Divorce Worksheet. Provided by Divorcesource.com. Example

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1 Divorce Worksheet Provided by Divorcesource.com Terms and Conditions of Use: The Divorce Worksheet and Separation Agreement is offered for free with the understanding that neither the author, publisher or seller or any entity involved in the preparation is engaging in rendering legal advice. If legal advice is needed or if you do not feel 100% comfortable in understanding the enclosed documents, you and/or your spouse should obtain the services of a lawyer in your area. You must realize that by completing and using the documents supplied in this software package you are acting on your own behalf. Divorce Source, Inc. disclaims all responsibility for the legal effects or consequences of any document completed or action taken in reliance upon information contained in this divorce software and documents. Purchasers and persons intending to use this divorce software for the preparation and filing of any legal documents are advised to check specifically on the current applicable laws in any jurisdiction in which they intend the documents to be effective. Introduction: This document contains all of the criteria (data) the system collected through the question and answer interface. This is also the same information used in the Separation Agreement. We suggest that you review this document and the Separation Agreement for accuracy. Using the Worksheet: 1. This worksheet is ideal for presentation to your spouse during the negotiation process. It acts as a "memorandum of understanding" regarding what you have or have not agreed upon regarding your separation and/or divorce. 2. This worksheet can also be provided to your attorney, so he or she has the relevant information and your expressed desires. Delivering this information in an organized fashion will often save in legal fees and provide much of what your lawyer will need to initiate and complete your divorce case. 3. Also keep in mind that you can easily upgrade your account to get ALL your divorce documents ready for signing and filing. Our upgrading feature inside your account delivers your divorce documents on the fly along with your step-by-step filing procedures. This is an ideal solution if you want to do your own divorce. Changing Your Answers: Changing your answer to a question is very easy. Simply locate your question in the "Question History" pull down menu and click the "Back" button to the right of the menu. This will take you to that specific question at which point you can change your answer and click the "Save Answer" button. Please keep in mind that changing answers to certain questions may prompt you to answer additional questions. These additional questions would follow in sequence should it be required. There is also a "editable version" of the Separation Agreement provided, which can be downloaded to your computer and opened in MSword for easy changes and additions. Using the "editable version" will provide the maximum control over the contents of your separation agreement, but please be advised that you may need to format the document to your liking.

2 Divorce Worksheet (Jane W. Smith and John B. Smith) Provided by Divorcesource.com State Information: Petitioner: Jane W. Smith Respondent: John B. Smith Filing Spouse: Jane W. Smith County/Parish: Orange Protective Order(s): No Grounds (reason for separating): Irreconcilable differences which have caused the irremediable breakdown of the marriage. Wife s Information: Name: Jane W. Smith Birth Name: Jane W. Miller Name Change: Yes New Name: Jane W. Miller Military Status: No Social Security #: XXX-XX-1234 Wife Race: White (Not Hispanic) Date of Birth: July 20, 1972 Birth State: California Age: 40 Driver s License # (or state ID#): CA Driver s License State: California Current Resident of California: Yes California Resident Since: March 5, 1988 Physical Address: 123 West Main Street, Anaheim California County: Orange Mailing Address: 123 West Main Street, Anaheim California Phone: jane@ .com Employment Status: Yes Employer: ABC Software Inc. Occupation: Web Designer Employer Address: One Software Way, Anaheim California Employer Phone: Monthly Gross Income: $6, Monthly Net Income: $5, Health Insurance Status: Yes Health Insurance Provider: Blue Cross Health Insurance Account Number: BC Husband s Information:

3 Name: John B. Smith Military Status: No Social Security #: XXX-XX-4321 Husband Race: White (Not Hispanic) Date of Birth: May 12, 1971 Birth State: California Age: 41 Driver s License # (or state ID#): CA Driver s License State: California Current Resident of California: Yes California Resident Since: March 10, 1999 Physical Address: 123 West Main Street, Anaheim California County: Orange Mailing Address: 123 West Main Street, Anaheim California Phone: john@ .com Employment Status: Yes Employer: Acme Meat Packaging Co. Occupation: Factory Production Manager Employer Address: One Fast Food Way, Anaheim California Employer Phone: Monthly Gross Income: $6, Monthly Net Income: $5, Health Insurance Status: Yes Health Insurance Provider: Highmark Health Insurance Account Number: HM Child(ren) s Information: The wife is currently NOT pregnant. There is one (1) child subject to this child custody proceeding. The name, social security number, sex, age, birth date, are as follows: Child #1 Full Name: William R. Smith Age: 5 Birth Date: March 6, 2007 Birth Place: Anaheim, California Sex: Male SS#: XXX-XX-3333 Current Address: 123 West Main Street, Anaheim, California, Length of Residence: 60 Currently Resides With:Jane Smith - Mother Previous Address #1:,,, Dates of Residence: Resided With: Previous Address #2:,,, Dates of Residence: Resided With:

4 Marriage Information: The parties were married on May 8, 2003 in the city of San Francisco, in the state of California, and separated on or about, September 18, 2011 Religious Cermony: Yes Last Marital Residence: 123 West Main Street, Anaheim California Property & Debt Information: Property Value: Above $50, Wife s Marital Property: 2007 Black Mazda GL (VIN# ) Brown Leather Couch and Love Seat Dell Desktop Computer Sony 37 inch Plasma TV Wife s Separate Property: Charles Schwab Money Market Account # Wife s Marital Debt: Bank of America Credit Card Account: (outstanding balance: $2,897.00) Wife s Separate Debt: ASFA Student Loan - Account: Husband s Marital Property: 2009 White BMW 3301 (VIN# ) LG 52 Inch LCD TV Dining Room Table and 6 Chairs John Deere Riding Mower 52 Gallon Fish tank With Pump Husband s Separate Property: Charles Schwab Money Market Account # Husband s Marital Debt: TD Bank Credit Card Account: (outstanding balance: $6,493.00) Husband s Separate Debt: CITI Student Loan - Account: Property Possession Status: Yes Possession Since: March 6, 2011 Marital Home: There is a marital home of this marriage located at: 123 West Main Street, Anaheim, California 92807, with a legal description of: Third house on west side of Washington Street facing east on the 2400 block of phase (3) three of Shady Trees Housing Development.

5 The parties have agreed that this real estate will not be sold and each party will remain as co-owners. Any future sale of this real estate will not take place unless both parties agree. The parties agree that the Wife and Husband both will reside in the above mentioned real estate and the expenses be disbursed as follows: Husband shall be responsible for paying 50% of the monthly mortgage payment of said real estate. Wife shall be responsible for paying 50% of the monthly mortgage payment of said real estate. The parties agree that the Husband will be responsible for sending the mortgage payment(s) to the approriate financial institution on timely basis. All penalties will be paid by the party delinquent on payment. The parties agree the Husband will be responsible for paying 50% and the Wife will be responsible for paying 50% of the monthly expenses which include, but are not limited to; real estate taxes, school taxes, routine maintenance, repairs, and insurance. The parties agree that the Husband will be responsible for sending the real estate tax payment(s), insurance payment(s), and routine monthly expenses to the appropriate agencies by the designated due date. All penalties will be paid by the party delinquent on payment. In the event either party defaults in the payment of the mortgage, the party not in default shall have the right to make payments and on delivery of an executed paid receipt by the mortgagee, the default party will be responsible for reimbursment of the default amount. Small Business: There is NO small business to be addressed. Retirement Accounts: The parties each waive all claims, present and future to pension benefits, retirement funds, 401k s, profit sharing plans and accounts of the like. Spousal Support/Alimony: The Husband shall pay to Wife for rehabilitative spousal maintenance, the sum of $ per month payable in advance on the first (1st) day of each month commencing on September 18, 2012 and continuing thereafter until the earliest of the following events (i) death of either party, (ii) remarriage of, (iii) the cohabitation by the Wife with a person of the opposite sex in a relationship similar to a husband-wife relationship for 90 continuous or noncontinuous days in a 12 month period, (iiii) a duration of 6 Months has pasted since the first payment was made. Due to the short length of the alimony/spousal support payment term and the amount of which is to be paid that having the Husband take out a term life insurance policy with the Wife as the sole beneficiary, in order to help secure the Wife s financial future should the Husband pre-decease the last alimony/spousal support payment, would NOT be necessary.

6 Future Modification of Order: Yes Spousal Health/Medical Insurance: Each party will be responsible for his and her own health and medical insurance coverage. Custody and Visitation: Physical Custody: Wife Legal Custody: Joint/Shared Visitation Schedule: Reference the Standard Schedule for Visitation/Possession Parenting Plan: No Child Support: Support Payor (obligor): Husband Support Payee (obligee): Wife Support Amount: $ per month. Secondary School Obligations: No Child Care: No Health/Medical Insurance: Husband ($$200.00/Month) Life Insurance Amount: $$100, Child Support Worksheet: Yes Filing as Dependent(s): Husband Income Tax Returns: Filing Status (this year): Separately Professional Fees: The parties have not acquired any professional service fees which they desire to be recognized, mentioned, or distributed. SPECIAL NOTES:

Superior Court of California, County of Orange. John B. Smith ) Case Number: Example. Separation Agreement

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