New Hampshire Final Decree on Divorce or Legal Separation Form

Clear Form
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
http://www.courts.state.nh.us
Court Name:
Case Name:
Case Number:
(if known)
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION,
OR CIVIL UNION DISSOLUTION
This decree is (choose one):
Agreed to by Parties
Proposed By
Ordered by the Court after hearing on
1.
at which
petitioner
respondent appeared.
Type of Case: (Choose Divorce, Legal Separation or Civil Union Dissolution)
DIVORCE:
A decree of divorce is granted to the
petitioner
respondent
parties based on:
Irreconcilable differences that have caused the irremediable breakdown of the
marriage; or
Grounds stated in the petition. Cross petition, if any, is dismissed.
LEGAL SEPARATION:
A decree of legal separation is granted to
petitioner
respondent
parties based on:
Irreconcilable differences that have caused the irremediable breakdown of the
marriage; or
Grounds stated in the petition. Cross petition, if any, is dismissed.
CIVIL UNION DISSOLUTION:
A decree of civil union dissolution is granted to
petitioner
respondent
parties based
on:
Irreconcilable differences that have caused the irremediable breakdown of the civil
union; or
Grounds stated in the petition. Cross petition, if any, is dismissed.
2.
Parenting Plan and Uniform Support Order
N/A
See attached Parenting Plan and Uniform Support Order
3.
Tax Exemptions for Children
N/A
The parties shall claim the minor child(ren) as dependent(s) for all income tax purposes, in
the following manner:
Petitioner shall be entitled to claim
as tax
dependent(s) in
all
even
odd years.
Respondent shall be entitled to claim
dependent(s) in
all
even
odd years.
as tax
A parent may only claim a child as a dependent if that parent is current on child
support for the applicable tax year.
NHJB-2071-FS (08/27/2013)
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Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
4.
OPTIONAL: Post-Secondary Educational Expenses
N/A
IMPORTANT NOTE: The court cannot order parties to pay for college or other educational expenses
beyond the completion of high school unless BOTH parties agree. However, if the parties agree to
contribute to these expenses by checking the boxes in Section 4, below, this agreement will become an
enforceable order of the court.
The parties agree to contributions to college or other educational expenses beyond the
completion of high school in the following manner:
Type of contribution (check all that apply):
Contributions to an account by
Petitioner
Respondent
Both
(Specify the amount and frequency of contributions and account information. Also specify what
will happen to the contributions in the event the child does not incur post-secondary educational
expenses):
Contribution of an asset:
(Specify the account or other asset being contributed and its current balance or value. If an asset
is identified specify how the asset will be used. Also specify what will happen to the contributions
in the event the child does not incur post-secondary educational expenses):
Payments shall be made as post-secondary education expenses are incurred.
Petitioner
Respondent
Both
Payments shall be made by
(Specify amount to be paid by each party or the percentage or other formula agreed upon to
determine the post-secondary education expense obligation agreed to by the parties):
Select one of the following:
Both parties agree that this post-secondary educational expense agreement
IS modifiable based on a substantial change in circumstances that was not
foreseeable when the agreement was signed.
Both parties agree that this post-secondary education expense agreement is
NOT modifiable and the specific dollar amount to be contributed by either or both
parents is set forth above.
Note: Before any court hearing to modify or enforce the agreement described above, the
parties shall participate in mediation.
5.
Guardian ad Litem Fees
See Order on Appointment of Guardian ad Litem
N/A
Other:
6.
Alimony
N/A
shall pay the sum of $
This obligation shall terminate:
NHJB-2071-FS (08/27/2013)
per
as alimony.
. See attached Uniform Support Order.
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Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
7.
Health Insurance for Spouse
N/A
The continuation of
’s employer-sponsored group medical
health insurance benefits on behalf of
shall be governed by RSA 415:18. VII-b, COBRA, or other applicable law. The following
additional provisions, if any, apply:
shall maintain health insurance for the benefit of
. This obligation shall terminate:
shall maintain dental insurance for the benefit of
. This obligation shall terminate:
shall be responsible for payment of the premiums.
This obligation shall terminate:
.
Each party shall be responsible for his/her own medical and dental insurance and for
paying all of his/her own unreimbursed medical, dental, optical, and other expenses not
otherwise covered by insurance.
8.
Life Insurance
N/A
Each party is awarded any and all life insurance policies owned by that party, free and
clear of any right, title, or interest of the other.
shall maintain a life insurance policy in the minimum
amount of $
designating
as trustee for the
benefit of the child(ren). This obligation shall continue as long as the insured is obligated
to pay support.
Other:
9.
Motor Vehicles
N/A
Each party is awarded the vehicles in his/her name or possession, free of any right, title or
interest of the other.
is awarded the
free
is awarded the
free
and clear of any interest of
and clear of any interest of
Each party shall be responsible for all expenses as to his/her vehicles, including car
payments, maintenance, registration and insurance.
NHJB-2071-FS (08/27/2013)
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Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
10.
Furniture and Other Personal Property
N/A
The parties have already fairly divided between themselves their household furniture,
furnishings and all other tangible property (other than as specifically set forth below), and each
party is awarded that property currently in his/her possession, free and clear of any
interest of the other.
Petitioner is awarded the following specific items of personal property:
Respondent is awarded the following specific items of personal property:
11.
Retirement Plans and Other Tax-Deferred Assets
N/A
Each party is awarded any interest in any pension, retirement, 401(k), IRA, or other
retirement account that s/he may have and as shown on his/her respective financial
affidavits free and clear of any interest of the other.
is awarded one-half of
IRA and/or 401(k) as of the date of this decree.
‘s
is awarded one-half of
‘s
pension plan which accrued between the date of the marriage or civil union and the date of
the filing of the petition for divorce, legal separation, or dissolution pursuant to the Hodgins
formula. Subject to the above distribution,
is awarded all other right, title, and interest in his/her
pension plan, free of any further interest of
A Qualified Domestic Relations Order (QDRO) shall be prepared by
within a reasonable period of time from the date of this decree and filed with the Court for
approval.
Other:
12.
Other Financial Assets
N/A
The parties are awarded their respective checking and/or savings bank accounts, credit
union accounts, certificates of deposits and the like, and all similar accounts as shown on
their individual financial affidavits filed with the court.
Petitioner is awarded the following bank accounts, stocks, bonds, mutual funds or other
intangible personal property:
Respondent is awarded the following bank accounts, stocks, bonds, mutual funds or other
intangible personal property:
Other:
NHJB-2071-FS (08/27/2013)
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.
Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
13.
Business Interests of the Parties
as
N/A
is awarded all right, title, and interest in the business known
free of any claim or interest of the other party.
shall be solely responsible for all debts of the business and
shall be entitled to receive all profits from the business.
shall
transfer all property interest and stock to
forthwith and
shall resign as an officer or director in the business forthwith.
Other:
14.
Division of Debt
N/A
The parties shall each be responsible for any debt they have incurred after the date of
separation, holding each other harmless of the same.
The parties’ joint marital/civil union debt shall be divided as follows:
Petitioner shall assume and be solely responsible for the following marital/civil union debts
and obligations incurred during the marriage/civil union:
Respondent shall assume and be solely responsible for the following marital/civil union
debts and obligations incurred during the marriage/civil union:
15.
Marital/Civil Union Home
N/A
is awarded all right, title and interest in the real estate located
at:
free of any right, title or
interest of the other party.
shall be responsible for the
payment of the mortgage, insurance, and real estate taxes for this property and all
expenses for this property.
shall refinance the mortgage on the home so as to remove
the other party’s name from the mortgage by
or the home
will be placed on the market and sold.
The marital/civil union home shall be sold and, upon sale, the net proceeds shall be
divided equally between the parties.
Other:
NHJB-2071-FS (08/27/2013)
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Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
16.
Other Real Property
N/A
The real estate located at
is awarded
to the
, free of any right, title or interest of the other party,
but subject to any encumbrance thereon.
Other:
17.
Enforceability after Death
N/A
The terms of this decree shall be a charge against each party’s estate.
18.
Signing of Documents
N/A
Each party shall, within thirty (30) days, sign and deliver to the other party any document
or paper that is needed to fulfill or accomplish the terms of this decree.
19.
Restraining Order
N/A
is restrained and enjoined from entering the home or the
place of employment of the other party, and from harassing, intimidating or threatening the
other party or his/her relatives or other household members.
Other:
20.
Name Change (Divorce or Civil Union Dissolution Only)
N/A
may resume use of her/his former name:
21.
Other Requests
Attorney's Fees: Any party that unreasonably fails to comply with this decree or other
court orders (including "Uniform Support Order") may be responsible to reimburse the
other party for whatever costs, including reasonable attorney’s fees, that may be incurred
in order to enforce compliance.
Tax Refunds: Any tax refund due or anticipated by the parties resulting from their having
filed a joint federal and/or state income tax return for this or any prior year shall, upon
receipt, be endorsed by both parties and equally distributed between them.
Disclosure of Assets: The parties warrant that they have fully disclosed all assets within
their knowledge on their respective Financial Affidavit, specifically including any pension,
profit sharing or retirement account, along with reasonable estimated values of each asset.
The financial information contained on each party's Financial Affidavit is accurate and
complete and has been relied upon by the other party.
Compliance With Rule 1.25-A (Family Division Only):
The parties have fully complied with Rule 1.25-A; or
The parties agreed to limit their document exchange under Rule 1.25-A.
Mutual Releases: Other than as set forth in this decree or other order of this court
(including "Uniform Support Order") each party releases and agrees to defend, indemnify
and hold the other harmless from any and all claims of any nature whatsoever arising out
of the marriage (including any claim for alimony).
NHJB-2071-FS (08/27/2013)
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Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
Obligations: Unless specifically mentioned in this decree, each party shall be solely
responsible for any bills, obligations or other indebtedness that he or she has charged or
incurred before or during the marriage or civil union.
Change in Address or Employment: Each party shall promptly notify the other of any
change in his/her address or telephone number, and of any material change in
employment as long as there are any continuing obligations under this decree. “Material
change” will include availability of medical, dental or life insurance and any substantial
increase or decrease in earnings or other income.
Waiver of Attendance: Both parties waive attendance at a final hearing.
Miscellaneous:
I/we believe that this is a fair and reasonable resolution of all the issues related to our marriage or civil
union. I/we request that the Court approve this decree and incorporate all of its terms and conditions as
part of the Decree of Divorce, Decree of Legal Separation, or Decree of Civil Union Dissolution.
Date
Signature of Petitioner
Date
Signature of Attorney/Witness for Petitioner
Date
Signature of Respondent
Date
Signature of Attorney/Witness for Respondent
I state that on this date I provided a copy of this document to
(other party) or to
(other party’s attorney) by:
Hand-delivery OR
US Mail OR
E-mail (E-mail only by prior agreement of the parties based on Circuit Court Administrative Order).
Date
Signature
Recommended:
Date
Signature of Marital Master
Printed Name of Marital Master
So Ordered:
I hereby certify that I have read the recommendation(s) and agree that, to the extent the marital
master/judicial referee/hearing officer has made factual findings, she/he has applied the correct legal
standard to the facts determined by the marital master/judicial referee/hearing officer.
Date
Signature of Judge
Printed Name of Judge
NHJB-2071-FS (08/27/2013)
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