Basic Information

SENDER Information

Information about you and how we can contact you.
Your Name *

First Name Last Name
Your Email *
example@example.com
Your Phone Number *

Area Code Phone Number
Which of the following best describes your situation? *
What is the name of the law fIrm? *
Is this the first time we have prepared a QDRO for your law firm? *
What is the name of your client? *
What is the name of the lawyer who is helping you? *
What is the Name of the Employee whose retirement is being divided? (This may not be you) *

First Name Middle Name Last Name
What is the Name of the Spouse who will receive a portion of the Employee's retirement? *

First Name Middle Name Last Name
Who Referred You to Us? *

EMPLOYEE Information

The Employee works for the company and is referred to in the QDRO as the Participant.
Please Read!

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Hey there!

It's very important that you identify the right person as the "Employee."

Remember, the employee is the spouse who works for the company that provides the retirement.

We'll get to the questions about the spouse who doesn't work for the company next.
What is the Name of the Employee whose retirement is being divided? (This may not be You) *

First Name Middle Name Last Name
Employee's Residential Mailing Address *

Street Address

Street Address Line 2 (Optional)

City State

Zip Code
Employee's Social Security Number *
The Social Security Number will not appear on the QDRO
Employee's Date of Birth *

Month Day Year

Non-Employee Information (spouse of the employee)

The Non-Employee Spouse is or was married to the Employee. The Non-Employee Spouse does not work for the company and is referred to in the QDRO as the Alternate Payee.
What is the Name of the Spouse who will receive a portion of the Employee's retirement? *

First Name Middle Name Last Name
Spouse's Residential Mailing Address *

Street Address

Street Address Line 2 (Optional)

City State

Zip Code
Spouse's Social Security Number *
The Social Security Number will not appear on the QDRO
Spouse's Date of Birth *

Month Day Year

DIVORCE DOCUMENT

You will find this information at the top of the first page of any court-filed document. Please refer to the example below in answering these questions.
State of Divorce *
What state was the divorce filed in?
What is the name of the Petitioner? *
Please enter the EXACT name as it appears on the document.
What is the name of the Respondent? *
Please enter the EXACT name as it appears on the document.
County of Divorce *
What County was the divorce filed in?
Case Number *
What is the EXACT case number that was assigned to the divorce?
Court Number *
What is the EXACT number of the court that the divorce was assigned to?

Signatures

Who will the sign the QDRO? The Plan Administrator does not require the signatures of either party or either party's attorney. However, the Judge may require signatures of the parties and/or attorneys.
Will the Employee sign the QDRO? *
Will the Spouse sign the QDRO? *
Will the Employee's Attorney sign the QDRO? *
What is the name of the Employee's Attorney? *
Will the Spouse's Attorney sign the QDRO? *
What is the name of the Spouse's Attorney? *

Upload Documents

These documents provide us with important information about your retirement plan and how it is to be divided.
Are you able to upload a copy of your Divorce Decree? *
Please Upload a copy of Your Divorce Decree *

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Upload Divorce Decree Cancel of
If you are unable to upload a copy of your Divorce Decree, please explain. *
Do you have a Benefit Statement or other correspondence from the retirement plan? *
Please upload a benefit statement or other correspondence from the plan. *

Browse Files

Cancel of
If you are unable to upload a copy of a Benefit Statement or other correspondence from the retirement plan, please explain. *
Is there anything else we should know?
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SENDER Information