A/B Comparison form

You can download the PDF version here.
*

AttorneyMediatorSelf Represented
Mediator's Name*
Attorney's Name*
Representing*

ParticipantNon-Participant
Name*
Firm Name
Email*
example@example.com
Phone Number

Area CodePhone Number
Fax Number

Area CodePhone Number
Jointly Retained?*

YesNo
Non-Participant Spouse Name
Joint Party's Email*
example@example.com
Participant Information:
Name
Gender
Email
example@example.com
Phone Number

Area CodePhone Number
Statistical Information: Please provide all applicable dates
Date of Marriage:

MonthDayYear
Date
Date of Separation:

MonthDayYear
Date
Date of Plan Entry:

MonthDayYear
Date
Date of Termination (if applicable)

MonthDayYear
Date
Participant's Assumed Benefit Commencement Date:

MonthDayYear
Date
Non-Participant's Assumed Benefit Commencement Date:

MonthDayYear
Date
Date of Birth (Participant):

MonthDayYear
Date
Date of Birth (Non-Participant)

MonthDayYear
Date
Salary Information: Please provide all applicable salaries
Member's Annual Salary at Dissolution:
Member's Current Annual Salary:
Please Enclose the Following:

- Current CalPERS Annual Member's Statement

- Member's current pay slip

Our fee for CalPERS A/B valuation is $325.

A retainer request will be provided via e-mail and payment is required before work can begin.
Please upload requested document below. If the document size is too large or includes sensitive information, please contact info@msmqdros.com for a secure upload link.
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Browse Files

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Participant Information:

Statistical Information: Please provide all applicable dates

Salary Information: Please provide all applicable salaries