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HomeMy WebLinkAbout04-4700 SAlOIS SHUFF, FLOWER & LINDSAY AITORNEYS.AT.LAW 26 W. High Street Carlisle, PA \I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA RICHARD L. BAS OM, Plaintiff No. 2004 - J/7tJO ~ v. CIVIL ACTION - LAW JOYCE E. BAS OM, Defendant (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 maniage, you may request maniage counseling. A list of maniage counselors is available in the Office of the Prothonotary at the Cumberland County Court House, High and Hanover Street, 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 Date: 3epbrt0vc ~O I 2-004 SAIDIS, SHUFF, FLOWE By: ~fnji- clay: E quire Supreme Court ID # 87954 26 West High Street Carlisle, P A 17013 (717) 243-6222 Attorneys for Plaintiff Y SAlOIS SHUFF, FLOWER & LINDSAY ATrORNEYS.AT-LAW 26 W. High Street Carlisle. P A II IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA RICHARD L. BASOM, Plaintiff No. 2004 - v. CIVIL ACTION - LAW JOYCE E. BASOM, Defendant (In Divorce) COMPLAINT UNDER SECTION 3301(c) OR 3301(d) OF THE DIVORCE CODE COUNT I - DIVORCE 1. Plaintiff is Richard L. Basom, who currently resides at 2109 Cedar Run Drive, Apartment 105, Camp Hill, Cumberland County, PelIDsylvania. 2. Defendant is Joyce E. Basom, who currently resides at 75 Stonecrop Lane, Manchester, York 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 April 25, 2002 III York County, Pennsylvania. 5. Plaintiff and Defendant have been living separate and apart since June 16, 2004. 6. There have been no prior actions of divorce or for annulment between the parties. SAIDlS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LAW 26 W. High Street Carlisle, PA II 7. Plaintiff has been advised of the availability of marriage counseling and the Plaintiff may have the right to request that the Court require the parties to participate in counseling. Having been so advised Plaintiff does not desire the Court to order counseling. See Plaintiff s Affidavit attached hereto as Exhibit "A" and incorporated herein by reference. 8. The marriage is irretrievably broken. The foregoing facts are averred under Sections 3301(c) or 3301(d) ofthe Divorce Code of1980, as amended. WHEREFORE, Plaintiff requests Your Honorable Court enter a Decree in Divorce, thereby divorcing Plaintiff and Defendant from the bonds of matrimony. Respectfully submitted, Date: ~bu 2D 12004 SAIDIS, SHUFF, FLOWER ~ . - Yt..tK4 11v' /L.{J ~saydQMd~~uir Supreme c~c~ # 87954 26 West High Street Carlisle, PA 17013 (717) 243-6222 By: Attorneys for Plaintiff AFFIDAVIT I, Richard L. Basom, being duly sworn according to law, depose and say: (I) I have been advised ofthe availability of marriage counseling and understand that I may request that the court require that my spouse and I participate in counseling. (2) I understand that the court maintains a list of marriage counselors in the Prothonotary'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 unsworn falsification to authorities. Dated: \~.fVIhtt 20J 2004 ~7.~ Richard L. Basom, Plaintiff VERIFICATION I 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 unswom falsification to authorities. Dated: &t~W 20,1004 ~ 'If- ~ Richard 1. Basom, Plaintiff \ ~) '-- """ \\~ ,~ ~ ~ . ' , ~ ~ ~ ..-. "- ~ ~ ....... \, ,"", '^ v ~. I;\.. . '\ ~ lv " ~. ~ )J ....,.- SAlOIS SHUFF, FLOWER & LINDSAY A1TORNEYSeAT.UW 26 W. High Street Carlisle. P A IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA RICHARD L. BASOM, Plaintiff No. 2004 - 4700 v. CNIL ACTION - LAW JOYCE E. BASOM, Defendant (In Divorce) ACCEPTANCE OF SERVICE I, Joyce E. Basom, Defendant in the above-captioned matter, hereby accept service of the Complaint in Divorce, which was filed on September 20, 2004. Dated: ~ By: ~~as~m,~ 75 Stonecrop Lane Manchester, Pennsylvania 17345 () 11 A2~ n~J ,C,",' ;;: :.' , '~~j ;:^ ,.":~, ~~f"" i;~:-: ~ ~ ....., C'..> = .L- a ,-, o -0'"1 -'I -r fii;n :'9;t:t! -,1.J,,-' ()(1. "'i.J ffN~ :-"-t ~:B -<' """1:") ::z:: ~ c..~ N SAlOIS SHUFF, FLOWER & LINDSAY A'ITORNEVS.AT-LAW 26 W. High Street Carlisle, PA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA RICHARD L. BASOM, Plaintiff No. 2004 - 4700 v. CIVIL ACTION - LAW JOYCE E. BAS OM, Defendant (In Divorce) PROPERTY SETTLEMENT AND SEPARATION AGREEMENT THIS AGREEMENT is made this ~ day of ~, 2004, BY and BETWEEN Richard L. Basom of2l09 Cedar Run Drive, Apartment 105, Camp Hill, Pennsylvania, hereinafter referred to as Husband, A N D Joyce E. Basom of75 Stonecrop Lane, Manchester, York County, Pennsylvania, hereinafter referred to as Wife. REeIT ALS R.1: The parties hereto are Husband and Wife, having been joined in marriage on April 25, 2002, in York County, Pennsylvania; and R.2: Differences have arisen between the parties, in consequence of which they have lived separate and apart since on or about June 16,2004; and R.3: The parties have resolved that it is not possible to continue the marital relationship between them for reasons known to them, in consequence of which they are living separate and apart; and Page 1 of 12 SAlOIS SHUFF, FLOWER & LINDSAY ATIORNEYS.AT-LAW 26 W. High Street Carlisle, P A R.4: It is the desire and intention of the parties, after long and careful consideration, to amicably adjust, compromise and settle all property rights, and all rights in, to or against the property or estate of the other, including property heretofore or subsequently acquired by either party, and to settle all disputes existing between them, including any claims or rights that they may have under the provisions of the Pennsylvania Divorce Code, as amended; and R.5: The parties also desire to settle their issues of counsel fees and costs, and the settling of any and all claims and possible claims against the other or against their respective estates; and R.6: The parties desire to resolve all claims pending between them, including the settlement of all of their respective property rights and other rights growing out of their marriage relationship including, but not limited to, all matters between them relating to the ownership of real and personal property, claims for spousal support, alimony, alimony pendente lite, counsel fees and costs; and R.7: Husband and Wife declare that each has had a full and fair opportunity to obtain independent legal advice of counsel of their selection; that Husband has been independently represented by Lindsay Gingrich Maclay, Esquire, of Saidis, Shuff, Flower and Lindsay, and that Wife, cognizant of her right to obtain legal representation, declares that it is her express, voluntary and knowing intention not to avail herself of her right to counsel and chooses instead to represent herself with respect to the preparation and execution ofthis Agreement; and Page 2 of 12 SAlOIS SHUFF, FLOWER & LINDSAY ATIORNEYS'AT'L\W 26 W. High Street Carlisle. P A R.8: Both Husband and Wife each covenant that they have made full and complete disclosure to the other of his and her respective property holdings and income; and R.9: Each party has had an opportunity to verify the financial disclosure of the other. Discovery, if any, has been conducted to the satisfaction of each party. Each party has had the opportunity to investigate further the jinancial disclosure of the other, and has had access to any desired books and/or records to investigate further. Each party had an opportunity to do an independent valuation of the assets, liabilities and income of the other party. To the extent either party decided not to pursue further discovery and investigation, he or she did so voluntarily and specifically waives the right to challenge this Agreement based on the absence of full and fair disclosure. R.lO: The parties warrant and represent that they have made a full disclosure of all assets and liabilities and their valuation prior to the execution of this Agreement. This disclosure was in the form of an informal exchange of information by the parties but also reflects the fact that the parties had personal knowledge before their separation of their various assets and debts, all of which form the basis of this Agreement between the parties. NOW THEREFORE, with the aforegoing recitals being hereinatler incorporated by reference and deemed an essential part hereof and in consideration of the covenants and promises hereinafter to be mutually kept and performed by each party, as well as for other good and valuable consideration, receipt of which is hereby acknowledged, and the parties, intending to be legally bound, hereby agree as follows: Page 3 of12 SAlOIS SHUFF, FLOWER & LINDSAY A1TORNEYS'AT'LAW 26 W. High Street Carlisle, P A (1) SEPARATION: It shall be lawful for each party at all times hereafter to live separate and apart from the other party at such place or places as he or she from time to time may choose or deem fit, free from any control, restraint or interference from the other. Neither party will molest the other or endeavor to compel the other to cohabit or dwell with him or her by any legal or other proceeding. Neither party shall disparage or discredit the other in any way, nor in any way injur<e his or her reputation; nor shall either of them act or permit anyone else to act in any way which might tend to create any disaffection or disloyalty or disrespect between the members of the family of either party. Each party shall be free of the interference, authority or contact by the other as if he or she was single and unmarried except as maybe necessary to carry out the terms of this Agreement or any Custody Stipulation and Agreement and/or Order of Court. (2) DIVORCE: The parties acknowledge that the marriage is irretrievably broken and that they will secure a mutual consent no-fault divorce decree. Simultaneous with the execution of this Agreement, the parties agree to execute their respective Affidavits of Consent and Waiver of Notice Forms necessary to finalize said divorce. If either party fails or refuses to execute and file the foregoing documents, said failure or refusal shall be considered a material breach of this Agreement and shall entitle the other party at his or her option to terminate this Agreement. (3) REAL PROPERTY: Husband does not own any real property. The parties agree that Wife, individually, owns the residence more commonly identified as 75 Stonecrop Lane, Manchester, York County, Pennsylvania. Husband hereby relinquishes any right, title or interest he may have in and to said property and Wife hereby agrees to Page 4 of 12 SAlOIS SHUFF, FLOWER & LINDSAY A1TORNEYS.AT.LAW 26 W. High Street Carlisle, P A indemnify and hold Husband harmless with regard to any and all payments associated with the Stonecrop Lane residence. (4) DEBT: Each of the parties hereto covenants and agrees that he or she has not in the past and will not at any time in the future incur or contract any debt, charge or liability for which the other of them, their legal representatives, or their property or estate may become liable; and each of them further cov,mants at all times to keep the other free harmless and indemnified of and from all debts, charges and liabilities hereafter or heretofore contracted by them, except as hereinafter provided. A. MARITAL DEBT: Other than those debts enumerated within this agreement, Husband and Wife acknowledge and agree that there are no other outstanding debts and obligations which are marital or for which the other might be liable incurred prior to the signing of this Agreement. 1. Except as otherwise herein provided, each of the parties will pay all current bills and outstanding bills incurred on or before the date of separation of the parties, June 16,2004, to the same extent that he or she has been paying then in the past and neither party shall incur any unusual bill which will bind the other party. B: POST SEPARATION DEBT: In the event that either party contracted or incurred any debt since the date of separation on June 16, 2004, the party who incurred said debt shall be responsible for the payment thereof regardless of the name in which the debt may have been incurred. c: FUTURE DEBT: From the date of this agreement neither party shall contract or incur any debt or liability for which the other party or his or her property or estate might be responsible and shall indemnify and save the other party harmless from any and all claims or demands made against him or her by reason of debts or obligations incurred by the other party. Page 5 of12 SAlOIS SHUFF, FLOWER & LINDSAY ATIORNEVS-AT.LAW 26 W. High Street Carlisle. P A (5) MOTOR VEHICLES: The parties acknowledge that Husband, individually, holds title to a 1999 Volkswagon Jetta. Wife hereby relinquishes any right, title or interest she may have in and to Husband's Jetta. Husband shall maintain separate insurance on his vehicle. Husband specifically agrees to assume full responsibility for and pay in due course, any encumbrance on the Jetta and Husband shall hold Wife harmless and indemnify Wife from any loss thereon. The parties further acknowledge that Wife, individually, holds title to a 1998 Buick Century. Husband hereby relinquishes any right, title or interest he may have in and to Wife's Buick. Wife shall maintain separate insurance on the Buick. Wife specifically agrees to assume full responsibility for and pay in due course, any encumbrance on the 1998 Buick and Wife shall hold Husband harmless and indemnify Husband from any loss thereon. (6) TANGIBLE PERSONAL PROP]~RTY: The parties hereto mutually agree that they have effected a satisfactory division ofthe furniture, household furnishings, appliances, tools and other household personal property between them, and they mutually agree that each party shall from and after the date hereof be the sole and separate owner of all such property presently in his or her possession whether said property was heretofore owned jointly or individually by the parties hereto. This Agreement shall have the effect of an assignment or bill of sale from each party to the other for such property as may be in the individual possession of the parties hereto. (7) INTANGIBLE PERSONAL PROPERTY; Each party hereto hereby relinquishes any right, title or interest he or she may have in or to any intangible personal property currently titled in the name of or in the possession of the other party, Page 6 of12 SAlOIS SHUFF, FLOWER & LINDSAY ATIORNEYS-AT.LAW 26 W. High Slreel Carlisle, P A I' I including, but not limited to, stocks, bonds, insurance, bank accounts, individual retirement accounts, employment benefits, including retirement accounts, savings plans, pension plans, stock plans, 401K plans, and the like. A list of each parties' respective property, income and holdings is attached hereto as an Exhibit. Husband's list is attached hereto as Exhibit "A" and is incorporated herein by reference and Wife's list is attached hereto as Exhibit "B" and is incorporated herein by reference. Each party hereto waives, one unto the other, any right, title or interest they may have in and to the respective property as outlined on each Exhibit. (8) LIFE INSURANCE: To the extent that either party had life insurance, each party waives, one unto the other, any right, title or interest they may have in and to the life insurance policy of the other by virtue of their marriage relationship. Each party shall be permitted to name anyone he or she wishes as the designated beneficiary under his/her life insurance policy. (9) WAIVER of ALIMONY: The parties acknowledge that each has income and assets satisfactory to meet his and her own reasonable needs. Each party waives any claim he or she may have, one against the other, for alimony, spousal support or alimony pendente lite. (10) ATTORNEY'S FEES: Except as otherwise provided herein, each of the parties waives the right to receive a payment for counsel fees from the other, and each shall be responsible for his or her own counsel fees, costs and expenses, if such fees or expenses are incurred. (11) ADVICE of COUNSEL: The parties hereto acknowledge and declare that each has had a full and fair opportunity to obtain independent legal advice of counsel of Page 7 of 12 SAIDIS SHUFF, FLOWER & LINDSAY AITORNEYS-AT.LAW 26 W. High Street Carlisle, P A their selection; that Husband has been independently represented by Lindsay Gingrich Maclay, Esquire, of Said is, Shuff, Flower and Lindsay, and that Wife, cognizant ofherright to legal representation, declares that it is her express, voluntary and knowing intention not to avail herself of her right to counsel and chooses instead to represent herself with respect to the preparation and execution ofthis Agreement. Each party acknowledges and accepts that this agreement is, under the circumstances, fair and equitable, and that it is being entered into freely and voluntarily after having received such advice and with such knowledge as each has sought from counsel, and the execution of this agreement is not the result of any duress or undue influence, and that it is not the result of any improper or illegal agreement or agreements. (12) ADDITIONAL INSTRUMENTS: Except as otherwise herein provided, each of the parties shall from time to time, at the request of the other, execute, acknowledge and deliver to the other party, within five (5) days of any request to do so, any and all further instruments that may be reasonably required to give full force and effect to the provisions of this Agreement. (13) INCOME TAX: The parties hereto agree to file separate income tax returns for all ongoing years, specifically including 2004 and 2005. (14) BANKRUPTCY: The parties hereby agree that the provisions of this Agreement shall not be dischargeable in Bankruptcy and expressly agree to reaffirm any and all obligations contained herein. In the event a party files such bankruptcy and pursuant thereto obtains a discharge of any obligations assumed hereunder, the other party shall have the right to declare this Agreement to be null and void and to terminate this Agreement in which event the division of the parties' marital assets and all other rights determined by this Page 8 of 12 SAlOIS SHUFF, FLOWER & LINDSAY ATIORNEYS.AT-LAW 26 W. High Street Carlisle, P A Agreement, including alimony, shall be subject to court determination the same as if this Agreement had never been entered into. (15) COMPLETE DISCLOSURE: The parties do hereby warrant, represent, acknowledge and agree that each is funy and completely informed of, and is familiar with, the wealth, real and personal property, estate and assets, earnings and income of the other and has made any inquiry he or she desires into the income or estate of the other and received any such information requested. Each has made a full and complete disclosure to the other of his and her entire assets, liabilities, income and expenses and any further enumeration or statement thereof in this Agreement is specifically waived. ( 16) WAIVER of APPRAISALS: The parties acknowledge that they are aware of their respective rights pursuant to the Pennsylvania Divorce Code to obtain formal valuations or appraisals of the real estate, the personal property, the vehicles, retirement accounts and businesses, some or all of which were acquired during the marriage and therefore constitute marital property. However, the parties have determined that they will not undertake the expense to have these items appraised and/or valuated, and that the division of property as set forth in this agre1ement, represents a fair and equitable distribution. (17) RIGHTS and RESPONSIBILITIES: Husband and Wife acknowledge that each of them has read and understand his and her rights and responsibilities under this Agreement and that they have executed this Agreement under no compulsion to do so but as a voluntary act. Page 9 of 12 SAIDIS SHUFF, FLOWER & LINDSAY ATIORNEYS.AT.LAW 26 W. Hlgb Street Carlisle. P A (18) FULL SETTLEMENT: Except as herein otherwise provided, each party hereby releases the other from any and all claims, or demands up to the date of execution hereof. It is further specifically understood and agreed by and between the parties hereto that each party accepts the provisions herein made in lieu of and in full settlement and satisfaction of any and all of said party's rights against the other for past, present and future claims on account of spousal support, maintenance, alimony, alimony pendente lite, counsel fees, costs and expenses, equitable distribution of marital property and any other claims of the party, including all claims which have been raised or may be raised in an action for divorce. (19) RELEASE of ALL CLAIMS: Except as otherwise provided herein, each party releases and discharges completely and forever the other from any and all right, title, interest or claim of past, present or future spousal support, division of property, including income of gain from property hereafter accruing, right of dower or curtesy, the right to act as administrator or executor of the estate of the other, the right to a distributive share of the other's estate, any right of exemption in the estate of the other, or any other property rights, benefits or privileges accruing to either party by virtue of their marriage relationship, or otherwise, whether the same are conferred by statutory or common law of the Commonwealth of Pennsylvania, or any other state, or of the statutory or common law of the United States of America. Except as provided herein, the parties specifically waive any and all rights that they may have to equitable distribution of marital property and/or alimony and counsel fees, except those counsel fees sought in the event of a breach of this Agreement, or any other marital rights as provided in the Pennsylvania Divorce Code, Act 26 of 1980 or any amendment thereto. Page 10 ofl2 SAlOIS SHUFF. FLOWER & LINDSAY ATIORNEYS.AT.LAW 26 W. High Street Carlisle, P A It is further specifically understood and agreed by and between the parties hereto, that each party accepts the provisions herein made in lieu of and in full settlement and satisfaction of any and all of said parties' rights against the other for any past, present and future claims on account of spousal support; maint,mance; alimony; alimony pendente lite; counsel fees, costs and expenses, except those counsel fees, costs and/or expenses sought in the event of a breach of this Agreement; equitable distribution of marital property and any other claims of each party, including all claims raised by them in the Divorce action to be filed between the parties. (20) SEPARABILITY of PROVISIONS: If any term, condition, clause or provision of this agreement shall be determined or declared to be void or invalid in law or otherwise, then only that term, condition, clause or provision shall be stricken from this Agreement and in all other respects this agreement shall continue in full force, effect and operation. (21) GOVERNING LAW: All matters affecting the interpretation of this Agreement and the rights of the parties hereto shall be governed by the laws of the Commonwealth of Pennsylvania. (22) INCORPORATION into DIVORCE DECREE: The Parties agree that 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. Upon entry of the Decree, the provisions of this Agreement shall be incorporated by reference or in substance, but they shall not be deemed merged into such Decree. The Agreement shall survive any such Decree in Divorce, shall be independent thereof, and the parties intend that all obligations contained in this Agreement shall retain their contractual nature in any enforcement Page 11 of 12 SAIDIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LAW 26 W. High Street Carlisle, PA proceedings, whether enforcement is sought in an action on the contract itself at law or in equity, or in any enforcement action filed to the Divorce Caption. (23) BREACH: In the event that either party breaches any provision of this Agreement, he or she shall be responsible for any and all costs incurred to enforce the Agreement, including, but not limited to, court cost and counsel fees of the other party. In the event of breach, the other party shall have the right, at his or her election; to sue for damages for such breach or to seek such other and additional remedies as may be available to him or her. (24) ENTIRE UNDERSTANDING: This Agreement constitutes the entire understanding between the parties and there are no covenants, conditions, representations, or agreements, oral or written, of any nature whatsoever, other than those herein contained. (25) AGREEMENT BINDING on PARTIES and HEIRS: It is understood and agreed that not only the parties hereto, but also their heirs, administrators, executors and assigns, shall be bound by all the terms, conditions and clauses of this Agreement. IN WITNESS WHEREOF, the parties hereto, intending to be legally bound hereby, have hereunto set their hands and seals to this Agreement the day and year first above written. WITNESS: ~1.~ Richard L. Basom ~~s: ~ RLB t<..,1!3 JEB~ Page 12 of 12 Exhibit ".A" Exhibit "A" Assets 1999 Vo1kswagon Jetta $5,000 IBM Group Life Insurance, Policy # GX16000 $15,000.00 AARP, NY Life Insurance Policy #A1234727 Income U.S. Army Retirement - $379.95 per month IBM Retirement - $790.56 per month Social Security - $1,207.60 per month Exhibit ""B" Exhibit "B" Assets 75 Stonecrop Lane, Machester, York County, Pennsylvania 1998 Buick Century Certificate of Deposit (Waypoint Bank) #7100004528 - valued at $5,324.85 on or about April 23, 2002 Checking Account (Waypoint Bank) #0800007578 -. approximate balance on or about April 23,2002 was $857.01 Checking Account (Waypoint Bank) #2000006765 -- approximate balance on or about April 23,2002 was $703.00 Savings Advantage #5500015086 - approximate balance on or about April 4, 2002 was $1,721.99 Savings (Waypoint Bank) #0802118721 - approximate balance on or about April 23, 2002 was $4,326.24 Magnus Group Profit Sharing (401K) - approximate balance on or about December 31, 2001 was $35,333.97 Prudential Life Insurance Policy #564601761 - $1,760.55 as of September 1, 1998 Prudential Life Insurance Policy #63043-562 - $5,104.05 Prudential Life Insurance Policy #63028-990 - $10,942.00 Prudential Mutual Fund # 03900355938 - $11,630.41 Prudential Variable Annuity #96-105-929 - $14,996.22 (cash surrender value) prudential Variable Annuity #96-114-454 - $12,716.14 Prudential Disc. Select #E0153459 - $12,807.39 Progressive Life Insurance Policy through Information Technologies OCT 0 1 2004 1 Q ,- c.> - ".> C'~') (,'::.:;, ..r.';'~ D C) -. , (," o "T1 ';:f n',']] r"... -,:)(q ,-:~I'"J (') r _-~-lC) ~,t~ ~.. , ,-:!j :>;... (~') ()IT, ;-::/ 1:'.. 'CJ --(' SAIDIS SHUFF, FLOWER & LINDSAY A1TORNEYS'AT'LAW 26 W. High Street Carlisle, P A IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA RICHARD L. BAS OM, Plaintiff No. 2004 - 4700 v. CIVIL ACTION - LAW JOYCE E. BASOM, Defendant (In Divorce) AFFIDAVIT OF CONSENT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filcd on September 20, 2004. 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 in Divorce after service of the Notice of Intention to Request Entry of a Divorce Decree. I verify that the statements made in this Affidavit 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. Date: UeUIYlbl.'t Z2.,iD04 r ~ / ~~,.} ------ RICHARD L. BASOM, Plaintiff ,-; c. ~ ,-,. SAlOIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LAW 26 W. High Street Carlisle, PA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA RICHARD L. BASOM, Plaintiff No. 2004 - 4700 v. CIVIL ACTION - LAW JOYCE E. BASOM, Defendant (In Divorce) AFFIDAVIT OF CONSENT COMMONWEALTH OF PENNSYLVANIA ) SS. COUNTY OF CUMBERLAND ) 1. A Complaint in Divorce under Section 3301(c) of the Divorce Code was filed on September 20, 2004. 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 in Divorce after service of the Notice of Intention to Request Entry of a Divorce Decree. 1 verify that the statements made in this Affidavit 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. Date:OrrLWlI1~A 22./2M~ ~<--<- ~ ~~------ J Y E E. BAS OM, Defendant , " , ,\ .\ ( " - SAlOIS SHUFF, FLOWER & LINDSAY ATIQRNEYS-AT.LAW 26 W. High Street Carlisle, PA II I IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA RICHARD L. BASOM, Plaintiff No. 2004 - 4700 v. CIVIL ACTION - LAW JOYCE E. BASOM, Defendant (In Divorce) 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. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses in do not claim them before a Divorce is granted. 3. I understand that I will not be divorced until a Divorce Decree lS entered by the Court and I further understand that a copy of the Decree wi 11 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 to the bcst of my knowledge, information, and belief. I understand that falsc statements hcrein are made subject to the penalties of 18 Pa. C.S. 94904, relating to unsworn falsification to authorities. Date: DemVlhfA 22, 2DO~ /lu..fc..t1..1 7 l)..<f.4-0r? RICHARD L. BASOM, Plaintiff SAlOIS SHUFF, FLOWER & LINDSAY ATTORNEYS-AT-LAW 26 W. High Street Carlisle, PA IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA RICHARD L. BAS OM, Plaintiff No. 2004 - 4700 v. CIVIL ACTION - LAW JOYCE E. BASOM, Defendant (In Divorce) WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER !l3301(c) OF THE DIVORCE CODE 1. I consent to the entry of a final Decree of Divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses ifI 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 I further understand that a eopy of the Decree will be sent to mc immediately after it is filed with the Prothonotary. I verify that the statements made in this Waiver are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein arc made subject to the penalties of 18 Pa. C.S. 94904, relating to unsworn falsification to authorities. Date: 'oW m'ruA 22 1004 , ~W~~. ~. J E. BAS OM, Defendant .\ SAlOIS SHUFF, FLOWER & LINDSAY AITORNEYS.AT.l.AW 26 W. High Street Carlisle, P A IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA RICHARD L. BASOM, Plaintiff No. 2004 - 4700 v. CIVIL ACTION - LA W JOYCE E. BASOM, Defendant (In Divorce) PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Please transmit the Record, together with the following infonnation, to the Court for entry of a Decree in Divorce: 1. Ground for Divorce: irretrievable breakdown under Section 3301(c) of the Divorce Code. 2. Date and manner of service of the Complaint: Defendant accepted service of the Complaint in Divorce by executing an Acccptance of Service on September 22, 2004. 3. As required by Section 330] (c) of the Divorce Code, both PlaintiJI and Defendant executed and filed their respective Affidavits of Consent on December 22,2004. 4. Related claims pending: None. A Property Separation and Scttlement Agreement was executed on October 6, 2004. 5. As required by Section 3301 (c) of the Divorce Code, Plaintiff and Defendant executed and filed their respective Waivcr of Notice fonus on December 22,2004. Date: flw~ 2Qj1Dd SAH;>IS, SHUFF, FLOWER & LlNDSA Y ) ...----.. - - - By: .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :+ot"''''''' :+: ;t;:f;+::f.'f. . . ;t;:.;;t;;+::f.:f.'f.'I':+:'I' '+. 'f::+:to '+ "":I';f '" ,., "":t; ~ +' Of 'Ii 'f. :+;+::+:+ + Of. 'to 'I':+: 'f. ;+;:+: '+':+:+ '+ . .. IN THE COURT OF COMMON PLEAS OFCUMBERLANDCOUNTY STATE OF PENNA. RICHARD L. BASOM, Plaintiff No. 2004-4700 (Civil Term) VERSUS JOYCE E. BASOM, Defendant DECREE IN DIVORCE AND NOW, 1_ua.y , ;;<>oS-, IT IS ORDERED AND / / . DECREED THAT RICHARD L. BASOM , PLAINTIFF. AND JOYCE R RI\SOM , DEFENDANT, ARE DIVORCED FROM THE BONDS OF MATRIMONY. THE COURT RETAINS JURISDICTION OF THE FOLLOWING CLAIMS WHICH HAVE BEEN RAISED OF RECORD IN THIS ACTION FOR WHICH A FINAL ORDER HAS NOT YET BEEN ENTERED; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .,;+; '" :+: +' T T + :+ ++ None. The parties' Property Settlement and Separation Agreement dated October 6, 2004, is herein incorporated but not merged. By THE COUR~/ PROTHONOTARY .. 'I' "':+ '+ +:+ Of' Of.:+ '+' + + Of "":f. Of' ... . .. + :+'1'+'+''+'+;+:'1' ;+: :+;'+>+''+0'*''1'+'1':+ . . . . . . . . . . . . . . . . . . . . , , . . . . . . . . . , . . . . . . , . , . . . . . . . . . . , . . , . . . . . . . J. . jL . .../7/'1'"1/ 7.lJ:.1[/ 1'77" '::2 (I . /' L. .' /7.;/'~'Y7/ hf7/ r'{/ "7:7J1td Jl;?/"J .7-'/ (I . " :-;j T..:.1 ,/ fV [iI - -------