Georgia Marital Separation Agreement Form

In the case of a divorce case in the State of Georgia in which both spouses want to negotiate terms for the divorce, the following form has to be completed and submitted.

Extracted Text for Proper Search

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IN THE SUPERIOR COURT OF 	      	 COUNTY 
STATE OF GEORGIA 	
FAMILY DIVISION 	
 
     
Petitioner:       	,     	
     
     
and      Civil Action File No:             
      Judge:                                                      	  	
     
Respondent:       	.     	
 
 	
SEPARATION AGREEMENT	 	
 
This is an Agreement by and between            	
 (hereinafter referred to as "Wife")  
and       	
 (hereinafter referred to as "Husband"). 
WITNESSETH	
 	
 	
WHEREAS, the parties are married but are currently living in a bona fide state of separation; 
 
and 
 
WHEREAS, there has/have been            	
 child(ren) born as issue of the marriage, to wit: 
 
      	
; 
 
WHEREAS, the parties desire to settle between themselves all questions of division of property, 
child custody, visitation, child support, alimony, and all other rights and obligations arising out of their 
marital relationship; 
NOW THEREFORE, in consideration of the mutual covenants hereinafter contained, the parties 
agree as follows: 
1. 
The parties shall continue to live separate and apart and each shall be free from interference, 
molestation, authority and control, direct or indirect, by the other, as fully as if sole and unmarried, and 
each may reside at such place or places as he or she may select.

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2. 
(Check a, b, or c) 	
   a)  The 	 Husband  	 Wife shall have the temporary and permanent legal and physical 
custody of the minor child(ren) born as issue of the marriage. 	
   b)  The Husband and Wife shall share joint legal custody of the minor child(ren). The parties 
shall share decision-making concerning the children; however the 	
 Husband 	 Wife shall have the 
right to make the final decision in the event the parties cannot agree. 
Primary Physical custody of the minor child(ren) shall be with the 	
 Husband 	 Wife as follows:  
      	
 
      
 
      
. 
Secondary Physical custody shall be with the 	
 Husband 	 Wife as follows: 
      	
 
      
 
      
. 	
   c)  The Husband and Wife shall share joint legal custody and joint physical custody of the 
minor children. 
Physical custody shall be shared by the parties as follows:            	
 
      
 
      
. 
The parties shall share decision-making concerning the children; however, in the event the parties cannot 
decide the 	
 Husband 	 Wife shall have the final decision concerning the following:           	                              
 
. 
3. 
The 	
 Husband 	 Wife shall have the right of visitation with the minor child(ren) as follows:

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OR 
as set out in the Visitation Schedule attached hereto and incorporated herein. 
4. 
The parties agree that the welfare of the child(ren) is of paramount importance and each agrees 
to foster a feeling of affection between themselves and the child(ren). Neither party shall do anything to 
hamper the natural development of the child(ren)'s love and respect for the other party. 
5. 
NOTICE NOTICE NOTICE 
The new Georgia Child Support Guidelines went into effect on 1/1/07. Any child support 
calculations must now be made using the new guidelines. To obtain the forms and instructions, 
go to: https://services.georgia.gov/dhr/cspp/do/public/SupportCalc.  
 
a) The 	
 Husband 	 Wife shall pay to the 	 Husband 	 Wife , as support of the minor  
child(ren), the sum of            	
 Dollars per 	 week/	 bi-weekly/	 semi-monthly/	 monthly, for a 
total of        	
 Dollars to be paid per 	 week/	 bi-weekly/	 semi-monthly/	 monthly starting on 
      	
, 2      	, and continuing per 	 week/	 bi-weekly/	 semi-monthly/	 monthly 
thereafter until the child reaches the age of eighteen, marries, dies or otherwise becomes emancipated or 
so long as the child is enrolled in and attending secondary school not to exceed age 20. The child support 
obligation shall be 	
 reduced as follows                                     	/ 	 terminated in the event of said 
occurrence. 
b)   All payments of child support shall be paid as follows:  (If you have an Income Deduction 
Order, payments must be paid into the Family Support Registry.) (Check 1 or 2) 	
   1)   Directly to 	 Wife/	 Husband at the following Address: 
      	
 
      
.  No Income Deduction Order 
will be entered into at this time. 	
   2)   To the Family Support Registry pursuant to an Income Deduction Order.        
(Make sure to complete the Income Deduction Order packet) 
 
6. 
The 	
 Husband/	 Wife shall maintain a policy of medical, dental and hospitalization insurance 
for the benefit of the minor child(ren) for so long as the child support obligation set forth herein exists. 
Costs not covered under the insurance policy shall be provided as follows:

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The 	
 Husband/	 Wife shall provide the 	 Husband/	 Wife with an insurance identification 
card or such other acceptable proof of insurance coverage and shall cooperate with the 	
 Husband/	 
Wife in submitting claims under the policy. 
 
7. 
(Check a or b) 	
   a)   The 	 Husband/	 Wife shall pay to the 	 Husband/	 Wife as alimony, the sum of 
                           	
 Dollars per                             	to be paid                            	beginning on                	day 
of                      ,	
 and continuing                            	 thereafter until the 	 Husband/	 Wife remarries or 
dies. 	
   b)   The parties hereby expressly waive alimony for past, present and future. 
 
8. 
(Check a or b) 
   a)   The parties acknowledge that they have previously made a division of their household 
furniture, furnishings, household goods, equipment and other such personalty. Neither party shall claim 
any of the property in the possession of the other as of the date of the signing of this agreement. 
 
   b)   The parties acknowledge that they possess various items of jointly owned property, which 
shall be divided as follows: 
1) To the Wife 
(a)       	
 
(b)       
 
(c )       
 
 
2) To the Husband 
(a)

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(b)       	 
(c)       
 
9. 
(Check a or b) 	
 a) The parties acknowledge that they have no outstanding joint debts. 
 	
 Husband’s initials _____ 	 Wife’s initials _____ 	
 b) The parties acknowledge they have the following joint debts: 
Creditor  Amount of debt 
      	
        	 
      	
        	 
      	
        	 
      	
        	 
1) The Husband shall be responsible for the following debts: 
      
 
and indemnifies and holds the Wife harmless for any collections on those obligations. 
2) The Wife shall be responsible for the following debts: 
      
 
and indemnifies and holds the Husband harmless for any collection on those obligations. 
 
10. 
The parties acknowledge that they have entered into this Agreement freely and voluntarily and 
that it is not the result of any duress or any undue influence. 
11. 
The Agreement constitutes the entire understanding of the parties. There are no representations, 
warranties, covenants, or undertaking other than those expressly set forth herein. 
12. 
It is expressly understood that this Agreement does not obligate the parties to continue to live in a 
state of separation or to proceed with an action for divorce. However, in the event that either party shall

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bring or maintain an action for dissolution of the marital relationship, this Agreement shall be presented to 
the court and incorporated by reference into any judgment or decree concerning the matters provided 
herein.  Notwithstanding such incorporation, this Agreement shall survive and be enforceable 
independently of the judgment or decree. 
IN WITNESS WHEREOF, the parties have signed their names, this            	
 day of  
      	
,       	 as to the Wife and this            	 day of       	,       	 as 
to the Husband. 
_______________________________ 
Wife 
 
Sworn to and subscribed before me this 
 
the       	
 day of       	,       	 
 
___________________________________________________________ 
NOTARY PUBLIC 
My commission expires:       
 
 
 
_______________________________ 
Husband 
Sworn to and subscribed before me this 
 
the       	
 day of       	,       	 
 
___________________________________________________________ 
NOTARY PUBLIC 
My commission expires: