FORMS: Military Pension Valuation Checklist

Forms: Military Pension Valuation Checklist

Full Name of Plan Participant:	(first, last)
Date of Birth of Participant:	(mm-dd-yyyy)
Participant's Gender:	Male Female
Do you, or your firm, represent the participant?	Yes No
Branch of Military Member has served / is serving in:	(army, army reserves, navy, etc.)
Value Participant's benefits as of what date?	(mm-dd-yyyy)
Date of Entry into service:	(mm-dd-yyyy)
Status of service:	Active Retired
Date of Separation from service (if inactive):	(mm-dd-yyyy)
Is Member currently receiving military retired pay?	Yes No
Were parties married for at least 10 years concurrent with Member's military service?	Yes No
Email Address: