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HomeMy WebLinkAbout03-0572KIMBERLY BELZ, : Plaintiff: VS. : STEPHEN BELZ, : Defendant : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW IN 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 of divorce or annulment may be entered against you by the court. A judgement 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 divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counselling. A list of marriage counselors is available at: The Office of the Prothonotary, Dauphin County Courthouse, Front and Market Streets, Harrisburg, Pennsylvania 17101. 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 (717) 249-3166 MEYERS, DESFOR, SAL'IrZGIVER & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 ° FAX (717) 236-2817 KIMBERLY BELZ, : Plaintiff: V~. : STEPHEN BELZ, : Defendant : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. CIVIL ACTION - LAW IN DIVORCE NOTICIA LE HAN DEMANDADO A USTED EN LA CORTE. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene veinte (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia escrita o en persona o por abogado y archivar en la corte en forma escrita sus defensas o sus objeciones a las demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomaro medidas y puede entrar una orden contra usted sin previo aviso o notificacion y por cualquier queja o alivio que es pedido en la peticion do demanda. Usted puede perder dinero o sus propiedades o otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATAMENTE. SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. CUMBERLAND COUNTY BAR ASSOCIATION 2 Liberty Avenue Carlisle, Pennsylvania 17013 (717) 249-3166 MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 · FAX (717) 236-2817 KIMBERLY BELZ, VS. STEPHEN BELZ, : IN THE COURT OF COMMON PLEAS Plaintiff: CUMBERLAND COUNTY, PENNSYLVANIA : CIVIL ACTION - LAW Defendant : IN DIVORCE COMPLAINT IN DIVORCE AND NOW, comes the Plaintiff, Kimberly Belz, by and through her attorneys, Meyers, Desfor, Saltzgiver & Boyle, and files the following Complaint in Divorce and in support thereof avers as follows: 1. Plaintiff is Kimberly Belz, an adult individual who currently resides at 519 Susan Road, Camp Hill, Pennsylvania. 2. Defendant is Stephen Belz, an adult individual who currently resides at 519 Susan Road, Camp Hill, Pennsylvania. 3. Plaintiff has been a bona fide resident of the Commonwealth of Pennsylvania for at least six (6) months immediately previous to the filing of this Complaint. 4. The Plaintiff and Defendant were married on June 25, 1988 in Lewisberry, Pennsylvania. 5. There have been no prior actions of divorce or annulment between the parties. 6. The marriage is irretrievably broken. 7. The Defendant is not a member of the United States Army or its allies. MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P.O~ BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 · FAX (717) 236-2817 8. Plaintiff has been advised that counseling is available and that Plaintiff may have the right to request the Court require the parties to participate in counseling, being so advised, Plaintiff waives that right. 9. Plaintiff requests the Court to enter a Decree of Divorce pursuant to Section 3301(C) or 3301(D) of the Divorce Code. WHEREFORE, Plaintiff, Kimberly Belz respectfully requests this Honorable Court enter a Decree in Divorce pursuant to Section 3301(C) or 3301{D) of the Divorce Code. COUNTS COUNT I EQUITABLE DISTRIBUTION 10. Paragraphs one through nine of the Complaint are incorporated by reference as if fully set forth herein. 11. During the marriage, Plaintiff and Defendant have acquired various items of marital property, both real and personal, which are subject to equitable distribution under the Divorce Code. 12. Plaintiff requests that this Honorable Court equitably distribute all marital property pursuant to the Divorce Code. MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 · FAX (717) 236-2817 WHEREFORE, Plaintiff, Kimberly Belz, respectfully requests this Honorable Court equitably distribute all property acquired by the parties during their marriage. Respectfully submitted, Laurie A ~al~iz~ v~r, ~ MEYERS , DESFOR, ALTZGI~ & BOYLE Attorney I.D. ~61382 410 North Second Street P.O. Box 1062 Harrisburg, PA 17108 (717) 236-9428 Attorney for Plaintiff iuire ~R Date: February 5, 2003 MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 171O8 (717) 236-9428 · FAX (717} 236-2817 VERIFICATION I, Kimberly B~lz , verify that the statements made in this Complaint in Divorce are true and correct to the best of my knowledge, information and belief. 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. Dated: 2/5/03 (X) plaintif~-~ ( ) Defendant MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 · FAX (717) 236-2817 KIMBERLY BELZ, VS. STEPHEN BELZ, Plaintiff: : : : : Defendant : IN THE CO[~T OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 03-572 CIVIL ACTION - LAW IN DIVORCE PROOF OF SERVICE · Complete items !, 2, and 3. Also ~:omplete 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 mallpiece, or on the front if space permits. 1. ~icle Addressed to: Stephen Belz 4070 Mayflower Road Fort Myers, FL 33916 X ~:' '~ [] A~ent [] Addm%~e D. Is delivery address different from ite~6,1~r-I Yes 3. Service Type ~ [] Certified Mail [] Express Mail ~ [] Registered I-I Return Receipt for Merchandise [] Insured Mail [] C.O.D. ~ 4. Restricted Delivery? (Extra Fee) 2. Article NUmber - - - .. (transfer f~om serv~e ,abe,) _ 700 ~_* 0320 .000 2 7583 .2893 . PS Form 3811, March 2001 Domestic Return Receipt 102595-01-M-1424 ............ =_~ :~,t a.a~ ~ ,am 1,.11.,11,1,1 ..... U,II,,,h,ll,,h,Jl,,.,lhl~ MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 ° HARRISBURG, PA 17108 (717) 236-9428 · FAX (717) 2:36-2817 MARITAL SETTLEMENT AGREF-MENT THIS AGREEMENT made this /~ day of ~ ~, 2003 by and between Kimberly M. Belz (hereinafter referred to as "Wife") of Camp Hill, PA and Stephen C. Belz (hereinafter referred to as "Husband") of Fort Myers, Florida. WI TNE S SETH : WHEREAS, Husband and Wife were lawfully married on June 25, 1988 in York County, Pennsylvania; and WHEREAS, no children have been conceived of this marriage; and WHEREAS, diverse differences and difficulties have arisen between the parties respecting their interests, rights and title in and to certain property, real and/or personal, owned by or in possession of the said parties to either of them; and WHEREAS, Husband and Wife desire to settle and determine their rights and obligations and to amicably adjust, compromise and forever settle all property rights and[ all rights in, to or against each other's property or estate of any kind or nature whatsoever, including property heretofore or subsequently acquired by either party and to settle all disputes existing between them, including any and all claims for Wife's and/or Husband's rights to equitable distribution., maintenance and/or support, alimony, alimony pendente lite, counsel fees and costs; and WHEREAS, the parties acknowledge and agree that in entering into this Agreement, including foregoing waivers, they are each relying on truth and completeness in all material respects as to all information provided by the other party hereto regarding the assets of such person. NOW THEREFORE, in consideration of the mutual promises, covenants and agreements hereinafter contained, each of the parties hereto intending to be legally bound hereby promises, covenants and agrees as follows: DIVORCE: The parties agree that their marriage is irretrievably broken and that they mutually consent to a divorce. The parties agree and have executed all necessary Affidavits of Consent and Waivers of Notice forms required by the court for the entry of a mutual consent divorce. The parties agree to immediately file with the Court said Affidavits and Waivers and file the appropriate documents to request a Decree in Divorce from the bonds of matrimony under Section 3301(c) of the Divorce Code. FULL FORCE AND EFFECT: This Agreement shall continue in full force and effect until such time of final Decree in Divorce is entered. 3 o AGREEMENT TO CONTINUE IN EVENT OF DIVORCE: In the event that the marriage of the parties hereto is terminated by divorce, this Agreement shall nevertheless remain in full force and effect, and shall survive such decree and shall not in any way be affected thereby, except as provided for herein. o INTERFERENCE: Each party shall be free from interference, authority, and contact by the other, as fully as if he or she were single and unmarried except as may be necessary to carry out the provisions of this Agreement. Neither party shall compel the other to cohabit with the other, or in any way harass or malign the other, nor in any way interfere with the peaceful existence, separate and apart from the other. WIFE'S DEBTS: Wife represents and warrants to Husband that since the parties' separation, to wit, January 24, 2003 she has not and in the future she will not, contract or incur any debt or liability for which Husband or his estate might be responsible and shall indemnify and save harmless Husband from any and all claims or demands made against him by reason of debts or obligations incurred by her. 3 R-dSBAND'S DEBTS: Husband represents and warrants to Wife that since the parties' separation, to wit, January 24, 2003 he has not and in the future he will not, contract or incur any debt or liability for which Wife or her estate might be responsible and shall indemnify and save harmless Wife from any and all claims or demands made a~iainst her by reason of debts or obligations incurred by him. 7 o DISCOV~RY/FINAi~CIAL DISCLOSURE: The parties agree and acknowledge that they have each had the opportunity to conduct discovery and investigation of the assets of both parties. The parties agree and acknowledge that they have made full and fair disclosure of all of their assets and income to the other party. The parties acknowledge that they have both been given the opportunity to conduct investigation into all assets, whether separate or marital, prior to entry into this agreement. Both Husband and Wife acknowledge they have had full and fair disclosure of all assets prior to execution of this agreement. Furthermore, the parties acknowledge that they have both had full disclosure as to both parties income and financial condition. MUTUAL RELEASES: Subject to the provisions of this Agreement, each party has released and discharged, and by 4 this Agreement does for himself or herself and his or her heirs, legal representatives, executors, administrators and assigns, release and discharge the other of and from all causes of action, claims, rights, or demands, whatsoever in law or equity, which either of the parties ever had or now has against the other, except any or all causes of action for termination of the marriage by divorce or annulment and except any or all causes of action for breach of any provisions of this Agreement. Husband and Wife specifically release and waive any and all rights he or she might have to raise claims under the Divorce Code of 1980, as amended in 1988 including, but not limited to claims for equitable distribution of marital property, support, alimony, alimony pendente lite, counsel fees or expenses. The fact that a party brings an action to enforce the property agreement as incorporated in the divorce decree, under the Divorce Code of 1980, as amended in 1988, does not give either party the right to raise other claims under the Divorce Code, specifically waived and released by this paragraph and all rights and obligations of the parties arising out of the marriage shall be determined by this Agreement. RELEASE OF TESTAMENTARY CLAIMS: Except as provided for in this Agreement, each of the parties hereto shall have the right to dispose of his or her property by Last Will and Testament or otherwise and each of them agree that the 5 estate of the other, whether real, personal or mixed, shall be and belong to the person or persons who would become entitled thereto as if the decedent had been the last to die. This provision is intended to constitute a mutual waiver by the parties of any rights to take against each other's Last Wills under the present or future laws of any jurisdiction whatsoever and is intended to confer third- party beneficiary rights upon the other heirs and beneficiaries of each. 10. AGREF~MENT BINDING ON HEIRS: The parties acknowledge that except as provided for in this Agreement, each of the parties shall have the right to dispose of their respective property by Last Will and Testament, and that each party waives the right to take under the Will of the other. This Agreement shall be binding on the respective heirs, executors, administrators and assigns of the parties thereto. 11. ENTIRE AGREEMENT: This Agreement represents the entire agreement between the parties. There are no representations, promises, agreements, conditions, or warranties between the parties other than those set forth herein. 12. LEGAL ADVICE/VOLUNTARY EXECUTION: Wife has employed and has 6 had the benefit of counsel of Laurie A. Saltzgiver, Esquire, as her attorney. Husband has not retained an attorney to represent him in this action, however, Husband has been aware at all times during this action, of his right to seek legal advice and legal counsel. Wife acknowledges that she has received independent legal advice from counsel and she fully understands the facts and has been fully informed of her legal rights and obligations. Husband acknowledges his right to seek independent legal advice from counsel and to have legal counsel review the within agreement. Each party acknowledges and accepts that this Agreement is, under the circumstances, fair and equitable, and that it is being entered into freely and voluntarily after having received such advice or with knowledge of the right to seek such advice, and with such knowledge the parties agree that execution of this Agreement is not the result of any duress or undue influence and that it is not the result of any collusion or improper or illegal agreement or agreements. Also, Wife acknowledges that she has been fully advised by her attorney of the current Pennsylw~nia Divorce Law and Husband is aware of his right to consult with an attorney regarding said law. With this knowledge, each party hereto still desires to execute this Agreement acknowledging that the terms and conditions set forth herein are fair, just, and equitable to each of the parties and waives their respective right to have the Court make any determination or 7 order affecting the respective parties' right to a divorce, alimony, alimony pendente lite, equitable distribution of all marital property, counsel fees and costs and expenses. 13. DIVISION OF PERSONAL PROPERTY: The parties have divided between them, to their mutual satisfaction, the personal effects, household furniture and furnishings, and all other articles of personal property which have heretofore been used by them in common. Should it become necessary, the parties each agree to sign any titles or documents necessary to give effect to this paragraph. 14. EQUITABLE DISTRIBUTION: a. Pension Plans/Retirement Accounts: The parties acknowledge that the Wife presently has a 401(k) known as the Drivekore Inc. 401(k) Plan. Wife shall keep this 401(k) plan and the loan against it as her sole and exclusive possession/liability. Husband waives any and all right or claim against said 401(k) plan. b. Automobiles: Wife shall keep the 1995 Toyota Camry automobile as her sole and exclusive possession, free of any claim or demand by Husband. Husband shall keep the 1991 Chevy Blazer automobile as his sole and exclusive possession, free and clear of any and all claim or demand by Wife. Wife agrees to transfer the title to the Chevy Blazer into 8 Husband's name alone. Wife acknowledges that she has paid the lien against the Chevy Blazer in full, and is transferring the Blazer to Husband free and clear. The parties agree to execute any and all documentation necessary to give effect to the above paragraphs. Checkinq/Savinqs Accounts: Wife shall keep as her sole and exclusive possession any and all checking and savings accounts in her name alone. Husband waives any and all right or claim to said checking and savings accounts. Husband shall keep as his sole and exclusive possession any and all checking and savings accounts in his name alone. Wife waives any and all right or claim to said checking and savings accounts. Advance on Equitable Distribution: The parties acknowledge that Wife has previously provided Husband with a $4,000.00 lump sum payment. Said payment was an advance on equitable, distribution to Husband. This lump sum payment shall remain Husband's sole and exclusive possession, free and clear of any claim or demand by Wife. Additionally, Wife has advanced moving costs on Husband's behalf of approximately $1,605.00. Said payment is hereby acknowledged by the parties as an additional advance on equitable distribution to Husband. 9 e o f ° Lake Georqe Property Interest: The parties acknowledge that during the marriage, Wife's mother deeded to them an eight (8%) percent interest in her vacation home, which is known as the Lake George Property. The parties agree that Husband shall transfer his portion of this interest unto Wife. Husband agrees that he shall execute a Quit Claim deed indicating the transfer of his interest to Wife. Said eight (8%) percent interest in the Lake George Property shall be Wife's sole and exclusive possession, free and clear of any claim or demand by Husband. Credit Card Debts: Wife shall be responsible for payment of the following credit card debts: i. PNC Bank joint account #4264 2990 6934 0652 with a balance of $12,800.00; ii. Bank One credit card account #4417 1215 3456 6222 in Husband's name alone with a balance of $13,051.00; and iii. BP/First USA VISA account #4266 5130 2575 2281 in Wife's name alone with a balance of $1,235.00. Wife shall indemnify and save harmless Husband from any and all claims or demands made against him for said credit card debts. The parties acknowledge and agree that Wife has previously sold the marital residence and used the proceeds of approximately $9,457.73 to pay marital 10 credit card debts. (1) Responsibility for debts and loans: Wife shall also be responsible for repayment of the loan from Perry Smith and the loan from her mother, Janice McLain. Wife shall indemnify and save harmless Husband from any and claims or demands made against him for said loans. 15. WAIVER OF RIGHT TO ALIMONY, ALIMONY PENDENTE LITE, SPOUSAL SUPPORT, COUNSEL FEES, COSTS AND EXPENSES: The parties hereby acknowledge that they each waive their right to request alimony, alimony pendente lite, spousal support, counsel fees, costs and expenses from the other unless otherwise provided for in this Agreement. 16. BREACH: If either party breaches any provision of this Agreement, the other party shall have the right, at his or her election, to sue for damages for such breach or seek such other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of legal fees and costs incurred by the other in enforcing their rights under this Agreement. 17. ADDITIONAL INSTRUMENTS: 11 so Each of the parties shall from time to time, at the request of the other, execute, acknowledge, and deliver to the other party any and all further instruments that may be reasonably required to give full force and effect to the provisions of this Agreement. This Agreement shall be incorporated into a Divorce Decree but not merged therein. 18. MODIFICATION AR-D WAIVER: A modification or waiver of any of the provisions of this Agreement shall be effective only if made in writing and executed with the same formality as this Agreement. The failure of either party to insist upon strict performance of any of the provisions of this Agreement shall not be construed as a waiver of any subsequent default of the same or similar nature. 19. DESCRIPTIVE HEADINGS: The descriptive headings used herein are for convenience only. They shall have no effect whatsoever in determining the rights or obligations of the parties. 20. VOID CLAUSES: If any term, condition, clause or provision of this Agreement shall be determined or declared to be void or invalid in law 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 12 valid and continue in full force, effect, and operation. 21. EXECUTION DATE: The execution date shall be defined as the date both parties have signed this Agreement. In the event that the parties do not sign this Agreement at the same time, the execution date shall be the date the last party has signed. 22. APPLICABLE LAW: This Agreement shall be construed pursuant to the laws of the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, the parties have hereunto set their hands and seals the day and year first above-written. Ste~en~. Belz / 13 KIMBERLY BELZ, VS. STEPHEN BELZ, Plaintiff: Defendant : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 03-572 CIVIL ACTION - LAW IN DIVORCE AFFIDAVIT OF CONSENT A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on February 6, 2003. The marriage of the Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the ~ate of filing and service of the Complaint. I consent to ~he 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 statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to ~nsworn falsification to authorities. ~ /~ MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 · FAX(717) 236-2817 KIMBERLY BELZ, : Plaintiff: VS. : :TEPHEN BELZ, : Defendant : IN THE CO~{T OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 03-572 CIVIL ACTION - LAW IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER ~3301(C) OF THE DIVORCE CODE ~. I consent to the entry of a final decree of divorce without notice. 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. lnsworn falsification to autho 'tie ~ / 4904 relating to MEYERS, DESFOR, SALTZGIVE:R & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 17108 {717) 236-9428 ° FAX (717) 236-2817 KIMBERLY BELZ, : Plaintiff: :TEPHEN BELZ, : Defendant : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 03-572 CIVIL ACTION - LAW IN DIVORCE AFFIDAVIT OF CONSENT A Complaint in Divorce under Section 3301(c) of the Divorce lode was filed on February 6, 2003. The marriage of the Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service 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 this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. § 4904 relating to unsworn falsification to authorities. Date: St ep~en Belz MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P*O. BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 · FAX (717) 236-2817 KIMBERLY BELZ, : IN THE COURT OF COMMON PLEAS Plaintiff: CUMBERLAND COUNTY, PENNSYLVANIA : vs. : NO. 03-572 : STEPHEN BELZ, : CIVIL ACTION - LAW Defendant : IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER ~3301(C) OF THE DIVORCE CODE 4. I consent to the entry of a final decree of divorce without notice. 5. 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. 6. 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. ~ 4904 relating to ~nsworn falsification to authorities. )ate ~'f~' ~Y~ St ePhen~ MEYERS, DESFOR, SALTZGIVER & BOYLE 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 - FAX (717) 236-2817 KIMBERLY BELZ, : Plaintiff: VS. : STEPHEN BELZ, : Defendant : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 03-572 CIVIL ACTION - LAW 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) of the Divorce Code. 2~ Date and manner of service of the Complaint: Served via certified mail, restricted delivery on February 24, 2003, proof of service filed with the Prothonotary on Mav 8, 2003. 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 the plaintiff September 11, 2003; by the defendant September 13, 2003. 4. Related claims pending: No other claims are pending. 5. Date and manner of service of the notice of intention to file praecipe to transmit record, a copy of which is attached, if the decree is to be entered under section 3301(d) (1) (i) of the Divorce Code. (b) Date plaintiff's Waiver of Notice in ~ 3301(c) Divorce was filed with the prothonotary: September 16, was 2003. Date defendant's Waiver of Notice in ~ 3301(c) Divorce filed with the prothonotary: September 16, 2003. ~ MEYERS, DESFOR, SALTZGIVER & BOYt. E 410 NORTH SECOND STREET · P.O. BOX 1062 · HARRISBURG, PA 17108 (717) 236-9428 · FAX(717) 236-2817 IN THE OF CUMBERLAND STATE OF ~ COURT OF COMMON COUNTY PENNA. PLEAS N() ...............0.3.r.5. 7 2~ ............... DECREE IN decreed that ..... ~.m?.e.r.]:¥. p.~l..z ............................ , plaintiff, and .........s. t~.ep.h..ep,' .~.e..1~: .................................. , 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; The Marital Settlement Agreement dated September 10, 2003 is ·..hg.r.e. by..i.~_.cp.r, po.r.a.t.e.d.. DAt...np.t., .m.e.r.c,{e..d..h.¢r .ei.n,.. ...................... Prothonotary IN TI-IE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff : Vs : File No. Defendant : ; IN DIVORCE NOTICE TO RESUME PRIOR SURNAME Notice is hereby given that the Plaintiff/defendant in the above matter, [select one l~y marking "x"] prior to the entry of a Final Decree in Divorce, or ~/' after ihe entry 0f a Final Decree in Divorce dated /°/z/°'s , --- F't_~.t~Y ~k¢ vT~rt~t~,., .~,~,, / , and gives this hereby elects to resume, the prior surname ox w6~en no,ce avowm his / her intention pursuant to _ - .... Signature o~ame being resumed COm~ONW~'H OF P~N~SYr,V~ ) cou, rr¥ oF on the I o~:~day of ~r'0 V~'n~'" , 200~ before me, the Prothonot~ or the notary public, personally appeared the above affiant known to me to be the person whose name is subscribed to the within document and acknowledged that he / she executed the foregoing for the purpose therein contained. In Withess Whereof, I have hereunto set my hand hereunto set my hand and official I ~ ' ~0TARIAL SI:AL ~ Notary Public CLA~JOI,~ ,~, §R~WBAKER, NOTARY PUBLIC C#r~ile Bore, Cumberland County My C~.~ml,slo~ Expires April 4, 2005