Separation Agreement Template Pa

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Updated – 2025 /2026


Important Notice

The provided template is intended solely as a general example for drafting formal separation agreements. It does not substitute for professional legal advice and should not be relied upon without consulting a qualified attorney experienced in family law. Legal requirements can vary by jurisdiction, and modifications may be necessary to ensure compliance with local laws. The use of this template is at the user’s own risk, and no liability is assumed for errors, omissions, or consequences resulting from its use without proper legal review.


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Please note: This is a sample Separation Agreement Template for Pennsylvania. Slight modifications may be necessary to suit specific circumstances.

Separation Agreement Sample – Pennsylvania

Parties Involved:

Paula Johnson
Address: 789 Maple Road, Philadelphia, PA 19103

Michael Johnson
Address: 789 Maple Road, Philadelphia, PA 19103

Purpose of Agreement:

This Agreement outlines the terms for the temporary separation of Paula and Michael Johnson, effective as of __________________, and addresses related matters such as property, support, and custody arrangements.

Separation Terms:

The parties agree to live separately starting from __________________. Both agree to maintain respectful communication and cooperate on matters related to their children and shared property.

Property and Assets:

The marital property located at 789 Maple Road shall be divided as follows: Paula shall retain the residence, and Michael shall transfer his interest within 30 days. Both parties agree to settle all joint debts and assets equitably.

Support and Custody:

Paula shall receive spousal support of $____ per month for a period of ____ months. Custody of the minor children shall be shared, with primary physical custody granted to __________________, and visitation rights to the other party.

Additional Provisions:

  • Both parties agree to keep the terms of this agreement confidential.
  • Any modifications must be in writing and signed by both parties.
  • This agreement is governed by Pennsylvania laws.

Philadelphia, ______________________

________________________
Paula Johnson
________________________
Michael Johnson