law offices

Henry J. novak

11782 Jollyville Road Suite 210, Austin, Texas 78759

(512) 764-5450

FAX (512) 532-6008

Retirement Plan Partition Intake

2. Are you a Lifestyles Unlimited Member?
3. Your Information
Home Phone
Home Phone
Cell Phone
Cell Phone
4. Your Spouse's Information
Home Phone
Home Phone
Cell Phone
Cell Phone
5. Date of Your Marriage *
5. Date of Your Marriage
Human Resources/Benefits Phone No.
Human Resources/Benefits Phone No.
7. Retirement Plan Information
PLEASE EMAIL ME A COPY OF YOUR MOST RECENT PLAN STATEMENT
Date you Enrolled
Date you Enrolled
Type of Plan
$
8. Plan Administrator
Many smaller companies, through their H.R. or Benefits departments, act as the administrators of their retirement plans. Larger companies outsource the administration to professional retirement plan administrators. In some but not all cases third-party administrators will also manage the investment decisions for the plan’s assets (See Par. 9, below). If you’re not certain who your plan administrator is, please ask your H.R. or Benefits departments before you submit this form.
Contact Phone
Contact Phone
Fax
Fax
9. Plan Assets Manager
Assets of retirement plans are typically managed by institutional money managers such Fidelity, Vanguard, T. Rowe Price, Prudential, J.P. Morgan Asset Management, Mass. Mutual, or others. You can usually find the identity of this company on your quarterly statement.
Contact Phone
Contact Phone
Fax
Fax
10. Partition of Plan Benefits
You may partition a percentage or a dollar amount of your Plan assets to your spouse.
If a percentage:
$
11. Important Facts About a 401(k), 457 and 403(b)(7) Withdrawals
> NO EARLY WITHDRAWAL PENALTY WILL BE ASSESSED. This procedure is exempt from the IRS’s 10% early withdrawal penalty for persons under 59½ years of age.
> The Plan Administrator must withhold 20% of the amount withdrawn for income tax withholding; and
> The entire amount withdrawn (including the 20% withheld by the plan administrator) must be included in a married couple’s gross income for the year of withdrawal and reported as community income on a married-filing-jointly federal income tax return for Texas residents. (If you and your spouse file separate tax returns, see you accountant for details). Your spouse will receive a Form 1099-R from the plan administrator showing the amount of the disbursement and a coding indicating to the IRS that the disbursement is exempt from the early withdrawal penalty.
12. Upon receipt of this intake form my office will email you my Engagement Letter for you and your spouse to sign. At the same time, we will generate an electronic invoice that will be emailed to you from QuickBooks for the sum of $3,865, representing the legal fee of $3,500, and court filing fee of $340 and the delivery fee, which you may pay by credit card or by electronic check.