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Judgment Entry Divorce With Children Form. This is a Ohio form and can be use in Cuyahoga County (Court Of Common Pleas).
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COURT OF COMMON PLEAS
DIVISION OF DOMESTIC RELATIONS
CUYAHOGA COUNTY, OHIO
___________________________________
PLAINTIFF
:
CASE NO. ____________________________
:
vs.
:
___________________________________
DEFENDANT
JUDGE _______________________________
:
:
JUDGMENT ENTRY OF DIVORCE
WITH CHILDREN
This cause came on for hearing on _______________ and was duly heard before the Honorable
_________________________, Judge of the Domestic Relations Division of the Court of Common Pleas,
upon the:
Complaint of Plaintiff and the evidence, Defendant being in default of Answer or other pleading
although duly served with process, according to law.
Complaint of Plaintiff and the evidence, Defendant having withdrawn his Answer and Counterclaim.
Complaint of Plaintiff, and
Counterclaim of Defendant, and the evidence.
Counterclaim of Defendant, and the evidence.
The Court finds that Plaintiff was a resident of the State of Ohio for more than six (6) months and
a bona fide resident of Cuyahoga County for more than ninety (90) days, both immediately preceding the
filing of the Complaint; the parties were married as alleged; and there are _____ minor child(ren) of the
marriage, to wit:
________________________________
DOB _________________
First and Last Name
________________________________
DOB _________________
First and Last Name
________________________________
DOB _________________
First and Last Name
The Court further finds Plaintiff Defendant both parties has/have established the cause of
living separate and apart for one year without cohabitation
incompatibility, not denied
___________________________________,
and by reason thereof
Plaintiff
Defendant
both parties is/are entitled to a divorce.
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that Plaintiff Defendant
both parties is/are hereby granted a divorce from Plaintiff Defendant each other and that the
marriage contract heretofore existing between the parties is hereby dissolved and set aside.
SPOUSAL SUPPORT
The Court finds, upon considering the factors set forth in Ohio Revised Code §3105.18 and in
particular those specified below, that it is appropriate for Plaintiff
Defendant to pay spousal
Defendant. The Court finds that the following factors support this award:
support to Plaintiff
_____________________________________________________________________________________
____________________________________________________________________________________.
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IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that Plaintiff
Defendant
shall pay spousal support to Plaintiff
Defendant in the sum of $_____________ per month plus
2% processing charge for a term of _____________
years
months commencing
____________________. Pursuant to Ohio Revised Code §3105.18(B), all payments shall terminate
upon the death of either party.
(Check if applicable)
In addition, spousal support shall terminate upon the remarriage of the spouse receiving
support.
The Court:
shall retain jurisdiction to modify this order
shall not retain jurisdiction to modify this order.
ALLOCATION OF PARENTAL RIGHTS AND RESPONSIBILITIES
FOR THE CARE OF THE CHILD(REN)
(Check applicable boxes)
The Court finds that a pleading or motion requesting shared parenting was filed by at least
one parent
both parents jointly and a plan for shared parenting was filed at least 30 days prior to
hearing which plan the Court determines to be in the best interest of the child(ren).
The Court finds that the parents have waived the requirement of a written request for shared
parenting and plan for shared parenting filed at least 30 days before hearing. The Court finds that the
parents have agreed to shared parenting and have jointly submitted a plan on the date of hearing which
plan the Court finds is in the best interest of the child(ren).
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that this Judgment Entry
shall constitute an ORDER FOR SHARED PARENTING and the parties shall share the rights and
responsibilities for the care of the children in accordance with the attached approved shared parenting
plan, which is adopted and incorporated herein by reference.
-ORIT IS THEREFORE ORDERED, ADJUDGED AND DECREED that parental rights and
responsibilities are allocated primarily to ________________________ who is hereby designated the
residential parent and legal custodian of the minor child(ren). The parent who is not the residential
parent, ________________________, shall have parenting time
in accordance with the schedule
in accordance with the Standard Parenting Time Guidelines attached as Exhibit ____
attached hereto
and incorporated by reference.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the residential parent(s)
shall file a notice of intent to relocate if he/she intends to move to a residence other than the one specified
in this order. Pursuant to the determination made under Ohio Revised Code §3109.051(G)(2) and subject
shall not be sent a
to further order of the Court, the parent who is not the residential parent shall
copy of any notice of relocation filed with the Court.
CHILD SUPPORT
For purposes of this order Plaintiff
Defendant is the Child Support Obligee.
Defendant is the Child Support Obligor and
Plaintiff
This order for child support and cash medical support is effective ________________.
The worksheet used to compute child support and cash medical support under Ohio Revise Code
§3119.022 or §3119.023 is attached as Exhibit ____.
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IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that when private health
insurance IS being provided by a party in accordance with this order for the child(ren) named above, the
Child Support Obligor shall pay child support for the minor child(ren) in the sum of $_____________
per month ($_____________ per month per child) to the Child Support Obligee, and/or his/her
assignee(s), plus 2% processing charge. (Line 29, Child Support Computation Worksheet-Sole Residential Parent or
Shared Parenting Order or Line 27, Child Support Computation Worksheet-Split Parental Rights and Responsibilities)
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that when private health
insurance IS NOT being provided by a party in accordance with this order for the child(ren) named
above, the Child Support Obligor shall pay child support for the minor child(ren) in the sum of
$_____________ per month ($_____________ per month per child) to the Child Support Obligee, and/or
his/her assignee(s), for the minor children, plus 2% processing charge. (Line 29, Child Support Computation
Worksheet-Sole Residential Parent or Shared Parenting Order or Line 27, Child Support Computation Worksheet-Split Parental
Rights and Responsibilities)
(Check if applicable)
The above child support deviates from the amount of child support that would otherwise result
from the use of the Basic Child Support Schedule and the applicable worksheet, through the line
establishing the actual annual obligation because, pursuant to Ohio Revised Code §3119.22 the amount
would be unjust and inappropriate and would not be in the best interest of the minor child(ren) for the
following reason(s):
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
IT IS FURTHER ORDERED ADJUDGED AND DECREED that when private health
insurance IS NOT being provided by a party in accordance with this order for the child(ren) named
above, the Child Support Obligor shall pay cash medical support in the sum of $_________________
per month ($_____________ per month per child), plus 2% processing charge. (Line 31, Child Support
Computation Worksheet-Sole Residential Parent or Shared Parenting Order or Line 29, Child Support Computation WorksheetSplit Parental Rights and Responsibilities)
If private health insurance coverage is being provided and becomes unavailable or is
terminated, the Child Support Obligor SHALL BEGIN paying cash medical support commencing
the first day of the month immediately following the month in which private health insurance
coverage became unavailable or is terminated, and SHALL CEASE paying cash medical support
on the last day of the month immediately preceding the month in which private health insurance
coverage begins or resumes. Cash medical support shall be paid in addition to child support.
(Check if applicable)
The Court finds that the parties have an administrative support order, case number P-_________,
(SETS #_________________) issued by the _______________County Child Support Enforcement
Agency (COPY ATTACHED HERETO) that requires ____________________ to pay
$_____________ per month per child, plus 2% processing charge, for the support of the above–named
child(ren). The Court finds it appropriate to adopt this order for the purpose of preserving and
determining arrearage accrued under the administrative order.
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the administrative order
is hereby adopted and any arrears and overpayments accrued under the administrative order are hereby
preserved. The _________________ County CSEA shall terminate any support withholding or deduction
notice issued in case number P-_________________. All support paid hereafter shall be under
Cuyahoga Domestic Relations case number _________________. The Child Support Obligor shall be
given credit for any payments received under the administrative order.
The Court further finds that as of ____________________ the arrearage is $_____________.
This sum includes all accrued child support, cash medical support, spousal support, processing charges,
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and arrearage accrued under the above-referenced administrative order, if any. This sum supercedes all
prior determinations of arrearage. The Support Obligor has been credited with all support payments made
through the CSEA, payments made directly to and acknowledged by the Child Support Obligee, credit
acknowledged by the Child Support Obligee for support provided directly to the child(ren), and credit for
support waived by the Child Support Obligee, as of the computation date.
The arrearage also
includes the Child Support Obligor’s share of health care expenses not covered by private health
insurance or cash medical support.
(Appropriate box must be checked)
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the Child Support
Obligor shall pay an additional $_____________ per month toward the existing arrearage.
-ORIT IS THEREFORE ORDERED, ADJUDGED AND DECREED that judgment is hereby
entered in favor of ___________________ and against ____________________, and upon which
execution may issue.
The duty of support shall continue until further order of Court or until the above-named child(ren)
reach(es) age 18 or so long as the child(ren) continuously attend(s), on a full-time basis, any recognized
and accredited high school, however, no later than age 19, or as otherwise provided in Ohio Revised Code
§3119.86.
Total monthly order is $_____________ when health insurance is provided.
This includes: $_____________ current child support (including 2% processing charge)
$_____________ current spousal support (including 2% processing charge)
$_____________ arrearage payment (including 2% processing charge).
Total monthly order is $_____________when health insurance is not provided.
This includes: $_____________ current child support (including 2% processing charge)
$_____________ current spousal support (including 2% processing charge)
$_____________ current cash medical support (including 2% processing charge)
$_____________ arrearage payment (including 2% processing charge).
All support shall be paid through Ohio Child Support Payment Central (OCSPC), P.O. Box
182372, Columbus, Ohio 43218-2372. Any payments not made through OCSPC shall not be
considered as payment of support. Checks or money orders shall be made payable to “OCSPC”. Cash
payments to OCSPC may be made at the Cuyahoga County Treasurer’s Office, County Administration
st
Building, 1 Floor – Cashier, 1219 Ontario Street, Cleveland, Ohio 44113. All payments shall include the
following: Obligor’s name, Social Security Number, SETS case number, and Domestic Relations Court
case number.
All support under this order shall be withheld or deducted from the income or assets of the
obligor pursuant to a withholding or deduction notice or appropriate order issued in accordance with
Chapters 3119., 3121., 3123., and 3125. of the Revised Code or a withdrawal directive issued pursuant to
sections 3123.24 to 3123.38 of the Revised Code and shall be forwarded to the obligee in accordance with
Chapters 3119., 3121., 3123., and 3125. of the Revised Code.
To secure the support obligations, the Court finds that:
(Check appropriate box)
The Child Support Obligor receives income from an income source. A withholding notice shall
issue in the amount of $_____________ per month.
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INCOME SOURCE
ADDRESS
__________________________________________
__________________________________________
__________________________________________
The income source shall be notified not to withhold a total amount, including all fees, in excess of
the amount allowed under Section 303(b) of the “Consumer Credit Protection Act,” 15 U.S.C. 1673(B).
Until the income source begins withholding in the appropriate amount, the Child Support Obligor
shall make payments directly to OCSPC.
The Child Support Obligor has nonexempt funds on deposit in an account at a financial
institution. A deduction notice shall issue upon the account in the amount of $_____________ per
month.
FINANCIAL INSTITUTION
ADDRESS
__________________________________________
__________________________________________
__________________________________________
The Obligor shall immediately notify the CSEA of the number of the account from which support
shall be deducted, and the name and location of the financial institution if not set forth above.
The Child Support Obligor has no attachable income source and has the ability to post a cash
bond. An order to post bond in the amount of $_____________ shall issue.
The Child Support Obligor has no attachable income and has no assets to post a bond. An order
to seek work and report income shall issue.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that pursuant to Revised Code
§3119.82 the following person(s) shall claim the child(ren) who is/are the subject of this order as (a)
dependent(s) for federal income tax purposes:
Mother
Father
Both Mother and Father according to the following terms: ____________________________
___________________________________________________________________________
___________________________________________________________________________
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the parties shall take
whatever action is necessary pursuant to section 152 of the “Internal Revenue Code of 1986,” 100 Stat.
2085, 26 U.S.C. 1, as amended, to enable the parent who has been awarded the right to claim the
exemption(s) to claim the child(ren) as (a) dependent(s) for federal income tax purposes in accordance
with this order. Failure of a party to comply with the order may be considered contempt of Court.
MEDICAL SUPPORT OF CHILDREN
Pursuant to Ohio Revised Code §3119.30(A) both parents are liable for the health care of the
child(ren) who is/are not covered by private health insurance or cash medical support as calculated in
accordance with §3119.022 or §3119.023, as applicable.
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the parents shall share
liability for the ordinary and extraordinary health care expenses of the child(ren) who is/are not covered
by private health insurance or cash medical support as calculated in accordance with §3119.022 or
§3119.023, as applicable,
in amounts equal to the percentages indicated on Line 16 of the Child Support
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Computation Worksheet.
in accordance with the following formula: _______________________________________.
(Check appropriate of two boxes)
Based upon the HEALTH CARE DETERMINATIONS, attached hereto as Exhibit ____ and
incorporated herein by reference, the Court finds that neither parent has private health insurance
coverage available for the child(ren) at a reasonable cost.
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the Child Support
Obligor and the Child Support Obligee shall immediately inform the CSEA if private health insurance
coverage for the child(ren) becomes available to either the Obligor or the Obligee. The CSEA shall
determine if the private health insurance is available at a reasonable cost and if coverage is reasonable,
order the Obligor or the Obligee to obtain private health insurance.
-ORBased upon the HEALTH CARE DETERMINATIONS, attached hereto as Exhibit ____ and
incorporated herein by reference, the Court finds that the mother and/or the father have the following
private health insurance coverage available for the child(ren) at a reasonable cost through a group
policy, contract, or plan:
Insurer:
_______________________________________________
_______________________________________________
Available to:
Mother
Father
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the following person(s)
is/are hereby designated as the Health Insurance Obligor(s), until further order of Court:
Mother
Father
Mother and Father
The Health Insurance Obligor(s) shall provide private health insurance through:
MOTHER
Name of employer/group/individual
Address of employer/group/individual
Name of health plan
Name of insurance company
Claims address of insurance company
Customer service telephone number
Group number
Identification/Subscriber number
FATHER
Name of employer/group/individual
Address of employer/group/individual
Name of health plan
Name of insurance company
Claims address of insurance company
Customer service telephone number
Group number
Identification/Subscriber number
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
_______________________________________
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and shall designate the following child(ren) as covered dependents under the private health insurance
policy, contract or plan:
Full name of each child subject to the Medical Support Order
_________________________________________________
_________________________________________________
_________________________________________________
Date of Birth
____________
____________
____________
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that pursuant to Ohio Revised
Code §3119.30 the parent(s) ordered to provide private health insurance for the child(ren) shall, not later
than thirty (30) days after the issuance of the order, supply the other parent with information regarding the
benefits, limitations and exclusions of the health insurance coverage, copies of any insurance forms
necessary to receive reimbursement, payment, or other benefits under the health insurance coverage and a
copy of any necessary insurance cards.
The following individual shall be reimbursed for covered out-of-pocket medical, optical, hospital,
dental, or prescription expenses paid for the above-named child(ren):
Name of party
Address
Telephone number
_________________________________________
_________________________________________
_________________________________________
_________________________________________
The health plan administrator(s) of the health insurer(s) that provide(s) the private health
insurance coverage for the child(ren) may continue making payment for medical, optical, hospital, dental,
or prescription services directly to any health care provider in accordance with the applicable private
health insurance policy, contract, or plan.
The employer(s) of the person(s) required to obtain private health insurance coverage is/are
required to release to the other parent, any person subject to an order issued under §3109.19 of the
Revised Code, or the CSEA, on written request, any necessary information on the private health insurance
coverage, including the name and address of the health plan administrator and any policy, contract or plan
number, and to otherwise comply with Ohio Revised Code §3119.32 and any order or notice issued under
this section.
If the person(s) required to obtain private health insurance coverage for the child(ren) subject to
this child support order obtain(s) new employment, the agency shall comply with the requirements of
section 3119.34 of the Revised Code, which may result in the issuance of a notice requiring the new
employer to take whatever action is necessary to enroll the child(ren) in private health insurance coverage
provided by the new employer.
Any employer who receives a copy of an order issued under Ohio Revised Code §3119.30,
§3119.33 or §3119.34 shall notify the CSEA of any change in or the termination of the Child Support
Obligor’s or the Child Support Obligee’s private health insurance coverage that is maintained pursuant to
the order.
Upon receipt of notice by the CSEA that private health insurance coverage is not available at a
reasonable cost, cash medical support shall be paid in the amount as determined by the child support
computation worksheets in §3119.022 or §3119.023 of the Revised Code, as applicable. The CSEA may
change the financial obligations of the parties to pay child support in accordance with the terms of
the court order and cash medical support without a hearing or additional notice to the parties.
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IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the Child Support
Obligor and the Child Support Obligee shall comply with the request of the CSEA in advance of an
administrative review of a support order to provide the following: copy of federal income tax return from
the previous year, copy of all pay stubs within the preceding six (6) months, copy of all other records
evidencing the receipt of any other salary, wages or compensation within the preceding six (6) months,
and, if the Obligor is a member of the uniformed services and on active military duty, a copy of the
Obligor’s Internal Revenue Service Form W-2, “Wage and Tax Statement,” and a copy of a statement
detailing the Obligor’s earnings and leave with the uniformed services. The Child Support Obligor and
the Child Support Obligee shall also provide a list of available group health insurance and health care
policies, contracts and plans, and their costs, the current health insurance or health care policy, contract,
or plan under which the Obligee and/or Obligor is/are enrolled, and their costs, including any Tricare
program offered by the United States Department of Defense available to the Obligee, and any other
information necessary to properly review the child support order.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the residential parent and
legal custodian of the child(ren) immediately shall notify, and the obligor under a child support order
may notify, the CSEA of any reason for which the child support order should terminate, including but not
limited to the child’s death, marriage, emancipation (age 18 or high school completion/termination),
enlistment in the Armed Services, deportation, or change of legal custody. A willful failure to notify the
CSEA is contempt of court.
The following information is provided for the use of the CSEA in accordance with §3121.24 and
§3121.30 of the Ohio Revised Code:
CHILD SUPPORT OBLIGEE:
NAME
MAILING ADDRESS
RESIDENCE ADDRESS
RESIDENCE PHONE NO.
SOCIAL SECURITY NO.
DATE OF BIRTH
DRIVER’S LICENSE NO.
______________________
______________________
______________________
______________________
______________________
______________________
______________________
CHILD SUPPORT OBLIGOR:
NAME
MAILING ADDRESS
RESIDENCE ADDRESS
RESIDENCE PHONE NO.
SOCIAL SECURITY NO.
DATE OF BIRTH
DRIVER’S LICENSE NO.
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
The parties affected by the support order shall inform the CSEA of any change of name or other
change of conditions that may affect the administration of the order. Willful failure to inform the CSEA
of the above information and any changes is contempt of court.
NOTICE TO CHILD SUPPORT OBLIGOR AND OBLIGEE
PURSUANT TO OHIO REVISED CODE § 3121.29
EACH PARTY TO THIS SUPPORT ORDER MUST NOTIFY THE CHILD SUPPORT
ENFORCEMENT AGENCY IN WRITING OF HIS OR HER CURRENT MAILING ADDRESS,
CURRENT RESIDENCE ADDRESS, CURRENT RESIDENCE TELEPHONE NUMBER,
CURRENT DRIVER’S LICENSE NUMBER, AND OF ANY CHANGES IN THAT
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INFORMATION. EACH PARTY MUST NOTIFY THE AGENCY OF ALL CHANGES UNTIL
FURTHER NOTICE FROM THE COURT OR AGENCY, WHICHEVER ISSUED THE
SUPPORT ORDER. IF YOU ARE THE OBLIGOR UNDER A CHILD SUPPORT ORDER AND
YOU FAIL TO MAKE THE REQUIRED NOTIFICATIONS, YOU MAY BE FINED UP TO $50
FOR A FIRST OFFENSE, $100 FOR A SECOND OFFENSE, AND $500 FOR EACH
SUBSEQUENT OFFENSE. IF YOU ARE AN OBLIGOR OR OBLIGEE UNDER ANY
SUPPORT ORDER ISSUED BY A COURT AND YOU WILLFULLY FAIL TO GIVE THE
REQUIRED NOTICES, YOU MAY BE FOUND IN CONTEMPT OF COURT AND BE
SUBJECTED TO FINES UP TO $1,000 AND IMPRISONMENT FOR NOT MORE THAN 90
DAYS.
IF YOU ARE AN OBLIGOR AND YOU FAIL TO GIVE THE REQUIRED NOTICES,
YOU MAY NOT RECEIVE NOTICE OF THE FOLLOWING ENFORCEMENT ACTIONS
AGAINST YOU: IMPOSITION OF LIENS AGAINST YOUR PROPERTY; LOSS OF YOUR
PROFESSIONAL OR OCCUPATIONAL LICENSE, DRIVER’S LICENSE, OR
RECREATIONAL LICENSE; WITHHOLDING FROM YOUR INCOME; ACCESS
RESTRICTION AND DEDUCTION FROM YOUR ACCOUNTS IN FINANCIAL
INSTITUTIONS; AND ANY OTHER ACTION PERMITTED BY LAW TO OBTAIN MONEY
FROM YOU TO SATISFY YOUR SUPPORT OBLIGATION.
Failure to comply with this support order can result in a contempt action; and, as provided in
Ohio Revised Code §2705.05, the penalty for which may be imprisonment for not more than thirty (30)
days in jail and/or fine of not more than $250.00 for a first offense, not more than sixty (60) days in jail
and/or fine of not more than $500.00 for a second offense, and not more than ninety (90) days in jail
and/or not more than $1,000.00 fine for a third or subsequent offense.
DIVISION OF PROPERTY
The Court finds that the “duration of the marriage” is from _____________ until __________.
IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the marital property
acquired during the marriage shall be divided in accordance with this order.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that, pursuant to Ohio Revised
Code §3105.171(A)(6) and (B), the following is determined to be separate property and is awarded as
follows:
ITEM
_____________________
_____________________
_____________________
_____________________
VALUE
___________
___________
___________
___________
PROPERTY OF
___________________
___________________
___________________
___________________
AWARDED TO
___________________
___________________
___________________
___________________
The Court makes the following findings of fact in support of its determination that the following
property, though found to be the separate property of _________________________, should not be
disbursed to that party: __________________________________________________________________
____________________________________________________________________________________.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Plaintiff is hereby awarded
the following property as division of property, free and clear from any claim by Defendant:
ITEM
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
VALUE
___________________
___________________
___________________
___________________
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IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Plaintiff pay and hold
Defendant harmless on the following marital debts:
ITEM
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
AMOUNT DUE
___________________
___________________
___________________
___________________
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Defendant is hereby
awarded the following property as division of property, free and clear from any claim by Plaintiff:
ITEM
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
VALUE
___________________
___________________
___________________
___________________
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Defendant pay and hold
Plaintiff harmless on the following marital debts:
ITEM
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
AMOUNT DUE
___________________
___________________
___________________
___________________
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that _________________ be
and he/she is hereby awarded as division of property ___________________’s interest in the real estate,
the legal description of which is attached as Exhibit ___ and incorporated herein as if fully rewritten and
(if personal jurisdiction) __________________ is ordered to execute a deed in favor of
__________________ to said property; upon his/her failure to do so within five (5) days of the signing
hereof, 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 Auditor and County Recorder.
The Court determines that the foregoing constitutes an equal division of the property.
-ORThe Court determines that the foregoing division of property, though not equal, is equitable
and makes the following findings of fact in support of that determination: _________________________
_____________________________________________________________________________________
____________________________________________________________________________________.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that___________________
pay to ________________________ as additional spousal support the expenses for his/her counsel fees in
the sum of $____________, for which judgment is rendered and execution may issue.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that any Qualified Domestic
Relations Order (QDRO) or Division of Property Order that is necessary to implement the orders herein,
and was not submitted at the time of this final hearing pursuant to Local Rule 28(E)(l) of the Court of
Common Pleas, Division of Domestic Relations, Cuyahoga County, Ohio, shall be prepared by the party
noted in that Rule or ___________________________, no later than ________________ days from this
date.
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IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the Court retains
jurisdiction with respect to the Qualified Domestic Relations Order or Division of Property Order 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 nonparticipant as set forth herein, including the re-characterization 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 the participant shall not take
actions, affirmative or otherwise, that can circumvent the terms and provisions of the Qualified Domestic
Relations Order or Division of Property Order, or that may diminish or extinguish the rights and
entitlements of the non-participant.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that ____________________
(DOB ________________) be and is hereby restored to 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.
IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the costs of this proceeding
shall be paid by ______________________________________ for which judgment is rendered in favor
of the Clerk of Court upon which execution may issue.
IT IS SO ORDERED.
______________________________________
JUDGE
___________________________________
___________________________________
PLAINTIFF
ATTORNEY FOR PLAINTIFF
___________________________________
___________________________________
DEFENDANT
ATTORNEY FOR DEFENDANT
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