COURT FORM 6

Eff. 7/1/04





IN THE COMMON PLEAS COURT OF HURON COUNTY, OHIO

DOMESTIC RELATIONS DIVISION



PENSION INFORMATION SHEET



 

Attorney Name:          _______________________________________________________

 

Employee Name:        _______________________________________________________

 

Date of Birth:             _______________________________________________________

 

Date of Marriage:       _______________________________________________________

 

Date for Beginning Employment:      ___________________________________________


Last date of work if not a current employee: ____________________________________


Evaluation Date(normally the hearing date): ____________________________________

 

Normal Retirement Age:        _________________________________________________

 

Social Security Number:        _________________________________________________

 

Pension Plan Name:   _______________________________________________________


Pension Plan Address: ______________________________________________________

 

Pension Plan Phone:   _______________________________________________________




Please provide the last benefit statement (Should be no older than a year!) ERISA requires one a year. The statement must have an accrued benefit section. That is the amount of yearly pension the employee will receive at normal retirement age if he/she were to terminate their employment at this time.