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THE STATE OF NEW HAMPSHIRE (State of New Hampshire)

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NHJB-2071-F (01/01/2020) Page 1 of 8
This decree is (choose one):
Agreed to by Parties Proposed By
Ordered by the Court after hearing on at which petitioner respondent appeared.
1. 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. Dependents N/A
The parties shall claim the minor child(ren) and/or other qualifying relative as dependent(s) for
all income tax purposes, in the following manner:
Petitioner, if otherwise qualified under federal/state law, shall be entitled to claim
as tax dependent(s) for all years even years odd years other
Respondent, if otherwise qualified under federal/state law, shall be entitled to claim
as tax dependent(s) for all years even years odd years other
A parent may only claim a child as a dependent if that parent is current on child support for the
applicable tax year.
THE STATE OF NEW HAMPSHIRE
JUDICIAL BRANCH
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Court Name:
Case Name:
Case Number:
(if known)
FINAL DECREE ON PETITION FOR DIVORCE,
LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
Clear Form
Top of Page
Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
NHJB-2071-F (01/01/2020) Page 2 of 8
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. Payments
shall be made by Petitioner Respondent Both
(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 N/A
See Order on Appointment of Guardian ad Litem
Other:
6. Alimony N/A
See attached Uniform Alimony Order.
Top of 1st Page
Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
NHJB-2071-F (01/01/2020) Page 3 of 8
7. Health Insurance for Spouse N/A
The continuation of 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 and clear of any interest of
is awarded the
free 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.
Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
NHJB-2071-F (01/01/2020) Page 4 of 8
10. Furniture and Other Personal Property N/A
is awarded the following animal(s):
Care for animal(s) shall be provided by:
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 ‘s
IRA and/or 401(k) as of the date of this decree.
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.
Top of 1st Page
Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
NHJB-2071-F (01/01/2020) Page 5 of 8
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:
13. Business Interests of the Parties N/A
is awarded all right, title, and interest in
the business known as
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:
Top of 1st Page
Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
NHJB-2071-F (01/01/2020) Page 6 of 8
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:
16. Other Real Property N/A
The real estate located at is
awarded to , 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.
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:
Top of 1st Page
Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
NHJB-2071-F (01/01/2020) Page 7 of 8
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.
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
Top of 1st Page
Case Name:
Case Number:
FINAL DECREE ON PETITION FOR DIVORCE, LEGAL SEPARATION, OR CIVIL UNION DISSOLUTION
NHJB-2071-F (01/01/2020) Page 8 of 8
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
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THE STATE OF NEW HAMPSHIRE (State of New Hampshire)

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Completed 16 December 2021

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