Form Adopted for Mandatory Use Pag e 1 of 1 STATEMENT OF COMPLIANCE, QDRO/OTHER RETIREMENT PLAN

Cal. Form L-0750

California Superior Local Rules

L-0750 (01/01/2025) Form Adopted for Mandatory Use Pag e of STATEMENT OF COMPLIANCE, QDRO/OTHER RETIREMENT PLAN (FAMILY LAW) Local Rule www.occourts.org ATTORNEY OR PARTY WITHOUT ATTORNEY (Name & Address): TELEPHONE NO.: E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): BAR NO.: FOR COURT USE ONLY SUPERIOR COURT OF CALIFORNIA, COUNTY OF ORANGE LAMOREAUX JUSTICE CENTER: 341 The City Drive, Orange, CA 92868-3205 PETITIONER: RESPONDENT: STATEMENT OF COMPLIANCE, QDRO/OTHER RETIREMENT PLAN (FAMILY LAW) CASE NUMBER: Pursuant to Local Rule 713, either party or a party’s attorney, a limited scope attorney, or a person who is appointed by stipulation of the parties to act as a referee under Code of Civil Procedure

section 638, may prepare and submit a qualified domestic relations order (QDRO) or other retirement plan order. I, (name of submitting party/counsel/referee): verify the following facts: (PRINT OR TYPE NAME) 1. All requirements of Family Code

section have been met. 2. A judgment was filed on (date): 3. The correct name of the employee benefit plan is listed in the judgment or is amended in the order. 4. The order is signed by (select one): a.  both parties b.  the referee appointed by stipulation of the parties under Code of Civil Procedure

section 638. c.  only one party with a copy served upon the other party together with proof of service that includes a notice that the responding party has 30 days from the date of mailing or personal service to file an objection with the clerk of the court and serve of copy on the other party. The service was completed by (select all that apply): 1)  mail with a written statement under oath of the manner in which the mailing address of the other party was obtained. 2)  personal service upon the other party together with a proof of service.

I declare under penalty of perjury under the laws of the State of California that I am a party, attorney of record, limited scope attorney, person who is appointed by stipulation of the parties to act as a referee under Code of Civil Procedure

section 638, or by Order of the Court authorized to prepare and submit a qualified domestic relations order (QDRO) or other retirement plan order. Date: (SIGNATURE OF DECLARANT )

Document details

Collection	California Superior Local Rules
Citation	Cal. Form L-0750
Type	court_rule
Language	en
Format	pdf
Source	CA_LOCAL
Identifier	518180b463b0d167dbfa0d2be42960ad9f581d8c

Source file is stored in the law ingest library (pdf).