Delivery Driver Attorney
Resume:
QDRO Questionnaire
This document lists of all the questions to be answered in order to prepare a QDRO. Please note that while we do provide this document as a convenience, our preferred method to submit this information to us is directly on our website https://simpleqdro.com. Instructions to Submit Your Order with SimpleQDRO
1. Answer the questions in the form below to the best of your knowledge. 2. Save the PDF.
3. Attach the PDF to an email along with the three documents listed below. 4. Send your email to *******@**********.***.
5. Proceed here to make your payment.
6. Once we receive your payment, we will process your QDRO in one business day. If you have any questions about how to answer these questions, don’t hesitate to contact us:
• *******@**********.***
• Live chat on https://simpleqdro.com
Attach These Documents
• Final Judgement and Decree
• Settlement Agreement
• Account Statement for plan being divided
Account Set Up
1. Name:
2. Email:
3. Phone number:
4. Your relationship to the parties needing a QDRO: Self: Spouse or Ex-Spouse
Family Member
Attorney
CPA
Other:
General Information
1. State of divorce filing:
2. Full name of court:
(i.e. Circuit Court of Jefferson County, or Superior Court of Fulton County) 3. Address of court
Street address:
City:
Zip code:
4. How are the parties listed in the court documents? Plaintiff / Defendant
Petitioner / Respondent
5. Plaintiff / Petitioner's name on court filings: 6. Defendant / Respondent's name on court filings: 7. County or Parish of divorce filing:
8. Case number / File number / Action number:
9. Assigned Judge:
10. Reason for dividing account (check all that apply): Divorce
Child support
Alimony
11. Date of marriage:
12. Current marital status between the parties:
Still married
Divorced
13. Date of divorce / separation:
Plaintiff / Petitioner’s Information
1. Contact information
Current legal name:
Phone number:
E-mail address:
Home address
Street address:
City:
State:
Zip code:
2. Is this party currently represented by an attorney? Yes
No
3. If Yes, does this party want their attorney’s signature on the QDRO(s)? Yes
No
4. If Yes, please provide the contact information for this attorney Name:
Street address:
City:
State:
Zip code:
Phone number:
Defendant / Respondent’s Information
1. Contact information
Current legal name:
Phone number:
E-mail address:
Home address
Street address:
City:
State:
Zip code:
2. Is this party currently represented by an attorney? Yes
No
3. If Yes, does this party want their attorney’s signature on the QDRO(s)? Yes
No
4. If Yes, please provide the contact information for this attorney Name:
Street address:
City:
State:
Zip code:
Phone number:
Retirement Account Information
1. Complete legal name of retirement plan:
(This can be obtained from Human Resources)
2. Type of retirement plan
1. Defined Benefit (Pension) Plan: Traditional, Cash balance, Money purchase 2. Defined Contribution Plan: 401(k) Plan, Profit Sharing Plan, 403 / 457 Plan, TIAA / CREF, Employee Stock Ownership Plan (ESOP), Individual Retirement Account (IRA) 3. Federal Government Plan
a. Civil Service Retirement System (CSRS)
b. Federal Employees Retirement System (FERS)
c. Thrift Savings Plan (TSP)
4. Military Retirement Plan
5. Railroad Retirement (Tier II) Plan
3. Who is the Participant for this account?
Defendant / Respondent
Plaintiff / Petitioner
5. Plan Administrator name:
6. Plan Administrator address
Attn (optional):
Street address:
Street address line 2 (optional):
City:
State:
Zip code:
7. Plan Administrator phone number:
Extension:
Amount to be divided by QDRO
8. Is the amount to be divided a specific dollar amount, or a percentage of the account listed above? Dollar amount:
Percentage:
Other:
9. What is the date for calculating the value of the Alternate Payee’s award? Date of divorce / separation
Other:
10. If the Plan Administrator charges a fee for review and/or processing of this QDRO, who is to be responsible for the fees?
Participant
Alternate Payee
Participant and Alternate Payee shall each be responsible for Defined Benefit Plans
11. Is the Participant retired and in pay status with the plan? Yes
No
12. If No, is the pension being divided using a “Shared Benefit Approach” or a “Separate Interest Approach”? Shared Benefit Approach
Separate Interest Approach
13. If you chose “Shared Benefit Approach”, is the Alternate Payee to receive a Surviving Spouse Annuity, or have they been designated as a “Surviving Spouse” for any such benefits that may exist pursuant to the Plan? YES, the Alternate Payee has been designated as a Surviving Spouse in the final Divorce Decree and/or Settlement Agreement.
NO, the Alternate Payee has NOT been designated as a Surviving Spouse in the final Divorce Decree and/or Settlement Agreement.
Defined Contribution Plans
14. Is the Alternate Payee’s share of the retirement account subject to any market fluctuations (or “gains and/or losses”) on their portion of the account?
Gains and/or Losses DO apply
Gains and/or Losses DO NOT apply
15. Are there any outstanding loans against the account to be divided? Yes
No
16. If Yes, should the loan balance be subtracted from the total before calculating the Alternate Payee’s portion? Yes
No
Military Retirement Plans
17. Is the Participant
Retired - Date of retirement:
Active Duty
Reserves
Answer the next 2 questions if you selected Active Duty / Reserves: What is the Service Member’s “High-3 Base Pay” as of the date of divorce / separation? What is the Service Member’s total years and months of creditable service as of the date of divorce / separation?
18. In what branch did the Member Serve?
U.S. Army
U.S. Navy
U.S. Air Force
U.S. Marine Corps
U.S. Coast Guard
19. Is the Former Spouse to be awarded Survivor Benefits Plan (“SBP”) protection in the event of the Service Member’s death?
Yes
No
IRA or TIAA / CREF Plans
20. Last 4 digits of account number:
Federal Plans
CSRS – answer question #13 above
FERS – answer question #13 above
TSP – answer questions #14, #15, and #16 above
Railroad Retirement (Tier II) Plans
Answer question #13 above
Contact this candidate