Fill and Sign the Domestic Partnership Application Form

Domestic Partnership Cohabitation Agreement Agreement made on       , between       (Done) (Name of First Party) of       , referred to herein as Party A; and (Street Address, City, County, State, Zip Code)       of       , referred (Name of Second Party) (Street Address, City, County, State, Zip Code) to herein as Party B. Whereas, the parties are domestic partners who desire to live together in a relationship in which Party A financially supports Party B, and Party B renders services to Party A as a companion, housekeeper, homemaker and cook; and Whereas, the parties desire to combine their efforts and earnings and share equally the property accumulated through their individual or combined efforts; Now, therefore, for and in consideration of the mutual covenants contained in this Agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree as follows: I. Sharing of Earnings, Services and Property. A. Party A shall use best efforts through       personal services and skills to (his or her) generate earnings, salaries, commissions or other income sufficient to provide a standard of living mutually acceptable to the parties. B. Party B shall render services to Party A as companion, housekeeper, homemaker and cook, and assume responsibility for related household tasks. C. The parties shall combine their efforts and earnings and shall share equally the property accumulated through their individual or combined efforts, as further provided in Paragraph IV. II. Support. Party A shall provide for all of Party B’s financial support until such time as the Parties are no longer cohabiting pursuant to the terms of this Agreement. This support obligation shall cease as of the date of the termination of this Agreement pursuant to Paragraph VII. Each party waives and disclaims any right to support from the other party after the termination of this Agreement. III. Disclosure of Present Assets and Obligations. Each party has fully disclosed to the other party the full extent of all assets presently owned and obligations presently owed by that party, as set forth in the attached Exhibits       , which are incorporated into ( specify exhibit numbers ) this Agreement by reference. Domestic Partnership Cohabitation Agreement Page 1 of 4 IV. Ownership of Jointly Owned Property. Except for the separately-owned property listed in Exhibit(s)       to this Agreement, the parties shall hold all ( specify exhibit numbers ) property, including all property acquired during the period of their cohabitation under this Agreement, equally as       . Both parties shall have equal ( specifies tenants in common or joint tenants) management and control of the jointly-owned property. V. Sharing Increase in Value of Residence. Party A presently holds sole title to the real property described as       , located at       , ( e.g. , a single-family dwelling) (Street Address)       , as more specifically described in Exhibit (City, County, State, Zip Code)       . This property of Party A will remain Party A’s sole and ( specify exhibit number ) separate property. However, the parties shall share equally in any increase in the value of this real property occurring on and after the date of this Agreement and until the Agreement is terminated. On termination of the Agreement, Party B will be entitled to receive       (his or her) share in the increase in the value of this property, within a reasonable time. The parties agree that the present value of this real property is $       . VI. Legal Names of Children of Relationship. The parties agree that any minor child or children of the parties who is/are their biological offspring, or adopted by them, shall be given the following surname:       . (Name) VII. Termination of Agreement . This Agreement shall terminate as to all unexecuted provisions on the first to occur of any of the following events: A . On the written consent of the parties, B. On the marriage or cohabitation of either party with a third person, or C. On the permanent separation of the parties, as defined in Paragraph VIII . VIII. Permanent Separation. As used in this Agreement, the permanent separation of the parties means that the parties have been regularly living apart in separate dwelling places for a period of at least       , after one party has notified the other in writing that ( specify period)       intends to cease cohabitation with that party. (he or she) IX. Division of Property. On termination of this Agreement, the parties shall immediately divide their jointly-owned property. The jointly-held property shall be divided equally, unless otherwise agreed to by the parties. In addition, Party B shall be entitled to       share (his or her) in the increase in value of the real property described in Paragraph V. Domestic Partnership Cohabitation Agreement Page 2 of 4 X. Representation by Independent Counsel. Each party hereby acknowledges that       has been represented by independent counsel in the negotiation of this (he or she) Agreement, that the counsel representing each party was of       own choosing, and (his or her) that the Agreement has been read by the parties and its meaning and legal consequences have been explained to them by such counsel. XI. Severability. The invalidity of any portion of this Agreement will not and shall not be deemed to affect the validity of any other provision. If any provision of this Agreement is held to be invalid, the parties agree that the remaining provisions shall be deemed to be in full force and effect as if they had been executed by both parties subsequent to the expungement of the invalid provision. XII. No Waiver. The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. XIII. Governing Law. This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of       . (Name of State) XIV. Notices. Unless provided herein to the contrary, any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. XV. Mandatory Arbitration . Any dispute under this Agreement shall be required to be resolved by binding arbitration of the parties hereto. If the parties cannot agree on an arbitrator, each party shall select one arbitrator and both arbitrators shall then select a third. The third arbitrator so selected shall arbitrate said dispute. The arbitration shall be governed by the rules of the American Arbitration Association then in force and effect. XVI. Entire Agreement . This Agreement shall constitute the entire Agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. XVII. Modification of Agreement. Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. XVIII. Counterparts. This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original, but all of which together shall constitute but one and the same instrument. Domestic Partnership Cohabitation Agreement Page 3 of 4 XIX. Compliance with Laws. In performing under this Agreement, all applicable governmental laws, regulations, orders, and other rules of duly-constituted authority will be followed and complied with in all respects by both parties. WITNESS our signatures as of the day and date first above stated. By: By: (Signature of Party A) (Signature of Party B)             (P rinted Name of Party A) (P rinted Name of Party B ) Acknowledgments Attach Exhibits Domestic Partnership Cohabitation Agreement Page 4 of 4