1 Any Attorney or Party

Any Street
2 Any Town, CA 55555

3 714-555-5555

4 Any Attorney or Party

8
Superior Court of the State of California
9 County of ___________

10

11 In re the marriage of: ) Case No.

)
12 Petitioner: _________________________ ) STIPULATION AND ORDER FOR BIFURCATION
) OF MARITAL STATUS
13 and )
)
14 Respondent:____________________________ )
)
)
15
)
)
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)
)
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STIPULATION AND ORDER FOR BIFURCATION OF MARITAL STATUS
 1 Be sure to remove these notices and all other notices before using
2

3
this document.
4 PURSUANT TO THE STIPULATION OF THE PARTIES HEREIN, THE COURT
5
ORDERS, ADJUDGES AND DECREES AS FOLLOWS:
6
1. The Court finds that both petitioner and respondent have served a preliminary
7

8
declaration of disclosure with a completed schedule of assets and debts as required by law and the

9 retirement or pension plan of LIST PETITIONER OR RESPONDENT HERE AS

10 APPROPRIATE AND LIST NAME OF RETIREMENT OR PENSION PLAN has been joined
11
as a party to this proceeding.
12
2. The Court finds that both petitioner and respondent have knowingly and with full
13
knowledge of the circumstances voluntarily entered into this stipulation to bifurcate their marital
14

15 status.

16 3. The Court orders that the marital status of the petitioner and respondent shall be
17
terminated on the following conditions:
18
4. LIST PETITIONER OR RESPONDENT HERE AS APPROPRIATE shall
19
indemnify and hold LIST PETITIONER OR RESPONDENT HERE AS APPROPRIATE
20

21 harmless from any taxes, reassessments, interest, and penalties payable by the other party in

22 connection with the division of the community estate that would not have been payable if the parties
23
were still married at the time the division was made.
24
5. Until judgment has been entered on all remaining issues and has become final
25
LIST PETITIONER OR RESPONDENT HERE AS APPROPRIATE shall maintain all existing
26

27 health and medical insurance coverage for LIST PETITIONER OR RESPONDENT HERE AS

28 APPROPRIATE and LIST NAMES AND AGES OF MINOR CHILDREN, IF NONE DELETE

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STIPULATION AND ORDER FOR BIFURCATION OF MARITAL STATUS
 1 THIS SECTION as named dependents, so long as they are eligible to do so. If at any time during
2 this period they are not eligible to maintain that coverage, at their sole expense they shall provide and
3
maintain health and medical insurance coverage that is comparable to the existing health and medical
4
insurance coverage to the extent it is available. To the extent that coverage is not available, they shall
5

6
be responsible to pay, for the health and medical care for LIST PETITIONER OR RESPONDENT

7 HERE AS APPROPRIATE and LIST NAMES AND AGES OF MINOR CHILDREN, IF NONE

8 DELETE THIS SECTION, to the extent that care would have been covered by the existing
9
insurance coverage but for the dissolution of marital status, and shall otherwise indemnify and hold
10
LIST PETITIONER OR RESPONDENT HERE AS APPROPRIATE harmless from any adverse
11
consequences resulting from the loss or reduction of the existing coverage. For purposes of this
12

13 stipulation and order, health and medical insurance coverage includes any coverage for which the

14 parties are eligible under any group or individual health or other medical plan, fund, policy, or
15
program.
16

17
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STIPULATION AND ORDER FOR BIFURCATION OF MARITAL STATUS