Pension Appraisers, Inc.: Pension Valuation Request

Unless you are very familiar with Pension Valuation procedures we suggest you either fax or mail us your request along with information you received from the plan. This will allow us to review the information for practicability and reasonableness.

SEND REPORT TO:
First Name: Last Name:
Is This Person an Attorney? Yes No
Firm Name:
Mailing Address:
City: County:
State: Zip:
Telephone: Fax:
E-mail:

METHODS OF VALUATION

GATT (GAM 83 Mortality Tables and 30 years Treasury Bond Rate)
PBGC (GAM 83 Mortality Tables & PBGC Annuity Rates)
LIFE (Life Tables Derived From GAM 83 Mortality Tables and Muni. Bond Rate)

Divorce action filed in the state of:

Valuation Date:

REQUIRED INFORMATION ABOUT PENSIONHOLDER
Name: Sex:
Date of Birth:
Date of Marriage:
Date of Classification:
Name of Pension Plan:
Date Employment Started:
(Date pensionholder began participation in the plan.)
Normal Retirement Age:
Please fill out the following If Applicable:
Termination Date:
(The date pensionholder terminated employment, if applicable.)
Retirement Date:
(The date pensionholder retired, if applicable.)

Was a survivor benefit selected? Yes No
Is the pensionholder receiving Disability Benefits? Yes No
If yes, are Social Security Disability Benefits being paid? Yes No

AS OF THE PENSIONHOLDER HAD ACCRUED (EARNED) A MONTHLY PENSION BENEFIT OF $ PAYABLE AT NORMAL RETIREMENT AGE.
IS THE EMPLOYEE ELIGIBLE FOR POST-RETIREMENT COST-OF-LIVING INCREASES? Yes No
(If the answer is yes, what has been the average historical percentage increase per year: %.
If you do not fill in the percentage, we will assume a rate equal to 60% of the increase in the Consumer Price Index for the year prior to the Date of Valuation)
WILL THE EMPLOYEE RECEIVE SOCIAL SECURITY FOR THE YEARS OF PLAN PARTICIPATION? Yes No
IS THE EMPLOYEE FULLY VESTED? Yes No
If the answer is no, how many years of service does the pension plan require for vesting:

Credit Card & Billing Information: The below credit card will be charged $160.00. The report requested will be sent from our office regular mail within 5 business days following the request. If you require same day service, an additional $85.00 will be charged to the credit card provided below. Our staff will then value the pension upon receipt of all information, and return the report to you via fax within 24 hours.
Credit Card Number:
(be sure to double check your number)
Expiration Date:
(format: month/year)
Credit Card Type:
Name on Card:
Billing Address:
Do you want same day service? (Additional $85.00) Yes No
Fax Number: (For 24 hour same day service only)
(Before submitting your order, please double check all the information you have entered to make sure it is correct).

Return to Request Forms

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Customer Support E-mail Form | Phone Toll-Free: 1-800-447-0084

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