Controlled Separation Agreement Template

Time Limits:  I agree to a _____________separation ending on ________.

Legal Counsel:  I agree not to make any efforts to file for divorce and will put divorce action on hold during the life of this Agreement. If I feel the need to contact an attorney for informational purposes, I will let my partner know in advance.

Living Arrangements:  Who is where and when

Home Furnishings:  Which furnishings will be moved and where

Household Repairs & Maintenance:  Process and responsibility for repairs. Allocation of chores and expectations about timing and standards.

Finances:  I agree to make as few changes in our finances as possible. If I need to make a purchase of _____ or more, I will discuss this with my partner. ________pays mortgage, _____pays utilities, etc.

Couple’s Interpersonal Relationship:
  Phone: May phone when. . .
  Text: May text when. . .
  Email: May email when. . .
  Entering Spouse’s Living Space/s: Under what circumstances, keys, etc.
  Social Events: Agreement for who goes to social events to which both are invited, etc.
  Frequency of Spousal Dating & Permissions for Spousal Sexual Contact:
E.G. Every other weekend, they will have x hours together as a couple. They will meet 2 x week for lunch
  M-F. Include desired provisions for reintroducing physical contact.
  Dating Others: E.G. Not for the duration of this Agreement.
  Holidays: (If there are children, see below and include this in the parenting section of this agreement.)
  Create a list of which holidays to include and specifics on how time is to be spent.

Parenting:
  Parenting Time: Who is on duty when. What is the transition arrangement? How to make decisions when it affects the other parent’s
  on-duty time.
  Parenting Decisions: Medical, religion, educational, friends & activities. How are these to be made and what happens in an
  emergency.
  Holidays: Create a list of which holidays to include and specifics on how time is spent.

Confidentiality:  I agree to limit explanations of this Agreement to family and friends in order to discourage any gossip. I also agree to refrain from maligning my spouse and will not encourage others to take sides.

Professional Resources:  Agree to individual therapy? Couples therapy? Therapy for children? Go to group therapy? AA?, etc.

Agreement:  No changes will be made in this Agreement unless both partners agree to the terms. Both spouses understand that this is a private agreement and not a legal contract.
Termination of Agreement:  I agree to inform my spouse verbally and in person of my intention to terminate this Agreement.
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Name Date Name Date