401K Questionnaire

SENDER Information

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

First Name Last Name
Your Email *
For help with this answer, /bclick/cb here.
Your Phone Number *

Area Code Phone Number
Your Client's Name

First Name Last Name
Information About Your 401K

PLEASE NOTE: the QDRO cannot award "50% of the community property" portion of the account to a spouse. The Plan Administrator will not calculate the community property. If the parties intend to award a percentage of just the community property, the parties must make that calculation themselves and submit it as a dollar amount. The Plan Administrator will not make the community property calculation for them.
How will the 401K be divided? *
Dollar or Percentage? BUT NOT A PERCENTAGE OF THE COMMUNITY!
What percentage of the TOTAL ACCOUNT BALANCE will the non-employee spouse receive? *
What dollar amount will the non-employee spouse receive? *
Do you want to use the date of divorce as the date of valuation? *
Please specify the date of valuation.
Do you want to award earnings after the date of valuation? *
Do you want the value of loans, if any, subtracted before the account is divided? *
If the Plan Administrator charges a fee to administer the QDRO, how do you want to allocate the cost? (This fee is separate from the fee charged by your lawyer or QDRO preparer) *

Assess all of the cost to the employee Assess all of the cost to the non-employee spouse Assess the cost equally to both parties
Is there anything else we should know?
Please Review Your Answers Carefully

There is a $50 charge for every change after you submit these answers
PLEASE NOTE: Your QDRO will be prepared exactly as you instruct us on this form. There is a $50 charge for every change to the information or instruction you provide us. If you do not know how to answer a question, please consult with your lawyer before submitting your answers. If you do not have a lawyer, we will attempt to explain the question to you, but we cannot provide you with an answer. If the answers you provide us differ from the terms of your Divorce Decree, your QDRO may be rejected by the Court and changes will be necessary.
Should be Empty:

SENDER Information

Please Review Your Answers Carefully