COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS CUYAHOGA COUNTY, OHIO : CASE NO. DR

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COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS CUYAHOGA COUNTY, OHIO PETITIONER-01 and : CASE NO. DR : JUDGE : PETITIONER-02 : JUDGMENT ENTRY OF DISSOLUTION (No Children) (No Spousal Support) This cause came on for hearing on, 20 and was duly heard before the Honorable, Judge of the Domestic Relations Division of the Court of Common Pleas Magistrate to whom it was referred by the Honorable, Judge of the Domestic Relations Division of the Court of Common Pleas, upon the Petition of the parties and the evidence. The Court finds that Petitioner-01 was Petitioner-02 was both parties were resident(s) of the State of Ohio for more than six months immediately preceding the filing of the Petition and venue is proper in this county. The parties were married as alleged and there are no minor children of the marriage. The Court further finds that the Petition for Dissolution of Marriage was filed on, service was waived thereon pursuant to law and attached thereto was a Separation Agreement signed by the parties. A copy of the Separation Agreement is attached hereto as Exhibit A and incorporated herein as if fully rewritten. The Court further finds, in open Court this date, the parties acknowledged that they were still in agreement as to the terms thereof and that there has been a full disclosure by each of the parties of all of his or her income, assets and liabilities. The Court further finds that the Separation Agreement is fair, just, and equitable. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the marriage contract heretofore existing between the parties is hereby dissolved and that the terms of the attached Separation Agreement are hereby ordered into execution. SPOUSAL SUPPORT The Court finds, upon considering the factors set forth in Ohio Revised Code 3105.18(C)(1), that spousal support is neither appropriate nor reasonable. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that neither party shall pay spousal support to the other party. The Court shall not retain jurisdiction to modify this order. H160 (Revised 06/2018 Case No. 1

DIVISION OF PROPERTY Real Property The Court finds that neither party owns or has an interest in any real property. The Court finds that the parties have an interest in real property located at: (Check one or both of the following boxes if real property is owned) IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that Petitioner-01 Petitioner-02 is hereby awarded as division of property Petitioner-01 Petitioner-02 interest in the real property located at, the legal description of which is attached as Exhibit and incorporated herein as if fully rewritten. Petitioner-01 Petitioner-02 is ordered to execute a Quit Claim Deed in favor of Petitioner-01 Petitioner-02 to said property within 14 days of the journalization of this order. Upon his/her failure to do so, this decree shall operate as a conveyance thereof, and the Clerk is directed to certify so much as is necessary of this decree to effectuate such conveyance to the county fiscal officer and county recorder. -AND/OR- IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that Petitioner-01 Petitioner-02 is hereby awarded as division of property Petitioner-01 Petitioner-02 interest in the real property located at, the legal description of which is attached as Exhibit and incorporated herein as if fully rewritten. Petitioner-01 Petitioner-02 is ordered to execute a Quit Claim Deed in favor of Petitioner-01 Petitioner-02 to said property within 14 days of the journalization of this order. Upon his/her failure to do so, this decree shall operate as a conveyance thereof, and the Clerk is directed to certify so much as is necessary of this decree to effectuate such conveyance to the county fiscal officer and county recorder. -AND/OR- IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that Retirement Assets The Court finds that neither Petitioner-01 nor Petitioner-02 has retirement assets earned during the marriage. The Court finds that the parties have the following retirement assets earned during the marriage: Petitioner-01 (name of party) is a Participant under the (name of the plan) administered by earned through employment with (name of employer) 2

Petitioner-02 (name of party) is a Participant under the (name of the plan) administered by earned through employment with (name of employer) IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that each party shall retain any retirement assets they have earned during the marriage. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that any retirement assets earned during the marriage shall be divided as follows:. (Check the appropriate boxes below) The Qualified Domestic Relations Order(s) (QDRO) or Division of Property Order(s) (DOPO) which effectuate(s) this provision is/are attached as Exhibit, and incorporated herein by reference. IT IS FURTHER ORDERED, ADJUDGED AND DECREED that any Qualified Domestic Relations Order (QDRO) or Division of Property Order (DOPO) necessary to implement these orders, not submitted at the time of final hearing pursuant to Local Rule 28(F)(1) of the Court of Common Pleas, Division of Domestic Relations, Cuyahoga County, Ohio, shall be prepared by Petitioner-01 Petitioner-02, by (date). IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the Court retains jurisdiction with respect to the QDRO or DOPO to the extent required to maintain its qualified status and the original intent of the parties. The Court also retains jurisdiction to enter further orders as are necessary to enforce the assignment of benefits to the non-participant as set forth herein, including the recharacterization thereof as a division of benefits under another plan, as applicable, or to make an award of spousal support, if applicable, in the event that the participant fails to comply with the provisions of this order. IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the participant shall not take actions, affirmative or otherwise, that can circumvent the terms and provisions of the QDRO or DOPO, or that may diminish or extinguish the rights and entitlements of the non-participant. IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Petitioner-01 Petitioner-02 (DOB: ) be and is hereby restored to his/her former name of. IT IS FURTHER ORDERED, ADJUDGED AND DECREED that all restraining orders previously issued by this Court are hereby dissolved and set aside. 3

IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the costs of this proceeding shall be paid by: (Check one of the following boxes.) Petitioner-01 Petitioner-02 Both Petitioner-01 and Petitioner-02 equally. IT IS SO ORDERED. JUDGE MAGISTRATE PETITIONER-01 PETITIONER-02 ATTORNEY FOR PETITIONER-01 ATTORNEY FOR PETITIONER-02 4

INSTRUCTIONS FOR SERVICE TO THE CLERK: PURSUANT TO CIVIL RULE 58(B), WITHIN THREE (3) DAYS OF THE FILING OF THIS JUDGMENT ENTRY, THE CLERK IS DIRECTED TO SERVE NOTICE OF THE FILING OF THIS JUDGMENT ENTRY, THE DATE OF ENTRY UPON THE JOURNAL, AND COPIES OF THE JUDGMENT ENTRY UPON THE FOLLOWING PARTIES AND COUNSEL BY U.S. MAIL AND/OR ELECTRONIC MEANS, IF AVAILABLE: PETITIONER-01: COUNSEL FOR PETITIONER-01: PETITIONER-02: COUNSEL FOR PETITIONER-02: THE CLERK IS FURTHER DIRECTED TO NOTE UPON THE DOCKET THE DATE OF SERVICE, THE JUDGMENT ENTRY SERVED, THE NAME AND ADDRESS OF THE PARTY SERVED, THE METHOD OF SERVICE, AND THE COSTS ASSOCIATED WITH THIS SERVICE. H160 (Revised 06/2018) Case No. 5