GA-DO-1
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 prior to effective date of this
Agreement. This form is for married persons with no children without joint property or
debts. This form is for the State of Georgia.
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 when approved by the
appropriate court. The parties will file a divorce proceeding prior to signing this Agreement, or
have pending a divorce action.
IN THE SUPERIOR COURT OF _______________ COUNTY, GEORGIA
FAMILY DIVISION
In Re the Family of:
____________________________
NO. _______________________
v.
____________________________
MARITAL SEPARATION AND PROPERTY SETTLEMENT AGREEMENT
WITH NO DEPENDENT OR MINOR 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 GEORGIA
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 the
marriage being irretrievably broken and there is no chance of staying together. The parties make
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
Husband Initials:___________ Wife Initials: ___________
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
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 Superior Court of _______ County,
State of Georgia, Family Division, 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
Husband Initials:___________ Wife Initials: ___________
all types and agree that the terms of this Agreement are fair, just, and equitable after
consideration of the financial status of the parties.
SECTION 3.
ASSETS
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 provided herein. There is no joint property to divide. All property
titled in the name of Husband shall be and remain his and all property titled in the name
of Wife shall be and remain hers.
Retirement Accounts . The parties represent that all retirement and pension types of
accounts have been disclosed and agree that there will not be a division of retirement
pension accounts and each party shall keep their respective retirement and pension type
accounts.
Life Insurance . The parties agree that they will remove each other’s names from their
respective life insurance policies. Further, that from and after the date of this Agreement,
husband and wife disclaim, waive and renounce the right to receive any life insurance
benefits or proceeds, if any, to which they would have been entitled as beneficiary on a
life policy maintained by the other even if they have not been removed as the designated
beneficiary on the date of death of the insured.
Household Furnishing and Effects. (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 below.
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, or as provided below.
Husband agrees that the Wife shall retain all of the household furnishings and effects
presently located on the premises at _________________________________________,
Husband Initials:___________ Wife Initials: ___________
excepting those items already removed by the Husband, or to be removed, with the
Wife's permission, or as provided below.
Husband shall be entitled to possession of the following household furnishing and
effects:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Wife shall be entitled to possession of the following household furnishings and effects:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Each party shall retain as his or her own all of their personal clothing, jewelry and
effects.
Marital Home .
Husband owns improved premises, which has been occupied as the marital residence
of the parties located at ___________________________________________________.
It is understood and agreed that the Husband shall remain and live in the house and be
fully responsible for its mortgage payments and utility charges and other expenses, if
any, in connection with the same. Wife shall retain no interest in said home, legal or
equitable.
Wife owns improved premises, which has been occupied as the marital residence of
the parties located at ______________________________________________________.
It is understood and agreed that the Wife shall remain and live in the house and be fully
responsible for its mortgage payments and utility charges and other expenses, if any, in
connection with the same. Husband shall retain no interest in said home, legal or
equitable.
Husband and Wife rent premises, which has been occupied as the marital residence
Husband Initials:___________ Wife Initials: ___________
of the parties located at _____________________________________. It is understood
and agreed that the Wife shall remain and live in the rental premises and be fully
responsible for all rental payments and utility charges and other expenses in connection
with the same. Husband shall retain no interest in said premises, legal or equitable.
Husband and Wife rent premises, which has been occupied as the marital residence
of the parties located at _____________________________________. It is understood
and agreed that the Husband shall remain and live in the rental premises and be fully
responsible for all rental payments and utility charges and other expenses in connection
with the same. Wife shall retain no interest in said premises, legal or equitable.
Other: _______________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
SECTION 4.
NO CHILDREN
There have been no children born to the marriage of Husband and Wife. Wife is
not now pregnant. No Children have been adopted by the parties.
SECTION 5.
MUTUAL WAIVER OF ALIMONY OR OTHER SUPPORT
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.
SECTION 6.
DEBTS, LIABILITIES AND EXPENSES
Each party agrees to pay their respective debts and agree that there are no joint
debts that remain unpaid at the time of the execution of this Agreement. Husband shall
pay his debts and Wife shall pay her debts.
Each party agrees to be fully responsible for their own individual medical
expenses and will maintain their own medical plans, which they may carry either
individually or through their place of employment.
Husband Initials:___________ Wife Initials: ___________
SECTION 7.
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.
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.
SECTION 10.
ADDITIONAL OR FURTHER DOCUMENTS; COOPERATION
Husband Initials:___________ Wife Initials: ___________
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 Superior Court of
_____________ County, Georgia, Family Division, 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 Superior Court of _____________ County, Georgia, Family
Division, 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
therefromby 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
Husband Initials:___________ Wife Initials: ___________
regardless of 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
Husband Initials:___________ Wife Initials: ___________
regarding any divorce proceeding.
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 Georgia.
SECTION 21.
EFFECTIVE DATE; HEIRS AND ASSIGNS
This Agreement shall become binding upon the parties and their legal
representatives, successor, heirs and assigns, immediately following the granting of a
final decree of divorce, and/or by the statutory period upon which said divorce shall be
effective, in a proceeding instituted by either party against the other party, or jointly,
provided that the provisions of the Agreement are approved by the Court in which such
proceedings are instituted. In the absence of the granting of a decree or approval of the
Court, the provisions of this Agreement shall have no effect.
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
Husband Initials:___________ Wife Initials: ___________
Printed Name:
Address:
City, State, Zip:
Telephone Number:
Fax Number:
Signed, sealed, and delivered in the presence of:
______________________________ ___________________________ (Seal)
Witness Print Name
______________________________ ___________________________ (Seal)
Notary Public Print Name
(Seal) ___________________________ (Seal)
Signed, sealed, and delivered in the presence of:
______________________________ ___________________________ (Seal)
Witness Print Name
______________________________ ___________________________ (Seal)
Notary Public Print Name
(Seal) ___________________________ (Seal)
Husband Initials:___________ Wife Initials: ___________