AGREEMENT TO TERMINATE COHABITATION

______________________________________, referred to as First Cohabitant and

________________________________, referred to as Second Cohabitant, agree:

The parties have resided together without establishing a statutory marriage relationship since
_________________(Date).

The parties have children who are listed as follows:

Child's Name and Date of Birth

_____________________________________________________

Child's Name and Date of Birth

_____________________________________________________

No further children are contemplated.

The parties shall henceforth live separately and without interference from one another.

The parties waive any legal, equitable, or statutory rights which are not set forth herein.

Other than those rights and obligations which are set forth herein, the parties mutually release one
another from any and all claims, demands, contracts, statutory rights, or other obligations.

The parties waive any and all rights to participate or share in the estate of one another. Each party waives
the right to act as the executor of the will or probate estate of the other party to this agreement. This
waiver shall not apply as to any obligations set forth in this agreement, and either party may present a
claim as a creditor or party in interest in the other's estate to the extent that those rights arise and are
derived from this agreement.

The parties have incurred the following joint debts:

_____________________________________________________

_____________________________________________________

_____________________________________________________

_____________________________________________________.

First Cohabitant shall be solely responsible for the following debts:

_____________________________________________________

_____________________________________________________

_____________________________________________________.
Second Cohabitant shall be solely responsible for the following debts:

_____________________________________________________

_____________________________________________________

_____________________________________________________.

As to debts which either party undertakes sole responsibility, said party shall indemnify and hold the other
party harmless from any and all claims related to such debt.

The following disposition is made of the joint debts of the parties:

_____________________________________________________

_____________________________________________________

_____________________________________________________.

Each party shall duly and promptly discharge his or her respective portion of each debt stated above.

Each party shall be liable in contribution to the other for any amounts paid under compulsion which are in
excess of the agreed shares stated above.

The following property is the separate property of First Cohabitant, and Second Cohabitant waives any
and all claims to such property:

_____________________________________________________.

First Cohabitant shall pay and hold Second Cohabitant harmless from any liabilities or claims related to
the separate property above.

The following property is the separate property of Second Cohabitant, and First Cohabitant waives any
and all claims to such property:

_____________________________________________________.

Second Cohabitant shall pay and hold First Cohabitant harmless from any liabilities or claims related to
the separate property above.

The following property is the joint property of the parties:

_____________________________________________________.

The following disposition shall be made of the jointly-held property:

_____________________________________________________.

The parties warrant to one another that all jointly-held property has been disclosed.
First Cohabitant and Second Cohabitant shall have joint custody of the children of this relationship. Any
major decision regarding the welfare of the children shall be made by consensus.

Support for the children shall be paid as follows:

_____________________________________________________.

The day to day custody and visitation of the children shall be decided upon by consensus of the parties.

The parties recognize that the Courts shall have the right to modify these arrangements upon appropriate
petitions.

The parties shall take income tax exemptions for the children as follows:

_____________________________________________________.

The parties agree that in the event either party deems there is a breach of this agreement, or that the
parties cannot agree upon any issue which shall be decided by consensus, they shall first mediate the
dispute before a certified family law mediator. Such mediation shall not be required in the event of an
emergency in which an adjudication is required urgently, provided that either party may object at any
court proceeding to the emergency nature of the dispute.

The parties herein are making a disposition of jointly-held property between co-owners and that the
transactions herein are not sales for the purpose of income tax. The parties agree that the basis for tax
purposes of the items is not changed by these transactions.

This agreement contains the entire agreement between the parties, and this agreement may only be altered
in writing executed by the parties hereto.

Each party has had a full opportunity to consult with independent counsel regarding this agreement.

This agreement was jointly drafted by the parties.

In the event of any litigation as a result of this agreement, the prevailing party shall be entitled to an
award of reasonable counsel fees, including appeal and post-judgment services.

This agreement shall be construed under the laws of the State of .

In the event of any reconciliation of the parties, this agreement shall remain in full force and effect unless
canceled or amended in writing.

__________________________________ ______________________
_ _
Signature of First Cohabitant Date

__________________________________ ______________________
_ _
Signature of Second Cohabitant Date