H134 (Revised 3/2016) Case No. COURT OF COMMON PLEAS DIVISION OF DOMESTIC RELATIONS CUYAHOGA COUNTY, OHIO : CASE NO. DR PLAINTIFF : vs. JUDGE : J U DGMENT ENTRY OF DEFENDANT : LEG A L SE P ARA T ION ( With Children ) : (No S e p a r ation/In - C ourt Agree m ent Attached) 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: 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 Answer of Defendant. Complaint of Plaintiff and the evidence, Defendant having withdrawn his/her Answer or Answer and Counterclaim. Complaint of Plaintiff, Counterclaim of Defendant and the evidence. Counterclaim of Defendant and the evidence, Plaintiff having withdrawn his/her Complaint. Present at the hearing was/were Plaintiff Defendant Counsel for Plaintiff Counsel for Defendant Other: . The Court finds that Plaintiff was a resident of the State of Ohio for more than six (6) months immediately preceding the filing of the Complaint and that venue is proper in this county. The Court further finds that it has personal jurisdiction over Defendant. The Court further finds that all service and notice provisions have been satisfied according to law. The Court finds that: (Check one of the following two boxes) Neither Plaintiff nor Defendant is in the military service of the United States. Plaintiff and/or Defendant is/are in the military service of the United States and his/her military service did not impact his/her ability to defend this action. The parties were married as alleged and there is/are minor child(ren) of the marriage, to wit: Full name and Date of Birth of each child: The Court further finds that Plaintiff has Defendant has both parties have established the cause of living separate and apart for one year without cohabitation; incompatibility, not denied; American LegalNet, Inc. www.FormsWorkFlow.com H134 (Revised 3/2016) Case No. and by reason thereof Plaintiff is Defendant is both parties are entitled to a Legal Separation. IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that Plaintiff is Defendant is both parties are hereby granted a Legal Separation from Plaintiff Defendant each other. DIVISION OF PROPERTY Real Property (Check one of the following two boxes) The Court finds that neither party owns or has an interest in any real property. -OR- 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 Plaintiff Defendant is hereby awarded as division of property Plaintiff222s Defendant222s interest in the real property located at , the legal description of which is attached as Exhibit and incorporated herein as if fully rewritten. Plaintiff Defendant is ordered to execute a Quit Claim Deed in favor of Plaintiff Defendant 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 Other Property and Debts (Check one of the following two boxes) The Court finds that the parties have divided all personal property and debts to their mutual satisfaction. (If this box is checked, skip remainder of this Section and go to SPOUSAL SUPPORT) IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that based upon the evidence presented, each party has received any separate property that he/she may have and that the parties have divided their marital property to their mutual satisfaction. Each party shall pay the debts in his and her name and hold the other harmless for those debts. -OR- The Court finds that the separate property, marital property and debts acquired during the marriage shall be divided as follows: American LegalNet, Inc. www.FormsWorkFlow.com H134(Revised 3/2016) Case No. Property IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that Plaintiff is hereby awarded the following items of personal property, free and clear from any claim by Defendant, subject to any indebtedness which the Plaintiff shall pay and from which the Plaintiff shall hold the Defendant harmless: ITEM VALUE IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Defendant is hereby awarded the following items of personal property, free and clear from any claim by Plaintiff, subject to any indebtedness which the Defendant shall pay and from which the Defendant shall hold the Plaintiff harmless: ITEM VALUE IT IS FURTHER ORDERED, ADJUDGED AND DECREED that, pursuant to Ohio Revised Code 2473105.171(A)(6) and (B), the following is determined to be separate property and is awarded as follows: ITEM VALUE PROPERTY OF AWARDED TO Debt IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Plaintiff shall pay and hold Defendant harmless on the following debts: ITEM AMOUNT DUE IT IS FURTHER ORDERED, ADJUDGED AND DECREED that Defendant shall pay and hold Plaintiff harmless on the following marital debts: ITEM AMOUNT DUE American LegalNet, Inc. www.FormsWorkFlow.com H134(Revised 3/2016) Case No. Retirement Assets (Check one of the following two boxes) The Court finds that neither Plaintiff nor Defendant has retirement assets earned during the marriage. -OR- The Court finds that the parties have the following retirement assets earned during the marriage: Plaintiff (name of party) is a Participant under the (name of the plan) administered by earned through employment with (name of employer) Defendant (name of party) is a Participant under the (name of the plan) administered by earned through employment with (name of employer) (Check one of the following two boxes) IT IS THEREFORE ORDERED, ADJUDGED AND DECREED that each party shall retain any retirement assets they have earned during the marriage. -OR- 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. -OR- 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 Plaintiff Defendant, 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 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. American LegalNet, Inc. www.FormsWorkFlow.com H134 (Revised 3/2016) Case No. 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. Equal/Equitable Property Division (Check one of the following two boxes) The Court finds that the above division constitutes an equal division of the property. -OR- The Court finds that the above division of property, though not equal, is equitable for the following reaso