IN THE COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS CUYAHOGA COUNTY, OHIO ____________________________________ PETITIONER-01 : CASE NO. DR ________________________ : and JUDGE ______________________________ : ____________________________________ PETITIONER-02 : JUDGMENT ENTRY OF DISSOLUTION (WITHOUT CHILDREN) This cause came on for hearing on the _____ day of ______________, 20__ and was duly heard before: the Honorable ______________________________, Judge of the Domestic Relations Division of the Court of Common Pleas Magistrate ______________________________ to whom this cause 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. Upon due consideration thereof, the Court finds one/both of the parties was a resident/were residents of the State of Ohio for more than six (6) months immediately preceding the filing of the Petition; they were married as alleged; and there are no minor children of the marriage. The Court further finds 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 which is fair, just and equitable. The Court further finds, in open court this date, the parties acknowledged they were still in agreement as to the terms thereof and there has been a full disclosure by each of the parties of all of his or her assets. The Court further finds a copy of said agreement is attached hereto, marked Exhibit "A", and is incorporated herein as if fully rewritten. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that the marriage contract heretofore existing between the parties be and is hereby dissolved and set aside and the terms of the attached separation agreement ordered into execution. 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. 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 H953/DR0908129 Dissolution/no children 1 American LegalNet, Inc. www.FormsWorkFlow.com jurisdiction to enter further orders as are necessary to enforce the assignment of benefits to the nonparticipant 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 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 the ___________________ (DOB: ___________) be and she hereby is restored to her former name of ________________________. IT IS FURTHER ORDERED, ADJUDGED AND DECREED that the costs of this proceeding shall be paid by ________________________________. ___________________________________________ MAGISTRATE ________________________________________ JUDGE Approved by: _______________________________________ PETITIONER-01 _________________________________________ PETITIONER-02 _______________________________________ ATTORNEY FOR PETITIONER-01 _________________________________________ ATTORNEY FOR PETITIONER-02 H953/DR0908129 Dissolution/no children 2 American LegalNet, Inc. www.FormsWorkFlow.com