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TORI L. CBOII08KI, I III THB COURT or COJOlOII PLDS
plaintiff I CUKBDLMlD COUJlTY, PDlJf8YLVUlIA
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v, I 110, "-4'54- Civil Tera
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DAVID (I, CBO.08KI, I CIVIL ACTIO. - LAW
DefendlUlt I III DIVORCB
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under S 3301 (c) of the Divorce
Code was filed on September 6, 1996.
2. The marriage of Plaintiff and Defendant is irretrievably
broken and ninety (90) days have elapsed from the date of filing
and service of the Complaint,
3, I consent to the entry of a final Decree of Divorce after
service of notice of intention to request entry of the decree.
I verify that the statements made in this Affidavit are true
and correct, I understand that false state.ents herein are made
subject to the penalties of 18 Pa,C.S. S 4904 relating to unsworn
falsification to authorities.
Date I
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.,dl/ d/
David G. Chona.lti (DEFEKDAMT)
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
.
ChO,1Ujk; .
--rer (/ L. :
.
.
Plaintiff : % - '-/15'1- (; ,II 7& t11
: File No.
.
.
vs. : IN DIVORCE
:
Du~' i d G. ChO.1:Ji~1 ' .
.
:
Defendant .
,
NOTICE TO RESUME PRIOR SURNAME
Notice is hereby given that the Plaintiff/Defendant in the
above .atter, having been granted a
J<fIA day of /1U}Il';d- ,19 Q'1
prior surna_ of Ke. JJey
this written notice pursuant to the
Final Decree in Divorce on the
, hereby elects to resu.8 the
, and gives
provisions of 54 P.S. S 704.
DATE:
q /Jdq')
, ,
1)J//tt rj~' lftvJ:4.'
Signature
resU8ed
COMMONWEALTH OF PENNSYLVANIA:
: 55.
COUNTY OF CUMBERLAND :
On the ~ day of&m~) , 19Gi . before _. a
Notary Public, personally appeii"rid - the above affiant known to _ to
be the penolt whose n_ is subscribed to the within doc_nt and
acknowledged that he/she executed the foregoing for the purpose
therein contained,
In Witness Whereof, I have hereunto aet ., hand and official
seal.
~,
1lIk~CitL-
Notary PUblic
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4. The name of the Plan to which this Order applies is the
eel Construction Company Inc. Salary Savings Plan. (hereinafter
referred to as the Plan). Further, any successor plan to the Plan
shall also be sUbject to the terms of this Order,
5. This Order is enterf'd in accordance with the Internal
Revenue Code of 1986, as amended.
6. This Order relates to the provision of marital property
rights to the Alternate Payee under the PennsylvanIa DIvorce Code,
23 Pa.C.S. !i!i3301 l!t~l!q.
7. ~unt of Alternate Payee's benefit: The Alternate Payee
is awarded fifty (50') percent of the Participant's vested account
balance in the Plan as of April 12. 1996, plus any interest accrued
thereon, plus any gains thereon. minus any losses or administrative
expenses, applicable to said fifty (50') percent from April 12,
1996 through the date of distribution to the Alterrate Payee.
8. Terll of the Alternate Payee's Benefit The term of said
benefit shall be selected by the Alternate Payee from any payment
option available to her under the terms of the Plan. Payments are
to commence upon the date chosen by the Alternate Payee, but in no
event earlier than the earliest dIstrIbution date available to the
Alternate Payee under lhe terms of the Plan.
9. ThIS Order IS not intended. and shall not be construed In
slIch /I manner as to r"'quae the Pia;!:
(a 1 10 pn>v i1. .,ny t Yl'e or form of bli'n.f 1 t opt ion not
oth.twl.~ prOVided under lhe terms of the rlan:
(hI 1n f"'l'l1t. U... PL.n 10 provi<l. lncr.....s..<1 ben.fns
determln..d 0n th.. ba~ls of ~rtll\rl~1 value: Of
(c) to require the payment of any benefits to the
Alternate Payee that are required to be paid to
another alternate payee under another Order
previously deemed to be a QDRO,
10. In the event a Plan provides the option to the
Participant to elect to obtain benetits at the earliest retirement
age, the benetits shall be payable to the Alternate Payee on or
after the date on which the Participant attains (or would have
attained) the earliest retirement age, as it the participant had
retired on that date even if the Participant has not actually
retired or separated from service.
11, If the Participant shall die before distribution under
this Plan, the Alternate Payee, for purposes of the Plan's
Qualified Pre-Retireaent Survivor Annuity provisions, shall be
treated as the spouse with respect to the designated aJlOunt
reserved tor the Alternate Payee.
12. COntinued Qualified status ot order: It is the intention
of the parties that this QDRO continue to quality as a QDRO under
Section 414(p) ot the Internal Revenue COde, as it uy be amended
troa ti.. to ti.., and that the Plan Administrator shall reserve
the rioht to reconfil'll the qualified statu. of the Order at the
ti.. benetits beco.e payable hereunder,
13. '!'ax 'l'reabent of Di.tributiona .... under ftl. order:
For purpoa.. of Section 402(a)(1) and 72 of the Internal Revenue
COde, any Alternate Pay.. who 18 the spouse or toner spou.e of the
Partlclp1ant shall be treated a. the distribut.. of any distribution
or payments made to the Alternate Payee under the terms of this
Order, and as such, will be required to pay the appropriate federal
income taxes on such distribution. The Alternate Payee shall have
the right to rollover the benefits distributed to her pursuant to
the terms and provisions of this Order to an eligible retirement
plan such as an Individual Retirement Account or to an Individual
Retirement Annuity. Subject to the conditions imposed by ERISA and
the Internal Revenue Code, such transfer shall be considered a tax-
free rollover of the benefits distributed,
14. continued Jurisdiction: The Court shall retain
jurisdiction with respect to this Order to the extent required to
maintain the original intent of the parties as stipulated herein.
15. Effect of Plan Tenlination: In the event that the
Participant's benefits, or any portion thereof, become payable to
the Participant as a result of a termination of partial termination
of the Plan pursuant to Title IV of ERISA, then the Alternate Payee
shall be entitled to co..ence her benefit. i..ediately in
accordance with the terms of the QDRO and in accordance with the
termination procedures of the Plan and the Pen.ion Benefit
Guarantee corporation ("PBGC")(if applicable).
16, R19hta of tbe Alternate Payee The Alternate Payee .hall
have the .... right. with regard to her portion of the account a.
are available to the Participant, with r8CJard to his reaain1ng
portion of the account, The.e right. include but are not liaited to
the right to designate a beneficiary of retlreaent benefita, the
right to elect frea then existing retireaent date. and payment
. .
options, and the rights to such increases in value in the account
as might occur as a result of general upgrading of the plan, plan
amendments, earned interest, profitability of plan investments,
etc. but not from increases in value which result from future
increases in the Participant's compensation or his future
contributions to the Plan, In no event shall the Alternate Payee
have greater rights than those which are available to the
Participant, except as are or uy be provided under ERISA, or under
the terms of the Plan. The Alternate Payee is not entitled to any
benefit not otherwise provided under the Plan.
17. Any reasonable costs incurred by the Plan Administrator
to effectuate the teras and provisions of the Qualified OOaestic
Relations Order shall be assessed against the parties such that the
Alternate Payee pays 50t of the costs and the Participant pays 50t
of the costs.
18, The parti_ shall proaptly notify the Plan Adainistrator
of any change in their addresses from those set forth above in this
Order,
19, The parties shall promptly subllit this Order to the Plan
Administrator for deteraination of iu status as a Qualified
oo.estic Relations Order.
rr 18 1._aau.u that tbis order .hall qualify.. a Qualified
OO...tic Relations Order under the reUreaent Equity Act of 19",
The COurt retains jurisdiction to ...net this Order a. 8iCJbt be
.. ----
. .
necessary to establish or maintain its status as a Qualified
Domestic Relations order under the Retirement Equity Act of 1984.
BY THE COURT:
.
COHStN'rED TO:
~d~
David G, Chonoaki
'f
Terri L. ChonoaJtl
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