Affidavit Of Plaintiff - Supreme Court Of The State Of New York (Page 6 of 9) in pdf

judgment.

continued

Living Separate and Apart Pursuant to a Separation Agreement (DRL §170(6)):

 (a)

That the Plaintiff and Defendant entered into a written agreement of separation, which they

subscribed and acknowledged on

, in the form required to entitle a deed to

be recorded; and

(b)

that the agreement /

memorandum of said agreement was filed on

the Office of the Clerk of the County of

, wherein Plaintiff / Defendant

resided; and

(c)

that the parties have lived separate and apart for a period of one year or longer after the execution

of said agreement; and

(d)

that the Plaintiff has substantially complied with all terms and conditions of such agreement.

Irretrievable Breakdown in Relationship for at Least Six Months (DRL §170(7)):

 That the relationship between Plaintiff and Defendant has broken down irretrievably for a period of at least six

months.

6a.

In addition to the dissolution of the marriage, I am seeking the following ancillary relief:

The nature of any ancillary or additional relief requested (see p.19 of Instructions) is:

______________________________________________________________________________________

________________________________________________________________

 Additional page describing ancillary relief requested is attached

;

 Marital property to be distributed pursuant to separation agreement/stipulation;

 I waive distribution of Marital property;

 NONE- I am not requesting any ancillary relief;

AND any other relief the court deems fit and proper

6b.

If DRL §170 subd. (7) is the ground alleged, then Plaintiff hereby affirms, by checking the Box A, B, or C

or D below (NOTE: BOX A, B, C or D below must be checked if DRL 170(7) is the ground alleged),

that the following statement is true:

All economic issues of equitable distribution of marital property, the payment or waiver of spousal support,

the payment of child support, the payment of counsel and experts' fees and expenses as well as the custody

and visitation with the minor children of the marriage:

 A. have been resolved by the parties and are to be incorporated into the Judgment of Divorce.

 by oral settlement/ stipulation on the record; or

 by written Settlement/ Separation Agreement

 B. will be determined by the Court and are to be Incorporated into the Judgment of Divorce.

 C. were determined by Family Court order (custody and visitation or child support and/ or spousal

support issues only) which will be continued.

 D. are not to be incorporated into the Judgment of Divorce, since neither party to the divorce has

contested any such issues.

(Form UD-6 Rev. 1/13)

Affidavit Of Plaintiff - Supreme Court Of The State Of New York Page 6

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