SEPARATION AGREEMENT

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SEPARATION AGREEMENT This agreement made and entered into this day of, 20, by and between here after referred to as Plaintiff or Petitioner-1, and here after referred to as Defendant or Petitioner-2, both of whom say the following: That they were married at, on, ; and, there are no minor children born as issue of the marriage and none are expected at this time, WHEREAS, unfortunate differences have arisen between the parties, and they both desire to completely settle all matters between them arising out of their marriage including: The past, present and future support of each other; The right to any and all property each may have by virtue of their marriage; and All other benefits and privileges conferred, and all obligations imposed on each by virtue of their marriage relation, or otherwise accruing to either. THEREFORE, in consideration of the mutual promises of the parties, and other good and valuable consideration from each to the other passing, it is hereby agreed to by and between the parties as follows: 1. SEPARATION. The parties shall at all times hereafter live separate and apart, and each shall be free from interference, authority or control, direct or indirect, of the other, as fully as if he or she were unmarried. Each may reside at such place or places as he or she may select. 2. FULL DISCLOSURE. Each party represents that he or she has made full and complete disclosure of all assets and debts, accounts receivable and payable, earnings and benefits from employment, or the like, to the other and neither has concealed any such fact from the other. 3. COMMON DEBTS. The Plaintiff/Petitioner-1 shall pay, indemnify, and hold the Defendant/Petitioner-2 harmless from the following debts of the marriage: CREDITOR AMOUNT OWED The Defendant/Petitioner-2 shall pay, indemnify and hold the Plaintiff/Petitioner-1 harmless from the following debts of the marriage: CREDITOR AMOUNT OWED Separation Agreement 1

And as otherwise provided in this Agreement. All future debts or liabilities of the parties shall be the responsibility of the party incurring the debts or liabilities unless the responsibility has been otherwise fixed by this Agreement. 4. NON-USE OF OTHER S CREDIT. Neither Plaintiff/Petitioner-1 nor Defendant/Petitioner- 2 shall, from the date of signing this Agreement, incur any debts or obligations upon the credit of the other. Each shall indemnify and hold the other harmless of any debt or obligation he or she has caused upon the credit of the other. 5. MOTOR VEHICLES. The following motor vehicles owned by the parties shall be divided as follows: The Plaintiff/Petitioner-1 shall take as his or her own property, free and clear of any claim of Defendant/Petitioner-2 and be solely responsible for any loan or encumbrance thereon, the (year, make, model), presently titled to (owner s) name. The Defendant/Petitioner-2 shall take as his or her own property, free and clear of any claim of the Plaintiff/Petitioner-1 and be solely responsible for any loan or lien thereon, the (year, make, model), presently titled to (owner s) name. The parties shall accordingly execute title transfer documents, if before the final hearing on this matter or as agreed. necessary, 6. REAL ESTATE. (Choose A or B or C) A. There is no real property owned by the parties. B. The Marital home is located at: and shall be retained by the (Plaintiff/Petitioner-1 or Defendant/Petitioner-2), free from any claims by the (other party) who shall execute and deliver a quitclaim deed to the effect. The (Plaintiff/Petitioner-1 or Defendant/Petitioner-2), who retains the marital home, shall pay any mortgages or indebtedness related to the marital home and shall hold the (other party) harmless thereupon. The party retaining the home shall refinance the mortgage to remove the other party s name and liability on or before C. The marital home shall be listed for sale at an agreed upon price and the parties will divide the net proceeds as follows: Separation Agreement 2

7. PENSIONS AND OTHER INTANGIBLE ASSETS. (Choose A or B or C) A. There are no pensions, retirement accounts, credit union accounts, profit sharing accounts, mutual funds, or any other similar equity accounts owned by either party. B. Each party will retain as his or her own any intangible asset titled in his or her own name, including but not limited to: pension and/or retirement accounts, credit union accounts, profit sharing accounts, mutual funds, or any other similar equity accounts, free and clear of any claims of the other. C. Retirement funds shall be divided as follows by the parties: 8. PERSONAL PROPERTY AND HOUSEHOLD GOODS. (Chose A or B) A. The parties agree that the personal property and household goods of the parties has already been divided and shall be held by the party in whose possession it is currently retained, free from claim by the other. B. Property listed below to be divided upon: (chose 1 or 2) 1) The date this Agreement is signed 2) On (date) As Follows: Plaintiff/Petitioner-1 takes the following: Separation Agreement 3

Defendant/Petitioner-2 takes the following: 9. BANK ACCOUNTS. (Choose A or B or C) A. The parties have no joint bank accounts. B. The parties agree that the bank account(s) of the parties has(have) already been divided and shall be held by the party in whose name it is currently held, free from any claim by the other. C. The accounts listed below will be divided upon (choose No. 1 or No. 2): 1) the date this agreement is signed; 2) on (date): as follows: Present Owner Name of Bank Present Value Will Go To 10. TAX RETURN. Petitioner-1/Petitioner-2/Both parties (cross out appropriate words) acknowledge that he/she/each of them (cross out appropriate words) has filed an income tax return for the year 20, and agree that any tax refunds or amounts owing will be the sole property or responsibility of the party who filed the return. 11. SPOUSAL SUPPORT. (choose A or B of each of the following two sections). Section 1 A. The parties each hereby waive any entitlement to or award of spousal support from the other. B. Beginning on, the (Plaintiff/Petitioner-1 or Defendant/Petitioner-2) shall pay to (Plaintiff/Petitioner-1 or Defendant/Petitioner-2), $ per month for a period of (months or years) or until the death of either party, remarriage of the recipient, or cohabitation with another adult person, whichever comes first, of the recipient, as and for spousal support. Separation Agreement 4

Section 2 A. The Court shall retain jurisdiction over the issue of spousal support. (This means that this agreement regarding spousal support could be brought back to court for a new agreement or a modification by the court in the future). B. The Court shall not retain jurisdiction over the issue of spousal support. (This means that this agreement regarding spousal support can never be brought back to court to establish or modify support). 12. LIFE INSURANCE. The (Plaintiff/Petitioner-1 and/or Defendant/Petitioner-2) shall maintain in effect any life insurance policy available through his and/or her employment, naming the other party as the sole beneficiary of any such policy until such time as his and/or her spousal support obligations terminate as enumerated above. 13. APPLICABLE LAW. All provisions of this Agreement shall be construed and enforced pursuant to the laws of the state of Ohio. 14. PARTIES BOUND. So long as any provision of this Separation Agreement is in effect, the provisions hereof shall be binding upon the heirs, executors, administrators, devisees, successors in interest, and fiduciaries of each party, and such persons are hereby authorized and directed to do all things necessary to comply with and effect the intent and purposes of this Agreement. 15. EFFECTIVE DATE. The Separation Agreement shall be binding as of the date that is has been signed by both Plaintiff/Petitioner-1 and Defendant/Petitioner-2. 16. MUTUAL RELEASE. Except as herein provided, each party does hereby release and discharge completely and forever the other from an y and all past, present and future rights to a division of property, and right of dower, any right to act as administrator or executor in the estate of the other, any right of distributive share in the estate, any right of exemption in the estate of the other, or any other property rights, benefits or privileges accruing to either party because of the marriage relationship or otherwise, whether the same are conferred by statutory law, or the common law of Ohio or of any other state of the United States. It is the understanding between the parties that this Agreement, except as otherwise provided herein, forever and completely adjusts, settles, disposes of and terminates any and all rights, claims, privileges and benefits that each now has or may have reason to believe each has against the other arising out of said marriage relationship or otherwise, and whether the same are conferred by the laws of the state of Ohio or any other state of the United States, which now or which may hereafter be in force and effect. 17. FULL UNDERSTANDING. Each party fully understand all of the terms of the Agreement and agrees that the terms represent the entire understanding between them; that each party has read this Agreement and understand it; and each party does hereby voluntarily sign this Agreement in the presence of the witnesses indicated below. Separation Agreement 5

18. MODIFICATION OF THIS AGREEMENT. This Agreement shall not be changed or modified, except by a written agreement, which is signed by both parties or by an order from a court of proper jurisdiction. 19. INCORPORATION INTO DIVORCE, DISSOLUTION OR LEGAL SEPARATION. If either Plaintiff/Petitioner-1 or Defendant/Petitioner-2 should begin an action for Divorce, Dissolution of Marriage, or for Legal Separation, in this state or elsewhere, this Agreement shall be disclosed and presented to the Court in such proceedings, with the request that if it be adjudicated to be fair, just and proper, that this Agreement and all its terms and provisions shall be adopted by this Court and made a final order of this court and incorporated into a final decree. 20. OTHER (YOU MAY ATTACH ADDITIONAL PAGES AS NEEDED) Signed this day of, 20. PLAINTIFF/PETITIONER-1 DEFENDANT/PETITIONER-2 Separation Agreement 6