | bet | gettin, | SRS | Ceetnes Lescol amen] Canene Tea —_aaTaTO HOw BHT Tae TETPAY ae ‘ro: 72700 44900417 330090. G27 18 00 aarti htip://md.sema-er.com/portal/comp/Y TDsttAllEnt.asp?mpid=1147&flg-MD&grp=SEMA..._ 8/26/2011Eamings Statement Page 1 of 1 SEMA [heck nam | Gheck Date | Poi Ena | oe ee 2100 Powell Street, Suite 900, Emeryville, California 94608 —_ _— met ener Reape Pe 1D: 495 ‘Tax Status Exempt ‘Tax Adjustments Fowl ried ° res 020 ute Naved 5 oie: 820 Seren] —YTO] To] Tra) Stand tae deacon: ste [Hours|untts| aminge| Hours] Units] Eamings eee! Curent v9 NENTORPOF Ber asec OS se Br Me Hosp oF " LOS BANOS ae 200.00 FED-MC 18.02 670.51 Wie HosP oF . usm FOSS foie 19028 MEMHOSEOF pequan coco naeson DSS. Ei Wen Hosp oF a MEUNOED OF sre xm 2atngo. TOTALS Tae a8 wentneD ork 1x doduons osu Nos OFF uo se200 an ) Siebtsro Deve curen) v0 wen ED rR KN “aaa Tate 5th REQUUR 2000 z50000 : fieBesro aovewr oma tro soi oma NEWEDCTA gue cove eeu 11000 ore rom dest ovesro TOTALS 48,727.00 Dose, | Curent Yr0) DENTAL “ag ata wsacor sas 162500 Neop eno ato vision “raat aad Sect noon: sue Te cana] funtion ross | yale | ie om ‘Acct. Type Penk Aes Num] EFT Amour] ‘Num EFT Amount] TWETPAY Caran THE Ta Team ‘ro: 4872700 uate 3 tTBaB S542 coo sreto%0 http://imd sema-er.com/portal/comp/Y TDsttAIEnt.asp?mpid=1 1478-flg-MD&grp-SEMA. 8/26/2011Earnings Statement Page 1 of | SEMA [heck war [ Chek Date [ Paid Enaing | 2100 Powell Street, Suite 900, Emeryville, California 94608 Vanesa. eaeON = som, ooo Po at awmmm! || Emmet Teta ao ‘ pops) = va] _Sarent] YTD] TO] __y7o] | Standard ax dedyctions - PayCode |Rate|Hours|Units| egenings| Hours|_Units|_Eamings| 1 ‘current Yr | = = con SBE a cum cas LOS BANOS Meera 200.00 FED.MC 670.51 oo = iat WEN HOSEOF geouLAR seoco watson FEDS, a WEEE ero aco aanaeTOTA a ane come) secT™ psc sew a WODESTO i 7 ae oo fenon a YEO pean mam rasmon oa MODESTO casio os COMM - surcovm 750.00 HSACCT 1,025.00 severe 0 aes Neo — = a oe = ieee ee | boas 7 EQNS | [Acct Type | Bank Acct. Num] rons tes | bet | geet | Am ae ‘Wararaoaguizesyrome eaniaa ae http://md.sema-er.com/portal/comp/YTDsttAlIEnt.asp?mpid=1147&flg-MD&grp-SEMA..._ 8/26/2011Earnings Statement Page | of 1 SEMA [Cretan See ae [Pod a 2100 Powell Street, Suite 900, Emeryville, California 94608 — — owen, rey au eas xompt TxA focal rid c ou 008 =" $ oie: 909 ard ene: cw [rocete ale]one] an] | Se] ean z ing] no a GEIRDESOF TOE ERCS eae Se cance Toa ar (MEM HOSP OF aunt ‘LOS BANOS. ae (200.00 FED-MC 67051 ve Hose oF ease aaa 0 " sa MENNCEE OF ReuAR 00 sco FEDS, a hey nose oF oa Meu #059 0 stp neso——zaongo TOTALS eae weueoore arts deduct: Tyce 01009 son000 , ebtsro os a wenyeocr anes Tame sere com, 9.00 ADV 90.00 9besro BONS a ese New yeD TR YEE gure ee ee) eee $S3tsr0 : ween cre owe! | coren] vO LSE neous mao stoma : ieemro FANE wi MEWMEDCTR gurcov MEWMEDETR suecovm reno ROACcT ‘wesc S200 ton oo Toms San we HE ee re ION suas Sed! noraton STs Tee) amt Pe tn vow | | spel EFT anom com) wate | ee | se | gga, | Sout | CaccteTeeaeecttenerramsen] = = Sa om Sm soe TEE ieee rs dorz7a0 | ana4i7e anT000 5asi42 S00 aastase http://md.sema-er.com/portal/comp/Y TDsttAllEnt.asp?’mpid+ 1478flg=-MD&grp=SEMA... 8/26/2011Earnings Statement Page | of 1 SEMA (Grea: [Sak bi Poids 2100 Powell Street, Suite 900, Emeryville, California 94608 _— — Bowerman, Gregor Pl 408 fol Exampt——_TaxAdustmens edna Hare ° fed: 820 Si: Marie ° oie: 820 — — | caren] Yio] To] ya) statin deco = ayCode |Rate|Houre| Units] eamings| Hours| Untts| Earings| Seasil = va] NEROSROF (Ds pANeS tetkiioe” Se 2agnco RDEABL mt Mey Hosr oF LOS BANOS — 200.00 FED-MC 4.22 e473 New Hose oF asso FEDSS 088 227300 LOS BANOS = Laan ‘500 FED.WH 0.00 esieeree oe a ane NEMHOSEOF ripen mea 2aogo TOTALS Bam aoa MeuyeooR er tx dodutons: tht novance 00 Sepesro oe a went eo cre ake Tosa sce sth rari rane : Gebtsro BOWE dead ooo wentweD corr out our OFF 4420589200 rst dade feoesro esa hes veD cre ome! | Curent] YTD bit REGULAR so00 2590000, ey Siodesro SEA a Mew veo cr Bouse gue cove e009 HSACCT 192500 HSBESTO weoren TOTALS TaTTaS ae STEAD MEDAN 114408 vison 2448 Speci ifomation ie ron cooee | arable ] tase | tees | spect | EQN | [acct Type | San Act. un] EFT Amo] Wea Taxes | Dees | piston ¥ a me Garent: Tarra TAIT? 53860 a0 735789 WETPAY ar ‘YTD: 56,604.29 54,119.07 3,719.46 6,551.42 000 44,648.18 ” http://md.sema-er.com/portal/comp/Y TDsttAlEnt.asp?mpid=I 147&flg-MD&erp=SEMA... 8/26/2011Earnings Statement Page 1 of 1 SEI 1 ain6i201 (2011 2100 Powell Street, Suite 900, Emeryville, California 94608 anions nt — Bonerman, Gregor Paul 10: 495 noone! Exempt Tax Adjustments Feder Maced a Fee: 0.00 ‘tte: Maries a ive: 0.99 Tenslaal TD] VIO] YTD) Standard tax deductions: (en __| .Papoeee, | Rete jHouraj nn Houre| Unis] Eaminas) [pese, | ‘caren v9 NENHOSPOF LOS 5ANOS or tGsemos OFF ce ae ao NeMHOsP OF Loseanos MEETING 200.00 FED-MC 6336 1,148.00 ew Hose oF ee : tearsoo FESS 105250 932550 MEMWOSEOF RecuLaR 10500 50000 175.00 . ee Be MEMHOse OF ‘ 5 coco TOTALS Taare bas MEMHOSE.OF gripe 200 200.00 8.00 3.80000 Mey veo CTR ar tax deductions COMM ADVANCE aoe i Current] yro| nosesTo ese = ew weo cre KUN wane aaa oiscre CoM BON 787729 aDveMT 3,000.00 u seta MEM MED CTR Str 7200 ¢8.00 we —_ Cova NGHTDIFF 12800 2400 072.00 704.00 prane deductions: {O8tsr0 Pretax deduct _—— MENMED CTR ag = Dose. ! current] v0] com tooo 160 +4600 srso00 55 ig gov DENTAL am ara MasIo a neacct sas 150780 co symoovr 200.00 sooo MEDPLN mo t7i8s2 modesto sion 12m 872 Er TEaea0O Gout ea TOTALS iam eee Taxable Les Le I ant | = Net Pay Disutbution: | rose | pane | dass | test | specla | SB | [hese pe EFT Amour l z c =n 2206096 Caren: Taam a6 TA TAIT Toe 220603 ETA Boor "7b: 290629 797e40 5.82.18 627.13 1.00 6.90815 http://md.sema-er.com/portal/comp/Y TDsttAlIEat.asp?mpid=1 147&flg-MD&grp-SEMA..._ 8/26/2011Earnings Statement Page 1 of | SEMA [Geka [Sak i | Pad Ean er asa 2100 Powell Street, Suite 900, Emeryville, California 94608 — al Bowerman, Gregory Paul 1D: 495 Tax Status | Exempt ‘Tax Adjustmente rave Hare ° es: 000 Sate Mave ° oe 020 aaron IS] FB] To] Sant i dectons Te [ reveote [rw own] oe] eae] | aE] alta) tsetse a Te wennose oF SoS a ee Sivos 70000 {SzERBS™ 38K cn ooo wennoseor ery rec enzo 38 ‘LOS BANOS = 20000 FEDSS 92775 4,253.25. MeWHOSeOF pecuuan a oe BEWASEOF accu 11500 jrsco FEW Taras Ta aaa wetinose oF siecovm sono aa VERBS SE rt dec MEM HOSP OF sTPEND 4,200 4, i Lossanos STIPE = a anne Dese. Current} ‘yTD| weayeoorn ame sane Sie BEER ance 00 sovont pike wovesTo to" size Saas MEMWEDCTR yecae : 5h 187729 pres dots cola BSNS ce hey ueo ors tee Cane yo] MEMMEDCTR csropr taco 1000 neato arg 119800 DENTE ae a HSACCT 51250 2,050.00 heyneo crn ‘COMM REGULAR 100.00 128.00 12,800.00 503.00 60,300.00 MEDPLN rans 2288.16 wets ‘sion aaa Neweoorm ESET. sa cove 50.00 Spell lfrmatn wrb85r0 SUTTER OAs a in SUTTEROAMS peouan s0500 200 camo enon ——_—oaoogo TorAGs mie maw wane Tam i ae Tie Te Tes Tam). tt Pet oo Se oo Cae BSED ee TH TART Sea TET sea ib oeaseze irae | easiaa asones oan sosthe0 http://md.sema-er.com/portal/comp/Y TDsttAlIEnt.asp?mpid=1147&flg-MD&grp-SEMA... 8/26/2011Earnings Statement Page I of 2 CEP America 2100 Powell Street, Suite 900, Emeryville, Califomia 94608 ‘Bowerman, Gregory Paul Pay Peres 2011080 ‘ety 42011 [Bective T "ABA Rating Nom] Bani Ace Nam EFT Amount) [bese [Curent] v0] c — 3434733 HOURS "0600 206.00 GROSS PAY seapico 964.00 Paycode | Paycoge | Toma) way] Toma Den opt. Bes, i | in Pee | Me] Fee] Famine) | ese. curren yo 1275 NENORALHOSPTTALLOS” pay aSeRATE 400 70000 1080000 DENTAL eee 1882 HsacoT siz 51250 MEMORIAL HOSPITAL LOS ‘27s MEMOR Pat DDSTIPEND 4.30000 enou rae eee MEMORIAL HOSPITAL Los eeTIne um soc 15000 138 Pe 100 20000 20000 Banos Fee MEDPLN i908 1.19865 74 MEMORIAL MEDCENTER ; TT PA eae Tae SOeS| 1274 MEMORIAL 1 BASE RATE 11300 18500 1751500 ‘NETPAY ee MTD MEMORIAL MED CENTER 1274 MEMORIAL P12 NGHTOIFF — soao 16520 4968.00 ‘MEMORIAL MED CENTER ara MEMORIAL P12 NGHTOIFF —ta00 s62.00 49000 ToTALs 780 seaBta0 ‘lack | Check | Cheek ] Tota Currant Num | “bate | ‘Numa | "Netray Teas SAGO THIQSTAE —94947.39 https://md.cep.com/portal/comp/Y TDsttAIEn®.asp?grp=&isArchive=true&scode=11125... 11/21/2011earnings Statement syapria na7 aM GIs (Shah, as CEP America 2100 Powell Street, Suite 900, Emeryville, California 94608 6 ae Ce oa omen, rego Pal Pay Pec: 2011000 cy: 52013 Tepe 7a Roun Ra Bank Ae Nam | EFF Amooml] [Base Sarena] 7] c — 346533 FOURS Ba700 71500 ROSS PAY sare 7327000 rarcote]_payoase | Taal] rey] iene oo i Desc. ‘Hre.| Rate] Eamings| ei co vn Tare HEMORACHOSPTALTGS ary gaseRATE roo 70000 1140000 ‘GERMAL a fee aoe MEMORIAL HOSPTAL LOS - wsacorT sas 10500 cs 75 NEMOR at” pp STPEND 190000 ea MEMORIA. HOSPITAL Los ween a ‘onm0 127s MEMOR pre ME 490 amco 22000 ‘ are NEMORALMED CENTER pa EASE RATE 9000 155001985000 “NETPAY 3as3s8 NENORAL MED CENTER ‘27a MEMORIA Piz NGHTDEF 2000 16040 3.26800 MENORAL MED CENTER sae MEMORIAL Pt NIGHT OF 2000 10820 .z00 NENORAL MED CENTER sare MEMORIAL Piz NGHTORF 1000 sen00 192000 MEMORIA. MED CENTER sare NEMORA Pia NOHT ORF 900 te209 164700 Tors a saa Cock ] Check | Check | Total Current Num. | “Date | Num. | "Not Pay "7545 GASZOTI 1126509 94,695.95, tps cep-om/potlfcomp/YTOStAllEst2asplgrp=bisArchive=trueicade=1326529°7545 Page 1 of 1Earnings Statement Page 1 of 2 CEP America 2100 Powell Steet, Suite 900, Emeryville, Californie 94608 Bowerman, Gregory Paul Pay Pa 201080 ay 084 [heat type | {RBA Routing Nam] EFTAmount] [Desc] Curent] YO] c 250079 FOURS e00 GROSS PAY ass079 exe0079 bere Dept Des. Poveee| aycode ese. | Tal] Hey] Total | nee cure yo {are KEUDRALNED CTE — 5, EARESTNE es079 OENTAL wae ToTALs ‘easore NSACCT ‘e.00 sacu ‘2000 uo mao MEDPLN 23000 NerPAY OTe Tatas Giock | Gheck | Check] Fata Gurent tur | Gate’ | Stim | “hecPar ets Genet raaade 969078 https://md.cep.com/portal/comp/Y TDsttAllEnt2.asp?grp=SisArchive=true8code=11126.... 11/21/2011Sarnlags Statement spsjin nas aM CEP America 2100 Powell Street, Suite 900, Emeryville, California 94608, Bowerman, Gregory Paul Pay Povied: 2011070 ety: 672011 heck Type ABA Routing Nam Simoni) [pase = TH] © 7.78200 HOURS 71500 ‘GROSS PAY e200 e298279 PayCode] PayCode | Total] Hey Total pet prt bese, Le] “Bose” | ire] Rato| _Eamings| rol 727s HERORALROSPTALIOS pag SURPLUS ern = ae TOTALS 77800 4925.00 280.00 ‘00.00 239030 Tasaoe —7a505.45 “Glock | Gheck | Check | Total Curent Nom. | “Dato | ‘Wum.| "Wet Poy Te45 Tiseovt Tviaser77 ——1,48200 rp: ond.cep.com/portal cormprYTORAlEnt2.arpgrp=tlsArchiventruetcode=11126677°7545 Page 1of2Earnings Statement spy as aK CEP America 2100 Powell Street, Suite 900, Emeryville, California 94608 Bowerman, Gregory Paul Pay Petit: 2011070 ‘ety tn 62011 — PayCode Dee] Tom] Hey] Tom = Car Yi ats iat ie | tie Hrs] Rae] Eamings) GouRs 79500 608.00 1275 MEWORALHOSPTALLOSpiy sage Rare 400 zon00 gang GROSS PAY 40800 tr. 21279 +275 MEMORIAL HOSPITAL LOS p21 pp sTIPEND 120000 | pose, 1 a ve] MEMORIAL HOSPITAL LOS EXFECTVE OENTAL a 218 Paw 1,482.00 — — HSACCT 512.50 1,537.50 ta7s MEMORAL HOSPTALLOS pts guRpLus -ER 4200 HSAGU 12500 S760 uD sso 45000 ‘274 UEMORIAL MED CENTER pay aS RATE 11200 16500 17.2000 pwn unset slates MEMORIAL MED CENTER ‘NeTpaYSzoeras—waea76 +274 MEMORIAL Pig NGHTDFF 37.00 18300 771.00 TOTALS cor) Err) ‘Giock | Check [Check | Total Curent fiom: | “Bate | tums | "het pay ‘tps: cep com portal comp/FTOstlen2-epgpadisArchvestructcoden73102196°7545 7545 TSO 2102105 82,087.39 Page Loftaris Satement spon nas AM CEP America 2100 Powell Street, Suite 900, Emeryville, California 94608 Bowerman, Gregory Pau Pay Pei 2011080 ‘Acsnty i: 712014 JPaveode] Paycode | Tomi] Hay] Total ese. Current] YH Dene Devt. Dose. Te | Bose re Rate| _camings| GOURS i) eoa7e “27s NEVORALHOSATALIOS oz ase mare — s800 aoo00 remngo GROSS PAY 3452525 151.8400 ‘27 MEMORIAL HOSPTALLOS pay 99 STIPEND 430000 | pase! oo vo] 1274 MEMORLNED CENTER yy ASE RATE 11875 16500 1840625 DENTAL wea 6a6 8 nsaccT 51250 205000 1274 MEMORIALMED CENTER yg gir DFE a.09 18900 732000 HSACU 2s 500.00 uD 150.00 £00.00 Te ‘t9578 3682825 YeDPLN 439065 4,798.0 NETPAY 3248288 143,285.36 Glock | Check | Check | Total Curent Num. | “Dato | ‘Wom- | "Net Pay 7e4s OFIDDHT v0z2s9 2.482 58 ‘aps: mdcep com/poralfcompy/TDStALEnt2aepParp=tishehiventruebcode=21102259°7545 Page LfEarnings Statement Page 1 of 2 CEP America 2100 Powell Street, Suite 900, Emeryville, California 94608 Bovoman, Gregory Pal Pay Pt 2011080 ebay 72081 (Doeet Type | ‘ABA Routing Num] Bank Acct Num] ET Amouni] [bese [Gurren] v0) c ‘7se678 HOURS wars Grossray —arsas7e 242880 Paycoue mrt] Dept bee 74 mode ose. | Tl] Heel, Tota oe ee 7s EDR NED CENTER Sane aaa 1274 MEMORAL po See 7.86678 DENTAL 5.08 TOTALS. rsere | HSACCT —- sac 0000 0 0020 MEDeLN NET PAY Tasers ieossa2 Goa | Goeck [check | Tout curont ftom | ‘Sate | ums] "Nore Teas Brasov Trizest 17 588-76 hitps://md,cep.com/portal/comp/Y TDsttAllEnt2.asp?erp=&isArchive=trued&-cod 1128... 11/21/2011Earnings Statement Page 1 of 2 CEP America 2100 Powell Steet, Suite 900, Emeryville, California 94608 ‘Bowerman Gregory Pau Pay Port 2011080 ‘ety 82011 (eax ] "RBA Rating Nam Tankhec um] —EFTAmouni] [bese Caren Wo) c =e 2009 HOURS 19600 1008.75 GROSS PAY season 205879. Payeode | Paycoge | Tora] ty] Tot Deo Donk Bese. yood arial P| "Boe? | ire] Rate] earings ese! | conn vol tars NEVORALHOSPTALLOS” pry gase Rare 9000 0000 eg0000 DENTAL ee 78260 MEnORIAL HOSPITAL LOS sacer sr2so 2250 175 MENOR Pet OD STIPEND 190000 fexcy een eer MEMORIAL MED CENTER uo 5000 75000 am Pit BASERATE 19500 18500 20328.00 eoesto MEDPUN somes 5.00025, 4 MEMORIAL MED CENTER TORE S40 te300 1655 27a MEMORIAL P12 NGHTOI sazac0 NETPAY Heats 18 Toras 00 3eaar00 ‘iock | Ghesk | Ghesk | Total Curent um] ‘Dawe | ‘Num | “'NotPey Teas GSO THiz00d7 5280839 https://md.cep.com/portal/comp/YTDsttAIEnt2.asp?grp=&isArchive=trueSccode=11129... 11/21/2011Earnings Statement Page 1 of 2 CEP America 2100 Powell Street, Suite 900, Emeryville, Californie 94608, Bowerman, Gregory Pau ay Pato 2011080 ‘Aeby 2011 (Gestiva | "ABA Rowing Nam] Banihcst Nm] EFTAmoone) [bese | curen] Yi ¢ =r 787652 HOURS 70875 ‘GROSS PAY revase — 2s75232 Payeade ol Dest, Dept. Dese. 779% | paycode Doce. | Tete Hy ecarninga| ome! | core ‘WERORIAT HOSTAL LOS ERFECTVE 1275 HEHOR po Seg 787052 DENTAL TOTALS Taresz | HSACCT sac Lo MEDPLN NETPAY Taree essar Giock | Shack | Ghose Tota Garant fom | ‘xe | Wum_| "Wet Pay Teas SSO THIDOIST 7872 https://md.cep.com/portal/comp/Y TDsttAlEnt2.asp?grp=&isArchive=true&code=11129... 11/21/2011Barnings Statement Page 1 of 2 CEP America 2100 Powell Sweet, Suite 900, Emeryville, California 94608 Bowerman, Gregory Paul ay Poi: 2011100 Aatrty 2011 [Fete] "RBA Rowing Nom] Bani Acct am EFTAnouni) [dese | Gureni] Yio) © — TOURS 72000) 120875 GROSS PAY 3482800 246880:32 code bene Dept Des, ro Tie LC |_ caren ve {EWORIN, HOSPTTAL LOS 127s MENOR Pu SASERATE 4000 ses oa? {7s NEMORIAL HOSPITAL LOS : size 307600 0 MEMO Fat DOSTiPEND ce eee MEMORIAL MED CENTER soc 900.00 a7 Pit BASERATE 18400 MOORS Toa Sie MEDPLN 119005 7,107.90 1274 NEMORIA P12 NGHTDIFF 2600 NET PAY Weteas3 — a7v030 TOTALS a0 ‘Giok | Chock ‘heck | Total Currant ‘Num | "Net Pay 7545 TOHTHOT Triae8ss 3260435 https://md.cep.comyportal/comp/Y TDsttAlIEnt2.asp?grp=&isArchive=true&code=11129... 11/21/2011earnings Statement wage 1012 CEP America 2100 Powell Sweet, Suite 900, Emeryville, Califia 94608 Bowen, Grae ay Pf 201100 cy 01 (aeactyee | “ABA Routing Num] Bank Aca Nam] EFT Amon) [bese [Current] Yo e — 7oiee 16 FOURS Tae Gross ray zo,ts0 8874848, Paveoae Teal fey] Tom opt] Dep. Doss yoo Dee ey], oa t We] : pee! | cura yro| tare HEMORACHEDCENTER pay EEFECTVE zoseeie | DENTAL were — seem WSACCT sorsan snow 1000 tr 200 20 Det oro weTPAY waaeeTe — aiaeoae Goa | check] eheck | Fil Sovent fore | ‘Bae’ | Rem | TNateap Tes Tait) Tawen? 0.0518 isArchive=true&code=1 1129. 11/21/2011 https://md.cep.com/portal/comp/Y TDsttAllEnt2.asp? erpFL-330 "AETORREY OR PARTY VMTROUT ATTORNEY ON GOVEROWENTAL RENT Us Foniy Cols ETO TOE FOR COURT OSEONTY {ame so bs mba ans aoa MICHAEL A. GOSS [Michael A. Goss, Esq. cA Bar #84109 GOSS & GOSS-A Professional Law Corporation 1119 Twelfth Street Modesto, CA 95354 retgponeno: (209) 576-1871 — raxno: (209) 577-8676 ATTORNEY FOR Mane!" GREGORY BOWERMAN ‘SUPERIOR COURT OF CALIFORNIA, COUNTY OF STANISLAUS stmeersooness: 800 Eleventh Street vusuncaooress: 1100 "I" Street erymozrcove Modesto, CA 95354 PETITIONERPLAINTIFF: GREGORY BOWERMAN RESPONDENTIDEFENDANT: KAREN BOWERMAN OTHER PARENT: PROOF OF PERSONAL SERVICE 455 922 1. Lam at least 18 years old, not 2 party to this action, and not a protected person listed in any of the orders. 2, Person served (namo): LESLIE F. JENSEN 3. | served copies of the following documents (specify): RESPONDENT'S INCOME AND EXPENSE DECLARATION 4. By personally delivering copies to the person served, as follows: a. Date: November 21, 2011 b. Time: business hours ©. Address: 1301 "G" Street, 2nd Floor Modesto, CA 95354 5. lam a, Lat] not a registered California process server. 4. (] exempt from registration under Bus. & Prof. b. [__] a registered Califomia process server. Code section 22350(b). cc. [] an employes or independent contractor of a ¢. (] a Califomia sheriff or marshal registered Califomia process server. 6. My name, address, and telephone number, and, if applicable, county of registration and number (specify): JULIE PHILIPPI 1119 Twelfth Street Modesto, CA 95354 (209) 576-1871 | dectere under pent of perjury under the laws ofthe State of Calfomia that the foregoing is true and correct. 8. [1] Lama Calforiasheri or marshal an | certy thatthe foregoing is tue a Date: November 21, 2011 x PPT (CVPE OR PANT NAME OF PERSON WHO SERVED THE PAPERS) "emi Soest Cale PROOF OF PERSONAL SERVICE “Ce tC Prowse, § 1071 USO Ren nan 1 8)INFORMATION SHEET FOR PROOF OF PERSONAL SERVICE Use these instructions to complete the Proof of Personal Service (form FL-330). A person at least 18 years of age or older must serve the documents. There are two ways to serve documents: (1) personal delivery and (2) by mail. See the Proof of Service by Mail (form FL-236) if the documents are being served by mail. The person who serves the documents must complete a proof of service form for the documents being served. You cannot serve documents if you are a party to the action. INSTRUCTIONS FOR THE PERSON WHO SERVES THE DOCUMENTS (TYPE OR PRINT IN BLACK INK) You must complete a proof of service for each package of documents you serve. For example, if you serve the Respon- dent and the Other Parent, you must complete two proofs of service, one for the Respondent and one for the Other Parent. Complete the top section of the proof of service forms as follows: First box, left side: In this box print the name, address, and phone number of the person for whom you are serving the documents. - Second box, left side: Print the name of the county in which the legal action is filed and the court's address in this box. Use the same address for the court that is on the documents you are serving “Third box. left side: Print the names of the Petitioner/Ptaintiff, Respondent/Defendant, and Other Parent in this box. Use the same names listed on the documents you are serving, First box, top of form, right side: Leave this box bank for the courts use. ‘Second box, right side: Print the case number in this box. This number is also stated on the documents you are serving. 4. You are stating that you are over the age of 18 and that you are neither a party of this action nor a protected person listed in any of the orders. Print the name of the party to whom you handed the documents. List the name of each document that you delivered to the party. a. Write in the date that you delivered the documents to the party. . Write in the time of day that you delivered the documents to the party. cc. Print the address where you delivered the documents. 5. Check the box that applies to you. If you are a private person serving the documents for a party, check box “a.” 6. Print your name, address, and telephone number. If applicable, include the county in which you are registered as a process server and your registration number. 7. You must check this box if you are not a California sheriff or marshal. You are stating under penalty of perjury that the information you have provided is true and correct. 8. Do not check this box unless you are a California sheriff or marshal Print your name, fill in the date, and sign the form. Ifyou need additional assistance with this form, contact the Family Law Facilitator in your county. Lo Ren try 1 a PROOF OF PERSONAL SERVICE Pose 2613