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HomeMy WebLinkAbout10-3606Lindsay Gingrich Maclay, Esquire DALEY ZUCKER MEILTON MINER & GINGRICH, LLC 1029 Scenery Drive Harrisburg, PA 17109 (717) 6574795 JtnacIAy(@dznunglaw.com P11.Ei)- 'YTCE t,NP ENE P,?TF,%, nT`M 2010 JUN -2 AM 10: 30 CUMKFIL ! iD i -UNTY PENNSYLVXtiA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER, Plaintiff No. 10 - 3100(0 li1Vi ! 1'?? V. ROGER K. POTTEIGER, Defendant CIVIL ACTION - LAW (In Divorce) NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take prompt action. You are warned that if you fail to do so, the case may proceed without you and a decree of divorce or annulment may be entered against you by the Court. A 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 Court House, One Courthouse Square, Carlisle, Pennsylvania. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. Cumberland County Bar Association 32 South Bedford Street Carlisle, Pennsylvania 17013 (717) 249-3166 DALEY ZUCKER MEILTON MINER & GrNGRIC ,LLC Date: 2:112alt? By: ODn sayGi h M lay, Esq i e eme urt ID # 87954 1029 Scenery Drive Harrisburg, Pennsylvania 17109 -4470-SO P D A-M-1 Attorneys for Plaintiff C, qO4 p# aq a9Y/ 66 Lindsay Gingrich Maclay, Esquire DALEY ZUCKER MEILTON MINER & GINGRICH, LLC 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 1mac1ay(a,dzmmg1aw. corn IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER, Plaintiff ; No. V. CIVIL ACTION - LAW ROGER K. POTTEIGER, : Defendant (In Divorce) COMPLAINT UNDER & 3301(c) OR & 3301(d) OF THE DIVORCE CODE COUNT I - DIVORCE 1. Plaintiff is Kristine E. Potteiger, who currently resides at 669 Lindsey Road, Carlisle, Cumberland County, Pennsylvania. 2. Defendant is Roger K. Potteiger, who also currently resides at 669 Lindsey Road, Carlisle, Cumberland County, Pennsylvania. 3. Plaintiff and Defendant have been bona fide residents in the Commonwealth for at least six (6) months immediately previous to the filing of this Complaint. 4. Plaintiff and Defendant were married on January 4, 1986, in Carlisle, Cumberland County, Pennsylvania. 5. Two children were born of this marriage, namely: Jessica E. Potteiger, whose date of birth is June 28, 1991; and Levi J. Potteiger, whose date of birth is June 16, 1999. 6. There have been no prior actions of divorce or for annulment between the parties. 7. The parties have been advised of the availability of marriage counseling and their ability to request that the Court require the parties to participate in counseling. They have been further advised that they can obtain a list of counselors from the Cumberland County Prothonotary's Office. Having been so advised Plaintiff does not desire the Court to order counseling. See Plaintiffs Affidavit attached hereto as Exhibit "A" and incorporated herein by reference. 8. Neither Plaintiff nor Defendant is a member of the United States armed forces. 9. The cause(s) of action and section(s) of Divorce Code under which Plaintiff is proceeding are: A. Section 3301(c). The marriage of the parties is irretrievably broken. After ninety (90) days have elapsed from the date of the filing of this Complaint, Plaintiff intends to file and Affidavit consenting to a divorce. Plaintiff believes that Defendant may also file such an Affidavit. B. Section 3301(d). The marriage of the parties is irretrievably broken. The Plaintiff and Defendant separated simultaneously with the filing of this Complaint in Divorce. WHEREFORE, Plaintiff requests your Honorable Court to enter a Decree in Divorce, divorcing plaintiff and Defendant from the bonds of matrimony. COUNT II - EQUITABLE DISTRIBUTION 10. Paragraphs 1 through 9 of this Complaint are incorporated herein by reference as though set forth in full. 11. Plaintiff and Defendant have acquired property, both real and personal, during their marriage which is subject to equitable distribution by the Court. WHEREFORE, Plaintiff requests this Honorable Court to equitably divide all martial property. COUNT III - ALIMONY 12. Paragraphs 1 through 11 of this Complaint are incorporated herein by reference as though set forth in full. 13. Plaintiff has no adequate means of support for herself and is unable to support herself through appropriate employment. 14. Plaintiff requires reasonable support to adequately maintain herself in accordance with the standard of living established during the marriage. 15. Defendant has the means by which to support Plaintiff. WHEREFORE, Plaintiff requests your Honorable Court to enter an award of Alimony in her favor. COUNT IV - ALIMONY PENDENTE LITE COUNSEL FEES AND EXPENSES 16. Paragraphs 1 through 15 of this Complaint are incorporated herein by reference as though set forth in full. IT Plaintiff lacks sufficient funds to support herself and pay Counsel fees and expenses incidental to this action. 18. Defendant is able to pay Plaintiff Alimony Pendente Lite, counsel fees and expenses incidental to this divorce action. WHEREFORE, Plaintiff requests your Honorable Court to enter an award of Alimony Pendente Lite, and of Plaintiff's counsel fees and the costs of this proceeding. Respectfully submitted, DALEY ZUCKER MEILTON MINER & GINGRICH, LLC Date: By: ! L' say Gi h clay, Esq 're upreme Court ID # 87954 1029 Scenery Drive Harrisburg, Pennsylvania 17109 Attorneys for Plaintiff Exhibit "A" AFFIDAVIT I, Kristine E. Potteiger, being duly sworn according to law, depose and say: (1) I have been advised of the availability of marriage counseling and understand that I may request that the court require that my spouse and I participate in counseling. (2) 1 understand that the court maintains a list of marriage counselors in the Prothonotaty's Office, which list is available to me upon request. (3) Being so advised, I do not request that the court require that my spouse and I participate in counseling prior to a divorce decree being handed down by the court. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unworn falsification to authorities. Dated: stine E. P0 tte' er, Plaints VERIFICATION I, Kristine E. Potteiger, verify that the statements made in this Complaint are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. Dated: aS . X20 (? ?, )? S' e E. Pott ger, Plainti .~ Lindsay Gingrich Maclay, Esquire DALEY ZUCKER MEILTON MINER &GINGRICH, LLC 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 lmaclay~a,dzmmglaw.com ~- ,: ...~. 2010 JU~d 29 A~ ~~ i ~3 -. . cur~~~~.,~:~~~ w.,~:~~ IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER, Plaintiff v. ROGER K. POTTEIGER, Defendant No. 2010-3606 CIVIL ACTION -LAW (In Divorce) AFFIDAVIT OF SERVICE I, Lindsay Gingrich Maclay, Esquire, being duly sworn according to law, deposes and says that I am an attorney at law duly authorized to practice in the Commonwealth of Pennsylvania, and that on the 8th day of June, 2010, I did serve upon Roger K. Potteiger, Defendant in the foregoing case, a true and correct certified copy of the June 2, 2010 Divorce Complaint, by sending a copy of same to Roger K. Potteiger via certified mail, restricted delivery, return receipt requested to 669 Lindsey Road, Carlisle, Pennsylvania, 17013. A copy of the Return Receipt is attached hereto as Exhibit "A". Sworn to and subscribed before me this c; ~h ~_ 1 ay of _ ~ , 2010 By: ~~ f COMMONWEALTH OF PENNSYLVANIA NOTARIAL SEAL Gloria M Rine, Naaty Public Lower Paxton Tow~1~p, Dauphin meaty My commission, exrires November 15, 2011 DALEY ZUCKER MEILTON MINER 8Z GINGRICH, LC L' say Gin is ac a ,Esquire tt rney I.D. o. 879 ~ 1029 Scenery Drive Harrisburg, PA 17109 (717) 657-4795 .~ rn u7 - - ' • ~~ ~ . . • ~-1- • ~ _ rn ~, a ` 9 ®l43 a ~ U Q Retum Receipt Fee (Er~doreemerrt Required) ~ ~ ~ ~ RestMxed Delivery Fee (EndoreemeM Required) • F `/ ~ ~ fU Tote) FoeteOe & Fees ,$ I ~' ~' 1 S ~ O O o a~~~. _~~..t~~.s.~ ..~'oacl ~ I~lisle, ~"°'~""~ p~ ~~13 • ofrlpies ienna ,, 2..nd 3. aNO oan,plsa +~ a a Ae.aioa~a D.w«y+. ce.M.d. ^ wlnt your ftsnts arW afifU~sss on the fstrofse a. that w. can ifiltlxfl tits aasd tp you. • /lroh this sand to ttts t~aolc tithe rrtdipkas, Of Oft th0 tlt]flt a apao~ ~serlils. 1. break Arldieesed to: MY~ ~agcr ~. ~ po~i9e~ V~q u nc~Sey ~~ X '""_ 0 B. ( C. /rUrapd OWwey V~~+~p D. M addess dMbrent 1Yam Nam 1? O Ytes M YE3, snbr deNvery address below: ^ Pb O lrrr..d NWl O C.OA. 4. Reshtotsd t)eNrsr~ ~ ~d Nn L ~' 7gD4 289© n0t11 391Q 5311 (IhrrsN-'ttoa~+irfjrlM~li~f111 ~.~ P3 Form 3811, fabrrafy ttttW Daaeess t~felrn ~.ee+pt iozena.~a-~,B,o IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER, -, Plaintiff No. 2010-3606 : := M M V. CIVIL ACTION - LAW =zF r Xc.; ROGER K. POTTEIGER, Defendant (In Divorce) r - -°? AFFIDAVIT OF CONSENT = C) - 1. A Complaint in Divorce under §3301(c) of the Divorce Code was filed on June 2, 2010. 2. The marriage of Plaintiff and Defendant is irretrievably broken and at least 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 in Divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this Affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. §4904, relating to unworn falsification to authorities. Date: 2 Is /I z' WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER.43301(c) OF THE DIVORCE CODE I . 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. 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 Waiver are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsifications to authorities. i t Ib-L- Date: tin , E. Potteiger, Plainti IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER, ; n r Plaintiff No. 2010-3606 c n r- _v' V. CIVIL ACTION - LAW i ROGER K. POTTEIGER 7Z ' , Defendant (In Divorce) ?' - AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under §3301(c) of the Divorce Code was filed on June 2, 2010. 2. The marriage of Plaintiff and Defendant is irretrievably broken and at least 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 in 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 cot7-ect. 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: T -3 ?Z Roger K. Po rger, Defend - t WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER §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. 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 Waiver are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904 relating to unsworn falsifications to authorities. Date: Roger K. P eiger, Defen ant Lindsay Gingrich Maclay, Esquire DALEY ZUCKER MEILTON MINER & GINGRICH, LLC 635 N. 120i Street, Suite 101 Lemoyne, PA 17043 (717) 724-9821 Imaclay(a)dzmm$law.com FILED-OFFICE OF THE RROTHONOTAR"I 2012 FEB 21 PM 2: 05 cu NNSYLVANIA T IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER, Plaintiff V. ROGER K. POTTEIGER, Defendant (In Divorce) PRAECIPE TO WITHDRAW ECONOMIC CLAIMS To the Prothonotary: Plaintiff hereby withdraws Count II, Equitable Distribution; Count III, Alimony; Count IV, Alimony Pendente Lite, Counsel Fees and Expenses of the Divorce Complaint which was filed on June 2, 2010 in the above-captioned matter. Respectfully submitted, DALEY ZUCKER MEILTON MINER & GINGRICH, LLC DATE: By: r Gi h M c ay, Es C I.D. 87954 Ouprein 635 N. 12th Street, Suite 101 Lemoyne, PA 17043 (717) 724-9821 Attorneys for Plaintiff No. 2010-3606 CIVIL TERM CIVIL ACTION - LAW Lindsay Gingrich Maclay, Esquire DALEY, ZUCKER MEILTON MINER & GINGRICH, LLC 635 N. 12'h Street, Suite 101 Lemoyne, PA 17043 (717) 724-9821 lmaclay@dzmmglaw.com i= 4i.cl)-Q? FiC?. OF THE PROTHONOTARY 2012 FEB 21 PM 2: 05 CUMBERLAND COUNTY IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER, Plaintiff V. : ROGER K. POTTEIGER, Defendant No. 2010-3606 CIVIL ACTION - LAW (In Divorce) PRAECIPE TO TRANSMIT RECORD To the Prothonotary: Transmit the record, together with the following information, to the Court for entry of a Divorce Decree: 1. Ground for divorce: irretrievable breakdown under § 3301 (c) of the Divorce Code. 2. Date and manner of service of the complaint: Defendant was served certified mail, return receipt requested, restricted delivery on June 8, 2010. An Affidavit of Service was filed on June 29, 2010. 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 Plaintiff, Kristine E. Potteiger, on February 3, 2012; by Defendant, Roger K. Potteiger, on February 3, 2012. Said Affidavits were filed on February 6, 2012. (b)(1) Date of execution of the Affidavit required by § 3301 (d) of the Divorce Code: N/A. (2) Date of filing and service of the Plaintiff's Affidavit upon the respondent: N/A. 4. Related claims pending: NONE. 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: N/A. (b) Date of execution of the Waiver of Notice: by Plaintiff, Kristine E. Potteiger, on February 3, 2012; by Defendant, Roger K. Potteiger, on February 3, 2012. Said Waivers were filed on February 6, 2012. Respectfully submitted, DALEY ZUCKER MEILTON MINER & GINGRICH, LLC DATE: By: i i ay Gin c Ma ay, Esau p eme Co I.D. 87954 635 N. 12th Street, Suite 101 Lemoyne, PA 17043 (717) 724-9821 Attorneys for Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER V. ROGER K. POTTEIGER DIVORCE DECREE AND NOW, ?2 , 14 1Z. it is ordered and decreed that KRISTINE E. POT EIGER , plaintiff, and ROGER K. POTTEIGER , 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.") NONE. By the Court, NO. 2010-3606 CIVIL TERM r Attest: J. Prothonotary 2 •-Ay /2 • a/? rofl 'ell eo f yI x/o fic e WC?//Ic,/ ? /?? ef (wry owe" Ao w A -5c?i e?r- /7?p Kristine E. Potteiger IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION - LAW (IN DIVORCE) Roger K. Potteiger NO. 2010-3606 (Civil Term) Defendant CENTRAL PENNSYLVANIA TEAMSTERS RETIREMENT INCOME PLAN 1987 QUALIFIED DOMESTIC RELATIONS ORDER I. Identifying Information 1. The Participant is Roger K. Potteiger. The Participant's Social Security number and date of birth are contained in an Addendum to this QDRO. The Participant's address is 2045 West Trindle Road, Carlisle, PA 17015. 2. The Alternate Payee is Kristine E. Potteiger. The Alternate Payee's Social Secity number and date of birth are contained in an Addendum to this QDRO. The Alternate Payee's address is 820 Forge Road, Carlisle, PA 17015. 3. This Order applies to benefits under the Central Pennsylvania Teamsters Retirement Income Plan 1987. 4. The parties were married on January 4, 1986, and separated on June 2, 2010. 5. The parties have raised claims of equitable distribution of marital property pursuant to the Pennsylvania Divorce Code. II. Method of Dividing Participant's Benefits The Central Pennsylvania Teamsters Retirement Income Plan 1987 shall pay to the Alternate Payee a portion of the Participant's vested accrued benefit under the Plan. The Alternate Payee shall receive a benefit equal to 50.0% of the Participant's vested account balance as of January 31, 2012. The Alternate Payee's benefit shall be credited with net income, loss or expense from January 31, 2012, until the date the Alternate Payee's share of the account is segregated on her behalf. 2. The Fund shall separately account for the benefits awarded in Paragraph 1 of this Section II as soon as administrable after this Order is determined to be a QDRO. The Alternate Payee's share of the account shall be credited with net income, loss or expense from the date of account segregation until the date benefits are distributed to the Alternate Payee. The Alternate Payee may elect to receive payment from the Plan in any form in which benefits may be paid under the Plan to the Participant (other than in the form of a joint and survivor annuity). QDRO Page 2 4. The Alternate Payee may select a beneficiary to receive her benefits in the event the Alternate Payee should die prior to receiving all of her benefits by filing a beneficiary designation form with the Fund Office. In the event the Alternate Payee should die prior to receiving benefits, the Plan shall pay benefits to a beneficiary selected by the Alternate Payee on a beneficiary form provided by the Fund Office on request, or if no beneficiary is selected, to the Alternate Payee's estate. 5. The Alternate Payee may elect to receive payment from the Plan at the Participant's earliest retirement age or, if earlier, at the earliest date permitted under the Plan. For purposes of this paragraph, the Participant's earliest retirement age means the earlier of W the date on which the Participant is entitled to a distribution under the Plan, or (ii) the later of (a) the date the Participant attains age 50 or (b) the earliest date on which the Participant could begin receiving benefits under the Plan if the Participant separated from service. III. Other Provisions 1. This Order is not intended, and shall not be construed in such a manner as, to require the Plan Administrator: (a) to provide any form of benefit option not otherwise provided under the terms of the Plan; (b) to require the Plan to provide increased benefits determined on the basis of actuarial value; or (c) to require the payment of any benefits to the Alternate Payee under another order which previously was deemed to be a Qualified Domestic Relations Order. 2. For federal income tax purposes, the Alternate Payee and not the Participant shall be treated as the distributee for all benefits made by the Plan to the Alternate Payee pursuant to this Order. The Fund will issue a Form 1099-R to the Alternate Payee with respect to each calendar year in which the Alternate Payee receives benefits and will report such income to the IRS under the Alternate Payee's name and Social Security number. 3. This Order is intended to constitute a qualified domestic relations order within the meaning of Section 414(p) of the Internal Revenue Code of 1986, as amended and Section 206(d) of the Employee Retirement Income Security Act of 1974, as amended, and shall be interpreted in a manner consistent with such intention. 4. The Court shall retain jurisdiction to amend this Order to the extent necessary to establish or maintain its status as a qualified domestic relations order. 5. It is recognized that the Alternate Payee may elect to commence receiving benefits before the Participant retires. If the Alternate Payee so requests, the Participant will cooperate with the Alternate Payee in substantiating a claim or application to the Fund QDRO Page 3 and shall provide any documentation or information reasonably necessary to establish their eligibility for benefits. EXECUTED this /* 7 day of , 241 BY THE COURT udge CONSENT TO ORDER: A4 L q),. ?3 i-Z f d - I Pl 'nti Alternate Pa ee Date -- jf Defend articipant Date c I 4 _ .?1??L 1302 Lf ey f Taint' ? Date Attor Defendant! Date e e ye AIternat Participan eAP.c'S ,nQ,le? ?//s/ice M r I '11 M N ?G r...x ip 'C C-3 c's -rl ?s C' CSC ?? I'i"1 ./ Kristine E. Potteiger IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA VS. CIVIL ACTION -- LAW (IN DIVORCE) Roger K. Potteiger NO. 2010-3606 (Civil Term) Defendant CENTRAL PENNSYLVANIA TEAMSTERS DEFINED BENEFIT PLAN QUALIFIED DOMESTIC RELATIONS ORDER I. Identifying Information 1. The Participant is Roger K. Potteiger. The Participant's Social Security number and date of birth are contained in an Addendum to this QDRO The Participant's address is 2045 West Trindle Road, Carlisle, PA 17015. 2. The Alternate Payee is Kristine E. Potteiger. The Alternate Payee's Social Security number and date of birth are contained in an Addendum to this QDRO. The Alternate Payee's address is 820 Forge Road, Carlisle, PA 17015. This Order applies to benefits under the Central Pennsylvania Teamsters Defined Benefit Plan. 4. The parties were married on January 4, 1986, and separated on June 2, 2010. The parties have raised claims of equitable distribution of marital property pursuant to the Pennsylvania Divorce Code. II. Method of Dividing Participant's Pension Assignment of Benefit to Alternate Payee: The Alternate Payee is hereby assigned a portion of the Participant's vested accrued benefit under the Plan. The Fund is to make payment of the Alternate Payee's benefits directly to the Alternate Payee. The Alternate Payee shall be entitled to 50% of the Participant's vested monthly benefit accrued under the Plan as of January 31, 2012. In addition, the Alternate Payee shall receive any postretirement cost-of-living adjustments or other economic improvements associated with the Participant's vested accrued benefit assigned to the Alternate Payee and made to the Participant's benefits on or after the date of his retirement. 2. Form of Benefits: The Alternate Payee is entitled to a separate interest. This means the benefit shall be paid by the Plan in the form of a single life annuity over the life expectancy of the Alternate Payee determined on an actuarial basis. This form of benefit includes a three-year certain feature. If the Alternate Payee should die prior to receiving 36 months of benefits, the Plan shall pay benefits for the number of months remaining in the three-year period to a beneficiary selected by the Alternate Payee on a QDRO Page 2 beneficiary form provided by the Fund office on request, or if no beneficiary is selected, to the surviving spouse, or if none, to the Alternate Payee's estate. The death of the Participant will not have an effect on the Alternate Payee's receipt of benefits. 3. Commencement of Payments to the Alternate Payee: The Plan may commence payment to the Alternate Payee at the Participant's earliest retirement age. For purposes of this Order, the Participant's earliest retirement age is the earlier of (i) the date on which the Participant is entitled to a distribution under the Plan or (ii) the later of (a) the date the Participant attains age 50 or (b) the earliest date on which the Participant could begin receiving benefits under the Plan if the Participant separated from service, regardless of whether the Participant has actually retired. 4. Early Retirement Subsidies: The Alternate Payee shall be entitled to a pro rata share of any early retirement subsidy (including the CMMB and the Rule of 82-85) that is payable to the Participant at retirement. If the Alternate Payee commences benefits before the Participant retires, then the amounts payable to the Alternate Payee will be increased, effective on the date the Participant commences receipt of benefits, on a prospective basis. 5. If the Participant dies before the Alternate Payee commences receipt of her benefits, the Alternate Payee's receipt of benefits shall not be affected. If the Alternate Payee dies before she commences receipt of her benefits, then the Alternate Payee's share shall revert to the Participant, if permitted under the terms of the Plan; otherwise, the Alternate Payee's share shall revert to the Plan. III. Other Provisions 1. This Order is not intended, and shall not be construed in such a manner as, to require the Plan Administrator: (a) to provide any form of benefit option not otherwise provided under the terms of the Plan; (b) to require the Plan to provide increased benefits determined on the basis of actuarial value; or (c) to require the payment of any benefits to the Alternate Payee under another order which previously was deemed to be a Qualified Domestic Relations Order. For federal income tax purposes, the Alternate Payee and not the Participant shall be treated as the distributee for all benefits made by the Plan to the Alternate Payee pursuant to this Order. The Fund will issue a Form 1099-R to the Alternate Payee with respect to each calendar year in which the Alternate Payee receives benefits and will report such income to the IRS under the Alternate Payee's name and Social Security number. It is recognized that the parties may need to provide certain information to the Fund Office. If the Fund Office or the Alternate Payee so requests, the Participant will QDRO Page 3 cooperate with the Alternate Payee in substantiating a claim or application to the Fund and shall provide any documentation or information reasonably necessary to establish eligibility for benefits. 4. This Order is intended to constitute a qualified domestic relations order within the meaning of Section 414(p) of the Internal Revenue Code of 1986, as amended and Section 206(d) of the Employee Retirement Income Security Act of 1974, as amended, and shall be interpreted in a manner consistent with such intention. 5. The Court shall retain jurisdiction to amend this Order to the extent necessary to establish or maintain its status as a qualified domestic relations order. EXECUTED this day of 49? , 2V BY THE COURT f Judge CONSENT TO ORDER; Pi in iff/Alternate ayee Date efendant/Participa Date t ney ain ff/ Date Al ernate ayee Ali WMI/ .11. 'L - Att r r Defendant/ Date Participant rn ? -0 w = U1 2p 3 co CO C' r'nF OM ' © ;Z7 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA KRISTINE E. POTTEIGER, Plaintiff No. 2010-3606 CIVIL TERM V. CIVIL ACTION - LAW `" ``' �.- ROGER K. POTTEIGER, "' 1 _<_1 I Defendant (In Divorce) � PRAECIPE ->C-- w < TO THE PROTHONOTARY: Kindly withdraw the appearance of Daley Zucker Meilton Miner & Gingrich, LLC, as counsel for Plaintiff in the above-captioned matter. Daley Zucker Meilton Miner& Gingrich, LLC Date: - Sandra L. Meilton, Es ire Attorney I.D.No. 325t1 635 N. 12`' Street, Suite 101 Lemoyne, PA 17043 (717) 724-9821 smeilton @dzmmglaw.com Kindly enter the appearance of Lindsay Gingrich Maclay, Esquire as counsel for the Plaintiff in the above-captioned matter. Law Offices of Peter J. Russo, P.C. Date: L' say G' g ch clay, Esq re 0 6 East rindle Road, Suite 203 Mechanicsburg, PA 17050 (717) 591-1755 lgmaclay @pjrlaw.com