Separation Agreement
Separation Agreement
guide prior to consultation with an attorney familiar with your specific legal situation. FindLaw is not engaged in rendering legal or
other professional advice, and this form is not a substitute for the advice of an attorney. If you require legal advice, you should seek
the services of an attorney by linking to FindLaw.com. 2005 FindLaw.com. All rights reserved.
A. Preliminary Matters
1. Husband and Wife were lawfully married on ____________, ______, at ________________ (city),
______________ (state), in the County of ________________. Because certain problems have
developed between Husband and Wife, they hereby agree to live separately and apart, subject to the
terms and conditions as set forth below.
2. Husband and Wife have made a complete, fair, and accurate disclosure to each other of all
financial matters affecting this agreement.
3. Husband and Wife have each been advised and counseled by attorneys of their choosing
regarding their legal rights as related to this agreement.
4. This agreement is intended to be a final disposition of the matters addressed herein and may be
used as evidence and incorporated into a final decree of divorce or dissolution.
5. Should a dispute arise regarding the enforcement of this agreement, the prevailing party will be
entitled to his or her reasonable costs and attorneys fees.
Date of Birth
_________________
_________________
_________________
______________________
______________________
______________________
_________________
_________________
_________________
____________________
____________________
____________________
C. Child Support
Husband will pay to Wife the amount of $_____________ each and every ____________ (week,
month, etc.) as and for child support.
Wife will pay to Husband the amount of $_____________ each and every ____________ (week,
month, etc.) as and for child support.
D. Spousal Support
Husband will pay to Wife the amount of $_____________ each and every ____________ (week,
month, etc.) as and for spousal support.
Wife will pay to Husband the amount of $_____________ each and every ____________ (week,
month, etc.) as and for spousal support.
E. Homestead
Husband / Wife (circle one) will remain in the family home, located at _____________________
__________________________________________. Husbands / Wifes (circle one) new address
will be ________________________________________________________________.
Page 2 of 4
The expenses relating to the family home will be paid by the parties as follows:
Husband will pay:
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
G. Personal Property
The personal property of the parties will be divided as follows:
To Husband:
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
To Wife:
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
H. Insurance
Husband will maintain life insurance in the amount of $_____________ for the benefit of:
_________________________________________________________________________________
_________________________________________________________________________________
______________________________________________________
Wife will maintain life insurance in the amount of $_____________ for the benefit of:
_________________________________________________________________________________
_________________________________________________________________________________
______________________________________________________
Page 3 of 4
Husband will maintain medical and dental insurance for the benefit of:
_________________________________________________________________________________
_________________________________________________________________________________
______________________________________________________
Wife will maintain medical and dental insurance for the benefit of:
_________________________________________________________________________________
_________________________________________________________________________________
______________________________________________________
I. Attestation
Agreed to this __________ day of _____________, ____________.
By:
_________________________________
Husband
______________________________
Wife
Witnessed by:
___________________________________
(Witness or counsel signature)
_________________________________
(Witness or counsel signature)
Page 4 of 4