HomeMy WebLinkAbout00-07787
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IN THE COURT OF COMMON PLEAS
OF CUMBERLAND COUNTY
STATE OF
PENNA.
DIANE K. KOTHE,
Plaintiff
No.
2000-7787 CIVIL TERM
VERSUS
MICHAEL T. KOTHE,
Defendant
AND
DECREE IN
DIVORCE
NOW'~ JB
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2001, IT IS ORDERED AND
DECREED THAT
DIANE K. KOTHE
, PLAINTIFF,
AND
MICHAEL T. KOTHE
, 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
. J.
ROTHONOTARY
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DIANE K. KOTHE,
Plaintiff
vs.
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)
)
)
)
)
)
)
)
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND
COUNTY, PENNSYL VANIA
CIVIL ACTION - LAW
NO. 2000-7787 CIVIL TERM
MICHAEL T. KOTHE,
Defendant
IN DIVORCE
MOTION FOR ENTRY OF QUALIFIED DOMESTIC RELATIONS ORDER
AND NOW comes the undersigned, as attorney for Plaintiff, Diane K. Kothe, and
moves the court to enter the attached Qualified Domestic Relations Order, which has been
reviewed, approved, and consented to by both parties, as evidence by their execution of the
order.
Date: 3 December 2001
,,3..$ 0 jJ,
Attorney for Plaintiff
Supreme Court ID # 17225
525 North 12th Street
Lemoyne, Pa 17043
(717) 761-5361
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,
DIANE K. KOTHE,
Plaintiff
vs.
MICHAEL T. KOTHE,
Defendant
)
)
)
)
)
)
)
)
)
IN THE COURT OF COMMON
PLEAS OF CUMBERLAND
COUNTY , PENNSYLVANIA
CIVIL ACTION - LAW
NO. 2000-7787 CIVIL TERM
IN DIVORCE
RDER
AND NOW, this day of , 2001, upon the
representations and stipulations of Plaintiff and Defendant in the above-captioned matter,
it is ordered and decreed as follows:
1. This Order creates and recognizes the existence of an Alternate Payee's right to
receive a portion of the Participant's Total Account Balance accumulated under an
employee sponsored 401 (k) Plan which is qualified under Section 501 of the Internal
Revenue Code (the "Code") and the Employee Retirement Income Security Act of 1974
("ERISA"). It is intended to constitute a Qualified Domestic Relations Order ("QDRO")
under Section 414 (p) of the Code and Section 206(d) (3) of ERISA.
2. The name, address, birth date and Social Security number of the "Participant"
are:
Michael T. Kothe
05/12/1963
198-58-2389
4079 Darius Drive
Enola, PA 17025
3. The name, address, birth date and Social Security number of the "Alternate
Payee", former spouse, are:
Participant:
Birth Date:
Social Security Number:
Address:
Alternate Payee:
Birth Date:
Social Security Number:
Address:
<\1
Diane K. Kothe
07/16/1959
198-50-2027
114 Hogestown Road
Mechanicsburg, PA 17055
Page I of 5
:1,:: II
4. The name of the Plan to which this Order applies is the Coventry Healthcare
Inc., Retirement 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 entered in accordance with the Internal Revenue Code of 1986, as
amended.
6. This order relates to the provisions of marital property rights to the Alternate
Payee under the Pennsylvania Divorce Code, 23 Pa.C.S. ~ ~ 3301 et seq.
7. Amount of Alternate Payee's benefit: The Alternate Payee is awarded the sum
of $5,000.00 from the Participant's account balance in the Plan as of May 26, 2000.
The Alternate Payee's 401 (k) Benefit shall be increased or reduced by earnings and
losses attributable to the investment performance of the Participant's Account between
April 17, 2000 and'the date of distribution.
Upon determination of the Alternate Payee's 401 (k) Benefit and any income or loss
attributable thereto, the Plan Administrator shall establish a separate amount for the
Alternate Payee to whom payments are due as soon as it is administratively practicable
after this Order is approved by the Plan Administrator.
The Alternate Payee's 401 (k) Benefit will be calculated based on the Participant's
entire vested and non-vested account balance under the Plan, but will be allocated first to
the Participant's vested account balance. Any portion of the Alternate Payee's 401 (k)
benefit which cannot be paid out of the Participant's vested account balance will be paid
out only as the Participant's vested account balance will be paid out only if the Participant
accrues additional vesting service under the Plan. The Alternate Payee's 401 (k) Benefit
shall be made in accordance with the terms of the Plan and in compliance with all
applicable income tax withholding rules and regulations.
The Participant's account balance shall be reduced to reflect any payment pursuant
to this QDRO, and any subsequent payment to the Participant or to an Alternate Payee
under a subsequent aDRO shall reflect said reduction in the Participant's account.
8. The period to which this Order applies begins on and shall continue until the
Alternate Payee's 401 (k) Benefit is completely distributed to her or to her beneficiary.
9. Term 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 term
Page 2 of 5
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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 the terms of the Plan.
10. This Order is not intended, and shall not be construed in such a manner as to
I require the Plan:
(a) to provide any type or form of benefit option not otherwise provided
under the terms of the Plan:
(b) to require the Plan to provide increased benefits determined on the
basis of actuarial value; or
(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.
11. In the event a Plan provides the option to the Participant to elect to obtain
benefits at the earliest retirement age, the benefits shall be payable to the Alternate Payee
on or after the date on which the Participant attains (or would have attainedl the earliest
retirement age, as if the Participant had retired on that date even if the Participant has not
actually retired or separated from service.
12. If the Participant shall die before distribution under this Plan, the Alternate
Payee, for purposes of the Plan's Qualified Pre-Retirement Survivor Annuity provisions,
shall be treated as the spouse with respect to the designated amount reserved for the
Alternate Payee.
13. In the event the Plan Administrator or its Agent does not approve the form of
this Order, then each party shall cooperate and do all things reasonably necessary to
devise a form of Order acceptable to the Plan Administrator.
14. Continued Qualified Status of Order: It is the intention of the parties that this
QDRO continue to qualify as a QDRO under Section 414(p) of the Internal Revenue Code,
as it may be amended from time to time, and that the Plan Administrator shall reserve the
right to reconfirm the qualified status of the Order at the time benefits become payable
hereunder.
15. Tax Treatment of Distributions Made Under This Order: For purposes of
Section 402(a) (1) and 72 of the Internal Revenue Code, any Alternate Payee who is the
Page 3 of 5
~- -1' -. --[n ., T -
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spouse or former spouse of the Participant shall be treated as the distribute 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 roll over 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.
16. 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.
17. Effect of Plan Termination: 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 commence her benefits immediately in accordance with the terms of the QDRO
and in accordance with the termination procedures of the Plan and the Pension Benefit
Guarantee Corporation ("PBGC") (if applicable).
18. Rights of the Alternate Payee. The Alternate Payee shall have the same rights
with regard to her portion of the account as are available to the Participant, with regard to
his remaining portion of the account. These rights include but are not limited to the right
to designate a beneficiary of retirement benefits, the right to elect from then existing
retirement dates 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 may be provided under
ERISA, or under the terms of the Plan. The Alternate Payee is not entitled to any benefit
not otherwise provided under this Plan.
19. Any reasonable costs incurred by the Plan Administrator to effectuate the
terms and provisions of the Qualified domestic Relations Order shall be assessed against
Page 4 of 5
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the parties such that the Alternate Payee pays 50% of the costs and the Participant pays
50% of the costs.
20. The parties shall promptly notify the Plan Administrator of any change in their
addresses from those set forth above in this Order.
21. The parties shall promptly submit this Order to the Plan Administrator for
determination of its status as a Qualified Domestic Relations Order.
IT IS INTENDED that this Order shall qualify as a Qualified domestic Relations Order
I under the retirement Equity Act of 1984. The Court retains jurisdiction to amend this
Order as might be necessary to establish or maintain its status as a Qualified Domestic
Relations Order under the Retirement Equity Act of 1984.
Consen ed to:
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IN THE COURT OF COMMON
PLEAS OF CUMBERLAND COUNTY,
PENNSYLVANIA
DIANE K. KOTHE.
Plaintiff
CIVIL ACTION - LAW
NO. 2000-7787 CIVIL TERM
I MICHAEL T. KOTHE,
Defendant
IN DIVORCE
PRAECIPE TO TRANSMIT RECORD
Iro THE PROTHONOTARY:
Transmit the record, together with the following information, to the Court for entry of a divorce
~ecree:
1. Grounds for Divorce: Irretrievable breakdown under Section 3301 (c).
2. Date and manner of service of the Complaint: Acceotance of Service filed bv Plaintiff's counsel
ndicatin~ service on or about 8 November 2000 on Defendant.
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: 29 November 2001 By Defendant: 29 November 2001
(b) (1) Date of execution of the Affidavit required by Section 3301 (d) ofthe Divorce
Coda: (2) Date of filing and service ofthe Plaintiffs Affidavit upon the
Respondent:
4. Related claims pending: None.
5. Complete either (a) or (b):
(a) Date and manner of service of the Notice ofIntention 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 29 November 2001. filed contemooraneouslv herewith. Date
Defendant's Waiver of Notice in Section 3301 (c) Divorce was filed with the Prothonotary:
Dated 29 November 2001. filed contemooraneouslv herewith.
Date:
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B~~ oof2a
- uel L. aes
Attorney for Plaintiff
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
; NO. {)C()O ~ 7-1%"1
Civil Term
v.
: IN DIVORCE
MICHAELT. KOTHE,
Defendant
NOTICE TO DEFEND AND CLAIM RIGHTS
YOU HA VE 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 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 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, Cumberland County Courthouse, I Courthouse Square, 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.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, P A 17013
(717) 249-3166
Le han demandado a usted a la corte. Si usted quiere defenderse en contra estas demandas
expuestas en las paginas siguientes, usted tiene veinte (20) dias de plazo al partir de la fecha de la
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demanda y la notificacion. Usted debe presentar una apariencia escrita 0 en persona 0 por abogado
y archivar en la corte en forma escrita sus defensas 0 sus objeciones alas demandas en contra suya.
Se has avisado que si usted no se defienda, la corte tomara medidas y puede entrar una orden
contra usted sin previo aviso 0 notificacion y por cualquier que ja 0 alivio que es pedido en la peticion
do demanda. USTED PUEDE PERDER DINERO 0 PROPIENDADES 0 OTROS DERECHOS
IMPORTANTES PARA USTED.
LLEVE ESTA DEMANDA A UN ABOGADO INMEDlATAMENTE. SI USTED NO
TIENE 0 CONOCES UN ABOGADO, VA Y A 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, P A 17013
(717) 249-3166
AMERICANS WITH DISABILITIES ACT OF 1990
The Court of Common Pleas of Cumberland County is required by law to comply with the
Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable
accommodations available to disabled individuals having business before the Court, please contact
our office. All arrangements must be made at least 72 hours prior to any hearing or business before
the Court. You must attend the scheduled Conference or Hearing.
Cumberland County Bar Association
2 Liberty Avenue
Carlisle, P A 17013
(717) 249-3166
''''!v,
IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: NO. Pf;- 11(;7
Civil Term
v.
: IN DIVORCE
MICHAEL T. KOTHE,
Defendant
COUNT I
COMPLAINT UNDER SECTION 3301(c)
OF THE DIVORCE CODE
AND NOW comes DIANE K. KOTHE, by and through her attorney,
Maryann Murphy, Esquire of Legal Services, Inc., who respectfully
avers as follows:
1. Plaintiff is DIANE K. KOTHE whose current address is 114
Hogestown Road, Mechanicsburg, Cumberland County, Pennsylvania.
2. Defendant is MICHAEL T. KOTHE whose current address is
4079 Darius Drive, Enola, Cumberland County, Pennsylvania.
3. Plaintiff and Defendant have been bona fide residents in
the Commonwealth for at least six months immediately previous to
the filing of this Complaint.
4. Plaintiff and Defendant were married on August 15, 1992
in Cumberland County, Pennsylvania.
5. There have been no prior actions for divorce or for
annulment between the parties.
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6. Defendant is not a member of the Armed Forces of the
United States of America or any of its Allies.
7. The marriage is irretrievably broken.
8. Plaintiff has been advised of the availability of
marriage counseling and that she may have the right to request the
Court to require the parties to participate in such counseling.
Being so advised, Plaintiff does not request that the Court require
the parties to participate in counseling prior to a Divorce Decree
being handed down by the Court.
9. Plaintiff requests this Court to enter a Decree in
Divorce from the bonds of matrimony.
~EREFORE, Plaintiff requests this Honorable Court to
enter a Decree dissolving the marriage between the Plaintiff and
Defendant.
Respectfully submitted,
Maryann Murphy, e
LEGAL SERVICES,
8 Irvine Row
Carlisle, PA 17013
(717) 243-9400
LD. # 61900
Attorney for Plaintiff
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AFFIDAVIT
I, DIANE K. KOTHE, verify that the statements made in the
foregoing Complaint in Divorce 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.
JJ- ~- 00
Date
b~cr? i!~
DIANE K. KOTHE
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: No.
Civil Term
v.
MICHAEL T. KOTHE,
Defendant
: IN DIVORCE
CERTIFICATE OF SERVICE
I, Maryann Murphy, Esquire, do hereby certify that a true and
correct copy of the within Divorce Complaint was mailed to the
Defendant, MICHAEL T. KOTHE, by first class U.S. mail, postage pre-
paid, certified/restricted delivery, addressed as follows:
Michael T. Kothe
4079 Darius Drive
Enola, PA 17025
Respectfully submitted,
Maryann urphy,
LEGAL SERVICES,
8 Irvine Row
Carlisle, PA 17013
(717) 243-9400
I.D. # 61900
Attorney for Plaintiff
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: NO. 'Joco-t7fr
Civil Term
v.
: IN DIVORCE
MICHAEL T. KOTHE,
Defendant
PRAECIPE TO PROCEED IN FORMA PAUPERIS
To the Prothonotary:
Kindly allow, DIANE K. KOTHE, Plaintiff, to proceed in fonna DauDeris.
I, Maryann Murphy, Esquire, of Legal Services, Inc., attorney for the party proceeding
in forma DauDeris, certify that I believe the party is unable to pay the costs and that I am providing
free legal services to the party. The party's affidavit showing inability to pay the costs of
litigation is attached hereto.
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Maryann M rphy, EsqUire
Legal Services, Inc.
8 Irvine Row
Carlisle, PA 17013
(717) 243-9400
J.D. # 61900
Attorney for Plaintiff
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: NO. fJv - 7731
Civil Term
v.
: IN DIVORCE
MICHAEL T. KOTHE,
Defendant
AFFIDAVIT IN SUPPORT OF PETITION
FOR LEAVE TO PROCEED IN FORMA PAUPERIS
1. I am DIANE K. KOTHE, Plaintiff in the above matter and because of my financial
condition am unable to pay the fees and costs of prosecuting, defending, or appealing the action
or proceeding.
2. I am unable to obtain funds from anyone, including my family and associates, to pay
the costs of litigation.
3. I represent that the information below relating to my ability to pay the fees and costs
is true and correct.
(a) Name: DIANE K. KOTHE
Address: 114 Hogestown Road, Mechanicsburg, PA 17055
(b) Social Security Number: 198-50-2027
If you are presently employed, state N/A
Employer: N/A
Address: N/A
Salary or wages per month: N/A
Type of work: N/A
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If you are presently unemployed, state
Date of last employment: August 2000
Salary or wages per month: $1353.00
Type of work: Server
(c) Other income within the past twelve months
Business or profession: -0-
Other self-employment: cleaning - aovroximately $300.00
Interest: -0-
Dividends: -0-
Pension and annuities: -0-
Social Security benefits: -0-
Support payments: $693.00
Disability payments: -0-
Unemployment compensation and
supplemental benefits: -0-
Workman's compensation: -0-
Public Assistance: -0-
Other: -0-
(d) Other contributions to household support
(Wife)(Husband) Name: N/A
If your (husband) (wife) is employed, state
Employer: N/A
,
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Salary or wages per month: N/A
Type of work: N/A
Contributions from children: -0-
(e) Property owned
Cash:
Checking Account:
Savings Account:
Certificates of Deposit:
Real Estate (including home): -0-
Motor vehicle: Make Oldsmobile
Cost $1.900.00
-0-
-0-
Stocks; bonds:
Other:
Year 1993
Amount owed
(f) Debts and obligations
Mortgage:
Rent:
-0-
$825.00
Loans:
Credit cards - unknown balance
Monthly Expenses:
$1.893.00
(g) Persons dependent upon you for support
(Wife) (Husband) Name: N/A
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Children, if any:
Name: Brandon Age: 18
Name: Aaron Age: 16
Name: Steven Age: 7
4. I understand that I have a continuing obligation to inform the court of improvement in
my financial circumstances which would permit me to pay the costs incurred herein.
5. 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: I ( ;;;"'-CO
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: No. 2000-7787 Civil Term
v.
MICHAEL T. KOTHE,
Defendant
: IN DIVORCE
AFFIDAVIT OF SERVICE
I, Maryann Murphy, Esquire, depose and say:
I. That I am an adult individual residing in Cumberland County, Pennsylvania.
2. That on November 3, 2000, I sent by U.S. first class mail, postage pre-paid, a
330 I (c) Complaint in Divorce to the Defendant, MICHAEL T. KOTHE, at the following address:
Michael T. Kothe
4079 Darius Drive
Enola, P A 17025
3. That on November 8, 2000, the Defendant signed an Acceptance of Service
indicating his receipt of the Complaint in Divorce. The Acceptance of Service is attached hereto.
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LEGAL SERVICES, INC.
8 Irvine Row
Carlisle, P A 17013
(717) 243-9400
LD. # 61900
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: No. 2000-7787 Civil Term
v.
MICHAEL T. KOTHE,
Defendant
: IN DIVORCE
ACCEPTANCE OF SERVICE
I, MICHAEL T. KOTHE, Defendant in the above-captioned case, do hereby depose and
say that I personally received and accepted service of a true and correct copy of the Complaint in
Divorce on the date written below.
I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.
Section 4904, relating unsworn falsification to authorities.
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MICHAEL T. KOTHE
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: No. 2000-7787 Civil Term
v.
MICHAEL T. KOTHE,
Defendant
: IN DIVORCE
AFFIDAVIT OF CONSENT
I. A Complaint in Divorce under Section 3301(c} of the Divorce Code was filed on
November 2, 2000.
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
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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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: No. 2000-7787 Civil Term
v.
MICHAEL T. KOTHE,
Defendant
: IN DIVORCE
WAIVER OF NOTICE OF INTENTION TO REOUEST
ENTRY OF A DIVORCE DECREE UNDER
SECTION 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 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,
Witness
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I E K. KOTH .
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: No. 2000-7787 Civil Term
v.
MICHAEL T. KOTHE,
Defendant
: IN DIVORCE
AFFIDAVIT OF CONSENT
1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on
November 2, 2000.
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 ofa final decree of divorce after service of notice ofintention 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. Section 4904 relating to unsworn
falsification to authorities.
1i/c;'1.41
Date
Witness
MICHAEL T. KOTHE
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IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA
CIVIL ACTION - LAW
DIANE K. KOTHE,
Plaintiff
: No. 2000-7787 Civil Term
v.
MICHAEL T. KOTHE,
Defendant
: IN DIVORCE
WAIVER OF NOTICE OF INTENTION TO REOUEST
ENTRY OF A DIVORCE DECREE UNDER
SECTION 3301(c) OF THE DIVORCE CODE
I. 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 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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Date
Witness
MICHAEL T. KOTHE
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