NHJB-2071-F (05/01/2019) Page 1 of 7 THE STATE OF NEW HAMPSHIRE JUDICIAL BRANCH htt p ://www.courts.state.nh.us Court Name: Case Name: Case Number: (if known) FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION This decree is (choose one): Agreed to by Parties Proposed By Ordered by the Court after hearing on at which petitioner respondent appeared. 1. Type of Case: (Choose Divorce, Legal Separation or Civil Union Dissolution) DIVORCE: A decree of divorce is granted to the petitioner respondent parties based on: Irreconcilable differences that have caused the irremediable breakdown of the marriage; or Grounds stated in the petition. Cross petition, if any, is dismissed. LEGAL SEPARATION: A decree of legal separation is granted to petitioner respondent parties based on: Irreconcilable differences that have caused the irremediable breakdown of the marriage; or Grounds stated in the petition. Cross petition, if any, is dismissed. CIVIL UNION DISSOLUTION: A decree of civil union dissolution is granted to petitioner respondent parties based on: Irreconcilable differences that have caused the irremediable breakdown of the civil union; or Grounds stated in the petition. Cross petition, if any, is dismissed. 2. Parenting Plan and Uniform Support Order N/A See attached Parenting Plan and Uniform Support Order 3. Dependents N/A The parties shall claim the minor child(ren) and/or other qualifying relative as dependent(s) for all income tax purposes, in the following manner: Petitioner, if otherwise qualified under federal/state law, shall be entitled to claim as tax dependent(s) for all years even years odd years other Respondent, if otherwise qualified under federal/state law, shall be entitled to claim as tax dependent(s) for all years even years odd years other A parent may only claim a child as a dependent if that parent is current on child support for the applicable tax year. American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION NHJB-2071-F (05/01/2019) Page 2 of 7 4. OPTIONAL: Post-Secondary Educational Expenses N/A IMPORTANT NOTE: The court cannot order parties to pay for college or other educational expenses beyond the completion of high school unless BOTH parties agree. However, if the parties agree to contribute to these expenses by checking the boxes in Section 4, below, this agreement will become an enforceable order of the court. The parties agree to contributions to college or other educational expenses beyond the completion of high school in the following manner: Type of contribution (check all that apply): Contributions to an account by Petitioner Respondent Both (Specify the amount and frequency of contributions and account information. Also specify what will happen to the contributions in the event the child does not incur post-secondary educational expenses): Contribution of an asset: (Specify the account or other asset being contributed and its current balance or value. If an asset is identified specify how the asset will be used. Also specify what will happen to the contributions in the event the child does not incur post-secondary educational expenses): Payments shall be made as post-secondary education expenses are incurred. Payments shall be made by Petitioner Respondent Both (Specify amount to be paid by each party or the percentage or other formula agreed upon to determine the post-secondary education expense obligation agreed to by the parties): Select one of the following: Both parties agree that this post-secondary educational expense agreement IS modifiable based on a substantial change in circumstances that was not foreseeable when the agreement was signed. Both parties agree that this post-secondary education expense agreement is NOT modifiable and the specific dollar amount to be contributed by either or both parents is set forth above. Note: Before any court hearing to modify or enforce the agreement described above, the parties shall participate in mediation. 5. Guardian ad Litem Fees N/A See Order on Appointment of Guardian ad Litem Other: 6. Alimony N/A See attached Uniform Alimony Order. American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION NHJB-2071-F (05/01/2019) Page 3 of 7 7. Health Insurance for Spouse N/A The continuation of employer-sponsored group medical health insurance benefits on behalf of shall be governed by RSA 415:18. VII-b, COBRA, or other applicable law. The following additional provisions, if any, apply: shall maintain health insurance for the benefit of . This obligation shall terminate: shall maintain dental insurance for the benefit of . This obligation shall terminate: shall be responsible for payment of the premiums. This obligation shall terminate: Each party shall be responsible for his/her own medical and dental insurance and for paying all of his/her own unreimbursed medical, dental, optical, and other expenses not otherwise covered by insurance. 8. Life Insurance N/A Each party is awarded any and all life insurance policies owned by that party, free and clear of any right, title, or interest of the other. shall maintain a life insurance policy in the minimum amount of $ designating as trustee for the benefit of the child(ren). This obligation shall continue as long as the insured is obligated to pay support. Other: 9. Motor Vehicles N/A Each party is awarded the vehicles in his/her name or possession, free of any right, title or interest of the other. is awarded the free and clear of any interest of is awarded the free and clear of any interest of Each party shall be responsible for all expenses as to his/her vehicles, including car payments, maintenance, registration and insurance. American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION NHJB-2071-F (05/01/2019) Page 4 of 7 10. Furniture and Other Personal Property N/A The parties have already fairly divided between themselves their household furniture, furnishings and all other tangible property (other than as specifically set forth below), and each party is awarded that property currently in his/her possession, free and clear of any interest of the other. Petitioner is awarded the following specific items of personal property: Respondent is awarded the following specific items of personal property: 11. Retirement Plans and Other Tax-Deferred Assets N/A Each party is awarded any interest in any pension, retirement, 401(k), IRA, or other retirement account that s/he may have and as shown on his/her respective financial affidavits free and clear of any interest of the other. is awarded one-half of 221s IRA and/or 401(k) as of the date of this decree. is awarded one-half of 221s pension plan which accrued between the date of the marriage or civil union and the date of the filing of the petition for divorce, legal separation, or dissolution pursuant to the Hodgins formula. Subject to the above distribution, is awarded all other right, title, and interest in his/her pension plan, free of any further interest of A Qualified Domestic Relations Order (QDRO) shall be prepared by within a reasonable period of time from the date of this decree and filed with the Court for approval. Other: 12. Other Financial Assets N/A The parties are awarded their respective checking and/or savings bank accounts, credit union accounts, certificates of deposits and the like, and all similar accounts as shown on their individual financial affidavits filed with the court. Petitioner is awarded the following bank accounts, stocks, bonds, mutual funds or other intangible personal property: Respondent is awarded the following bank accounts, stocks, bonds, mutual funds or other intangible personal property: American LegalNet, Inc. www.FormsWorkFlow.com Case Name: Case Number: FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION NHJB-2071-F (05/01/2019) Page 5 of 7 Other: 13. Business Interests of the Parties N/A is