Fill and Sign the Marital Domestic Separation and Property Settlement Agreement Adult Children Parties May Have Joint Property or Debts Where 497428983 Form

VT-DO-3 INSTRUCTIONS When should this form be used? This form should be used when the parties desire to enter into a Separation Agreement in contemplation of a divorce, which has been filed or will be filed. This form is for married persons with adult children. Parties may have joint property or debts. This form is for the State of Vermont. This form should be completed on your computer, typed or printed in black ink. Both parties must sign the Agreement and have their signatures witnessed by a notary public . You may desire to print and sign duplicate originals so that both parties will have a signed original of the document. Transfers of Title to Property This form may not be sufficient to transfer title to property such as real estate, automobiles and other property to be divided. These transfers must be done by a deed, bill of sale, title or other instruction before the ownership is final. Opportunity to Consult with Attorney This Agreement provides that you were given an opportunity to consult with an attorney of your choice prior to execution of the Agreement. Divorce Proceeding This form provides that the parties intend to be bound by this Agreement subject to approval by the appropriate Court. The parties will file a divorce proceeding prior to signing this Agreement, or have pending a divorce action at the time of execution. MARITAL SEPARATION AND PROPERTY SETTLEMENT AGREEMENT WITH ADULT CHILD (REN) NOTICE: THIS IS AN IMPORTANT LEGAL AGREEMENT AND HAS SUBSTANTIAL LEGAL CONSEQUENCES ON YOU, YOUR RIGHTS AND OBLIGATIONS. YOU ARE ADVISED TO CONSULT AN ATTORNEY FOR INDEPENDENT LEGAL ADVICE PRIOR TO EXECUTION OF THIS AGREEMENT. STATE OF VERMONT COUNTY OF _________________ WHEREAS, ____________________________________ (full legal name), hereinafter referred to as "Wife", and _________________________________ (full legal name), hereinafter referred to as "Husband", are now married, having been married on the _____ day of ____________, _______, in ______________ County, _________________; and WHEREAS, the parties were separated on or about the _______ day of _______________, 20___, while residing in _______________ County, _________________, and since that date have been living separate and apart; and WHEREAS, differences have arisen between the parties that have resulted in their decision to live separate and apart and there is no chance of staying together. The parties make Family Court, _____________ County, State of Vermont, this Agreement to settle once and for all that the parties owe to each other and what the parties can expect to receive from each other; and WHEREAS, the parties desire to make a mutually acceptable settlement of their rights, liabilities, obligations and property rights arising out of and during the course of their marital relationship. No reconciliation is contemplated; and WHEREAS, the parties agree to execute and exchange any papers that might be needed to complete this Agreement, including deeds, title certificates, bills of sale, etc.; and Husband Initials:___________ Wife Initials: ___________ WHEREAS, the parties intend that this Agreement shall be binding and effective subject to approval by the Court in that certain action pending in the Family Court, _____________ County, State of Vermont, Cause Number _______________, which is a divorce action involving Husband and Wife. NOW THEREFORE, FOR AND IN CONSIDERATION of the mutual benefits and advantages accruing to each party, the undersigned do hereby solemnly covenant, agree and contract as set forth above and below and being sworn, certify that the all statements contained herein are true and correct: SECTION 1. SEPARATION; RELINQUISHMENT OF MARITAL RIGHTS The parties shall continue to live separate and apart, free from interference, authority and control by the other, as if each were sole and unmarried, and each may conduct, carry on and engage in any employment, business or trade which each shall seem advisable for their sole and separate use and benefit, without, and free from any control, restraint or interference by the other party in all respects as if each were unmarried. Neither of the parties shall molest or annoy the other or seek to compel the other to cohabit or dwell with the other by any proceedings for restoration of conjugal rights or otherwise, or exert or demand any right to reside in the home of the other, if any. SECTION 2. FINANCIAL DISCLOSURES By execution of this instrument, each party warrants and represents to the other party that he or she has fully disclosed their financial status, including their assets and liabilities of all types and agree that the terms of this Agreement are fair, just, and equitable after consideration of the financial status of the parties. Husband Initials:___________ Wife Initials: ___________ SECTION 3. ASSETS A. In General . Husband and Wife are in possession of all personal property belonging to each, and neither makes any claim to any personal property in the possession of the other except as otherwise stated in this Agreement. The parties agree to divide their assets (everything they own and that is owed to parties) as provided below. Any personal item(s) not listed below is the property of the party currently in possession of the item(s). Each party shall retain as his or her own all of their personal clothing, jewelry and effects. B. Wife shall receive as her own and Husband shall have no further rights or responsibilities regarding these assets: ASSETS: DESCRIPTION OF ITEM(S) WIFE SHALL RECEIVE (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any title/deed/account described below is wife’s, husband’s, or both.) Current Fair Market Value Cash (on hand) $ Cash (in banks/credit unions) Stocks/Bonds Notes (money owed to you in writing) Money owed to you (not evidenced by a note) Real estate: (Home) (Other) Business interests Automobiles Boats Other vehicles $ $ Husband Initials:___________ Wife Initials: ___________ ASSETS: DESCRIPTION OF ITEM(S) WIFE SHALL RECEIVE (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any title/deed/account described below is wife’s, husband’s, or both.) Current Fair Market Value Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.) Furniture & furnishings in home Furniture & furnishings elsewhere Collectibles Jewelry Life insurance (cash surrender value) Sporting and entertainment (T.V., stereo, etc.) equipment Other assets Total Assets to Wife $ C. Husband shall receive as his own and Wife shall have no further rights or responsibilities regarding these assets: ASSETS: DESCRIPTION OF ITEM(S) HUSBAND SHALL RECEIVE (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any title/deed/account described below is wife’s, husband’s or both.) Current Fair Market Value Cash (on hand) $ Cash (in banks/credit unions) $ Stocks/Bonds $ Husband Initials:___________ Wife Initials: ___________ ASSETS: DESCRIPTION OF ITEM(S) HUSBAND SHALL RECEIVE (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any title/deed/account described below is wife’s, husband’s or both.) Current Fair Market Value Notes (money owed to you in writing) Money owed to you (not evidenced by a note) Real estate: (Home) (Other) Business interests Automobiles Boats Other vehicles Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.) Furniture & furnishings in home Furniture & furnishings elsewhere Collectibles Jewelry Life insurance (cash surrender value) Sporting and entertainment (T.V., stereo, etc.) equipment $ Other assets $ Husband Initials:___________ Wife Initials: ___________ ASSETS: DESCRIPTION OF ITEM(S) HUSBAND SHALL RECEIVE (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any title/deed/account described below is wife’s, husband’s or both.) Current Fair Market Value Total Assets to Husband $ D. Contingent Assets and Liabilities shall be divided as follows: _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ _________________________________________________________________ E. Additional Retirement Account Provisions . The parties represent that all retirement and pension types of accounts have been disclosed and agree to the following division of same: Retirement Accounts Person to Receive Current Fair Market Value Husband Accounts: $ $ Wife Accounts: $ $ F. Additional Life Insurance Provisions . The parties agree in reference to their respective life insurance policies the following (indicate policies, owner, beneficiary): _______________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Husband Initials:___________ Wife Initials: ___________ __________________________________________________________________ __________________________________________________________________ G. Additional Household Furnishing and Effects Provisions. (Select as appropriate) The household furnishings and effects of the parties have been mutually divided by the parties and neither makes claim to any such property in the possession of the other except as provided above. Wife agrees that the Husband shall retain all of the household furnishings and effects presently located on the premises at ______________________________, excepting those items already removed by the Wife, or to be removed, with the Husband’s permission, except as listed and provided above. Husband agrees that the Wife shall retain all of the household furnishings and effects presently located on the premises at ______________________________, excepting those items already removed by the Husband, or to be removed, with the Wife's permission, and except listed and provided above. H. Additional Marital Home Provisions . The marital home of the parties shall be: i) Occupied by ( ) Husband ( ) Wife. ii) Titled in the name of ( ) Husband ( ) Wife. The expenses of the marital home are and shall be paid as follows: i) ( ) Wife ( ) Husband shall pay the mortgage payments. This obligation terminates ___________________________________. ii) ( ) Wife ( ) Husband shall pay the utilities and other expenses in connection with the upkeep and maintenance of the home. This obligation terminates ____________________________________. iii) ( ) Wife ( ) Husband shall pay all taxes, insurance and assessments. This obligation terminates ___________________ _____________________________________________________. I. Additional Provisions or explanations: _________________________________ ________________________________________________________________ ________________________________________________________________ ________________________________________________________________ Husband Initials:___________ Wife Initials: ___________ SECTION 4. DEBTS, LIABILITIES AND EXPENSES A. Except as otherwise provided herein each party agrees to pay their respective individual debts. B. Division of Liabilities/Debts. The parties divide their liabilities (everything they owe) as follows: Wife shall pay as her own the following and will not at any time ask Husband to pay these debts/bills: LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY WIFE (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any mortgage, note, or account described below is wife’s, husband’s, or both.) Monthly Payment Current Amount Owed Mortgages on real estate: (Home) $ $ (Other) Charge/credit card accounts Auto loan Auto loan Bank/credit union loans Money you owe (not evidenced by a note) $ $ Judgments $ $ Other Husband Initials:___________ Wife Initials: ___________ LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY WIFE (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any mortgage, note, or account described below is wife’s, husband’s, or both.) Monthly Payment Current Amount Owed Total Debts to Be Paid by Wife $ $ C. Husband shall pay as his own the following and will not at any time ask Wife to pay these debts/bills: LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY HUSBAND (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any mortgage, note or account described below is wife’s, husband’s, or both.) Monthly Payment Current Amount Owed Mortgages on real estate: (Home) $ $ (Other) Charge/credit card accounts Auto loan Auto loan Bank/credit union loans Money you owe (not evidenced by a note) Judgments $ $ $ $ Other Husband Initials:___________ Wife Initials: ___________ LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY HUSBAND (To avoid confusion at a later date, describe each item as clearly as possible. You do not need to list account numbers. Where applicable, include whether the name on any mortgage, note or account described below is wife’s, husband’s, or both.) Monthly Payment Current Amount Owed Total Debts to Be Paid by Husband $ $ SECTION 5. FUTURE EARNINGS AND ACQUISITIONS All income, earnings, or other property received or acquired by either party to this Agreement on or after the date of execution of this Agreement shall be the sole and separate property of the receiving or acquiring party. Each party, as of the effective date of this Agreement, does hereby and forever waive, release, and relinquish all right, title, and interest in all such income, earnings and other property except as necessary to collect any sums due hereunder in the event of default. SECTION 6. SPOUSAL SUPPORT (ALIMONY) [  one only] _________ 1. In consideration of the provisions contained herein for the respective benefits of the parties and other good and valuable considerations, the parties hereto mutually waive any and all claim or right to temporary or permanent alimony, maintenance or support, whether past, present or future. Thus, each of the parties forever give up any right to spousal support (alimony) that they may have from the other. __________ 2. ( ) Husband ( ) Wife agrees to pay spousal support (alimony) in the amount of $ ___________ every ( ) week ( ) other week ( ) month, beginning __________________ {date} and continuing until ______________________________ {date or event}. Explain type of alimony (temporary, permanent, rehabilitative, and/or lump sum) and any other specifics: Husband Initials:___________ Wife Initials: ___________ [  if applies] ( ) Life insurance in the amount of $ to secure the above support, will be provided by the obligor. SECTION 7. CHILD (REN) The following child (ren) have been born to the marriage of the parties: Name Birth date All child (ren) are adults, self-supporting and emancipated and there is no need to agree on child custody or visitation. The parties shall maintain a meaningful parent/child relationship with the child (ren) of the parties. SECTION 8. MUTUAL INDEMNITY The parties agree in regard to the payment of debts and other liabilities as stated in this Agreement that each shall indemnify and hold harmless the other for the payment of same. SECTION 9. INCOME TAXES With respect to any earlier year in which the parties filed joint Federal and State Income Tax Returns, each party agrees to indemnify the other for any income tax liability, penalty or deficiency associated with his or her income and shall hold the other party harmless therefor. The parties shall file separately for the year _______ and each year thereafter. The parties acknowledge that they have been advised that there may be certain tax consequences pertaining to this Agreement and have been directed and advised to obtain independent tax advice from qualified tax accountants or tax counsel prior to signing this Agreement, and that each party has had an opportunity to do so. Husband Initials:___________ Wife Initials: ___________ SECTION 10. ADDITIONAL OR FURTHER DOCUMENTS; COOPERATION Each party agrees that he or she will sign and execute any further or additional documents as may be necessary to put into effect the intended purposes hereof. Each party shall execute, acknowledge and deliver to the other party any and all instruments and assurances that the other party may reasonably require or find convenient, expedient, or businesslike for the purpose of giving full force and effect to the provisions of this Agreement, specifically including any deeds, affidavits, tax forms or other instruments required of one party to the other in order to pass good or merchantable title to any property owned by either party during the marital relationship. SECTION 11. DIVORCE It is agreed and understood that this Agreement finally settles all rights of the parties and the property jointly or individually owned by the parties, and that this Agreement shall be incorporated into judgment of the Family Court, _____________ County, State of Vermont, Cause Number _______________. The parties agree that this Agreement shall be made a part of a final decree or judgment and such decree or judgment shall not conflict with the terms hereof except to the extent disapproved by the Court. The parties agree that each mutually submits to the personal jurisdiction of the Family Court, _____________ County, State of Vermont, so that said Court has the power to decide any and all matters and questions concerning the dissolution of the parties’ marriage, and the division of the parties’ property and debts. SECTION 12. MODIFICATION This Agreement shall stop and preclude either party from making other or further demands and claims upon the other, not included herein, except that such legal action may be taken by either party as is necessary to enforce or modify the terms and provisions hereof, except that the Property Settlement provision shall not be subject to modification. SECTION 13. Husband Initials:___________ Wife Initials: ___________ ABSENCE OF DURESS OR UNDUE INFLUENCE The parties agree and state that each has freely and voluntarily entered into this Agreement. This Agreement was executed free of any duress, coercion, collusion, or undue influence. In some instances, the Agreement represents a compromise of disputed issues; however, both parties believe that its terms and conditions are fair and reasonable. SECTION 14. RELEASE, WAIVER, BINDING EFFECT, AND ESTATES Except as otherwise provided for in this Agreement, each party shall be divested of and each party waives, renounces and gives up all right, title and interest in and to the property awarded to the other. All property and money received and retained by the parties shall be the separate property of the respective party, except as is specifically stated herein. Except for those rights and obligations contained in this Agreement, or arising therefrom by operation of law, both parties do hereby release and forever discharge the other party from all actions, causes of actions, claims and demands whatsoever, known and unknown, suspected and unsuspected, apparent now or hereafter. It is the specific Agreement and purpose of this paragraph to release and discharge any and all claims and causes of actions of any kind or nature whatsoever whether specifically mentioned or not, which may exist or might be claimed to exist at or prior to the date of this Agreement; and, both parties specifically waive any claim or right to assert that any cause of action or alleged cause of action or claim or demand has been, through oversight or error or intentionally or unintentionally, omitted from this release and Agreement. The parties shall refrain from, release and relinquish any and all claims that he or she may have had, may now have, or may hereafter acquire to share in any capacity or to any extent whatsoever, in the estate of the other, whether by way of statutory allowance, heirship, homestead rights, or election to take against or under the other party’s Last Will and Testament. It is the intent of the parties that neither shall be a beneficiary or recipient of property of the other by Will or intestate succession from and after the date of this Agreement and expressly waive and reliquinsh any such right regardless of Husband Initials:___________ Wife Initials: ___________ whether the Will of the other has been changed to delete the gift to her or him and regardless of whether one party shall die prior to the entry of a final judgment of divorce. SECTION 15. ENFORCEMENT This Agreement may be enforced by actions and proceedings for Contempt of Court, or attachment and garnishment, for specific performance, or any other remedy legally available to either Husband or Wife, for the enforcement of the provisions and covenants of this Agreement. SECTION 16. BANKRUPTCY To the extent of any obligation contained herein is discharged in bankruptcy and the non- bankrupt party is held liable for said debt, the non-bankrupt party shall have the right to petition a court of competent jurisdiction for spousal support in an amount sufficient to cover any amounts so discharged. SECTION 17. ENTIRE AGREEMENT This Agreement constitutes the entire Agreement between the parties and each party acknowledges that there are no further Agreements not expressly included herein and that this Agreement may be modified, altered, or amended only in writing, duly signed and notarized by each in the form of this original. SECTION 18. FULLY READ AND UNDERSTAND; INFORMED CONSENT Each party represents and acknowledges that he or she has fully read this Agreement, consulted with each other, carefully considered same, and have signed and executed same after such consultation, that the signing of this Agreement is free and voluntary without force or collusion by either party or any third party, and that each party signed same with the full knowledge of said party's rights, obligations, and responsibilities. Each party agrees that they have had a reasonable opportunity to consult with an attorney of their choice in the negotiation and preparation of this document, and regarding any divorce proceeding. Husband Initials:___________ Wife Initials: ___________ SECTION 19. SEVERABILITY If any portion of the Agreement shall be held to be void, voidable or unenforceable for any reason, then all the remaining parts or portions shall be construed, implemented and administered as if such void, voidable or unenforceable portion did not appear herein. SECTION 20. CONTROLLING LAW This Agreement shall be governed, enforced and interpreted according to the laws of the State of Vermont. SECTION 21. EFFECTIVE DATE; HEIRS AND ASSIGNS This Agreement is binding upon the parties and their legal representatives, successor, heirs and assigns, subject only to approval by the Court in which divorce proceedings are instituted. EXECUTED AND AGREED ON THE DATES SET FORTH BELOW. I certify that I have been open and honest in entering into this Settlement Agreement. I am satisfied with this Agreement and intend to be bound by it. Dated: Signature of Wife Printed Name: _____________________________ Address: __________________________________ City, State, Zip: Telephone Number: Fax Number: Dated: Signature of Husband Printed Name: Address: City, State, Zip: Telephone Number: Fax Number: STATE OF VERMONT COUNTY OF _________________ Husband Initials:___________ Wife Initials: ___________ On this _________ day of ____________________________, _______________, before me personally appeared ____________________________________________ (name of person acknowledging) to me known to be the person who executed the foregoing instrument, and _____________________________ he/she/they thereupon duly acknowledged to me that _____________ he/she/they executed the same to be _______ his/her/their free act and deed. ______________________________ Notary Public Print Name: ___________________ My commission expires: _____________________ STATE OF VERMONT COUNTY OF _________________ On this _________ day of ____________________________, _______________, before me personally appeared ____________________________________________ (name of person acknowledging) to me known to be the person who executed the foregoing instrument, and _____________________________ he/she/they thereupon duly acknowledged to me that _____________ he/she/they executed the same to be _______ his/her/their free act and deed. ______________________________ Notary Public Print Name: ___________________ My commission expires: _____________________ Husband Initials:___________ Wife Initials: ___________