Marital Separation Agreements Parties With Children

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Kit used, by couples with children, to create a comprehensive and successful marital settlement agreement (also known as a separation agreement and property settlement agreement).

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The end of a marriage is difficult. However, with a marital settlement agreement (also known as a separation agreement or property settlement agreement) the parties can avoid future conflicts and additional stress by working out issues together and establishing each party's rights and duties, all before they become problems. Once completed, this comprehensive agreement can then be incorporated into a divorce decree or independently survive as a separate contract between husband and wife. This kit is designed for divorcing couples that have children.

Among others, this form includes the following key provisions:
  • Children Identification Clause: Identifies children of the marriage
  • Property Division: Describes how the marital property will be divided
  • Division of Bills: Clarifies which spouse is responsible for which bills
  • Alimony: Declares any alimony that will be paid
  • Insurance: This clause may be used to remove a spouse as an insurance beneficiary
This attorney-prepared packet contains:
  1. Comprehensive instructions which explain the various clauses you may choose to include in the marital settlement agreement
  2. A completed sample marital settlement agreement for your reference.
  3. A marital settlement agreement form

State Law Compliance: This form complies with the laws of all states
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.










Marital Settlement/Separation Agreement Kit
(Parties With Children)









This Packet Includes:
1. Information
2. Step-by-Step Instructions
3. A completed sample marital settlement agreement for your reference
4. Marital Settlement / Separation Agreement
(Parties With Children)





Information
Marital Settlement / Separation Agreement Kit


(Parties With Children)

The alternative to both the uncontested default divorce (in which one spouse does not participate in the decision-making) and the contested divorce is the divorce or legal separation by agreement. In this type of divorce or separation, fault is not a factor.

In a divorce or legal separation by agreement, both spouses play a part in all of the decisions affecting the couple and any children that they may have. For this type of divorce or separation to succeed, the agreement between the spouses must be as fair and as just as is possible under the circumstances.

A marital settlement agreement is not only accepted but is actually encouraged in virtually all state and is an indispensable alternative to the traditional hostility of ending a marriage.

There are many important benefits to obtaining a divorce or separation by agreement. Perhaps the most important benefit is that there is far less chance that the divorce will escalate into a hostile battle. When revenge and animosity are not factors, there is a greater opportunity that the divorce/separation settlement will accurately reflect what the spouses really desire to obtain from the divorce. If the decisions regarding the care and custody of any children are reached through rational and mature discussions, there is a greater chance that the decisions reached will be abided by without future hostility.  

This agreement includes all the essential components for a marital settlement agreement including division of property, child custody, visitation, support and more. This package is best for divorcing couples that have children.



Step-by-Step Instructions
Marital Settlement / Separation Agreement Kit
(Parties With Children)

   To complete the Marital Settlement Agreement, simply fill in the necessary information and delete those clauses which do not apply to your divorce.  Do not type any portions of a clause which are shown in italics, unless it is language directly relating to your agreement.  In addition, the only blank lines that should appear on your original should be spaces for the signatures on the final page.  Delete any clauses and italicized text you do not include in your agreement.

   Below you will find explanations for the various clauses which make up a marital settlement agreement.  Read the explanations to determine which clauses apply to your particular situation.  Following each clause title you will find a number that corresponds to the blank sample agreement.

   Following the explanations is a complete sample marital settlement agreement. It has been assembled using clauses from this instruction sheet. By reviewing this sample agreement, you will be able to see what a final completed settlement agreement should look like and how the various parts are put together.  For the purposes of preparing the sample agreement, a fictional family was used.

   Follow the link below to our free State Law Digest for Divorce Law, which includes information regarding your states divorce laws and procedures.  Use this information to help you complete your Marital Settlement Agreement.  


   EXPLANATIONS:

   Title And Introductory Clause:

This introductory clause specifies the effective date of the agreement and identifies the spouses, their places of residence, and the date and place of their marriage. Fill in the appropriate information. This information is important and is mandatory in all agreements.





   Children Identification Clause:

Chose the clause that applies to your particular circumstances. This clause identifies whether or not any children will be involved in the terms of the agreement. Fill in the names and birth dates of any children. One of these clauses is mandatory.


   Preliminary Explanation Clause:

Chose this clause to set forth the divorce grounds that you have chosen in your state and your particular circumstances.  

   General Agreement Clause:

This clause outlines the basic desire to reach an agreement. This clause is mandatory in all agreements.

   Separation Clause: Paragraph 1

This clause relates that the spouses desire to live apart as if they were single. This clause should be used in all situations in which the spouses have already separated or in which they desire to separate as soon as an agreement is reached. In the vast majority of cases, you will use this clause.

   Property Division Clause (Property Not Listed):  Paragraph 2

This clause should be used for cases where there is very little or even no property and there are no significant bills to divide. It simply allows each spouse to keep the property currently in his or her possession. It also provides that any bills have already been divided and taken care of by you and your spouse. If you have significant property (car, furniture, appliances, etc.) or bills owed or if you have property that you have not yet divided, you should use a different clause. Also, if you or your spouse have a pension or retirement plan that will be divided, you must use a different clause so that such a plan may be listed and identified specifically. You may use this clause, however, if you have no property or bills or all of your property and bills have actually been divided.

   Property Division Clause (List Included): Paragraph 2



This clause should be used if you and your spouse have agreed to a division of property and you are able to specifically list the property that each of you will retain. This clause provides that both of you have transferred the property mentioned and quitclaimed it to the other spouse. It should be used if you have relatively significant property (home, car, appliances, major furniture items, etc.), and if your method of division is in the form of a trade-off or off-set. If this clause is chosen, you will also need to choose a further clause listed later that describes the division of your bills. For each item of property, provide a complete description. For real estate, list the legal description as shown on the deed to the property. For other property, list the serial number, if available, or a clear description. If either of you has a pension plan or retirement plan, list that plan under the appropriate spouse and describe it fully.



   Division of Property (By Sale): Paragraph 2

This clause should be used if there is marital property that is to be sold and the proceeds of the sale divided between you and your spouse. It may be used for the disposition of anything from items to be sold at a yard sale to the sale of your home. An exact description of the property to be sold should be included. If the property is real estate, the description should be the legal description as shown on the deed to the property. This clause provides for an equal division of the proceeds of the sale after any expenses of the sale are deducted. In the case of the sale of a home, this would allow for any appraisal expenses and real estate broker fees to be deducted from the proceeds of the sale before dividing the profits. This clause may be used in conjunction with the previous clause.

   Division Of Bills (Bills Listed): Paragraph 3

This clause is used to specifically divide your bills. It should be used if you have relatively significant bills (outstanding loans, unpaid credit card balances, etc.). It provides that you will each individually assume and pay the bills listed after your name and not hold the other liable for the debts (hold harmless and indemnify). It also provides that neither of you will incur any more debts that the other spouse would be liable for. For each bill, list to whom the bill is owed and the amount to be paid. If you have used the first clause listed in this instruction sheet for dividing your property and bills [Property Division Clause (Property Not Listed)], do not use this clause.

   No Alimony to Either Spouse Clause: Paragraph 4

This clause should only be used if, after careful consideration, both you and your spouse agree that neither of you should be required to pay any alimony to the other. By using this clause, you will be giving up forever any rights that you may have to alimony. However, if this is what you have both decided is fair, then you should use this clause.

   Alimony Payable in Monthly Payments Clause: Paragraph 4



This clause should be used if you and your spouse have agreed that one of you should receive and one of you should pay alimony to the other in the form of periodic monthly payments. You will need to decide the amount of each payment, the day of the month that each payment will be due, and the date on which the payments should begin.



You will also need to decide when the payments are to end. You may wish the payments to end on remarriage, on death, or on a particular date. Or you may decide that the alimony payments should end on the first happening of any one of these events. If you decide that the payments are to end on the death of either spouse and the duration of the payments is for a long period, you may wish to consider the use of life insurance coverage to protect the support of the receiving spouse. Please see the clauses relating to insurance coverages.

In addition, in this clause you will need to decide if you wish for your decisions to be modifiable by a court in the future. If you decide that your alimony provisions may not be modified by a court, then a court will only modify this clause if it can be shown that there was fraud, coercion, or threats made in reaching the agreement or if the agreement is obviously and grossly unfair to one spouse.  In order to allow for a modification due to changed circumstances in the lives of either spouse, it is recommended that you allow for a future court modification of this clause.

Finally, through the use of this clause you will need to choose a method by which the payments should be made. Some states have enacted legislation which allows or requires any support payments to be made through the court or through certain state agencies and then be passed on to the spouse who is to receive the payment. This indirect method of payment, although generally slower, has the benefit of allowing for immediate action to be taken if any payments are missed. There is a clear record of payment in the hands of the appropriate state authorities. In fact, some states automatically take direct action against any spouse who is late with a payment, which may include garnishing wages, requiring a bond or deposit, or actually seizing a delinquent spouses property. However, in virtually all states that allow this indirect method of payment, there are provisions that allow the spouses to opt out of the state requirement. If you and your spouse agree that the payments may be made directly to the spouse who is to receive them, you must make this decision in the clause below. If you do make the decision to allow payments to be made directly to a spouse and not through a court or state agency, it is extremely advisable to make this clause modifiable by a court at a later date. By making the clause subject to court modification, the spouse receiving the payments will retain the right to have the payments made through the court or state at a later date should any problems in late or delinquent payments arise.

   Alimony Payable in a Lump-Sum Payment Clause: Paragraph 4





This clause should be used if you and your spouse agree that the fairest method of dealing with the payment of alimony is for one spouse to pay the other a one-time lump-sum payment. The funds may then be used by the spouse who receives the payment to obtain education, job skills, or training to become self-supporting. This lump-sum payment is separate from and in addition to any shift in funds or property under the terms of your property settlement. To be fair, this alimony lump-sum payment should be taken out of a spouses share of separate and marital property after all of their property has been equally or equitably divided.

This method of spousal support has the benefit of lessening the future ties between you and your spouse and, thus, lessening the opportunities for problems to develop. It also has the benefit of not leaving one spouse subject to over-due payments from the other spouse. This method, however, is not workable if the spouse who is to pay the lump-sum payment does not currently have the assets by which to pay.

   Insurance Clause (Neither Spouse as Beneficiary): Paragraph 5

If you or your spouse currently have insurance policies, but agree that neither of you will be retained as beneficiaries on the others policy, use this clause. If you use the clause providing for one of you to be retained as beneficiary (below), do not use this clause.

   Life Insurance Clause: Paragraph 5

This clause should be used if you and your spouse have agreed that one of you will remain as a beneficiary on a life insurance policy of the other. Retaining a position as beneficiary on the others life insurance is generally a good idea if there are continuing support payments to be paid. The spouse who pays the alimony will be the spouse who maintains the insurance. The spouse who receives the alimony will be the spouse who is designated as beneficiary. In the event of the supporting spouses death, this allows the spouse who is due the support to collect the benefits of any insurance and apply it to the continuing maintenance or child support obligations.



The use of this clause may be wise in any situation where there are support obligations. It is, however, highly recommended in the following circumstances: (1) if you have decided that alimony should be payable in monthly payments; and (2) the duration of the payments is for a long period; and (3) the payments are to end on either spouses death. In a situation of this nature, it is prudent to have the spouse who is to receive the payments be the beneficiary of a life insurance policy on the life of the spouse who is to make the payments. In this manner, the one receiving payments will not be left destitute on the death of a long-time ex-spouse.



   Life and Health Insurance Clauses: Paragraph 6

Two provisions regarding insurance as additional child support are provided here. These require that, as additional child support, the parent who is to pay the support must: (1) maintain a life insurance policy naming the children as beneficiaries; and (2) maintain health insurance coverage for the children.

These provisions are highly recommended and are required in some states. Federal law requires that states require a parent responsible for child support to include any children under a health and dental insurance plan if such a plan is available to the parent through their place of employment or otherwise at a relatively low cost. The life insurance provision provides some measure of security and insurance protection for the children in the event of death of the paying parent. The health insurance protection provides the child with protection in case of illness or injury.

   Marital Settlement Agreement Taxation Clause: Paragraph 7

The following clause may be used to define your various decisions regarding the tax consequences of your divorce. If you are living apart under the terms of your marital settlement agreement or under the terms of a separation decree but your divorce is not final by the end of the year, you may choose to file: (1) a joint tax return with your spouse; (2) a separate return; or (3) you may be considered unmarried and file a “head of household” return. You may choose to file a joint income tax return with your spouse for the current tax year only if your divorce has not been made final before the end of the year. If your divorce is final by the end of the year, you must file either an individual return or a “head of household” return. In addition, if your divorce is finalized prior to the end of the current tax year, you may not claim your spouse as an exemption, even if you have provided all of the support for your spouse for the year.

   Marital Settlement Agreement Name Change Clause: Paragraph 8



Most states have specific laws which allow a person to request that his or her former name be restored upon divorce. Although many of these laws are now written to make no reference to the sex of the person requesting this type of change, it is generally a wife who desires to use either her maiden name or her former name (if her former name was a previous married name). The restoration of this name may be accomplished by a simple request in the divorce papers and a provision in the divorce decree or judgment.  You may use this clause also to state the last name that the children of your marriage will be known by, if you did not use a clause that contained a provision for childrens names.  It is useful to have your spouses agreement to such a name change request.



   Agreement Clause: Paragraph 9

There are various other marital settlement agreement issues which must be included in order for your agreement to have the necessary legal force. This will always be the last numbered clause in your marital settlement agreement. These standard legal phrases are important and should not be altered. They cover the following points:

   That you both want the terms of your marital settlement agreement to be the basis for your a court order in the event of a divorce;
   That you both have prepared complete and honest Financial Statements and they are attached to your agreement;
   That you both know that you have the right to see your own lawyers and that you both understand your legal rights;
   That you both will sign any necessary documents;
   That you both intend that your agreement is the full statement of your rights and  responsibilities; and
   That your agreement will be binding on any future representatives of yours.






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Sample Marital Settlement Agreement


Following, a complete sample marital settlement agreement is presented. It has been assembled using clauses from this instruction sheet. By reviewing this sample agreement, you will be able to see what a final completed settlement agreement should look like and how the various parts are put together

For the purposes of preparing this sample agreement, a fictional family was used. Mrs. Mary Ellen Smith is the wife and Mr. John William Smith is the husband. They were married on January 1, 1999.  The parties live in the fictional town of Centerville, in the County of Washington, State of Superior.

They own the following property:

   A home valued at $50,000, with an outstanding mortgage balance of $40,000.
   A Chevrolet car valued at $7,500, with an outstanding loan balance of $1,000.
   Furniture and household furnishings worth $3,000.
   Tools worth $2,000.
   Cash in a checking account in the amount of $2,000.
   Jewelry which Mrs. Smith inherited from her mother valued at $1,500.
   A boat valued at $2,000 which Mr. Smith owned prior to the marriage.

They jointly owe the following debts (other than mortgage and car payments):

   Visa Credit Card: Balance of $1,500.
   Jones Furniture Store: Balance of $1,000.

The value of their separate or non-marital property is as follows:

   Mrs. Smith: Jewelry valued at $1,500.
   Mr. Smith: Boat valued at $2,000.

The value of their marital or community property is as follows:

   Tools:                        $ 2,000
   Car: equity value                  $ 6,500
   Furniture and furnishings               $ 3,000
   Home: equity value                  $10,000
   Cash:                        $ 2,000
                     Equals (=)
      Sub-total                  $23,500
                     Minus (-)
   Visa Credit balance                  ($1,500)
   Jones Furniture Credit balance            ($1,000)
                     Equals (=)
   Total value of marital property            $21,000

Mr. Smith has a life insurance policy on his life for $100,000 and health insurance through his place of employment.  Mr. Smith works full-time, while Mrs. Smith works only part-time. She is, however, educated and capable of full-time employment.

They have agreed to the following terms:
   
?   Mrs. Smith will keep the home and Mr. Smith will transfer (by quitclaim deed) his share of the home to her. She also will keep two-thirds of the home furnishings. None of the cash in the bank account will be hers. She agrees to pay off the Visa bill. The value of her share of the marital or community property is $10,500 ($10,000 (home equity) + $2,000 (furnishings) - $1,500 (Visa bill) = $10,500).

?   Mr. Smith will keep the tools, the car, and the one-third of the home furnishings. All of the cash in the bank will be his to keep. He agrees to pay off the Jones Furniture bill. His share of the marital or community property is also $10,500 ($1,000 (furnishings) + $6,500 (car equity) + $2,000 (tools) + $2,000 (cash) - $1,000 (furniture bill) = $10,500). They have separated their furnishings, closed their joint bank account, and opened individual accounts. In addition to signing this Marital Settlement Agreement and their Financial Statements, they will need to prepare a quitclaim deed for their home and have the title to their car transferred

Various other minor decisions that they have made are shown in the appropriate sections of the clauses in their Agreement. Although not shown here, each spouse will also need to have prepared a Financial Statement. The Marital Settlement Agreement which embodies all of their agreements and which will be used in their later divorce follows. 


SAMPLE
Marital Settlement Agreement

This agreement is made on the 1st day of May, 2006, between Mary Ellen Smith, the Wife, who lives at 150 Emerald Lane in the Town of Centerville, County of Washington, State of Superior, and John William Smith, the Husband, who lives at 2000 Main Street, Apartment #2, in the Town of Centerville, County of Washington, State of Superior.

We were married on the 1st day of January 1999, in the City of Columbia, County of Lincoln, State of Superior.

No children were born into our marriage.

As a result of disputes and serious differences, we sincerely believe that our marriage is irretrievably broken and that there is no possible chance for reconciliation.

We both desire to settle by agreement all of our marital affairs, including the division of all of our property and bills, spousal support or maintenance.

THEREFORE, in consideration of our mutual promises, and other good and valuable consideration, we agree as follows:

1.   We both desire and agree to permanently live separate and apart from each other, as if we were single, according to the terms of this agreement. We each agree not to annoy, harass, or interfere with the other in any manner.

2.   We agree that the following property shall be the sole and separate property of the Wife, and the Husband transfers and quitclaims any interest that he may have in this property to the Wife:

      Diamond Ring and Bracelet valued at $1,500;
      All of the furnishings currently in the family home;
      The family home located at 150 Emerald Lane, Centerville, Superior, with the legal description as follows:

         Lot 5 of Centerville Subdivision as shown on Plat 3 on Page 65
         of Book 200 in the Records of Washington County, Superior.

   We also agree that the following property shall be the sole and separate property of the Husband, and the Wife transfers and quitclaims any interest that she may have in this property to the Husband:

      Woodworking Tools valued at $2,000;
      1998 Chevrolet, serial #123456, Superior License #ABC 789, valued at $6,500;
      $2,000 cash currently in the Centerville Bank in his individual account;
      Household furnishings currently located at 2000 Main Street, Apartment #2, Centerville, Superior.

3.   We agree that the Wife shall pay and indemnify and hold the Husband harmless from the following debts:

      Visa Credit Card Account # 987654;
      Home mortgage currently held by the Centerville National Bank on the family home located at 150 Emerald Lane, Centerville, Superior, with the legal description as follows:

         Lot 5 of Centerville Subdivision as shown on Plat 3 on Page 65
         of Book 200 in the Records of Washington County, Superior.

   We agree that the Husband shall pay and indemnify and hold the Wife harmless from the following debts:

      Jones Furniture Store Account #321;
      Auto loan currently held with the GMAC Finance Company on the 1998 Chevrolet, serial #123456, Superior License #ABC 789.

   We also agree not to incur any further debts or obligations for which the other may be liable.

4.   We both agree that, as alimony and maintenance, the Husband shall pay to the Wife the sum of $400 per month, payable on the 1st day of each month. The first payment will be due on the 1st day of June, 2004, and the payments shall continue until the first of the following occurrences: (1) the date that either of us dies; (2) the date that the spouse receiving alimony remarries; or (3) June 1, 2004. We both intend that the amount and the duration of the payments may be modified by a court in the future. We also both agree that these payments should be made directly to the spouse to whom they are due.

5.   We both agree that neither of us shall remain as the beneficiary on any life insurance policy carried by the other.

6.   We both agree that we will cooperate in the filing of any necessary tax returns. We also agree that any tax refunds for the current year will be the property of the Husband and that any taxes due for the current tax year will be paid by the Husband.

7.   We both agree that, in the event of divorce or dissolution of marriage, the Wife desires to and shall have the right to be known by the name of Mary Ellen Carter.

8.   We both desire that, in the event of our divorce or dissolution of marriage, this marital settlement agreement be approved and merged and incorporated into any subsequent decree or judgment for divorce or dissolution of marriage and that, by the terms of the judgment or decree, we both be ordered to comply with the terms of this agreement, but that this agreement shall survive.

   We have prepared this agreement cooperatively and each of us has fully and honestly disclosed to the other the extent of our assets, income, and financial situation. We have each completed Financial Statements which are attached and incorporated by reference.

   We each understand that we have the right to representation by separate lawyers. We each fully understand our rights and we each consider the terms of this agreement to be fair and reasonable. Both of us agree to execute and deliver any documents, make any endorsements, and do any and all acts that may be necessary or convenient to carry out all of the terms of this agreement.

   We agree that this document is intended to be the full and entire settlement and agreement between us regarding our marital rights and obligations and that this agreement should be interpreted and governed by the laws of the State of Superior.   

   We also agree that every provision of this agreement is expressly made binding upon the heirs, assigns, executors, administrators, successors in interest, and representatives of each of us.

Signed and dated this 1st day of May, 2006.


______________________________   ______________________________
  [Wifes signature]                [Witness signature]

                  ______________________________
                     [Witness signature]


______________________________   ______________________________
  [Husbands signature]             [Witness signature]

                  ______________________________
                     [Witness signature]

State of Superior
                  SS.
County of Washington

On May 1st, 2006, Mary Ellen Smith and John William Smith personally came before me and, being duly sworn, did state that they are the persons described in the above document and that they signed the above document in my presence as a free and voluntary act for the purposes stated.

      ______________________________
      (signature)
   Notary Public, for the County of Washington
   State of Superior
   My Commission expires June 1, 2008



Marital Settlement Agreement


This agreement is made on the ____ day of ___________, 20___, between _____________, the Wife, of ________________, City of ________________,  County of _____________, State of ________________, and ________________, the Husband, of ________________, City of ______________, County of ____________, State of ________________.  We were married on the ____ day of _________, 20 _____ in the City of _______________ County of _____________, State of _____________.


The following children were born [or adopted] into our marriage:

Childs name               Childs Birth date       Childs Sex

_________________________________   _________________      ___________
                        

Childs name               Childs Birth date       Childs Sex

_________________________________   _________________      ___________


Childs name               Childs Birth date       Childs Sex

_________________________________   _________________      ___________   


As a result of disputes and serious differences, we sincerely believe that our marriage is irretrievably broken and that there is no possible chance for reconciliation.

[or]

As a result of disputes and serious difficulties, we sincerely believe that there are irreconcilable differences between us and that there is no possible chance for reconciliation.

[or]

As a result of disputes and serious differences, we sincerely believe that there is a complete incompatibility of temperament between us and that there is no possible chance for or reconciliation. 

[or]

As a result of disputes and serious differences, we have separated and are now living apart and intend to continue to remain permanently apart.

We both desire to settle by agreement all of our marital affairs, including the division of all of our property and bills, spousal support or maintenance, and all issues relating to our children, including custody, visitation, and child support.

THEREFORE, in consideration of our mutual promises, and other good and valuable consideration, we agree as follows:

1.  We both desire and agree to permanently live separate and apart from each other, as if we were single, according to the terms of this agreement. We each agree not to annoy, harass, or interfere with the other in any manner.

2.  We both agree that our property and bills are minimal, and that we have already divided all of our property and bills to our mutual satisfaction. We each transfer and quitclaim to the other any interest that we may have in the property of the other. We both agree that all of the property that the other now possesses is the sole and separate property of the other. We also agree not to incur any further debts or obligations for which the other may be liable.

[or]  

We agree that the following property shall be the sole and separate property of the Wife, and the Husband transfers and quit-claims any interest that he may have in this property to the Wife: [Here list Wifes property].
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________

We also agree that the following property shall be the sole and separate property of the Husband, and the Wife transfers and quit-claims any interest that she may have in this property to the Husband: [Here list Husbands property].
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
____________________________________________________________
[or]

We agree that the following property will be sold as soon as possible and any proceeds from the sale of this property, after the deduction of any expenses of the sale, will be divided equally between us: [Here list a description of the property to be sold].
    
    ____________________________________________________________
   ____________________________________________________________
____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________


3.  We agree that the Wife shall pay and indemnify and hold the Husband harmless from the following debts: [Here list debts that Wife will pay].
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________

We agree that the Husband shall pay and indemnify and hold the Wife harmless from the following debts: [Here list debts that Husband will pay].
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
____________________________________________________________

We also agree not to incur any further debts or obligations for which the other may be liable.

4.  After careful consideration of our circumstances and all of the other terms of this agreement, we both agree to waive any rights or claims that we may have now or in the future to receive alimony, maintenance, or spousal support from the other. We both fully understand that we are forever giving up any rights that we may have to alimony, maintenance, or spousal support.  

[or]

We both agree that, as alimony and maintenance, the ___________________ shall pay to the _________ the sum of $ __________________ per month, payable on the ___ day of each month. The first payment will be due on the    ___ day of  ______________, 20___, and the payments shall continue until the first of the following occurrences: We both intend that the amount and the duration of the payments not _______________ be modified by a court in the future. We also both agree that these payments should be made directly to the spouse to whom they are due.

[or]

We both agree that in full payment of any claims or rights to alimony, spousal support, or maintenance, the ____________________shall pay to the _____________ the sum of $           , which shall be paid on or before the ___day of ______________, 20___.

5.  We both agree that neither of us shall remain as the beneficiary on any life insurance policy carried by the other.

[or]

The life of the __________________is currently insured by___________________   in the amount of $ ______ and    agrees to keep this policy in full force until death. We agree that the ____________   shall be designated as irrevocable sole beneficiary of this policy. The spouse obligated to provide such insurance will provide the other spouse with annual proof of such coverage.
                 
6.  We both agree that it is in the best interests of our child[ren] that the ___________________ have sole physical and legal custody of our child[ren]. We also agree that the other parent has the right to be with our child[ren] on a frequent and liberal basis through reasonable visitation, at such times as we and the child[ren] can agree upon. We agree that we will share as equally as possible the right to be with our child[ren] on holidays, birthdays, and during the child[ren]s school vacations. We agree that our child[ren]s time with either of us should not interfere with their attendance at school. We also agree that the parent with custody should have the right to make the major decisions regarding the care and up-bringing of the child[ren], but that the other parent has the right to be notified of any major decisions.  

[or]

We both agree that it is in the best interests of our child[ren] that the _________________________ have sole physical and legal custody of our child[ren]. We _______________ also agree that the other parent has the right to be with our child[ren] on a frequent and liberal basis through reasonable visitation, at such times as we and the child[ren] can agree upon. If in the future we are unable to agree upon visitation, the _______________will have the right to be with our child[ren] as follows:

(A).    On the following holidays during even-numbered years:  _____________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

(B).    On the following holidays during odd-numbered years: _______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

(C).    On the following dates and times each [or every other] weekend:   _______________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

(D).    On the following dates and times during each [or every other] week: ____________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________



(E).    For the following vacation periods each year: _______________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


We agree that our child[ren]s time with either of us should not interfere with attendance at school. We also agree that the parent with custody should have the right to make the major decisions regarding the care and up-bringing of our child[ren], but that the other parent should have the right to be notified of any major decisions.

[or]

We both agree that it is in the best interests of our child[ren] that we both have joint legal custody of our child[ren]. We also agree that it is in the best interests of our child[ren] that the __________________ have sole physical custody of our child[ren]. We acknowledge that our child[ren] presently live[s] with the _________ and that the actual physical residence of our child[ren] may be changed at any time as we may mutually agree.

All decisions pertaining to the education, discipline, health, extracurricular and summer activities, religious training, medical and dental care, and welfare of our child[ren] will be decided by both of us after reasonable and adequate discussion. We also agree that the parent with physical custody shall have control over the minor day-to-day decisions affecting the child, including any medical or dental emergencies. We agree that if, after reasonable attempts, we are unable to reach an agreement on any of the decisions affecting our child[ren], we will jointly seek professional mediation to resolve our differences.

We also agree that each of us has the right to know of any circumstances or decisions that affect our child[ren] and that each of us has the right to any medical, dental, or school records of our child[ren]. Neither of us will do anything to hamper or interfere with the natural and continuing relationship between our child[ren] and the other parent.

We both realize that the well-being of our child[ren] is of paramount importance and, therefore, we agree that our child[ren] should have as much contact as possible with the parent that does not have physical custody and that our child[ren] may visit that parent as often as may be agreed upon. Although visitation may be scheduled more often, the parent that does not have physical custody will have the right to be with our child[ren] at least as follows:

(A).    On the following holidays during even-numbered years: ______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(B).    On the following holidays during odd-numbered years: _______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

   
(C).  On the following dates and times each [or every other] weekend ______________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(D).    On the following dates and times during each [or every other] week: ___________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(E).    For the following vacation periods each year: ______________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

We additionally agree to use our very best efforts to insure that our child[ren] receive the most care, love, and affection possible from both parents throughout their entire childhood.

[or]

We both agree that it is in the best interests of our child[ren] that we both have joint legal and physical custody of our child[ren]. We also agree that it is in the best interests of our child[ren] that the home of the __________ be the primary residence of the child[ren]. We acknowledge that our child[ren] presently live[s] with the _______________    and that the actual physical residence of our child[ren] may be changed at any time as we may mutually agree.

All decisions pertaining to the place of residence, discipline, education, health, extracurricular and summer activities, vacations, religious training, medical and dental care, and welfare of our child[ren] will be decided by both of us after reasonable and adequate discussion. We also agree that the parent with physical custody shall have control over the minor day-to-day decisions affecting the child, including any medical or dental emergencies. We agree that if, after reasonable attempts, we are unable to reach an agreement on any of the decisions affecting our child[ren], we will jointly seek professional mediation to resolve our differences. 

We also agree that each of us has the right to know of any circumstances or decisions that affect our child[ren] and that each of us has the right to any medical, dental, or school records of our child[ren]. Neither of us will do anything to hamper or interfere with the natural and continuing relationship between our child[ren] and the other parent.

We both agree that our child[ren] will be known by the last name of ____________________________.

We both agree that frequent and continuing contact with both parents is vital to our child[ren], and therefore we both agree that neither of us will permanently remove our child[ren] from this state without the express written permission of the other parent.

We both realize that the well-being of our child[ren] is of paramount importance and, therefore, we agree that our child[ren] should have as much contact as possible with the parent that does not have physical custody and that our child[ren] may visit that parent as often as may be agreed upon. Although contact may be scheduled more often, the parent that does not live in the primary physical residence of the child[ren] will have the right to be with our child[ren] at least as follows:

(A).    On the following holidays during even-numbered years: ______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(B).    On the following holidays during odd-numbered years: _______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(C).    On the following dates and times each [or every other] weekend:   _______________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(D).    On the following dates and times during each [or every other] week: ____________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(E).    For the following vacation periods each year: _______________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


We additionally agree to use our very best efforts to insure that our child[ren] receive the most care, love, and affection possible from both parents throughout their entire childhood.

7.  We both agree that the __________________________    will pay to the _____________, for child support, the amount of $ _____________    per child per month, for a total monthly payment of $_______.  The payments will begin on the ____ day of _____________, 20        and will continue for each child until that child has reached the age of majority, died, become self-supporting, or married. We both agree that this obligation is subject to modification by a court at any time.

We both further agree that should the parent obligated to pay the support receive a salary or income increase in the future, the amount of child support due per child per month shall be increased proportionately. The parent obligated to pay support agrees to notify the other parent immediately of any salary or income increase.

[Choose one: Either:] We agree that the required child support payments should be made directly to the parent to whom they are due. However, in the event of a divorce or dissolution of marriage, we agree that the required child support payments are to be paid directly to the court or state official or agency so designated by the laws of this state to receive and disburse such payments. We both further agree that, in the event of a divorce or dissolution of marriage, we will cooperate in obtaining any necessary income withholding orders or income assignments if required to guarantee this obligation.

[Or:] We agree that the required child support payments should be made directly to the parent to whom they are due and should not be required to be paid through any court or state agency or official. The parent receiving the payments, however, does not waive the right to request, at any time and in his or her sole discretion that such payments be made directly through a court or state agency or official in the future. We both further agree that, in the event of a divorce or dissolution of marriage, we will cooperate in obtaining any necessary income withholding orders or income assignments if required to guarantee this obligation.

   8.  As additional child support, we both agree that as long as support payments are due the _________ will carry and maintain life insurance in the amount of $ _____________, naming our child[ren] as sole irrevocable beneficiary[ies]. The parent obligated to provide such insurance will provide the other parent with annual proof of such coverage.

   9.  As additional child support, we both agree that as long as support payments are due the __________ will carry and maintain adequate health, dental, and hospitalization insurance for the child[ren]s benefit, pay any required deductible amount, and pay for any necessary medical or dental expenses of the child[ren] that are not covered by such insurance. The parent obligated to provide such insurance will provide the other parent with annual proof of such coverage.

   10.  We both agree that we will cooperate in the filing of any necessary tax returns. We also agree that any tax refunds for the current year will be the property of the _______________and that any taxes due for the current tax year will be paid by the _________________.

[Use if necessary:] We both agree to file a joint income tax return for the current year.

   [Use if you have children:] We also agree that the___________________ may claim the federal dependency tax exemption for our child[ren].

11.   We both agree that, in the event of divorce or dissolution of marriage, the Wife desires to and shall have the right to be known by the name of   _______________________.  [Desired name]

We both also agree that, in the event of divorce or dissolution of marriage, our child[ren] will be known by the last name of _________________   . [Desired name]

12.   We both desire that, in the event of our divorce or dissolution of marriage, this marital settlement agreement be approved and merged and incorporated into any subsequent decree or judgment for divorce or dissolution of marriage and that, by the terms of the judgment or decree, we both be ordered to comply with the terms of this agreement, but that this agreement survive.

We have prepared this agreement cooperatively and each of us has fully and honestly disclosed to the other the extent of our assets, income, and financial situation. We have each completed Financial Statements which are attached and incorporated by reference.

We each understand that we have the right to representation by separate lawyers. We each fully understand our rights and we each consider the terms of this agreement to be fair and reasonable. Both of us agree to execute and deliver any documents, make any endorsements, and do any and all acts that may be necessary or convenient to carry out all of the terms of this agreement.

We agree that this document is intended to be the full and entire settlement and agreement between us regarding our marital rights and obligations and that this agreement should be interpreted and governed by the laws of the State of __________________________.

We also agree that every provision of this agreement is expressly made binding upon the heirs, assigns, executors, administrators, successors in interest, and representatives of each of us.


Signed and dated this day ___ of    _______________ , 20___.


_____________________________   _____________________________
     [Wifes signature]             [Witness signature]

                  _____________________________
                     [Witness signature]



_____________________________   _____________________________
     [Husbands signature]          [Witness signature]

                  _____________________________
                     [Witness signature]


State of    ___________
               SS.
County of    ___________

On ____________________, 20 ___, ____________________ personally came before me and, being duly sworn, did state that they are the persons described in the above document and that they signed the above document in my presence as a free and voluntary act for the purposes stated.

   ____________________
      (signature)
   Notary Public, for the County of ____________________
   State of    ____________________
   My Commission expires: ____________________

Number of Pages25
DimensionsDesigned for Letter Size (8.5" x 11")
EditableYes (.doc, .wpd and .rtf)
UsageUnlimited number of prints
Product number#22225
This is the content of the form and is provided for your convenience. It is not necessarily what the actual form looks like and does not include the information, instructions and other materials that come with the form you would purchase. An actual sample can also be viewed by clicking on the "Sample Form" near the top left of this page.










Marital Settlement/Separation Agreement Kit
(Parties With Children)









This Packet Includes:
1. Information
2. Step-by-Step Instructions
3. A completed sample marital settlement agreement for your reference
4. Marital Settlement / Separation Agreement
(Parties With Children)





Information
Marital Settlement / Separation Agreement Kit


(Parties With Children)

The alternative to both the uncontested default divorce (in which one spouse does not participate in the decision-making) and the contested divorce is the divorce or legal separation by agreement. In this type of divorce or separation, fault is not a factor.

In a divorce or legal separation by agreement, both spouses play a part in all of the decisions affecting the couple and any children that they may have. For this type of divorce or separation to succeed, the agreement between the spouses must be as fair and as just as is possible under the circumstances.

A marital settlement agreement is not only accepted but is actually encouraged in virtually all state and is an indispensable alternative to the traditional hostility of ending a marriage.

There are many important benefits to obtaining a divorce or separation by agreement. Perhaps the most important benefit is that there is far less chance that the divorce will escalate into a hostile battle. When revenge and animosity are not factors, there is a greater opportunity that the divorce/separation settlement will accurately reflect what the spouses really desire to obtain from the divorce. If the decisions regarding the care and custody of any children are reached through rational and mature discussions, there is a greater chance that the decisions reached will be abided by without future hostility.  

This agreement includes all the essential components for a marital settlement agreement including division of property, child custody, visitation, support and more. This package is best for divorcing couples that have children.



Step-by-Step Instructions
Marital Settlement / Separation Agreement Kit
(Parties With Children)

   To complete the Marital Settlement Agreement, simply fill in the necessary information and delete those clauses which do not apply to your divorce.  Do not type any portions of a clause which are shown in italics, unless it is language directly relating to your agreement.  In addition, the only blank lines that should appear on your original should be spaces for the signatures on the final page.  Delete any clauses and italicized text you do not include in your agreement.

   Below you will find explanations for the various clauses which make up a marital settlement agreement.  Read the explanations to determine which clauses apply to your particular situation.  Following each clause title you will find a number that corresponds to the blank sample agreement.

   Following the explanations is a complete sample marital settlement agreement. It has been assembled using clauses from this instruction sheet. By reviewing this sample agreement, you will be able to see what a final completed settlement agreement should look like and how the various parts are put together.  For the purposes of preparing the sample agreement, a fictional family was used.

   Follow the link below to our free State Law Digest for Divorce Law, which includes information regarding your states divorce laws and procedures.  Use this information to help you complete your Marital Settlement Agreement.  


   EXPLANATIONS:

   Title And Introductory Clause:

This introductory clause specifies the effective date of the agreement and identifies the spouses, their places of residence, and the date and place of their marriage. Fill in the appropriate information. This information is important and is mandatory in all agreements.





   Children Identification Clause:

Chose the clause that applies to your particular circumstances. This clause identifies whether or not any children will be involved in the terms of the agreement. Fill in the names and birth dates of any children. One of these clauses is mandatory.


   Preliminary Explanation Clause:

Chose this clause to set forth the divorce grounds that you have chosen in your state and your particular circumstances.  

   General Agreement Clause:

This clause outlines the basic desire to reach an agreement. This clause is mandatory in all agreements.

   Separation Clause: Paragraph 1

This clause relates that the spouses desire to live apart as if they were single. This clause should be used in all situations in which the spouses have already separated or in which they desire to separate as soon as an agreement is reached. In the vast majority of cases, you will use this clause.

   Property Division Clause (Property Not Listed):  Paragraph 2

This clause should be used for cases where there is very little or even no property and there are no significant bills to divide. It simply allows each spouse to keep the property currently in his or her possession. It also provides that any bills have already been divided and taken care of by you and your spouse. If you have significant property (car, furniture, appliances, etc.) or bills owed or if you have property that you have not yet divided, you should use a different clause. Also, if you or your spouse have a pension or retirement plan that will be divided, you must use a different clause so that such a plan may be listed and identified specifically. You may use this clause, however, if you have no property or bills or all of your property and bills have actually been divided.

   Property Division Clause (List Included): Paragraph 2



This clause should be used if you and your spouse have agreed to a division of property and you are able to specifically list the property that each of you will retain. This clause provides that both of you have transferred the property mentioned and quitclaimed it to the other spouse. It should be used if you have relatively significant property (home, car, appliances, major furniture items, etc.), and if your method of division is in the form of a trade-off or off-set. If this clause is chosen, you will also need to choose a further clause listed later that describes the division of your bills. For each item of property, provide a complete description. For real estate, list the legal description as shown on the deed to the property. For other property, list the serial number, if available, or a clear description. If either of you has a pension plan or retirement plan, list that plan under the appropriate spouse and describe it fully.



   Division of Property (By Sale): Paragraph 2

This clause should be used if there is marital property that is to be sold and the proceeds of the sale divided between you and your spouse. It may be used for the disposition of anything from items to be sold at a yard sale to the sale of your home. An exact description of the property to be sold should be included. If the property is real estate, the description should be the legal description as shown on the deed to the property. This clause provides for an equal division of the proceeds of the sale after any expenses of the sale are deducted. In the case of the sale of a home, this would allow for any appraisal expenses and real estate broker fees to be deducted from the proceeds of the sale before dividing the profits. This clause may be used in conjunction with the previous clause.

   Division Of Bills (Bills Listed): Paragraph 3

This clause is used to specifically divide your bills. It should be used if you have relatively significant bills (outstanding loans, unpaid credit card balances, etc.). It provides that you will each individually assume and pay the bills listed after your name and not hold the other liable for the debts (hold harmless and indemnify). It also provides that neither of you will incur any more debts that the other spouse would be liable for. For each bill, list to whom the bill is owed and the amount to be paid. If you have used the first clause listed in this instruction sheet for dividing your property and bills [Property Division Clause (Property Not Listed)], do not use this clause.

   No Alimony to Either Spouse Clause: Paragraph 4

This clause should only be used if, after careful consideration, both you and your spouse agree that neither of you should be required to pay any alimony to the other. By using this clause, you will be giving up forever any rights that you may have to alimony. However, if this is what you have both decided is fair, then you should use this clause.

   Alimony Payable in Monthly Payments Clause: Paragraph 4



This clause should be used if you and your spouse have agreed that one of you should receive and one of you should pay alimony to the other in the form of periodic monthly payments. You will need to decide the amount of each payment, the day of the month that each payment will be due, and the date on which the payments should begin.



You will also need to decide when the payments are to end. You may wish the payments to end on remarriage, on death, or on a particular date. Or you may decide that the alimony payments should end on the first happening of any one of these events. If you decide that the payments are to end on the death of either spouse and the duration of the payments is for a long period, you may wish to consider the use of life insurance coverage to protect the support of the receiving spouse. Please see the clauses relating to insurance coverages.

In addition, in this clause you will need to decide if you wish for your decisions to be modifiable by a court in the future. If you decide that your alimony provisions may not be modified by a court, then a court will only modify this clause if it can be shown that there was fraud, coercion, or threats made in reaching the agreement or if the agreement is obviously and grossly unfair to one spouse.  In order to allow for a modification due to changed circumstances in the lives of either spouse, it is recommended that you allow for a future court modification of this clause.

Finally, through the use of this clause you will need to choose a method by which the payments should be made. Some states have enacted legislation which allows or requires any support payments to be made through the court or through certain state agencies and then be passed on to the spouse who is to receive the payment. This indirect method of payment, although generally slower, has the benefit of allowing for immediate action to be taken if any payments are missed. There is a clear record of payment in the hands of the appropriate state authorities. In fact, some states automatically take direct action against any spouse who is late with a payment, which may include garnishing wages, requiring a bond or deposit, or actually seizing a delinquent spouses property. However, in virtually all states that allow this indirect method of payment, there are provisions that allow the spouses to opt out of the state requirement. If you and your spouse agree that the payments may be made directly to the spouse who is to receive them, you must make this decision in the clause below. If you do make the decision to allow payments to be made directly to a spouse and not through a court or state agency, it is extremely advisable to make this clause modifiable by a court at a later date. By making the clause subject to court modification, the spouse receiving the payments will retain the right to have the payments made through the court or state at a later date should any problems in late or delinquent payments arise.

   Alimony Payable in a Lump-Sum Payment Clause: Paragraph 4





This clause should be used if you and your spouse agree that the fairest method of dealing with the payment of alimony is for one spouse to pay the other a one-time lump-sum payment. The funds may then be used by the spouse who receives the payment to obtain education, job skills, or training to become self-supporting. This lump-sum payment is separate from and in addition to any shift in funds or property under the terms of your property settlement. To be fair, this alimony lump-sum payment should be taken out of a spouses share of separate and marital property after all of their property has been equally or equitably divided.

This method of spousal support has the benefit of lessening the future ties between you and your spouse and, thus, lessening the opportunities for problems to develop. It also has the benefit of not leaving one spouse subject to over-due payments from the other spouse. This method, however, is not workable if the spouse who is to pay the lump-sum payment does not currently have the assets by which to pay.

   Insurance Clause (Neither Spouse as Beneficiary): Paragraph 5

If you or your spouse currently have insurance policies, but agree that neither of you will be retained as beneficiaries on the others policy, use this clause. If you use the clause providing for one of you to be retained as beneficiary (below), do not use this clause.

   Life Insurance Clause: Paragraph 5

This clause should be used if you and your spouse have agreed that one of you will remain as a beneficiary on a life insurance policy of the other. Retaining a position as beneficiary on the others life insurance is generally a good idea if there are continuing support payments to be paid. The spouse who pays the alimony will be the spouse who maintains the insurance. The spouse who receives the alimony will be the spouse who is designated as beneficiary. In the event of the supporting spouses death, this allows the spouse who is due the support to collect the benefits of any insurance and apply it to the continuing maintenance or child support obligations.



The use of this clause may be wise in any situation where there are support obligations. It is, however, highly recommended in the following circumstances: (1) if you have decided that alimony should be payable in monthly payments; and (2) the duration of the payments is for a long period; and (3) the payments are to end on either spouses death. In a situation of this nature, it is prudent to have the spouse who is to receive the payments be the beneficiary of a life insurance policy on the life of the spouse who is to make the payments. In this manner, the one receiving payments will not be left destitute on the death of a long-time ex-spouse.



   Life and Health Insurance Clauses: Paragraph 6

Two provisions regarding insurance as additional child support are provided here. These require that, as additional child support, the parent who is to pay the support must: (1) maintain a life insurance policy naming the children as beneficiaries; and (2) maintain health insurance coverage for the children.

These provisions are highly recommended and are required in some states. Federal law requires that states require a parent responsible for child support to include any children under a health and dental insurance plan if such a plan is available to the parent through their place of employment or otherwise at a relatively low cost. The life insurance provision provides some measure of security and insurance protection for the children in the event of death of the paying parent. The health insurance protection provides the child with protection in case of illness or injury.

   Marital Settlement Agreement Taxation Clause: Paragraph 7

The following clause may be used to define your various decisions regarding the tax consequences of your divorce. If you are living apart under the terms of your marital settlement agreement or under the terms of a separation decree but your divorce is not final by the end of the year, you may choose to file: (1) a joint tax return with your spouse; (2) a separate return; or (3) you may be considered unmarried and file a “head of household” return. You may choose to file a joint income tax return with your spouse for the current tax year only if your divorce has not been made final before the end of the year. If your divorce is final by the end of the year, you must file either an individual return or a “head of household” return. In addition, if your divorce is finalized prior to the end of the current tax year, you may not claim your spouse as an exemption, even if you have provided all of the support for your spouse for the year.

   Marital Settlement Agreement Name Change Clause: Paragraph 8



Most states have specific laws which allow a person to request that his or her former name be restored upon divorce. Although many of these laws are now written to make no reference to the sex of the person requesting this type of change, it is generally a wife who desires to use either her maiden name or her former name (if her former name was a previous married name). The restoration of this name may be accomplished by a simple request in the divorce papers and a provision in the divorce decree or judgment.  You may use this clause also to state the last name that the children of your marriage will be known by, if you did not use a clause that contained a provision for childrens names.  It is useful to have your spouses agreement to such a name change request.



   Agreement Clause: Paragraph 9

There are various other marital settlement agreement issues which must be included in order for your agreement to have the necessary legal force. This will always be the last numbered clause in your marital settlement agreement. These standard legal phrases are important and should not be altered. They cover the following points:

   That you both want the terms of your marital settlement agreement to be the basis for your a court order in the event of a divorce;
   That you both have prepared complete and honest Financial Statements and they are attached to your agreement;
   That you both know that you have the right to see your own lawyers and that you both understand your legal rights;
   That you both will sign any necessary documents;
   That you both intend that your agreement is the full statement of your rights and  responsibilities; and
   That your agreement will be binding on any future representatives of yours.






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Sample Marital Settlement Agreement


Following, a complete sample marital settlement agreement is presented. It has been assembled using clauses from this instruction sheet. By reviewing this sample agreement, you will be able to see what a final completed settlement agreement should look like and how the various parts are put together

For the purposes of preparing this sample agreement, a fictional family was used. Mrs. Mary Ellen Smith is the wife and Mr. John William Smith is the husband. They were married on January 1, 1999.  The parties live in the fictional town of Centerville, in the County of Washington, State of Superior.

They own the following property:

   A home valued at $50,000, with an outstanding mortgage balance of $40,000.
   A Chevrolet car valued at $7,500, with an outstanding loan balance of $1,000.
   Furniture and household furnishings worth $3,000.
   Tools worth $2,000.
   Cash in a checking account in the amount of $2,000.
   Jewelry which Mrs. Smith inherited from her mother valued at $1,500.
   A boat valued at $2,000 which Mr. Smith owned prior to the marriage.

They jointly owe the following debts (other than mortgage and car payments):

   Visa Credit Card: Balance of $1,500.
   Jones Furniture Store: Balance of $1,000.

The value of their separate or non-marital property is as follows:

   Mrs. Smith: Jewelry valued at $1,500.
   Mr. Smith: Boat valued at $2,000.

The value of their marital or community property is as follows:

   Tools:                        $ 2,000
   Car: equity value                  $ 6,500
   Furniture and furnishings               $ 3,000
   Home: equity value                  $10,000
   Cash:                        $ 2,000
                     Equals (=)
      Sub-total                  $23,500
                     Minus (-)
   Visa Credit balance                  ($1,500)
   Jones Furniture Credit balance            ($1,000)
                     Equals (=)
   Total value of marital property            $21,000

Mr. Smith has a life insurance policy on his life for $100,000 and health insurance through his place of employment.  Mr. Smith works full-time, while Mrs. Smith works only part-time. She is, however, educated and capable of full-time employment.

They have agreed to the following terms:
   
?   Mrs. Smith will keep the home and Mr. Smith will transfer (by quitclaim deed) his share of the home to her. She also will keep two-thirds of the home furnishings. None of the cash in the bank account will be hers. She agrees to pay off the Visa bill. The value of her share of the marital or community property is $10,500 ($10,000 (home equity) + $2,000 (furnishings) - $1,500 (Visa bill) = $10,500).

?   Mr. Smith will keep the tools, the car, and the one-third of the home furnishings. All of the cash in the bank will be his to keep. He agrees to pay off the Jones Furniture bill. His share of the marital or community property is also $10,500 ($1,000 (furnishings) + $6,500 (car equity) + $2,000 (tools) + $2,000 (cash) - $1,000 (furniture bill) = $10,500). They have separated their furnishings, closed their joint bank account, and opened individual accounts. In addition to signing this Marital Settlement Agreement and their Financial Statements, they will need to prepare a quitclaim deed for their home and have the title to their car transferred

Various other minor decisions that they have made are shown in the appropriate sections of the clauses in their Agreement. Although not shown here, each spouse will also need to have prepared a Financial Statement. The Marital Settlement Agreement which embodies all of their agreements and which will be used in their later divorce follows. 


SAMPLE
Marital Settlement Agreement

This agreement is made on the 1st day of May, 2006, between Mary Ellen Smith, the Wife, who lives at 150 Emerald Lane in the Town of Centerville, County of Washington, State of Superior, and John William Smith, the Husband, who lives at 2000 Main Street, Apartment #2, in the Town of Centerville, County of Washington, State of Superior.

We were married on the 1st day of January 1999, in the City of Columbia, County of Lincoln, State of Superior.

No children were born into our marriage.

As a result of disputes and serious differences, we sincerely believe that our marriage is irretrievably broken and that there is no possible chance for reconciliation.

We both desire to settle by agreement all of our marital affairs, including the division of all of our property and bills, spousal support or maintenance.

THEREFORE, in consideration of our mutual promises, and other good and valuable consideration, we agree as follows:

1.   We both desire and agree to permanently live separate and apart from each other, as if we were single, according to the terms of this agreement. We each agree not to annoy, harass, or interfere with the other in any manner.

2.   We agree that the following property shall be the sole and separate property of the Wife, and the Husband transfers and quitclaims any interest that he may have in this property to the Wife:

      Diamond Ring and Bracelet valued at $1,500;
      All of the furnishings currently in the family home;
      The family home located at 150 Emerald Lane, Centerville, Superior, with the legal description as follows:

         Lot 5 of Centerville Subdivision as shown on Plat 3 on Page 65
         of Book 200 in the Records of Washington County, Superior.

   We also agree that the following property shall be the sole and separate property of the Husband, and the Wife transfers and quitclaims any interest that she may have in this property to the Husband:

      Woodworking Tools valued at $2,000;
      1998 Chevrolet, serial #123456, Superior License #ABC 789, valued at $6,500;
      $2,000 cash currently in the Centerville Bank in his individual account;
      Household furnishings currently located at 2000 Main Street, Apartment #2, Centerville, Superior.

3.   We agree that the Wife shall pay and indemnify and hold the Husband harmless from the following debts:

      Visa Credit Card Account # 987654;
      Home mortgage currently held by the Centerville National Bank on the family home located at 150 Emerald Lane, Centerville, Superior, with the legal description as follows:

         Lot 5 of Centerville Subdivision as shown on Plat 3 on Page 65
         of Book 200 in the Records of Washington County, Superior.

   We agree that the Husband shall pay and indemnify and hold the Wife harmless from the following debts:

      Jones Furniture Store Account #321;
      Auto loan currently held with the GMAC Finance Company on the 1998 Chevrolet, serial #123456, Superior License #ABC 789.

   We also agree not to incur any further debts or obligations for which the other may be liable.

4.   We both agree that, as alimony and maintenance, the Husband shall pay to the Wife the sum of $400 per month, payable on the 1st day of each month. The first payment will be due on the 1st day of June, 2004, and the payments shall continue until the first of the following occurrences: (1) the date that either of us dies; (2) the date that the spouse receiving alimony remarries; or (3) June 1, 2004. We both intend that the amount and the duration of the payments may be modified by a court in the future. We also both agree that these payments should be made directly to the spouse to whom they are due.

5.   We both agree that neither of us shall remain as the beneficiary on any life insurance policy carried by the other.

6.   We both agree that we will cooperate in the filing of any necessary tax returns. We also agree that any tax refunds for the current year will be the property of the Husband and that any taxes due for the current tax year will be paid by the Husband.

7.   We both agree that, in the event of divorce or dissolution of marriage, the Wife desires to and shall have the right to be known by the name of Mary Ellen Carter.

8.   We both desire that, in the event of our divorce or dissolution of marriage, this marital settlement agreement be approved and merged and incorporated into any subsequent decree or judgment for divorce or dissolution of marriage and that, by the terms of the judgment or decree, we both be ordered to comply with the terms of this agreement, but that this agreement shall survive.

   We have prepared this agreement cooperatively and each of us has fully and honestly disclosed to the other the extent of our assets, income, and financial situation. We have each completed Financial Statements which are attached and incorporated by reference.

   We each understand that we have the right to representation by separate lawyers. We each fully understand our rights and we each consider the terms of this agreement to be fair and reasonable. Both of us agree to execute and deliver any documents, make any endorsements, and do any and all acts that may be necessary or convenient to carry out all of the terms of this agreement.

   We agree that this document is intended to be the full and entire settlement and agreement between us regarding our marital rights and obligations and that this agreement should be interpreted and governed by the laws of the State of Superior.   

   We also agree that every provision of this agreement is expressly made binding upon the heirs, assigns, executors, administrators, successors in interest, and representatives of each of us.

Signed and dated this 1st day of May, 2006.


______________________________   ______________________________
  [Wifes signature]                [Witness signature]

                  ______________________________
                     [Witness signature]


______________________________   ______________________________
  [Husbands signature]             [Witness signature]

                  ______________________________
                     [Witness signature]

State of Superior
                  SS.
County of Washington

On May 1st, 2006, Mary Ellen Smith and John William Smith personally came before me and, being duly sworn, did state that they are the persons described in the above document and that they signed the above document in my presence as a free and voluntary act for the purposes stated.

      ______________________________
      (signature)
   Notary Public, for the County of Washington
   State of Superior
   My Commission expires June 1, 2008



Marital Settlement Agreement


This agreement is made on the ____ day of ___________, 20___, between _____________, the Wife, of ________________, City of ________________,  County of _____________, State of ________________, and ________________, the Husband, of ________________, City of ______________, County of ____________, State of ________________.  We were married on the ____ day of _________, 20 _____ in the City of _______________ County of _____________, State of _____________.


The following children were born [or adopted] into our marriage:

Childs name               Childs Birth date       Childs Sex

_________________________________   _________________      ___________
                        

Childs name               Childs Birth date       Childs Sex

_________________________________   _________________      ___________


Childs name               Childs Birth date       Childs Sex

_________________________________   _________________      ___________   


As a result of disputes and serious differences, we sincerely believe that our marriage is irretrievably broken and that there is no possible chance for reconciliation.

[or]

As a result of disputes and serious difficulties, we sincerely believe that there are irreconcilable differences between us and that there is no possible chance for reconciliation.

[or]

As a result of disputes and serious differences, we sincerely believe that there is a complete incompatibility of temperament between us and that there is no possible chance for or reconciliation. 

[or]

As a result of disputes and serious differences, we have separated and are now living apart and intend to continue to remain permanently apart.

We both desire to settle by agreement all of our marital affairs, including the division of all of our property and bills, spousal support or maintenance, and all issues relating to our children, including custody, visitation, and child support.

THEREFORE, in consideration of our mutual promises, and other good and valuable consideration, we agree as follows:

1.  We both desire and agree to permanently live separate and apart from each other, as if we were single, according to the terms of this agreement. We each agree not to annoy, harass, or interfere with the other in any manner.

2.  We both agree that our property and bills are minimal, and that we have already divided all of our property and bills to our mutual satisfaction. We each transfer and quitclaim to the other any interest that we may have in the property of the other. We both agree that all of the property that the other now possesses is the sole and separate property of the other. We also agree not to incur any further debts or obligations for which the other may be liable.

[or]  

We agree that the following property shall be the sole and separate property of the Wife, and the Husband transfers and quit-claims any interest that he may have in this property to the Wife: [Here list Wifes property].
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________

We also agree that the following property shall be the sole and separate property of the Husband, and the Wife transfers and quit-claims any interest that she may have in this property to the Husband: [Here list Husbands property].
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
____________________________________________________________
[or]

We agree that the following property will be sold as soon as possible and any proceeds from the sale of this property, after the deduction of any expenses of the sale, will be divided equally between us: [Here list a description of the property to be sold].
    
    ____________________________________________________________
   ____________________________________________________________
____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________


3.  We agree that the Wife shall pay and indemnify and hold the Husband harmless from the following debts: [Here list debts that Wife will pay].
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________

We agree that the Husband shall pay and indemnify and hold the Wife harmless from the following debts: [Here list debts that Husband will pay].
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
   ____________________________________________________________
____________________________________________________________

We also agree not to incur any further debts or obligations for which the other may be liable.

4.  After careful consideration of our circumstances and all of the other terms of this agreement, we both agree to waive any rights or claims that we may have now or in the future to receive alimony, maintenance, or spousal support from the other. We both fully understand that we are forever giving up any rights that we may have to alimony, maintenance, or spousal support.  

[or]

We both agree that, as alimony and maintenance, the ___________________ shall pay to the _________ the sum of $ __________________ per month, payable on the ___ day of each month. The first payment will be due on the    ___ day of  ______________, 20___, and the payments shall continue until the first of the following occurrences: We both intend that the amount and the duration of the payments not _______________ be modified by a court in the future. We also both agree that these payments should be made directly to the spouse to whom they are due.

[or]

We both agree that in full payment of any claims or rights to alimony, spousal support, or maintenance, the ____________________shall pay to the _____________ the sum of $           , which shall be paid on or before the ___day of ______________, 20___.

5.  We both agree that neither of us shall remain as the beneficiary on any life insurance policy carried by the other.

[or]

The life of the __________________is currently insured by___________________   in the amount of $ ______ and    agrees to keep this policy in full force until death. We agree that the ____________   shall be designated as irrevocable sole beneficiary of this policy. The spouse obligated to provide such insurance will provide the other spouse with annual proof of such coverage.
                 
6.  We both agree that it is in the best interests of our child[ren] that the ___________________ have sole physical and legal custody of our child[ren]. We also agree that the other parent has the right to be with our child[ren] on a frequent and liberal basis through reasonable visitation, at such times as we and the child[ren] can agree upon. We agree that we will share as equally as possible the right to be with our child[ren] on holidays, birthdays, and during the child[ren]s school vacations. We agree that our child[ren]s time with either of us should not interfere with their attendance at school. We also agree that the parent with custody should have the right to make the major decisions regarding the care and up-bringing of the child[ren], but that the other parent has the right to be notified of any major decisions.  

[or]

We both agree that it is in the best interests of our child[ren] that the _________________________ have sole physical and legal custody of our child[ren]. We _______________ also agree that the other parent has the right to be with our child[ren] on a frequent and liberal basis through reasonable visitation, at such times as we and the child[ren] can agree upon. If in the future we are unable to agree upon visitation, the _______________will have the right to be with our child[ren] as follows:

(A).    On the following holidays during even-numbered years:  _____________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

(B).    On the following holidays during odd-numbered years: _______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

(C).    On the following dates and times each [or every other] weekend:   _______________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

(D).    On the following dates and times during each [or every other] week: ____________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________



(E).    For the following vacation periods each year: _______________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


We agree that our child[ren]s time with either of us should not interfere with attendance at school. We also agree that the parent with custody should have the right to make the major decisions regarding the care and up-bringing of our child[ren], but that the other parent should have the right to be notified of any major decisions.

[or]

We both agree that it is in the best interests of our child[ren] that we both have joint legal custody of our child[ren]. We also agree that it is in the best interests of our child[ren] that the __________________ have sole physical custody of our child[ren]. We acknowledge that our child[ren] presently live[s] with the _________ and that the actual physical residence of our child[ren] may be changed at any time as we may mutually agree.

All decisions pertaining to the education, discipline, health, extracurricular and summer activities, religious training, medical and dental care, and welfare of our child[ren] will be decided by both of us after reasonable and adequate discussion. We also agree that the parent with physical custody shall have control over the minor day-to-day decisions affecting the child, including any medical or dental emergencies. We agree that if, after reasonable attempts, we are unable to reach an agreement on any of the decisions affecting our child[ren], we will jointly seek professional mediation to resolve our differences.

We also agree that each of us has the right to know of any circumstances or decisions that affect our child[ren] and that each of us has the right to any medical, dental, or school records of our child[ren]. Neither of us will do anything to hamper or interfere with the natural and continuing relationship between our child[ren] and the other parent.

We both realize that the well-being of our child[ren] is of paramount importance and, therefore, we agree that our child[ren] should have as much contact as possible with the parent that does not have physical custody and that our child[ren] may visit that parent as often as may be agreed upon. Although visitation may be scheduled more often, the parent that does not have physical custody will have the right to be with our child[ren] at least as follows:

(A).    On the following holidays during even-numbered years: ______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(B).    On the following holidays during odd-numbered years: _______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

   
(C).  On the following dates and times each [or every other] weekend ______________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(D).    On the following dates and times during each [or every other] week: ___________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(E).    For the following vacation periods each year: ______________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

We additionally agree to use our very best efforts to insure that our child[ren] receive the most care, love, and affection possible from both parents throughout their entire childhood.

[or]

We both agree that it is in the best interests of our child[ren] that we both have joint legal and physical custody of our child[ren]. We also agree that it is in the best interests of our child[ren] that the home of the __________ be the primary residence of the child[ren]. We acknowledge that our child[ren] presently live[s] with the _______________    and that the actual physical residence of our child[ren] may be changed at any time as we may mutually agree.

All decisions pertaining to the place of residence, discipline, education, health, extracurricular and summer activities, vacations, religious training, medical and dental care, and welfare of our child[ren] will be decided by both of us after reasonable and adequate discussion. We also agree that the parent with physical custody shall have control over the minor day-to-day decisions affecting the child, including any medical or dental emergencies. We agree that if, after reasonable attempts, we are unable to reach an agreement on any of the decisions affecting our child[ren], we will jointly seek professional mediation to resolve our differences. 

We also agree that each of us has the right to know of any circumstances or decisions that affect our child[ren] and that each of us has the right to any medical, dental, or school records of our child[ren]. Neither of us will do anything to hamper or interfere with the natural and continuing relationship between our child[ren] and the other parent.

We both agree that our child[ren] will be known by the last name of ____________________________.

We both agree that frequent and continuing contact with both parents is vital to our child[ren], and therefore we both agree that neither of us will permanently remove our child[ren] from this state without the express written permission of the other parent.

We both realize that the well-being of our child[ren] is of paramount importance and, therefore, we agree that our child[ren] should have as much contact as possible with the parent that does not have physical custody and that our child[ren] may visit that parent as often as may be agreed upon. Although contact may be scheduled more often, the parent that does not live in the primary physical residence of the child[ren] will have the right to be with our child[ren] at least as follows:

(A).    On the following holidays during even-numbered years: ______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(B).    On the following holidays during odd-numbered years: _______________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(C).    On the following dates and times each [or every other] weekend:   _______________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(D).    On the following dates and times during each [or every other] week: ____________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


(E).    For the following vacation periods each year: _______________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________


We additionally agree to use our very best efforts to insure that our child[ren] receive the most care, love, and affection possible from both parents throughout their entire childhood.

7.  We both agree that the __________________________    will pay to the _____________, for child support, the amount of $ _____________    per child per month, for a total monthly payment of $_______.  The payments will begin on the ____ day of _____________, 20        and will continue for each child until that child has reached the age of majority, died, become self-supporting, or married. We both agree that this obligation is subject to modification by a court at any time.

We both further agree that should the parent obligated to pay the support receive a salary or income increase in the future, the amount of child support due per child per month shall be increased proportionately. The parent obligated to pay support agrees to notify the other parent immediately of any salary or income increase.

[Choose one: Either:] We agree that the required child support payments should be made directly to the parent to whom they are due. However, in the event of a divorce or dissolution of marriage, we agree that the required child support payments are to be paid directly to the court or state official or agency so designated by the laws of this state to receive and disburse such payments. We both further agree that, in the event of a divorce or dissolution of marriage, we will cooperate in obtaining any necessary income withholding orders or income assignments if required to guarantee this obligation.

[Or:] We agree that the required child support payments should be made directly to the parent to whom they are due and should not be required to be paid through any court or state agency or official. The parent receiving the payments, however, does not waive the right to request, at any time and in his or her sole discretion that such payments be made directly through a court or state agency or official in the future. We both further agree that, in the event of a divorce or dissolution of marriage, we will cooperate in obtaining any necessary income withholding orders or income assignments if required to guarantee this obligation.

   8.  As additional child support, we both agree that as long as support payments are due the _________ will carry and maintain life insurance in the amount of $ _____________, naming our child[ren] as sole irrevocable beneficiary[ies]. The parent obligated to provide such insurance will provide the other parent with annual proof of such coverage.

   9.  As additional child support, we both agree that as long as support payments are due the __________ will carry and maintain adequate health, dental, and hospitalization insurance for the child[ren]s benefit, pay any required deductible amount, and pay for any necessary medical or dental expenses of the child[ren] that are not covered by such insurance. The parent obligated to provide such insurance will provide the other parent with annual proof of such coverage.

   10.  We both agree that we will cooperate in the filing of any necessary tax returns. We also agree that any tax refunds for the current year will be the property of the _______________and that any taxes due for the current tax year will be paid by the _________________.

[Use if necessary:] We both agree to file a joint income tax return for the current year.

   [Use if you have children:] We also agree that the___________________ may claim the federal dependency tax exemption for our child[ren].

11.   We both agree that, in the event of divorce or dissolution of marriage, the Wife desires to and shall have the right to be known by the name of   _______________________.  [Desired name]

We both also agree that, in the event of divorce or dissolution of marriage, our child[ren] will be known by the last name of _________________   . [Desired name]

12.   We both desire that, in the event of our divorce or dissolution of marriage, this marital settlement agreement be approved and merged and incorporated into any subsequent decree or judgment for divorce or dissolution of marriage and that, by the terms of the judgment or decree, we both be ordered to comply with the terms of this agreement, but that this agreement survive.

We have prepared this agreement cooperatively and each of us has fully and honestly disclosed to the other the extent of our assets, income, and financial situation. We have each completed Financial Statements which are attached and incorporated by reference.

We each understand that we have the right to representation by separate lawyers. We each fully understand our rights and we each consider the terms of this agreement to be fair and reasonable. Both of us agree to execute and deliver any documents, make any endorsements, and do any and all acts that may be necessary or convenient to carry out all of the terms of this agreement.

We agree that this document is intended to be the full and entire settlement and agreement between us regarding our marital rights and obligations and that this agreement should be interpreted and governed by the laws of the State of __________________________.

We also agree that every provision of this agreement is expressly made binding upon the heirs, assigns, executors, administrators, successors in interest, and representatives of each of us.


Signed and dated this day ___ of    _______________ , 20___.


_____________________________   _____________________________
     [Wifes signature]             [Witness signature]

                  _____________________________
                     [Witness signature]



_____________________________   _____________________________
     [Husbands signature]          [Witness signature]

                  _____________________________
                     [Witness signature]


State of    ___________
               SS.
County of    ___________

On ____________________, 20 ___, ____________________ personally came before me and, being duly sworn, did state that they are the persons described in the above document and that they signed the above document in my presence as a free and voluntary act for the purposes stated.

   ____________________
      (signature)
   Notary Public, for the County of ____________________
   State of    ____________________
   My Commission expires: ____________________

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