Statement of Compliance QDRO_Other Retirement Plan

Orange County Superior Court · Locally Approved Forms

Verified current as of July 16, 2026

This form is used to confirm that a Qualified Domestic Relations Order (QDRO) properly follows all legal requirements when dividing a retirement account (other than a standard pension) between spouses during a divorce. A person going through a divorce who needs to split a retirement account like an IRA, 401(k), or similar plan would use this form to verify the division is legally correct.