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HomeMy WebLinkAbout07-5601TOMMY E. MOOSE, Plaintiff V. JOAN M. MOOSE, Defendant : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2007- SG 61 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 will proceed without you and a decree in divorce or annulment may 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 or your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary at the First Floor, Cumberland County Courthouse, 1 Courthouse Square, Carlisle, Pennsylvania 17013. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF MARITAL PROPERTY, LAWYER'S FEES, OR EXPENSES BEFORE A DIVORCE 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 32 S. Bedford Street Carlisle, Pennsylvania 17013 (717) 249-3166 TOMMY E. MOOSE, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. NO.2007- SG U 1 CIVIL ACTION - LAW JOAN M. MOOSE, . Defendant IN DIVORCE COMPLAINT IN DIVORCE UNDER SECTION 3301(C) OR 3301(D) OF THE DIVORCE CODE AND NOW comes Tommy E. Moose, plaintiff herein, by and through his attorney, Jacqueline M. Verney, Esquire, and represents the following: 1. Plaintiff is Tommy E. Moose, an adult individual, currently residing at 7 Terri Drive, Carlisle, Cumberland County, Pennsylvania 17013 since 1994. 2. Defendant is Joan M. Moose, an adult individual, currently residing at 12324 Williams Road, Cumberland, Maryland 21502 since September 5, 2007. 3. Plaintiff is a bona fide resident of the Commonwealth of Pennsylvania and has been so for at least six months immediately previous to the filing of this complaint. 4. Plaintiff and Defendant were married on September 28, 1994, in Carlisle, Cumberland County, Pennsylvania. 5. There have been no prior actions for divorce or annulment between the parties. 6. The Plaintiff has been advised of the availability of marriage counseling and the Plaintiff may have the right to request that the Court require the parties to participate in counseling. Having been so advised Plaintiff does not desire the Court to order counseling. 7. This marriage is irretrievably broken. WHEREFORE, Plaintiff prays Your Honorable Court enter a decree in divorce. Respectfully submitted, ?k acq line M. Verney, Esquire Supreme Ct. ID. 23167 44 South Hanover Street Carlisle, PA 17013 (717) 243-9190 Attorney for Plaintiff VERIFICATION I verify that the statements made in the foregoing divorce complaint are true and correct. I understand that false statements herein made are subject to the penalties of 18 Pa.C.S. Section 4904 relating to unworn falsification to authorities. q-c-,:W-0? Date Tommy oose, Plaintiff 45 W NQ ? O ? A t%a o K r1l ' c co _. ? Z TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2007-5601 CIVIL ACTION - LAW JOAN M. MOOSE, Defendant IN DIVORCE AFFIDAVIT OF SERVICE BY MAIL PURSUANT TO Pa. R.C.P. 1930.4 (c) COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS I, Jacqueline M. Verney, Esquire, being duly sworn according to law, deposes and says that she is the attorney for plaintiff, Tommy E. Moose, and that she did serve a true and correct copy of the divorce Complaint that was filed in the above matter, by U.S. mail, postage prepaid, certified with restricted delivery, return receipt requested, unto the defendant, Joan M. Moose, on October 1, 2007. The receipt form is attached hereto as EXHIBIT "A". U?V acq line M. Verney, Esquire 3167 44 S. Hanover Street Carlisle, PA 17013 (717) 243-9190 Attorney for Plaintiff ri I ,L 0*&A-, Sworn to and subscribed be re me this ?` day of Notary Public COMMOMWRALTH OF PCP MMVAW ..rte .?..,r.?.`.._ NOTARIAL SEAT. VALERIE F. GSELL, Notary Pubk Carlisle Sm., Cumberland County My Commission Expires October 9, 2010 2007. R ¦ Complete items 1, 2, and 3. Also complete it 4 if R t i t d D li i i _eiv by se Print /early 0 ?+ r?1 ` em es r c e e red. very s des ¦ P i t d 1 ` (' ' f r n your name an address on the reverse nature _ so that we can return the card to you. ¦ Attach this card to the back of the mailpiece " . gent ? , or on the front if space permits. y Ad dre D.; Is ivery address different from item 1j 13...! , 1. Article Addressed to: elow: ''. _ No If ES, enter delivery address below:' JOAN A. MooSE Cu A sg- `,4W J A b 3. Service Type tif C d M il ? E er ie a xpress Mail Registered ? Return Receipt for Merchandise 2 f; Q ? Insured Mail ? C.O.D. 0 4. Restricted Delivery? (Extra Fee) yes 2. Article Number 7003 1010 0001 1198 2943 (Transfer from service label) PS Form 3811, March 2001 Domestic Return Receipt 102595-01-M-1424 EXHIBIT "A" C :) ^? E' ?; ? C. r ?, ,. ? ? P '- 1 r`- 1 ._` GJ ? ? ? _ _ - ?: . C :? ?.? _ ? ; Ci IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA TOMMY E. MOOSE, CIVIL ACTION - LAW Plaintiff VS. JOAN M. MOOSE To the Prothonotary: : NO. 2007-5601 Defendant : IN DIVORCE PRAECIPE FOR THE ENTRY OF APPEARANCE Kindly enter the appearance of Suzanne Spencer Abel, Esquire and Neuharth Law Offices on behalf of Joan M. Moose, Defendant in the above captioned Civil Action. The undersigned shall accept service on behalf of the Defendant at the address below. j M 1 jllflfi5?volfifi via L" 'm 4 N A PRP - S e Wen- & Abel, Atty ID # 02443 Neuharth Law Offices P.O. Box 359 232 Lincoln Way East Chambersburg, PA 17201 (717) 264-2939 FAX (717) 263-2928 cs C„? Ca i. ?,... 13 * <., c z 7 , m .4 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA TOMMY E. MOOSE, Respondent / Plaintiff VS. JOAN M. MOOSE, Petitioner / Defendant : CIVIL ACTION - LAW NO. 2007-5601 IN DIVORCE PETITION FOR RELATED CLAIMS UNDER THE DIVORCE CODE - ALIMONY PENDENTE LITE AND NOW, this ? day of November, 2007, comes Petitioner, Joan Moose, by and through her attorney, Suzanne Spencer Abel, Esq., and who avers as follows: 1. The parties were married on September 28, 1991, and were separated on September 12, 2007, when Petitioner unilaterally changed the locks at the marital residence. 2. Respondent filed a Complaint for Divorce under Sections 3301 (c) and 3301 (d) of the Divorce Code on September 25, 2007, alleging irreconcilable differences. 3. Respondent resides at 7 Terri Drive, Carlisle, Cumberland County, Pennsylvania. 4. Petitioner resides at 12324 Williams Road, SE, Cumberland, Maryland. 5. Respondent has not provided sufficient support for Petitioner. 6. Pursuant to 23 Pa.C.S. §3702, Petitioner filed a Petition for Spousal Support on or about October 9, 2007. 7. On November 1, 2007, a support conference was held wherein the support officer referred the matter to the Support Master for a full hearing on the merits. A hearing has been scheduled before the Support Master for December 5, 2007. 8. Respondent is presently employed with Giant Foods, Carlisle, PA, and earns approximately $53,400.00 monthly gross, or $3366.00, monthly net. Additionally, Respondent receives income of $200.00 for in-kind-services from J & J Properties. Respondent's combined monthly net income is approximately $3566.00. 9. Petitioner presently receives approximately $452.12 in monthly retirement benefits, and approximately $1073.00 in monthly Social Security Disability benefits, totaling approximately $1525.00 in monthly income. 10. Petitioner is without sufficient means to adequately support herself and to meet the costs and expenses of this litigation, and is therefore, unable to maintain herself during the pendency of this action. 11. Petitioner seeks Alimony Pendente Lite in the amount of $816.00 per month to support herself, to pay counsel fees and expenses, and to ensure Defendant continues to provide health insurance / medical benefits. WHEREFORE, Petitioner, Joan Moose, respectfully requests this Honorable Court award her Alimony Pendente Lite as permitted by statute. Respectfully submitted, Neuharth Law Office Waft [--I V Iq P 0, r) Yf S e Spe r Abe , Esq. Atty #202443 P.O. Box 359 232 Lincoln Way East Chambersburg, PA 17201 (717) 264-2939 FAX (717) 263-2928 spencer abel_esq@fastmail.fm OF COMMON PLEAS OF IN TUE COURT OjJNTY? PENNSYLV ANIA CUMBE?,AND C CIVIL ACTION - LAW TOMMY E• MOOSE, iff NO. 200'1-5601 VS. IN DIV ORCE JOAN M MOOSE, Defendant VE?FICATION not of record set forth m the that I have persona' knowledge of all facts knowledge, I VERIFY true and correct to the best of my statements are made subject to the pleading, and that such foregoing d mat false statements herein are derstan to authorities. inforination and belief. I sworn falsification and the 4904 relating to un this court a'C.S.A• § sdiction of p verbally enalties of I% P outside the l'm er VERIFY mat Petitioner is read to Petitioner, who veri d. This pleading, was I fug timely obtaine fcation cann°t be the averments contained therein. verified _ 0 N. (I Date: ? del, Esq,, anne Spencer S u and for Joan Moose, Petitioner Ey IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA TOMMY E. MOOSE, Plaintiff vs. JOAN M. MOOSE, Defendant : CIVIL ACTION - LAW NO. 2007-5601 : IN DIVORCE CERTIFICATE OF SERVICE I certify that, concurrent with filing the foregoing Petition for Alimony Pendente Lite am this day serving a copy of same via a?- T T •- ' I taa , to the following counsel of record for Plaintiff: F d -rll}wd Jacqueline Verney, Esq. 44 South Hanover Street Carlisle, PA 17013 Date: C i anne S ncer Abel, Esq. A ID #202443 P. O. Box 359 232 Lincoln Way East Chambersburg, PA 17201 (717) 264-2939 FAX (717) 263-2928 spencer abel esq@fastmail.fm n o a . In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION JOAN MOOSE ) Docket Number 07-5601 CIVIL Plaintiff ) vs. ) PACSES Case Number 569109633 THOMAS E. MOOSE ) Defendant ) Other State ID Number ORDER OF COURT You, JOAN MOOSE plaintiff/defendant of 12324 WILLIAMS RD SE, CUMBERLAND, MD. 21502-7961-24 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the DECEMBER 5, 2007 at 8: 3 OAM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. the Income Statement and the appropriate Expense Statement, if required, attached to this order, completed as required by Rule 1910.11 (c). 4. verification of child care expenses, and 5. proof of medical coverage which you may have, or may have available to you 6. information relating to professional licenses 7. other: Service Type M Form CM-509 Rev. 1 Worker ID 21302 f % MOOSE V. MOOSE PACSES Case Number: 569109633 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest and/or enter an interim support order. If paternity is an issue, the court shall enter an order establishing paternity. THE APPROPRIATE COURT OFFICER MAY ENTER AN ORDER AGAINST EITHER PARTY BASED UPON THE EVIDENCE PRESENTED WITHOUT REGARD TO WHICH PARTY INITIATED THE SUPPORT ACTION. BY THE COURT: Date of Order: I( _ )-1 '0* A4 JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE-HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (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 at: (717) 240-6225 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of 2 Form CM-509 Rev. 1 Service Type M Worker ID 21302 IV r; s"F'7 _ Q0 l 13 # CA R C? In the Court of Common Pleas of CUMBERLAND County, Pennsylvania DOMESTIC RELATIONS SECTION JOAN MOOSE ) Docket Number 07-5601 CIVIL Plaintiff ) vs. ) PACSES Case Number 569109633 THOMAS E. MOOSE ) Defendant ) Other State ID Number ORDER OF COURT You, THOMAS E. MOOSE plaintiff/defendant of 7 TERRI DR, CARLISLE, PA. 17013-9295-07 are ordered to appear at DOMESTIC RELATIONS HEARING RM DOMESTIC RELATIONS OFC, 13 N HANOVER ST, CARLISLE, PA. 17013-3014-13 before a hearing officer of the Domestic Relations Section, on the DECEMBER 5, 2007 at S: 3 OAM for a hearing. You are further required to bring to the hearing: 1. a true copy of your most recent Federal Income Tax Return, including W-2s, as filed, 2. your pay stubs for the preceding six (6) months, 3. the Income Statement and the appropriate Expense Statement, if required, attached to this order, completed as required by Rule 1910.11 (c). 4. verification of child care expenses, and 5. proof of medical coverage which you may have, or may have available to you 6. information relating to professional licenses 7. other: Service Type M Form CM-509 Rev. 1 Worker ID 213 02 t ,N%% MOOSE V. MOOSE PACSES Case Number: 569109633 If you fail to appear for the conference/hearing or to bring the required documents, the court may issue a warrant for your arrest and/or enter an interim support order. If paternity is an issue, the court shall enter an order establishing paternity. THE APPROPRIATE COURT OFFICER MAY ENTER AN ORDER AGAINST EITHER PARTY BASED UPON THE EVIDENCE PRESENTED WITHOUT REGARD TO WHICH PARTY INITIATED THE SUPPORT ACTION. BY THE COURT: Date of Order: I-a 1-0 -1 JUDGE YOU HAVE THE RIGHT TO A LAWYER, WHO MAY ATTEND THE CONFERENCE-HEARING AND REPRESENT YOU. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. CUMBERLAND CO BAR ASSOCIATION 32 S BEDFORD ST CARLISLE PA 17013-3302-32 (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 at: (717) 2 4 0 - 6 2 2 5 . All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled hearing. Page 2 of 2 Form CM-509 Rev. 1 Service Type M Worker ID 21302 0 A ;xaC i L C? r n CD JOAN MOOSE, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION TOMMY E. MOOSE, PACSES NO. 313109501 Defendant DOCKET NO. 809 SUPPORT 2007 TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION JOAN MOOSE, : PACSES NO. 569109633 Defendant/Petitioner : DOCKET NO. 2007-5601 CIVIL INDEX OF EXHIBITS Plaintiff's Exhibit No. I - DRS attachment for APL proceedings Plaintiff's Exhibit No. 2 - Social security disability statement Plaintiff's Exhibit No. 3 - Pension statement Plaintiff's Exhibit No. 4 - 2006 tax return Plaintiff's Exhibit No. 5 - Defendant's pay statement Plaintiff s Exhibit No. 6 - Income and expense statement with attachments Defendant's Exhibit No. 1 - 2006 tax return Defendant's Exhibit No. 2 - Pay statements Defendant's Exhibit No. 3 - Benefits statement Defendant's Exhibit No. 4 - Income statement f j i•-- Cj ? '.. t' - i CTI y ... r.i t ` ' 1+x ( .. s?' 1 ,,, ? ;C?! ., . ""5` JOAN MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION TOMMY E. MOOSE, PACSES NO. 313109501 Defendant DOCKET NO. 809 SUPPORT 2007 TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent : CUMBERLAND COUNTY, PENNSYLVANIA V. : DOMESTIC RELATIONS SECTION JOAN MOOSE, : PACSES NO. 569109633 Defendant/Petitioner : DOCKET NO. 2007-5601 CIVIL INTERIM ORDER OF COURT AND NOW, this 6th day of December, 2007, upon consideration of the Support Master's Report and Recommendation, a copy of which is attached hereto as Exhibit "A", it is ordered and decreed as follows: A. The Husband shall pay to the Pennsylvania State Collection and Disbursement Unit as spousal support the sum of $673.00 per month. B. The Husband shall pay to the Pennsylvania State Collection and Disbursement Unit the additional sum of $22.00 per month on arrearages. C. The Husband shall provide health insurance coverage for the benefit of his wife as provided through employment or other group coverage at a reasonable cost. D. The effective date of the order is September 28, 2007. E. The Wife's claim for alimony pendente lite is dismissed because of the award of spousal support. IMPORTANT LEGAL NOTICE PARTIES MUST WITHIN SEVEN DAYS INFORM THE DOMESTIC RELATIONS SECTION AND THE OTHER PARTIES, IN WRITING, OF ANY MATERIAL CHANGE IN CIRCUMSTANCES RELEVANT TO THE LEVEL OF SUPPORT OR THE ADMINISTRATION OF THE SUPPORT ORDER, INCLUDING, BUT NOT LIMITED TO, LOSS OR CHANGE OF INCOME OR EMPLOYMENT AND CHANGE OF PERSONAL ADDRESS OR CHANGE OF ADDRESS OF ANY CHILD RECEIVING SUPPORT. A PARTY WHO WILLFULLY FAILS TO REPORT A MATERIAL CHANGE IN CIRCUMSTANCES MAY BE ADJUDGED IN CONTEMPT OF COURT, AND MAY BE FINED OR IMPRISONED. PENNSYLVANIA LAW PROVIDES THAT ALL SUPPORT ORDERS SHALL BE REVIEWED AT LEAST ONCE EVERY THREE (3) YEARS IF SUCH REVIEW IS REQUESTED BY ONE OF THE PARTIES. IF YOU WISH TO REQUEST A REVIEW AND ADJUSTMENT OF YOUR ORDER, YOU MUST DO THE FOLLOWING: CALL YOUR ATTORNEY. AN UNREPRESENTED PERSON WHO WANTS TO MODIFY (ADJUST) A SUPPORT ORDER SHOULD CONTACT THE DOMESTIC RELATIONS SECTION. ALL CHARGING ORDERS FOR SPOUSAL SUPPORT AND ALIMONY PENDENTE LITE, INCLUDING UNALLOCATED ORDERS FOR CHILD AND SPOUSAL SUPPORT OR CHILD SUPPORT AND ALIMONY PENDENTE LITE, SHALL TERMINATE UPON DEATH OF THE PAYEE. A MANDATORY INCOME ATTACHMENT WILL ISSUE UNLESS THE DEFENDANT IS NOT IN ARREARS IN PAYMENT IN AN AMOUNT EQUAL TO OR GREATER THAN ONE MONTH'S SUPPORT OBLIGATION AND (1) THE COURT FINDS THAT THERE IS GOOD CAUSE NOT TO REQUIRE IMMEDIATE INCOME WITHHOLDING; OR (2) A WRITTEN AGREEMENT IS REACHED BETWEEN THE PARTIES WHICH PROVIDES FOR AN ALTERNATE ARRANGEMENT. UNPAID ARREARAGE BALANCES MAY BE REPORTED TO CREDIT AGENCIES. ON AND AFTER THE DATE IT IS DUE, EACH UNPAID SUPPORT PAYMENT SHALL CONSTITUTE, BY OPERATION OF LAW, A JUDGMENT AGAINST YOU, AS WELL AS A LIEN AGAINST REAL PROPERTY. IT IS FURTHER ORDERED THAT, UPON PAYOR'S FAILURE TO COMPLY WITH THIS ORDER, PAYOR MAY BE ARRESTED AND BROUGHT BEFORE THE COURT FOR A CONTEMPT HEARING; PAYOR'S WAGES, SALARY, COMMISSIONS, AND/OR INCOME MAY BE ATTACHED IN ACCORDANCE WITH LAW. PAYOR IS RESPONSIBLE FOR COURT COSTS AND FEES. The parties are hereby advised that they may file written exceptions to the Support Master's Report and Recommendation within twenty (20) days of this order. Exceptions shall conform with the requirements of Rule 1910.12(f), Pa. R.C.P. If written exceptions are filed by any party, the other party may file exceptions within twenty (20) days of the date of service of the original exceptions. If no exceptions are filed within twenty (20) days of this interim order, this order shall then constitute a final order. the C. ``,4 Kevin A. Hess, J. Cc: Joan Moose Tommy E. Moose Suzanne Spencer Abel, Esquire For the Plaintiff Jacqueline M. Verney, Esquire For the Defendant DRO JOAN MOOSE, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION TOMMY E. MOOSE, PACSES NO. 313109501 Defendant DOCKET NO. 809 SUPPORT 2007 TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff/Respondent : CUMBERLAND COUNTY, PENNSYLVANIA V. DOMESTIC RELATIONS SECTION JOAN MOOSE, : PACSES NO. 569109633 Defendant/Petitioner : DOCKET NO. 2007-5601 CIVIL SUPPORT MASTER'S REPORT AND RECOMMENDATION Following a hearing held before the undersigned Support Master on December 5, 2007, the following supplemental report and recommendation are made: FINDINGS OF FACT 1. The Plaintiff in the support action and the Petitioner in the divorce action is Joan Moose, who resides at 12324 Williams Road SE, Cumberland, Maryland; she will hereafter be referred to as "the Wife." 2. The Defendant in the support action and the Respondent in the divorce action is Tommy E. Moose, who resides at 7 Terry Drive, Carlisle, Pennsylvania; he will hereafter be referred to as "the Husband." 3. The parties were married on September 28, 1991. 4. The parties have no minor children. 5. On September 5, 2007 the Husband told the Wife that he was no longer in love with her. 6. The Wife became extremely upset, packed some of her clothing and personal effects, and left the marital residence. 7. The Husband told the Wife that she did not have to leave the house that night. 8. The Wife went to stay with her parents. EXHIBIT ".A" 9. Within a few days the Husband telephoned the Wife and told her that he had investigated the cost of a no-fault divorce. 10. On September 12, 2007 the Wife returned to the marital residence to obtain more of her clothing and personal effects. 11. When she arrived at the home the Wife found that the Husband had the locks changed on the doors. 12. On September 25, 2007 the Husband filed a complaint for divorce. 13. On September 28, 2007 the Wife filed a complaint for spousal support. 14. On November 26, 2007 the Wife filed a claim for alimony pendente lite in the divorce action. 15. In November, 2007 another woman moved into the marital residence with the Husband. 16. The Husband refers to the other woman as his "girlfriend." 17. The Wife was last employed in 2004 as a customer service representative by Sprint. 18. The Wife left her employment because of the medical disability. 19. The Wife suffers from fibromyalgia, depression, anxiety, and a neurological condition which causes pain to radiate into her legs. 20. The Wife has been a recipient of social security disability benefits since 2005. 21. The Wife currently receives $1,073.70 per month in disability benefits. 22. The Wife receives a retirement pension in the amount of $452.12 per month from Embarq, formerly Sprint. 23. The Husband is employed as a truck driver by Giant. 24. Through the pay period ending November 24, 2007 the Husband has earned $46,595.19. 25. The Husband pays $11.02 per week for health insurance coverage on himself and his wife. 26. The Husband receives a $200.00 per month reduction in rent for performing maintenance services for his landlord. 2 27. Both parties will file federal income tax returns as married/separate. DISCUSSION A dependent spouse is entitled to support until it is proven that conduct on the part of the dependent spouse constitutes grounds for a fault divorce. Crawford v. Crawford, 633 A.2d 155 (Pa. Super. 1993). However, where a dependent spouse voluntarily and without the consent of his/her spouse vacates the marital residence, the dependent spouse has the burden of proving that his/her spouse's conduct constituted adequate legal cause to justify the departure from the home. McKolanis v. McKolanis, 644 A.2d 1256 (Pa. Super. 1994). The Wife left the marital residence on September 5, 2007 after being told by her husband that he was no longer in love with her. The departure was not, however, without the consent of the Husband. Although he told her that she did not have to leave that night, it was clear by the Husband's conduct that he consented to the separation. Within a few days of his Wife's departure he notified her of the cost of a no-fault divorce, and within a week of the departure he had changed the locks on the marital home. Within two months his "girlfriend" was residing with him in the home. Consequently the holding in McKolanis, supra. does not apply to the facts of this case. Because no conduct on the part of the Wife establishes grounds for a fault divorce, she is entitled to an award of spousal support. The Wife has income from two sources. She receives social security disability benefits of $1,073.70 per month and a monthly pension of $452.12 per month. With this gross income and a tax filing status of married/separate, the Wife has net monthly income for support purposes of $1,512.00.' The Husband has average gross monthly income of $4,296.00. Filing his federal income tax return as married/separate, he has net monthly income for support purposes of $3,195.00.2 With no minor children, the spousal support obligation of the Husband is 40% of the difference of their net monthly incomes,3 or $673.00 per month.4 The Husband pays health insurance coverage on himself and his wife through his employment, but the cost does not exceed what he would pay for himself alone.s Consequently no adjustment to the order will be made. Because an award of spousal support is being entered, the claim for alimony pendente lite is moot.6 ' See Exhibit "A" for the tax deductions from gross income. `' See Exhibit "A" for the tax deductions from gross income. s Pa. R.C.P. 1910.16-4(a) 4 See Exhibit "B" for the calculation. s See Defendant's Exhibit 3. 6 See Pa. R.C.P. 1910.16-1(c). 3 RECOMMENDATION A. The Husband shall pay to the Pennsylvania State Collection and Disbursement Unit as spousal support the sum of $673.00 per month. B. The Husband shall pay to the Pennsylvania State Collection and Disbursement Unit the additional sum of $22.00 per month on arrearages. C. The Husband shall provide health insurance coverage for the benefit of his wife as provided through employment or other group coverage at a reasonable cost. D. The effective date of the order is September 28, 2007. E. The Wife's claim for alimony pendente lite is dismissed because of the award of spousal support. Date Michael R. Rundle Support Master 4 t'? Win, ---t "" C ? r- ' _ _.3; r ?"p „u . l C :yE?? 4 ? + ..1? TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. . NO. 2007-5601 CIVIL ACTION - LAW JOAN M. MOOSE, Defendant IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under Section 3301 (c) or (d) of the Divorce Code was filed on September 25, 2007. 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: 2 - 3 - D 4oy E. Moose, Plaintiff FIL'0 F TFf ) ' a rr-; APY 2009 JUL 31 All 11: 14 )i ?e ! TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 2007-5601 CIVIL ACTION - LAW JOAN M. MOOSE, Defendant IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST 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. 1 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: '3"4? Tommy E. Wow, Plaintiff 'OF THF ; ? ?Y 2009 JUL 31 A'11; 14 Cu??1i?,:. ,? l I 1h TOMMY E. MOOSE, Plaintiff V. JOAN M. MOOSE, Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA NO. 2007-5601 : IN DIVORCE NOTICE CIVIL ACTION - LAW If you wish to deny any of the statements set forth in this Affidavit, you must file a counter-affidavit within twenty days after this affidavit has been served on you or the statements will be admitted. AFFIDAVIT UNDER SECTION 3301(D) OF THE DIVORCE CODE 1. The parties to this action separated on September 5, 2007 and have continued to live separate and apart for a period of at least two years. 2. The marriage is irretrievably broken. 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. 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.A. section 4904 relating to unsworn falsification to authorities. DATE: / TOMM E. MOOSE, Plaintiff A LED-- 2009 SEP 16 ,, a 10: 19 TOMMY E. MOOSE, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. F. R. 2007-5601 CIVIL TERM JOAN M. MOOSE, TO THE PROTHONOTARY: PRAECIPE ENTRY OF APPEARANCE Please enter my appearance on behalf of the Defendant in the above-captioned matter. Respectfully submitted, Date: q QQ-cj9 MR'?l am, 441A Hannah Herman-Snyder, Esquke GRIFFIE AND ASSOCIATES 200 North Hanover Street Defendant : IN DIVORCE Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 if"'F THE 2009 IS P 28 F X 2: 2 8 TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 2007-5601 CIVIL ACTION - LAW JOAN M. MOOSE, Defendant IN DIVORCE COUNTER-AFFIDAVIT UNDER SECTION 3301(D) OF THE DIVORCE CODE 1. Check either (a) or (b) (a) I do not oppose the entry of a divorce decree. (b) I oppose the entry of a divorce decree because (Check (i), (ii) or both): (i) The parties to this action have not lived separate and apart for a period of at least two years. (ii) The marriage is not irretrievably broken. 2. Check either (a) or (b): (a) I do not wish to make any claims for economic relief. 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. (b) I wish to claim economic relief which may include alimony, division of property, lawyer's fees or expenses or other important rights. I understand that in addition to checking (b) above, I must also file all of my economic claims with the prothonotary in writing and serve them on the other party. If I fail to do so before the date set forth on the Notice of Intention to Request Divorce Decree, the divorce decree may be entered without further delay. 1 verify that the statements made in this counter-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. DATER-a)?-o q QMn r Mmoz, Jo R. Moose, Defendant NOTICE: IF YOU DO NOT WISH TO OPPOSE THE ENTRY OF A DIVORCE DECREE AND YOU DO NOT WISH TO MAKE ANY CLAIM FOR ECONOMIC RELIEF, YOU SHOULD NOT FILE THIS COUNTER-AFFIDAVIT FILED-3-:` CE OF THE PL O T HCNOTARY 2009 OCT -2 Pty 2: 4 5 CViY1J'"dy;: vij lfljJ1V PENNSYLVANA. . s TOMMY E. MOOSE, Plaintiff V. JOAN M. MOOSE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : NO. 2007-5601 CIVIL TERM IN DIVORCE PETITION FOR ECONOMIC RELIEF: ALIMONY AND EQUITABLE DISTRIBUTION AND NOW comes Petitioner, the above named Defendant, by and through her attorney, Hannah Herman-Snyder, Esquire, and the law firm of Griffie and Associates and avers as follows: 1. The Petitioner is the above named Defendant, an adult individual currently residing at 12324 William Road SE, Cumberland, Maryland. 2. Respondent is the above named Plaintiff, an adult individual currently residing at 7 Terri Drive, Carlisle, Cumberland County, Pennsylvania. 3. A divorce action was filed by Respondent on September 25, 2007. 4. Respondent filed his Affidavit of Consent and Waiver of Notice of Intention to Proceed on July 31, 2009, and has also indicated his intention to move forward with a 3301(d) divorce, however, there are economic issues that remain to be resolved, and contemporaneously with this Petition, Petitioner is filing a Counter- Affidavit to the 3301(d) divorce. 5. Petitioner is without sufficient property and otherwise unable to financially support herself through appropriate employment as she is currently receiving social security disability. V 6. Respondent is presently employed and receiving a substantial income with benefits and is able to pay alimony to the Petitioner. 7. Petitioner and Respondent are joint owners of various items of personal property, furniture and household furnishings acquired during their marriage which are subject to equitable distribution. 8. Petitioner and Respondent have also accrued during their marriage retirement and intangible property which may be subject to equitable distribution. WHEREFORE, Petitioner requests your Honorable Court to enter an Order equitably dividing the parties' property and enter an Order requiring Respondent to pay appropriate alimony to Petitioner. Respectfully Submitted, Hannah Herman-Snyder, Esquire U Attorney for Petitioner/Defendant GRIFFIE AND ASSOCIATES 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 VERIFICATION I verify that the statements made in the foregoing document 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 falsifications to authorities. oq DATE: Ai?i M. MOOSE TOMMY E. MOOSE, Plaintiff V. JOAN M. MOOSE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2007-5601 CIVIL TERM : IN DIVORCE CERTIFICATE OF SERVICE I, Hannah Herman-Snyder, Esquire, hereby certify that I did, the ? day of October, 2009, cause a copy of Petitioner's Petition for Economic Relief. Alimony and Equitable Distribution to be served upon Plaintiff by serving his attorney of record, Jacqueline Verney, Esquire, by first-class mail, postage prepaid at the following address: Jacqueline Verney, Esquire 44 South Hanover Street Carlisle, PA 17013 DATE: 1 O - ?j - O c -asy.ml. ? p, .cam- t Hannah Herman-Snyder, Esqui Attorney for Petitioner/Defendant GRIFFIE & ASSOCIATES 200 North Hanover Street Carlisle, PA 17013 (717) 243-5551 (800) 347-5552 FiLEC- ;;TIUL 2009 OCT -2 Pty 2: 4 6 gj ??. v A? 1 xxm4 h- 4nq,4r egg I ?Z12 # .l S/ t16N FILED, C r-1 CE TARY 20 10 FEB 24 Pri 12: 50 Tommy E. Moose 'L t Plaintiff Vs. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Docket No. 2007-5601 Civil Action-Law Joan M. Moose Defendant MOTION FOR APPOINTMENT OF MASTER respect to the following claims: (Plaintiff) (Defendant), moves the court to appoint a master with k) Divorce ( Distribution of Property ( ) Annulment () Support O Alimony O Counsel Fees ( ) Alimony Pendente Lite ( ) Costs and Expenses and in support of the motion states: (1) Discovery is complete as to the claims (s) for which the appointment of a master is requested. (2) The defendant 0%;.as) (has. -Rot) appeared in the action (perseaall?+) (by his attorney, ?4AAI,Vfk? 14zAmaw- $NYbE /_ , Esquire). (3) The Staturory ground (s) for divorce (is) (are) 3301 (c) (4) Delete the inapplicable paragraph(s): a. The action is not contested. b. An agreement has been reached with respect to the following claims: c. The action is contested with respect to the following claims: Distribution of property (5) The action (mi mires) (does not involve) complex issues of law or fact (6) The hearing is expected to take 4 (hours) flays). (7) Additional information, if any, relevant to the motion: Date: 07 ' .Z y - o -010 AIf AttorUe for (Plaintiff) (Defendant) Print Attorney Name Jacqueline M. Verney, Esquire ORDER APPOINTING MASTER AND NOW, , 20 is appointed master with respect to the following claims: By By the Court: FILED- F THE P„,r r' -C -TARY Y 25 J010 2010 FEB 24 P11 12: 50 f 10 : IN THE COURT OF COMMON PLEAS OF J'=' 'y 11? CUMBERLAND COUNTY, PENNSYLVANIA Tommy E. Moose Plaintiff Vs. Joan M. Moose Docket No. 2007-5601 Civil Action-Law Defendant MOTION FOR APPOINTMENT OF MASTER (Plaintiff) (Defendant), moves the court to appoint a master with respect to the following claims: Divorce ( Distribution of Property () Annulment () Support O Alimony O Counsel Fees O Alimony Pendente Lite O Costs and Expenses and in support of the motion states: (1) Discovery is complete as to the claims (s) for which the appointment of a master is requested. (2) The defendant (l as) (has -Rot) appeared in the action (persei?) (by his attorney, AAJ,q/A(, µi,:M'w- SuuaE 4 , Esquire). (3) The Staturory ground (s) for divorce (is) (am) 3301 (c) (4) Delete the inapplicable paragraph(s): a. The action is not contested. b. An agreement has been reached with respect to the following claims: c. The action is contested with respect to the following claims: Distribution of property (5) The action (inraf=) (does not involve) complex issues of law or fact (6) The hearing is expected to take 4 (hours) {clots). (7) Additional information, if any, relevant to the motion: Date: 07 y - .2-01 0 A tto a for (Plaintiff) (Defendant) Print Attorney Name ......... Jacqueline M. Verney, Esquire ORDER APPOINT MASTER AND NOW, a-,20/0 Esquire is appointed master with respect to the following claims: ey C o By the Co z e 6L -11 h4? 4 3[.? TOMMY E. MOOSE, OF Plaintiff PENNSYLVANIA V. JOAN M. MOOSE, Defendant : IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, NO. 2007-5601 CIVIL TERM IN DIVORCE NOTICE TO RESUME PRIOR SURNAME C nCO ,7X M 2 W = -- :rsr? < «- r M Notice is hereby given that the Plaintiff in the above matter, [select one by marking "XI X prior to the entry of a Final Decree in Divorce, _r"), "t7 rn co ...o 3 N rv N or after the entry of a Final Decree in Divorce, hereby elects to resume the prior surname of JOAN M. ISER, and gives this written notice avowing her intention pursuant to the provisions of 54 P.S. 704. DATE:1 COMMONWEALTH OF COUNTY OF CUMBERLAND : SS. 2O On this, the day of j?r ,-2 , before me the undersigned officer, personally appeared JOAN DOSE, now known as JOANM. ISER, known to me (or satisfactorily proven) to be the person whose name is subscribed to the foregoing instrument and acknowledge that she executed the same for the purposes therein contained. rn rn a° 4C) IN WITNESS WHEREOF, I hereunto set my hand and official seal. -A/, e-, a 1, X NOWAL SEAL Notary blic KELLY L PEREZ Notcry rubft II.Ob PO pTt'/ CAKW BOROUGH, CUAAMRN0 COUNIY Mr Cm"N610n Expires JOn B. 2012 6-0 01313 Q,#Zgs17 E 9 J .J? r. ? l C 4?r ER i A'$ tY? 104 '31 y TOMMY E. MOOSE, Plaintiff V. JOAN M. MOOSE, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 2007-5601 CIVIL TERM IN DIVORCE AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under §3301 (c) of the Divorce Code was filed on September 25, 2007, and served on October 1, 2007, by certified mail, restricted delivery. 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 THE FOREGOING 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: ;? a6- I ( +l..f aJ ??I I € tj _ TOMMY E. MOOSE, Plaintiff V. JOAN M. MOOSE, Defendant A R_ 8 P I Ti "H' L 3k.1.a?s`fp IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : NO. 2007-5601 CIVIL TERM IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST THE ENTRY OF A DIVORCE DECREE UNDER 43301(c) OF THE DIVORCE CODE I consent to the entry of a final decree in divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I VERIFY THAT THE STATEMENTS MADE IN THE FOREGOING 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: JO M. MOOSE, Defendant q TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 07-5601 CIVIL TERM , FT7 JOAN M. MOOSE, Defendant : IN DIVORCE QUALIFIED DOMESTIC RELATIONS ORDER a WHEREAS, this Court has jurisdiction over the parties and the subject matter of this Order; and WHEREAS, the parties and the Court intend that this Order shall be a Qualified Domestic Relations Order (hereinafter referred to as a "QDRO") as defined in Section 206(d)(3) of the Employee Retirement Income Security Act of 1974, as amended ("ERISA") and Section 414(p) of the Internal Revenue Code of 1986, as amended; and WHEREAS, pursuant to the referenced statutes, the Plan Administrator shall make a determination of the qualified status of this Order; and WHEREAS, following approval by the Plan Administrator, this Order shall constitute a Qualified Domestic Relations Order; and WHEREAS, the parties have stipulated that the court enter this Order. NOW THEREFORE, pursuant to this state's Domestic Relations Laws, IT IS HEREBY ORDERED BY THE COURT as follows: 1. As used in this Order, the following terms shall apply: (a) "Participant" shall mean Tommy E. Moose, whose current address is 7 Terri Drive, Carlisle, Pa 17013 (b) "Alternate Payee" shall mean Joan M. Moose, whose current address is 12324 William Road SE, Cumberland, MD 21502. (c) "Plan" shall mean Ahold USA, Inc. 401(k) Retirement Savings Plan. 2. The Order relates to marital property rights. 3. The date of marriage was 09/28/1991. 4. A copy of the divorce decree is attached hereto and incorporated herein as Exhibit «A " 5. The Alternate Payee is the former spouse of the Participant. 6. With respect to marital property, alimony and spousal awards, the Participant and the Alternate Payee are/were married for federal income tax purposes. 7. The Alternate Payee's award will be calculated as of the date of the Property Settlement Agreement. The date of the Property Settlement Agreement shall hereinafter be referred to as the "Valuation Date," with said date being February 23, 2011. 8. The Alternate Payee's interest in the Plan shall be $20,000.00 of the Participant total vested account balance under the Plan as of the Valuation Date. 9. The Alternate Payee's award is entitled to earnings (dividends, interest, and gains) from the valuation Date to the date that the award is segregated from the Participant's account. From and after the date of segregation, the Alternate Payee's award shall be held in an account under the Plan and shall be entitled to all earnings attributable to the investments therein. 10. If Participant dies prior to the distribution as set forth above, Alternate Payee shall be deemed the surviving spouse solely for purposes of the $20,000.00. 11. In the event there is an outstanding loan balance as of the Valuation Date, the loan balance will not be included for purposes of calculating the account balance to be divided. 12. The Alternate Payee's award will be paid proportionately from all investment options as of the date of the account segregation. 13. The Alternate Payee's interest in the Plan shall be payable to the Alternate Payee in a lump sum distribution, as soon as administratively feasible following the date that the Order is determined to be a QDRO. The Alternate Payee shall initiate the distribution in accordance with the terms of the Plan and the administrative procedures that have been established by the Plan Administrator. The amount distributed to the Alternate Payee will be based on the value of the Alternate Payee's account on the date the distribution is processed. 14. The Alternate Payee will have the right to designate a beneficiary. In the event that the Alternate Payee dies without designating a beneficiary, or if the beneficiary predeceases the Alternate Payee, the Alternate Payee's award will be distributed pursuant to the administrative procedures established for the Plan. However, all beneficiary designations must be made after qualification of the Order and segregation of a separate account for the Alternate Payee pursuant to the administrative procedures established for the Plan and cannot be changed in the Order. 15. Neither Party shall accept any benefits from the Plan which are the property of the other Parry. In the event that the Plan Administrator inadvertently pays to the Participant any benefits that are assigned to the Alternate Payee pursuant to the terms of this Order, the Participant shall forthwith return such benefits to the Plan. In the event that the Plan Administrator inadvertently pays to the Alternate Payee any benefits that are not assigned to the Alternate Payee pursuant to the terms of this Order, the Alternate Payee shall forthwith return such benefits to the Plan. 16. For purposes of Sections 402 and 72 of the Internal Revenue Code, any Alternate Payee who is the spouse or former spouse of the Participant will be treated as the recipient of any distributions or payments made to the Alternate Payee under the terms of this Order, and as such, will be required to pay the appropriate federal and/or state income taxes on such distribution. If the Alternate Payee is a child or other dependent of the Participant, the Participant will be responsible for any federal and/or state income taxes. BY THE COURT: /nA? c? I ?? Zoo/ J. AGREED TO: y TOMMY MOOSE, Plaintiff V ac line M. Verney, Esquire 44 South Hanover Street Carlisle, PA 17013 Attorney for Plaintiff M. MOOSE, Defendant ?er -Srfder, Esquire 200 North -Hanover Street Carlisle, PA 17013 Attorney for Defendant VeA-". &I eqta ?Isltt okb MOOSE TOMMY E : IN THE COURT OF COMMON PICAS QF - , . Plaintiff LN : CUMBERLAND COUNTY, PENN IA V. , -71 NO. 07-5601 CIVIL TERM , - ? JOAN M. MOOSE, ' -- Defendant : IN DIVORCE DOMESTIC RELATIONS ORDER Based upon the entry of a Divorce Decree, a copy of which is attached hereto and incorporated herein by reference as Exhibit "A," of the Court of Common Pleas of Cumberland County, entered at Docket Number 2007-5601, dissolving the marriage of Tommy E. Moose, Plaintiff and Joan M. Moose, Defendant, the Court hereby issues the following Domestic Relations Order (the "Order"): 1. Effect of this Order. This Order creates and recognizes the existence of an Alternate Payee's right to receive a portion of the Participant's benefit payable under an employer- sponsored defined benefit pension plan that is qualified under Section 401 of the Internal Revenue Code of 1986, as amended (the "Code") and the Employee Retirement Income Security Act of 1974 as amended ("BRISA"). 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 Plan Name and Plan Administrator. The name of the Plan to which this Order applies is the Ahold USA, Inc. Frozen Pension Plan. Further, any successor plan to the Plan or other plan(s), to which liability for a provision of the Participant's benefits described below is incurred, shall also be subject to the terms of this Order. Also, any benefits accrued by the Participant under a predecessor plan of the employer or any other defined benefit plan sponsored by the Participant's employer, where liability for benefits accrued under the such predecessor plan or other defined benefit plan has been transferred to the Plan, shall also be subject to the terms of this Order. The Plan Administrator is the Plan Committee for the Ahold USA, Inc. Frozen Pension Plan. All correspondence relating to the qualification of this Order under ERISA and the Code should be sent to the following address: Emily Mao Alston & Bird, LLP The Atlantic Building 950 F. Street, NW Washington, DC 20004-1404 Once it is determined that the order is a "qualified domestic relations order" under ERISA and the Code, all correspondence relating to this Order should be sent to the following address: Ahold USA, Inc. Retirement Department P.O. Box 829 Boston, MA 02205-5829 3. Pursuant to State Domestic Relations Law: This Order is entered pursuant to the authority granted in the applicable domestic relations laws of the State of Pennsylvania. 4. Participant Information: The Participant's information is as follows: Tommy E. Moose 7 Terri Drive Carlisle, PA 17013 ss #: 202-46-6550 dob: November 8, 1956 phone: 717-514-3207 5. Alternate Payee Information: The Alternate Payee's information is as follows: Joan M. Moose 12324 William Road SE Cumberland, MD 21502 ss#: 214-52-1793 dob: September 16, 1957 phone: 301-707-7480 6. Formula/Allocation method: This order hereby assigns to the Alternate Payee a lump sum of $25,000.00. 7. Form of Payment. A lump sum of $25,000.00, which the Alternate Payee shall elect to receive no later than December 31, 2011. 8. Commencement Date: The payment to Alternate Payee shall be made as soon as administratively possible after implementation of this Order as a QDRO. 9. Death of Participant or Alternate Payee: In the event that the Participant dies prior to the commencement of benefits to the Alternate Payee, the Alternate Payee shall be deemed the "surviving spouse" for her marital portion of the benefit (within the meaning of Section 414(p)(5) of the Code and Section 206(d)(3)(F) of ERISA) for purposes of receiving death benefits payable to a surviving spouse under the terms of the Plan to the extent necessary to provide the benefit described in paragraph 6. If the Participant dies after benefit commencement to the Alternate Payee, the Alternate Payee's benefit shall continue in accordance with the form of benefit elected by the Alternate Payee and the Alternate Payee shall not be entitled to any other benefit. 10. Payments. If for any reason the Plan fails to make the payments required to the Alternate Payee pursuant to this Order and makes the full payment to the Participant, it is the Participant's obligation, and he or she hereby agrees to make sure payment to the Alternate Payee, and to so notify the Plan Administrator of the error, and to continue to make the required payments to the Alternate Payee until such time as the administrative error is corrected. If the Participant fails to notify the Plan Administrator or fails to make the payments necessary to the Alternate Payee, the Participant hereby authorizes the Plan Administrator to withhold future payments from the Plan until such time as the amounts owed to the Alternate Payee are recouped. 11. Savings Clause. This Order is not intended and shall not be administered to require the Plan to provide any benefit, any form of benefit, or any other option that is not otherwise provided for under the terms of the Plan. Nor is this Order intended and shall not be administered to require the Plan to provide increased benefits, determined on an actuarial equivalency basis. Nor shall this Order require the payment of benefits to the Alternate Payee that are required to be paid to another alternate payee under the terms of a qualified domestic relations order previously submitted to the Plan Administrator and determined to be a qualified domestic relations order. This Order is not intended and shall not be administered to violate the terms of ERISA, the Code and, any other applicable statute or regulations. 12. Certification of Necessary Information. All payments made pursuant to this Order shall be conditioned on the certification by the Alternate Payee and the Participant to the Plan Administrator of such information as the Plan Administrator may reasonably require from such parties to make necessary calculation of the benefit amounts contained herein. 13. Continued Qualified Status of Order. It is the intention of the parties that this QDRO continue to qualify as a QDRO under the Code and ERISA, and that the Plan Administrator shall reserve the right to reconfirm the qualified status of the Order at the time benefits become payable hereunder. 14. Tax Treatment of Distributions Made Under This Order. For purposes of Section 402(a) and Section 72(t) of the Code, any Alternate Payee who is the spouse or former spouse of the Participant shall be treated as the recipient 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 income taxes on such distribution. 15. Continued Jurisdiction: In the event that this Order is held not to be a qualified domestic relations order within the meaning of applicable law and the Plan, this Court retains jurisdiction over this matter and the parties agree to request this Court to modify this Order so that it does comply with all relevant provisions of law. 16. Effect of Plan Termination. In the event that the Plan is terminated, whether on a voluntary or involuntary basis, and the Participant's benefits become guaranteed by the Pension Benefit Guaranty Corporation ("PBGC"), the Alternate Payee's benefits, as stipulated herein, shall also be guaranteed to the same extent in accordance with the Plan's termination rules and the same ratio as the Participant's benefits are guaranteed by the PBGC. 17. Fees. The Plan, its sponsor, contributing employer, fiduciaries and administrators shall not be responsible for any costs and expenses, including attorney's fees, incurred by the Participant or Alternate Payee in connection with obtaining or enforcing a determination that this Order is a QDRO. ISSUED this /7 * day of /Maw 2 o?? BY THE COURT: J. AGREED TO: TOMMY MOOSE, Plain ff Jac eMlVerney, Esquire Attorney for Plaintiff ? uGli ne M . VW hey, ?A.w" ` DO M. MOOSE, Defendant , Esquire for Defendant TOMMY E. MOOSE, THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. NO. 07 - 5601 CIVIL JOAN M. MOOSE, s Defendant IN DIVORCE` ORDER OF COURT AND NOW, this day of 2011, the economic claims raised in the proceedings having been resolved in accordance with a property and separation agreement dated February 28, 2011, the appointment of the Master is vacated and counsel can file a praecipe transmitting the record to the Court requesting a final decree in divorce. BY THE COURT, Kevir,/tk. Hess, P.J. cc: / Jacqueline M. Verney Attorney for Plaintiff Hannah Herman-Snyder Attorney for Defendant j81' 013 W 1 TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 07-5601 CIVIL TERM JOAN M. MOOSE, Defendant : IN DIVORCE PROPERTY AND SEPARATION AGREEMENT BETWEEN JOAN M. MOOSE AND TOMMY E. MOOSE GRIFFIE AND ASSOCIATES 200 NORTH HANOVER STREET CARLISLE, PA 17013 ?0l1 THIS AGREEMENT, made this ?h day of rl.(GZr , 2816'by and between JOAN M. MOOSE, of 12324 William Road SE, Cumberland, Allegany County, Maryland, party of the first part, hereinafter referred to as "Wife, " AND TOMMY E. MOOSE, of 7 Terri Drive, Carlisle, Cumberland County, Pennsylvania, party of the second part, hereinafter referred to as "Husband," WITNESSETH: WHEREAS, the parties hereto are Husband and Wife, having been married on September 28, 1991, in Cumberland County, Pennsylvania. WHEREAS, diverse unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of Wife and Husband to live separate and apart, and the parties hereto are desirous of settling their respective financial rights and obligations as between each other including the settling of matters between them relating to the past, present and future support and/or maintenance of Wife by Husband and Husband by Wife. WHEREAS, the parties hereto wish finally and for all time to settle and determine their respective property and other rights growing out of their marital relation; wish to live separate and apart; and, wish to enter into this property and separation Agreement; WHEREAS, both and each of the parties hereto have been advised of their legal rights and the implications of this Agreement and the legal consequences which may and will ensue from the execution hereof; WHEREAS, Wife acknowledges that she is thoroughly conversant with and knows accurately the size, degree, and extent of the estate and income of Husband, and Husband acknowledges that he is thoroughly conversant with and knows accurately the size, degree and extent of the estate and income of Wife; NOW, THEREFORE, in consideration of the mutual promises, covenants and undertakings hereinafter set forth which are hereby acknowledged by each of the parties hereto, Wife and Husband, each intending to be legally bound hereby, covenant and agree as follows: 1. ADVICE OF COUNSEL: The provisions of this Agreement and their legal effect have been fully explained to the parties by their respective counsel, Hannah Herman-Snyder, Esquire for Wife and Jacqueline M. Verney, Esquire for Husband. The parties acknowledge that they have received independent legal advice from counsel of their selection and that they fully understand the facts and have been fully informed as to their legal rights and obligations and they acknowledge and accept 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 this Agreement is not the result of any duress or undue influence and that it is not the result of any collusion or improper or illegal agreement or agreements and the parties hereto state that he or she in the procurement and execution of this Agreement, has not been subjected to any fraud, concealment, overreaching, imposition, coercion, or other unfair dealing on the part of the other, or on the part of the other's counsel. 2. WARRANTY OF DISCLOSURE: The parties warrant and represent that they have made a full disclosure of all assets and their valuation prior to the execution of this Agreement. This disclosure was in the form of an informal exchange of information by the parties' attorneys and/or parties, and this Agreement between the parties is based upon this disclosure. 3. MUTUAL RELEASE: Husband and Wife each do hereby mutually remise, release, quitclaim, and forever discharge the other and the estate of such other, for all times to come and for all purposes whatsoever, of and from any and all right, title and interest, or claims in or against the property (including income and gain from property hereafter accruing) of the other or against the estate of such other, of whatever nature and wheresoever situate, which he or she now has or at any time hereafter may have against such other, the estate of such other, or any part thereof, whether arising out of any former acts, contracts, engagements, or liabilities of such other as by way of dower or curtesy, or claims in the nature of dower or curtesy or widow's or widower's rights, family exemption, or similar allowance, or under the intestate laws, or the right to take against the spouse's Will; or the right to treat a lifetime conveyance by the other as testamentary, or all other rights of a surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of (a) Pennsylvania, (b) any state, commonwealth or territory of the United States, or (c) any other country, or any rights which either party may have or at any time hereafter have for past, present, or future support or maintenance, alimony, alimony pendente lite, counsel fees, costs or expenses, whether arising as a result of the marital relation or otherwise, except and only except, all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any thereof. It is the intention of Husband and Wife to give to each other by execution of this Agreement a full, complete, and general release with respect to any and all property of any kind or nature, real or personal, not mixed, which the other now owns or may hereafter acquire, except and only except, all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any thereof. 4. PERSONAL RIGHTS AND SEPARATION: Wife and Husband may and shall, at all times hereafter, live separate and apart. They shall be free from any control, restraint, interference or authority, direct or indirect, by the other in all respects as if they were unmarried. They may reside at such place or places as they may select. Each may, for his or her separate use or benefit, conduct, carry on and engage in any business, occupation, profession or employment which to him or her may seem advisable. Wife and Husband shall not molest, harass, disturb or malign each other or the respective families of each other nor compel or attempt to compel the other to cohabit or dwell by any means or in any manner whatsoever with him or her. 5. AGREEMENT NOT A BAR TO DIVORCE PROCEEDINGS. This Agreement shall not be considered to affect or bar the right of Wife or Husband to a limited or absolute divorce on lawful grounds if such grounds now exist or shall hereafter exist or to such defense as may be available to either party. This Agreement is not intended to condone and shall not be deemed to be a condonation on the part of either party hereto of any act or acts on the part of the other party which have occasioned the disputes or unhappy differences which have occurred prior to or which may occur subsequent to the date hereof. The parties intend to secure a mutual consent, no-fault divorce pursuant to the terms of Section 3301 (c) or (d) of the Divorce Code of 1980. 6. AGREEMENT TO BE INCORPORATED IN DIVORCE DECREE: The parties agree that the terms of this Agreement may be incorporated into any divorce decree which may be entered with respect to them. Notwithstanding such incorporation, this Agreement shall not be merged in the decree, but shall survive the same and shall be binding and conclusive on the parties for all times. 7. DATE OF EXECUTION: The "date of execution" or "execution date" of this Agreement shall be defined as the date upon which it is executed by the parties if they have each executed the Agreement on the same date. Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. 8. PERSONAL PROPERTY: Husband and Wife do hereby acknowledge that they have previously divided their tangible personal property, including, but without limitation, jewelry, clothes, furniture, furnishings, rugs, carpets, household equipment and appliances, pictures, books, works of art and other personal property and hereafter Wife agrees that all of the property in the possession of Husband shall be the sole and separate property of Husband; and Husband agrees that all of the property in the possession of Wife shall be the sole and separate property of Wife. The parties do hereby specifically waive, release, renounce and forever abandon whatever claims, if any, he or she may have with respect to the above items which shall become the sole and separate property of the other, with full power to him or her to dispose of the same as fully and effectually, as though he or she were unmarried. 9. BANK ACCOUNTS: For the mutual promises and covenants contained in this Agreement, Husband and Wife hereby waive all right, title, claim or interest they may have to equitable distribution in their respective bank accounts, checking or savings, if any, and each party waives against the other any duty of accounting for disposition of any jointly held funds. 10. AFTER-ACQUIRED PERSONAL PROPERTY: Each of the parties shall hereafter own and enjoy, independently of any claim or right of the other, all items of personal property, tangible or intangible, hereafter acquired by him or her after the parties date of separation, with full power, in him or her to dispose of the same as fully and effectively, in all respects and for all purposes, as though he or she were unmarried. 11. MOTOR VEHICLES The parties agree to the division of their motor vehicles, acquired during their marriage, as follows: A. The 1997 Chevrolet 1500 pickup currently titled in Husband's name alone shall remain the sole and exclusive property of Husband. Wife hereby waives any right, title, claim and/or interest she has or may have in said vehicle. B. The 1999 Honda VT 110002 Shadow motorcycle currently titled in Husband's name alone shall remain the sole and exclusive property of Husband. Wife hereby waives any right, title, claim and/or interest she has or may have in said vehicle. 12. PENSION, RETIREMENT, PROFIT SHARING, STOCK: A. The parties recognize that Husband has Ahold USA, Inc. shares as a result of his employment with Giant. For the mutual promises and covenants contained in this Agreement, Wife waives all right, title, claim and/or interest she has or may have in said shares. B. The parties recognize that Husband has a 401(k) account with Ahold USA, Inc. as a result of his employment with Giant. For the mutual promises and covenants contained in this Agreement, Wife waives all right, title, claim and/or and interest she has or may have in said 401(k) account, except that she shall receive a rollover of TWENTY THOUSAND AND 00/100 ($20,000.00), including any gains on this amount from the date of this Agreement to the date of disbursement, which shall be effectuated pursuant to a Qualified Domestic Relations Order, with the Qualified Domestic Relations Order to drafted by counsel for Husband within thirty (30) days of the date of this Agreement. If Husband dies prior to the distribution as set forth above, Wife shall be deemed the surviving spouse solely for purposes of the TWENTY THOUSAND AND 00/100 ($20,000.00). C. The parties recognize that Husband has an Ahold USA, Inc. Frozen Pension Plan for which Wife is entitled to 50% of the coverture fraction. The coverture fraction is such that the numerator of the fraction is the number of years and months of marriage when the Participant, Husband, was both married to the Alternate Payee, Wife, and covered by the Plan. The denominator of the fraction is the number of years and months during which the Participant, Husband, was covered by the Plan. The parties agree that, as allowed by the Plan, Wife shall receive her portion, with a present value of TWENTY-FIVE THOUSAND AND 00/100 ($25,000.00), in a lump sum, which shall be effectuated pursuant to a Qualified Domestic Relations Order, with the Qualified Domestic Relations Order to drafted by counsel for Husband within thirty (30) days of the date of this Agreement. If Husband dies prior to the distribution as set forth above, Wife shall be deemed the surviving spouse solely for purposes of the TWENTY-FIVE THOUSAND AND 00/100 ($25,000.00). D. The parties recognize that Wife has a CenturyLink pension as a result of her employment with Sprint, now known as CenturyLink. For the mutual promises and covenants contained in this Agreement, Husband waives all right, title, claim, and/or interest he has or may have in said pension. E. The parties recognize that Wife has an IRA with American Funds. For the mutual promises and covenants contained in this Agreement, Husband waives all right, title, claim and/or interest he has or may have in said IRA. 13. LIFE INSURANCE: Each party agrees that the other party shall have sole ownership and possession of any life insurance policies owned by the other, with the right to designate a beneficiary as each of the party sees fit for his/her respective policy. Each party agrees to sign any documents necessary to waive, relinquish, or transfer any rights on such policies to the respective party who presently owns such policies. The parties recognize that Wife has a life insurance policy with Boston Mutual. For the mutual promises contained in this Agreement, Husband waives all right, title claim and/or interest he has or may have in said life insurance policy. 14. MARITAL DEBT: Each party hereby confirms they have not incurred any additional debt since separation that has in any way obligated the other party. Neither party will take any action to incur additional debt of any nature whatsoever in the other party's name from the date of execution of this Agreement forward. Any debts that existed during the marriage shall be the sole responsibility of the person in whose name the debt was incurred, and each party indemnifies and holds the other harmless from and against any and all demands for payment or collection activity of any nature whatsoever. 15. WARRANTY AS TO FUTURE OBLIGATIONS: Wife and Husband each covenant, warrant, represent and agree that each will now and at all times hereafter save harmless and keep the other indemnified from all debts, charges and liabilities incurred by the other after the execution date of this Agreement, except as may be otherwise specifically provided for by the terms of this Agreement and that neither of them shall hereafter incur any liability whatsoever for which the estate of the other may be liable. 16. ALIMONY, ALIMONY PENDENTE LITE, SPOUSAL SUPPORT AND MAINTENANCE: A. Husband hereby waives any right or claims of any nature whatsoever relative to alimony, alimony pendente lite, spousal support, spousal maintenance, counsel fees and expenses against Wife. B. Wife hereby waives any right or claims of any nature whatsoever relative to alimony, alimony pendente lite, spousal support, spousal maintenance, counsel fees and expenses against Husband. Wife shall file to terminate the existing spousal support obligation, pursuant to PACSES Case No. 313109501, as of the date the Divorce Decree is entered. Any arrears remaining from the existing spousal support obligation shall be due and owing. 17. INCOME TAX PRIOR RETURNS: A. Husband agrees that in the event any deficiency in Federal, state or local income tax is proposed, or any assessment of any such tax is made against Wife by reason of her having joined in the filing of said joint returns, Husband will indemnify and hold Wife harmless from and against any loss or liability for any such tax deficiency or assessment and any interest, penalty, and expense incurred in connection therewith, and such tax, interest, penalty or expense shall be paid solely and entirely by Husband, unless said tax, interest, penalty or expense is finally determined to be attributable to misrepresentation or failure to disclose the nature and extent of Wife's separate income on the aforesaid joint returns. B. Wife agrees that in the event any deficiency in Federal, state or local income tax is proposed, or any assessment of any such tax is made against Husband by reason of him having joined in the filing of said joint returns, Wife will indemnify and hold Husband harmless from and against any loss or liability for any such tax deficiency or assessment and any interest, penalty, and expense incurred in connection therewith, and such tax, interest, penalty or expense shall be paid solely and entirely by Wife, unless said tax, interest, penalty or expense is finally determined to be attributable to misrepresentation or failure to disclose the nature and extent of Husband's separate income on the aforesaid joint returns. 18. DIVORCE: Husband has commenced an action for divorce from Wife pursuant to Section 3301 (c) of the Pennsylvania Divorce Code by the filing of a Divorce Complaint. Each of the parties shall sign an Affidavit of Consent and Waiver of Notice of Intention to Request the Entry of a Divorce Decree at the same time of execution of this Agreement, and provide the necessary documents to counsel for Husband so that counsel for Husband can finalize the divorce. It is further agreed and understood that any Decree of Divorce issuing in this matter shall reflect the fact that Husband shall bear the cost of same in his individual capacity. A. Each of the parties agree that this Agreement represents a complete and final agreement as to their respective property rights which arose from the marital relation and therefore mutually waive any and all rights they may have under Section 3501 (Equitable Distribution) of the Pennsylvania Code, Act No. 1990- 206. B. This Agreement may be offered in evidence in the action for divorce and may be incorporated by reference in the decree to be granted therein. Notwithstanding such incorporation, this Agreement shall not be merged in the decree, but shall survive the same and shall be binding and conclusive on the parties for all time. 19. LEGAL FEES: In the review and preparation of this Agreement, each party shall bear his/her own legal fees. 20. REMEDY FOR BREACH: If either party breaches any provision of this Agreement, the other party shall have the right, at his or her election, either to sue for damages for such breach, in which event the breaching party shall be responsible for payment for reasonable legal fees and costs incurred by the other in enforcing their rights hereunder, or to seek such other remedies or relief as may be available to him or her. 21. EQUITABLE DISTRIBUTION: It is specifically understood and agreed that this Agreement constitutes an equitable distribution of property, both real and personal, which was legally and beneficially acquired by Husband and Wife or either of them during the marriage as contemplated by The Act of December 19, 1990 (P.L. No. 1240, No. 206) known as "The Divorce Code," 23 P.S. 3501 et seq. of the Commonwealth of Pennsylvania, and as amended. 22. SUMMARY OF EFFECT OF AGREEMENT: It is specifically understood and agreed by and between the parties hereto, and each party accepts the provisions herein made in lieu of and in full settlement and satisfaction of any and all of said parties' rights against the other for any past, present and future claims on account of support, maintenance, alimony, alimony pendente lite, counsel fees, costs and expenses, equitable distribution of marital property and any other claims of each party, including all claims raised by them in the divorce action pending between the parties. 23. TAX CONSEQUENCES: By this agreement, the parties have intended to effectuate and have equitably divided their marital property. The parties have determined that such equitable division conforms to a right and just standard with regard to the rights of each party. The division of existing marital property is not, except as may be otherwise expressly provided herein, intended by the parties to constitute in any way a sale or exchange of assets and the division is being effected without the introduction of outside funds of other property not constituting a part of the marital estate. 24. MUTUAL COOPERATION/DUTY TO EFFECTUATE AGREEMENT: Each party shall, at any time and from time to time hereafter, take any and all steps and execute, acknowledge, and deliver to the other party any and all further instruments and/or documents that the other party may reasonably require for the purpose of giving full force and effect to the provisions of this Agreement. 25. RECONCILIATION: The parties shall only effect a legal reconciliation which supersedes this agreement by their signed agreement containing a specific statement that they have reconciled and that this agreement shall be null and void; otherwise, this agreement shall remain in full force and effect. Further, the parties may attempt a reconciliation, which action, if not consummated by the aforesaid agreement, shall not affect in any way the legal effect or this agreement or cause any new marital rights or obligations to accrue. 26. SEVERABILITY: The parties agree that the separate obligations contained in this Agreement shall be deemed to be interdependent. If any term, clause, or provision of this Agreement shall be determined by a court of competent jurisdiction to be invalid or unenforceable, then the parties agree that the Agreement may be reviewed and renegotiated in order to fulfill as closely as possible the purpose of the invalid provision. Notwithstanding any release contained herein, the parties intend that they may reinstate any and all economic claims to the extent available under the Divorce Code of 1980. Further, any court of competent jurisdiction may, under the equitable provisions and purposes of the Divorce Code, reinstate any economic claim which was available at the time of the parties' separation or avoid any waiver herein contained to renegotiate or effectuate as nearly as possible the purpose of the unenforceable provision. 27. NO WAIVER OF DEFAULT: This Agreement shall remain in full force and effect unless and until terminated under and pursuant to the terms of this Agreement. The failure of either party to insist upon strict performance of any of the provisions of this Agreement shall in no way affect the right of such party hereafter to enforce the same, nor shall the waiver of any breach of any provision hereof be construed as a waiver of any subsequent default of the same or similar nature, nor shall it be construed as a waiver of strict performance of any other obligations herein. 28. INTEGRATION: This Agreement constitutes the entire understanding of the parties and supersedes any and all prior agreements and negotiations between them. There are no representations or warranties other than those expressly set forth herein. This Agreement shall survive integration by any court into any judgment for divorce and shall continue to have independent legal significance as written contract separate from such judgment for divorce and may be enforced as an independent contract. 29. EFFECT OF DIVORCE DECREE: The parties agree that unless otherwise specifically provided herein, this Agreement shall continue in full force and effect after such time as a final decree in divorce may be entered with respect to the parties. 30. NOTICES: Any and all notices given hereunder shall be in writing and shall be sent registered mail, return receipt requested: A. To the Wife, at 12324 William Road SE, Cumberland, Maryland, 21502. B. To the Husband, at 7 Terri Drive, Carlisle, Pennsylvania, 17013. 31. WAIVER OR MODIFICATION TO BE IN WRITING: No modification or waiver of any of the terms hereof shall be valid unless in writing and signed by both parties and no waiver of any breach hereof or default hereunder shall be deemed a waiver of any subsequent default of the same or similar nature. 32. CAPTIONS: The captions of this Agreement are inserted only as a matter of convenience and for reference and in no way define, limit or describe the scope and intent of this Agreement, nor in any way effect this Agreement. 33. AGREEMENT BINDING ON HEIRS: The Agreement shall be binding and shall inure to the benefit of the parties hereto and their respective heirs, executors, administrators, successors and assigns. 34. LAW OF PENNSYLVANIA APPLICABLE: This Agreement shall be construed in accordance with the laws of the Commonwealth of Pennsylvania. IN WITNESS WHEREOF, the parties have set their hands and seals to two counterparts of this Agreement, each of which shall constitute an original, the day and year first above written. Witness: i V 61 Tommy E oose m"[C?ld COMMONWEALTH OF RENW" :'4--??A ) . COUNTY OF SS On this, the day of Ij - , 2011, before me, a notary public, the undersigned officer, personally appeared Joan M. Moose, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. In Witness Whereof, I,hereunt my hand and notarial seal. Notary Public COMMONWEALTH OF PENNSYLVANIA ) ) SS. COUNTY OF CUMBERLAND ) On this, the 67,,?Z day of tuj , 2011, before me, a notary public, the undersigned officer, personally appeared Tommy E. Moose, known to me (or satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that he executed the same for the purposes therein contained. In Witness Whereof, I hereunto set my hand and notarial seal. Notary Public COMMOryyy` TMPEIVr4 ?VANIA 4 e ?Nmr1mi sell .N dome ' mloMOn end County OCt 2 2014 18N1l0 Notaries TOMMY E. MOOSE, Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA vs. JOAN M. MOOSE, CIVIL DIVISION Defendant NO 2007-5601 CIVIL TERM PRAECIPE TO TRANSMIT RECORD To the Prothonotary: Transmit the record, together with the following information, to the court for entry of ace a M4; L decree: ?r 1. Ground for divorce:'= Irretrievable breakdown under § (3301(c)) and - § (3301(d)(1)) of the Divorce Code. (Strike out inapplicable section.) r 2. Date and manner of service of the complaint: W Certified Mail, return receipt requested, restricted delivery on October 1, 2007 3. Complete either paragraph (a) or (b). (a) Date of execution of the affidavit of consent required by § 3301(c) of the Divorce code: by plaintiffJuly 31, 2009 ; by defendant February 26, 2011 (b) (1) Date of execution of the affidavit required by § 3301(d) of the Divorce Code: - -La (2) Date of filing and service of the plaintiff's § 3301(d) affidavit uli4rttie respondent opposing party: 1 ry rya 4. Related claims pending: None '77 77' 5. Complete either (a) or (b) ---F (a) Date and manner of service of the notice of intention to file praecipe to transmit record, a copy of which is attached: (b) Date plaintiff's Waiver of Notice was filed with the Prothonotary: July 31, 2009 Date defendant's Waiver of Notice was filed with the Prothonotary: March 8, 2011 Attorney for Plaintiff/Defendant IN THE COURT OF,COMMON PLEAS OF. TOMMY.E. MOOSE CUMBERLAND COUNTY, PENNSYLVANIA V. JOAN M. MOOSE NO. 2007-5601 DIVORCE DECREE AND NOW, M4-- a4 a Z , Z e Ii , it is ordered and decreed that TOMMY E. MOOSE plaintiff, and JOAN M. MOOSE , defendant, are divorced from the bonds of matrimony. Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") The parties' Marital Settlement Agreement dated February 28, 2011 is incorporated herein and the court has jurisdiction over no other claims. By the Court, Cert. Copy mailed -jo l Verney Sn4der N040a 4- CON ryl"404 4b 014 fkn"00 TOMMY E. MOOSE, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYPVA IAf V. `! - NO. 07-5601 CIVIL TERM _ JOAN M. MOOSE, r'it Defendant : IN DIVORCE _T` r.ay +Z- QUALIFIED DOMESTIC RELATIONS ORDER WHEREAS, this Court has jurisdiction over the parties and the subject matter of this Order; and WHEREAS, the parties and the Court intend that this Order shall be a Qualified Domestic Relations Order (hereinafter referred to as a "QDRO") as defined in Section 206(d)(3) of the Employee Retirement Income Security Act of 1974, as amended ("ERISA") and Section 414(p) of the Internal Revenue Code of 1986, as amended; and WHEREAS, pursuant to the referenced statutes, the Plan Administrator shall make a determination of the qualified status of this Order; and WHEREAS, following approval by the Plan Administrator, this Order shall constitute a Qualified Domestic Relations Order; and WHEREAS, the parties have stipulated that the court enter this Order. NOW THEREFORE, pursuant to this state's Domestic Relations Laws, IT IS HEREBY ORDERED BY THE COURT as follows: 1. As used in this Order, the following terms shall apply: (a) "Participant" shall mean Tommy E. Moose, whose current address is 7 Terri Drive, Carlisle, Pa 17013 (b) "Alternate Payee" shall mean Joan M. Moose, whose current address is 12324 William Road SE, Cumberland, MD 21502. (c) "Plan" shall mean Ahold USA, Inc. 401(k) Retirement Savings Plan. 2. The Order relates to marital property rights. 3. The date of marriage was 09/28/1991. 4. A copy of the divorce decree is attached hereto and incorporated herein as Exhibit "A." 5. The Alternate Payee is the former spouse of the Participant. 6. With respect to marital property, alimony and spousal awards, the Participant and the Alternate Payee are/were married for federal income tax purposes. 7. The Alternate Payee's award will be calculated as of the date of the Property Settlement Agreement. The date of the Property Settlement Agreement shall hereinafter be referred to as the "Valuation Date," with said date being February 23, 2011. 8. The Alternate Payee's interest in the Plan shall be $20,000.00 of the Participant total vested account balance under the Plan as of the Valuation Date. 9. The Alternate Payee's award is entitled to earnings (dividends, interest, gains, and losses) from the valuation Date to the date that the award is segregated from the Participant's account. From and after the date of segregation, the Alternate Payee's award shall be held in an account under the Plan and shall be entitled to all earnings attributable to the investments therein. 10. If Participant dies prior to the distribution as set forth above, Alternate Payee shall be deemed the surviving spouse solely for purposes of the $20,000.00. 11. In the event there is an outstanding loan balance as of the Valuation Date, the loan balance will not be included for purposes of calculating the account balance to be divided. 12. The Alternate Payee's award will be paid proportionately from all investment options as of the date of the account segregation. 13. The Alternate Payee's interest in the Plan shall be payable to the Alternate Payee in a lump sum distribution, as soon as administratively feasible following the date that the Order is determined to be a QDRO. The Alternate Payee shall initiate the distribution in accordance with the terms of the Plan and the administrative procedures that have been established by the Plan Administrator. The amount distributed to the Alternate Payee will be based on the value of the Alternate Payee's account on the date the distribution is processed. 14. The Alternate Payee will have the right to designate a beneficiary. In the event that the Alternate Payee dies without designating a beneficiary, or if the beneficiary predeceases the Alternate Payee, the Alternate Payee's award will be distributed pursuant to the administrative procedures established for the Plan. However, all beneficiary designations must be made after qualification of the Order and segregation of a separate account for the Alternate Payee pursuant to the administrative procedures established for the Plan and cannot be changed in the Order. 15. Neither Party shall accept any benefits from the Plan which are the property of the other Party. In the event that the Plan Administrator inadvertently pays to the Participant any benefits that are assigned to the Alternate Payee pursuant to the terms of this Order, the Participant shall forthwith return such benefits to the Plan. In the event that the Plan Administrator inadvertently pays to the Alternate Payee any benefits that are not assigned to the Alternate Payee pursuant to the terms of this Order, the Alternate Payee shall forthwith return such benefits to the Plan. 16. For purposes of Sections 402 and 72 of the Internal Revenue Code, any Alternate Payee who is the spouse or former spouse of the Participant will be treated as the recipient of any distributions or payments made to the Alternate Payee under the terms of this Order, and as such, r will be required to pay the appropriate federal and/or state income taxes on such distribution. If the Alternate Payee is a child or other dependent of the Participant, the Participant will be responsible for any federal and/or state income taxes. BY THE COURT: "'? V#%. L4 AGREED TO: TOMM MOOSE, Plaintiff La // MV VJacq line M. Verney, Esquire 44 South Hanover Street Carlisle, PA 17013 Attorney for Plaintiff M. MOOSE, Defendant Hannah Herman-Snyder, Esq 200 North Hanover Street Carlisle, PA 17013 Attorney for Defendant ?0 6 IN THE COURT OF.COMMON PLEAS _OF_ CUMBERLAND COUNTY, PENNSYLVANIA TOMMY 'E. MOOSE V. JOAN M. MOOSE NO. 2007-5601 DIVORCE DECREE AND NOW, /7J z Z , z o i? it is ordered and decreed that TOMMY E. MOOSE plaintiff, and JOAN M. MOOSE bonds of matrimony. defendant, are divorced from the Any existing spousal support order shall hereafter be deemed an order for alimony pendente lite if any economic claims remain pending. The court retains jurisdiction of any claims raised by the parties to this action for which a final order has not yet been entered. Those claims are as follows: (If no claims remain indicate "None.") The parties' Marital Settlement Agreement dated February 28, 2011 is incorporated herein and the court has jurisdiction over no other claims. By the Court,