10 44 QUALIFIED DOMESTIC RELATIONS ORDER

• Jurisdiction: Arkansas
• Library: Arkansas Form Book - Complete (2023 Ed.)

10-44 QUALIFIED DOMESTIC RELATIONS ORDER

[CAPTION] QUALIFIED DOMESTIC RELATIONS ORDER

WHEREAS, [plaintiff/defendant name] (the "Participant") and [plaintiff/defendant name] (the "Alternate Payee") entered into a marital settlement agreement or decree dated [date of decree] (the "Agreement"), whereby they agreed to an equitable division of their marital property; and

WHEREAS, the Agreement requires the entry of a domestic relations order (this "Order") to provide for the division and disposition of certain benefits of the participant under one or more tax-qualified retirement plans maintained by [EMPLOYER NAME] ["EMPLOYER"], and to grant Alternate Payee certain rights to such benefits on the terms set forth in this order; and

WHEREAS, this Order is intended to be a qualified domestic relations order ("QDRO"), as defined in Section 414(p) of the Internal Revenue Code of 1986, as amended.

NoW, THEREFoRE, it is hereby oRDERED AND ADJUDGED as follows:

1. Identifying Information.

Participant's last known mailing address is [plaintiff/defendant address]. Participant's Social Security [is [plaintiff/defendant social security number]] [will be provided in a separate sheet when this order is provided to the Plan].

Alternate Payee's last known mailing address is [defendant/plaintiff address]. Alternate Payee's Social Security Number [is [plaintiff/defendant social security number]] [will be provided in a separate sheet when this Order is provided to the Plan]. Alternate Payee's date of birth is [defendant/plaintiff date of birth].

This Order applies to benefits under the Retirement Savings Plan of [EMPLOYER NAME] (the "Plan").

2. Division of Plan Account...