Division Of Property Order (Page 5 of 7) in pdf

Applicable Benefit:

The monthly benefit amount used to determine the amount paid to

the Alternate Payee from the Participant’s monthly benefit shall be whichever applies:

If the Participant is receiving a monthly benefit, the monthly benefit shall be the

gross monthly benefit the Participant is receiving at the time the decree of divorce

or dissolution becomes final.

The effective date of the decree of divorce,

dissolution, or legal separation is

;

If the Participant has applied for but is not yet receiving a monthly benefit, the

monthly benefit shall be the benefit for which the Participant is eligible;

If the Participant has not applied for a benefit, the monthly benefit shall be the

benefit calculated at the time the Participant elects to take the benefit.

Minimum Benefit Notice:

The total amount paid to the Alternate Payee pursuant to

this order plus any administrative fee charged to the Participant and Alternate Payee as

authorized by Section 3105.84, Revised Code, shall not exceed fifty percent of the

amount of a benefit or lump sum payment that the Plan Participant is to receive or, if

withholding is to be made from more than one benefit or lump sum payment, fifty percent

of the total of the benefits or lump sum payments that the Plan Participant is to receive.

If the Plan Participant’s benefit or lump sum payment is or will be subject to more than

one order issued pursuant to Section 3105.81, Revised Code, the Public Retirement

Program shall not withhold an aggregate amount for all the orders plus the administrative

fee(s) charged to the Participant and Alternate Payee as authorized by Section 3105.84,

Revised Code, that exceeds fifty percent of the benefit or lump sum payment.

Any cost-of-living allowance (“COLA”) granted to a

Cost of living allowances:

Participant while this Order is in effect shall be apportioned between the Participant and

Alternate Payee in the same proportion that the amount being paid the Alternate Payee

bears to the amount paid the Participant, as provided under Sections 145.323(B),

742.3711(G), 742.3716(F), 742.3717(B)(3), 3307.67(C), 3309.374(B), and 5505.174(C),

Revised Code.

III.

Notification to Alternate Payee:

The Alternate Payee is hereby notified of the following:

The Alternate Payee’s right to payment under this Order is conditional on the Plan

Participant’s right to a benefit payment or lump sum payment from the Public Retirement

Program;

When the Plan Participant’s benefit or lump sum payment is subject to more than one

order under Section 3105.81, Revised Code, or to an order described in Section 3105.81,

Revised Code and a withholding order under Section 3121.03, Revised Code, the amount

paid to the Alternate Payee under this order may be reduced based on the priority of the

other orders;

Division Of Property Order Page 5