Form Dr-100 - Petition For Dissolution Of Marriage (No Minor Children) Page 6
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85. Retirement Benefits. We understand that this agreement is only between us and that
pension plan provider(s) may require other documents to accept our agreement. We
also understand that the court will not draft a waiver document or an order including a
qualified domestic relations order (QDRO) that divides the retirement asset(s).
Neither of us earned retirement or military pension benefits during the marriage.
One or both of us earned retirement or pension benefits during the marriage:
Party A earned retirement or military pension benefits during the marriage:
Last 3 numbers of account
Value of account
Being paid now? (Y/N)
Party B earned retirement or military pension benefits during the marriage:
Last 3 numbers of account
Value of account
Being paid now? (Y/N)
We agree that we will each keep our own retirement and pension benefits.
This is fair and equitable because:
Our agreement about the distribution of retirement or military pension benefits is
attached. If the agreement is not accepted by the retirement plan administrator as a
qualified domestic relations order (QDRO), we agree that the court, upon motion by
a party, may make any necessary changes. If changes are necessary, we agree that
the effective date of the order will remain the date of our original dissolution decree.
A copy of the present value statement from the plan administrator for each
retirement account is attached. [Note: This is required. An account statement is
not the same as a present value statement. You should consult an attorney if you
have concerns about the valuation of pension benefits.]
6. Transfer Deadline.
All payments from one party to the other party will be done by
.
All documents necessary to carry out this agreement (including but not limited to signing
quit claim deeds, refinancing, transferring title) will be done by
.
Any property stored by one party for the other will be transferred by
.
B. Debts
[List every debt owed whether or not it is a joint debt. List to whom each debt is owed and
the amount that is owed. Then check the boxes showing whether the debt was incurred
during the marriage, who now owes the debt, and who you agree will be responsible for
paying it. Include ALL debts that are currently owed (mortgages, car loans, credit cards,
etc.) For credit card, bank card, or debit card accounts, you may list the last 4 digits of the
account number and the name of the issuing institution. Note: Even though you agree
which spouse is responsible to pay a debt that is in both of your names, the bank or other
creditor may still hold the other spouse responsible for the debt if payments are not made.]
Signature of Party A
Signature of Party B
Page 6 of 8
DR-100 (8/15)(cs)
AS 25.24.200-.260
PETITION FOR DISSOLUTION OF MARRIAGE (NO MINOR CHILDREN)
Civil Rule 90.1(a), f(2)(A)(B), (i)(1)
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