This letter is to be sent with the court order acceptable for processing dividing retirement benefits under the Civil Service Retirement System or Federal Employees’ Retirement System. Special provisions about documentation required by the Office of Personnel Management are contained in 5 C.F.R. § 838.221. If the court order acceptable for processing is to be sent by any means other than the United States Postal Service, the letter should be addressed and delivered to United States Office of Personnel Management, Court-Ordered Benefits Section, 1900 E Street, NW, Washington, DC 20415.
Letter Forwarding Court Order Acceptable for Processing
[Civil Service Retirement System or Federal Employees Retirement System]
[Date]
Office of Personnel Management
Court Ordered Benefits Branch
P.O. Box 17
Washington, DC 20044-0017
Re: Court Order Acceptable for Processing relating to the [Civil Service/Federal Employees] Retirement System annuity of [name of employee]
[Salutation]
This letter is intended to be an application under 5 C.F.R. section 838.221 relating to the employee annuity of [name of employee], employee, under the [Civil Service/Federal Employees] Retirement System.
1.A certified copy of the [agreed] final decree of divorce and of the court order acceptable for processing directed at the employee are attached.
2.The former spouse, [name of former spouse], certifies that the court order is currently in force and has not been amended, superseded, or set aside.
3.Information sufficient to identify the employee or retiree is as follows:
Full name: [name of employee]
Current address:
Social Security number: [full number]
Date of birth:
4.Information relating to the former spouse is as follows:
Full name: [name of former spouse]
Current address:
Social Security number: [full number]
Date of birth:
5.The current mailing address of the employee is shown above in item 3.
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When court-ordered payments are subject to termination (under the terms of the court order) if the former spouse remarries, the following statement must be submitted to the Office of Personnel Management. |
The former spouse has not remarried. The former spouse will notify the Office of Personnel Management within fifteen calendar days of the occurrence of any remarriage. The former spouse understands that [he/she] will be personally liable for any overpayment to [him/her] resulting from a remarriage. If a specific form is required, please send the form so that it may be executed and returned to you.
Please notify me, in accordance with 5 C.F.R. section 838.223, of the determination whether the order does or does not qualify as a court order acceptable for processing.
My client and I look forward to hearing from you at your earliest convenience.
Sincerely,
[Name]
Attorney for [name of former spouse]
[Name of former spouse]