Case 11-40913

Doc 5

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 1 of 12

Desc Main

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Case 11-40913

Doc 5

Hennepin Couniy
300 S 6th Street
Minneapolis,!>.fN 55437

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 2 of 12

Pay Group:
Pay Begin Date:

ITN-ll Frob Of'fftcer Unit NonExpt

1112112010
12104/2010

Pay End I)me:

I Employee
ID,
Department:

Stott Sargent
16609 77th PI N
Maple Grove, MN 5531\

711840001
18541(}.Juv Prob - Gencm! Supervision
Juvenile Justice Center
ProbatfPa."Ole Offieer, Career
$2,B98,oo Biweekly

Loeaiion:
, Job Title:
PAy Rate:

E_

HOURS AND EARNINGS

Current
Df1riptitm

RItl!:.

ulUgcvity Paymem
Stability Pay
Holiday Hourly
Regu]arPay
Sick Leave - Hourly
Vacation - Hourly

16.00
64,OQ

......

TOTAL:

Ilo!uJ!

S.77

~edi~a.l No Imputed Income

Dental with No Imputed Ineome
Deferred Comp 457(b) Plan
flexible Spending ACCQUllt
HCEA
PERA Coordinated Plan
MTC Metropass

579.60
2,318.40
0,00
0,00

4,11)3.77

72.47

4;J!i'
fs
8@.64

1% SuppJemenlat Retirement
AFSCME Prob Officer LoeB1

15.00
76.93

315.00
1,923.08

PERA Life Ins High

146_23
45.60

4,427.75
547.20'

I{KCTY
000000(100%36741
12/10/2010

TAX DATA:

Federal

MN State

MariHl.! Status:
Allowances:
Add!. Pet:
Add!. Amt:

t.1arrlOO

Married
3

TAXES
Y'fD
~

Ilo!uJ!

Ul&s:[ilHliln

Fed Wilhholdng
Fed MEDIEE
Fed OASDL'EE
MN Withholdng

24.00
160.00

144.2B
1,100.00
3,187.80
62,S96.SO
869".40
5,7%.00

2.,000,00

73,794.18

TOTAL:

1,200.00

36.225000
36.225000

Business Unit:
Advicc#;
Advice Date:

Desc Main

88.00
1,72iUm

"2

7~

35-40'

424.80'

OJ)O

176.00

!;,~~,:~~~!::":.~:~ncome
Long-Term Disability
f'BRA CQOrdiufltcd Plan
MTC Metropass S69 Subsidy
J% Supplemental RtnnD[ Match

J:oia:l:!ll

YII!

361.76
54.17
13J.62
169.60

5,040,18
%0.93
4,lOs'82
2,469.86

,fU7.15

12.,579.19

~
L6(l

14.20
287,26
30.40'
41.04

,~

15,631.03
19.20
355.00
5,143.75

36U.
738.00 .
i

i
1;J3U.

76.44

I
Current
Y11)

TOTAL GROSS
4,103,17
73,794.28

FED TAXABLE GROSS

3,433.58
60,730.53

Advire #000000000236741

TOTAL:

MESSAGE:

TOTAL DEDUCTIONS
746.63
14,402.55

:"VE'fPAY
2,539.99
46,lHL94

NE1' PAY DISTRIBUTION

Acrgunt Nmuher
Ag;oomType
XXXXXXXXXX
Checking

Hoop'" Amount

TOTAL TAXES
817.15
12,579.79

I
I

$2,539,99 :

Case 11-40913

Doc 5

Hennepin County

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 3 of 12
IIN~II

Pay Group:
Pay Begin Date:
Pay End Date:

300 S 6tb Street

MlnJleRpolis, MN 55487

Prob OffJlCet Unit NonEKpt

I2/Q512010

HNC1Y

BllSiness Unit
Advice #:
Advice Date:

12118/2010

Desc Main

OOOi.IDOOO{)l44469

12123,'2010
Federal
Married

TAX DATA:
S~ott Sargent

Employee ID:

16609 77th Pl N

Department

: Looation:

MupJe Grove, MN 55311

J
!

--Marilal Status:
Allowauces'

111&40001
2854\0-Juv Pfflb General Supervision

Juvenile Justice Center

PtobatIParole omeer, CaretT
$1,&9S.00 Biweekly

lQbTitle:

Pay RAte:

HOURS AND AR'IINGS

Curreut

DillrioUrw
Lougevily Payment
RegularPu)'
Sick Leave - Hourly
Holiday. Hourly
Stability Pay
Vacation ~ Hourly

I!liJ<

Hom

36.225QOO
36.22:5000

69,00

5.77
2,49953

11.00

398.48

35_00

0_00
0-00
0-00

88.00

ilirlIlIII:>

iIlUIn

160.00

AddL Pet
AddJ.Am!:

Dncriutign
Fed Witbholdll8
Fed MEDIEE
fed OASDl!EE
MN Withholdng

150,05
65,0%..33
1,267.88
3,187.80
1,200.00
5,796.00

1,797.00

Married

TAXES

ilirlIlIII:>

TD

MN State

l:m<nI

Ym

200.38
3831
163.80
98.40

5,240.56
999.24.
4.212.62

2.568.26

500."

13,081).68

:
-tOTAL,

80.00

2,903.78
AITE.R~TAX

BEFORE-TAX DEDUCTIONS
Pwnptil)Q

l:m<nI

Medical No Jmputed Income

Deferred Ccmp 457(b) PIau
Flexible Spending ACCQUuf

213.96

15.00
76.92

Deaerip1jPD

Ym

PERA Life Ins Higb

1% Supplem.::otal ReLircment
AFSCME Prob Otlicer Local

5,135.04
390.00
2.000.00

HeEA

2,080.'.

76,69$.06

DEDUCTIONS

Ym -'PwwtiM

l:m<nI

192.00

16.00
29.04

767.04
424,80

0.0.

552

PF.RA Coordinated Plan

Oe-utal with No lmputed IllC(!tne
MTC Mtropass

174.23
0.00
0.00

TOTAL:

4,601.98
869.64
547.20 "

EMPLOYER PAID BE~EFITS

Medica! No Imputed Inome

Long-Term Disability
PERA Coordinated Plan
1% Supplemeutal Rtrmnt Mateh
BlISie LIfe and AD&D
MTC Metropass $69 Subsidy

l:m<nI
619.61
]4,20
203.26
29.64

MO
0.00

Ym

16,310.64
369.20
5.347.01
767.04
19.2(} ,
364.Sf}

TOTAL:

480.11
TOTAL GROSS
2,90),78

76.698..06

13,543.86

TOTAL:

,84

45.04

FED TAXABLE GROSS

2,423.67
63,154.20

TOTAL TAXES
500.89
13,080.68

*TAXABLE
TOTAl, DEOtsCTIONS
525.15
14,927.70

NET PAY DISTRIBUnON

A$cgupt Number
ArcmmtType
Checking
XXXXXXXXXX

TOTAL:

MESSAGE:

NET PAY
1,877.74
48,689.68

IlepqMt AmWDt
$1,877.74 :

$1.877,"\

Case 11-40913

Doc 5

Hennepin County

300 S 6th Stl'ee1

MirtnellpQlis, MN 55481

Puy Group;
Pay Begin Date:
Pay End Oa!c;

Fm,"',., 10,

1660917th"'N
Map-Ie Grove. M~ 55311

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 4 of 12
HNU Prob Offficer Unl! NonExpt
1211912(l1O
0110112011

Job Title:
Pay Rate;

HOURS AND EARNINGS

Current
Dmrlpdqn

.8m

Longevity Payment

36.225000

RegulnrPay

36225000

IllIW:>

lWnilllI1
5.17
869.'1(1
2,028.60

24.00
56.00

Business Unit:

HNCTY

Advice#:
AdVIce Dale;

00000000I.)251157
Oli07f2{)ll

I~

2854 J0-1U'l Prob {'.eneml Super;tision

Juvenile Justice Center
ProbatIParole Officer, career
S2.89!l.OO Biweekly

Location:

Holiday. Hourly

Desc Main

M.m,~

, Allowances:
Addl.Pe!:
AddLAml:

-IllIW:>

TAXES
YTO

5,77

S69AO
2,028.60

24.00

56,00

lJil:I<m

IliiJ!:dulW.D

lWnilllI1

175JW
35.%
104.17
90.65

Fed Withholdns

FedMEDIEE
FedOASDVEE

MN Withhojdng

.....

TOTAL;
BEFORETAX DEDUCTIONS
Jlw:rWtiop

lJil:I<m

Medical No ImpWed [ncome

Pental with No Imputed 1nwmc

Deferred Comp 457(b) Plan
Flexible Spending Account

213.%
77.56
15.00
115.38

2,903.77
AFTER~TAX

80.00

29.04
35.03

29J14

AFSCME Frob Officer L~nl

35.03

"2

EMPLOYER PAID BE.~EFlTS

Medical No Impuled lucorne

Basic LIfe lind AD&D

umg-Term Disability
PERA Coordinated Plan

HCEA
PERA Coordinated Plan
MTC~

11H.49

45.60

lJil:I<m

De$fript!vp

MTC Mctropass $159 Subsidy

1% 5\upplemenlal R:rmnt Match

181.49
45.60

!75.04
35,96
W4.17
90.65

_112

' ' '112

TOTAL.:

lJil:I<m

1% Supplemental Retirement

213.96
7756
15.00
115.38

2;903.71

DEDUCTIONS

Qegrintion

Mru-ri""

619.61

US\)

679.61
1,60

14.20

1420

210,52

21(t52

30040

30.40
29.04

29.04

:
TOTAL:
Current

YTD

643.99

TOTAL GROSS
2.9{lJ.77
2,903.77

648.99

TOTAl,,;

64.(17

64,1}7

"'TAXARLE

FED TAXABLE GROSS

TOTAL TAXES

TOTAL DEDUCTIONS

NET PAY

2,254.78

405.82
405.82

713.%
713.(16

1,784.89
1,784.89

NET fAY DISTRIBUTION

Ag;oont 1'yne
"WUDt N!!mber
Chocking
XXXXXXXXXX

Dewjt Am9uut
$1,784.89

2,254.78

AdVIce fIOOooo0000252157

TOTAL:

MESSf\.GE:

$1.784.89

Case 11-40913

Doc 5

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 5 of 12

Desc Main

Hennepin County

Dare:
Pay End Date:

300 S 6th Street

Minneapolis. MN 5548-'

Pl~

Department:

Maple Gn;lVe, MN 5531 J

28S410-Juv Prob - General Supervision

Allow:mces:
Addt Pet:
AddLAmt:

Juvenile lustice Center

Location,
lob Title:
Pay R.ate:

000000000259839
Q1I2112011

Adviee#:
Ad"iee Date:

Olf:5l2011

ProbatIParole Officer, Career

$2$98.00 Biweekly

'''-'''i
I

-I!JIl<

pwriutiGn

Lcngcvlty Payment

ReguJarPay
Hollday - Hourly

36.225QOO

HOURS AND EARNINGS

Current

TAXES

'iT/)

IIw>

lImiIIu

iIlIIIn

80.00

5.77
2,898.00
0.00

136.00
24.00

D:aWlJ;ikm

lImiIIu

Fed Witbholdng
Fed MEDJE
Fed OASDIIEE

11.54
4,926.60
869.40

MN Withholdng

l:.oJ:wIl
193.52
37.75
109.35
99.33

36856
13.71
21352
189.98

:
~-TOTAL:

2~O3.77

80.00

BEFORE-TAx-DEDUCTIONS
I'h:st:riptinD
l:.oJ:wIl
Medieal No lmpute<! InCOffi
213.96
Deferred C<>mp 457(b) Pl:m
15JiO
Flcxible Spending Aecoun!
11538

AFfER~TAX

160,00

DEDUCTIONS

ne1icdnti9 8

16.00
29.04
0,00

1% Supplementlli Rctirement
AFSCME Prob Officer Local

DmrintiruJ

16.00
58.08
35JH

552

HCEA
PERA Coordinated Plan
Dental with No ]mpufcd Income
MTC Mctropass

181.49
0.00
0,00

362.98
7756
45.60 :

845.77

439.95

EMPLOYER PAID BENEFITS

l:.oJ:wIl

PERA Life Ins High

427.92
30.00
230.76

TOTAL:

5,867.54

Medical No lmputed lncomc

wng-Tenn Disability
?ERA Coordinated Plan
1% Supplemental Rtmmt I!.iatch
Basic Ure and AD&D
MfC Mctropass 569 Subsidy

l:.oJ:wIl

679'.61
14.20
21051
29.04
0.00

\,359.22
28.40
421.04
5K08

{tOO

30.40

tOO

I
TOTAL:
C~nt

YTD

525.83

TOTAL GROSS
2,903.77
5,807.54

1,174.81

TOTAL:

109.11

45.04

FED TAXABLE GROSS

2377.94
4,632.72

TOTAL TAXES
439.9'5
845.77

*TA.XABLE

TOTAL DEDUCTIONS
570,87
1.283.93

NET PA DISTRIBUTION
Al;rnpnt Type
Al;CQunt Number
Adviee #000000000259839

Checking

XXXXXXXXXX

NETI"AY
l,S92.95
3,6nS4
fumit Amm fBt
$l,892.95

I
TOTAL:
MESSAGE;

$1,892.95

Case 11-40913

Doc 5

Hennepin County

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 6 of 12

Yay Groop;
Pay Begin Date:
Pay End Date:

)00 S 6th Street

Minneapolis. MN 55487

UN-jf Prob Offficer Unit NooExpt

0111612011
Oj129!20lJ

BlISioossUnit:
Advice#;
i Advice Date:

IlNCfY
OOOOOOOODUi7S5I}
02l04/20lJ

TAX DATA:
Marital Status;
Allowances:

Federal
Mruriod
3

! Srott Sargent

Employee ID:
Depmment:

, 16609 77th PI N
, Maple Grove, MN 55311

711840001
285410-Juv PrOO - Genel1li Supervision
Juvooi!e Justiee Center
ProbatlParole Offic-er, Career
$2,89KOO B~weekly

Location".

Job Tltle:
Pay Rate:

B;;k

DmrtpUpU
Longevity l'1Iyment

Holiday ~ Hoody
Regular Pay
VI!Il;tltion - Hourly

36,225000
36.225000
36.22.5000

~
64.00

3U)()
200.00

8.00

289.80

8.00

IlluIn

5.77
289.80
2,318.4Q

8,00

M.;.""( State
MlIrried
3

AddL Pet:
AddL Amt;

HI}

E.8rJIlW

Desc Main

E.8rJIlW

17.31
1,159,20
7,245.00
289,80

!:iImllI

1k:11;[lnrioa

Fed Withholdng
fedMEDiEE
FedOASDUEE
MN Withholdng

llll

195,91
35m
90.65

564.47
109.68
3l7.69
280.63

426.1.

1~12.47

\04.17

TOTAL,

....00
BEroRE~TAX

DEDUCTIONS

De!irdptWn

Medical NQ Imputed Income

Du;tat with No hnpuled J!iCCfII(;
Deferred OJmp 457(b) PIlL'!
Flexible Spending Account
HeEA
PERA Coordinaicd Plan
MTC MetroppS1l

TOTAL:

"903.77

=m
213.%

AFrER~ T,4.X

641.88
J55.12

77.%
1.5.00
I15.39

346,15

181.49

544.47

45.60

91.20

649.00

1.&23.82

TOTAL GROSS
CI.H1Ctlt

2.903.77

YTD

S.71 \.31

Dey;ripti9l!

llll

1% Supplemental Retirement
AFSCME Prob Officer lAca!
552
PERA Life Ins High

45,00

8,111.31

TOTAL,

DEDUCTlONS

EMPLOYER PAID BENEFITS

=m

YIl!

29.04

87.12

35JiJ

70.06
J6.00

OJ'"

Drserlptjog
MedicaJ No Imputed lnoome
Basic Life and AD&D
Long-Tenu Disabmty
PER..... Coordinated piaJI
MTC Metropasll 169 Subsidy
1% Supplemental Rtrmllt Mntc.'l

=m
679.61
1.60
)4.20

21052

x:m

2,038.83

3.20

42,60
631.56

30AO

60.80

29,{}4

87,12

TOTAL:

64.07

FED TAXABLE GROSS

2,254,77
6,887.49

TO'l'Al,TAXES
426.70

TOTAL DEDUCTIONS

~ETPAY

713.07

1,272.47

1,991.00

J,764.00
.5,441.84

AC;COIIDtTynf

AcCOunt Nllmber

DernWt Amount

Cheddng

XXXXXXXXXX

$1.764.00

113.18

"'TAXABLE

NET PAY DISTRIBUTION

MESSAGE:

Case 11-40913

Doc 5

R07100 2/3l2011

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 7 of 12

Desc Main
Route:

COUNCIL

CITY OF MAPLE GROVE

SARGENT, LEANN B

Check No:

PO BOX 1180

16609 - 77TH PlACE NORTH

Check Date 12110/2010

MAPLE GROVE MN 55311-6180

MAPLF GROVE,

MN 55311

Period Ertd

_ _ _ HOUfS

Regular

80.00

..

a010

480.77

Period Amount
----.~

480.n

12,019.25 Groos wages

29,ao

Federal FICA Wrthheld

Tmal Deducbons

Year to Date
... _ - -
12,019.25

745.19

Federa! Medicare Withheld

6,97

174.28

MNSIT

8.49

212.25

24.04

601,00

PERA DC

450.77

12/512010

0,00

Federal Income Tax

Gross Pay

87623

Net Pay

411.47

Case 11-40913

Doc 5

R07ie6 213/2011

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 8 of 12

CITY OF MAPLE GROVE

SARGENT, LEANN

PO BOX 1180

16609 - mH PLACE NORTH

MAPLE GROVE MN 55311-6180

MAPLE GROVE,

H....

80.00

Regular

6..010

Route:

Amount
4S0.77

Period End:

Oe~ri~o~

Year to Date

12,500.02 Gross Wages

....

Period Amount
480,77

69.31

Year to Date

12,500.02

0.00
29,81

775_00

Federal Medicare W\ttlheld

6,97

is-US

MNSIT

8A9

2W.74

24.04

625.04

PERADC

Total Deductions

1211912010

------~--

Federal FICA Withheld

480.n

87965

CheckOate: 12l2412G10

Federai Income Tax

Gross Pay

COUNCIL

Chect<No:

MN 55311

R...

Desc Main

Net Pay

411.46

Case 11-40913

Doc 5

R07186 2/3/2.011

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 9 of 12

Desc Main
Route:

COUNCIL

CITY OF MAPLE GROVE

SARGEN-r. LEANN B

Check No:

PO BOX 1180

18609-77TH PLACE NORTH

Cbei::k Date:

1f712011

MAPLEGROVEMN 55311-6180

MAPLE GROVE,

Period End:

11212011

Period

Hours
80.00

Regular

MN

Rate
5.010

55311

Amount

480.77

Oescri~on

Yearto Date
480~TI

Gross Wages

......

Period Amount

48'H1

T oCal Deductions

78,68

Yearto Date

--------~

480.77

480.n

Federallncome -rax

15.29

15.29

Federal FICA Withheld

20,19

20.19

6.97

6Jl7

MNSIT

12.19

12.19

PERADC

24.04

24.04

Federal Medicare Withheld

Gross-Pay

88300

NeiPay

402.09

Case 11-40913

Doc 5

R07186 2i3J2011

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 10 of 12

Desc Main
Route:

COUNCIL

CITY OF MAPLE GROVE

SARGENT, LEANN B

Check No:

PO BOX 1180

16609 ~ 77TH PLACE NORTH

Check Date:

112112011

MAPLE GROVE MN 55311-6180

MAPLE GROVE,

Period End:

1/1612011

_ _ ~'?~&mings

Hours

Regular

:=''=0'''.0"'0--'

MN

Rate

55311

Amount

Year to

Description

_~_~_

~--~---

6.010

480.77

961.54

Gross Wages

480.77

T~al

DeduClions

76.66

Year to Date

480.77

961.54

Federal Income Tax

15.29

30.68

Federal. FICA W1hheld

20.19

40.""

6.\fl

1-3.94

MNSIT

12.19

24.38

PERA DC

24.04

48,08

Federal Medicare Wthhe!d

Gross Pay

Period
AmOunt
._--_.

88637

Net Pay

Case 11-40913

Doc 5

R07186 2f312011

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 11 of 12

Desc Main
Route:

COUNCIL

CITY OF MAPLE GROVE

SARGENT, LEANN B

Check No:

PO BOX 1180

16609 - 77TH PLACE NORTH

Check

MAPlE GROVE MN S5311-i'i180

MAPLE GROVE,

MN

Ram

BO.""

Regular

6.010

55311

AmQunt
480.77

Year to Date
1,442.31

21412011

Period End:

113012011

480.77

Tmal Deductions

__

480.77

Oate
...Year to
._

1,442.31

Federal Income Tax

15..29

45.87

Federal FICA Wlthhekl

20.20

60.58

Period Amount
GrossWages

Federal Medicare Withheld

Gross Pay

89315

Date:

6.97

20.91

MNSIT

12.19

36.57

PERA DC

24.04

7212

Net ?-dY

402.08

BKY
Case 11-40913

Doc 5

Filed 02/10/11 Entered 02/10/11 11:12:28

Document
Page 12 of 12

Page 1 of 1
Desc Main

From: mmjoen <mmjoen@cs.com>

To: sargle <sargle@comcast.net>

Subject: BKY

Date: Tue, Feb 8, 2011 10:12 am

Attachments: petition.pdf (183K), bkyincomeform.pdf (56K)

Hello:
We loaded in the info you gave us and I am sending a revised draft to review. There is still some missing info I
will need:
Schedule A-I need the tax assessed value of the home for 2011
B-1 will need your bank balances effective Wed moming. Email me the balances and print off statements for your
records. I need book values for all vehicles. Again, print off statements for your records. What is currently in the
CDs, and what was paid out from them? I need dates, amounts and recipients. Check each category to make
sure no assets are missing. This is where people often get caught missing something.
D-F-all creditors listed?
GtH-any missing?
I/J-Iloaded in the pay for Scott and have the rent I do have your paystubs from Maple Grove. I understand there
has been no commissions paid since 8/1, and you have nothing in the pipeline, correct? No listings at this time?
Make sure all out of pocket expenses are listed on J, I note that he has money in an HSA. Does that cover the
out of pocket mediCal? If so, we need to remove that entry from J. What about insurances, Let me know if any of
those listed On J are actually deducted from Scott's paystub.
Statement of Financial Affairs-I will load in the number for 201 gross. I did not see any notes on #10, so I will trust
that there have been no applicable transfers of money or property.
I have the forms you signed and returned. I am sending the income form again, because you BOTH need to sign
that. Have Scott sign in middle and you sign on bottom. I will complete. You can scan and email or fax to 952

943-3901.
Let me know if you have any questions. I will look for your info first thing in the moming and make final changes.
I will get back to you with any issues. Although the combined income does exceed the median income for a
family of 5, the mortgages and other deductions allow you to avoid the filing being dubbed an abuse. That does
mean that we can still not be required to verify all the information. Also, as we discussed, the payments from the
CD can be looked at and questioned. There is no getting around that. We will just have to comply with any
documentation requests.
MCM

http://maiLaol.coml33189-1111aol-6/en-usimaillPrintt\1essage.aspx

2/812011