MD -DO -11A
INSTRUCTIONS
When should this form be used?
This form should be used when the parties desire to enter into a Separation Agreement to be
effective immediately. This form is for married persons with children with joint property
or debts. This form is for the State of Maryland.
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 pr int 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 div ided. 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 as a contract between
the parties regardless of whether a divorce action is filed. Certain conduct may invalidate the
Agreement such as cohabitation and sexual relations with each other after signing the
Agreement. If a divorce action is filed, the Court may or may not be bou nd by all provisions
contained in the Agreement. For example, Courts generally have the final say about child
custody, child support, alimony and other like matters.
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MARITAL SEPARATION AND PROPERTY SETTLEMENT AGREEMENT
WITH DEPENDENT 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 MARYLAND
COUNT Y 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 ,
20 , 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 in the marriage of the parties that have resulted in
the spouses voluntarily living separate and apart for 1 year without interruption or cohabitation
and there is no reasonable expectation of reconciliation. The parties make this Agreement to
settle once and for all that the parties owe to each other an d 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
relatio nship. 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
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WHEREAS, the parties intend that this Agreement shall be binding on them from and
after the date and time of execution, if permitted, and that this Agreement may be incorporated
into a final judgment of divorce at some future time.
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 moles t 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 DISCLOSUR ES
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, j ust, and equitable after consideration
of the financial status of the parties.
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 po ssession of the
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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 currentl y 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 bel ow 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
Retirement plans (Profit Sharing, Pension, IRA, 401(k)s, etc.)
Furniture & furnishings in home
Furniture & furnishings elsewhere
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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 bel ow is wife’s,
husband’s, or both.)
Current Fair Market Value
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
Mar ket 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)
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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
Mar ket Value
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
Total Assets to Husband
$
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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):
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.
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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:
iii.) Wife Husband shall pay the mortgage payments. This obligation terminates
.
iv.) Wife Husband shall pay the utilities and other expenses in connection with the
upkeep and maintenance of the home. This obligation terminates
.
v.) Wife Husband shall pay all taxes, insurance and assessments. This obligation
terminates .
I. Additional Provisions or explanations:
SECTION 4.
DEBTS, LIABILITIES AND EXPENSES
A. Except as otherwise provided herein each party agree s 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
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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 con fusion 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
Curr ent
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
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LIABILITIES: DESCRIPTION OF DEBT(S) TO BE PAID BY HUSBAND
(To avoid con fusion 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
Curr ent
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 p arties 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:
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[ √ if applies]
Life insurance in the amount of $ to secure the above support, will be
provided by the obligor.
SECTION 7.
CHILD CUSTODY, PARENTAL RESPONSIBILITY, AND VISITATION
A. The following child(ren) have been born to the marriage of the parties:
Name Birth date
B. Parental Responsibility - Child Custody
Both Husband and Wife are proper persons to have the permanent legal and physical
custody, parental responsibility, care and control of the minor children of the parties. Husband
and Wife shall share t he decision -making rights, the responsibilities and the authority relating to
the health, education and welfare of the children, and shall, therefore, make joint decisions
concerning the children’s health, education and welfare. Both Husband and Wife shal l exchange
information concerning the health, education and welfare of the minor children, and shall confer
with one another in the exercise of decision -making rights, responsibilities and authority.
Husband and Wife shall have equal access to all medical , dental and school records concerning
the minor children.
However, the parties agree that the best interest of the child(ren) at this time is that
primary parental responsibility and physical custody of the minor child(ren) will be and agree as
follows:
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Husband shall have primary parental responsibility and custody of the minor child(ren) of
the parties subject to the visitation rights of Wife.
Wife shall have primary parental responsibility and custody of the minor child(ren) of the
parties subject to the visitation rights of Husband.
Husband and Wife shall have joint primary parental responsibility and custody of the
minor child(ren) of the parties, both legal and physical.
C. Secondary Parental Responsibility, Visi tation, or Time Sharing - General
Provisions .
Visitation shall be conducted pursuant the following general provisions:
i) Visitation should be pleasant for the children and for the parent. Visitation should
help the children maintain a good relationship with the non -custodial parent.
ii) Visitation means the visiting parent will have the children visit in his or her home
overnight. It may include trips and outings elsewhere.
iii) Visitation schedules shall be followed and the visiting parent shall inform the
other parent when he or she cannot comply with the schedule.
iv) Adjustment of the visitation schedule from time to time may be necessary
according to the children's ages, h ealth and interests.
v) Visitation should provide meaningful personal contact for both the visiting parent
and the children.
vi) Visitation should not be used to check on the other parent and the children should
not be questioned for information about the other parent.
vii) Both parents should strive to agree on matters pertaining to the children,
including discipline, so that one parent is not undermining the other parent's
efforts.
viii) It is in the child's best interest for each parent to have a frequent, meaningful and
continuing relationship with their children. For children to make an adequate
adjustment to the dissolution of their parents marriage, the children must be
allowed to continue their relationship with both parents, experience min imal
changes in their lifestyle if at all possible, and not experience post -divorce
conflict between their parents.
D. Secondary Parental Responsibility, Visitation, or Time -Sharing -Schedule.
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The non -custodial parent is entitled to reasonable visitati on with the minor child(ren).
Husband and Wife adopt the following visitation schedule for the non -custodial parent:
Birth to 1 Year of Age
i) Non -custodial parent shall have four (4) visits with the child per week, with such
contact lasting four (4) ho urs in length.
ii) If the child is taken from the home of the custodial parent, the child shall be
returned at least one (1) hour before evening bedtime.
iii) Holiday Access
Holiday access takes precedence over the regularly scheduled visitation plan.
The non -custodial parent shall be entitled to the following:
On each child's birthday from 5:00 p.m. until 8.00 p.m.;
Memorial Day Monday from 2:00 p.m. until 6:00 p.m.;
Labor Day Monday from 2:00 p.m. until 6:00 p.m.;
Thanksgiving Day from 2:0 0 p.m. until 6:00 p.m.;
Christmas Day from 2:00 p.m. until 6:00 p.m.;
Independence Day from 2:00 p.m. until 6:00 p.m.;
Mother's Day with Mother from 2:00 p.m. until 4:00 p.m. and Father's Day
with Father from 2:00 p.m. until 4:00 p.m.
1 Year of Age to 5 Years of Age
i) The non -custodial parent shall have access on alternate weekends from Friday at
6:00 p.m. until Sunday at 6:00 p.m.
ii) Additionally, the non -custodial parent shall be permitted one (1) week night each
and every week with the child from 5:30 p.m. until 7:30 p.m.
iii) Holiday Access
Holiday access takes precedence over the regularly scheduled access/visitation
plan.
The non -custodial parent shall be entitled to the following:
In years ending in an odd number:
The night before each child's birthday from 5:00 p.m. until 8:00 p.m.;
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Memorial Day Monday from 9:00 a.m. until 6:00 p.m.;
Independence Day from 9:00 a.m. until 6:00 p.m.;
Thanksgiving Day from 9:00 a.m. until 6:00 p.m.;
Christmas Eve from 6:00 p. m. until Christmas Day at 10:00 a.m.;
In years ending in an even number:
Each child's birthday from 5:30 p.m. until 7:30 p.m.;
Easter from 8:00 a.m. until 6:00 p.m.;
Labor Day Monday from 9:00 a.m. until 6:00 p.m.;
Halloween evening from 5:30 p. m. until 8:00 p.m.;
Christmas Day from 10:00 a.m. until 7:00 p.m.
iv) Summer Visitation
The non -custodial parent shall have one (1) week of vacation with the children
each June, July and August of each year. The non -custodial parent shall notify
the custodial parent in writing no later than May 1st of each year as to the specific
weeks of su ch summer visitation.
5 Years of Age and Beyond
i) Non -custodial parent shall have access with the child on alternate weekends from
Friday at 6:00 p.m. until Sunday at 6:00 p.m. and on the Wednesday preceding the
weekend access from 5:30 p.m. to 7:30 p.m .
ii) In addition, the non -custodial parent shall have access with the child during the
week immediately following the weekend visitation on Tuesday and Thursday
evening from 5:30 p.m. until 7:30 p.m.
iii) Holiday Access:
Holiday access takes precedence over the regularly scheduled access/visitation
plan.
The non -custodial parent shall be entitled to the following:
In years ending in an odd number:
The night before each child's birthday from 5:00 p.m. to 8:00 p.m.;
Spring Break from Friday at 6:00 p.m. to the Sunday prior to the start of
school at 6:00 p.m.;
Memorial Day weekend from 6:00 p.m. on Friday until 6:00 p.m. on
Monday;
Independence Day from 6:00 p.m. on July 3rd until 6:00 p.m. on July 5th;
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Thanksgiving holiday from 6:00 p.m. on Wednesday until 6:00 p.m. on
Sunday;
From 6:00 p.m. on December 26th until 6:00 p.m. on January 1st.
In years ending in an even number:
Each child's birthday from 5:30 p.m. until 7:30 p.m.;
Easter weekend from 6:00 p.m. on Good Friday until 6:00 p.m. on Easter
Sunday;
Labor Day weekend from 6:00 p.m. on Friday until 6:00 p.m. on Monday;
Halloween evening from 5: 30 p.m. until 9:00 p.m. Christmas holiday
from 6:00 p.m. on December 20th until 6:00 p.m. on Dec ember 26th.
iv) Mother's Day/Father's Day
The mother shall have access every Mother's Day weekend from Friday at 6:00
p.m. until Sunday at 6:00 p.m.; the father shall have access every Father's Day
weekend from Friday at 6:00 p.m. until Sunday at 6:00 p. m.
v) Summer Visitation:
The non -custodial parent shall have five (5) weeks of summer visitation with the
child to be taken in no more than two (2) week intervals and with such weekly or
two (2) week visits to be nonconsecutive. The non -custodial parent shall notify
the custodial parent in writing no later than May 1st of each year as to the specific
weeks of such summer visitation.
E. Secondary Parental Responsibility, Visitation, or Time Sharing - Additional
Provisions.
In exercising visitation right s the following additional provisions apply:
1. Conflicts Between Regular Weekend, Holiday, and Extended Summer
Visitation. Where there is a conflict between a holiday weekend and the regular weekend
visitation, the holiday takes precedence. Thus, if the non -custodial parent misses a regular
weekend because it is the custodial parent's holiday, the regular alternating visita tion schedule
will resume following the holiday. If the non -custodial parent received two consecutive
weekends because of a holiday, the child will spend the following weekend with the custodial
parent. When there is a conflict between holiday visitation and extended summer visitation, the
holiday visitation takes precedence. When there is a conflict between regular weekend visitation
and extended summer visitation, extended summer visitation takes precedence.
2. Appropriate Conduct By Parents . Parent s shall, at all times, avoid speaking
negatively about each other and should firmly discourage such conduct by relatives or friends.
Each parent should encourage the children to support the other parent. The basic rules of
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conduct and discipline establis hed by the custodial parent should be the baseline standard for
both parents, and consistently enforced by both, so that the children do not receive mixed
signals.
3. Parental Communication. Parents shall at all times keep each other advised of
their ho me and work addresses and telephone numbers. So far as possible, all communication
concerning the children shall be conducted between the parents in person, or telephonically at
their residences (and not at their places of employment).
4. Grade Reports and Medical Information. The custodial parent shall provide
the non -custodial parent with grade reports and notices from school as they are received and
shall, consistent with law, permit the non -custodial parent to communicate
concerning the children directly with the school and with the children's doctors and other
professionals, outside the presence of the custodial parent. Each parent shall immediately notify
the other of any medical emergencies or serious illnesses of the children. The custodial parent
shall notify the non -custodial parent of all school or other events (like Church or Scouts)
involving p arental participation. If the children are taking medications, the custodial parent shall
provide a sufficient amount and appropriate instructions.
5. Visitation Clothing. The custodial parent shall send an appropriate supply of the
children's clothing with them, which shall be returned clean (when reasonably possible), with the
children, by the non -custodial parent. The non -custodial parent shall advise, as far in advance as
possible, of any special activities so that the appropriate clothing may be s ent.
6. Visitation or Support Disputes. Neither visitation nor child support is to be
withheld because of either parent's failure to comply with a court order. The children have a right
to both support and visitation, neither of which is dependent upon the other. In other words,
failure to pay support does not mean no visitation and no visitation does not mean no support. If
there is a violation of either a visitation or a support order, the exclusive remedy is to apply to
the court for appropriate san ctions.
7. Adjustments to This Visitation Schedule. Although this is a rather specific
schedule, the parties are expected to fairly modify visitation when family necessities, illnesses or
commitments reasonably so require. The requesting party shall gi ve as much notice as
circumstances permit.
8. Pickup and Drop -off. Unless other arrangements are made, the non -custodial
parent shall pick up the children at the times specified and return them at the times specified.
The custodial parent shall have th e children ready for visitation at the time they are to be picked
up and shall be present at the home to receive the children at the time they are returned.
Unjustified violations of this provision may result in the offender being subject to contempt of
court. (Commentary: While it is most desirable for the parents to pick up and return the
children, this provision does not prohibit grandparents, current spouses or other appropriate
adults known to the children.)
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9. Extracurricular Activities. Children are often involved in sports, lessons, and
other extracurricular activities, which are generally to their benefit and enjoyment. Each parent
shall recognize that a reasonable amount of extracurricular activities are generally assumed to be
in the children 's best interests. Each parent should attempt to be flexible in order to
accommodate the children's extracurricular activity schedules as must as reasonably possible,
although extracurricular activities should not supersede summer visitation with non -cust odial
parents, nor should they be used as a method by which to deny access to the non -custodial
parent. In recognition of the scheduling difficulties that can be caused by children's
extracurricular activities, custodial parents should act in good faith i n attempting to schedule
such extracurricular activities as not to unreasonably infringe upon the non -custodial parent's
access to the children. Likewise, the non -custodial parent should act in good faith in attempting
to assist in transportation needs an d in accommodating the children's extracurricular schedules as
much as reasonably possible. Good faith communication by the parents is essential with regard
to the difficult issue of the scheduling of children's extracurricular activities.
10. Notice of Canceled Visitation. Whenever possible, the non -custodial parent
shall give a minimum of three (3) days notice of intent not to exercise all or part of the scheduled
visitation. When such notice is not reasonably possible, the maximum notice permitted b y the
circumstances, and the reason therefore, shall be given. The custodial parent shall give the same
type of notice when good cause exists making the cancellation or modification of scheduled
visitation necessary.
11. Missed Visitation. In the event the non -custodial parent misses visitation as the
result of illness of the child or parent, an emergency, or other such reasonable excuse, the parties
shall make a good faith effort to make up a portion of that visitation within a reasonable period
of tim e, understanding the importance of the non -custodial parent's continuing and frequent
contact with the children. (Commentary: It is important to remember that illness should not
necessarily deprive the non -custodial parent of visitation with the children. Clearly, a non -
custodial parent can take care of a sick child as well as the custodial parent in many
circumstances.)
12. Custodial Parent's Vacation. Unless otherwise specified, the custodial parent
shall be entitled to a period of vacation with the c hildren no less than that accorded the non -
custodial parent, whose visitation shall abate during the first fourteen days thereof, and thereafter
only so long as distance makes visitation impracticable.
13. Caretaker Provision. As a general rule, each parent shall have the right of first
refusal for childcare or baby -sitting needs of the other parent for durations of four hours or more.
Whenever either parent has a need for child care or baby sitting for a duration of four hou rs or
more, that parent should always make a good faith attempt first to inquire of the other parent,
with as much advance notice as reasonably possible, whether the other parent desires to provide
child care or baby sitting. The other parent is under no o bligation to provide the childcare or
baby sitting. If the other parent elects to provide such childcare or baby -sitting, it shall be done
at no cost. This provision is intended to provide each parent additional access to the children
whenever reasonably possible.
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14. Telephone and Mail Privileges. Each parent shall allow liberal and reasonable
telephone and mail privileges with the children.
15. Medical Reports and Bills. The Custodial parent shall provide copies of all
medical information, and do cumentation, including bills, within seven (7) days of their receipt
and shall immediately notify the other parent in the event of a medical emergency. Every effort
shall be made for the custodial parent to provide the non -custodial parent with the necess ary
information of a medical expense in order to get the bill satisfied. The parent with the medical
insurance shall provide the other parent with a copy of the explanation of benefits within seven
(7) days from the date of receipt of same so that the uni nsured portion of the bill can be quickly
calculated and paid within a reasonable period of time.
16. Abatement of Support During Extended Visitation. If the non -custodial
parent's support obligation is current, support shall abate by 50 percent during any visitation of
seven (7) consecutive days or more. If support is not current, the 50 percent that would have
been abated shall be paid and shall appl y to the existing arrearage. (Commentary: If the
custodial parent actually receives the full amount of child support during this period and if
support is current, it is the custodial parent's obligation to refund the money immediately to the
non -custodial parent. This alleviates many of the problems that arise when wage -withholding
orders have been issued.)
17. Modification. If the parties mutually agree permanently to change the provisions
of their decree of divorce, they must petition the Court to ap prove and order that change. In the
event that the parties do not obtain a court order, the Court will not be bound by any alleged
agreement of the parties.
F. Other Provisions. {explain any other agreed -upon arrangements}
Neither parent shall take the child(ren) from the custody of the other parent or any child
care provider or other person entrusted by the other parent with the care of the child(ren) without
the agreement of the other party during the other party’s time of parental responsibility or
visitation.
SECTION 8.
CHILD SUPPORT, HEALTH INSURANCE, DENTAL INSURANCE
A. Amount and Person to Pay.
Husband Wife will pay child support to Wife Husband for the benefit of the minor
children of the parties in the amount of $ , per child, every week other week
month, beginning {date} and continuing until modified by court o rder, or
the minor child(ren) becomes an adult, emancipated, marries, dies, otherwise becomes self -
supporting. (Note: Child support is stated in terms of amount per child.)
B. Child Support Arrearage.
There currently is a child support arrearage of $ for retroactive child support and/or
$ for previously ordered unpaid child support. The total of $ in c hild
support arrearage shall be repaid at the rate of $ every week other week
month, beginning , until paid in full including statutory interest.
C. Healt h Insurance.
Husband Wife will maintain health insurance coverage for the parties’ minor
child(ren). The party providing coverage will provide insurance cards to the other party showing
coverage.
OR
Health insurance is not reasonably available at this time. Any uninsured/unreimbursed
medical cost s for the minor child(ren) shall be assessed as follows:
a. Shared equally by both parents.
b. Prorated according to the child support guideline percentages.
c. Other {explain} :
As to these uninsured/unreimbursed medical expenses, the party who incurs the expense
shall submit a request for reimbursement to the other party within 30 days, and the other party,
within 30 days of receipt, shall submit the applicable reimbursement for that expense, according
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to the schedule of reimbursement set out in this paragraph.
D. Dental Insurance.
Husband Wife will maintain dental insurance coverage for the parties’ minor child(ren).
The party providing coverage will provide insurance cards to th e other party showing coverage.
OR
Dental insurance is not reasonably available at this time. Any uninsured/
unreimbursed dental costs for the minor child (ren) shall be assessed as follows:
a. Shared equally by both parents.
b. Prorated according to the child support guideline percentages.
c. Other {explain}:
As to these uninsured/unreimbursed dental expenses, the party who incurs the expense
shall submit a request for reimbursement to the other party within 30 days, and the other party,
within 30 da ys of receipt, shall submit the applicable reimbursement for that expense, according
to the schedule of reimbursement set out in this paragraph.
E. Life Insurance.
Husband Wife shall be required to ma intain life insurance coverage for the benefit
of the parties’ minor child(ren) in the amount of $ until the youngest chi ld becomes
an adult, becomes emancipated, marries, dies, or otherwise becomes self -supporting.
F. IRS Income Tax Deduction(s).
The parent granted primary residential responsibility or sole parental responsibility of the
parties’ minor child(ren) shall have the benefit of any tax deductions for the child(ren) or as
follows {explain} :
The other parent will convey any applicable IRS form regarding the income tax
deduction.
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G Other provisions relating to child support (e.g., uninsured medical/dental
expenses, insurance coverage, life insurance to secure child support, orthodontic payments,
college fund, etc.):
SECTION 9.
MUTUAL INDEMNITY
The parties agree in regard to the payment of debts and other liabilities as stated in this
Agreemen t that each shall indemnify and hold harmless the other for the payment of same.
SECTION 10.
INCOME TAXES
With re spect 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 h armless therefor.
The parties shall file separately for the year and each year thereafter.
The parties ackn owledge 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, a nd that each party has had an opportunity to do so.
SECTION 11.
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 pu rposes 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
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purpose of giving full force and e ffect 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 12.
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, and the
enforceability thereof, is not c ontingent upon either party or both parties being granted a divorce
on any grounds. However, if either or both parties are granted a divorce on any grounds, the
parties agree that this Agreement shall be made a part thereof and that such decree or judgmen t
shall not conflict with the terms hereof except to the extent disapproved by the Court. In the
event that the law governing this Agreement prohibits this Agreement from being effective until
a divorce action has been filed, or a Judgment of Divorce ente red, then the parties agree that
such event shall be the effective date of this Agreement. In the event a divorce action or
judgment is required prior to this Agreement becoming effective, or in the event that a divorce
action is desire by one or more of the parties, both parties agree and sign and execute all
pleading and papers required to obtain a divorce and jointly request and consent to the
immediate submission of this Agreement to the applicable Court and to an entry of a judgment
by incorporation o f this Agreement into the final decree or judgment of divorce. The parties
agree that each mutually submits to the personal jurisdiction of the Circuit Court for
, Maryland,
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 13.
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
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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 14.
ABSENCE OF DURESS OR UNDUE INFLUENCE
The parties agree and state that each has freely and voluntarily entered into this
Agreement. Th is 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.
SECTIO N 15.
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 t he
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 ot her party’s Last Will and Testament.
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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 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 16.
ENFORCEMENT
This Agreement may be enforce d 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 17 .
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 suppor t in an amount sufficient to cover any
amounts so discharged.
SECTION 18.
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 a nd 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 19.
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 pa rty, and that each party signed same with the full
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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 prepara tion of this document, and regarding any divorce proceeding.
SECTION 20.
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, implemen ted and
administered as if such void, voidable or unenforceable portion did not appear herein.
SECTION 21.
CONTROLLING LAW
This Agreement shall be governed, enforced and interpreted according to the laws of the
State of Maryland.
SECTION 22.
HEIRS AND AS SIGNS
This Agreement shall be binding upon their legal representatives, successor, heirs and
assigns.
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:
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Fax Number:
Husband Initials:___________ Wife Initials: ___________ Page 8
STATE OF MARYLAND
COUNTY OF
Personally appeared befor e me, a Notary Public, in and for said county and state, on this
day of , 20 , the within named
, known to me, or satisfactorily pr oven, to be the person
whose name is subscribed to the within instrument and who acknowledges that he/she/they
(strike one) executed the same for the purposes therein contained.
______________________________
NOTARY PUBLIC
Print Name:
My Commission Expires:
STATE OF MARYLAND
COUNTY OF
Personally appeared before me, a Notary Public, in and for said county and state, on this
day of , 20 , the within named
, known to me, or satisfactorily proven, to be the person
whose name is subscribed to the within instrument and who acknowledges th at he/she/they
(strike one) executed the same for the purposes therein contained.
______________________________
NOTARY PUBLIC
Print Name:
My Commission Expires:
