This form is a sample letter in Word format covering the subject matter of the title of the form.
[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Name of Pension Plan Administrator] [Pension Plan Administrator's Address] [City, State, ZIP] Subject: Request for Division of Plan Proceeds per Court Order — [Participant's Name], [Plan Name], [Plan Number] Dear [Pension Plan Administrator's Name], I hope this letter finds you in good health. I am writing to bring to your attention a court order related to the division of plan proceeds for [Participant's Name] in accordance with [Case/Court Order Reference Number]. As the designated representative for [Participant's Name] in this matter, I seek clarification and request your assistance in implementing the court-ordered division of the pension plan proceeds. 1. Case Background: On [Date], [Participant's Name] and their former spouse, [Former Spouse's Name], were legally divorced by [Court Name]. As part of the divorce settlement, the court issued a final decree addressing the division of assets, including the [Participant's Name]'s pension plan. The court explicitly ordered the division of the pension plan proceeds pursuant to the applicable state laws and provisions outlined in the Employee Retirement Income Security Act (ERICA). 2. Participant's Details: Participant's Full Name: [Participant's Full Name] Participant's Date of Birth: [Participant's Date of Birth] Participant's Social Security Number: [Participant's SSN] Participant's Address: [Participant's Address] Participant's Phone Number: [Participant's Phone Number] Participant's Email Address: [Participant's Email Address] 3. Pension Plan Details: Plan Name: [Plan Name] Plan Number: [Plan Number] Plan Administrator: [Plan Administrator's Name] Plan Administrator's Address: [Plan Administrator's Address] Plan Administrator's Phone Number: [Plan Administrator's Phone Number] 4. Court Order Details: Court Name: [Court Name] Court Order Date: [Court Order Date] Court Case Number: [Court Case Number] 5. Division of Pension Plan Proceeds: As per the court order, the pension plan proceeds are to be divided in accordance with applicable state laws and federal regulations governing pension plan divisions during divorce proceedings. I kindly request you to review the provided court order in order to facilitate the correct division of the assets within the pension plan. Please verify the following information: — Calculate the participant's accrued benefits and pension plan balance as of the date of divorce. — Deduct appropriate fees anwithholdinggs as outlined in the plan's policies and state laws. — Allocate the former spouse's portion as specified in the court order. — Confirm the method of division (lump-sum payment, rollover, etc.), as noted in the court order or as per the pension plan's provisions. 6. Required Documentation: To expedite the process, I have enclosed the following documents: — Full copy of the court order regarding the division of the participant's pension plan proceeds. — Participant's Social Security Statement. — Participant's latest pension plan statement. — Participant's marriage certificate and divorce decree. I kindly request your timely action and compliance with the court order. If you require any additional documentation or information, please let me know, and I will promptly provide it to facilitate a smooth division of the pension plan proceeds. Please acknowledge receipt of this letter and provide a timeline for completion of the necessary tasks. Additionally, please inform me of any specific forms or procedures required by your office to effectuate this division of assets. Thank you for your prompt attention to this matter. I look forward to your positive response and prompt resolution of this issue. Should you have any questions or concerns, please do not hesitate to contact me at [Phone Number] or via email at [Email Address]. Yours sincerely, [Your Name]
[Your Name] [Your Address] [City, State, ZIP] [Email Address] [Phone Number] [Date] [Name of Pension Plan Administrator] [Pension Plan Administrator's Address] [City, State, ZIP] Subject: Request for Division of Plan Proceeds per Court Order — [Participant's Name], [Plan Name], [Plan Number] Dear [Pension Plan Administrator's Name], I hope this letter finds you in good health. I am writing to bring to your attention a court order related to the division of plan proceeds for [Participant's Name] in accordance with [Case/Court Order Reference Number]. As the designated representative for [Participant's Name] in this matter, I seek clarification and request your assistance in implementing the court-ordered division of the pension plan proceeds. 1. Case Background: On [Date], [Participant's Name] and their former spouse, [Former Spouse's Name], were legally divorced by [Court Name]. As part of the divorce settlement, the court issued a final decree addressing the division of assets, including the [Participant's Name]'s pension plan. The court explicitly ordered the division of the pension plan proceeds pursuant to the applicable state laws and provisions outlined in the Employee Retirement Income Security Act (ERICA). 2. Participant's Details: Participant's Full Name: [Participant's Full Name] Participant's Date of Birth: [Participant's Date of Birth] Participant's Social Security Number: [Participant's SSN] Participant's Address: [Participant's Address] Participant's Phone Number: [Participant's Phone Number] Participant's Email Address: [Participant's Email Address] 3. Pension Plan Details: Plan Name: [Plan Name] Plan Number: [Plan Number] Plan Administrator: [Plan Administrator's Name] Plan Administrator's Address: [Plan Administrator's Address] Plan Administrator's Phone Number: [Plan Administrator's Phone Number] 4. Court Order Details: Court Name: [Court Name] Court Order Date: [Court Order Date] Court Case Number: [Court Case Number] 5. Division of Pension Plan Proceeds: As per the court order, the pension plan proceeds are to be divided in accordance with applicable state laws and federal regulations governing pension plan divisions during divorce proceedings. I kindly request you to review the provided court order in order to facilitate the correct division of the assets within the pension plan. Please verify the following information: — Calculate the participant's accrued benefits and pension plan balance as of the date of divorce. — Deduct appropriate fees anwithholdinggs as outlined in the plan's policies and state laws. — Allocate the former spouse's portion as specified in the court order. — Confirm the method of division (lump-sum payment, rollover, etc.), as noted in the court order or as per the pension plan's provisions. 6. Required Documentation: To expedite the process, I have enclosed the following documents: — Full copy of the court order regarding the division of the participant's pension plan proceeds. — Participant's Social Security Statement. — Participant's latest pension plan statement. — Participant's marriage certificate and divorce decree. I kindly request your timely action and compliance with the court order. If you require any additional documentation or information, please let me know, and I will promptly provide it to facilitate a smooth division of the pension plan proceeds. Please acknowledge receipt of this letter and provide a timeline for completion of the necessary tasks. Additionally, please inform me of any specific forms or procedures required by your office to effectuate this division of assets. Thank you for your prompt attention to this matter. I look forward to your positive response and prompt resolution of this issue. Should you have any questions or concerns, please do not hesitate to contact me at [Phone Number] or via email at [Email Address]. Yours sincerely, [Your Name]