Loading...
HomeMy WebLinkAbout08-6698BARBARA FEARNBAUGH, Plaintiff VS. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA NO. 09 - 609 THEODORE FEARNBAUGH, : CIVIL ACTION - LAW Defendant : 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 AT THE CUMBERLAND COUNTY COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE, PA 17013. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY LAWYER REFERRAL SERVICE 2 LIBERTY AVENUE CARLISLE, PA 17013 (717) 249-3166 BARBARA FEARNBAUGH, Plaintiff VS. THEODORE FEARNBAUGH, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. DJ- ( , ?- 99 CIVIL ACTION - LAW IN DIVORCE COMPLAINT DIVORCE UNDER §3301(c) or §3301(d) OF THE DIVORCE CODE 1. Plaintiff is Barbara Fearnbaugh, who currently resides at 1215 Gross Drive, Mechanicsburg, Cumberland County, Pennsylvania, 17050. 2. Defendant is Theodore Fearnbaugh, who currently resides at 1215 Gross Drive, Mechanicsburg, Cumberland County, Pennsylvania, 17050. 3. Plaintiff and Defendant have been bona fide residents in the Commonwealth of Pennsylvania for at least six months immediately previous to the filing of this Complaint. 4. Plaintiff and Defendant were married on April 8, 1995 in Mechanicsburg, Pennsylvania. 5. The parties are the parents of one (1) minor child: Richard Fearnbaugh, born on May 29, 1996. 6. There have been no prior actions of divorce or for annulment between the parties. 7. Neither party is presently a member of the Armed Forces on active duty. 8. Plaintiff has been advised that counseling is available and that she may have the right to request that the court require the parties to participate in counseling. Being so advised, Plaintiff does not request that the Court require the parties to participate in counseling prior to a Divorce Decree being issued. 9. The cause of action and sections of the Divorce Code under which Plaintiff is proceeding are: (a) §3301(c). The marriage of the parties is irretrievably broken; and (b) §3301(d). The marriage of the parties is irretrievably broken and, at the appropriate time, Plaintiff will submit an affidavit stating that the parties have been living separate and apart for a period of at least two (2) years. 10. Plaintiff requests This Honorable Court enter a Decree of Divorce. WHEREFORE, Plaintiff respectfully requests This Honorable Court enter an Order dissolving the marriage between Plaintiff and Defendant. Respectfully submitted, COLG RZZACCO LLC ? By: _/ Thomas M. Clark, Esquire Attorney ID # 85211 130 West Church Street Suite 100 Dillsburg, PA 17019 Phone: (717) 502-5000 Fax: (717) 502-5050 Dated: /i c v BARBARA FEARNBAUGH, Plaintiff VS. THEODORE FEARNBAUGH, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. CIVIL ACTION - LAW IN DIVORCE VERIFICATION I, Barbara Fearnbaugh, verify that the statements made in this Complaint are true and correct to the best of my knowledge, information, and belief. 1 understand that false statements herein are made subject to the penalties of 18 Pa. CS..§4904, relating to unworn falsification to authorities. Lid o&' - &4"" - Date: BARBARA FEARNBAU014 Plaintiff I IDI I0 ? q r+s To ? " 00 15 D I BARBARA FEARNBAUGH, Plaintiff VS. THEODORE FEARNBAUGH, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA NO. 08-6698 CIVIL TERM CIVIL ACTION - LAW IN DIVORCE ACCEPTANCE OF SERVICE I accept service of Plaintiff's Complaint in Divorce filed on November 12, 2008 in the above- captioned matter, which service satisfies the requirements of the Pennsylvania Rules of Civil Procedure. Date:-/1,!_199 Theodore Fearnbaugh 1215 Gross Drive Mechanicsburg, PA 17050 G'3 ~' L IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Pl ntiff Vs File No. D IN DIVORCE De ndant 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 after the entry of a Final Decree in Divorce dated , hereby elects to resume the prior surname of , and gives this written notice avowing his / her intention pursuant to a provisions of 54 P.S. 704. Date: l01 10 0`3 J"A"ia-Ab Signature Tct'c'bo'? 6- ", Signature of name being sumed COMMONWEALTH OF PENNSYLVANIA ) COUNTY OF On the?ay of lar?? - , 200q, before me, the Prothonotary or the notary public, personally appeared th 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. Notary PubTic NOTARIAL SEAL PROTHONOTARY, NOTARY PUBLIC CARLISLE CUMBERLAND COUNTY COURTHOUSE MY COMMISSION EXPIRES JANUARY 4, 2010 ? `? ? ?? ? ? . ? ?' , ? `-a = _ ?? i .. ` ? ? -. '\ BARBARA FEARNBAUGH, Plaintiff Vs. : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 08-6698 CIVIL TERM THEODORE FEARNBAUGH, : CIVIL ACTION - LAW Defendant : IN DIVORCE MARITAL SETTLEMENT AGREEMENT THIS MARITAL SETTLEMENT AGREEMENT, made this 2y+-k day of T--e- &r-%l r , 2009, by and between BARBARA FEARNBAUGH, of Mechanicsburg, Cumberland ounty, Pennsylvania (hereinafter referred to as "WIFE") and, THEODORE FEARNBAUGH of Mechanicsburg, Cumberland County, Pennsylvania (hereinafter referred to as ` HUSBANU ): WITNESSETH: WHEREAS, the parties were married on April 8, 1995 in Mechanicsburg, Pennsylvania; WHEREAS, HUSBAND and WIFE are the natural parents of one (1) minor child: Richard Fearnbaugh, born on May 29,1996; WHEREAS, diverse, unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of HUSBAND and WIFE to live separate and apart, and the parties hereto are desirous of settling fully and finally their respective financial and property rights and obligations as between each other, including, without limitation by specification: the settling of all platters between them in relation to the ownership and equitable distribution of real and personal property; settling ofall matters between them relating to the past, present and future support, alimony and/or maintenance of WIFE by HUSBAND or of HUSBAND by WIFE; settling of custody matters and in general, the settling of any and all claims and possible claims by either party against the estate of the other party. NOW, THEREFQI?k, in consideration of the premises and of the mutual promises, covenants and undertakings f hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby covenant and agree as follows: 1. INTERFERENCE: Each party shall be free from interference, authority, and contact by the other, as fully as though he or she were single and unmarried, except as may be necessary to carry out the provisions of this Agreement. Neither party shall molest the other or attempt to endeavor to molest the other, nor compel the other to cohabitate with the other, or in any way harass or malign the other, nor in any way interfere with the peaceful existence, separate and apart from the other. 2. AGREEMENT NOT A BAR TQ DIVORCE PROCEEINNGS: This Agreement shall not affect or bar the right of HUSBAND or WIFE to a divorce on lawful grounds or to any 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. 3. SUBSEQUENT DIVORCE: The parties hereby acknowledge that WIFE filed a Complaint in Divorce in Cumberland County, Pennsylvania, claiming that the marriage is irretrievably broken under Section 3301(c) of the Pennsylvania Divorce Code and that the parties have lived separately and apart as required under Section 3301(d) of the Pennsylvania Divorce Code. The parties hereby express their agreement that the marriage is irretrievably broken and express their intent to execute an Affidavit of Consent and Waiver of Notice under Section 3301(c) of the Divorce Code. Additionally, the parties hereby express their agreement that the marriage is irretrievably broken and express their intent to execute any Affidavit or other documents necessary for the patties to obtain an absolute divorce pursuant to Section 3301(d) of the Divorce Code. The parties hereby waive all rights to request court ordered counseling under the Divorce Code. It is further specifically understood and agreed by the parties that the provisions of this Agreement as to equitable distribution of property of the parties are accepted by each party as a full and final settlement for all purposes whatsoever, as contemplated by the Pennsylvania Divorce Code. Should a decree, judgment or order of divorce be obtained by either of the parties in this or any other state, country or jurisdiction, each of the parties hereby consents and agrees that this Agreement and all of its covenants shall not be affected in any way by such separation or divorce; nothing in any such decree, judgment, order or further modification or revision thereof shall alter, amend or vary any term of this Agreement. It is the specific intent of the parties to permit this Agreement to survive any judgment and to be forever binding and conclusive upon the parties. 4. INCORPORATION OF DjV ME RECREE: It is further agreed, covenanted and stipulated that this Agreement, or the essential parts hereof, shall be incorporated in any decree hereinafter entered by any court of competent jurisdiction in any divorce proceedings that have been or may be instituted by the parties for the purpose of enforcing the contractual obligations of the parties. This agreement shall not be merged in any such decree but shall in all respects survive the same and be forever binding and conclusive upon the parties. 5. EFFECTIVE DATE: The effective date of this Agreement shall be the "date of execution" or "execution date," defined as the date upon which it is executed by the parties if they have each executed this 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. 6. DISTR1BUjj0N DATES: The transfer of property, funds and/or documents provided for herein, shall only take place on the "distribution" date, which shall be defined as the effective date ofthis Agreement, unless otherwise provided for herein, includingany spousal support and/or alimony payments. 7. MUTUAL RELEASE: HUSBAND and WIFE each do hereby mutually remise, release, quit-claim and forever discharge the other and the estate of such other, for all time to come, and for all purposes whatsoever, of and from any and all rights, 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 situated, which he or she now has or at any time hereafter may have against the other, the estate of such other or any part hereof, whether arising out of any former acts, contracts, engagements or liabilities of such other or by way of dower or courtesy, or claims in the nature of dower or courtesy 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 a 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 country or any rights which either party may have or at any time hereafter shall have for past, present or future support or maintenance, alimony, alimony pendente lite, counsel fees, division ofproperty, costs or expenses, whether arising as a result of the marital relations or otherwise, except, all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provisions thereof. It is the intention of HUSBAND and WIFE to give each other by the execution of this Agreement a full, complete and general release with respect to any and all property of any kind or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and only except all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision thereof It is further agreed that this Agreement shall be. and constitute a full and' final resolution of any and all claims which each of the parties may have against the other for equitable division oi'property, alimony, counsel fees and expenses, alimony pendente lite or any other claims pursuant to the Pennsylvania Divorce Code or the divorce laws of any other jurisdiction. 8. REPRESENTATION BY COUNSEL: WIFE has been represented by Thomas M. Clark, Esquire, and WIFE acknowledges that she has signed this Agreement freely and voluntarily after full consultation with her counsel. This Agreement has been prepared by Thomas M. Clark, Esquire, counsel for WIFE. At the commencement of and at all stages during the negotiations of this Agreement, HUSBAND has been inforined that "Thomas M. Clark, Esquire has acted solely as counsel for WIFE and has not advised nor represented HUSBAND in any manner whatsoever. HUSBAND, at the commencement of and at all stages during the negotiation of this Agreement, has been advised that he could be represented by counsel but at all times has elected not to be so represented. HUSBAND has read this Agreement carefully and thoroughly, fully understanding each of its provisions, and therefore signs it clearly and voluntarily. The parties acknowledge that this Agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreement. The parties further acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this Agreement. 9. WARRANTY AS TO EXISTING OBLIGATIONS: Each party represents (that they have not heretofore incurred or contracted for any debt or liability or obligation for which) the estate of the other party may be responsible or liable except as may be provided for in this Agreement. Each party agrees to indemnify and hold the other party harmless from and against any and al i such debts, liabilities or obligations of every kind which may have heretofore been incurred by them, including those for necessities, except for the obligations arising out of this Agreement. 10. WARRANTY AS TO FUTURE OBLIGATIONS: HUSBAND and WIFE covenant, warrant, represent and agree that, with the exception of obligations set forth it this Agreement, neither of them shall hereafter incur any liability whatsoever for which the estate of the other may be liable. Each party shall indemnify and hold harmless the other party from and against any and 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. 11. PERSONAL PROPERTY: The parties agree to divide the personal property items as follows: 1-ILISBAND shall retain the following: a) Tools in garage; b) Sofa; and, C) Camper. WIFE shall retain the following: a) 51 " Flat Screen Television; b) Master bedroom suite; C) Chaise; and, d) Dining room suite. The parties have divided between them, to their mutual satisfaction, all other personal effects, household furniture and furnishings, and all other articles of personal property which have heretofore been used by them in common, and neither party will make any claim to any such items which are now in the possession or under the control of the other. By these presents, each of the parties hereby specifically waives, releases, renounces and forever abandons whatever claims he or she may have with respect to any personal property which is in the possession of the other, and which shall become the sole and separate property of the other from the date of execution hereof. 12. DIVISION OF MARIJAL RESIDENCE: The parties acknowledge that they are Joint owners of real estate situate at 1215 Gross Drive, Mechanicsburg, Cumberland Cou6ty, Pennsylvania. This real estate is subject to an existing mortgage in the present princt1pal indebtedness of approximately $116,105.00. Additionally, there is a second mortgage in the amount of approximately $21,501.00. The parties are in agreement that the real estate shall be listed for sale no later than January 1, 2009. The parties agree that the real estate shall remain on the market until the property is sold. The real estate shall be available at reasonable times for inspection by brokers and by perspective purchasers. Loth parties shall cooperate and use efforts reasonably calculated to produce the best sales price available on the market and shall agree in a prior writing on a listing price and a minimum sales price "Sales Price". "Sales Price" is defined as the gross sales price that the parties agree to accept. If the parties can not agree on a "Sales Price', then each will chose a real estate broker at their own cost and expense, and the two brokers shall then chose a third mutual broker and the average of the three appraisals shall be the "Sales Price". The cost of the third broker shall be paid equally by the parties. If the real estate remains unsold after remaining on the market for three (3) ,Months at the "Sales Price", there shall be a reevaluation of the "Sales Price" by the three brokers, and the reevaluated amount shall be the "Sales Price". The parties shall accept the first bona fide ofl'or at or above the "Sales Price" unless otherwise mutually agreed. Upon the sale of the real estate, WIFE shall receive fifty (50%) percent of the net proceeds, and HUSBAND shall receive fitly (50%) percent of the aforesaid net proceeds. The team net proceeds "Net Proceeds "is defined as all monies remaining after satisfaction of mortgage, business 1 i ne of credit, taxes, broker's commissions, and other charges normally incurred as a result of the sale of the property. Upon the closing of the sale of the said property, purchaser shall deliver separate checks which shall be distributed as and for part of the equitable distribution of the martial property of HUSBAND and WIFE as follows: a. WI1=1 shall receive from the purchaser a bank or certified check in the amount of fifty (50%) percent of the Net Proceeds; and b. HUSBAND shall receive from the purchaser a bank or certified check in the amount of fitly (50%) percent of the Net Proceeds. From the tune of the signing of this Agreement until Net Proceeds are distributed to the parties. HUSBAND shall be responsible for all bills on this property, including bills that have been incurred. although not yet due, that are associated with the real estate including; but not limited to, mortgage, electricity, garbage, water and sewer and all other reasonable and necessary expenses necessary to maintain the real estate. 13. BANK ACCOUNTS: HUSBAND and WIFE have owned various accounts during their marriage in both their individual and joint names. It is acknowledged that they have divided the jointly held accounts to their mutual satisfaction and they hereby agree that each shall become sole owner of their respective accounts and they each hereby waive any interest in, or claim to, any funds held by the other in any accounts. Specifically, the accounts held jointly by the parties that have been closed and divided to the mutual satisfaction of the parties include the savings and checking accounts. 14. MOTOR VEHICLES: The parties agree to divide the motor vehicles as follows: HUSBAND shall retain sole and exclusive possession of the 2008 Ford which is tilted in his dame alone. WIFE shall retain sole and exclusive possession of the 2008 Honda which is tilted in her name alone. Each party is responsible for the vehicles distributed to them, including the payment of insurance and maintenance, and each party agrees to indemnify and hold harmless the other party for failure to make payments thereon. Further, each parry agrees to execute any and all documentation to give effect to this paragraph within ten (10) days of a request of the other patty. 15. DEBT: It is agreed that the parties have accumulated debt during the marriage and that said debt shall be divided in the following manner: a) Chase (Account No. xxxx xxxx xxxx 8880)(Credit Card) - Husband and Wife agree that they shall divide this debt equally and they shall each be responsible to make equal monthly payments until this debt is paid in full. Husband and Wife agree that, as of the date of the signing of this Agreement, no further transactions shall be made on this Credit Card; b) Mortgage - The parties are joint owners of real estate situate at 1215 Cross Drive, Mechanicsburg, Cumberland County, Pennsylvania. This real estate is subject to an existing mortgage in the present principal indebtedness of approximately $116,105.00. Additionally, there is a second mortgage in the amount of approximately $21,501.00. Upon the sale of 1215 Gross Drive, Mechanicsburg, Cumberland County, Pennsylvania, these debts shall immediately be paid in full. C) Except as may be set forth above and elsewhere in this Agreement, the parties agree that they have no joint liabilities. All remaining debts accumulated during the marriage are in the sole and separate name of the individual parties and shall become the sole and separate responsibility of the named party. Each party agrees to indemnify and hold harmless the other party for failure to make payments on any debts that are in their individual names. ]b. RETIREMENT ACCOUNTS: HUSBAND is the owner of a 401(k) through his employment with Giant Foods. It is agreed that HUSBAND shall retain sole and exclusive ownership of this account, and that HUSBAND shall transfer to WIFE $10,000.00 from the 401(k). In consideration for this transfer, WIFE hereby waives any right, claim or interest she may have to the remainder of the 401(k). To facilitate the transfer, a Qualified Domestic Relations Order will k., drafted and approved by Giant Foods, and shall be executed by both parties. Each party further agrees to execute any and all documents to give effect to this paragraph. WIFE shall retain her Aflac Stock. HUSBAND hereby waives any right, claim or interest he may have in the Aflac Stock. The parties agree to execute any documents necessary to give effect to this paragraph. 17. HUSBAND'S PENSION: Wife is awarded 50% of the marital portion of Husband's accrued pension through the Ahold USA, Inc. Pension Plan. The marital portion shall be determined by applying a coverture fraction to the accrued pension determined as of the earlier of the date be=nefit payments commence to the Alternate Payee or the date that Husband ceases to accrue benet'its under the Plan. The numerator of the coverture fraction is the years and months of credited service which Husband earned during the marriage from April 8, 1995 (marriage date) to November 12L 2008 (date of separation). The denominator of the coverture fraction is the years and months of credited service which Husband ceases to accrue benefits under the Plan. Wife's share of the accrue benefit shall be payable in any form of payment that the Plan'may pen-nit her to elect, including a life annuity payable over Wife's lifetime. If the plan adjusts Wife's benefit to be payable over her lifetime, any actuarial adjustments made by the Plan shall be applied to the Wife's benefit. Wife may elect to commence receipt of her benefit at the earliest time as permitted under the terms of the Plan, subject to any early retirement reductions imposed by the Plan. 11' Wife predeceases Husband prior to commencing receipt of her benefit, her benefit shall revert to Husband. If Husband predeceases Wife prior to commencement of Wife's benefit, Wife shall be deemed to be the surviving spouse with respect to the payment of any pre-retirement death benefits attributable to the marital portion of the accrued pension. 1- Wife shall share proportionately in any cast-of-living adjustments or other economic improvements made by the Plan, but only to the extent such enhancements were not paid for by Husband's own post-separation contributions. Wife shall also share proportionately in any early retirement subsidies which may become payable upon the Husband's commencement of benefits. 18. LIFE INSURANCE: Each party agrees that HUSBAND shall retain the Eric Life Insurance Policy (No. 413352) in his name and WIFE hereby waives any right, claim or interest she may have therein. WIFE expresses her understanding that HUSBAND shall be free to remove her as the beneficiary of that policy if he chooses. Each party agrees that WIFE shall retain the Aflac Insurance Policy (No. PR365996) in her name and HUSBAND hereby waives any right, claim or interest he may have therein. HUSBAND expresses his understanding that WIFE shall be free to remove him as the beneficiary of that policy if she chooses. Each party agrees that WIFE shall retain the Transamerica Insurance Policy (No. 41557377) in her name and HUSBAND hereby waives any right, claim or interest he may have therein. HUSBAND expresses his understanding that WIFE shall be free to remove the children as the beneficiaries of that policy if she chooses. 19. HEALTH INSURANCE: HUSBAND has provided health insurance coverage to WIFE; and to their son through his employment. As long as HUSBAND has the existing coverage available to him through his employment, he shall continue to cover WIFE until such time as a Decree in Divorce is issued. As long as HUSBAND has the existing coverage available to him through his employment, he shall continue to cover his son and shall be solely responsible for the payment of premiums. Should HUSBAND change employment, his obligations pertaining to health insurance as detailed in this Paragraph shall continue in full force and effect so long as health insurance coverage is available to him at the same or reasonably similar expense. The parties shall share all unreimbursed medical expenses equally. Additionally, as long as HUSBAND is able to cover Matthew Gruber (D.O.B. 10-29-1986) with his existing coverage available to him through his employment, he shall continue to cover Matthew Gruber (D.O.B. I0-29-1986). 20. CUSTODY: Custody of the parties' minor child (Richard Fearnbaugh, born on May 29, 1996) shall be as follows: Legg! Custody: The parties shall share legal custody of the minor child. Joint legal custody means the right of both parents to control and share in making decisions of importance in the life of their child, including educational, medical and religious decisions. Both parents shall be entitled to equal access to the child's school, medical, dental and other important records. As soon as practicable after receipt by a party, copies of the child's school schedules, special events notifications, report cards and similar notices shall be provided to the other party. Each party shall notify the other of any medical, dental, optical and other appointments of the child with health care providers sufficiently in advance thereof so that the other party can attend. Notwithstanding that both parents share legal custody, non-major decisions involving the child's day to day living; shall be made by the parent then having custody, consistent with the other provisions of this Agreement. Physical Custody: Mother shall have primary physical custody, as defined in the Custody Act, of the minor child. Partial physical custody is the right to take possession of a child away from the custodial parent for a certain period of time. Father shall have partial physical custody of the minor child for at least one (1) weekend a month and at such other times as the parties can mutually agree. Holidays: The parties agree to share custody on holidays as follows: The parties will share custody on Thanksgiving and Christmas as follows: In odd numbered years, Mother shall have the child from 4:00 p.m. on the day before Thanksgiving to 4:00 p.m. on Thanksgiving day, at which time Father will have custody until 4:00 p.m. the following day. Father shall have the child from 4:00 p.m. on Christmas Eve to 4:00 p.m. on Christmas day, at which time Mother will have custody until 4:00 p.m. the following day. In even numbered years the schedule shall be reversed. The holiday schedules shall supersede the regular custody schedule where applicable. 21. C„ .D SUPPORT: The parties agree that, commencing on the first (Ist) day of February 2009,14USBAND shall pay to WIFE child support in the amount of $275.00 per month until the closing date of the sale of the marital residence (1215 Gross Drive, Mechanicsburg, Cumberland County, Pennsylvania) or beginning June 1, 2009, whichever occurs sooner. Upon the closing date of the sale of the marital residence (1215 Gross Drive, Mechanicsburg, Cumberland County, Pennsylvania) or beginning June 1, 2009, whichever occurs sooner, HUSBAND shall' pay to WIFE child support in the amount of $550.00 per month. Either party may seek to modify the child support by filing the appropriate petition with the Cumberland County Domestic Relations Office whereby the amount of child support may be modified according to the then applicable Pennsylvania guidelines for child support. The parties acknowledge that all support obligations detailed herein were arrived at by considering HUSBAND and WIFE's income from their regular employment. A modification shall be entered only upon a finding of a change in circumstances of one or both parties. Said support payments shall be made in two (2) monthly installments (First payment to be made by the 8" of the month and second payment to be made by the 22" of the month). A direct payment from HUSBAND to WIFE shall continue as long as HUSBAND makes timely payments. WIFE reserves the right to request a wage attachment through the Domestic Relations Section of the Court if HUSBAND shall fail to make the payments in a timely manner. The Domestic Relations Office is authorized to enforce this provision upon request of WIFE. If HUSBAND fails to make timely payments, WIFE shall have the right to forthwith bring any other enforcement action permitted by law or provided for under this Agreement for any sums due her, including counsel' fees incurred with respect to enforcement of this provision. 22. WAIVER OF ALIMONY: HUSBAND and WIFE recognize and acknowledge that the foregoing; provisions for their individual benefit are satisfactory with regard to support and maintenance, past, present and future. The parties release and discharge the other absolutely and forever for the rest of their lives for all claims and demands, past, present or future, for alimony, alimony pendente lite or for any provisions for support and maintenance. The parties further acknowledge that in consideration of the transfers made herein, each completely waives and relinquishes any and all claims and/or demands they may now have or hereafter have against the other for alimony, alimony pendente lite, spousal support, counsel fees and court costs. 23. TER-ACQUIRED PROPERTY: Each of the parties shall hereafter own and enjoy, independently of any claim or right of the other, all items of property, be they real, personal or mixed, tangible or intangible, which are hereafter acquired by him or her, 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. 24. INCOME TAX: HUSBAND and WIFE agree to file a joint tax return for the tax year 2008. The parties agree to equally split any return that they receive. That is to say that J , HUSBAND shall receive fifty (50%) percent of the 2008 tax return and WIFE shall receive fifty (50%) percent of the 2008 tax return. In the event that there is a deficiency , Both parties agree to equally split any deficiency in Federal, State or local income tax. HUSBAND and WIFE agree to file separate tax returns beginning with the tax year 2009. Both parties agree 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 either of them, each will indemnify and hold harmless the other from and against any loss or liability for any such tax deficiency or assessment and any interest, penalty and expense incurred in connection therewith. Such tax, interest, penalty or expense shall be paid solely and entirely by the individual who is finally determined to be the cause of the misrepresentations or failures to disclose the nature and extent of his or her separate income on the aforesaid joint returns. 25. APPLICABILITY OF TAX LAW TO PROPERTY TRANSFERS: The parties hereby agree and express their intent that any transfer of property pursuant to this Agreement:. shall be within the scope and applicability of the Deficit Reduction Act of 1984 (hereinafter the "Act"), specifically, the provisions of said Act pertaining to the transfers of property between spouses and former spouses. The parties agree to sign and cause to be filed any elections or other documents required by the Internal Revenue Service to render the Act applicable to the transfers set forth in this Agreement without recognition ofgain on such transfer and subject to the carry-over basis provisions of said Act. 26. EFFECT OF DIVORCE DECREE: The parties agree that, except as 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. 27. BREACH: If either party breaches any provision of this Agreement, the other party shall have the right, at his or her election to sue for damages for such breach or seek such other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of reasonable legal fees and costs incurred by the other in enforcing their rights under this Agreement. 28. WAIVER OF CLAIMS: Except as herein otherwise provided, each party may dispose of his or her property in any way, and each party hereby waives and relinquishes any and all rights lie or she shall now have, or hereafter acquire, under the present and future laws of any to ""are itt the ot'opertV or i=11;; esuiie c}lt_he of her aS a t??stYi€ LA €ilC hi rttal 16dl,1u11's111??. ??cti_;c'ti?1 witllntlt 1i1111taljotl, dog jer, couF tes%, siatu€flri1 alivt?ral!1 . 4?!t1aE 's ai:vi?ciilcc. r1? It tc? take iz' .:1E( rust'. _ rl,201 t;l t.-WI(e ?wainst the \Vili of i41e tltller. and llte !1t_'itt if:' act ds a ditimi.,jt!'aLul t)! cst,-It , and cacti Rh'?{{. eft tilc request o h ('ithor' execute, wktlowleCi4,y and t: (t E!t 2?t;CiE!Cii+°--F1F!: L?` itGiZ1 t:lily' Ile t1E:Cetiti„tY tlt' ?ffvttial}#i €t} f at'1v 1t1€f2 i l#ef L .ill's Illutual -A i;no_?Fshmew of -such interest,,, CtF.'.l1{` and cla.trns4 ?•}. € N"I t?ti<: t RF•F?!!IF T: This: :3F'ee111eF1 ciitZta t .l ez.n{il'ellettfel {.lrlflallw?.t?i #lte oa-til-amd, ttlerl- orf no representations. .v'3-antics- CC1\;t:!1a11t's of Cif"t•..`tel ta Kmi!s otile! Wiwi ttio>,e - : t',.s':.- '" et )t'f"t-p 31eF =111. tf1. ACT:R = it }4 FN i' BINDING O HEIRS: I llts:°ll?t`eetTjelll: ? tl: ll l)e hlllrtniv.. (}rt VW z::tt iiltti, Ysf'izL!?t`i f ti t?e C}e7t`tte'= iiel'E it? i111f# (ItC'.lt Ite:F''s. It t !1€ttf i. 3d lilt lit sUatufs. 41, A )U)11°ION,'.AI.. INSTRI;MFN`I S- EUch of ibe p hie s11;31 #ltllll #lt.le, #t} molt, it ? FC U4t ? Itie 0111-IN" exeolne, acklltswled e at Id de; ivC!' €:? the Qtl1i:1' anaaa all itii?iies ±flStf'tifkltf?t E'..ftttirµ l fit Five 1111i lorc:e and eiicci to Lia ?1u\!S Q!1S o-, this h.aeemeat. 't)II} Ci_< °SFS: I? ?F?? terr 1_ tcitlC tlt?ll, or pi t tall }{ t1!ls tgt'eetltetl€ 1E ry,:erra.t tlC'C`I4ret l tcZ lie v-,1d ow M-vi:?lil - Jnw enr othervvise, then oniv that term. C 4111cc or orovisio t shall be sTri ken fi-o 't th!':A#_'i-eenteil atilt: in dii C the icsoccb- this € ad; he 4ahd and k-oll#ttlue lit #tlfl [orce. eliec;€ Una u'pciatko 1. :. OIIF,I'FNDENT:SEPAILXTE CONT,NANTS. ?t o itt-id i` _"l;'L',t1 the paYtteti hereto €ita€ each Pl UaLiapil lte!eco. silall oe dee111eo tc c sc-i a-tc ,?i;;::Yt:t_'??e'??Ctt?lt /?l`F'eetllet`.t, 14. FINANCIAL DISCLOSURE: Fhe parties c:o tltrlll that. they have reitecl oft the ? .u•_. a.;ftr.? ? :IC?`Lil.,.i-<< `?? ?jt? 1.. __. F., t?,t ?R.?t_ i _ ? ,1 tiir? ,?ttt,.r- ae fey F}3'?i?r'('2?lC'61? ?t :h.' ,o'? ??t?^E1 t'`. ;"Lvrc'emenit d h giltttf ?:'14:E4i1t11ldtee?f'e dial there ha:, been 114} wit'!1al d1 sccivci il}F1e't??i.._d ??i tlieFr 01112(lttl`3 ki'v Jt'c-e action am that net€het' par€N i!as ifled an iotviz- 1tofy aaa ,i`. rec,tnreu by Section ; ,v{E1{ i}) C.+€ tilC VC11R5Y1WU1Id 1.}iv(11?.?. l,` si.rt? tt 1 t'1c _``]s''tlati of elther party to pursue a Calm iv!' ccjultaLiC di5tti0ji€ion, pursl41111 W Mc ,7¢lT%spft?i-c} fNvi,tt ,`f h 4YFIr.Zth ?r??ft i?t s1 c;t`tnf''irE?`t'..ttim,FlYiIn ,_;:' t.i`ii:11 lf? tile' t?atf E!l f ?tf'C UllftFl (}i tilts f??+_I"l'.inco't i[) It was not disclosed to the. ouse party or Ii15 or her counsel prior to the date of the within A.Qrcement is exnressiv reserved. In the event that either party. at anv time hereafter, discovers such an undisclosed asset. the party shall have the rip-ht to petition the Court of Common Pleas of Cumberland County to make equitable distribution ol 'said asset. -i'he non-disclosing party shall be responsible for payment of counsel fees, costs or expenses incurred by the other party in seeking equitable distribution of said asset. Notwithstanding the l-ores-oinLy this Agreement shall in all other respects remain in full force and ellect. M()l IM'ATION AND WAIVER: A modification or waiver of any of the nrovistons of this Aereernent shall be effective only if made in writing, and executed with the sarne t«riii,ciiity rrs this At?reeiiient. The failure of either paryv to insist upon strict perfomlance of anv of t tie nrovisions ofthis Aereement shalt not be construed as a waiver of anv subsequent defaults ofthe r?e1 tr0, ?9Zlrtt? -16- OPSCRIPTIVF HEADINGS: The descriptive headings used herein are for oonventence only. Thev shall have no affect whatsoever in determininIg the riarhts or oblii?atlons of the narlies. 7, arPPLICAtV LE LA'W: This Agreement shall be construed tinder the laws of rile commonwealth of Pennsvivania and more specifically under the Divorce Code of* 1980 and ativ •:x ?tZ F?rZ r{rtt r>r11C fli,-n-to JN WITNESS WHEREOF. the parties hereto have set their hands and seals the date and veer first above written. ?aa?' _? "&? PARRARA FFARNPAUCT-l -1 honjas M. Clark, Esquire 414 N;000RV FEA AIJGH ons C? ? ? <<::? t'' - r? ,?? -?-? '-.? W ? ry .. j,:,...'t Cs.7 '? BARBARA FEARNBAUGH, Plaintiff VS. THEODORE FEARNBAUGH, Defendant J IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 48-6698 CIVIL TERM CIVIL ACTION - LAW IN DIVORCE kFFIDAVIT OF CONSENT 1. A complaint in Divorce under §3301(c) of the Divorce Code was filed on November 12, 2008. 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 made herein are subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. z -oq Date Barbara Fearnbaugh Plaintiff ..? '?; ?„ ?? -i .? ? ? ?? C.3 ^+ BARBARA FEARNBAUGH, Plaintiff VS. THEODORE FEARNBAUGH, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 08-6698 CIVIL TERM 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 1. 1 consent to the entry of a final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees, or expenses if I do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. z-a? -off Date Barbara Fearnbaugh Plaintiff r T7 ?- -r ITI f V ? ?= >r BARBARA FEARNBAUGH, : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA vs. NO. 08-6698 CIVIL TERM THEODORE FEARNBAUGH, : CIVIL ACTION - LAW Defendant : IN DIVORCE AFFIDAVIT OF CONSENT 1. A complaint in Divorce under §3301(c) of the Divorce Code was filed on November 12, 2008. 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. 1 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 made herein are subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. 02 bd owl?r?? -- Date Theodore Fearnbaugfi Defendant 71 ?.GS M r BARBARA FEARNBAUGH, Plaintiff vs. THEODORE FEARNBAUGH, Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO. 08-6698 CIVIL TERM 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 1. I consent to the entry of a final decree of divorce without notice. 2. 1 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. 1 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 made herein are subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. Date Theodore Fearnbaugh Defendant r^" ? rv ? _h G"C7 ?? ? ?_.A+ y??: {, ? -??; ,?« .i "'` t... BARBARA FEARNBAUGH, Plaintiff VS. THEODORE FEARNBAUGH, Defendant : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA : NO. 08-6698 CIVIL TERM : CIVIL ACTION - LAW : IN DIVORCE PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry of a divorce decree: 1. Grounds for Divorce: Irretrievable breakdown under Section 3301(c). 2. Date and manner of service of the Complaint: The Defendant Accepted Service of the Complaint on November 14, 2008, said Acceptance of Service was filed with this Honorable Court on November 18, 2008. 3. Complete either Paragraph (a) or (b): (a) Date of execution of the Affidavit of Consent required by Section 3301(c) of the Divorce Code: By Plaintiff. February 20, 2009 ; By Defendant: February 20, 2009. (b) (1) Date of execution of the Affidavit required by Section 3301(d) of the Divorce Code: N/A (2) Date of filing and service of the Plaintiffs Affidavit upon the Respondent: NlA. 4. Related claims pending: All related claims were settled by a Marital Settlement Aueement dated February 20, 2009 and filed with the Court on February 23_, 2009 5. Complete either (a) or (b): (a) Date and manner of service of the Notice of Intention to File Praecipe to Transmit Record, a copy of which is attached: (b) Date Plaintiff s Waiver of Notice in Section 3301(c) Divorce was filed with the Prothonotary: February 23, 2009; Date Defendant's Waiver ofNotice in Section 3301(c) Divorce was filed with the Prothonotary: February 23, 2009. Respectfully submitted, COLGAN MARZZACCO LLC By: F"/- 4 ---. Thomas M. Clark, Esquire Attorney ID # 85211 Dated: 3 D 7 130 West Church Street Suite 100 Dillsburg, PA 17019 Phone: (717) 502-5000 Fax: (717) 502-5050 ALED-OFFICE CF Tf-? PR OTHICI OT,RY 2009 APR -7 PH l: 48 I 887118788 Barbara Fearnbaugh (n 1 K/4 BarhwL Oe+AL ) vs. Theodore Fearnbaugh ) CASE NO. 08-6698 QUALIFIED DOMESTIC RELATIONS ORDER Court of Common Pleas of Cumberland County, PA 1 Courthouse Square Carlisle PA 17013 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 Theodore Fearnbaugh, whose current address is 1215 Gross Drive, Mechanicsburg, PA 17050. (b) "Alternate Payee" shall mean Barbara Fearnbaugh, whose current address is 813 South Market Street, Mechanicsburg, PA 17055. (c) "Plan" shall mean Ahold USA, Inc. 401(k) Savings Plan for Salaried Associates. 2. This Order relates to marital property rights. 3. The Alternate Payee is the Participant's former spouse. 4. The Participant and Alternate Payee were married on 04/08/1995. 5. The Participant and Alternate Payee were legally separated or legally divorced on 11/12/2008. 6. The Alternate Payee's award will be calculated as of the date the award is segregated into the Alternate Payee's account. The date of segregation shall hereinafter be referred to as the "Valuation Date". 7. The Alternate Payee's interest in the Plan shall be $10,000.00 of the Participant's total vested account balance under the Plan as of the Valuation Date. 8. The Alternate Payee's award is not entitled to earnings (dividends, interest, gains and losses) from the Valuation Date to the date that the award is segregated from the Partici- pant'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. 9. In the event there is an outstanding loan balance as of the Valuation Date, the loan bal- ance will not be included for purposes of calculating the account balance to be divided. 10. The Alternate Payee's award will be paid proportionately from all investment options as of the date of account segregation. 11. 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. 12. All beneficiary designations will be made after qualification of the Order and segrega- tion of a separate account for the Alternate Payee pursuant to the administrative proce- dures established for the Plan. 13. Nothing contained in the Order shall be construed to require any Plan or Plan Adminis- trator to provide to the Alternate Payee any type or form of benefit or option not other- wise available under the Plan, to provide the Alternate Payee increased benefits (determined on the basis of actuarial value) not available to the Participant, or to pay any benefits to the Alternate Payee that are required to be paid to another Alternate Payee under another Order, which has been determined to be a QDRO before this Order is determined to be a QDRO. 14. 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 Ad- ministrator 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. .4.1 Attorney For Alternate Payee: Participant: Thomas Clark, Esq. Theodore Fearnbaugh (unrepresented) Colgan Marzzacco, LLC 1215 Gross Drive Judge of the Court: ` 130 West Church Street, Suite 100 Mechanicsburg, PA 17050 Dillsburg, PA 17019 Dated: ti ` t 1k 240 Track No: 887118788 ,3/3r/oq Barbara Fearnbaugh Date ` (n/k/a Barbara Detz) Plaintiff / Alternate Payee Thomas Clark, Esq. Date Attorney for Alternate Payee heod-re Fearnbaugh Date Defendant/Particip ant ADDENDUM TO DOMESTIC RELATIONS ORDER For Submission to Fidelity QDRO Administration ONLY Due to the Federal Privacy Act, many state courts prohibit the inclusion of personal data in pub- lic records to prevent identity theft. Therefore, please forward the following information sheet to Fidelity Employer Services Company LLC when you submit the court certified copy of your Do- mestic Relations Order. Do NOT file the Addendum with your court when you file your Domestic Relations Order. Name: Theodore Fearnbaugh Address: 1215 Gross Drive Mechanicsburg, PA 17050 SSN: 172-64-5405 Date Of Birth: 4/21/1971 Name: Barbara Fearnbaugh (n/k q 6w.bam Deta Address: 813 South Market Street Mechanicsburg, PA 17055 SSN: 170-58-3495 Date Of Birth: 4/4/1963 Name: N/A Address: N/A Phone Number: N/A Plan Number: 35846 Plan Name: Ahold USA, Inc. 401(k) Savings Plan for Salaried Associates Name: Thomas Clark Address: Colgan Marzzacco, LLC 130 West Church Street, Suite 100 Dillsburg, PA 17019 Phone Number: 717-502-5000 Client Name: Ahold USA, Inc. Client No: 000015930 In accordance with D.O.L Field Assistance Bulletin 2003-03, the Parties to the Domestic Rela- tions Order are notified as follows: Defined Contributions Plans are allowed to assess a fee for the review to determine whether the Order is "Qualified" Domestic Relations Order. Please consult the Plan's QDRO Approval Guidelines and Procedures to determine if the Plan assesses a fee for review and the amount of that fee. Please send your court certified copy of the Domestic Relations Order to: Attn: Ahold USA, Inc. Fidelity Investments P. O. Box 770003 Cincinnati, OH 45277-0066 Track No: 887118788 I ; ?l el D4z%c e , - &PC Ae ,,?009 Apr. /,- pot 6tm ber 1aKc,1 C'eu, 4y BARBARA FEARNBAUGH, V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA THEODORE FEARNBAUGH, NO. 08-6698 CIVIL TERM DIVORCE DECREE AND NOW, _ 40tP4 1LI am?. , it is ordered and decreed that BARBARA FEARNBAUGH, THEODORE FEARNBAUGH, bonds of matrimony. plaintiff, and 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.") 1voki, The terms and provisions of the Marital Settlement Agreement signed by the parties and dated February 20, 2009 are hereby incorporated but not merged in the Decree in Divorce and remain binding upon the parties. By the Attest: J. i Prothonotary U. oq Y ' -q aA4- APR 2 8 209Q? Barbara Fearnbaugh (n/k/a Barbara Detz) IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - LAW Theodore Fearnbauah Defendant NO. 08-6698 QUALIFIED DOMESTIC RELATIONS ORDER The parties to this action have entered into a Property Settlement Agreement dated February 2% 2009. The Court incorporated the Property Settlement Agreement into its Decree of Dissolution of Marriage dated ' 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 ("ERISA" ). It is intended to constitute a Qualified Domestic Relations Order ("QDRO") under Section 414(p) of the Code and Section 206(d)(3) of ERISA. 2. The Plan Name and Plan Administrator. The name of the Plan to which this Order applies is the Ahold USA, Inc. 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. Pension Plan. All correspondence relates to this Order should be sent to the following address: Ahold USA, Inc. Retirement Department P.O. Box 55829 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: Theodore Fearnbaugh 1215 Gross Drive Mechanicsburg, PA 17050 Date of Birth: April 21, 1971 Social Security No.: 172-64-5405 ?$ ! ; QDRO Page 2 5. Alternate Payee Information. The Alternate Payee's information is as follows: Barbara Fearnbaugh (n/k/a Barbara Detz) 813 South Market Street Mechanicsburg, PA 17055 Date of Birth: April 4, 1963 Social Security No.: 170-58-3495 6. Formula /Allocation Method. This Order hereby assigns to the Alternate Payee an amount equal to the actuarial equivalent of 50% of the Marital Portion of Participant's accrued benefit under the Plan (including any temporary or supplemental benefits that may become payable) as of the Participant's benefit commencement date, or the Alternate Payee's benefit commencement date, if earlier. For purposes of calculating Alternate Payee's benefit hereunder, the Plan Administrator is instructed to use, as applicable, the Participant's average compensation and/or benefit multiplier in effect as of the Alternate Payee's benefit commencement date. The Alternate Payee and Participant were married on April 8, 1995. The Marital Portion of Participant's Accrued Benefit shall be determined by multiplying the Participant's Accrued Benefit by a fraction, the numerator of which is the number of years and months of the Participant's creditable service under the Plan earned while married to the Alternate Payee, and the denominator of which is the total number of years and months of the Participant's creditable service under the Plan as of the earlier of the date the Participant permanently ceases to accrued benefits thereunder or the date the Alternate Payee commences to receive benefits hereunder. For this purpose, the marriage shall be treated as having terminated as of November 12, 2008. In addition to the above, the Alternate Payee shall receive a pro rata share of any postretirement cost-of-living adjustments or other economic improvements made to the Participant's benefits on or after the date of his retirement. Such pro rata share shall be calculated in the same manner as the Alternate Payee's share of the Participant's retirement benefits is calculated pursuant to this Section 6. If there should be a legal cause by which the Participant's benefits under the Plan may be offset by the amount of a judgment or settlement that the Participant is required to pay as a result of a crime involving the Plan, nevertheless, the award in this Order to the Alternate Payee shall be based on the Participant's benefits before any such offset. Notwithstanding the language set forth in this Section 6, in the event that the Alternate Payee becomes entitled to a qualified preretirement survivor annuity under Section 9 of this Order, then the Alternate Payee's right to a share of the Participant's benefits as called for under this Section 6 shall be terminated as of the date of the Participant's death, and such preretirement death benefit shall be payable to the Alternate Payee in lieu of any other benefits to which she may be entitled under the terms of this Order. 7. Form of Payment. The form of payments to be made to the Alternate Payee shall be in any form permitted under the terms of the Plan as of the date benefits commence to the Alternate Payee. However, the Alternate Payee's benefits shall not be distributed in the form of a qualified joint and survivor annuity. If the present value of the Alternate Payee's benefit is less than or equal to $5,000, the Plan Administrator will pay out the entire amount as a lump sum. The form of benefits paid to the Alternate Payee shall be based on the life expectancy of the Alternate Payee. Any actuarial reduction that might be necessary to convert Alternate Payee's benefits to one based on the Alternate Payee's lifetime shall be borne by the Alternate Payee. Further, QDRO Page 3 should any early commencement reduction be necessary in the event that the Alternate Payee commences her benefits prior to Participant's Normal Retirement Date, then such reduction shall be applied to Alternate Payee's benefits. The Alternate Payee shall be entitled to a pro rata share of any early retirement subsidy (including any temporary or supplemental benefits) provided under the Plan to the Participant on the date of his retirement, and in the event the Alternate Payee has already commenced her share of the benefits on the date of the Participant's retirement, then the amounts payable to the Alternate Payee shall be recalculated in accordance with the Plan Administrator's practices and the Plan's actuarial principles in order to provide the Alternate Payee with the pro rata share of such early retirement subsidy. Such pro rata share shall be calculated in the same manner as the Alternate Payee's share of the Participant's retirement benefits is calculated pursuant to Section 6 of this Order. 8. Commencement Date. The payments to be made to the Alternate Payee shall commence at such time as the Alternate Payee shall elect in accordance with the terms of the Plan. The Alternate Payee may elect benefit commencement on the first of any month concurrent with or after the Participant's Earliest Retirement Age (as defined in Section 414(pX4XB) of the Code), even if the Participant has not yet retired or elected to commence benefit payment and no later than the latest date as of which the Participant may elect to commence the payment of his benefits under the Plan. 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" (within the meaning of Section 414(p)(5) of the Code and Section 206(d)(3XF) of ERISA) for purposes of receiving death benefits payable to a surviving spouse under the terms of the Plan. This designation applies to the Marital Portion of the Participant's accrued benefit as set forth in Section 6 of this Order. The Alternate Payee shall be treated as the surviving spouse for the purposes of the preretirement survivor annuity benefits that are attributable to the Marital Portion of the Participant's accrued benefit and any subsequent spouse of the Participant shall not be treated as a surviving spouse for such purposes. In the event that the costs associated with providing this preretirement survivor annuity benefit are not fully subsidized by the Participant's employer, the Participant must make an affirmative election for such preretirement survivor annuity benefit coverage in a timely manner and in accordance with the Plan's election procedures. Further, if the Plan provides for any death benefit in excess of a qualified preretirement survivor annuity, the Alternate Payee shall be designated as the beneficiary with respect to the Alternate Payee's share of the Marital Portion of the excess death benefit payable. 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. If the Alternate Payee dies before commencement of the Alternate Payee's benefit, the Alternate Payee's benefit shall be canceled and shall revert to the Participant. 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 hereby agrees to make such 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. QDRO Page 4 11. The Participant shall not take any actions, affirmative or otherwise, that can circumvent the terms and provisions of this QDRO, or that could diminish or extinguish the rights and entitlements of the Alternate Payee as set forth herein. Should the Participant take any action or inaction to the detriment of the Alternate Payee, he shall be required to make sufficient payments directly to the Alternate payee to the extent necessary to neutralize the effects of his actions or inactions and to the extent of the Alternate Payee's full entitlements hereunder. 12. After payment of the amount required by this QDRO, the Alternate Payee shall have no further claim against the Participant's interest in the Plan. 13. 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 which 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. 14. 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 the necessary calculation of the benefit amounts contained herein. 15. 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. 16. 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. 17. 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. 18. Effect of Plan Termination. In the event that the Plan is terminated, where 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. QDRO Page 5 19. 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 Qualified Domestic Relations Order. Issues this Z it day of by Judge AGREED TO: &)tw,a- ? 0 ? v Plaintiff/Alternate Pay 0e Date Attorney for Plaintiff/ Date Alternate Payee efendant/Participant dow? Date j 20 5 Attorney for Defendant/ Date Participant !1 co f w r W