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Separation and Support Agreement Providing for Support of Spouse and Custody and Support of Children Agreement made on the       day of       , 20       , between       of       , (Name of Husband) (Street Address, City, County, State, Zip Code) referred to herein as Husband, and       , of (Name of Wife)       , referred to herein as Wife. (Street Address, City, County, State, Zip Code) 1. Statement of Marriage. Husband and Wife were married on       , in (Date of Marriage)       ,       ,       , and as a result of their (Name of City) (Name of County) (Name of State) marriage, they have two children, namely       and (Name of first child)       . (Name of second child) 2. Agreement to Separate. As a result of disputes and differences between Husband and Wife, they have (been separated and living apart since       and/or agreed to (Date of Separation) dissolve their marriage . 3. Custody and Support of Children. Husband and Wife intend that this Agreement will provide for the custody, visitation and support of their children. 4. Living Separate and Apart. The parties may and shall live separate and apart, each free from all dominion, restraint and control by the other, whether direct or indirect, as fully as if unmarried. Each party may reside at such place or places as he or she may select. 5. No Molestation or Interference. Neither party shall molest 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. 6. Division of Property. The property, both real and personal, owned by either of the parties at the time of their marriage or subsequently acquired, separately or together, and owned by the parties or either of them at the time of their separation has previously been equitably divided and apportioned between them as follows:                   . (Description of real and personal property) The parties ratify and confirm that division and apportionment. 7. Separate Property. Each party shall retain, have and enjoy, independently of any claim, right or demand of the other party, all property of every kind, nature and description and Separation and Support Agreement Page 1 of 6 whatsoever situated that is now owned or held or is in the future acquired by him or her, or stands in his or her name. 8. Release of Estate Rights. Each party releases all right to share in the estate of the other party, or to serve as personal representative of the estate of the other party, except only as provided by will or codicil executed after the date of this Agreement. 9. Support and Maintenance of Spouse.       shall pay to       (Husband or Wife) (Husband or Wife) as and for       necessary support and maintenance, and       shall (his or her) (Husband or Wife) accept in full settlement and satisfaction of       right, claim and demand for such (his/her) support, maintenance and alimony against       , the following amounts: (Husband or Wife)       . (Support Schedule and Conditions) 10. Debts and Obligations. Each of the parties shall pay all debts incurred by him or her after the date of this Agreement and shall indemnify the other party against liability for the same.       shall pay debts incurred by       or by       (Husband or Wife) (him or her) (Husband or Wife) or by the parties jointly prior to the date of this Agreement, including the following:                   . (description of debts of both parties and of Husband or Wife, along with nature of obligation and payee of each) 11. Child Custody.       shall have the sole care, custody and control of the (Husband or Wife) following named children of the marriage:       (list of each child and his or her gender and age) and the named children shall reside with       . Such care, custody and control shall (him or her) continue with respect to each child until the child reaches majority or sooner becomes emancipated, subject, however, to the visitation provisions set forth in this Agreement. 12. Child Custody – Place and Condition of Residence.       shall not (Husband or Wife) remove any of the unemancipated children to a permanent residence outside       (Name of State) without       's prior written consent or prior approval of a court of competent (Wife or Husband) jurisdiction on due hearing and notice.       and the children are now residing (Husband or Wife) at       .       shall at all times keep (Street Address, City, County, State, Zip Code) (Husband or Wife) Separation and Support Agreement Page 2 of 6       informed of the residential address of the children in       (Husband or Wife) (his or her) custody, and their location during vacation and holiday periods if they will be away from their normal residence for more than       days in succession. (number of days) 13. Child Custody and Visitation Rights A.       shall have the right to visit the children, individually or (Husband or Wife) together, at their place of residence with       , at reasonable times (Husband or Wife) and at reasonable intervals; and to have the children, or any of them, accompany       from their place of residence at reasonable times and for reasonable (him or her) periods provided that       shall not keep any of the children away from their (he/she) residence later than       on any such occasion, without (time of day)       's prior consent.       shall have the privilege (Wife or Husband) (Wife or Husband) of having the children, or any of them, visit       at       residence (him or her) (his or her) and stay with       not more often than       per (him or her) (number of times per month) calendar month on weekends and during holiday periods for not to exceed       (Number) hours. B. During such periods when the children or any of them are with       , (Husband/Wife)       may take them on short journeys as       may choose and they (he/she) (he/she) may desire, provided that       shall not without the prior consent of (he/she)       take them from this state. (Wife or Husband) C.       shall make prior arrangements with       (Husband or Wife) (Wife or Husband) for each such weekend or holiday visit at least       days prior to the (number of days) commencement of the visit. The rights of visitation expressed in this section shall not be exercised by       at any time or in such a manner as to interfere with (Husband or Wife) the education and normal social and school activities of any of the children. D. The parties may freely agree to any different arrangements for exercise of the Separation and Support Agreement Page 3 of 6 visitation rights of       , from time to time, as future exigencies and (Husband or Wife) the welfare of the children may require, but no such substitute or additional privilege shall be deemed to amend this Agreement, unless expressed in writing and signed by the parties. Each of the parties shall at all times in good faith endeavor to maintain in all the children respect and affection for the other party. 11. Child Custody – Consultation Concerning Education, Health & Welfare of Children. Notwithstanding       general custody of the children, (his or her)       shall confer with       from time to (Husband or Wife) (Wife or Husband) time with respect to the welfare of the children, or any of them, and particularly as to educational, health and disciplinary matters of a substantial nature, such as, by way of examples, during the serious illness or prior to a scheduled operation of any of the children, or in connection with the selection of a college for the higher education of any of the children. It shall at all times be the objective of both parties to decide all questions affecting each of their children in such manner as to promote the welfare, happiness and well-being of the children. 12. Support and Maintenance of Children.       shall pay to (Husband or Wife)       for the support, maintenance, care and education of each child in (Wife or Husband)       custody $       per month, beginning (his or her) (dollar amount of monthly child support)       . On the occurrence of the first to occur of any of the following (date of first child support payment) events with respect to each child, the obligation of       to pay support for (Husband/Wife) that child shall terminate at the end of the month in which such event occurs: (1) the death of the child; (2) the attainment of the child's twenty-first birthday; or (3) an emancipation event as defined in Section 13. The obligation of       for support and maintenance (Husband or Wife) of the children in the custody of       , as provided in this Section, shall be (Wife or Husband) separate from all other obligations contained in this Agreement and shall continue as obligations of and charges against       's estate on       death, to the extent and (Husband or Wife) (his or her) for the period that such obligation shall be in force and effect at the time of       death. (his or her) 13. Support and Maintenance of Children – Emancipation Events. For the purposes of this Agreement, a child in the custody of       shall become emancipated on (Husband of Wife) the occurrence of any one of the following events: A. The valid marriage of the child; Separation and Support Agreement Page 4 of 6 B. The full and permanent employment of the child gainfully and for a reasonable living wage, excluding vacation and seasonal employment of a temporary nature; C. The induction, enlistment or entry on active duty in the Armed Services of the United States for a term of service of not less than       years. (number of years) The emancipation of any child shall be postponed beyond the event that would otherwise result in his or her emancipation if, at the time of such event, the child is enrolled as a full-time student in an accredited institution of higher learning. Instead, the emancipation event for any such child shall be the date of the child's graduation from that institution, provided, however, that the emancipation of any child shall not be extended beyond the child's twenty-third birthday. 14. Effect of Divorce or Dissolution of Marriage A. This Agreement shall not be construed in any measure as consent to or condonation of a divorce in favor of either party or dissolution of marriage, but this Agreement shall not be a bar to an action for divorce or a proceeding for dissolution of marriage previously or in the future filed. B. If a judgment or decree of divorce or dissolution of marriage is entered in any action or proceeding for the same, this Agreement and in particular the provisions for the custody and support of the children of the parties shall, if the court approves, be incorporated in, merged with, and become a part of such judgment or decree. 15. Severability. The invalidity of any portion of this Agreement will not and shall not be deemed to affect the validity of any other provision. If any provision of this Agreement is held to be invalid, the parties agree that the remaining provisions shall be deemed to be in full force and effect as if they had been executed by both parties subsequent to the expungement of the invalid provision. 16. No Waiver. The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. 17. Notices. Any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. 18. Governing Law. This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of       . (Name of State) 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 or an authorized representative of each party. Separation and Support Agreement Page 5 of 6 20. 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. WITNESS our signatures as of the day and date first above stated. By: By: (Signature of Husband) (Signature of Wife)             (P rinted Name of Husband ) (P rinted Name of Wife ) Separation and Support Agreement Page 6 of 6

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