Separation Agreement - Massachusetts Family Court (Page 7 of 8) in pdf

RESUMING FORMER NAME

As requested in the Complaint for Divorce, - - - - - - - - - - -seeks to resume

his/her former name,

- - - - - - - - - - - - - - - - - -

GOVERNING LAW

This Separation Agreement shall be construed and governed according to the laws of the

Commonwealth of Massachusetts.

FULL DISCLOSURE OF ASSETS AND LIABILITIES

Party A and Party B hereby represent that they have each made full disclosure to the other

party of their individual assets. Each party represents that Party A I Party B has provided the other

with a current financial statement on the form promulgated pursuant to Supplemental Probate Court

Rules, Rule 401, which discloses fully and completely all of Party A I Party B's income, expenses,

assets and liabilities. By executing this Separation Agreement, the parties represent that the terms and

provisions of this agreement are fair, just and reasonable and are not the product of fraud, coercion or

undue influence, and that each signs this agreement freely and voluntarily.

SUBMISSION OF AGREEMENT TO COURT

Party A and Party B each agree that this Separation Agreement shall be submitted to the

Worcester Division of the Probate & Family Court for a Judge's approval of the terms and entry of a

Judgment of Divorce.

The parties further agree that the terms and provisions of this Separation Agreement shall be:

(Choosefrom thefollowing)

incorporated and merged into the Judgment of Divorce Nisi of the Court.

incorporated, but not merged, into the Judgment of Divorce Nisi, and shall remain as an

independent contract between the parties.

incorporated, but not merged, into the Court's Judgment, and shall survive and remain as an

independent contract, except for the terms and provisions relating to the care, custody, support

and education of the minor child(ren), (attach Schedule A) which terms and provisions shall

merge in said Judgment.

incorporated, but not merged, into the Court's Judgment, and shall survive and remain as an

independent contract, except for the terms and provisions relating to alimony and medical

insurance (strike inapplicable term) which terms and provisions shall merge in said Judgment.

Page 7 of 8

Separation Agreement - Massachusetts Family Court Page 7