Division Of Property Order printable pdf download

Division Of Property Order

IN THE COURT OF COMMON PLEAS OF

COUNTY, OHIO

DIVISION OF DOMESTIC RELATIONS

Plaintiff/Petitioner,

Case No.

Judge

Defendant/Petitioner.

DIVISION OF PROPERTY ORDER

The Court finds the following facts and issues the following Order pursuant to Sections 3105.80 to

3105.90, Revised Code:

Terms:

The “Plan Participant” or “Participant” means ____________________________, Social

Security number ________________, whose date of birth is ___________, whose current

address is _________________________________________, and whose current mailing

address is _______________________________________________________________.

The “Alternate Payee” means ____________________________________, Social

Security number _________________, whose date of birth is __________, whose current

address is _________________________________________, and whose current mailing

address is _______________________________________________________________.

The “Public Retirement Program(s)” means (please check the name and address of the

public retirement program(s) and/or University/College Alternative Retirement Plan

Administrator):

Ohio Public Employees Retirement System

277 East Town Street

Columbus, Ohio 43215

State Teachers Retirement System of Ohio

275 East Broad Street

Columbus, Ohio 43215

This form was created under Ohio Revised Code Section 3105.90. Since Ohio Revised Code Section 3105.82 requires that this form be used,

variance from this form will result in non-acceptance of the order by the Public Retirement Program.

(Rev. 04/2015)

Division Of Property Order