.

Divorce Separation Agreement

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

Secured
Survio
Create a survey
Division of Marital Assets
1

Annual Income

Select one answer
2

Do you own real estate individually, jointly, or in trust?

Select one answer
3

Do you have a retirement account or pension?

Select one answer
4

Do you have a life insurance policy?

Select one answer
5

Do you have any debts or liabilities?

Select one answer
Create a survey
Division of Marital Assets
6

Do you plan to keep or sell your real estate property?

Select one or more answers
7

Has personal property been divided and are you satisfied that the division is fair?

Personal property includes but is not limited to bank accounts, stocks, bonds, mutual funds, clothing, jewelry, furniture, cars, boats, and motorcycles.
8

Specific personal property items requested:

Create a survey
Division of Marital Assets
9

Do you waive all rights you may have to past and present alimony from your spouse?

Select one answer
10

Do you waive any and all rights you may have to future alimony from your spouse?

Select one answer
11

When should alimony payments be made?

Select one answer
12

When should alimony terminate?

Alimony will terminate on marriage, order of the court, or a date set by the parties, whichever comes first.
Create a survey
Division of Marital Assets
13

Who will provide your health insurance?

Select one answer
14

Will you provide your spouse's health insurance?

Select one answer
15

If there is an additional cost for health insurance, who will pay that cost?

Select one answer
16

Who will provide health insurance for your child(ren)?

Select one answer
Create a survey