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Qualified Domestic Relations ORDER (QDRO) Sample (PDF)

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The document is a Qualified Domestic Relations Order (QDRO) intended to assign a portion of a participant's retirement benefits to an alternate payee, typically in the context of divorce. It outlines the necessary participant and alternate payee information, specifies the percentage of benefits assigned, and details the rights and responsibilities of both parties regarding the retirement plan. The QDRO ensures compliance with federal laws under ERISA and the Internal Revenue Code, while also addressing administrative costs and tax implications.

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