JDF 1256 R 2 /1 8 SEPARATION AGREEMENT (CIVIL UNION Page 1 of 9 District Court County, Colorado Court Address: In re the Civil Union of: Petitioner: and Co - Petitioner/Respondent: COURT USE ONLY Attorney or Party Without Attorney (Name and Address) : Phone Number: E - mail: FAX Number: Atty. Reg. #: Case Number: Division Courtroom SEPARATION AGREEMENT (CIVIL UNION) To promote the amicable settlement of d isputes among parties, parties that are dissolving their civil union or getting a legal separation , may enter into a written separation agreement containing pro visions for maintenance (partner support) for either party and for the disposition of property and debt. The Court must follow the separation agreement as it pertai ns to the parties themselves and to property, unless the Court finds the agreement unconscionable, in which case it may order the parties to submit a revised agreement. You may use this form as a separation agreement to submit to the Court. This standard form does not include every possible issue that may be relevant to the facts of your case. A section entitled "Other Terms" is available for you to identify unique issues that you may have in your case. If you need more space than is provided, attach ad ditional pages to the form. Any additional pages must include notarized signatures. This is a: Full Agreement (We agree to everything and this Agreement is signed by both parties) Partial Agreement (We agree to some things and this Agreement is signed by both parties) No Agreement (Prepared by signer and mailed to the other party) If this i s a partial Agreement or the Agreement was prepared by one party, please complete and file with the Court JDF 1129 - Pretrial Statement to identify issues that you have not agreed on. This is a required form if you have any issues that you cannot agree on . A hearing may be necessary to address the issues. Section 1: Assets You must list all assets as identified on the Sworn Financial Statement (JDF 1111). If you do not own any assets within the category identified, please check the appropriate box . If you do own the asset, please identify who will have possession of the asset and who will be responsible for any obligations for the asset, if applicable. It is important to remember that it is the responsibility of the party who is awarded the asse t to prepare the necessary documents to change the title of the property with the county and to notify any financial institutions, insurance companies, etc. of any changes. (name). Co - - Pet./Resp.) throughout this Agreement means and refers to (name.) American LegalNet, Inc. www.FormsWorkFlow.com JDF 1256 R 2 /1 8 SEPARATION AGREEMENT (CIVIL UNION Page 2 of 9 A. Real Estate (Check all that apply.) The parties do not own any Real Estate. The parties agree to the following te rms relating to all Real Estate owned. Identify address Party who will take ownership and title. Party who will assume all obligations. (Mortgage, Taxes, Insurance) P R P R Both (indicate %) P % R % P % R % The par ties agree to sell the Real Estate. Any proceeds or monies owed following the sale with be divided to the parties as follows: Petitioner : $ or % and Co - Pet./Resp. : $ or %. The parties agree to prepare documents (e .g. Quit Claim Deed) to transfer title by (date). The party who will take ownership and title of the property will have months from (date) or will have until (date) to refinance the loan and remove the other partner fro m the debt. The parties agree to an equity payout. The Petitioner Co - Pet/Resp. will pay $ to the Petitioner Co - Pet/Resp. by (date). The parties have already transferred title and have notified the lender of the ch ange in ownership per this agreement. Other: B. Motor Vehicles and/or Recreation Vehicles (Check all that apply.) The parties do not own any Motor Vehicles and/or Recreation Vehicles. The parti es agree to the following terms relating to all Motor Vehicles & Recreation Vehicles owned. Identify type Party who will take ownership and title. Party who will assume all obligations. (Loan Payment, Registration, Insurance) Year Make Model VIN# P R P R Both (indicate %) P % R % P % R % P % R % P % R % P % R % American LegalNet, Inc. www.FormsWorkFlow.com JDF 1256 R 2 /1 8 SEPARATION AGREEMENT (CIVIL UNION Page 3 of 9 The parties agree to sign over the respective title of each vehicle by (date). The party who will take ownership and title of the vehicles will have months from (date) or will have until (date) to refinance the loan and remove the other partner from the debt. The parties have already transferred title per this agreement. Ot her: C. Cash on Hand, Bank, Checking, and Savings Accounts (Check all that apply.) The parties do not have any accounts. The parties agree to the following terms relating to all accounts. Identify Name of Ba nk or Financial Institution Identify Type of Bank Account Distribution of each account. P = 100% R = 100% Both (indicate %) P % R % P % R % P % R % P % R % P % R % The parties agre e to divide/transfer the funds by (date). The parties have already divided/transferred the funds per this agreement. Other: D. Life Insurance (Check all that apply.) The parties do not have life insuran ce. The parties agree to the following terms relating to all life insurance accounts. Neither party will be required to carry life insurance on his / her life. or The Petitioner will carry life insurance on his life in the am ount of $ wit h (name of partner ) as beneficiary for (years/months) or until (specific date) and/or American LegalNet, Inc. www.FormsWorkFlow.com JDF 1256 R 2 /1 8 SEPARATION AGREEMENT (CIVIL UNION Page 4 of 9 The Co - Petitioner/Respondent will carry life insurance on her life in the am ount of $ with (name of partner ) as beneficiary for (years/months) or until (specific date) . Other: E. Furniture, Household Goods, and Other Personal Property (Check all that apply.) The parties do not have any assets in this category. The parties have divided the furniture, household goods, and other personal property and are satisfied with the division. The parties agree to the following terms relating to all furniture, household goods and other personal property. Identify Items P R Identify Items P R The parties agree to divide the furniture, household good s, and other personal property by (date). Other: F. Stocks, Bonds, Mutual Funds, Securities & Investment Accounts (Check all that apply.) The parties do not have any accounts. The pa rties agree to the following terms relating to all accounts. Identify name of Stock, Bond, Mutual Fund, etc. Distribution of Funds, Shares, etc. P = 100% R = 100% Both (indicate %) P % R % P % R % P % R % The parties agree to divide/transfer the funds by (date). American LegalNet, Inc. www.FormsWorkFlow.com JDF 1256 R 2 /1 8 SEPARATION AGREEMENT (CIVIL UNION Page 5 of 9 The parties have already divided/transferred the funds per this agreement. Other: G. Pension, Profit Shari ng or Retirement Funds (Check all that apply.) The parties do not have any funds. The parties agree to the following terms relating to all retirement accounts. Identify type of Pension, Profit Sharing or Retirement Fund Distribution of Funds, Shares, e tc. within the various accounts. P = 100% R = 100% Both (indicate %) P % R % P % R % P % R % The parties agree to divide/transfer the funds by (date). The parties have alread y divided/transferred the funds per this agreement. The Petitioner Co - Petitioner/Respondent is responsible for preparing and submitting a Qualified Domestic Relations Order (QDRO) by contacting their fund provider or an attorney by (date). The cost to prepare the QDRO will be paid as follows: Petitioner : % and Co - Petitioner/Respondent : %. Note: A QDRO is necessary in order for the division of the retirement plan to be completed. Without a QDRO, plans this form. Other: H. Miscellaneous Assets (When completing this section, please consider items identified on ) The parties do not have any assets in this category. The parties agree to the following terms relating to all miscellaneous assets listed below. Identify Items P R Identify Items P R American LegalNet, Inc. www.