3259 (Rev 08/08) MARITAL SETTLEMENT AGREEMENT (Joint Simplified Dissolution of Marriage) - Dom Rel UNITED STATES OF AMERICA STATE OF ILLINOIS IN THE CIRCUIT COURT OF THE EIGHTEENTH JUDICIAL CIRCUIT COUNTY OF DU PAGE IN RE THE MARRIAGE OF CO-PETITIONER CASE NUMBER CO-PETITIONER MARITAL SETTLEMENT AGREEMENT vs This Agreement made and entered on File Stamp Here by and between referred to as the "Wife" and referred to as the "Husband." RECITALS A. The Husband and Wife were lawfully married in State of County, on . B. Irreconcilable difficulties and differences has arisen between the Husband and Wife. C. The Husband and Wife have filed a Joint Petition for Simplified Dissolution. The Husband and Wife wish to settle between themselves a divsion of all property interest and all debts. This agreement is entered into to satisfy the requirements of 750 ILCS 5/425(j). (Joint Simplified Dissolution Procedure) D. Both Husband and Wife, as co-petitioners, state that they have freely and voluntarily entered into this Agreement with full knowledge of each and every provision contained in this Agreement. The Husband and Wife, after carefully considering the terms of this Agreement, state that they believe same to be fair and reasonable under their present circumstances. Husband and Wife made a full disclosure to one another of all assets and debts including tax returns for all years of marriage. In consideration of the mutual promises and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties do freely and voluntarily agree to each and every term and provision set forth in the Marital Settlement Agreement as follows: ARTICLE I ASSETS Assets of the marriage shall be divided as follows: (show any property of value over $100) HUSBAND WIFE VALUE VALUE Pension Profit Sharing 401K/ Savings Plan Automobile (show value after payment of outstanding loan) CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707 Page 1 of 3 American LegalNet, Inc. www.FormsWorkflow.com 3259-2 (Rev 08/08) MARITAL SETTLEMENT AGREEMENT (Joint Simplified Dissolution of Marriage) - Dom Rel ARTICLE I ASSETS continued HUSBAND WIFE VALUE VALUE Checking Accounts Savings Accounts Furniture, Furnishings Jewelry Loans due and owing to Husband Loans due and owing to Wife Others (Please List) use additional sheet of paper if necessary ARTICLE II DEBTS CREDITOR ACCOUNT NO. TOTAL AMOUNT TOTAL AMOUNT use additional sheet of paper if necessary Tax Liability Indicate the year the tax liability was incurred CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707 Page 2 of 3 American LegalNet, Inc. www.FormsWorkflow.com 3259-3 (Rev 08/08) MARITAL SETTLEMENT AGREEMENT (Joint Simplified Dissolution of Marriage) - Dom Rel ARTICLE III MAINTENANCE/SPOUSAL SUPPORT The Husband and Wife hereby waive, remise and release any and all claims against the other for maintenance, alimony and spousal support, whether past, present or future, and the parties hereby stipulate this Agreement, when effective, shall terminate each party's rights to receive maintenance, alimony or spousal support from the other whether past, present or future. ARTICLE IV AFFIDAVIT The Husband and Wife being first duly sworn on oath state: That all of the assets have been divided in accordance with this Agreement and all documents have been executed to effectuate this Agreement. The Husband and Wife further agree to deliver documents and to execute any and all title transfers or documents as may be required to fulfill the terms of this agreement. Co-Petitioners Signature Co-Petitioners Signature Signed and sworn to before me Signed and sworn to before me Date Date Circuit Clerk or Notary Public Circuit Clerk or Notary Public Name and Address of above signed Co-Petitioner Name and Address of above signed Co-Petitioner Name: Name: Address: Address: City/State/Zip: City/State/Zip: Telephone Number: Telephone Number: CHRIS KACHIROUBAS, CLERK OF THE 18th JUDICIAL CIRCUIT COURT © WHEATON, ILLINOIS 60187-0707 Page 3 of 3 American LegalNet, Inc. www.FormsWorkflow.com