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PDF Fillable/saveable: FL-VB1 (size 1.3 Mb)
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Last Update: January 2021
Form No.: PF-109E
Title: Application for Family Law Value – Variable Benefit Account (FSRA Family Law Form FL–VB1)
Purpose of Form:
This Form is to be used by a retired member and/or a married spouse of the retired member to request the Family Law Value of the variable benefit account.
Instructions on How to Use the Form: Instructions are included in the form.