QDRO Process Form

Your Information:

Your Name (last, first, middle)

Address

City

State

Zip Code

Email

Date of Birth

SSN

Phone (Home)

Phone (Cell)

 

Opposing Party Information:

Name (last, first, middle)

Address

City

State

Zip Code

Email

Date of Birth

SSN

Phone (Home)

Phone (Cell)

 

General Details:

Attorney Name

Attorney Phone No.

Date of Marriage

Date of Divorce

County of Case

Case Number

Document Attachment:

Attach the following documents

  • - A copy of the court-signed Decree of Dissolution of Marriage

  • - All relevant portions of the Separation Agreement or Permanent Orders concerning retirement division

  • - Either a quarterly or an annual statement for each retirement plan (no online printouts). Balance statements for the date of marriage and the date of decree may be necessary if a pre-marital interest is claimed.

  • - For Military Retired Pay, the information required depends on whether the service member is active duty, in the the reserves, or retired.

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