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HomeMy WebLinkAbout02-1816IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A. ANDERSON, Plaintiff VS. DAREN D. ANDERSON, Defendant CIVIL ACTION - LAW IN DIVORCE NOTICE TO DEFEND AND CLAIM RIGHTS YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND AGAINST THE CLAIMS SET FORTH IN THE FOLLOWING PAGES, YOU MUST TAKE PROMPT ACTION. YOU ARE WARNED THAT IF YOU FAIL TO DO SO, THE CASE MAY PROCEED WITHOUT YOU AND A DECREE OF DIVORCE OR ANNULMENT MAY BE ENTERED AGAINST YOU BY THE COURT. A JUDGMENT MAY ALSO BE ENTERED AGAINST YOU FOR ANY OTHER CLAIM OR RELIEF REQUESTED IN THESE PAPERS BY THE PLAINTIFF. YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS IMPORTANT TO YOU, INCLUDING CUSTODY OR VISITATION OF YOUR CHILDREN. WHEN THE GROUND FOR THE DIVORCE IS INDIGNITIES OR IRRETRIEVABLE BREAKDOWN OF THE MARRIAGE, YOU MAY REQUEST MARRIAGE COUNSELING. A LIST OF MARRIAGE COUNSELORS IS AVAILABLE IN THE OFFICE OF THE PROTHONOTARY AT THE CUMBERLAND COUNTY COURTHOUSE, 1 COURTHOUSE SQUARE, CARLISLE, PA 17013. IF YOU DO NOT FILE A CLAIM FOR ALIMONY, DIVISION OF PROPERTY, LAWYER'S FEES OR EXPENSES BEFORE A DIVORCE OR ANNULMENT IS GRANTED, YOU MAY LOSE THE RIGHT TO CLAIM ANY OF THEM. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP. CUMBERLAND COUNTY LAWYER REFERRAL SERVICE 2 LIBERTY AVENUE CARLISLE, PA 17013 (717) 249-3166 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A. ANDERSON, Plaintiff VS. DAREN D. ANDERSON, Defendant CIVIL ACTION - LAW IN DIVORCE COMPLAINT IN DIVORCE UNDER SECTION 3301(c) or 3301(dl OF THE DIVORCE CODE COUNT I AND NOW, comes Marcy A. Anderson, by and through her attorney Timothy J. Colgan, Esquire of Wiley, Lenox, Colgan & Marzzacco, P.C., and files the instant Complaint in Divorce and in support thereof, avers as follows: 1. The Plaintiff is Marcy A. Anderson, who currently resides at 1550 Williams Grove Road, Lot 70, Mechanicsburg, Cumberland County, Pennsylvania, 17055 since March, 2002. 2. The Defendant is Daren D. Anderson, who currently resides at 521 Hogestown Road, Mechanicsburg, Cumberland County, Pennsylvania, 17050 since 1995. 3. Plaintiff and Defendant have been bona fide residents in the Commonwealth for at least six months immediately previous to the filing of this Complaint. 4. The Plaintiff and Defendant were married on September 5, 1992 in Grovania, Pennsylvania. 5. There have been no prior actions of divorce or annulment between the parties. 6. The marriage is irretrievably broken. 7. Plaintiff has been advised that counseling is available and that Plaintiff may have the right to request that the court require the parties to participate in counseling. Being so advised, Plaintiff does not request that the Court require the parties to participate in counseling prior to a Divorce Decree being issued by the Court. 8. Plaintiff request the court to enter a decree of divorce. WHEREFORE, the Plaintiff requests the Court enter an a Decree in Divorce. Respectfully submitted, WILEY, LENOX, COLGAN & MARZZACCO, P.C. Dated: 1 South Baltimore Street Dillsburg, PA 17019 (717) 432-9666 I.D. #77944 Date: VERIFICATION I, Marcy A. Anderson, verify that the statements made in this document are tree 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. §4904, relating to unswom falsification to authorities. Marcy A. ~/nderson Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A, ANDERSON VS. DAREN D. ANDERSON Plaintiff Defendant * CIVIL ACTION - LAW * IN DIVORCE , * NO. 02-1816 , * CIVIL TERM * ACCEPTANCE OF SERVICE I, Daren D. Anderson, Defendant in the above-captioned matter, have accepted service of the Complaint as of this, the /O day of ~9'//q 7 ,2002. DAREN D. ANDERSON Address City, State, Zip MARITAL SETTLEMENT AGREEMENT THIS AGREEMENT is made this (3 day of ,~-a#g 2002, by and between MARCY A. ANDERSON (hereinafter referred to as "WIFE") and DAREN D. ANDERSON (hereinafter referred to as "HUSBAND"). WITNESSETH WHEREAS, the parties were married on September 5, 1992 at Grovania, Pennsylvania; WHEREAS, a Complaint for divorce was filed in the Cumberland County Court of Common Pleas on April 12, 2002; WHEREAS, diverse unhappy differences, disputes and difficulties have arisen between the parties and it is the intention of Husband and Wife to live separate and apart for the rest of their natural lives, and the parties desire to settle fully and f'mally their respective financial and property rights and obligations as between each other including, without limitation by specification; settling of all matters between them relating to the ownership and equitable distribution of real and personal property; settling of all matters between them relating to the past, present, and future support, alimony and/or maintenance of Wife by Husband or of Husband by Wife; and in general, the settling of any and all claims and possible claims by one against the other or against their respective estates. NOW, TI-IEREFORE, in consideration of the premises and of the mutual promises, covenants and undertakings hereinafter set forth and for other good and valuable consideration, receipt of which is hereby acknowledged by each of the parties hereto, HUSBAND and WIFE, each intending to be legally bound hereby covenant and agree as follows: 1. INTERFERENCE: Each party shall be free from interference, authority, and contact by the other, as fully as though he or she were single and unmarried, except as may be necessary to carry out the provisions of this Agreement. Neither party shall molest the other or attempt to endeavor to molest the other, nor compel the other to cohabitate with the other, or in any way harass or malign the other, nor in any way interfere with the peaceful existence, separate and apart from the other. 2. AGREEMENT NOT A BAR TO DIVORCE PROCEEDINGS: This Agreement shall not be considered to affect or bar the right of HUSBAND or WIFE to a divome on lawful grounds as such grounds now exist or shall hereafter exist or to such defense as may be available to either party. This Agreement is not intended to condone and shall not be deemed to be a condonation on the part of either party hereto of any act or acts on the part of the other party which have occasioned the disputes or unhappy differences which have occurred prior to or which may occur subsequent to the date hereof. 3. SUBSEOUENT DIVORCE: The parties hereby acknowledge that WIFE filed a Complaint in Divorce in Cumberland County on April 12, 2002 claiming that the marriage is irretrievably broken under Section 3301(c) of the Pennsylvania Divorce Code. HUSBAND hereby expresses his agreement that the marriage is irretrievably broken and upon execution of this Agreement shall execute any and all Affidavits or other documents necessary for the parties to obtain an absolute divorce pursuant to Section 3301(c) of the Divorce Code and deliver same to counsel for WIFE. The parties hereby waive all rights to request court ordered counseling under the Divorce Code. It is further specifically understood and agreed by the parties that the provisions of this Agreement as to equitable distribution of property of the parties are accepted by each party as a final settlement for all purposes whatsoever, as contemplated by the Pennsylvania Divorce Code and shall be incorporated but not merged into the Decree in Divorce. 4. EFFECTIVE DATE: The effective date of this Agreement shall be the "date of execution'' or "execution date," defined as the date upon which it is executed by the parties if they have each executed this Agreement on the same date. Otherwise, the "date of execution" or "execution date" of this Agreement shall be defined as the date of execution by the party last executing this Agreement. 5. DISTRIBUTION DATE: The transfer of property, funds and/or documents provided for herein, shall only take place on the "di~/~ibution" date which shall be defined as the date of execution of this Agreement unless otherwise specified herein. 6. MUTUAL RELEASE: HUSBAND and WIFE each do hereby mutnally remise, release, quit-claim and forever discharge the other and the estate of such other, for all time to come, and for all purposes whatsoever, of and from any and all fights, title and interest, or claims in or against the property (including income and gain from property hereafter accruing) of the other or against the estate of such other, of whatever nature and wheresoever situated, which he or she now has or at any time hereafter may have against the other, the estate of such other or any part hereof, whether arising out of any former acts, contracts, engagements or liabilities of such other or by way of dower or courtesy, or claims in the nature of dower or courtesy or widow's or widower's rights, family exemption or similar allowance, or under the intestate laws, or the right to take against the spouse's will; or the right to treat a lifetime conveyance by the other as a testamentary, or all other rights ora surviving spouse to participate in a deceased spouse's estate, whether arising under the laws of(a) Pennsylvania, (b) any State, Commonwealth or territory of the United States, or (c) any country or any rights which either party may have or at any time hereafter shall have for past, present or future support or maintenance, alimony, alimony pendente lite, coun~l fees, division of property, costs or expenses, whether arising as a result of the marital relations or otherwise, except, all fights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provisions thereof. It is the intention of HUSBAND and WIFE to give each other by the execution of this Agreement a full, complete and general release with respect to any and all property of any kind or nature, real, personal or mixed, which the other now owns or may hereafter acquire, except and only except all rights and agreements and obligations of whatsoever nature arising or which may arise under this Agreement or for the breach of any provision thereof. It is further agreed that this Agreement shall be and constitute a full and final resolution of any and all claims which each of the parties may have against the other for equitable division of property, alimony, counsel fees and expenses, alimony pendente lite or any other claims pursuant to the Pennsylvania Divorce Code or the divorce laws of any other jurisdiction. 7. REPRESENTATION BY COUNSEL: This agreement ha~q been prepared by Timothy J. Colgan, Esquire, counsel for WIFE. At the commencement of and at all stages during the negotiation of this Agreemem, HUSBAND has been informed that Timothy J. Colgan, Esquire has acted solely as counsel for WIFE and has not advised nor represented HUSBAND in any manner whatsoever. HUSBAND, at the commencement of and at all stages during the negotiation of this Agreement, has been advised that she could be represented by counsel but at all times has elected not to be so represented. HUSBAND has read this Agreement carefully and thoroughly, fully understanding each of its provisions, and therefore signs it clearly and voluntarily. The parties acknowledge that Agreement is not the result of any duress, undue influence, coercion, collusion and/or improper or illegal agreemem. The parties further acknowledge that they have each made to the other a full and complete disclosure of their respective assets, estate, liabilities, and sources of income and that they waive any specific enumeration thereof for the purposes of this Agreement. 8. WARRANTY AS TO EXISTING OBLIGATIONS: Each party represents that they have not heretofore incurred or contracted for any debt or liability or obligation for which the estate of the other party may be responsible or liable except as may be provided for in this Agreement. Each party agrees to indemnify and hold the other party ham-~less for and against any and all such debts, liabilities or obligations of every kind which may have heretofore been incurred by them, including those for necessities, except for be obligations arising out of this Agreement. 9. WARRANTY AS TO FUTURE OBLIGATIONS: HUSBAND and WIFE covenant, warrant, represent and agree that, with the exception of obligations set forth in this Agreement, neither of them shall hereafter incur any liability whatsoever for which the estate of the other may be liable. Each party shall indemnify and hold bare, less the other party for and against any and all debts, charges and liabilities incurred by the other a~ter the execution date of this Agreemem, except as may be otherwise specifically provided for by the terms of this Agreement. 10. PERSONAL PROPERTY AND DEBTS: The parties have divided between them, to their muV_m! satisfaction, the personal effects, household furniture and furnishings, and all other articles of personal property which have heretofore been used by ~em in common, and neither party will make any claim to any such items which are now in the possession or under the control of the other with the exception of the Kubota Mower and the fold up bed. Said items are still in HUSBAND's possession but HUSBAND agrees to transfer these items to WIFE upon her request at any time prior to June 27, 2002. Should it become necessary, the parties each agree to sign any rifles or documents necessary to give effect to this paragraph upon request. By these presents, each of the parties hereby specifically waives, releases, renounces and forever abandons whatever claims he or she may have with respect to any personal property which is in the possession of the other, and which shall become the sole and separate property of the other from the date of execution hereof, with the exception of the Kubota Mower and the fold up bed. Once possession of those items has been transferred to WIFE, they shall become the sole and separate property of the WIFE from the date of transfer forward. 11. REAL PROPERTY: The parties jointiy own real estate situate at 521 Hogestown Road, Mechanicsburg, Cumberland County, Pennsylvania. Said property has been sold with settlement to occur on or about June 27, 2002. The parties agree that after payment of the customary costs of sale (to include Realtor's commission, transfer tax, deed preparation, and mortgage payoff), the proceeds from the sale of the home shall be divided equally between the parties. Furthermore, the parties agree to divide equally the escrow account refund held by the mortgage company following the closing on the property at 521 Hogestown Road. Until settlement on the property, HUSBAND agrees to make all mortgage payments on the residence, pay all taxes as they become due, pay for all upkeep and maintenance on said property. HUSBAND shall indemnify WIFE and hold WIFE harmless fi.om all claims of any nature arising fi.om the ownership and use of the marital residence. In consideration of HUSBAND's agreement as outlined in the preceding paragraph, HUSBAND shall be entitled to claim the mortage interest expense relative to the property on his 2002 Federal income tax return. 12. II]~I~[~JI.F~ The parties jointly own a time share in Lake Buena Vista, Florida. Said time share shall be listed for sale within thirty 00) days of the signing of this agreement. Upon sale and settlement of said time share, the proceeds shall be divided equally between the parties after deducting the usual and customary costs of sale. 13. BANK ACCOUNTS; HUSBAND and WIFE acknowledge that they each possess certain bank accounts and the like in their respective names. They hereby agree that each shall become sole owner of their respective accounts and they each hereby waive any interest in, or claim to, any funds held by the other in any accounts. 14. MUTUAL FUND ACCOUNT; HUSBAND and WIFE are the joint owners of a mutual fund account with Davis Funds. Said account shall become the sole and exclusive property of WIFE. WIFE agrees to provide HUSBAND with a check equaling one half(½) of the value of the account as of the close of business on September 16, 2002. WIFE shall provide the check to HUSBAND for his share no later than September 23, 2002. HUSBAND thereafter waives any interest he may have in the Davis mutual fund account. 15. MOTOR VEHICLES: With respect to the motor vehicles owned by one or both of the parties, each party shall retain as his or her sole and separate property the vehicle now in his or her possession. The parties shall execute the titles necessary to transfer ownership of the vehicles. Each party retaining a vehicle agrees to indemnify and hold the other harmless from any and all claims resulting from use, operation, or financing of the vehicle. 16. PENSIONS. ANNUITIES AND/OR RETIREMENT BENEFITS: HUSBAND and WIFE each possess retirement benefits. HUSBAND has a 401(k) with the Vang~jord Group and a pension plan with his employer, Square D. WIFE has a 401(k) with CIGNA Retirement and Investment Services. HUSBAND agrees to sign a Qualified Domestic Relations Order (QDRO) and all other necessary documents immediately upon WIFE's request which allows her one half of the amount that his 401(k) exceeded her 401(k) account as of November 30, 2001. HUSBAND agrees to assist in whatever manner necessary to effectuate this paragraph. The parties thereafter waive any interest they may have in the 401 (k), retirement accounts or employee pension plans of the other. 17. AFTER-ACOUIRED PROPERTY: Each of the parties shall hereafter own and enjoy, independently of any claim or fight of the other, all items of property, be they real, personal or mixed, tangible or intangible, which are hereafter acquired by him or her, with full power in him or her to dispose of the same as fully and effectively, in all respects and for all purposes as though he or she were unmarried. 18. I]5[C,~)~IF.~ The parties have heretofore filed joint Federal and State tax returns. Both parties agree that in the event any deficiency in Federal, State or local income tax is proposed, or any assessment of any such tax is made against either of them, each will indemnify and hold harmless the other fi.om and against any loss or liability for any such tax deficiency or assessment and any interest, penalty and expense incurred in connection therewith. Such tax, interest, penalty or expense shall be paid solely and entirely by the individual who is finally determined to be the cause of the misrepresentations or failures to disclose the nature and extent of his or her separate income on the aforesaid joint returns. 19. APPLICABILITY OF TAX LAW TO PROPERTY TRANSFERS: The parties hereby agree and express their intent that any transfer of property pursuant to this Agreement shall be within the scope and applicability of the Deficit Reduction Act of 1984 (hereinafter the "Act"), specifically, the provisions of said Act pertaining to the transfers of property between spouses and former spouses. The parties agree to sign and cause to be filed any elections or other documents required by the Internal Revenue Service to render the Act applicable to the transfers set forth in this Agreement without recognition of gain on such transfer and subject to the carry- over basis provisions of said Act. 20. WAIVER OF ALIMONY: HUSBAND and WIFE recognize and acknowledge that the foregoing provisions for their individual benefit are satisfactory with regard to spousal support and maintenance, past, present and future. The parties release and discharge the other absolutely and forever for the rest of their lives from all claims and demands, past, present or future, for alimony, alimony pendente lite or for any provision for support or maintenance. The parties further acknowledge that in consideration of the transfers made herein each completely waives and relinquishes any and all claims and/or demands they may now have or hereafter have against the other for alimony, alimony pendente lite, spousal support, counsel fees and court costs. 21. EFFECT OF DIVORCE DECREE; The parties agree that, except as otherwise specifically provided herein, this Agreement shall continue in full force and effect after such time as a final Decree in Divorce may be entered with respect to the parties. 22. ~ Il'either party breaches any provision of this Agreement, the other party 9 shall have the right, at his or her election to sue for damages for such breach or seek such other remedies or relief as may be available to him or her, and the party breaching this contract shall be responsible for payment of reasonable legal fees and costs incurred by the other in enforcing their rights under this Agreement. 23. WAIVER OF CLAIMS: Except as herein otherwise provided, each party may dispose of his or her property in any way, and each party hereby waives and relinquishes any and ail rights he or she shall now have or hereafter acquire, under the present and future laws of any jurisdiction, to share in the property or the estate of the other as a result of the marital relationship, including without limitation, dower, courtesy, statutory allowance, widow's allowance, right to take in intestacy, right to take against the Will of the other, and the right to act as administrator or executor of the other's estate, and each will, at the request of the other, execute, acknowledge and deliver any and ail instraments which may be necessary or advisable to carry into effect this mutual waiver and relinquishment of such interests, rights and claims. 24. ENTIRE AGREEMENT; This Agreement contains the entire understanding of the parties and there are no representations, warranties, covenants or undertakings other than those expressly set forth herein. 25. AGREEMENT BINDING ON HEIRS: This Agreement shall be binding and shall inure to the benefits of the parties hereto and their respective heirs, executors, administrators, successors and assigns. 26. ADDITIONAL INSTRUMENTS; Each of the parties shall from time to time, at the request of the other, execute, acknowledge and deliver to the other any and all further instruments that may be reasonably required to give full force and effect to the provisions of this 10 Agreement. 2'/. ~ 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 be valid and continue in full force, effect and operation. 28. INDEPENDENT SEPARATE COVENANTS; It is specifically understood and agreed by and between the parties hereto that each paragraph hereof shall be deemed to be separate and independent Agreement. 29. FINANCIAL DISCLOSURE: The parties confim~ that they have relied on the completeness and substantial accuracy of the ~nancial disclosure of the other as an inducement to the execution of this Agreement. The parties acknowledge that there has been no formal discovery conducted in their pending divorce action and that neither party has filed an inventory and appraisement as required by Section 3505(b) of the Pennsylvania Divorce Code. Notwithstanding the foregoing, the rights of either party to pursue a claim for equitable distribution, pursuant to the Pennsylvania Divorce Code, of any interest owned by the other party in an asset of any nature at any time prior to the date of execution of this Agreement that was not disclosed to the other party or his or her counsel prior to the date of the within Agreement is expressly reserved. In the event that either party, at any time hereafter, discovers such an undisclosed asset, the party shall have the right to petition the Court of Common Pleas of Cumberland County to make equitable distribution of said asset. The non-disclosing party shall be responsible for payment of counsel fees, costs or expenses incurred by the other party in seeking equitable distribution of said asset. Notwithstanding the foregoing the Agreement shall 11 in ail other respects remain in full force and effect. 30. MODIFICATION AND WAIVER; A modification or waiver of any of the provisions of this Agreement shail be effective only if made in writing and executed with the same formaiity as this Agreement. The failure of either party to insist upon strict performance of any of the provisions of this Agreement shail not be construed as a waiver of any subsequent defaults oft_he same or similar nature. 31. DESCRIPTIVE HEADING8; The descriptive headings used herein are for convenience only. They shail have no affect whatsoever in determining the rights or obligations of the parties. 32. APPLICABLE LAW; This Agreement shail be construed under the laws of the Commonweaith of Pennsylvania and more specificaily under the Divorce Code of 1980 and any amendments thereto. IN WITNESS WHEREOF, the parties hereto, after full disclosure, intending to be legaily bound, have signed, seaied and acknowledged this Stipulation. SIGNED, SEALED AND DELIVERED IN THE PRESENCE OF: Witness Witness MARCY A. A~/DERSON DAREN D. ANDERSON 12 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A. ANDERSON VS. DAREN D. ANDERSON Plaintiff Defendant * CIVIL ACTION - LAW * IN DIVORCE * * NO. 02-1816 * * CIVIL TERM * * 2002. AFFIDAVIT OF CONSEI~T 1. A complaint in Divorce under §3301(c) of the Divorce Code was filed on April 12, 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. §4904 relating to unswom falsification to authorities. Date Daren D. Anderson Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A. ANDERSON VS. DAREN D. ANDERSON Plaintiff Defendant * CIVIL ACTION - LAW * IN DIVORCE , * NO. 02-1816 , * CIVIL TERM WAIVER OF NOTICE OF INTENTION TO REOUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(c) OF THE DIVORCE CODE 1. I consent to the entry ora final decree of divorce without notice. 2. I understand that I may lose rights concerning alimony, division of property, lawyer's fees, or expenses if! do not claim them before a divorce is granted. 3. I understand that I will not be divorced until a divorce decree is entered by the Court and that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. Date Daren D. Anderson Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A. ANDERSON VS. DAREN D. ANDERSON Plaintiff * NO. 02-1816 * * C1VIL TERM * CIVIL ACTION - LAW IN DIVORCE Defendant * 2002. AFFIDAVIT OF CONSENT 1. A complaint in Divorce under §3301(c) of the Divorce Code was filed on April 12, 2. The marriage of Plaintiff and Defendant is irretrievably broken and ninety (90) days have elapsed from the date of filing and service of the Complaint. 3. I consent to the entry of a final decree of divorce after service of notice of intention to request entry of the decree. I verify that the statements made in this affidavit are true and correct. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. Date Marcy A. Andterson Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A. ANDERSON VS. DAREN D. ANDERSON Plaintiff Defendant CWIL ACTION - LAW IN DIVORCE NO. 02-1816 CIVIL TERM WAIVER OF NOTICE OF INTENTION TO REOUEST ENTRY OF A DIVORCE DECREE UNDER SECTION 3301(c) OF TIlE 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 that a copy of the decree will be sent to me immediately after it is filed with the Prothonotary. I verify that the statements made in this affidavit are true and correct. I understand that false statements made herein are subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. Date Marcy A. A~derson Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A, ANDERSON VS. DAREN D. ANDERSON Plaintiff Defendant * CIVIL ACTION - LAW * IN DIVORCE , * NO. 02-1816 , * CIVIL TERM PRAECIPE TO TRANSMIT RECORD TO THE PROTHONOTARY: Transmit the record, together with the following information, to the Court for entry of a divorce decree: 1. Grounds for Divorce: Irretrievable breakdown under Sectien 3301(c). 2. Date and manner of service of the Complaint: B re ular mail on Ma 10 2002. An Acce tance of ervice was filed with the court on January_ 20, 2002 indicating a date of delivery to Defendant on May 10, 2002. 3. Complete either Paragraph (a) or (b): (a) Date of execution of the Affidavit of Consent required by Section 3301 (c) of the Divorce Code: By Plaintiff: October 28, 2002; By Defendant: October 28 - (b) (1) Date of execution of the Affidavit required by Section 3301 (d) of the Divorce Code: (2) Date of filing and service of the Plaintiff's Affidavit upon the Respondent: 4. Related claims pending: All related claims were resolved by a Marital Settlement Agreement dated June 6, 2002. Said Marital Settlement Agreement was filed with the Court on June 20, 2002. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A. ANDERSON, Plaintiff VS. DAREN D. ANDERSON, Defendant * CIVIL ACTION - LAW * IN DIVORCE * NO. 02-1816 * CIVIL TERM ACKNOWLEDGMENT OF PARTIES TO ENTRY OF AND NOW, to wit, this o~~ day o£~~_~ ,2002, the parties in the above-referenced action do hereby agree that the attached Stipulation shall be entered as an Order o£ Court. Witness Marcy A. AaUc~erson Daren D. Anderson IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A. ANDERSON, Plaintiff VS. DAREN D. ANDERSON, Defendant * CIVIL ACTION - LAW * IN DIVORCE * NO. 02-1816 * CIVIL TERM ORDER This Order is intended to meet the requirements of a "qualified domestic relations order" as defined in Section 414(p) of the Internal Revenue Code of 1986 ("Code") and Section 206(d) of ERISA. It is hereby Ordered as Follows: 1. Definitions. (a) (b) This Order relates to the Square D Company Employees Retirement Savings Plan ("Plan"), a defined contribution plan maintained by the Square D Company. The Participant in the Plan is Daren D. Anderson ("Participant"), whose last known address is 1417 Timber Brook Drive, Mechanicsburg, PA 17050 and whose Social Security number is 454-29-9511. The Participant's date of birth is 04/04/63. (c) (d) The Alternate Payee is Marcy A. Anderson ( lternate Payee"), whose last known "A address is 71 Rainbow Circle, Elizabethtown, Pennsylvania 17022 and whose Social Security number is 176-54-9633. 'l'he Alternate Payee's date of birth is 08/22/70. The Alternate Payee is the spouse of the Participant. The Plan Administrator is the Square D Company Employee Benefits Administrative Committee. Amount Assigned. The Court hereby assigns to the Alternate payee Fifteen Thousand Three Hundred Sixty Dollars and Eighty-Seven Cents ($15,360.87) of the Participant's vested account balance under the Plan. Such amount shall be credited with a pro rata share of the earnings and losses credited to the Participant's account from November 30, 2001 until a separate account is established for the Alternate Payee in accordance with Paragraph 3. 3. Investment. As soon as practicable after this Order is determined to be qualified by the Plan Administrator, such amounts shall be withdrawn from the investment funds in the Participant's account on a pro rata basis and invested in such fashion in a separate account under the Plan maintained for the benefit of the Alternate Payee. On and after the date such account is established, the Alternate Payee shall have the same ability to designate the investment of those amounts as the Participant would otherwise have had with respect to those amounts. All amounts assigned to the Alternate Payee will separately share in the gains and losses of the Plan in accordance with the terms of the Plan beginning on the date the Alternate Payee's account is established until the date of payment of such assigned amounts to the Alternate Payee. Time and Form of Payment. Payment of the Alternate Payee soon as administratively practicable .y s oenenr shall be made as after the Order is determined to be qualified and after the Plan Administrator receives a payment request from the Alternate Payee. Such request shall be on a form provided by the Plan Administrator. Payment shall be made in a single lump sum payment. Notwithstanding the foregoing, if the current value of the benefit assigned to the Alternate Payee does not exceed $5,000.00, the benefit assigned to the Alternate Payee shall be paid to the Alternate Payee in a single lump sum as soon as practicable after the Order is determined to be qualified. Effect of Alternate Payee's Death on Payments. The Alternate Payee may designate a beneficiary to receive payment of the Alternate Payee's remaining interest in the Plan, if any, upon the Alternate Payee's death. Any such beneficiary designation shall be made without regard to any designation by the Participant of a beneficiary with respect to the Participant's interest. o Effect of Participant Predeceasing Alternate Payee. The assignment of benefits to the Alternate Payee shall not be reduced, abated or terminated as a result of the death of the Participant. Upon the Participant's death, the Alternate Payee will not be entitled to any survivor benefits attributable to the Participant's benefits under the Plan unless the Participant designates the Alternate Payee as beneficiary in accordance with the terms of the Plan. o Qualified Domestic Relations Order. The Participant, Alternate Payee and the court intend this Order to be qualified domestic relations order within the meaning of Section 414(p) of the Code and Section 206(d) of ERISA. Accordingly, tlhis Order shall not require the Plan to provide under any circumstances: (i) any type or form of benefit, or any benefit option, not otherwise provided under the Plan; (ii) provide benefits in excess of the value of the Participant's account, determined as of the valuation date described in Paragraph 2 or as of the date the separate account is established for the .Alternate Payee pursuant to Paragraph 3; or (iii) benefits that are required to be paid to another alternate payee under another order previously determined to be a qualified domestic relations order. This Order relates to the provision of child support, alimony/maintenance payments, or marital .property rights of a spouse, former spouse, child or other dependent of the Participant and ~s made pursuant to this State's domestic relations laws. Jurisdiction. In the event this Order is found by the Plan Administrator of the Plan not to be a qualified domestic relations order, the Court shall retain jurisdiction to modify the Order as necessary for the Plan Administrator to accept the Order and pay benefits in accordance with its provisions. 9. No Other Interests. The assignment made by this Order shall be permanent. On and after the date of this Order, the Participant shall have no further right or interest in the portion of the Participant's account balance which is hereby assigned to the Alternate Payee and the Alternate Payee shall have no right or interest in the portion of the Participant's account balance that is not assigned to the Alternate Payee pursuant to Paragraph 2 above. Nothing in this Order shall restrict the Participant's ability to obtain a distribution under the Plan or designate a beneficiary under the Plan, with respect to the portion of the Participant's account balance not assigned to the Alternate Payee. 10. Taxation. The Alternate Payee shall be responsible for the payment of all taxes due on amounts paid to the Alternate Payee. The Plan Administrator and trustee of the Plan are hereby authorized to withhold tax as required under law and to report any such withholdings and taxable income to the taxing authorities. Date: BY THE COURT: £g. ¢/./ ,.,~ PLEAS ~I OF CUMBERLAND ,COUNTY STATE OF PENNA. ~ .......... ~RCY A,~ ANDE, S.0.N ................ f Versus DAREN D. ANDERSON 1~0, 02-1 816 I CE AND NOW ......... /~'~t. /~ 1~ ~:~ it is ordered and decreed that MARCY A. ANDERSON ................................................. , plaintiff, and ..............[~a~rN .O.. AI~DER.qOt~ ....................... , 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; ......................... /V. ',"~' IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA MARCY A, ANDERSON VS. DAREN D. ANDERSON Plaintiff Defendant CWIL ACTION - LAW IN DWORC, E NO. 02-1816 CWIL TERM NOTICE OF INTENTION TO RESUME PRIOR NAME Notice is hereby given that the Plaintiff in the above matter intends to resume and hereafter use the previous name of Marcy Anne McCormick and gives this written notice avowing her intention in accordance with the provisions of 54 Pa.C.S. Section 704(a) as amended which permits a party in a divorce action at any time prior to or subsequent to the entry of the divorce decree to resume any prior surname used by that person. TO BE KNOWN AS: Marcy A. lV~Cormick COMMONWEALTH OF PENNSYLVANIA ' · SS COUNTY OF ~ ' On this, the ~ day of )~_ ffj ,2003, before me, the undersigned officer, personally appeared Marcy A. Anderso~ known to me (o; satisfactorily proven) to be the person whose name is subscribed to the within instrument, and acknowledged that she executed the same for the purposes therein contained. IN WITNESS WHEREOF, I have hereunto set my hand and official seal. MY COMMISSION lqO'i AF<iAL SEAL TAMSON S. KNORR, Notary Public Mifflin Twp., Columbia County NO~rARY ptrftLIC'";-"