Pipe Trades Pension of Montana
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(888)290-3596
CompuSys, Inc.
2156 West 2200 South
Salt Lake City, UT84119-1376
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DOMESTIC RELATIONS ORDER CHECKLIST
The purpose of this list is to identify certain issues, which should be included in a domestic relations order, which meets the requirements of the Retirement Equity Act of 1984. You are not required to use this list if you do not wish to. Please be advised that the Trustees have no opinion and remain neutral on the questions of whether the spouse should have an interest in a Plan Participant’s retirement benefit, especially if that issue has not yet been resolved. Whether or not you choose to use this checklist, please furnish this office with a copy of the final Order entered with the court.
This is not a conclusive list of the requirements under REA, but is merely intended to be a guide to help in the preparation of a DRO.
INFORMATION ON A DOMESTIC RELATIONS ORDER (QDRO)
___1.Participant’s Name, Social Security No., Birthdate, Address
___2.Alternate Payee’s Name, Social Security No., Birthdate, Address
___3.Name of the Retirement Plan to which the DRO applies
___4.The Order must be a judgement, decree, order, or approval of a property settlement which relates to the provision of child support, alimony payments, or marital property rights with respect to a spouse (present or former), child, or other dependent of a Plan Participant and be made pursuant to a State domestic relations law (including a community property law).
___5.The Order must create or recognize the existence of an alternate payee’s right to, or assign to an alternate payee the right to, receive all or a portion of the benefits payable with respect to a participant under a plan.
___6.Manner in which benefits payable to the alternate payee are to be determined. One way of accomplishing this is to specify the percentage of the participant’s benefit which is payable to the alternate payee (Example: the alternate payee would receive 50% of the participant’s accrued benefit).
___7.Time period to use when determining the amount of the participant’s accrued benefit, which is to be divided. This could be the period of the marriage or another time period.
___8.Time period when alternate payee will be eligible to start receiving the benefit. For the Pipe Trades Pension of Montana Individual Account Plan, benefits to the Alternate Payee may be distributed upon receipt of a Qualified Domestic Relations Order and all required documents.
___9.Type or form of benefit payable must be one that is allowed under the plan.
___10.Amount of benefit payable must not be larger than would otherwise be payable had the participant’s benefit not been divided with an alternate payee.
___11.Pre-retirement Death Benefits. The parties may want to indicate how to handle the situation in which the participant dies before retirement and is eligible for a pre-retirement death benefit. The alternate payee may or may not be awarded all or a portion of the pre-retirement death benefits.
___12.Situation in which the alternate payee dies prior to receiving the benefit payment.
Note: It is important for the users of this form to read Section 414p, et.seq., of the Internal Revenue Code.
IN THE SUPERIOR COURT OF THE STATE OF______
IN AND FOR THE COUNTY OF ______
______, )
Petitioner) CASE NO.
)
AND)
)QUALIFIED DOMESTIC RELATIONS ORDER
______, )
Respondent)
I. DEFINITIONS AND TERMS
A.Definitions:
As used in the Order to be entered in this section:
1.The term “Participant” means ______(name), Social Security Number______, whose mailing address is ______and whose date of birth is ______.
2.The term “Alternate Payee” means ______(name), Social Security Number ______, whose mailing address is ______and whose date of birth is ______.
3.The term “Plan” means the Pipe Trades Pension of Montana.
B.This Order is to be entered pursuant to the laws of the State of ______governing the division of marital property between spouses in dissolution of marriage action and Section 414p of the Internal Revenue Code.
C.The Participant became a Participant in the Plan on ______(date ) and (CHECK ONE)
(1)___ retired on ______;
(2) ___ is still an active participant;
(3) ___ terminated participation on ______.
D.Participant is _____% vested.
E.The parties to this dissolution were married on ______and separated on ______.
II. DISPOSITION OF PENSION BENEFITS
IT IS ORDERED THAT:
1.Interest of Alternate Payee: (CHECK ONE)
(a) ___ IT IS ORDERED that there shall be no division of Participant’s account balance under the Plan.
(b) ___ IT IS ORDERED that the Alternate Payee has an interest in Participant’s account balance under the Plan, if, when and as paid, as follows:
2.Amount of Benefit: (CHECK ONE)
(a) ___ Alternate Payee is awarded a _____% interest in the total value of the Participant’s account balance under the Plan as of the Valuation Date of ______.
(b)___ Alternate Payee is awarded $______(set dollar amount) of Participant’s account balance.
3.Commencement of Benefits: (CHECK ONE)
(a) ____Alternate Payee elects distribution of his/her share of the account as soon as administratively feasible following receipt on a Qualified Domestic Relations Order payable in accordance with terms and conditions of the Plan.
(b)____Alternate Payee elects to delay distribution of his/her share of the account until he/she seeks distribution at a later date.
Survivor Benefit:
In the event the Alternate Payee dies before full distribution of benefits awarded by this Order, such benefits shall be distributed to the Alternate Payee’s beneficiary in a manner prescribed by the Plan.
III. CONDITIONS
1.Remarriage:
The subsequent remarriage of either party shall not affect the disposition of pension benefits described herein.
2.Death of Either Party:
Upon notification of the death of a party hereto, the surviving party shall notify the Trust Fund of the death as soon as possible.
3.Address
Participant and Alternate Payee shall advise the Pension Plan of any changes in the mailing address(es) or legal name(s) as set forth above at the following address: 2156 West 2200 South, Salt Lake City, UT 84119-1376.
4.Rights and Responsibilities
Nothing contained in this Order shall be construed to require the Plan or the Plan Administrator:
(a)To provide to the Alternate Payee any type or form of benefit or any option not otherwise available to the Participant under the Plan.
(b) To provide to the Alternate Payee benefits not available to the Participant.
(c)There has been no Qualified Domestic Relations Order prior to this Order, which required the payments of benefits to another Alternate Payee (other than______). Therefore, this Order does not require the payment of benefits to the Alternate Payee, which are already required to be paid to another Alternate Payee under another order previously determined to be a Qualified Domestic Relations Order.
Copies of this Order shall be sent by ordinary mail to the Plan’s Administrative Office, Pipe Trades Pension of Montana at 2156 West 2200 South, Salt Lake City, Utah 84119-1376, who shall, pursuant to 29 USC 1056(c) (3) (G):
(a)Promptly notify the Participant, the Alternate Payee, and any other Alternate Payee of:
(1)The receipt of a copy of this Order by the Plan Administrative Office.
(2) The Plan’s procedure for determining the status of the Qualified Domestic Relations Order.
(b)Within a reasonable period of time after the receipt of a copy of this Order, determine whether this Order is a Qualified Domestic Relations Order, the Participant, the Alternate Payee and any other Alternate Payee shall be notified of such determination.
This Court retains the jurisdiction over the matter to amend this Qualified Domestic Relations Order in order to establish or maintain its qualification as a Qualified Domestic Relations Order under the Retirement Equity Act of 1984, provided that no such amendment shall require the Plan to provide any type or form of benefit or any option not otherwise provided under the Plan, and that no such amendment or the right of the Court to so amend will invalidate this Order as “Qualified” under the Act. The provisions of this Qualified Domestic Relations Order are the sole form of payment of Alternate Payee’s interest in the Plan (as provided in the Retirement Equity Act, Sections 104(a) and 204(b).
The parties certify that they are not aware of any orders, which purport to dispose of these benefits.
______
PARTICIPANT:ALTERNATE PAYEE:
DATE:______DATE:______
PARTICIPANT’S ADDRESS:ALTERNATE PAYEE’S ADDRESS:
______
______
DONE IN OPEN COURT this ______day of ______, 20______
______
SUPERIOR COURT JUDGE
Presented by:______
______
Attorney for Respondent
Copy Received, Approved for Entry
Notice of Presentation Waived:
______
Attorney for Petitioner