Legal Dynamics, Inc. 424 E. Central Blvd, #405 • Orlando, FL 32801 • Toll Free 800-565-8067
QDROs are Simple to Create with Legal Dynamics.The QDRO process is easy with Legal Dynamics. We make QDROs simple and easy for you through Legal DynamicsQDRO files made simple for your through Legal DyanmicsYou have an advocate for your QDRO with Legal Dynamics.

Initial Consult Free - 1-800-690-6445

Order a QDRO
 

ONLINE QDRO ORDER FORM

REFUND POLICY-&- PRIVACY STATEMENT

Submitter's Email Address *

*If you don't have your case Information or don't understand
any part of this form, submit only your email address. A client
service specialist will e-mail you simplified instructions.

*Simply complete this form to the best of your ability and we will
contact you or your attorney to obtain other needed information.
CLIENT NAME
Client Titles: Are you Participant? Spouse of Participant?
Phone:
Day: Night: Cell:

ATTORNEYS’ INFORMATION
ATTORNEY FOR PETITIONER/PLAINTIFF
ATTORNEY FOR RESPONDENT/DEFENDANT
Name:
 Name:
Firm:
 Firm:
Address:


City/St/Zip
 		Address:


City/St/Zip:
Phone:
 Phone:
Fax:
 Fax:
e-mail:
 e-mail:

PETITIONER / RESPONDENT / BOTH PARTIES
COURT INFORMATION
Court/Division:
 Circuit:
County/State:
 Case #:
 
DOMESTIC CASE INFORMATION

Petitioner / Plantiff Full Name:

Respondent / Defendent Full Name:
Restoring Maiden Name? To:
Petitioner/Plaintiff is:?

Husband Wife 		Respondent/Defendant is :?

Husband Wife
Address:


City/St/Zip:
 		Address:


City/St/Zip:
SSN:
 SSN:
Date of Birth (or Approx. Age):
 Date of Birth (or Approx. Age):
Petitioner/Plaintiff Email Address:
 Respondent/Defendant Email Address:


Date of Marriage:
Date of Petition (or other date used to determine marital settlement ratios):
Courthouse City:

County:
State:
Divorce Filing Date:

Final Judgment:
Marital
Settlement
Agreement:
 

Amount Awarded to Spouse:
Minor Children Live With:
Wife Husband Reside 50/50

 

QUALIFIED PLAN INFORMATION Plan #1

Death Protection:
Already Awarded Need Death Protection

Name of Employer Sponsoring Retirement Plan:

Contact Person:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:

Participant Still Works There?
Yes No 		Participant is:
Partially Vested Fully Vetsed

Participant is:  
Not Yet Receiving Monthly Benefits
Will Soon Be Receiving Monthly Benefits
Already Receiving Monthly Benefits 

 

Legal Name of Plan:


Type of Plan(s):

 401(k)
Profit Sharing / Money Purchase
Employee Stock Ownership Plan
Monthly Pension Payment
Disability Pension
Other:

Employer / Plan Administrator for QDRO Submission:
Contact Name :
Phone:
FAX:
Email:
Address:
City:
State:
Zip:



QUALIFIED PLAN INFORMATION Plan #2

Death Protection:
Already Awarded Need Death Protection

Name of Employer Sponsoring Retirement Plan:

Contact Person:
Address:
City:
State:
Zip:
Phone:
Fax:
Email:

Participant Still Works There?
Yes No 		Participant is:
Partially Vested Fully Vetsed

Participant is:  
Not Yet Receiving Monthly Benefits
Will Soon Be Receiving Monthly Benefits
Is Already Receiving Monthly Benefits 

 

Legal Name of Plan:


Type of Plan(s):

 401(k)
Profit Sharing / Money Purchase
Employee Stock Ownership Plan
Monthly Pension Payment
Disability Pension
Other:

Employer / Plan Administrator for QDRO Submission:
Contact Name :
Phone:
FAX:
Email:
Address:
City:
State:
Zip:
 

 


METHOD OF PAYMENT

Online Payment Options:
Visa - Discover - Master Card - American Express - E-Check

 

Pay online now with Secure
Sockets Layer Technology

DELIVERY METHOD:
Your QDRO will be drafted and mailed
to you via U.S. Mail, and Faxed to your
attorney within 10 business days upon completion of form & receipt of payment.

I will call Legal Dynamics Inc. to provide payment. Check this Box Before you submit this form.

 


 

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