How to Fill Out Dissolution / Legal Separation Agreement (JD-FM-172)

The Dissolution / Legal Separation Agreement (JD-FM-172) is one of the most critical documents in a Connecticut divorce or legal separation. It serves as a legally binding contract that you and your spouse create to settle all aspects of your case. When you file for an uncontested divorce, this agreement outlines your mutual decisions on everything from alimony and property division to debt allocation. It essentially provides the court with a complete roadmap of how you have chosen to untangle your lives financially and, if applicable, as co-parents.

This form is typically completed towards the end of the divorce process, after both parties have exchanged financial information and negotiated the terms. It is submitted to the court for review and approval by a judge. Once the judge signs off on the agreement, its terms are incorporated into your final divorce decree, making them official and enforceable court orders. A well-drafted agreement is crucial because it provides clarity, finality, and helps prevent future conflicts and costly post-judgment litigation. It is the document that formally ends the financial partnership of the marriage or civil union.

Requirements

Before you begin filling out this form, gather the following documents and information. Having everything organized will make the process much smoother:

• Case Information: Your court case's Judicial District, town, and docket number.
• Financial Affidavits: A completed and signed Financial Affidavit (JD-FM-006-SHORT or JD-FM-006-LONG) from both you and your spouse. This agreement often references the information in those affidavits.
• Real Estate Documents: Property deeds, recent mortgage statements, and property tax bills for any real estate you own.
• Vehicle Information: Vehicle titles (or registration) and any auto loan statements.
• Financial Account Statements: Recent statements for all bank accounts (checking, savings), investment accounts (stocks, bonds, mutual funds), and retirement accounts (401(k), IRA, pensions). Important: You need the information from these statements, but do not attach them to the form or write account numbers on the form.
• Debt Information: Recent statements for all credit cards, personal loans, student loans, and other debts, showing the creditor and current balance.
• Insurance Policies: Life insurance and health insurance policy information.
• Children's Information: Full legal names and dates of birth for all children under the age of 23.
• Parenting Plan: If you have minor children, you must also complete a Custody Agreement and Parenting Plan (JD-FM-284). It's best to work on these two forms together.

Step-by-Step Instructions

Case Caption and Introduction

This top section of the form identifies your case for the court and states the basic purpose of the agreement.

Judicial district of: Enter the name of the Judicial District where your case was filed. Example: Stamford/Norwalk

At (Town): Enter the town where the courthouse is located. Example: Stamford

Docket number: Enter the docket number assigned to your case by the court clerk. This number is on all previous court documents. Example: SNT-FA22-1234567-S ⚠️ This must be accurate. The court uses this number to identify your file.

Plaintiff's name (Last, first, middle initial): Enter the full name of the person who started the divorce case (the Plaintiff). Example: Doe, Jane A.

Defendant's name (Last, first, middle initial): Enter the full name of the other spouse (the Defendant). Example: Doe, John B.

Select one: dissolution of marriage, dissolution of civil union, or legal separation: Check the box that matches the legal action you are taking. Example: Check 'dissolution of marriage'.

1. Our (Select one) marriage... or civil union...: Check the box that corresponds to your relationship type. This statement confirms the legal grounds for your divorce in Connecticut (irretrievable breakdown). Example: Check 'marriage'.

2. Alimony

This section details your agreement regarding spousal support (alimony). Read these options carefully, as they have significant long-term financial consequences.

A. Both Parties Waive Alimony: Check this box ONLY if both you and your spouse agree that neither of you will ever pay or receive alimony from the other. This is a permanent waiver. ⚠️ If you waive alimony, you generally cannot come back to court later and ask for it, even if your financial circumstances change dramatically.

B. Alimony Awarded: If one person is paying alimony, do NOT check box A. Instead, check the appropriate box here to indicate who is waiving alimony and who will be paying it. Example: Check 'The plaintiff waives forever the right to claim or receive alimony from the defendant. The defendant shall pay the plaintiff alimony...'

C. Periodic Alimony: If alimony will be paid in regular installments (e.g., weekly, monthly), fill this out. Specify who pays whom, the amount, the frequency (per week/month), and the duration (for a specific number of years or until a certain date). Example: The defendant shall pay the plaintiff alimony in the amount of: $1,000 per month for a period of 5 years. ⚠️ Pay close attention to the 'modifiable' checkboxes. 'Non-modifiable as to term' means the duration can't be changed. 'Non-modifiable as to amount' means the dollar figure can't be changed. These are critical decisions.

The alimony shall terminate upon the first of the following to occur:: Check all standard conditions that will end the alimony payments. Death and remarriage are standard. You can add other specific conditions in the 'other' line.

The provisions of section 46b-86(b) of the General Statutes regarding cohabitation shall / shall not apply.: This refers to the Connecticut law that allows alimony to be suspended or terminated if the recipient lives with another person. Decide if this law will apply to your agreement. 'Shall apply' is standard.

D. Lump Sum Alimony: Use this option if alimony will be paid as a single, one-time payment. Specify who pays whom, the total amount, and the date by which it must be paid. Example: The plaintiff shall pay the defendant lump sum alimony in the amount of $25,000 on or before (date). ⚠️ Lump sum alimony is typically non-modifiable.

3. Real Estate

This section outlines how you will divide any real property, such as the marital home. If you have more than one property, use the separate sections for Property #1 and Property #2.

The parties do not own any real estate together or separately: If neither of you owns any real estate, check this box and skip to Section 4.

Real Estate Property #1 (address): Enter the full street address of the first property.

Transfer of property by quit claim deed: Select this if one spouse is giving their ownership interest to the other. Specify who is transferring the property, who is receiving it, and the deadline for the transfer. The receiving party typically assumes all related debts (mortgage, taxes, etc.). ⚠️ A quitclaim deed transfers ownership, but it does NOT remove the transferring spouse's name from the mortgage. Refinancing is usually required for that.

Refinance of Mortgage(s) Secured by Property: If the spouse keeping the house must refinance the mortgage to remove the other's name, check this box and specify the deadline for the refinance.

Sale of Property: Select this if you agree to sell the house. Specify the date it will be listed for sale, how proceeds (or debt) will be split by percentage, and who will pay the mortgage and other expenses until it sells. Example: Upon sale of the property... shall be divided between the parties as follows: Plaintiff 50% Defendant 50%. ⚠️ Be specific about who pays for what while the house is on the market (e.g., 'Plaintiff shall pay the mortgage, taxes, and insurance pending the sale.').

The court shall retain jurisdiction over the sale of Property #1.: It is highly recommended to check this box. This allows you to go back to court for help if there are disagreements about the sale (e.g., a spouse refusing to sign papers or agree on a price).

4. Motor Vehicles

Use this section to assign ownership of cars, trucks, motorcycles, or other vehicles.

The parties do not own any motor vehicles together or separately: If you don't own any vehicles, check this box and skip to Section 5.

The (Select one) plaintiff defendant is awarded the vehicle (year, make, model): For each vehicle, check whether the Plaintiff or Defendant is receiving it. Clearly identify the vehicle by its year, make, and model. The person receiving the vehicle is responsible for all associated costs, including loans, insurance, and taxes. Example: The plaintiff is awarded the vehicle (2020, Honda, CR-V). ⚠️ Similar to a house, transferring a title does not automatically remove a co-signer from a car loan. The person keeping the car may need to refinance the loan.

5. Bank Accounts

This section details how you will handle checking, savings, money market, and CD accounts. DO NOT write full account numbers on this form.

Table for dividing bank accounts: If you are dividing a joint bank account, list it here. Enter the name of the bank, the type of account (e.g., 'Joint Checking'), the approximate balance, and the percentage each person will receive. The percentages must add up to 100%. Example: Name of Bank: Bank of America, Type: Joint Savings, Balance: $10,000, % to Plaintiff: 50, % to Defendant: 50. ⚠️ Never include full account numbers for security reasons. The name of the institution and a general description is sufficient.

The parties agree to divide/transfer the funds as set forth in section 5C by (date): Set a clear deadline by which all account divisions and transfers must be completed.

6. Stocks, Bonds, Mutual Funds, Securities, and Investment Accounts

This section is for dividing non-retirement investment accounts. DO NOT write full account numbers on this form.

Table for dividing investment assets: List each investment asset to be divided. Include the name of the asset or brokerage firm (e.g., 'Fidelity Brokerage Account', '100 shares of XYZ Corp stock'), its approximate current value, and the percentage division. The percentages must add up to 100%. Example: Name of Stock: Vanguard S&P 500 ETF, Value: $50,000, % to Plaintiff: 50, % to Defendant: 50. ⚠️ Dividing stocks or funds may have tax consequences (capital gains). It's wise to consult a financial advisor.

7. Pension, Profit Sharing, Deferred Compensation, or Retirement Funds

This section is for dividing retirement assets like 401(k)s, 403(b)s, IRAs, and pensions. This is a complex area. DO NOT write full account numbers on this form.

Table for dividing retirement funds: List each retirement fund to be divided. Specify the type of plan (e.g., 'Plaintiff's 401(k) through ABC Company'), its approximate value, and how it will be divided. This can be a percentage or a specific dollar amount. Example: Type of Pension: Defendant's State of CT Pension, Value: Varies, % to Plaintiff: 50% of the marital portion, % to Defendant: 50% of the marital portion. ⚠️ The 'marital portion' is the value that accumulated between the date of marriage and the date of divorce. You may need an expert to calculate this.

Note: A Domestic Relations Order/Qualified Domestic Relations Order (DRO/QDRO): This is a critical note from the court. To divide most retirement plans (like 401(k)s and pensions), you need a separate, special court order called a QDRO. You must specify how you will split the cost of preparing this document. Example: The cost to prepare the... Order will be paid as follows: Plaintiff 50% Defendant 50%. ⚠️ You MUST consult with the plan administrator to get the correct language for the QDRO. Failure to do this can result in the division being rejected. It is highly recommended to hire an attorney or specialized service to draft the QDRO.

8. Life Insurance

This section addresses whether either party will be required to maintain life insurance, often to secure an alimony or child support obligation.

The plaintiff will secure and/or maintain life insurance...: If one party is required to maintain life insurance for the other's benefit, fill this out. Specify the amount of the death benefit, who the beneficiary will be, and how long the policy must be maintained (e.g., 'until the alimony obligation terminates'). Example: The defendant will secure and/or maintain life insurance on his/her life in the amount of $250,000 with plaintiff as beneficiary until (date alimony ends).

9. Medical Insurance

This section clarifies who is responsible for their own health insurance after the divorce.

Each party shall be responsible for their own medical insurance needs.: This is the most common option. Once divorced, you cannot remain on your ex-spouse's employer-provided health insurance. Check this box if you each will obtain your own coverage. ⚠️ Losing coverage due to divorce is a 'qualifying life event,' which allows you to enroll in a new plan through your employer or the state marketplace (Access Health CT) outside of the normal open enrollment period. You have a limited time (usually 30-60 days) to do this.

The plaintiff will secure and/or maintain medical insurance for the benefit of the defendant...: In some cases, a party may be ordered to pay for the other's COBRA coverage for a period of time. If you agree to this, specify the terms here.

10. Furniture, Household Goods, and Other Personal Property

This section covers the division of your personal belongings.

The parties have already divided the furniture...: If you have already physically divided all your personal property and are both satisfied, check this box.

Table to divide personal property: If you have not yet divided items, you can list them here and check the box for who will receive each item. It's often better to create a separate, more detailed list that you both sign and attach to this agreement. Example: Identify Items: Living Room Sofa, Plaintiff: [check], Defendant: [ ]. Identify Items: Dining Room Table, Plaintiff: [ ], Defendant: [check]. ⚠️ The court does not want to be involved in dividing every pot and pan. The arbitration clause included in this section is a mechanism to resolve disputes without returning to court.

12. Debts - Credit Card, Consumer, Taxes, Health Care, Other

This section details how you will divide any debts you owe. DO NOT write full account numbers on this form.

The parties have separately held debts.: Check this box if you agree that each of you will be responsible for any debt that is solely in your own name.

Table for dividing joint debts: List all joint debts here. Include the name of the creditor (e.g., 'Capital One Visa'), the approximate balance, and the percentage of responsibility for future payments for each party. The percentages must add up to 100%. Example: Name of Creditor: Chase Sapphire, Balance: $5,000, % Plaintiff: 100, % Defendant: 0. ⚠️ Your agreement is between you and your spouse. It is NOT binding on the creditor. If your ex-spouse is assigned a joint debt but fails to pay, the creditor can still come after you for payment. The 'indemnify and hold harmless' language means you could then sue your ex-spouse for reimbursement.

14. Change of Name

This section allows either party to request that their former or birth name be restored.

The Plaintiff's name is restored to...: If the Plaintiff wishes to change their name, check this box, then check either 'birth name' or 'former name' and write in the full name they wish to be restored to. Example: Check 'The Plaintiff's name is restored to', check 'birth name', and write 'Smith, Jane Ann'.

15. Children and Post-Majority Education

This section is ONLY for couples with children under the age of 23. If you have no children in this age range, skip this section.

We have the following minor children...: Check this box if you have children under 18 (or under 19 and still in high school). List their full names and birth dates. ⚠️ If you check this box, you MUST also complete and submit a Custody Agreement and Parenting Plan (form JD-FM-284).

Agreement as to Post-Majority Educational Support as to all listed children: (Select only one): This concerns paying for college or other post-secondary education for children up to age 23. Under Connecticut law (C.G.S. § 46b-56c), a judge can issue an educational support order. Here, you must choose one option: waive the right to ask for it, agree to specific terms for it, or ask the court to 'reserve jurisdiction,' which means you can come back and ask for an order later. ⚠️ Waiving this right is a permanent decision. Reserving jurisdiction is often a safe choice if you are unsure what the future holds.

Signatures

Both parties must sign this agreement to certify that it is accurate and voluntary.

Plaintiff's signature: The Plaintiff must sign and date the form, and print their name clearly. ⚠️ Do not sign an agreement you do not understand or that does not accurately reflect what you have agreed to. Your signature makes it a binding contract once approved by the court.

Defendant's signature: The Defendant must sign and date the form, and print their name clearly. ⚠️ Both parties must sign the same original document.

Common Mistakes to Avoid

1. Including Account Numbers: The form explicitly warns against this in multiple sections for your security. Do not write full bank, investment, or retirement account numbers.
2. Vague Terms: Using unclear language like 'divide personal property fairly' is unenforceable. Be specific. For property division, use percentages or lists. For deadlines, use specific dates.
3. Forgetting the Parenting Plan: If you have minor children (Section 15), you MUST also file a Custody Agreement and Parenting Plan (JD-FM-284). Forgetting this will delay your case.
4. Misunderstanding QDROs: Believing you can just write a check from a 401(k) is a costly mistake. You must state that a QDRO will be used and specify who pays for its preparation.
5. Ignoring 'Modifiable' vs. 'Non-Modifiable': The decision to make alimony non-modifiable is permanent and cannot be changed, even with a major life event. Understand the long-term impact of this choice.
6. Not Addressing Debts Correctly: Forgetting that creditors are not bound by your divorce agreement. If possible, close joint accounts to protect your credit.
7. Incomplete Case Information: Forgetting to write the docket number and judicial district on every page can cause filing issues.

Frequently Asked Questions

What if we can't agree on all the issues in this form? This form is designed for parties who have reached a full agreement. If you have unresolved issues, you are not ready to file this form. You may need to consider mediation, collaborative divorce, or having a judge decide the contested issues at a trial.

Can we change this agreement after the divorce is final? It depends on the specific term. Property and debt division are almost always final and cannot be changed. Alimony and child-related issues (custody, support) can potentially be modified in the future if there is a 'substantial change in circumstances,' unless you specifically agreed to make them 'non-modifiable'.

What is a QDRO and do I really need one? A QDRO (Qualified Domestic Relations Order) is a separate court order required by federal law to divide funds from most employer-sponsored retirement plans, like a 401(k) or a pension, without tax penalties. If you are dividing such a plan, you absolutely need a QDRO. You should specify in Section 7 how you will split the cost of having it professionally drafted.

Do we need a lawyer to fill out this form? While you are not required to have a lawyer, it is highly recommended. This is a complex legal document with long-lasting consequences. An attorney can help you understand your rights and obligations, ensure the agreement is drafted correctly, and protect your interests. At a minimum, consider having an attorney review your completed agreement before you sign it.

Next Steps

After you have both completed and signed the Dissolution / Legal Separation Agreement:

1. Make Copies: Make at least two complete copies of the signed agreement. The original will be filed with the court.
2. Filing: File the original, signed JD-FM-172 with the Superior Court Clerk's office in the judicial district where your case is located. You will likely file this along with your Financial Affidavits and, if applicable, your Parenting Plan.
3. Serve the Other Party: Provide one of the copies to your spouse for their records.
4. Keep a Copy: Keep one copy for your own personal records.
5. Final Hearing: The court will schedule a final, uncontested divorce hearing. The judge will review your agreement to ensure it is fair and equitable. They may ask you a few questions to confirm you understand and agree to its terms. If the judge approves the agreement, it will be incorporated into the final Judgment of Dissolution, making it a legally binding court order.