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THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name:
Case Name:
Case Number:
(if known)
TEMPORARY DECREE ON PE TITION FOR DIVORCE, LEGAL SEPARATION, OR
CIVIL UNION DISSOLUTION
This decree is (choose one):
Agreed to by Parties Proposed By
Ordered by the Court after hearing on at which petitioner respondent appeared.
1.
Type of Case: (choose one) DIVORCE
LEGAL SEPARATION
CIVIL UNION DISSOLUTION
2. Parenting Plan and Uniform Support Order
N/A
See attached Parenting Plan and Uniform Support Order
3. Dependents
N/A
The parties shall claim the mino r child(ren) and/or other qualifying relative as dependent(s) for
all income tax purposes, in the following manner:
Petitioner, if otherwise qual ified under federal/state law, shall be entitled to claim
as tax dependent(s) for
all years even years odd years other
Respondent, if otherwis e qualified under federal/state law, shall be entitled to claim
as tax dependent(s) for
all years even years odd years other
A parent may only claim a child as a dependent if that parent is current on child support for the
applicable tax year.
4. Guardian ad Litem Fees
N/A
See Order on Appoi ntment of Guardian ad Litem
Other:
5. Alimony
N/A
shall pay the sum of $ per as
temporary alimony. See atta ched Uniform Support Order.
NHJB-2072-F (03/28/2018) Page 1 of 5
Case Name:
Case Number:
TEMPORARY DECREE ON PETITION FOR DIVORCE, LEGA L SEPARATION, OR CIVIL UNION DISSOLUTION
6. Health Insurance for Spouse N/A
Each party shall be responsible for his/her own medical and dental insuranc e and for paying all
of his/her own unreimbursed medical, dental, optical, and other expenses not otherwise
covered by insurance.
shall maintain health insurance for the benefit of
on a temporary basis.
shall be responsible for payment of the premiums.
7. Life Insurance
N/A
Each party shall mainta in existing life insurance policies. No cha nge in beneficiaries or the
amount of coverage shall be ma de and no encumbrances shall be placed on the policies.
shall maintain a life insurance policy in the minimum
amount of $ designating as trustee for the
benefit of the child(ren).
Other:
8. Motor Vehicles
N/A
Each party is awarded the use of the vehicles in his/her possession. Each party shall be
responsible for all expenses as to the vehicles in his/ her possession, including car payments,
maintenance, registra tion and insurance.
Other:
9. Furniture and Other Personal Property
N/A
Each party is awarded the temp orary use of the furniture, furnishings, and other personal
property currently in his/her possession.
Petitioner is awarded th e temporary use of the following specific items of personal property:
Respondent is awarded the temp orary use of the following specific items of personal property:
10. Retirement Plans and Other Tax-Deferred Assets
N/A
Each party shall mainta in any pension, retiremen t, 401(k), IRA, or other retirement account in
his/her name, and no reduction in, or encumbrance thereon, shall be made.
Other:
NHJB-2072-F (03/28/2018) Page 2 of 5
Case Name:
Case Number:
TEMPORARY DECREE ON PETITION FOR DIVORCE, LEGA L SEPARATION, OR CIVIL UNION DISSOLUTION
11. Other Financial Assets N/A
Each party is awarded the use of any ba nk accounts currently in his/her name.
Eachparty is awarded the use of any stocks, bonds, or other investments currently in his/her
name.
Other:
12. Business Interest s of the Parties
N/A
is awarded the te mporary control of the
business, including the payment of al l expenses for the business, known as
Other:
13. Division of Debt
N/A
The parties shall each be responsible for any debt they have incurred after the date of
separation.
Petitioner shall be responsible for paymen t of the following debts:
Respondent shall be responsible for payment of the following debts:
14. Marital/Civil Union Home
N/A
is awarded the temporary exclusive
occupancy of the marital/ci vil union home located at:
shall be responsible for the payment of
the mortgage, insurance, and real estate taxes for the marital home and all expenses for this
property.
Other:
15. Other Real Property
N/A
is awarded the temporary exclusive
occupancy of the real estate located at:
shall be responsible for the payment of the
mortgage, insurance, and real estate taxes for this property and all expenses for this property.
NHJB-2072-F (03/28/2018) Page 3 of 5
Case Name:
Case Number:
TEMPORARY DECREE ON PETITION FOR DIVORCE, LEGA L SEPARATION, OR CIVIL UNION DISSOLUTION
Other:
16. Restraints against the Property
The parties are enjoined and restrained from sellin g, transferring, encumbering, hypothecating,
concealing or in any other manner whatsoever disposing of any property, real or personal, belonging
to either or both of them except by written agreement of the pa rties, for reasonable and necessary
expenses of living or in the ordinary course of investing, or by further order of the Court.
17. Restraining Order N/A
is restrained and enjoined from entering
the home or the place of employ ment of the other party, and from harassing, intimidating or
threatening the other party or his/her re latives or other household members.
Other:
18. Other Requests
Attorney's Fees: Any party that un reasonably fails to co mply with this decree or other court
orders (including "Unifo rm Support Order") may be responsibl e to reimburse the other party for
whatever costs, includin g reasonable attorney’s fees, that ma y be incurred in order to enforce
compliance.
Change in address or employment: Each party shall promptly notify the court and the other
party of any change in his/her address or te lephone number, and notify the other party of any
material change in employment as long as there are an y continuing obligations under this
decree. “Material ch ange” will include availability of medi cal, dental or life insurance and any
substantial increase or decrease in earnings or other income.
Miscellaneous:
I/we request that the Court app rove this temporary decree.
Date Signature of Petitioner
Date Signature of Attorney/Witness for Petitioner
Date Signature of Respondent
Date Signature of Attorney/Witness for Respondent
I certify that on this date I provided a copy of this document to (other party) or to
(other party’s attorney) by: Hand-delivery OR US Mail OR
E-mail (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order) .
Date Signature
NHJB-2072-F (03/28/2018) Page 4 of 5
Case Name:
Case Number:
TEMPORARY DECREE ON PETITION FOR DIVORCE, LEGA L SEPARATION, OR CIVIL UNION DISSOLUTION
Recommended:
Date Signature of Marital Master
Printed Name of Marital Master
So Ordered:
I hereby certify that I have r ead the recommendation(s) and agree tha t, to the extent the marital
master/judicial referee/hearing officer has made factual findings, she/he has applied the correct legal
standard to the facts determined by the marital master/judicial referee/hearing officer.
Date Signature of Judge
Printed Name of Judge
NHJB-2072-F (03/28/2018) Page 5 of 5
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