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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
STATE OF
DECREE IN
DIVORCE
NOW'~ 2/
JEFFREY R. WHITE,
Plaintiff
VERSUS
SUSAN WHITE,
Defendant
AND
DECREED THAT
AND
PENNA,
NO.
2000-580 CIVIL TERM
it. 4; 1-3 P.i1 ~
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2001
,
IT IS ORDERED AND
JEFFREY R. WHITE
, PLAINTIFF,
SUSAN WHITE
, 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;
NONE
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COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL V ANlA
JEFFREY K WHITE,
FAMILY DIVISION
PLAINTIFF
v.
NO. 00-/)7)6 C~v~ \
SUSAN WHITE,
DEFENDANT
IN DIVORCE
ORDER
1\
AND NOW, thi2J day Of~ ,2001, the attached Stipulation
and Agreement dated ~ " , lot. , of the paliies in this case is incorporated,
but not merged, into this Order of Comi.
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ATTEST:
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COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA
JEFFREY R. WHITE,
FAMILYDNISION
PLAINTIFF
v.
NO.
SUSAN WHITE
DEFENDANT
IN DIVORCE
STIPULATUION FOR THE ENTRY OF "DOMESTIC RELATIONS ORDER"
AND NOW, this IIH day of M"l ' 1001, the pmiies, JEFFREY R. WHITE,
Plaintiff, and SUSAN WHITE, Defendm1t, do hereby Agree and Stipulate as follows:
I. The Plaintiff, JEFFREY R. WHITE, (hereinafter refereed to as "Member") is a
member of the Commonwealth of Perm sylvania , State Employes' Retirement System
(hereinafter refereed to as "SERS '}
2
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2. SERS, as a creature of statute, is controlled by the State Employes' Retirement Code,
71 Pa. C.S. $$ 5101-5956 ("Retirement Code").
3. Member's date of birth is Feqruary 20,1951, and his Social Security number is 202-
42-6018.
4. The Defendant, Susan White,' (hereinafter referred to as "Alternate Payee") is the
fonner spouse of Member. Alternate Payee's date of birth is February 12, 1952 and
her Social Security number is: 188-42-9227.
5. Member's last know mailing address is:
4054 Caissons Court
Enola, P A 17025
6. Alternate Payee's current mailing address is:
1017 Wooded Pond Drive
Harrisburg, P A 17111
It is the responsibility of the Alternate Payee to keep a current mailing address on
file with SERS at all times.
7. Alternate Payee's share of the member's retirement benefits is $18,000.00, (Eighteen
thousand dollars) which shall be paid in a lump sum amount, which said amount will
be paid when Member receives his lump sum withdraw in accordance with Paragraph
10 hereof.
3
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8. Member's retirement benefit is defined as all monies paid to or on behalf of Member
by SERS, including any lump sum withdrawals or scheduled or ad hoc increases, but
excluding the disability portion of any disability annuities paid to Member by SERS
as a result of a disability which occurs before the Member's marriage to Alternate
Payee or after the date of the Member and Alternate Payee's fmal separation.
Member's retirement benefit does not include any deferred compensation benefits
paid to member by SERS. The equitable distribution portion of the marital property
component of Member's retirement benefit, as set forth in Paragraph Seven (7), shall
be payable to Alternate Payee and shall commence as soon as administratively
feasible on or about the date the member actually enters pay status and SERS
approves a Domestic Relations Order incorporating this Stipulation and Agreement,
whichever is later.
9. Member hereby nominates Alternate Payee as an irrevocable beneficiary to the extent
of Alternate Payee's equitable distribution portion in Member's retirement benefit for
any death benefits payable to SERS. This nomination shall become effective upon
approval by the Secretary of the Retirement Board or his authorized representative, of
any Domestic Relations Order incorporating the Stipulation and Agreement. The
balance of any death benefit remaining after allocation of Alternate Payee's equitable
distribution portion ("Balance") shall be paid to the beneficiaries named by the
member on the last Nomination of Beneficiaries Form filed with the Retirement
Board prior to the Member's death.
4
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(a) If the last Nomination of Beneficiaries Form filed by Member prior to Member's
death (a) predates any approved Domestic Relations Order incorporating this
Stipulation and Agreement; and (b) names the Alternate Payee as a Beneficiary; then:
(1) the terms of the Domestic Relation Order shall alone govern Alternate Payee's
share of any death benefit; and (2) for purposes of paying the Balance via the last
Nomination of Beneficiaries Form filed with the Retirement Board prior to Member's
death, Alternate Payee shall be treated as if Alternate Payee predeceased the Member.
No portion of the Balance shall be payable to Alternate Payee's estate.
(b) In addition, Member shall execute and deliver to Alternate Payee an
authorization, in a form acceptable to SERS, which will authorize SERS to release to
Alternate Payee all relevant information concerning Member's retirement account.
Alternate Payee shall deliver the authorization to SERS which will allow the
Alternate Payee to check that she has been and continues to be properly nominated
under this paragraph.
5
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10. The term and amounts of Member's retirement benefits payable to the Alternate
Payee after SERS approves a Domestic Relations Order incorporating this Stipulation
and Agreement is dependent upon which option is selected by Member upon
retirement. Member and Alternate Payee expressly agree that, at the time of
retirement, Member shall take an Option 4 lump sum withdrawal of his accumulated
deductions in an amount not less than Alternate Payee's equitable distribution share
of this retirement benefit, as set forth in paragraph seven (7). Alternate Payee shall be
paid her entire equitable distribution portion of this benefit from Member's lump sum
withdrawal, and no additional amounts shall be payable to Alternate Payee by SERS.
II. Alternate Payee may not exercise any right, privilege or option offered by SERS.
SERS shall issue individual tax forms to Member and Alternate Payee for the
amounts paid to each.
12. In the event of the death of Alternate Payee prior to receipt of all her payments
payable to her from SERS under this Order, any death benefit or retirement benefit
payable to Alternate Payee by SERS shall revert to Member.
13. In no event shall the Alternate Payee have greater benefits or rights other than those
which are available to Member. Alternate Payee is not entitled to any benefit not
otherwise provided by SERS. The Alternate Payee is only entitled to the specific
benefits offered by SERS as provided in this Order. All other rights, privileges and
options offered by SERS not granted to Alternate Payee by this Order are preserved
for Member.
6
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14. It is specifically intended and agreed by the parties hereto that this Order:
(a) Does not require SERS to provide any type or form of benefit, or any
option not other provided under the Retirement Code; and
(b) Does not require SERS to provide increased benefits (determined on
the basis of actuarial value) unless increased benefits are paid to Order
and this Stipulation and Agreement and any attendant documents shall
be Member based upon cost of living or increases based on other than
actuarial values.
15. The parties intend and agree that the terms of this Stipulation and Agreement shall be
approved, adopted and entered as a Domestic Relation Order.
16. The Court of Common Pleas of Cumberland County Pennsylvania, shall retain
jurisdiction to amend any Domestic Relations Order incorporating this Stipulation
and Agreement, but only for the purpose of establishing it or maintaining is as a
Domestic Relations Order; provided, however, that no such amendment shall require
SERS to provide any type or form of benefit, or any option not otherwise provided by
SERS, and further provided that no such amendment or right of the Court to so amend
will invalidate this existing Order.
17. Upon entry as a Domestic Relation Order, a certified copy of the Domestic Relations Order
served upon SERS immediately. The Domestic Relation Order shall take effect
immediately upon SERS approval and SERS approval of any attendant documents
and then shall remain in effect until further Order of the Court.
7
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WHEREFORE, the parties, intending to be legally bound by the terms of this
Stipulation and Agreement, do hereunto place their hands and seals.
Dated: ~ - \ ~ - C l
Dated:
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Defendant! Alternate Payee
Dated:
15 M'&.l 2.co\
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Dated: 5---11'" 01
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Attorney for Alternate Payee
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1lI1!!oat
JEFFREY R. WHITE (202-42-6018).
Plaintiff
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
vs.
CIVIL ACTION - LAW
NO. 2000-580 CIVIL TERM
SUSAN WHITE (188-42-9227).
Defendant
IN DIVORCE
PRAECIPE TO TRANSMIT RECORD
TO THE PROTHONOTARY:
Transmit the record, together with the following information, to the Court for entry of a divorce
decree:
1. Ground for Divorce: Irretrievable breakdown under Section 3301 (c).
2. Date and manner of service of the Complaint: Acceotance of Service filed on 23 Februarv
2000 indicatina service on 8 Februarv 2000.
3. Complete either Paragraph (al or (bl:
(a) Date of execution af the Affidavit of Consent required by Section 3301 (c) of the
Divorce Code: by Plaintiff: 10 March 2001 by Defendant: 15 March 2001
(b) (1) Date of execution of the Affidavit required by Section 3301 (dl of the Divorce
Code: (2) Date of filing and service of the Plaintiff's Affidavit upon the
Respondent:
4. Related claims pending: None
5. Complete either (a) or (b):
(al Date and manner of service of the Notice of Intention to File Praecipe to Transmit
Record, a copy of which is attached:
(b) Date Plaintiff's Waiver of Notice in Section 3301 (c) Divorce was filed with the
Prothonotary: Dated 10 March 2001. filed on or about 17 March 2001. Date Defendant's Waiver
of Notice in Section 3301 (c) Divorce was filed with the Prothonotary: dated 15 March 2001. filed
on or about 17 March 2001..
-
Date: /4- {)"'7~ ~I
By () r\.()~__(b
S~ ~
Attorney for Plaintiff
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JEFFREY R. WHITE,
Plaintiff
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
vs.
CIVIL ACTION - LAW
NO. 2000- .5?o
CIVIL TERM
SUSAN WHITE,
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
foregoing 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 in 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 the 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:
Office of the Prothonotary
Cumberland County Court House
1 Courthouse Square
Carlisle, Pennsylvania 17013
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.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, Pennsylvania 17013
Telephone: (717) 249-3166
I
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JEFFREY R. WHITE,
Plaintiff
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
vs.
CIVil ACTION - lAW
NO. 2000- SJ>D
CIVil TERM
SUSAN WHITE,
Defend,mt
IN DIVORCE
NOTICE OF AVAilABILITY OF COUNSELING
TO THE WITHIN-NAMED DEFENDANT:
You have been named as the Defendant in a Complaint in a divorce proceeding filed in
the Court of Common Pleas of Cumberland County. This notice is to advise you that in
accordance with Section 3302(d) of the Divorce Code, you may request that the court
require you and your spouse to attend marriage counseling prior to a divorce being handled
down by the court. A list of professional marriage counselors is available at the Domestic
Relations Office, 13 North Hanover Street, Carlisle, Pennsylvania. You are advised that this
list is kept as a convenience to you and you are not bound to choose a counselor from 1this
list. All necessary arrangements and the cost of counseling sessions are to be borne by you
and your spouse.
If you desire to pursue counseling, you must make your request for counseling within
twenty days of the date on which you receive this notice. Failure to do so will constitute a
waiver of your right to request counseling.
I
2
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. \
JEFFREY R. WHITE, ) IN THE COURT OF COMMON
Plaintiff ) PLEAS OF CUMBERLAND COUNTY,
) PENNSYLVANIA
)
vs. ) CIVIL ACTION - LAW
)
) NO. 2000- 5'J'D CIVIL TERM
SUSAN WHITE, )
Defendant ) IN DIVORCE
COMPLAINT IN DIVORCE
AND NOW comes the above-named Plaintiff, JEFFREY R. WHITE, by his attorney,
Samuel L. Andes, and makes the following Complaint in Divorce:
1. The Plaintiff is JEFFREY R. WHITE, an adult individual who currently resides at
4054 Caissons Court, Enola, Cumberland County, Pennsylvania.
2. The Defendant is SUSAN WHITE, an adult individual who currently resides at
1017 Wooded Pond Drive, Harrisburg, Dauphin County, Pennsylvania.
3. Both the Plaintiff and Defendant have been bona fide residents of the Common-
wealth of Pennsylvania for at least six months immediately previous to the filing of this
Complaint.
4. The Plaintiff and Defendant were married on 18 May 1974 in Philadelphia,
Pennsylvania.
5. There have been no prior actions of divorce or annulment between the parties.
6. This marriage is irretrievably broken.
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7. Plaintiff has been advised of the availability of marriage counseling and the Plaintiff
may have the right to request that the Court require the parties to participate in counseling.
8. The Plaintiff requests this Court to enter a Decree of Divorce.
WHEREFORE, Plaintiff requests this Court to enter a decree in divorce pursuant to the
Divorce Code of Pennsylvania.
I verify that the statements made in this Complaint are true and correct. I understand
that any false statements in this Complaint are subject to the penalties of 18 Pa. C.S. 4904
(unsworn falsification to authorities).
DATE:
l- ~'-\- ,"0c:>0
~.~~
el L. Andes
Attorney for Plaintiff
Supreme Court 10 17225
525 North 12th Street
Lemoyne, PA 17043
4
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JEFFREY R. WHITE,
Plaintiff
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND
COUNTY, PENNSYLVANIA
vs.
CIVIL ACTION - LAW
NO. 2000-580 CIVIL TERM
SUSAN WHITE,
Defendant
IN DIVORCE
ACCEPTANCE OF SERVICE AND ENTRY OF APPEARANCE
I hereby enter my appearance for the Defendant, Susan White, in the above-
captioned action. I acknowledge receipt of a true and correct copy of the Complaint in
Divorce filed in the above action on behalf of the Defendant.
Date: J.-- y- (JU
Nora. Blair
Attorney for Defendant
5440 Jonestown Road
P.O. Box 6216
Harrisburg, PA 17112-0216
Supreme Court 10 # 4.!J:".'7
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JEFFREY R. WHITE, ) IN THE COURT OF COMMON
Plaintiff ) PLEAS OF CUMBERLAND COUNTY,
) PENNSYLVANIA
)
vs. ) CIVIL ACTION - LAW
)
) NO. 2000-580 CIVIL TERM
SUSAN WHITE, )
Defendant ) IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under Section 3301 (c) of the Divorce Code was filed on 1
February 2000 and was served upon the Defendant on or about 8 February 2000.
2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90)
days have elapsed from the date of filing of the complaint and the date of service of the
complaint on the Defendant.
3. I consent to the entry of a final decree in divorce either after service of a Notice of
Intention to Request Entry of the Decree or upon filing of my Waiver of the Notice of
Intention to Request Entry of the Decree.
4. I have been advised of the availability of marriage counseling and understand that
the Court maintains a list of marriage counselors and that I may request the Court to require
" my spouse and I to participate in counseling and, being so advised, do not request that the
I
I" Court require that my spouse and I participate in counseling prior to the divorce becoming
i final.
I verify that the statements made in this Affidavit are true and correct and 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.
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JEFFREY R. WHITE,
Plaintiff
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
vs.
CIVIL ACTION - LAW
NO. 2000-580 CIVIL TERM
SUSAN WHITE,
Defendant
IN DIVORCE
WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY
OF A DIVORCE DECREE UNDER SECTION 3301 Ic) OF THE DIVORCE CODE
1. I consent to the entry of a final decree in divorce without notice.
2. I understand that I may lose rights concerning alimony, division of property,
lawyer's fees, or expenses if I do not claim them before a divorce is granted.
3. I understand that I will not be divorced until a divorce decree is entered by the
court and that a copy of the decree will be sent to me immediately after it is filed with the
Prothonotary.
I verify that the statements made in this Affidavit are true and correct. I understand
that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904
relating to unsworn falsification to authorities.
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Dated:
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JEFFREY R. WHITE,
Plaintiff
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
vs.
CIVIL ACTION - LAW
NO. 2000-580 CIVIL TERM
SUSAN WHITE,
Defendant
IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under Section 3301 (c) of the Divorce Code was filed on 1
February 2000 and was served upon the Defendant on or about 8 February 2000.
2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90)
days have elapsed from the date of filing of the complaint and the date of service of the
complaint on the Defendant.
3. I com;ent to the entry of a final decree in divorce either after service of a Notice of
Intention to Request Entry of the Decree or upon filing of my Waiver of the Notice of
Intention to Request Entry of the Decree.
4. I have been advised of the availability of marriage counseling and understand that
the Court maintains a list of marriage counselors and that I may request the Court to require
my spouse and I to participate in counseling and, being so advised, do not request that the
Court require that my spouse and I participate in counseling prior to the divorce becoming
final.
I verify that the statements made in this Affidavit are true and correct and 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.
. .J;/o-IJI
DATE . ...
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SUSAN WHITE. .. . ... .. .... .." ... "..
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JEFFREY R. WHITE,
Plaintiff
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
vs.
CIVIL ACTION - LAW
NO. 2000-580 CIVIL TERM
SUSAN WHITE,
Defendant
IN DIVORCE
WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY
OF A DIVORCE DECREE UNDER SECTION 3301lcl OF THE DIVORCE CODE
1. I consent to the entry of a final decree in divorce without notice.
2. I understand that I may lose rights concerning alimony, division of property,
lawyer's fees, or expenses if I do not claim them before a divorce is granted.
3. I understand that I will not be divorced until a divorce decree is entered by the
court and that a copy of the decree will be sent to me immediately after it is filed with the
Prothonotary.
I verify that the statements made in this Affidavit are true and correct. I understand
that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4H04
relating to unsworn falsification to authorities.
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Dated:
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SlJSAN WHITE
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