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Home My WebLink About03-3148 CAROL G. KETNER, Plaintiff vs. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA ; NO. 03- 3/41 c.....,/ W. RAYMOND KETNER, Defendant CIVIL ACTION - LAW IN DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS YOU HAVE BEEN SUED IN COURT, If you wish to defend against the claims set forth in the 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 the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary, 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 LA WYER 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 Cumberland County Courthouse 4th Floor, One Courthouse Square Carlisle, P A 17013 (717) 240-6200 CAROL G. KETNER, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. : NO. uj ~ 3/'16 w. RAYMOND KETNER, Defendant : CNIL ACTION - LAW : IN DIVORCE COMPLAINT IN DIVORCE Count I Divorce Under Section 3301(c) 1, Plaintiff is Carol G. Ketner, an adult individual who resides at 34 Kinsington Drive, Camp Hill, Cumberland County, Pennsylvania 17011. 2. Defendant is W. Raymond Ketner an adult individual who resides at 51 Drexel Place, New Cumberland, Cumberland County, Pennsylvania 17070. 3. Defendant has been a bona fide resident in the Commonwealth for at least six months immediately previous to the filing of this complaint. 4, The plaintiff and defendant were married on February 21, 1975, at Hagerstown, Maryland. 5. There have been no prior actions for divorce or annulment between the parties. 6, The marriage is irretrievably broken. 7. Plaintiff has been advised of the availability of counseling and that plaintiff has the right to request that the court require that the parties participate in counseling. 8. Defendant is not a member of the armed services of the United States or any of its allies. WHEREFORE, plaintiff requests the Court to enter a Decree of Divorce Count II Equitable Distribution 9, Paragraphs 1 through 8 are incorporated herein by reference. 10. Plaintiff states that the plaintiff and defendant possess various items of both real and personal marital property which is subject to equitable distribution by the Court. WHEREFORE, plaintiff requests that this Court: a) equitably distribute all property, personal and real, owned by the parties b) such other relief as the Court may deem equitable and just. Count III Alimonv Pendente Lite, Attornev's Fees and Costs II. Paragraphs I through 10 are incorporated herein by reference, 12. By reason of this action, plaintiff will be put to considerable expense in the preparation of her case in the employment of counsel and the payment of costs, 13. Plaintiff is without sufficient funds to support herself and to met the costs and expenses of this litigation and is unable to appropriately maintin herself during the pendency of this action. 14. Plaintiffs income is not sufficient to provide for her reasonable needs and to pay her attorney's fees and the costs of this litigation. 15. Defendant has adequate earnings to provide for plaintiffs support and to pay her counsel fees, costs and expenses. WHEREFORE, plaintiff requests this Honorable Court direct defendant to pay her alimony pendente lite, attorney's fees and costs. Count IV Alimonv 16. Paragraphs I through 15 are incorporated herein by reference. 17, Plaintiff lacks sufficient property to provide for her reasonable needs. 18. Plaintiff is unable to support herself through appropriate employment. 19. Defendant has sufficient income and assets to provide continuing support for plaintiff, WHEREFORE, plaintiff requests this Honorable Court to compel defendant to pay alimony to plaintiff. r-Ti~rrncll' &qillre- 4415 North Front Street Harrisburg, PA 17110 (717) 232-4551 Attorney for plaintiff Verification I verifY that the statements made in the foregoing Complaint are true and correct. I understand false statements herein are made subject to the penalties of 18 Pa. C,S,A. Section 4904 relating to unsworn falsification to authorities. Date: 1/~/6!3 c~€f~ ~~ ~ ~ ~ ~ i>>- ~ \)', d ~ ~ :t::::, -;;:- ", " ~ ~ ';) ~ ~ ~ c?- , ~ .<> - r:) < ;:, 1;- "'" ...... ~ "\ () ~ \) o .'> ., (" ~ -. (') ~ rhi" ~:_~ OJ -,~ r:; <- ~j;( 5;: ~;~~ :;J @ ('~ , 8 L - '";:' .....) '0 ~~ o COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CAROL G, KETNER, Plaintiff NO. 03-3148 IN DIVORCE w. RAYMOND KETNER, Defendant ORDER AND NOW, this I'" day of ()..n.I~ ,2003, the attached Stipulation and Agreement dated Jn~ 1/ ;l.tro3 ofthe parties in this case is incorporated, but not merged, into this Order of Court, -/<Vt ' ,4;l ;7 ATTEST: o COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CAROL G. KETNER, Plaintiff NO. 03-3148 W. RAYMOND KETNER, Defendant IN DIVORCE ORDER AND NOW, this IS"' day of t1t.h'-.r ,2003, the attached Stipulation and Agreement dated ~ 7/ ;).0{)3 of the parties in this case is incorporated, but not merged, into this Order of Court. .44- ATTEST: -~'" ~,;rP' P?~ ~/ \f1~1V/\1}S0!Njd AH."rr:r-y-:',. :'--~v:~!r:;:~ In.''"' , , ,,'!"I h,.J 91] :Zllld ell 'f'u" c:l _,' .....'-' 1..._. )'JjV.~C-~,: I COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA CAROL G. KETNER, Plaintiff NO, 03-3148 W. RAYMOND KETNER, Defendant IN DIVORCE STIPULATION FOR THE ENTRY OF "DOMESTIC RELATIONS ORDER" AND NOW, this 7'h day of May, 2003, the parties, Carol G. Ketner, Plaintiff, and W. Raymond Ketner, Defendant, do hereby Agree and Stipulate as follows: I. The Defendant, W. Raymond Ketner, (hereinafter referred to as "Member") is a member of the Commonwealth of Pennsylvania, State Employees' Retirement System (hereinafter referred to as "SERS") 2. SERS, as a creature of statute, is controlled by the State Employees' Retirement Code, 71 PA C.S, SS 5101-5956 ("Retirement Code"). 3. Member's date of birth is October 29,1944, and his Social Security number is 171-36-9447. 4. The Plaintiff, Carol G. Ketner, (hereinafter referred to as "Alternate Payee") is the former spouse of Member. Alternate Payee's date of birth is April 6, 1953, and her Social Security number is 191-40-7862. 5. Member's last known mailing address is: 51 Drexel Place New Cumberland, P A 17070 6. Alternate Payee's current mailing address is: 34 Kensington Drive Camp Hill, PA 17011 It is the responsibility of Alternate Payee to keep a current mailing address on file with SERS at all times. 7. (a) The marital property component of Member's retirement benefit equals: (I) The Coverture Fraction multiplied by (2) the Member's retirement benefit on the effective date of Member's retirement calculated by using the Member's final average salary on August 17,2002 instead of the Member's actual final average salary. (b) The Coverture Fraction is a fraction with a value less than or equal to one, The numerator is the amount of Member's service, as defined by SERS, for the period oftime from October 21, 1975 to August 17,2002. The denominator is the total amount of Member's service, as defined by SERS, on the effective date of Member's retirement. (c) Fifty percent (50%) of the marital property component of Member's retirement benefit is to be allocated to the Alternate Payee as her equitable distribution portion of this marital asset. 8. Member's retirement benefit is defined as all monies paid to or on behalf of Member by SERS, including any lump sum withdrawals or scheduled or ad hoc increases, but excluding the disability portion of any disability annuities paid to Member by SERS as a result of a disability which occurs before the Member's marriage to Alternate Payee or after the date of the Member and Alternate Payee's final separation. Member's retirement benefit does not include any deferred compensation benefits paid to Member by SERS, The equitable distribution portion of the marital property component of Member's retirement benefit, as set forth in Paragraph Seven (7), shall be payable to Alternate Payee and shall commence as soon as administratively feasible on or about the date the Member actually enters pay status and SERS approves a Domestic Relations Order incorporating this Stipulation and Agreement, whichever is later. 9, Member hereby nominates Alternate Payee as an irrevocable beneficiary to the extent of Alternate Payee's equitable distribution portion of Member's retirement benefit for any death benefits payable by SERS. This nomination shall become effective upon approval by the Secretary of the Retirement Board, or his authorized representative, of any Domestic Relations Order incorporating this Stipulation and Agreement. The balance of any death benefit remaining after the allocation of Alternate Payee's equitable distribution portion ("Balance") shall be paid to the beneficiaries named by Member on the last Nomination of Beneficiaries Form field with the Retirement Board prior to Member's death. a, If the last Nomination of Beneficiaries Form field by Member prior to Member's death (a) predates any approved Domestic Relations Order incorporating this Stipulation and Agreement, and (b) names Alternate Payee as a beneficiary, then: (I) the terms of the Domestic Relations Order shall alone govern Alternate Payee's share of any death benefit, and (2) for purposes of paying the Balance via the last Nomination of Beneficiaries From field with the Retirement Board prior to Member's death, Alternate Payee shall be treated as if Alternate Payee predeceased Member. No portion of the Balance shall be payable to Alternate Payee's estate, b, In addition, Member shall execute and deliver to Alternate Payee an authorization, in a form acceptable to SERS, which will authorize SERS to release to Alternate Payee all relevant information concerning Member's retirement account. Alternate Payee shall deliver the authorization to SERS which will allow the Alternate Payee to check that she has been and continues to be property nominated under this paragraph. 10. (a) The term and amounts of Member's retirement benefits payable to the Alternate Payee after SERS approves a Domestic Relations Order incorporating this Stipulation and Agreement is dependent upon which option is selected by Member upon retirement. Member and Alternate Payee expressly agree that: Member shall select the following retirement option upon filing an application for Retirement Allowance with SERS: Special Option 4. - A joint and equitable distribution percent (or portion) (as defined in paragraph 7) annuity payable during the lifetime of the Member with an equitable distribution percent (or portion) (as defined in paragraph 7) of such annuity payable thereafter to his survivor annuitant, ifliving at his death, as set forth in 71 Pa, C.S. Section 5705(a)(4), or any succeeding statute. The Member shall designate the Alternate Payee as his irrevocable survivor annuitant. The intent of this Special Option 4 selection is to maintain levelized payments to the Alternate Payee for her life in the event of Member's death and retirement. The Alternate Payee shall receive her equitable distribution percentage (or portion) of the annuity which is payable to the Member during his lifetime, so that she shall receive a percentage (or portion) of the Member's check during his lifetime and the same amount, all other things being equal, if he predeceases her after retirement. (b) The Member and Alternate Payee acknowledge that if the Alternate Payee predeceases the Member, the following will occur under this Special Option 4 selection: (I) the same monthly benefit which had been paid or would have been paid to the Alternate Payee during Alternate Payee's lifetime will be paid to the Alternate Payee's estate for the duration of the life of the Member, and (2) upon the Member's death, all payments to the Alternate Payee's estate shall cease. I I. Alternate Payee may not exercise any right, privilege or option offered by SERS. SERS shall issue individual tax forms to Member and Alternate Payee for amounts paid to each person, 12. In the event of the death of Alternate Payee prior to receipt of all of her payments payable to her from SERS under this Order, any death benefit or retirement benefit payable to Alternate Payee by SERS shall be paid to Alternate Payee's Estate to the extent of Alternates Payee's equitable distribution portion of Member's retirement benefit as set forth in Paragraphs Seven through Nine. I3, In no event shall Alternate Payee have greater benefits or rights other than those that are available to Member. Alternate Payee is not entitled to any benefit not otherwise provided by SERS. The Alternate Payee is only entitled to the specific benefits offered by SERS as provided in this Order. All other rights, privileges and options offered by SERS not granted to Alternate Payee by this Order are preserved for Member. 14, It is specifically intended and agreed by the parties hereto that this Order: (a) Does not require SERS to provide any type of benefit, or any option, not otherwise provided under the Retirement Code; (b) Does not require SERS to provide increased benefits (determined on the basis of actuarial value) unless increased benefits are paid to Member based upon cost of living or increases based on other than actuarial values, 15. The parties intend and agree that the terms of this Stipulation and Agreement shall be approved, adopted and entered as a Domestic Relations Order. 16. The Court of Common Pleas of Cumberland County, Pennsylvania, shall retain jurisdiction to amend any Domestic Relations Order incorporating this Stipulation and Agreement, but only for the purpose of establishing it or maintaining it as a Domestic Relations Order; provided, however, that no such amendment shall require SERS to provide any type or form of benefit, or any option not otherwise provided by SERS, and further provided that no such amendment or right of the Court to so amend will invalidate this existing Order. 17, Upon entry as a Domestic Relations Order, a certified copy of the Domestic Relations Order and this Stipulation and Agreement and any attendant documents shall be served upon SERS immediately. The Domestic Relations Order shall take effect immediately upon SERS approval and SERS approval of any attendant documents and then shall remain in effect until further Order of Court, WHEREFORE, the parties, intending to be legally bound by the terms of this Stipulation and Agreement, do hereunto place their hands and seals. 1~ Plaintiff/Altern Payee #-~~~ Defenda ember for DGK,udanu 1v1t::Iubc;I ~ fL,*''''i--fJl /fJl-k-IN4nc p'7'~<... ~~';r:. ,!:',. Q; ~~~' f::'" )." (") c; -< r,:,:) (..) ..':> ") ,-"-i I C:I -on --1 -'J -\: C) " ~n C) .,Srn . '-~! ~ ~) :v o PROPERTY SETTLEMENT AGREEMENT This agreement is made this ~ day of DeJD be.(' ,2003, by and between CAROL G. KETNER, of 34 Kensington Drive, Camp Hill, Pennsylvania 17011, hereinafter for the purpose of brevity referred to as "Wife", and W. RAYMOND KETNER, of 51 Drexel Place, New Cwnberland, Pennsylvania 17070, hereinafter for the purpose of brevity referred to as "Husband", Witnesseth: WHEREAS, the parties hereto are husband and wife, having been lawfully joined in marriage on February 21,1975, and diverse unhappy differences, disputes, misunderstandings and difficulties have arisen between the parties, as a result of which they are living separate and apart; and WHEREAS, Wife has instituted an action for divorce in the Court of Common Pleas of Cwnberland County; and WHEREAS, the parties hereto are the parents of one child, Ryan Philip Ketner, born March 24, 1984; and WHEREAS, it is the desire of the parties, after long and careful consideration, to amicably adjust, compromise and settle all property rights and all rights in, to or against each other's property and estate, 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 maintenance and/or for support, alimony, counsel fees and costs. NOW THEREFORE, in consideration of the several mutual promises and/or covenants and/or agreements hereinafter contained, each of the parties hereto, intending to be legally bound hereby, promises, covenants and agrees as follows: First: Divorce The parties hereto further agree that the marriage is irretrievably broken, and that they mutually consent to a divorce and agree to execute all necessary affidavits required by the Court at the appropriate times. This agreement shall remain in full force and effect regardless of any change in the marital status of the parties. It is warranted, covenanted, and represented by Husband and Wife, each to the other, that this agreement is lawful and enforceable and this warranty, covenant and representation is made for the specific purpose of inducing Husband and Wife to execute the agreement. Husband and Wife each knowingly and understandingly waive any and all possible claims that this agreement is, for any reason, illegal or for any reason whatsoever of public policy, unenforceable in whole or in part. Husband and Wife each does hereby warrant, covenant and agree that, in any possible event, he and she are and shall forever be estopped from asserting any illegality or unenforceability as to all or any part of this agreement. Second: Releases Except as provided for in this agreement, Husband and Wife each hereby forever releases, remises, discharges and quitclaims the other and the estate of the other, for all time to come and for all purposes whatsoever, from any action of any nature whatsoever in law or in equity, 2 Each of the parties specifically covenants and agrees and warrants and represents that the execution of this agreement and its terms and provisions are accepted by them as including, inter alia, full and complete payment by the other for any and all past, present or future obligations for support, care, education, maintenance, and property rights of the other. Each further covenants, warrants, represents and agrees that no action will be instituted by them (or claim of any kind be made) for their support, or for any claim for property or rights other than as set forth in this agreement, directly or indirectly, against the other, in any court or any jurisdiction whatsoever. The parties hereto recognize, acknowledge and agree that each of them hereafter shall not have and does not have any rights or claims for support, care and maintenance or for any rights or claims of property because the provisions herein in the nature of a post-nuptial agreement are fair and reasonable and the property distributions herein are fair and reasonable. Wife acknowledges that the property conveyed to her is a fair and substantial portion of and division of Husband's assets and Wife's rights to equitable distribution of property; Husband acknowledges that property allocated to him is fair and a substantial portion of and division of the assets of the parties and Husband's rights to equitable distribution of property. Third: Release of Testamentarv 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 agrees that the estate of the other, whether real, personal or mixed, shall be and belong to the person or persons who would have become entitled thereto as if the 3 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. Either party may, however, make such provision for the other as he or she may desire in and by his or her Last Will and Testament. Each of the parties further covenants and agrees that he or she will permit any will of the other to be probated and allow administration upon his or her personal, real or mixed estate and effects to be taken out by the person or persons who would have been entitled to do so had Husband or Wife died during the lifetime of the other; and that neither Husband nor Wife will claim against or contest the will and the estate of the other, Each of the parties hereby releases, relinquishes and waives any and all rights to act as executor or executrix or administrator or administratrix of the other party's estate, Each of the parties hereto further covenants and agrees for himself and herself and his and her heirs, executors, administrators and assigns, that he or she will never at any time hereafter sue the other party or his or her heirs, executors, administrators or assigns, for the purpose of enforcing any of the rights relinquished under this paragraph, Fourth: Lee:al Advice The provisions of this agreement and their legal effect have been fully explained to the parties by their respective counsel. The Wife has employed and had the benefit of counsel of Timothy J. O'Connell, Esquire, as his/her attorney, The Husband has elected to represent himself in this matter. Each party acknowledges that he or she fully understands the facts and fully understands his or her legal rights and obligations and 4 each party acknowledges and accepts that this agreement is, in the circumstances, fair and equitable, and that it is being entered into freely and voluntarily after having received such advice and with such knowledge, and that execution of the 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. The respective parties do hereby warrant, represent and declare and do acknowledge and agree that each is and has been fully and completely informed of and is familiar with and cognizant of the wealth, real and/or personal property, estate and assets, earnings and income of the other and that each has made a full and complete disclosure to the other of his and her entire assets and liabilities and any further enumeration or statement thereof in this agreement is hereby specifically waived, and the parties do not wish to make or append hereto any further enumeration or statement. Each of the parties hereto further covenants and further agrees for himself and herself and his or her heirs, executors, administrators and assigns, that he or she will never at any time sue the other party or his or her heirs, executors, administrators or assigns, in any action or contention, direct or indirect, that there was any absence or lack of full disclosure or that there was any absence or lack of full, proper or independent representation. Fifth: Separation and Non-Molestation Aereement It shall be lawful for Husband and Wife at all times hereafter to live separate and apart from each other and to reside from time to time at such place or places as they shall respectively deem fit, free from any authority, control, restraint or interference, direct or indirect, by each other. Each party agrees that he or she will not molest or harass the other, or compel or endeavor to compel the other to cohabit or dwell with him or her by 5 any legal or other proceedings. Each may have for her or his separate use and benefit the right to conduct, carry on or engage in any business, profession or occupation. Neither of the parties shall, in any way whatsoever, interfere with the other's employment or occupation, The parties are free to mutually and voluntarily make any efforts at reconciliation as he or she or they shall deem proper. The foregoing provision, however, shall not be taken to be an admission on the part of either Husband or Wife of the lawfulness or unlawfulness of the causes leading to their living apart, and shall not be taken to be an admission on the part of either Husband or Wife as to whether either party committed desertion and continues in such desertion, and nothing contained in this agreement is to be deemed to justify such continued desertion. It is specifically intended and understood and agreed by and between the parties hereto that each is to be enabled to live not only separate and apart from each other, but is also free to act as if he or she were unmarried so far as any other persons are concerned and each covenants and agrees not to harass or embarrass the other or any other person who either party may hereafter see socially. Each of the parties hereto covenants and agrees that neither will deny or endeavor to abridge any right of support or maintenance which the other might have because of any alleged conduct with regard to any third persons; provided, however, that the parties hereto recognize that it is intended that this agreement shall and does supersede any and all rights or claims to support. Each of the parties hereto covenants and agrees that he and she will not charge the other with adultery in any action of any nature whatsoever, directly or indirectly, or whether involving the parties or third persons. 6 Sixth: Debts All debts, contracts, obligations or liabilities incurred at any time in the past or future by either of the parties will be paid promptly by said party, unless and except as otherwise specifically set forth in this agreement; and each of the parties hereto further promises, covenants and agrees that each will now and at all times hereafter save hannless and keep the other or his or her estate indemnified and saved hannless from all debts or liabilities incurred by him or her, as the case may be, and from all actions, claims and demands whatsoever with respect thereto, and from all costs, legal or otherwise, and counsel fees whatsoever appertaining to such actions, claims and demands. Neither party shall, after the date of this agreement, contract or incur any debt or liability for which the other or his or her property might be responsible, and shall indemnify and save hannless the other from any and all claims or demands made against her or him by reason of debts or obligations incurred by her or him and from all costs, legal costs and counsel fees unless provided to the contrary herein, Seventh: Equitable Distribution Real Estate. Husband agrees to transfer all of his right, title and interest in the marital domicile located at 34 Kensington Drive, Camp Hill, Pennsylvania, to Wife, said transfer shall be subject to the mortgage thereon in favor of Homeside Lending. Husband agrees to continue to make the monthly mortgage payment until such time as he retires from his current employment with the Commonwealth of Pennsylvania. When Husband retires, Wife shall be solely responsible for payment of the mortgage and agrees to indemnify and hold Husband hannless from any claim, debt or obligation arising from 7 ownership of the property, Wife will continue to pay all maintenance and taxes on the property until Husband's retirement. Husband's S.E.R.s. Pension. Husband agrees to give Wife one-half interest in his S.E,R.S, pension pursuant to the Qualified Domestic Relations Order signed by the parties concurrently herewith. Automobiles. Husband agrees to and does hereby sell, set over, transfer and assign all of his right, title and interest in the 1993 Nissan Maxima to Wife, releasing and relinquishing all claims to said automobile. Husband further agrees to pay the cost of insurance on this vehicle up to $3,000.00 annually until such time as he retires from his employment with the Commonwealth of Pennsylvania or Wife remarries. Personal Propertv. The parties agree to set over, transfer and assign all their right, title and interest in the property now in the possession of the other. Eiehth: Alimonv. Support and Counsel Fees Husband agrees to pay the sum of$300,00 per month in spousal support (or alimony in the event Husband does not retire prior to the entry of the divorce decree) until such time as he retires from his current employment with the Commonwealth of Pennsylvania. The parties waive any other rights each may have against the other for alimony, spousal support or counsel fees, Ninth: Colleee Expenses-Rvan P. Ketner Husband agrees to pay the costs of tuition and other college related expenses for the parties' son, Ryan p, Ketner. 8 Tenth: Confirmatory Documents Husband and Wife covenant and agree that they will forthwith (and within at least fifteen days after demand therefor) execute any and all written instruments, assignments, releases, satisfactions, deeds, notes or such other writings as may be necessary or desirable for the proper effectuation of this agreement. The parties will further deliver to each other whatever personal papers, documents or writings that each now possess which are the property of the other. Eleventh: Ae:reement to Continue in Event of Divorce This agreement shall remain in full force and effect unless and until it is terminated either by mutual written consent of both parties, or to the extent it is appropriately terminated by the death of either party under the terms of 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. In the event that the marriage of the parties hereto is terminated by divorce, this agreement shall nevertheless remain in full force and in effect and shall survive such decree and shall not in any way be affected thereby, except as provided herein, Twelfth: Ae:reement Bindine: on Heirs The terms, provisions and conditions of this agreement shall be binding upon any and all of their heirs, executors, administrators, successors and assigns of either the respective parties hereto, except as otherwise herein provided. 9 Thirteenth: Applicable Law This agreement shall be construed under the laws of the Commonwealth of Pennsylvania. Fourteenth: Prior Al!:reements It is understood and agreed that any and all property settlement agreements which mayor have been executed prior to the date and time of this agreement are null and void and of no effect. Fifteenth: 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 respects this agreement shall be valid and continue in full force, effect and operation. No provision of this agreement shall be interpreted for or against any party because that party or that party's representative drafted this agreement in whole or in part, Sixteenth: Enforcement It is expressly understood and agreed by and between the parties hereto that this agreement may be specifically enforced by Husband or Wife in a court of equity, and the parties hereto agree that if an action to enforce this agreement is brought in equity by either party, the other party will make no objection on the alleged ground oflack of jurisdiction of said court on the ground that there is an adequate remedy of law. The parties do not intend or purport hereby to improperly confer jurisdiction on a court in equity by their agreement, but they agree as provided herein for the forum of equity in 10 mutual recognition of the present state of law, and in recognition of the general jurisdiction of courts in equity over agreements such as this one. Notwithstanding anything to the contrary herein, Wife or Husband may also proceed with an action at law for redress of any of his or her rights under the terms of this agreement. In the event that for any reason whatsoever either party is obliged to proceed at law for redress of his or her rights under the terms of this agreement, then it is specifically understood and agreed that for and in specific consideration of the other provisions and convents of this agreement, each shall waive any right to jury trial so as to expedite the hearing and disposition of such case and so as to avoid delay. It is specifically understood and agreed by the parties that in the event of a default under the terms of this agreement, the non-defaulting party shall have the right to file a petition for contempt and request such relief and remedies as authorized by law of the court. Each party further hereby agrees to pay and to save and hold harmless the other party from any and all attorney's fees, costs and legal expenses that either may sustain, or incur or become liable or answerable for, in any way whatsoever, or shall pay upon, or in consequence of, any default or breach by the other of any of the terms or provisions of this agreement by reason of which either party shall or shall be obliged to retain or engage counsel to initiate or maintain or defend proceedings against the other at law or equity or both or in any way whatsoever; provided that the party who seeks to recover such attorney's fees, costs, and legal expenses and expenses must first be successful in whole or in part, before there would be any liability for attorney fees, 11 All remedies provided by law and all remedies provided for in this agreement for enforcement of this agreement shall be deemed to be cumulative and the exercise of one remedy shall not bar or prevent the pursuit of any other remedy and either party may elect to pursue such remedies simultaneously and the exercise of a remedy one or more times shall not exhaust its use or prevent further pursuit of such remedy. This agreement shall not be deemed to merge into the decree of divorce, In witness whereof, and intending to be legally bound hereby, the parties hereto have hereunto set their hands and seals the date and year first written above, Witness: ~~. fP 7~(seal) Carol G, Ketner II!:- gMMn.h"~ (seal) W,Ra~ 12 (") r'::1 C) C C,," -11 s~ Q C' ('") P! -, -,. I <- " -J ~~! (-} r.:;. , ..r.., "i ~ ,- " ;}-: :le: . ~.::...- \, ;_J -<:'. rn ~ ~ -~~ ''-l " :J \ 0 -< CAROL G. KETNER, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs, : NO. 03-3148 CIVIL W, RAYMOND KETNER, Defendant CIVIL ACTION - LAW IN DIVORCE AFFIDAVIT OF CONSENT I. A complaint in divorce under Section 3301(c) of the Divorce Code was filed on July 3, 2003. 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. Date: 10/1/03 ~!;;.~ff ~ Social Security No, ) q J - If /) , 7 f t;, 0 0 0 c W -il t";:- C) -0 C) en -i ,~~ - z L' I i-n 7~ y ej) "....J ~} -< C) ~ C. ....., -.,", ~ ~ -n 0 , . ::;t; " (""j ~- C" "c.;: r-n )> C '-" ,--' ....\ 2:, N ').~" ::i:J =< \0 -< CAROL G. KETNER, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. NO. 03-3148 CIVIL W. RAYMOND KETNER, Defendant CIVIL ACTION - LAW IN DIVORCE AFFIDAVIT OF CONSENT 1. A complaint in divorce under Section 3301{c) of the Divorce Code was filed on July 3, 2003. 2, The marriage of plaintiff and defendant is ilTetrievably 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. Date: /t//7/t;.3 L~f~~ W, R, ond Ketner Social Security No. /7/-.3'6 --?4L?? CJ c' 0 c:: f....-) --;-, :C.t, 0 -0(':' C} m C --j , , -,_.. z ,Y., z( ,~ , '.' (JJ ,,_ "- (') ../ " i r:::C "u '" ~.~ --~-?2S ~c:' - 'il ,..) in 5c' --.j Z N )>- -:;I :J:1 -, u:> -< CAROL G. KETNER, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs, : NO, 03-3148 CIVIL W. RAYMOND KETNER, Defendant CIVIL ACTION - LAW IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(c) OF THE DIVORCE CODE I. I consent to the entry of a final decree in divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if! 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, o ~ "TJ ij'~ ml', ;-~:. zc ~r " -, o w o n -l , -.J C) -n ~ , '~~;9 -'\':) (..1 ::.-.) :...> C::J -r, (0') _;;:'1'1. .--\ ~5S -< CAROL G. KETNER, Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA vs. : NO. 03-3148 CIVIL W. RAYMOND KETNER, Defendant CIVIL ACTION - LAW IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(c) OF THE DIVORCE CODE I, I consent to the entry of a final decree in divorce without notice, 2, I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if! 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, Date: IO/~? ~~ W. Ra nd Ketner /7/- ~6'~~?-7 Social Security No, (") 0 () c W -n ?;: 0 "1.l rr' " .D n.l i .-1 ~ .- ,,>-n Z I .~~y U) -J --, .- ~? C..: .-1) . ..,-j ~~ -- ) (") ~ , - ( W ,.) in :;> C- .,,~\ _.~; :..:> 5i ~~ C) -<. CAROL Q, KETNER, Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYL VANIA v. : NO. 03-3148 CIVIL W, RAYMOND KETNER, Defendant : CIVIL ACTION - LAW : IN DIVORCE ACCEPTANCE OF SERVICE I hereby accept service of the Complaint under Section 3301(c) filed in the above captioned action. Date: 7 Jq I () ;> ///~~~ ~(etner ) 7/-3.6 -cJ~q. 7 Social Security No. (") '" (,.) c 0_~. -,) -,..,. .::J -0::,' ;-) n-j : ..., L;" .. 2: P' I C0:J -....J ~;- <-'. " ;;,?,:c, .-. L-.. '-, :;;<.. '-:? '....,.1 c. ':8;' 2; ':,.,) ".J:] =< co :..:: CAROL G. KETNER, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA v, : NO. 03-3148 CIVIL W, RAYMOND KETNER, Defendant CIVIL ACTION - LAW IN DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following infi)rmation, to the court for entry of a divorce decree: I. Ground for Divorce: irretrievable breakdowrI under Section 330lc of the Divorce Code. 2. Date and manner of service of the complaint: July 9, 2003--See Acceptance of Service filed herewith, 3. Date of execution of the affidavit of consent required by Section 330lc of the Divorce Code: by plaintiff: October 7,2003 and filed herewith; by defendant: October 7, 2003 and filed herewith. 4. Related claims pending: none 5, Date of plaintiffs Waiver of Notice in Section 330lc Divorce: dated October 7, 2003 and filed herewith, Date of defendant's Waiver of Notice in Section 3301c Divorce: dated October 7, 2003 and filed herewith. ~/ hy J. O'Connell, Esquire Turner and O'Connell 4415 North Front Street Harrisburg, PA l7110 (717) 232-4551 Attorney for plaintiff (") c:: ? -rJ;~-": rt1 '.>' ...,.r ..0:.. .;' 65"{~-~ r~'.,:, ~.'-- --"j s-;:~-- - :!3 ;;; ~ w o c." <:::> CJ --t t -.; o -['1 'T, ) .m ",C;} :cS '-,- -" <(5 :~5n-, -,,,I -,,' sS -< . . . . . . . . . . . . . IN THE COURT OF COMMON PLEAS . . . OF CUMBERLAND COUNTY . PEN NA. . . STATE OF . . . . . . No. 03--3148 Civil CAROL G. KETNER . VERSUS . . . iJi/. RAYM:)N]) KETNER . . . DECREE IN DIVORCE . . . Ocr., .6..... /,S-I- AND NOW, 2003 , IT IS ORDERED AND . . . . . . DECREED THAT Carol G. Ketner , PLAINTIFF, . AND iJi/.Ravmond Ketner , 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 . . . . . . . . The Property Settlement Agreement between Carol G. Ketner, plainti.ff, and w. Haymond Ketner, defendant, dated October I, lUU] , shall be lnco:qJorated but not merged into this decree. . . . . . . By THE COURT: I H4~ . . . . . . . . . . . . . . . '. . . . . ;f. :t: 'I' 'i';+: . '" 'I'''':+::+:;+: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . J. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .' . . CT .-L.,~ _. '-P'/"" e "1:r~'Y ~.k; ~.,?,j? ~~ "'P'~;;'~~ E:'a _$/'- 17/ E't7 5'/. 17/ f~ [..,l c.- 1 (ft ~(~~ I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA C (r fJ) G" \L~+~ev' Plaintiff Vs fa V~ bvt J vi lCe +~ V Defendant File No. () 3 - ,1/'1 f IN DIVORCE NOTICE TO RESUME PRIOR SURNAME Notice is hereby given that the Plaintiff / defendant in the above matter, [select one by marking "x"] _ prior to the entry of a Final Decree in Divorce, or --2L- after the entry of a Final Decree in Divorce dated / 0 ~ ~ I .20 0, j' hereby elects to resume the prior surname of , and gives this written notice avowing his I her intention pursuant to the provisions of 54 P.S. 704. Date: eel/sic). . ~. ff-. t'~ Signature ~ , ,~'''''' ,"'.....~ ~ "," Signature of name being resumed c.. {iV (\ \ C3' \ () ~ t:( II" ~ S 0 ~. COMJV.l:O~TH OF PENNSYLVANIA ) COUNTY O~~/)) On the ~ day of .2!2P , 2004, before me, the Prothonotary 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 Witness 'Whereof, I have hereunto set my hand hereunto set my hand and official seal. IOTARIAL SEAL ~NOTARY'" CMIaE ClJM8SlI.AM) COIInY COUJmfOUSE MY COIMS8IOI EXPIRES JAIIMRY "1010 Pro Sf i<:""l ~,~) : . , ::::J F r """ \.) ~ ~. '- ~ '"<) ~ ~ r-o,) ~ .. :-4 % r Tlat.. .....,."..~ . lfI"'-l t ",Mvt;;~::~~~;~~~~ J ; );;t!OORUoa YTMIJO:l '.h~AJii' , 'J.~ :!"l.A~' t c:; O~ t. VRAU~AL 2JftF;x3 ~Ql &:VI.V,j1:,l1!...) COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVARIA CAROL G. KETNER, m Plaintiff NO.: 03-3148 ter' -- -< Ev rc) vs.�--, W. RAYMOND KETNER, IN DIVORCE Defendant crs STIPULATED PETITION TO VACATE "DOMESTIC RELATIONS ORDER" AND NOW, this /2 day of , 2014, the parties, Carol G. Ketner, Plaintiff, by and through the Executor of her Estate, Janene Bendrick, and W. Raymond, Ketner, Defendant, do hereby Agree and Stipulate as follows: 1. On May 7, 2003, the parties, Carol G. Ketner and W. Raymond Ketner, entered into a "Stipulation for the Entry of `Domestic Relations Order', whereby plaintiff received fifty percent (50%) of the marital property component of the Member's, W. Raymond Ketner's, retirement benefits from the Pennsylvania State Employees' Retirement System (PSERS). (See a copy of the Stipulation for the Entry of "Domestic Relations Order", attached hereto and incorporated by reference as Exhibit "A"). 2. On October 15, 2003, a Final Decree in Divorce was entered in the matter. 3. On September 15, 2006, Plaintiff, Carol G. Ketner filed a notice to resume her prior surname, which was changed to Carol Giomariso. 4. In September of 2013, plaintiff, Carol Ketner/Giomariso passed away. (See Carol Giomariso's Death Certificate attached hereto and incorporated by reference as Exhibit "B"). 5. On September 18, 2013, Letters of Administration were issued to Janene Bendrick who was appointed as Executor of the Estate of Carol Giomariso and who remains the Executor. (See the Letters Testamentary attached hereto and incorporated by reference as Exhibit «C„ 6. Carol Giomariso and W. Raymond Ketner's son, Ryan Ketner, is the only living heir of Carol Giomariso and the sole beneficiary of her estate. 7. After plaintiff's death, the retirement benefits from PSERS were paid into her estate and continue to be paid to said Estate on a monthly basis. 8. Ryan Ketner, as the sole beneficiary of plaintiff's estate, wishes to relinquish his right to the retirement benefits under the May 2003 Domestic Relations Order so that they revert back to his father. 9. The parties, the Estate of Carol Giomariso, formerly known as Carol G. Ketner, and W. Raymond Ketner, intend and agree that the terms of this Stipulation and Agreement to vacate the Domestic Relations Order be approved and entered so that W. Raymond Ketner will receive the full amount of his retirement benefits. 10. Upon entry of the Vacated Domestic Relations Order, a certified copy of the Order and this Stipulation and any attendant documents shall be served upon PSERS immediately. WHEREFORE, the parties, intending to be legally bound by the terms of this Stipulation and Vacation of the Domestic Relations Order, do hereunto place their hands and seals this day written above. laintiff/Alternate Payee Janene Bendrick, Executor of the Estate of Carol Giomariso, formerly known as Carol G. Ketner i•Defe Kant/Member W. Raymond Ketner Age Ryan Ketner, sole beneficiary of the Estate of Carol Giomariso aetX Nicble L. Javitt, Esire Dethlefs-Pykosh Law Group, LLC 2132 Market Street Camp Hill, PA 17011 (717) 975-9446 njavitt@dplglaw.com Attorney for Plaintiff/Alternate Payee and Ryan Ketner, sole beneficiary COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CAROL G. KETNER, Plaintiff NO. 03-3148 W. RAYMOND KETNER, IN DIVORCE Defendant STIPULATION FOR THE ENTRY OF "DOMESTIC RELATIONS ORDER" AND NOW, this 7`h day of May, 2003, the parties, Carol G. Ketner, Plaintiff, and W. Raymond Ketner, Defendant, do hereby Agree and Stipulate as follows: 1. The Defendant, W. Raymond Ketner, (hereinafter referred to as "Member") is a member of the Commonwealth of Pennsylvania, State Employees' Retirement System (hereinafter referred to as "SERS") 2. SERS, as a creature of statute, is controlled by the State Employees' Retirement Code, 71 PA C.S. §§ 5101-5956 ("Retirement Code"). 3. Member's date of birth is October 29, 1944, and his Social Security number is 171-36-9447. EXHIBIT A 4. The Plaintiff, Carol G. Ketner, (hereinafter referred to as "Alternate Payee") is the former spouse of Member. Alternate Payee's date of birth is April 6, 1953, and her Social Security number is 191-40-7862. 5. Member's last. known mailing address is: 51 Drexel Place New Cumberland, PA 17070 6. Alternate Payee's current mailing address is: 34 Kensington Drive Camp Hill, PA 17011 It is the responsibility of Alternate Payee to keep a current mailing address on file with SERS at all times. 7. (a) The marital property component of Member's retirement benefit equals: (1) The Coverture Fraction multiplied by (2) the Member's retirement benefit on the effective date of Member's retirement calculated by using the Member's final average salary on August 17, 2002 instead of the Member's actual final average salary. (b) The Coverture Fraction is a fraction with a value less than or equal to one. The numerator is the amount of Member's service, as defined by SERS, for the period of time from October 21, 1975.to August 17, 2002. The denominator is the total amount of Member's service, as defined by SERS, on the effective date of Member's retirement. (c) Fifty percent (50%) of the marital property component of Member's retirement benefit is to be allocated to the Alternate Payee as her equitable distribution portion of this marital asset. 8. Member's retirement benefit is defined as all monies paid to or on behalf of Member by SERS, including any lump sum withdrawals or scheduled or ad hoc increases, but excluding the disability portion of any disability annuities paid to Member by SERS as a result of a disability which occurs before the Member's marriage to Alternate Payee or after the date of the Member and Alternate Payee's final separation. Member's retirement benefit does not include any deferred compensation benefits paid to Member by SERS. The equitable distribution portion of the marital property component of Member's retirement benefit, as set forth in Paragraph Seven (7), shall be payable to Alternate Payee and shall commence as soon as administratively feasible on or about the date the Member actually enters pay status and SERS approves a Domestic Relations Order incorporating this Stipulation and Agreement, whichever is later. 9. Member hereby nominates Alternate Payee as an irrevocable beneficiary to the extent of Alternate Payee's equitable distribution portion of Member's retirement benefit for any death benefits payable by SERS. This nomination shall become effective upon approval by the Secretary of the Retirement Board, or his authorized representative, of any Domestic Relations Order incorporating this Stipulation and Agreement. The balance of any death benefit remaining after the allocation of Alternate Payee's equitable distribution portion ('Balance") shall be paid to the beneficiaries named by Member on the last Nomination of Beneficiaries Form field with the Retirement Board prior to Member's death: a. If the last Nomination of Beneficiaries Form field by Member prior to Member's death (a) predates any approved Domestic Relations Order incorporating this Stipulation and Agreement, and (b) names Alternate Payee as a beneficiary, then: (1) the terms of the Domestic Relations Order shall alone govern Alternate Payee's share of any death benefit, and (2) for purposes of paying the Balance via the last Nomination of Beneficiaries From field with the Retirement Board prior to Member's death, Alternate Payee shall be treated as if Alternate Payee predeceased Member. No portion of the Balance shall be payable to Alternate Payee's estate. b. In addition, Member shall execute and deliver to Alternate Payee an authorization, in a form acceptable to SERS, which will authorize SERS to release to Alternate Payee all relevant information concerning Member's retirement account. Alternate Payee shall deliver the authorization to SERS which will allow the Alternate Payee to check that she has been and continues to be property nominated under this paragraph. 10. (a) The term and amounts of Member's retirement benefits payable to the Alternate Payee after SERS approves a Domestic Relations Order incorporating this Stipulation and Agreement is dependent upon which option is selected by Member upon retirement. Member and Alternate Payee expressly agree that: Member shall select the following retirement option upon filing an application for Retirement Allowance with SERS: Special Option 4. - A joint and equitable distribution percent (or portion) (as defined in paragraph 7) annuity payable during the lifetime of the Member with an equitable distribution percent (or portion) (as defined in paragraph 7) of such annuity payable thereafter to his survivor annuitant, if living at his death, as set forth in 71 Pa. C.S. Section 5705(a)(4), or any succeeding statute. The Member shall designate the Alternate Payee as his irrevocable survivor annuitant. The intent of this Special Option 4 selection is to maintain levelized payments to the Alternate Payee for her life in the event of Member's death and retirement. The Alternate Payee shall receive her equitable distribution percentage (or portion) of the annuity which is payable to the Member during his lifetime, so that she shall receive a percentage (or portion) of the Member's check during his lifetime and the same amount, all other things being equal, if he predeceases her after retirement. (b) The Member and Alternate Payee acknowledge that if the Alternate Payee predeceases the Member, the following will occur under this Special Option 4 selection: (1) the same monthly benefit which had been paid or would have been paid to the Alternate Payee during Alternate Payee's lifetime will be paid to the Alternate Payee's estate for the duration of the life of the Member, and (2) upon the Member's death, all payments to the Alternate Payee's estate shall cease. 11. Alternate Payee may not exercise any right, privilege or option offered by SERS. SERS shall issue individual tax forms to Member and Alternate Payee for amounts paid to each person. 12. In the event of the death of Alternate Payee prior to receipt of all of her payments payable to her from SERS under this Order, any death benefit or retirement benefit payable to Alternate Payee by SERS shall be paid to Alternate Payee's Estate to the extent of Alternates Payee's equitable distribution portion of Member's retirement benefit as set forth in Paragraphs Seven through Nine. 13. In no event shall Alternate Payee have greater benefits or rights other than those that are available to Member. Alternate Payee is not entitled to any benefit not otherwise provided by SERS. The Alternate Payee is only entitled to the specific benefits offered by SERS as provided in this Order. All other rights, privileges and options offered by SERS not granted to Alternate Payee by this Order are preserved for Member. 14. It is specifically intended and agreed by the parties hereto that this Order: (a) Does not require SERS to provide any type of benefit, or any option, not otherwise provided under the Retirement Code; (b) Does not require SERS to provide increased benefits (determined on the basis of actuarial value) unless increased benefits are paid to Member based upon cost of living or increases based on other than actuarial values. 15. The parties intend and agree that the terms of this Stipulation and Agreement shall be approved, adopted and entered as a Domestic Relations Order. 16. The Court of Common Pleas of Cumberland County, Pennsylvania, shall retain jurisdiction to amend any Domestic Relations Order incorporating this Stipulation and Agreement, but only for the purpose of establishing it or maintaining it as a Domestic Relations Order; provided, however, that no such amendment shall require SERS to provide any type or form of benefit, or any option not otherwise provided by SERS, and further provided that no such amendment or right of the Court to so amend will invalidate this existing Order. 17. Upon entry as a Domestic Relations Order, a certified copy of the Domestic Relations Order and this Stipulation and Agreement and any attendant documents shall be served upon SERS immediately. The Domestic Relations Order shall take effect immediately upon SERS approval and SERS approval of any attendant documents and then shall remain in effect until further Order of Court. WHEREFORE, the parties, intending to be legally bound by the terms of this Stipulation and Agreement, do hereunto place their hands and seals. Plaintiff/Alternatd Payee / Defendai ,i ember r-T t/ A zn for # COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CAROL G. KETNER, Plaintiff NO. 03-3148 W. RAYMOND KETNER, IN DIVORCE Defendant ORDER AND NOW, this /5-' day of ear , 2003, the attached Stipulation and Agreement dated '7 ACrO3 of the parties in this case is incorporated, but not merged, into this Order of Court. ATTEST: 00+0000000p0o0010+-00000o0op000oo0000000*oo 000000,0000000000000oo0000000000p+OO + O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O 0 O 0 0 0 0 0 0 0 O 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 O O 0 0 + 0 0 0 0 0 0 0 o+0000000 IN THE COURT OF COMMON PLEAS OFCUMBERLAND COUNTY STATE OF CAROL G. KETNER VERSUS n. RAYMOND KETNER PENNA. NC). 03-3148 Civil DECREE IN DIVORCE AND NOW, October 15 DECREED THAT Carol G. Ketner AN D W. Raymond Ketner ARE DIVORCED FROM THE BONDS OF MATRIMONY. 2003 , IT IS ORDERED AND , PLAINTIFF, , 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; none The Property Settlement agreement between Carol G. Ketner, plaintiff, and W. Raymond Ketner, defendant, dated October.'/, 2003, shall be incorporated but not merged into this decree. :rC BY THE COURT: Kevin A. Hess ATTEST: Curtis R. Long PAY • Certified Copy Issued: October 15, 2003P OTH i TARY 000000+ 0000oo0oop0000000+0000000,00000+000000000000000000++0+i 0 0 0 0 0 0 0 O O 0 O 0 0 O 0 0 O 0 0 0 O 0 0 0 0 0 0 0 0 0 0 O 0 4 0 0 0 0 0 4 0 0 0 0 0 1 H105.805 REV (9/11) LOCAL REGISTRAR'S CERTIFICATION OF DEATH WARNING: It is illegal to duplicate this copy by photostat or photograph. Fee for this certificate, $6.00 P 19854154 Certification Number Type/Print In Permanent Black Ink ri 1S 0 NAME OF DECEDENT This is to certify that the information here given is correctly copied from an original Certificate of Death duly filed with me as Local Registrar. The original certificate will be forwarded to the State Vital Records Office for permanent filing. a-' 1ld?0/3 Local R6gistrar COMMONWEALTH OF PENNSYLVANIA • DEPARTMENT OF HEALTH • VITAL RECORDS CERTIFICATE OF DEATH State File Number: Date Issued To Be Completed/Verified By: FUNERAL DIRECTOR 1. Decedent's Legal Name (First, Middle, Last. Suffix) Carol Giomariso 2. Sex female 3. Social Security Number 191-40-7862 4. Date of Death (Mo/Day/Yr) (Spell Mo) September8, 2013 A, ;k' 5a. Age -Last Birthday (Yrs) Sb. Under 1 Year 5c. Under 1 Day 6. Date of Birth (Mo/Day/Year) (Spell Month) 7a. Birthplace (City and State or Foreign Country) 60 Months Days Hours Minute: April 6, 1953 Harrisburg, Pennsylvania 7b. Birthplace (County) Dauphin 8a. Residence (State or Foreign Country) Pennsylvania 8b. Residence (Streetand Number - Include Apt No.) 6809 Clubhouse DrG5 Sc. Did Decedent Live In a Township? WYes, decedent lived in Tr,t.ter Pa,rrnn Twp two. 8d. Residence (County) Dauphin 8e. Reticence (Zip Code) 17 1 11 ONo, decedent lived within limits of city/born. 9. Ever in US Armed Forces? 0 yes f[] No 0 Unknown 10. Mar SD Divorced tal Status at Time of Death 0 Married 0 Widowed 0 Never Married 0 Unknown 11. Surviving Spouse's Name (If wife, give name prior to first marriage) 12. Father's Name (First, Middle, Last, Suffix) Philip Giomariso 13. Mother's Name Prior to First Marriage Fin Middle, Last) Margaret Hal 14a. Informant's Name Ryan P. Ketner 14b. Relationship to Decedent Son 14c. Informant's Mailing Address (Street and Number, City, State, Zip Code) 535 Bridgeboro St., Riverside, NJ 08075 if Death Occurred In a Hospital: If Inpatient 0 Emergency Room/Outpatient 0 Dead on Arrival 15a. Place of Death (Check only one) y.j If Death Occurred Somewhere Other Than a Hospital: CI Hospice Facility QtDecedent's Home 0 Nursing Home/Long-Term Care FacIlity 0 Other (Specify) 15b. Facility Name (If net institution, give street and number) 6809 Clubhouse Drive Apt G-5 15c. City er Town, State, end Zip Code Lower Paxton Twp, PA. 17111 15d. County of Death Dauphin 16a. Method of Disposition 0 Burial Cremation O Removal from State 0Donatl 0 Other (Specify) 16b. Date of Disposition Sept17,2013 16c. Place of Disposition (Name of cemetery, crematory, or other place) Hoover Funeral Homes Crematory led. Location of Disposition (City or Town, State, and Zip) Harrisburg,�pI�PA 17112 17a. Signature o I Service Licensee or Person in Charge of Interment / /Z3 -i.e..-- 1 b LicC�Is1e.IJ�r L 17c pl1-looveZm2'ueial flrOmes`il y Crematory Inc., 6011 Liinglestown Rd. Harrisburg, PA 17112 18. Decedent's Education - Check the box that best describes the highest degree or level of school completed at the time of death. 0 8th grade or less 0 No diploma, 9th - 12th grade 0 High school graduate or GED completed 0 Some college credit, but no degree 0 Associate degree (e.g. AA, AS) 0 Bachelor's degree (e.g. BA, AB, BS) Master's degree (e.g. MA, MS, MEng, MEd, MSW, MBA) octorate (e.g. PhD, Edo) or Professional degree 19. Decedent of Hispanic Origin - Check the box that best describes whether the decedent is Spanish/Hispanic/Latino. Check the "No" box if decedent is not Spanish/Hispanic/Latino. igeNo, not Spanish/Hispanic/Latino 0 Yes, Mexican, Mexican American, Chicano 0 Yes, Puerto Rican 0 Yes, Cuban 0 Yes, other Spanish/Hispanic/Latino (Speclfy) 20. Decedent's Race - Check ONE OR MORE races to Indicate what the decedent considered himself or herself to be. 12rWhite 0 Korean 0 Black or African American 0 Vietnamese 0 American Indian or Alaska Native 0 Other Asian 0 Asian Indian 0 Native Hawaiian 0 Chinese 0 Guamanian or Chamorro 0 Filipino 0 Samoan 0 Japanese 0 Other Pacific Islander 0 Other (Specify) (e.g. MD, DOS, DVM, LLB, JD) 21. Decedent's Single Race Self -Designation - Check ONLY ONE to indicate what the decedent considered himself or herself to be. JEL.White 0 lapane5e 0 Samoan 0 Black or African American 0 Korean0 Other Pacific Islander 0 American Indian or Alaska Native 0 Vietnamese 0 Don't Know/Not Sure 22a. Decedent's Usual Occupation - indicate type of work done during most of working life. DO NOT USE RETIRED. Teacher 0 Asian Indian 0 Other Aslan 0 Refused 0 Chinese 0 Native Hawaiian 0 Other (Specify) 22b. Kind of Business/Industry Education 0 Filipino 0 Guamanian or Chamorro To Be Completed By: MEDICAL CERTIFIER REMS 23a - 23d MUST BE COMPLETED BY PERSON WHO PRONOUNCES OR CERTIFIES DEATH 23a. Date Pronounced Dead (Mo/Day/Yr) September 13, 2013 23b. Signature of Person Pronouncing Death (Only when applicable) 23c. License Number 23d. Date Signed (Mo/Day/Yr) 24. Time of Death ues\-NJt4.-% 25. Was Medical Examiner or Coroner Contacted? ® Yes 0 No CAUSE OF DEATH 26. Part I. Enter the chain of a -di eases, Injuries, or mplications--that directly caused the death. DO NOT enter terminal events such as cardiac arrest. Approximate Interval: respiratory arrest, or ventricular fibrillation without showing the etiology. DO NOT ABBREVIATE. Enter only one cause on a line. Add additional lines if necessary IMMEDIATE CAUSE > a. Cardiac Dysrhythmia Onset to Death (Final disease or condition Due to (or as a consequence of): resulting in death) b. Sequentially list conditions, D,;e to (or as a consequence of): if any, leading to the cause listed on line a. Enter the c. UNDERLYING CAUSE Due to (or as a consequence of): (disease or injury that initiated the events resulting d. in death) LAST. Due to (or as a consequence of): 26. Part II. Enter other claniflrant conditions contributing to death but not resulting in the underlying cause given In Part I 27. Was an autopsy performed? O yes S7 No Diabetes Mellitus 28. Were autoh ses fv ilable death? to complete the cause of tleath7 0 Yes IPS No 29, If Female: ® Not pregnant within past year 0 Pregnant at time of death 0 Not pregnant, but pregnant within 42 days of death 30. Did Tobacco Use Contribute to Death? 0 Yes 181 Probably 0 No 0 Unknown 31. Manner of Dea h ® Natural 0 Homicide 0 Accident 0 Pending Investigation 0 Suicide 0 Could not be determined 0 Not pregnant, but pregnant 43 days to 1 year before death 32. Date o Injury (Mo/Day/Yr) (Spell Month) 0 Unknown If within the past year 33. Time of Injury . pregnant 34. Place of Injury (e.g. home; construction site; farm; school) 35. Location of injury (Street and Number, City, State, Zip Code) y EXHIBIT 36. Injury at Work 0 Yes 0 No 37. If Transportation Injury, Specify: 0 Driver/Operator 0 Pedestrian 0 Passenger 0 Other (Specify) 38. Describe How Injury Occurred: S DT a 39a. Certifier (Check only one): a0 .1� / Certifying physic an - To the best of my -_T death occurred due to the cau e(s) and manner stated 0 Pronouncing & Certifying physician . -' of my knowledge, death occurred at the time, date, and place, and due to the cause(s) and manner ® Medical Examiner/Coroner- On,i!,., yJ'/y xat .n, and/or investigation, In my opinion, death occurred at the time, date, and place, and due to Signature of certifier: -• / Title of certifier: Coroner License Number: 39b. Name, Address and Zip Code of Person Completing Cause of Death (Item 26) Graham S. Hetrick, 1271 South 28th Street, Harrisburg, PA 17111 39c. Date Signed (Mo/Day/Yr) September 25, 2013 40. Registrar's District Number d�-:tea L4 41. Registrar's Signature._42. . isC�C� `�-CA Regi ar File Date (Mo/Day/Yr) q- a7 -a20)3 43. Amendments Disposition Permit No. 0957156 H1O5-143 REV 07/2011 •.4, '01•-•i fsld>M� lrr=- ,.-a a;.t 1 f (1,4 0, f4 4 r1 w . :.�«-„p •s 4#0.if� ,a •start awu^#4,4%art ,e j. -srrw+».°ger`..• ..t� y .-.++a:. a`YL. .. is .4er ;1,004, ke 'c�'a's3ri .'s. 1it .'#'.tt;d+ Fie b..11,4 i:.:' e+:• A GS1 P t COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA c_ c=> -T) rrICO - rn ar— Fr, (J) CD • CAROL G. KETNER, Plaintiff NO.: 03-3148 vs. W. RAYMOND KETNER, Defendant C•3 —0 IN DIVORCE cp, f • ORDER re--. AND NOW, this / day of , 2014, after consideration of the Stipulated Petition to Vacate "Domestic Relations" Order, it is hereby ORDERED and DECREED that the existing Domestic Relations Order be VACATED, and the retirement benefits shall revert back to Defendant, W. Raymond Ketner. BY THE COURT: .....,igtribution Legend: Nicole L. Javitt, Esquire Dethlefs-Pykosh Law Group, LLC 2132 Market Street Camp Hill, PA 17011 Attorney