Application for Court-Ordered Benefits for Former Spouse
This file is for former spouses of Federal employees/annuitants covered by CSRS or FERS who wish to apply for court-ordered retirement benefits. Users need to submit supporting documentation along with the application. The form includes sections for identifying information, marital information, payment instructions, and certifications.
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How do I fill this out?
To fill out this form, follow the instructions carefully and provide all required information. Make sure to submit all necessary supporting documents, including court orders and relevant certificates. Use legible handwriting or type your responses, and attach additional sheets if more space is needed.

How to fill out the Application for Court-Ordered Benefits for Former Spouse?
1
Enter the Federal employee/annuitant's identifying information.
2
Provide your (former spouse's) information as requested.
3
Complete the marital information section with relevant dates and details.
4
Fill out the payment instructions section with your payment preferences.
5
Sign and date the application, and include any supporting documentation.
Who needs the Application for Court-Ordered Benefits for Former Spouse?
1
Former spouses of Federal employees covered under the Civil Service Retirement System (CSRS) who need to apply for retirement benefits.
2
Former spouses of Federal employees covered under the Federal Employees Retirement System (FERS) seeking retirement benefits.
3
Legal representatives applying on behalf of a former spouse for court-ordered benefits.
4
Individuals who require the court-ordered retirement benefits and have obtained a court order acceptable for processing.
5
Former spouses of Federal employees needing to update their benefit payment information.
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What are the instructions for submitting this form?
Submit the completed form with supporting documentation to OPM, Court Ordered Benefits, P.O. Box 17, Washington, D.C. 20044. If your address changes after submission, contact OPM at 1-888-767-6738 or use the Federal Relay Service by dialing 711. Include your claim number if available. Ensuring all documentation is included will expedite processing.
What are the important dates for this form in 2024 and 2025?
The form may need to be updated periodically; ensure you have the latest version if filing in 2024 or 2025. Generally, it's advised to check for any changes or updates annually.

What is the purpose of this form?
The purpose of this form is to facilitate the application process for court-ordered benefits for former spouses of Federal employees covered by the CSRS or FERS. This application ensures that the former spouse receives entitled retirement benefits as mandated by court orders. By submitting the required information and documentation, applicants can secure their financial benefits in accordance to legal provisions.

Tell me about this form and its components and fields line-by-line.

- 1. Federal Employee/Annuitant Identifying Information: Includes full name, other names used, address, date of birth, and Social Security Number.
- 2. Former Spouse Information: Consists of full name, current name, date of birth, Social Security Number, mailing address, telephone number, email address, and legal representation details.
- 3. Marital Information: Involves dates of marriage and divorce from the Federal employee, remarriage details, current marital status, and dates of all marriages.
- 4. Payment Instructions: Requires bank account details or Direct Express debit card information for automatic deposit of benefit payments.
- 5. Applicant's Certifications: Information to certify the current court order's validity and whether payments are being received from the annuitant/employee.
What happens if I fail to submit this form?
Failure to submit this form can result in delays or inability to receive court-ordered benefits.
- Delay in Benefits: Submission delays could postpone the processing and receipt of benefits.
- Denial of Benefits: Lack of a proper application could result in the denial of entitled benefits.
How do I know when to use this form?

- 1. Court-Ordered Benefits: When applying for benefits as directed by a court order.
- 2. Retirement Benefits: To receive retirement benefits as a former spouse of a Federal employee/annuitant.
- 3. Legal Representation: If you are a legal representative applying on behalf of a former spouse.
Frequently Asked Questions
What is this PDF file for?
This file is for former spouses of Federal employees/annuitants covered by CSRS or FERS who wish to apply for court-ordered retirement benefits.
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After editing your PDF on PrintFriendly, use our sharing options to email the document or generate a shareable link.
What information do I need to provide in the form?
You need to provide identifying information of the Federal employee/annuitant, your details as the former spouse, marital information, payment preferences, and certifications.
Do I need to submit supporting documentation with this form?
Yes, you need to submit an original or certified copy of the court order and any referenced documents, such as marriage or divorce certificates.
How do I know if my court order is acceptable for processing?
The court order must include the judge's signature and meet all requirements for state certification of court orders.
What happens if I change my address after submitting the form?
You should contact OPM at 1-888-767-6738 or write to them to inform them of your address change.
How long does it take to complete this form?
We estimate that it takes an average of 60 minutes to complete this form, including time for reviewing instructions and gathering needed data.
What if I can't provide all the requested information?
If you don't know an answer, write 'unknown' or provide the best possible information followed by a question mark.
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