Pension Evaluation Form

To request this Basic Pension Evaluation from an experienced Pension Appraiser,please enter your information on the form below.

  • REQUESTING ATTORNEY / PARTY INFORMATION

    If you are a Party in this action and requesting the report yourself please complete this section with your information.

  • Please enter your full name.
  • Please enter your phone number.
    This isn't a valid phone number.
  • This isn't a valid fax number.
  • Please enter your email address.
    This isn't a valid email address.

  • CASE DATA

  • Please enter your pensioners name.
  • Please enter your plan name.
  • (Jurisdictional End of Marriage Date), (Date of Last Acquisition of maritalbenefit. If there is none filed use Current Date. [State Specific Statutes apply]).
  • (Federal/Civil is SCD Date. Military is Enlistment Date)

  • EVALUATION DATA

      • *If you are unable to provide the Accrued Monthly Benefit, requested above, our firm at no additional cost shall decipher the Plan's Retirement Benefit Statement, (if available), provided that we are supplied the Specific Plan details relevant to this Pensioner. You may scan/copy & paste your benefit statement for interpretation email to us

    • PUBLIC / CITY / STATE / GOVERNMENT

      ANNUAL PENSIONABLE SALARY

      SUPPLY THE ANNUAL PENSIONABLE SALARY FOR THE TWO YEARS PRIOR PLUS FOR THE YEAR OF YOUR JURISDICTIONAL CUTOFF DATE. As per your Plan’s Benefit Formula (i.e. 1 Year, 3 Years (Standard), or 5 Years). Note if your Plan's formula requires a Five-Year Average (i.e. Florida retirement system), supply applicable Five-Year Pensionable Salaries.

    • *Required for Federal, State and Municipal plans unless pensioner is in pay status.

    • MILITARY / REGULAR / RESERVIST

    • Regular:

    • Reservist:

    • *Complete this Section Only for Military, Reserve and Regular Component Service Members

    • UNION MEMBERS

      If the Annuity Fund Requires Evaluation, Simply Provide the Statement Indicating the Cash Balance for the Quarter Closest to the End of Marriage Date, and the date of plan entry (only if different from the pension fund/plan)

    • *Complete this Section Only for Union Members: Please note the Pension Fund is the Pension Plan with a Monthly Annuity and the Annuity Fund is a Cash Account. To value the Pension Fund simply provide the Monthly Accrued Benefit as of the End of Marriage Date. Simply attach the Benefit Statement indicating such Monthly Accrued Benefit or fill-in same.

    • COMPANY / CORPORATE / PRIVATE / CLOSELY HELD CORPORATIONS

      Supply the Benefit Statement indicating an ACCRUED MONTHLY BENEFIT, for the year or date subject to this evaluation. You may scan/copy & paste your benefit statement for interpretation

  • PENSION EVALUATION SERVICES/FEES

    (Check appropriate box(s) based on the services required)

  • Estimated Total: $$$

  • By submitting, you agree to be contacted about your request & other information using automated technology. Message frequency varies. Msg & data rates may apply. Text STOP to cancel. Acceptable Use Policy
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