1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Attachment 4.P. To Judgment Of Dissolution, Status Only (Family Code § 2337(d)) Each party: (name and address of petitioner) ________________________________ ________________________________ ________________________________ ________________________________ (name and address of respondent) ________________________________ ________________________________ ________________________________ ________________________________ is provisionally awarded without prejudice and subject to adjustment by a subsequent domestic relations order, a separate interest equal to one-half of all benefits accrued or to be accrued under the plan _______________________________________________ _______________________________________________________________________ (name each plan individually) as a result of employment of the other party during the marriage or domestic partnership and prior to the date of separation. In addition, pending further notice, the plan shall, as allowed by law, or in the case of a governmental plan, as allowed by the terms of the plan, continue to treat the parties as married or domestic partners for purposes of any survivor rights or benefits available under the plan to the extent necessary to provide for payment of an amount equal to that separate interest or for all of the survivor benefit if at the time of the death of the participant, there is no other eligible recipient of the survivor benefit. /// Page __ of ___ Print Button Clear Button American LegalNet, Inc. www.FormsWorkFlow.com