SEPARATION AGREEMENT

AGREEMENT made by and between ______________ of __________, __________ County, Massachusetts (the "Husband") and _______________ of ____________, __________ County, Massachusetts (the "Wife"), referred to in this Agreement individually as a "Party" or together as the “Parties," as of the date both Parties have signed the Agreement.

STATEMENT OF FACTS

The Parties were married on ______________, in ____________, and last lived together at ________________ in _______________, Massachusetts on or about __________, 20__. This is the ________ marriage for the Husband and the __________ marriage for the Wife.

There are __________ unemancipated children born of the marriage whose names and dates of birth are: ____________ (date of birth _____________) and ____________ (date of birth ___________) (collectively, the “Children”).

The Parties are living separate and apart. Serious and irreconcilable differences have arisen between the Parties, and the Parties acknowledge there is an irretrievable breakdown of their marriage. The Parties intend to file a joint petition for a divorce in the ________________ County Probate and Family Court.

[The Parties have jointly hired [MEDIATOR NAME] of [MEDIATOR FIRM] as a neutral mediator to help them in the planning, negotiation, and preparation of this Agreement. At no time has the mediator acted as counsel for either Party, and neither Party shall request that he testify or produce evidence in connection with any Court proceeding.]

Each of the Parties has obtained the advice of independent legal counsel of his or her own choosing prior to executing this Agreement. The Husband is represented by _________________, and the Wife is represented by ______________________.

PURPOSE

The purpose of this Agreement is to determine:

The custody of and parenting schedule for the Children of the Parties;

The support of the unemancipated Children of the Parties and to determine what should be paid for educational expenses of the Children;

An equitable distribution of property;

What should be paid to the Husband and/or the Wife as alimony, including whether and to what extent either Party shall have an obligation to provide healthcare coverage for the other beyond the date of the judgment of divorce;