STATE OF [Your State], COUNTY OF [Your County]

Introduction

I, [Your Name], currently residing at [Your Address], hereby depose and state as follows:

Statement of Facts

1. I am over the age of 18 and competent to make this affidavit.

2. I am one of the parties involved in the marriage between myself and [Spouse's Name], hereinafter referred to as "my spouse," which began on [Date of Marriage].

3. My spouse and I have mutually agreed to separate and have been living apart since [Date of Separation].

4. The reason for our separation is irreconcilable differences, which have led to the breakdown of our marital relationship.

5. During our separation, we have agreed upon the following arrangements:

• Living Arrangements: Since our separation, I have been residing at [Your Address], and my spouse has been residing at [Spouse's Address].

• Property Division: We have agreed to divide our assets as follows:

Home: [Spouse's Name] keeps the house at [Spouse's Address], while the other relinquishes any ownership claim. The party keeping the house is responsible for any associated mortgage or loans.

Vehicles: Each spouse keeps one vehicle:

• [Vehicle 1 Make, Model, Year] goes to [Your Name].

• [Vehicle 2 Make, Model, Year] goes to [Spouse's Name]. Any related loans or liabilities are the responsibility of the respective owner.

Bank Accounts: Joint accounts at [Bank Name] are split equally upon closure.

Retirement Accounts: Each spouse keeps their respective retirement accounts.

Personal Property: Household items are divided fairly between the parties, resolving any disputes amicably or through mediation if needed.

• Financial Arrangements: We have agreed that each party will be responsible for their individual debts incurred during the separation period. Additionally, we have agreed to maintain separate bank accounts and have divided joint savings and checking accounts as per mutual agreement.

• Child Custody and Support: We have agreed to joint legal custody of our children, [Child's Name(s)], with primary physical custody granted to [Spouse's Name]. Visitation rights have been established for the non-custodial parent. Furthermore, we have agreed upon child support payments in the amount of [Amount] per month, to be paid by [Your Name] to [Spouse's Name], beginning on [Date].

• Other Agreements: We have agreed to maintain communication regarding significant decisions concerning our children's education, healthcare, and general welfare. Additionally, we have agreed to consult with a mediator should any disputes arise during the separation period.

6. Both parties have voluntarily entered into this separation agreement without coercion, duress, or undue influence.

7. I understand that this affidavit is a legal document and may be used as evidence in any legal proceedings related to our separation.

I declare under penalty of perjury under the laws of [Your State] that the foregoing is true and correct.

[Your Name]

[Date]

Sworn to and subscribed before me on this [Date] by [Your Name], who is personally known to me or who has provided [Identification Type and Number] as identification.

Notary Public for [Your State]

My Commission Expires: [Date]

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