Legal Economic Evaluations
437 Century Park Drive
Suite A
Yuba City, CA 95991
Phone: (800) 221-6826
Fax: (530) 671-0337

Defined Contribution Retirement Plan Apportionment Form

Attorney / Mediator / Other Mailing Information

Name:

Firm:

Street Address:

City:

State:

ZIP:

Phone:

FAX:

Case Information

* required field

Pensioner Name:*

Date of Marriage:

Email Address:*

Employer:

Name of Plan:*

Date Entered Plan:*

Is the Pensioner still_employed?*
Yes No

If "NO", Date of termination:

Date spouse's interest in plan ends:

(Date of separation, filing, dissolution or trial as appropriate in your state.

The "Tracing Method"

The "Tracing Method" is one common method of tracing changes in contributions, forfeitures and earnings less fees during the statement period.

Documentation Required

Did the pensioner enter plan after date_of_marriage?* Yes No

If "NO", send each and every periodic statement from immediately before marriage to present.

Did the spouse's interest in the pension end recently?* Yes No

If "NO", send each and every periodic statement from immediately before spouse's interest ended to present.

If the answers to both questions were "YES", you may not need the plan apportioned unless there were loans, transfers or rollovers during marriage, since all the contributions and earnings were marital.

Payment Information

Please submit a check for $250 payable to Legal Economic Evaluations

For more complex tracings, one of our analysts will contact you to discuss our fees.

We make no attempt to independently verify your data.
The accuracy of our report depends upon the validity and completeness of the
data submitted with this form.