! District Court _________________________________________ County, Colorado Court Address: In Re: Petitioner: v. Respondent/Co-Petitioner: COURT USE ONLY Attorney or Party Without Attorney (Name and Address): Case Number: Phone Number: FAX Number: Division E-mail: Atty. Reg. #: Courtroom ! SEPARATION AGREEMENT (WITHOUT CHILDREN) OR ! PARTIAL SEPARATION AGREEMENT OR ! INFORMATION FOR THE COURT This form may be used for several purposes: 1. SEPARATION AGREEMENT. Check this box above if your divorce is NON-CONTESTED, i.e., you and your spouse agree on ALL issues. 2. PARTIAL SEPARATION AGREEMENT. Check this box above if your divorce is CONTESTED and you and your spouse agree on SOME BUT NOT ALL issues. After each topic, please use the appropriate box to indicate: ! that both parties agree about the topic, OR ! information on the topic represents only one party’s position (check appropriate party). 3. INFORMATION FOR THE COURT. Check this box if you do not have any agreements. You still must fill out this form to tell the Court what orders you want on each issue in the case. A husband and wife getting a divorce (dissolution of marriage) or legal separation may enter into a written agreement containing provisions for maintenance (financial support) of either party, disposition of property and the allocation of parental responsibilities (not applicable to the use of this form) (see §14-10112, C.R.S.). The Court must follow the agreement as it pertains to the parties themselves and to property, unless the Court finds the agreement unconscionable. If the Court finds the agreement unconscionable, it may order the parties to submit a revised agreement. You may use this form as an outline for your Separation Agreement / Partial Separation Agreement. It DOES NOT include every possible issue you may want to address. An "Other Terms" section has been provided for items you would like to add. If you need more space than is provided, attach additional pages to the form. If the form includes issues that do not apply to your situation, write "Not Applicable" or "N/A" in that section. You DO NOT have to use this form if you prefer to write your OWN Separation Agreement / Partial Separation Agreement. However, if your case is NON-CONTESTED, you MUST submit to the Court some form of WRITTEN Separation Agreement addressing all of the issues that are relevant to the facts of your case. If your case is CONTESTED, use this document to tell the Court what you want. 4. MAINTENANCE (financial support formerly known as alimony) ! The parties do not agree on this issue. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement.) ! Both parties waive (give up forever) maintenance. (Once the Court accepts a party’s waiver, that party may never again seek maintenance.) OR JDF 1215 R12/01 SEPARATION AGREEMENT (WITHOUT CHILDREN) OR PARTIAL SEPARATION AGREEMENT OR INFORMATION FOR THE COURT Page 1 of 7 2002 © American LegalNet, Inc. ! The ! Husband ! Wife (check one) shall pay maintenance to the ! Husband ! Wife (check one) in the amount of $ __________ per month beginning _______________________ (date), for _____________ ! years ! months (check one), or until the Court modifies maintenance. Maintenance ! will ! will not (check one) be paid through the Registry of the court. OR ! Other: 5. REAL ESTATE ! The parties do not agree on this issue. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement.) ! The parties own no real estate. OR The parties own real estate located at _________________________________________, and the parties have agreed to divide the real estate as follows (be specific as to use, ownership, or arrangements for sale and distribution of funds): Title for the real estate will be transferred by the following method(s) (i.e., one party will execute a quitclaim deed, etc.): ! The parties agree that any mortgage on the property will be paid by: OR ! Husband and Wife ! Husband OR ! Wife OR ! The parties do not agree on the mortgage of the property. (Note: Change of title does not end the obligation you may have to the mortgage company. Court approval of any provision to remove either party from a mortgage loan does not require the lender to actually release the party from the commitment). The Parties understand that if either of them refuses to execute any documents under this agreement, C.R.C.P. 70 allows the Clerk of the Court to do so. The other party may also ask the court for sanctions for the refusal to follow this order. 6. MOTOR VEHICLE(S) ! The parties do not agree on this issue. JDF 1215 R12/01 SEPARATION AGREEMENT (WITHOUT CHILDREN) OR PARTIAL SEPARATION AGREEMENT OR INFORMATION FOR THE COURT Page 2 of 7 2002 © American LegalNet, Inc. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement.) ! The parties have no motor vehicle(s) acquired during the marriage. OR ! The motor vehicle(s) acquired during the marriage are divided as follows (include the year, VIN number and make of each motor vehicle(s)): The party(ies) will: ! Sign over the document required by the motor vehicle department, AND / OR ! Sign over the title to the vehicle to the party receiving the vehicle within _____ days of entry of Decree. ! The parties agree that any loan/lease on the vehicle(s) will be paid by: OR ! Husband and Wife ! Husband OR ! Wife OR ! The parties do not agree on the loan/lease of the vehicle(s). (Note: Change of title does not end the obligation you may have to the loan/lease company. Court approval of any provision to remove either party from a loan/lease does not require the lender to actually release the party from the commitment). The Parties understand that if either of them refuses to execute any documents under this agreement, C.R.C.P. 70 allows the Clerk of the Court to do so. The other party may also ask the Court for sanctions for the refusal to follow this order. 7. PERSONAL PROPERTY (furniture, boats, clothing, jewelry, household goods, etc.) ! The parties do not agree on this issue. ! Both parties agree on this issue (if you agree, please indicate the terms of agreement below). ! The personal property has been divided and both parties are satisfied with the division. OR ! The personal property is awarded to each party as follows: Husband: Wife: JDF 1215 R12/01 SEPARATION AGREEMENT (WITHOUT CHILDREN) OR PARTIAL SEPARATION AGREEMENT OR INFORMATION FOR THE COURT Page 3 of 7 2002 © American LegalNet, Inc. The Parties understand that if either of them refuses to execute any documents under this agreement, C.R.C.P. 70 allows the Clerk of the Court to do so. The other party may also ask the Court for sanctions for the refusal to follow this order. 8. STOCKS / BONDS / BANK ACCOUNTS ! The parties do not agree on this issue. ! Both parties agree on this issue (if you agree, please indicate the terms of agreement below). ! The parties own no stocks or bonds. OR ! The stocks and / or bonds will be divided as follows: ! The parties do not have any bank accounts. OR ! The bank accounts will be divided as follows: The Parties understand that if either of them refuses to execute any documents under this agreement, C.R.C.P. 70 allows the Clerk of the Court to do so. The other party may also ask the Court for sanctions for the refusal to follow this order. 9. DEBTS ! The parties do not agree on this issue. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) ! There are no unpaid marital debts. OR ! The marital debts are to be paid by each party as follows (for each debt listed on the Affidavit with Respect to Financial Affairs, write the name of the creditor by the party who will be responsible for paying the debt): Husband: Wife: The party responsible for the debts ! will hold him / her harmless for those debts. JDF 1215 R12/01 ! will not (check one) indemnify the other party and SEPARATION AGREEMENT (WITHOUT CHILDREN) OR PARTIAL SEPARATION AGREEMENT OR INFORMATION FOR THE COURT Page 4 of 7 2002 © American LegalNet, Inc. 10. LIFE INSURANCE ! The parties do not agree on this issue. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) ! Neither party will be required to carry life insurance on his / her life. OR ! The husband will carry life insurance on his life in the amount of $ _____________________ with (name of spouse or child(ren)) as beneficiary. AND/OR ! The wife will carry life insurance on her life in the amount of $ ______________________with (name of spouse or child(ren)) as beneficiary. The Parties understand that if either of them refuses to execute any documents under this agreement, C.R.C.P. 70 allows the Clerk of the Court to do so. The other party may also ask the Court for sanctions for the refusal to follow this order. 11. PENSIONS / RETIREMENT ACCOUNTS ! The parties do not agree on this issue. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) ! Neither party has pensions or retirement accounts, which were earned during the marriage. OR ! The pensions and retirement accounts of the parties shall be divided as follows: The Parties understand that if either of them refuses to execute any documents under this agreement, C.R.C.P. 70 allows the Clerk of the Court to do so. The other party may also ask the Court for sanctions for the refusal to follow this order. 12. TAXES ! The parties do not agree on this issue. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) ! The parties will file ! joint ! separate (check one) tax returns for the year(s) . After the date of the Decree, the parties will file separate tax returns. OR ! Other arrangements: JDF 1215 R12/01 SEPARATION AGREEMENT (WITHOUT CHILDREN) OR PARTIAL SEPARATION AGREEMENT OR INFORMATION FOR THE COURT Page 5 of 7 2002 © American LegalNet, Inc. 13. FUTURE CONFLICT RESOLUTION ! The parties do not agree on this issue. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) ! The parties agree to go to mediation to resolve any future conflicts. OR ! Other arrangements for future conflict resolution: 14. COSTS RELATED TO DIVORCE PROCESS ! The parties do not agree on this issue. ! Both parties agree on this issue. (If you agree, please indicate the terms of agreement below.) ! The parties agree to each pay their own costs related to the divorce process. OR ! The parties agree to split the costs related to the divorce process 50/50. OR ! Other arrangements: 15. OTHER TERMS (Add any other items you would like to include in your Separation Agreement / Partial Separation Agreement / Information for Disclosure for Permanent Orders Hearing.) Please use additional sheets, if necessary. ! The parties do not agree on this/these issue(s). ! Both parties agree on this/these issue(s). (If you agree, please indicate the terms of the agreement below: JDF 1215 R12/01 SEPARATION AGREEMENT (WITHOUT CHILDREN) OR PARTIAL SEPARATION AGREEMENT OR INFORMATION FOR THE COURT Page 6 of 7 2002 © American LegalNet, Inc. PLEASE RE-READ THIS DOCUMENT CAREFULLY TO MAKE SURE IT IS AN ACCURATE REPRESENTATION OF YOUR AGREEMENT WITH THE OTHER PARTY. YOUR SIGNATURE BELOW INDICATES THAT YOU HAVE READ AND AGREE WITH EVERYTHING IN THIS DOCUMENT. IF BOTH PARTIES AGREE TO THIS PLAN, BOTH PARTIES MUST SIGN. THIS DOCUMENT MUST BE SIGNED IN THE PRESENCE OF A NOTARY PUBLIC. Petitioner: ! Respondent ! Co-Petitioner (check one): Signature Signature Address Address City, State, Zip Code City, State, Zip Code (Area Code) Telephone Number (home) (Area Code) Telephone Number (home) Area Code) Telephone Number (work) (Area Code) Telephone Number (work) Subscribed and affirmed, or sworn to before me Subscribed and affirmed, or sworn to before me in the County of ________________________, in the County of _________________________, State of ____________________, this _______ State of ____________________, this ________ day of ________________. 20 ____. day of ________________. 20 ____. My commission expires: My commission expires: Notary Public Notary Public JDF 1215 R12/01 SEPARATION AGREEMENT (WITHOUT CHILDREN) OR PARTIAL SEPARATION AGREEMENT OR INFORMATION FOR THE COURT Page 7 of 7 2002 © American LegalNet, Inc.