Fill and Sign the Mn Administrator 497312642 Form

_________________ , 20     ___________________ ___________________ ___________________ Re: [Name of Participant - Name of Plan] [Social Security Number] Dear ___________________ : Enclosed herewith and served upon you by United States mail, please find Notice of a Domestic Relations Order relating to (Mr.)(Ms.) ___________________ , a participant in the ___________________ Plan. Also enclosed and served upon you as an attachment to the Notice is a copy of the Findings of Fact, Conclusions of Law, Order for Judgment and Judgment and Decree and the Domestic Relations Order, entered by the ___________________ County District Court Administrator on ___________________ in the following matter: In Re the Marriage of ___________________ , Petitioner, and ___________________ , Respondent, Court File No. ___________________ . (Mr.)(Ms.) ___________________ 's interest in the ___________________ Plan is to be (equally divided between Mr. and Ms. ___________________ )( ___________________ ) pursuant to Paragraph __ of the Domestic Relations Order. Please review these enclosures to determine whether the enclosed Domestic Relations Order, relating to the division and assignment of the Participant's rights and benefits in the Plan, is qualified. Please also provide me with a summary of your qualification procedures and written notice of your qualification determination. If you have any questions or concerns regarding the foregoing, please contact me. Thank you for your time and consideration. Sincerely, {Name of Attorney}