This information is required for the Plan Participant:
Full Name of Parties (Petitioner and Respondent)
Complete and most recent address of each party
Social Security Numbers of each party
Dates of Birth of each party
Date of Marriage
Date of Division
Significance of Date of Division
Name of Judge
County and State of Action
Case Number
Name of Member
Percentage/Dollar Amount of Award
$550 FEE! (payable in advance or before commencement of work)
For Military Service Members
Branch of Military in which Member served/is serving, i.e. Army, Army Reserves, Navy, etc;
Marital Settlement Agreement
Date of Entry into the service
Is Member currently Active or has he/she Retired? If Retired, please provide date of retirement Date of Separation from Service if no longer active or Reservist
Is Member currently receiving military retired pay? If so, what amount?
Were parties married for at least 10 years concurrent with Member’s military service?
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