Fill and Sign the Separation Agreement Sample Form

- 1 - COMBINED SEPARATION, PROPERTY SETTLEMENT, SUPPORT AND CUSTODY AGREEMENT HUSBAND WIFE Address Address City/County/State/Zip City/County/State/Zip1.The parties hereto were married on _________________ , in the City of _________________, County of _________________, State of _________________, and ever since have been and now are husband and wife.2. They have the following children, all of whom are the issue of this marriage:Name: Date of Birth Name: Date of Birth1. 2. 3. 4. 5. 6. 3. As a result of disputes and irreconcilable differences between the parties, they have agreed to an immediate and permanent separation.4. Husband and Wife intend and it is the purpose of this Agreement to make a complete and final settlement of all claims that Wife may have against Husband for alimony, support, and maintenance, to provide fairly and adequately for her support and maintenance, to memorialize the separation of the parties and their agreement to remain separated, to finalize their agreements as to the division of the property, both real and personal, owned by them or either of them and to provide for the custody, support, and maintenance of their minor children.5. In order to insure the full information and advice of both Husband and Wife, each has retained and has been represented by independent legal counsel in connection with the negotiations for and the drafting of this Agreement in the consideration of the respective rights, duties, and obligations of the parties.6.A proceeding for dissolution of the marriage of the parties is now pending in the County of _________________, State of _________________, Action No. _________________.For the reasons set forth above, and in consideration of the mutual covenants and promises of the parties hereto, Husband and Wife agree as follows:1. Living Separate. Husband and Wife may and shall hereafter 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 hereafter reside at such place or places as he or she may select.2. 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. - 2 - 3.Property Owned By Husband. The following property is owned by Husband alone:Description Location Value: 1. 2. 3. 4. 5. 6. 7. 4. Property Owned By Wife. The following property is owned by Wife alone:Description Location Value: 1. 2. 3. 4. 5. 6. 7. 5. Property Owned By Husband and Wife. The following property is owned by Husband and Wife together:Description Location Value: 1. 2. 3. 4. 5. 6. 7. 6. Property Apportioned to Wife. There is hereby apportioned, set aside, transferred, and confirmed to Wife, free of all claim and demand of Husband, the following items described as:Description Location Value: 1. 2. 3. 4. 7. Property Apportioned to Husband. There is hereby apportioned, set aside, transferred, and confirmed to Husband, free of all clam and demand of Wife, the following items described as: Description Location Value: 1. 2. 3. 4. 8. Release of Property Rights. Each party releases, quitclaims, and assigns to the other party all his or her right, title, and interest, present and prospective, in each item of property herein apportioned, set aside, transferred, and confirmed to the other party. - 3 - 9.Execution of Instruments. Each party shall promptly execute and deliver to the other party or any nominee or nominees of the other party, all instruments that may be necessary, convenient, or appropriate to carry into effect, fully and fairly, all the provisions of this Agreement for division and confirmation of property, and mutual release thereof.10. Full Disclosure of Property Interests. Each party represents and warrants that he or she has made a full disclosure of all his or her property and that neither has knowledge of any other property of any kind in which the party so representing has any beneficial interest.11.Release of Estate Rights. Each party releases all right to share in the estate of the other, or to serve as executor or administrator of the estate of the other, except only as provided by will or codicil to will executed subsequent to the date of this Agreement.12. Debts and Obligations. Each of the parties shall pay all debts incurred by him or her after the date of this Agreement and indemnify the other party against liability thereof.13.Support and Maintenance of Wife. Husband shall pay to Wife as and for her necessary support and maintenance, the sum of $_______________________ , on or before the _______ day of each month, and continuing thereafter until the remarriage of Wife, the death of Wife, or the death of Husband, whichever event shall first occur.All payments by Husband for the support and maintenance of Wife shall be separate from any other obligation of Husband hereunder to make payments to Wife.14.Wife's Attorney's Fees. Husband shall pay to _______________________, attorney for Wife, upon the execution of this Agreement, the sum of $_______________________ _ for services rendered to Wife in all matters relating to the separation of the parties and the negotiations for and preparation of this Agreement. Wife waives and releases all other and further right to reimbursement by Husband for attorneys' fees heretofore or hereafter incurred by her.15.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, or other property so received or acquired by the other.16.Custody and Visitation. Subject to the further order of any court of competent jurisdiction, Wife shall have the custody and control of the minor children of the parties. Husband shall have the right of reasonable visitation at times and places to be agreed upon by the parties. Neither Husband nor Wife shall remove the children from the State of _______________________, without the prior written consent of the other or the order of a court of competent jurisdiction on motion after notice to the other party authorizing such removal.17. Child Support. The parties agree to the following provisions for the support and maintenance of the children: Husband shall pay to Wife for the support, maintenance, and education of their minor children, the sum of $_______________________ each month for each minor child. The parties agree that this amount is reasonable and sufficient for the needs of each of the children and it is based on Husband's financial ability to pay support. These payments shall be made on the _______ day of every month commencing on _______________________, and shall continue until further order by a court of competent jurisdiction. Husband's obligation to make such payments shall terminate as to each child who dies, reaches the age of maturity, is married, or otherwise emancipated, whichever of these events - 4 - shall occur first. In consideration for such payments, Wife agrees to assume sole responsibility for the support, maintenance, and education of the minor children.18. Entire Agreement. This Agreement supersedes any and all other agreements, either oral or in writing, between the parties relating to the rights and liabilities arising out of their marriage. This Agreement contains the entire agreement of the parties.19. Modification and Binding Effect of Agreement. The provisions of this Agreement shall not be modified or changed except by mutual consent and agreement of the parties, expressed in writing. This Agreement shall be binding upon the parties and their respective heirs, executors, administrators, and assigns.IN WITNESS WHEREOF, the parties have Agreed and Executed this Agreement.Husband___________________________________ Wife______________________________________On this ____ d ay o f _ _____ ___, 2 0_ _, personally appeared before me, the Parties personally known to me or proved to me on the basis of satisfactory evidence to be the persons whose names are subscribed to this instrument, and acknowledged that they executed the same.Notary Public_______________________________________________________________ (seal)