Qualified Domestic Relations Order

STATE OF SOUTH CAROLINA	IN THE FAMILY COURT FOR THE XXXXXXXX JUDICIAL CIRCUIT
COUNTY OF	DOCKET NO:
Plaintiff, vs. Defendant.	QUALIFIED DOMESTIC RELATIONS ORDER

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This Qualified Domestic Relations Order is issued pursuant to the Final Decree and Judgment of Divorce issued by this Court on XXXX, which, in pertinent part, provides that a Qualified Domestic Relations Order be prepared and issued pursuant to and meeting the requirements of the Rules and Regulations promulgated under Internal Revenue Code Section 414 (p) as provided by the Retirement Equity Act of 1984, and as amended by the Tax Reform Act of 1986 and the Technical and Miscellaneous Act of 1988, and the Income Tax Regulations of the United States Department of Treasury, as amended, and is intended to create and recognize Plaintiff XXXX right to a portion of the vested balance of Defendant XXXXX interest in the retirement plan described herein in accordance with the provisions hereof, without precipitating tax or penalties to Plaintiff but which will be taxable to Plaintiff in the year of distribution, or at a subsequent date if a qualified rollover is not timely made by Plaintiff.

This apportionment of marital property is made pursuant to Section 20-7-471, et. seq., South Carolina Code of Laws, 1976, as amended, regarding the equitable apportionment of marital property between spouses and former spouses in actions for dissolution of a marriage.

NOW, THEREFORE, it is accordingly

ORDERED that the Plan Administrator of the XXXXXX Money Purchase Plan is hereby provided the information set forth in this Qualified Domestic Relations Order and is hereby ordered and directed to apportion and pay benefits in the manner set forth herein and in accordance with the following particulars, to-wit:

A. PLAN TO WHICH ORDER APPLIES: Purchase Plan (hereafter "Plan").
B. PLAN ADMINISTRATOR:
C. PLAN PARTICIPANT, PARTICIPANT'S ADDRESS & SOCIAL SECURITY NUMBER:
D. COUNSEL FOR PLAN PARTICIPANT:
E. ALTERNATE PAYEE, NAME, ADDRESS AND SOCIAL SECURITY NUMBER:
F. COUNSEL FOR ALTERNATE PAYEE:
G. AMOUNT OF SUBJECT BENEFIT: The Plan Administrator is hereby ordered to pay to the Alternate Payee, XXXXXXX the sum of $ from the segregated account of the Participant, plus any accrued earnings, dividends, interest, and capital appreciation from through the date of distribution to said Alternate Payee.
H. MANNER AND TIME OF PAYMENT: The sum set forth in Paragraph G above shall be paid in cash within 10 days of the date of this Order.
I. NUMBER OF PAYMENTS: The sum set forth above in Paragraph G shall be paid in a single lump sum.
J. DEATH OF PARTICIPANT OR ALTERNATE PAYEE:
Should Participant die before payment is made from the Plan as ordered herein, Alternate Payee is hereby designated as "surviving spouse" only to the extent of her entitlement to payment ordered herein. In the event of the death of the Alternate Payee prior to the payment provided herein, such payment shall be made to Alternate Payee's estate.
K. ORDER NOT TO ALTER PLAN BENEFITS: Nothing contained in this Order shall be construed to require the Plan Administrator:
(a) To provide the Alternate Payee any type or form of benefit or any option not otherwise available to the Participant under the Plan;
(b) To provide to the Alternate Payee increased benefits (determined on the basis of actuarial value) not available to the Participant; or
(c) To pay any benefits to the Alternate Payee which are required to be paid to another Alternate Payee under another Order determined by the Plan Administrator to be a Qualified Domestic Relations Order (hereinafter "QDRO"), before this Order is determined by the plan Administrator to be a QDRO.
L. PLAN TERMINATION: Should the Plan terminate such that the Participant becomes entitled to any election regarding the payment, deferral, former benefit, or any other matter, the Alternate Payee shall be entitled to the same election as the Participant as to those benefits assigned.
N. INTENTION TO CONSTITUTE QDRO: These provisions are intended to constitute a QDRO made pursuant to Section 414 (b) of the Internal Revenue Code of 1986, as amended, and its provisions shall be administered and interpreted in conformity with said Act.
O. RESERVATION OF JURISDICTION AND/OR CHANGES OR AMENDMENTS TO ORDER: This Court hereby reserves jurisdiction to amend this Order limited to those changes necessary to qualify this Order as a Qualified Domestic Relations Order. Both Plaintiff and Defendant agree that their mutual intent is to provide the Alternate Payee with the payments that fairly represent her marital share of he retirement benefit. If any Order submitted to the Plan Administrator or duly recognized representative of the retirement plan is held not to be a Qualified Domestic Relations Order within the meaning of Internal Revenue Code Section 414 (b), both Plaintiff and Defendant agree to request a Court of competent jurisdiction to modify the Order to make it a Qualified Domestic Relations Order that reflects that parties' intent, said modification Order to be entered nunc pro tunc, if appropriate.

NOW, THEREFORE, based upon the foregoing, it is accordingly

ORDERED that the findings, conclusions and Orders set forth above are hereby rendered the Order of the Court and all parties, and the XXXXXXX Plan, together with its Plan Administrator, are hereby ordered and directed to fully and completely comply with such provision in a timely and prompt fashion.

AND IT IS SO ORDERED.

, JUDGE
FAMILY COURT FOR THE ELEVENTH JUDICIAL CIRCUIT

_________________________________, South Carolina

Dated:

WE SO MOVE AND CONSENT:

WITNESS , Plaintiff

WITNESS

WITNESS , Defendant

WITNESS