SENDER Information
Information about you and how we can contact you.
Your Name
*
First Name
Last Name
Your Email
*
For help with this answer, /bclick/cb here.
Your Phone Number
*
-
Area Code
Phone Number
Your Client's Name
*
First Name
Last Name
Information About Your Military Retirement
What is the service member's status?
*
Active Duty
Reserve Duty
Retired
What is the service member's current Base Pay?
*
Current Base Pay
What was the service member's Date of Entry?
*
-
Month
-
Day
Year
Date of Entry
What was the service member's Date of Retirement?
*
-
Month
-
Day
Year
Date of Retirement
How many years and months had service member served at the time of divorce or retirement?
*
Years and months of service
What was service member's Rank at the time of divorce or retirement?
*
Rank at time of divorce or retirement
Please check each of the following that apply:
*
Service Member attended the final hearing
Service Member's Attorney attended the final hearing
Service Member signed the Final Decree of Divorce
None of the above (Please note that DFAS will not approve an Order arising from a default hearing).
What portion of the retirement will be divided?
*
Community Property Only
The entire retirement
What percentage of the community portion of the retirement will be awarded?
*
Percentage awarded
What percentage of the entire retirement will be awarded?
*
Percentage awarded
Will Survivor Benefits be awarded? Please note that DFAS will not approve Survivor Benefits unless they receive the Order within ONE YEAR after the date of divorce.
*
Yes
No
Who will pay the premium for the survivor benefits?
*
The parties will split the premium in proportion to the award
Former spouse will pay the entire premium
Service Member will pay the entire premium
Is there anything else we should know?
Save
Submit Answers
Clear Form
Print Form
Should be Empty: