Getting Started

Use this form to request model language and procedures for a Qualified Domestic Relations Order ("QDRO"). Each Plan has specific model language templates that contain the necessary language to divide a retirement plan as required by Plan procedures and federal law.

Keep in mind, the more detailed information you provide on this form, the more quickly we can confirm benefits and provide the model language and procedures.

Your Name*

Email*

Phone*

Who is a Participant?
An individual who has accrued a benefit in a retirement plan based on their employment.

Relationship to Participant*

Participant Name*

Participant Date of Birth*

Address* Street

City

State

Zip

Participant's Employer* Company where benefits were earned

Plan Name(s) or type(s)*

401(k)

pension

Other

Your Contact*

Message* Please include plan name, if known

*indicates a required field