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Home My WebLink About05-2945 LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION - LAW : IN DIVORCE KEVIN ROY SEIFRIT, Defendant : NO. 05- .;191../$ CIVIL TERM 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 right important to you, including custody or visitation of your children. When the ground for the divorce is indignities or irretrievable breakdown of the marriage, you may request marriage counseling. A list of marriage counselors is available in the Office of the Prothonotary, Cumberland County Courthouse, Carlisle, Pennsylvania. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR 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, P A 170 \3 (717) - 249-3166 AMERICANS WITH DISABILITIES ACT OF 1990 The Court of Common Pleas of Cumberland County is required by law to comply with the Americans with Disabilities Act of 1990. For information about accessible facilities and reasonable accommodations available to disabled individuals having business before the court, please contact our office. All arrangements must be made at least 72 hours prior to any hearing or business before the court. You must attend the scheduled conference or hearing. 4 LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION - LAW : IN DIVORCE KEVIN ROY SEIFRIT, Defendant : NO. 05- ,.l. q.p' CIVIL TERM COMPLAINT UNDER !l!l3301(a)(5),(a)(6),(c), and (d) OF THE DIVORCE CODE, Title 23 The plaintiff, Lisa Dawn Seifrit, by her attorneys, the Family Law Clinic, sets forth the following cause of action: I. Plaintiff is Lisa Dawn Seifrit, who currently resides at 8 Wilbert Drive, Carlisle, Cumberland County, Pennsylvania. 2. Defendant is Kevin Roy Seifrit, who currently is incarcerated at Dallas State Correctional Institution, Follies Road, Drawer K, Dallas, Pennsylvania. 3. Plaintiff has been a bona fide resident of Cumberland County and the Commonwealth for at least six months immediately previous to the filing of this Complaint. 4. The plaintiff and defendant were married on November 2, 200 I, in Newville, Pennsylvania. 5. Plaintiff and defendant have lived separate and apart since August 16,2002. 6. There have been no prior actions of divorce or for annulment between the parties. 7. The marriage is irretrievably broken. . 8. Plaintiff has been advised that counseling is available and that plaintiff or defendant may have the right to request that the court require the parties to participate in counseling. 9. Defendant assaulted the plaintiff on August 16,2002 by punching the plaintiff and also punched a hole in the plaintiff's bedroom wall. As a result, defendant pled guilty to violating 18 Pa.C.S. !i 2709 (a)(l). This offense constituted a parole violation, and defendant was re-incarcerated at State Correctional Institution Dallas to serve the remainder of a previously imposed eight to sixteen year prison sentence. To date, defendant remains incarcerated at SCI Dallas. His maximum release date is May 2, 2009. A true and correct copy of the "Notice of Board Decision," also known as the "Green Sheet," directed to Kevin Seifert, indicating denial of parole on September 9, 2004 is attached hereto as Plaintiff's Exhibit "A" and incorporated herein by reference. 10. Defendant, by his actions, has offered such indignities to the innocent and injured spouse as to render Plaintiff's condition intolerable and life burdensome. WHEREFORE, plaintiff requests the court to enter a decree of divorce dissolving the marriage. -- . - Date: JvV/< 7, ?-oo5' , - IA f:/ /kub~ DO~l 1. Boorstein Certified Legal Intern ~1W4-S: ~~ THOMAS M. PLACE ROBERT E. RAINS LUCY JOHNSTON-WALSH ANNE MACDONALD-FOX Supervising Attorneys F AMIL Y LA W CLINIC 45 North Pitt Street Carlisle, P A 17013 Phone: (717) 243-2968 Fax: (717) 240-5204 717/243-2968 VERIFICATION I verifY that the statements made in the foregoing complaint are true and correct, to the best of my knowledge, information and belief. I understand making any false statement would subject me to the penalties of 18 Pa.C.S. S 4904, relating to unsworn falsification to authorities. Date to /q 10 5 / I -.. cG[ih'1)!1 ;t,lrt Lisa Dawn Seifrit I Plaintiff NAME: KE:VIN ROY SEIFERT INSTITUTION: SCI- DALLAS C0M1\10NWEALTHOFPENNSYL V ANIA BOARD OF PROBATION AND PAROLE 1101 S. Front Sl(\!(lj Illirri.bw'll. Po, 17Wo! - 2519 NOTICE Of' B01\fm DECISIOl\ PAROLE 00: 805AK INSTrnJT10N NO: BW13557 AS RECORDED ON SEPTEMBE:R 09, 2004 THE BOARD OF PROBATION AND PAROLE RENDERED THE FOLLOWING DECISION IN YOUR CASE: FOLLOWING AN INTERVIEW WITH YOU AND A REVIEW OF YOUR FILE. AND HAVING CONSIDERED ALL MATTERS REQUIRED PURSUANT TO THE PAROLE ACT OF 1941, AS AMENDED, 61 P.S, !\ 331,1 ET SEa,. THE BOARD OFPFlOBATION ANn PAROLE, IN THE EXERCISE OF ITS DISCRETION, HAS DETE:RMlNED AT TH1S TIME THAT: YOUR BEST INTERESTS DO NOT JUSTIFY OR REQUIRE YOU BEING PAROLED/REPAflOlED; AND, mE INTERESTS OF THE COMMONWEALTH WILL B'EIN.,lIJRED IF You WERE PAROLEDJREPAROlED, THEREFORE, you ARE REFUSED PAROlEJREPAROlE AT THIS TIME, THE REASONS FOR THE BOARD'S DECISION INCLUDE THE FOLLOWING: -YOUR VERSION OF THE NATURE AND CIRCUMSTANCES OF THE OFFENSE/B) COMMITTED. .YOURLACl< OF REMORSE FOR THE OFFENSE(S) COMMITTED. -YOUR PRIQfl HISTORY OF SUPERVISION FAIUJRE/B): -REPORTS, EVALUATIONS AND AsseSSMENTS CONCERNING YOUR PHYSICAL, MENTAL AND BEHAVIOR CONDITION AND HISTORY. .YOUR INTERVIEW WITH THE HEARING EXAMINER ANO/GRBOARD MeMSER. YOU WILl. BE REVIEWED IN OR AFTER AUGUST, 2005, AT YOUR NEXT INTERVIEW. THE BOARD WilL REVIEW YOUR ALE AND CONSIDER: WHETHER YOU HAVE PARTICIPATED IN/SUCCESSFULLY COMPLETED A TREATMENT PROGRAM FOR: SEX OFFENDERS PHASE 3. (CONTINUE ON PAGE 2) PAROLE VIOLATION MAX DATE: 05102/2009 FILE COPY Nltri;:.e.afF.lnotd n,),:kil..uI Pl/t-I.P J$({lK/(U) I I,D I PAROLE NO: BOSAK (CONTINUED FROM PAGE 1 \ WHETHER YOU HAVE MAINTAINED A FAVORABLE RECOMMENDATION FOR REPAROLE FROM THE DEPARTMENT OF CORRECTIONS. WHETHER YOU HAVE RECeIVED A CLEAR CONDUCT RECORD ANDCOMPlET,ED THE DEPARTMENT OF CORRECTIONS' PRESCRIPTIVE PROGRAM<S). YOUR EFFORTS TO SECURE AN APPROVED HOME PLAN Will BESUBMIITED TO THE BOARD AT THE TIME OF REVIEW. UPDATED MENTAL HEALTH EVALUATION AND SEX OFFENDER PROGRAMEVALUAT10N TO BE AVAILABLE AT riME OF REVIEW. LAH 0910912004 PAROLE VIOLATION MAX DATE: 05102I2009 FILE COpy d~ -r: JnU- LaWranoe'l=. Murray Board Secretary Nulb:enl Do.ard I~UlI~ P'Bf'p 1 S<I.IJL.)):J)' "" 0 "" ~ c = ~ :.:;:.,. "'-> ;F~'-:t~ c.n '-- :r! = ~.,,-.~ m~ ""'"'"~ >-f I -0 . U) CD? () P' """ :;j~ :x (j:D ',,0 z Orn =2 ._, N ,1> VI ::0 .< LISA DA WN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION-LAW : IN DIVORCE : OJ' : NO. -0l9~ CIVIL TERM KEVIN DAWN SEIFRIT, Defendant PRAECIPE TO PROCEED IN FORMA PAUPERIS To the Prothonotary: Kindly allow Lisa Seifrit, through her attorneys, the Family Law Clinic to proceed in forma pauperis. The Family Law Clinic, attorneys proceeding in forma pauperis, certifies that we believe the party is unable to pay the costs and that we are providing free legal service to the party. Respectfully Submitted, ~Boni/i- Do 1 J. Boorstein Certified Legal Intern ~1~:2~'v{~1_ ROBER . INS THOMAS M. PLACE LUCY JOHNSON-WALSH ANNE MACDONALD-FOX Supervising Attorneys THE FAMILY LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 (717) 243-2968 o C.: ;;:~;. ;"r :::j -< ....., = =, "-" L. ~~ ~ ~ m:n r- ::om _(JO g(L :r.'-rl O:n ";;:0 5rn ~ -< I \.0 "'" :Ji:: N U'j LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION - LAW : IN DIVORCE KEVIN ROY SEIFRIT, Defendant : NO. 05-2945 CIVIL TERM NOTICE TO DEFENDANT If you wish to deny any of the allegations set forth in this affidavit, you must file a counter-affidavit within twenty days after this affidavit has been served on you or the statements will be admitted. PLAINTIFF'S AFFIDAVIT UNDER SECTION 3301(d) OF THE DIVORCE CODE 1. The parties to this action separated on August 16, 2002, and have continued to live separate and apart for a period of at least 2 years. 2. The marriage is irretrievably broken. 3. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divorce is granted. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. S 4904, relating to unsworn falsification to authorities. 1~/I'7-J /\L Date: It'' I J C! J / I d" ~\ ,/ ,( { '/'J.,<.~ I "( (/) (A... fJcJI,~ [ isa Dawn Seifrit Plaintiff Sjt.Lf , I Q ~~? t--' c:;::.> .:,::.;.1 U' c- <;:~ --- .----------.-.. . - (..,) o -n .-1 :I:--I\ rnp" -0 I'"' .~~ ,(;')fCt ~:::;\ -or:':,. ~p .....(~ ~ -' -.1~.'" - C;'? - s::- LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION - LA W : IN DIVORCE KEVIN ROY SEIFRIT, Defendant : NO. 05-2945 CIVIL TERM AFFIDAVIT OF SERVICE I, ~~ ~ ~ ' hereby certify that I am a competent adult and that I personally served a true and correct copy of the Complaint for Divorce and the Plaintiff s Affidavit Under Section 330l(d) of the Divorce Code on the Defendant, Kevin Roy Seifrit, at the State Correctional Institution at Dallas in Dallas, Pennsylvania at /J,: 1/J a.m~ on the A day of ~rvL. 2005. /' I verify that the statements made in this certificate are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. S 4904, relating to unsworn falsification to authorities. Date: rl?;?tl' /5; tlCltJS: / ' ~k~#?/V Signature C) r-,' ~ = c: = c..n , '- -1 :J:-n ~~.~ rnp -0 li1 N :QY (::3~~;;~ ;':", 2~~~S ':}.;: " ill .-~')rn ~::\ U1 ~ ..... LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION - LAW : IN DIVORCE KEVIN ROY SEIFRIT, Defendant : NO. 05-2945 CIVIL TERM NOTICE OF INTENTION TO REOUEST ENTRY OF & 330Hd) DIVORCE DECREE TO: KEVIN ROY SEIFRIT DEFENDANT You have been sued in an action for divorce. You have failed to answer the complaint or file a counter-affidavit to the S 3301(d) affidavit. Therefore, on or after August 15, 2005, the other party can request the court to enter a final decree in divorce. If you do not file with the prothonotary of the court an anSWllr with your signature notarized or verified or a counter-affidavit by the above date, the court can enter a final decree in divorce. A counter-affidavit which you may file with the prothonotary is attached to this notice. Unless you have already filed with the court a written claim for economic relief, you must do so by the above date or the court may grant the divorce and you will lose forever the right to ask for economic relief. The filing of the form counter-affidavit alone does not protect your economic claims. YOU SHOULD TAKE THIS PAPER TO YOUR LA WYER AT ONCE, IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAYBE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 South Bedford Street Carlisle, P A 17013 (717) - 249-3166 .. ..... " .,... " . , ." .'C" . LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v. : CIVIL ACTION - LAW : IN DIVORCE KEVIN ROY SEIFRIT, Defendant : NO. 05-2945 CIVIL TERM CERTIFICATE OF SERVIC]~ I, Douglas James Boorstein, hereby certify that on the 26th day of July, 2005, I served a true and correct copy of a Notice of Intention to Request Entry of a S 3301 (d) Divorce Decree and a Counter-Affidavit Under S 3301(d) of the Divorce Code on Kevin Seifrit by first class U.S. mail, addressed as follows: Mr, Kevin Seifrit Inmate Number BW8557 Follies Road, Drawer K Dallas, PA 18612-0286 Date: ~/Z ~/zoor FAMILY LAW CLINIC 45 Nordl Pitt Street Carlisle, PA 17013 .. ",' " .. , .. ,...:> c::~::> r~1 .:.1' o -n .-\ .-,- H"i <- c' i^ \".,) C':i ---::'> C) CO LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYL VANIA v. : CIVIL ACTION - LAW : IN DIVORCE KEVIN ROY SEIFRIT, Defendant : NO. 05-2945 CIVIL TERM COUNTER-AFFIDAVIT UNDER & 330Hd) OF TilE DIVORCE CODE 1. Check either (a) or (b): (a) I do not oppose the entry of a divorce decree. [ ] (b) I oppose the entry of a divorce decree becaus,e (Check (i), (ii), or both): (i) The parties to this action have not lived separate and apart for a period of at least two years. [ ] (ii) The marriage is not irretrievably broken. l><I 2. Check either (a) or (b): (a) I do not wish to make any claims for economi,; relief. I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim them before a divon:e is granted. [><I (b) I wish to claim economic relief which may include alimony, division of property, lawyer's fees, expenses, or other important rights. [ ] I understand that in addition to checking (b) above:, I must also file all of my economic claims with the prothonotary in writing and serve them on the other party. IfI fail to do so before the date set forth on the Notice ofIntention to Request Divorce Decree, the divorce decree may be entered without further notice to me, and I shall be unable therea:fter to file any economic claims. I verify iliat the statements made in iliis counter-affidavit are true and correct. I understand that false statements herein are made subject to 18 Pa.C.S. S 4904, relating to unsworn falsification to auiliOfities. Date: 7~2 fi'~ oS- ~ -tf!. ~ :;?'~'- Bld,y'sS7 Kevin Roy Seifrit, Defendant NOTICE: If you do not wish to oppose the entry of a divorce decree and you do not wish to make any claim for economic relief, you should not file this counter-affidavit. ~!~::~~. NOIMIAL: SEAL ~'fSOM SMlERWlNE, ~ JacksoIIlbWnShIPr I..UZllI1le I4Y Comm~sston EXjlIreI ~ 2, 2 ~ o uJ:z: 90 tL-~' '.I- .J- 90 @\$: :duJ U-::c >- 15 U") ..::r ,. - - 2 \0 (.!) :::> '"" LI"> = = <'-' ~ ?. ::)~r.. 0= , ,;Z: I."~. "'L '-8'* 'J '~;,.'?' ..,..~~ :':J(:a ,,\} 0.. '.....';>> :s (.) , . '. " "," ,', ' ' .' " LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYL VANIA v, : CIVIL ACTION - LAW : IN DIVORCE KEVIN ROY SEIFRIT, Defendant : NO, 05-2945 CIVIL TERM AFFIDAVIT OF CONSENT L A Complaint in Divorce under 9330 I (c) of the Divorce Code was filed on June 9,2005 and served on the defendant on June 15,2005, 2, The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. 3, I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree, I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa,C,S, 94904, relating to unsworn falsification to authorities, Date: I 2-/ l & / 0 5 ~~rDtDusY /.~ Lisa Dawn Seifrit, Plai iff c) "\1 f'c -:,'; \.C ------- " ... LISA DAWN SEIFRlT, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v, CIVIL ACTION-LAW DIVORCE KEVIN ROY SEIFRIT, Defendant NO, 05-2945 CIVIL TERM MOTION FOR APPOINTMENT OF MASTER Ms, Lisa Seifrit, Plaintiff, through her counsel, the Family Law Clinic, moves the court to appoint a Master with respect to the following claims: (X) Divorce ( ) Annulment ( ) Alimony ( ) Alimony Pendente Lite () () () () Distribution of Property Support Counsel Fees Costs and Expenses Plaintiff, in support of the motion, states: 1, Discovery is complete as to the claim for which the appointment of a master is requested, 2, Plaintiff filed for divorce on June 9, 2005 under ~S 3301(a)(5),(a)(6),(c) and (d) of the Divorce Code, The divorce complaint did not include counts for Custody, Alimony, Equitable Distribution, or Alimony Pendente Lite, 3, Defendant was served with the divorce complaint on June 15,2005, 4, Defendant filed a Counter-Affidavit on July 28, 2005 under 3301(d) of the Divorce Code contesting the irretrievable breakdown of the marriage, 5, The claim for Divorce does not involve complex issues of law and/or fact. 6, A hearing is expected to take one hour. " ... WHEREFORE, Plaintiff requests that a master be appointed to hear the Divorce claim, .~/;~ ' :; '/. ["?t- o Date ~ ,.:::' ;C:"'- ,0// /~ J--'" '.;//,' . "c/, /;. / ,_,."" / / /b t~ /' p::;,," /d' /l // Lauren Navalkowsky ;./ Certified Legal Intern (/ ? c- 'i(J (<<2.. 7'-)1 C/ FAMILY LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 717.240.2968 (', ~', - i . LISA DAWN SEIFRlT, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v, CIVIL ACTION-LAW DIVORCE, CUSTODY KEVIN ROY SEIFRIT, Defendant NO, 05-2945 CIVIL TERM ORDER APPOINTING MASTER AND NOW. this )}:h day ofj/l\ftAJ' 1 ,2006, Robert Elicker, Esquire, is appointed master with respect to the following claim: Divorce under ~~i 3301(a)(6) and (d) of the Divorce Code regarding indignities and irretrievable breakdown, ~coo;(-;;:n , ~v \f \(&~~ 1. ~,(') , \", , ,,~'l Lisa Seifrit, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v, : CIVIL ACTION - LAW : IN DIVORCE Kevin Seifrit, Defendant : NO, 05 - 2945 CIVIL TERM WAIVER OF NOTICE OF INTENTION TO REOUEST ENTRY OF A DIVORCE DECREE UNDER 11330Hc) OF THE DIVORCE CODE I, I consent to tI1e entry of a final decree of divorce witl10ut notice, 2, I understand that I may lose rights concerning alimony, division of property, lawyer's fees or expenses if I do not claim tI1em before a divorce is granted. 3, I understand that I will not be divorced until a divorce decree is entered by the Court and tI1at a copy of tI1e decree will be sent to me immediately after it is filed with tI1e prothonotary, I verify tI1at tI1e statements made in 'this affidavit are true and correct. I understand that false statements herein are made subject to tI1e penalties of 18 Pa,C,S, S4904 relating to unsworn falsification to autl1orities, Date &/;~Jt% / <~ r-' c~ g; ~~ (--: :6- - (.oJ ~ ..... ""'1:-n rflp -;l~ =-~jl)-~ ~~'~"':'.~--\ ;"-'~r) <'1'"\ '-.' '~.l. ))j :.<; -0 _(C~ .- - .' ;;;- $"- Lisa Seifrit, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYL VANIA v. : CIVIL ACTION - LA W : IN DIVORCE Kevin Seifrit, Defendant : NO. 05-2945 CIVIL TERM AFFIDAVIT OF CONSENT 1. A Complaint in Divorce under ~~ 330l(c) of the Divorce Code was filed on June 9, 2005. 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S. 94904, relating to unsworn falsification to authorities. ~((~ Kevin Seifrit, Defendant Date?-~ 06 "'''.) = C:) ::::;:> '-1 0..." ::;:] I..C (:) CJ"! LISA DAWN SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY , PENNSYLVANIA vs. NO. 05 - 2945 CIVIL KEVIN ROY SEIFRIT, Defendant : IN DIVORCE WAIVER OF NOTICE OF INTENTION TO REQUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301fC) OF THE DIVORCE CODE 1. I consent to the entry of a [mal 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 THE FOREGOING AFFIDAVIT ARE TRUE AND CORRECT. I UNDERSTAND THAT FALSE STATEMENTS HEREIN ARE MADE SUBJECT TO THE PENALTIES OF 18 PA.C.S, SECTION 4904 RELATING TO UNSWORN FALSIFICATION TO AUTHORTIES. ~r R-o b DATE: ~j r- .Jj~~~ Kevin Roy Seifrit () c"~ r' r....:> <= c~ o~ <- c I.D :I:;" -," ...1J. o (J-t LISA DAWN SEIFRIT, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA Vs. NO. 05 - 2945 CIVIL KEVIN ROY SEIFRIT, Defendant IN DIVORCE ORDER OF COURT AND NOW, this IQ~ day of ~ filed affidavits of Qonsent 2006, both parties having and waivers of notice of intention to request entry of divorce decree allowing the divorce to proceed under Section 330l(c) of the Domestic Relations Code, and there being no economic claims raised in the proceedings, the appointment of the Master is vacated and counsel can file a praceipe transmitting the record to the record requesting a final decree in divorce, Edgar B, ~ cc: ,~/\JVJ D\J --r:: ...., ,~ = c.... o "T1 ::::l fll:JJ c- rT": cri (-~l -"'r' , :;?E'; ".sm -, :> :0 -< '-- c:: ,.0 " w 0--' Lisa Seifrit, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v, : CIVIL ACTION-LAW : DIVORCE Kevin Seifrit, Defendant : NO, 05 - 2945 CIVIL TERM CERTIFICATE OF SERVICE I, Stephanie Botabara, Certified Legal Intern oftl1e Family Law Clinic, hereby certify tI1at I served true and correct copies of tI1e Praecipe to Transmit tI1e Record and the Divorce Information Sheet on Mr, Kevin Seifrit, residing at 1132 West Chew St., Allentown, PA 18102, by depositing a copy of the same in the United States mail, postage prepaid, on July 17,2006, " ~a Certified Legal Intern rzJ on-Walsh, Esq, g Attorney FAMIL Y LAW CLINIC 45 North Pitt Street Carlisle, PA 17013 (717) 243-2968 Fax: (717) 243-3639 "\- ::;j ~" :.' .'; ....~_J LISA SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v, : CIVIL ACTlON- LAW : IN DIVORCE KEVIN SElFRIT, Defendant : No. 05 - 2945 CIVIL TERM PRAECIPE TO TRANSMIT RECORD To the Protl1onotary: Please transmit the record, togetl1er witl1 tI1e following information, to the court for entry of a divorce decree: I, Ground for divorce: irretrievable breakdown under ~330 I (c) of the Divorce Code, 2, Date and manner of service oftl1e complaint: Served on Defendant by U,S, mail, certified, restricted delivery, return receipt requested, postage prepaid, Service was complete upon receipt by Mr, Kevin Seifrit, June 15, 2005, 3, Date of execution of the affidavit of consent required by ~3301 (c) oftl1e Divorce Code: by plaintiff - December 16,2005; by defendant - June 8, 2006, 4, Related claims pending: none 5, Date plaintiff's Waiver of Notice was filed with tI1e Protl1onotary: June 13,2006, Date defendant's Waiver of Notice was filed witl1 tI1e Prothonotary: June 19,2006, or! l-;rlexe Date ~a Certified Legal Intern ~~~ Supervising Attorneys FAMILY LAW CLINIC 45 N, Pitt Street Carlisle, P A 17013 717-243-2968 Fax: 717-243-3639 Attorneys for Plaintiff -~J " "".~,} c:', :,-j IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY STATE OF PENNA, Lisa Seifrit Plaintiff NO. 05 - 2945 VERSUS Kevin Seifrit Defendant DECREE IN DIVORCE . AND NOW, ::r u kt-I "1 2.0~b IT IS ORDERED AND DECREED THAT Lisa Seifrit , PLAINTIFF, AND Kevin Seifrit , 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; . . BYTHE~: ATT ST: J. . . ROTHONOTARY * :t ~ ~Ii. ~"" tf"L "?;ff~~~"('l ~Jt'"L J .;) .. .. ~ . . . . ,Y,"" . '. '. '., ~ " , , " VS. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CML ACTION - LAW John E. Yankowski Plaintiff Suzie M, Gorse-Yankowski Defendant NO, 05-5734 QUALIFIED DOMESTIC RELATIONS ORDER 1. This Order relates to the provision of marital property rights to'thl! Altern/ite Payee pursuant to a Property Settlement Agreement entered into on December 14, 2005, 2, This Order creates and recognizes the existence of an Alternate Payee's right to receive a portion of the Participant's benefits payable under an employer sponsored defined contribution plan which is intended to be qualified under Internal Revenue Code of 1986 ("Code") H01(a). The Court intends this order to be a Qualified Domestic Relations Order ("QDRO") within the meaning of Code ~414(p) and ~206(d) of the Employee Retirement Income Security Act of 1974 aaamended ("ERISA"), The Court enters this QDRO pursuant to its authority under the 23 P,C,S.A ~3502, 3, This QDRO applies to the FC! USA, mc, Employee 401(k) Savings Plan ("Plan"), Further, this Order shall apply to any successor plan to the Plan or any other planes) to which liability for provision of the Participant's benefits described below is incurred, Anybenefits accrued by the Participant under a predecessor plan of the employer or any other defined contribution plan sponsored by the Participant's employer, whereby liability for benefits accrued under such predecessor plan or other defined contribution plan has been transferred to the Plan, shall also be subject to the terms of this Order, Any changes in Plan Administrator, Plan sponsor, or name of the Plan shall not affect Alternate Payee's rights as stipulated under this Order, 4, John E, Yankowski ("Participant") is a participant in the Plan, Suzie M, Gorse- Yankowski ("Alternate Payee"), the former spouse of the Participant, is the alternate payee for purposes of this QDRO, 5, The Participant's name, mailing address, Social Security number and date of birth are: John E. Yankowski 423 Walnut Street, Apt, 103 Harrisburg, PA 17101 Social Security #: 286-60-0991 Date of Birth: July 2, 1961 6, The Alternate Payee's name, mailing address, Social Security number and date of birth are: . " QDRO Page 2 Suzie M, Gorse-Yankowski 24257 Rosebud Avenue East Pointe, MI 48021 Social Security #: 378-84-9504 Date of Birth: April 8, 1964 The Alternate Payee shall have the duty to notify the Plan Administrator in writing of any changes in this mailing address subsequent to the entry ofthis Order, 7, The portion of the Participant's plan benefits payable to the Alternate Payee under this QDRO is $4,925 of the Participant's total account balance under the Plan as of December 14, 2005, together with investment gains or losses attributable thereon from December 14, 2005, until the date of distribution, 8, This QDRO does not require the Plan to provide any type or form of benefit the Plan does not otherwise provide, 9, This QDRO does not require the Plan to provide increased benefits, 10, This QDRO does not require the Plan to pay any benefits which another order previously determined to be a qualified domestic relations order requires the Plan to pay to another alternate payee, , 11. The Plan shall distribute to the Alternate Payee her benefits (as designated in Paragraph 7 of this Order), as soon as administratively feasible following the Plan Administrator's approval ofthis Order, 12, The distribution pursuant to an election by the Alternate Payee shall be a lump sum payment to her or a direct rollover to an Individual Retirement Account for her benefit, 13. On and after the date that this order is deemed to be a QDRO, but before the Alternate Payee receives her distribution under the Plan, the Alternate Payee shall be entitled to all of the rights and election privileges that are afforded to Plan beneficiaries, including, but not limited to, the right to name a beneficiary and the right to direct her Plan investments to the extent permitted under the Plan, 14, 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, 15, It is the intention of the parties that this QDRO continue to qualify as a QDRO under Code g414(p), as it may be amended from time to time, 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. In the event that the Plan inadvertently pays to the Participant any benefits that are assigned to the Alternate Payee pursuant to the terms of this order, the Participant shall innediately reimburse the Alternate Payee to the extent that he has received such benefit 111 ;~" .' . " QDRO Page 3 payments and shall forthwith pay such amount so received directly to the Alternate Payee within ten (10) days of receipt, In the event that the Plan inadvertently pays to the Alternate Payee any benefits that are assigned to the Participant pursuant to the terms of this order, the Alternate Payee shall immediately reimburse the Participant to the extent that she has received such benefit payments and shall forthwith pay such amount so received directly to the Participant within ten (10) day of receipt. 17, 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, 18, The Alternate Payee assumes sole responsibility for the tax consequences of the distribution under this QDRO, 19, The Alternate Payee's right to the amount assigned to her under this QDRO shall not be affected by the Participant's death (whether before or after benefit payments to the Alternate Payee have commenced). In the event of the Alternate Payee's death prior to the commencement of benefit payments to the Alternate Payee pursuant to this QDRO, the Plan shall pay the remaining benefits under this QDRO as soon as practicable to any beneficiary designated by the Alternate 'Payee and recorded with the Plan Administrator under the terms of the Plan, If no designated beneficiary survives the Alternate Payee, benefits shall be paid to the Alternate Payee's estate, 20. The Plan shall treat this QDRO in accordance with Code ~414(p)(7), While the Plan is determining whether this order is. a qualified domestic relations order, the Plan Administrator shall separately account for the amounts which would have been payable to the Alternate Payee while the Plan is determining the qualified status of this QDRO, 21. The Plan Administrator promptly shall notify the Participant and the Alternate Payee of the receipt of this QDRO and shall notify the Participant and the Alternate Payee of the Plan's procedures for determining the qualified status of this QDRO, The Plan Administrator shall determine the qualified status of the QDRO and shall notify the Participant and the Alternate Payee of the determination within a reasonable period of time after receipt of this QDRO, " .' , . . QDRO Page 4 22, The Court shall retain jurisdiction with respect to this Order to the extent required to maintain its qualified status and the original intent of the parties as stipulated herein, Accepted and ordered this ~ ~ day of >> ' ~ BY THE COURT ,..~ Judge CONSENT TO ORDER: PLAINTIFFIPARTICIPANT DEFENr/ALTERNATE PAYEE >lIS(bG \>jf~~Jzr_ CfmIJ()~ --Signature ( . a~. /0'~ J v' .)i~^t) ( ? , Date ATrORNEY FOR DEFENDANTI ALTERNATE PAYEE ?,~.~e,.... . Signature .~~{, Dati /Ie A'ITORNEY FOR PLAINTIFFI PARTIe T ~ l~l06 . . , . . ,^ , ~~~ ~ 'iF It I'f7-:' ~.,.f"J '?Q-x L r:.' <~ 11 \ .,., (. .~.. I' ",. n'" - ,",' '7 v:.. h:: ,;;.;J;... j -','" '-~, :, ~-ll. , \.. JOHN E, YANKOWSKI, Plaintiff : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PENNSYLVANIA v, : NO. 05-5734 - CIVIL TERM SUZIE M. GORSE-YANKOWSKI, Defendant : CIVIL ACTION - LAW : IN DIVORCE MOTION TO ENTER OUALIFIED DOMESTIC RELATIONS ORDER AND NOW, this ~, day of ~ , 2006, comes Plaintiff, JOHN E, YANKOWSKI, by and through his attorney, KRISTOPHER T, SMULL, ESQUIRE and Defendant, SUZIE M, GORSE-YANKOWSKI, by and through her attorney, ROBERT B, LIEBERMAN, ESQUIRE, and respectfully represent as follows: 1, JOHN E, YANKOWSKI is tI1e Plaintiff in tI1e above captioned divorce action represented by KRISTOPHER T, SMULL, ESQUIRE, 2, SUZIE M, GORSE- YANKOWSKI is the Defendant in tI1e above captioned divorce action represented by ROBERT B, LIEBERMAN, ESQUIRE, 3, Plaintiff and Defendant entered into a Property Settlement Agreement under date of December 14,2005 which Agreement provides for the division of Plaintiffs FeI USA, Inc, Employee 401 (k) Savings Plan pursuant to a Qualified Domestic Relations Order, 4, The Qualified Domestic Relations Order has been executed by botl1 Plaintiff and Defendant. , 5, In order for tI1e Qualified Domestic Relations Order to be implemented by the appropriate authorities, it is required that tI1e Order be entered by tI1is Honorable Court, WHEREFORE, Plaintiff, JOHN E. YANKOWSKI and Defendant, SUZIE M,GORSE- YANKOWSKI respectfully requests this Honorable Court to enter tI1e Qualified Domestic Relations Order as attached hereto. Respectfully submitted, Kristo r, Smull, squire MARIA T. COGNETTI & ASSOCIATES 210 Grandview Ave" Suite 102 Camp Hill, P A 170 II (717) 909-4060 Attorney for Plaintiff ~~.~,~_~~~ Robert B, Lieberman, Esquire 500 North Third Street, Izth Floor Harrisburg, PA 17101 (717) 236-1485 Attorney for Defendant r) f'<' <~ '-'::-~' ,~':", , .. ) -n =' c:,=,-r. 'l! i;-~ l'~.; c:.i' ~~ C,_) r . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY STATE OF PENNA. JOHN E. YANKOWSKI, No. 05-5734 CIVIL TERM Plaintiff VERSUS SUZIE M. GORSE-YANKOWSKI, Defendant DECREE IN DIVORCE AND NOW, ~~/r JOHN E, YANKOWSKI Jt/.'tJ fA." . 2006 , IT IS ORDERED AND DECREED THAT , PLAINTIFF, AND SUZIE M. GORSE-YANKOWSKI , 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; The terms ofthe parties' Property Settlement Agreement dated Deeember 14, 2005, herewith. Ams21~ { -_:: ,. - - -f P"~HONOTA"Y J, ~ 1''$ r ~'. .1h. ~ljet.. ~ 1- ~ f(,,;;..r.:r: '# ~c. .. ,..... ' . ",'" "'i " .' ~ ," lI> ' 'a' ; ..... ~ ,~ LISA SEIFRIT, Plaintiff : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA v, : CIVIL ACTION - LAW : IN DIVORCE KEVIN SEIFRIT, Defendant : NO, 05 - 2945 CIVIL TERM NOTICE OF ELECTION TO RETAKE FORMER NAME Notice is hereby given that the Plaintiff in the above matter, having been granted a Final Decree in divorce from the bonds of matrimony on July 19, 2006, hereby elects to retake and hereafter use her previous name of LISA CROMER, and gives tI1is written notice avowing her intention in accordance with the provisions of 54 Pa.C.S, S704, Wishes To Be Known As: oL~ A~> Ie 2EIFRIT LISA ao(i:(QJ1 (l./? COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND SS, On the 10th day of August, 2006, before me, a Notary Public, personally appeared LISA SEIFRIT, known to me to be the person whose name is subscribed to the within document, and acknowledged that she executed the foregoing for the purpose therein contained, N.Alu1ll.... Laurle L WoJt Notuy Publlo Carlisle Bolo. Cumberland County My Comml"ion Expires Feb. 14,2010 IN WITNESS THEREOF, I have hereunto set my hand a~d Notarial Se,l. ~//A~~0fcd/ ARY LC -0 ''''1 . ,'~, 7J t - ~ ...... ~ ~ "'t' -tQ ~ o o ~ r- ~ D1 ;- ~o ;;: ~ !il H,~' 5 iC; :s:C ~ ~f'J~ i8 "b ;:,j'g -C"" ~ ~i# ;!'; -::- 61l'i ~ c.., -,. c.n ~ .... fa,2 fshstoT-( oiMlJ'I YldQl1.1foW .J ~h"..,! 'f' , , " > ' ,,,~, _~') ,,'t'1"'t'"'. ....~~<) . . "",,,..")