1. It is hereby agreed that _________________ and _________________, who have been domestic partners living together at [specify address and type of premises, apartment or house], shall separate and go their own ways. At this time neither party has the intention of resuming their former domestic partnership arrangement.
2. It is also agreed that each party shall retain complete and total control over his/her separate property, including any furnishings or furniture, that each brought into the relationship. A list of each party’s separate property is attached hereto as Exhibit A.
3. It is further agreed that the items listed in Exhibit B were purchased and are owned jointly by the parties. The parties divided these items in a fair and equitable manner. Each party is entitled to complete and total control over the items listed under their respective names in Exhibit B.
4. The parties agree to dispose of any and all joint debts and other joint obligations in the following manner: [specify each creditor, amount owed, who will pay obligation, indemnification clause].
5. The parties also agree [that both of them are leaving the shared premises] or [that __________________________________ is leaving the shared premises and _____________________________ will remain in the shared premises]. The one staying shall assume all responsibility for said premises from this date forward, except for any common debts incurred by the parties during their relationship. ____________ will take whatever action is required to [remove ______________’s name from the lease] or [refinance the mortgage].
6. The party who is leaving agrees not to reenter the premises without the remaining party’s permission, nor will he/she remove any items from the premises without the other party’s knowledge.
7. [Specify how jointly owned real estate is to be valued, listed, and sold].
8. Neither party shall have any claim against the other party’s business interests, pension or retirement funds, insurance proceeds, rights of inheritance, or any other property not specifically described in this Agreement.
9. Neither party shall have a claim to compensation from the other for services rendered during the time they lived together, for financial support of any kind, or for any other property, assets, or money not described in this Agreement.
10. The parties agree to resolve any dispute arising from this agreement through mediation. The mediator shall be an objective third party who is mutually agreed upon. The mediator’s role shall be to help the parties dissolve their relationship and resolve any differences concerning a division of jointly held property or other issues in a mature and unemotional manner. The parties agree to enter into mediation in good faith. [Parties agree to engage attorneys practicing collaborative law in order to resolve the issues involved in the termination of their relationship. Both parties understand that the collaborative process is engaged in with the specific intent to avoid litigation.]
11. In the event that the parties’ attempt at good-faith mediation is unsuccessful to resolve all issues in dispute, either party may seek to resolve the issues through arbitration through the use of the following protocol:
a. Deliver a written demand for arbitration to the other person and name one arbitrator;
b. The other party shall respond with the name of a second arbitrator within five days from receipt of the notice;
c. The two named arbitrators shall select and name a third arbitrator;
d. The arbitration meeting will take place within seven days following the selection of the third arbitrator;
e. Each party is entitled to retain legal counsel at his/her own expense;
f. Each party may present witnesses and evidence at the arbitration hearing;
g. The arbitrators shall issue their decision within five days after the hearing. Their decision shall set forth their findings and conclusion and shall be in writing. The decision shall be binding upon each party. The parties agree that neither one shall seek relief from the arbitration decision in court.
h. If the person to whom an arbitration demand is made fails to respond within five days, the other party may give an additional five days’ written notice of his/her intent to proceed. If there is still no response, the person initiating the arbitration may proceed with the arbitration before an arbitrator he/she has designated. Any award shall have the same force and effect as if all three arbitrators had settled it.
12. Each party states that he/she entered into this Agreement freely and voluntarily, without fraud, duress, threats, or coercion.
The parties, by signing below, indicate their intention to participate in this Agreement and the provisions set forth herein. Signed this ___ day of ______, 20__.
State of ___________________
County of _________________
_______________________ and ________________________, the Principals, personally appeared before me and executed and acknowledged this Termination of Domestic Partnership/Living Together Arrangement before me this ____ day of _________, 20__.