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General Information

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[HIDDEN] ticket_number
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[HIDDEN] term_for
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[HIDDEN] term_agst
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[HIDDEN] dissolution_term
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[HIDDEN] Interest End Date
What is the Case / Matter Number?*
In which state will the (Q)DRO be filed?*
In which county will the (Q)DRO be filed?*
In which district court will the (Q)DRO be filed?
Larger counties have multiple district courts. If applicable, please select the district court where this QDRO will be filed.
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Is this a domestic partnership?*
- Yes
- No
How do I know if I am in a domestic partnership?
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Date of Domestic Partnership:
MM slash DD slash YYYY
What is the date of marriage?*
MM slash DD slash YYYY
Has the divorce or legal separation been entered by the court?*
- Yes
- No
If necessary, a space will be provided in the (Q)DRO for the parties to enter the date of divorce once known.
What is the date of divorce?*
MM slash DD slash YYYY
Is the date of division known?*
- Yes
- No
The date of division, which varies by state, is the marital division date based on your state law, court order and/or the parties’ agreement. In , the date of division is generally the Date of Division.
If necessary, a space will be provided in the (Q)DRO for the parties to enter the date of division once known.
What is the date of division?*
MM slash DD slash YYYY
Neutral (Q)DRO Expert Data
Is this (Q)DRO being prepared by a Mediator/Neutral (Q)DRO Expert who is an attorney and whose name should appear on the first page of the (Q)DRO?*
- Yes
- No
NQE Name:
First Last
Bar Number:
NQE Law Firm:
NQE Firm Address:
Street Address City State ZIP Code
Telephone:
Fax:
Email:
Petitioner / Plaintiff Data
Petitioner / Plaintiff First Name:*
Petitioner / Plaintiff Middle Name:
Petitioner / Plaintiff Last Name:*
Address:*
Street Address City State ZIP Code
Date of Birth:*
MM slash DD slash YYYY
Telephone:
Fax:
Email:
Is the Petitioner / Plaintiff represented by a family law attorney?*
- Yes
- No
Will the Petitioner / Plaintiff's family law attorney be signing?*
- Yes
- No
Name of Family Law Attorney:*
Bar Number for Attorney Representing the Petitioner / Plaintiff:
Name of Law Firm:*
Address:*
Street Address City State ZIP Code
Telephone:
Fax:
Email:
Has the Petitioner / Plaintiff remarried?*
- Yes
- No
What is the approximate date of remarriage?
MM slash DD slash YYYY
Respondent / Defendant Data
Respondent / Defendant First Name:*
Respondent / Defendant Middle Name:
Respondent / Defendant Last Name:*
Address:*
Street Address City State ZIP Code
Date of Birth:*
MM slash DD slash YYYY
Telephone:
Fax:
Email:
Is the Respondent / Defendant represented by a family law attorney?*
- Yes
- No
Will the Respondent / Defendant's family law attorney be signing?*
- Yes
- No
Name of Family Law Attorney:*
Bar Number for Attorney Representing the Respondent / Defendant:
Name of Law Firm:*
Address:*
Street Address City State ZIP Code
Telephone:
Fax:
Email:
Has the Respondent / Defendant remarried?*
- Yes
- No
What is the approximate date of remarriage?
MM slash DD slash YYYY
If available, please upload a copy of your Divorce Judgment, Divorce Decree or MSA:
Drop files here or

Accepted file types: pdf, docx, xlsx, Max. file size: 256 MB.
Who filled out this form?*
- Petitioner / Plaintiff
- Respondent / Defendant
- Attorney Representing the Petitioner / Plaintiff
- Attorney Representing the Respondent / Defendant
Where would you like the drafted order sent?*
Liability Check*
- By clicking the checkbox, I acknowledge that the information submitted above is true and factual at the time of submission. I further acknowledge that QDROCounsel, LLC will not be held responsible for any liabilities that may arise due to the information submitted.

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A domestic partnership is a legally-recognized relationship that offers non-married couples similar benefits as those provided to married couples. If you are or were married in this matter, please answer “No”.