CIVIL UNION DIVORCE DECREE Without Minor and/or Dependent Child(ren)

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This document is prepared by: D Attorney for D Plaintiff D Defendant (Full Name) v. PLAINTIFF Name Address City, State, Zip Code (Full Name) DEFENDANT Telephone Numbers Print Presiding Judge s Name Date of Hearing/Review by Judge A hearing was held before the Presiding Judge or an affidavit was submitted and the Court waived hearing on this matter. After full consideration of the evidence, the Court finds the material allegations of the Complaint for Civil Union Divorce to be true. Plaintiff is entitled to a divorce from the bonds of civil union. The Court has jurisdiction to enter this Civil Union Divorce Decree. IT IS HEREBY ORDERED, ADJUDGED, AND DECREED that: 1. Decree A decree of divorce D Plaintiff D Defendant. The bonds of civil union between the Plaintiff and Defendant are hereby dissolved. The parties are restored to the status of single persons. Either party is permitted to enter a civil union or marry after the effective date of this Civil Union Divorce Decree. 2. Effective Date This Civil Union Divorce Decree is effective after it is signed and filed by the Court. COURT USE ONLY FC Adm 4/12/18 Page 1 of 6 Pages (without children) RG-AC-508 (5/18) 1F-P-2037 In accordance with the Americans with Disability Act, as amended, and other applicable state and federal laws, if you require accommodation for a disability, please contact the ADA Coordinator at the First Circuit Family Court office by telephone at 954-8200, fax 954-8308, or via email at adarquest@courts.hawaii.gov at least ten (10) working days prior to your hearing or appointment date. Please call the Family Court Service Center at 954-8290 if you have any questions about forms or procedures.

3. Alimony D 3A. Neither party shall be required to pay alimony to the other party. D 3B. Beginning with a first payment on the day of (Month/Year) D Plaintiff D Defendant shall pay D Plaintiff D Defendant alimony of $ per month to be paid: D in one amount of $ by the day of each month. D in two equal installments of $ by the and days of each month. Alimony shall continue for months and terminate with the payment due. (Month/Day/Year) Alimony shall terminate upon the death of either Plaintiff or Defendant. Alimony D shall D shall not terminate upon the recipient entering a new civil union or marriage. 4. Bank Savings, Checking, Credit Union Accounts and Securities (Stocks, Bonds, Mutual Funds, etc.) D 4A. There are none. D 4B. Each is awarded those titled in their name alone. D 4C. Plaintiff is awarded: D 4D. Defendant is awarded: 5. Vehicles (Autos, Trucks, Motorcycles, Trailers, Campers, Boats, etc.) D 5A. There are none. D 5B. Each party is awarded the vehicles titled in their name alone. D 5C. Plaintiff is awarded: D 5D. Defendant is awarded: D 5E. Necessary transfer documents shall be signed no later than ten (10) days following the filing of this Civil Union Divorce Decree. If either party fails to do so, the Director of Finance of the City and County of Honolulu is authorized and directed to transfer the ownership of the vehicle(s) if requested to do so. FC Adm 4/12/18 Page 2 of 6 Pages (without children)

6. Real Property D 6A. Neither party owns any interest of any kind in any real property. D 6B. The real property shall be divided as follows: 7. Life Insurance D 7A. There are none. D 7B. Each party is awarded the life insurance policy/policies now held on his/her life, together with any cash value therein and subject to any debt thereon. D 7C. The life insurance shall be divided as follows: 8. Retirement Accounts/Benefits: D 8A. There are none. D 8B. Each party shall keep their own. D 8C. The retirement accounts/benefits of the parties shall be divided as follows: FC Adm 4/12/18 Page 3 of 6 Pages (without children)

9. All Other Assets (Personal Belongings, Furniture, Household Effects, Art, Stamps, Coins, Tools, Equipment, Jewelry, Accounts Receivable, Investment Assets, Business Assets, Cemetery Plots or Niches, Tax Refunds Due, etc.) D 9A. There are no other assets. D 9B. Each party is awarded the personal belongings and the household effects in his/her possession. D 9C. Plaintiff is awarded: D 9D. Defendant is awarded: 10. All Outstanding Debts D 10A. There are no joint debts D 10B. Each party shall pay all of the credit card and other debt, if any, now in his/her name alone. D 10C. Plaintiff shall pay: D 10D. Defendant shall pay: FC Adm 4/12/18 Page 4 of 6 Pages (without children)

11. Name Change D 11A. Plaintiff shall resume the use of his/her D middle and last name used prior to the marriage D middle and last name used prior to the civil union and shall be known hereafter as: (First, Middle, and Last Name) D 11B. Defendant shall resume the use of his/her D middle and last name used prior to the marriage D middle and last name used prior to the civil union and shall be known hereafter as: (First, Middle, and Last Name) D 12. D 13. There is a supplemental order filed concurrently with this Civil Union Divorce Decree. Other: FC Adm 4/12/18 Page 5 of 6 Pages (without children)

D 14. Failure of Party to Perform: If either party fails to execute any document in compliance with this Decree, the other party may submit a motion to the Court, requesting that the Court appoint the Chief Clerk of the Court to execute said document on behalf of the non-compliant party. Said motion may be done without further notice to the non-compliant party. Such execution by the Chief Clerk shall have the same effect as if executed by the non-compliant party. Date Judge s Signature Kapolei, Hawai i Print Judge s Name: APPROVED AS TO FORM AND CONTENT: Signature of Plaintiff Signature of Defendant Date Plaintiff Signed Decree: Date Defendant Signed Decree: Social Security No.: -- Social Security No.: -- Address: Address: Employer s Name and Address: Employer s Name and Address: APPROVED AS TO FORM: Signature of Attorney for Plaintiff Print Attorney s Name: Signature of Attorney for Defendant Print Attorney s Name: FC Adm 4/12/18 Page 6 of 6 Pages (without children)