SEPARATION AGREEMENT

SUPPORT AND CUSTODY

This agreement is made _________ (Month & Day), ____ (Year), between _________
__________ (Name of Husband), residing at _________________________ (Address)
here referred to as husband, and _______________________ (Name of Wife), residing at
_______________________________________ (Address), here referred to as wife.

RECITALS

Husband and wife recite and declare that:

They were married on _________ (Month & Day), _____ (Year) in ________________
(Location and Address) and since have been and now are husband and wife.

As the result of disputes and unhappy differences occurring and persisting between
them, they have been separated and living apart since __________ (Month & Day),
_____ (Year) or have agreed to an immediate and permanent separation.

A proceeding for dissolution of marriage is now pending or will shortly be filed by

_________________ in __________________ (Court and Location).

___________ (Number) children have been born to the parties of the marriage and are
now living. They are listed as follows:

_______________________________________
Name

Age

_______________________________________
Name

______________

Age

_______________________________________
Name

______________

Age

_______________________________________
Name

______________

Age

______________

(If appropriate, add: The following named children of the parties are fully emancipated
and no provision for the custody or support of such children is required or is made in
this agreement.)

The parties intend, and it is the purpose of this agreement, to provide fully for the
custody, support, maintenance, and education of their __________ (Child or Children);
to memorialize the separation of the parties, and to remain permanently apart.

(If appropriate, add: and to make a complete and final settlement of all claims that
husband/wife may have against husband/wife for alimony, support and maintenance and
provide fairly and adequately for him/her support and maintenance, and to provide for
the equitable and fair division of the common/community property of the parties).

To insure the full information and advice of each party, each of them has retained and
has been represented by independent legal counsel in connection with the negotiations
for and the drafting of this agreement: _______________________________________
(Wifes Attorney), of _____________________________________________ (Address)
has represented wife, and _________________________________________________
(Husbands Attorney), of _________________________________________ (Address),
has represented husband.
In consideration of the foregoing recitals and the mutual covenants and agreements of
the parties, they agree as follows:

1. LIVING SEPARATE AND APART

1.1

The parties may and shall hereafter live separate and apart, each free from all

dominion, restraint and control by the other, whether direct or indirect, as fully as if
unmarried.

1.2

Each party may hereafter reside at such place or places as he or she may select.

2. NO MOLESTATION OR INTERFERENCE

2.1

Neither party shall molest or interfere with the other nor compel or attempt to

compel the other to cohabit or dwell with him or her, by any means whatsoever, by legal
action or otherwise.

3. DIVISION OF PROPERTY

3.1

The property, both real and personal, owned by either of the parties at the time of

their marriage or subsequently acquired, separately or together, and owned by the parties
or either of them at the time of their separation has previously been equitably divided
and apportioned between them as follows: ___________________________
___________________________________________________________________

___________________________________________________________________
___________________________________________________________________.

3.2

The parties ratify and confirm that division and apportionment.

4. SEPARATE PROPERTY

Each party shall retain, have and enjoy, independently of any claim, right or demand of
the other party, all property of every kind, nature and description and whatsoever
situated that is now owned or held or is hereafter acquired by him or her, or stands in his
or her name.

5. RELEASE OF ESTATE RIGHTS

5.1

Each party releases all right to share in the estate of the other party, or to serve as

personal representative of the estate of the other party, except only as provided by will
or codicil executed after the date of this agreement.

6. SUPPORT AND MAINTENANCE OF SPOUSE

6.1

Husband or Wife shall pay to husband or wife as and for his or her necessary

support and maintenance, and husband or wife shall accept in full settlement and
satisfaction of his or her right, claim and demand for such support, maintenance and
alimony against husband or wife, the following amounts: ______________________
___________________________________________________________________
___________________________________________________________________
________________________________________ (Support Schedule and Conditions).

7. DEBTS AND OBLIGATIONS

7.1

Each of the parties shall pay all debts incurred by him or her after the date of this

agreement and shall indemnify the other party against liability therefor.

7.2

Husband or Wife shall pay debts incurred by him or her or by husband or wife or

by the parties jointly prior to the date hereof, including the following: ____________
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________
(Itemize debts of both parties including amount, nature of obligation and payee of
each).

(If appropriate, add: Husband or Wife represents that he or she had made a full
disclosure to husband or wife of all debts and obligations incurred by him or her and in
his or her name prior to the date hereof and that all such unpaid debts and obligations
are included in the foregoing list).

8. CHILD CUSTODY

8.1

Husband or Wife shall have the sole care, custody and control of the following

named children of the marriage:

_______________________________________
Name

Age

_______________________________________
Name

______________

Age

_______________________________________
Name

______________

Age

______________

and the named children shall reside with him or her. Such care, custody and control
shall continue with respect to each child until the child reaches majority or sooner
becomes emancipated, subject, however, to the visitation provisions set forth in this
agreement.

9. CHILD CUSTODY-PLACE AND CONDITION OF RESIDENCE

9.1

Husband or Wife shall not remove any of the unemancipated children to a

permanent residence outside the State of ____________________ without husband or

wife's prior written consent or prior approval of a court of competent jurisdiction on due
hearing and notice.

9.2

Husband or Wife and the children are now residing at ______________________

______________________________ (Address), Husband or Wife shall at all times keep

husband or wife informed of the residential address of the children in his or her custody,
and their location during vacation and holiday periods if they will be away from their
normal residence for more than ________ days in succession.

10.

CHILD CUSTODY-VISITATION RIGHTS

10.1 Husband or Wife shall have the right to visit the children, individually or
together, at their place of residence with husband or wife at reasonable times and at
reasonable intervals; and to have the children, or any of them, accompany him or her
from their place of residence at reasonable times and for reasonable periods provided

that he or she shall not keep any of the children away from their residence later than
__________ (Time of Day) on any such occasion, without husband or wife's prior
consent.

10.2 Husband or Wife shall have the privilege of having the children, or any of them,
visit him or her at his or her residence and stay with him or her not more often than
_______ per calendar month or as the case may be and on weekends and during holiday
periods for not to exceed ______ hours or as the case may be.

10.3 During such periods when the children or any of them are with husband or wife
he or she may take them on short journeys as he or she may choose and they may desire,
provided that he or she shall not without the prior consent of __________ husband or
wife take them from this state.

10.4 Husband or Wife shall make prior arrangements with husband or wife for each of
such weekend or holiday visit at least _____ days prior to the commencement thereof.

10.5 The rights of visitation expressed in this section shall not be exercised by
husband or wife at any time or in such a manner as to interfere with the education and
normal social and school activities of any of the children.

10.6 The parties may freely agree to any different arrangements for exercise of the
visitation rights of husband or wife from time to time, as future exigencies and the

welfare of the children may require, but no such substitute or additional privilege shall
be deemed to amend this agreement, unless expressed in writing and signed by the
parties.

10.7 Each of the parties shall at all times in good faith endeavor to maintain in all the
children respect and affection for the other party.

11.

CHILD CUSTODY CONSULTATION CONCERNING EDUCATION,

HEALTH AND WELFARE OF CHILDREN

11.1

Notwithstanding his or her general custody of the children, husband or wife shall

confer with husband or wife from time to time with respect to the welfare of the
children, or any of them, and particularly as to educational, health and disciplinary
matters of a substantial nature, such as, by way of examples, during the serious illness or
prior to a scheduled operation of any of the children, or in connection with the selection
of a college for the higher education of any of the children.
11.2

It shall at all times be the objective of both parties to decide all questions

affecting each of their children in such manner as to promote the welfare, happiness and
well-being of the children.

12.

SUPPORT AND MAINTENANCE OF CHILDREN

12.1 Husband or Wife shall pay to husband or wife for the support, maintenance, care
and education of each child in his or her custody ________ Dollars per month,
beginning ___________ (Month & Day), _____ (Year).

12.2 On the occurrence of the first to occur of any of the following events with respect
to each child, the obligation of husband or wife to pay support for that child shall
terminate at the end of the month in which such event occurs: (1) the death of the child;
(2) the attainment of the child's twenty-first birthday; or (3) an emancipation event as
defined in Section 13.

12.3 The obligation of husband or wife for support and maintenance of the children in
the custody of husband or wife as provided in this section, shall be separate from all
other obligations contained in this agreement and shall continue as obligations of and
charges against husband or wife's estate on his or her death, to the extent and for the
period that such obligation shall be in force and effect at the time of his or her death.

13.

SUPPORT AND MAINTENANCE OF CHILDREN-EMANCIPATION

EVENTS

13.1 For the purposes of this agreement, a child in the custody of husband or wife
shall become emancipated on the occurrence of any one of the following events:

13.1.1 The valid marriage of the child;

13.1.2

The full and permanent employment of the child gainfully and for a

reasonable living wage, excluding vacation and seasonal employment of a temporary

nature;

13.1.3 The induction, enlistment or entry on active duty in the Armed Services of the
United States for a term of service of not less than one year.

13.1.4 The emancipation of any child shall be postponed beyond the event that would
otherwise result in his or her emancipation, if, at the time of such event, the child is
enrolled as a full-time student in an accredited institution of higher learning. instead, the
emancipation event for any such child shall be the date of the child's graduation from
that institution. provided, however, the emancipation of any child shall not be extended
beyond the child's twenty-third birthday.

14.

SPOUSES ATTORNEY FEES

14.1 Husband or Wife shall pay husband or wife's attorney for __________ (his or her)
services rendered and to be rendered to him or her in connection with the preparation of
this agreement and advice with respect to his or her rights and obligations. Husband or
wife agrees that such payment shall fully and finally discharge any right or claim he or
she may have against husband or wife for reimbursement of expenses for all such legal

services rendered to him or her.

15.

EFFECT OF DIVORCE OR DISSOLUTION OF MARRIAGE

15.1 This agreement shall not be construed in any measure as a consent to or

condonation of a divorce in favor of either party or dissolution of marriage, but this
agreement shall not be a bar to an action for divorce or a proceeding for dissolution of
marriage previously or hereafter filed.
15.2 If a judgment or decree of divorce or dissolution of marriage is entered in any
action or proceeding therefor, this agreement and in particular the provisions for the
custody and support of the children of the parties shall, if the court approves, be
incorporated in, merged with, and become a part of such judgment or decree.
(If appropriate, add: and for the support and maintenance of husband or wife)

16.

EXECUTION OF NECESSARY INSTRUMENTS

16.1 Each party shall hereafter execute all instruments necessary to carry out the terms
of this agreement.

17.

BINDING EFFECT OF AGREEMENT

17.1 This agreement shall be binding on the parties and their respective heirs, personal
representatives and assigns.

In witness whereof, each party to this agreement has caused it to be executed at

_____________________________ (Place of Execution) on the date indicated below.

______________________________
Signature of Husband

_____________________

Date

______________________________
Signature of Wife

_____________________

Date

______________________________

_____________________

Signature of Husband's Attorney

Date

______________________________

_____________________

Signature of Wife's Attorney

Date