Model Domestic Relations Order - The Teachers' And State Employees' Retirement System

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M
D
R
O
ODEL
OMESTIC
ELATIONS
RDER
The Teachers’ and State Employees’ Retirement System
STATE OF NORTH CAROLINA
IN THE GENERAL COURT OF JUSTICE
DISTRICT COURT DIVISION
COUNTY OF __________
___ CVD ________
_______________________,
)
Plaintiff,
)
)
v.
)
DOMESTIC RELATIONS ORDER
)
(Teachers’ and State Employees’
_______________________,
)
Retirement System)
Defendant.
)
THIS MATTER coming on for hearing before the Honorable ________________,
District Court Judge presiding, in the civil District Court for ___________ County, North
Carolina;
AND IT APPEARING to the Court that an equitable distribution judgment has been
entered in this action [OR: that the parties have agreed to the entry of a Consent Domestic
Relations Order] concerning distribution of plaintiff’s/defendant’s interest in benefits payable
by the Teachers’ and State Employees’ Retirement System of North Carolina;
NOW, THEN, the Court makes the following:
FINDINGS OF FACT
1.
That the parties were formerly husband and wife, having married on
_____________________, separated on _____________________, and are now divorced.
2.
That an action seeking an equitable distribution of the parties’ marital property
and a judgment dividing said property has been entered by the Court [OR: That parties have
agreed to the entry of a Consent Domestic Relations Order regarding the division of
benefits in a pension plan containing marital property] pursuant to G.S. 50-20.
3.
That at the time of the parties’ separation, plaintiff/defendant,
[name] ,
(redacted) Social Security number xxx-xx-___, was a member of the Teachers’ and State
Employees’ Retirement System of North Carolina (hereinafter “the Retirement System”).

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