Type of agreement: Co-habitation

Governing Jurisdiction:

This document will be governed by the laws of which nation? Australia Canada India Philippines United Kingdom United States

Select a State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Select a Province or Territory: Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory

Select a State / Territory: New South Wales South Australia Queensland Victoria Tasmania Western Australia Australian Capital Territory Northern Territory Norfolk Island Ashmore and Cartier Islands Christmas Islands Australian Antarctic Territory Cocos Islands Coral Sea Islands Heard Islands Jervis Bay McDonald Islands

Select a Country: England Northern Ireland Scotland Wales

Select a Region: Ilocos Region Cagayan Valley Central Luzon CALABARZON MIMAROPA Bicol Region Western Visayas Central Visayas Eastern Visayas Zamboanga Peninsula Northern Mindanao Davao Region SOCCSKSARGEN Caraga Autonomous Region in Muslim Mindanao Cordillera Administrative Region National Capital Region

Select a State or Union Territory: Andhra Pradesh Arunachal Pradesh Assam Bihar Chhattisgarh Goa Gujarat Haryana Himachal Pradesh Jammu and Kashmir Jharkhand Karnataka Kerala Madhya Pradesh Maharashtra Manipur Meghalaya Mizoram Nagaland Orissa Punjab Rajasthan Sikkim Tamil Nadu Tripura Uttar Pradesh Uttarakhand West Bengal Andaman and Nicobar Islands Chandigarh Dadra and Nagar Haveli Daman and Diu Lakshadweep National Capital Territory of Delhi Puducherry

First Partner's Information:

First Partner's Information:

First Partner's Information:

Full Name:

Address Line 1:

Address Line 2: (optional)

Second Partner's Information:

Second Partner's Information:

Second Partner's Information:

Full Name:

Address Line 1:

Address Line 2: (optional)

Financial Declaration:

The parties must exchange financial information before signing this agreement. You may use this declaration or choose a different format.

Do you wish to print out a generic financial declaration for each party with your document? Yes No

Current Property:

Do you wish to list the current property of each party? Yes, as specified below Yes, as specified in attached list No

Number of First Partner's items to describe: 0 1 2 3 4 5 6 7 8 9 10

First item:

Second item:

Third item:

Fourth item:

Fifth item:

Sixth item:

Seventh item:

Eighth item:

Ninth item:

Tenth item:

Number of Second Partner's items to describe: 0 1 2 3 4 5 6 7 8 9 10

First item:

Second item:

Third item:

Fourth item:

Fifth item:

Sixth item:

Seventh item:

Eighth item:

Ninth item:

Tenth item:

Separate Property:

Separate property will remain the property of its owner and the other party will have no rights to it.

Which items of each party's current property will be considered Separate Property? All property not documented as being co-owned Only certain property As determined by law

Select all that apply:

Property owned before this agreement is signed Yes No

Property owned after this agreement is signed Yes No

Property obtained from the sale/exchange of present property Yes No

Income obtained from the sale/exchange of present property Yes No

Property obtained using income from the sale/exchange of present property Yes No

Property received as a gift from the other party Yes No

Property received as a gift from a third party Yes No

Income from rises in value of property Yes No

Property acquired through inheritance Yes No

Game/Lottery/Sport winnings Yes No

Costs/Settlements from lawsuits Yes No

Income from insurance policies Yes No

Retirement or savings plan contributions Yes No

Income and/or salary before and during the marriage Yes No

Savings accrued before and during the marriage Yes No

Describe Other Yes No

Describe the other Separate Property here:

Shared Property:

Shared property is owned by both parties and must be divided if the partnership ends.

Do you wish to make a list of Shared Property? Yes, as specified below Yes, as specified in attached list No

How many items do you wish to list? 0 1 2 3 4 5 6 7 8 9 10

First item:

Second item:

Third item:

Fourth item:

Fifth item:

Sixth item:

Seventh item:

Eighth item:

Ninth item:

Tenth item:

Upon separation of the parties, how will Shared Property be divided? Equally owned by both parties Divided based on the financial contribution of each party Other

Describe how Shared Property will be divided:

Are the parties allowed to transfer property to each other? Yes No

Current Debts:

Do you wish to list the current debts of each party? Yes, as specified below Yes, as specified in attached list No

Number of First Partner's debts to describe: 0 1 2 3 4 5 6 7 8 9 10

First item:

Second item:

Third item:

Fourth item:

Fifth item:

Sixth item:

Seventh item:

Eighth item:

Ninth item:

Tenth item:

Number of Second Partner's debts to describe: 0 1 2 3 4 5 6 7 8 9 10

First item:

Second item:

Third item:

Fourth item:

Fifth item:

Sixth item:

Seventh item:

Eighth item:

Ninth item:

Tenth item:

Separate Debts:

Separate Debts will remain the responsibility of the owing party. The other party will not be obligated, in any situation, to help pay off these debts.

Which items of each party's current debts will be considered Separate Debts? All debts not documented as being shared Only certain debts As determined by law

Select all that apply:

Debts owned by a party before this agreement is signed Yes No

Debts a party accrues during this agreement Yes No

Describe other Yes No

Describe the other Separate Debts:

Shared Debts:

Shared debts are owed by both parties. If the partnership ends, the parties must decide how to split up the financial responsibility.

Do you wish to make a list of Shared Debts? Yes, as specified below Yes, as specified in attached list No

How many items do you wish to list? 0 1 2 3 4 5 6 7 8 9 10

First item:

Second item:

Third item:

Fourth item:

Fifth item:

Sixth item:

Seventh item:

Eighth item:

Ninth item:

Tenth item:

Upon separation of the parties, how will Shared Debts be divided? Owed equally by both parties Divided based on the financial contribution of each party Other

Describe how Shared Debts will be divided:

Children:

Does the First Partner have any children from previous relationships? Yes No

How many children? 1 2 3 4 5 6

First Child's Information:

Full Name:

Birthday (e.g. January 3rd, 1993):

Second Child's Information:

Full Name:

Birthday:

Third Child's Information:

Full Name:

Birthday:

Fourth Child's Information:

Full Name:

Birthday:

Fifth Child's Information:

Full Name:

Birthday:

Sixth Child's Information:

Full Name:

Birthday:

Does the Second Partner have any children from previous relationships? Yes No

How many children? 1 2 3 4 5 6

First Child's Information:

Full Name:

Birthday (e.g. January 3rd, 1993):

Second Child's Information:

Full Name:

Birthday:

Third Child's Information:

Full Name:

Birthday:

Fourth Child's Information:

Full Name:

Birthday:

Fifth Child's Information:

Full Name:

Birthday:

Sixth Child's Information:

Full Name:

Birthday:

Do the partners have any children together? Yes No

How many children? 1 2 3 4 5 6

First Child's Information:

Full Name:

Birthday (e.g. January 3rd, 1993):

Second Child's Information:

Full Name:

Birthday:

Third Child's Information:

Full Name:

Birthday:

Fourth Child's Information:

Full Name:

Birthday:

Fifth Child's Information:

Full Name:

Birthday:

Sixth Child's Information:

Full Name:

Birthday:

Support Payments:

In the event of separation, support will be: One party will receive support As determined by law Other None

Describe the nature of the support:

Who will be receiving support? First Partner Second Partner

Choose all applicable types of payment:

Lumpsum Payment Yes No

The amount of payment will be: A fixed amount Dependent on length of marriage/partnership Payable ONLY if marriage/partnership lasts a certain length Other

Enter the amount (e.g. 10,000.00):

Enter the amount of payment per year of marriage/partnership (e.g. 500.00):

Describe the nature of the lumpsum payment:

Enter the amount of payment (e.g. 8,000.00):

How long does the marriage/partnership have to last? (e.g. 5 years)

Monthly Payment Yes No

The monthly payment will be: A fixed amount Payable ONLY if marriage/partnership lasts a certain length Other

Enter the amount per month (e.g. 100.00):

Enter the amount per month (e.g. 100.00):

How long does the marriage/partnership have to last (e.g. 2 years)?

Describe the nature of the monthly payments:

How long will monthly payments continue? Indefinitely As long as the parties were married/partnered Enter the number of months

Enter the number of months (e.g. 12):

Property Yes No

Please enter a detailed description of the property:

The property will be given Unconditionally ONLY if marriage/partnership lasts a certain length Other

How long does the marriage/partnership have to last (e.g. 3 years)?

Describe how the property will be given:

Estate Matters:

Do you wish to specify if the parties will receive any of each other's estates? Yes No

Will the parties be entitled to part of each other's estate? Yes No

What are the conditions for entitlement? None The parties must be together at the time of death Other

Describe the conditions for entitlement:

Select all benefits that apply:

Death/Survivor Benefits Yes No

List Other Yes No

How many additional benefits do you wish to list? 1 2 3 4 5

First benefit

Second benefit

Third benefit

Fourth benefit

Fifth benefit

Additional Clauses:

Do you wish to add any additional clauses? Yes No

How many additional clauses do you wish to add? 1 2 3 4 5

First extra clause:

Second extra clause:

Third extra clause:

Fourth extra clause:

Fifth extra clause:

Signing Conditions:

To ensure the validity of this document, we recommend that it be signed in front of a notary public and one or more witnesses. An affidavit of execution is sworn by witnesses in front of a notary public.

Will a notary public be present? Yes No

How many witnesses will be present? 0 1 2

Will witnesses be signing an affidavit of execution? Yes No

Would you like each party to obtain a certificate of independent legal advice? Yes No

Date of Signing, if known:

Do you know when you will be signing the agreement? Yes No