This order assigns to [Alternate Payee's Name] ("Alternate Payee") the right to receive a portion of the pension benefits provided by the Sprinkler Industry Supplemental (SIS) Pension Fund to [Name of Participant] (" Participant").

The last known mailing address of the Participant, (Participant's name and social security number), is . . .

The last known mailing address of the Alternate Payee, (Alternate Payee's name and social security number), is . . .

Alternate Payee shall receive 50% of Participant's individual account accrued during the marriage (state period of marriage or state specific dollar amount) plus any investment income less administrative expenses at the rate allocated by the Plan to participant's accounts from [state date of account division] and until the time of the first benefit payment.

Once this order is determined by the SIS Pension Fund to be a QDRO as defined in ERISA, the SIS Pension Fund will establish a separate account in the name of the Alternate Payee into which the Alternate Payee's portion of the Participant's benefit will be transferred. Upon establishment of this separate account, the Alternate Payee will have the same rights with respect to her benefit account as do Participants under the terms of the SIS Pension Plan, except to the extent that such rights are limited by this order.

The Alternate Payee may elect to receive her portion of the benefit on the earlier of the date the Participant is entitled to a distribution from the plan or the date the Participant attains (or would have attained) age 50.

Alternate Payee may elect to receive her benefits in any form of payment allowed by the Plan, except in the form of a Qualified Joint and Survivor annuity. All benefits due the Alternate Payee shall be sent directly from the Sprinkler Industry Supplemental Pension Fund to Alternate Payee.

The Alternate Payee may designate a beneficiary for her portion of the account, in the event the Alternate Payee dies before the account is fully distributed. If the Alternate Payee does not make a valid beneficiary designation in accordance with the Plan, the Alternate Payee's benefits will be distributed in accordance with the Plan.