HomeMy WebLinkAbout07-0686
ABRAHAM LAW OFFICES
45 East Main Street, Hummelstown, PA 17036
(717) 566-9380
JEAN F. VASILOFF
Plaintiff
v.
GEORGE M. VASILOFF, SR.
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
.NO. Off' -4-R.
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CIVIL ACTION - LAW
DIVORCE
NOTICE
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 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
Court Administrator, 4 h Floor, 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
4`h Floor, Cumberland County Courthouse
Carlisle, PA 17013
(717) 240-6200
JEAN F. VASILOFF
Plaintiff
V.
GEORGE M. VASILOF>a, SR.
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
:NO. 07 - G i" /- 6-t,- J -7-1,...,
: CIVIL ACTION - LAW
: DIVORCE
COMPLAINT
AND NOW, comes Plaintiff, Jean F. Vasiloff, by and through her attorney, James W.
Abraham, Esquire, Abraham Law Offices, Hummelstown, Pennsylvania, and files the following:
COUNT I - DIVORCE
(Pursuant to 23 Pa.C.S.A. Section 3301(c))
1. Plaintiff, Jean F. Vasiloff, is an adult individual who currently resides at 11 Silver
Drive, Mechanicsburg, Cumberland County, Pennsylvania, 17050.
2. Defendant, George M. Vasiloff, Sr., is an adult individual who currently resides at 11
Silver Drive, Mechanicsburg, Cumberland County, Pennsylvania, 17050.
3. Plaintiff and Defendant have been bona fide residents of the Commonwealth of
Pennsylvania for at least six (6) months immediately prior to the filing of this Complaint.
4. Plaintiff and Defendant were married on August 8, 1964 in Gettysburg, Pennsylvania.
5. There have been no prior actions of divorce or for annulment between the
parties.
6. The marriage is irretrievably broken.
7. Plaintiff has been advised that counseling is available and that Plaintiff may
have the right to request that the Court require the parties to participate in counseling.
8. Plaintiff and Defendant are not members of the Armed Forces of the United States.
WHEREFORE, Plaintiff requests Your Honorable Court to enter a decree in divorce
dissolving the marriage.
Respectfully su itted:
James W. Abraham, Esq.
Abraham Law Offices
45 East Main Street
Hummelstown, PA 17036
(717) 566-9380
Attorney for Plaintiff.
Jean F. Vasiloff
DATE: 2/5/07
VERIFICATION
I, ti4 +?( U , I/'4S / L D F F , the undersigned, hereby
verify and confirm that the foregoing document and the statements made therein are true and
correct to the best of my knowledge, information and belief. I further understand that any false
statements made herein are subject to the penalties of 18 Pa.C.S.A. Section 4904 relating to
unsworn falsification to authorities.
DATE:/
CERTIFICATE OF SERVICE
I, James W. Abraham, Esquire, the undersigned, hereby certify that I have served a true
and correct copy of the foregoing document, by certified mail, upon the following person at the
following address on the date stated herein:
George M. Vasiloff, Sr.
11 Silver Drive
Mechanicsburg, PA 17050
DATE: 2/5/07
James W. Abraham, Esquire
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JEAN F. VASILOFF : IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : NO. 07 - 686 CIVIL TERM
GEORGE M. VASILOFF, SR. : CIVIL ACTION - LAW
Defendant : DIVORCE
AFFIDAVIT OF SERVICE
I, James W. Abraham, Esquire, the undersigned, as attorney for Plaintiff, Jean F.
Vasiloff, in the above-captioned action, hereby affirm that the Complaint in Divorce filed herein,
was served upon Defendant, George M. Vasiloff, Sr., by certified mail on February 7, 2008, as
verified by the green return receipt card from the US Post Office, which is attached below:
¦ Complete items 1, 2, and 3. Also complete
item 4 If Restricted Delivery is desired.
¦ Print your name and address on the reverse
so that we can return the card to you.
¦ Attach this card to the back of the mailpieos,
or on the front If space permits.
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DATE: 4/29108
James W. Aboitham, Esquire
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JEAN F. VASILOFF : IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : NO. 07 - 686 CIVIL TERM
GEORGE M. VASILOFF, SR. : CIVIL ACTION - LAW
Defendant : IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under Section 3301 (c) of the Divorce Code was filed on
February 5, 2007.
2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days
have elapsed from the date of service and filing 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 the Affidavit are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C,S.A. Section 4904, relating to
the unworn falsification to authorities.
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DATE: S -oe Qda,2 -
JE F. VASILOFF, Pl ' tiff
WAIVER OF NOTICE OF INTENTION TO REQUEST
ENTRY OF DIVORCE DECREE UNDER SETION 3301(c) OF THE DIVORCE CODE
1. I consent to the entry of a final decree of 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 Waiver are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to the
unworn falsification to authorities.
DATE: C{'? 6 e bL z,-,&
JEAN V. VASILOFF, Plaintiff
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JEAN F. VASILOFF
Plaintiff
V.
GEORGE M. VASILOFF, SR.
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
: NO. 07 - 686 CIVIL TERM
: CIVIL ACTION - LAW
: IN DIVORCE
AFFIDAVIT OF CONSENT
A Complaint in Divorce under Section 3301 (c) of the Divorce Code was filed on
February 5, 2007.
2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days
have elapsed from the date of service and filing of the Complaint.
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 the Affidavit are true and correct. I understand that
false statements herein are made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to
the unsworn falsification to authorities.
G
DATE: 07
GEORGE M. V ILO F, SR., Defend
WAIVER OF NOTICE INTENTION TO REQUEST
ENTRY OF DIVORCE DECREE UNDER SETION 3301(c) OF THE DIVORCE CODE
1. 1 consent to the entry of a final decree of 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 Waiver are true and correct. I understand that false
statements herein are made subject to the penalties of 18 Pa.C.S.A. Section 4904, relating to the
unsworn falsification to authorities.
DATE: 07
GEAR M. VASILOFF, SR., endant
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JEAN F, VASILOFF
Plaintiff
V.
GEORGE M. VASILOFF, SR.
Defendant
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
: NO. 07 - 686 CIVIL TERM
CIVIL ACTION - LAW
IN DIVORCE
MA]tLTAL SETTLEMENT AG MENT
THIS AGREEMENT, made this ' o2sPt day of 4PPI- , 2048, by and
between JEAN F. VASILOFF ("Wife"), of Mechanicsburg, Pennsylvania and GEORGE M.
V ASILOFF, SR. ("Husband"), of Mechanicsburg, Pennsylvania.
WITNEIMTH
WHEREAS, the parties hereto are Husband and Wife, married on August 8,1964 in
Gettysburg, Pennsylvania.
WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the
parties and it is the intention of Husband and Wife to live separate and apart for the
rest of their natural lives, and the parties hereto are desirous of settling fully and finally their
respective financial and property rights and obligations as between each other including,
without limitation by specification: the settling of all matters between. them relating to the
ownership and equitable distribution of real and personal property, and the settling of any and all
claims and possible claims by one against the other or against their respective estates, as well as
any other matters related hereto.
NOW THEREFORE, in consideration of the mutual promises, covenants and undertakings
hereinafter set forth and for other good and valuable consideration, receipt of which is hereby
acknowledged by each of the parties hereto, Husband and. Wife, each intending to be legally bound
hereby, covenant and agree as follows:
1. AGREEMENT NOT A BAR TO DIVORCE PROCEEDINGS:
This Agreement shall not be considered to affect or bar the right of Husband and Wife to an
absolute divorce on lawful grounds if such grounds now exist or shall hereafter exist or to
such defense as may be available to either party. This Agreement is not intended to condone and
shall not be deemed to be a condonation on the part of either party hereto of any art or acts
on the part of the other party which have occasioned the disputes or unhappy differences which
may occur subsequent to the date hereof. The parties intend to secure a mutual consent, no-fault
divorce pursuant to the terms of Section 3301(c) of the Divorce Code of 1980, as amended February
12,1988.
2. EFFECT OF DIVORCE DECREE:
The parties agree that unless otherwise specifically provided herein, this Agreement shall
continue in full force and effect after such time as a final decree in divorce may be entered with
respect to the parties. The parties agree that in the event of absolute divorce between them, they
shall nonetheless continue to be bound by all the terms of this Agreement.
3. DATE OF EXECUTION:
The "date of execution" or "execution date" of this Agreement shall be defined as the date
of execution by the party last executing this Agreement.
4. DISTRIBUTION DATE:
The transfer of property, funds and/or documents provided for herein shall only take place
on the "distribution date" which shall be defined as the date of execution of this Agreement, unless
otherwise specified herein.
5. CONSENT OF PARTIES/ADVICE OF COUNSEL:
Husband and Wife acknowledge that they fully understand the facts as to their legal rights
and obligations under this Agreement. Husband and Wife acknowledge and accept that this
Agreement is, under the circumstances, fair and equitable and that it is being entered into freely and
voluntarily, and that the execution of this Agreement is not the result of any collusion or improper
or illegal agreement or agreements. Husband and Wife acknowledge that they have each had the
opportunity to have this Agreement reviewed by an attorney and/or have done so, prior to signing.
6. FINANCIAL DISCLOSURE:
The parties acknowledge, confirm and verify that each has relied on the substantial accuracy
of the financial disclosure of the other, except as set forth herein as an inducement to the execution
of this Agreement. In the event Husband or Wife has failed to disclose any information regarding
any marital asset and/or marital debt, the parties' reserve the right to equitable distribution of said
marital asset(s) and/or debt(s), even after the entry of a decree in divorce; and further reserve any
other rights which may arise from said non-disclosure, even after the entry of a decree in divorce.
7. PERSONAL PROPERTY:
A. Household. Furnishings: Husband and Wife agree that Husband shall receive the
following items of personal property:
12 point Weider exercise machine,
Computer desk in family room.
JVC 36" TV and stand.
Oak Armoire.
Gun cabinet.
Black leather recliner.
Personal belongings and tools.
Lazyboy sofa on porch.
2
B, Husband's Accident Claim: Wife hereby waives any and all marital, equitable or other
legal interest in Husband's injury claim for an accident which occurred on or about March
14, 2007 and Wife will sign any documents necessary to accomplish this result.
Except as otherwise stated in this Agreement, Husband and Fife agree that all other
personal property has been divided to the parties' mutual satisfaction, including but not limited to,
bank accounts, vehicles and household items, and neither party shall make a claim against the
property in the other's possession.
& REAL PROPERTY:
Husband and Wife hereby agree that the former marital residence, located at I I Silver
Drive, Mechanicsburg, Pennsylvania, is marital property. Husband and Wife agree that said
property shall become the sole and separate property of Wife upon Wife's refinancing of the
mortgage and payment to Husband in the amount of Twenty Five Thousand ($25,000.00) Dollars.
Husband and Wife agree that Husband shall execute a deed transferring sole title to the property to
Wife upon the execution of this Agreement, which deed shall be held by Husband's attorney
pending the refinancing. Fife further agrees to pay off the parties' credit card debt, in the amount
of approximately Seven Thousand ($7,000.00) Dollars from said refinancing.
Wife shall refinance the property and pay Husband the aforesaid amount within six (6)
months from the date of this Agreement. In. the event Wife fails to refinance within said time
period, Wife agrees to list the property for sale with a realtor and to sell the property for at least its
fair market value and Husband shall receive the aforesaid amount and the aforesaid credit card debt
shall be paid from the net sales proceeds. Wife shall keep any remaining sales proceeds as her sole
and separate property.
Husband and Wife further agree that Wife shall be responsible to pay the mortgage, utilities,
homeowners insurance, taxes and all other liens and/or costs relating to the property pending the
refinancing and/or sale and shall hold Husband harmless and indemnify Husband as to any default
as to said financial and/or legal obligations.
Husband and Wife agree that Wife shall have exclusive possession of the property as of the
date of this Agreement, pending the refinancing or sale of the property.
9. PENSION AND RETIREMENT BENEFITS/FINANCIAL ACCOUNTS:
Husband and Wife agree that Husband shall receive Thirty Five Thousand ($35,000.00)
Dollars _from Wife's 401(k) account through her employer, less any income tax consequences or
penalties incurred by Wife as a result of the payment to Husband from Wife's 401(k) account.
Wife hereby waives any and all entitlement to Husband's remaining retirement account,
except that Fife shall continue to be the sole death beneficiary of Husband's retirement account.
Husband shall be the sole death beneficiary of Wife's retirement account.
Husband shall be entitled to receive the aforesaid $35,000.00 from Wife's 401(k), less any
income tax consequences or penalties to Wife as a result of said payment to Husband from Wife's
401(k) account, in a lump sum pursuant to a Qualified. Domestic Relations Order which shall be
prepared and submitted by Wife's attorney.
Except as stated herein, Husband and Wife shall forever waive any and all legal or equitable
interest in the other's pension and/or retirement benefits or any other financial accounts, which
either party has through their respective employer or otherwise; and neither party shall make any
claim against the other's pension or retirement benefits at any time.
10. AFTER ACQUIRED PROPERTY:
Each of the parties shall own and enjoy, independently of any claims or right of the other,
all items of personal properly, tangible or intangible, and/or real property, acquired by him or her,
after the date of final separation, on or about March 1, 2006, with full power in him or her to
dispose of the same as fully and effectively, in all respect and for all purposes, as though he or she
were unmarried.
11. WIFE'S DEBTS:
Fife represents and warrants to Husband that since the date of final separation, on or about
March 1, 2006, she has not contracted or incurred any debt or liability for which Husband or his
estate might be responsible and Wife further represents and warrants to Husband that she will not
contrac or incur any debt or liability after the execution of this Agreement for which Husband or
his estate might be responsible. Wife shall indemnify and save harmless Husband from any and all
claims or demands made against Husband by reason of debts or obligations incurred by Wife.
12. HUSBAND'S DEBTS:
Husband represents and warrants to Wife that since the date of final separation, on or about
March 1, 2006, he has not contracted or incurred any debt or liability for which Wife or her estate
might be responsible and Husband further represents and warrants to Wife that he will not contract
or incur any debtor liability after the execution of this Agreement for which Wife or her estate
might be responsible. Husband shall indemnify and save harmless Wife from any and all claims or
demands against Wife by reason of debts or obligations incurred by Husband.
13. WAIVER OF RIGHTS:
The parties hereto fully understand their rights under and pursuant to the Divorce Code, Act
of 1980, as Amended February 12,1988, particularly the provisions for alimony, alimony pendente
4
lite, spousal support, equitable distribution of marital property, attorney fees and expenses. Both
parties agree that this Agreement shall conclusively provide for the distribution of property under
the said law, the parties hereby waive, release and forever relinquish any further rights they may
respectively have against the other for alimony, alimony pendente lite, spousal support, equitable
distribution of marital property, attorney fees and expenses.
14. PERSONAL RIGHTS:
Husband and Wife may and shall, at all times hereafter, live separate and apart. They shall
be free from any control, restraint, interference or authority, direct or indirect, by the other in all
respects as fully as if they were unmarried. They may reside at such place or places as they may
select. Each may, for his or her separate use or benefit, engage in any business, occupation,
profession or employment which to him or her may seem advisable. Husband and Wife shall not
molest, harass, disturb or malign each other or the respective families of each other nor compel or
attempt to compel the other to cohabitate or dwell by any means or in any manner whatsoever with
him or her.
1 S. MUTUAL RELEASE:
Except as otherwise stated hereto, Husband and Wife each hereby mutually remise, release,
quitclaim and forever discharge the other and the estate of each other, for all time to come, and
for all purposes whatsoever, of and from any and all rights, title and interests, or claims in or
against the property (including income and gain from property hereafter accruing) of the other or
against the estate of each other, of whatever nature and wheresoever situate, which he or she now
has or may have at any time in the future.
Husband and Wife each hereby further mutually remise, release, quitclaim, waive and
forever discharge the other and the estate of each other, for all time to come and for all purposes
whatsoever, of and from any and all rights which either party may have, or at any time hereafter
have, for past, present or future spousal support or maintenance, alimony, alimony pendente lite,
equitable distribution of marital property, attorney fees, costs or expenses, whether arising as a
result of the marital relation or otherwise, except, and only except, all rights and agreements and
obligations of whatsoever nature arising or which may arise under this Agreement or for the breach
of any provision thereof..
It is the intention of Husband and. Wife to give to each other by the execution of this
Agreement a full, complete and general release with respect to any and all property of any kind
or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and
only except all rights and agreements and obligations of whatsoever nature arising or which
may arise under this Agreement or for the breach of any provision thereof.
16. WAIVER OR MODIFICATION TO BE IN WRITING:
A modification or waiver of any of the terms of this Agreement shall be effective only if in
writing, signed by both parties and executed with the same formality as this Agreement. No waiver
of any breach hereof or default hereunder shall be deemed a waiver of any subsequent default of
the same or similar nature.
17. MUTUAL COOPERATION:
Each party shall, at any time and from time to time hereafter, take any and all steps and
execute, acknowledge and deliver to the other party, any and all future instruments and/or
documents that the other party may reasonably require for that purpose of giving full force and
effect to the provisions of this Agreement.
18. INTEGRATION:
This Agreement constitutes the entire understanding of the parties and supersedes any and
all prior agreements and negotiations between them. There are no representations or warranties
other than those expressly set forth herein.
19. AGREEMENT BINDING ON HEIRS:
This Agreement shall be binding and shall inure to the benefit of the parties hereto and their
respective legatees, devises, heirs, executors, administrators, successors and assigns in the interest
of the parties.
20. OTHER. DOCUMENTATION:
Wife and Husband covenant and agree that they will forthwith and within thirty (30) days
after demand or due date, execute any and all written instruments, assignments, releases,
satisfactions, deeds, notes, stock certificates, or such other writings as may be necessary or
desirable for the proper effectuation. of this Agreement, and as their respective counsel
shall mutually agree, should be so executed in order to carry out fully and effectively the terms of
this Agreement.
21. NO WAIVER OF DEFAULT:
This Agreement shall remain in full force and effect unless and until terminated under and
pursuant to the terms of this Agreement. The failure of either party to insist upon strict
performance of any of the provisions of this Agreement shall in no way affect the right of such.
party hereafter to enforce the same, nor shall the waiver of any subsequent default of the same or
similar nature, nor shall it be construed as a waiver of strict performance of any other obligations
herein.
6
22. BREACH:
If either party breaches any provision of this Agreement, the other party shall have the
rights, at his or her election, to sue in law or in equity to enforce any rights and remedies which
the party may have, and the party breaching this Agreement shall be responsible for payment of
attorney fees and all costs incurred by the other in enforcing his or her rights under this
Agreement.
23. SEVERABILITY:
If any term, condition, clause or provisions of this Agreement shall be determined or
declared to be void or invalid in laws or otherwise, then only that term, condition, clause or
provision shall be stricken from this Agreement and in all other respects this Agreement shall be
valid and continue in full force, effect and operation. Likewise, the failure of any party
to meet his or her obligations under any one or more of the provisions herein, with the exception of
the satisfaction of the conditions precedent, shall in no way avoid or alter the
remaining obligations of the parties.
24. LAW OF PENNSYLVANIA APPLICABLE:
This Agreement shall be construed in accordance with the laws of the Commonwealth of
Pennsylvania.
25, HEADINGS NOT PART OF AGREEMENT:
Any headings preceding the text of the several paragraphs/provisions and subparagraphs
hereof, are inserted solely for convenience of reference and shall not constitute a part of this
Agreement nor shall they affect its meaning, construction or effect.
26. DIVORCE:.
The parties hereto agree that their marriage is irretrievably broken, and subsequent to the
filing of a Complaint in Divorce, both parties agree to enter into a mutual consent divorce under
Section 3301(c) of the Pennsylvania Divorce Code of 1980, as amended February 12,1988. The
parties further agree to sign the necessary documents, including the Affidavit of Consent
and. Waiver, concurrently with the execution of this Agreement. Wife shall finalize the divorce in
January, 2007 and provide Husband with a certified copy of the divorce decree. This Agreement
shall be incorporated, but shall not merge, into the final decree in divorce.
7
WITNESS WHEREOF, the parties hereto, have set their hands and seals the day and year
first above written.
Witness:
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JEAbt F. VASILOFF
GEORGE VASILOFF, SR.
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF ?)OtJo4ivL SS:
On this o? ??tF day of Apkilc- , 2008, before me, the subscriber, a Notary
Public, in and for the said Commonwealth and County, came the above-named person,
Jean F. Vasiloff, satisfactorily proven to me to be the person whose name is subscribed to the
within instrument and acknowledged that she executed the same for the purposes stated herein
contained and that such instrument may be recorded.
W72; Notarial seal.
NOTARY PUBLIC
MY COMMISSION EXPIRES:
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF CLU-P
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SS:
On this Ord day of n/3? 2008, before me, the subscriber, a Notary
Public, in and for the said Commonwealth and County, came the above-named person,
George M. Vasiloff Sr. satisfactorily proven to me to be the person whose name is subscribed to
the within instrument and acknowledged that she executed the same for the purposes stated herein
contained and that such instrument may be recorded.
WITNESS my hand and Notarial seal.
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ABRAHAM LAW OFFICES
45 East Main Street, Hummelstown. PA 17036
(717) 566-9380
JEAN F. VASILOFF : IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : NO. 07 - 686 CIVIL TERM
GEORGE M. VASILOFF, SR. : CIVIL ACTION - LAW
Defendant : DIVORCE
PRAECIPE TO TRANSMIT RECORD
TO THE PROTHONOTARY:
Transmit the Record, together with the following information, to the Court for the entry
of a divorce decree:
1. Ground for Divorce: irretrievable breakdown under Section x 3301(c)
( ) 3301(d)(1) of the Divorce Code.
2. Date and manner of service of the Complaint: Febniary 7, 2007 by certified mail, see
attached Affidavit of Service.
3. Complete either paragraph (a) or (b):
(a) Date of execution of the Affidavit of Consent required by Section 3301(c)
of the Divorce Code: by Plaintiff on 4/25/08; and by Defendant on 4/23/08.
(b)(1) Date of execution of the affidavit required by Section 3301(d) of the
Divorce Code:
(2) Date of filing and service of plaintiff's affidavit upon the Defendant
4. Related claims pending: None pursuant to April 25, 2008 Marital Settlement
Agreement.
5. Complete either paragraph (a) or (b).
(a) Date and manner of service of the notice of intention to file praecipe to
transmit record, a copy of which is attached:
(b) Date Plaintiffs Waiver of Notice was filed with the Prothonotary: 4/29/08.
(c) Date Defendant's Waiver of Notice was filed with the Prothonotary: 4/29/08.
Respectfully sub 'tted:
James W. Abraham, Esquire
Abraham Law Offices
45 East Main Street
Hummelstown, PA 17036
(717) 566-9380
DATE: 4/29/08 Attorney for Plaintiff, Jean F. Vasiloff
C"` ry
CEO
IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
STATE OF PENNA.
JEAN F. VASILOFF
VERSUS
GEORGE M. VASILOFF, SR.
No. 07 - 686
DECREE IN
DIVORCE
AND NOW, 2008, IT IS ORDERED AND
JEAN F. VASILOFF
DECREED THAT PLAINTIFF,
AND
GEORGE M. VASILOFF, SR.
ARE DIVORCED FROM THE BONDS OF MATRIMONY.
,DEFENDANT,
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;
The Marital Settlement Agreement dated April 25, 2008, attached hereto,
shall be incorporated, but shall not e,--b4to the Decree in Divorce.
B't T H E
ATTEST: 1
PROTHONOTARY
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JAN 0 l Z009
JEAN F. VASILOFF : IN THE COURT OF COMMON PLEAS
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
V. : NO. 07 - 686 CIVIL TERM
GEORGE M. VASILOFF, SR. : CIVIL ACTION - LAW
Defendant : DIVORCE
QUALIFIED DOMESTIC RELATIONS ORDER
This order relates to the provision of marital property rights to a former spouse of
the Participant and is made pursuant to the domestic relations law of the Commonwealth
of Pennsylvania. The cause coming on to be heard upon the motion of both parties, the
court having entered a Decree in Divorce and this order having been agreed to by each of
the parties, and said agreement being incorporated into Decree in Divorce.
IT IS HEREBY ORDERED THAT:
Identification of Parties:
1. The name, social security number, address and birth date of the Participant is
as follows:
Jean F. Vasiloff
Social Security No.: 205-34-8161
D.O.B. : June 11, 1943
11 Silver Drive
Mechanicsburg, PA 17050
2. The name, social security number, address and birth date of the Alternate
Payee is as follows:
George M. Vasiloff, Sr.
Social Security No: 210-32-0502
D.O.B: June 8, 1942
6554 Win&*re Road
Harrisburg, PA 17110
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Name of Plan To Which This Order Applies:
3. This order applies only to the Highmark Investment Plan (the "Plan").
Plan Sponsor:
4. The Plan sponsor is Highmark, Inc.
Plan Administrator:
5. The Plan administrator is:
Mr. Rich Little
Highmark, Inc.
1800 Center Street
PO Box 890089
Camp Hill, PA 17089
Award to Alternative Pavee:
6. The Alternate Payee will obtain Thirty Five Thousand ($35,000.00) Dollars
of Participant's vested account balance under the Plan determined as of May 6, 2008.
The determined amount will not be credited or debited with any gains or losses
attributable to such amount for the period from the date of determination to the date of
transfer of the calculated award to an account in the Alternate Payee's name under the
Plan.
7. After transfer of the aforesaid amount to the Alternate Payee's account, the
Participant shall be awarded all right, title and interest in and to the Participant's account
balance, as reduced above, under the Plan free and clear of any interest of the Alternate
Payee.
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8. In the event of the Participant's death, there will be no effect on the payment
of the benefit assigned to the Alternate Payee hereunder. With respect to the
Participant's account balance under the Plan not assigned and/or transferred to Alternate
Payee under this Order, the Alternate Payee shall not be entitled to any survivor benefits.
10. In the event of the Alternate Payee's death before receipt of the assigned
benefit, such benefit shall be payable to the designated beneficiary of the Alternative
Payee or, if there is no designated beneficiary, to the Alternate Payee's (a) spouse or, if
none, (b) living children or, if none, (c) living parents or, if none, (d) living brothers and
sisters or, if none (e) estate; provided, however, that once benefits have commenced to
the Alternate Payee, the form of benefit elected shall determine if any additional amounts
shall be paid upon the Alternate Payee's death.
Compliance With The Provisions Of The Law:
11. It is the Court's intention that the provisions of the Order operate as an
effective assignment of said interest under both state and federal law, for all purposes,
and constitute a "qualified domestic relations order" ("QDRO") as defined in Section
414(p) of the Internal Revenue Code of 1986, as amended (the "Code") and Section
206(d)(3)(B) of the Employee Retirement Income Security Act of 1974, as amended
("ERISA" ).
This QDRO is granted in accordance with Title 23 Pa. C. S. Section 3301 et. seq.
and Section 3501 et. seq. of the Pennsylvania Divorce Code, which relate to marital
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property rights between spouses and former spouses in matrimonial actions. In the event
that it is subsequently determined by the Plan Administrator for the Plan, by a court of
competent jurisdiction, or otherwise, that the provisions of this Order fail to meet the
requirements of a QDRO, both parties shall cooperate fully and shall execute any and all
documents necessary to obtain an Amended Judgment and Decree containing the Order
of this Court, meeting all requirements of a QDRO and this Court expressly reserves
jurisdiction over the Participant's benefits in the above named Plan as of the date of entry
of the Judgment and Decree, in order to effectuate the assignment of benefits ordered
above. This Order supersedes all previously filed Orders in this matter relating to this
subject, except for the parties' Marital Settlement Agreement, dated April 25, 2008.
Savings Clause:
12. This Order is not intended, and shall not be construed in such a manner as, to
require the Plan:
(a) to provide any type or form of benefit option not otherwise provided uner
the terms of the Plan;
(b) to increased benefits;
(c) to require the payment of any benefits to the Alternate Payee which are
required to be paid to another Alternate Payee under another order which
was previously deemed to be a QDRO.
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Plan Administration/Recove of Excess Amounts:
13. The Alternate Payee is ordered to report any retirement payments received
on any applicable income tax return. The Plan Trustee is authorized to issue a
forml099-R on any direct payments to the Alternate Payee.
14. The Alternate Payee shall keep Highmark, Inc. informed of their current
address. Notice of change of address shall be made in writing, witnessed by a Notary,
and mailed to:
Wachovia Bank, N.A.
ATTN: QDRO Administrator
901 Marquette Avenue, Suite 500
Minneapolis, MN 55402
15. In the event that the Plan Trustee inadvertently pays to the Participant any
benefits that are assigned to the Alternate Payee pursuant to the terms of this Order, the
Participant shall immediately reimburse the Alternate Payee to the extent that he or she
has received such benefit payment and shall forthwith pay such amount so received
directly to the Alternate Payee within ten (10) days of receipt.
16. The Participant and the Alternate Payee shall hold the Plan, Highmark, Inc.,
and any fiduciary harmless from any liabilities, which arise from this QDRO, including
all reasonable attorney's fees which may be incurred in connection with any claims
which are asserted because the Plan honors this Order.
BY CO
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AGREED AND ACCEPTED:
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Partici t, Jean F. Vasiloff
Participant's Attorney,
James W. Abraham, Esquire
Abraham Law Offices
Alternate ayee, George M. Vasil r:
5".. lid
Alternate Payee's Attorney,
Ira H. Weinstock, Esquire
Ira H Weinstock, PC