Domestic Partnership Dissolution and Property Settlement This Agreement is made this the _____day of ______________________, 20____
between ___________________________________________ (Name of First Party), (hereafter referred to as First Party), who resides at ____________________________________________
______________________________________________________________________________ ____________________________________________ (street address, city, state, zip code) and
____________________________________________ (Name of Second Party), (hereafter referred to as Second Party) who resides at __________________________________________
______________________________________________________________________________ ____________________________________________ (street address, city, state, zip code).WHEREAS, the parties to this Agreement have been living together as domestic partners
since on or about; and WHEREAS, First Party and Second Party intend, and it is the purpose of this
Agreement, to dissolve their domestic partnership with one another and make a complete and
final settlement of any and all claims that either party may have against the other, to memorialize
the dissolution of their domestic partnership, and to finalize their agreements as to the division of
the property, both real and personal, between them, that either or both own separately or jointly; NOW, THEREFORE, in consideration of the above, and the terms and covenants of this
Agreement, and other valuable consideration, the receipt of which is acknowledged, the parties
agree as follows: 1.Living Separate First Party and Second Party shall, after the effective date of this Agreement, live
separate and apart, each free from all dominion, restraint, and control by the other, whether direct
or indirect. Each party may, after the effective date of this Agreement, reside at such place or
places as he or she may select. 2. No Harassment or Interference Neither party shall harass or interfere with the other nor compel or attempt to compel the
other to cohabit or dwell with him or her, by any means whatsoever, by legal action or
otherwise. 3.Property Owned by First Party The following property is owned by First Party alone: A..(E.g., That certain real property situated in _______________________________
__________________________ (county, state), and more specifically described as
follows: (legal description) ________________________________________________ ________________________________________________________________________ _______________________________________________________________________________________________________________________________________________;
B.(E.g., ________shares of common stock of _________________; C. (E.g., One ____________________________ (make) automobile, serial number
___________________________ , title certificate number ____________________,
registered in the State of _________________________; D. (E.g., List separately items of personal property, such as: clothing, furniture,
books, works of art, stamp and coin collections, and similar property). ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________4.Property Owned by Second Party The following property is owned by Second Party alone:A..(E.g., That certain real property situated in _______________________________
_______________________________________________ (county, state), and more
specifically described as follows: (legal description) ____________________________
________________________________________________________________________ _______________________________________________________________________________________________________________________________________________;B.(E.g., ____________shares of common stock of _________________; C.(E.g., One ________________________ (make) automobile, serial number
___________________________ , title certificate number _______________________,
registered in the State of __________________________; D. (E.g., List separately items of personal property, such as: clothing, furniture,
books, works of art, stamp and coin collections, and similar property). ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________5.Property Owned by First Party and Second Party The following property is owned by First Party and Second Party together (as joint
tenants with right of survivorship or as tenants in common or as the case may be): A..(E.g., That certain real property situated in _______________________________
____________________________ (county, state), and more specifically described as
follows: (legal description) ________________________________________________ ________________________________________________________________________ _______________________________________________________________________________________________________________________________________________; B.(E.g., ___________ shares of common stock of _______________________;
C.(E.g., One __________________ (make) automobile, serial number
______________________________ , title certificate number _____________________, registered in the State of ___________________________;D. (E.g., List separately items of personal property, such as: clothing, furniture,
books, works of art, stamp and coin collections, and similar property).
________________________________________________________________________________________________________________________________________________ ________________________________________________________________________6.Property Apportioned to Second Party A.There is hereby apportioned, set aside, and/or transferred and confirmed to
Second Party, free of all claim and demand of First Party, the following items as
numbered and described in Paragraphs 3, 4, and 5 of this agreement. 1.Example: Items A, B, C, and D of Paragraph 4;2. Example: Item A of Paragraph 5; and 3.Example: Item C of Paragraph 5. B. Each item of property set aside and transferred to Second Party is assigned to and
taken by him or her with all encumbrances and other obligations to which such items
may be subject. Second Party shall pay and discharge all such encumbrances and
obligations and hold First Party harmless from such encumbrances and obligations. 7.Property Apportioned to First Party A.There is hereby apportioned, set aside, and/or transferred and confirmed to
First Party, free of all claim and demand of Second Party, the following items as
numbered and described in Paragraphs 3, 4, and 5 of this agreement. 1.Example: Items A, B, C, and D of Paragraph 4;2. Example: Item A of Paragraph 5; and 3.Example: Item C of Paragraph 5. B. Each item of property set aside and transferred to First Party is assigned to and
taken by him or her with all encumbrances and other obligations to which such items
may be subject. First Party shall pay and discharge all such encumbrances and
obligations and hold Second Party harmless from such encumbrances and obligations. 8. Value of Property Apportioned A. The present net value of all items apportioned to Second Party under Paragraph
6 of this Agreement, after deducting all encumbrances and obligations outstanding
against such property and assumed by Second Party, but including the equity and interest
of Second Party in such property prior to the apportionment and transfer to him or her, is
$_________________________.B. The present net value of all items apportioned to First Party under Paragraph 7
of this Agreement, after deducting all encumbrances and obligations outstanding against
such property and assumed by First Party, but including the equity and interest of First
Party in such property prior to the apportionment and transfer to him or her, is
$_________________________. 9.Differences in Values of Property Apportioned; Payment of DifferenceA. The difference between the net value of the property apportioned to (First Party
or Second Party) __________________________________ and the net value of the
property apportioned to ___________________________________ (First Party or Second Party), as set forth in Paragraph 8 of this Agreement is $ __________________ in favor of _________________________________ (First Party or Second Party) .B. ______________________________________ (First Party or Second Party)
shall pay to ____________________________________ (First Party or Second Party)
the amount of the difference in net values in equal monthly installments of
$___________________ commencing __________________________________ (date).
[Alternate language: The amount of the difference in net values being minimal,
_____________________________________ (First Party or Second Party) waives and releases all claims arising from such difference].10.Real Property Not Covered AboveFirst Party and Second Party each own a _________________________ (e.g., one-half)
interest in and to that certain real property located at ___________________________________
______________________________________________________________________________________________________________________________ (street address, city, state, zip code),
as more particularly described in Exhibit A attached hereto, and the undersigned agree that when
said property is sold by mutual agreement of the parties, they shall divide the net proceeds of
such sale _______________________ (e.g., equally).11.Execution of Instruments Each party shall promptly execute and deliver to the other party, all instruments that may
be necessary, convenient, or appropriate to carry into effect fully and fairly, all the provisions of
this Agreement for division and confirmation of property, and appropriate mutual releases. 12.Release of Property Rights Each party releases, quitclaims, and assigns to the other party all his or her right, title, and
interest, present and prospective, in each item of property apportioned in this Agreement, set
aside, transferred, and confirmed to the other party. 13.Full Disclosure of Property Interests Each party represents and warrants that he or she has made a full disclosure of all his or
her property and that neither has knowledge of any other property of any kind in which the party
so representing has any beneficial interest. 14.Insurance on Property
All fire and extended coverage, and liability and casualty insurance policies upon or
relating to any real or personal property described or referred to in this Agreement, and now in
existence, shall be transferred with the property to which such insurance pertains to the party
receiving such property pursuant to this Agreement, without charge or credit to either party in
respect of the surrender value of such insurance. 15.Debts and Obligations Each of the parties shall pay all debts incurred by him or her after the effective date of
this agreement and indemnify the other party from and against any and all liability relating to
such debts. 16. 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. 17.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. 18.If any section, paragraph, sentence or portion of this Agreement or the application thereof
to any party or circumstance shall, to any extent, be or become invalid or illegal, such provision
is and shall be null and void, but, to the extent that said null and void provisions do not
materially change the overall agreement and intent of this entire agreement, the remainder of this
Agreement shall not be affected thereby and each remaining provision of this Agreement shall be
valid and enforceable to the fullest extent provided by law.19.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. 20.Governing Law It is agreed that this Agreement shall be governed by, construed, and enforced in
accordance with the laws of the State of _________________________________.WITNESS our signatures as of the day and date first above stated.___________________________________ ____________________________________First PartySecond Party (Acknowledgments are optional and form may vary by state)
STATE OF _______________________________ COUNTY OF _______________________________ Personally appeared before me, the undersigned authority in and for the said county and
state, on this _____ day of ___________________________________, 20____, within my
jurisdiction, the within named, _______________________________________ (First Party and
Second Party), who acknowledged that they executed the above and foregoing instrument. ____________________________________ NOTARY PUBLIC My Commission expires:_________________________